Evaluation of HIV, STI and CD4 results among voluntary attendees at the HIV/AIDS program of Mexico City / Evaluación de resultados de VIH, ETS y CD4 en asistentes al programa de VIH/SIDA de la Ciudad de México

Abstract: Objective: To describe results of HIV, sexually transmitted diseases (STI) and CD4 counts at the HIV-specialized Condesa Clinic (CC) in Mexico City. Materials and methods: Individuals who requested voluntary counseling and testing at CC were studied. We identified antibodies against HIV, syphilis, hepatitis C, and hepatitis B HBsAg. CD4 cell counts and viral load of HIV positive individuals were also obtained. Late HIV infection diagnosis was established if CD4 counts were lower than 200 cells/μL. Results: Global seroprevalence of HIV, syphilis, HBsAg, and anti HCV markers was of 20.1, 6, 1 and 1, respectively. Men displayed higher seroprevalence of infection markers than women. Among men, HIV infection was related to age and with all STI markers. Late HIV diagnosis was 31.8%. The risk of late HIV diagnosis was higher among women and it increased as age increased. Conclusions: Differences between genders regarding HIV and STIs prevalence as well as risk factors for HIV infection and late HIV diagnosis were observed.

Resumen: Objetivo: Describir resultados del programa VIH/SIDA de la Clínica Especializada Condesa (CC). Material y métodos: Se identificaron anticuerpos contra VIH, sífilis y hepatitis C, así como HBsAg del virus de la hepatitis B. Se hizo un conteo de CD4 y carga viral en los positivos a VIH asistentes a la CC. El conteo CD4 menor a 200 células/μL definió el diagnóstico tardío de la infección por VIH. Resultados: La prevalencia de VIH, sífilis, HBsAg y virus de la hepatitis (HCV) fue de 20.1, 6, 1 y 1, respectivamente. Los hombres mostraron prevalencias mayores de infección que las mujeres y en ellos la infección por VIH estuvo relacionada con la edad y con los marcadores de ITS. El diagnóstico tardío de VIH fue de 31.8% y su riesgo fue mayor en las mujeres y se incrementó conforme la edad. Conclusión: Se encontraron diferencias de género en las prevalencias de VIH e ITS, en los riesgos de infección por VIH y en el diagnóstico tardío de esta infección.

Factores de riesgo para la infección por el virus de la hepatitis C en la Costa Caribe colombiana: un estudio de casos y controles / Risk factors for hepatitis C virus infection in the Colombian Caribbean coast: A case-control study

Resumen Introducción. Se estima que, aproximadamente, 6,8 a 8,9 millones de personas están infectadas por el virus de la hepatitis C en Latinoamérica, de las cuales menos del 1 % llega a recibir tratamiento antiviral. En los estudios llevados a cabo hasta ahora en Colombia, se ha propuesto determinar la prevalencia de la enfermedad en algunos grupos de riesgo, y no se ha hecho el análisis de otros factores potencialmente implicados en el contagio. Objetivos. Determinar los factores de riesgo tradicionalmente analizados y otros no estudiados antes para la hepatitis C crónica en la Costa Caribe colombiana. Materiales y métodos. Se hizo un estudio de casos y controles (1:3) emparejados por empresa promotora de salud y edad (± 10 años), en el primer nivel de atención de hepatología y gastroenterología. A todos los pacientes positivos en la prueba ELISA se les hizo una prueba confirmatoria de carga viral. En el análisis de regresión logística multivariable se determinaron los factores predictores independientes de infección. Resultados. La transfusión sanguínea (odds ratio, OR=159,2; IC95% 35,4-715; p<0,001) y el antecedente de hospitalización antes de 1994 (OR=4,7; IC95% 1,3-17,1; p=0,018) se determinaron como los dos únicos factores independientes predictores de infección. Conclusión. Es necesario comprobar la reproducibilidad de estos resultados y hacer estudios de costo-efectividad antes de recomendar su utilización en el diseño de nuevas estrategias de cribado.

Abstract Introduction: An estimated 6.8-8.9 million people are infected with hepatitis C virus in Latin America, of which less than 1% receives antiviral treatment. Studies so far in Colombia have attempted to determine the prevalence of the disease in some risk groups, thus preventing the identification of other factors potentially involved in the spread of the infection. Objectives: To identify traditional and non-traditional risk factors for chronic hepatitis C in the Colombian Caribbean coast. Materials and methods: This was a case-control study (1:3) matched by health care provider and age (± 10 years) conducted at the primary care level of gastroenterology and hepatology outpatient services. All patients with a positive ELISA underwent a confirmatory viral load test. A multivariate logistic regression analysis identified the independent predictors of infection. Results: Blood transfusion (OR=159.2; 95% CI: 35.4-715; p<0.001) and history of hospitalization before 1994 (OR=4.7; 95% CI: 1.3-17.1; p=0.018) were identified as the only two independent predictors of infection. Conclusion: It is necessary to check the reproducibility of these results and to conduct cost-effectiveness studies before recommending their use in the design of new screening strategies.

Serological and virological evaluation of human T-lymphotropic virus type 1 infection in family groups from Tumaco, Colombia / Evaluación serológica y virológica de la infección por el virus linfotrópico de células T humanas de tipo 1 en grupos familiares de Tumaco, Colombia

Introduction: To date there has been no statistical evaluation of the profiles of immunoglobulin classes and viral replication as variables in the study of HTLV-1 infection and circulation among families in virus-endemic areas of Colombia. Objective: To evaluate the correlation of several immunological and molecular characteristics with the transmission and circulation of HTLV-1 among families in the town of Tumaco. Materials and methods: Plasma levels of HTLV-1 specific immunoglobulin classes IgG, IgM and IgA1, as well as IgG and sIgA in oral fluids, were calculated for 32 members of 10 family groups from Tumaco in which the mother and at least one child were infected with the virus. Levels of the different immunoglobulin classes were correlated with viral RNA circulating in plasma or oral fluids and the proviral burden as detected by RT-PCR. Results: Significant differences were determined between mothers and carrier children for immunoglobulin levels (p=0.037) and proviral burden (p=0.002). The overall estimate of IgG in plasma and sIgA in oral fluids could be correlated with the circulation of free viral RNA in both fluids and high proviral burden, and associated with HAM/TSP mothers. The detection of anti- tax IgG in plasma revealed differences between HAM/TSP mothers and their offspring. Conclusion: The study of immunological and molecular variables permitted the analysis of HTLV-1 circulation among families of Tumaco. The strong correlation between levels of IgM specific for the virus and viral RNA circulating in fluids indirectly confirmed the transmission of HTLV-1 among families.

Introducción. Todavía no hay una evaluación estadística de los perfiles de las clases de inmuno- globulina s y la replicación viral, como variables para estudiar la infección y la circulació n del HTLV-1 en familias de zonas endémicas en Colombia. Objetivo. Evaluar la correlación de varias características inmunológicas y moleculares, con la transmisión y circulación del virus en familias del municipio de Tumaco. Materiales y métodos. Se calcularon los niveles de IgG, IgM e IgA1 en plasma, e IgG y IgA secretoria en fluido oral, de 32 miembros de 10 grupos familiares de Tumaco, en los que la madre y, al menos, un hijo estaban infectados con el virus. La concentración de las diferentes clases de inmunoglobulinas se pudo correlacionar con la circulación de ARN viral libre en plasma y fluido oral, y la carga proviral, según su detección mediante reacción en cadena de la polimerasa de transcripción inversa. Resultados. Se encontraron diferencias significativas en los niveles de inmunoglobulinas (p=0,037) y en la carga proviral (p=0,002) entre madres e hijos portadores. La estimación total de IgG en plasma e IgA secretoria en fluido oral, se pudo correlacionar con la circulación de ARN viral libre en ambos fluidos y una alta carga proviral, y se asoció con las madres paraparesia espástica tropical o mielopatía asociada con el HTLV-1. La detección en plasma de IgG anti-Tax reveló diferencias entre ellas y sus hijos. Conclusión. El estudio de las variables inmunológicas y moleculares permitió analizar la circulación del HTLV-1 en familias de Tumaco. La fuerte asociación entre los niveles de IgM específica para el virus y el ARN viral circulante en los fluidos y la carga proviral, confirmó indirectamente la transmisión intrafamiliar del virus.

Frequency of blood-borne viral infections among leukemic patients in central Iraq

To determine the prevalence of hepatitis B virus [HBV], hepatitis C virus [HCV], cytomegalovirus [CMV], Epstein-Barr virus [EBV], and human immunodeficiency virus [HIV] and other epidemiological criteria among leukemic patients to establish basic knowledge for future leukemic patient's care. This cross-sectional study was carried out between February 2006 and June 2008 in the Children's Central Teaching Hospital and Medical City Teaching Hospital in Baghdad, Iraq. A total of 641 blood samples [291 samples from leukemic patients and 350 samples from controls] were collected and the sera were tested for the presence of HBV, HCV, CMV, EBV, and HIV serological markers. A significantly higher prevalence of hepatitis B surface antigen [HBsAg] was detected among leukemic patients [32.3%] than controls [2.3%]. The seroprevalence of anti-HBs was 29.9% among patients, and 20.6% among controls. This difference was also found to be statistically significant. A significantly higher prevalence of anti-HCV antibodies among leukemic patients [3.4%] than controls [0.3%] was also detected. A higher prevalence of IgG and IgM markers specific for CMV [96.2% and 12% for patients; 91.6% and 8% for controls], and for EBV [88.3% and 26.5% for patients; 75.1% and 13.4% for controls], were detected among leukemic patients than controls, while none of the patients and controls were positive for HIV I and II markers. We conclude that HBV, HCV, CMV, and EBV infections are more prevalent among leukemic patients. There was an increase in the seropositivity rates of HCV, CMV, and EBV infections with increasing ages of leukemic patients. The male leukemic patients were more exposed to HBV, HCV, and EBV infections than females

Transmisión nosocomial de la hepatitis C asociada a procedimientos anestésicos: un estudio de casos y controles

OBJETIVO: Medir la asociación entre el antecedente de procedimientos anestésicos y el riesgo de infección por el virus de la hepatitis C (VHC) en pacientes con cirugía previa. MATERIAL Y MÉTODOS: Diseño de casos y controles; los casos fueron pacientes con anticuerpo (anti-VHC) positivo confirmado por RIBA y/o RNA VHC y los controles fueron sujetos con el anti-VHC negativo. El riesgo de infección se estimó por razón de momios (RM) y análisis multivariado con regresión logística. RESULTADOS: Se incluyeron 362 sujetos, 211 casos y 151 controles; en 70 casos (33.2 por ciento), con cirugía previa, los procedimientos anestésicos se identificaron como único factor de riesgo significativo para la infección por el VHC (RM ajustada 2.44, IC 95 por ciento 1.44 - 4.11). CONCLUSIONES: Este es el primer estudio en México que demuestra asociación de riesgo significativa con el antecedente de procedimientos anestésicos por cirugía previa, en uno de cada tres enfermos con hepatitis C.

OBJECTIVE: Nosocomial transmission of hepatitis C virus (HCV) infection had been related with anesthesia procedures. The study aim was to measure the association between anesthesia procedures in cases with previous surgery and HCV infection. MATERIAL AND METHODS: In a case-control study were included subjects that attended to the Central Blood Bank of the West Medical National Center, Mexican Institute of the Social Security in Guadalajara, Jalisco between july 2005 and september 2007. Cases were patients with positive hepatitis C antibody (anti-HCV) confirmed by recombinant immunoblot assay (RIBA) and/or nucleic acid test (HCV RNA); the control group was blood donors with negative antibody. An exhaustive questionnaire about risk factors for hepatitis C, was applied. The risk of HCV infection was determined with the Odds Ratio (OR) and multivariate analysis was made by logistic regression. RESULTS: We included 362 subjects, 211 cases and 151 controls; in 70 (33.2 percent) cases were found significant association between the anesthesia procedures and HCV infection in patients with previous surgery (OR adjusted 2.44, CI 95 percent 1.44 - 4.11) CONCLUSION: This is the first study in México that demonstrate association between history of anesthesia procedures and HCV infection in cases with previous surgery.

Fatores de risco para a ocorrência de viremia pelo herpesvirus 8 humano (HHV-8) em pacientes com aids e sarcoma de Kaposi / Risk factors for human herpesvirus 8 (KSHV/HHV-8) viremia in AIDS patients with Kaposi's sarcoma

Existem várias evidências epidemilógicas, virológicas e sorológicas de que o herpesvírus 8 humano (HHV-8) seja o agente causal do sarcoma de Kaposi (SK) e que a replicação do HHV-8 esteja associada à patogênese do SK. Entretanto, poucos estudos têm investigado de maneira seriada e prospectiva a relação da replicação do HHV-8 com possíveis fatores de risco. O presente estudo avaliou a presença do DNA do HHV-8 pela técnica da reação em cadeia de polimerase em células mononucleares do sangue periférico de 42 pacientes com aids e SK e investigou a relação da viremia do HHV-8 com os dados epidemiológicos, clínicos e laboratoriais relacionados à co-infecção pelo HIV e HHV-8 e ao SK. /to HIV/HHV-8 There are several epidemiological, virological and serological lines of evidence suggesting that human herpesvírus 8 (HHV-8) is the cause of Kaposi's sarcoma (KS) and that the HHV-8 replication is important for KS pathogenesis. However, few prospective studies investigating the relationship of the HHV-8 replication and possible risk factors have been published...

Fatores de risco para a ocorrência de viremia pelo herpesvírus 8 humano (HHV-8) em pacientes com aids e sarcoma da Kaposi / Risk factors for human herpesvirus (KSHV/HHV-8) viremia in AIDS patients with Kaposi´s sarcoma

Existem várias evidências epidemiológicas, virológicas e sorológicas de que o herpesvírus 8 humano (HHV-8) seja o agente causal do sarcoma de Kaposi (SK) e diversos estudos sugerem que a replicação do HHV-8 está associada à patogênese do SK. Entretanto, poucos estudos têm investigado de maneira seriada e prospectiva a relação da replicação do HHV-8 com possíveis fatores de risco. O objetivo do presente estudo foi avaliar a dinâmica da replicação do HHV-8 e da resposta humoral ao vírus em uma coorte de pacientes com aids e SK atendidos no ambulatório de SK da Casa da Aids - Fundação Zerbini, e estimar a prevalência e os fatores de risco para a ocorrência de viremia pelo HHV-8 nessa população. Os pacientes foram acompanhados prospectivamente e avaliações clínico-laboratoriais foram realizadas periodicamente ao longo do estudo para coleta de sangue e coleta de dados clínicos quanto à evolução da infecção pelo HIV/aids e a evolução do SK. Viremia positiva do HHV-8 foi definida pela presença de DNA do HHV-8 em células mononucleares do sangue periférico (PBMC) por pelo menos um dos dois métodos de "nested"-PCR realizados, amplificando fragmentos de 170 pb ou 233 pb. Para o diagnóstico sorológico da infecção pelo HHV-8 foram realizados os métodos de imunofluorescência indireta (IFA) para detectar anticorpos contra antígenos nuclear latente (LANA) e citoplasmáticos (LíTICO) e a técnica imunoenzimática (ELlSA) para detectar anticorpos contra antígeno recombinante do capsídeo viral (ORF 65). Para estimar o efeito das variáveis independentes sobre a viremia foi utilizado um modelo de equações de estimação generalizadas, considerando que cada paciente representa um "cluster" de observações...