性病淋巴肉芽肿2024年度流行病学报告

Lymphogranuloma venereum Annual Epidemiological Report for 2024 Key facts •Lymphogranuloma venereum (LGV) is a systemic sexually transmitted infection (STI) caused byChlamydia trachomatis serovars L1, L2 or L3.•In 2024, 21 European Union/European Economic Area countries reported 3 490 cases of LGV, an increaseof 12% compared with 2023 and 250% compared with 2015.•Two countries (the Netherlands and Spain) accounted for 73% of all notified cases.•Almost all cases in 2024 were reported among men who have sex with men; among cases with knownHIV status, 35% were HIV positive. Introduction Lymphogranuloma venereum (LGV) is a systemic sexually transmitted infection (STI) caused by a specific typeofChlamydia trachomatis bacterium (serovars L1, L2 and L3). In the European Union/European Economic Area(EU/EEA), LGV is primarily seen among men who have sex with men. It is transmitted through anal sex andpossibly through practices such as fisting, using sex toys or receiving an enema. LGV is more common among menwho have sex with men who are living with HIV [1,2]. The primary clinical features of the disease among men who have sex with men include rectal ulcerations, mucoidor bloody discharge from the rectum, anal pain, constipation, lower abdominal pain and tenesmus (the feeling ofneeding to pass stool). Complications of prolonged infection include abscesses and fissures around the rectum.Systemic symptoms like fever, malaise, weight loss or fatigue can also be present. Reactive polyarthropathy (painand swelling in several joints) with or without conjunctivitis (inflammation of the thin membrane that covers thesurface of the eye) has also been reported. LGV infection can, however, also be asymptomatic. Amongheterosexual populations, LGV can present with one or more ulcers in the genital area, swelling and pain in theurethra, or swollen lymph nodes in the groin [1-3]. Methods This report is based on data for 2024 retrieved from EpiPulse Cases on 7 April 2026. EpiPulse Cases is a system forthe collection, analysis and dissemination of data on communicable diseases; it replaced The European SurveillanceSystem (TESSy) in October 2024. For a detailed description of the methods used to produce this report, refer to the Methods chapter of the ‘Introduction tothe ECDCAnnual epidemiological report’ [4]. An overview of the national surveillance systems is available online [5]. A subset of the data used for this report isavailable through ECDC’s online ‘Surveillance Atlas of Infectious Diseases’ [6]. In 2024, most reporting countries (15 EU/EEA countries) used the standard EU case definitions [7]. Four countriesreported using national case definitions and two did not report which case definition was used. Surveillance systemsfor LGV in Europe vary: 16 countries reported having comprehensive surveillance systems, three countries (Belgium,France and the Netherlands) reported that they operate sentinel systems that only capture LGV diagnoses reported bya selection of healthcare providers, and two countries did not report the type of surveillance system. Reporting of LGV infections is mandatory in 17 countries, 16 of which have comprehensive surveillance systems;one country with mandatory reporting did not specify the coverage of the surveillance system. In the threecountries that have sentinel systems, reporting is voluntary. One country did not specify whether reporting of LGVis mandatory or not, nor the coverage of the surveillance system. The reporting system in France changed in 2020 and data reported from 2020 onwards are based on a smallersample of laboratories compared with previous years. This report does not contain information on LGV infection rates because many LGV surveillance systems do notgenerate data that are considered representative of the national population. There are also significant differencesin the availability of LGV diagnostics across Europe. Epidemiology In 2024, 21 EU/EEA countries provided LGV surveillance data. Fifteen countries reported a total of 3 490 cases,while the remaining six reported no cases (Table 1). This represents an increase of 12% compared with 2023. Two countries (the Netherlands and Spain) accounted for 73% of all notified cases (Table 1). Transmission category and HIV status Transmission category was reported for 1 967 cases in 2024 (56% of all reported cases). All but 17 of these caseswere reported among men who have sex with men. In 2024, information on HIV status was available for 1 076 cases (31% of all reported cases). Of these cases, 372(35%) occurred in people who were HIV positive. Discussion After an overall decline in the number of reported LGV cases in 2020 and 2021 – likely due to the COVID-19 pandemic’simpact on the availability and accessibility of STI care services, changes in sexual behaviour, reduced testingopportunities and a decrease in STI surveillance capacity [8] – there was a noticeable increase in cases in mostreporting countries in 2022.