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1.
J Infect Dis ; 219(2): 275-283, 2019 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-30137482

RESUMO

Background: Condylomata acuminata (anogenital warts [AGWs]) are prevalent in human immunodeficiency virus (HIV)-infected individuals and sexually active populations at risk for HIV acquisition and have been associated with HIV transmission. We compared AGW specimens to control tissue specimens for abundance, types, and location of HIV target cells and for susceptibility to HIV infection in vitro, to provide biologic evidence that AGWs facilitate HIV transmission. Methods: We used immunohistologic staining to identify HIV target cells in AGW and control specimens. We also inoculated HIV in vitro into AGW and control specimens from HIV-negative men and assessed infection by means of TZM-bl and p24 assays. Results: CD1a+ dendritic cells, CD4+ T cells, and macrophages were significantly more abundant in the epidermis of AGW specimens than control specimens. These HIV target cells also often appeared in large focal accumulations in the dermis of AGW specimens. Two of 8 AGW specimens versus 0 of 8 control specimens showed robust infection with HIV in vitro. Conclusions: Compared with normal skin, AGWs contain significantly higher concentrations of HIV target cells that may be susceptible to HIV infection. Condylomata may thus promote HIV transmission, especially in the setting of typical lesion vascularity and friability. Prevention or treatment of AGWs may decrease the sexual transmission of HIV.


Assuntos
Condiloma Acuminado/patologia , Condiloma Acuminado/virologia , Infecções por HIV/transmissão , Adulto , Idoso , Antígenos CD , Antígenos de Diferenciação Mielomonocítica , Linfócitos T CD4-Positivos/virologia , Linfócitos T CD8-Positivos , Condiloma Acuminado/imunologia , Células Dendríticas/imunologia , Células Dendríticas/patologia , Feminino , Granulócitos , Células HEK293 , Proteína do Núcleo p24 do HIV , Infecções por HIV/virologia , HIV-1 , Humanos , Antígenos CD15 , Macrófagos/patologia , Masculino , Pessoa de Meia-Idade , Papillomaviridae , Infecções por Papillomavirus/virologia , Receptores CXCR4 , Pele/imunologia , Pele/patologia , Adulto Jovem
2.
Clin Infect Dis ; 51(1): 107-10, 2010 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-20482370

RESUMO

Human papillomavirus causes anal condylomata, high-grade anal intraepithelial neoplasia, and anal squamous cell cancer. We found high-grade intraepithelial neoplasia or squamous cell cancer in 75 (47%) of 159 HIV-seropositive men who have sex with men (MSM) and in 42 (26%) of 160 HIV-seronegative MSM with anal condylomata meriting surgery (P<.001, determined by use of the chi(2) test). Anal condylomata in MSM often harbor high-grade intraepithelial neoplasia and squamous cell cancer.


Assuntos
Doenças do Ânus/complicações , Neoplasias do Ânus/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Condiloma Acuminado/complicações , Homossexualidade Masculina , Infecções por Papillomavirus/complicações , Adolescente , Adulto , Idoso , Alphapapillomavirus , Doenças do Ânus/cirurgia , Doenças do Ânus/virologia , Neoplasias do Ânus/complicações , Neoplasias do Ânus/patologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Estudos de Coortes , Condiloma Acuminado/cirurgia , Condiloma Acuminado/virologia , Soronegatividade para HIV , Soropositividade para HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estudos Retrospectivos , Adulto Jovem
3.
Arch Gynecol Obstet ; 279(6): 905-7, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18850105

RESUMO

BACKGROUND: Hernias commonly coexist with pregnancy; however, an incarcerated hernia with bowel obstruction is rare at advanced gestation and requires urgent intervention. CASE: A multiparous woman with a known large incisional hernia presented at 33 weeks and 5 days gestational age with acute-onset, upper abdominal pain and nausea. The patient was diagnosed with small bowel obstruction secondary to an incarcerated hernia. She was managed with serial abdominal exams until her repeat cesarean section and simultaneous hernia repair were performed 24 h after admission and betamethasone administration. The patient and infant did well postoperatively. CONCLUSION: Bowel incarceration through an incisional hernia can occur during pregnancy and result in favorable maternal and neonatal outcomes with simultaneous delivery and surgical repair.


Assuntos
Hérnia Abdominal/complicações , Obstrução Intestinal/etiologia , Complicações na Gravidez/etiologia , Feminino , Idade Gestacional , Humanos , Gravidez
5.
Clin Infect Dis ; 38(10): 1490-2, 2004 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-15156490

RESUMO

We compared the pathological diagnoses obtained by anal Papanicolaou (Pap) smear with those obtained by anal biopsy or by surgical excision for 153 men who have sex with men (MSM). Analysis of these paired specimens showed that anal Pap smears were an inaccurate predictor of high-grade anal dysplasia, regardless of human immunodeficiency virus (HIV) serostatus. The presence of any abnormal anal cytological finding indicates a potential for high-grade dysplasia on histological examination of MSM.


Assuntos
Neoplasias do Ânus/patologia , Soropositividade para HIV , Homossexualidade Masculina , Doenças do Ânus/epidemiologia , Doenças do Ânus/patologia , Neoplasias do Ânus/epidemiologia , Biópsia , Humanos , Masculino , Teste de Papanicolaou
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