June 19, 2006
Health officials in Toronto have recently recorded cases of lymphogranuloma venereum (LGV), an STD caused by a strain of the chlamydia family, and generally seen only in the tropics of Africa, South America, Asia, and the Caribbean. Since the city already has a syphilis outbreak, experts worry because both diseases are associated with an increased risk for HIV/AIDS.
"It's a marker for high-risk sex and partner change," said Dr. Kelly McDonald, chair of the Ontario HIV Treatment Network. "In every study with explosive rates of HIV you see syphilis."
Plus, LGV is a tropical disease "we shouldn't see" in Toronto, McDonald said. LGV starts with a painless sore on the vagina, penis, rectum or oral cavity and can be cured by antibiotics. Left untreated, it can cause scarring, deformity, and infection of the spinal cord and brain.
In Toronto, all but one of the 30 cases of LGV occurred in gay or bisexual men, according to Dr. Rita Shanin, associate medical officer of health. Cases of LGV have also been reported in gay men in the Netherlands and other European countries.
The current syphilis outbreak began in May 2002, mostly in gay or bisexual men, and peaked in 2004 with 368 cases. Last year, there were 241. "It's a true epidemic and related to an increasing rate of unsafe sexual behavior," said Dr. Robert Remis, a University of Toronto HIV/AIDS researcher.
According to Remis, 30-40 percent of the new cases of syphilis since 2002 were in men co-infected with HIV. Nearly all the LGV-positive men had HIV.
An estimated 55,000 Canadians have HIV. In Toronto, 15,300 patients are infected; of those, 10,700 are men.