Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There are certain special considerations in the management of sexually transmitted diseases (STDs) in homosexual men, with the impact of human immunodeficiency virus (HIV) infection on the presentation, diagnosis, and management of certain STDs just becoming apparent recently. Rectal and pharyngeal gonorrhea are usually asymptomatic and also more difficult to treat. The serological diagnosis of syphillis may be unreliable in acquired immunodeficiency syndrome (AIDS) patients, and HIV-seropositive homosexual men may be at risk of accelerated progression to neurosyphilis, despite treatment with benzathine penicillin. Chlamydia trachomatis is infrequently detected in patients with proctitis so therapy should be directed only at culture-positive cases. Herpes simplex is usually severe and persistent in immunosuppressed patients and may be further complicated by the development of acyclovir-resistance. Concurrent HIV infection may be associated with increased infectivity of homosexual chronic hepatitis B carriers, but milder hepatic injury and reduced efficacy of hepatitis B vaccines and immodulatory or antiviral agents. Although there is some concern regarding the possibility of increased risk of anal cancer in homosexual men, conservative management of human papilloma-virus-associated conditions is advised. The carriage of Entamoeba histolytica in this group is rarely associated with any deleterious effects and treatment should be directed only at symptomatic patients in whom other enteric pathogens have been excluded.
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PMID:Sexually transmitted diseases and enteric infections in the male homosexual population. 220 14

Physicians treating adolescents should take a complete sexual history, including sexual orientation and practices, to determine whether their patients are homosexually active. Lesbians are at very low risk for sexually transmitted diseases, but they do have other health concerns. Four general groups of conditions may be encountered in homosexually active men: classical sexually transmitted diseases (gonorrhea, infections with Chlamydia trachomatis, syphilis, herpes simplex infections, genital warts, pubic lice, scabies); enteric diseases (infections with Shigella species, Campylobacter jejuni, Entamoeba histolytica, Giardia lamblia, hepatitis A, hepatitis B, hepatitis non-A, non-B, and cytomegalovirus); trauma (fecal incontinence, hemorrhoids, anal fissure, foreign bodies, rectosigmoid tears, allergic proctitis, penile edema, chemical sinusitis, inhaled nitrite burns, and sexual assault of the male patient); and the acquired immunodeficiency syndrome (AIDS). Clinicians can assist homosexual teenagers by understanding their special health needs, by counseling them about safe sexual practices, and by accepting their relationships nonjudgmentally.
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PMID:Medical problems of the homosexual adolescent. 383 19

Lymphogranuloma venereum is a sexually transmitted disease caused by L1, L2, and L3 serovars of Chlamydia trachomatis. In the last 10 years outbreaks have appeared in North America, Europe, and Australia in the form of proctitis among men who have sex with men. Three stages of disease have been described. The disease in primary stage may go undetected when only a painless papule, pustule, or ulceration appears. The diagnosis is difficult to establish on clinical grounds alone and frequently relies upon either serologic testing, culture, or more recently, nucleic acid amplification testing of direct specimens. A proper treatment regimen cures the infection and prevents further damage to tissues. Lymphogranuloma venereum causes potentially severe infections with possibly irreversible sequels if adequate treatment is not begun promptly. Early and accurate diagnosis is essential. Doxycycline is the drug of choice. Pregnant and lactating women should be treated with erythromycin or azithromycin. Patient must be followed up during the treatment, until disease signs and symptoms have resolved. Repeated testing for syphilis, hepatitis B and C, and HIV to detect early infection should be performed.
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PMID:Lymphogranuloma venereum: diagnostic and treatment challenges. 2587 May 12