STDs 3 Flashcards
HPV
- human papilloma virus
- genital warts
- virus
- there are 25 types of genital warts, 4 are most common
- most common viral STD
type 6 & 11 HPV
“low risk” - cause visible warts
type 16 & 18 HPV
“high risk” - don’t usually cause visible warts
HPV-HIV connection
- studies not yet available, but broken & bleeding warts may be potential portals of entry for HIV
- HPV & genital warts do not facilitate HIV transmission but are rather promoted by HIV related immunosuppresion
transmission of HPV
- direct skin to skin or mucous membrane contact
- NOT transmitted via blood or body fluids
- direct contact with infected areas of skin with or without visible warts
- mother to infant transmission is rare
- fomites (inanimate object)
location of genital warts
- areas of coital friction
- perianal warts do not always imply anal
- intra anal warts in those who had receptive anal
- multiple types of HPV can be found in warts
s/s of genital warts
- visible warts
- fleshy bumps that can be flat, round or shaped like tiny cauliflowers
- usually painless, but can itch & burn
- *for most people, nothing will happen, immune system will eliminate
complications of genital warts
- cervical CA
- other CA linked with penile, urethral, anal, rectum, & throat
- pregnancy: cervical CA can rapidly spread, grow, & block birth canal
diagnosing genital warts
- external: visual exam for warts; acetic acid wash for warts; colposcopy; biopsy
- cervical HPV: pap smear; hybrid capture 11
- blood test in research seeting
- DNA test for cervical CA
tx of genital warts
- usually have to repeat tx
- podifilox
- podophyllin
- topical trichloracetic acid
- cryotherapy
- surgical incision
- laser tx
podifilox
liquid or gel
-used for external warts only, not safe during pregnancy
podophyllin
- liquid applied over several visits
- used on external or internal warts
- causes mild to moderate pain
- not safe during pregnancy
cryotherapy
- tissue fozen with liquid nitrogen
- may be painful
- may require several visits
- safe during pregnancy
tx for cervical HPV
- cryotherapy
- laser tx
- cone biopsy
prevention of genital warts
- avoid direct contact with warts
- use latex barriers
- seek medical attention if abnormal growth noted
HSV
- herpes simplex virus
- virus
- HSV1 causes sores on or near face
- HSV2 causes sores on genitals
- either type of HSV can infect either area
HSV-HIV connection
- blisters or open sores can be portals of entry for HIV
- increased susceptibility to HIV
transmission of HSV
- mucous membranes
- skin to skin contact with or without recognizable symptoms; lesions do NOT have to be present
- vaginal, oral, anal, autoinnoculation
- mother to infant transmission during childbirth
s/s of HSV
- 50% have mild or no symptoms
- *first episode:
- painful blister appears 2-20 days after infection
- blister lasts about 2-3 wks, breaks, crusts, heals
- blisters seen in & around vaginal areas, on penis, in urethra, around anus, or on buttocks or thighs
- most severe & includes flu like symptoms
- extremely contagious
- women may develop cervicitis
recurring s/s of HSV
- some people will never have another outbreak
- symptoms last 7-10 days
- blisters of recurrent outbreaks on or near site of original blisters
- possible forewarning: tingling sensation, itching or burning in the genital area of pain in the buttocks or down leg
asymptomatic shedding
- virus can be passed to other when no sores are present
- virus reactivates, comes to skin but doesn’t cause visible sores
- virus can shed during this time
complications of HSV
adults: no long term health complications, but psychosocial effect
- infected blisters
- eye infections
- herpes meningitis/encephalitis
- pregnancy: passed to baby during birth; greater risk if mother is having first episode
complications of HSV in infant
- encephalitis
- liver problems
- lung inflammation
- blood coagulation problems
- skin, eye, & mucous membrane lesions
diagnosing HSV
- viral culture
- antigen detection tests
- blood test
tx of HSV
- famiclovir
- acyclovir
- valacyclovir
- dosage/duration depends on type of episode
- suppressive tx taken on a lower dosage to reduce the outbreaks
prevention of HSV
- keep area clean
- avoid direct contact with sore
- abstain from sex when s/s are present
- use condoms
- spermicides may provide additional protection
GSK
- glaxosmithkline
- vaccine 74% effective in preventing disease at 48% in preventing infection
