Rare Strain of Chlamydia Might Be Spreading in U.S. Among MSM, Increasing HIV Risk, Specialists Say

A strain of chlamydia "rarely seen outside" Africa and Southeast Asia appears to be spreading among men who have sex with men in the U.S., increasing the risk of HIV transmission, according to health officials and specialists, the AP/Washington Post reports (Neergaard, AP/Washington Post, 2/6). Lymphogranuloma venereum chlamydia, or LGV, is caused by the same bacteria that causes more common strains of chlamydia. LGV -- which is associated with genital ulcers, swelling in the lymph glands in the groin and flu-like symptoms and can cause severe gastrointestinal distress -- most often is diagnosed among heterosexuals and can be treated with antibiotics. Men who experience rectal symptoms -- including bleeding of the rectum and colon -- most likely have contracted LGV through unprotected anal intercourse. Rectal inflammation and ulceration sometimes caused by LGV could increase the risk of transmitting or contracting HIV and other bloodborne diseases (Kaiser Daily HIV/AIDS Report, 4/1/05). According to the AP/Post, U.S. health officials have confirmed 27 diagnoses of LGV since last year after indicating that the strain could spread to the U.S. (AP/Washington Post, 2/6). In December 2004, San Francisco public health officials issued a warning about LGV and announced that four MSM there had been diagnosed with the infection. In February 2005, New York City health officials issued a warning after two local cases were reported among MSM. At least 90 MSM in the Netherlands have been diagnosed with LGV, and officials have reported cases in Belgium, France, Sweden and the United Kingdom (Kaiser Daily HIV/AIDS Report, 4/1/05).

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Specialists say the actual number of LGV cases in the U.S. is unclear because it is difficult to diagnose and few clinics and laboratories are able to test for the strain, the AP/Washington Post reports. "My feeling is that what we're seeing now is still the tip of the iceberg," Philippe Chiliade -- a doctor at the Whitman-Walker Clinic in Washington, D.C., which last month diagnosed its first cases of LGV -- said. Catherine McLean of CDC's HIV and STD prevention program said that expanding testing is "critically important," adding, "The prevalence of the disease is probably quite a bit higher than the reported cases indicate ... but we don't yet know that" (AP/Washington Post, 2/6).

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