RESUMO
Resumen Introducción: Para el desarrollo de cáncer de cuello de uterino la infección con el Virus de Papiloma Humano (VPH) es una causa necesaria. Sin embargo, la eliminación viral está asociada a múltiples factores, algunos modificables y otros no, que varían según las características poblacionales y áreas geográficas. Objetivo: Determinar factores asociados a la prevalencia de infección por virus de Papiloma Humano de alto riesgo en mujeres entre 35-65 años con riesgo moderado o alto de cáncer de cuello uterino de la zona norte de Bucaramanga. Metodología: Estudio analítico de corte transversal. A las mujeres clasificadas como de moderado/alto riesgo para cáncer de cuello uterino en una encuesta corta estandarizada, se les realizó una encuesta sobre factores potenciales asociados a infección, seguida de una autónoma de muestra cervical, que se utilizó para detección de DNA viral. Se realizó análisis múltiple de regresión log-binomial para obtener Razones de Prevalencia ajustadas (RPa). Resultados: Se entrevistaron 810 mujeres, de éstas 435 tuvieron moderado/alto riesgo para cáncer y se realizaron la autotoma. La prevalencia de infección por VPH de alto riesgo fue de 5,1% (IC 95% 3,2-7,6). El sedentarismo (RPa 2,51; IC95% 1,15-5,50) y el sobrepeso/obesidad (PRa 4,20; IC95% 1,00-15,51) se asociaron a mayor prevalencia. Además, hubo una tendencia de incremento en la prevalencia de infección en las usuarias de anticonceptivos inyectables; así como una tendencia de disminución de esta prevalencia según porciones de frutas y verduras consumidas diariamente. Conclusión: Factores modificables como sedentarismo y sobrepeso/obesidad, se asociaron independientemente a mayor prevalencia de infección por VPH en la población estudiada.
Abstract Introduction: Infection with Human Papillomavirus is mandatory for cervical cancer development. However, viral elimination is associated to multiple factors, according to the population characteristics and geographic areas, some are modifiable and others not. Objective: To determine the factors associated with the prevalence of high risk human papillomavirus infection in women between 35-65 years old with moderate or high risk of cervical cancer located at the northern zone of Bucaramanga. Methodology: Cross-sectional analytical study. Women classified as moderate/ high risk for cervical cancer in a short standardized survey, were surveyed on the side effects associated to chronic viral infection and self-sampling cervical test. Bivariate analysis and multiple analysis of log-binomial regression were performed. Results: 810 women were interviewed; 435 cases of high cancer risk were presented. The prevalence of high risk human papilloma virus infection was 5.1% (95% CI 3.2-7.6). The sedentary lifestyle (RPa 2.51, 95% CI 1.15-5.50) and overweight/obesity (PRa 4.20, 95% CI 1.00-15.51) were associated with higher prevalence. In addition, there was a trend of increased prevalence of infection among users of injectable contraceptives; as well as a tendency to decrease this prevalence according to portions of fruits and vegetables consumed daily. Conclusion: modifiable factors such as sedentary lifestyle and overweight / obesity were independently associated with a higher prevalence of infection by human high risk papilloma virus in the population studied.
Assuntos
Humanos , Fatores de Risco , Papillomaviridae , Sobrepeso , Comportamento Sedentário , ObesidadeRESUMO
O câncer de colo uterino é uma importante causa de morte entre as mulheres em países subdesenvolvidos. A infecção persistente pelo papilomavírus humano (HPV) oncogênico e o comprometimento da resposta imune são fatores de risco para o desenvolvimento da neoplasia intraepitelial cervical (NIC) e sua progressão para o câncer cervical invasivo. O diagnóstico precoce e o tratamento das lesões precursoras do câncer são de grande importância. Estudos epigenéticos estão sendo realizados com o objetivo de avaliar sua influencia nos processos de oncogênese, visto que alterações epigenéticas estão presentes em quase todos os tumores. A metilação de DNA e a acetilação de histonas são as duas mudanças epigenéticas mais estudadas. O melhor entendimento do perfil epigenético na neoplasia intraepitelial cervical e no câncer cervical invasor pode ser utilizado no diagnóstico e prognóstico deste câncer. O objetivo desta revisão consistiu em entender as mudanças epigenéticas encontradas até o momento nas pacientes com NIC e câncer de colo uterino. Foi realizada revisão da literatura de estudos indexados em banco de dados, como PubMed e LILACS. Verificou-se que, até o presente momento, não há um marcador de metilação que tenha o desempenho adequado para servir como indicador para as lesões precursoras do câncer, ou mesmo para o carcinoma cervical.
The cervical cancer is a major cause of death among women in developing countries. Persistent infection by human papillomavirus (HPV) and oncogenic involvement of the immune response are risk factors for the development of cervical intraepithelial neoplasia (CIN) and its progression to invasive cervical cancer. Early diagnosis and treatment of cancer precursor lesions are of great importance. Epigenetic studies are being conducted to evaluate its influence in the process of oncogenesis, since epigenetic alterations are present in almost all tumors. DNA methylation and histone acetylation are the two most studied epigenetic changes. An improved understanding of the epigenetic profile in CIN and invasive cervical cancer can be used in the diagnosis and prognosis of this cancer. The aim of this review was to understand the epigenetic changes found to date in patients with CIN and cervical cancer. We performed a literature review of studies indexed in databases such as PubMed and LILACS. It was found that, to our knowledge, there is no methylation marker with an adequate performance to serve as an indicator for cancer precursor lesions, or even for cervical carcinoma.
Assuntos
Humanos , Feminino , Metilação de DNA , Displasia do Colo do Útero/etiologia , Displasia do Colo do Útero/genética , Detecção Precoce de Câncer , Epigênese Genética , Histonas/genética , Infecções por Papillomavirus/imunologia , Lesões Pré-Cancerosas/prevenção & controle , Neoplasias do Colo do Útero/genética , PrognósticoRESUMO
Introducción: El virus del papiloma humano, es uno de los más frecuentes de trasmisión sexual y conocer los mecanismos de transmisión tiene vital importancia para el control de la incidencia de esta enfermedad. Objetivo: Evaluar el nivel de conocimientos de las pacientes con virus del papiloma humano, sobre los mecanismos de transmisión. Metodología: Se incluyeron 109 pacientes subsecuentes y de primera vez que acudieron a la clínica de displasias por diagnóstico de VPH. Para evaluar el nivel de conocimiento, se consideraron tres indicadores: Bueno (>20 aciertos), Regular (16-20 aciertos) y Malo (≤15 aciertos). El cuestionario fue validado por rondas de expertos. Resultados: Del total de pacientes 31.2% tuvo conocimiento bueno, 42.2% regulary 26.6% malo. De 109 pacientes47.7% son de estrato socioeconómico medio bajo, 49.5% con estudios de primaria, casadas 67%, con una pareja sexual 54.1%, con vida sexual activa 44% y 77.1 % no habían recibido pláticas informativas en relación al virus del papiloma humano. Conclusiones: Es evidente la necesidad de implementar nuevas y diversas estrategias dirigidas a la población afectada encaminadas al aprendizaje de los mecanismos de transmisión para incrementar su nivel de conocimiento y coadyuvar en el control de la propagación del virus.
Introduction: HPV is one of the most often sexual transmitted diseases, and knowing the transmission mechanisms is vital to control the incidence of this infection. Objective: To evaluate the level of knowledge regarding transmission mechanisms in patients with HPV infection. Methodology: 109 first timers and subsequent patients who showed up to the Displasias Clinic for diagnosis of HPV were included in the study. To evaluate the level of knowledge, three indicators were considered; good (>20 items answered correctly), regular (16-20 items answered correctly), and bad (= or < 15 items answered correctly). The questionnaire was validated by review of experts. Results: From the total, 31.2% patients had good, 42.2% regular, and 26.6% bad knowledge. 47.7% out of 109 patients are half low socioeconomic status; 49.5% with elementary school of education; 67% got married; 54.1% with a single sexual partner; 44% sexual actives; and 77.1% had not received any sort of information talks regarding HPV. Conclusions: It is evident the necessity of implementing new and diverse strategies lead to affected population through learning the transmission mechanisms to increase their level of knowledge and collaborate in the control of virus spreading.
Assuntos
Humanos , Viroses , Doenças Virais Sexualmente Transmissíveis , Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus , MéxicoRESUMO
Se estudió un total de 275 adolescentes en las edades comprendidas entre 10 y 19 años procedentes de la consulta infanto-juvenil, de interrupción de embarazos y de infecciones de transmisión sexual del Hospital Docente Ginecoobstérico "Ramón González Coro" y el Hospital "Eusebio Hernández", ambos de Ciudad de La Habana, en el período comprendido de agosto de 1999 a septiembre de 2000, para conocer el comportamiento de la infección por Trichomonas vaginalis en este grupo poblacional. Se reportó 18,1 % de positividad a la parasitosis. Se demostró mediante el cálculo de riesgo relativo que las adolescentes que presentaron una infección activa o pasada por Trichomonas vaginalis tenían más posibilidades de contraer una infección por Papiloma virus humano que las que no presentaban esta condición. Se pudo comprobar que 78 (28,3 %) del total de pacientes examinadas presentaron algún tipo de lesión en el cuello uterino. Se dan a conocer algunos factores de riesgo como el no uso de condón, el tener múltiples parejas sexuales así como el comienzo precoz de las relaciones sexuales; los cuales pueden facilitar la adquisición de esta parasitosis en una población tan vulnerable como son las adolescentes.
275 adolescents aged 10-19 receiving attention at the infantojuvenile department of pregnancy interruption and of sexually transmitted infections of "Ramón Gonzalez Coro" and "Eusebio Hernández" Gynecoobstetric Teaching Hospitals, both in Havana City, were studied from August, 1999, to September, 2000, aimed at knowing the behavior of the infection caused by Trichomonas vaginalis in this population group. The results yielded 18.1 % of positivity to parasitosis. It was proved by the calculation of relative risk that the adolescents that had an active or past infection due to Trichomonas vaginalis have more possibilities of getting an infection produced by human Papilomavirus than those without this condition. It was demonstrated that 78 (28.3 %) of the total of patients examined had some type of lesion in the uterine cervix Some risk factors as non using condon, having multiple sexual partners and the early beginning of sexual relations, which may facilitate the adquisition of this parasitosis in a population so vulnerable as the adolescents, were made known..