Differences in risky sexual behaviors and HIV prevalence between men who have sex with men and transgender women in the Midwest Brazil.

Men who have sex with men (MSM) and transgender women (TW) are disproportionally affected by HIV infection. This cross-sectional study evaluated the HIV-1/2 prevalence, risk factors and HIV molecular features of MSM and TW from Midwest Brazil. Four hundred and thirty participants (278 MSM and 152 TW) from Mato Grosso do Sul, Brazil, were interviewed and tested for HIV-1/2 infection between November 2011 and September 2013. Participants who were assigned male at birth, older than 18 years old and self-declared as MSM or TW were recruited from LGBT+ associations, as well as public (parks, square, streets, etc) and private [nightclubs, saunas, brothels, etc] places. The prevalence of HIV-1 was 14.4% (9.0% among MSM and 24% among TW; p<0.001). The factor independently associated with HIV-1 infection among MSM was being 30 years-old or older. Among TW, having suffered sexual coercion, lifetime syphilis infection and hepatitis C virus exposure were associated with HIV-1 infection. Phylogenetic analyses classified 65% sequences as subtype B and 35% as possible recombinants. All but one recombinant sample were from TW individuals. High HIV-1 prevalences were observed in both groups, highlighting the urgent need to devise specific HIV interventions targeting these key populations. Notably, TWs are more vulnerable to HIV infection, which was associated with sexual violence and co-infection with other STIs. With regard to MSM, being 30 years old or older was significanty associated to HIV, reinforcing the idea that MSM are less exposed [or exposed later] to STIs than TWs, although MSM are clearly more vulnerable than the general population.

Dinâmica temporal, subtipos e caracteristicas epidemiológicas da infecção pelo hiv-1, Brasil Central / Dinamic temporal, subtypes and epidemiological characteristics of hiv1 infection, Central Brazil

O objetivo deste estudo foi identificar os principais subtipos de HIV-1 circulantes no Mato Grosso do Sul (MS), Brasil Central. Métodos: Trata-se de um estudo transversal de séries temporais com dados de laboratório e relato de doença, analisados por período de diagnóstico e variáveis sociodemográficas e clínicas. Resultados: Subtipo B HIV-1 predominou quando os períodos foram analisados (85,4% vs 85,3%). Além disso, foi detectado um aumento na frequência do subtipo C do HIV-1, mas nenhuma diferença significativa foi observada entre os dois períodos. Após análise univariada, a faixa etária entre 25 e 45 anos (p = 0,004) e o gênero masculino (p = 0,04) mostraram-se associados ao subtipo B HIV-1. Os achados relacionados à resistência do HIV-1 à ARV mostraram que 30,6% dos pacientes diagnosticados com AIDS entre 1985 e 2012, submetidos a testes de genotipagem (212), eram resistentes a mais de três classes de ARVs (MDR). Conclusões: Estudos sobre a diversidade genética, bem como o perfil de mutações de resistência no HIV-1, são ferramentas importantes para a reconstrução histórica de epidemias regionais, vigilância epidemiológica local e diretrizes de tratamento.

The objective of this study was to identify the major subtypes of HIV-1 circulating in Mato Grosso do Sul (MS), Central Brazil. Methods:This is a cross-sectional study of time series with data from laboratory and disease report, analyzed by period of diagnosis and sociodemographic and clinical variables. Results: Subtype B HIV-1 predominated when periods were analyzed (85.4% vs 85.3%). In addition, an increase in the frequency of HIV-1 subtype C was detected, but no significant difference was seen between the two periods. After univariate analysis, the age range between 25 and 45 years (p = 0.004) and the masculine gender (p = 0.04) were found to be associated with subtype B HIV-1. The findings related to the resistance of HIV-1 to ARV showed that 30.6% of the investigated patients diagnosed AIDS between 1985 and 2012 who underwent genotyping tests (212) were resistant to more than three ARV classes (MDR). Conclusions: Studies on the genetic diversity, as well as the profile of resistance mutations in HIV-1, are important tools for both the historical reconstruction of regional epidemics and local epidemiological surveillance and treatment guidelines.

High vertical HIV transmission rate in the Midwest region of Brazil

ABSTRACT Objectives To estimate vertical HIV transmission rate in a capital city of the Midwest region of Brazil and describe the factors related to transmission. Methods A descriptive epidemiological study based on the analysis of secondary data from the Notifiable Diseases Information System (SINAN). The analysis considered all HIV-infected pregnant women with delivery in Campo Grande-MS in the years 2007-2013 and their HIV-exposed infants. Results A total of 218 births of 176 HIV-infected pregnant women were identified during the study period, of which 187 infants were exposed and uninfected, 19 seroconverted, and 12 were still inconclusive in July 2015. Therefore, the overall vertical HIV transmission rate in the period was 8.7%. Most (71.6%) of HIV-infected pregnant women were less than 30 years at delivery, housewives (63.6%) and studied up to primary level (61.9%). Prenatal information was described in 75.3% of the notification forms and approximately 80% of pregnant women received antiretroviral prophylaxis. Among infants, 86.2% received prophylaxis, but little more than half received it during the whole period recommended by the Brazilian Ministry of Health. Among the exposed children, 11.3% were breastfed. Conclusion The vertical HIV transmission rate has increased over the years and the recommended interventions have not been fully adopted. HIV-infected pregnant women need adequate prophylactic measures in prenatal, intrapartum and postpartum, requiring greater integration among health professionals.

High vertical HIV transmission rate in the Midwest region of Brazil.

OBJECTIVES: To estimate vertical HIV transmission rate in a capital city of the Midwest region of Brazil and describe the factors related to transmission. METHODS: A descriptive epidemiological study based on the analysis of secondary data from the Notifiable Diseases Information System (SINAN). The analysis considered all HIV-infected pregnant women with delivery in Campo Grande-MS in the years 2007-2013 and their HIV-exposed infants. RESULTS: A total of 218 births of 176 HIV-infected pregnant women were identified during the study period, of which 187 infants were exposed and uninfected, 19 seroconverted, and 12 were still inconclusive in July 2015. Therefore, the overall vertical HIV transmission rate in the period was 8.7%. Most (71.6%) of HIV-infected pregnant women were less than 30 years at delivery, housewives (63.6%) and studied up to primary level (61.9%). Prenatal information was described in 75.3% of the notification forms and approximately 80% of pregnant women received antiretroviral prophylaxis. Among infants, 86.2% received prophylaxis, but little more than half received it during the whole period recommended by the Brazilian Ministry of Health. Among the exposed children, 11.3% were breastfed. CONCLUSION: The vertical HIV transmission rate has increased over the years and the recommended interventions have not been fully adopted. HIV-infected pregnant women need adequate prophylactic measures in prenatal, intrapartum and postpartum, requiring greater integration among health professionals.

Transitioning through AIDS epidemics - gender and temporality.

OBJECTIVE: To understand the evolution of AIDS over time in Mato Grosso do Sul, Brazil, using incidence, lethality, and mortality coefficients. METHODS: A descriptive epidemiological study based on time series analysis of secondary data from the Notifiable Diseases Information System reported between 1985 and 2012. RESULTS: The prevalence of AIDS was higher among men, with evidence of feminization during the first 14 years of the epidemic. There was no statistically significant sex difference in AIDS lethality. Women were 1.3 times more likely to survive than men. CONCLUSIONS: Gender differences must be considered when designing new HIV/AIDS prevention strategies.

Pertussis in the central-west region of Brazil: one decade study

In many parts of the world, numerous outbreaks of pertussis have been described despite high vaccination coverage. In this article we report the epidemiological characteristics of pertussis in Brazil using a Surveillance Worksheet. Secondary data of pertussis case investigations reported from January 1999 to December 2008 recorded in the Information System for Notifiable Diseases (SINAN) and the Central Laboratory for Public Health (LACEN-MS) were utilized. The total of 561 suspected cases were reported and 238 (42.4%) of these were confirmed, mainly in children under six months (61.8%) and with incomplete immunization (56.3%). Two outbreaks were detected. Mortality rate ranged from 2.56% to 11.11%. The occurrence of outbreaks and the poor performance of cultures for confirming diagnosis are problems which need to be addressed. High vaccination coverage is certainly a good strategy to reduce the number of cases and to reduce the impact of the disease in children younger than six months.

Pertussis in the central-west region of Brazil: one decade study.

In many parts of the world, numerous outbreaks of pertussis have been described despite high vaccination coverage. In this article we report the epidemiological characteristics of pertussis in Brazil using a Surveillance Worksheet. Secondary data of pertussis case investigations reported from January 1999 to December 2008 recorded in the Information System for Notifiable Diseases (SINAN) and the Central Laboratory for Public Health (LACEN-MS) were utilized. The total of 561 suspected cases were reported and 238 (42.4%) of these were confirmed, mainly in children under six months (61.8%) and with incomplete immunization (56.3%). Two outbreaks were detected. Mortality rate ranged from 2.56% to 11.11%. The occurrence of outbreaks and the poor performance of cultures for confirming diagnosis are problems which need to be addressed. High vaccination coverage is certainly a good strategy to reduce the number of cases and to reduce the impact of the disease in children younger than six months.

Infecção pelo vírus da hepatite C em gestantes em Mato Grosso do Sul, 2005-2007 / Hepatitis C virus infection among pregnant women in Central-Western Brazil, 2005-2007 / Infección por el virus de la hepatitis C en gestantes en Mato Grosso do Sul, Centro-Oeste de Brasil, 2005-2007

O estudo teve por objetivo estimar a prevalência da infecção e genótipo do vírus da hepatite C (HCV), bem como determinar a subnotificação de casos. O total de 115.386 gestantes atendidas pelo Programa Estadual de Proteção à Gestante de Mato Grosso do Sul foi submetido à coleta de sangue para a detecção de anti-HCV, de 2005 a 2007. A prevalência da infecção pelo HCV foi de 1,07 casos/1.000. As amostras positivas foram submetidas à detecção do HCV-RNA e genotipadas. O genótipo 1 foi encontrado em 73 por cento das amostras, 24,3 por cento pertenciam ao genótipo 3 e 2,7 por cento ao genótipo 2. A subnotificação de casos de hepatite C foi de 35,5 por cento.

The study was aimed at estimating the prevalence of infection with and the genotype of hepatitis C virus (HCV), and to determine the extent of underreporting of HCV cases. A total of 115,386 pregnant women seen by the Program for Protection of Pregnancy [Programa Estadual de Proteção à Gestante] of the state of Mato Grosso do Sul, Central-Western Brazil, were tested for anti-HCV antibodies between 2005 and 2007. Prevalence of HCV infection was 1.07 cases per thousand. Positive samples were tested for HCV RNA and genotyped. Genotype 1 was detected in 73 percent of samples, genotype 3 in 24.3 percent, and genotype 2 in 2.7 percent. Underreporting of hepatitis C cases was 35.5 percent.

El estudio tuvo por objetivo estimar la prevalencia de la infección y genotipo del virus de la hepatitis C (HCV), así como determinar la subnotificación de casos. El total de 115.386 gestantes atendidas por el Programa Estatal de Protección a la Gestante de Mato Grosso do Sul (Centro-Oeste de Brasil) fueron sometidas a la colecta de sangre para la detección de anti-HCV, de 2005 a 2007. La prevalencia de la infección por el HCV fue de 1,07 casos/1000. Las muestras positivas fueron sometidas a la detección del HCV-RNA y genotipadas. El genotipo 1 fue encontrado en 73 por ciento de las muestras, 24,3 por ciento pertenecían al genotipo 3 y 2,7 por ciento al genotipo 2. La subnotificación de casos de hepatitis C fue de 35,5 por ciento.

Hepatitis C virus infection among pregnant women in Central-Western Brazil, 2005-2007.

The study was aimed at estimating the prevalence of infection with and the genotype of hepatitis C virus (HCV), and to determine the extent of underreporting of HCV cases. A total of 115,386 pregnant women seen by the Program for Protection of Pregnancy [Programa Estadual de Proteção à Gestante] of the state of Mato Grosso do Sul, Central-Western Brazil, were tested for anti-HCV antibodies between 2005 and 2007. Prevalence of HCV infection was 1.07 cases per thousand. Positive samples were tested for HCV RNA and genotyped. Genotype 1 was detected in 73% of samples, genotype 3 in 24.3%, and genotype 2 in 2.7%. Underreporting of hepatitis C cases was 35.5%.