RESUMO
In Chilean children and adolescents, human papillomavirus (HPV) infection prevalence is unknown. In 2014, the HPV vaccine was incorporated into the National Immunization Program for girls, and since 2019 for boys. OBJECTIVE: To determine the prevalence, genotypes, and characteristics of HPV infection in children and adolescents with anogenital lesions not vaccinated against HPV. PATIENTS AND METHOD: Children and adolescents with anogenital lesions who consulted at the Luis Calvo Mackenna Children's Hospital between 2013 and 2017 were studied. The reason for consultation, age, sex, family history of HPV lesions, history of sexual abuse, and consensual sexual activity were recorded. HPV was detected by PCR and typification by reverse hybridization of the L1 gene. The samples were analyzed in the Oncogenic Virus Section of the Institute of Public Health. RESULTS: 110 patients were studied; 44.5% were children. HPV was detected in 34 cases (30.9% [CI95% 22.4- 40.4]), 22 (44.9%) were children and 12 (19.7%) adolescents. Eleven (91.7%) adolescents had a history of sexual con tact (p < 0.005); 4 (18.2%) children disclosed sexual abuse. HPV was found in 25% of patients with genital lesions and 50% with perianal lesions (p < 0.015). The most frequent genotypes were 59, 58, 16, 18, 6, and 11. Only low-risk genotypes were detected in children and high-risk genotypes were detected in 11/12 (91.7%) of HPV (+) adolescents. CONCLUSION: The prevalence of HPV infection was 30%. In adolescents, the infection was related to sexual contact and high-risk HPV. In children, it was associated with low-risk genotypes. Perianal lesions are more frequently associated with HPV infec tion than genital lesions in children and adolescents. The visual inspection does not allow to specify the etiology of the genital lesions, so it is necessary to perform a PCR test for HPV.
Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Masculino , Feminino , Humanos , Criança , Adolescente , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Papillomavirus Humano , Estudos Transversais , Papillomaviridae/genéticaRESUMO
La terapia antiretroviral (TARV) de alta actividad cambió la epidemiología de la neumonía por Pneumocystis jiroveci (NPj) en pacientes con SIDA. La incidencia global ha descendido y ahora prevalece en pacientes sin TARV o con fracaso de ésta. Además, la restauración inmune por TARV genera una forma de NPj incluida en los síndromes inflamatorios por restauración inmune (SIRI). A fines del 2004, 75,5% de pacientes con infección por VIH en control en el Hospital de Enfermedades Infecciosas Dr. Lucio Córdova tenían TARV. Esta serie describe las características clínicas de la NPj, comparando el grupo con TARV (n: 6) y sin TARV (n: 12). De aquellos con TARV, 83,3% (5/6) estaban con fracaso inmunológico y 16,7% (1/6) en éxito virológico. El recuento de CD4 fue bajo en ambos grupos (mediana 20 céls/mm3 sin TARV y 51 céls/mm3 con TARV). No hubo diferencia en la mayoría de las características de la NPj, tampoco casos de SIRI. El grupo con TARV tuvo menos severidad y complicaciones, y menos indicación de corticoterapia (p 0,023).
Assuntos
Humanos , Masculino , Adulto , Feminino , Infecções por HIV/microbiologia , Infecções por HIV/tratamento farmacológico , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS , Fármacos Anti-HIV , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Pneumonia por Pneumocystis/imunologiaRESUMO
Highly active antiretroviral therapy (HAART) has changed the epidemiology of Pneumocystis jiroveci pneumonia (PCP) in AIDS patients. Global incidence of PCP has decreased and now it is prevalent in AIDS patients who do not receive HAART or are unsuccessfully treated with persistent immune depression. Moreover, the immunologic response to HAART has caused a PCP form which is included in the immune restoration inflammatory syndrome (IRIS). As of late 2004, 75.5% of patients cared for at Dr. Lucio Córdova Infectious Diseases Hospital were receiving HAART. This study compares PCP clinical characteristics in patients under the effect of HAART (n: 6) with those without antiretroviral therapy (n: 12). Among those with HAART, 83.3% (5/6) were without immunologic responses and 16.7% with virologic response. The median CD4 counts were low in both groups: 20 cells/mm(3) without HAART and 51 cells/mm(3) with HAART. There were no differences in most of PCP characteristics, and no IRIS cases were observed. HAART-receiving group had less severe disease and lower frequency of both, complications and steroidal therapy prescription (P 0.023).