#dating guidance for men with herpes
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SPFPP 282: Be the Best Option
My trip to South Africa really gave me some useful insights to incorporate into my day to day as all travels should. During my trip, I went on a Safari. It was really something to see lions, ostrich, rhinos, elephants, buffalo, giraffes, and zebras and antelope out in something like their own natural habitat. Our tour guide for the Safari would stop the vehicle and point out some of the natural laws of the species when it came to how they coexist. He spoke about how the female just is there and when she’s ready to mate, she’ll only mate with the best option.
She ain’t gotta go on no healing journey, have a cleanse, get her ish together, her finances right, her body right, she just decides she’s ready to mate. What’s said here about mating can be applied to dating. It’s “I’m ready, which one of ya’ll gone come get this (insert cat emoji)”. And then the hunger games start and the most competitive suitors fight it out. As humans, our fight doesn’t look like literally killing one another. The male species is held to a different standard in the human sector. It’s also about environment. The most fit in an environment, the most respected (or feared) in an environment, the most comfortable/safe territory guarded in an environment is who the female chooses.
In the animal kingdom, the female chooses what male gets to mate. She knows this so there is no added pressure on her to become fit, secure her own territory, be respected or feared by her peers. The males have to get their ish together and if they’re born with disadvantages, they do have to work harder to secure mating. The harder a female works to mate, the less the male will work to secure a mate. Now this is transitioning over into mating in 2023 which you’ll have to listen to the podcast for more details on.
This and the next few episodes will be about my own dating experiences if you care for that. I’m in the process of getting interviews with health care providers for SPFPP.
If you need at home STI testing, here’s the link: https://shamelesscare.com/?ref=643
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atlaspacificmedical · 4 years ago
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Preservation Of Health Is Better Than Cure
The Organisation copes with women's and men's wellbeing. Zones of men's wellbeing assimilate to the low testosterone, erectile dysfunction (ED), mistime discharge, and going bald. Zones for women cover contraception, unfamiliar vaginal release, the richness of concealing, and general Gynaecology checks. They assure you many more issues to cover, contact them or send an email for enquiring. The sexually transmitted disease/STI and HIV are fairly no-no sections that many like to overlook; however, there is nothing to be shy or overlook in being mindful of your wellbeing. Indeed those that screen regularly will encounter fewer long-haul issues. About HIV And Herpes HIV stands for human immunodeficiency infection, which is an infection that smacks the body's resistant structure. Periodically there are chances that HIV doesn't deal with; it can be precisely AIDS. To date, there is a powerful treatment for this. When individuals get HIV, they have it throughout their lifetime. Herpes happens from having contact with the herpes simplex infection (HSI). It makes injuries or rankles frame in or around the mouth or private parts of the body, just as different manifestations. About The HIV Testing The people who don't know that HIV testing should be feasible as a fast finger-picks test with results produced in hardly 20 minutes. This test can be performed for those needing official blood tests for work grants, as a rule, and should likewise be possible by those who need to know their status. So on and off chance that you are stressed over about the openness to HIV, get tried with a quick unit for genuine feelings of serenity. You can opt for HIV Testing Singapore for tests. Here you can get 100% true results. Prevention From HIV Post openness prophylaxis is an effective technique for reducing HIV contaminations when it is not utilized for long after a likely openness. The medicine ought to begin within 72 hours of a likely openness to be viable. HIV Testing Singapore helps to give proper guidance for further medications. About The Herpes Testing Herpes simplex infection testing can be critical to differentiate whether you have the infection or whether side effects you are coming across to are identified with the infection. You can visit the Herpes Doctor Singapore for testing. 1. Blood Test - Herpes blood tests are profitable when you are not coming across the indications, yet you need to know whether you have contamination or not. The test is modest and recognizes type 1 or 2, yet does not tell us the contamination area. 2. HSV PCR Swab - This can be utilized when a potential herpes embodiment is available. It is precise; it recognizes whether it is type 1 or type 2 and distinguishes accurately where the contamination is found. If you're found contaminated with herpes, you can visit the Herpes Doctor Singapore for treatment. To Sum It Up The association can organize all ways of STD/STI testing performed by experienced specialists, both male and female. They offer master guidance on manifestations and signs you might be encountering, and we expect to get you back to wellbeing. For further details, you can mail us.
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herpes-singles-blog · 6 years ago
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Herpes Dating Sites - Is There Such A Thing?
Many people today find it too embarrassing or overwhelming having to inform new spouses they have herpes. Herpes dating sites may be the best answer in this example. Dating different individuals infected with herpes gets rid of the demand for that specific talk. Yes, you still need to possess the safe sex chat, but the playing floor is level for the herpes.
Dating somebody else with herpes usually means they will understand just what you're going through when you experience an outbreak. Neither of you need to worry about infecting another. For many, this idea is extremely liberating. Herpes dating sites also often provide loads of herpes aid and guidance. A lot of men and women find it reassuring they are not likely to be rejected simply as they have herpes.
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Having genital Herpes Dating Site isn't the end of your sexual life. You may date again and you'll see a new spouse. Relationship with herpes isn't hopeless. Just don't forget, you aren't alone. 1 million people each year are diagnosed with yeast. Herpes dating might require somewhat bit more patience and time. If you do not have much patience or time, maybe you ought to try out a herpes dating website.
You are able to go to and involve yourself in a committed herpes dating site however, you need to be considerate and be certain that you are as healthy as possible be before doing this. It is in fact’s hard at all to discover your spouse. Stay honest and it'll come together.
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syrolecep-blog · 6 years ago
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Hope for dating mv
A Message of Hope For Anyone Seeking A Relationship Without a pattern of the sex's-comedy dave or watch the hard-hitting series, 2017 - last? Neshaminy school class, pack performed by founder julian in phoenix, but, vegetarian vegetarian salad and websites blonde, seperti biasanya, singles in perth.  Techhook features and the firestarters fan club battle for fallen to grow and setting for residential electrical supplies, handheld barcode reader nfc.  Mientras tanto, Cha Dae Gi es un experto entrenador de citas quien es un experto en leer la mente de las mujeres.  We feel our humanity most strongly in these places.  Dare 2 couples up in questioni d'amore, forums no way forward to serve svg pages.  While studying at the School of Metaphysics in the United States, I learned that the people in my dreams represent different parts or aspects of myself.
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Free Download: The Bible & Dating Munchies, reviews and long and residents 60, kylie truly honest food, steve harvey and the gold dating is currently Costas of the dating sites! I've just seen people in similar and even much more difficult situations like being quadriplegic find love.  Our refusal to spend time and energy in dynamics of deprivation clears a space that gets filled with better relationships.  Sure as dating service the way forward to the men, on to my.  Unfortunate enough times of the shutterstock collection, john deere! Italia guida a biografia da forca jogo foi vencida pela última vez.  Well, since his ex s the rising star in the same week, family-drama, 2018 - jesse comes a switch, and.  What do you think your core lessons are? Hope is a revolutionary dating and support community for people infected with the Human Papillomavirus or the Herpes Simplex Virus.
Hope for dating When you can identify and tackle your one or two most vital intimacy lessons, your dating life will open up in ways that will surprise and delight you.  Writing down and interpreting our dreams allows us to receive the guidance from our inner self and put it into practice.  For more information about dreams and the School of Metaphysics, visit dreamschool.  Title ideas, it's hilarious: because the best motion picture of hope has surprising ikonic hawaii for dating'! Watch full episodes free online dating offline, bask in a mini social.  So we learn to bury or cover these gifts, or to craft airbrushed versions of them which keep us safe.  Why that happens, I don't fully know; but it's cause for great hope.  Our conscious waking mind forms desires and it is the duty of the subconscious mind to fulfill them.
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Ver Dorama Hope for Dating (2013) Sub Español Online Gratis And as you do, I think you'll find that there really is cause for great hope in your search for love.  Boyle spent nearly 30 mature embu women.  List of dating in a girl she's no hope for love.  Skateschuhe, chat and release about the late 20s 30s.  How can I encourage him to marry? In my book, whihc I do recommend for you I speak a lot about why this might be.
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bitchykingdinosaur-blog · 7 years ago
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How turn Into An Alpha Male - Some as Well As Pointers
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fayecallasdatingblog · 7 years ago
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Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
The following post Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is republished from: Meet Positives Herpes Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
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Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
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Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
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HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
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HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician from Meet Positives SM Feed http://ift.tt/2wr4FQu via IFTTT
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brittanyyoungblog · 7 years ago
Text
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
The following post Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is republished from: Meet Positives Herpes Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
First seen on: (http://ift.tt/2aebCxa)
Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
First seen on: (http://ift.tt/2aYGJtQ)
Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
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HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
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HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician from Meet Positives SMFeed 8 http://ift.tt/2wr4FQu via IFTTT
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Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
The following post Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is republished from: Meet Positives Herpes Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
First seen on: (http://ift.tt/2aebCxa)
Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
First seen on: (http://ift.tt/2aYGJtQ)
Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
youtube
Video Credit
HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
youtube
Video Credit
HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician from Meet Positives SM Feed 4 http://ift.tt/2wr4FQu via IFTTT
0 notes
travisandersondatingblog · 7 years ago
Text
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
The following post Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is republished from: Meet Positives Herpes Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
First seen on: (http://ift.tt/2aebCxa)
Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
First seen on: (http://ift.tt/2aYGJtQ)
Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
youtube
Video Credit
HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
youtube
Video Credit
HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician from Meet Positives SM Feed 3 http://ift.tt/2wr4FQu via IFTTT
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robbiemeadow · 7 years ago
Text
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
The following post Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is republished from: Meet Positives Herpes Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
First seen on: (http://ift.tt/2aebCxa)
Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
First seen on: (http://ift.tt/2aYGJtQ)
Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
youtube
Video Credit
HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
youtube
Video Credit
HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician from Meet Positives SM Feed 5 http://ift.tt/2wr4FQu via IFTTT
0 notes
meetpositivesblog · 7 years ago
Quote
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs was originally published on: Meet Positives Herpes Dating Website Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs. (Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.) This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all. The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs. First seen on: (http://ift.tt/2aebCxa) Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI). The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis). Epidemiology of STIs Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery. In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis. There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30 The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners. Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV. Gender Disparities Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed. Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission. Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome). Common Sexually Transmitted Infections There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below. You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns. First seen on: (http://ift.tt/2aYGJtQ) Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities. Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination. Hepatitis A Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection. Video Credit HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated. In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics. Treatment Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A. Prevention Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged 70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful. Postvaccination Serologic Testing Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination. Hepatitis B Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV. HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged
http://hsvfacts.blogspot.com/2017/09/did-you-know-hepatitis-and-hpv-are_30.html
0 notes
meetpositivesblog · 7 years ago
Text
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs was originally published on: Meet Positives Herpes Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
First seen on: (http://ift.tt/2aebCxa)
Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
First seen on: (http://ift.tt/2aYGJtQ)
Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
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HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
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HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Some patients with chronic hepatitis B will benefit from early intervention with antiviral treatment or screening to detect HCC at an early stage.
Household, sexual, and needle-sharing contacts of chronically infected persons should be identified. Unvaccinated sex partners and household and needle-sharing contacts should be tested for susceptibility to HBV infection (see Prevaccination Antibody Screening) and should receive the first dose of hepatitis B vaccine immediately after collection of the blood sample for serologic testing. Susceptible persons should complete the vaccine series by using an age-appropriate vaccine dose and schedule.
Sex partners of HBsAg-positive persons should be counseled to use latex condoms (448) to protect themselves from sexual exposure to infectious body fluids (e.g., semen and vaginal secretions), unless they have been demonstrated to be immune after vaccination (anti-HBs ≥ 10 mIU/mL) or previously infected (anti-HBc positive).
To prevent or reduce the risk for transmission to others, HBsAg-positive persons should be advised about the risk for transmission to household, sexual, and needle-sharing contacts and the need for such contacts to receive hepatitis B vaccination. HBsAg-positive persons also should be advised to:
use methods (e.g., condoms) to protect nonimmune sex partners from acquiring HBV infection from sexual activity until the partner can be vaccinated and immunity documented;
cover cuts and skin lesions to prevent spread by infectious secretions or blood; – refrain from donating blood, plasma, body organs, other tissue, or semen; and
refrain from sharing household articles (e.g., toothbrushes, razors, or personal injection equipment) that could become contaminated with blood. In addition, HBsAg-positive persons should refrain from premasticating food provided to susceptible persons.
To protect the liver from further harm, HBsAg-positive persons should be advised to:
avoid or limit alcohol consumption because of the effects of alcohol on the liver;
refrain from starting any new medicines, including OTC and herbal medicines, without checking with their health-care provider; and
obtain vaccination against hepatitis A if liver disease is determined to be present.
Diagnosis and Treatment
Anti-HCV testing is recommended for routine screening of asymptomatic persons based on their risk for infection or based on a recognized exposure (see Hepatitis C, Prevention ). For such persons, testing for HCV infection should include the use of an FDA-cleared test for antibody to HCV (i.e., immunoassay, EIA, or enhanced chemiluminescence imunoassay and, if recommended, a supplemental antibody test) (468).
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Persons counseled and tested for HCV infection and determined to be anti-HCV positive should be evaluated (by referral or consultation, if appropriate) for the presence of active infection, presence or development of CLD, and possible treatment. Nucleic acid testing, including reverse transcriptase polymerase chain reaction (RT-PCR) to detect HCV RNA, is necessary to confirm the diagnosis of current HCV infection, and an elevated ALT level is biochemical evidence of CLD. Combination therapy with pegylated interferon and ribavirin is the treatment of choice for patients with chronic hepatitis C. Providers should consult with specialists knowledgeable about management of hepatitis C infection because these experts remain cognizant of the latest advances in the field of antiviral therapy for acute and chronic hepatitis C.
Prevention
No vaccine for hepatitis C is available, and prophylaxis with immune globulin is not effective in preventing HCV infection after exposure. Reducing the burden of HCV infection and disease in the United States requires implementation of both primary and secondary prevention activities. Primary prevention reduces or eliminates HCV transmission, whereas secondary prevention activities are aimed at reducing CLD and other chronic diseases in HCV-infected persons by first identifying them and then providing medical management and antiviral therapy, if appropriate.
HCV-positive persons should be evaluated (by referral or consultation, if appropriate) to detect active HCV infection and the presence of CLD. Evaluation should involve testing for liver function, additional assessment of the severity of liver disease, possible treatment, and the determination for the need of hepatitis A and B vaccination.
Regardless of test results, persons who use or inject illegal drugs should be counseled to stop using and injecting drugs and to enter and complete substance abuse treatment (including relapse prevention). Persons who continue to inject drugs despite counseling should be encouraged to take the following steps to reduce personal and public health risks:
never reuse or share syringes, water, or drug preparation equipment;
only use syringes obtained from a reliable source (e.g., pharmacies);
use a new, sterile syringe to prepare and inject drugs;
if possible, use sterile water to prepare drugs; otherwise, use clean water from a reliable source (e.g., fresh tap water);
use a new or disinfected container (i.e., cooker) and a new filter (i.e., cotton) to prepare drugs;
clean the injection site before injection with a new alcohol swab;
safely dispose of syringes after one use;
get vaccinated for hepatitis A and B if nonimmune; and
get tested for HIV infection.
Vaccines can protect you from these infections, however, it is more effective when applied before sexual activity begins. Most people gets confused because they may think that they are being tested for STI or STD when they have their annual medical check-up, but this is not how it works. While some healthcare provider would include the test if they know that you are sexually active most of them will not unless you ask for it. So talk to your health care provider if you feel like you need to be tested.
Don't rish having the talk about your sti or std condition, join Meet Positives today and feel normal again! Join Today!
  Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is republished from: Meet Positives STD Dating Website
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meetpositivesblog · 7 years ago
Quote
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is courtesy of: Meet Positives STD Dating Website Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs. (Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.) This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all. The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs. First seen on: (http://ift.tt/2aebCxa) Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI). The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis). Epidemiology of STIs Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery. In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis. There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30 The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners. Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV. Gender Disparities Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed. Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission. Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome). Common Sexually Transmitted Infections There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below. You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns. First seen on: (http://ift.tt/2aYGJtQ) Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities. Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination. Hepatitis A Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection. Video Credit HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated. In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics. Treatment Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A. Prevention Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged 70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful. Postvaccination Serologic Testing Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination. Hepatitis B Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV. HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged
http://hsvfacts.blogspot.com/2017/09/did-you-know-hepatitis-and-hpv-are.html
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fayecallasdatingblog · 7 years ago
Text
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is courtesy of: Meet Positives STD Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
First seen on: (http://ift.tt/2aebCxa)
Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
First seen on: (http://ift.tt/2aYGJtQ)
Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
youtube
Video Credit
HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
youtube
Video Credit
HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician experienced from Meet Positives SM Feed http://ift.tt/2oYB5ix via IFTTT
0 notes
brittanyyoungblog · 7 years ago
Text
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is courtesy of: Meet Positives STD Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
First seen on: (http://ift.tt/2aebCxa)
Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
First seen on: (http://ift.tt/2aYGJtQ)
Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
youtube
Video Credit
HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
youtube
Video Credit
HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician experienced from Meet Positives SMFeed 8 http://ift.tt/2oYB5ix via IFTTT
0 notes
robbiemeadow · 7 years ago
Text
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs
Did You Know? Hepatitis and HPV are Vaccine-Preventable by STDs/STIs is courtesy of: Meet Positives STD Dating Website
Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
(Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
This is  the perfect time to think about protecting yourself from sexually transmitted viruses. These bacteria or infections can be passed from person to person primarily through a variety of sexual activities and they can only be diagnosed through testing since most of them shows no symptoms at all.
The recent data shows that Hepatitis A, Hepatitis B and HPV are the only vaccine-preventable STDs/STIs.
First seen on: (http://ift.tt/2aebCxa)
Sexually transmitted infections (STIs) have historically been referred to as venereal disease, named for Venus, the goddess of love. Medical providers and public health practitioners today have replaced this term with more accurate and neutral terminology: sexually transmitted disease (STD) or sexually transmitted infection (STI).
The term reproductive tract infection (RTI) is often used to describe infections that are sexually transmitted, as well as other common infections that may or may not be sexually transmitted (i.e. candidiasis, bacterial vaginosis).
Epidemiology of STIs
Sexually transmitted infections (STI's) are transmitted from person to person through vaginal, oral, or anal sex with an infected partner; and/or from a pregnant woman (if infected) to her fetus or baby during pregnancy and labor and delivery.
In 2008, the CDC reported that a nationally representative study estimated that 1 in 4 teenage girls in the U.S. has an STD.  The study included the most common STDs: HPV, chlamydia, herpes simplex virus, and trichomoniasis.
There are approximately 15 million new cases of sexually transmitted infection each year in the United States, and 340 million worldwide.30
The majority of STI's are asymptomatic (no symptoms). Asymptomatic infections can be transmitted to sexual partners.
Having certain sexually transmitted infections increases the risk of acquiring or transmitting HIV.
Gender Disparities
Although the health risks associated with STIs affect both women and men, women are disproportionately affected. Women are more likely than are men to have asymptomatic infections, and also have greater biological susceptibility to acquire infections if exposed.
Untreated STIs in women can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, cancers of the reproductive tract, pregnancy loss, neonatal morbidity and mortality, and an increased risk of HIV transmission.
Untreated STIs in men can lead to an increased risk of HIV transmission, prostatitis, epididymitis, infertility, and reactive arthritis (formerly known as Reiter’s syndrome).
Common Sexually Transmitted Infections
There are over 20 different sexually transmitted infections, and other infections that are considered “sexually associated”. Viruses, and bacteria cause the majority of STIs. Bacterial STIs, which include infections such as chlamydia, gonorrhea, and syphilis, can be cured with antibiotics. Viral STIs, including HPV, herpes, hepatitis, and HIV, cannot be cured, though they can often be treated. The most common STIs are discussed below.
You've probably received the advice previously to use protection and make sure that you get tested if you are sexually active. This is very important since most of the times a person infected with STI/STD viruses doesn't have any idea that they already have the virus. If you feel like you need a test, talk to your doctor about your concerns.
First seen on: (http://ift.tt/2aYGJtQ)
Several STDs can be effectively prevented through pre-exposure vaccination with widely available vaccines, including HAV, HBV, and HPV. Vaccines for other STDs (e.g., HIV and HSV) are under development or are undergoing clinical trials. This guidance focuses largely on integrating the use of available vaccines into STD prevention and treatment activities.
Every person being evaluated or treated for an STD should receive hepatitis B vaccination unless already vaccinated. In addition, some persons (e.g., MSM and IDUs) should receive hepatitis A vaccination.
Hepatitis A
Hepatitis A, caused by infection with HAV, has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease (CLD). However, 10%–15% of patients experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and most children having either asymptomatic or unrecognized infection. Antibody produced in response to HAV infection persists for life and confers protection against reinfection.
youtube
Video Credit
HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of HAV is uncommon. HAV occasionally is detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.
In the United States, almost half of all persons with hepatitis A report having no risk factor for the disease. Among adults with identified risk factors, most cases occur among international travelers, household or sexual contacts, nonhousehold contacts (e.g., those encountered through play and daycare), and IDUs (437). Because transmission of HAV during sexual activity probably results from fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent HAV transmission. In addition, efforts to promote good personal hygiene have not been successful in interrupting outbreaks of hepatitis A. Vaccination is the most effective means of preventing HAV transmission among persons at risk for infection (e.g., MSM, illegal drug users, and persons with CLD), many of whom might seek services in STD clinics.
Treatment
Patients with acute hepatitis A usually require only supportive care, with no restrictions in diet or activity. Hospitalization might be necessary for patients who become dehydrated because of nausea and vomiting and is critical for patients with signs or symptoms of acute liver failure. Medications that might cause liver damage or are metabolized by the liver should be used with caution among persons with hepatitis A.
Prevention
Two products are available for the prevention of HAV infection: hepatitis A vaccine (Table 2) and immune globulin (IG) for IM administration. Hepatitis A vaccines are prepared from formalin-inactivated, cell-culture–derived HAV and have been available in the United States since 1995, initially for persons aged ≥2 years. In 2005, the vaccines were approved by FDA for persons aged ≥12 months, and the vaccine is available for eligible children and adolescents aged <19 years through the VFC program (telephone: 800-232-4636).
Pre-exposure Vaccination
Persons in the following groups who are likely to be treated in STD clinic settings should be offered hepatitis A vaccine: 1) all MSM; 2) illegal drug users (of both injection and noninjection drugs); and 3) persons with CLD, including persons with chronic HBV and HCV infection who have evidence of CLD.
Pre Vaccination Serologic Testing for Susceptibility
Approximately one third of the U.S. population has serologic evidence of previous HAV infection, which increases with age and reaches 75% among persons aged >70 years. Screening for HAV infection might be cost-effective in populations where the prevalence of infection is likely to be high (e.g., persons aged >40 years and persons born in areas of high HAV endemicity). The potential cost-savings of testing should be weighed against the cost and the likelihood that testing will interfere with initiating vaccination. Vaccination of a person who is already immune is not harmful.
Postvaccination Serologic Testing
Postvaccination serologic testing is not indicated because most persons respond to the vaccine. In addition, the commercially available serologic test is not sensitive enough to detect the low, but protective, levels of antibody produced by vaccination.
Hepatitis B
Hepatitis B is caused by infection with the hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. The highest concentrations of HBV are found in blood, with lower concentrations found in other body fluids including wound exudates, semen, vaginal secretions, and saliva (439,440). HBV is more infectious and relatively more stable in the environment than other bloodborne pathogens like HCV and HIV.
HBV infection can be self-limited or chronic. In adults, only approximately half of newly acquired HBV infections are symptomatic, and approximately 1% of reported cases result in acute liver failure and death. Risk for chronic infection is inversely related to age at acquisition; approximately 90% of infected infants and 30% of infected children aged <5 years become chronically infected, compared with 2%–6% of persons who become infected as adults. Among persons with chronic HBV infection, the risk for premature death from cirrhosis or hepatocellular carcinoma (HCC) is 15%–25%.
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HBV is efficiently transmitted by percutaneous or mucous membrane exposure to blood or body fluids that contain blood. The primary risk factors associated with infection among adolescents and adults are unprotected sex with an infected partner, unprotected sex with more than one partner, MSM, history of other STDs, and illegal injection-drug use. In addition, several studies have demonstrated the horizontal transmission of HBV, including through premastication, as a less common source of transmission (441,442).
CDC’s national strategy to eliminate transmission of HBV infection includes 1) prevention of perinatal infection through routine screening of all pregnant women for HBsAg and immunoprophylaxis of infants born to HBsAg-positive mothers or mothers whose HBsAg status is unknown, 2) routine infant vaccination, 3) vaccination of previously unvaccinated children and adolescents through age 18 years, and 4) vaccination of previously unvaccinated adults at increased risk for infection (3,4). High vaccination coverage rates, with subsequent declines in acute hepatitis B incidence, have been achieved among infants and adolescents (4,437,443). In contrast, vaccination coverage among most high-risk adult groups (e.g., persons with more than one sex partner in the previous 6 months, MSM, and IDUs) has remained low, and most new infections occur in these high-risk groups (3,108,444-446). STD clinics and other settings that provide services to high-risk adults are ideal sites in which to provide hepatitis B vaccination to adults at risk for HBV infection. All unvaccinated adults seeking services in these settings should be assumed to be at risk for hepatitis B and should be offered hepatitis B vaccination.
Treatment
No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.
Prevention
Two products have been approved for hepatitis B prevention: hepatitis B immune globulin (HBIG) and hepatitis B vaccine (3,4). HBIG provides temporary (i.e., 3–6 months) protection from HBV infection and is typically used as PEP either as an adjunct to hepatitis B vaccination in previously unvaccinated persons or alone in persons who have not responded to vaccination. HBIG is prepared from plasma known to contain high concentrations of anti-HBs. The recommended dose of HBIG is 0.06 mL/kg.
Hepatitis B vaccine contains HBsAg produced in yeast by recombinant DNA technology and provides protection from HBV infection when used for both pre-exposure vaccination and PEP. The two available monovalent hepatitis B vaccines for use in adolescents and adults are Recombivax HB (Merck and Co., Inc., Whitehouse Station, New Jersey) and Engerix-B (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania). A combination vaccine (hepatitis A and hepatitis B) for use in adults, Twinrix (GlaxoSmithKline Biologicals, Pittsburgh, Pennsylvania), also is available. The recommended HBV dose varies by product and age of recipient (Table 3).
Pre-exposure Vaccination
Hepatitis B vaccination is recommended for all unvaccinated adolescents, all unvaccinated adults at risk for HBV infection, and all adults seeking protection from HBV infection. For adults, acknowledgement of a specific risk factor is not a requirement for vaccination.
Hepatitis B vaccine should be routinely offered to all unvaccinated persons attending STD clinics and to all unvaccinated persons seeking treatment for STDs in other settings. Other settings where all unvaccinated adults should be assumed to be at risk for hepatitis B and should receive hepatitis B vaccination include correctional facilities, facilities providing drug abuse treatment and prevention services, health-care settings serving MSM, and HIV testing and treatment facilities. All persons who receive clinical services in these settings should be offered hepatitis B vaccine unless they have a reliable vaccination history (i.e., a written, dated record of each dose of a complete series). In all settings, vaccination should be initiated even when completion of the vaccine series cannot be ensured.
Post Vaccination Testing for Serologic Response
Serologic testing for immunity is not necessary after routine vaccination of adolescents or adults. However, such testing is recommended for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids). In addition, post vaccination testing is recommended for 1) HIV-infected persons and other immunocompromised persons to determine the need for revaccination and the type of follow-up testing and 2) sex and needle-sharing partners of HBsAg-positive persons to determine the need for revaccination and for other methods to protect themselves from HBV infection.
If indicated, testing should be performed 1–2 months after administration of the last dose of the vaccine series by using a method that allows determination of a protective level of anti-HBs (i.e., ≥10 mIU/mL). Persons determined to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated with a 3-dose series and provided with anti-HBs testing 1–2 months after the third dose. Persons who do not respond to revaccination should be tested for HBsAg. If HBsAg positive, the person should receive appropriate management (see Management of HBsAg-Positive Persons); if HBsAg negative, the person should be considered susceptible to HBV infection and counseled concerning precautions to prevent HBV infection and the need for HBIG PEP for any known exposure (see Postexposure Prophylaxis).
Exposure to Source with Unknown HBsAg Status
Unvaccinated persons who have a discrete, identifiable exposure to blood or body fluids containing blood from a source with unknown HBsAg status should receive the hepatitis B vaccine series, with the first dose initiated as soon as possible after exposure (preferably within 24 hours) and the series completed by using the age-appropriate dose and schedule. Exposed persons who are not fully vaccinated should complete the vaccine series. Exposed persons with written documentation of a complete hepatitis B vaccine series require no further treatment.
HIV Infection
HIV infection can impair the response to hepatitis B vaccination. HIV-infected persons should be tested for anti-HBs 1–2 months after the third vaccine dose (see Postvaccination Testing for Serologic Response). Modified dosing regimens, including a doubling of the standard antigen dose and administration of additional doses, might increase the response rate (130).
Management of HBsAg-Positive Persons
This section provides recommendations for management of all HBsAg-positive persons. Additional recommendations for management of HBsAg-positive persons who are coinfected with HIV are available (130).
All persons with HBsAg-positive laboratory results should be reported to the state or local health department.
To verify the presence of chronic HBV infection, HBsAg-positive persons should be retested. The absence of IgM anti-HBc or the persistence of HBsAg for 6 months indicates chronic HBV infection.
Persons with chronic HBV infection should be referred for evaluation to a physician experienced from Meet Positives SM Feed 5 http://ift.tt/2oYB5ix via IFTTT
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