Posts filed under ‘Infecciones de transmision sexual’

Sexually Transmitted Diseases Treatment Guidelines, 2015

MMWR Recommendations and Reports  June 2015 V.64 N.RR-3

Workowski KA, Bolan GA

These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30–May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR–12]).

These updated guidelines discuss

1) alternative treatment regimens for Neisseria gonorrhoeae;

2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis;

3) alternative treatment options for genital warts;

4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications;

5) updated HPV vaccine recommendations and counseling messages;

6) the management of persons who are transgender;

7) annual testing for hepatitis C in persons with HIV infection;

8) updated recommendations for diagnostic evaluation of urethritis; and

9) retesting to detect repeat infection.

Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.

FULL TEXT

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm?s_cid=rr6403a1_e

PDF

http://www.cdc.gov/mmwr/pdf/rr/rr6403.pdf

June 7, 2015 at 11:23 am

Pelvic Inflammatory Disease

N Engl J Med 2015;372:2039-2048

REVIEW ARTICLE

R.C. Brunham, S.L. Gottlieb, and J. Paavonen

From the Department of Medicine, University of British Columbia, Vancouver, Canada (R.C.B.); the Department of Reproductive Health and Research, World Health Organization, Geneva (S.L.G.); and the Department of Obstetrics and Gynecology, University of Helsinki, Helsinki (J.P.).

Address reprint requests to Dr. Brunham at the Department of Medicine, University of British Columbia, 655 West 12th Ave., Vancouver, BC V5Z 4R4, Canada, or at robert.brunham@bccdc.ca

Pelvic inflammatory disease is an infection-induced inflammation of the female upper reproductive tract (the endometrium, fallopian tubes, ovaries, or pelvic peritoneum); it has a wide range of clinical manifestations.

Inflammation spreads from the vagina or cervix to the upper genital tract, with endometritis as an intermediate stage in the pathogenesis of disease.

The hallmark of the diagnosis is pelvic tenderness combined with inflammation of the lower genital tract; women with pelvic inflammatory disease often have very subtle symptoms and signs.

Many women have clinically silent spread of infection to the upper genital tract, which results in subclinical pelvic inflammatory disease….

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMra1411426

May 20, 2015 at 9:07 pm

Possible Sexual Transmission of Ebola Virus — Liberia, 2015

MMWR May 1, 2015 V.64 P.1-3 Early Release

Athalia Christie, MIA, Gloria J. Davies-Wayne, MPH, Thierry Cordier-Lasalle, DESS, et al.

1CDC; 2World Health Organization; 3Ministry of Health and Social Welfare, Liberia; 4US Army Medical Research Institute of Infectious Diseases; 5National Institutes of Health; 6Médecins Sans Frontières, 7Liberian Institute for Biomedical Research

Corresponding author: Athalia Christie, akc9@cdc.gov

On March 20, 2015, 30 days after the most recent confirmed Ebola Virus Disease (Ebola) patient in Liberia was isolated, Ebola was laboratory confirmed in a woman in Monrovia. The investigation identified only one epidemiologic link to the patient’s Ebola: unprotected vaginal intercourse with an Ebola survivor….

PDF

http://www.cdc.gov/mmwr/pdf/wk/mm64e0501.pdf

May 1, 2015 at 12:29 pm

Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccination Recommendations of the Advisory Committee on Immunization Practices

MMWR Weekly March 27, 2015 V.64  N.11 P.300-304

Emiko Petrosky, MD, Joseph A. Bocchini Jr, MD, Susan Hariri, PhD, et al.

1Epidemic Intelligence Service, CDC; 2National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, CDC; 3Louisiana State University Health Sciences Center, Shreveport, Louisiana; 4National Center for Immunization and Respiratory Diseases, CDC; 5National Center for Chronic Disease Prevention and Health Promotion, CDC; 6National Center for Emerging and Zoonotic Infectious Diseases, CDC (Corresponding author: Emiko Petrosky, xfq7@cdc.gov, 404-639-1817)

During its February 2015 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended 9-valent human papillomavirus (HPV) vaccine (9vHPV) (Gardasil 9, Merck and Co., Inc.) as one of three HPV vaccines that can be used for routine vaccination (Table 1).

HPV vaccine is recommended for routine vaccination at age 11 or 12 years (1). ACIP also recommends vaccination for females aged 13 through 26 years and males aged 13 through 21 years not vaccinated previously.

Vaccination is also recommended through age 26 years for men who have sex with men and for immunocompromised persons (including those with HIV infection) if not vaccinated previously (1). 9vHPV is a noninfectious, virus-like particle (VLP) vaccine.

Similar to quadrivalent HPV vaccine (4vHPV), 9vHPV contains HPV 6, 11, 16, and 18 VLPs. In addition, 9vHPV contains HPV 31, 33, 45, 52, and 58 VLPs (2). 9vHPV was approved by the Food and Drug Administration (FDA) on December 10, 2014, for use in females aged 9 through 26 years and males aged 9 through 15 years (3).

For these recommendations, ACIP reviewed additional data on 9vHPV in males aged 16 through 26 years (4). 9vHPV and 4vHPV are licensed for use in females and males. Bivalent HPV vaccine (2vHPV), which contains HPV 16, 18 VLPs, is licensed for use in females (1).

This report summarizes evidence considered by ACIP in recommending 9vHPV as one of three HPV vaccines that can be used for vaccination and provides recommendations for vaccine use….

FULL TEXT

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6411a3.htm?s_cid=mm6411a3_e

PDF See P.300-304

http://www.cdc.gov/mmwr/pdf/wk/mm6411.pdf

April 9, 2015 at 3:12 pm

Behavioral Sexual Risk-Reduction Counseling in Primary Care to Prevent Sexually Transmitted Infections – An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force

Annals of Internal Medicine Sept.23, 2014

Elizabeth A. O’Connor, PhD; Jennifer S. Lin, MD, MCR; Brittany U. Burda, MPH; Jillian T. Henderson, PhD; Emily S. Walsh, MPH; and Evelyn P. Whitlock, MD, MPH

From Kaiser Permanente Center for Health Research, Portland, Oregon.

Background

Sexually transmitted infections (STIs) are common and preventable.

Purpose

To update a previous systematic review about the benefits and harms of sexual risk-reduction counseling to prevent STIs for the U.S. Preventive Services Task Force.

Data Sources

Selected databases from January 2007 through October 2013, manual searches of references lists and grey literature, and studies from the previous review.

Study Selection

English-language fair- or good-quality trials conducted in adolescents or adults.

Data Extraction

One investigator abstracted data and a second checked the abstraction. Study quality was dual reviewed.

Data Synthesis

31 trials were included: 16 were newly published (n = 56 110) and 15 (n = 14 214) were from the previous review. Most trials targeted persons at increased risk for STIs based on sociodemographic characteristics, risky sexual behavior, or history of an STI. High-intensity (>2 hours) interventions reduced STI incidence in adolescents (odds ratio, 0.38 [95% CI, 0.24 to 0.60]) and adults (odds ratio, 0.70 [CI, 0.56 to 0.87]). Lower-intensity interventions were generally not effective in adults but some approaches were promising. Although moderate-intensity interventions may be effective in adolescents, data were very sparse. Reported behavioral outcomes were heterogeneous and most likely to show a benefit with high-intensity interventions at 6 months or less. No consistent evidence was found that sexual risk-reduction counseling was harmful.

Limitations

Low-risk populations and male adolescents were underrepresented. Reliability of self-reported behavioral outcomes was unknown.

Conclusion

High-intensity counseling on sexual risk reduction can reduce STIs in primary care and related settings, especially in sexually active adolescents and in adults at increased risk for STIs.

Primary Funding Source

Agency for Healthcare Research and Quality.

PDF (CLIC PDF)

September 26, 2014 at 8:23 am

Immunosuppression in Patients with Chronic Hepatitis B.

Curr Hepatol Rep. 2014 Jun 21;13:235-244. eCollection 2014.

Seetharam A1, Perrillo R2, Gish R3.
Author information
1Banner Transplant and Advanced Liver Disease Center, Phoenix, AZ USA ; University of Arizona College of Medicine, Phoenix, AZ USA.
2Hepatology Division, Baylor University Medical Center, Dallas, TX USA ; Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX USA.
3St. Joseph’s Hospital Medical Center/Liver Center, Phoenix, AZ USA ; 6022 La Jolla Mesa Drive, San Diego, CA 92037 USA.
Abstract
After hepatitis B virus (HBV) infection, HBV DNA persists in minute amounts in hepatocyte nuclei even in individuals with “resolved” infection.

Viral replication and development of liver disease depend on the balance between viral mechanisms promoting persistence and host immune control. Patients with active or inactive disease or resolved HBV infection are at risk for reactivation with immunosuppressive therapy use.

HBV reactivation varies from a clinically asymptomatic condition to one associated with acute liver failure and death. We review recent studies on HBV reactivation during immunomodulatory therapies for oncologic, gastroenterological, rheumatic, and dermatologic disorders.

Risk calculation should be determined through HBV screening and assessment of immunosuppressive therapy potency. We also discuss monitoring for reactivation, prophylactic antiviral therapy, and treatment of reactivation.

Prophylactic antiviral treatment is needed for all HBsAg carriers and selected patients who have anti-HBc without HBsAg and is critical for preventing viral reactivation and improving outcomes.
PDF
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119588/pdf/11901_2014_Article_238.pdf

August 19, 2014 at 12:17 pm

Making serological diagnosis of syphilis more accurate.

Indian J Sex Transm Dis. 2014 Jan;35(1):70-1.

 

Archana BR1, Prasad SR1, Beena PM1, Okade R2.

Author information

1Department of Microbiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.

2Department of Dermatology and Venereology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India.

FULL TEXT

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066607/

 

August 19, 2014 at 12:15 pm

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