ABSTRACT
BACKGROUND INFORMATION: Hepatitis B has different routes of transmission and it is maintained in human populations mainly via transmission from person to person during intense physical contact, such as perinatal contact, contact during hetero and homosexual intercourse and non-sexual physical contact between children, their mothers and siblings.Migration from the provinces to the big cities of the country, added to changes in social behavior, specially among young people, have led to an increase in unprotected sexual encounters, with the resulting greater risk of contracting hepatitis B. PATIENTS AND METHODS: We included 1048 adolescent women between the ages of 14 and 19, pregnant and apparently healthy, who came to the Perinatal Maternal Institute (IMP) between August 2003 and February 2004. The sample included 52 promiscuous pregnant young women with 3 or more sexual partners or contacts. After informed consent, they all filled a clinical epidemiological chart and a 5mL blood sample was taken to determine antiHBc IgG, HBsAg, HBeAg and anti-HBe using the third generation ELISA method. RESULTS: Sixty eight point seven percent (68.7%) were older than 16 years, 29.7% had not been born in Lima, 6.1% had been born in the jungle and 10.4% had lived in the jungle, 30.1% were from San Juan de Lurigancho. Fourteen point three percent (14.3%) referred having had two partners and 4.3% three or more, 5.4% had three or more sexual contacts and 61.5% said that their partner never used a condom. Over 98% referred that they had not had jaundice or Hepatitis A, B or C. Twelve point four percent (12.4%) of the partners were womanizers, 3.1% visited prostitutes, 8.4% had another partner, 23.3% said that they liked anal sex, 3% were alcoholics, 9% used drugs, 2% had been in jail and 5.7% had received blood transfusions. The prevalence of anti-HBc IgG was 3.53% and for HBsAg it was 0.67%. A statistically significant association (p<0.026) was found between the risk of infection and having been born elsewhere from Lima, with a history of jaundice (p<0.02) and with having lived in the jungle (p<0.001) and, surprisingly, with a history of hepatitis A (p<0.074). The application of the partner perception indicator established that when the partner had three or more infection risk factors compared to none, there was a 2.37 times greater risk of hepatitis B. CONCLUSIONS: The prevalence of HBV infection at the IMP has increased over the last 7 years by 18.45% and 76.31% the rate of HBsAg carriers. There was a positive correlation between HBV infection and the number of sexual partners, although it did not reach statistical significance. The risk indicator of the perception of the partners' sexual behavior is a marker of greater risk of HBV infection among those ranked as high risk.
Subject(s)
Hepatitis B/epidemiology , Adolescent , Adult , Female , Hepatitis B/blood , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hospitals, Maternity/statistics & numerical data , Humans , Peru/epidemiology , Pregnancy , Prevalence , Risk Factors , Seroepidemiologic Studies , Sexual Partners , Surveys and QuestionnairesABSTRACT
Antecedente: La hepatitis B tiene diversas rutas de transmisión y es mantenida en las poblaciones humanas principalmente por la transmisión de persona a persona durante el contacto físico intenso, como ocurre perinatalmente, en las relaciones hetero y homosexuales y contactos físicos no sexuales entre niños y sus madres y hermanos. La migración del interior a las grandes ciudades del país, sumando a los cambios en la conducta social, especialmente en los jóvenes, ha llevado a un incremento de las relaciones sexuales no protegidas con el consiguiente mayor riesgo para el hepatitis B. Pacientes y Métodos: Se incluyó 1048 mujeres adolescentes entre 14 y 19 años, gestantes aparentemente sanas, que acudieron al Instituto Materno Perinatal entre Agosto del 2003 y Febrero del 2004. La muestra incluyó 52 gestantes promiscuas con 3 ó más parejas o contactos sexuales; previo consentimiento informado todas completaron una ficha clínico-epidemiológica y se les tomó una muestra de 5mL de sangre para determinar el anti-HBc IgG HBsAg, HBeAg y anti-HBe por el método de ELISA de 3a generación. Resultados: El 68,7 por ciento tenia mas de 16 años, 29,7 por ciento nació fuera de Lima, el 6,1 por ciento nació en la selva y el 10,4 por ciento vivió en la selva, el 30,1 por ciento procedía de San Juan de Lurigancho. El 14,3 por ciento refiere haber tenido dos parejas y el 4,3 por ciento tres o mas y el 5,4 por ciento tres o mas contactos sexuales y el 61,5 por ciento refiere que su pareja nunca usó condón. Mas del 98 por ciento refiere no haber tenido ictericia, hepatitis A,B,C. El 12,4 por ciento de las parejas eran mujeriegos, el 3,1 por ciento frecuentaba prostitutas, el 8,4 por ciento tiene otra pareja, el 23,3 por ciento refiere que le gusta el sexo anal, 3,0 por ciento es alcohólico, el 9 por ciento consume drogas, el 2 por ciento ha estado en la cárcel y el 5,7 por ciento tiene antecedentes de transfusión. La prevalencia del anti-HBc IgG fue de 3,53 por ciento...
Background Information: Hepatitis B has different routes of transmission and it is maintained in human populations mainly via transmission from person to person during intense physical contact, such as perinatal contact, contact during hetero andhomosexual intercourse and non-sexual physical contact between children, theirmothers and siblings. Migration from the provinces to the big cities of the country, added to changes in social behavior, specially among young people, have lead to an increase in unprotectedsexual encounters, with the resulting greater risk of contracting hepatitis B. PATIENTS AND METHODS: We included 1048 adolescent women between the ages of 14 and 19, pregnant and apparently healthy, who came to the Perinatal Maternal Institute (IMP) between August 2003 and February 2004. The sample included 52 promiscuous pregnant young women with 3 or more sexual partners or contacts. After informed consent, they all filled a clinical epidemiological chart and a 5mL blood sample was taken to determine antiHBc IgG, HBsAg, HBeAg and anti-HBe using the third generation ELISA method. RESULTS: Sixty eight point seven percent (68.7 per cent) were older than 16 years, 29.7 per centhad not been born in Lima, 6.1 per cent had been born in the jungle and 10.4 per cent had lived in the jungle, 30.1 per cent were from San Juan de Lurigancho.Fourteen point three percent (14.3 per cent) referred having had two partners and 4.3 per cent three or more, 5.4 per cent had three or more sexual contacts and 61.5 per cent said that their partner never used a condom. Over 98 per cent referred that they had not had jaundice or Hepatitis A, B or C. Twelve point four percent (12.4 per cent) of the partners were womanizers, 3.1 per cent visitedprostitutes, 8.4 per cent had another partner, 23.3 per cent said that they liked anal sex, 3 per cent were alcoholics, 9 per cent used drugs, 2 per cent had been in jail and 5.7 per cent had received blood transfusions...
Subject(s)
Humans , Adolescent , Female , Pregnancy in Adolescence , Risk Factors , Hepatitis B , Sexual Partners , PrevalenceABSTRACT
Diffuse vascular endothelial dysfunction, secondary to oxidative stress, is an important pathological feature of preeclampsia. Oxidative conversion of low density lipoproteins (LDL) to oxidized-LDL (Ox-LDL) is considered an important step in transforming macrophages into lipid-laden foam cells destined to develop into early atherosclerotic-like lesions. In our study of 95 women with preeclampsia and 100 controls, we evaluated the association between maternal plasma Ox-LDL concentrations and preeclampsia risk. Ox-LDL concentrations were measured using a solid phase two-site enzyme immunoassay. Plasma lipids were measured using standard enzymatic procedures. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for confounders. Plasma Ox-LDL concentrations were positively correlated with cholesterol, triglyceride (TG), and LDL concentrations in cases and controls, (Spearman's r ranging from 0.39-0.48, p-values all <0.01). There was no evidence of an increased risk of preeclampsia across increasing quartiles of Ox-LDL. The ORs for successive quartiles, with the lowest as the reference group, were as follows: 1.0, 1.1, 0.6, and 1.2. Women with extremely high concentrations of Ox-LDL (> or =73 U/L, the upper decile), as compared with those with lower values (<73 U/L) had a 2.7-fold increased risk of preeclampsia (95% CI 1.0-6.8). Women with high Ox-LDL and high TG concentrations (> or =284 mg/dl), as compared with those without these two factors, had a 9.6-fold increased preeclampsia risk (95% CI 2.0-45.6). Elevated Ox-LDL, particularly in conjunction with elevated TG, appears to be a risk factor of preeclampsia.
Subject(s)
Lipoproteins, LDL/blood , Pre-Eclampsia/blood , Adult , Body Mass Index , Case-Control Studies , Cholesterol/blood , Cholesterol, LDL/blood , Female , Humans , Immunoenzyme Techniques , Pregnancy , Risk Factors , Triglycerides/bloodABSTRACT
BACKGROUND: In a case-control study of 100 preeclamptics and 100 controls, we assessed plasma transforming growth factor-beta1 (TGF-beta1) concentrations in relation to preeclampsia risk among Peruvian women with and without systemic inflammation. METHODS: Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The OR of preeclampsia increased across quartiles of TGF-beta1 concentrations. Women with elevated TGF-beta1 and a proinflammatory profile experienced the highest risk of preeclampsia (OR = 15.4, 95% CI 4.7-50.4). CONCLUSIONS: Our results confirm an association between TGF-beta1 and risk of preeclampsia and extend the literature by indicating a strong association in women with systemic inflammation.
