Sexually Transmitted Diseases: Diagnosis and Work-Up (GC, Chlamydia, Herpes, HPV)

Abstract

There is an array of tests available to diagnose each of the above sexually transmitted diseases. Each test has its own sensitivity, specificity, and specific clinical situation for which it is ideally situated. Nucleic acid amplification tests (NAATs) tend to have the highest sensitivity and specificity when testing for gonorrhea and chlamydia. However, depending on the clinical scenario and site to be tested, there may be other tests which are better suited. Testing for HSV lesions has variable sensitivity and specificity based on the time interval between testing and outbreak and amount of viral shedding. To negate this variability, indirect testing which exams the patient’s blood for antibodies to HSV has been created. This test can detect antibodies against HSV, even after lesions have resolved. The human papillomavirus is extremely prevalent worldwide. Cytology and HPV co-testing still remain the gold standard for diagnosing and triaging HPV. A thorough knowledge of the common presentation, available testing, and current treatments is essential for all healthcare providers. Early detection, diagnosis, and treatment will prevent continued spread to other parties and decrease morbidity in patients.

The purpose of this chapter is to present the current standards for diagnosis and treatment of sexually transmitted diseases. In this text, presentation, diagnosis, and treatment of the sexually transmitted diseases, gonorrhea, chlamydia, herpes simplex virus, and human papillomavirus, are discussed. In order to obtain the most current and accurate data, a comprehensive literature review was performed for each of the abovementioned sexually transmitted diseases in regard to presentation, available screening and diagnostic testing, and treatment. The CDC database was cross-referenced to confirm concordance in the treatment of the abovementioned sexually transmitted diseases.