Type: Viral
Incubation period: 2–14 days. Testing is most appropriate for patients with symptomatic lesion(s)
Sample site: Urine

Genital herpes caused by the herpes simplex virus (HSV). The virus lives in the nerves and when active it travels to the surface of the infected area and makes copies of itself – called shedding, because new virus cells can at this time rub off onto another person. The virus travels back down the nerve to a ganglion usually at the base of the spine where it lies dormant for a while. It causes painful blisters on the genitalia and surrounding areas. It can be passed through intimate sexual contact and for this reason is referred to as an STI. Once infected, it remains a chronic long term condition with the virus remaining with recurrent activity with variable frequency.

There are two types of herpes simplex virus: Type I and Type 2. Both are highly contagious and can be passed easily from one person to another. There is no cure for genital herpes, the symptoms can usually be controlled by antiviral medication. Although using a condom can reduce the risk of herpes transmission, condoms are not 100% effective as herpes can be spread from skin-to-skin.

Source: TDL

Type: Bacterial
Incubation period: 9 –21 days, but up to 90 days
Sample site: Blood

What is syphilis?
Syphilis is a bacterial infection that is most commonly contracted by having sex with someone who already has the infection. It can be cured relatively easy with a short course of antibiotics, however if it goes unnoticed and untreated it can spread in the form of “tertiary syphilis” and affect you later on in life.

What are the symptoms of syphilis?
Primary syphilis
The symptoms of syphilis can be separated into three stages, the first symptoms develop two to three weeks after infection. This stage of infection is known as “primary syphilis” and the first signs are: –

A small painless sore or ulcer called a chancre that can often go unnoticed. Most patients have just one chancre, but others may have multiple.
It will typically be on the penis, vagina or anus, although they have been known to develop on the mouth or lips.
You may also have swollen glands in your neck, groin or armpit indicating infection without many other symptoms.
These symptoms will usually pass within two to eight weeks, but if they go unnoticed then the condition will progress to secondary syphilis.

Secondary syphilis
Once your initial symptoms have passed you may develop further symptoms a number of weeks down the line. This phase is known as “secondary syphilis” and the main symptoms are: –

A blotchy red rash which may appear anywhere on the body, but is most common on the soles of the feet or palms of the hand.
Small skin growths that look similar to genital warts appearing predominantly around the anus, but sometimes on the vulva for women.
White patches in the mouth.
Flu-like symptoms, including joint pains, fever, fatigue and headaches.
Swollen glands indicating the presence of an infection.
One occasional symptom could be patchy hair loss.
These can come and go for a period of months before they disappear. Some people may not notice any symptoms following the primary phase, but are still infected and can pass the condition to other people.

Tertiary syphilis
If the symptoms of syphilis pass without treatment then the condition can last for decades without causing any further symptoms. However it can spread to parts of the body, including the nerves or brain which is known as “tertiary syphilis”. It is not usually contagious at this stage.

People with tertiary syphilis can experience a range of serious health complications, including: –

Meningitis
Strokes
Dementia symptoms
Loss of co-ordination
Numbness
Vision problems
Heart problems
Even at this stage Syphilis is still treatable with antibiotics, but the effects are much harder to reverse that in the early stages.

How is it contracted?
Syphilis is usually spread through close contact with an infected sore during vaginal, anal or oral sex. However, syphilis can also be spread by sharing sex toys with someone who is infected. It is also possible to contract the condition by sharing needles or from blood transfusions, but this is very rare.

What private syphilis test options are available?
Here at GP Matters we have a range of private STD tests which can be used to diagnose syphilis. They include our individual syphilis test, which is accurate from 21 days following the contraction of the condition. It uses a blood sample to detect antibodies present in your blood. We also offer a range of profile STD tests, many of which can diagnose syphilis as well as many other conditions using the same sample.

How is syphilis treated?
Following diagnosis of the condition syphilis is treated one of two ways. One way is through an injection of antibiotics into the buttocks. This can be administered once or up to three times at weekly intervals depending how long you may have had the condition. The other way to treat the condition is through a course of anti-biotic tablets which usually lasts two or four weeks.  

How can you prevent syphilis?
Syphilis is a sexually transmitted infection that is passed from infected individuals during sex meaning that anyone who has sex with an infected person is at risk. As with any sexually transmitted disease though, practising safe sex will reduce your chance of contracting the condition. The following methods will reduce the risk involved: –

Use a condom – whether male or female, the use of a condom for vaginal, oral and anal sex will reduce your chance of getting infected.
Use a dental dam during oral sex.
Avoid sharing sex toys or wash and cover them with a condom before each use.

How common is the condition?
Like many STDs in the UK, syphilis is currently on the rise with cases jumping by 76% between 2012 and 2015. That said, it’s not the most common sexually transmitted disease. In 2015 there were 5,228 cases reported in the UK.

Source: NHS, TDL

Type: Viral
Incubation period: Usually 10 –90 days, but up to 180 days
Sample site: Blood

HIV (human immunodeficiency virus) is a virus that damages the cells in your immune system and weakens your ability to fight everyday infections and disease.

AIDS (acquired immune deficiency syndrome) is the name used to describe a number of potentially life-threatening infections and illnesses that happen when your immune system has been severely damaged by the HIV virus.

While AIDS cannot be transmitted from 1 person to another, the HIV virus can.

There's currently no cure for HIV, but there are very effective drug treatments that enable most people with the virus to live a long and healthy life.

With an early diagnosis and effective treatments, most people with HIV will not develop any AIDS-related illnesses and will live a near-normal lifespan.

Symptoms of HIV infection
Most people experience a short flu-like illness 2 to 6 weeks after HIV infection, which lasts for a week or 2.

After these symptoms disappear, HIV may not cause any symptoms for many years, although the virus continues to damage your immune system.

This means many people with HIV do not know they're infected.

Anyone who thinks they could have HIV should get tested.

Some people are advised to have regular tests as they're at particularly high risk.

Causes of HIV infection
HIV is found in the body fluids of an infected person. This includes semen, vaginal and anal fluids, blood and breast milk.

It's a fragile virus and does not survive outside the body for long.

HIV cannot be transmitted through sweat, urine or saliva.

The most common way of getting HIV in the UK is through having anal or vaginal sex without a condom.

Other ways of getting HIV include:

sharing needles, syringes or other injecting equipment
transmission from mother to baby during pregnancy, birth or breastfeeding
The chance of getting HIV through oral sex is very low and will be dependent on many things, such as whether you receive or give oral sex and the oral hygiene of the person giving the oral sex.

Diagnosing HIV
Seek medical advice as soon as possible if you think you might have been exposed to HIV.

You can get tested in a number of places, including at a GP surgery, sexual health clinics and clinics run by charities.

The only way to find out if you have HIV is to have an HIV test. This involves testing a sample of your blood or saliva for signs of the infection.

It's important to be aware that:

emergency anti-HIV medicine called post-exposure prophylaxis (PEP) may stop you becoming infected if started within 72 hours of possible exposure to the virus – it's recommended that you start it as soon as possible, ideally within 24 hours
an early diagnosis means you can start treatment sooner, which can improve your chances of controlling the virus, reduce the risk of becoming more unwell and reduce the chance of passing the virus on to others
Both positive and negative HIV tests may need to be repeated 1 to 3 months after potential exposure to HIV infection (this is known as the window period), but you should not wait this long to seek help:

clinics may offer a finger prick blood test, which can give you a result in minutes, but it may take up to a few days to get the results of a more detailed HIV test
home testing or home sampling kits are available to buy online or from pharmacies – depending on the type of test you use, your result will be available in a few minutes or a few days
If your first test suggests you have HIV, a further blood test will need to be carried out to confirm the result.

If this is positive, you'll be referred to a specialist HIV clinic for some more tests and a discussion about your treatment options.

Treatment for HIV
Antiretroviral medicines are used to treat HIV. They work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage.

These come in the form of tablets, which need to be taken every day.

HIV is able to develop resistance to a single HIV medicine very easily, but taking a combination of different medicines makes this much less likely.

Most people with HIV take a combination of medicines. It's vital these are taken every day as recommended by your doctor.

The goal of HIV treatment is to have an undetectable viral load. This means the level of HIV virus in your body is low enough to not be detected by a test.

Living with HIV
If you're living with HIV, taking effective HIV treatment and being undetectable significantly reduces your risk of passing HIV on to others.

You'll also be encouraged to:

take regular exercise
eat a healthy diet
stop smoking
have yearly flu jabs to minimise the risk of getting serious illnesses
Without treatment, the immune system will become severely damaged, and life-threatening illnesses such as cancer and severe infections can occur.

If you're planning on getting pregnant, it's important to talk to a GP. Although rare, it's possible to transmit HIV to your baby.

Preventing HIV
Anyone who has sex without a condom or shares needles is at risk of HIV infection.

There are many effective ways to prevent or reduce the risk of HIV infection, including:

using a condom for sex
post-exposure prophylaxis (PEP)
pre-exposure prophylaxis (PrEP)
treatment for HIV to reduce the viral load to undetectable
if you use drugs, never sharing needles or other injecting equipment, including syringes, spoons and swabs
Speak to your local sexual health clinic or a GP for further advice about the best way to reduce your risk.

For people with HIV, if you have been taking effective HIV treatment and your viral load has been undetectable for 6 months or more, it means you cannot pass the virus on through sex.

Source: NHS , TDL

Type: Viral
Incubation period:  Usually 45–180 days, average of 60–90 days
Sample site: Blood

Hepatitis B is an infection of the liver caused by a virus that's spread through blood and body fluids.

It often does not cause any obvious symptoms in adults, and typically passes in a few months without treatment.

But in children, it often persists for years and may eventually cause serious liver damage.

Hepatitis B is less common in the UK than other parts of the world, but certain groups are at an increased risk.

This includes people originally from high-risk countries, people who inject drugs, and people who have unprotected sex with multiple sexual partners.

A hepatitis B vaccine is available for people at high risk of the condition.

Symptoms of hepatitis B
Many people with hepatitis B will not experience any symptoms and may fight off the virus without realising they had it.

If symptoms do develop, they tend to happen 2 or 3 months after exposure to the hepatitis B virus.

Symptoms of hepatitis B include:

flu-like symptoms, including tiredness, a fever, and general aches and pains
loss of appetite
feeling and being sick
diarrhoea
tummy pain
yellowing of the skin and eyes (jaundice)
These symptoms will usually pass within 1 to 3 months (acute hepatitis B), although occasionally the infection can last for 6 months or more (chronic hepatitis B).

When to get medical advice
Hepatitis B can be serious, so you should get medical advice if:

you think you may have been exposed to the hepatitis B virus – emergency treatment can help prevent infection if given within a few days of exposure
you have symptoms associated with hepatitis B
you're at a high risk of hepatitis B – high-risk groups include people born in a country where the infection is common, babies born to mothers infected with hepatitis B, and people who have ever injected drugs
You can go to your local GP surgery, drug service, genitourinary medicine (GUM) clinic or sexual health clinic for help and advice.

A blood test can be carried out to check if you have hepatitis B or have had it in the past.

The hepatitis B vaccine may also be recommended to reduce your risk of infection.

Treatments for hepatitis B
Treatment for hepatitis B depends on how long you have been infected for.

If you have been exposed to the virus in the past few days, emergency treatment can help stop you becoming infected.

If you have only had the infection for a few weeks or months (acute hepatitis B), you may only need treatment to relieve your symptoms while your body fights off the infection.

If you have had the infection for more than 6 months (chronic hepatitis B), you may be offered treatment with medicines that can keep the virus under control and reduce the risk of liver damage.

Chronic hepatitis B often requires long-term or lifelong treatment and regular monitoring to check for any further liver problems.

How hepatitis B is spread
The hepatitis B virus is found in the blood and bodily fluids, such as semen and vaginal fluids, of an infected person.

It can be spread:

from a mother to her newborn baby, particularly in countries where the infection is common (read more about hepatitis B in pregnancy)
within families (child to child) in countries where the infection is common
by injecting drugs and sharing needles and other drug equipment, such as spoons and filters
by having sex with an infected person without using a condom
by having a tattoo, body piercing, or medical or dental treatment in an unhygienic environment with unsterilised equipment
by sharing toothbrushes or razors contaminated with infected blood
Hepatitis B is not spread by kissing, holding hands, hugging, coughing, sneezing or sharing crockery and utensils.

Preventing hepatitis B
A vaccine that offers protection against hepatitis B is routinely available for all babies born in the UK.

It's also available for people at high risk of the infection or complications from it.

This includes:

babies born to hepatitis B-infected mothers
close family and sexual partners of someone with hepatitis B
people travelling to a part of the world where hepatitis B is widespread, such as sub-Saharan Africa, east and southeast Asia, and the Pacific Islands
families adopting or fostering children from high-risk countries
people who inject drugs or have a sexual partner who injects drugs
people who change their sexual partner frequently
men who have sex with men
male and female sex workers
people who work somewhere that places them at risk of contact with blood or body fluids, such as nurses, prison staff, doctors, dentists and laboratory staff
people with chronic liver disease
people with chronic kidney disease
prisoners
people who receive regular blood or blood products, and their carers
The hepatitis B vaccine is given to infants as part of the routine childhood vaccination schedule and those at high risk of developing the infection.

Outlook for hepatitis B
The vast majority of people infected with hepatitis B in adulthood are able to fight off the virus and fully recover within 1 to 3 months.

Most will then be immune to the infection for life.

Babies and children with hepatitis B are more likely to develop a chronic infection.

Chronic hepatitis B affects around:

90% of babies with hepatitis B
20% of older children with hepatitis B
5% of adults with hepatitis B
Although treatment can help, there's a risk that people with chronic hepatitis B could eventually develop life-threatening problems, such as scarring of the liver (cirrhosis) or liver cancer.

Source: NHS , TDL

Type: Viral
Incubation period: Usually 9–180 days, average of 45–65 days
Sample site: Blood

Hepatitis C is a virus that can infect the liver. If left untreated, it can sometimes cause serious and potentially life-threatening damage to the liver over many years.

But with modern treatments, it's usually possible to cure the infection, and most people with it will have a normal life expectancy.

It's estimated around 118,000 people in the UK had chronic hepatitis C in 2019.

You can become infected with it if you come into contact with the blood of an infected person.

Symptoms of hepatitis C
Hepatitis C often does not have any noticeable symptoms until the liver has been significantly damaged.

This means many people have the infection without realising it.

When symptoms do occur, they can be mistaken for another condition.

Symptoms can include:

flu-like symptoms, such as muscle aches and a high temperature (fever)
feeling tired all the time
loss of appetite
stomach ache
feeling and being sick
The only way to know for certain if these symptoms are caused by hepatitis C is to get tested.

How do you get hepatitis C?
The hepatitis C virus is usually spread through blood-to-blood contact.

Some ways the infection can be spread include:

sharing unsterilised needles – particularly needles used to inject recreational drugs
sharing razors or toothbrushes
from a pregnant woman to her unborn baby
through unprotected sex – although this is very rare
In the UK, most hepatitis C infections happen in people who inject drugs or have injected them in the past.

It's estimated around half of those who inject drugs have been infected with the virus.

Getting tested for hepatitis C
Seek medical advice if you have persistent symptoms of hepatitis C or there's a risk you're infected, even if you do not have any symptoms.

A blood test can be carried out to see if you have the infection.

GPs, sexual health clinics, genitourinary medicine (GUM) clinics or drug treatment services all offer testing for hepatitis C.

Early diagnosis and treatment can help prevent or limit any damage to your liver, as well as help ensure the infection is not passed on to other people.

Treatments for hepatitis C
Hepatitis C can be treated with medicines that stop the virus multiplying inside the body. These usually need to be taken for several weeks.

Tablet-only treatments are now available.

These new hepatitis C medicines have been found to make treatment more effective, are easier to tolerate, and have shorter treatment courses.

Using the latest medications, more than 90% of people with hepatitis C may be cured.

But it's important to be aware that you will not be immune to the infection and should take steps to reduce your risk of becoming infected again.

Complications of hepatitis C
If the infection is left untreated for many years, some people with hepatitis C will develop scarring of the liver (cirrhosis).

Over time, this can cause the liver to stop working properly.

In severe cases, life-threatening problems, such as liver failure, where the liver loses most or all of its functions, or liver cancer, can eventually develop.

Treating hepatitis C as early as possible can help reduce the risk of these problems happening.

Preventing hepatitis C
There's no vaccine for hepatitis C, but there are ways to reduce your risk of becoming infected.

These include:

not sharing any drug-injecting equipment with other people – including needles and other equipment, such as syringes, spoons and filters
not sharing razors or toothbrushes that might be contaminated with blood
The risk of getting hepatitis C through sex is very low. But it may be higher if blood is present, such as menstrual blood or from minor bleeding during anal sex.

Condoms are not usually necessary to prevent hepatitis C for long-term heterosexual couples, but it's a good idea to use them when having anal sex or sex with a new partner.

Source: NHS , TDL