Efavirenz/lamivudine/tenofovir (EFV/3TC/TDF), sold under the brand name Symfi among others, is a fixed-dose combination antiretroviral medication for the treatment of HIV/AIDS. It combines efavirenz, lamivudine, and tenofovir disoproxil. As of 2019, it is listed by the World Health Organization as an alternative first line option to dolutegravir/lamivudine/tenofovir. It is taken by mouth.Side effects can include joint pain, sleepiness, headaches, depression, trouble sleeping, and itchiness. Severe side effects may include depression, psychosis, or osteonecrosis. In those with a history of epilepsy, it may increase the frequency of seizures. Greater care should also be taken in those with kidney problems. Its use during pregnancy appears to be unsafe.It is on the World Health Organizations List of Essential Medicines. The combination received tentative approval in the United States in 2014, and was granted approval in February 2018. Its availability and importance is supported by Medecins Sans Frontieres. It is available as a generic medication. References
External links
"Efavirenz". Drug Information Portal. U.S. National Library of Medicine. "Lamivudine". Drug Information Portal. U.S. National Library of Medicine. "Tenofovir disoproxil". Drug Information Portal. U.S. National Library of Medicine. "Tenofovir disoproxil fumarate". Drug Information Portal. U.S. National Library of Medicine.
Chancroid ( SHANG-kroyd) is a bacterial sexually transmitted infection characterized by painful sores on the genitalia. Chancroid is known to spread from one individual to another solely through sexual contact. However, there have been reports of accidental infection through another route which is by the hand. While uncommon in the western world, it is the most common cause of genital ulceration worldwide. Signs and symptoms
These are only local and no systemic manifestations are present. The ulcer characteristically:

Ranges in size dramatically from 3 to 50 mm (1/8 inch to 2 inches) across
Is painful
Has sharply defined, undermined borders
Has irregular or ragged borders, described as saucer-shaped. Has a base that is covered with a gray or yellowish-gray material
Has a base that bleeds easily if traumatized or scraped
Painful swollen lymph nodes occur in 30–60% of patients. Dysuria (pain with urination) and dyspareunia (pain with intercourse) in femalesAbout half of infected men have only a single ulcer. Women frequently have four or more ulcers, with fewer symptoms. The ulcers are typically confined to the genital region most of the time. The initial ulcer may be mistaken as a "hard" chancre, the typical sore of primary syphilis, as opposed to the "soft chancre" of chancroid.Approximately one-third of the infected individuals will develop enlargements of the inguinal lymph nodes, the nodes located in the fold between the leg and the lower abdomen.Half of those who develop swelling of the inguinal lymph nodes will progress to a point where the nodes rupture through the skin, producing draining abscesses.