LGV-net: a clinical, molecular and epidemiological study of LGV in the UK

性淋巴肉芽肿(LGV)是由一种衣原体细菌引起的性传播感染。直到最近，它还被认为是一种在英国很少见的热带感染。自2003年以来，这种感染在英国、欧洲、北美和最近的澳大利亚再次出现。它正在影响男男性行为者(MSM)。大多数病例还感染了艾滋病毒。与常见的衣原体不同，LGV是一种侵袭性疾病，能够导致组织破坏和严重症状。一旦确诊，很容易用一个疗程的抗生素进行治疗。然而，这些症状可能类似于其他胃肠道疾病，一些患者被误诊，导致住院和不必要的手术。此外，LGV会导致生殖器或直肠发炎，从而增加感染艾滋病毒并将其传染给伴侣的风险。在英国，卫生保护局于2004年10月建立了一个诊断和监测LGV的国家服务机构。自那时以来，已诊断出400多例病例，比任何其他国家都多。这一系统提供了疫情的广泛概述，但还不够详细，不足以让我们了解和控制疾病。我们要求MRC为一个网络提供资金，以便对此次疫情进行更详细的调查。我们将要求患有LGV的患者或有LGV症状的患者，以及他们的性伴侣，进行基于计算机的采访。这将包含有关他们的症状、其他医疗问题和性史的问题。这将与他们的体征、测试结果和治疗的详细临床记录联系起来。我们还将对LGV毒株进行分子分型(遗传指纹)。这将帮助我们确定这是一个大型网络(通过性别联系的一群人)中的一次疫情，还是一系列较小的疫情。该研究网络包括英格兰(四个在伦敦，一个在布莱顿)和苏格兰(格拉斯哥)出现最多病例的诊所。这项研究的结果将用于帮助医生诊断和治疗LGV。我们还将就识别和预防LGV的最佳方式向患者和社区团体提供建议。

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by a type of chlamydia bacteria. Until recently it has been considered a tropical infection that is rarely seen in the UK. Since 2003 there has been a re-emergence of this infection in the UK, Europe, North America and most recently Australia. It is affecting men who have sex with men (MSM). Most of the cases have also had HIV infection. Unlike the common form of Chlamydia, LGV is an invasive disease capable of causing tissue destruction and severe symptoms. Once diagnosed, it is easily treated with a course of antibiotics. However, the symptoms can be similar to other gastrintestinal diseases, and a number of patients have been misdiagnosed resulting in hospitalisation and unnecessary operations. In addition, LGV causes inflammation of the genitals or rectum that will increase the risk of acquiring HIV and of passing it on to partners. In the UK in October 2004 the Health Protection Agency (HPA) established a national service to diagnose and monitor LGV. Since then over 400 cases have been diagnosed, more than in any other country. This system provides a broad overview of the outbreak, but is not in enough detail to allow us to understand and control the disease. We are asking the MRC to fund a network to carry out more detailed investigations of this outbreak. We will ask patients who have LGV or who have symptoms suggesting LGV, plus their sexual partners, to do a computer-based interview. This will contain questions on their symptoms, other medical problems and their sexual history. This will be linked to a detailed clinical record of their signs, test results and treatment. We will also carry out molecular sub-typing (genetic fingerprinting) of the LGV strains. This will help us to decide whether this is a single outbreak in a large network (a group of people linked by sex) or a series of smaller outbreaks. The research network includes the clinics that have seen most cases in England (four in London and one in Brighton) and Scotland (Glasgow). The results of the study will be used to help doctors diagnose and treat LGV. We will also advise patient and community groups about the best way to recognise and prevent LGV.