Epidemic Lymphogranuloma venereum during epidemics of crack cocaine use and HIV infection in the Bahamas.

Abstract:

BACKGROUND:Since the early 1980s, the Bahamas has experienced sequential epidemics of freebase/crack cocaine use, genital ulcer-inguinal adenopathy disease (GUD), and heterosexual HIV infection. GOAL:To prospectively define the etiology of GUD in patients at the Princess Margaret Hospital during outbreaks of crack cocaine use, GUD, and HIV infection in the Bahamas. STUDY DESIGN:In Nassau, 47 consecutive patients with GUD underwent serologic testing for syphilis and for infections with HIV, herpes simplex virus type 2 (HSV-2), and Chlamydia trachomatis. Genital ulcer specimens were tested by culture and/or polymerase chain reaction (PCR) assay for Haemophilus ducreyi; by PCR and/or antigen assay for HSV; and by PCR for C trachomatis. Lymph node aspirates were tested by PCR for C trachomatis and H ducreyi. RESULTS:Twenty patients (43%) had HIV infection; eight had lymphogranuloma venereum (LGV), confirmed by PCR detection of C trachomatis sequences consistent with the L2 serovar; and nine others had possible LGV, on the basis of serum microimmunofluorescent C trachomatis antibody titers > or =256. Inguinal lymphadenopathy or bubo was present in 15 of 17 patients, who thus met the laboratory criteria for definite or possible LGV, and in 7 of 30 who did not meet such laboratory criteria (P < 0.001). Thirteen patients had confirmed genital herpes, seven had confirmed chancroid, and four had probable or possible primary syphilis. CONCLUSIONS:The epidemics in the Bahamas of crack use, heterosexual HIV infection, and GUD apparently included epidemic transmission of LGV.

journal_name

Sex Transm Dis

authors

Bauwens JE,Orlander H,Gomez MP,Lampe M,Morse S,Stamm WE,Cone R,Ashley R,Swenson P,Holmes KK

doi

10.1097/00007435-200205000-00001

subject

Has Abstract

pub_date

2002-05-01 00:00:00

pages

253-9

issue

5

eissn

0148-5717

issn

1537-4521

pii

00007435-200205000-00001

journal_volume

29

pub_type

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