Gonorrhea treatment guidelines: revised guidelines to preserve last effective treatment option

In response to recent surveillance data suggesting that the oral antibiotic cefixime is becoming less effective in treating gonorrhea, CDC has revised its gonorrhea treatment guidelines to preserve the last available effective treatment option for as long as possible. The new guidelines are published in the August 10, 2012 issue of the Morbidity and Mortality Weekly Report. In addition to revising its treatment guidelines, CDC is also urging researchers in the public and private sectors to step up efforts to develop new treatments for this common but potentially serious sexually transmitted disease (STD).Gonorrhea treatment : a shrinking arsenal -- Revised guidelines -- Urgent action needed -- About gonorrhea -- Gonorrhea: protect yourself.December 2012.Mode of access: Internet as an Acrobat .pdf file (200.05 B, 3 p.).System requirements: Adobe Acrobat Reader

Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV-infected children: recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics

This report updates and combines into one document earlier versions of guidelines for preventing and treating opportunistic infections (OIs) among HIV-exposed and HIV-infected children, last published in 2002 and 2004, respectively. These guidelines are intended for use by clinicians and other health-care workers providing medical care for HIV-exposed and HIV-infected children in the United States. The guidelines discuss opportunistic pathogens that occur in the United States and one that might be acquired during international travel (i.e., malaria). Topic areas covered for each OI include a brief description of the epidemiology, clinical presentation, and diagnosis of the OI in children; prevention of exposure; prevention of disease by chemoprophylaxis and/or vaccination; discontinuation of primary prophylaxis after immune reconstitution; treatment of disease; monitoring for adverse effects during treatment; management of treatment failure; prevention of disease recurrence; and discontinuation of secondary prophylaxis after immune reconstitution. A separate document about preventing and treating of OIs among HIV-infected adults and postpubertal adolescents (Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents) was prepared by a working group of adult HIV and infectious disease specialists. The guidelines were developed by a panel of specialists in pediatric HIV infection and infectious diseases (the Pediatric Opportunistic Infections Working Group) from the U.S. government and academic institutions. For each OI, a pediatric specialist with content-matter expertise reviewed the literature for new information since the last guidelines were published; they then proposed revised recommendations at a meeting at the National Institutes of Health (NIH) in June 2007. After these presentations and discussions, the guidelines underwent further revision, with review and approval by the Working Group, and final endorsement by NIH, CDC, the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Disease Society (PIDS), and the American Academy of Pediatrics (AAP). The recommendations are rated by a letter that indicates the strength of the recommendation and a Roman numeral that indicates the quality of the evidence supporting the recommendation so readers can ascertain how best to apply the recommendations in their practice environments. An important mode of acquisition of OIs, as well as HIV infection among children, is from their infected mother; HIV-infected women coinfected with opportunistic pathogens might be more likely than women without HIV infection to transmit these infections to their infants. In addition, HIV-infected women or HIV-infected family members coinfected with certain opportunistic pathogens might be more likely to transmit these infections horizontally to their children, resulting in increased likelihood of primary acquisition of such infections in the young child. Therefore, infections with opportunistic pathogens might affect not just HIV-infected infants but also HIV-exposed but uninfected infants who become infected by the pathogen because of transmission from HIV-infected mothers or family members with coinfections. These guidelines for treating OIs in children therefore consider treatment of infections among all children, both HIV-infected and uninfected, born to HIV-infected women. Additionally, HIV infection is increasingly seen among adolescents with perinatal infection now surviving into their teens and among youth with behaviorally acquired HIV infection. Although guidelines for postpubertal adolescents can be found in the adult OI guidelines, drug pharmacokinetics and response to treatment may differ for younger prepubertal or pubertal adolescents. Therefore, these guidelines also apply to treatment of HIV-infected youth who have not yet completed pubertal development. Major changes in the guidelines include 1) greater emphasis on the importance of antiretroviral therapy for preventing and treating OIs, especially those OIs for which no specific therapy exists; 2) information about the diagnosis and management of immune reconstitution inflammatory syndromes; 3) information about managing antiretroviral therapy in children with OIs, including potential drug--drug interactions; 4) new guidance on diagnosing of HIV infection and presumptively excluding HIV infection in infants that affect the need for initiation of prophylaxis to prevent Pneumocystis jirovecii pneumonia (PCP) in neonates; 5) updated immunization recommendations for HIV-exposed and HIV-infected children, including hepatitis A, human papillomavirus, meningococcal, and rotavirus vaccines; 6) addition of sections on aspergillosis; bartonella; human herpes virus-6, -7, and -8; malaria; and progressive multifocal leukodystrophy (PML); and 7) new recommendations on discontinuation of OI prophylaxis after immune reconstitution in children. The report includes six tables pertinent to preventing and treating OIs in children and two figures describing immunization recommendations for children aged 0--6 years and 7--18 years. Because treatment of OIs is an evolving science, and availability of new agents or clinical data on existing agents might change therapeutic options and preferences, these recommendations will be periodically updated and will be available at http://AIDSInfo.nih.gov.Background -- Bacterial Infections -- Mycobacterial Infections -- Fungal Infections -- Parasitic Infections -- Viral Infectionsprepared by Lynne M. Mofenson, Michael T. Brady, Susie P. Danner, Kenneth L. Dominguez, Rohan Hazra, Edward Handelsman, Peter Havens, Steve Nesheim, Jennifer S. Read, Leslie Serchuck, Russell Van Dyke"September 4, 2009.""The material in this report originated in the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention."- p. 1Also available via the World Wide Web.Includes bibliographical references (p. 99-126)

Health disparities in HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis: issues, burden, and response, a retrospective review, 2000-2004

"The Centers for Disease Control and Prevention (CDC) uses surveillance data from state and local health departments to monitor disparities and other patterns in HIV/AIDS, viral hepatitis, STDs, and tuberculosis. In this report, health disparities are measured by examining differences in HIV/AIDS, viral hepatitis, STDs, and tuberculosis surveillance data with respect to such sociodemographic factors as race/ethnicity, gender, and age. In addition, where possible, disparities are measured by examining differences by sexual orientation and geographic location. This report includes a retrospective review of CDC surveillance data for HIV/AIDS, viral hepatitis, STDs, and tuberculosis over the period 2000-2004. This time period was selected because at the time this report was written, 2004 was the most recent year for which surveillance data were available for all diseases. The inclusion of surveillance data from the same time period allows for comparisons between diseases. In addition to an overview of the surveillance data, this report includes information on some of the CDC programmatic, educational, and research activities that have been implemented to address health disparities related to HIV/AIDS, viral hepatitis, STDs, and tuberculosis. An overview of CDC priorities for future." - p. 1Health Disparities Issues -- How are health disparities defined? -- What factors contribute to health disparities? -- How are health disparities measured? -- -- What Data Do CDC Use to Monitor Health Disparities in HIV/AIDS, Viral Hepatitis, STDs, and Tuberculosis? -- The Burden of disease -- HIV/AIDS -- AIDS -- Viral hepatitis -- Sexually transmitted diseases -- Tuberculosis -- -- What is CDC Doing to Help Reduce Health Disparities in HIV/AIDS, Viral Hepatitis, STDs, and Tuberculosis? -- Initiatives -- Programs -- Research -- Educational outreach -- Workforce diversity -- -- Priorities and Recommendations for Future Action to Address Health Disparities -- Partnerships -- Screening and testing for infectious diseases -- Collaborative and integrated programs -- Improved monitoring for infections and effectiveness of prevention programs -- new technologies -- -- Conclusion -- References"November 2007""Publication of this report would not have been possible without the contributions of staff from the Divisions of HIV/AIDS Prevention, Viral Hepatitis, Sexually Transmitted Disease Prevention, and Tuberculosis Elimination, Centers for Disease Control and Prevention, as well as state and territorial health departments and community- based partners." - p. iIncludes bibliographical references (p. 50-56).Mode of access: World Wide Web.Adobe Acrobat required.C. Brooke Steele, Lehida Mele\ucc?ndez-Morales, Richard Campoluci, Nickolas DeLuca, and Hazel D. Dean. Health Disparities in HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis: Issues, Burden, and Response, A Retrospective Review, 2000-2004. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, November 2007. Available at: http://www.cdc.gov/nchhstp/healthdisparities/ [p. i]Text in PDF format (6.57 MB , 60 p.)

Disease profile

"The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) of the Centers for Disease Control and Prevention (CDC) continues to recognize the value of establishing an integrated approach to disease control and prevention. Identifying patterns and trends in the populations affected by more than one of the diseases within the purview of the center creates efficiencies at the federal level and helps public health practitioners at all levels improve upon their efforts to prevent, control, and treat disease. Of the five divisions in NCHHSTP, four (i.e., the Division of HIV/AIDS Prevention, the Division of Viral Hepatitis, the Division of STD Prevention, and the Division of Tuberculosis Elimination) publish yearly surveillance reports on the infections and diseases in their respective programs. In addition to these reports, NCHHSTP published its inaugural 2006 Disease Profile in 2008 as a first step toward an integrated approach to the prevention of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB). This profile not only gathered program-specific data into a single publication but also highlighted the disease trends and relationships stratified by selected demographic groups and risk categories. The 2007 Disease Profile reflects NCHHSTP's continuing commitment to enhancing its mission through better integration of center-based data and programs." - p. 3Introduction -- HIV/AIDS -- Viral hepatitis -- Sexually transmitted diseases -- Tuberculosis -- Special focus: Women of reproductive age -- Selected bibliography"Editor: Deborah Holtzman ; contributors: Michael L. Campsmith, Ruth Jiles, Hillard Weinstock, Valerie Robinson, Rachel J. Wilson." - t.p. verso"This is a product of the Surveillance Work Group of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. We acknowledge Karen Resha, Office of Communication Science, NCHHSTP, for contract assistance; Marie S. Morgan, Natinoal Center for Health Marketing, for editing; and Faith Berrier, Novia Knight, and Michelle Bonds of Danya International, Inc., for production. The data presented in the 2007 Disease Profile represent the work of state and local health departments."- t.p. versoAlso available via the World Wide Web as an Acrobat .pdf file (5.44 MB, 57 p.).Includes bibliographical references (p. 61-64).Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. 2007 Disease Profile. Atlanta, GA: Centers for Disease Control and Prevention; 2009

Tuberculosis: a an overview

General information -- Latent TB infection vs. TB disease -- TB in the United States -- Drug-resistant tuberculosis -- TB treatment -- ImmunizationMarch 2013.Available via the World Wide Web as an Acrobat .pdf fiel (291.84 KB, 3 p.)

PCSI

"CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's (NCHHSTP) program collaboration and service integration (PCSI) strategic priority is working to strengthen collaborative work across disease areas and integrate services that are provided by related programs, especially prevention activities related to HIV/AIDS, viral hepatitis, other sexually transmitted diseases (STDs), and tuberculosis (TB) at the client level. PCSI is a mechanism for organizing and blending interrelated health issues, activities, and prevention strategies to facilitate a comprehensive delivery of services. There are five principles that form the decision making framework for PCSI: appropriateness, effectiveness, flexibility, accountability, and acceptability. By following these five principles for PCSI, programs can deliver more comprehensive integrated services to identify and treat disease more effectively to improve the health outcomes of the persons they serve. PCSI combines two approaches for improving public health outcomes: program collaboration and service integration. Program Collaboration involves a mutually beneficial and well-defined relationship between two or more programs, organizations, or organizational units to achieve common goals. It involves many aspects of comprehensive program management at state and local levels; the 10 essential public health functions, developed by the Core Public Health Functions Steering Committee in 1994, provide a useful framework for categorizing collaboration strategies among programs. Service Integration provides persons with seamless comprehensive services from multiple programs without repeated registration procedures, waiting periods, or other administrative barriers. NCHHSTP describes three levels of service integration at the client-provider interface: nonintegrated services, core integrated services, and expanded integrated services. "Core" integrated services are combinations of services for which CDC has published guidance or recommendations, and "expanded" integrated services are best and promising evidence-based practice for which CDC has not yet published specific guidance. NCHHSTP is committed to supporting PCSI efforts initiated by staff, grantees, and partners. The use of PCSI as a structural intervention by CDC's national, state and local partners will help achieve multiple related health goals to appropriate populations whenever they interact with the health system." -- p. 1Executive summary -- Introduction -- Program collaboration and service integration -- Program collaboration -- Service integration -- Public health and related prevention services -- Monitoring and evaluation -- Toward implementation -- Conclusions -- References. -- Appendix 1: Key Findings from the 2007 CDC PCSI Consultation Meeting -- Appendix 2: Framework for Integrated Diagnostics -- Appendix 3: PCSI Logic Model -- Appendix 4: Key Recommendations for PCSI ResearchMode of access: World Wide Web as an Acrobat .pdf file (1.09 MB, 50 p.)Includes bibliographical references (p. 35-37).Centers for Disease Control and Prevention. Program Collaboration and Service Integration: Enhancing the Prevention and Control of HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis in the United States. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention annual report fiscal year 2007

About NCHHSTP -- A Year in review: Program accomplishments -- A Year in review: Scientific findings -- NCHHSTP budget -- NCHHSTP performance indicators -- Appendix: Performance measures for HIV, viral hepatitis, STD, and TB preventionNational Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention."A new beginning." - cove

A Public health approach for advancing sexual health in the United States: rationale and options for implementation : final meeting report - 2011

"The purpose of this document is to provide highlights of a technical consultation with experts in the field of sexual health convened by the Centers for Disease Control and Prevention (CDC). CDC sought current perspectives on the topic to inform their work in the area. This meeting was the first of a series of conversations held with a broad range of stakeholders. This report is a summary of the meeting's proceedings and reflects the views of meeting attendees; such accounts do not necessarily reflect the opinions of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) or CDC." - p. [5]Title from PDF title screen (CDC, viewed Sept. 7, 2011)."CS218507-A.""Publication date: 05/201." - back cover"On April 28-29, 2010, CDC held a consultation with 67 experts in the field of sexual health to discuss the elements of the green paper [a discussion document outlining a more positive health-based approach addressing sexual behavior across the lifespan and serving as a potential framework for public health action to build upon and advance 2001 Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior and to further explore the rationale, vision, and priority actions for a public health approach to advance sexual health in the United States. Consultants included experts from public interest groups, communities of faith, sexual health researchers, professional organizations, media and communications, private sector businesses, and government agencies. These experts met in plenary sessions and later formed small groups to address specific topic areas." - p. [5]Mode of access: World Wide Web.Centers for Disease Control and Prevention. A Public Health Approach for Advancing Sexual Health in the United States: Rationale and Options for Implementation, Meeting Report of an External Consultation. Atlanta, Georgia: Centers for Disease Control and Prevention; December, 2010

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention annual report fiscal year 2010

About NCHHSTP -- A Year in review: Program accomplishments -- A Year in review: Scientific findings -- NCHHSTP budget -- Performance indicators -- Appendix 1: Performance measures for HIV, viral hepatitis, STD, and TB preventionNational Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention."Publication date: 03/2011" - back cover"CS 220770-A

Strategic plan 2010-2015

"This strategic plan represents a collaborative effort by staff in the NCHHSTP Office of the Director (OD), the Center's divisions and branches, and other key partners within and outside CDC. It articulates a vision, overarching strategic directions, and innovative strategies to guide the Center's programs to prevent HIV/AIDS, viral hepatitis, sexually transmitted diseases (STDs) and tuberculosis (TB) infections. The plan supports and provides context to the disease-specific strategies and activities being done within divisions. The plan is intended to be a working document--one that will change as we gain additional input, experience, and perspective." - p. 31. Background -- 2. Why a strategic plan? Why now? -- 3. About NCHHSTP -- 4. Health Protection in NCHHSTP -- 5. NCHHSTP overarching goals 2010-2015 -- 6. Implementation, monitoring, and evaluation . -- 7. Next steps -- 8. Appendix"February 2010."Title from title screen (viewed on February 19, 2010).Mode of access: Internet.Mode of access: World Wide Web as an Acrobat .pdf file (1.01 MB, 24 p.).Includes bibliographical references