Resultados de la encuesta nacional de la infección por el VIH en Guinea Ecuatorial en 2004 / No disponible

Objetivos: Determinar la situación actual de la epidemia de VIH en Guinea Ecuatorial en población adulta de 15 a 49 años y calibrar los resultados con los actuales sistemas de vigilancia de la infección por el VIH en el país. Introducción: Las estimaciones de la carga de VIH en el África subsahariana presentan potenciales sesgos porque están basadas en los sistemas de vigilancia centinela obtenidos de las clínicas prenatales. Las encuestas nacionales de hogares pueden aportar datos para mejorar las estimaciones de la infección por el VIH. Material y Métodos: Se diseñó una encuesta nacional con muestreo polietápico por conglomerados y estratificado entre zonas rurales y urbanas. Se recogió sangre capilar en papel de filtro Whatmann Nº4 y se realizó detección de anticuerpos frente a VIH-1/2 mediante ELISA y posterior confirmación por Inmunoblot. Resultados: De las 1.449 muestras de sangre recogidas un total de 52 muestras resultaron positivas, 51 para VIH-1 y 1 para VIH-2. La prevalencia total de VIH fue del 3,2% IC = [2,0-4,4]. Para las mujeres fue de 3,4% [2,0-4,8] y para los hombres algo inferior, 2,9% [1,1-4,8] aunque sin diferencias estadísticamente significativas. Los resultados por estratos fueron para la población rural de 3,1% [1,4-4,7]) y en la zona urbana 3,3% (..) (AU)

Objective: To establish the reference situation of HIV epidemic in Equatorial Guinea in adult population aged 15-49 years and to calibrate the results with the current sentinel surveillance of the HIV infection in the country. Introduction: The estimates of HIV burden in sub-Saharan Africa are potentially biases because they are based on the sentinel surveillance among pregnant women attending antenatal clinics. National population based surveys can contribute additional information to improve the HIVestimates. Population and methods: A national survey was drawn using stratified (rural and urban settlement) multi-stage cluster sampling. Blood samples were collected on Whatmann Nº4 filter paper and were tested for HIV-1/2 antibodies by ELISA and Inmunoblot was used for confirmation. Results: From 1.449 dried blood spots collected a total of 52 samples were HIV positive, 51 were infected by HIV-1 and 1 by HIV-2. For the whole country HIV prevalence was 3,2% CI = [2,0-4,4]. In females, the prevalence was 3,4% [2,0-4,8] and in males it was slightly low, 2,9% [1,1-4,8]though without statistically significant differences. The results for each strata were 3,1% [1,4-4,7]), for the rural population, and 3,3% [1,5-5,1] in the urban area. A significant association was detected between HIV and; age, had suffered from STIs (OR=2,62; CI 95% = [1,21-5,7]), to manicure(2,53; [1,16-5,55]) and in the use of traditional medicine (8,26; [2,24-30,47]). Also between those who use condom sometimes versus those whonever use it (2,92; [1,24-6,89]).Conclusions: HIV prevalence in Equatorial Guinea is in intermediate levels between central (..) (AU)

Infección perinatal por el VIH-1 en un niño sin formación de anticuerpos anti-VIH-1 / Perinatal HIV-1 infection in a child without HIV- antibody formation

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Human T-cell leukemia virus type I infection in various recipients of transplants from the same donor.

BACKGROUND: The human T-cell lymphotrophic virus (HTLV) causes adult T-cell leukemia-lymphoma, tropical spastic paraparesis-HTLV type I, and associated myelopathy. METHODS: An analysis was performed of serum samples from a multiorgan donor and the five recipients. Also studied was the donor's family and the partner of one of the renal recipients. Serologic detection of anti-HTLV antibodies was carried out by enzyme immunoassay and Western blot to confirm and discriminate between HTLV types. Analysis of proviral DNA was performed by polymerase chain reaction and sequenced in the long terminal repeat region and the env gene. Peripheral blood mononuclear cell samples from all the recipients of the HTLV-I-positive organs and the donor's mother were studied. RESULTS: Two years after transplantation, three organ recipients positive for antibodies to HTLV-I were detected (two kidney transplants and one liver). All the recipients' serum samples were negative at the time of transplantation except those from the multiorgan donor. The donor's mother was born in Venezuela and was confirmed positive for antibodies to HTLV-I. The remaining family members were negative. HTLV-I DNA sequences were recovered, amplified, and sequenced from all the samples from the HTLV-I-positive recipients and the donor's mother. The homology of HTLV-I sequences was 100% in all cases. CONCLUSIONS: The authors are reporting the first documented case of HTLV-I infection in several transplant recipients sharing the same donor. The donor was infected by vertical transmission. HTLV-I infection has devastating consequences for some immunocompromised organ recipients. This emphasizes the need for a systematic survey of HTLV antibodies in all potential donors.

Genetic analysis of RET, GFR alpha 1 and GDNF genes in Spanish families with multiple endocrine neoplasia type 2A.

Multiple endocrine neoplasia type 2A (MEN 2A) is associated with specific germline missense mutations in the RET proto-oncogene. This locus encodes a receptor tyrosine kinase whose activation requires the formation of a multimeric receptor complex including GDNF as a ligand and GFR alpha 1 as a coreceptor. In order to explore the role of RET, GFR alpha 1 and GDNF genes in the variation of phenotypes observed in MEN2A families, we analysed germline mutations of these genes in 4 unrelated Spanish MEN2A families (23 cases studied). We found 2 novel variants corresponding to a single change in position + 47 (intron 12) of RET and position +22 (intron 7) of GFR alpha 1. Furthermore, we observed strong co-segregation between 2 polymorphisms of RET [G691S (exon 11) and S904S (TCC-TCG, exon 15) (100%, Fisher's exact test, p< 0.001)]. More interestingly, we found that these polymorphisms occurred at a significantly high frequency in patients with age at onset < 20 years old (Kruskal-Wallis's and Fisher's exact test, p = 0.007). These findings suggest that the G691S and S904S variants of RET may somehow play a role on the age of onset of MEN 2A.

Evolución de la seroprevalencia del virus de la inmunodeficiencia humana en madres de recién nacidos entre 1996 y 1999 / Time-trend in HIV seroprevalence among mothers of new-borns. Spain, 1996-1999

Fundamento: Analizar la evolución de la prevalencia del VIH en madres de recién nacidos. Población y métodos: Cribado anónimo y no relacionado de anticuerpos anti-VIH en todas las muestras de sangre neonatales para detección de metabolopatías, entre 1996 y 1999, en las comunidades autónomas de Baleares, Canarias, Castilla-La Mancha, Castilla y León, Galicia, Melilla y Murcia. El cribado se realizó mediante una prueba ELISA y la confirmación con un inmunoblot. Resultados: La prevalencia de anticuerpos anti-VIH fue de 0,99 por 1.000 en 1996, 1,29 en 1997, 1,42 en 1998 y 1,54 en 1999. La tendencia global fue creciente (p = 0,0015), al igual que la de Canarias (p < 0,0001) y Castilla y León (p = 0,0389). La prevalencia del VIH-1 en el período 1996-1999 fue de 1,31 por 1.000 y la del VIH-2 de 1,13 por 100.000. Conclusiones: Dado el aumento de la prevalencia del VIH en madres de recién nacidos, son necesarios el consejo y la oferta sistemática de la prueba del VIH a todas las mujeres embarazadas. (AU)