RESUMEN
Even though syphilis can be easily diagnosed by simple and low-cost laboratory methods, it continues to be an important health problem. Rapid tests (RT) for the detection of treponemal antibodies can facilitate earlier diagnosis, access to treatment and linkage to care. The aim of this study was to analyse the usefulness of the incorporation of a RT in the detection of patients infected with T. pallidum in a sexually-transmitted disease (STD) clinic. Between March and December 2015, a syphilis RT was offered to patients who spontaneously attended the clinic. Conventional serology testing was additionally indicated to every participant. The RT for syphilis was offered to 1887 patients, of whom 31.1% agreed to get tested. VDRL test was performed in 84.0% of patients that were also tested with syphilis RT, with a significantly higher frequency observed among participants with reactive RT (94.3% vs. 79.8%, p < 0.001). These results showed that 33.7% of the participants were reactive for the RT and 27.0% were reactive for the VDRL test. Both tests were reactive in 24.9% and non-reactive in 64.3%. A high prevalence of active syphilis was detected in patients attending the clinic. The use of a syphilis RT had a positive impact, which in combination with the VDRL test increased the number of patients that were effectively diagnosed.
Asunto(s)
Cardiolipinas/análisis , Colesterol/análisis , Fosfatidilcolinas/análisis , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Serodiagnóstico de la Sífilis/métodos , Sífilis/diagnóstico , Adulto , Argentina/epidemiología , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Bacterianas de Transmisión Sexual/inmunología , Sífilis/epidemiología , Sífilis/inmunologíaRESUMEN
El virus del papiloma humano es una de las infecciones de transmisión sexual más comunes, se encuentra asociado con varias enfermedades desde cáncer cervical y anal, hasta verrugas genitales. Sus particulares inmunológicas le permiten subsistir en algunos pacientes y causar enfermedades malignas. Con la aprobación de la vacuna tetravalente contra el VPH los médicos poseemos una nueva arma en la prevención primaria contra el cáncer cervical, las verrugas genitales y el cáncer anal. Este trabajo revisa los conocimientos actuales sobre esta vacuna y sus indicaciones en medicina general.
Asunto(s)
Humanos , Papiloma , Vacunas Virales , Inmunoterapia Activa , Enfermedades Bacterianas de Transmisión Sexual/inmunología , Enfermedades Virales de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/patología , Enfermedades Virales de Transmisión Sexual/terapia , Costa RicaRESUMEN
To investigate a possible cause-and-effect relationship between sexually transmitted diseases and cervical cancer, we performed a sero-epidemiological study on the presence of antibodies against a number of sexually transmitted agents (STAs) in patients with cervical cancer and their matched controls. In this study, we used serological techniques to investigate the presence of antibodies to cytomegalovirus, herpes simplex virus type 2, human immunodeficiency virus, Chlamydia trachomatis, Treponema pallidum and human papillomavirus (HPV) early protein E7 in sera from patients with cervical cancer, cervical intra-epithelial neoplasia and individually matched, healthy controls. The presence of antibodies to infectious agents other than HPV appeared not to be associated with risk of cervical neoplasia in either univariate or multivariate analysis. After adjustment for cytology, schooling and presence of HPV DNA in cervical scrapes, there was a significantly higher prevalence of antibodies to HPV-16 E7 protein in sera from patients with cervical cancer (OR = 3.6, 95% CI 1.0-12.9) than in healthy controls. The highest antibody prevalence was found among HPV-16 DNA-positive cervical cancer patients (33%). Our results indicate that in these study groups past infections with the STA considered seems to be of no apparent relevance for cervical carcinogenesis and that the HPV-16 anti-E7 response appears to be associated with cervical cancer.
Asunto(s)
Anticuerpos Antibacterianos/sangre , Anticuerpos Antivirales/sangre , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Virales de Transmisión Sexual/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Adulto , Anciano , Estudios de Casos y Controles , Chlamydia trachomatis/inmunología , ADN Viral/análisis , Femenino , VIH/inmunología , Herpesviridae/inmunología , Honduras/epidemiología , Humanos , Persona de Mediana Edad , Proteínas Oncogénicas Virales/inmunología , Papillomaviridae/inmunología , Proteínas E7 de Papillomavirus , Factores de Riesgo , Estudios Seroepidemiológicos , Enfermedades Bacterianas de Transmisión Sexual/complicaciones , Enfermedades Bacterianas de Transmisión Sexual/inmunología , Enfermedades Virales de Transmisión Sexual/complicaciones , Enfermedades Virales de Transmisión Sexual/inmunología , Treponema pallidum/inmunología , Neoplasias del Cuello Uterino/inmunología , Neoplasias del Cuello Uterino/microbiología , Neoplasias del Cuello Uterino/virología , Displasia del Cuello del Útero/epidemiología , Displasia del Cuello del Útero/inmunología , Displasia del Cuello del Útero/microbiología , Displasia del Cuello del Útero/virologíaRESUMEN
Fetal behaviour as an intrauterine patient is unknown. In the diagnosis of sexually transmitted diseases (STD) and in the criteria for treatment only the mother is considered leaving the fetus out. The presence of immunoglobulin M in the amniotic fluid is an indicator of fetal infection and could allow an accurate diagnosis of fetal disease or treatment, if the measurement is related to the presence or absence of organism in the amniotic fluid. In this way, the study of fetal behaviour under these conditions could be done. The objective of this research was to determine the presence of STD organism in the amniotic fluid of the STD infected pregnant women and to evaluate the prevalence and evolution of these pathologies in the fetus. No STD organism, nor immunoglobulin M were found in the 13 samples of amniotic fluid (8 pre and 5 post-treatment) of infected pregnant women. The presence of microorganisms and its relation to immunoglobulin M was not observed. More cases are needed to arrive to a conclusion regarding fetal immunology and to a better understanding of antibacterial properties of the amniotic fluid. We concluded that no contamination in the amniotic fluid or fetal infection was found in pregnant women with STD.