In the last column, I discussed general information about sexually transmitted diseases and more detailed information on bacterial STDs. In this column, I’ll pick up where I left off and cover viral STDs in more detail.
Human papilloma virus, herpes, hepatitis and HIV are the most common viral STDs.
There are many types of HPV. Some cause genital warts and others cause cervical and other cancers. Genital warts and precancerous cervical lesions caused by HPV can be successfully treated. Cervical and other cancers caused by HPV are more treatable when they are caught early, but as with most cancers, can be deadly. We now routinely test for the cancer-causing types of HPV along with the pap smear for women starting at age 30. HPV infections and the health problems they cause can be prevented by a vaccine. Ideally, boys and girls should get vaccinated at around 11 or 12 years of age. Vaccination well before a young person becomes sexually active confers the most protection against HPV and could save your child from getting cancer as an adult.
There are two types of herpes simplex virus, type 1 (HSV-1) and type 2 (HSV-2). Genital herpes is most often caused by HSV-2. HSV-1 usually causes cold sores. Infection causes painful blister-like sores on or around the mouth or genitals that take a week or more to heal. After initial infection, outbreaks of these sores can recur throughout your lifetime. Future outbreaks are typically less severe than the first outbreak and the frequency of outbreaks may decrease over time. Treatment of herpes involves medication that can prevent or shorten outbreaks and make it less likely that you will pass your infection on to others.
Hepatitis A (HAV), B (HBV) and C (HCV) can each be transmitted through sexual contact; however, it is much more common for HBV to be transmitted this way than it is for the other two. HAV causes short-term illness whereas HBV and HCV can cause both short and long-term infections.
Hepatitis generally causes fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowl movements, and jaundice. Hepatitis A is “self-limited” meaning that you get over it and become immune. Hepatitis B if caught as an adult usually goes away and you become immune, but Hepatitis C usually becomes chronic and lifelong. Both chronic Hepatitis B and C can be treated with antiviral medications that for the most part can clear the infection. If the infection is not cleared they can cause cirrhosis and liver cancer, both of which can be fatal.
Vaccines are available to prevent HAV and HBV. Both of these viruses are transmittable through mechanisms other than sexual activity, so vaccination is the best way to prevent infection via any route.
HIV, or human immunodeficiency virus, can be caught through sexual contact or through contact with blood or body fluids. It is generally fatal over a period of years if not treated. There are good treatments, but they require continuous and disciplined use of anti-viral medications. Individuals who choose lifestyles that increase their risk of HIV can take medications daily to decrease the risk of infection through a practice known as PREP, or pre-exposure prophylaxis.
Reduce your risk of getting or transmitting an STD by being in a long-term mutually exclusive relationship with a partner who has been tested and has negative STD test results and by using latex condoms the right way every time you have sex. If you do become infected, do not hesitate to see your health care provider because there are treatment options available.
Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.
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