Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?

Chlamydia is a Sexually Transmitted Disease. It is generally found in men and women under the age of 25. Researchers have found that in the United States about 2.9 million individuals develop this disease every year. 

Here are things that you must know about the disease:

What is it all about?
It is caused due to bacterial infection and is transferred sexually. You can be infected with disease by having vaginal, oral or anal sex with the patient. You must be aware of the fact that you can develop chlamydia even if your partner doesn t ejaculate inside your vaginal tract. If you had suffered from this disease in the past, you can still get it again by having unprotected sex with an infected person.

What are the symptoms of this disease?
There aren t any obvious symptoms for this disease. Most of the patients show no sign of developing this disease. Thus, you never get to know when you were infected actually. However, some patients do reflect some symptoms after 4 to 5 days of infection. These symptoms include abnormal penis or vaginal discharge and painful, burning urination. Men can also develop a bleeding rectum.

How do you know for sure that you are infected?
Well, you can get yourself tested to confirm about the infection.

What happens if you don t get treated?
If the patient doesn t seek medical help, he or she is posing threat to his or her health. Women may develop pelvic inflammatory diseases, infertility or ectopic pregnancy. In men, it can cause pain and fever as the infection spreads along the tube carrying sperm.

Is there any treatment?
This disease is curable. But it is important to avoid sexual contact with anyone during the period of treatment or medication. First, you need to undertake the test to confirm the infection. You shouldn t have sex for seven days after the treatment is over. It is advisable to get yourself tested thrice in a year.

Chlamydia - Things You Must Know About It!

Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

How Can We Achieve HIV-Free Generation?

In most diseases, early detection of the disease is the key to control the symptoms, cure, reduce progression and improve prognosis. This holds true for sexually transmitted diseases too. As soon as there is a mild degree of suspicious of having contracted a sexually transmitted disease, it is advisable to go for a test. Most of the STDs can develop into serious complications over a period of time, ranging from infertility to even death.

Complications: Why early diagnosis is important: When left undiagnosed and untreated, most STDs progress to cause severe damage from sterility to cancer to even death. Listed below are some complications associated with each of the common STDs.

Chlamydia: If left untreated, can lead to epididymitis and testicles shrinking and infertility in males. This is a condition where there is pus formation in the scrotum. In women, it can lead to pelvic inflammatory disease which is deep-seated and unable to cure completely. This brings with it symptoms ranging from abdominal pain to uterine infections to sterility.
Syphillis: Undiagnosed syphilis can lead to blindness and deafness. It can also be passed onto the newborn and lead to severe disabilities.
Gonorrhea: If diagnosed early, it can be cured completely with antibiotics. However, if left untreated, it can lead to infertility.
HIV/AIDS: Early diagnosis can help in curtailing the disease. If detected late, then the damage is quite extensive and treatment is both expensive and cannot help restore a lot of functions. 
Symptoms of Sexually transmitted diseases: If there is a doubt of having contracted an STD, then it is very important to get tested for the same. Some of the most common symptoms are listed below.

Women: The most common symptoms in women including painful urination, burning sensation, abnormal vaginal discharge (sometimes bleeding), warts, and abdominal pain.
Men: Testicular pain, urethral pain, painful urination, pain and inflammation in the prostate, sores, fever, and abdominal pain.
Prevention: Always practice safe sexual practices. When in doubt, refrain from sex until diagnosis and treatment is complete.

Testing for STDs: Some of the standard tests include:

1. Herpes- HSV I & II - 
2. Testing HIV-- Kits and ELISA available for testing 
3. Blood test for syphilis antibodies 
4. Chlamydia and Gonorrhoea - from urine as well as swabs for culture
It is understandable that getting tested for STDs is an embarrassing situation. However, there are options available where anonymity can be maintained when getting tested for STDs. This is a wise choice to make as the risk is not just for the person affected but for the partner and in some cases even for the fetus. Early testing can help prevent complications like infertility and cancer.

STD Testing - Why You Should Never Delay?

Sexually Transmitted Diseases (STDs) are the infections that spread primarily from unprotected sexual intercourse or any kind of sexual contact. Men, like women, are equally prone to contracting STDs on having unprotected sexual intercourse; anal, vaginal or oral. Having multiple sex partners just increases the risks of it. So, you need to consult a specialist sexologist if anything these sort of things happening to you:

Common STD Symptoms in Men

Blisters on or around penis 

Spots, bumps or lesions on the penis 

Discharge (clear, white, or yellow) 

Oozing from the tip of the penis (thick or thin) 

Painful urination 

Painful ejaculation 

Itching on the tip of the penis 

Rash on the penis, testicles, or groin

Here is a list of STDs for men

Chlamydia- Chlamydia is a type of bacterial STD transmitted during oral, anal or vaginal sex with an already infected person. Some of the symptoms of Chlamydia in men are swollen testicles, penile discharge or pain while urinating.

Gonorrhea- This is another bacterial infection, majorly affecting the urethra, anus or the throat and primarily spreads through vaginal, oral or anal sex with someone already suffering from it. The symptoms are quite similar to those of Chlamydia.

Hepatitis B- Hepatitis B Virus (HBV) is the cause of the disease Hepatitis B and can cause severe inflammation of the liver. It spreads from one person to the other on coming into contact with the bodily fluids or blood of the person affected. Few signs of Hepatitis B include jaundice, vomiting, nausea, body aches, mild fever, lethargy and appetite loss.

Herpes (Simplex) - It is a viral infection caused by the herpes simplex virus (HSV) and generally tends to develop on or near to the mouth and the genitals. Primarily, herpes spreads through direct contact with the genitals or mouth of a person already diagnosed with the same.

Syphilis- Another bacterial Sexually Transmitted Disease, unprotected oral, vaginal and anal sex are the primary carriers of this disease. It is considered to be one of the most serious STDs because the risks of contracting HIV (Human Immunodeficiency Virus) get magnified once infected with Syphilis.

Human Papillomavirus (HPV) - In men, HPV is capable of causing cancers in the throat, anus or the penis. It is either passed on through skin-to-skin or unprotected sexual contact with an infected partner.

Preventing STDs

Many people can be infected with an STD without experiencing any visible symptoms. This means that practicing safe sex is crucial if you want to prevent STD infection.

The only way to completely prevent an STD is abstinence from any type of sexual contact or contact with open sores and bodily fluids of an infected person. But there are other ways to prevent STDs too.

Condoms during intercourse and dental dams or barriers during oral sex are proven effective when used correctly. Refraining from sex with multiple partners and instead opting for a monogamous sexual relationship can also help to prevent STDs. To understand it better and get treated you can always consult a sexologist.

Common STDs in Men

Gonorrhea : Disease + Symptoms

Gonorrhea is a contagious disease that can affect both men and women. It is caused by a bacterium called Neisseria gonorrhoeae that can easily grow in the mucus membranes of the human body.

It is mostly transmitted when an uninfected person gets in sexual contact with an infected person. It can also be spread when a mother's infected body fluids come in contact with her newborn during childbirth.

It is a common infection and the symptoms vary for both men and women. The symptoms are:

Symptoms in Women:

- White or greenish-yellow vaginal discharge
- Burning sensation while urinating
- Pain in the lower abdomen and in the pelvic region
- Occurrence of Conjunctivitis
- Spotting or light bleeding after sexual intercourse
- Bleeding between periods
- Vulvitis

Symptoms in Men:

- White or greenish-yellow discharge from the penis
- Swelling and pain in the testicles
- Burning sensation while urinating

The symptoms come to notice usually within 2 to 10 days of the infection in case of women and it takes approximately 14 days for them to be recognized in the case of men. However in a few cases, the symptoms may take as long as 30 days to appear or they may appear so negligibly that they are hardly noticeable if they occur at all.



Gonorrhea is Contagious. But is it Only Sexually Transmitted?

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