Oral HPV among people who use crack-cocaine: prevalence, genotypes, risk factors, and key interventions in a remote Northern Brazilian region

OBJECTIVES

This study estimated the prevalence, genotype distribution, and the factors associated with oral human papillomavirus (HPV) in people who use crack-cocaine (PWUCC) in a remote Brazilian region.

MATERIALS AND METHODS

This cross-sectional study used community-based snowball sampling methods for participant recruitment. Socio-demographic, economic, drug use, and health-related information was collected from 278 PWUCC in the cities of Bragança and Capanema in northern Brazil. HPV diagnosis and genotyping were performed by a real-time polymerase chain reaction. Logistic regression identified the factors independently associated with oral HPV.

RESULTS

In total, 111 (39.9%) PWUCC had HPV DNA. Several genotypes were identified, some of them with high oncogenic potential. Crack-cocaine use ≥40 months, unprotected sex, more than 10 sexual partners in the last 12 months, oral sex, exchange of sex for money or illicit drugs, oral mucosa lesions, not having access to public health services, and the absence of vaccination against HPV was all associated with HPV DNA.

CONCLUSIONS

This study identified important epidemiological characteristics of oral HPV infection among PWUCC-a highly marginalized risk population-underlining the high prevalence of oral HPV with oncogenic potential and the urgent need for control and prevention measures, especially vaccination against this virus.

CLINICAL RELEVANCE

It is necessary to understand the prevalence and risk factors of oral HPV in risk populations as people who use crack-cocaine.

[Cholelithiasis in chronic Chageas' disease patients]

The studies on the occurrence of biliary lithiasis in patients with chronic Chagas' disease have shown conflicting results. Aiming at contributing to a better understanding of the topic was assessed, by ultrasonographic scan, the frequency of Colelithiasis in chagasic patients with different anatomo-clinical forms of the disease. A total of 128 patients were studied, 85 males (mean age: 53 +/- 13 years) and 43 females (mean age: 53 +/_ 10 years) nineteen males and 18 females had the cardiac form ; 32 males and 19 females the digestive form; 20 males and 3 females the cardiac and digestive forms simultaneously; and 14 males and 3 females the indeterminate form. Controls were a series of 1139 individuals without Chagas' disease, 716 males and 423 females (mean age 46 +/_ 14 years for both sexes), who were submitted to postmortem examination. The frequency of cholelithiasis in chagasic males (14.1%) was significantly higher than in the controls (6%); by subgroup, it was significantly higher in the individuals with the cardiac and cardiac-digestive form (26.3% and 20% respectively), but not in those with the digestive form (9.4%). The frequency of colelithiasis was also significantly higher in chagasic females in the total (42%) and in the cardiac (50%) and digestive (31.6%) forms, when compared to the control group (14%). Male and female chronic chagasic patients have an increased frequency of colelithiasis, and therefore the preoccupation about this finding should not be restricted to the digestive form of the disease, as previous studies on this subject have suggested.