RESUMO
OBJECTIVES: To evaluate the prevalence of human papillomavirus (HPV) types, and risk factors for HPV positivity across cervix, vagina and anus, we conducted a study among 138 women with human immunodeficiency virus (HIV). GOAL: Compare the prevalence of different HPV types and the risk factors for HPV positivity in three sites. RESULTS: The most frequently detected HPV types in all sites were, in decreasing order, HPV16, 53, 18, 61 and 81. Agreement between the cervix and vagina was good (kappa 0.60 - 0.80) for HPV16 and 53 and excellent (Kappa > 0.80) for HPV18 and 61. HPV positivity was inversely associated with age for all combinations including the anal site. CONCLUSION: In HIV positive women, HPV18 is the most spread HPV type found in combinations of anal and genital sites. The relationship of anal to genital infection has implications for the development of anal malignancies. Thus, the efficacy of the current HPV vaccine may be considered not only for the cervix, but also for prevention of HPV18 anal infection among immunossuppressed individuals.
RESUMO
OBJECTIVES: Better information on the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection is needed in many world areas. STUDY DESIGN: Cross-sectional study of population-based samples of nonpregnant women aged 15 to 44 years in Nigeria, Colombia, Argentina, Vietnam (2 areas), China, Thailand (2 areas), Korea, and Spain. 5,328 consenting women aged 15 to 44 years participated. Exfoliated cervical cells were collected and testing for CT and NG and human papillomavirus (HPV) was done using PCR-based assays. RESULTS: Age-standardized CT prevalence ranged between 0.2% (95% confidence interval, CI: 0.0-0.7%) in Spain and 5.6% (95% CI: 3.4-7.8%) in Nigeria. NG ranged between 0% (with broad CIs) in several areas and 2.6% (95% CI: 1.0-4.2%) in Nigeria. Prevalence of CT in all areas combined was greater in women aged 15 to 24 (4.5; 95% CI: 3.4-5.8%) than 25 to 44 (2.6; 95% CI: 2.1-3.1%), whereas NG prevalence was similar in the 2 age groups (0.3%). The only significant risk factors were NG infection (for CT), CT infection (for NG) and infection with high-risk HPV types (for both). CONCLUSIONS: The prevalence of CT and, most notably, NG was relatively low in a variety of countries. Our findings, however, do not apply to subsets of high-risk women who are likely to be underrepresented in our population-based samples.
Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis , Gonorreia/epidemiologia , Doenças do Colo do Útero/epidemiologia , Adolescente , Adulto , Ásia/epidemiologia , Infecções por Chlamydia/etiologia , Infecções por Chlamydia/prevenção & controle , Colômbia/epidemiologia , Estudos Transversais , Feminino , Gonorreia/etiologia , Gonorreia/prevenção & controle , Humanos , Neisseria gonorrhoeae , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Espanha/epidemiologia , Doenças do Colo do Útero/etiologia , Doenças do Colo do Útero/prevenção & controleRESUMO
The natural course of Chlamydia trachomatis infection and its risk factors were studied in Colombian women with normal cytological results, during a 5-year period. Eighty-two women who were found to be positive for C. trachomatis at the start of the study were studied at 6-month intervals. At each visit, a cervical scrape sample was obtained for detection of C. trachomatis by use of C. trachomatis endogenous-plasmid polymerase chain reaction (PCR)-enzyme immunoassay and VD2-PCR-reverse line blot assay. Of the women studied, 67% had a single-serovar infection, 10% had a mixed-serovar infection, and 23% had an infection with an unidentified type. An inversed rate of clearance of C. trachomatis infection was observed with oral contraceptive use (hazard ratio [HR], 1.7 [95% confidence interval {CI}, 1.1-2.7]) and first sexual intercourse at >/=20 years of age (HR, 4.3 [95% CI, 2.3-8.0]). Serovars of group B (B, D, and E) and C (H, I, J, and K) had a decreased rate of clearance (rate ratio, 0.4 [95% CI, 0.1-0.9]), compared with that for serovars of the intermediate group (F and G). At 4 years of follow-up, 94% of the women had cleared their infections.
Assuntos
Infecções por Chlamydia/fisiopatologia , Chlamydia trachomatis/classificação , Chlamydia trachomatis/isolamento & purificação , Adolescente , Adulto , Colo do Útero/microbiologia , Infecções por Chlamydia/imunologia , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis/genética , Colômbia , Feminino , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Plasmídeos/genética , Reação em Cadeia da Polimerase/métodos , Fatores de Risco , Sorotipagem , Manejo de Espécimes/métodosRESUMO
Objetivo: estudiar el curso natural de las infecciones por Chlamydia trachomatis (C.trachomatis) y su asociación con el virus del papiloma humano (VPH) en mujeres bogotanas con citología normal, durante un periodo de cinco años. Metodología: se analizaron 82 mujeres positivas para C. trachomatis a itervalos de ses meses. En cada visita se realizó un cepillado cervical para hacer la detección del plásmido endógeno de C.trachomatis con el uso de los indicadores específicos Bio PL6.1/PL6.2 y, para la detección de VPH, con los iniciadores Bio GP5+/GP6+, mediante el desarrollo de un PCR-EIA. De estas mujeres, 18 (21,9 porciento)fueron positivas para VPH genérico, 13(15,8 por ciento) de las cuales tuvieron VPH de alto riesgo y 5 (6,1por ciento) VPH de bajo riesgo. Resultados: durante el seguimiento, el VPH genérico no se asoció con la eliminación o persistencia de la infección por C. trachomatis. después de cuatro años de seguimiento, 6 por ciento de las mujeres infectadas por C. trachomatis aún no habían superado la infección. Conclusión: en este estudio se observó un bajo porcentaje de infecciones persistentes por C. trachomatis después de cuatro años de seguimiento, y el VPH no fue un factor de riesgo para la persistencia o eliminación de las infecciones por este germen.
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Humanos , Chlamydia trachomatis , Colômbia , Papillomaviridae , SeguimentosRESUMO
Introducción: El virus del papiloma humano es el principal factor de riesgo asociado con el desarrollo de cáncer cervical, uno de los cánceres más comunes en mujeres colombianas. En Colombia, donde las tasas de incidencia de cáncer cervical son altas, se tiene poca información acerca de la prevalencia de la infección y no se tienen datos de seguimiento sobre la persistencia o eliminación de la infección y los factores de riesgo asociados. En este reporte se presentan los resultados de la prevalencia de la infección por HPV y los factores de riesgo asociados en mujeres que tuvieron una citología normal al comienzo del estudio así como el seguimiento de 227 mujeres positivas para la infección por HPV durante un periodo de cinco años, en la ciudad de Bogotá, Colombia
Assuntos
Papiloma , Neoplasias do Colo do Útero , História Natural das DoençasRESUMO
Little is known about the factors that influence clearance of human papillomavirus (HPV), the primary cause of cervical carcinoma. A total of 227 women cytologically normal and HPV positive at baseline were identified from a population-based cohort of 1,995 Bogota, Colombia, women aged 13-85 years followed between 1993 and 2000 (mean follow-up, 5.3 years). HPV DNA detection and viral load determination were based on a GP5+/GP6+ polymerase chain reaction enzyme immunoassay. Rate ratio estimates for HPV clearance were calculated by using methods for interval-censored survival time data. Analyses were based on 316 type-specific HPV infections. HPV 16 had a significantly lower clearance rate than infections with low-risk types (rate ratio (RR) = 0.47, 95% confidence interval (CI): 0.32, 0.72), HPV types related to HPV 16 (types 31, 33, 35, 52, 58) had intermediate clearance rates (RR = 0.62, 95% CI: 0.47, 0.94), and other high-risk types did not show evidence of slower clearance compared with low-risk types. Infections with single and multiple HPV types had similar clearance rates. There was no evidence of a dose-response relation between clearance and viral load. Observed was slower clearance in parous women (RR = 0.64, 95% CI: 0.47, 0.89) and faster clearance in ever users of oral contraceptives (RR = 1.38, 95% CI: 1.07, 1.77).