RESUMEN
Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.
Asunto(s)
Coinfección/epidemiología , Infecciones por VIH/epidemiología , Hepatitis Viral Humana/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Coinfección/virología , Femenino , Infecciones por VIH/virología , Hepatitis Viral Humana/virología , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Salud Pública , Estados Unidos/epidemiología , Adulto JovenRESUMEN
This descriptive study compares individual- and area-level factors among HIV-infected transgender and cisgender individuals in Florida using data from the Florida Department of Health HIV/AIDS surveillance system (2006-2014). Of those individuals diagnosed with HIV, 7 (0.01 %) identified as transgender males, 142 (0.3 %) as transgender females, 12,497 (25.7 %) as cisgender females, and 35,936 (74.0 %) as cisgender males. Transgender females resided in rural and urban areas, were disproportionately non-Hispanic black, and were more likely than cisgender women to be diagnosed with AIDS within 3 months of their HIV diagnosis. Results suggest HIV screening and outreach efforts should be enhanced for transgender women.
Asunto(s)
Identidad de Género , Infecciones por VIH/diagnóstico , Conducta Sexual , Personas Transgénero/estadística & datos numéricos , Adulto , Femenino , Florida/epidemiología , Infecciones por VIH/epidemiología , Humanos , Masculino , Población Rural , Determinantes Sociales de la Salud , Factores Socioeconómicos , Población UrbanaRESUMEN
Arthroscopic acromioplasty is an effective technique to treat refractory impingement syndrome of the shoulder; however, it is a technically demanding procedure and failure due to inadequate acromial resection has been reported. The purpose of this study was to describe a more reliable technique of arthroscopic acromioplasty ("arthroscopic impingement test") that allows determination of subacromial space available (SSA) during shoulder flexion after acromioplasty. During a 2-year period, 70 consecutive patients (group I) underwent arthroscopic acromioplasty by a conventional technique and 50 consecutive patients (group II) underwent the modified technique. Both groups were comparable in terms of age, gender, chronicity of symptoms, incidence of workman's compensation cases, side of surgery, and operative findings. In group I, four patients (6%) failed due to inadequate acromioplasty and at time of revision were found to have 0 mm SSA at 120 degrees flexion (contact of cuff on acromion). After revision acromioplasty, SSA at 120 degrees flexion was measured as > 3 mm, and impingement symptoms resolved postoperatively. In group II, there were no failures and SSA after initial acromioplasty was found to average 13 mm at 0 degree 10 mm at 45 degrees, 8 mm at 90 degrees, and 6 mm at 120 degrees flexion. In four cases, the "arthroscopic impingement test" determined that there was inadequate SSA at 120 degrees (< 3 mm) after initial acromioplasty, and these were revised by further acromioplasty at time of surgery. It was concluded that the "arthroscopic impingement test" improves reliability of arthroscopic acromioplasty by verifying adequate acromial resection in a position of impingement.