الفهرس 
Sexually transmissible infectionsOnly 14 pages are availabe for public view
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Abstract
S
exually transmitted disease (STDs),also known as sexually transmissible infection (STIs) or venereal diseases (VD) that has a significant probability of transmission from person to anther by sexual contact, including vaginal intercourse, oral sex and anal sex or skin to skin contact (eg: HPV and HSV). Centers for disease control and prevention (CDC) estimate that there a approximately 19 million new STDs infection each year in united states, almost half of them among young people 15 to 24 of ages.
There are more than 30 (STDs) now classified according to the predominant mode of transmission of pathogen as sexual transmitted pathogens (transmitted in adults predominantly by sexual intercourse) or as sexually transmissible pathogens (Sexual transmission frequently described but not will defined or not the predominant mode) and classified also according to type of pathogen into:
Bacterial as (Sexually Transmitted Pathogens): Neisseria gonorrhoeae, Chlamydia trachomatis serovars (D-K, L1, L2 and L3), Treponema pallidum, Klebsiella granulomatis. Haemophilus ducreyi and Ureaplasma urealyticum. And (Sexually Transmissible Pathogens): Gardnerella vaginalis, Mycoplasma hominis, mobiluncus spp or anerobic Gram-negative rods (Bacteroides spp ”prevotella, porphyromonas” and pebtostreptococcus), Mycoplasma genitalum, Shigella spp, Campylobacter spp and Helicobacter (cinaedi or fennelliae).
Viral as (Sexually Transmitted Pathogens): Human immunodeficiency virus (HIV) types 1 and 2, Human T- cell lymphotropic virus type 1 (HTLV-1), Herpes simplex virus type 2 (HSV-2), Human papilloma virus (HPV) about 35 genital types: low risk types of HPV especially (HPV6, 11) high risk types of HPV especially (HPV16, 18, 31,33,45,52 and 58), Hepatites B virus (HBV), and Molluscum contagiosum virus (MCV). And (Sexually Transmissible Pathogens): Cytomegalovirus (CMV), Epstein - Barr virus (EBV), Human T-cell lymphotropic virus type 2 ( HTLV-2), Hepatitis C virus (HCV), Hepatitis D virus (HDV), Herpes simplex virus type1 (HSV-1), Human herpes virus type 8 (HHV-8), and Hepatitis A virus (HAV).
Ectoparasitical as (Sexually Transmitted Pathogens): Phthirus pubis. And (Sexually Transmissible Pathogens): Srcoptes scabiei.
Fungal as (Sexually Transmitted Pathogens): Candida albicans.
protozoal as (Sexually Transmitted Pathogens): Trichomonas vaginalis. And (Sexually Transmissible Pathogens): Giardia lamblia, Entamoeba histolytica.
Vaccines are any biological preparations intended to produce immunity to particular disease by stimulating the production of antibodies. Vaccines include for e.g.; suspension of killed (inactivated) or live (attenuated) microorganisms , or purified products or derivative of microorganism (recombinant subunit). The most common method of administrating is by injection (intramuscular or subcutaneous) but some are given by mouth or nasal spray.
Vaccines can be prophylactic (to prevent or ameliorate the effects of a future infection or therapeutic vaccine against cancer) Vaccines can be (monovalent) formed of one type of microorganism or (polyvalent) formed of more than one type of microorganisms. Some (STDs) can be effectively prevented through pre-exposure vaccination for e.g.; HBV, some type of HPV (6, 11, 16, and 18), and HAV. Unfortunately vaccines are under development or are under clinical trials for STDs, including HIV, HSV, Chlamydia, Treponema pallidum Cytomegalovirus (CMV), Epstein-Barr virus (EBV) and Hepatitis C virus (HCV) due to many obstacles as antigenic diversity and hypervariability and immune evasion of the organisms and lake of an ideal animal model and requiring long and expensive human clinical trials for development of vaccines against the remaining (STIs).
As regard current licensed vaccines:
Humn papillomavirus (HPV): are formed by a genetically engineered as virus-like particles (VLPs) which are empty viral capsid (L1) which copy the structure of the natural virion but are devoid of DNA, they are non infectious but generate a potent immune response.
The 1st generation of HPV vaccine are formed of two licensed types: (a) Gardasil (quadrivalent) derived from a yeast recombinant (Saccharomyces Cerevisiae). protect against regimen HPV (6, 11, 16, and 18) which cause genital warts and cervical, vaginal, vulvar and anal cancers and associated precancerous lesions. Regimen of Gardasil in the form of three doses at 0, 2, 6 months. (b) cervarix (bivalent) protect against HPV16, 18, Which causes cervical, vaginal, vulgar and anal cancers and associated precancerous lesions. Regimen of cervarix in the form of three doses at 0, 1, 6 months. The 2nd generation is still under developmental trial as vaccine that include (L1) VLPs of types (HPV6, 11, 16, 18, 31, 33, 45, 52, 58). The 3rd generation (therapeutic vaccine) still under trial for treatment of cervical, vaginal, vulvar and anal cancers and associated precancerous lesions.
Hepatitis B virus (HBV): Active vaccine are formed by a genetically engineered manufactured in a yeast recombinant (Saccharomyces Cerevisiae) expressing the gene for the surface antigen (HBsAg). This yeast-derived vaccine is immunogenic and safe cast effective in preventing HBV infection in neonates, children and adults. HBV vaccination is also protective against Hepatitis D (delta), Which requires simultaneous or prior HBV infection to replicate.
HBV vaccine can be combined with other vaccines with high efficacy such as HAV, Diphtheria, Tetanus, Pertussis and Haemophilous influenza type B (Hib). HBV Vaccine can used as pre-exposure vaccine with effecting 80% to 100%, Or as post- exposure immunoprophylaxis with HBIG with efficacy 85%-95% in preventing chronic HBV infection. Regimen of HBV vaccine in the form of intramuscular injection in the form of three or four doses.
As regard vaccines in development:
Human immunodificiency virus (HIV): There is no licensed vaccine for it until now but there is multiple ongoing trials such as neutralizing antibody against highly variable loops (gp120v3) with neutralizing monoclonal antibodies such as 2G12, 2F5, b12, 4E10. or used subunit vaccine such as (Env or Tat) and live recombinant (vectored viral or bacterial) as NYVAC or ad5 or MVA and ALVAC in the form of prime + gp120 boost (RV-144) with efficacy of 31%.
Herpes simplex virus (HSV): There is no licensed vaccine for it until now but there is multiple ongoing trials such as gB/gD-MF59 vaccine and gD-ASO4 vaccine (HERPEVAC study).
Treponema pallidum (Tp): There is no licensed vaccine for it until now but there is multiple ongoing trials such as recombinant treponemal antigens and proteins as TROMPS or TprK and recombinant endoflagellar proteins as TpN47 or TpN19
Chlamydia Trachomatis (Ct): There is no licensed vaccine for it until now but there is multiple ongoing trials such as whole organism vaccine (live attenuated) or Subunit vaccine (MOMP) or Recombinant proteins or DNA vaccines.
Neisseria gonorrhea (Ng): There is no licensed vaccine for it until now but there is multiple ongoing trials such as outer membrane vesicles (OMV) which express PorB or Recombinant protein vaccines such as rrPorB or Viral Replicon particles (VRP) as VEE or DNA vaccines.
Cytomegalovirus (CMV): There is no licensed vaccine for it until now but there is multiple ongoing trials such as gB/MF59 adjuvant or gB/PP65 bivalent DNA vaccine or recombinant modified vaccinia virus Ankara (MVA).
Hepatitis C virus (HCV): There is no licensed vaccine for it until now but there is multiple ongoing trials such as recombinant protein vaccines, peptide vaccines, DNA vaccines and vector-based vaccines.
Epstein-Barr virus (EBV): There is no licensed vaccine for it until now but there is multiple ongoing trials such as prophylactic vaccines (gp350 and EBNA-3) and therapeutic vaccines (EBNA-1 and LMP-2).