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Hepatitis can be caused by many different things including viral infections, parasites, bacteria, chemicals, autoimmunity, drugs or alcohol. Of these, viral infection is the most common cause of chronic (long-term) hepatitis, which can lead to severe liver damage including cirrhosis and liver cancer.

Hepatitis B and C viruses (HBV and HCV) are among the world’s most common infectious pathogens. It is estimated that 500 million people – 1 in 12 of the global population – are chronically infected with one or both of these viruses.1,2  The majority of these people live in the developing world and many of them are unaware that they are infected. Chronically infected patients are at increased risk of developing cirrhosis, hepatic decompensation and hepatocellular carcinoma (HCC), which together account for more than 1 million deaths annually.3

The hepatitis B virus is a resilient virus present in all bodily fluids of infected individuals. It is resistant to breakdown and able to survive outside the body. It can be transmitted effectively through contact with infected bodily fluids in the same way as HIV. However, HBV is 50–100 times more infectious than HIV.

Screening for HBV and HCV infection is crucial, not only to detect patients who may require treatment to reduce the risk of progression to severe sequelae, but also to reduce transmission rates.

The primary objective of therapy for chronic HBV is to achieve control of viral replication and halt disease progression/improve liver histology. This will decrease pathogenicity and infectivity and thereby stop or reduce hepatic necroinflammation.

Chronic hepatitis C infection may result in severe liver damage leading to liver failure, HCC and death. As a consequence, therapeutic intervention can arrest, and perhaps even reverse, the disease before irreversible liver damage occurs. 

Enter the Hepatitis B and C Knowledge Centre


1. World Health Organization. World Health Organization Hepatitis B Fact Sheet. 1998.
2. World Hepatitis Alliance.
3. Lai CL, Ratziu V, Yuen MF, Poynard T. Viral hepatitis B. Lancet 2003;362:2089–94

Men's Health

Men's Health

As a disease topic Men's Health covers a broad set of issues affecting men of all ages. Some of the issues requiring greater focus and more thorough dissemination of information amongst the healthcare community, are those that have the potential to go undetected in the early stages. Diseases where early detection and more regular health checks not only improve prognosis and efficacy of treatment outcomes, but also quality of life.

These include:

Erectile Dysfunction (ED)

Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. Although not considered a part of the aging process, it is associated with certain physiologic and psychological changes related to age. ED is most common in men between 40-70 years of age. However incidence is also higher amongst men with certain medical conditions which include, diabetes, heart disease, and hypertension. ED can also be a warning sign/symptom of these underlying conditions. 1

Hypogonadism (low testosterone)

Testosterone is an essential male hormone produced in the testes that plays a crucial role in the health and well being of male bodies. It is responsible for typical male sexual characteristics and is required by all men for a healthy life physically and psychologically.

Low testosterone, clinically known as hypogonadism, consists of decreased functional activity of the testes with diminished production and action of testosterone.  Although there is a progressive decline in testosterone levels as men age, hypogonadism can occur in men of any age.

Men with low testosterone are also at increased risk of cardiovascular disease, diabetes and metabolic syndrome and osteoporosis.

For your information, the Mens Health knowledge centre concentrates on the understanding, management and treatment of erectile dysfunction and hypogonadism.  The website also provides extensive details on up-coming conferences as well as an extensive library of useful resource. You can also access the knowledge centre via

Enter the Men's Health Knowledge Centre


1. McVary, Kevin T. Erectile. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL et al., editors. Harrison's Internal Medicine. 16th ed. New York: McGraw-Hill; 2005. p. 272-274

Clinical Case Studies

Cryptococcal Disease in HIV

Infection: HIV Infection

Neil D. Ritchie, Clinical Lecturer in Infectious Diseases, Medical Faculty, University of Glasgow, Glasgow, UK

Case History
A 43-year-old Zimbabwean woman presented with headache and meningism of several weeks' duration.

HIV and Syphilis in Pregnancy

Infection: Genitourinary Infection

Nneka Nwokolo, Consultant in Genitourinary Medicine, Chelsea and Westminster Hospital, Chelsea and Westminster NHS Foundation Trust, London, UK

Case History
A 35-year-old Ethiopian woman was referred from the antenatal clinic with the following results from her booking blood tests: human immunodeficiency virus type 1 (HIV-1) antibody-positive, venereal disease research laboratory (VDRL) test 1:64, syphilis immunoglobulin G/immunoglobulin M positive, Treponema pallidum particle agglutination (TPPA) positive. She was 20 weeks pregnant with her fourth child.


Would you trust a doctor to decide if you are an appropriate subject for assisted dying? I wouldn't, neither should you, and my colleagues who are not fortunate enough to be retired will be crazy if they allow themselves to be dragged into the process. Proponents of legislative change should man up and face the implications of their proposals, without hiding behind the medical profession.

Medical Videos

The Risk Factors Associated With Sexually Transmitted Diseases
The Risk Factors Associated With Sexually Transmitted Diseases

Recent Drug Updates

Medical Journal Abstracts on Sexual Health

The Association Between Belief in God and Fertility Desires in Slovenia and the Czech Republic

Fri 13 Feb 2015 -  The Association Between Belief in God and Fertility Desires in Slovenia and the Czech Republic

Context: Research on the association between religiosity and fertility—and, particularly, on the effects of secularization on fertility desires and outcomes—has been concerned ...

Evidence for an Altered Sex Ratio in Clinic-Referred Adolescents with Gender Dysphoria

Thu 22 Jan 2015 -  Evidence for an Altered Sex Ratio in Clinic-Referred Adolescents with Gender Dysphoria

Introduction: The number of adolescents referred to specialized gender identity clinics for gender dysphoria appears to be increasing and there also appears to be a corresponding shift in the sex ...

Medical Images

HIV-1 group M subtypes and CRFs
HIV-1 group M subtypes and CRFs
HIV-1 genome
HIV-1 genome
HIV envelope glycoprotein
HIV envelope glycoprotein
Pneumocystis jirovecii pneumonia
Pneumocystis jirovecii pneumonia
gp120 and the CCR5 co-receptor
 gp120 and the CCR5 co-receptor
Key events leading up to the era of HAART
Key events leading up to the era of HAART

Online CME

Chlamydia screening

After completing this module you should know: why it is important to screen for chlamydia, who to screen under the chlamydia screening programme and which samples to request, how to...

Clinical Trials

Treatment With MSC in HIV-infected Patients With Controlled Viremia and Immunological Discordant Response


Clinical trial phase I/II, of test of concept, blind double, and controlled with placebo, randomized 2:1 (Treatment: placebo), in which a total of 15 patients will be included

Effects of VSL#3 on Neuro-cognitive Profile of HIV Patients


Aim of the study is to evaluate the effects of a change in the intestinal microflora on the neuro-cognitive profile of patients with HIV infection receiving HAART treatment. Improvements will be evaluated with questionnaires on Quality of life and..

... Cognitive and Behavior function.

20 patients will be enrolled and will receive 4 sachets of VSL#3 per day.

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