Prevalence and risk factors for oral human papillomavirus infection in Mexican HIV-infected men / Prevalencia y factores de riesgo para infección oral con virus de papiloma humano en hombres mexicanos con VIH

Abstract: Objective: To determine the prevalence and risk factors for oral high-risk human papillomavirus (HR-HPV) infection in human immunodeficiency virus(HIV)-infected men. Materials and methods: Consecutive male outpatients with HIV-infection were enrolled. Demographic and behavioral risk data were obtained. Anal swabs and oral rinses were tested for HR-HPV DNA. Oral, pharyngeal and video laryngoscopy examinations were performed for detection of lesions. Results: The prevalence of HR-HPV oral infection was 9.3% (subtypes other than HR HPV 16/18 predominated). The prevalence of anal HR-HPV infection was 75.7%. The risk factors for oral infection with HR-HPV were tonsillectomy (OR=13.12) and years from HIV diagnosis (OR=1.17). Conclusions: Tonsillectomy and years from HIV diagnosis were associated with oral HPV infection. No association was found between oral and anal HR-HPV infections. This is the first study reporting the prevalence and risk factors for oral HR-HPV infection in Mexican HIV-infected population.

Resumen: Objetivo: Determinar la prevalencia y los factores de riesgo para infección oral por virus de papiloma humano de alto riesgo (VPH-AR) en individuos con VIH. Material y métodos: Se incluyeron pacientes ambulatorios consecutivos con VIH. Se recabó información demográfica y sobre factores de riesgo conductuales. Se detectó DNA de VPH-AR en hisopado rectal y enjuague bucal. Se efectuó exploración de boca, faringe y videolaringoscopía para detectar lesiones. Resultados: La prevalencia de VPH-AR oral fue 9.3% (predominaron subtipos diferentes de VPH-AR 16/18). La prevalencia de VPH-AR anal fue 75.7%. Los factores de riesgo para VPH-AR oral fueron la tonsilectomía (OR=13.12) y los años de diagnóstico del VIH (OR=1.17). Conclusiones: La tonsilectomía y los años de diagnóstico del VIH se asociaron con VPH-AR oral. No hubo asociación entre VPH-AR oral y anal. Este es el primer reporte sobre prevalencia y factores de riesgo para VPH-AR oral en población mexicana con VIH.

Fatores preditores de fístula salivar pós-laringectomia total / Predictors of salivary fistula after total laryngectomy

OBJETIVO: Avaliar a incidência de fístula faringocutânea após laringectomia total e tentar identificar os fatores preditores. MÉTODOS: No período de maio de 2005 a abril de 2010, 93 pacientes foram submetidos à laringectomia total. Foram avaliadas as complicações per e pós-operatórias e comparadas com as seguintes variáveis: sexo, estado nutricional, traqueostomia prévia, localização do tumor primário, tipo de operação realizada, estadiamento de acordo com o TNM, tratamento prévio com quimioterapia e/ou radioterapia, utilização de retalhos para reconstrução e margem cirúrgica. Todos os pacientes apresentavam a neoplasia em estádio avançado segundo o TNM. RESULTADOS: 14 (15,1%) pacientes evoluíram com fístula salivar no pós-operatório. O tempo médio de aparecimento da fístula salivar foi 3,5 dias, com desvio padrão de 13,7 dias. Comparando a fístula salivar com as variáveis TNM, tipo de operação e esvaziamento cervical, traqueostomia prévia, utilização de retalho miocutâneo, rádio e quimioterapia pré-operatória e margem cirúrgica, não foi observado diferença estatisticamente significativa (p>0,05). CONCLUSÃO: A incidência de fístula salivar foi 15,1% e não foi encontrado fator preditor para sua formação.

OBJECTIVE: To evaluate the incidence of pharyngocutaneous fistula after total laryngectomy and try to identify its predictors. METHODS: From May 2005 to April 2010, 93 patients underwent total laryngectomy. We evaluated complications during and after surgery and compared them with the following variables: gender, nutritional status, previous tracheotomy, tumor location, type of surgery, TNM staging, prior treatment with chemotherapy and/or radiotherapy, use of flaps for reconstruction and surgical margin. All patients presented with advanced neoplastic disease according to TNM. RESULTS: 14 (15.1%) patients developed postoperative salivary fistula. The mean time to onset of salivary fistula was 3.5 days, with a standard deviation of 13.7 days. Comparing salivary fistula with TNM variables, type of operation and neck dissection, prior tracheotomy, use of flap, preoperative radio and chemotherapy and surgical margin, there was no statistically significant difference (p> 0,05). CONCLUSION: The incidence of salivary fistula was 15.1% and no predictive factor for its formation was found.