RESUMEN
Masked sera from 194 cases and 217 controls participating in a case-control study of cervical cancer in Brazil were examined for antibodies to human papillomavirus (HPV) 16 E6 and E7 by radioimmunoprecipitation assay. Radiolabeled full-length E6 and E7 proteins expressed by in vitro transcription and translation in rabbit reticulocyte lysate were used as antigens. The antibody prevalences in cases and controls were: 54.1% versus 6% for E6; 30.4% versus 4.6% for E7; 63.4% versus 10.1% for either E6 or E7; and 21.1% versus 0.5% for both E6 and E7. The corresponding odds ratios were 35 ([95% confidence interval (CI)], 15-83), 10 (95% CI, 4-25), 28 (95% CI, 13-61) and 87 (95% CI, 10-736). The most marked contrast between cases and controls was observed for sera with high antibody titers (cpm > 6000) with an odds ratio of 239 (95% CI, 29-1946) for E6 or E7. Seroreactivity in cases was partially type specific; women who had HPV-16 DNA in the genital tract had higher antibody prevalence rates than those who were negative for HPV DNA. Reactivity to the E6 protein was associated with the stage of disease; the antibody prevalence was 62.7% in cases with stages II-IV and 31.0% in cases with stage I (P < 0.005). HPV-16 serology and HPV polymerase chain reaction were compared as markers for invasive cervical cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Anticuerpos Antivirales/sangre , Carcinoma/virología , Proteínas Oncogénicas Virales/inmunología , Papillomaviridae/inmunología , Proteínas Represoras , Neoplasias del Cuello Uterino/virología , Adulto , Anciano , Biomarcadores , Brasil , Carcinoma/sangre , Carcinoma/patología , Estudios de Casos y Controles , ADN Viral/análisis , Femenino , Humanos , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Papillomaviridae/aislamiento & purificación , Proteínas E7 de Papillomavirus , Prevalencia , Ensayo de Radioinmunoprecipitación , Factores de Riesgo , Sensibilidad y Especificidad , Neoplasias del Cuello Uterino/sangre , Neoplasias del Cuello Uterino/patologíaRESUMEN
A hospital-based case-control study was undertaken to examine the role of human papillomavirus (HPV) in the development of invasive cervical cancer in Brazil. The study included 199 histologically confirmed incident cases and 225 age-frequency-matched controls selected from a wide range of diagnostic categories. A polymerase chain reaction technique was used to detect HPV DNA in cervical specimens collected with spatula and brush. HPV DNA was detected in 84% of the cases compared with 17% of controls. Grouping HPV types 16, 18, 31 and 33, 66% of the cases were positive compared with only 6% of the controls. In addition to HPV, number of sexual partners, early age at first intercourse, parity and duration of oral contraceptive use were significantly associated with an increased risk of cervical cancer. A history of previous Papanicolaou smears was significantly associated with a decreased risk. After adjustment, only presence of HPV DNA, parity and history of previous smears remained as independent risk factors. The adjusted odds ratios of cervical cancer associated with HPV 16, 18, 31, and 33 was 69.7 (95% confidence interval 28.7-169.6) and with unidentified types was 12.0 (5.1-28.5). The very high risks found in this study further implicate this virus in the aetiology of cervical cancer.
PIP: 67 different types of human papillomavirus (HPV) have been described, and 28 have been isolated from benign and malignant genital lesions. Good experimental data have been produced to support an etiological role for HPV in the pathogenesis of anogenital cancer, especially cervical cancer which is the leading cancer in developing countries. Sao Paolo, Brazil, has one of the highest incidence rates for invasive cervical cancer worldwide. The authors therefore applied a hospital-based case-control study approach to examine the role of HPV in the development of the disease in Brazil. The study included 199 histologically confirmed incident cases and 225 age-frequency-matched controls selected from a wide range of diagnostic categories. HPV DNA was found in cervical specimens via a polymerase chain reaction technique in 84% of cases compared with 17% of controls. Grouping HPV types 16, 18, 31, and 33, 66% of the cases were positive compared with only 6% of the controls. Number of sex partners, early age at first intercourse, parity, and duration of oral contraceptive use were also significantly associated with an increased risk of cervical cancer. A history of previous Papanicolaou smears was significantly associated with a decreased risk. After adjustment, only presence of HPV DNA, parity, and history of previous smears remained as independent risk factors. The adjusted odds ratios of cervical cancer associated with HPV 16, 18, 31, and 33 was 69.7 with a 95% confidence interval of 28.7-169.6; that with unidentified types was 12.0 in an interval of 5.1-28.5. These very high risks therefore further implicate HPV in the etiology of cervical cancer.
Asunto(s)
Papillomaviridae , Infecciones por Papillomavirus/epidemiología , Infecciones Tumorales por Virus/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Adulto , Anciano , Brasil/epidemiología , Estudios de Casos y Controles , Anticonceptivos Orales/efectos adversos , ADN Viral/análisis , Femenino , Amplificación de Genes , Globinas/genética , Humanos , Incidencia , Persona de Mediana Edad , Invasividad Neoplásica , Papillomaviridae/genética , Infecciones por Papillomavirus/genética , Reacción en Cadena de la Polimerasa , Prevalencia , Factores de Riesgo , Parejas Sexuales , Fumar/efectos adversos , Infecciones Tumorales por Virus/genética , Neoplasias del Cuello Uterino/virologíaRESUMEN
Programmes to control Ascaris lumbricoides, Trichuris trichiura and hookworm infections have often been targeted at each infection separately, but the advent of benign and broad-spectrum anthelmintics suggests that combined control may be feasible. The extent to which the infections co-occur in communities will determine the need for, and potential benefits of, such a combined approach. This paper examines the comparative distribution of the three geohelminths in different geographical areas and shows that A. lumbricoides and T. trichiura have closely related distributions, while hookworm infection is largely independent of the other two. These results indicate that many communities are at risk of disease from infection by more than one species of helminth. The similar distributions and epidemiological characteristics of A. lumbricoides and T. trichiura suggest that simultaneous control of these two parasites by the same strategy would be feasible and highly beneficial to communities. Multiple species control strategies which aim to control hookworm infection may require a more complicated protocol with more precise locality targeting.
Asunto(s)
Ascariasis/epidemiología , Infecciones por Uncinaria/epidemiología , Tricuriasis/epidemiología , África Oriental/epidemiología , Animales , Ascariasis/prevención & control , Brasil/epidemiología , Camerún/epidemiología , Chile/epidemiología , Infecciones por Uncinaria/prevención & control , Humanos , India/epidemiología , Indonesia/epidemiología , Prevalencia , Tricuriasis/prevención & controlRESUMEN
Part I of this series compared characteristics of 546 Chicanos and Anglo men and women methadone maintenance (MM) clients. In Part II, specific differences between Chicanos and Anglos are analyzed, by sex, for each of five stages in the addiction career: preexperimentation, experimentation addiction, initial MM treatment, and posttreatment. The analysis examines narcotic and other drug use, arrest, incarceration and legal supervision histories, criminal involvement, employment, interpersonal relationships, and treatment history. Whereas preaddiction differences between addicts parallel ethnic differences found in the general population, after addiction occurs the similarities are greater than the dissimilarities between ethnic groups, except for Chicanas. Chicanos appear to continue to function as part of their community after addiction, but Chicanas appear to risk becoming marginal. Treatment outcomes for Chicanos were, in general, less successful than for Anglos.
Asunto(s)
Dependencia de Heroína/etnología , Hispánicos o Latinos/psicología , Adulto , California , Crimen , Femenino , Estudios de Seguimiento , Dependencia de Heroína/psicología , Dependencia de Heroína/rehabilitación , Humanos , Relaciones Interpersonales , Masculino , Metadona/uso terapéutico , México/etnologíaRESUMEN
This paper reviews the research literature comparing Chicano (Mexican American) to Anglo heroin addicts. In addition, characteristics of 546 Chicano and Anglo men and women who had been clients of southern California methadone maintenance programs in 1978 are compared. Background factors examined include nativity, family socioeconomic status (SES) and family interpersonal relationships, education, and gang membership. Lifetime characteristics and status at follow-up interview are reported with particular attention to legal status, criminality, employment, and interpersonal relationships. Drug experimentation history and circumstances surrounding narcotics initiation are also compared. Most observed differences prior to addiction are similar to ethnic differences found in the general population. Part II analyzes ethnic differences progressing through five stages of the addiction career.