The Better2Know Blog

What is Hepatitis C?

Hepatitis is a viral infection of the liver caused by the hepatitis C virus. The infection of the liver causes inflammation and eventually scarring when treatments are not instituted early.

Hepatitis C is spread primarily through blood contact with an infected individual or by blood products during transfusions. About 170 million people worldwide are infected with hepatitis C. Up to 80% of individuals recovers from the infection and gets cured. The remaining 20% leads to cirrhosis and may require liver transplant. In fact, most cases of liver transplant in the world occur because of hepatitis C infection. Other forms of hepatitis may have vaccines against it, however, not in the case of hepatitis C, which does not have vaccines yet at the present.

Transmission of Hepatitis C

Hepatitis C can be spread via the following mechanisms:

• Sexual intercourse
• Sharing if needles
• Having tattoo or piercing
• Sharing of razors and toothbrushes with infected individuals
• Placental transmission from the mother to the baby
• Blood transfusions of infected blood
• Needle-stick injuries from an infected needle

Hepatitis C Symptoms

The symptoms of hepatitis C is synonymous to the symptoms of all viral hepatitis infection, which include:

• Jaundice
• Lethargy, irritability, fatigue, weakness
• Myalgia and arthralgia
• Anorexia
• Nausea and Vomiting
• Right upper quadrant abdominal pain
• Diarrhoea
• Fever
• Flu-like symptoms
• Pruritus
• Dark urine
• Clay colored stools
• Bleeding tendencies
• Anemia
• Hepatic encephalopathy
• Asterixis or the rapid flexion and extension of the fingers

Hep C usually results in liver cirrhosis when managements are not instituted early. In order for early management, early detection is essential from the moment signs and symptoms appear.

Hepatitis C testing

Hepatitis tests involve blood tests including HCV antibody enzyme immunoassay, RNA polymerase chain reaction test or recombinant immunoblot assay. The tests for hep C are more reliable when checked one to two weeks after the exposure because antibodies usually form during these stages of the disease.

The drugs pegylated interferon alpha and ribavirin are used to treat hepatitis C.

Please contact Better2Know on the number listed above if you’re worried about Hepatitis C or to book your confidential appointment at one of our STD clinics throughout the UK and Ireland.

Human Immunodeficiency virus (HIV) is one of the dreaded STDs because it causes severe autoimmune deficiency and major complications. People with HIV usually keep the disease for themselves and are afraid of getting medical check-ups because of fear of embarrassment and social stigma.

What is Hepatitis B?

Hepatitis B is an inflammation of the liver, which involves the infection from a hepatitis B virus.

Hepatitis B is transmitted through the exchange of body fluids or blood in the case of:

• Sexual intercourse with an infected person
• Blood transfusion from an infected blood
• Contact with large amounts of saliva
• Sharing of contaminated needles in substance abuse individuals
• Needle stick injuries
• Contact with an infected needle from getting a tattoo, piercing or acupuncture
• Breastfeeding from an infected mother

Risk factors for Hepatitis B

Certain people are more at risk for acquiring hepatitis B. These include health care workers, people receiving multiple blood transfusions and dialysis, homosexual individuals who are sexually active, morticians, drug abusers using the parenteral route and those getting frequent tattoos or body piercings.

Hepatitis B symptoms

The hepatitis B symptoms are attributed to the damage on the liver, which include:

• Jaundice
• Lethargy, irritability, fatigue, weakness
• Myalgia and arthralgia
• Anorexia
• Nausea and Vomiting
• Right upper quadrant abdominal pain
• Diarrhoea
• Fever
• Flu-like symptoms
• Pruritus
• Dark urine
• Clay colored stools
• Bleeding tendencies
• Anemia
• Hepatic encephalopathy
• Asterixis or the rapid flexion and extension of the fingers

The hepatitis B symptoms usually present during the late stage of the disease. Hep B infection may also lead to complications such as brain damage as a result of unable to metabolize and excrete toxins from the body, leading to hepatic encephalopathy.

Hepatitis testing is important to determine the presence of hep B infection. Testing for hepatitis B involves the collection of blood samples and subjecting it to assays to determine presence of hepatitis B antigen and antibodies. The results of the tests are usually available 2 to 3 working days.

The treatment for Hepatitis B involves the administration of antiviral medications to reduce the symptoms and duration of the infection.  However, in some cases of acute hepatitis B, treatments are not instituted because adults can eliminate the disease by themselves because viral infections are usually self-limiting.

If you’re worried about Hepatitis B please contact Better2Know on the number above, to book your confidential appointment for a Hepatitis B Test today.

The diagnosis of HIV has increased dramatically from the time it was discovered in the 80s. Despite the increase in incidence, this is still far lesser than the actual number of people with HIV. This is for the reason that a lot of people fear to go for HIV testing even if they have a high risk of developing it. In fact, only 1% of the population in areas of HIV epidemic is tested. These leave other people with HIV still able to spread the disease because of not knowing that they are infected.

HIV is transmitted through sexual contact and exchange of body fluids of an infected person. HIV testing is performed by getting a sample of the venous blood. HIV tests involve the checking of HIV antigens and antibodies in the blood. Another test done is the CD4 T cells determination, which reveals a low CD4 T cells count as a result of immunosuppression.

Before, HIV tests could be slow and give results for a matter of days. In the advent of technology, there have been instant HIV testing techniques that are more convenient and cost-effective. However, more intensive diagnostic procedures such as the ELISA test and Western Blot test should still be performed in cases of a positive instant HIV testing to determine the extent of the disease and size of antigens.

Instant HIV tests include:

•Home Access Express HIV-1 Test

This is an FDA approved home HIV testing that involves the collection of blood sample through finger stick and sending the specimen through mail. The results are given via phone.

•OraQuick

This is an HIV test that involves the collection of blood, oral fluid or plasma and testing for antibodies using a stick-like device. The results are available after 20 minutes.

•Orasure

This involves the use of mucosal samples from the gums and cheek and checking for antibodies using ELISA and western blot.

•INSTI HIV Rapid Antibody Test

This test is used in clinical laboratories that can provide HIV test results as fast as 60 seconds. It involves the use of the patient’s blood, plasma or serum.

If you’re worried about HIV please contact Better2Know on the number given at the top of the page to book your confidential appointment for an HIV Test today.

A report published by drfox.co.uk shows that seven out of ten women regularly risk their health by having unprotected sex, with the average woman having unprotected sex eleven times with four different partners.  The reasons being given were they forgot in the heat of the moment (33%) and they trusted their partner not to have an infection (20%).  Surprisingly 18% said they were too drunk with 8% saying they didn’t like condoms.

New evidence shows that in addition to being a leading cause of Cervical Cancer in women, HPV (Human Papilloma virus) is also a leading cause or oral cancer and likely to lead to a major bone density loss.

HIV or Human Immunodeficiency Virus is the causative agent in the development of AIDS. HIV is usually asymptomatic with AIDS as the more debilitating form that causes life-threatening diseases.

The mortality rate from HIV is also high. Up to 90% of patient dies within 4 years of AIDS diagnosis. The most commonly affected individuals are those aged 20 to 49 years old. The risk for HIV increases with homosexual activity, heterosexual activity involving multiple sexual partners, repetitive anal intercourse, presence of genital lesions and unprotected sexual contact.

HIV infection can be transmitted through sexual contact, exposure to blood or blood products infected with HIV or placental transmission from an infected mother to the fetus. HIV may also be transmitted through sharing of needles with infected people, accidental needle stick and breastfeeding of babies by infected mothers. HIV infection is never transmitted through casual contact only. It should involve exposure to the infected person’s body fluids.

HIV testing is done to determine HIV infection. HIV tests involve four methods depending on the length or interval of exposure from the day of HIV test.

Instant HIV testing

This involves an antibody test for people who had an exposure at least 3 months from the testing. Instant HIV testing can be in the form of HIV DNA test or HIV DUO test. This method is available from various HIV clinics.

HIV RNA PCR test

This involves blood tests for exposure that occurred more than 10 days from the day of the testing.

HIV DUO test

This test can be done to detect HIV infection from exposures that occurred more than 28 days from the day of testing.

HIV Antibody Test

This involves tests for people who had an exposure at least 3 months from the testing.

HIV tests involve the testing for HIV antibodies such as IgG or IgM. HIV antigens are also detected to determine the extent and severity of the disease. Additional blood tests may include the determination of the CD4 T Cell count, which is usually decreased in Human Immunodeficiency Virus or AIDS infection.

If you’re worried about HIV please contact Better2Know on the number above to book your confidential appointment for an HIV Test today.

Hepatitis is a growing problem, and the numbers of people with undiagnosed hepatitis is growing. If you are worried that you might be one of them, then this may be a good choice of screen for you. Better2Know launched its hepatitis screen in April 2012, and it is popular with our patients who have a specific worry.

The hepatitis screen needs a blood sample and the results are available the same day as the sample is received in the laboratory.  It is available in any of our STD clinics across the UK.

The screen tests for:

• Hepatitis A
• Hepatitis B
• Hepatitis C

The hepatitis screen can be done 28 days after any incident you are concerned about.

If you have any questions please call the Better2Know booking team on the number above who are waiting for your call 24 hours a day, 7 days a week.

The Chlamydia infection is a sexually transmitted disease (STD) caused by a bacterium called Chlamydia trachomatis. It is transmitted through sexual contact among individuals who have had multiple sexual partners. Chlamydia is a very contagious sexually transmitted disease which accounts for most of the STDs that have been reported. In fact, the occurrence of Chlamydia is three times the incidence of gonorrhea.

Symptoms of Chlamydia are often similar to the symptoms of Gonorrhea, so a definite diagnosis should be made to come up with the right treatment. Some individuals are asymptomatic and may experience manifestations later in the disease when complications arise.

Chlamydia symptoms in women

Half of women with Chlamydia are often asymptomatic. Female Chlamydia symptoms include:

• Mucopurulent discharge from the vagina and urethra
• Clear to white discharges coming out of the rectal area
• Painful urination or dysuria
• Rectal pain
• Edema on the cervix
• Post-coital bleeding
• Bleeding between periods or mid-cycle spotting
• Painful sexual intercourse of dyspareunia
• Abdominal Pain

More advanced disease may lead to salpingitis (inflammation of the fallopian tubes) and liver inflammation.

Complications of Chlamydia in Women

Chlamydia often leads to infertility in women as a result of inflammation in the fallopian tubes which results in constriction of the fallopian tubes. The egg cells are unable to travel through the tubes to meet sperm cells for fertilization. If this is not the case, the egg cell may be fertilized, yet, not able to travel to the uterus for implantation causing ectopic pregnancy.

Chlamydia infection may also be detrimental among pregnant women. The bacteria can lead to infection and cause amnionitis that may affect the growing fetus. However, it is never transmitted through placental perfusion, but may affect the neonate during vaginal delivery leading to eye infections. In cases of Chlamydia infections during pregnancy, an elective cesarean section is usually planned and employed to prevent contact of the neonate with the Chlamydia bacterial infection.

Treatment for Chlamydia usually involves the administration of the antibiotic doxycycline for 7 days or longer depending on the severity of the disease.

If you’re worried that you may have Chlamydia please contact Better2Know on the number above and book a quick and confidential appointment for a Chlamydia Test to put your mind at rest.

Syphilis is a systemic sexually transmitted disease caused by the spirochete Treponema pallidum. The organism enters the body through abraded skin or intact mucous membrane exclusively by direct sexual contact. The transmission happens when there is contact with the syphilitic lesion. After the entry in the reproductive tract, the organism spread through the body by the lymphatic system and blood circulation.

When the spirochete reaches the organs in the body, it usually causes severe complications such as aneurysms.

Syphilis is the third most common STD, but its prevalence has been reduced due to the advent of antibiotics.

The risk factors for syphilis include being an adolescent, young adult, homosexual male or having multiple sexual partners.

Syphilis has four stages. The presence of syphilis symptoms differ at each stage. These include:

1. Primary stage – This stage involves the appearance of chancre and enlargement of the lymph nodes. Chancres are oval ulcers that appear on the genitals, anus or mouth. These sores disappear after 4 to 6 weeks.

2. Secondary Stage – This stage occurs 2 weeks to 8 months after the disappearance of the chancre. This stage involves the appearance of Condylomata lata, a highly contagious, broad based flat papules that develop in the labia, anus or corners of the mouth.

3. Latent Stage – This stage occurs 2 or more years after the appearance of primary lesions. In this stage, there are no symptoms and transmission is not possible through sexual contact. Some patients remain in this stage.

4. Late Stage – This stage of infection involves affectation of the other organs such as joint inflammation, bone disorders, aneurysms, heart valve involvement and CNS disorders. This stage, however, is not infectious.

Syphilis Test

Syphilis testing is important to prevent progress of the disease due to prompt treatment. Syphilis tests involve the collection of blood samples for laboratory testing such as the treponemal and non-treponemal syphilis tests including VDRL tests.

When the diagnosis is ascertained, treatment for syphilis usually includes the administration of antibiotics, specifically penicillins. Early stages of syphilis may only require a single dose of intramuscular penicillin. Late stages may require more frequent administration.

If you’re worried about Syphilis please contact Better2Know on the number above to book your confidential appointment for a Syphilis test today.

In advance of World Hepatitis Day this Saturday 28 July, The Hepatitis C Trust warns that high numbers of people remain unaware of the risks associated with the virus, which if left untreated can cause cirrhosis, liver cancer and even death.

Better2Know is now offering the latest in rapid HIV testing at many of its locations.  This HIV test gives results in just 20 minutes with over 99% accuracy just 26 days post your potential exposure. (The number of days is a minimum – so you can take the test at any time starting at day 26).  This test looks for HIV I and II antibodies as well as the p24 antigen.

This HIV test is available in:

London

Belfast

Cardiff

Cheltenham

Chichester

Edinburgh

Guildford

Liverpool

Manchester

Milton Keynes

Newcastle

Oxford

Portsmouth

Sheffield

Swansea

If you have any questions or want to book, please call us on the number above.

Herpes infection is a sexually transmitted disease caused by the herpes virus. Herpes has two types: Herpes simplex type 1 and herpes simplex type 2. Herpes simplex type 1 is otherwise known as oral herpes while herpes simplex type 2 is genital herpes.

The FDA (Food and Drug Administration) in the United States, has approved the use of a drug called Truvada to prevent HIV.

Home STD testing is now available to diagnose STD’s without going to STD clinics. This is sometimes a more conventional way for STD testing because it saves time and also avoids stigma for the patient that goes for the diagnosis of STD. Patients are usually reluctant to go for tests because they fear being judged by other people. Home STD testing is the solution for the problems of patients who want to be tested for STD and is reliable, cost efficient and confidential.

STD’s vary and can include:

• HIV/AIDS
• Gonorrhea
• Syphilis
• Chlamydia
• Herpes (Herpes simplex Virus type 2)
• Genital warts or Human Papilloma Virus infection
• Hepatitis B
• Hepatitis C
• Ureaplasma
• Mycoplasma
• Candidiasis
• Trichomoniasis
• Non-specific Urethritis

The advantage of the Home STD test is the patient can choose whether to test the presence of most, if not all, of the STD’s or can choose what STD to check, depending on the possible exposure of the individual. Symptoms of STD’s are usually vague and often resemble each other, which makes the Full STD screening advantageous.

STD clinics offer home STD test kits that can be applied online. The home STD test kits are usually mailed to recipients where they collect urine samples and resend it back to STD clinics for testing. In this way, patients don’t have to be present for testing. Results are also reliable and quick and are sent to the recipient again. Results may also be checked online.

Home STD test kits compose of a specimen bottle for urine. These are mailed through posts from the online store or clinic. After which, the container is mailed back using prepaid postage. Results are available after 3 days or more depending on the STD to be checked.

By using the home STD kits, the privacy of the individual is protected. Private STD clinics also allow the use of false or anonymous names to protect the client. In addition, STD clinics also do not share the information to third parties, thereby ensuring confidentiality and maintaining privacy of the client.

Chlamydia is a sexually transmitted disease caused by the bacterium Chlamydia Trachomatis. It infects the reproductive tract and may lead to possible inflammations of the abdominal organs. Chlamydia is the most common sexually transmitted disease with an incidence of 2 million cases per year. Chlamydia is transmitted through intimate sexual intercourse.

A report by the National AIDS Trust has found that police advice on dealing with their own risk of HIV and that of people in custody is outdated and inaccurate.

A study based in four different settings in London found that by testing people (regardless of their risk profile) for HIV.  The HINTS study was conducted between August 2009 and September 2010, in an A and E dept, inpatients dept, a skin conditions clinic, and a large GP practice.

As reported in our blog on 18 May 2012 the FDA in the US has now approved an over the counter HIV test which can provide a result at home in 20 to 40 minutes.  The test uses saliva which does have a higher rate of false positives, but recommends that all positive tests are followed up with a blood test.

The Health Protection Agency (HPA) has called for everyone in the UK to be tested for HIV. The HPA’s Annual Report states that the number of people who are living with HIV in the UK is now just under 100,000, but more than 21,000 (I in 4) of these do not know that they have the virus.  Increasing the number of people who are tested would help early diagnosis, which has two benefits:

• early treatment and medical intervention is key to preventing the disease from progressing
• prevents new infections

Currently, 1 in 5 people attending a GUM clinic refuse an HIV test and are only tested for Chlamydia, gonorrhoea and syphilis.  This is because they are scared to know their status, or do not think it can happen to them. If you think you may be at risk of catching one STD, you cannot tell which one it might be, which is why Better2Know offers a comprehensive screening choice and range of tests.

The HPA also reported that the standard of care in the UK for people with HIV is excellent with excellent access to treatment and lower than expected CD4 counts (a measure of the progress of the infection).

Better2Know offers HIV testing at 10 days after potential exposure (such as unprotected sex) using an advanced technique looking for the actual HIV virus, and then the 28 days after potential exposure test called the H- Duo which looks for both the antibodies and the antigen (the body’s reaction to being infected with the virus).  The Terrence Higgins Trust recommends testing:

• immediately you are worried – to get initial peace of mind, but also help with contact tracing should you later be HIV+
• at 28 days with the H-DUO test
• at 3 months
• at 6 months

Better2Know only uses blood tests (not saliva which is less reliable) to test for HIV.  Instant (up to 20 minutes) tests for HIV are also available in some of our clinics.  HIV tests at 10 and 28 days post potential exposure are available at all our Nationwide clinics.

A new study published by the BMJ shows that the UK’s national screening programme for chlamydia which started in 2000, and aimed to test all 16-24 year olds, has meant a significant decreased in the prevalence of the infection.

The number of new cases of gonorrhoea rose 25% in 2011 from the year before in England.  There are now cases of gonorrhoea (a bacterial infection) in Japan and Europe which so far have failed to respond to antibiotics which are used to cure the Sexually Transmitted Infection (STI).

In a new survey of General Practitioners (GPs) in South East London, where more than 2 in 1,000 of the population is HIV+ (the highest in the UK), Family Doctors reveal why they do not routinely give their patients HIV tests:

The below is the abstract to a report which shows why men as well as women should be tested for Gardnerella.

Although the incidence of Hepatitis C in the UK is relatively low, A study conducted using residual sera collected as part of the HPA Sero-epidemiology programme suggested that around 106,000 individuals became infected with hepatitis C between 1986 and 2001 (HPA 2009 report Hepatitis in the UK).

Primary prevention of hepatitis C infection involves a variety of practical measures, some aimed particularly at risk groups, and other more general measures to ensure that the national blood supply is safe through donor selection and screening. Rates of HCV-related serious liver disease are increasing. Unfortunately, many people living with hepatitis C are unaware of their infection status, resulting in a silent reservoir of infection in society.

An important part of the overall strategy to control hepatitis C is to improve awareness of the infection and encourage testing in risk groups. Once diagnosed, effective treatment can help eliminate a persistent infection, in at least some patients, and so reduce the number of infected individuals. Treatment before the onset of recognisable disease reduces the progression to late complications of infection. Patients who respond to therapy by clearing the virus can avoid the risk of serious liver damage. Among patients who do not respond to therapy, the risk of developing long-term liver damage can be reduced by modifying other risk factors, such as alcohol consumption and avoiding infection with other hepatitis causing viruses.

Having a clear strategy is only the first step in achieving a real impact. Equally important is the delivery of interventions and review of their efficiency.

Progress made to date in the UK varies from country to country, reflecting the different stages of implementation of hepatitis C control programmes and the different approaches taken in the different administrations. A four nations approach will encourage the sharing of good practice and help to identify best practice.

The number of deaths in England due to end-stage liver disease (ESLD) or hepatocellular carcinoma (HCC) with any mention of hepatitis C on the death certificate continues to increase. The number of deaths registered has increased from 81 in 1996 to 230 in 2008. The majority of deaths are in men. The number of deaths in women has remained relatively stable over the last decade.

It is clear from the above facts and report from both the Hepatitis C Trust and the Health Protection Agency, that there is a very considerable health gain from the detection of a Hepatitis C infection. A gain to be enjoyed not only by the individual in whom the infection is detected, where if it had remained undiagnosed, might have lead to cirrhosis, cancer and possibly death, but gains also to society, where infection rates remain on the rise, are recognised by the HPA to be a national health risk, and for which detection of each case can lead to treatment, and the prevention of onward transmission of the disease.

Leaving Hepatitis C undetected can lead to severe complications.

HIV (Human Immunodeficiency Virus) is a retrovirus that can lead to Acquired Immunodeficiency Syndrome (AIDS), a condition in which the immune system begins to fail, leading to life-threatening infections we ordinarily would be able to fight naturally.

You can reduce your chances of catching and/or transmitting an STI or STD by following the suggestions: