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Martinez CA, Rikhi R, Fonseca Nogueira N, Pester MS, Salazar AS, Ashinne B, Aguilar N, Melara A, Porras V, Parker M, Mendez A, Cyrus E, De Santis JP, Jones DL, Brown TT, Hurwitz BE, Alcaide ML. Estrogen-Based Gender-Affirming Hormone Therapy and Subclinical Cardiovascular Disease in Transgender Women with HIV. LGBT Health 2023; 10:576-585. [PMID: 37459150 PMCID: PMC10712365 DOI: 10.1089/lgbt.2023.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Purpose: Transgender women (TW) are disproportionately affected by HIV infection and cardiovascular disease (CVD). This study evaluated whether estrogen-based gender-affirming hormone therapy (GAHT) in TW with HIV (TWH-GAHT) is associated with indices of subclinical CVD. Methods: Of the 40 HIV-seropositive persons enrolled, 20-60 years of age, on antiretroviral treatment with undetectable viral load, assessments were performed on 15 TWH; of these persons, 11 were GAHT treated. These TWH-GAHT were matched with HIV+ cisgender men and women based on age, ethnicity/race, body mass index, and antihypertensive medication use. Sex hormones, and cardiometabolic (waist circumference, blood pressure, insulin resistance, lipid profile, and C-reactive protein), vascular (flow-mediated dilation [FMD] and arterial stiffness), and proinflammatory measures were obtained. Results: TWH-GAHT displayed elevated estradiol and suppressed testosterone levels relative to normative ranges. Analyses indicated the TWH-GAHT displayed lower low-density lipoprotein compared with cisgender groups (p < 0.05). Although no difference was seen on FMD, the central augmentation index of aortic stiffness was higher in cisgender HIV+ women than cisgender HIV+ men (p < 0.05). No other group difference on subclinical CVD markers was observed. For TWH, partial correlations indicated associations of certain sex hormones with selected cardiometabolic outcomes and the inflammatory cytokine, interleukin-8. Conclusion: When well matched to HIV+ cisgender men and women, subclinical CVD pathophysiology did not appear elevated in TWH-GAHT, although tendencies emerged suggesting that some subclinical CVD indices may be higher, but others lower than cisgender groups. Longitudinal studies of TWH are needed to more precisely evaluate the moderating effect of GAHT on cardiometabolic pathophysiology.
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Affiliation(s)
- Claudia A. Martinez
- Division of Cardiovascular Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Rishi Rikhi
- Division of Cardiology, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Nicholas Fonseca Nogueira
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mollie S. Pester
- Behavioral Medicine Research Center and Department of Psychology, University of Miami, Miami/Coral Gables, Florida, USA
| | - Ana S. Salazar
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Beteal Ashinne
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Natalie Aguilar
- Division of Cardiovascular Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Abraham Melara
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Valeria Porras
- Division of Cardiovascular Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Meela Parker
- Behavioral Medicine Research Center and Department of Psychology, University of Miami, Miami/Coral Gables, Florida, USA
| | - Armando Mendez
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Elena Cyrus
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Joseph P. De Santis
- School of Nursing and Health Studies, University of Miami, Miami, Florida, USA
| | - Deborah L. Jones
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
- Behavioral Medicine Research Center and Department of Psychology, University of Miami, Miami/Coral Gables, Florida, USA
| | - Todd T. Brown
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Barry E. Hurwitz
- Behavioral Medicine Research Center and Department of Psychology, University of Miami, Miami/Coral Gables, Florida, USA
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Maria L. Alcaide
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
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Moradi G, Soheili M, Rashti R, Dehghanbanadaki H, Nouri E, Zakaryaei F, Amini EE, Baiezeedi S, Ahmadi S, Moradi Y. The prevalence of hepatitis C and hepatitis B in lesbian, gay, bisexual and transgender populations: a systematic review and meta-analysis. Eur J Med Res 2022; 27:47. [PMID: 35346371 PMCID: PMC8962539 DOI: 10.1186/s40001-022-00677-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/14/2022] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES This study aimed to systematically review the literature on the prevalence of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in transgender and LGBT people and determine their pooled estimates worldwide. METHODS Databases (PubMed, Scopus, Web of Science, Embase, Ovid, Cochrane, PsycInfo) were searched from April 2000 to July 2021. The analyses were executed using the random-effects model in Stata 16. RESULTS Ten studies, including eight studies on four transgender people and two studies on 2150 LGBTs, were included. The pooled prevalence of HCV and HBV in all transgender populations globally were 9% (95% CI 3-15%) and 11% (95% CI 2-20%), respectively. The corresponding prevalence in male-to-female transgender people were estimated as 5% (95% CI 1-9%) and 6% (95% CI 3-10%), respectively. These estimates in American transgenders were 10% (95% CI 5-25%) and 16% (95% CI 8-23%), respectively. CONCLUSION This study was identified the overall prevalence of HBV and HCV infections in transgender people, which were higher than those in the general population.
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Affiliation(s)
- Ghobad Moradi
- Social Determinant of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, 6617713446 Sanandaj, Iran
| | - Marzieh Soheili
- Faculty of Medicine, Kermanshah University of Medical Sciences, 6714415153 Kermanshah, Iran
| | - Roya Rashti
- Social Determinant of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, 6617713446 Sanandaj, Iran
| | - Hojat Dehghanbanadaki
- Endocrinology, and Metabolism Research Centre, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 1416753955 Tehran, Iran
| | - Elham Nouri
- Social Determinant of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, 6617713446 Sanandaj, Iran
| | - Farima Zakaryaei
- Department of Emergency Medicine, Kurdistan University of Medical Sciences, 6617713446 Sanandaj, Iran
| | - Elnaz Ezzati Amini
- Social Determinant of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, 6617713446 Sanandaj, Iran
| | - Sheno Baiezeedi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, 1449614535 Tehran, Iran
| | - Sanaz Ahmadi
- Social Determinant of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, 6617713446 Sanandaj, Iran
| | - Yousef Moradi
- Social Determinant of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, 6617713446 Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, 6617713446 Sanandaj, Iran
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3
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Stutterheim SE, van Dijk M, Wang H, Jonas KJ. The worldwide burden of HIV in transgender individuals: An updated systematic review and meta-analysis. PLoS One 2021; 16:e0260063. [PMID: 34851961 PMCID: PMC8635361 DOI: 10.1371/journal.pone.0260063] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/02/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction Transgender individuals are at risk for HIV. HIV risks are dynamic and there have been substantial changes in HIV prevention (e.g., pre-exposure prophylaxis [PrEP]). It is thus time to revisit HIV prevalence and burden among transgender individuals. The objective of this systematic review and meta-analysis was thus to examine worldwide prevalence and burden of HIV over the course of the epidemic among trans feminine and trans masculine individuals. Methods We conducted an updated systematic review by searching PsycINFO, PubMed, Web of Science, and Google Scholar, for studies of any research design published in in a peer-reviewed journal in any language that reported HIV prevalence among transgender individuals published between January 2000 and January 2019. Two independent reviewers extracted the data and assessed methodological quality. We then conducted a meta-analysis, using random-effects modelling, to ascertain standardized prevalence and the relative burden of HIV carried by transgender individuals by country and year of data collection, and then by geographic region. We additionally explored the impact of sampling methods and pre-exposure prophylaxis (PrEP). Results Based on 98 studies, overall standardized HIV prevalence over the course of the epidemic, based on weights from each country by year, was 19.9% (95% CI 14.7% - 25.1%) for trans feminine individuals (n = 48,604) and 2.56% (95% CI 0.0% - 5.9%) for trans masculine individuals (n = 6460). Overall OR for HIV infection, compared with individuals over age 15, was 66.0 (95% CI 51.4–84.8) for trans feminine individuals and 6.8 (95% CI 3.6–13.1) for trans masculine individuals. Prevalence varied by geographic region (13.5% - 29.9%) and sampling method (5.4% - 37.8%). Lastly, PrEP effects on prevalence could not be established. Conclusion Trans feminine and trans masculine individuals are disproportionately burdened by HIV. Their unique prevention and care needs should be comprehensively addressed. Future research should further investigate the impact of sampling methods on HIV prevalence, and monitor the potential impact of PrEP.
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Affiliation(s)
- Sarah E. Stutterheim
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
- * E-mail:
| | - Mart van Dijk
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Haoyi Wang
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Kai J. Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
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Nguyen H, Hampel B, Nuñez DG, Battegay M, Hachfeld A, Bernasconi E, Calmy A, Cavassini M, Vernazza P, Fellay J, Rudolph H, Huber M, Leuzinger K, Perreau M, Scherrer A, Ramette AN, Yerly S, Günthard HF, Kouyos RD, Kusejko K. Identifying and Characterizing Trans women in the Swiss HIV Cohort Study as an Epidemiologically Distinct Risk Group. Clin Infect Dis 2021; 74:1468-1475. [PMID: 34282827 DOI: 10.1093/cid/ciab628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND As trans women are disproportionately affected by the HIV epidemic, and are still understudied, we aimed to identify and characterize the trans women in the Swiss HIV Cohort Study (SHCS). METHODS A combination of criteria from pre-existing cohort data was used to identify trans women. Information on socioeconomic factors, clinical data, risk behaviors, and mental health was collected. We also described their phylogenetic patterns within HIV transmission networks in relation to other risk groups. RESULTS We identified 89 trans women out of a total 20925 cohort participants. Trans women were much more likely to be Asian (30.3%) and Hispanic (15.7%) compared to men-who-have-sex with-men/MSM (2.5% and 4.1%, P value<0.001) and cis heterosexual (HET) women (7.0% and 3.3%, P value<0.001). Trans women were more similar to cis HET women in some measures like education level (post-secondary education attainment: 22.6% and 20.7% [P value =0.574], vs. 46.5% for MSM [P value<0.001]), while being more similar to MSM for measures like prior syphilis diagnosis (36.0% and 44.0% [P value=0.170], vs. 6.7% for cis HET women [P value <0.001]). 11.2% of trans women have been priorly hospitalized for psychological reasons, compared to 4.2% of MSM (P value=0.004) and 5.1% of cis HET women (P value=0.025). An analysis of transmission clusters containing trans women suggested greater affinity within the transmission networks to MSM compared to cis HET women. CONCLUSIONS Trans women are epidemiologically distinct in the setting of the Swiss HIV epidemic, warranting better identification and study to better serve this underserved risk group.
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Affiliation(s)
- Huyen Nguyen
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Benjamin Hampel
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Department of Public Health, Epidemiology, Biostatistics and Public Health Institute, University of Zurich, Zurich, Switzerland
| | | | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Anna Hachfeld
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland
| | - Alexandra Calmy
- Laboratory of Virology and Division of Infectious Diseases, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Matthias Cavassini
- Division of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Pietro Vernazza
- Division of Infectious Diseases, Cantonal Hospital St Gallen, St. Gallen, Switzerland
| | - Jacques Fellay
- School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Hannes Rudolph
- Transgender Network Switzerland, Checkpoint Zurich, Zurich, Switzerland
| | - Michael Huber
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Karoline Leuzinger
- Clinical Virology Division, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Matthieu Perreau
- Department of Immunology and Allergy, University of Lausanne, Lausanne, Switzerland
| | - Alexandra Scherrer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Sabine Yerly
- Laboratory of Virology and Division of Infectious Diseases, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Katharina Kusejko
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
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Weldesenbet H, Asrat D, Weldeamanuel Y. The prevalence and associated factors of Treponema pallidum among HIV-positive and HIV-negative individuals who attended voluntary counseling and testing center of St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: A cross-sectional study design. SAGE Open Med 2020; 8:2050312120904604. [PMID: 32110402 PMCID: PMC7026812 DOI: 10.1177/2050312120904604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/23/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Treponema pallidum and HIV are among the most common public health problems in Ethiopia. These infections are interrelated. Treponema pallidum causes genital ulcer which enhances HIV transmission and complicates HIV by causing severe ulcer among HIV-positive individuals. Although Treponema pallidum and HIV have a similar route of transmission, screening services for Treponema pallidum are not available in most of the voluntary counseling and testing centers. Objectives: This study aimed to assess the seroprevalence of Treponema pallidum and sociodemographic factors among HIV-positive and HIV-negative individuals from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: In this research, a cross-sectional study was conducted and a total of 292 consecutive samples were collected from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College. Data were collected using an interviewer-administered questionnaire. A blood specimen was tested for the presence of Treponema pallidum using rapid plasma reagin and a rapid test kit for HIV. The data were entered and analyzed using SPSS version 20. Results: The overall prevalence of Treponema pallidum was 5/292 (1.7%). All HIV-positive clients were negative for Treponema pallidum. None of the risk factors were significantly associated with Treponema pallidum. Conclusion: In this study, the prevalence of Treponema pallidum was 5/292 (1.7%). None of the study participants were co-infected with Treponema pallidum and HIV. Recommendation: There was a lack of association between syphilis and HIV in this study, but still the prevalence of Treponema pallidum among voluntary counseling and testing center clients is a public health problem. Therefore, Treponema pallidum infection control strategies should be designed in parallel with HIV control strategy and actions should be taken to avert the problem, including the provision of better health education and screening services at voluntary counseling and testing centers parallel with HIV.
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Affiliation(s)
- Habtamu Weldesenbet
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yimtubezinash Weldeamanuel
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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6
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Lazarus JV, Bromberg DJ, Del Amo J, Norgaard O, García-Samaniego J, Casellas A, Calleja JL, Requena-Méndez A. Hepatitis C prevalence among the migrant population in Spain: A systematic review and meta-analysis. Enferm Infecc Microbiol Clin 2018; 37:222-230. [PMID: 29759423 DOI: 10.1016/j.eimc.2018.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/11/2018] [Accepted: 04/11/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Spain, which has one of the largest migrant populations in Europe, has committed to eliminating the hepatitis C virus (HCV). The aim of this study was to estimate the prevalence of HCV among migrant groups in Spain, a country of 46 million people, with an estimated HCV-antibody prevalence of 1.7%. METHODS Studies on HCV and migration in Spain were identified by systematically searching three databases from the first records to 30 November 2017, and consulting experts at the Ministry of Health and in the 17 Spanish autonomous communities. A meta-analysis was conducted to determine pooled HCV prevalence for the general migrant population. Prevalences were also calculated for high-risk migrant populations and populations who had undergone hospital screening, stratified by region of origin. RESULTS Out of 243 studies identified, 26 met the eligibility criteria. The meta-analysis of the general migrant population found HCV antibody prevalence to be 1.6%. Migrants originating from European countries, including those at high or moderate risk for HCV, had the highest pooled prevalence (7.1%). In the general migrant population, prevalence was highest among sub-Saharan African migrants (3.1%) and lowest among Latin American migrants (0.2%). CONCLUSION Based on the limited available data, the prevalence among the general migrant population was found to be the same as the general Spanish population. Further research is needed to more accurately determine HCV prevalence for the overall migrant population and specific migrant subpopulations with a higher risk in the country as a whole and in each of Spain's 17 autonomous communities.
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Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Daniel J Bromberg
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Julia Del Amo
- National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Aina Casellas
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | - Ana Requena-Méndez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
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Abstract
: Human T-lymphotropic virus type 1 (HTLV-1) infection is a neglected disease despite roughly 15 million people are chronically infected worldwide. Lifelong less than 10% of carriers develop life-threatening diseases, mostly a subacute myelopathy known as tropical spastic paraparesis (TSP) and a lymphoproliferative disorder named adult T-cell leukemia (ATL). HTLV-1 is efficiently transmitted perinatally (breastfeeding), sexually (more from men to women) and parenterally (transfusions, injection drug user (IDU), and transplants). To date there is neither prophylactic vaccine nor effective antiviral therapy. A total of 327 cases of HTLV-1 infection had been reported at the HTLV-1 Spanish registry until December 2016, of whom 34 had been diagnosed with TSP and 25 with ATL. Overall 62% were Latin American immigrants and 13% were persons of African origin. The incidence of HTLV-1 in Spain has remained stable for nearly a decade with 20-25 new cases yearly. Of the 21 newly diagnosed HTLV-1 cases during year 2016, one was a native Spaniard pregnant woman, and four presented with symptomatic disease, including three with ATL and one with TSP. Underdiagnosis of HTLV-1 in Spain must be high (iceberg model), which may account for the disproportionate high rate of symptomatic cases (almost 20%) and the late recognition of preventable HTLV-1 transmissions in special populations, such as newborns and transplant recipients. Our current estimate is of 10 000 persons living with HTLV-1 infection in Spain. Given the large flux of immigrants and visitors from HTLV-1 endemic regions to Spain, the expansion of HTLV-1 screening policies is warranted. At this time, it seems worth recommending HTLV testing to all donor/recipient organ transplants and pregnant women regardless place of birth. Although current leukoreduction procedures largely prevent HTLV-1 transmission by blood transfusions, HTLV testing of all first-time donors should be cost-effective contributing to unveil asymptomatic unaware HTLV-1 carriers.
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8
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de Vos AS, Lieshout-Krikke RW, Slot E, Cator EA, Janssen MP. A novel approach to detect test-seeking behaviour in the blood donor population: making the invisible visible. Vox Sang 2016; 111:274-280. [PMID: 27281653 DOI: 10.1111/vox.12422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Individuals may donate blood in order to determine their infection status after exposure to an increased infection risk. Such test-seeking behaviour decreases transfusion safety. Instances of test seeking are difficult to substantiate as donors are unlikely to admit to such behaviour. However, manifestation in a population of repeat donors may be determined using statistical inference. MATERIALS AND METHODS Test-seeking donors would be highly motivated to donate following infection risk, influencing the timing of their donation. Donation intervals within 2005-2014 of all Dutch blood donors who acquired syphilis (N = 50), HIV (N = 13), HTLV (N = 4) or HCV (N = 2) were compared to donation intervals of uninfected blood donors (N = 7 327 836) using the Anderson-Darling test. We adjusted for length bias as well as for age, gender and donation type of the infected. Additionally, the power of the proposed method was investigated by simulation. RESULTS Among the Dutch donors who acquired infection, we found only a non-significant overrepresentation of short donation intervals (P = 0·54). However, we show by simulation that both relatively short and long donation intervals among infected donors can reveal test seeking. The power of the method is >90% if among 69 infected donors >35 (51%) are test seeking, or if among 320 infected donors >90 (30%) are test seeking. CONCLUSION We show how statistical analysis may be used to reveal the extent of test seeking in repeat blood donor populations. In the Dutch setting, indications for test-seeking behaviour were not statistically significant. This may, however, be due to the low number of infected individuals.
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Affiliation(s)
- A S de Vos
- Transfusion Technology Assessment Unit, Sanquin Research, Amsterdam, the Netherlands.
| | - R W Lieshout-Krikke
- Department of Blood-Borne Infections, Sanquin Research, Amsterdam, the Netherlands
| | - E Slot
- Department of Blood-Borne Infections, Sanquin Research, Amsterdam, the Netherlands
| | - E A Cator
- Institute of Mathematics, Astrophysics and Particle Physics, Radboud University, Nijmegen, the Netherlands
| | - M P Janssen
- Transfusion Technology Assessment Unit, Sanquin Research, Amsterdam, the Netherlands. .,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.
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9
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Perez-Brumer AG, Oldenburg CE, Reisner SL, Clark JL, Parker RG. Towards 'reflexive epidemiology': Conflation of cisgender male and transgender women sex workers and implications for global understandings of HIV prevalence. Glob Public Health 2016; 11:849-65. [PMID: 27173599 DOI: 10.1080/17441692.2016.1181193] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The HIV epidemic has had a widespread impact on global scientific and cultural discourses related to gender, sexuality, and identity. 'Male sex workers' have been identified as a 'key population' in the global HIV epidemic; however, there are methodological and conceptual challenges for defining inclusion and exclusion of transgender women within this group. To assess these potential implications, this study employs self-critique and reflection to grapple with the empiric and conceptual implications of shifting understandings of sexuality and gender within the externally re-created etic category of 'MSM' and 'transgender women' in epidemiologic HIV research. We conducted a sensitivity analysis of our previously published meta-analysis which aimed to identify the scope of peer-reviewed articles assessing HIV prevalence among male sex workers globally between 2004 and 2013. The inclusion of four studies previously excluded due to non-differentiation of cisgender male from transgender women participants (studies from Spain, Thailand, India, and Brazil: 421 total participants) increased the overall estimate of global HIV prevalence among 'men' who engage in sex work from 10.5% (95% CI 9.4-11.5%) to 10.8% (95% CI 9.8-11.8%). The combination of social science critique with empiric epidemiologic analysis represents a first step in defining and operationalising 'reflexive epidemiology'. Grounded in the context of sex work and HIV prevention, this paper highlights the multiplicity of genders and sexualities across a range of social and cultural settings, limitations of existing categories (i.e. 'MSM', 'transgender'), and their global implications for epidemiologic estimates of HIV prevalence.
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Affiliation(s)
- Amaya G Perez-Brumer
- a Department of Sociomedical Sciences , Columbia Mailman School of Public Health , New York , NY , USA
| | - Catherine E Oldenburg
- b Department of Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Sari L Reisner
- b Department of Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA.,c Division of General Pediatrics , Boston Children's Hospital/Harvard Medical School , Boston , MA , USA.,d The Fenway Institute, Fenway Community Health , Boston , MA , USA
| | - Jesse L Clark
- e Department of Medicine , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
| | - Richard G Parker
- a Department of Sociomedical Sciences , Columbia Mailman School of Public Health , New York , NY , USA.,f ABIA (Brazilian Interdisciplinary AIDS Association) , Rio de Janeiro , Brazil
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10
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Monge S, Pérez-Molina JA. [HIV infection and immigration]. Enferm Infecc Microbiol Clin 2016; 34:431-8. [PMID: 27016136 DOI: 10.1016/j.eimc.2016.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 02/22/2016] [Indexed: 11/26/2022]
Abstract
Migrants represent around one third of patients newly diagnosed with HIV in Spain and they constitute a population with higher vulnerability to its negative consequences due to the socio-cultural, economical, working, administrative and legal contexts. Migrants are diagnosed later, which worsens their individual prognosis and facilitates the maintenance of the HIV epidemic. In spite of the different barriers they experience to access healthcare in general, and HIV-related services in particular, access to antiretroviral treatment has been similar to that of the autochthonous population. However, benefits of treatment have been not, with women in general and men from Sub-Saharan Africa exhibiting the worse response to treatment. We need to proactively promote earlier diagnosis of HIV infection, the adoption of preventive measures to avoid new infections, and to deliver accessible, adapted and high-quality health-care.
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Affiliation(s)
- Susana Monge
- Facultad de Medicina, Universidad de Alcalá de Henares; CIBERESP, Madrid, España.
| | - José A Pérez-Molina
- CSUR de Medicina Tropical, Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal; IRYCIS, Madrid, España
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Hadikusumo AA, Utsumi T, Amin M, Khairunisa SQ, Istimagfirah A, Wahyuni RM, Lusida MI, Soetjipto, Rianto E, Juniastuti, Hayashi Y. High Rates of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus Infections and Uncommon HBV Genotype/Subtype and HCV Subtype Distributions among Transgender Individuals in Surabaya, Indonesia. Jpn J Infect Dis 2016; 69:493-499. [PMID: 27000450 DOI: 10.7883/yoken.jjid.2015.384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Transgender people are at a high risk for sexually transmitted viruses such as hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Moreover, Indonesia has a moderate-to-high rate of HBV infection and rapid epidemic growth of HIV infection; hepatitis C virus (HCV) infection can co-occur with HBV and HIV infections. In this study, 10 of 107 individuals (9.3%) were positive for HBV surface antigen (HBsAg) and/or HBV DNA, whereas 19 of 101 individuals (18.8%) with negative results for HBsAg were positive for HBV core antibody (anti-HBc). Seven of the 107 individuals (6.5%) were anti-HCV positive, and 16 of the 100 tested samples (16.0%) were HIV positive. Genotype and subtype analyses of all 10 HBV DNA (6 HBsAg positive and 4 anti-HBc positive) strains showed that 3 were of the HBV genotype/HBsAg subtype C/adrq+, one was of C/adw2, and 5 were of B/adw2. The HCV subtype distribution showed that 33.3% were of HCV-1b, and 66.7% were of HCV-3k (n = 6). These distributions differed from those found in the general population of Surabaya, Indonesia. Interestingly, HIV subtype analysis showed a high prevalence of HIV, with possible recombinants of CRF01_AE and subtype B.
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12
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A rare case of HBV genotype fluctuation (shifting and reversion) after liver transplantation. J Clin Virol 2015; 71:93-7. [PMID: 26342803 DOI: 10.1016/j.jcv.2015.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/17/2015] [Accepted: 08/19/2015] [Indexed: 02/06/2023]
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13
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Roura M, Domingo A, Leyva-Moral JM, Pool R. Hispano-Americans in Europe: what do we know about their health status and determinants? A scoping review. BMC Public Health 2015; 15:472. [PMID: 25948239 PMCID: PMC4430018 DOI: 10.1186/s12889-015-1799-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 04/24/2015] [Indexed: 12/19/2022] Open
Abstract
Background Policy makers and health practitioners are in need of guidance to respond to the growing geographic mobility of Hispano-American migrants in Europe. Drawing from contributions from epidemiology, social sciences, demography, psychology, psychiatry and economy, this scoping review provides an up-to-date and comprehensive synthesis of studies addressing the health status and determinants of this population. We describe major research gaps and suggest specific avenues of further inquiry. Methods We identified systematically papers that addressed the concepts “health” and “Hispano Americans” indexed in five data bases from Jan 1990 to May 2014 with no language restrictions. We screened the 4,464 citations retrieved against exclusion criteria and classified 193 selected references in 12 thematic folders with the aid of the reference management software ENDNOTE X6. After reviewing the full text of all papers we extracted relevant data systematically into a table template to facilitate the synthesising process. Results Most studies focused on a particular disease, leaving unexplored the interlinkages between different health conditions and how these relate to legislative, health services, environmental, occupational, and other health determinants. We elucidated some consistent results but there were many heterogeneous findings and several popular beliefs were not fully supported by empirical evidence. Few studies adopted a trans-national perspective and many consisted of cross-sectional descriptions that considered “Hispano-Americans” as a homogeneous category, limiting our analysis. Our results are also constrained by the availability and varying quality of studies reviewed. Conclusions Burgeoning research has produced some consistent findings but there are huge gaps in knowledge. To prevent unhelpful generalisations we need a more holistic and nuanced understanding of how mobility, ethnicity, income, gender, legislative status, employment status, working conditions, neighbourhood characteristics and social status intersect with demographic variables and policy contexts to influence the health of the diverse Hispano-American populations present in Europe. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1799-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Roura
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB) Hospital Clínic, Universitat de Barcelona, Rosselló 132, 4th floor, 08036, Barcelona, Spain.
| | - Andreu Domingo
- Centre for Demographic Studies, Autonomous University of Barcelona, Carrer de Ca n'Altayó. Edifici E2, Bellaterra, Barcelona, 08193, Spain.
| | - Juan M Leyva-Moral
- Escola Superior d'Infemeria del Mar, University Pompeu Fabra, Doctor Aiguader, 80, Barcelona, Spain.
| | - Robert Pool
- Social Science and Global Health, Centre for Social Science and Global Health, University of Amsterdam, Postbus 15718, 1001, NE, Amsterdam, The Netherlands.
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Pérez-Molina JA, Mora Rillo M, Suárez-Lozano I, Casado-Osorio JL, Teira Cobo R, Rivas González P, Pedrol Clotet E, Hernando-Jerez A, Domingo P, Barquilla Díaz E, Esteban H, González-García J. Response to Combined Antiretroviral Therapy According to Gender and Origin in a Cohort of Naïve HIV-Infected Patients: GESIDA-5808 Study. HIV CLINICAL TRIALS 2015; 13:131-41. [DOI: 10.1310/hct1303-131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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15
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Belhassen-García M, Pérez Del Villar L, Pardo-Lledias J, Gutiérrez Zufiaurre MN, Velasco-Tirado V, Cordero-Sánchez M, Muñoz Criado S, Muñoz Bellido JL, Muro A. Imported transmissible diseases in minors coming to Spain from low-income areas. Clin Microbiol Infect 2014; 21:370.e5-8. [PMID: 25636386 DOI: 10.1016/j.cmi.2014.11.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 11/18/2014] [Accepted: 11/21/2014] [Indexed: 10/24/2022]
Abstract
We prospectively studied the prevalence of imported transmissible diseases in 373 immigrant children and adolescents coming from Sub-Saharan Africa, North Africa and Latin America to Salamanca, Spain. The most frequent transmissible diseases in this group were latent tuberculosis (12.7%), chronic hepatitis B virus infection (4.2%), hepatitis C virus infection (2.3%), syphilis (1.5%) and human T-lymphotropic virus type 1 or 2 infections (1.4%). A total of 24.2% of patients had serologic profiles suggesting past hepatitis B virus infection. Anti-human immunodeficiency virus antibodies were not detected in any subject. Largely asymptomatic immigrant children show a high prevalence of communicable diseases. Thus, infectious disease screenings are highly advisable in immigrant children coming from low-income countries.
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Affiliation(s)
- M Belhassen-García
- Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salmanca, Spain.
| | | | - J Pardo-Lledias
- Servicio de Medicina Interna, General Hospital of Palencia, Palencia, Spain
| | - M N Gutiérrez Zufiaurre
- Servicio de Microbiologia, CAUSA, IBSAL, CIETUS, Grupo de Investigación Reconocido MICRAPE de la Universidad de Salamanca, Salmanca, Spain
| | - V Velasco-Tirado
- Servicio de Medicina Interna, CAUSA, IBSAL, CIETUS, Universidad de Salamanca, Salmanca, Spain
| | - M Cordero-Sánchez
- Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salmanca, Spain
| | - S Muñoz Criado
- Servicio de Microbiologia, CAUSA, IBSAL, CIETUS, Grupo de Investigación Reconocido MICRAPE de la Universidad de Salamanca, Salmanca, Spain
| | - J L Muñoz Bellido
- Servicio de Microbiologia, CAUSA, IBSAL, CIETUS, Grupo de Investigación Reconocido MICRAPE de la Universidad de Salamanca, Salmanca, Spain
| | - A Muro
- Laboratorio de Inmunología Parasitaria y Molecular, IBSAL, CIETUS, Facultad de Farmacia, Universidad de Salamanca, Salmanca, Spain
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Diez M, Bleda MJ, Varela JR, Ordonana J, Azpiri MA, Vall M, Santos C, Viloria L, de Armas C, Urena JM, Trullen J, Pueyo I, Martinez B, Puerta T, Vera M, Sanz I, Junquera ML, Landa MC, Martinez E, Camara MM, Belda J, Bru FJ, Diaz A. Trends in HIV testing, prevalence among first-time testers, and incidence in most-at-risk populations in Spain: the EPI-VIH Study, 2000 to 2009. ACTA ACUST UNITED AC 2014; 19:20971. [PMID: 25443036 DOI: 10.2807/1560-7917.es2014.19.47.20971] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
During 2000 to 2009, data on people undergoing HIV testing and on those newly diagnosed with HIV were collected in a network of 20 Spanish clinics specialising in sexually transmitted infections and/or HIV testing and counselling. The number of tests performed, overall and disaggregated by different variables, was obtained. HIV prevalence among first-time testers and HIV incidence among repeat testers were calculated. To evaluate trends, joinpoint regression models were fitted. In total, 236,939 HIV tests were performed for 165,745 individuals. Overall HIV prevalence among persons seeking HIV testing was 2.5% (95% CI: 2.4 to 2.6). Prevalence was highest in male sex workers who had sex with other men (19.0% (95% CI: 16.7 to 21.4)) and was lowest in female sex workers (0.8% (95% CI: 0.7 to 0.9)). Significant trends in prevalence were observed in men who have sex with men (MSM) (increasing) and heterosexual individuals (decreasing). The incidence analysis included 30,679 persons, 64,104 person-years (py) of follow-up and 642 seroconversions. The overall incidence rate (IR) was 1.0/100 py (95% CI: 0.9/100 to 1.1/100). Incidence was significantly higher in men and transgender females than in women (1.8/100 py (95% CI: 1.6 to 1.9), 1.2/100 py (95% CI: 0.5 to 2.8) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively) and increased with age until 35–39 years. IRs in MSM and people who inject drugs were significantly greater than in heterosexual individuals (2.5/100 py (95% CI: 2.3 to 2.7), 1.6/100 py (95% CI: 1.1 to 2.2) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively), and an upward trend was observed in MSM. Our results call for HIV prevention to be reinforced in MSM and transgender women in Spain.
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Affiliation(s)
- M Diez
- Plan Nacional sobre el sida, Ministerio de Sanidad, Servicios Sociales e Igualdad, Madrid, Spain
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Carobene M, Bolcic F, Farías MSDR, Quarleri J, Avila MM. HIV, HBV, and HCV molecular epidemiology among trans (transvestites, transsexuals, and transgender) sex workers in Argentina. J Med Virol 2013; 86:64-70. [PMID: 24123155 DOI: 10.1002/jmv.23805] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2013] [Indexed: 12/15/2022]
Abstract
Commercial sex work is frequent among male-to-female transvestites, transsexuals and transgenders in Argentina, leading to high susceptibility to HIV, HBV, and HCV among other sexually transmitted infections. In a global context of scarce data on the trans sex workers population, this study was aimed to study the genomic characterization of these viruses. Plasma presence of HIV, HBV, and HCV genomic material was evaluated in samples from 273 trans sex workers. Genomic sequences of HIV-gag, pol, and vif-vpu genes, HBV-S gene, and HCV-5'UT and NS5B genes were obtained. Molecular characterization involved phylogenetic analysis and several in silico tools. Resistance-associated mutations in HIV and HBV pol genes were also analyzed. The HIV genomic characterization in 62 trans sex workers samples showed that 54.8% of the isolates corresponded to BF intersubtype recombinants, and 38.7% to subtype B. The remaining were classified as subtypes C (4.8%) and A (1.6%). HBV and HCV co-infection prevalence among HIV positive trans sex workers yielded rates of 3.2% and 6.5% respectively. Drug resistance-associated mutations were found in 12/62 (19%) HIV pol sequences, but none among HBV. Based on phylogenetic relationships, HIV isolates characterized as subtypes BF and B appeared intermingled with those from other high-risk groups. Despite trans sex workers declared not to have received antiviral treatment, complex drug resistance-associated mutation patterns were found in several HIV isolates. Planned prevention, screening, and treatment are needed to reduce further transmission and morbidity.
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Affiliation(s)
- Mauricio Carobene
- Instituto de Investigaciones Biomedicas en Retrovirus y SIDA (INBIRS), University of Buenos Aires, Buenos Aires Province, Argentina; National Research Council (CONICET), Buenos Aires Province, Argentina
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18
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Gómez Rodríguez R, Guardiola Arévalo A, Gómez Moreno AZ, García Vela A, Gómez Hernando C, Rodríguez Merlo R, Sánchez Ruano JJ, de la Cruz Pérez G. [Characteristics of patients with chronic hepatitis B virus infection. analysis of a series of 474 patients]. GASTROENTEROLOGIA Y HEPATOLOGIA 2013; 36:243-53. [PMID: 23414836 DOI: 10.1016/j.gastrohep.2012.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 10/21/2012] [Accepted: 10/29/2012] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the clinical, laboratory, serological and histologic characteristics of chronic hepatitis B virus carriers in our environment. MATERIAL AND METHODS A retrospective cohort study was performed that included chronic AgHBs carriers aged more than 13 years attending our service since January 2000. RESULTS A total of 474 patients were included. At diagnosis, 55.49% were men, with a mean age of 41.05±13.93 years. Alanine aminotransferase (ALT) levels were within the normal range in 57.17% of the patients, and 87.76% were AgHBe(-). Hepatitis C and D virus coinfection was found in 3.62% and 1.86%, respectively. Liver biopsy was performed in 31.22%; varying grades of inflammation-fibrosis were found in 63.51% and cirrhosis was found in 12.84%. Compared with AgHBe(-) patients, those who were AgHBe(+) were younger and had greater disease activity. This difference was statistically significant. Patients in the immunotolerant phase were the least numerous (5.26%), while AgHBe(-) patients with chronic HBV infection were the most numerous (48.32%). Patients in the immunoreactive phase showed greater histological involvement (16.67% cirrhosis). A familial history of chronic HBV was found in 21.52%. The percentage of non-Spanish patients increased in the last few years and accounted for 18.78%. CONCLUSION Chronic HBV infection in our environment occurs mainly in middle-aged persons. GPT values are normal in more than 50%, most are AgHBe(-), and approximately half are inactive carriers. The incidence of chronic infection has increased in the non-Spanish population in recent years.
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Praseeda S. D, Anuradha D, Jayanthi S. S. A Study on the HBV and the HCV Infections in Female Sex Workers and their Co-Infection with HIV. J Clin Diagn Res 2013; 7:234-7. [PMID: 23543505 PMCID: PMC3592281 DOI: 10.7860/jcdr/2013/4322.2735] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 11/10/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sexually Transmitted Infections (STIs) have been shown to enhance the transmission of the Human Immunodeficiency Virus (HIV). The Hepatitis B and the Hepatitis C viral infections are highly prevalent among the HIV-infected persons as a result of shared transmission routes. AIM To determine the seroprevalence of the HIV, Syphilis, HBV and HCV infections and their co-infection rates among Female Sex Workers (FSWs). SETTINGS AND DESIGN 250 blood samples were collected from FSWs from a red light area of Mumbai by using an outreach strategy. MATERIALS AND METHODS Their sera were tested for the HIV antibodies as per the strategy II of the NACO guidelines, for syphilis by RPR, for the HCV antibodies and for HBsAg by ELISA. RESULTS The study group showed (105/250) 42% HIV reactivity, (15/250) 6% RPR reactivity, (20/250) 8% HBsAg positivity, (7/250) 2.8% HCV reactivity, (11/250) 4.4% HIV-RPR reactivity, (7/250) 2.8% HIV-HBV co-infection and (3/250)1.2% HIV-HCV co-infection. Statistical test which was used: The Chi square test. CONCLUSION A high HIV sero-prevalence was found among the FSWs. A high HIV prevalence was found among the RPR reactive FSWs. The relationship between the HIV reactivity and the RPR reactivity was statistically significant. Co-infections with HBV and HCV were detected among the HIV reactive FSWs, but they were not statistically significant.
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Affiliation(s)
- Desai Praseeda S.
- Resident, Department of Microbiology, TNMC & BYL Nair Hospital,Mumbai, India
| | - Dutta Anuradha
- Associate Professor, Faculty of Dentistry, Jamia Milia Islamia, New Delhi 110025, India. (formerly Associate Professor, Department of Microbiology, TNMC & BYL Nair Hospital, Mumbai, India)
| | - Shastri Jayanthi S.
- Professor & Head, Department of Microbiology, TNMC & BYL Nair Hospital,Mumbai, India
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Platt L, Jolley E, Rhodes T, Hope V, Latypov A, Reynolds L, Wilson D. Factors mediating HIV risk among female sex workers in Europe: a systematic review and ecological analysis. BMJ Open 2013; 3:bmjopen-2013-002836. [PMID: 23883879 PMCID: PMC3731729 DOI: 10.1136/bmjopen-2013-002836] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We reviewed the epidemiology of HIV and selected sexually transmitted infections (STIs) among female sex workers (FSWs) in WHO-defined Europe. There were three objectives: (1) to assess the prevalence of HIV and STIs (chlamydia, syphilis and gonorrhoea); (2) to describe structural and individual-level risk factors associated with prevalence and (3) to examine the relationship between structural-level factors and national estimates of HIV prevalence among FSWs. DESIGN A systematic search of published and unpublished literature measuring HIV/STIs and risk factors among FSWs, identified through electronic databases published since 2005. 'Best' estimates of HIV prevalence were calculated from the systematic review to provide national level estimates of HIV. Associations between HIV prevalence and selected structural-level indicators were assessed using linear regression models. STUDIES REVIEWED Of the 1993 papers identified in the search, 73 peer-reviewed and grey literature documents were identified as meeting our criteria of which 63 papers provided unique estimates of HIV and STI prevalence and nine reported multivariate risk factors for HIV/STI among FSWs. RESULTS HIV in Europe remains low among FSWs who do not inject drugs (<1%), but STIs are high, particularly syphilis in the East and gonorrhoea. FSWs experience high levels of violence and structural risk factors associated with HIV, including lack of access to services and working on the street. Linear regression models showed HIV among FSWs to link with injecting drug use and imprisonment. CONCLUSIONS Findings show that HIV prevention interventions should be nested inside strategies that address the social welfare of sex workers, highlighting in turn the need to target the social determinants of health and inequality, including regarding access to services, experience of violence and migration. Future epidemiological and intervention studies of HIV among vulnerable populations need to better systematically delineate how microenvironmental and macroenvironmental factors combine to increase or reduce HIV/STI risk.
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Affiliation(s)
- Lucy Platt
- Centre for Research on Drugs and Health Behaviour, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Emma Jolley
- Centre for Research on Drugs and Health Behaviour, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Tim Rhodes
- Centre for Research on Drugs and Health Behaviour, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Vivian Hope
- Centre for Research on Drugs and Health Behaviour, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Alisher Latypov
- The Central Asia Program, Institute for European, Russian, and Eurasian Studies, George Washington University, Washington DC, USA
- Global Health Research Centre of Central Asia, Columbia University, New York, USA
| | - Lucy Reynolds
- Centre for Research on Drugs and Health Behaviour, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - David Wilson
- Global HIV/AIDS Programme, World Bank, Washington DC, USA
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Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. THE LANCET. INFECTIOUS DISEASES 2012; 13:214-22. [PMID: 23260128 DOI: 10.1016/s1473-3099(12)70315-8] [Citation(s) in RCA: 1003] [Impact Index Per Article: 83.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Previous systematic reviews have identified a high prevalence of HIV infection in transgender women in the USA and in those who sell sex (compared with both female and male sex workers). However, little is known about the burden of HIV infection in transgender women worldwide. We aimed to better assess the relative HIV burden in all transgender women worldwide. METHODS We did a systematic review and meta-analysis of studies that assessed HIV infection burdens in transgender women that were published between Jan 1, 2000, and Nov 30, 2011. Meta-analysis was completed with the Mantel-Haenszel method, and random-effects modelling was used to compare HIV burdens in transgender women with that in adults in the countries for which data were available. FINDINGS Data were only available for countries with male-predominant HIV epidemics, which included the USA, six Asia-Pacific countries, five in Latin America, and three in Europe. The pooled HIV prevalence was 19·1% (95% CI 17·4-20·7) in 11 066 transgender women worldwide. In 7197 transgender women sampled in ten low-income and middle-income countries, HIV prevalence was 17·7% (95% CI 15·6-19·8). In 3869 transgender women sampled in five high-income countries, HIV prevalence was 21·6% (95% CI 18·8-24·3). The odds ratio for being infected with HIV in transgender women compared with all adults of reproductive age across the 15 countries was 48·8 (95% CI 21·2-76·3) and did not differ for those in low-income and middle-income countries compared with those in high-income countries. INTERPRETATION Our findings suggest that transgender women are a very high burden population for HIV and are in urgent need of prevention, treatment, and care services. The meta-analysis showed remarkable consistency and severity of the HIV disease burden among transgender women. FUNDING Center for AIDS Research at Johns Hopkins and the Center for Public Health and Human Rights at the JHU Bloomberg School of Public Health.
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Pérez-Molina JA, Pulido Ortega F. [Assessment of the impact of the new health legislation on illegal immigrants in Spain: the case of human immunodeficiency virus infection]. Enferm Infecc Microbiol Clin 2012; 30:472-8. [PMID: 22939565 DOI: 10.1016/j.eimc.2012.07.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 07/15/2012] [Accepted: 07/17/2012] [Indexed: 12/17/2022]
Abstract
The immigrant population in Spain, whether legal or not, has been entitled to healthcare under the same conditions as the Spanish population since the year 2000. The entry into vigour of the Royal Decree-Law 12/2012 of 20 April has significantly restricted this right, so that unauthorized or non-resident foreigners may now only receive emergency care, if they are under 18 or pregnant women. Out of an estimated 459,909 illegal immigrants in our country, 2,700 to 4,600 are probably infected with HIV; 1,800 to 3,220 know that they are infected, and 80% of the latter could receive antiretroviral treatment. The Royal Decree-Law is likely to cause many undesirable consequences in this population infected with HIV: increasing mortality, promoting the emergence of opportunistic diseases, increasing hospital admissions, increasing infections in the population (by HIV and other pathogens), or contributing to mother to child transmission of HIV. The expected increase in morbidity and mortality will be a greater cost in patient care, a cost which will be significantly higher in the more immunosuppressed patients. Therefore, the enforcement of the Royal Decree-Law will be much less cost-effective in the short term than was expected, and will negatively affect our country's public health, especially for those patients infected with HIV who will not be covered, thus increasing healthcare medium to long term costs, and moving away from the international health goals that were established.
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Affiliation(s)
- José A Pérez-Molina
- Medicina Tropical, Servicio de Enfermedades Infecciosas, Hospital Ramon y Cajal, Madrid.
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Turchetti P, Pacella F, Pacella E, Mirisola C, Uccella I. An immunocompetent migrant presenting with neurosyphilis with an unusual unilateral papillitis: a case report. Eur J Med Res 2012; 17:3. [PMID: 22472320 PMCID: PMC3337542 DOI: 10.1186/2047-783x-17-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 02/14/2012] [Indexed: 11/13/2022] Open
Abstract
Unilateral papillitis caused by Treponema pallidum was found in an immunocompetent homosexual patient with severe vision loss who had received previous antibiotics treatment. Syphilis-related ocular manifestation is more common in the early stages of the disease and it can be associated with a central nervous system localization. In this patient, neurosyphilis was diagnosed on the basis of clinical and laboratory findings. Optical examination revealed unilateral papillitis in the left eye and no relative afferent pupillary defects. The patient underwent visual field examinations with conventional perimetry using the 30-2 program of the Humphrey Visual Field Analyzer, which indicated a blind spot enlargement in the left eye. Optical coherence tomography, visual evoked potentials (VEP), and fluorescein angiograms revealed inflammation of the optic nerve head with edematous and blurred margins. A reactive T. pallidum hemagglutination assay with low rapid plasma reagin (RPR) serum titer was performed; an HIV antibody test and MRI of the orbits and head with contrast gave negative results. Resolution of the ocular inflammation after intravenous penicillin treatment was obtained. The reported case illustrates the importance of early recognition of this treatable disease. The rise of syphilis, especially in urban areas, necessitates a high level of suspicion when dealing with patients with intraocular inflammation of unknown origin. Lues serology should be incorporated into routine laboratory diagnostics to aid in the detection of such cases. Considering the re-emergence of syphilis, screening of migrants from countries with high syphilis seroprevalences should be recommended.
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Affiliation(s)
- Paolo Turchetti
- National Institute for Health, Migration and Poverty (INMP/NIHMP), Rome, Italy
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Díaz-Menéndez M, Pérez-Molina JA, Norman F, López-Vélez R. Prevalencia de infección por VIH en población inmigrante asintomática. Enferm Infecc Microbiol Clin 2011; 29:712-3. [DOI: 10.1016/j.eimc.2011.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 04/26/2011] [Accepted: 05/06/2011] [Indexed: 10/18/2022]
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25
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Baldin-Dal Pogetto MR, Silva MG, Parada CMGDL. Prevalence of sexually transmitted diseases in female sex workers in a city in the interior of São Paulo, Brazil. Rev Lat Am Enfermagem 2011. [DOI: 10.1590/s0104-11692011000300007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Changes in the profile of sexually transmitted diseases have increased the need for their detection, particularly where there is a concentration of individuals with risk behavior, so that diagnosis and immediate treatment can be translated in the reduction of resulting problems. The objective was to identify the prevalence of sexually transmitted diseases in female sex workers in a medium-sized city in São Paulo state. This population prevalence study was conducted in 2008 on 102 females. The prevalence was 71.6%. When considered separately and in association, the highest values found were: HPV (67.7%) and Chlamydia (20.5%). HPV typing showed oncogenic genotypes. The prevalence of syphilis was 4.0% and of trichomoniasis 3.0%. No cases of hepatitis B or gonorrhea were identified. It was concluded that the prevalence of sexually transmitted diseases in the studied group was high, since approximately two thirds of the women showed some type of disease under this classification.
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Pérez-Molina JA, Herrero-Martínez JM, Norman F, Pérez-Ayala A, Monge-Mahillo B, Navarro-Beltrá M, López-Vélez R. Clinical, epidemiological characteristics and indications for liver biopsy and treatment in immigrants with chronic hepatitis B at a referral hospital in Madrid. J Viral Hepat 2011; 18:294-9. [PMID: 20367791 DOI: 10.1111/j.1365-2893.2010.01306.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The increase in immigration from less developed countries to Europe has led to an increase in the incidence of hepatitis B infection. The objective of this study was to describe the clinical, epidemiological characteristics and indications for treatment of chronic hepatitis B in a cohort of immigrants, given the relative lack of current evidence. We performed a noninterventional retrospective chart review; different characteristics depending on geographical origin were compared. A case-control study was also performed to describe factors potentially associated with chronic or past hepatitis B virus (HBV) infection. We selected a random sample of 436 patients out of the 2989 immigrants attending during the study period (1989-2008). Hepatitis B serology was performed in 74% (322/436): 10.6% had chronic HBV infection (95% CI: 7.4-13.7%), and 46.9% had evidence of past infection (95% CI: 41.7-52.0%). The average age was 31 years, 60% were men, and 70% were sub-Saharan Africans. Chronic infection was related to being men (OR 2.03; 95%CI: 1.29-3.18), younger (OR 0.98; 0.96-0.99) and sub-Saharan African (OR 5.41; 2.71-10.83). Past or current infection was related to male sex (OR 2.80; 1.81-4.30), longer time elapsed until first seen at the unit (OR 0.998; 0.997-1.000), HIV infection (OR 4.99; 1.15-21.60) and being sub-Saharan African (OR 15.46; 8.97-27.18). These associations were not confirmed after adjustment for geographical origin. In 27% and 29.5% of patients, liver biopsy and treatment, respectively, would have been indicated. Prevalence of chronic HBV infection amongst immigrants is high, especially in sub-Saharan Africans. Almost a third could be considered for liver biopsy or antiviral therapy.
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Affiliation(s)
- J A Pérez-Molina
- Tropical Medicine and Clinical Parasitology Unit, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain.
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27
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van Veen MG, Götz HM, van Leeuwen PA, Prins M, van de Laar MJW. HIV and sexual risk behavior among commercial sex workers in the Netherlands. ARCHIVES OF SEXUAL BEHAVIOR 2010; 39:714-723. [PMID: 18815876 DOI: 10.1007/s10508-008-9396-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Revised: 02/12/2008] [Accepted: 04/08/2008] [Indexed: 05/26/2023]
Abstract
In 2002-2005, a cross-sectional study to assess the potential for HIV transmission was carried out among 557 female and male-to-female transgender commercial sex workers (CSW) in three cities in the Netherlands. Female CSW (F-CSW), drug-using female CSW (DU), and transgender sex workers were recruited in street-based and establishment-based sites. An anonymous questionnaire was administrated by interviewers and a saliva sample was collected for HIV antibody testing. The overall HIV prevalence was 5.7% (31/547; 10 samples were excluded because of "intermediate" test results). HIV was more prevalent among transgender (18.8%, 13/69) and DU (13.6%, 12/88) sex workers than among F-CSW (1.5%, 6/390). Of the HIV positive CSW, 74% were unaware of their infection. Consistent condom use with clients was 81%. Regular condom failure with clients was reported by 39%. In multivariate analyses, transgender sex workers (OR = 22.9), drug-using CSW who ever injected drugs (OR = 31.1), African (OR = 19.0), and South European ethnicity (OR = 7.2) were independently associated with HIV. Condom failure (PRR = 2.0), anal sex (PRR = 2.1), and drug use (PRR = 3.8) were associated with inconsistent condom use with clients. There is a potential risk for further spread of HIV, through clients and (private) partners of sex workers, to the general population. Targeted health promotion activities are indicated for transgender sex workers and drug-using female CSW; active HIV testing must be continued.
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Affiliation(s)
- Maaike G van Veen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720BA, Bilthoven, The Netherlands.
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28
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HIV-1 non-B subtypes: High transmitted NNRTI-resistance in Spain and impaired genotypic resistance interpretation due to variability. Antiviral Res 2010; 85:409-17. [DOI: 10.1016/j.antiviral.2009.11.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 10/29/2009] [Accepted: 11/30/2009] [Indexed: 01/10/2023]
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Mazaira M, Almagro M, Fonseca E. Indicaciones de la punción lumbar en pacientes con sífilis precoz activa coinfectados por el VIH. Casuística en un hospital terciario de La Coruña (España) 2003-2006. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s0001-7310(08)76176-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Valerio L, Barro S, Pérez B, Roca C, Fernández J, Solsona L, Aguilar A, Escribà J. Seroprevalencia de marcadores de hepatitis crónica vírica en 791 inmigrantes recientes en Cataluña, España. Recomendaciones de cribado y de vacunación contra la hepatitis B. Rev Clin Esp 2008; 208:426-31. [DOI: 10.1157/13127602] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Indications for Lumbar Puncture in Patients With Early Active Syphilis and Human Immunodeficiency Virus Coinfection: Experience in a Tertiary Level Hospital in La Coruña, Spain, 2003-2006. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s1578-2190(08)70348-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Esteban JI, Sauleda S, Quer J. The changing epidemiology of hepatitis C virus infection in Europe. J Hepatol 2008; 48:148-62. [PMID: 18022726 DOI: 10.1016/j.jhep.2007.07.033] [Citation(s) in RCA: 334] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 07/30/2007] [Indexed: 02/07/2023]
Abstract
The epidemic of hepatitis C virus (HCV) infection in Europe is continuously evolving and epidemiological parameters (prevalence, incidence, disease transmission patterns and genotype distribution) have changed substantially during the last 15 years. Four main factors contribute to such changes: increased blood transfusion safety, improvement of healthcare conditions, continuous expansion of intravenous drug use and immigration to Europe from endemic areas. As a result, intravenous drug use has become the main risk factor for HCV transmission, prevalent infections have increased and genotype distribution has changed and diversified. Hence, prevalence data from studies conducted a decade ago may not be useful to estimate the current and future burden of HCV infection and additional epidemiological studies should be conducted, as well as new preventive strategies implemented to control the silent epidemic. This review summarizes recently published data on the epidemiology of HCV infection in Europe focusing on the factors currently shaping the epidemic.
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Affiliation(s)
- Juan I Esteban
- Liver Unit, Department of Medicine, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
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Holguín A, Pena MJ, Troncoso F, Soriano V. Introduction of non-B subtypes among Spaniards newly diagnosed with HIV type 1 in the Canary Islands. AIDS Res Hum Retroviruses 2007; 23:498-502. [PMID: 17451342 DOI: 10.1089/aid.2006.0191] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Spanish Canary Islands face the northwest coast of Africa, being one gate of entrance of African immigrants into Europe and of HIV-1 non-B strains, prevalent in most African regions. The presence and nature of HIV-1 non-B subtypes were examined in Spanish natives newly diagnosed with HIV-1 infection from 1998 to 2004 in a reference hospital located in one of the largest islands of the archipelago. Subtyping of HIV-1 pol genes was performed in 139 out of 429 individuals found to be HIV-1 positive during that period. Non-B strains infected 40 (28.8%) subjects, 12 (13.7%) out of 87 native Spaniards and 28 (53.8%) out of 52 immigrants (75% Africans) (p < 0.01). HIV-1 non-B subtypes, mostly recombinant forms, were present in Spaniards at least since 1998. HIV-1 non-B subtypes are frequently recognized in HIV+ Africans arriving in the Canary islands and continuously introduced into the newly diagnosed HIV-1+ native population living in the archipelago.
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Affiliation(s)
- Africa Holguín
- Service of Infectious Diseases, Hospital Carlos III, Calle Sinesio Delgado 10, 28029 Madrid, Spain
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Valencia Ortega ME, Holguín Fernández A, Moreno Celda V, Alvarez Ferrero A, Lago Núñez M, González Lahoz J. Infección por el virus de la inmunodeficiencia humana tipo 1 e inmigración: manifestaciones clínicas, subtipos y evolución de 78 pacientes ingresados durante los últimos 5 años. Med Clin (Barc) 2007; 128:302-4. [PMID: 17338863 DOI: 10.1157/13099579] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE To analyse the characteristics and HIV-1 subtype in a group of HIV+ hospitalised immigrants in our Infectious Diseases Unit. PATIENTS AND METHOD Clinical reports of 78 immigrants HIV+ were reviewed. HIV-1 subtyping was carried out examining the protease and transcriptase genes by phylogenetic analysis. Statistical study was done by SPSS 11.0 program. RESULTS 57% of patients come from sub-Saharian Africa. Mainly they had been infected by heterosexual contact. HIV was diagnosed at the hospitalisation time in 35 cases. Only 28% were receiving highly active antiretroviral therapy and 48,7% had CD4+ cells less than 200/microl. The more frequent diagnosed diseases were: tuberculosis (20.5%), candidiasis (24.4%), bacterial pneumonia (19.2%) and malaria (21.8%). HIV-1 subtype B was isolated in 26 patients, none Africans. Twenty nine individuals (52.8%) were infected with HIV-1 non-B subtypes. Relationship between HIV-1 subtype, immunodepression, diagnosed diseases and origin countries was not found apart from malaria. CONCLUSIONS Most HIV-1 infected immigrants are from Africa, being predominantly infected with HIV-1 non-B subtypes. No relationship between HIV subtype and diagnosed diseases was found.
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Chen XS, Yin YP, Liang GJ, Gong XD, Li HS, Poumerol G, Thuy N, Shi MQ, Yu YH. Sexually transmitted infections among female sex workers in Yunnan, China. AIDS Patient Care STDS 2005; 19:853-60. [PMID: 16375618 DOI: 10.1089/apc.2005.19.853] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A cross-sectional prevalence survey of sexually transmitted infections (STIs) was conducted among female sex workers (FSWs) in Kunming, Yunnan Province, China. A total of 505 FSWs participated in the survey. All eligible participants gave informed consent. Demographic, behavioral, and clinical information of the participants was gathered by direct structured interviews. Tampon swabs were collected to test for Chlamydia trachomatis, Nesseria gonorrhoeae, and Trichomonas vaginalis and serum specimens were collected to test for HIV antibody by enzyme-linked immunosorbent assay (ELISA) screening and Western blot confirmation, syphilis with rapid plasma reagin (RPR) and T. pallidum hemagglutination (TPHA) confirmation, and for HSV-2 antibodies with the HerpeSelect 2 ELISA. The most prevalent bacterial STI was Chlamydia trachomatis (58.6%), followed by Trichomonas vaginalis (43.2%) and Neisseria gonorrhoeae (37.8%). Three hundred twenty-seven (65.1%) sex workers had serologic evidence of exposure to HSV-2 infection. Ten percent were positive for HIV infection, all injecting drug users (IDUs); and 9.5% had infection with syphilis. Comprehensive prevention and effective STI services for sex workers and their clients will be the key strategies to the control of STIs, including HIV. Policies and prevention strategies for STI/HIV need to focus on high-risk subpopulations, such as sex workers (particularly sex workers who inject drugs) and their clients.
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Affiliation(s)
- Xiang-Sheng Chen
- National Center for STD and Leprosy Control, 12 Jiangwangmiao Street, Nanjing 210-042, China.
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Lospitao E, Alvarez A, Soriano V, Holguín A. HIV-1 subtypes in Spain: a retrospective analysis from 1995 to 2003. HIV Med 2005; 6:313-20. [PMID: 16156878 DOI: 10.1111/j.1468-1293.2005.00313.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To perform a retrospective analysis of all HIV-1 non-B variants circulating in Spain from 1995 to 2003 and extend their virological characterization. METHODS Samples from a total of 396 HIV-infected subjects with epidemiological suspicion of being infected with non-B clades were analysed during the study period. Subtyping was carried out on the protease (PR), reverse transcriptase (RT) and envelope (env) genes. RESULTS PR sequences belonging to non-B subtypes were recognized in 43.2% of cases (23 A, 13C, 6D, 3F, 118 G, 3H, 4 J and 1 U). Subtype G and AG recombinants were the most frequent variants (69%), and were found most often in subjects from West and Central Africa. Up to 70% of pol (PR, RT) sequences belonging to subtype G harboured env sequences belonging to clade A (55%), B (13.8%) or K (3.4%). Nearly half were mosaic GA viruses, and a few were CRF 14 BG viruses. Up to 14 new recombinant viruses, which could not be assigned to previously described circulating recombinant forms (CRFs), were found. CONCLUSIONS There is great diversity in the HIV-1 variants and recombinant viruses circulating in Spain. Non-B sequences may be underestimated if only the env region is examined in phylogenetic analyses. Drug resistance testing provides the advantage of pol subtyping, and its additional use for this purpose should be encouraged.
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Affiliation(s)
- E Lospitao
- Infectious Diseases Service, Hospital Carlos III, Madrid, Spain
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