<p> Sexually Transmitted Infections (STIs, previously known as STDs)</p><p>Human Immunodeficiency Virus (HIV) Disease: Acquired Immunodeficiency Syndrome (clinically, AIDS defined as <200 CD4 T cells per mm3)</p><p>Two major virus types (several groups and subtypes)– HIV-1 (pandemic), HIV-2 (mostly Africa)</p><p>Transmission: direct blood and sexual fluids (transmitted into blood stream), breast milk, congenital (though virus found in very low levels in most bodily fluids)</p><p>Target tissue/tropism: (cells containing CD4 and CXCR4) helper T cells, macrophages</p><p>Treatment: several antiviral drug families used in combination</p><p>Human Papilloma Virus (HPV)- about 40 known strains Disease: warts (benign epithelial growths)</p><p>Flat warts, planters warts, seed warts…commonly found on fingers, hands, feet, elbows, and even throat or tongue</p><p>Genital warts- 15% population, usually self-limiting clusters of bumps, certain strains can infect cervical epithelia and cause cervical cancer</p><p>Transmission: direct contact with wart, fomites (virus must enter tiny cracks in epithelia)</p><p>Treatment: removal by freezing, acid, or laser (vaccine for prevention) Detection of cancerous cervical cells by Pap smear (surgical cervix removal)</p><p>Herpes Simplex Virus (HSV) Disease: epithelial lesions</p><p>HSV2- primarily genital (genital herpes)…</p><p>HSV1- primarily orofacial (cold sore, fever blisters, etc.)…</p><p>Fatal in infants..HSV1=30% mortality, HSV2=50-80% mortality</p><p>Transmission: viral contaminated secretions, oozing lesions</p><p>Remain latent in neurons (once you got them, you got them!), when nerve is stimulated the lesions appear</p><p>Treatments: acyclovirs, OTC=Abreva, menthol, camphor Other Herpes Virus family members (not necessarily STIs):</p><p>Varicella-Zoster Virus (VZV) Diseases: Primary-chicken pox</p><p>Recurrent- shingles (zoster)</p><p>Transmission: respiratory droplets, fluid from skin pox (respiratory entry)</p><p>Cytomegalovirus (CMV) Disease: (usually asymptomatic in adults), immunosuppressed, infants, newborns… enlarged spleen and liver, jaundice, capillary bleeding, ocular damage, mental retardation</p><p>Transmission: body fluids and feces</p><p>Epstein-Barr Virus (EBV) Disease: most commonly Infectious Mononucleosis</p><p>Transmission: virus harbored in lymph nodes and salivary glands…saliva (maybe blood)</p><p>Treponema pallidum (spirochete bacterium) Disease: Syphilis</p><p>Primary- painless purple ulcers at site of infection, treatable</p><p>Secondary- (weeks later) fever, flu-like symptoms, jaundice, hair loss, rash on palms and feet (treatable)</p><p>Tertiary- (~1/3 patients, often years later) soft, gummy lesions, vascular damage, nerve damage leading to insanity and personality changes</p><p>Treatment: penicillin, other substitutions Neisseria gonorrhoeae (G- diplococcus) Poor survival outside body, easy to kill</p><p>Disease: Gonorrhea (“ the Clap”), 50% asymptomatic, ~1 week incubation</p><p>Women- reddened cervix, vaginal discharge, painful abdomen and urination, scared Fallopian tubes and sterility</p><p>Men- urethral discharge, painful urination, sterility</p><p>Transmission: direct sexual contact (any epithelial cell can be infected…rectum, pharynx, etc.)</p><p>Treatment: standard antibiotics, silver nitrate added to newborn eyes</p><p>Chlamydia trachomatis (very small G- cocci, intracellular bacterium) Disease: Chlamydia (chlamydial urethritis)</p><p>75% women and 50% men asymptomatic…gonorrhea-like symptoms but often milder, therefore higher incidence of sterility</p><p>Transmission: direct sexual contact (any epithelial cell can be infected…rectum, pharynx, etc.)</p><p>Treatment: standard antibiotics</p><p>Trichomonas vaginalis (flagellated protozoan) Disease: Trich (vaginitis, urethritis)</p><p>(Many women and most men are asymptomatic) Women- vaginitis, watery discharge, painful urination, itching and burning</p><p>Men- urethritis, prostatitis</p><p>Transmission: sexual contact, occasionally fomites (typically men are reservoirs without symptoms)</p><p>Treatment: typically metronidazole</p>