Prevalência e fatores associados à presença de infecções sexualmente transmissíveis em gestantes infectadas pelo HIV acompanhadas em um centro especializado na Baixada Fluminense / Prevalence and factors associated with the presence of sexually transmitted infections in hiv-infected pregnant women attending a specialized center in the Baixada Fluminense area

A transmissão sexual é responsßvel por aproximadamente 90 por cento dos casos novos de infecção pelo vírus da imunodeficiência humana (HIV) no mundo. As infecções sexualmente transmissíveis (ISTs) constituem um importante cofator na aquisição deste vírus. Dados acerca da co-infecção HIV/ISTs em gestantes, população considerada de alto risco para sua aquisição, são escassos. O objetivo principal do nosso estudo foi descrever as características sociodemogrßfica se aspectos clínicos de uma coorte de gestantes infectadas pelo HIV e avaliar a prevalência de diversas ISTs e fatores associados à co-infecção HIV/ISTs, além de estabelecer correlações entre a ocorrência destas infecções e a morbimortalidade perinatal neste grupo de pacientes. Métodos: Estudo de coorte prospectivo comgestantes infectadas pelo HIV, recrutadas entre 2005 e 2007, no Hospital Geral deNova Iguaçu, centro de referência de atendimento de HIV/ISTs. As diversasvarißveis de interesse foram coletadas por meio de formulßrio pré-estruturado.Resultados: Ao todo, 210 pacientes, a maioria com baixos níveis de escolaridade erenda familiar, participaram do estudo; destas, 137 (65,2 por cento) possuíam ao menosuma IST além do HIV. A média de idade foi de 26 anos. As prevalências de infecçãopor vírus herpes simplex tipo 2 (HSV-2), sífilis, infecção por clamídia e pelo vírus da hepatite B foram, respectivamente, 66 por cento, 10,5 por cento, 5,3 por cento e 2,9 por cento; menos de 1 por cento das pacientes apresentava sorologia reagente para vírus da hepatite C ou infecção gonocócica...

Sexual transmission accounts for approximately 90 percent of all newhuman immunodeficiency virus (HIV) infections in the world. Sexually transmittedinfections (STIs) are an important cofactor in the acquisition of this virus. Dataregarding HIV/STI co-infection in pregnant women, a high-risk population for theiracquisition, are scarce. Our studyÆs primary aim was to describe social-demographiccharacteristics and clinical aspects of a cohort of HIV-infected pregnant women andto evaluate the prevalence of STIs and factors associated with HIV/STI co-infection.We also aimed to establish correlations between the diagnosis of STIs duringpregnancy and perinatal morbidity and mortality in this group of patients. Methods:Prospective cohort study with HIV-infected pregnant women, recruited between 2005and 2007 in the Hospital Geral de Nova Iguaçu, a referral center for HIV/STI patients.Variables were collected through a pre-structured questionnaire. Results: Overall,210 patients, the majority of which had low educational levels and household income,participated in this study. One-hundred thirty-seven (65.2 por cento) tested positive for atleast one STI besides HIV...

Prevalence of hrrpes simplex virus type 2 and rsk factors associated with thiss infection in women in southern Brazil / Prevalencia do herpes virus tipo 2 e fatores de risco associados a sua infeccao em mulheres do sul do Brasil

SUMMARY The herpes simplex virus type 2 (HVS-2) is the most prevalent infection worldwide. It is a cofactor in the acquisition of human immunodeficiency virus (HIV) and the persistence of human papillomavirus (HPV). This study evaluated the prevalence of HSV-2, using the polymerase chain reaction (PCR), and associated factors in patients treated at the Federal University of Rio Grande (FURG) and Basic Health Units (BHU) in Rio Grande, Brazil. The observed prevalence of HSV-2 was 15.6%. Among the 302 women studied, 158 had received assistance in BHU and 144 were treated at FURG. The prevalence of HSV-2 in these groups was 10.8% and 20.8%, respectively, RR 1.9 and p = 0.012. Knowledge about the Pap smear, and the presence of lesions showed no association with HSV-2 infection. Multivariate analysis showed that the variable that most influenced the risk of HSV-2 infection was the presence of HIV infection, with a relative risk of 1.9 and p = 0.04. Discussion: Genital ulcers are an important entry point for HIV, and condom use is an important strategy to reduce transmission of HIV and HSV-2. .

RESUMO O vírus herpes simplex tipo 2 (HVS-2) é uma das infecções mais prevalentes em todo o mundo. Considera-se um co-factor na aquisição do vírus da imunodeficiência humana (HIV) e na persistência do papilomavirus humano (HPV). Este estudo tem como objetivo avaliar a prevalência de HSV-2 usando a reação em cadeia da polimerase (PCR) e fatores associados em pacientes atendidos na Universidade Federal do Rio Grande e em Unidades Básicas de Saúde (UBS) do Rio Grande, Brasil. A prevalência de HSV-2 encontrada neste estudo foi de 15,6%. Entre as 302 mulheres estudadas, 158 haviam recebido assistência na UBS e 144 foram atendidos na FURG. A prevalência de HSV-2 nestes grupos foi de 10,8 e 20,8%, respectivamente, com RR: 1,9 e p = 0,012. Conhecer o exame de Papanicolaou, e presença de lesão não teve associação com infecção HSV-2. A análise multivariada mostrou que a variável que influencia no risco de infecção HSV-2 foi o paciente ter HIV, com risco relativo 1,9 e p = 0,04. Discussão: As úlceras genitais são importante porta de entrada para o vírus HIV e o uso do preservativo é estratégia importante para reduzir a transmissão do HIV e do HSV-2. .

Diseño de un programa psicoeducativo para el cuidado de pacientes con herpes simple genital / Design of a psycho-educational program for the care of genital herpes simplex

Introducción: En Cuba, se reporta alta incidencia y prevalencia de herpes simple genital. Sin embargo, los/as enfermeros/as encuestadores carecen de una herramienta metodológica para el cuidado de estos pacientes en la Atención Primaria de Salud. Objetivos: Por tal motivo, se realizó un estudio que respondió a un proyecto de desarrollo con el objetivo de diseñar un programa psicoeducativo para disminuir el riesgo en la salud sexual y los problemas psicosociales de los pacientes con diagnóstico clínico de herpes simple genital. Métodos: Para el diseño del programa psicoeducativo se utilizaron las tres primeras etapas del modelo de Giordan. En este sentido, se realizó un estudio fenomenológico en 8 pacientes con diagnóstico de herpes simple genital, para determinar las necesidades de aprendizaje y se sometió a criterio de expertos para establecer los objetivos, métodos y contenidos del programa psicoeducativo. Resultados: El programa quedó conformado por seis sesiones encaminadas a disminuir los problemas psicosociales, incrementar la autoeficacia en el uso del condón, el conocimiento sobre la enfermedad, la eficacia para tener sexo seguro y la eficacia para comunicar la enfermedad. Conclusiones Se diseñó un programa psicoeducativo que incorporó cinco ejes (problemas psicológicos, conocimientos sobre la enfermedad, uso del condón, sexo seguro y revelado de la enfermedad)(AU)

Introduction: In Cuba a high incidence and prevalence of genital herpes simplex is reported. However, nurses and pollters have not available a methodological means for the care of these patients in Primary Health Care. Objectives: Thus, authors conducted an study that is in keeping with to a project of development to design a psycho-educational program to decrease the risk in sexual health and the psychosocial problems of patients clinically diagnosed with genital herpes simplex. Methods: For design of above mentioned program the three stages of the Giordan form were used. In this sense, a phenomenology study was conducted in 8 patients diagnosed with genital herpes simplex, to determine the needs of learning submitting to expert's criteria to establish the objectives, methods and contents of psycho-educational program. Results: The program included six sessions aimed to decrease the psychosocial problems, to increase the self-effectiveness in the use of condom, the knowledge on disease, a safe intercourse and the efficiency to communicate the disease. Conclusions: A psycho-educational program was designed incorporating five key features (psychological problems, knowledges on disease, use of condom, safe intercourse and developing of disease)(AU)

Incidence of herpes simplex virus type 2 in young reproductive age women in Mysore, India.

Context: There are sparse data on herpes simplex virus type 2 (HSV-2) infection in India. HSV-2 is one of the most common sexually transmitted infections and the primary cause of genital ulcer disease worldwide. Aim: The aim of this study is to describe the incidence of HSV-2 infection among young reproductive age women in Mysore, India. Setting and Design: Between October 2005 and April 2006, 898 women were enrolled into a prospective cohort study in Mysore, India, and followed quarterly for 6 months. Materials and Methods: An interviewer administered questionnaire was used to collect demographic and social risk factors, and physical examination was conducted for collection of biological specimens to screen for reproductive tract infections at each visit. Serologic testing was conducted for the presence of HSV-2 antibodies using HerpeSelect HSV-2 enzyme-linked immunosorbent assay. Statistical Analysis Used: Data were analyzed using R. Incidence density rates were calculated using Poisson distributions with person-time of follow-up as denominator. Person-time was calculated as time from enrollment until time of first positive HSV-2 test. Results: There were 107 women with HSV-2 antibodies leaving 700 women with negative results at enrollment. The analysis included 696 out of which, there were 36 HSV-2 seroconversions during the study period. The study cohort accumulated roughly 348 woman-years of follow-up, yielding an HSV-2 acquisition rate of 10.4 cases/100 woman-years. All detected infections were asymptomatic. Conclusions: HSV-2 incidence is moderate in this community sample of young reproductive age monogamous women. More research is needed to establish incidence estimates in different Indian settings.

Seroepidemiology of infection with herpes simplex virus types 1 and 2 [HSV1 and HSV2] among asymptomatic university students attending Islamic Azad University of Kazeroun, southwest of Iran

Herpes simplex virus type 1 and type 2 [HSV-1 and HSV-2] are common infectious agents worldwide. Data on prevalence of HSV-1 and HSV-2 infections are limited in Asia, especially in Iran. Our study aimed on determination of seroepidemiology of HSV-1 and HSV-2 infections in asymptomatic healthy students of Islamic Azad University of Kazeroun, Fars province, southwest of Iran. The study population included 360 students with a mean age of 22.2 years. Demographic data were gathered by a well-designed questionnaire. For serological studies, 5 ml of blood sample was collected and centrifuged. Enzyme linked immunosorbent assay [ELISA] was used to determine immunoglobulin G [IgG] antibody titer to the HSV-1 and HSV-2. Totally, HSV-1 and HSV-2 IgG antibody were positive in 285 [79.2%] and 84 [23.3%] subjects, respectively. The seroprevalence of HSV-2 was higher among females [29.0%] compared with males [17.5%] [p<0.05], however, there was no significant correlation between gender and HSV-I seroprevalence. Results confirm a high prevalence of HSV infection. Our findings were in agreement with in prior studies in which HSV-2 infection was more prevalent among female subjects. The high prevalence of HSV infection underlines the need for focusing on preventive efforts and education among the population

Community-based study on seroprevalence of herpes simplex virus type 2 infection in New Delhi.

PURPOSE: To determine the seroprevalence of herpes simplex virus type 2 (HSV-2) in two urban communities in Delhi and to correlate the presence of HSV-2 seroprevalence with sociodemographic profile, risk factors and presence of other reproductive tract infections (RTIs). METHODS: Men and women aged between 15-49 years from an urban slum and an urban middle class colony were invited to participate in the study. They provided interview information; blood for HSV-2, HIV and syphilis serology; first void urine specimens for diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis infection; and genital specimens for diagnosis of bacterial vaginosis, vaginal candidiasis and trichomoniasis. RESULTS: The prevalence of HSV-2 seropositivity was found to be 7 and 8.6% in men and women, respectively. HSV-2 seropositivity was found to be significantly associated with urban middle class community and older age. No statistically significant correlation was found between HSV-2 seropositivity and other laboratory-confirmed RTIs. CONCLUSIONS: The findings of our study indicate a relatively low prevalence of HSV-2 seropositivity and other sexually transmitted infections in the two communities that were studied.

Infección por Herpes Simple Genital: revisión global / A systematic review on Genital Herpes Infection

Nuevas evidencias denotan que el Herpes Genital es un importante problema de salud. Sin embargo, las investigaciones son limitadas en cuanto a un enfoque bio-psico-social de esta enfermedad. Por lo que nos proponemos en el siguiente manuscrito realizar una revisión bibliográfica encaminada a la epidemiología, tratamiento e impacto psicosocial del Herpes Genital. La combinación de estos conceptos en español como en inglés fueron buscadas en las bases de datos EBSCO, CINHAL, CIELO y MEDLINE. E l artículo concluye que el Herpes Genital es la enfermedad crónica de transmisión sexual de mayor incidencia en el mundo; sin embargo, no se registran estadísticas en nuestro país que denoten la magnitud de este flagelo. Se aprecian escasos estudios en la revisión realizada tanto nacional como internacional sobre sus consecuencias psicosociales.

New evidence notes that Genital Herpes is an important health problem. Nevertheless, investigations have been limited about a bio-psyco-social approach of this disease. Therefore, in this manuscript we have as a purpose, to perform a systematic review leading to epidemiology, treatment and social impact of genital herpes . The combination of these concepts in Spanish as well as in English, were drawn from electronic databases such as EBSCO, CINHAL, Scielo and MEDLINE. This article bring to a close that genital herpes is the most frequent in the world sexually transmitted disease, however, there are no statistics in Cuba which denote the presence of this disease. There are very scarce studies both national and international that show the presence of this disease and its social and psychological impact.

Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and managemenT

Eight of the more than 80 known herpesviruses are human pathogens. Human herpes simplex virus (HSV) is a contagious infection with a large reservoir in the general population. It has a potential for significant complications in the immunocompromised host. In addition, psychological distress caused by the negative stigma associated with genital herpes and visible facial lesions in those experiencing frequent outbreaks renders it a challenging clinical dilemma. This article reviews the epidemiology, pathogenesis, and diagnostic features of HSV infections, providing the clinician with an up-to-date understanding of the available management strategies for mucocutaneous HSV-induced disease.

Seroepidemiological study of herpes simplex virus type 2 in patients with the acquired immunodeficiency syndrome in the city of Niterói, Rio de Janeiro, Brazil

This study was designed to determine the seroprevalence of herpes simplex virus type 2 (HSV-2) and to evaluate its association with age, sex as well as other demographic and behavioural factors in 150 human immunodeficiency virus (HIV) positive adults patients attending the general medical outpatient ward for routine care of Niterói, state of Rio de Janeiro, Brazil. Serum samples were screened for HSV-2 antibodies using an indirect ELISA. Eighty-three patients were men (mean age: 38.8) and 67 were women (mean age: 35.4). The estimated prevalence of HSV-2 was 52 percent (95 percent CI: 44-60 percent) and it was higher among men (53 percent) than among women (50.7 percent). Overall, the age of first sexual intercourse and past history of genital herpes were associated with HSV-2 seropositivity. Analysis by gender disclosed significant association of number of lifetime sex partners only among men. Although HSV-2 antibodies were frequent in the study group, genital herpes was reported by 21.8 percent of the HSV-2 positive subjects, indicating low awareness of the HSV-2 infection. These results may have public health importance for Brazil as the high rate of HSV-2 infection may act as a cofactor of HIV transmission.

Study of STD pattern and its associated risk factors--a hospital study.

This study was conducted to know the STD prevalence and its associated risk factors among patients attending STD clinic of Govt using cross sectional hospital based data collected on 255 patients visited STD clinic during Jan. 2005- Dec.2005. Results suggested that highest prevalence found was of Herpes genitalis (31.8%), followed by Venereal warts (25.1%), Gonorrhoea (11.0%), Syphilis (10.6%). The most commonly associated risk factor found to be multiple sexual partners followed by factor as visit to prostitutes. Since most diseases are of social nature, IEC activities to improve the awareness in the community about STDs and about risk factors associated with them should bring behaviour related risk taking among people spreading STDs in the community.

Prevalência e fatores de risco para a infecção pelo herpes simples vírus tipo-2 em uma coorte de homens que fazem sexo com homens no Rio de Janeiro / Prevalence and risk factors for herpes simplex type-2 virus in a cohort of men who have sex with men in Rio de Janeiro

O HSV-2 é a principal causa de herpes genital, sendo a maior parte destas infecções assintomática. A infecção pelo HSV-2 pode ser um fator de risco para a aquisição e transmissão de outras DST, inclusive da infecção causada pelo HIV. Objetivo: Estimar a prevalência e identificar os fatores de risco associados à infecção pelo HSV-2 em uma coorte de homens que fazem sexo com homens da Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. Métodos: Estudo transversal, com avaliação de dados sócio-demográficos, comportamentais e laboratoriais referentes à linha de base de 403 voluntários incluídos na referida coorte, no período de 1994-1998. As amostras foram testadas através do ELISA para detecção de anticorpos tipo-específicos contra a gG2 do HSV-2 (HerpeSelect - Focus Technologies)Resultados: A prevalência para anticorpos anti-HSV-2 encontrada nesta população foi de 65,2 por cento. Após análise multivariada, os fatores que se mostraram independentemente associados à infecção pelo HSV-2 foram idade mais elevada (maior ou igual a 26 anos), raça não branca, ter sorologia positiva para sífilis (TPHA), ter feito sexo desprotegido com parceria sexual masculina e ter feito sexo desprotegido com parceria sexual feminina nos seis meses que antecederam a visita. Conclusão: Este estudo mostra uma elevada prevalência da infecção pelo HSV-2 neste grupo e associação dessa infecção com outras DST, em concordância com outros estudos. Estes dados podem ter uma importante contribuição no sentido de avaliar estratégias que possam contribuir para a prevenção desta infecção na população de homens que fazem sexo com homens, que é tida como uma população vulnerável e central à dinâmica da disseminação do HSV-2 em todo o mundo...

HSV-2 is the primary cause of genital herpes and most of the infections are asymptomatic. The infection by HSV-2 may be a risk factor to acquisition and transmission of other sexually transmitted diseases (STD), including infection by HIV virus. Objective: Estimate the prevalence and identify the risk factors associated of infection by HSV-2 in a cohort of men who have sex with men (MSM) in Fundação Oswaldo Cruz [Oswaldo Cruz Foundation], Rio de Janeiro, Brazil.Methods: Cross-sectional study, evaluating sociodemographic, behavioral, and laboratorialdata from baseline of 403 volunteers included in this cohort, in the period of 1994-1998. The samples were tested by ELISA to detect type-specific antibodies against HSV-2 gG2 (HerpeSelect - Focus Technologies). Results: The prevalence to antibodies anti-HV2-2 observed in this population was 65.2 percent.After multivariate analysis, the factors independently associated to HSV-2 infection were older age (> 26 years), non-white race, positive serology for syphilis (TPHA), history of unprotected sex with male partners and history of unprotected sex with female partners inthe last six months before the visit.Conclusion: This study shows a high prevalence of HSV-2 infection in this group and association with other STD, consistent with other studies. This data may have a significant contribution to evaluate strategies that may contribute to prevent this infection amongMSM, as this is considered a vulnerable core-population to the dynamics of HSV-2 spreading all over the world...

Sexually-transmitted viral diseases in women: clinical and epidemiological aspects and advances in laboratory diagnosis

Sexually transmitted diseases (STDs) have long been known, but they have only recently been recognized as causes of significant long-term morbidity, mainly as a result of increased knowledge concerning viral STDs. The relationship of these diseases with conditions such as anogenital cancer and acquired immunodeficiency syndrome (AIDS) has made viral STDs an important issue in the healthcare of women and infants, and in reproductive health. The evolution of the AIDS pandemic is now characterized by growing differences between rich and poor nations. New diagnostic tools include rapid tests of blood, urine and saliva samples. New techniques, such as computerized cytology, have been developed for the diagnosis of human papillomavirus (HPV). Women infected with HIV are at a greater risk of being co-infected with HPV, and they are also more prone to the progression and persistence of HPV lesions. The herpes simplex virus presents high rates of co-infection with HIV, and it plays a particularly important role in increasing transmission rates of this virus.

Seropervalencia de la infección por virus herpes simplex tipo 2 en pacientes atendidos en centros de referencia de ETS de Santiago / Seroprevalence of herpes simplex virus type 2 (HSV-2) infection in two clinics for sexually transmitted diseases in Santiago, Chile

Background: Genital herpes, a sexually transmitted disease caused by herpes simplex virus type 2 (HSV-2), is found in 3.8percent of all sexually transmitted diseases (STD) in Chile. Aim: To determine the seroprevalence of herpes simplex virus type 2 (HSV-2) and to identify an association between HSV-2 and HIV-1, other STD, and to study its demographic characteristics. Material and methods: A cross-sectional study at two STD public clinics in Santiago was conducted among 200 consecutive patients. Samples were tested for HSV-2, HIV-1, syphilis and hepatitis B virus surface antigen. Results: The seroprevalence for HSV-2 was 43percent. Four patients had a history of genital herpes. There was a strong association between HSV-2 infection and HIV-1 positivity (OR=8.7, 95percent CI 3.4-22.4, p <0.001) and the condition of being a sexual worker (OR=4.5, 95percent CI 1.7-11.9, p <0.01). Conclusions: The high association with HIV-1 and sexual workers, emphasizes the need of having HSV-2 specific diagnostic tests, counseling on sign and symptom recognition and taking preventive measures.

Asymptomatic herpes simplex virus type 2 (HSV-2) infection among pregnant women in Turkey.

BACKGROUND & OBJECTIVES: A large proportion of individuals with serologic evidence of infection with herpes simplex virus type 2 (HSV-2) are asymptomatic. HSV-2 is the main cause of genital herpes infections. The acquisition of genital herpes during pregnancy has been associated with spontaneous abortion, premature labour and congenital and neonatal herpes. The present study was undertaken to determine asymtomatic genital HSV-2 shedding and seroprevalence of HSV-2 infection among asymptomatic pregnant women at the time of delivery in Adana, Turkey. METHODS: Asymptomatic 130 pregnant women without a history of genital herpes were enrolled in the study. HSV-2 shedding was determined by viral culture of the swabs collected from cervix and vulva and HSV-2 antigen was detected by direct immunofluorescence assay (IFA), HSV-2 IgG and IgM antibodies were detected by HSV-2 type specific IgG and IgM enzyme-linked immunosorbent assay (ELISA). RESULTS: HSV-2 IgG and IgM antibodies were found in 82 (63.1%) and 18 (11.3%) of 130 pregnant women. HSV-2 type-specific antigen was detected in 22 (16.9%) pregnant women by IFA test, 17 (13.1%) of whom had HSV-2 IgM antibodies. HSV-2 was isolated only in 3 women. INTERPRETATION & CONCLUSION: The seroprevalence of HSV-2 (63.1%) and genital HSV-2 infection (16.9%) was high among asymptomatic pregnant women in Adana, Turkey. Therefore, to reduce the risk of neonatal herpes, HSV-2 type-specific antibodies should be detected in pregnant women using serological tests that allow to identify women with asymptomatic or subclinical genital HSV-2 infection and those susceptible to primary genital HSV-2 infection.

Seroprevalencia de la infección por el virus herpes simplex tipo 2 en tres grupos poblacionales de la Ciudad de México / Herpes simplex virus type 2 seroprevalence among three female population groups from Mexico City

OBJETIVO: Determinar la seroprevalencia de infección por el virus herpes simplex tipo 2 y los factores epidemiológicos asociados a ella, en tres grupos de población femenina de la Ciudad de México. MATERIAL Y MÉTODOS: Estudio transversal efectuado en el año 2000, que incluyó mujeres de la Ciudad de México diagnosticadas con cáncer de mama, cáncer cervical , y mujeres de población general negativas al Papanicolaou. Todas las participantes proporcionaron su consentimiento informado para responder un cuestionario sociodemográfico y de vida sexual, y permitir la toma de una muestra sanguínea. La presencia de anticuerpos contra el virus herpes simplex tipo 2 entre las mujeres se realizó por la técnica de "Western blot"específica para el virus herpes simplex tipo 2; las asociaciones entre estos resultados y los datos de la encuesta se analizaron estadísticamente, de manera cruda y ajustada. RESULTADOS: Las mujeres concáncer cervical tuvieron una seroprevalencia de infección por el virus herpes simplex tipo 2 de 46.8 por ciento (191/408); las de población general negativas al Papanicolaou de 29.3 por ciento (214/730), y aquellas con cáncer de mama de 22.6 por ciento (29/128). Las variables asociadas significativamente a la seropositividad contra este virus fueron la edad creciente, el aumento en el número de parejas sexuales, tener cáncer cervical, y entre las mujeres con esa patología, el inicio antes de los 21 años de edad de la actividad sexual y el estar divorciadas o separadas. CONCLUSIONES: Los hallazgos observados revelaron diferencias estadísticas en la seroprevalencia del virus herpes, de acuerdo con los grupos poblacionales estudiados. La frecuencia global de la infección viral entre las participantes las sitúa en un riesgo intermedio, en comparación con otros grupos poblacionales que en México son de alto y bajo riesgo (trabajadoras sexuales y estudiantes universitarias, respectivamente), analizados en años recientes. Las principales características relacionadas al contacto con el virus herpes simplex tipo 2 para las subpoblaciones estudiadas correspondieron, como era de esperarse, a los antecedentes del estilo de vida sexual y a la probabilidad de infección que confiere la mayor edad.

Prevalencia y factores asociados con sífilis y herpes genital en dos grupos de población femenina / Prevalence and factors associated with syphilis and genital herpes in two female population groups

OBJETIVO: Evaluar la frecuencia de marcadores de infección por el VHS-2 y Treponema pallidum, y su relación con algunas características de las mujeres que acuden a consulta ginecológica. MATERIAL Y MÉTODOS: Durante 1994 y 1995 se estudiaron 388 y 448 mujeres en sendos hospitales, el primero en Cuernavaca, Morelos, México, y el segundo en la Ciudad de México. Las participantes proporcionaron una muestra de sangre para identificar, a través de la técnica de Western blot y las pruebas de VDRL y FTA-ABS, anticuerpos específicos contra los microrganismos mencionados; asimismo, contestaron un cuestionario sobre sus características sociodemográficas y de comportamiento sexual. Los datos se analizaron con los paquetes estadísticos SPSS y EGRET. RESULTADOS: Las frecuencias de anticuerpos contra el VHS-2 fueron 28.3 por ciento, para las mujeres del primer hospital, y 18.1 por ciento para las del segundo. En el caso de anticuerpos contra T pallidum las frecuencias fueron de 2.3 por ciento y 1.1 por ciento, respectivamente. La edad, el estado civil, la escolaridad y el número de compañeros sexuales de las mujeres estudiadas estuvieron asociados con los marcadores de infección por el VHS-2. CONCLUSIONES: Se encontraron frecuencias bajas de infección por los microrganismos estudiados en ambos grupos de mujeres. La infección por el VHS-2 estuvo asociada a periodos de exposición, comportamiento sexual y nivel socioeconómico de las mujeres.

Prevalence of type specific Epstein-Barr virus in the genital tract of genital herpes suspected patients.

A total of 62 clinical specimens from the genital tract of patients who were suspected of contracting genital herpes were investigated for HSV infection by the virus isolation method, and also investigated for the co-infection with EBV infection by detecting EBV DNA using nested PCR. HSV infection was diagnosed in 30 (48.4%) of the study cases, and so was EBV. EBV DNA was present in 17 (56.7%) of the 30 HSV positive samples. No correlation was found between the co-existence of these two viruses together. EBV DNA was detected in genital specimens of cervical, vaginal, urethral, and anal swabs. Ninety per cent of EBV belonged to type 1, and the remainder belonged to type 2 and mixed types. The role of EBV in genital tract infection needs to be further investigated.

Prevalence of herpes simplex virus infection in patients suspected of genital herpes; and virus typing by type specific fluorescent monoclonal antibodies.

During the period between April 1994 and February 1996, a total of 154 female patients who attended the Clinic of Female Sexually Transmitted Diseases, Siriraj Hospital with clinical symptoms suspected of genital herpes were investigated for herpes simplex virus (HSV) infection by the virus isolation method in Vero cell cultures. Swabs from external genital lesions and the cervix from each patient were collected separately and used as the clinical specimens for isolation of HSV. The virus isolates were identified by indirect immunofluorescence (IIF) staining of the infected cell cultures using polyclonal HSV-2 specific antiserum which was reactive to common HSV antigens for both types of viruses. Typing of HSV was performed by direct IF using monoclonal antibody specific to HSV-1 or HSV-2. HSV was isolated from 78.6 per cent (121 of 154) of the cases studied; and among the infected cases, there were 47.9 per cent (58 of 121) in whom the infection involved both external genital lesions and cervixes, and 50.4 per cent (61) in whom the infection was limited to external genital lesions only. There were 2 cases (1.7%) in whom HSV was isolated from cervixes but not external genital lesions. Seventy-five HSV isolates were further subjected to typing. The present study showed that HSV-1 was accounted for 18.7 per cent (14 isolates), while HSV-2 took the remaining part of 81.3 per cent (61 isolates). The data demonstrated an increase in the prevalence of HSV-1 in genital herpes in our people.

A comparison of prevalence rates of genital ulcers among persons attending a sexually transmitted disease clinic in Jamaica

Two cross-sectional surveys were undertaken, from December 1982 to August 1983 and from November 1990 to January 1991, to estimate the prevalence rates of genital ulcer disease (GUD) in all patients presenting with a new sexually transmitted disease (STD) complaint to the STD clinic at the Comprehensive Health Centre in Kingston, Jamaica. Diagnosis of syphilis and human immunodeficiency virus (HIV) infection was based on results of laboratory tests, but diagnosis of other STDs was based on clinical features. Data from these two surveys were compared, and reported national annual incidence data for GUD reviewed. In 1982/83 6.8 percent of 23,050 patients had GUD, men (9.3 percent) more often than women (4.2 percent; p < 0.001). In 1990/91 the prevalence rate was 12.8 percent with increased rates for both men (18.2 percent) and women (6.8 percent; p < 0.001). In patients with GUD, a clinical diagnosis of genital herpes was made, in 1982/83 and 1990/91, respectively, in 16.8 percent and 7.8 percent of the patients; syphilis, in 12.9 percent and 18.8 percent; chancroid, in 12.4 percent and 13.3 percent; viral warts, in 5.7 percent and 6.3 percent; lymphogranuloma venereum, in 4.1 percent and 3.9 percent; and granuloma inguinale, in 3.6 percent and 2.3 percent. In men the rate for syphilis was 19 percent in 1990/91 and 8 percent in 1982/83 (p=0.001); and for genital herpes it was 7 percent in 1990/91 and 17 percent in 1982/83 (p=0.025). These reversals were attributed to intense media coverage of herpes in 1982/83. There was no difference in prevalence rates between the two surveys for these diseases in women, or for lymphogranuloma venereum, granuloma inguinale and genital warts in men and women. A clinical diagnosis could not be made in 44.4 percent of cases in 1982/83 (particularly in men), and in 47.6 percent of cases in 1990/91. GUDs faciltate transmission and adversely affect the prognosis of HIV. The increase in their prevalence has implications for the evolution of the local HIV epidemic, and hould be addressed effectively by stregthening the STD/HIV control programme.

Herpes simples genital, uma doença sexualmente transmissível / Genital herpes simplex, a sexually transmitted disease

Na avaliaçäo da transmissibilidade sexual dos herpes simples genital, foi estudada a prevalência de anticorpos específicos contra o herpes simples vírus do tipo 2 (HSV-2), em populaçöes de baixo e de alto risco para doenças sexualmente transmissíveis (DST). A populaçäo de baixo risco para a aquisiçäo das DST foi constituída por 155 doadores voluntários de sangue no HUCFF/UFRJ, entre fevereiro e junho de 1994. Todos foram submetidos a um questionário acerca dos fatores de risco para a aquisiçäo das DST e que traçou o perfil sócio-epidemiológico desta populaçäo. Os pacientes de alto risco para a aquisiçäo das DST incluíram 85 portadores do vírus da imunodeficiência humana (HIV), tendo como fatores de risco o homossexualismo, a promiscuidade heterossexual ou contato sexual com o parceiro soropositivo para o HIV. Foram avaliadas, sorologicamente, 20 prostitutas, entre maio e julho de 1994. O teste usado para a análise de todas as amostras de soro, provenientes dos pacientes, foi o ELISA convencional específico para a detecçäo de IgG anti-HSV-2. Para os doadores de sangue, a prevalência do HSV-2 foi de 53,8 por cento, superior à observada em países ocidentais desenvolvidos. Entre os pacientes HIV positivos, ela atingiu 73 por cento (p<0,01). Para todo o grupo de alto risco para a aquisiçäo das doenças sexualmente transmissíveis atingiu 72 por cento de prevalência (p<0,05, razäo de chance = 6,27). As variáveis que mais se associaram à soroprevalência do HSV-2 foram a multiplicidade de parceiros sexuais, relaçöes sexuais com portador de herpes genital, história prévia de abortos e de relaçöes homossexuais. Os nossos achados permitem sugerir a realizaçäo de estudos adicionais de soroprevalência em nosso meio, especialmente entre os pacientes HIV positivos. Os pacientes soropositivos para o HSV-2 devem ser orientados quanto aos mecanismos de transmissäo do vírus