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Sexually transmitted disease AIDs. Sexually transmitted disease.
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Sexually transmitted disease Sexually transmitted infections (STI), also referred to as sexually transmitted diseases (STD) and venereal diseases (VD), are infections that are commonly spread by sex, especially vaginal intercourse, anal sex and oral sex. Most STIs initially do not cause symptoms This results in a greater risk of passing the disease on to others. Symptoms and signs of disease may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. STIs acquired before or during birth may result in poor outcomes for the baby.
The World Health Organization(WHO) has recommended sexually transmitted infection as the preferred term since 1999 An infection is a colonization by a parasitic species, which may not cause any adverse effects. In a disease, the infection leads to impaired or abnormal function..
Sexually transmitted diseases (STDs) are infections that can get from having sex with someone who has the infection. The causes of STDs are bacteria, parasites and viruses. There are more than 20 types of STDs, including • Chlamydia • Gonorrhea • Genital herpes • HIV/AIDS • HPV • Syphilis • Trichomoniasis
1- Viral Infections A- Human Papilloma Virus (HPV): The human papilloma virus or HPV is the most common viral infection. B-Genital Herpes: Genital Herpes is caused by the Herpes Simplex Virus. C-Hepatitis B Virus: Hepatitis B affects the liver. It is not to be mistaken with Hepatitis A or C, which are other forms of liver disease. Hepatitis B is easily transmitted not only through sexual activities, but by sharing items like razors, needles and toothbrushes. D-Human ImmunodeficiencyVirus (HIV): Human Immunodeficiency virus or HIV/Aids attacks the body’s immune system, leaving infected individuals unable to fight off other illness. It is transmitted through sexual activities, but also spread by sharing items like razors, needles and toothbrushes.
2- Bacterial Infections A-Chlamydia: Chlamydia is one of the most common STIs especially among people ages 15 to 24. If left untreated it can cause infertility in both women and men. C-Gonorrhea (“the clap”): Gonorrhea is an infection that often is transmitted at the same time as Chlamydia and shares the same symptoms. It is found most commonly in people aged 15 to 29. If left untreated it can cause infertility in both women and men. C-Syphilis (“the great imitator”): Syphilis is called the great imitator because it shows signs that other diseases show. There are three stages of Syphilis. Stage 1 starts with a small painless sore where the bacteria entered the body. In stage two, a person may develop a general feeling of being unwell or flat smooth warts in the genital area. In stage three, syphilis that has been left untreated can cause heart problems, mental issues, and even death.
3- Parasitic Infections A- Trichomoniasis (Trich): This single-celled organism can infect the urethra, bladder, vagina, cervix or get under the foreskin. B-Pubic Lice (Crabs): Pubic lice are also called crabs, because that’s what they look like under a microscope. Public Lice live in pubic hairs around the genitals. They lay eggs at the base of the hair. C-Scabies (Mites): Scabies are tiny mites that dig little holes below the surface of the skin where they lay eggs.
4- Fungal Infections Yeast Infection (Candida): Yeast is normally found in a woman’s vagina in small numbers, but sometimes they can multiply and change the normal balance of bacterial growth. When the fungi begin to grow in excess, they may develop into candidiasis.
Preventionof STDs The interventions for preventing the spread of STDs depend on several sociocultural factors such as culture, age, employment, education, religion and gender. These factors can influence sexual conduct and therefore spread of the infections. The main prevention approaches include: 1- Abstinence: One of the best ways to prevent transmission of STDs is to avoid sexual contact with other individuals. 2- Barrier contraceptives: Contraceptives such as condoms provide a barrier against the contraction of STDs from an infected individual. Condoms, however, need to be used correctly to prevent transmission.
3-Sexual health checks: Attending a sexual health screen before engaging in sexual contact with a partner helps to prevent new cases of infection. 4-Vaccination: Examples of important vaccines now available are those offering protection against hepatitis B and some strains of human papilloma virus (HPV).
5-Nonoxynol-9: This is a spermicidal and microbicidal agent used to lubricate condoms that can kill some of the local vaginal microbes. However, the compound is not completely protective against all STDs.
Treatment of STD • Individuals at high risk of contracting a disease such as rape victims can be given broad-spectrum antibiotics such as azithromycin and cefixime. . For HIV infection, individuals are treated with antiretroviral agents to keep the viral load low. • Antiviral agents may be effective to a certain extent against herpes infection. In addition, warts may be treated using certain local treatments such as freezing therapy.
ACQUIRED IMMUNODEFICIENCYSYNDROME (HIV infection, AIDS) 1. Identification a- Acquired Immunodeficiency Syndrome (AIDS) was first recognized in 1981 in a cluster of diseases associated with loss of cellular immunity in adults who had no obvious reason for presenting such immune deficiencies b-AIDS was subsequently shown to be the late clinical stage of infection with the human immunodeficiency virus (HIV) Within several weeks after infection with HIV
Signs and symptoms 1-The absolute T-helper cell (CD4+) count or percentage is used most often to evaluate the progression of HIV infection and to help clinicians make treatment decisions (depletion of T- cell) 2-Hyper gammaglbulinaemia 3-Opportunistic infection (e.g Pneumocystis carinii) &Kaposi’s sarcoma and TB usually occurred . AIDs/ May include: Fever , Lymphadenopathy ,Night sweating, Head ache &cough AIDs dementia 1/3 patient if progressive ---- incontinence ¶plegia HIV +ve ----- remain +ve life long
Spectrum of diseases caused by HIV infection AIDS HIV +ve asymptomatic AIDS refers only to the last stage of HIV infection
AIDS can be diagnosed by 1- Clinical 2- Serological tests including HIV /AB detected within 1 -3 months after infection by EIA, ELISA and Western blot test. This gap time called window period (i.e from infection and before detection of AB). 3- virus isolation from blood , secretions and others
4- complete blood picture a-Lymphopenia,CD4 ↓↓ (normally 800 / mm3), when decrease below 200 / mm3 → prone to opportunistic infections. So CD4 count helps to predict course of disease. b-Anemia. c-Thrombocytopenia. d-↑ ESR.
2.Infectious agent Human immunodeficiency virus (HIV), a retro-virus. Two serologically and geographically distinct species, HTV-1 and HIV-2, have been identified. The transmissibility and pathogenicity of HIV-2 may be lower than that of HTV-1. Three groups of HIV-1 have been identified—M, N and O. Group M is the most prevalent and is subdivided into seven subtypes
*-Can spread throughout the body & pass blood –brain barrier. *-Easily killed by heat, ether, acetone, ethanol 20% *-Relatively resist UV & ionizing radiation 3. reservoir—Humans. HIV-1 4- Mode of transmission— a- Person-to-person transmission through unprotected penile-vaginal or penile-anal intercourse b- the use of HIV-contaminated needles and syringes, including sharing by intravenous drug users c- transfusion of infected blood or its components (platelets, factor 8 &9, plasma) risk of blood transfusion is higher than skin piercing
d- vertical transmission from mother to infant during pregnancy, delivery, or breastfeeding Placenta and during delivery → risk 15 - 30%. With prolonged breast feeding the risk increases to reaches 45%. treatment of infected pregnant with zidovudine → marked decrease of infant infection.
5- incubation period a- Variable.-Although-the-time-from-infection-to-the-development-of detectable antibodies is generally less than one month b-the time from HIV infection to diagnosis of AIDS has an observed range of less than 1 year to 15 years or longer c-The-median-time-to-development-of AIDS in infected infants is shorter than in adults.