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Lancet. 1989 Feb 18; 1(8634):396.The World Health Organization (WHO) issued a consensus statement about AIDS and sexually transmitted diseases (STD) and partner notification for patients with HIV infection. Evidence that genital ulcer disease (GUD) is a risk factor and facilitator for HIV-1 infection in heterosexual people is strong, especially in developing countries. A few studies have shown an association of antibodies to herpes simplex virus type 2 (HSV-2) and Treponema pallidum (the chief cause of genital and anorectal ulcers in developing countries). A consistent relation between HIV-1 and HSV-2 and T. pallidum has been demonstrated in seroepidemiological studies. Data assessing the link between other STD pathogens and HIV-1 transmission are insufficient, but it is plausible that all STD pathogens that cause genital ulcers or inflammation are risk factors for increased susceptibility to HIV-1 infection. Investigating this possibility should be a research priority, as genital ulcer diseases intervention may help to prevent sexual transmission of HIV-1 infection. Partner notification programs, as part of a comprehensive AIDS prevention and control program, should be carefully designed. Because the notification procedure can cause individual and social harm and detract from other AIDS prevention and control activities, a careful assessment of medical, legal, logistic, social, and ethical issues needs to be made. Other variables, such as cost, local environment, and epidemiology need to be taken into account. Issues of patient referral, target populations, training of notification personnel, patient consent, diagnostic accuracy, and the logistics of notification need to be addressed. WHO suggests that the following criteria be monitored when assessing efficiency of partner notification activities: number of index persons; number of partners identified; number of partners notified and their seroprevalence; cost; satisfaction; compliance and acceptability; counseling and support; staff training; confidentiality; and adequacy of follow-up.
Bulletin of the Pan American Health Organization. 1983; 17(3):323.A World Health Organization (WHO) Consultative Group on Hepatitis met during July 1983 to draft a global program for viral hepatitis control. At this time, hepatitis viruses infects tens of millions of people every year. These viruses can be transmitted by the fecal-oral route, in blood or certain blood products, and through intimate personal contact. Of the various forms (heptitis A, hepatitis B, and hepatitis non-A, non-B) hepatitis B arouses particular concern because it can produce chronic liver disease and premature death. Currently, there are over 200 million persistent carriers of this virus, many of whom will die of chronic liver damage. Firm evidence recently shows a clear cause and effect relationship between infection with hepatitis B virus and primary liver cancer, a common cancer that claims hundreds of thousands of lives a year. The July meeting made recommendations to improve the situation. One of the most important recommendations was to strengthen national capabilities to control viral hepatitis. The group also reviewed available diagnosis and control methods and suggested areas where action by the WHO would be most effective. The group agreed that the availability of safe and effective vaccines against hepatitis B provides a unique opportunity to break the chain of transmission and to prevent acute and chronic liver disease, including primary liver cancer. There has been concern that the plasma-derived hepatitis B vaccines could contain transmissible agents that might be implicated in the acquired immune deficiency syndrome (AIDS). It was felt that much care needs to be taken in selecting plasma donors and in purifying the immunizing component of the vaccine, known as hepatitis B surface antigen, so as to ensure a very high degree of purity and freedom from all infectious agencts. No evidence exists at this time of AIDS transmission by any hepatitis B vaccine.