RESUMO
Abstract: Objective: The aim of this study is to evaluate the prevalence of T. pallidum infection markers in HIV-positive individuals receiving highly active antiretroviral therapy (ART) in the Mexico City HIV/AIDS Program, as well as predictive characteristics. Materials and methods: The reverse serologic algorithm method was used for the T. pallidum diagnosis, and applied to 2 383 HIV-positive individuals. Sociodemographic characteristics, sexual practices, previous syphilis diagnosis, and length of antiretroviral treatment, were evaluated. Variables significantly associated with syphilis markers were analyzed using a logistic regression model. Results: Prevalence of "active or resolved" and "probable active" infection markers were 44.2 and 28.8%, respectively. Predictive factors were: Clínica Especializada Condesa Iztapalapa (CECI), previous syphilis diagnosis, men in who have sex with men (MSM), and receptive sex practices. Conclusions: The prevalence of T. pallidum infection markers was the highest ever reported in Mexico, and was related to specific sexual practices as well as previous syphilis diagnosis, elements which require preventive measures in the Mexico City HIV/AIDS Program.
Resumen: Objetivo: Evaluar las prevalencias de marcadores de infección por T. pallidum en personas que viven con VIH y reciben tratamiento antirretroviral en el Programa de VIH/SIDA de la Ciudad de México, así como sus características asociadas. Material y métodos: Se siguió el método del algoritmo reverso para el diagnóstico de T. pallidum aplicado a 2 383 individuos VIH positivos, quienes contestaron un cuestionario sobre características sociodemográficas, prácticas sexuales, diagnóstico previo de sífilis y tiempo de tratamiento antirretroviral. Las variables significativamente asociadas con los marcadores de sífilis se analizaron mediante un modelo de regresión logística. Resultados: Las prevalencias de marcadores de infección "activa o resuelta" y "probablemente activa" fueron 44.2 y 28.8%, respectivamente. Las características asociadas con los marcadores fueron Clínica Especializada Condesa Iztapalapa (CECI), diagnóstico previo de infección por sífilis, hombres que tienen sexo con hombres (HSH) y prácticas sexuales receptivas. Conclusiones: Las prevalencias de marcadores de infección por T. pallidum fueron altas y estuvieron relacionadas con prácticas sexuales específicas y con el diagnóstico previo de sífilis, características que requieren medidas preventivas dentro del programa.
RESUMO
The World Health Organization (WHO) and the Joint United Nations Programme on HIV and AIDS (UNAIDS) suggest that sexually transmitted infection (STI) surveillance should include other genital infections and not only human immunodeficiency virus (HIV). To monitor the concomitance of bacterial vaginosis (BV) and STIs in HIV-seropositive (HIV+) and HIV-seronegative (HIV-) patients, a prospective study was conducted in a cohort of 349 volunteers at a clinic specializing in treating STIs in Mexico City. Microbiological and molecular methods were used to detect STIs and dysbiosis in HIV+ and HIV- individuals. The prevalence of infection was higher in HIV+ (69.28%) than in HIV- (54.87%) individuals. BV was the most frequent infection in HIV+ individuals, and polymicrobial infections were 3 times more common in HIV+ individuals than in HIV- individuals (31.48 vs. 10.98%). Behaviors documented in a self-administered questionnaire included low condom use frequency in HIV+ individuals co-infected with BV or a STI. This finding highlights the importance of surveillance using routine microbiological evaluations for the correct management of genital infections in HIV+ patients because in the presence of HIV, the clinical presentations, courses, and therapeutic responses of some STIs can differ from those in patients without HIV infection.
RESUMO
OBJECTIVE: The aim of this study is to evaluate the prevalence of T. pallidum infection markers in HIV-positive individuals receiving highly active antiretroviral therapy (ART) in the Mexico City HIV/AIDS Program, as well as predictive characteristics. METHODS: The reverse serologic algorithm method was used for the T. pallidum diagnosis, and applied to 2,383 HIV-positive individuals. Socio-demographic characteristics, sexual practices, previous syphilis diagnosis, and length of antiretroviral treatment, were evaluated. Variables significantly associated with syphilis markers were analyzed using a logistic regression model. RESULTS: Prevalence of "active or resolved" and "probable active" infection markers were 44.2% and 28.8%, respectively. Predictive factors were: Clinic Specialized Condesa Iztapalapa (CECI), previous syphilis diagnosis, MSM, and receptive sex practices. CONCLUSIONS: The prevalence of T. pallidum infection markers was the highest ever reported in Mexico, and was related to specific sexual practices as well as previous syphilis diagnosis, elements which require preventive measures in the Mexico City HIV/AIDS Program.
Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Sífilis , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , México/epidemiologia , Prevalência , Fatores de Risco , Sífilis/diagnóstico , Sífilis/epidemiologiaRESUMO
OBJECTIVE:: To describe results of HIV, sexually transmitted diseases (STI) and CD4 counts at the HIV-specialized Condesa Clinic (CC) in Mexico City. MATERIALS AND METHODS:: Individuals who requested voluntary counseling and testing at CC were studied. We identified antibodies against HIV, syphilis, hepatitis C, and hepatitis B HBsAg. CD4 cell counts and viral load of HIV positive individuals were also obtained. Late HIV infection diagnosis was established if CD4 counts were lower than 200 cells/µL. RESULTS:: Global seroprevalence of HIV, syphilis, HBsAg, and anti HCV markers was of 20.1, 6, 1 and 1, respectively. Men displayed higher seroprevalence of infection markers than women. Among men, HIV infection was related to age and with all STI markers. Late HIV diagnosis was 31.8%. The risk of late HIV diagnosis was higher among women and it increased as age increased. CONCLUSIONS:: Differences between genders regarding HIV and STIs prevalence as well as risk factors for HIV infection and late HIV diagnosis were observed.
Assuntos
Instituições de Assistência Ambulatorial , Contagem de Linfócito CD4 , Infecções por HIV/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Diagnóstico Tardio , Feminino , Infecções por HIV/sangue , Soroprevalência de HIV , Humanos , Masculino , México , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , População Urbana , Carga Viral , Viremia/sangue , Viremia/epidemiologia , Adulto JovemRESUMO
Abstract: Objective: To describe results of HIV, sexually transmitted diseases (STI) and CD4 counts at the HIV-specialized Condesa Clinic (CC) in Mexico City. Materials and methods: Individuals who requested voluntary counseling and testing at CC were studied. We identified antibodies against HIV, syphilis, hepatitis C, and hepatitis B HBsAg. CD4 cell counts and viral load of HIV positive individuals were also obtained. Late HIV infection diagnosis was established if CD4 counts were lower than 200 cells/μL. Results: Global seroprevalence of HIV, syphilis, HBsAg, and anti HCV markers was of 20.1, 6, 1 and 1, respectively. Men displayed higher seroprevalence of infection markers than women. Among men, HIV infection was related to age and with all STI markers. Late HIV diagnosis was 31.8%. The risk of late HIV diagnosis was higher among women and it increased as age increased. Conclusions: Differences between genders regarding HIV and STIs prevalence as well as risk factors for HIV infection and late HIV diagnosis were observed.
Resumen: Objetivo: Describir resultados del programa VIH/SIDA de la Clínica Especializada Condesa (CC). Material y métodos: Se identificaron anticuerpos contra VIH, sífilis y hepatitis C, así como HBsAg del virus de la hepatitis B. Se hizo un conteo de CD4 y carga viral en los positivos a VIH asistentes a la CC. El conteo CD4 menor a 200 células/μL definió el diagnóstico tardío de la infección por VIH. Resultados: La prevalencia de VIH, sífilis, HBsAg y virus de la hepatitis (HCV) fue de 20.1, 6, 1 y 1, respectivamente. Los hombres mostraron prevalencias mayores de infección que las mujeres y en ellos la infección por VIH estuvo relacionada con la edad y con los marcadores de ITS. El diagnóstico tardío de VIH fue de 31.8% y su riesgo fue mayor en las mujeres y se incrementó conforme la edad. Conclusión: Se encontraron diferencias de género en las prevalencias de VIH e ITS, en los riesgos de infección por VIH y en el diagnóstico tardío de esta infección.