Diagnosis and treatment of viral STDs in women

Viral sexually transmitted diseases (STDs) are a major health problem for women. Over many years the incidence of these infections has increased steadily to epidemic proportions. These infections not only cause short-term morbidity but also have been associated with significant long-term morbidity and mortality. This paper focuses on two of the most common viral STDs- Genital Herpes Simplex Virus (HSV) infection and Human Immunodeficiency Virus (HIV) infection of the female. The steady increase in the incidence of HIV infection and subsequent adult immunodeficiency disease (AIDS) among women requires health care providers to assume an active role in detection and treatment in order to avoid transmission, to protect the health of women with HIV/AIDS, and to reduce the risk of maternal-fetal (vertical) transmission. Because treatment with zidovudine has been shown to reduce vertical transmission, routine offering of HIV testing is currently recommended for all pregnant women. The approach to testing nonpregnant patients, i.e., the choice between selective screening or routine testing, rests with the individual clinician. Testing large numbers of patients within a practice may be facilitated by the availability of an oral antibody testing system. The sensitivity and specificity of the oral test is equivalent to blood testing. Serum and oral specimens are tested by enzyme-linked immunosorbent assays (ELISA) and confirmatory Western blot assays specifically designed for use with oral samples. Controversies in diagnosis as well as the most updated treatments for these infections are discussed.