- The Washington Times - Monday, February 6, 2006


A particularly bad strain of chlamydia not usually seen in this country appears to be slowly spreading among homosexual and bisexual men, an infection that can increase their chances of getting or spreading the AIDS virus.

Called LGV chlamydia, this sexually transmitted disease (STD) has caused a worrisome outbreak in Europe, where some countries have confirmed dozens of cases. The number of diagnoses confirmed by U.S. health officials is low — 27 since they warned a year ago that the strain was headed here.

But specialists say the low number indicates only a fraction of the infections because this illness is difficult to diagnose: Few U.S. clinics and laboratories can test for it. Painful symptoms can be mistaken for other illnesses, such as irritable bowel syndrome.

And because LGV chlamydia doesn’t always cause noticeable symptoms — right away, at least — an unknown number of people may silently harbor and spread it, with an increased risk of transmitting human immunodeficiency virus (HIV).

“My feeling is that what we’re seeing now is still the tip of the iceberg,” says Dr. Philippe Chiliade of the Whitman-Walker Clinic in Washington, which diagnosed its first few cases of LGV last month and is beginning to push for asymptomatic men to be screened.

The Centers for Disease Control and Prevention was counting an 8 percent increase in HIV among homosexual and bisexual men from 2003 to 2004, before LGV’s arrival was recognized.

“We are really concerned about this,” says Catherine McLean of the CDC’s HIV and STD prevention program.

Increasing the ability to test for LGV is “what’s really critically important,” she adds. “The prevalence of the disease is probably quite a bit higher than the reported cases indicate, either here or in Europe, but we don’t yet know that.”

Three weeks of the antibiotic doxycycline effectively treats LGV chlamydia. But patients have to know they’re at risk, and then find a test.

Chlamydia, caused by bacteria, is among the most common STDs. As many as 3 million Americans a year may become infected with common strains, best known for causing infertility in women if left untreated.

This more virulent strain is called lymphogranuloma venereum, or LGV. It’s not a new form, but one rarely seen outside Africa or Southeast Asia. So STD specialists were stunned in late 2004 when the Netherlands announced an outbreak that reached more than 100 cases; last summer, one clinic there reported seeing one to two new patients a week. Cases also have surfaced in much of Western Europe and Britain. As with the U.S. cases, many also have HIV.

Symptoms differ from regular chlamydia: swollen lymph nodes in the groin, genital or rectal ulcers, and painful bowel movements and other gastrointestinal symptoms that may mimic inflammatory bowel disease. Such symptoms leave patients particularly susceptible to HIV infection if they also encounter that virus.

LGV can infect both sexes, although new cases diagnosed are among men having sex with men.

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