TABLE 3.5 Sexually Transmitted Diseases That Are Endemic to Southwest and South-Central Asia and Have Potential Long-Term Adverse Health Outcomes



Potential Long-Term Outcomes in Adults with Clinical Disease

Disease or Syndrome

Acute Syndrome(s) in Adults

Disease(s), Syndrome(s), or Clinical Features

Frequency of Occurrence of Outcomesa

Delay Between Acute Infection and Onset of Outcomesb

More prevalent in Southwest and South-Central Asia Than in the United States


(Haemophilus ducreyi)

Genital ulcers, inguinal lymphadenopathy


Very rare

Yes (weeks)

Hepatitis A

(hepatitis A virus [HAV])

Acute hepatitis (jaundice, nausea, anorexia, fever) if symptomatic

Liver failure

Very rare


Hepatitis B

(hepatitis B virus [HBV])

Severe cases: acute hepatic necrosis

Chronic infection


Yes (months to years)



Yes (years)

Most cases: no clinical signs

Hepatocellular carcinoma

Very rare

Yes (years to decades)

Clinically evident cases: insidious onset with anorexia, vague abdominal discomfort, nausea, vomiting Sometimes arthralgias and rash Jaundice: 30-50% of cases




Lymphogranuloma venereum

(Chlamydia trachomatis serovars L1-L3)

Genital ulcers, inguinal lymphadenopathy, proctitis

Genital scarring and fistulae; perirectal abscess

Unknown, but presumably rare

Yes (month to years)


(Treponema pallidum)

Genital ulcers (primary stage)

Rash, fever, meningitis, stroke, nephrotic syndrome, hepatitis (secondary stage)

Spontaneous abortion (any stage)

Gummas, tabes dorsalis, dementia, meningovascular disease, generalized paresis, aortitis (tertiary stage)

Common (if untreated)

Yes (months to years)

Potentially More Prevalent Among Troops in Southwest and South-Central Asia Than Among US Adult Population


(Chlamydia trachomatis serovars D-K)

Usually: asymptomatic

Chronic pelvic pain, tubal infertility, ectopic pregnancy

Common in untreated women

Yes (months to years)

Sometimes: cervicitis, pelvic inflammatory

In infants born to infected



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