Wellness Exam 2 Study Guide Sexually Transmitted Diseases The Major STDs o STDs or STIs infectious disease that are spread from person to person mainly through sexual activity o 7 main STDs that pose a major health threat HIV AIDS Hepatitis Syphilis Chlamydia Gonorrhea Herpes Human papillomavirus HPV o Caused by viruses bacteria fungi and protozoa Pathogrens that commonly cause STDs VIRUSES BACTERIA Hepatitis B virus HBV Herpes simplex viruses HSV Human immunodeficiency virus HIV Chlamydia trachomatis causes PID Gardnerella vaginalis causes vaginitis Haemophilus ducreyi causes chancroid Human papillomavirus HPV Neisseria gonorrhoeae causes gonhorrhea Treponema pallidum causes syphillis o US has highest rate of STDs of any developed nation At current rates of all young people will acquire an STD by age 25 2007 report from CDC showed that many of the most common STDs are on the rise in the US 2008 CDC estimated approx 65 million Americans infected with STD and 19 million become newly infected with an STD each year o HIV human immunodeficiency virus causes AIDS acquired immunodeficiency HIV Infection and AIDS syndrome AIDS kills most of its victims esp in parts of the world where no adequate Tx o About 65 million people have been infected with HIV since the epidemic began this is about 1 of the world s population About 34 million are currently infected most will die w in next 10 years About 70 of them live in sub Saharan Africa What is HIV Infection AIDS 1 cause of death in Africa o Chronic disease that progressively damages the body s immune system o Makes your body less able to resist infection o HIV attacks immune system by invading and taking over CD4 T cells lymphocytes macrophages and monocytes o HIV enters a human cell and converts its own genetic material RNA into DNA o The viral DNA then takes over the CD4 cell and makes it produce more copies of HIV also causes CD4 cells to stop performing their normal immune functions o Those with AIDS are vulnerable to opportunistic secondary infections most common is o Asymptomatic period aka latency phase can last from 2 20 yrs avg 11 yrs in o As CD4 levels decrease HIV RNA levels increase takes 2 12 weeks for body to make yeast fungal infection untreated adults antibody for HIV Transmitting the Virus o HIV lives only within cells and body fluids o Transmitted by blood and blood products semen vaginal and cervical secretions and breast milk o HIV s 3 primary routes for transmission Sexual contact Direct exposure to infected blood From an HIV infected mother to her fetus during pregnancy OR to her infant during breastfeeding Populations of Special Concern for HIV Infection o The top 3 most commons means of HIV exposure in America Sexual activity between men IV abuse Heterosexual contact proportion of all U S AIDS cases o Women especially African American women and Latinas make up an increasingly large HIV is increasingly becoming a disease that affects ethnic minorities women and o Af Amer men and women are vastly overrepresented among people newly diagnosed the poor with AIDS Symptoms of HIV Infection o Within a few days or weeks avg 2 4 wks after exposure to virus people will develop initial symptoms which are flu like body ache low grade fever etc This stage is called the primary acute infection o Most common infection in HIV patients is Pneumocystitis carinii pneumonia fungal o Kaposi s sarcoma rare cancer is commonly seen in HIV patients esp men o Symptoms take months or even years to develop but as the immune system weakens a variety of more problems develop o HIV infected women often have difficult to treat yeast infections o Cases of TB increasingly being reported Diagnosing HIV Infection o Most common tests check for presence of antibodies to the virus First test done HIV antibody test used for screening cheap and widely available test If positive followed up with ELISA standard test for HIV If positive this is followed up with Immunofluorescence assay or Western blot this confirms results o If tests determine HIV positive next step is to determine severity of disease To do this count the CD4 in the blood Treatment o Antiviral drugs such as AZT zidovudine work by inhibiting the target the protein HIV uses to create a protein coat for each Reverse transcriptase inhibitors integration of HIV RNA into human cells Protease inhibitors viral copy Entry inhibitors block HIV from entering and infecting cells HAART highly active antiretroviral therapy high dose of 4 5 antiviral meds can reduce HIV in blood to undetectable level Post exposure Prophylaxis PEP 28 days of HAART Should be started with 3 days 72 hrs of exposure to virus This Tx option is used if you are exposure to virus but not definitely positive Chlamydia o Most common bacterial STD in U S o Can cause sterility in men and women Women can lead to pelvic inflammatory disease infertility and ectopic pregnancy Men most common cause of epididymitis inflam of sperm carrying ducts causes half of all cases of urethritis inflame of urethra Women vaginal discharge painful bleeding intercourse abdominal cramps lymphatic pain around groin Men painful urination watery discharge from penis lymphatic pain around o Symptoms groin o Treatment Typically diagnosed through lab tests on a urine sample or small amt of fluid discharge from urethra or cervix Both patient and partner given antibiotics after diagnosed Gonorrhea o Can cause arthritis rashes eye infections PID epididymitis urethritis and gonococcal conjunctivitis or gonorrheal infection of blood or joints in infants of infected mothers o Being infected with gonorrhea increases likelihood that HIV will be transmitted o Symptoms Men urinary discomfort thick yellow white discharge inflamed lips of urethral opening enlarge lymph nodes in groin region Women most are asymptomatic If do have Sx painful urination increased vaginal discharge severe menstrual cramps Up to 40 of untreated women develop PID o Diagnosis Treatment Microscopic exam of discharge or urine can diagnose infection Oral antibiotics can cure Growing number of drug resistant strains of gonorrhea major concern only 1 class of antibiotics remain effective cephalosporins Pelvic Inflammatory Disease PID o Problem in 10 40 of women with untreated gonorrhea or chlamydia Occurs when initial infection with gonorrhea or chlamydia travels up to reproductive organs o Often serious enough to require hospitalization and surgery o 25 of women have long term problems such as chronic