French expert warns: ‘Two-thirds of STDs are asymptomatic’

Jean-Michel Molina at the XX Scientific Symposium of the Huésped Foundation

Jean-Michel Molina at the XX Science Symposium of the Huésped Foundation – Photo credit: @Fabian Marelli

sexually transmitted diseasesDue to the growth of the perception that HIV-AIDS is no longer a deadly problem (because it can be controlled with medication), it can be divided into two categories.Those with good vaccines (such as hepatitis B, HPV, mpox, or monkeypox) and those without vaccines, such as gonorrheachlamydia and syphilis. Jean Michel MolinaThe pathogens responsible for the diseases are also different: those for which there is no vaccine are of bacterial origin, which explains part of the difficulty, the professor of infectious diseases at the University of Paris points out.

“The reason we don’t have vaccines and are so hard to get is that the same diseases don’t elicit a good immune response to the point where it’s possible to get them over and over again, no natural immunity And you may get the same disease again.That’s why it’s so difficult,” he told nation Experts who came to Buenos Aires for this conference Huésped Foundation XX Science Symposiumended last Friday.

Therefore, immunization through vaccines must achieve effects that cannot be achieved even by the antibodies produced by the person itself when exposed to the pathogen. But that’s not the only reason. “The second one has to do with the market, which is not very big. They are not considered serious illnessesand then the drug companies decided it wasn’t worth it for these STDs,” said Molina, who has led the country’s HIV/AIDS vaccine research team for more than a decade.

But, he added, he believed that was changing as experts worried These diseases bring many problems to women’s health, such as infertility caused by chlamydia or gonorrhea, and infertility in newborns, such as congenital syphilis. “So we think more needs to be done to combat these STDs, and a vaccine is always ideal. It’s been tried, but it’s been hard to find good ones,” he explains.

For Jean-Michel Molina, the biggest concern is congenital syphilis

For Jean-Michel Molina, the biggest worry was congenital syphilis – Credit: @Fabian Marelli

He shared the podium with Tomás Orduna (Muñiz Hospital), Pablo Bonvehí (SADI, Argentine Society of Infectious Diseases) and Analía Urueña in a panel presentation entitled “Emerging and Re-emerging Diseases” in Buenos Aires , said Molina of the Argentine Society of Vaccinology and Epidemiology (SAVE), that there were 82 million cases of gonorrhea in the world in 2020, which is why the World Health Organization’s goal of less than 10 million cases in 2030 is still far away. Far.

On the other hand, however, given some similarities between the bacteria that cause gonorrhea and those that cause meningitis, it is hoped that a vaccine will be available for this disease, for which there is already a vaccine. In fact, he says cross-protection is questionable: Meningitis vaccines are less effective against gonorrhea (a sexually transmitted disease that, when symptomatic, causes genital pain and bleeding).

“There have been many efforts in this direction by the scientific community to try to make this happen. It’s the same with chlamydia, and maybe one day with syphilis,” adds Molina.

As for the latter, he noted that this is a growing problem in Argentina, Brazil and the United States. “The problem is, it doesn’t just affect people’s genitals, it can cause other serious health problems like the skin, ears, eyes and central nervous system. The most worrying thing is congenital syphilis, a disease we thought was going away but is You’re seeing a lot of new baby cases of syphilis.”

– After the MPOX or monkeypox that caused such a panic in 2022, will there be other sexually transmitted diseases?

-if possible. When MPOX resurfaced, it was considered a sexually transmitted disease. Not before. The same can happen with other disorders, depending on the type of sexual activity in each disorder. For example, ShigellaAnother type of bacteria can also be transmitted during some forms of sexual intercourse and is multidrug resistant to antibiotics. We also found that many viral diseases have reservoirs in the genitals. Ebola virus, for example, can linger in sperm for months. We must be aware of these potential problems and monitor them. A few years ago, STDs weren’t getting as much attention, now we have great ways to diagnose them, and we know it’s a young person’s problem, not just theirs. Collectively, we need to do better when it comes to sexual health. Also contraception and other sexual issues, infertility, bringing it all together and generating broad spectrum knowledge. We’ve learned a lot with HIV, so…

– If vaccines against these diseases become available, is there a risk that condom use will be discontinued?

Yes, it does, you have to adapt to how people behave. Condoms are very important, but not everyone uses them all the time during all sexual activity. You must know that you can contract STDs in different ways, through oral sex and even through kissing. Condoms are important, must be used, and remain an important part of the fight against STDs, but it’s not enough. You have to combine multiple prevention tools, reduce the number of sexual partners, and if possible, make sure the sexual partners are not infected before sex. … The thing is, two-thirds of STDs are asymptomatic, and that’s a problem. People don’t know and spread it. That’s why it’s so difficult, like HIV: A person who’s ostensibly healthy can transmit it. The same thing happens. So people have to be told that they have to get tested and make sure they don’t get infected, and the tests have to be accessible and accessible.

After 40 years, why is there still no vaccine against HIV/AIDS?

– Partly for the same reason that there are no vaccines against bacteria that cause sexually transmitted diseases: ways must be found to induce an immune response against pathogens that do not produce antibodies

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