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What’s Old Is New: the Evolution of Lymphogranuloma Venereum Proctitis in Persons Living with HIV

  • HIV/AIDS (C Yoon, Section Editor)
  • Published:
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Abstract

Purpose of Review

Lymphogranuloma venereum (LGV) has re-emerged as a consequential anorectal sexually transmitted infection with high burden among persons living with HIV, especially men who have sex with men (MSM).

Recent Findings

Surveillance programs are limited without widely available LGV-specific diagnostics, but LGV prevalence is becoming increasingly recognized as it spreads globally. The LGV epidemic remains high among MSM living with HIV and is now shifting to include more HIV-negative MSM. LGV testing of asymptomatic persons at high risk will increase case finding and potential for earlier intervention. Doxycycline remains the guideline-directed treatment of choice, but recent data may support shorter duration or even use of azithromycin as alternatives.

Summary

While the burden of LGV is appreciated as a significant cause of proctitis, especially among MSM living with HIV, lack of accessible diagnostics limits our understanding of actual incidence and its impact on the HIV epidemic. Future directions should include assay validation for widespread use and rigorous clinical trials to examine treatment durations based on symptom burden.

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  1. Division of Infectious Diseases, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Ronnie M. Gravett & Jeanne Marrazzo

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Gravett, R.M., Marrazzo, J. What’s Old Is New: the Evolution of Lymphogranuloma Venereum Proctitis in Persons Living with HIV. Curr Infect Dis Rep 24, 97–104 (2022). https://doi.org/10.1007/s11908-022-00781-6

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