If you have a sex life, be careful of its symptoms: what is lymphogranulomatosis venereum which has jumped by 58%

IST : qu’est-ce que la lymphogranulomatose vénérienne qui a bondi de 58 % en Europe ?

Gonorrhea, syphilis, Chlamydia… Sexually transmitted infections have progressed worryingly in the European Union in 2022. This is particularly the case for lymphogranulomatosis venereum (LGV) which shows an increase of 58% in cases compared to 2022. The point on this little-known disease which is gaining ground.

The European Center for Disease Control (ECDC) warned last week of a worrying increase in sexually transmitted infections in the European Union. Thus, in 2022, cases of syphilis by 34% and cases of bacterial chlamydia infections by 16%. Corresponding, in total, to 70,881 confirmed cases of gonorrhea, 35,391 cases of syphilis and 216,508 of Chlamydia infections. That's it for the most common sexually transmitted infections.

Another STI, lymphogranulomatosis venereum (LGV) is much less known and rarer. However, over the period studied, the number of cases jumped by 58% between 2021 and 2022, with 2,059 cases. And the ECDC estimates in its report that the number of cases is underestimated in several European countries. Four countries alone account for 84% of recorded contaminations: Spain, the Netherlands in the first place, but also France and Belgium to a lesser extent.

The chlamydia trachomatis bacteria in question

Lymphogranulomatosis venereal disease is caused by subtypes of the bacterium Chlamydia trachomatis. Without appropriate treatment, the disease progresses in three stages. First, between 3 and 30 days after transmission one or more lesions form at the point of entry of the bacteria into the body (anus, rectum, glans, mouth…). They disappear without treatment and can therefore go unnoticed. But the bacteria remains present.

Then, in the second stage, 2 to 6 weeks later, the following symptoms may appear and last from a few weeks to several months:

painful swelling of the lymph nodes (adenopathy) in the groin or neck; discharge of blood and pus from the anus; fever and chills; muscle and/or joint pain;

In some cases, the lymph nodes open with a discharge of pus.

If left untreated, symptoms linked to the tertiary stage can lead to serious, sometimes permanent, damage:

narrowing or perforation of the vagina, rectum or colon caused by chronic inflammation; swelling of the genitals caused by blockage of the lymphatic vessels; discharge of pus, inflammation of the mucous membranes accompanied by bleeding.

More rarely, inflammation of the liver or a joint is observed.

Men who have sex with men most affected

LGV, also called Nicolas-Favre disease, endemic in certain tropical and subtropical regions, was still very rare until the early 2000s in industrialized countries.

In 2022, the majority of cases were reported in men, aged 25 to 44, who have sex with men (MSM). "Between 2018 and 2022, the proportion of HIV-negative LGV cases increased, from 47% in 2018 to 69% in 2022", note the ECDC which hypothesizes an increased vulnerability among HIV-negative MSM.

The disease is diagnosed by a blood test – or a sample in the presence of symptoms – which will detect the presence of the bacteria. This must be detected within a window of 14 days after transmission. The treatment is based on taking antibiotics which will completely eliminate the infection. Throughout the duration of treatment, it is necessary to protect yourself sexually.

The ECDC regrets that the diagnostic capabilities of this disease are still too limited in several countries of the European Union, "which makes difficult infection control and limits the availability of epidemiological data. In addition, early diagnosis is essential to prevent serious complications of LGV.