Epidemiology

L1, L2, and L3 genovars/serovars of Chlamydia trachomatis are endemic to tropical regions of Southeast Asia, Latin America, the Caribbean and Africa. Historically, LGV has been considered a rare disease in developed countries of temperate climates; however, in urban areas of Europe and North America, outbreaks of LGV proctocolitis have been reported among men who have sex with men (MSM), often in association with transmission of syphilis, HIV, and hepatitis C.[9][10] LGV occurs rarely in the US but as it is not a notifiable STI, current incidence rates are difficult to ascertain. 

LGV may occur at any age, but the peak incidence is between 15 and 40 years, the ages when sexual activity is at its peak.[11] LGV is more commonly reported in men because early signs are more apparent in men, but it is thought that men and women are probably equally affected.[11] Studies among MSM who reported receptive anal intercourse in Germany, the UK, and Netherlands have shown that LGV may be asymptomatic in about one quarter of cases.[12][13]

Reporting from endemic regions suggest that LGV is less common than herpes simplex virus or syphilis as a predominant cause of genital ulcer disease, and less common than chancroid as a cause of inguinal lymphadenopathy.[14][15][16]

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