Kimberly Spector, an adolescent-health educator in Los Angeles, is concerned that young girls will lose the opportunities to ask questions about their sexual health if they aren’t routinely coming in for a Pap test. She says that even if no tests are performed, a simple conversation with the doctor can be very informative.

While the new guidelines suggest that girls under 21 visit their gynecologist,  many people are worried that if women hear that they don’t need to have a Pap test annually, they won’t make the effort to get any preventive care against STDs such as chlamydia, gonorrhea, genital herpes, and human papillomavirus (HPV).

Harold Wiesenfeld, M.D., director of the division of reproductive infectious diseases at the University of Pittsburgh School of Medicine, acknowledges that many STDs do not show symptoms. If someone is positive for an STD and it is left untreated, often the STD will develop into more serious complications including pelvic inflammatory disease and infertility.

Many experts have agreed that Pap tests are unnecessary for teenage girls, and that waiting until they’re 21 years old will not put them at risk. Bobbie Gostout, M.D., chair of the department of obstetrics and gynecology at the Mayo Clinic in Rochester, Minnesota says that the guidelines are well thought out, and that she is not afraid of any consequences.

Ideally teens should receive the appropriate vaccines and develop a relationship with their doctor before becoming sexually active, but if they do not it is not a bad idea to receive a Pap test annually for the sake of their own health.

*For the complete article, please visit http://stdtestingblog.com/original-articles/

Uchitel’s decision to get tested is a smart one indeed. By having sex with Tiger, who supposedly has had unprotected sex with many different women throughout his marriage, Uchitel potentially exposed herself to several possible infections.

Several of Woods’ extramarital affairs have been exposed following his car crash last week, however no comments have been made as to whether his wife, model Elin Nordegren, will have any STD testing done.

All in all, it is probably a good idea for all of Tiger’s partners to get tested at some point following these allegations. Affairs are obviously something that people would rather keep private, but if you are at higher risk like these women for contracting an STD it is better to be safe than sorry.

*For the complete article, please visit http://stdtestingblog.com/original-articles/

Recently, the Royal Adelaide Hospital found that an employee was positive for Hepatitis C.  This raised concern, because as many as 30 patients could have been exposed to the virus.  These patients have been offered precautionary screening tests for Hepatitis C, as well as counseling, if needed.

An investigation was began immediately to determine which patients could have been at risk for Hepatitis C.  They determined that, by national and international guidelines, 30 patients were at risk of transmission.

Hepatitis C is spread by blood-to-blood contact. Newly infected people do not usually have any symptoms but some will eventually develop liver cirrhosis.

Hepatitis C affects around one per cent of South Australians, with around 16,000 cases recorded in SA since 1995.

For the original article, please refer to www.stdtestingblog.com/original-articles/ ]]> http://stdtestingblog.com/2009/10/13/hepatitis-c/hepatitis-c-scare-at-royal-adelaide-hospital/feed/ 0 http://stdtestingblog.com/2009/10/06/hepatitis-c/hepatitis-c-rate-high-in-trucker-study/#utm_source=feed&utm_medium=feed&utm_campaign=feed http://stdtestingblog.com/2009/10/06/hepatitis-c/hepatitis-c-rate-high-in-trucker-study/#comments Tue, 06 Oct 2009 21:16:18 +0000 std_test http://stdtestingblog.com/?p=117 Long-haul truckers have shown high rates of hepatitis C, and most of the infected truckers were unaware of their status.

Many truckers engage or have engaged in high risk behavior, including injection drug use.

International studies have shown similar results, that long-haul truck drivers have high rates of sexually transmitted diseases.

Testing for hepatitis C should be considered by truck drivers, especially if they have ever injected drugs or received blood transfusions prior to 1992.

Also, many drivers engage in high-risk behavior, including having sex with casual partners and commercial sex workers.  It is recommended that workers should follow safe sex practices, including consistent condom use.  It is also recommended by the CDC to get tested for the majority of STDs at least once every six months.

For the complete article, please refer to www.stdtestingblog.com/original-articles/

Hepatitis C virus (HCV) test is a blood test that looks for proteins (antibodies) or genetic material (RNA) of the virus that causes hepatitis C. These proteins will be present in your blood if you have a hepatitis C infection now or have had one in the past. It is important to identify the type of hepatitis virus causing the infection, to prevent its spread and start the proper treatment.

HCV is spread through infected blood.

• Anti-HCV antibody tests look for antibodies to HCV in the blood, indicating an HCV infection has occurred. This test cannot tell the difference between an acute or long-term infection. The enzyme immunoassay (EIA) may be the first test done to detect anti-HCV antibodies.
• HCV RIBA is an additional test that detects antibodies to HCV. This test can tell whether a positive result was caused by an actual HCV infection or whether the result was a false-positive. This test may be done to double-check a positive EIA test result.
• HCV RNA PCR genetic material (RNA) testing uses polymerase chain reaction (PCR) to identify an active hepatitis C infection. The RNA can be found in a person’s blood within 1 to 2 weeks after exposure to the virus. HCV RNA testing may be done to double-check a positive result on an HCV antibody test, measure the level of virus in the blood (called viral load), or show how well a person with HCV is responding to treatment.
  • HCV quantitative test (also called viral load) is often used before and during treatment to find out how long treatment needs to be given and to check how well treatment is working.
  • HCV viral genotyping is used to find out which genotype of the HCV virus is present. HCV has 6 genotypes, and some are easier to treat than others.

There is no vaccine available to prevent hepatitis C.

Explanation of test results:

There are 2 situations in which a quantitative test is useful:

The quantitative HCV RNA test is checked before a patient starts treatment.

For each patient, the result can be described as either a “high” viral load, which is usually >800,000 IU/L, or a “low” viral load, which is usually <800,000 IU/L. Knowing the viral load before starting treatment is useful because patients with “high” viral loads can have a difficult time getting the virus to become completely undetectable on treatment. Patients with “low” viral loads have a better chance of getting their virus to become completely undetectable on treatment.

The quantitative HCV RNA test is used to monitor a patient who is currently on treatment.

The response to treatment is considered good when the quantitative HCV RNA measurement drops and the virus eventually becomes completely undetectable.

Department of Internal Medicine, Ospedale San Paolo, Milan, Italy.

Whether sustained biochemical response and absence of serum HCV RNA in the 6-12 months following suspension of interferon-alpha (IFN-alpha) therapy reflect definitive viral clearance in patients with chronic hepatitis C virus (HCV) infection is controversial. To obtain more information on this topic, HCV RNA was sought in both liver and serum samples of 25 long-term responders who were followed for a median period of 39 months (range 21-79) after discontinuation of IFN-alpha. Liver biopsy was undertaken before and 6 to 12 months after IFN-alpha withdrawal. Liver and serum HCV RNA were tested by a nested polymerase chain reaction. Twenty-two patients (88%) tested negative for both liver and serum HCV RNA, two patients had detectable HCV RNA in both liver and serum, and one patient showed persistent HCV RNA only in the liver. Post-treatment liver histology improved markedly in all patients, including those with viral persistence. During further follow-up, biochemical remission was maintained in all patients except one in whom both serum and liver specimens remained HCV RNA positive. The data indicate that the large majority of long-term responders test negative for HCV RNA in the liver, which suggests definitive eradication of HCV RNA infection.

Many people are scared to get tested for sexually transmitted diseases (STD) or ask about their sexual health because of myths that exist about it. Some of these myths respond to confidentiality. Many people are worried that if they test, their friends, colleagues, or parents might find out about it. The truth is that many places offer confidential testing and treatment, where all information is held between the patient and provider.

Other people are worried that the testing process is painful or uncomfortable, when in fact one can test for almost every STD with either a blood or urine sample. If a blood draw sounds uncomfortable, it may help to know that it involves only a small needle and a short time of actual drawing.

Some individuals are concerned that if they contract an STD they will have it for life. In reality all STDs can be treated, and most of them can be cured. Curable diseases include syphilis, chlamydia, gonorrhea, and trichomoniasis. STDs that cannot be cured, but are treatable are the human immunodeficiency virus (HIV) and herpes.

A lot of people believe that if they haven’t had sex they cannot receive an STD. The truth is that STDs can be contracted through oral, vaginal, and anal intercourse. If someone has had any of these types of intercourse it might be a good idea to get tested.

But if you’re not showing any signs of symptoms there’s no need to get tested, right? Wrong, many STDs progress without showing symptoms in certain individuals. While not having any symptoms is a great sign, nevertheless it is probably a good idea to get tested if you’ve had any risky sexual behaviors.

Keep in mind that condoms, when used correctly, do a great job of protecting people against STDs. However, things like herpes that are transmitted through skin-to-skin contact can still be contracted even when using a condom. For that reason you should always be aware of symptoms that may exist where the condom did not cover. Herpes can also be carried orally in the form of a cold sore. While cold sores are common and not something to be worried about, it is important to be aware of them on yourself or on partners because they can transmit the type-1 herpes virus through skin-to-skin contact as well.

Carrying on or starting a relationship with an STD can be difficult or uncomfortable in some situations.  A suggestion for getting through this is to be knowledgeable about your STD. The more you know about it, the better you will be able to inform your partners and make smart decisions. If you have a current partner at the time of diagnosis, they should be tested and treated as well for the STD. If the STD is incurable, stay adherent to the medication and make sure you inform any potential partners of your infection before any sexual contact.

If you decide to do some testing, make sure you are open and honest about any symptoms, possible exposures, or recent partners you’ve had when you speak with someone. They use this information to make sure you are doing the right tests at the right time so you don’t receive any false results.

Some final words of wisdom are “treat your body like you treat your toothbrush – don’t share it with everybody… STDs are equal opportunity employers. They don’t discriminate.”

* For the complete article, please visit http://stdtestingblog.com/original-articles/

Quantitative HCV RNA tests allow your doctor to determine exactly how much virus is in the blood. This is referred to as the viral load. The viral load is usually expressed as units per milliliter or copies per milliliter. In patients with chronic hepatitis C infection, viral loads vary widely from 50,000 to 5 million copies per milliliter. A higher viral load may not necessarily be a sign of more severe or more advanced disease but it does correlate with likelihood to respond to treatment. HCV RNA tests can also be used to monitor response to hepatitis C treatment. For example, if the viral load decreases during treatment, this suggests that treatment is working and should be continued. Conversely, if the viral load remains the same, it suggests that the patient is not responding to treatment.

Now, the Boston Public Health Commission (BPHC) has incorporated these new media outlets into an ambitious campaign to educate teenagers about sexually transmitted infections, diseases such as chlamydia and gonorrhea, that affect one out of four sexually active teenagers in the U.S.

Health and new media experts said the BPHC’s viral messaging approach is a step in the right direction but that it needs to be taken to the next level in order to change teenage sexual behavior.

“The underlying principle on this campaign that is different from past campaigns is that if we want to be successful, we need to be youth driven and youth appropriate,” said Dr. Barbara Ferrer, executive director of the BPHC, particularly in terms of what venues are most likely to be sought after and seen by adolescents. “They have input into how messages are created that target them. The content is definitely not ours.”

Youth-to-Youth Internet STI Education Efforts

The youth-driven campaign, launched yesterday, utilized an interactive Facebook page where users can post anonymous health questions, YouTube video skits about STIs that also run on the cable channels MTV, BET and FX, advertisements on billboards and buses around Boston, and in-person outreach in the form of public skits performed by youth volunteers.

“In terms of today’s vehicles, you have to meet teens where they’re at,” said Tara Cousineau, a psychologist and founder of bodimojo.com, a health site for teens, citing the Internet, Facebook, Twitter and MTV as popular information disseminators. “The part that is still a challenge is how to get the messages to sink in. … You have to be passing the message along but engaging the kid in the message along the way.”

Cousineau said using interactive Web features such as quizzes that could be completed and forwarded to friends was one way to continue spreading a message.

Starting this fall, the health centers in New York’s Port Chester public school district — including Port Chester elementary, middle and high schools — will begin providing STD and pregnancy testing to requesting students.

Any student who tests positive for infection or pregnancy can be referred to a nearby off-campus treatment facility.

The proposal was tabled by Open Door Family Medical Centers, which provides the district’s schools with federally funded clinics staffed with nurse practitioners, and the school board passed it last month.

Hepatitis C is one of the many viral infections with the tendency to affect the liver. In approximately 75% of cases, the infection will become chronic, meaning that it does not go away. After about 20 years of a chronic Hepatitis C infection, approximately 20% of these people will develop cirrhosis (or hardening) of the liver. Liver failure is also a very common complication, although Hepatitis C infection may also result in a number of blood cell disorders which manifest most typically in the skin as itching, bruises and other odd discolorations as well as intestinal bleeds manifesting as vomiting blood or passing stools that are black, indicating the presence of digested blood. There is also an increased tendency to develop a type of cancer known as Non-Hodgkin’s Lymphoma.

Depending on your general state of health and the type of Hepatitis C infection that you have, you may not be treated for the infection. This is because of the high costs associated with treatment, as well as the associated side effects and the fact that a small number of persons will recover without treatment and furthermore, only about 60% of persons will actually be cured by the current medical standards. The goals of treating Hepatitis C infections are to eliminate the virus as well as to prevent the development of liver cirrhosis and liver failure, thereby reducing the likelihood that a liver transplant will be required. How long you are treated for will depend on the type of Hepatitis C virus with which you have been infected, whether you have an acute (short-term) or chronic (long term) infection and your response to the treatment being given.

Most persons with an acute infection will not be treated, simply because they do not know they have it. If, however, it is known that a person is infected with Hepatitis C, prompt treatment may help prevent the progression to chronic Hepatitis though the actual guidelines for treatment in this case are still being debated. It is common for persons not to discover Hepatitis C infection until it has already become chronic. When this happens, treatment becomes necessary only in the presence of liver damage and a combination of medicines (such as interferon and ribavirin) may be required to fight the infection.

You will also need to be followed up by your doctor with routine blood tests to determine your level of liver function in response to treatment and any possible adverse reactions which might occur. Also, if you choose not to take your medicine then you will need to have a liver biopsy done every 5 years to assess the level of liver damage.

Note, that antiviral therapy for Hepatitis C is not recommended for persons who use IV drugs or drink alcohol, have advanced cirrhosis, are pregnant or may become pregnant, suffer from major depression or other mental disorder, have an autoimmune disease (e.g. psoriasis, lupus, or rheumatoid arthritis), or have other medical conditions such as seizures, heart disease or severe diabetes.

Alternatively, there are certain alternative and complimentary treatments for Hepatitis C which include plant extracts like ginseng, licorice root and milk thistle. Other therapies that may be used include relaxation techniques, chiropractic care and massage; none of which are curative, but they have been credited with relieving the pain associated with Hepatitis C. These natural therapies are used to boost the immune system, reduce liver inflammation and improve gastrointestinal function and they have been reported as being successful by as much as 40% of Hepatitis C patients who were not cured by traditional medicine.

For the complete article and more information from this author, please refer to http://ezinearticles.com/?expert=Nicholas_Russi ]]> http://stdtestingblog.com/2009/08/07/hepatitis-c/hepatitis-c/feed/ 0 http://stdtestingblog.com/2009/07/28/safe-sex-tips/use-the-internet-to-break-the-news-about-an-std/#utm_source=feed&utm_medium=feed&utm_campaign=feed http://stdtestingblog.com/2009/07/28/safe-sex-tips/use-the-internet-to-break-the-news-about-an-std/#comments Tue, 28 Jul 2009 14:00:58 +0000 std_test http://stdtestingblog.com/?p=92

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The State Board of Education approved a curriculum that allows teachers to point out different methods of contraception, such as birth control or condoms, and encourages testing for STDs such as chlamydia, gonorrhoeae, or herpes. However, the curriculum does not allow teachers to promote the use of birth control. With such a fine line between appropriate and inappropriate material, teachers are nervous about what they say in the classroom. If they go too far they could face serious repercussions.

School boards are allowed to teach less than the new curriculum permits; however, they are not allowed to teach more than what is permitted. HB189, a proposed bill, would require discussions regarding  contraceptives in all health classes.

* For the complete article, please visit http://stdtestingblog.com/original-articles/

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Nearly half the African-Americans in the study of teenagers ages 14 to 19 were infected with at least one of the diseases monitored in the study — human papillomavirus (HPV), chlamydia, genital herpes and trichomoniasis, a common parasite.

The 50 percent figure compared with 20 percent of white teenagers, health officials and researchers said at a news conference at a scientific meeting in Chicago.

The two most common sexually transmitted diseases, or S.T.D.’s, among all the participants tested were HPV, at 18 percent, and chlamydia, at 4 percent, according to the analysis, part of the National Health and Nutrition Examination Survey.

Each disease can be serious in its own way. HPV, for example, can cause cancer and genital warts.

Among the infected women, 15 percent had more than one of the diseases.

Women may be unaware they are infected. But the diseases, which are infections caused by bacteria, viruses and parasites, can produce acute symptoms like irritating vaginal discharge, painful pelvic inflammatory disease and potentially fatal ectopic pregnancy. The infections can also lead to longterm ailments like infertility and cervical cancer.

The survey tested for specific HPV strains linked to genital warts and cervical cancer.

Officials of the Centers for Disease Control and Prevention said the findings underscored the need to strengthen screening, vaccination and other prevention measures for the diseases, which are among the highest public health priorities.

About 19 million new sexually transmitted infections occur each year among all age groups in the United States.

“High S.T.D. infection rates among young women, particularly young African-American women, are clear signs that we must continue developing ways to reach those most at risk,” said Dr. John M. Douglas Jr., who directs the centers’ division of S.T.D. prevention.

The president of the Planned Parenthood Federation of America, Cecile Richards, said the new findings “emphasize the need for real comprehensive sex education.”

“The national policy of promoting abstinence-only programs is a $1.5 billion failure,” Ms. Richards said, “and teenage girls are paying the real price.”

Although earlier annual surveys have tested for a single sexually transmitted disease in a specified population, this is the first time the national study has collected data on all the most common sexual diseases in adolescent women at the same time. It is also the first time the study measured human papillomavirus.

Dr. Douglas said that because the new survey was based on direct testing, it was more reliable than analyses derived from data that doctors and clinics sent to the diseases center through state and local health departments.

“What we found is alarming,” said Dr. Sara Forhan, a researcher at the centers and the lead author of the study.

Dr. Forhan added that the study showed “how fast the S.T.D. prevalence appears.”

“Far too many young women are at risk for the serious health effects of untreated S.T.D.’s, ” she said.

The centers conducts the annual study, which asks a representative sample of the household population a wide range of health questions. The analysis was based on information collected in the 2003-4 survey.

Extrapolating from the findings, Dr. Forhan said 3.2 million teenage women were infected with at least one of the four diseases.

The 838 participants in the study were chosen at random with standard statistical techniques. Of the women asked, 96 percent agreed to submit vaginal swabs for testing.

The findings and specific treatment recommendations were available to the participants calling a password-protected telephone line. Three reminders were sent to participants who did not call.

Health officials recommend treatment for all sex partners of individuals diagnosed with curable sexually transmitted diseases. One promising approach to reach that goal is for doctors who treat infected women to provide or prescribe the same treatment for their partners, Dr. Douglas said. The goal is to encourage men who may not have a physician or who have no symptoms and may be reluctant to seek care to be treated without a doctor’s visit.

He also urged infected women to be retested three months after treatment to detect possible reinfection and to treat it.

Dr. Forhan said she did not know how many participants received their test results.

Federal health officials recommend annual screening tests to detect chlamydia for sexually active women younger than 25. The disease agency also recommends that women ages 11 to 26 be fully vaccinated against HPV.

The Food and Drug Administration has said in a report that latex condoms are “highly effective” at preventing infection by chlamydia, trichomoniasis, H.I.V., gonorrhea and hepatitis B.

The agency noted that condoms seemed less effective against genital herpes and syphilis. Protection against human papillomavirus “is partial at best,” the report said.

For the full article, please refer to http://www.nytimes.com/2008/03/12/science/12std.html?_r=3&scp=3&sq=std%20testing&st=cse

This fact sheet from the federal Centers for Disease Control and Prevention sums up the reason for such hesitation: “Genital ulcer diseases can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered.”

Then there’s the problem of transmission without visible signs of infection. As the National Institutes of Health states: “Most people get genital herpes by having sex with someone who is shedding the herpes virus either during an outbreak or an asymptomatic (without symptoms) period. People who do not know they have herpes play an important role in transmission because they are unaware they can infect a sexual partner.”

Researchers at the University of Washington, the federal Centers for Disease Control and Prevention and elsewhere decided to try to clarify just how much condoms can reduce the spread of genital herpes, known medically as herpes simplex virus 2 (or HSV-2).
 
They analyzed six studies of various types, all of which featured data on individual condom use and on HSV-2 acquisition.

They found that people who always used condoms had a 30% decreased risk of acquiring genital herpes when compared with people who never used condoms.

In clarifying further, the researchers stated: “Risk of HSV-2 acquisition decreased by 7% for every additional 25% of the time that condoms were used during anal or vaginal sex. Risk of HSV-2 acquisition also rose steadily and significantly with increasing frequency of unprotected sex acts, and our findings were consistent throughout multiple analysis strategies.”

The results were published today in the Archives of Internal Medicine. Here’s the abstract.

The upshot of the study: “Although the magnitude of protection was not as large as has been observed with other STIs, we found that condoms offer moderate protection against HSV-2 acquisition in men and women.”

Here’s more information on genital herpes from the National Institutes of Health, including details on asymptomatic shedding:

“Sometimes, the virus can become active but not cause any visible sores or any symptoms. During these times, small amounts of the virus may be shed at or near places of the first infection, in fluids from the mouth, penis, or vagina, or from barely noticeable sores. This is called asymptomatic shedding. Even though you are not aware of the shedding, you can infect a sexual partner during this time. Asymptomatic shedding is an important factor in the spread of herpes.”

And here’s the aforementioned fact sheet on genital herpes from the CDC.

The key here is consistent use. Not sometime use, but consistent use.

For the complete article, please refer to http://latimesblogs.latimes.com/booster_shots/2009/07/condoms-genital-herpes-.html

Lyon and Christina Breda Antoniades recently wrote a guide that aims to steer parents toward appropriate ways to respond to such a revelation: “My Teen Has Had Sex, Now What Do I Do?” (Fair Winds Press).

“We wanted to provide ways kids and parents could talk,” said Lyon. In her work, she sees the results of poor parent-teen communication on the topic: STDs, unwed pregnancies, and broken relationships.

Though many parents prefer to think that their teen is not sexually active, the book cites statistics that suggest otherwise: 17 percent of seventh- and eighth-graders have had sex at least once, as have 33 percent of ninth-graders, 44 percent of 10th-graders, 56 percent of 11th-graders, and 65 percent of 12th-graders.

Lyon said parents should try to adopt as neutral and non-judgmental a tone as possible. Arguing and screaming often serve only to inflame an already difficult situation, she cautioned. “This can be a teachable moment about the value of sex in the context of a relationship,” said Lyon. “It doesn’t have to end up being a power struggle.”

“First, find the right time, a time when you’ll be uninterrupted and calm, and a private place to speak truthfully from your heart,” Lyon suggests. “Second, share with your teen what your values are and what your concerns are. Third, now that he or she has engaged in adult sexual behavior, let them know you have scheduled an appointment to meet with their pediatrician or adolescent medicine or family doctor for a checkup.”

For the complete article, and for more information from the Centers for Disease Control and Prevention, please refer to http://www.cdcnpin.org/

For the complete article, please refer to http://www.theledger.com/article/20090626/NEWS/906265055/1410?Title=Worry-Over-AIDS-Hides-Rising-STD-Infections

However, the government agency thinks that’s a low estimate, and suspect that there are actually twice as many people who are carrying the infections. Unfortunately, the infections often go undiagnosed because they can be asymptomatic.

While gonorrhea and chlamydia frequently come together in one big STD package, they are both cured with antibiotics. However, if someone isn’t a responsible sexy time partner and doesn’t get tested regularly, the diseases can wreak havoc and even do things jeopardize your ability to get pregnant.

Since young women, age 15-34, are in the highest risk categories, it’s essential that we take care of our business!

For the full article http://www.thefrisky.com/post/246-cdc-releases-latest-std-statistics/

It is unclear whether hepatitis C virus (HCV) has been eradicated or persists at a low level in HCV antibody-positive HCV RNA-negative individuals. The natural history and liver histology are not well characterized. One hundred seventy-two HCV antibody-positive, serum HCV RNA-negative patients underwent diagnostic liver biopsy between 1992 and 2000 and were followed a median 7 years (range, 5-12). Patients with any possible cause of liver injury other than HCV were excluded. A single histopathologist scored sections using Ishak criteria. Characterization of the inflammatory infiltrate in selected cases used a novel semiquantitative technique and compared with HCV RNA-positive patients and healthy controls. One hundred two patients were excluded because of a risk factor for liver injury other than HCV. Seventy patients met the study criteria; four (5.7%) became HCV RNA-positive during follow-up. Sixty-six cases remained HCV RNA-negative; five (7.5%) had a normal liver biopsy; 54 (82%) had fibrosis (stage 2 or 3 in 16 (24%)). Nonviremic cases revealed expanded portal tracts (P < 0.05), with fewer CD4+ (P < 0.05) and more CD8+ cells (P < 0.05) than healthy controls, but were indistinguishable from HCV RNA-positive cases for these parameters. Lobular CD4 staining, absent in healthy controls, was noted in both HCV RNA-negative and -positive cases and was more marked in the latter (P < 0.05) with a sinusoidal lining cell distribution. Conclusion: Nonviremic HCV antibody-positive patients have a liver biopsy that is usually abnormal. Fibrosis was present in most with similar inflammatory infiltrate to viremic cases. The presence of a CD8+ rich inflammatory infiltrate suggests an ongoing immune response in the liver, supporting the view that HCV may persist in the liver in the majority of HCV RNA-negative cases.

Discussion:

HCV infection leads to chronic viremia in the majority of individuals exposed to HCV. The natural history in this group, the risk factors for progressive injury and the benefits of antiviral therapy are well established. However, the clinical status of the minority without viremia after exposure to HCV is less clear. It is uncertain whether this group has resolved infection, with or without long-term immunity and protection from further exposure to HCV or, alternatively, low-level viral replication, where HCV RNA can only be detected within the liver.[11][19] Neither the natural history nor the liver histology in this cohort has been described in detail.
For the complete article, please refer to http://www.natap.org/2008/HCV/122208_01.htm

1. A ring tone to remember:

In India, people stigmatize condoms and refuse to wear them because they believe only prostitutes must use prophylactics. Leave it to one of the world’s richest men to find a solution — the Bill and Melinda Gates Foundation donated money for a national condom ring tone.

2. Perks you right up:

Ethiopians claim they hate condoms because the smell of latex sickens them. To combat the odor, DKT International, a United Sates nonprofit, created coffee condoms. These dark brown condoms allegedly (I’m not testing the products) taste and smell like the favorite coffee of Ethiopia — the macchiato, an espresso with cream and sugar.

3. Condom trees:

In western Australia, the rate of HIV infection is the highest in the nation. When public health nurses were looking for an effective way to distribute condoms, someone suggested trees. Young people in the countryside hang out under trees, so the shady spots are the perfect places for nurses to hang condom-filled canisters.

4. Scare tactics:

Perhaps some safe sex programs skirt the issue — unprotected sex causes HIV, which leads to AIDS and often death. The Tulipan Company launched its “Be Careful” ads in Argentina. Showing skeletons positioned in flagrante delicto, these ads make no bones about how important it is to wear a condom while engaging in coitus.

5. Spray-on protection:

Since his teens, Jan Vinzenz Krause struggled to find a condom that fit correctly. He thought the pursuit of the perfect prophylactic was hopeless — until he went to the carwash. Inspired by the spray-on soap and wax, the German Krause developed a spray-on latex condom, which he claims always fits perfectly and feels natural.

For the full article, please refer to http://www.cnn.com/2008/LIVING/personal/10/31/mf.safe.sex/index.html?iref=newssearch

An estimated 19 million new infections occur each year, most of them not HIV. Almost half are in people 15- to 24 years old.

Chlamydia diagnoses are skyrocketing. Syphilis, at an all-time low nine years ago, is increasing steadily with a big boost in men.

Although its numbers are fairly stable nationwide, gonorrhea still occurs more than it should.

The southeastern United States has the highest rates of those three, said Toney, a professor with the University of South Florida College of Medicine’s infectious diseases division.

Getting people tested for STDs and teaching them how to keep from getting infected involves issues similar to those reported by Polk County’s HIV/AIDS outreach workers, Toney said.

“We still have issues in the United States talking about sexuality,” he said. “There are beliefs we have to look at.”

HIV/AIDS gets the attention, in large part, because of the number of people who die from it. The statistics for other STDS didn’t seem as compelling or deadly, despite the sterility, infertility and pain they can cause.

But here are some statistics that can put STDs in a whole new light:

People infected with other STDS, like gonorrhea or syphilis, are at least 2-to-5 times more likely than uninfected people to get HIV infection when exposed to HIV during sex. That’s according to the federal Centers for Disease Control and Prevention. It’s true for all races.

Higher rates of poverty among blacks than whites, accompanied by socioeconomic barriers to prevention and treatment, are associated with their higher rates of both STDs and HIV.

Syphilis and herpes, producing sores and ulcers, make it much easier for the HIV virus to get into the body.

“You need less virus to cause an infection,” Toney said.

With gonorrhea and chlamydia, inflammation pushes cells that could get infected closer to the surface, again making HIV infection easier.

Blacks had about 70 percent of reported gonorrhea cases, 48 percent of all chlamydia cases and 46 percent of syphilis cases nationwide in 2007, the CDC reported. They’re about 12 percent of the population.

Black teenagers who are 15-to-19 years old have the highest rates of chlamydia or gonorrhea of any group, CDC said in January.

Black women were 16 times more likely to have syphilis than white women, 15 times more likely to have gonorrhea and seven times more likely to have chlamydia in 2006, according to the Black AIDS Institute’s report on “The State of AIDS in Black America 2009.”

Many cases of STDS don’t get diagnosed. Some don’t cause symptoms or the symptoms are mild. Some common viral infections, like human papillomavirus and genital herpes, don’t get reported.

Collectively, the CDC estimates STDs cost the U.S. health system as much as $15.3 billion a year.

Because of the link between HIV and other STDs, Polk County’s outreach workers often test for both when they’re doing community programs such as the one being held in Haines City today for National HIV Testing Day.

That’s essential, but not enough on its own to solve the problem, Toney said.

Combatting STDs has to take place through the offices of individual practitioners – doctors, nurses and advanced nurse practitioners – nationwide.

CDC recommends annual chlamydia screening for all sexually active women younger than 25. The U.S. Preventive Services Task Force recommends screening all high risk, sexually active women for gonorrhea. CDC agrees with that recommendation.

Toney is affiliated with a Southeast Regional STD-HIV Prevention Training Center in Tampa that trains health-care providers in diagnosing, treating and managing sexually transmitted diseases, including HIV. Its standard courses are one to five days long, but there are some alternatives.

The center formed in 1988 because of Florida’s high rates of sexually transmitted diseases. It has gotten CDC funding since then. It’s also the only state-supported STD-HIV prevention center of this type.

The Hillsborough County Health Department also is involved.

For more information, e-mail Calvin Doss at calvin_doss@doh.state.fl.us. The Web site for the national program is www.nnptc.org.

For the complete article, please refer to http://www.theledger.com/article/20090626/NEWS/906265055/1410?Title=Worry-Over-AIDS-Hides-Rising-STD-Infections.