Lymphogranuloma Venereum Epidemiology and Clinical Management

Lymphogranuloma venereum (LGV) is an invasive sexually transmitted infection caused by specific genovars of Chlamydia trachomatis. Historically endemic in tropical and subtropical regions, LGV has re-emerged in high-income countries over the past two decades, particularly among men who have sex with men (MSM). Transmission occurs through mucosal contact, most frequently rectal exposure, and may present with proctitis, inguinal lymphadenopathy and, in some cases, systemic symptoms. A substantial proportion of rectal infections are asymptomatic, which contributes to undetected transmission. Molecular diagnostics, including nucleic acid amplification and genovar-specific sequencing, have become essential for accurate detection and differentiation from non-LGV chlamydial infections. First-line therapy remains doxycycline for a minimum of 21 days, although considerations such as adherence, potential side-effects and the rising diversity of genotypes call for enhanced surveillance. Preventive strategies, including routine screening in high-risk populations and integration with HIV pre-exposure prophylaxis programmes, are vital for controlling spread. Ongoing evolution of circulating strains underscores the need for genomic monitoring to inform both public health interventions and tailored clinical management protocols.

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Lymphogranuloma Venereum Epidemiology and Clinical Management publication trend

The graph below shows the total number of articles in lymphogranuloma venereum epidemiology and clinical management across all publications each year (not limited to Nature Index journals).

Technical terms

Genovar: A classification of Chlamydia trachomatis strains based on variations in the ompA gene, which encodes the major outer membrane protein and determines tissue tropism.

ompA genotyping: Molecular sequencing of the ompA gene to identify specific genovars of C. trachomatis associated with LGV or non-LGV infections.

Multilocus sequence typing (MLST): A genotyping method that analyses sequences from multiple housekeeping genes to distinguish between closely related bacterial strains and track transmission.

Pre-exposure prophylaxis (PrEP): The use of antiretroviral medication by individuals at high risk of HIV acquisition, which may be linked to STI screening initiatives where LGV testing can be integrated.

References

1. Anorectal lymphogranuloma venereum among men who have sex with men: a 3-year nationwide survey, France, 2020 to 2022. Eurosurveillance (2024).
2. Chlamydia trachomatis genomes from rectal samples: description of a new clade comprising ompA-genotype L4 from Argentina. Microbial Genomics (2025).
3. ompA Sequencing and Multilocus Sequence Typing of Lymphogranuloma Venereum Cases in Buenos Aires Reveal New Chlamydia trachomatis Genotypes. Microorganisms (2024).