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Characteristics of LGV repeaters: analysis of LGV surveillance data
  1. Minttu Rönn1,
  2. Gwenda Hughes2,
  3. Peter White3,4,
  4. Ian Simms2,
  5. Catherine Ison5,
  6. Helen Ward1
  1. 1Department of Infectious Disease Epidemiology, Imperial College London, London, UK
  2. 2Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
  3. 3Modelling and Economics Unit, Public Health England, London, UK
  4. 4Department of Infectious Disease Epidemiology, MRC Centre for Outbreak Analysis and Modelling, Imperial College London, London, UK
  5. 5Sexually Transmitted Bacteria Reference Laboratory, Public Health England, London, UK
  1. Correspondence to Dr Minttu Rönn, Department of Infectious Disease Epidemiology, Imperial College London, Old Medical School, Norfolk Place, London W2 1PG, UK; minttu.ronn08{at}imperial.ac.uk

Abstract

Objectives A number of individuals have acquired lymphogranuloma venereum (LGV) infection multiple times since its re-emergence. We describe the characteristics of reinfections and those who acquire them.

Methods The LGV Enhanced Surveillance system collected detailed information on LGV episodes in the UK from 2004 to 2010. Using logistic regression we compared the baseline characteristics of men who have sex with men (MSM) who had a repeat LGV episode (‘repeaters’) to MSM with a single reported episode (‘non-repeaters’).

Results There were 66 individuals among the 1281 MSM (5.2%) with LGV episode who had a recorded reinfection during the data collection period. Those who acquired LGV reinfection were more likely to be HIV positive (97% vs 79%), visit a clinic in London (OR 2.0, 95% CI 1.1 to 3.8), and have hepatitis C (OR 2.2, 95% CI 1.1 to 4.6) or concurrent gonorrhoea (OR 2.2, 95% CI 1.2 to 3.8) on their first recorded LGV episode. Repeaters reported higher levels of unprotected sex, but behavioural variables were not significantly different between repeaters and non-repeaters.

Conclusions Among LGV repeaters, risk behaviour alone did not explain subsequent reinfection. LGV repeaters have a high level of other sexually transmitted infections (STIs) which may be linked to their central position in the sexual network that contributes to their heightened risk of STI acquisition. Given the low prevalence of LGV in the general MSM population, momentary increases in incidence in subsets of the population may be an important factor for LGV risk where the overall level of sexual risk behaviour is higher. Validating this would require research into sexual network structures.

  • LYMPHOGRANULOMA VENEREUM
  • HOMOSEXUALITY
  • INFECTION CONTROL

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/

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