Virulent Chlamydia Detected Largely Among Gay Men in US
Los Angeles Times
Thomas H. Maugh II
(05.11.06)
On Wednesday at the 2006 National STD Prevention Conference in Jacksonville,
Fla., researchers reported there have been about 80 confirmed cases of
lymphogranuloma venereum (LGV), chiefly among gay men, in the United States. The
researchers suspect, however, that the true number of cases could be
considerably higher because the disease, a virulent form of chlamydia, is hard to diagnose and is unfamiliar to
many doctors.
"Many cases are not suspected, and many of those suspected are not tested," said Dr. Ron Ballard, branch chief of CDC's STD lab. There is no requirement that LGV diagnoses be reported to authorities.
Officials are worried because the STD can accelerate the spread of HIV and may enhance viral replication in patients with HIV. LGV's symptoms include bleeding, inflammation of the rectum and colon, and abdominal cramping. If untreated, the infection can be fatal. LGV can be cured by a three-week regimen of antibiotics such as doxycycline, much longer than the treatment for regular genital chlamydia.
LGV is most prevalent in areas of Asia, Africa and South America near the equator, but it made a sudden appearance in Europe in 2004, when the Netherlands went from reporting four to five cases a year to finding two per week. Other European countries then reported LGV, and it spread to Canada and the United States, mainly to cities with a high prevalence of other STDs.
Because of the complexity of testing, which involves sequencing part of the genome of the bacterium, and the dangers of the infection, physicians should "presumptively treat suspected cases" as though they were confirmed, said Dr. John Douglas, director of CDC's Division of STD Prevention.
A genetic test CDC has developed takes only a few hours and could be done in most labs. Now being performed only at CDC, the new test will be offered to other labs once proved, Douglas said.