30 Jahre Venerologie: 1974 - 2004 (ohne HIV-Infektionen)

Zusammenfassung

Die Venerologie der letzten 30 Jahre wurde von der AIDS-Pandemie geprägt. Im Gefolge der AIDS-Prävention wurde weltweit ein Rückgang der venerischen Infektionen beobachtet. Im letzten Jahrzehnt kam es zu erneutem Anstieg der Syphilisinzidenz, vorerst in Osteuropa, dann auch im übrigen Europa. In der Syphilisdiagnostik wurden neue spezifische IgM-Tests eingeführt. Vor rund 30 Jahren begann die weltweite Ausbreitung der penizillinresistenten Gonokokkenstämme. Hochspezifische PCR-Tests für Gonokokken, Chlamydia trachomatis, Herpes simplex und Haemophilus ducreyi, wurden eingeführt. Bei den humanen Papillomviren wurden immer neue Serotypen entdeckt. Derzeit sind es schon über 100. Eine enge Assoziation bestimmter HPV-Typen mit intraepithelialen Neoplasien der Genitalregion, sowie mit invasiven ano-genitalen Carcinomen wurde erkannt. In der Therapie weckte Azithromycin, das gegen verschiedene STD-Erreger wirkt und die perorale Scabiesbehandlung mit Ivermectin, neue Hoffnungen.

Abstract

The veneral diseases of the last 30 years were strongly influenced by the AIDS-pandemic. As a result of AIDS-prevention a worldwide decrease of veneral infections was observed. A new increase of incidence in syphilis happened in the last decade; first of all in Eastern-European countries and later on everywhere in Europe. The specific IgM-tests were established in serology of syphilis. Thirty years ago the worldwide spread of penicilline-resistant strains of Gonococci started. Highly-specific PCR-tests were established for Gonoccoci, Chlamydia trachomatis, Herpes simplex virus and Haemophilus ducreyi. In the field of human papilloma-virus more and more new serotypes were discovered. Currently more than 100 serotypes are recognized. Certain specific HPV-types can induce the development of intraepithelial dysplasia and malignant epithelial tumors in the ano-genital area. Many new therapies have been established. Two of them should be mentioned: azithromycin, which is effective in many different infectious agents in STD, and Ivermectin, the first systemic agent against human scabies.

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