SEXUALLY TRANSMISSIBLE DISEASES CAUSED BY HERPES-SIMPLEX, WART, HEPATITIS-B, AND HUMAN IMMUNODEFICIENCY VIRUSES

Sexually transmissible diseases (STD), caused by viruses are by far th e most important ones, even though German legislation has ignored them up to now as STD. Anogenital herpes is easily diagnosed by means of m onoclonal antibodies. This makes therapy available with acyclovir with out delay in atypical cases or for example in persons with immunodefic iency. The therapy regimen usually is 5x200-400 mg/day. Recurrent herp es in high frequency and with severe pain may be successfully suppress ed by 2-5x200 mg/day of acyclovir orally without serious side effects. This will not eliminate herpes viruses. Anogenital warts may look ver y different and occasionally cannot be detected before local applicati on of 3% acetic acid. Histology is diagnostic. There are different str ains causing diseases in men. Therapy of choice is destroying infected cells by CO2-laser coagulation. The incidence of hepatitis B in devel oped countries is decreasing slowly within the past years, this may pa rtly be due to vaccines, that are available since the early eighties, producing immunity in about 95%. Treatment of chronic hepatitis with i nterferons seems to be beneficial. Infections with the human immunodef iciency virus (HIV) and their end stage disease AIDS are a growing pro blem all over the world. Interventions are possible with different nuc leoside analogs, e. g. zidovudin (AZT), dideoxycytidin (DDC), dideoxyi nosin (DDI). Up to now there is no agreement on when to start with one of the drugs and if or when to switch to combination therapy. Hopeful ly this may stabilize immunologic parameters and hold disease progress ion to some time.