STD

Human Pappilomavirus

Human papillomavirus DNA typing has demonstrated over 90 genotypes, of which HPV-6, HPV-11, HPV-16 and HPV-18 most commonly infect the genital tract through sexual transmission. It is important to differentiate between the benign genotypes (HPV-6 and 11) that cause anogenital warts, and genotypes such as 16 and 18 that are associated with dysplastic conditions and cancers of the genital tract but are not a cause of benign warts. All genotypes usually result initially in subclinical infection of the genital tract rather than clinically obvious lesions affecting penis, vulva, vagina, cervix, perineum or anus. It can also infect the mouth and throat. Many of them infected with HPV are asymptomatic and do not know that they have it.

HPV

  • Transmission of  HPV 

  • Signs and symptoms of HPV

  • The health effects of HPV

  • Prevention of  HPV transmission

  • Screening measures available for the HPV

  • Prevention of HPV related diseases

  • Treatment for HPV

  • Is HPV vaccine safe ?

 

Video of  Human Pappilomavirus

Transmission of HPV 

         The route of transmission HPV is through sexual contact. It’s mainly transmitted through vaginal and anal sex but sometimes through oral sex also. HPV can be passed on the client with single sex partner as well as the one with multiple sexual partners. A person can develop HPV infection even if years have passed since he / she had sexual contact with an infected person. Most infected persons are not aware that they are infected or they are passing the virus to their sex partner. Sometimes there is also a chance to get more than one type of HPV.

          If the pregnant woman is infected with genital HPV, rarely there is chance of transmitting infection from mother to her baby during the vaginal delivery. In such cases, the baby may develop recurrent respiratory papillomatosis (RRP), a rare condition in which warts grows in the throat. In children, this is known as juvenile-onset recurrent respiratory papillomatosis (JORRP).

Signs and symptoms of HPV

          In most of them the HPV is asymptomatic without causing not even a single symptom or health problems from it. In 90% of cases, the body’s immune system clears HPV within two years. But it is difficult to know which people who get HPV will go on to develop health problems.

          One of the most common manifestations of HPV is genital warts in males and females. Genotype (HPV-6 and 11) is responsible for developing anogenital warts in males and females. Rarely, HPV can also leads to a condition called recurrent respiratory papillomatosis or RRP which is manifested by warts in the throat.

The health effects of HPV

           In most of the individual HPV is silent without causing any symptoms but in some it can cause major health problems. There are about 90 genotype of HPV virus, of which some produces serious health problems. Lower risk HPV infection produces genital wart which is otherwise known as condyloma acuminata. Anogenital warts are the result of HPV-driven hyperplasia and usually develop after an incubation period of between 3 months and 2 years. They may be single or multiple, exophytic, papular or flat. Condylomata are papillary lesions caused by human papilloma virus usually type 6 and type11. These are usually multiple and can be contaminated from other parts of the body. They can be transmitted sexually. They are found in heterosexual men and women. Associated vaginal discharge favours their growth and so does pregnancy. Typically they grown in clusters along a narrow stalk giving it a cauliflower appearance but at times the stalk may be broad and thick. The warts are usually painless and not a serious problem. Usually it is diagnosed by the Health care providers by looking at the genital area during the visit. Women with HPV might have warts on the vagina, vulva, or cervix. In men HPV causes warts on the groin, penis and scrotum. Both the men and women can have genital warts on the anus or thigh.

         Left untreated the condylomata may at times, spread to the vagina or even the cervix. These lesions should be differentiated from syphilitic condylomata or vulval carcinoma. Very rarely, it becomes malignant. Rarely, a giant condyloma (Buschke-Lewenstein tumour) develops with local tissue destruction. Atypical warts should be biopsied. In pregnancy warts may dramatically increase in size and number, making treatment difficult. Rarely, they are large enough to obstruct labour and in this case delivery by CS will be required. Perinatal transmission of HPV rarely leads to anogenital warts, or possibly laryngeal papillomas, in the neonate. Recurrent respiratory papillomatosis ( RRP )causes warts to grow in the throat blocking the airway, causing troubled breathing and hoarseness in the sound . Although rare, RRP can occur among adults and children.

        High-risk HPV infections can sometimes develop into carcinoma of cervix (the opening of the uterus). There may be an association between HPV infection and malignant epithelial transformation of the cervix, vagina and vulva. These infections may also leads to anal cancer. In some cases, high-risk HPV infections can persist and leads to cell changes. If these cell changes are not treated on time, they may lead to cancer over time. It is usually associated with HPV type 16 or 18. HPV plays important role in the development of cervical intra epithelial neoplasia (CIN). Cervical cancer usually does not have symptoms until it is quite advanced, very serious and hard to treat. HPV infected cells are characterised by enlarged cells with perinuclear halos. The nucleus is large, irregular and hyperchromatic. Depending on their oncologenic potential, HPV types are broadly grouped into two.

  1.  High oncogenic risk-type 16,18,31,58.
  2.  Low ongenic risk-types 6,11,42,43.

 

          Over 90 % of patients with CIN and invasive cancer are found to be positive with HPV DNA. So it is important that all high risk women should do regular screening for cervical cancer. Screening test helps to identify the early signs of disease so that the problem can be treated early, before it turns to malignancy.

        Other HPV-related cancers include the cancer of vulva, vagina, penis, anus, and oropharynx (including the base of the tongue and tonsils, cancers of the back of the throat). It may also have no signs or symptoms until they are advanced and hard to treat.

Prevention of HPV transmission

           One of the best ways to prevent HPV is not to have sex with anyone. If you are sexually active, always have safe sex practices like using condoms lowers risk of getting HPV, cervical cancer or genital warts. But it is important to use condoms every time you have sex, from the beginning to the end. This is not a 100 percent reliable method to prevent transmission of HPV, as this virus can also infect the areas that are not covered by condom. Immediately washing the genitals, urinating or douching after sexual intercourse will not prevent the transmission of the any sexually transmitting diseases. Another method to lower the risk of HPV is by maintaining a faithful relationship with one partner, limiting their number of sex partners and being with a partner who has had no or few prior sex partners.

             Vaccination is available to protect the females and males from HPV. These vaccines are given in 3 doses over 6 months. Ideally, the same vaccine product should be used for the entire 3-dose series. The vaccines are most effective when all doses are received before a person has first sexual contact with his / her first partner.

         Two licensed HPV vaccines are bivalent vaccine (Cervarix) containing HPV types 16 and 18 and a quadrivalent vaccine (Gardasil) containing HPV types (6, 11, 16, &18.) These both vaccines offer protection against the HPV types that cause 70% of cervical cancers (i.e., types 16 and 18), and the quadrivalent HPV vaccine also protects against the types that cause 90% of genital warts (i.e., types 6 and 11). Either vaccine can be administered to girls aged 11–12 years or can be administered to those as young as 9 years of age and it can be also given to the women between the age of 13–26 years who have not taken the vaccine before. The quadrivalent (Gardasil) HPV vaccine can also be used in males aged 9–26 years to prevent genital warts (17).

           Women should continue routine cervical cancer screening, even after the vaccination because 30% of cervical cancers are caused by HPV types other than 16 or 18. Vaccination >26 years of age is recommended for the prevention of HPV.

Screening measures available for HPV

  •  Pap Smear test:-This is a test used to detect the cervical cancer. It helps to identify precancer cells which may turn to cervical cancer if not treated properly. All woman should start doing the Pap smear test at the age of 21 years and every three years after that.
  • HPV DNA detection in cervical tissues is a screening procedure as that of pap smear. Polymerase chain reaction or southern blot or hybrid capture technique is also used for HPV DNA detection. HPV testing using hybrid capture method can reliably detect the high risk HPV DNA will ever develop CIN (cervical intra-epithelial neoplasia).This test is recommended for all woman above the age of 30 years.
  • There is no specific test is recommended to identify HPV related health problems like genital wart ,cancer of penis, vulva, anus, vagina and oropharynx.

 

Prevention of HPV-related diseases

  •  Preventing Genital wart:-This is one of the most common problem caused by HPV. Gardasil is the vaccine which protect against most genital warts in men and women.
  • Preventing Cervical Cancer: – Cervical cancer can also prevented by routine cancer screening (Pap test) and follow-up of abnormal results. This helps to identify abnormal cells on the cervix so that the early treatment can be initiated before turning cancerous cell. Success of the treatment depends on the woman’s age, their severity in the progress of the disease, past medical history, and other test results. In some cases along the Pap test HPV DNA test, is also available to detect certain HPV types on a woman’s cervix. Even the vaccinated women should also undergo continuous regular screening because the vaccines do not protect against all cervical cancers.
  •  Preventing Anal and Penile Cancers:Gardasil is the vaccine to protect against most of the anal cancers. Specifically there is no routine screening test for anal or penile cancer. More over there is no data regarding the efficacy of vaccine to prevent cancers of the penis, but most of the HPV related cancers of the penis are prevented by the vaccines.
  • Preventing Cancers of the Oropharynx :- There is no approved test to find early signs of oropharyngeal as well as there is no data on efficacy of the vaccine to prevent cancers of the oropharynx but most HPV-associated cancers of the oropharynx are caused by the HPV types prevented by the vaccines.
  • Preventing (JORRP) Juvenile-Onset Recurrent Respiratory Papillomatosis: Usually the vaginal delivery is not encouraged for the women with genital wart because the baby will get HPV while it passes through the birth canal so she can electively decide for Cesarean.

 

Treatment for the HPV

  •  There is no specific treatment for genital HPV. In 90 % of the individual the body immune system will fight against the virus. The treatment is available for the condition caused by the genital HPV like cervical changes, genital warts, and cervical cancer.
  • Podophyllotoxin, 0.5% solution or 0.15% cream (contraindicated in pregnancy) applied 12-hourly for 3 days, followed by 4 days’ rest, for up to 4 weeks is suitable for home treatment of external warts.
  •  Imiquimod cream (contraindicated in pregnancy) applied 3 times weekly (and washed off after 6-10 hours) for up to 16 weeks is also suitable for home treatment of external warts.
  • Cryotherapy using liquid nitrogen to freeze warty tissue is suitable for external and internal warts but often requires repeated clinic visits.
  • Hyfrecation-electrofulguration that causes superficial charring-is suitable for external and internal warts. Hyfrecation results in smoke plume which contains HPV DNA and the potential to cause respiratory infection in the operator/patient. Masks should be worn during the procedure and adequate extraction of fumes should be provided.
  • Surgical removal- surgical removal is one of the treatment modality.
  •  Cervical cancer can be treatable when it is diagnosed early. Prognosis depends on the severity of illness, age of the woman, past medical history, and other test results. So all the women after the age 20 should undergo routine screening for cervical cancer, for the early identification and treatment cervical cancer. Prevention is always better than treatment. Other HPV-associated cancers are also more treatable when diagnosed and treated early.
  •  Recurrent Respiratory Papillomatosis (RRP) is a condition in which HPV causes warts grow in the throat. It can be treated with surgery or medicines. It can sometimes take many surgeries or treatments over a period of years.
  •  The virus will remains in the body even after the treatment of underlying condition. It means that you may still pass HPV to your sex partners.

 

Is HPV Vaccine Safe?

        All vaccines used in the United States are required to go through years of extensive safety testing before they are licensed by the U.S. Food and Drug Administration (FDA). Once in use, they are continually monitored for their safety and effectiveness.

      Gardasil and Cervarix are two human papillomavirus (HPV) vaccines. These vaccines are mainly to protect females against the two HPV types that cause most cervical cancers. The safety of Gardasil and Cervarix was studied in clinical trial in US before it was licensed. Till now there is no reported case of any adverse effect for this vaccine in the study trail.

Conclusion

           Human pappiloma virus is one of the most common sexually transmitted organisms which can infect large number of people. But it can be prevented by maintaining safe sex practices like using condom, single sex partner and vaccination. This virus is very common and most of them will be salient carrier of it. Most women have not had regular Pap tests before diagnosing cervical cancer. So all women above the age of 20 years should do regular and continuous Pap test to check for any problem to prevent the occurrence of cervical cancer. Be sincere and faithful to your partner, talk openly about sexually transmitting disease and treat immediately to prevent the further progress.

 

We will be expanding on this important topic in future articles. While I recommend you to register to download an e-book: “Adult Prevention Guide” for better health, a FREE

 

Click here for PDF

 

We welcome your comments at the end of the article.

The Team Manager Web Diseases

 

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Sexually Transmitted Diseases

What are Sexually Transmitted Diseases?

Sexually transmitted diseases or better known as STD or venereal disease is not uncommon. It is one of the commonest illness in the world with extensive impact to public health care and socially. As the rate of sexual activities increases with higher high risk sexual behaviour and not practicing safe sex, the incidence of STD s increases steadily each year. The World Health Organization estimates that 340 million people are infected each year by a curable STD.  STDs are mostly seen in young men and women, more in homosexual or bisexual men.

Although it could be very traumatising or embarrassing to seek medical help, it is very important to do so if suspected the sign and symptoms of STD. The healthcare staff also should be alert and be sensitive to ensure privacy and confidentiality.

std

  • Causes of STDs
  • Symptoms of STDs
  • Diagnosis and Investigation of STD
  • Treatment Chlamydia Trachomatis
  • STD Prevention
  • Conclusion

Causes of STDs

There is a long list of causes for STD, commonly bacteria, viruses, fungi and even parasites. These infections can be spread by all types of unprotected sexual activity that involves semen and vaginal discharges. It is not uncommon that one could get infected by multiple pathogens especially in those with high risk sexual behaviour.

A high risk sexual behaviour is characterized by multiple sexual partners, frequent sexual partner changes and unprotected sex.  STD has also been shown have higher incidence in young people, homo or bi-sexual men, recreational drug use, alcohol and frequent travels.

Bacterial STD

The commonest cause is Chlamydia Trachomatis, a intracellular obligate bacteria and Neiserria Gonorrhea, a intracellular diplococcic bacteria that infects epithelium of conjunctiva, pharynx, urogenital tract and rectum. They usually coexist together, thus the STD screening includes these 2 organisms.

Another common organism is Treponema Pallidum, a motile spirochetes that is not limited to genitourinary system but could cause systemic illness if not treated early. The common name for this infection is syphilis. It is acquired by close sexual contact and transplacentally to neonates.

A less common bacteria is Klebsiella Granulomatis,a gram negative bacillus, also known as granuloma inguinale.

Video of STD

Viral STD

The commonest virus is Human Papillomavirus (HPV) 6,11,16 and 18 that causes genital warts. Most HPV is acquired by direct sexual contact and neonates acquired them from the infected birth canal. Neonates may have anogenital warts or laryngeal papillomas from inhalation.

Another common viral STD is Herpes Simplex Virus (HSV) 1 and 2 that causes genital herpes. They are spread by mucosal exposure or non intact skin surface to the virus. Most genital herpes are cause by HSV 2 and oral lesion by HSV 1. With the increasing practice of oral sex, HSV 1 and HSV 2 are no longer confined to oral cavity or genitals.

Hepatitis B (HBV) and Hepatitis C (HCV) are DNA viruses that are spread by blood products and sexual contact. Although there are vaccinations, HBV and HCV remains endemic in Asia.

Human Immune Deficiency Virus (HIV) is RNA retrovirus that is transmitted by blood product, bodily fluid and sexual contact.  The acute infection is often asymptomatic or just a mild viral fever. The symptoms of illness are mainly due to complications of immunodeficiency.

 

Fungi STD

In women, vaginal infection of Candida Albicans is common and not necessary signify STD. However, it is not common for men to be infected. So, if a men presents with candida infection, he most likely contracted it during sexual activity.

Parasite STD

Phthirus pubis is a blood sucking insect, known as lice that cause pediculosis pubis. They are transferred by close contact to the host where they are attached to the pubic hair. These lice can also be found at the eyelashes and eyebrows.

Sarcoptes Scabiei, also known as mites is spread by close sexual contact or within the same household. It can affect any part of the body but rarely the face.

Trichomonas Vaginalis, a flagellates protozoa causes trichomoniasis, mostly in women. They are less common but has high prevalence of coinfection with other STDs.

Symptoms of STDs

There are many symptoms of STD, but the common symptoms that are presented are painful or painless urethral discharge in men, vaginal discharge and genital ulceration. Some women will have itching and redness at the vagina.

The common causative agents for urethral discharge in men are Neiserria Gonorrhea, Chlamydia Trachomatis, Trichomonas Vaginalis, HPV, HSV and Treponema pallidum.

The common causative agents for vaginal discharge in women are Neiserria Gonorrhea, Chlamydia Trachomatis, Trichomonas Vaginalis, HSV and Candida Albicans.

Genital Ulcerations in STD are caused by Treponema Pallidum, Chalamydia Trachomatis, HPV and HSV infection.

STD also causes miscarriages and fetal abnormalities. Pelvic Inflammatory Disease (PID) is the complication of untreated STD.

Chlamydia Trachomatis

In men, 50% of Chlamydia infections are asymptomatic. The symptomatic infection will cause anterior urethritis(inflammation of urethra) with dysuria and urethral discharge.  If the infection is not treated, it will ascends and cause epididymitis. Men who practise anoreceptive intercourse may experience proctitis.

In women, up to 80% are asymptomatic as infection in endocervix is difficult to be notices. Some will have vaginal discharge, lower abdominal pain or post coital bleeding. If left untreated, the infection will ascend to cause acute salphingitis. Most women will experience dysuria (pain during urination).

Neonates can acquire this infection through the birth canal and presents with mucopurulent conjunctivitis or pneumonia.

Neiserria Gonorrhea

In men, 90% are symptomatic with anterior urethritis is and urethral discharge. The ascending infection leads to epididymitis and proctatitis. Rectal infection causes pain, itch and discharges.

In women, up to 50% are asymptomatic. The infected site is usually the endocervix that could cause vaginal discharge. Ascending infection leads to dysuria, pelvic pain and intermenstrual bleeding. The complications of gonorrhoea include Bartholin’s abscess and Fitzhugh Curtis Syndrome that develops perihepatitis.  Gonorrhea is also the leading cause of infertility in women.

Neonates acquire gonorrhoea from their infected mothers and presents with opthalmia neonatorum, similar to conjunctivitis.

Treponema Pallidum

Treponema Pallidum is better known as Syphilis, which is a chronic systemic disease with 3 stages. The early stage of disease, or primary syphilis manifest as painless hard chancre(at infected site, usually at penile shaft or vulva) and painless regional lymphadenopathy. This lesion will resolve spontaneously.

If not treated, secondary syphilis will occur after 3 to 6 weeks with fever, rash, malaise and generalised lymphadenopathy.  The rash is red or brown in colour, non itching, usually starts from trunk and spread to the extremities, palms and soles.

Tertiary syphilis can occur 3 to 20years after primary syphilis. There will be generalised granulomatous lesions(gumma) at skin, bones and viscerals. Cardiovascular involvement manisfest as thoracic aneurysm or aortic regurgitation. Neurosyphilis includes meningitis and tabes dorsalis.

Congenital syphilis could cause still birth. Babies who survive often fail to thrive, has nasal discharge and mucous membranous lesion similar to secondary syphilis. In late stages, commonly after 2 years old, there could be facial gumma, Hutchinson’s teeth, abnormalities of long bone and uveitis.

 Klebsiella Granulomatis

The symptoms start late after an incubation period of 1 to 6 months. It begins with subcutaneous nodules at the genitals and subsequently progress to beefy red painless ulcerative lesion that is highly vascular and is easy to bleed. Commonly involve the genitalia, but any mucosa membrane can be affected, including mouth and anus. Painless lymphadenopathy accompanies too.

HPV

In men, warts (small painless nodules) develop at the penile shaft and subpreputial space and sometimes involving urethra and meatus. In immunosuppressed or men who practise anoreceptive intercourse, warts can be found in the perianal region and rectum.

In women, warts starts at the external genitalia and perianal region, and could ascend up to the vagina and cervix.

HSV

Genital Herpes is one of the commonest STD and the symptoms are easy to recognize.  Primary genital herpes starts with low grade fever, generalised malaise, myalgia and headache for a day. Then, the painful vesicles (blister like) starts to appear at the genitalia, crust after a few days and finally heal without scarring. The painful vesicles can also be found at thigh, buttock and perianal region. While both men and women will develop vesicles, most women will experience severe dysuria that could cause urinary retention.

Tender inguinal lymphadenopathy is often present. Aseptic meningitis can happen as neurological complication.

 

Hepatitis B & Hepatitis C

Around 50% of infected people will experience acute infection. They cause fever, generalized malaise, jaundice and hepatomegaly. Lymphadenopathy is also present with abdominal pain. Most acute infections are simple and not life threatening. It is the complication that is disabling. After acute infection, most will resolve, some will be chronic carriers with chronic hepatitis causing liver cirrhosis or liver failure. This predispose to hepatocellular carcinoma, or liver cancer.

 

HIV

Acute infection is often symptomatic. After seroconversion, most will have maculopapular rash, generalized myalgia, malaise and fever. Most will recover completely after 1-2 weeks. Some will proceed to have constitutional symptoms such as loss of appetite, loss of weight and night sweats. Few years later, or even later when the CD4 count drops, if untreated they will have symptomatic HIV infection, or AIDS – Acquires Immune Deficiency Syndrome. AIDS is defined by a list of infection or condition. Some common examples of AIDS defining conditions are candidiasis in trachea or lungs, extrapulmonary Cryptococcus infection,CMV, chronic HSV, Kaposi’s sarcoma, Burkitt’s lymphoma, disseminated tuberculosis, toxoplasmosis encephalopathy and many more.

 

Trichomonas Vaginalis

In men, they are usually asymptomatic. But some do complaint of mild urethral discharge and urinary frequency.

In women, some may be asymptomatic but most will experience offensive vaginal discharge and vaginal irritation.

Candida Albicans

In men, the affected region is usually around the foreskin causes itching and pain.

In women, itchiness and pain at the vulva is the commonest symptom. Depending on each individual, vaginal discharge may or may not be present. The vaginal discharge are curdy white thick discharges.

Phthirus Pubis

The symptoms usually start early with itching at the pubic area in both men and women. Very tiny bugs could be seen at the pubic hair or from undergarments.

Scabies

Similar to pubic lice, the symptoms are intense itching at the pubic area in both men and women. Small moving bugs could be seen at the pubic hair or undergarments. Itchy papules and pustules are often seen with linear skin burrows.

 

Diagnosis and Investigation of STD

It is important to seek medical care if you suspect yourself being exposed to STD.  As most infections can be asymptomatic, it is crucial to be investigated early before being symptomatic or complications set it. Often times, STD could have multiple causative organism at once.

The investigations vary between symptomatic and asymptomatic individuals.

In asymptomatic women

A high vaginal swab is taken and tested for Gonorrhoea and Chlamydia by culture. A urine test is also done by Nuclei Acid Amplification Test (NAAT) for Gonorrhoea and Chlamydia. There are also simple urine test kits that can be taken at home if she feels shy to go to a clinic.

Blood test is taken for serology test of syphilis, HIV and Hepatitis.

In asymptomatic men

A urethral swab is taken for culture and also urine NAAT to test for Gonorrhoea and Chlamydia.

Blood test is taken for serology test of syphilis, HIV and Hepatitis.

In asymptomatic homosexual men

A urethral, rectal and oropharyngeal  swab is taken for culture and also urine NAAT to test for Gonorrhoea and Chlamydia.

Blood test is taken for serology test of syphilis, HIV and Hepatitis.

 

In symptomatic men

Swabs are taken from urethra, rectum and the oropharynx to test for Gonorrhea, Chlamydia and Trichomonas. Urine test for Chlamydia is taken as well as blood for seroly test of HIV, Hepatitis, HSV and Syphilis.

In symptomatic women

Swabs are taken from cervix, vagina, rectum and the oropharynx to test for Gonorrhea, Chlamydia and Trichomonas. Urine test for Chlamydia is taken as well as blood for seroly test of HIV, Hepatitis, HSV and Syphilis.

In the symptomatic patients will ulcers, a sample will be taken for microscopy examination to determine Treponema and Klebsiella, and also culture for HSV.

Other test that can be done for women includes a pregnancy test and cervical cytology – pap smear.

 

Treatment

Chlamydia Trachomatis

1st line treatment is with single oral Azithromycim or oral Doxycycline for a week. Erythromycin, Oflaxacin and Levofloxacin can be used as alternatives for a week.

Neiserria Gonorrhea

1st line treatment is single oral Cefixime or intramuscular injection of Ceftriaxone. Other alternatives are intramuscular injection of Cefotaxime, Cefoxitin and Ceftizoxime.

Treponema Pallidum

A single dose of intramuscular injection of Penicillin G is the treatment. Oral Doxycycline and Tetracycline can be used as alternatives for 2 weeks.

Klebsiella Granulomatis

Oral Doxycycline for 3 weeks or longer; until complete healing of the ulcers. Other alternatives are oral Azithromycin, Ciprofloxacin and Trimethoprim-sulfamethoxazole.

HPV

There is no cure for HPV, therapies are only to reduce the size of warts. Topical cream of Podofilox, Imiquimod can be used externally. Cryotherapy and trichloroacetic acid can be administered by dermatologist.

HSV

Oral Acyclovir for 10 days is the standard treatment. Some centres uses Famciclovir which is equally potent.

Hepatitis B & Hepatitis C

There is only supportive treatment for infectious hepatitis. For chronic HBV carrier, Lamivudine is given depending on the case.

HIV

There is no cure for HIV. Highly Active Antiretroviral therapy (HAART) aims to supress the HIV RNA concentration to ensure immune function of the patient.  There are many other drugs that are still in experimental phase for better outcome.

Trichomonas Vaginalis

Single dose of oral Metronidazole is effective or some will opt for a week.

Candida Albicans

A single dose of vaginal pessary – Clotrimazole is sufficient or an oral dose of Fluconazole. Antifungal cream for external genitalia in men and women help with the itching.

Phthirus Pubis & Scabies

5% Permethrin is used to treat entire household and sexual partners. It is to be applied over whole body including neck and scalp, wash off only after 12 hours. The process has to be repeated a week later.

 

 Pregnancy

For pregnant patients, they should be cared in a combined prenatal clinic consist of infectious physician and also an obstetrician.  Oral penicillin, Ceftriaxone, Azithromycin and Metronidazole are safe in pregnancy.

 

Sexual Assault

For sexually assaulted patients, prophylaxis should be given after the investigations are done.  They will be given a single dose of IM Ceftriaxone, oral Doxycycline, Metronidazole and Azithromycin.  Hepatitis B vaccination should be given, and to complete a course of 3 injections. HIV prophylaxis is depending on the case.

 

STD Prevention

Sexual promiscuity is the main cause of STD. So, the prevention starts from avoiding sexual promiscuity, practicing monogamous sexual relationship.

Practicing safe sex with condoms has 90% protection from STD. This is because close sexual contact is not protected by a condom.

It is important to have regular check-up and early investigation if suspected STD. Vaccinations for Hepatitis B and Human Papillomavirus are available.

 

Conclusion

Prevention of STD is better than cure as some diseases are incurable.  Most of the common STD can be cured with simple medical treatment. So, it is important to seek help immediately if you suspect yourself having STD.

 

We will be expanding on this important topic in future articles. While I recommend you to register to download an e-book: “Adult Prevention Guide” for better health, a FREE

Click here for PDF

We welcome your comments at the end of the article.
The Team Manager Web Diseases

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Be the first to comment - What do you think?  Posted by Natalie C - April 11, 2013 at 11:41

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