RESUMEN
HIV-1 strain diversity in Bulgaria is extensive and includes contributions from nearly all major subtypes and the Circulating Recombinant Forms (CRF): 01_AE, 02_AG, and 05_DF. Prior to this study, HIV-1 sequence information from Bulgaria has been based solely on the pro-RT gene, which represent less than 15% of the viral genome. To further characterize HIV-1 in Bulgaria, assess participant risk behaviors, and strengthen knowledge of circulating strains in the region, the study "Genetic Subtypes of HIV-1 in Bulgaria (RV240)" was conducted. This study employed the real time-PCR based Multi-region Hybridization Assay (MHA) B/non-B and HIV-1 sequencing to survey 215 of the approximately 1100 known HIV-1 infected Bulgarian adults (2008-2009) and determine if they were infected with subtype B HIV-1. The results indicated a subtype B prevalence of 40% and demonstrate the application of the MHA B/non-B in an area containing broad HIV-1 strain diversity. Within the assessed risk behaviors, the proportion of subtype B infection was greatest in men who have sex with men and lowest among those with drug use risk factors. During this study, 15 near full-length genomes and 22 envelope sequences were isolated from study participants. Phylogenetic analysis shows the presence of subtypes A1, B, C, F1, and G, CRF01_AE, CRF02_AG, CRF05_DF, and one unique recombinant form (URF). These sequences also show the presence of two strain groups containing participants with similar risk factors. Previous studies in African and Asian cohorts have shown that co-circulation of multiple subtypes can lead to viral recombination within super-infected individuals and the emergence of new URFs. The low prevalence of URFs in the presence of high subtype diversity in this study, may be the result of successful infection prevention and control programs. Continued epidemiological monitoring and support of infection prevention programs will help maintain control of the HIV-1 epidemic in Bulgaria.
Asunto(s)
Variación Genética , Infecciones por VIH/epidemiología , Infecciones por VIH/virología , VIH-1/genética , Adulto , Bulgaria/epidemiología , Femenino , Genoma Viral , Geografía , Seropositividad para VIH/epidemiología , Seropositividad para VIH/virología , Homosexualidad Masculina , Humanos , Masculino , Persona de Mediana Edad , Epidemiología Molecular , Filogenia , Prevalencia , Reacción en Cadena en Tiempo Real de la Polimerasa , Análisis de Regresión , Factores de Riesgo , Asunción de Riesgos , Trastornos Relacionados con Sustancias/prevención & controlRESUMEN
OBJECTIVE: To assess the level of serum sperm antibodies after mumps orchitis. DESIGN: Controlled descriptive study. SETTING: Academic research environment. PATIENT(S): Seventy-four mumps orchitis patients. INTERVENTION(S): Sampling of serum at different intervals after the onset of orchitis symptoms: 1 to 7 days, 31 to 60 days, and 61 to 431 days. MAIN OUTCOME MEASURE(S): Level of serum sperm antibodies, using Kibrick's gelatin agglutination test, Friberg's tray agglutination test, Isojima's sperm immobilization test, and ELISA. RESULT(S): Clinically relevant sperm antibody values were detected by the Friberg method among patients tested from 1 to 7 days (10.5%) and 61 to 431 days (10.5%) after the onset of disease. The Isojima test revealed a statistically insignificant higher incidence among patients at 61 to 431 days (31.6%) as compared with those sampled at 1 to 7 days (10.5%). None of the orchitis sera tested positive by the Kibrick and ELISA techniques. The established incidences did not differ significantly from the results for negative controls (blood donors) and were lower than the values acquired from positive controls (males with unexplained infertility). CONCLUSION(S): Mumps orchitis does not cause enhanced humoral immunity to spermatozoa.