TreatmentUpdate
149

2005 April/May 

Key facts about LGV

LGV is a sexually transmitted disease spread by certain strains (or serovars) of Chlamydia bacteria called L1, L2 and L3.

Initial infection with these bacteria causes a small, raised lesion within the penis or rectum which is painless. This lesion can turn into an ulcer within three days to one month. Common signs/symptoms associated with LGV include:

  • swollen lymph nodes in the groin
  • bleeding from the anus

Lab tests specific for LGV are not routinely available, although tests for Chlamydia from samples taken from a lesion or the rectum can help support a diagnosis of LGV.

Treatment for LGV is essential; otherwise, the infection can spread and damage lymph nodes and the intestines, causing scarring. The American Centers for Disease Control and Prevention (CDC) recommends the following antibiotics for treatment:

  • doxycycline, 100 mg taken twice daily for 21 days, or alternatively
  • erythromycin 500 mg, four times daily for 21 days

Erythromycin has the potential to interact with other medications, including two classes of anti-HIV drugs—protease inhibitors and non-nukes (non-nucleoside reverse transcriptase inhibitors).

Some specialists believe that another antibiotic, azithromycin (Zithromax), taken in a dose of 1 gram once weekly for three consecutive weeks, is effective against LGV. However, the CDC points out that there are no data from controlled clinical trials to support such a conclusion.

REFERENCE:

Centers for Disease Control and Prevention (CDC). Lymphogranuloma venereum among men who have sex with men--Netherlands, 2003-2004. Morbidity and Mortality Weekly Report 2004;53(42):985-988.