Lymphogranuloma venereum in human immunodeficiency virus-infected individuals in New York City

Lymphogranuloma venereum (LGV), or chlamydial proctitis, is a classic sexually transmitted disease with prominent gastrointestinal manifestations. The disease has received little attention in recent years, especially in relation to human immunodeficiency virus (HIV) infection. However, outbreaks of LGV have been reported in several large cities in Europe and the United States over the past few years, occurring in both HIV-infected and -uninfected individuals, and the reports have been largely limited to the sexually transmitted disease literature. We recently diagnosed four cases of chlamydial proctitis in HIV-infected individuals, who had different clinical presentations but very similar endoscopic and histopathologic features, as well as prompt and complete response to therapy. It is important for gastroenterologists to recognize that LGV may be reemerging as a relevant clinical entity, because of its similarity to inflammatory bowel diseases and its response to treatment with antibiotics.