RESUMEN
Viral venereal diseases remain difficult to treat. Human papilloma virus (HPV) and herpes simplex virus (HSV) are two common viral venereal diseases. HPV infections are characterized by anogenital warts and less commonly by premalignant or malignant lesions. HSV infections classically present as grouped vesicles on an erythematous base with associated burning or pain; however, immunosuppressed patients may have atypical presentations with nodular or ulcerative lesions. This review discusses the epidemiology, diagnosis, and management of anogenital HPV and HSV infections with an emphasis on treatment modalities for the practicing dermatologist. Diagnosis of these diseases typically relies on clinical assessment, although multiple diagnostic techniques can be utilized and are recommended when diagnosis is uncertain or evaluating an individual with increased risk of malignancy. Management of HPV and HSV infections involves appropriate counseling, screening, and multiple treatment techniques. Particularly for HPV infections, a practitioner may need to use a combination of techniques to achieve the desired outcome.
Asunto(s)
Infecciones por Herpesviridae/diagnóstico , Infecciones por Papillomavirus/diagnóstico , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Cutáneas Virales/diagnóstico , Alphapapillomavirus/aislamiento & purificación , Terapia Combinada/métodos , Terapia Combinada/normas , Consejo/normas , Dermatología/métodos , Dermatología/normas , Herpesviridae/aislamiento & purificación , Infecciones por Herpesviridae/epidemiología , Infecciones por Herpesviridae/terapia , Infecciones por Herpesviridae/transmisión , Humanos , Tamizaje Masivo/normas , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/terapia , Infecciones por Papillomavirus/transmisión , Guías de Práctica Clínica como Asunto , Prevalencia , Factores de Riesgo , Enfermedades Virales de Transmisión Sexual/epidemiología , Enfermedades Virales de Transmisión Sexual/terapia , Enfermedades Virales de Transmisión Sexual/transmisión , Piel/patología , Piel/virología , Enfermedades Cutáneas Virales/epidemiología , Enfermedades Cutáneas Virales/terapia , Enfermedades Cutáneas Virales/transmisiónRESUMEN
As COVID-19 infections wreak havoc across the globe, attention has rightly been focused on the vital organ systems (lung, kidney and heart) that are vulnerable to viral attack and contribute to the acute pathology associated with this disease. However, we should not lose sight of the fact that COVID-19 will attack any cell type in the body expressing ACE2 - including human spermatozoa. These cells possess the entire repertoire of receptors (AT1R, AT2R, MAS) and ligand processing enzymes (ACE1 and ACE2) needed to support the angiotensin signalling cascade. The latter not only provides COVID-19 with a foothold on the sperm surface but may also promote integration, given the additional presence of a range of proteases (TMPRSS2, TMPRSS11B, TMPRSS12, furin) capable of promoting viral fusion. This article reviews the roles played by these various cellular constituents in maintaining the vitality of human spermatozoa and their competence for fertilization. The reproductive consequences of a viral attack on these systems, in terms of fertility and the risk of sexual transmission, are currently unknown. However, we should be alive to the possibility that there may be reproductive consequences of COVID-19 infection in young males that go beyond their capacity to survive a viral attack.
Asunto(s)
COVID-19/virología , Infertilidad Masculina/virología , SARS-CoV-2/aislamiento & purificación , Enfermedades Virales de Transmisión Sexual/virología , Espermatozoides/virología , Animales , COVID-19/diagnóstico , COVID-19/metabolismo , COVID-19/transmisión , Humanos , Infertilidad Masculina/diagnóstico , Infertilidad Masculina/metabolismo , Masculino , Receptores Virales/metabolismo , Medición de Riesgo , Factores de Riesgo , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/metabolismo , Enfermedades Virales de Transmisión Sexual/transmisión , Espermatozoides/metabolismoRESUMEN
Research is needed to understand the presence of the SARS-CoV-2 virus in semen, sexual transmissibility, and impact on sperm quality. Several studies have examined men recovering from COVID-19, but large-scale community-based testing is needed to ascertain the effects on the male reproductive tract, and the potential for prolonged transmission.
Asunto(s)
COVID-19/virología , SARS-CoV-2/patogenicidad , Semen/virología , Enfermedades Virales de Transmisión Sexual/virología , Espermatozoides/virología , Animales , COVID-19/diagnóstico , COVID-19/transmisión , Prueba de COVID-19 , Interacciones Huésped-Patógeno , Humanos , Masculino , Análisis de Semen , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/transmisión , Espermatozoides/patología , VirulenciaRESUMEN
OBJECTIVES: Transgender men who have sex with men (TMSM) represent an understudied population in relation to screening for HIV and sexually transmitted infections (STIs). We examined HIV and STI testing prevalence among TMSM along with the factors associated with testing in a diverse US nationwide sample of TMSM. METHODS: Data from a cross-sectional online convenience sample of 192 TMSM were analysed using multivariable binary logistic regression models to examine the association between sociodemographic and behavioural factors and lifetime testing for HIV, bacterial STIs and viral STIs, as well as past year testing for HIV. RESULTS: More than two-thirds of TMSM reported lifetime testing for HIV (71.4%), bacterial STIs (66.7%), and viral STIs (70.8%), and 60.9% had received HIV testing in the past year. Engaging in condomless anal sex with a casual partner whose HIV status is different or unknown and having fewer than two casual partners in the past 6 months were related to lower odds of lifetime HIV, bacterial STI, viral STI and past year HIV testing. Being younger in age was related to lower probability of testing for HIV, bacterial STIs and viral STIs. Furthermore, TMSM residing in the South were less likely to be tested for HIV and viral STIs in their lifetime, and for HIV in the past year. Finally, lower odds of lifetime testing for viral STIs was found among TMSM who reported no drug use in the past 6 months. CONCLUSIONS: These findings indicate that a notable percentage of TMSM had never tested for HIV and bacterial and viral STIs, though at rates only somewhat lower than among cisgender MSM despite similar patterns of risk behaviour. Efforts to increase HIV/STI testing among TMSM, especially among those who engage in condomless anal sex, are needed.
Asunto(s)
Infecciones por VIH/diagnóstico , Tamizaje Masivo/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/diagnóstico , Personas Transgénero , Adolescente , Adulto , Bisexualidad , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Homosexualidad Masculina , Humanos , Masculino , Persona de Mediana Edad , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual/diagnóstico , Estados Unidos , Sexo Inseguro/estadística & datos numéricos , Adulto JovenAsunto(s)
Servicios de Diagnóstico/organización & administración , Pruebas Diagnósticas de Rutina/métodos , Manejo de la Enfermedad , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/epidemiología , Salud Global , HumanosRESUMEN
For Brazil, there are no nationwide data on HPV prevalence against which the impact of the HPV immunization program can be measured in the future. Therefore, we aim to evaluate the prevalence of genital HPV infection among adolescents and young adults in Brazil. A cross-sectional, multicentric, nationwide survey was conducted between September 2016 and November 2017. Sexually active unvaccinated women and men aged 16 to 25 years old were recruited from 119 public primary care units, including all 26 state capitals and the Federal District. All participants answered a face-to-face interview and provided biological samples for genital HPV analysis. We used an automated DNA extraction method and HPV genotyping was performed using the Linear Array genotyping test (Roche). Of 7,694 participants, 53.6% (95% CI 51.4-55.8) were positive for any HPV type. The prevalence of high-risk HPV types was significantly higher in women (38.6% vs. 29.2%, P < 0·001). The HPV types included in the quadrivalent vaccine were detected in 1002 (14.8%) specimens, with a different pattern of HPV infection between sexes. Characteristics associated with overall HPV detection included female gender, self-declaration of race as brown/pardo, lower socioeconomic class, single or dating, current smoking and having 2 or more sex partners in the past year. We found a high prevalence of HPV, with significant differences between regions. Our data provide information that may be considered when developing HPV prevention policies and constitute a baseline against which the impact of the HPV immunization program in Brazil can be measured in future years.
Asunto(s)
Infecciones por Papillomavirus/epidemiología , Enfermedades Virales de Transmisión Sexual/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Genotipo , Humanos , Masculino , Tamizaje Masivo , Papillomaviridae/genética , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/transmisión , Infecciones por Papillomavirus/virología , Prevalencia , Vigilancia en Salud Pública , Enfermedades Virales de Transmisión Sexual/diagnóstico , Adulto JovenRESUMEN
INTRODUCTION: Human papillomavirus (HPV) is among the reported etiologies of laryngeal squamous cell carcinoma (LSCC). Understanding the impact of HPV on LSCC may help reduce its incidence. This study investigates the association between HPV and LSCC as well as the roles for different immunohistochemical stains in HPV detection. METHODS: A total of fifty-two formalin-fixed, paraffin-embedded tissue samples of LSCC, diagnosed between 2005 and 2015, were obtained from the archives of the Pathology Department. The samples were stained and processed to evaluate the relationship of HPV to LSCC. RESULTS: Patients had a mean age of 65.02 ± 14.341 years. By polymerase chain reaction (PCR), high-risk strains of HPV were detected in 15.4% of tissue samples. HPV-16 was found in 75% of the positive samples for an overall prevalence of 13.5%. P16 immunostaining was positive in 15.4% of cases while cyclin B and cyclin E were positive in 65.4% and 76.9%, respectively. Over half of the cases were histologically graded as moderately-differentiated, 28.8% as well-differentiated, and 15.4% as poorly-differentiated. DISCUSSION: The prevalence of HPV-positive LSCC was lower than previously stated in the literature. HPV-16 was the most commonly detected subtype, in concordance with the findings of multiple other studies. HPV-positive LSCC trended with higher histologic grade. P16 and cyclin E immunohistochemical stains were of limited use in identifying HPV in LSCC. In contrast, cyclin B had a high sensitivity which could be used to rule out HPV in LSCC.
Asunto(s)
Neoplasias Laríngeas/virología , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Enfermedades Virales de Transmisión Sexual/diagnóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/virología , Adulto , Anciano , Femenino , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/epidemiología , Masculino , Persona de Mediana Edad , Papillomaviridae , Prevalencia , Enfermedades Virales de Transmisión Sexual/epidemiología , Carcinoma de Células Escamosas de Cabeza y Cuello/diagnóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/epidemiologíaRESUMEN
BACKGROUND: Bolivia has the highest prevalence of cervical cancer in South America and the prevalence of viral sexually transmitted infections (STIs) among people in urban cities is increasing. Little is known about the prevalence of viral STIs in rural communities, which generally have limited access to health care. In order to study the prevalence of viral STIs in rural Bolivia, we recruited women from villages and towns in the Department of La Paz in Bolivia. METHODS: Three hundred ninety-four female participants were assessed for IgG-antibodies to herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV) and hepatitis B virus (HBV, anti-HBc), as well as for the presence of HBV surface antigen (HBsAg) in dried blood spots. The prevalence of 12 high-risk types of human papillomavirus (HPV) was assessed by qPCR in dried cervicovaginal cell spots from 376 of these women. χ2 test was used to compare variables between the populations and binary logistic regression was used to identify risk factors associated with the positivity of the tests. RESULTS: The seroprevalence of HSV-2 was 53% and of HBV 10.3%. HBAg was detected in 15.8% of women with anti-HBV antibodies indicating chronic infection. The frequency of high-risk HPV infection was 27%, with the most prevalent high-risk HPV types being HPV 56, 39 and 31 followed by HPV 16 and 18. Finally, none of the 394 women were seropositive for HIV, and about 64% of the studied population was positive for at least one of the viral infections. CONCLUSIONS: Women in Bolivian rural communities in La Paz show a high prevalence of HBV, HPV and, in particular, HSV-2. In contrast, none of the women were HIV positive, suggesting that the HIV prevalence in this population is low. The pattern of high-risk HPV types differed from many other countries with a predominance of HPV-types not included in the Gardasil vaccine which was officially introduced in Bolivia in April 2017.
Asunto(s)
Herpesvirus Humano 2/genética , Infecciones por Papillomavirus/diagnóstico , Enfermedades Virales de Transmisión Sexual/diagnóstico , Adulto , Anticuerpos Antivirales/sangre , Bolivia/epidemiología , Femenino , Genotipo , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Herpesvirus Humano 2/aislamiento & purificación , Humanos , Persona de Mediana Edad , Infecciones por Papillomavirus/epidemiología , Prevalencia , Riesgo , Población Rural , Enfermedades Virales de Transmisión Sexual/epidemiología , Adulto JovenRESUMEN
OBJECTIVE: The expanding use of human papilloma virus (HPV) testing within cervical screening requires an evaluation of public understanding of HPV. This study aimed to explore HPV awareness and knowledge using a previously psychometrically validated measure in a sample of UK women aged 25 years and over. METHODS: An anonymous web-based cross-sectional survey design was used, and responses were recorded for 246 women (mean age = 37.59, SD = 9.20). RESULTS: Findings indicated limits to women's understanding of HPV, its transmission, treatment and link with cancer. The mean HPV knowledge score was 9.35 (4.43), and the mean HPV testing score was 3.34 (1.91). Multivariate analyses revealed that information seeking following cervical screening and being a student is associated with higher HPV knowledge and that having a positive HPV test result and having university education is associated with higher HPV testing knowledge. CONCLUSIONS: These results highlight that there is a lack of knowledge and misunderstanding relating to HPV and its link with cancer in adult women in the UK. The findings suggest that public health HPV information campaigns are urgently needed, especially with a drop in UK cervical screening attendance rates, and with the upcoming change to HPV primary testing within the UK NHS cervical screening programme.
Asunto(s)
Detección Precoz del Cáncer , Conocimientos, Actitudes y Práctica en Salud , Infecciones por Papillomavirus , Enfermedades Virales de Transmisión Sexual , Neoplasias del Cuello Uterino , Adulto , Escolaridad , Femenino , Humanos , Conducta en la Búsqueda de Información , Persona de Mediana Edad , Prueba de Papanicolaou , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/terapia , Infecciones por Papillomavirus/transmisión , Vacunas contra Papillomavirus/uso terapéutico , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/prevención & control , Enfermedades Virales de Transmisión Sexual/terapia , Enfermedades Virales de Transmisión Sexual/transmisión , Encuestas y Cuestionarios , Reino Unido , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología , Frotis VaginalRESUMEN
BACKGROUND AND AIM: The incidence of acute hepatitis A [AH (A)] is decreasing because of improvements in hygiene; however, cases of sporadic severe hepatitis are still being reported. We assessed the epidemiology of AH (A) in Japan. METHODS: This was a hospital-based retrospective study, in which 126 AH (A) patients (96 men [76%], median age 39 [range, 19-66] years) were enrolled. Patients diagnosed with AH (A) before 2001 (n = 79) and after 2001 (n = 47) were compared. RESULTS: The incidence of AH (A) showed peaks in 1990, 1999, and 2018. After 2001, one patient had hepatitis B virus, four had human immunodeficiency virus, and three had syphilis coinfections. Before and after 2001, HAV was transmitted, respectively, by raw oysters (28% and 26%), overseas travel (19% and 28%), and sexual contact (0% and 19%) (P < 0.01). The frequencies of symptoms were appetite loss (51% and 32%), fever (63% and 81%), and diarrhea (3% and 13%) (all P < 0.05), respectively. On admission, the median levels of alanine aminotransferase (1455 and 3069 U/L) and γ-glutamyl transpeptidase (221 and 345 U/L) were significantly higher (P < 0.01), and the prothrombin time (77.5% and 65.9%) and platelet count (22.7 and 16.4 × 10/µL) were significantly lower after 2001 (P < 0.05). A time to normalization of the bilirubin level ≥ 30 days was associated with older age and a diagnosis of AH (A) after 2001. CONCLUSIONS: Outbreaks and severe AH (A) cases due to sexual transmission have been reported recently. It is necessary to examine their sexual behavior and other sexual infection.
Asunto(s)
Hepatitis A/epidemiología , Hospitales , Enfermedades Virales de Transmisión Sexual/epidemiología , Enfermedad Aguda , Adulto , Factores de Edad , Anciano , Biomarcadores/sangre , Coinfección , Femenino , Hepatitis A/sangre , Hepatitis A/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Conducta Sexual , Enfermedades Virales de Transmisión Sexual/sangre , Enfermedades Virales de Transmisión Sexual/diagnóstico , Factores de Tiempo , Tokio/epidemiología , Adulto JovenAsunto(s)
Complicaciones Infecciosas del Embarazo/diagnóstico , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedad Relacionada con los Viajes , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/transmisión , Aborto Espontáneo/etiología , Aborto Espontáneo/virología , Adulto , Femenino , Feto/virología , Humanos , Recién Nacido , Técnicas de Diagnóstico Molecular , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Reacción en Cadena en Tiempo Real de la Polimerasa , Virus Zika/genética , Infección por el Virus Zika/congénitoRESUMEN
Zika virus (ZIKV) is a re-emerging mosquito-transmitted flavivirus associated with congenital abnormalities in newborns and with Guillain-Barré syndrome in adults. The virus can also be sexually transmitted and can persist in the male genital tract. Studies evaluating the kinetics of ZIKV in seminal shedding of men who have been infected, as well as in animal and cellular models of infection, have shown that, in addition to the testis and epididymis, the prostate and seminal vesicles could also be involved in persistent ZIKV infection. Additionally, some studies have reported that men infected with ZIKV can present with genitourinary symptoms such as haematospermia, prostatitis, painful ejaculation, penile discharge, and oligospermia; however, little is known about the effect of ZIKV on fertility. Understanding the mechanisms that underlie persistent ZIKV infections in men is crucial to developing guidelines, effective vaccines, and therapies.
Asunto(s)
Genitales Masculinos/virología , Semen/virología , Enfermedades Virales de Transmisión Sexual/diagnóstico , Infección por el Virus Zika/diagnóstico , Virus Zika/aislamiento & purificación , Transmisión de Enfermedad Infecciosa , Femenino , Enfermedades de los Genitales Masculinos/diagnóstico , Enfermedades de los Genitales Masculinos/virología , Humanos , Masculino , Enfermedades Virales de Transmisión Sexual/transmisión , Enfermedades Virales de Transmisión Sexual/virología , Infección por el Virus Zika/transmisiónRESUMEN
Sexually acquired hepatitis C virus (HCV) infections among human immunodeficiency virus (HIV)-uninfected men who have sex with men (MSM) have been rare. With the introduction of preexposure prophylaxis (PrEP) against HIV, we hypothesized that these infections would increase. Between 2013 and 2018, we diagnosed 15 likely sexually acquired HCV infections among 14 MSM using PrEP. Most (87%) were asymptomatic, detected by routine alanine transaminase (ALT) or HCV monitoring. Half reported increasing sex partners and drug use after starting PrEP; 5 reported injection of methamphetamine. Interventions are needed to prevent sexually acquired HCV infections by MSM using PrEP. Centers for Disease Control and Prevention guidelines for monitoring during PrEP should include regular ALT and HCV testing.
Asunto(s)
Infecciones por VIH/prevención & control , Seronegatividad para VIH , Hepatitis C/diagnóstico , Enfermedades Virales de Transmisión Sexual/diagnóstico , Adulto , Genotipo , Hepacivirus/genética , Hepatitis C/virología , Humanos , Masculino , Profilaxis Pre-Exposición , Conducta Sexual , Minorías Sexuales y de Género , Enfermedades Virales de Transmisión Sexual/virologíaRESUMEN
Human papilloma viruses (HPV) are a small group of nonenveloped viruses belonging to the Papillomaviridae family with strong similarities to polyoma viruses. The viral particles consist of a genome in the form of a circular doublestranded DNA, encompassing eight open reading frames, as well as a nonenveloped icosahedral capsid. HPV infection is considered the most common sexually transmitted disease in both sexes and is strongly implicated in the pathogenesis of different types of cancer. 'Highrisk' mucosal HPV types, predominantly types 16, 18, 31, 33 and 35, are associated with most cervical, penile, vulvar, vaginal, anal, oropharyngeal cancers and precancers. Screening for HPV is necessary for the prognosis and for determining treatment strategies for cancer. Novel HPV markers, including proteomic and genomic markers, as well as antipapillomavirus vaccines are currently available. The aim of this comprehensive review was to thoroughly present the updated information on virus development, cancer occurrence, treatment and prevention strategies, in an attempt to shed further light into the field, including novel research avenues.
Asunto(s)
Carcinogénesis , Neoplasias/virología , Papillomaviridae/patogenicidad , Infecciones por Papillomavirus/virología , Enfermedades Virales de Transmisión Sexual/virología , Biomarcadores/análisis , Detección Precoz del Cáncer/métodos , Epitelio/virología , Femenino , Humanos , Incidencia , Masculino , Neoplasias/diagnóstico , Neoplasias/epidemiología , Neoplasias/terapia , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/terapia , Vacunas contra Papillomavirus/uso terapéutico , Proteómica/métodos , Factores Sexuales , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/epidemiología , Enfermedades Virales de Transmisión Sexual/terapiaRESUMEN
BACKGROUND: The aim of this study was to analyze the prevalence and treatment of sexually transmitted diseases (STDs) in gynecological practices in Germany. MATERIALS AND METHODS: This study included women who were followed in gynecological practices in Germany between 2013 and 2015. The first outcome was the prevalence of women diagnosed with STDs during this time period. Eight different types of STD infections were included in the analysis: chlamydial infection, gonococcal infection, anogenital warts, anogenital herpes infection, trichomoniasis, ulcus molle, phthiriasis, and syphilis. The second outcome was the prevalence of women with STDs who received appropriate medication within 90 days of STD diagnosis. RESULTS: There were 1,030,968 patients available for analysis. The most frequent infection was chlamydia (0.59%), and the least frequent one was syphilis (0.01%). The prevalence of STDs was found to be the highest in women aged 21 - 25 years (3.42%). Mean age at diagnosis ranged from 27.3 years (chlamydia infection) to 40.6 years (syphilis). Finally, the share of women receiving medication therapy was the highest for syphilis (83.3%) and the lowest for anogenital warts (52.7%). CONCLUSIONS: The prevalence of STDs ranged from 0.01 to 0.59% in women followed in gynecological practices in Germany between 2013 and 2015.â©.
Asunto(s)
Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Ginecología , Enfermedades Bacterianas de Transmisión Sexual/tratamiento farmacológico , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Virales de Transmisión Sexual/tratamiento farmacológico , Enfermedades Virales de Transmisión Sexual/epidemiología , Adulto , Femenino , Alemania/epidemiología , Humanos , Persona de Mediana Edad , Pautas de la Práctica en Medicina , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/virología , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenAsunto(s)
Enfermedades Bacterianas de Transmisión Sexual , Enfermedades Virales de Transmisión Sexual , Antiinfecciosos/uso terapéutico , Comorbilidad , Femenino , Humanos , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/prevención & control , Enfermedades Bacterianas de Transmisión Sexual/terapia , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/epidemiología , Enfermedades Virales de Transmisión Sexual/prevención & control , Enfermedades Virales de Transmisión Sexual/terapia , Sífilis/diagnóstico , Sífilis/terapia , VacunaciónAsunto(s)
Hepatitis C/transmisión , Homosexualidad Masculina , Matrimonio , Enfermedades Virales de Transmisión Sexual/transmisión , Sexo Inseguro , Adulto , Trazado de Contacto , Genotipo , Seroclasificación por VIH , Hepacivirus/genética , Hepatitis C/diagnóstico , Hepatitis C/virología , Humanos , Masculino , Persona de Mediana Edad , ARN Viral/genética , Factores de Riesgo , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/virología , Proteínas no Estructurales Virales/genéticaRESUMEN
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