One in five Americans has a sexually transmitted infection (STI). Gaps in testing and patient care exacerbate an existing challenge as health systems shift their focus back to pre-pandemic operations.
Many STIs have no symptoms and are highly transmissible. Some can not be treated easily while others have developed resistance to antibiotics.1 In worst-case scenarios, untreated STIs may cause complications, such as infertility, ectopic pregnancy, sepsis, pelvic inflammatory disease, meningitis, stroke, cranial nerve palsies or even death.2-7 Fortunately, most STIs can be easily detected, with symptoms treated and often cured.
Sexual health is threatened by higher prevalence of existing STIs and newer infections with ambiguous transmission rates. It’s never been more important to provide accurate testing information quickly to doctors and their patients for assessing risk and helping to diagnose, monitor and treat patients.
Chlamydia, caused by Chlamydia trachomatis, historically accounts for the largest proportion of reported STIs in the United States. It often doesn't cause symptoms and is easily spread, so people may not know that they have it. Cases of chlamydia are highest among adolescents and young adults, which account for two-thirds of all reported cases.8 Roche has created a dual target test with internal control to provide confidence in test results.
Over the last decade, cases of gonorrhea have grown by more than 100%, which makes it the second most common reportable STI.8 Infection with Neisseria gonorrhea may often have no symptoms, especially in women. While easily treatable, the U.S. saw the first cases of gonorrhea in 2023 that showed resistance or reduced response to five classes of antibiotics for gonorrhea.9 Accurate diagnosis and appropriate treatment are necessary for reducing cases of gonorrhea. Roche’s commitment has created a dual-target test with internal control to provide confidence in test results.
Syphilis rates have surged in the past few years, hitting a 70-year high in 2021.10 The disease has been discovered at a much higher rate in newborns and, in some cases, resulted in stillbirths and infant deaths. Syphilis is easily treatable, especially when diagnosed in the earlier stages of infection.11
Sexually acquired hepatitis infections remain a public health problem. An estimated 35% to 50% of acute HBV infection in the United States is attributed to sexual transmission, and even less for HCV.12 The rate of co-infection for HCV and HIV is high.13
Hepatitis causes inflammation of the liver, which can seriously damage its function. Of all the five hepatitis strains, hepatitis B and hepatitis C can lead to chronic disease, liver cirrhosis, liver cancer and death.
Recent efforts to combat these strains include new CDC screening updates for hepatitis B and a commitment from the U.S. government to eradicate viral hepatitis by 2030. The new CDC recommendations call for hepatitis B screening using laboratory tests at least once during an adult’s lifetime. Also, the CDC expanded from earlier risk-based recommendations to include those who are engaging in risky behaviors.13
Updated CDC guidelines on human immunodeficiency virus and PrEP have elevated the need for reliable HIV testing. HIV transmission typically takes place through unprotected vaginal or anal intercourse, when a condom is not used and medication to prevent or manage HIV is not taken.14 The importance of HIV RNA screening, especially in detecting LEVI syndrome, a long-acting early viral inhibition, reinforces the importance of early detection.
Roche pioneered the dual target approach for HIV-1/2 viral monitoring and continuously works to ensure assays can stay ahead of their highly mutagenic targets. Roche products, supporting the molecular and immunoassay testing, such as Elecsys® HIV duo, can take labs through the full continuum of HIV testing as recommended by the CDC. Qualitative and quantitative HIV RNA assays enable laboratories and healthcare providers to identify the most critical HIV targets quickly and accurately, while eliminating manual intervention and minimizing errors.
Cervical cancer is primarily caused by human papillomavirus, and about 80% of men and women will have had an HPV infection by age 45. Regular screenings for HPV that can detect disease before progressing beyond the pre-cancer stage can lessen the chances of cervical cancer developing.15
Roche has been using advances in science to develop ways to more meaningfully answer clinician and patient questions earlier in the progression of cervical cancer, assisting them in making treatment decisions. Roche Diagnostics is committed to eliminating cervical cancer and improving patient outcomes through earlier diagnosis which can lead to earlier treatment.
Contemporary OB-GYN:HPV and Cervical Cancer Screening Implementation and Risk Considerations
CLP: Why the Triage Approach Will Improve Cervical Cancer Screening and Diagnosis
Mycoplasma genitalium, herpes and Trichomonas vaginalis may not attract as much attention as other STIs, but they are important. And new viruses, such as mpox, continue to emerge.
Mycoplasma genitalium, identified 40 years ago and linked to infertility, is treatable but is becoming difficult to treat due to increasing drug resistance. Trichomoniasis, known for often not having symptoms, can be easily cured. Genital herpes, caused by herpes simplex virus, is different from many other STIs, as it can be spread by skin-to-skin contact during sexual activity. Unfortunately, no cure for herpes exists, but treatment can help alleviate symptoms and prevent outbreaks.16
Roche has developed real-time PCR tests to detect these microorganisms and assist in patient diagnosis. T. vaginalis and M. genitalium can be detected from the same specimen used for chlamydia and gonorrhea testing.
Diagnostics are often the first line of defense. Roche knows this well, organizing a consortium of HIV experts to develop the first HIV viral-load test in 1992 and later launching the first NAT test to differentiate and confirm diagnosis of HIV-1 and/or HIV-2 in 2021. Roche is committed to quality diagnostics and innovative testing approaches to transform previously life-altering infections into manageable conditions.
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