Prevalence, genotype profile and risk factors for multiple human papillomavirus cervical infection in unimmunized female adolescents in Goiânia, Brazil: a community-based study.

BACKGROUND: The epidemiology of infection with multiple human papillomavirus (HPV) types in female adolescents is poorly understood. The purpose of this study was to explore the epidemiology of infection with multiple HPV types in adolescents and its association with demographic, behavioral and biological variables, as well as with cytological abnormalities. METHODS: This community-based study included 432 sexually active females between 15 and 19 years of age. Genotyping for 30 HPV types was performed using a reverse blot strip assay/restriction fragment length polymorphism. Unconditional multivariate logistic regression was performed to identify factors significantly associated with HPV infection. The association between HPV infection and cytological abnormalities was calculated using a prevalence ratio. RESULTS: The most common HPV types detected were 16, 51, 31, 52 and 18. Of the 121 HPV-positive women, 54 (44.6%) were infected with multiple HPV types. Having more than one lifetime sexual partner was associated with infection with any HPV infection, single HPV infection, and infection with multiple HPV types. The presence of cytological abnormalities was associated with infection with multiple HPV types. CONCLUSIONS: Co-infecting HPV genotypes occur in a high proportion of sexually active adolescents. Socio-demographic or sexual behavior factors associated with single HPV infection were similar to those associated with multiple HPV types. The higher risk of cytological abnormalities conferred by infection with multiple HPV types suggests a potential role of co-infection in the natural history of HPV infection.

Prevalence of Chlamydia trachomatis in asymptomatic Brazilian military conscripts.

BACKGROUND: Few data are available on the prevalence and risk factors for Chlamydia trachomatis infection among young men in Brazil. OBJECTIVES: To assess prevalence and risk factors for C. trachomatis infection in male military conscripts. METHODS: In 2000, 627 young men recruited for military service in Goiania, Goias, Brazil, were enrolled in this cross-sectional study. Participants completed a demographic and sexual risk behavior questionnaire, and urine samples were screened for C. trachomatis by polymerase chain reaction. RESULTS: The prevalence of chlamydial infection among asymptomatic conscripts was 5.0% (95% confidence interval [CI], 3.3-7.3). In multivariate analysis, failure to use condoms (odds ratio [OR](adjusted) 5.3; 95% confidence interval [CI], 1.2-23.4; P = 0.028) and having more than 2 sexual partners in the last 2 months (OR(adjusted) 2.6; 95% CI, 1.1-6.9; P = 0.049) were significantly associated with positivity for C. trachomatis. CONCLUSIONS: A substantial number of asymptomatic young male military recruits were infected with C. trachomatis, and risk factors for this infection were related to sexual behavior. Further research is required to determine if routine screening may be considered as a strategy to reduce prevalence among this population.

Doenças sexualmente transmissíveis: infecção por Chlamydia trachomatis / Sexually transmitted diseases: Chlamydia trachomatis infection

Este trabalho reviu a infecção urogenital por Chlamydia trachomatis, considerada a doença bacteriana sexualmente transmissível mais comum no mundo, especialmente na população de adolescentes e jovens. Grande parte das infecções clamidiais é assintomática, principalmente nas mulheres, e se não tratadas podem causar complicações, como a doença inflamatória pélvica (DIP), com seqüelas como a infertilidade, gravidez ectópica e dor pélvica crônica. Por várias décadas, a cultura foi considerada como o padrão ouro no diagnóstico dessa infecção. Nos últimos anos foram introduzidos os testes de detecção ácidos nucléicos, como a reação em cadeia da polimerase (PCR) e a reação em cadeia da ligase (LCR). Apresentou-se o tratamento recomendado pelo Ministério da Saúde, bem como os princípios da prevenção que incluem a educação sexual, o diagnóstico e tratamento dos casos diagnosticados e de seus parceiros sexuais, abrangendo a proposta de rastreamento nas populações de risco.