What is Hepatitis and sexually transmitted infections?

Hepatitis B is an infectious disease caused by hepatitis B virus (HBV) that damages liver resulting in its inflammation.

Hepatitis B virus influences the functions of the liver replicating in its cells that are called hepatocytes. Hepatitis B can be acute (self-limited) or chronic (long-term). Patients with self-limited infection recover in three weeks or months.

Over 95% of patients who were infected by the virus in the adulthood make a full recovery and develop a protective immunity against the virus. However, this probability drops to 30% in smaller children, and only 5% of newborns that were  infected by their mother in the process of childbirth get rid of the virus. With a 40% probability, these people will die of cirrhosis or hepatocellular carcinoma. 70% of those infected in the age from 1 to 7 will discard the infection.

According to the estimates, 350 million people of the world were infected in 2004. National and regional spread varies from 10% in Asia to less than 0.5% in the USA and Northern Europe. Ways of contagion include vertical transmission (at birth), horizontal transmission in the early years of life (bites, injuries, and sanitary habits), and horizontal transmission in adulthood (sexual contacts, intravenous injection of preparations).

Hepatitis C is an infectious disease caused by hepatitis C virus (HCV) that damages mainly the liver. Infection is often asymptomatic, however, chronic infection leads to fibrosis and, eventually, cirrhosis or liver cancer (hepatocarcinoma). Transmission takes place parenterally due to virus penetration into blood during intravenous injection of drugs or blood transfusion because of using poorly sterilized medical accessories. The virus is preserved in the liver of about 85% of infected people. Usually, hepatitis C is treated by long-term combined anti-virus therapy, and 50-80% of people undergoing such treatment recover.

According to some estimates, 130-170 million people in the world are infected by hepatitis C.

Hepatitis C is often asymptomatic, but chronic infection may cause fibrosis, and in several years - cirrhosis. If cirrhosis progresses, liver failure occurs, and cancer/cirrhosis of liver may develop. Dilatation of esophagus and stomach veins may cause fatal bleeding.

Pegylated interferon and ribavirin are the standard HCV medications. Patients with cirrhosis or liver cancer require liver transplantation, however, the virus usually recurs after transplantation.

What are sexually transmitted infections and how are they transmitted?

STIs, which are caused by 30 different bacteria, viruses and parasites, are usually transmitted during sexual contacts, including vaginal, anal, and oral sex.

Some STIs may be transmitted through skin sexual contact. Microorganisms causing STIs may also be transmitted in the course of blood product transfusion and tissue transplantation. Many STIs, including  chlamydiosis, gonorrhea, hepatitis B, HIV, HPV, HSV-2, and syphilis may be transmitted from the mother to the child during pregnancy and childbearing.

A person may have STIs without any manifest symptoms. Therefore, the term "sexually transmitted infection" is broader than the term "sexually transmitted disease" (STD). General symptoms of STDs include vaginal discharge, urethral discharge in men, genital ulcers, and abdominal pain.

The highest incidence is connected with eight out of over 30 known pathogens that are transmitted in the course of sexual contacts. Today, 4 out of 8 of these infections can be treated. These are syphilis, gonorrhea, chlamydiosis, and trichomoniasis. The other four, such as hepatitis B, herpes, HIV, and HPV are viral diseases that cannot be cured, but treatment may decrease their influence.

Treatment of STIs

At present, some STIs can be effectively treated.

Three bacterial STIs (chlamydiosis, gonorrhea, and syphilis), and one parasitic STI (trichomoniasis) can, as a rule, be treated using effective one-dose antibiotics.

What concerns herpes and HIV, most effective medications here include antiretroviral agents that can mitigate the course of the disease, but they cannot cure it.

What concerns hepatitis B, there is immunomodulator (interferon) and antiretroviral agents that help fight the virus and slow down the destruction of the liver.

The resistance of STIs to antibiotics has grown dramatically over the last years limiting treatment options. The appearance of  gonorrhea with reduced sensitivity to the “last line” therapy (oral and injectional cephalosporins) accompanied by  resistance to antimicrobial agents is already manifested in regard to penicillins, sulphonamides, tetracyclines, quinolones, and macrolides, and caused the fact that gonococcus became a microorganism with multiple drug resistance. The resistance of STIs to antimicrobial agents is not that spread, but it does exist, which makes prevention and immediate treatment critical.

Vaccines and other biomedical measures

There are safe and effective vaccines against two STIs – hepatitis B and human papilloma virus (HPV). These vaccines are a great achievement in the area of STI prevention. Hepatitis B vaccine is included into the program of child immunization in 93% of countries. According to the estimates, it has already prevented 1.3 lethal cases caused by chronic liver disease and cancer.

HPV vaccine is available as a part of regular immunization programs in 45 countries, the majority of which are countries with the high and medium level of income. In the next decade, the HPV vaccine may prevent more than 4 million deaths of women in countries with low and medium income level, which have the highest incidence of cervical cancer, on condition that 70% of the population will be vaccinated.

A certain success has been reached in research aimed at the creation of herpes and HIV vaccines, however, there are no acceptable vaccines against these diseases yet. Vaccines against chlamydiosis, gonorrhea, syphilis, and trichomoniasis are being developed.

Carefully HIV!

The public institution "Public Health Center of the Ministry of Health of Ukraine" constantly monitors the health situation in Ukraine. Including, systematic research on the prevalence of HIV infection within the country is conducted.

At the end of last year, operative information about officially registered cases of HIV infection, AIDS and the number of deaths caused by AIDS in December 2017 was published.

 

Згідно цього документу, в грудні 2017 року в Україні офіційно зареєстровано 1 983 випадки ВІЛ- інфекції серед громадян України та 3 серед іноземців. За період 1987-листопад 2017 рр (без урахування даних АР Крим з 2014 року та частини території проведення антитерористичної операції з 2015 року ) в Україні офіційно зареєстровано 315 617 випадків ВІЛ-інфекції серед громадян України, у тому числі 102 203 випадки захворювання на СНІД та 45 023 випадків смерті від захворювань, зумовлених СНІДом.

According to this document, in December 2017, in Ukraine officially registered 1 983 cases of HIV infection among Ukrainian citizens and 3 among foreigners. In the period from 1987 to November of 2017 (excluding data from Crimea and parts of the counterterrorist operation), 315,617 cases of HIV infection among Ukrainian citizens were officially registered in Ukraine, including 102,203 cases of AIDS and 45,023 deaths due to AIDS-related illnesses.

Keep track of your health and take care of yourself!

 

What is HIV?

HIV-infection is a socially dangerous infectious disease that results from the contagion of human immunodeficiency virus (HIV), long-term persistence of HIV in lymphocytes, macrophages, and cells of nervous tissue. This disease is characterized by progressing dysfunction of the immune, nervous, lymphatic and other systems of the organism. According to the current ideas, HIV-infection belongs to incurable diseases, is chronic and, in the case of lack of effective therapy, ends in patient’s death.

At present, HIV-infection is spread on all continents and its spread is called HIV/AIDS pandemics, while in Ukraine HIV/AIDS epidemics is developing. Over 179 thousand HIV-infected persons are registered in the country; but according to the estimates of experts, only one-third of those infected knows about it; the total number of people living with HIV in Ukraine reaches 377,600.

HIV is transmitted:

  • Through blood: in case of transfer of blood or other biological fluids containing blood (sperm, vaginal discharge, breast milk) from an HIV-infected person to a healthy one. Most commonly, this happens in cases of drug injection using impure syringes and needles that have already been used by other people.
  • Sexually: during unprotected sexual intercourse, regardless of whether it is vaginal, oral, or anal sex.
  • By transmission of virus from an HIV-infected mother to her child during pregnancy, labor, and breastfeeding. The risk of infection rises during breastfeeding, in case of severe course of the disease in the mother, and difficult delivery.

HIV is not transmitted:

  • By using household things, dishes, work in the same premises
  • In bathhouse or sauna
  • Through kissing
  • Through hugging and shaking hands
  • By coughing and sneezing
  • Through rails, doorknobs, tables, chairs
  • Through mosquito or other insect bites.

After contagion, the virus starts to proliferate rapidly, damages different cells, organs, and systems of the organism. In 6-8 weeks, one-third of the infected develops an acute HIV-infection that takes the form of a fever with tenderness, increased temperature, pain in the joints, as it happens often in cases of an ARD; in others, this process remains unnoticed.  In 1.5-3 months after infection, HIV antibodies appear in the blood of the infected person; HIV-infection diagnostics is based on detection of these antibodies. The period from the moment of infection to the formation of HIV antibodies is called “seroconversion or diagnostic window”.

After the acute stage of HIV-infection, the asymptomatic period lasts for 8-10-12 years: usually, people feel well, lead a regular life, however, their lymphonodes are often enlarged and they often catch a cold. Such people are HIV carriers and pose a big threat for their sexual partners and “needle partners”; they cannot be blood or organ donors. The virus that remains in the organism all this time constantly damages cells of the immune system, the so-called CD4 Lymphocytes, which protect the organism against microorganism (bacteria, viruses, fungi, etc.) invasion. In a healthy organism, their number amounts to 1,000 in a ml of blood. Each year, the number of CD4 in the blood of HIV-infected persons decreases on average by 50 cells, and when their number drops to 300-200 and less, the system of immune protection gets impaired, and the diseases caused by different infectious agents, called ‘opportunistic infection’ in the HIV/AIDS practice, develop. A person feels bad, loses weight, and feels tenderness and fatigability. This stage of the disease is called AIDS. Its manifestations may include herpetic infection (primarily herpes zoster), fungal dermatitis and mycotic stomatitis, tuberculosis is activated or develops for the first time.

Annually, 2 to 3 thousand AIDS cases are diagnosed in Ukraine. A network of specialized prevention and treatment facilities – centers for preventing and fighting AIDS – have been created to provide medical care to patients with AIDS. They provide clinic supervision of HIV-infected patients and AIDS patients, diagnose the stage of the disease, and determine the treatment technique. Starting from 1996, the so-called antiretroviral combination therapy (ACT) has been implemented in the world; it influences directly on HIV, suppresses the proliferation of viral particles, and facilitates strengthening of the immunity, and growth of SD4 numbers, which returns health to the patient. The legislation envisages free of charge treatment of HIV-infected patients at the cost of the State and local budgets, and the funds of donor organizations.

The main means of prevention of HIV-infection spread in the country is a healthy lifestyle, refusal from HIV-risky behavior, mainly the use of drugs, constant use of means of personal protection – condoms – during sexual contacts. Conscious attitude to your health will protect you against AIDS.

Due to the great variability of HIV, the creation of HIV vaccine remains a question to be solved in the future, even despite the fact that AIDS agent was discovered back in 1983 by French researchers at the Dr. Luc Montagnier’s laboratory and American researcher Robert Gallo.

A new batch of HIV Voluntary counseling and testing manuals is available in the Southern region.

Today, HIV infection in Ukraine is a widespread problem among representatives of various groups of the population, including servicemen of the Armed Forces of Ukraine. This issue remains very relevant, as according to information of World Health Organization, the epidemic and HIV/AIDS mortality rate in Ukraine still the highest in Europe. According to information of the Ministry of Health, the number of HIV infections reaches over 220 thousand.

Informing servicemen about the availability of voluntary counseling and testing cabinets (VCT cabinets) for HIV/AIDS, who continue to work actively in Odessa, is part of the function of a psychologist and this is an important measure to prevent the spread of diseases. At the meeting, doctor provides counseling about sexually transmitted diseases and its prevention. Preventive measures in the South region are being very active for four years in military units such as Naval Academy and the operational command "South".

To reduce the prevalence of HIV infection, persons aged 14 and over are tested. Testing can be performed only with the informed consent of the person who will be tested. This consent is obtained after giving preliminary advice about peculiarities of testing its results and possible consequences, subject to all conditions of confidentiality of personal information, including the health of this person.

According to the head of the VCT cabinet in the Southern region Galina Gutjerez-Molina, a sufficient number of Guidelines for Voluntary Counseling and HIV testing was recently received to the Military Clinical Center.

"Due to such a very valuable, material and cooperation the process of detection of HIV-infection will be greatly improved in the Armed Forces of Ukraine. During January of 2018, more than 200 military personnel on various issues and agreements agreed to try VCT's office for testing and getting information about HIV/AIDS and quick tests. Testing for the presence of antibodies to HIV in the blood of the subjects is conducted in accordance with the principles of VCT. The quick test algorithm consists of several steps and serves to identify antibodies to HIV. The procedure is very easy to use. I would like to thank for the specialized training, where doctors from all over the country have learned how to work with rapid test system. This training was held with the support of the International Institute for HIV/AIDS and Tuberculosis in partnership with the Preventive Medicine Service of the Ministry of Defense of Ukraine.

Unfortunately, the cure for this deadly disease is still not found. But we already know that the best treatment is prevention of the disease. The issue of preventing HIV and other socially dangerous diseases among Ukrainian youth, and especially the military personnel of the Armed Forces of Ukraine, is a priority of our present. The servicemen of the Armed Forces of Ukraine are our hope and reliance of future, so they should be healthy - and this is one of the main priorities of the state policy" - said Galina.

 

 

 

 

 

 

 

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