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HIV

HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS.

There's no cure for HIV/AIDS, but medications can dramatically slow the progression of the disease. These drugs have reduced AIDS deaths in many developed nations.

The symptoms of HIV and AIDS vary, depending on the phase of infection.

Some people infected by HIV develop a flu-like illness within two to four weeks after the virus enters the body. This illness, known as primary (acute) HIV infection, may last for a few weeks. Possible signs and symptoms include:

  • Fever
  • Headache
  • Muscle aches and joint pain
  • Rash
  • Sore throat and painful mouth sores
  • Swollen lymph glands, mainly on the neck
  • Diarrhea
  • Weight loss
  • Cough
  • Night sweats

These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage.

As the virus continues to multiply and destroy your immune cells — the cells in your body that help fight off germs — you may develop mild infections or chronic signs and symptoms such as:

  • Fever
  • Fatigue
  • Swollen lymph nodes — often one of the first signs of HIV infection
  • Diarrhea
  • Weight loss
  • Oral yeast infection (thrush)
  • Shingles (herpes zoster)
  • Pneumonia

Progression to AIDS:  Thanks to better antiviral treatments, most people with HIV in the U.S. today don't develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.

When AIDS occurs, your immune system has been severely damaged. You'll be more likely to develop opportunistic infections or opportunistic cancers — diseases that wouldn't usually cause illness in a person with a healthy immune system.

The signs and symptoms of some of these infections may include:

  • Sweats
  • Chills
  • Recurring fever
  • Chronic diarrhea
  • Swollen lymph glands
  • Persistent white spots or unusual lesions on your tongue or in your mouth
  • Persistent, unexplained fatigue
  • Weakness
  • Weight loss
  • Skin rashes or bumps

 

How is HIV spread?

HIV is caused by a virus. It can spread through sexual contact or blood, or from mother to child during pregnancy, childbirth or breast-feeding.

To become infected with HIV, infected blood, semen or vaginal secretions must enter your body. This can happen in several ways:

  • By having sex. You may become infected if you have vaginal, anal or oral sex with an infected partner whose blood, semen or vaginal secretions enter your body. The virus can enter your body through mouth sores or small tears that sometimes develop in the rectum or vagina during sexual activity.
  • By sharing needles. Sharing contaminated IV drug paraphernalia (needles and syringes) puts you at high risk of HIV and other infectious diseases, such as hepatitis.
  • From blood transfusions. In some cases, the virus may be transmitted through blood transfusions. American hospitals and blood banks now screen the blood supply for HIV antibodies, so this risk is very small.
  • During pregnancy or delivery or through breast-feeding. Infected mothers can pass the virus on to their babies. Mothers who are HIV-positive and get treatment for the infection during pregnancy can significantly lower the risk to their babies.

You can't become infected with HIV through ordinary contact. That means you can't catch HIV or AIDS by hugging, kissing, dancing or shaking hands with someone who has the infection.

HIV isn't spread through the air, water or insect bites.

How to test for HIV?

HIV can be diagnosed through blood or saliva testing. Available tests include:

  • Antigen/antibody tests. These tests usually involve drawing blood from a vein. Antigens are substances on the HIV virus itself and are usually detectable — a positive test — in the blood within a few weeks after exposure to HIV.
  • Antibodies are produced by your immune system when it's exposed to HIV. It can take weeks to months for antibodies to become detectable. The combination antigen/antibody tests can take two to six weeks after exposure to become positive.
  • Antibody tests. These tests look for antibodies to HIV in blood or saliva. Most rapid HIV tests, including self-tests done at home, are antibody tests. Antibody tests can take three to 12 weeks after you're exposed to become positive.
  • Nucleic acid tests (NATs).  These tests look for the actual virus in your blood (viral load). They also involve blood drawn from a vein. If you might have been exposed to HIV within the past few weeks, your doctor may recommend NAT. NAT will be the first test to become positive after exposure to HIV.

Talk to your doctor about which HIV test is right for you. If any of these tests are negative, you may still need a follow-up test weeks to months later to confirm the results.

Prevention

There's no vaccine to prevent HIV infection and no cure for AIDS. But you can protect yourself and others from infection.

To help prevent the spread of HIV:

  • Use treatment as prevention (TasP). If you're living with HIV, taking HIV medication can keep your partner from becoming infected with the virus. If you make sure your viral load stays undetectable — a blood test doesn't show any virus — you won't transmit the virus to anyone else. Using TasP means taking your medication exactly as prescribed and getting regular checkups.
  • Use post-exposure prophylaxis (PEP) if you've been exposed to HIV. If you think you've been exposed through sex, needles or in the workplace, contact your doctor or go to the emergency department. Taking PEP as soon as possible within the first 72 hours can greatly reduce your risk of becoming infected with HIV. You will need to take medication for 28 days.
  • Use a new condom every time you have sex. Use a new condom every time you have anal or vaginal sex. Women can use a female condom. If using a lubricant, make sure it's water-based. Oil-based lubricants can weaken condoms and cause them to break. During oral sex use a nonlubricated, cut-open condom or a dental dam — a piece of medical-grade latex.
  • Consider preexposure prophylaxis (PrEP). The combination drugs emtricitabine plus tenofovir (Truvada) and emtricitabine plus tenofovir alafenamide (Descovy) can reduce the risk of sexually transmitted HIV infection in people at very high risk. PrEP can reduce your risk of getting HIV from sex by more than 90% and from injection drug use by more than 70%, according to the Centers for Disease Control and Prevention. Descovy hasn't been studied in people who have receptive vaginal sex.
  • Your doctor will prescribe these drugs for HIV prevention only if you don't already have HIV infection. You will need an HIV test before you start taking PrEP and then every three months as long as you're taking it. Your doctor will also test your kidney function before prescribing Truvada and continue to test it every six months.
  • You need to take the drugs every day. They don't prevent other STIs, so you'll still need to practice safe sex. If you have hepatitis B, you should be evaluated by an infectious disease or liver specialist before beginning therapy.
  • Tell your sexual partners if you have HIV. It's important to tell all your current and past sexual partners that you're HIV-positive. They'll need to be tested.
  • Use a clean needle. If you use a needle to inject drugs, make sure it's sterile and don't share it. Take advantage of needle-exchange programs in your community. Consider seeking help for your drug use.
  • If you're pregnant, get medical care right away. If you're HIV-positive, you may pass the infection to your baby. But if you receive treatment during pregnancy, you can significantly cut your baby's risk.
  • Consider male circumcision. There's evidence that male circumcision can help reduce the risk of getting HIV infection.

 

Treatment

If you've been diagnosed with HIV, it's important to have a specialist trained in diagnosing and treating HIV to help you:

  • Determine whether you need additional testing
  • Determine which HIV antiretroviral therapy (ART) will be best for you
  • Monitor your progress and work with you to manage your health

If you receive a diagnosis of HIV/AIDS, several tests can help your doctor determine the stage of your disease and the best treatment, including:

  • CD4 T cell count. CD4 T cells are white blood cells that are specifically targeted and destroyed by HIV. Even if you have no symptoms, HIV infection progresses to AIDS when your CD4 T cell count dips below 200.
  • Viral load (HIV RNA). This test measures the amount of virus in your blood. After starting HIV treatment the goal is to have an undetectable viral load. This significantly reduces your chances of opportunistic infection and other HIV-related complications.
  • Drug resistance. Some strains of HIV are resistant to medications. This test helps your doctor determine if your specific form of the virus has resistance and guides treatment decisions.

Your doctor might also order lab tests to check for other infections or complications, including:

  • Tuberculosis
  • Hepatitis B or hepatitis C virus infection
  • STIs
  • Liver or kidney damage
  •  Urinary tract infection
  • Cervical and anal cancer
  • Cytomegalovirus
  • Toxoplasmosis

 

Dr. Marc Tribble is board certified in Infectious Disease and has been treating HIV in patients for over 15 years. 

Syphilis

Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a painless sore — typically on your genitals, rectum or mouth. Syphilis spreads from person to person via skin or mucous membrane contact with these sores.

After the initial infection, the syphilis bacteria can remain inactive (dormant) in your body for decades before becoming active again. Early syphilis can be cured, sometimes with a single shot (injection) of penicillin. Without treatment, syphilis can severely damage your heart, brain or other organs, and can be life-threatening. Syphilis can also be passed from mothers to unborn children.

Syphilis develops in stages, and symptoms vary with each stage. But the stages may overlap, and symptoms don't always occur in the same order. You may be infected with syphilis and not notice any symptoms for years.

  • Primary Syphilis: The first sign of syphilis is a small sore, called a chancre (SHANG-kur). The sore appears at the spot where the bacteria entered your body. While most people infected with syphilis develop only one chancre, some people develop several of them.
  • The chancre usually develops about three weeks after exposure. Many people who have syphilis don't notice the chancre because it's usually painless, and it may be hidden within the vagina or rectum. The chancre will heal on its own within three to six weeks
  • Secondary syphilis:  Within a few weeks of the original chancre healing, you may experience a rash that begins on your trunk but eventually covers your entire body — even the palms of your hands and the soles of your feet. This rash is usually not itchy and may be accompanied by wartlike sores in your mouth or genital area. Some people also experience hair loss, muscle aches, a fever, a sore throat and swollen lymph nodes. These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year.
  • Latent syphilis:  If you aren't treated for syphilis, the disease moves from the secondary stage to the hidden (latent) stage, when you have no symptoms. The latent stage can last for years. Signs and symptoms may never return, or the disease may progress to the third (tertiary) stage.
  • Tertiary syphilis:  About 15% to 30% of people infected with syphilis who don't get treatment will develop complications known as late (tertiary) syphilis. In the late stage, the disease may damage your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur many years after the original, untreated infection.
  • Neurosyphilis:  At any stage, syphilis can spread and, among other damage, cause damage to the brain and nervous system (neurosyphilis) and the eye (ocular syphilis).

 

Syphilis can cause a number of problems with your nervous system, including:

·       Headache

·       Stroke

·       Meningitis

·       Hearing loss

·       Visual problems, including blindness

·       Dementia

·       Loss of pain and temperature sensations

·       Sexual dysfunction in men (impotence)

·       Bladder incontinence

 

How is Syphilis spread?

The cause of syphilis is a bacterium called Treponema pallidum. The most common route of transmission is through contact with an infected person's sore during sexual activity. The bacteria enter your body through minor cuts or abrasions in your skin or mucous membranes. Syphilis is contagious during its primary and secondary stages, and sometimes in the early latent period.

Less commonly, syphilis may spread through direct unprotected close contact with an active lesion (such as during kissing) or through infected mothers to their babies during pregnancy or childbirth (congenital syphilis).

Syphilis can't be spread by using the same toilet, bathtub, clothing or eating utensils, or from doorknobs, swimming pools or hot tubs.

Once cured, syphilis doesn't recur on its own. However, you can become reinfected if you have contact with someone's syphilis sore.

You face an increased risk of acquiring syphilis if you:

·       Engage in unprotected sex

·       Have sex with multiple partners

·       Are a man who has sex with men

·       Are infected with HIV, the virus that causes AIDS

 

How to test for Syphilis?

Syphilis can be diagnosed by testing samples of:

  • Blood. Blood tests can confirm the presence of antibodies that the body produces to fight infection. The antibodies to the syphilis-causing bacteria remain in your body for years, so the test can be used to determine a current or past infection.
  • Cerebrospinal fluid. If it's suspected that you have nervous system complications of syphilis, your doctor may also suggest collecting a sample of cerebrospinal fluid through a procedure called a lumbar puncture (spinal tap).

 

Prevention

There is no vaccine for syphilis. To help prevent the spread of syphilis, follow these suggestions:

  • Abstain or be monogamous. The only certain way to avoid syphilis is to not have (abstain from) sex. The next-best option is to have mutually monogamous sex in which both people have sex only with each other and neither partner is infected.
  • Use a latex condom. Condoms can reduce your risk of contracting syphilis, but only if the condom covers the syphilis sores.
  • Avoid recreational drugs. Misuse of alcohol or other drugs can inhibit your judgment and lead to unsafe sexual practices.

If tests show that you have syphilis, your sex partners — including your current partners and any other partners you've had over the last three months to one year — need to be informed so that they can get tested. If they're infected, they can then be treated.

Official, confidential partner notification can help limit the spread of syphilis. The practice also steers those at risk toward counseling and the right treatment. And since you can contract syphilis more than once, partner notification reduces your risk of getting reinfected.

 

Treatment

When diagnosed and treated in its early stages, syphilis is easy to cure. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you're allergic to penicillin, your doctor may suggest another antibiotic or recommend penicillin desensitization.

The first day you receive treatment you may experience what's known as the Jarisch-Herxheimer reaction. Signs and symptoms include a fever, chills, nausea, achy pain and a headache. This reaction usually doesn't last more than one day.

After you're treated for syphilis, your doctor will ask you to:

·       Have periodic blood tests and exams to make sure you're responding to the usual dosage of penicillin. Your specific follow-up will depend on the stage of syphilis you're diagnosed with.

·       Avoid sexual contact with new partners until the treatment is completed and blood tests indicate the infection has been cured.

·       Notify your sex partners so that they can be tested and get treatment if necessary.

·       Be tested for HIV infection.

Hepatitis A

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function. 

You're most likely to get hepatitis A from contaminated food or water or from close contact with a person or object that's infected. 

Mild cases of hepatitis A don't require treatment. Most people who are infected recover completely with no permanent liver damage. Practicing good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.

Hepatitis A signs and symptoms typically don't appear until you've had the virus for a few weeks. But not everyone with hepatitis A develops them. If you do, hepatitis signs and symptoms can include:

  • Fatigue
  • Sudden nausea and vomiting
  • Abdominal pain or discomfort, especially on the upper right side beneath your lower ribs (by your liver)
  • Clay-colored bowel movements
  • Loss of appetite
  • Low-grade fever
  • Dark urine
  • Joint pain
  • Yellowing of the skin and the whites of your eyes (jaundice)
  • Intense itching

These symptoms may be relatively mild and go away in a few weeks. Sometimes, however, hepatitis A infection results in a severe illness that lasts several months.

How is Hepatitis A spread?

The virus most commonly spreads when you eat or drink something contaminated with fecal matter, even just tiny amounts. It does not spread through sneezing or coughing.

Here are some of the specific ways the hepatitis A virus can spread:

  • Eating food handled by someone with the virus who doesn't thoroughly wash his or her hands after using the toilet
  • Drinking contaminated water
  • Eating raw shellfish from water polluted with sewage
  • Being in close contact with a person who's infected — even if that person has no signs or symptoms
  • Having sex with someone who has the virus


How to test for Hepatitis A?

Blood tests are used to look for signs of the hepatitis A virus in your body. A sample of blood is taken, usually from a vein in your arm. It's sent to a laboratory for testing.


Prevention

The hepatitis A vaccine can prevent infection with the virus. The vaccine is typically given in two shots. The first one is followed by a booster shot six months later.

The Centers for Disease Control and Prevention recommends a hepatitis A vaccine for the following people:

  • All children at age 1, or older children who didn't receive the childhood vaccine
  • Anyone age 1 year or older who is experiencing homelessness
  • Infants ages 6 to 11 months traveling internationally
  • Family and caregivers of adoptees from countries where hepatitis A is common
  • People in direct contact with others who have hepatitis A
  • Laboratory workers who may come in contact with hepatitis A
  • Men who have sex with men
  • People who work or travel in parts of the world where hepatitis A is common
  • People who use any type of illicit drugs, not just injected ones
  • People with clotting-factor disorders
  • People with chronic liver disease, including hepatitis B or hepatitis C
  • Anyone wishing to obtain protection (immunity)

If you're concerned about your risk of hepatitis A, ask your doctor if you should be vaccinated.

Treatment

No specific treatment exists for hepatitis A. Your body will clear the hepatitis A virus on its own. In most cases of hepatitis A, the liver heals within six months with no lasting damage.

Hepatitis A treatment usually focuses on keeping comfortable and controlling signs and symptoms. You may need to:

  • Rest. Many people with hepatitis A infection feel tired and sick and have less energy.
  • Manage nausea. Nausea can make it difficult to eat. Try snacking throughout the day rather than eating full meals. To get enough calories, eat more high-calorie foods. For instance, drink fruit juice or milk rather than water. Drinking plenty of fluids is important to prevent dehydration if vomiting occurs.
  • Avoid alcohol and use medications with care. Your liver may have difficulty processing medications and alcohol. If you have hepatitis, don't drink alcohol. It can cause more liver damage. Talk to your doctor about all the medications you take, including over-the-counter drugs.

Hepatitis B

Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that permanently scars of the liver.

Most adults with hepatitis B recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic (long-lasting) hepatitis B infection.

A vaccine can prevent hepatitis B, but there's no cure if you have the condition. If you're infected, taking certain precautions can help prevent spreading the virus to others.

Signs and symptoms of hepatitis B range from mild to severe. They usually appear about one to four months after you've been infected, although you could see them as early as two weeks post-infection. Some people, usually young children, may not have any symptoms.

Hepatitis B signs and symptoms may include:

  • Abdominal pain
  • Dark urine
  • Fever
  • Joint pain
  • Loss of appetite
  • Nausea and vomiting
  • Weakness and fatigue
  • Yellowing of your skin and the whites of your eyes (jaundice)


How is Hepatitis B spread?

Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is passed from person to person through blood, semen or other body fluids. It does not spread by sneezing or coughing.

Common ways that HBV can spread are:

  • Sexual contact. You may get hepatitis B if you have unprotected sex with someone who is infected. The virus can pass to you if the person's blood, saliva, semen or vaginal secretions enter your body.
  • Sharing of needles. HBV easily spreads through needles and syringes contaminated with infected blood. Sharing IV drug paraphernalia puts you at high risk of hepatitis B.
  • Accidental needle sticks. Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.
  • Mother to child. Pregnant women infected with HBV can pass the virus to their babies during childbirth. However, the newborn can be vaccinated to avoid getting infected in almost all cases. Talk to your doctor about being tested for hepatitis B if you are pregnant or want to become pregnant.

How to test for Hepatitis B?

Your doctor will examine you and look for signs of liver damage, such as yellowing skin or belly pain. Tests that can help diagnose hepatitis B or its complications are:

  • Blood tests. Blood tests can detect signs of the hepatitis B virus in your body and tell your doctor whether it's acute or chronic. A simple blood test can also determine if you're immune to the condition.

Prevention

The hepatitis B vaccine is typically given as three or four injections over six months. You can't get hepatitis B from the vaccine.

The hepatitis B vaccine is recommended for:

  • Newborns
  • Children and adolescents not vaccinated at birth
  • Those who work or live in a center for people who are developmentally disabled
  • People who live with someone who has hepatitis B
  • Health care workers, emergency workers and other people who come into contact with blood
  • Anyone who has a sexually transmitted infection, including HIV
  • Men who have sex with men
  • People who have multiple sexual partners
  • Sexual partners of someone who has hepatitis B
  • People who inject illegal drugs or share needles and syringes
  • People with chronic liver disease
  • People with end-stage kidney disease
  • Travelers planning to go to an area of the world with a high hepatitis B infection rate

Other ways to reduce your risk of HBV include:

  • Know the HBV status of any sexual partner. Don't engage in unprotected sex unless you're absolutely certain your partner isn't infected with HBV or any other sexually transmitted infection.
  • Use a new latex or polyurethane condom every time you have sex if you don't know the health status of your partner. Remember that although condoms can reduce your risk of contracting HBV, they don't eliminate the risk.
  • Don't use illegal drugs. If you use illicit drugs, get help to stop. If you can't stop, use a sterile needle each time you inject illicit drugs. Never share needles.
  • Be cautious about body piercing and tattooing. If you get a piercing or tattoo, look for a reputable shop. Ask about how the equipment is cleaned. Make sure the employees use sterile needles. If you can't get answers, look for another shop.
  • Ask about the hepatitis B vaccine before you travel. If you're traveling to a region where hepatitis B is common, ask your doctor about the hepatitis B vaccine in advance. It's usually given in a series of three injections over a six-month period.

Treatment

If you know you've been exposed to the hepatitis B virus and aren't sure if you've been vaccinated, call your doctor immediately. An injection of immunoglobulin (an antibody) given within 12 hours of exposure to the virus may help protect you from getting sick with hepatitis B. Because this treatment only provides short-term protection, you also should get the hepatitis B vaccine at the same time, if you never received it.

If your doctor determines your hepatitis B infection is acute — meaning it is short-lived and will go away on its own — you may not need treatment. Instead, your doctor might recommend rest, proper nutrition and plenty of fluids while your body fights the infection. In severe cases, antiviral drugs or a hospital stay is needed to prevent complications.

Most people diagnosed with chronic hepatitis B infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver disease and prevents you from passing the infection to others. Treatment for chronic hepatitis B may include:

  • Antiviral medications. Several antiviral medications — including entecavir (Baraclude), tenofovir (Viread), lamivudine (Epivir), adefovir (Hepsera) and telbivudine (Tyzeka) — can help fight the virus and slow its ability to damage your liver. These drugs are taken by mouth. Talk to your doctor about which medication might be right for you.
  • Interferon injections. Interferon alfa-2b (Intron A) is a man-made version of a substance produced by the body to fight infection. It's used mainly for young people with hepatitis B who wish to avoid long-term treatment or women who might want to get pregnant within a few years, after completing a finite course of therapy. Interferon should not be used during pregnancy. Side effects may include nausea, vomiting, difficulty breathing and depression.
  • Liver transplant. If your liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.


Hepatitis C

Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood.


Still, about half of people with HCV don't know they're infected, mainly because they have no symptoms, which can take decades to appear. For that reason, the U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease. The largest group at risk includes everyone born between 1945 and 1965 — a population five times more likely to be infected than those born in other years.

Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a "silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.

Signs and symptoms include:

  • Bleeding easily
  • Bruising easily
  • Fatigue
  • Poor appetite
  • Yellow discoloration of the skin and eyes (jaundice)
  • Dark-colored urine
  • Itchy skin
  • Fluid buildup in your abdomen (ascites)
  • Swelling in your legs
  • Weight loss
  • Confusion, drowsiness and slurred speech (hepatic encephalopathy)
  • Spiderlike blood vessels on your skin (spider angiomas)


How is Hepatitis C spread?

Hepatitis C infection is caused by the hepatitis C virus (HCV). The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person.

Your risk of hepatitis C infection is increased if you:

  • Are a health care worker who has been exposed to infected blood, which may happen if an infected needle pierces your skin
  • Have ever injected or inhaled illicit drugs
  • Have HIV
  • Received a piercing or tattoo in an unclean environment using unsterile equipment
  • Received a blood transfusion or organ transplant before 1992
  • Received clotting factor concentrates before 1987
  • Received hemodialysis treatments for a long period of time
  • Were born to a woman with a hepatitis C infection
  • Were ever in prison
  • Were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection

How to test for Hepatitis C?

Blood tests. Blood tests can detect signs of the hepatitis C virus in your body.

If an initial blood test shows that you have hepatitis C, additional blood tests will:

  • Measure the quantity of the hepatitis C virus in your blood (viral load)
  • Identify the genotype of the virus


Prevention

Protect yourself from hepatitis C infection by taking the following precautions:

  • Stop using illicit drugs, particularly if you inject them. If you use illicit drugs, seek help.
  • Be cautious about body piercing and tattooing. If you choose to undergo piercing or tattooing, look for a reputable shop. Ask questions beforehand about how the equipment is cleaned. Make sure the employees use sterile needles. If employees won't answer your questions, look for another shop.
  • Practice safer sex. Don't engage in unprotected sex with multiple partners or with any partner whose health status is uncertain. Sexual transmission between monogamous couples may occur, but the risk is low.

Treatment

Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. The goal of treatment is to have no hepatitis C virus detected in your body at least 12 weeks after you complete treatment.


Gonorrhea

Gonorrhea is an infection caused by a sexually transmitted bacterium. Gonorrhea most often affects the urethra, rectum or throat. 

Gonorrhea is most commonly spread during vaginal, oral or anal sex. 

It's not difficult to treat, but if left untreated it can lead to more-serious health problems.

In many cases, gonorrhea infection causes no symptoms. Symptoms, however, can affect many sites in your body, but commonly appear in the genital tract.

Signs and symptoms of gonorrhea infection in men include:

  • Painful urination
  • Pus-like discharge from the tip of the penis
  • Pain or swelling in one testicle

Gonorrhea can also affect these parts of the body:

  • Rectum. Signs and symptoms include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements.
  • Eyes. Gonorrhea that affects your eyes can cause eye pain, sensitivity to light, and pus-like discharge from one or both eyes.
  • Throat. Signs and symptoms of a throat infection might include a sore throat and swollen lymph nodes in the neck.
  • Joints. If one or more joints become infected by bacteria (septic arthritis), the affected joints might be warm, red, swollen and extremely painful, especially during movement.


How is Gonorrhea spread?

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse.

How to test for Gonorrhea?

To determine whether you have gonorrhea, your doctor will analyze a sample of cells. Samples will be collected by:

  • Urine test. This can help identify bacteria in your urethra.


Prevention

To reduce your gonorrhea risk:

  • Use a condom if you have sex.  if you choose to have sex, use a condom during any type of sexual contact, including anal sex, oral sex or vaginal sex.
  • Be sure you and your partner are tested for sexually transmitted infections. Before you have sex, get tested and share your results with each other.
  • Don't have sex with someone who appears to have a sexually transmitted infection. If your partner has signs or symptoms of a sexually transmitted infection, such as burning during urination or a genital rash or sore, don't have sex with that person.
  • Consider regular gonorrhea screening. Annual screening is recommended for those who are sexually active. 

To avoid getting gonorrhea again, abstain from sex until after you and your sex partner have completed treatment and after symptoms are gone.

Treatment

Gonorrhea treatment in adults

Adults with gonorrhea are treated with antibiotics. Uncomplicated gonorrhea can be treated with the antibiotic ceftriaxone — given as an injection — with oral azithromycin (Zithromax).


Chlamydia 

Chlamydia is a common sexually transmitted infection (STI) caused by bacteria. You might not know you have chlamydia because many people don't have signs or symptoms, such as genital pain and discharge from the penis.

It's not difficult to treat, but if left untreated it can lead to more-serious health problems.

Early-stage Chlamydia infections often cause few or no signs and symptoms. Even when signs and symptoms occur, they're often mild, making them easy to overlook.

Signs and symptoms of Chlamydia infection can include:

  • Painful urination
  • Vaginal discharge in women
  • Discharge from the penis in men
  • Painful sexual intercourse in women
  • Bleeding between periods and after sex in women
  • Testicular pain in men

Chlamydia can also infect the rectum, either with no signs or symptoms or with rectal pain, discharge or bleeding. You also can get chlamydial eye infections (conjunctivitis) through contact with infected body fluids.

How is Chlamydia spread?

The Chlamydia bacterium is most commonly spread through vaginal, oral and anal sex. 

Prevention

The surest way to prevent chlamydia infection is to abstain from sexual activities. Short of that, you can:

  • Use condoms. Use a male latex condom or a female polyurethane condom during each sexual contact. Condoms used properly during every sexual encounter reduce but don't eliminate the risk of infection.
  • Limit your number of sex partners. Having multiple sex partners puts you at a high risk of contracting chlamydia and other sexually transmitted infections.
  • Get regular screenings. If you're sexually active, particularly if you have multiple partners, talk with your doctor about how often you should be screened for chlamydia and other sexually transmitted infections.

Treatment

Chlamydia is treated with antibiotics. You might receive a one-time dose, or you might need to take the medication daily or multiple times a day for five to 10 days.

In most cases, the infection resolves within one to two weeks. During that time, you should abstain from sex. Your sexual partner or partners also need treatment even if they have no signs or symptoms. Otherwise, the infection can be passed back and forth between sexual partners.

Having chlamydia or having been treated for it in the past doesn't prevent you from getting it again.


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