Systematic review and meta-analysis of doxycycline efficacy for rectal lymphogranuloma venereum in men who have sex with men.
Open accessAbstract
Rectal lymphogranuloma venereum (LGV) has reemerged as a sexually transmitted infection among men who have sex with men (MSM), particularly those who are HIV-positive. We undertook a systematic review and meta-analysis to determine the efficacy of doxycycline (100 mg 2×/d for 21 days) for rectal LGV in MSM. Nine studies were included: 4 prospective, 4 retrospective, and 1 combined retrospective and prospective. In total, 282 MSM with rectal LGV were included in the studies. All studies reported using nucleic acid amplification tests to assess microbial cure. Most patients (>80%) had symptomatic rectal infection. The fixed-effects pooled efficacy for doxycycline was 98.5% (95% CI 96.3%-100%, I (2) = 0%; p = 0.993). Doxycycline at 100 mg twice daily for 21 days demonstrated a high microbial cure rate. These data support doxycycline at this dosage and duration as first-line therapy for rectal LGV in MSM.
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The recommended 21-day course of doxycycline for LGV is based on long-standing clinical practice and is highly effective, with an estimated cure rate of >98.5%.
“The recommended 21-day course of doxycycline is based on long-standing clinical practice and is highly effective, with an estimated cure rate of >98.5% (555,556).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [556]
The Results (Treatment Efficacy; page not provided) estimate 98.5% microbial cure—not >98.5%—for 21-day doxycycline treatment of rectal LGV in men who have sex with men. The Discussion supports the regimen as first-line therapy, but the paper does not establish that the 21-day recommendation is based on long-standing clinical practice or that this cure estimate applies to all LGV. (LLM, conf=0.89)
Experimental — accuracy not yet measuredGenital HSV and LGV proctitis are more prevalent among persons with HIV infection.
“Genital HSV and LGV proctitis are more prevalent among persons with HIV infection (545,556,1382).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [556]
The Abstract (page unavailable) says rectal LGV infections are overrepresented among HIV-positive men who have sex with men, supporting the LGV part of the claim in that population. The paper does not address whether genital HSV is more prevalent among people with HIV, and its LGV evidence does not establish the claim for all persons with HIV. (LLM, conf=0.88)
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- Authors
- Leeyaphan, C., Ong, J. J., Chow, E. P. F., Kong, F. Y. S., Hocking, J. S., Bissessor, M., Fairley, C. K., & Chen, M.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- Chen, Marcus
- ORCID
- Venue
- Emerging infectious diseases
- Published
- 2016-10
- Volume
- 22
- Issue
- 10
- Pages
- 1778-1784
- ISSN
- 1080-6040 (ISSN-L)
- 1080-6059
- PMC
- PMC5038401
- OpenAlex
- W2509082357
- Cited by
- 31
- References
- 39
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 6
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Emerging infectious diseases (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Mahidol University
- Medical Research Council
- National Health and Medical Research Council (1091226, 1104781)
- Faculty of Medicine Siriraj Hospital, Mahidol University
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- lymphogranuloma venereum, rectal infection, doxycycline, men who have sex with men, sexually transmitted infections, HIV coinfection, treatment efficacy, Chlamydia trachomatis, first-line therapy
- MeSH terms
- Anti-Bacterial Agents, Chlamydia trachomatis, Doxycycline, Humans, Lymphogranuloma Venereum, Male, Rectal Diseases, Treatment Outcome, Homosexuality, Male
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