Location:
The Kirby Institute Level 6 Seminar Room Wallace Wurth Building UNSW Australia Sydney NSW 2052
Open to
All
Contact for enquiries
Rata Joseph +61 (0)2 9385 0900 rjoseph@kirby.unsw.edu.au
The Kirby Institute is pleased to present:
Professor David A. Lewis - "Lymphogranuloma venereum: resurgence of a tropical STI in pastures new"
Tuesday 3rd February 2015
12:30 - 2pm
RSVP to rjoseph@kirby.unsw.edu.au for catering purposes(COB Monday 2nd February)
Location:
The Kirby Institute
Level 6 Seminar Room
Wallace Wurth Building
UNSW Australia
Sydney NSW 2052
Abstract:Lymphogranuloma venereum (LGV), caused by lymphotropic invasive strains of Chlamydia trachomatis (L1-L3 serovars), is a sexually transmitted infection characterised by severe inflammation, often with systemic symptoms. The primary stage, often unnoticed by the patient, consists of a small painless papule which may ulcerate. The secondary stage occurs a few weeks later and may manifest as either regional bubo formation or as the anorectal syndrome with haemorrhagic proctocolitis. If left untreated, LGV may result in the tertiary stage characterized by extensive fibrosis of tissue, strictures and genital elephantiasis. LGV is endemic in parts of Africa, Asia, South America and the Caribbean. More recently, LGV has re-emerged among men-who-have-sex-wtih-men (MSM) in Europe and North America. Molecular typing has demonstrated that the majority of the European LGV-associated C. trachomatis strains are clonal (serovar L2b) and detection of LGV is strongly associated with HIV co-infection. Diagnosis of LGV has traditionally relied upon serological techniques. A number of in-house nucleic acid amplification tests (NAATs) have now been developed which can diagnose LGV infections from the primary stage onwards. LGV is best treated with a 3-weeks’ course of doxycyline (100 mg 12-hourly) or, alternatively, with a 3-weeks’ course of erythromycin (500 mg 6-hourly). In summary, LGV has re-emerged as an important STI among HIV-infected MSM. Clinicians should consider LGV as a differential diagnosis for proctocolitis and genital ulceration in this patient group. Whenever possible, LGV-specific NAATs should confirm a presumptive LGV diagnosis
Biography:David commenced his appointment as Director of the Western Sydney Sexual Health Centre and conjoint Professor at the University of Sydney in September 2014. Prior to this, he spent a decade at the was National Institute for Communicable Diseases in South Africa, initially as Head of the STI Reference Centre and subsequently as Head of the newly created Centre for HIV and STIs. His initial UK-based training was in infectious diseases, specializing in HIV/STIs and microbiology. He undertook his PhD in chancroid pathogenesis as a Wellcome Trust Fellow in Tropical Medicine at Imperial College London (UK) and the University of Texas Southwestern Medical Center (USA). David’s main research interests focus on antimicrobial resistance of STI pathogens, in particular gonorrhoea, as well as genital ulcer disease and men’s sexual health. David regularly provides technical support at meetings of the World Health Organization in relations to HIV/STIs. He serves as Deputy Editor for Sexually Transmitted Infections and a Joint Editor for Sexual Health. He also holds the elected position of President of the International Union against STIs (IUSTI) and is a past elected member of the Board of the International Society for STI Research (ISSTDR).