RESUMEN
We report an epidemic of parvovirus B19 infections in Denmark during the first quarter of 2024, with a peak incidence 3.5 times higher than during the most recent epidemic in 2017. In total, 20.1% (130/648) of laboratory-confirmed cases were pregnant. Severe adverse outcomes were observed among 12.3% (16/130) of pregnant people and included foetal anaemia, foetal hydrops and miscarriage. Parvovirus B19 infection is not systematically monitored, but a national laboratory-based surveillance system is currently being established in Denmark.
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Infecciones por Parvoviridae , Parvovirus B19 Humano , Complicaciones Infecciosas del Embarazo , Humanos , Femenino , Embarazo , Dinamarca/epidemiología , Parvovirus B19 Humano/aislamiento & purificación , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/virología , Adulto , Incidencia , Infecciones por Parvoviridae/epidemiología , Infecciones por Parvoviridae/diagnóstico , Epidemias , Hidropesía Fetal/epidemiología , Hidropesía Fetal/virología , Índice de Severidad de la Enfermedad , Adulto Joven , Eritema Infeccioso/epidemiología , Eritema Infeccioso/diagnóstico , Adolescente , Aborto Espontáneo/epidemiología , Aborto Espontáneo/virología , Vigilancia de la PoblaciónRESUMEN
A surge in gonorrhoea in Denmark has occurred since 2022, a 46% increase from 2021. National surveillance, leveraging mandatory reporting and epidemiological data, highlights three distinct clades linked to heterosexual transmission. Despite the rise, these exhibit high susceptibility, contrasting MSM-associated strains. Geographical hotspots and age-specific patterns further illuminate transmission dynamics. The combination of genomic and epidemiological data provides novel insights into the evolving landscape of gonorrhoea, indicating potential shifts in infection dynamics and transmissibility.
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Gonorrea , Humanos , Antibacterianos/uso terapéutico , Dinamarca/epidemiología , Gonorrea/tratamiento farmacológico , Gonorrea/epidemiología , Heterosexualidad , Neisseria gonorrhoeae/genéticaRESUMEN
Gonorrhoea cases increased steeply in women aged 20 to 24 years across 15 EU/EEA countries in July to December 2022 and January to June 2023 with, respectively, 73% and 89% more cases reported than expected, based on historical data from 2015 to 2019. Smaller increases among men due to heterosexual transmission were observed in nine EU/EEA countries. Interventions to raise awareness among young people about sexually transmitted infection risks are needed, emphasising the benefit of safe sexual practices and testing.
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Gonorrea , Enfermedades de Transmisión Sexual , Masculino , Humanos , Femenino , Adolescente , Gonorrea/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Conducta Sexual , HeterosexualidadRESUMEN
OBJECTIVE: Syphilis is an STI that potentially affects any organ. Syphilitic hepatitis and neurosyphilis have been reported in both HIV-uninfected and HIV-infected individuals. The aim of this study was to investigate syphilitic hepatitis and neurosyphilis among HIV-infected individuals during a 13-year period. METHODS: This retrospective study included all HIV-infected individuals ≥18 years diagnosed with syphilis between 1 May 2004 and 31 December 2016 in Copenhagen, Denmark. We used the unique 10-digit personal identification number assigned to all individuals in Denmark to link data from two nationwide registers to identify the patients. Patient files were revised to obtain clinical and laboratory data. RESULTS: A total of 509 episodes of syphilis were diagnosed in 427 HIV-infected individuals attending three hospitals in Copenhagen, Denmark. The majority of the patients were men (99.5%), and the majority of men were men who have sex with men (96%). Twenty-seven patients (6%) met the criteria for neurosyphilis, and the neurological symptoms included ocular and auditory abnormalities, headache, paraesthesia, vertigo, facial paresis, motor weakness and unexplained pain in the legs. The patients with neurosyphilis were diagnosed in the secondary stage (84%) and in the early latent (8%) or late latent (8%) stage. Among the patients tested for liver affection, 41% met the criteria for syphilitic hepatitis. The patients with syphilitic hepatitis were diagnosed in the secondary stage (82%), primary stage (10%), and in the early latent (5%) or late latent (3%) stage. CONCLUSIONS: The study emphasises that patients with syphilis, also those seen at STI clinics, should undergo a thorough clinical examination and questioning to reveal neurological symptoms. Identification of patients with neurosyphilis is crucial since these patients undergo a different treatment. The study also emphasises that syphilis should be considered as a diagnosis in sexually active patients with liver .
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Infecciones por VIH/complicaciones , Hepatitis/epidemiología , Neurosífilis/epidemiología , Adulto , Dinamarca/epidemiología , Femenino , Infecciones por VIH/epidemiología , Hepatitis/complicaciones , Hepatitis/diagnóstico , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Neurosífilis/complicaciones , Neurosífilis/diagnóstico , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Bacterial vaginosis (BV) has been found to be associated with HIV acquisition and transmission. This is suggested to be due to higher HIV RNA levels in cervicovaginal fluids in women living with HIV (WLWH) with BV, as bacteria associated with BV may induce viral replication and shedding in the genital tract despite undetectable HIV RNA plasma viral load. We examined the prevalence and diagnostic predictors of BV and HIV-1 RNA vaginal shedding in women living with HIV (WLWH) in Denmark, taking into account the presence of human papillomavirus (HPV) and herpes viridae. METHODS: WLWH between 18-51 years were recruited from six Departments of Infectious Diseases in Denmark during enrolment in the SHADE cohort; a prospective cohort study of WLWH attending regular outpatient care. BV was diagnosed by microscopy of vaginal swabs and PCR was used for detection of BV-associated bacteria, HPV, herpes viridae, and vaginal HIV viral load. RESULTS: Median age of the 150 included women was 41 years; ethnicity was predominantly White (35%) or Black (47%). The majority (96%) was on ART and had undetectable (85%) plasma HIV RNA (<40 copies/mL). BV was diagnosed in 32%. Overall, 11% had detectable vaginal HIV RNA. Both before and after adjustment for BV, age, ethnicity, plasma HIV RNA, CD4 cell count, herpes viridae and HPV, we found no significant predictors of HIV RNA vaginal shedding. CONCLUSION: In well-treated WLWH, BV, herpes viridae or HPV do not predict vaginal HIV RNA shedding. This implies that HIV shedding does not seem to be increased by BV.
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Infecciones por VIH/virología , Infecciones por Herpesviridae/virología , Vaginosis Bacteriana/epidemiología , Vaginosis Bacteriana/virología , Esparcimiento de Virus , Adolescente , Adulto , Recuento de Linfocito CD4 , Dinamarca/epidemiología , Femenino , Infecciones por VIH/epidemiología , VIH-1/genética , VIH-1/patogenicidad , Infecciones por Herpesviridae/epidemiología , Humanos , Persona de Mediana Edad , Papillomaviridae/genética , Papillomaviridae/patogenicidad , Infecciones por Papillomavirus/epidemiología , Estudios Prospectivos , ARN Viral/análisis , Vagina/microbiología , Vagina/virología , Vaginosis Bacteriana/microbiología , Carga Viral , Adulto JovenRESUMEN
OBJECTIVES: We aimed to update the estimated prevalence of both diagnosed and undiagnosed chronic hepatitis B virus infection in Denmark. Moreover, we aimed to determine the number of people with chronic hepatitis B virus infection in specialised care and to assess the completeness of reporting to the national register of communicable diseases. METHODS: Using four registers with national coverage, we identified all individuals registered with chronic hepatitis B virus infection, aged 16 years or older, and alive in Denmark on 31 December 2016. The diagnosed population was then estimated using capture-recapture analysis. The undiagnosed population was estimated using data from the Danish pregnancy screening program. RESULTS: We estimated that 14,548 individuals were living with chronic hepatitis B virus infection corresponding to 0.3% of the Danish population. Of them, 13,530 (93%) were diagnosed and 7942 (55%) were registered in one or more of the source registers. Only 4297 (32%) diagnosed individuals had attended specialised care and only 3289 cases (24%) were reported to the Danish communicable disease register. CONCLUSION: The prevalence of chronic hepatitis B virus infection increased from 2007 to 2017. The majority that had been diagnosed did not receive care as recommended by national guidelines and were not reported to the communicable diseases register responsible for hepatitis B virus surveillance. Future efforts should focus on linking individuals diagnosed with chronic hepatitis B virus infection to specialised care and improving reporting to the hepatitis B virus surveillance system.
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Hepatitis B Crónica , Hepatitis B , Embarazo , Femenino , Humanos , Hepatitis B Crónica/epidemiología , Virus de la Hepatitis B , Prevalencia , Dinamarca/epidemiología , Hepatitis B/epidemiologíaRESUMEN
In 2009, 2.5 million children under the age of 15 y were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS); 370,000 were diagnosed with HIV and 260,000 died due to AIDS. More than 90% of the children infected with HIV live in sub-Saharan Africa. Most children infected with HIV contract the infection in utero, during delivery, or via breast milk. This review outlines the current diagnostic methods to determine the HIV status of infants born to HIV-infected mothers. The HIV DNA and RNA polymerase chain reaction (PCR) tests are highly accurate and are recommended as the first-choice diagnostic methods. However, they are expensive and require complex laboratory procedures. Consequently, a search for less costly and complicated methods has led to the testing of p24 antigen analyses as an alternative to the gold-standard PCR tests, with encouraging results. The p24 antigen Perkin Elmer assay currently most often used has a sensitivity of 98.8% and a specificity of 100% (infants 6 weeks of age). Larger-scale studies should be performed in resource-limited settings to confirm these findings.
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Técnicas de Laboratorio Clínico/métodos , Proteína p24 del Núcleo del VIH/sangre , Infecciones por VIH/diagnóstico , Transmisión Vertical de Enfermedad Infecciosa , Virología/métodos , África del Sur del Sahara , Técnicas de Laboratorio Clínico/economía , ADN Viral/sangre , Países en Desarrollo , Humanos , Inmunoensayo/economía , Inmunoensayo/métodos , Lactante , Recién Nacido , Reacción en Cadena de la Polimerasa/economía , Reacción en Cadena de la Polimerasa/métodos , ARN Viral/sangre , Sensibilidad y Especificidad , Virología/economíaRESUMEN
OBJECTIVES: Anti-müllerian hormone (AMH) is a marker of ovarian reserve. The purpose of this study was to compare AMH in women living with HIV with an age-matched control group of HIV-uninfected women, and to identify possible variables associated with decreasing AMH levels in women living with HIV. METHODS: AMH was measured in frozen EDTA samples from 84 white women living with HIV, aged 20 -40 years, with fully suppressed HIV RNA viral loads for at least 6 months and no hepatitis B or C virus co-infection. All women living with HIV were age-matched with HIV-uninfected control women. RESULTS: Eighty-four women living with HIV and 252 control women were included. Median age for the women living with HIV was 33.5 years (interquartile range [IQR] 30.6-35.3), and 33.2 years (IQR 30.6-35.5) for the control women. A significant difference (P=0.03) was found in the mean AMH levels for all age groups combined, which was 17.23 pmol/L (95% confidence interval [CI] 14.56-19.89) in the women living with HIV versus 21.65 pmol/L (95% CI 19.50-23.81) in the control women, although levels were within reference limits in both groups.Only increasing age was significantly associated with decreasing AMH levels and not CD4 cell count, AIDS prior to inclusion, antiretroviral treatment/lack of treatment or antiretroviral treatment regimen. CONCLUSIONS: Well-treated, white women living with HIV in Denmark, have reduced AMH levels compared with age-matched control HIV-uninfected women. The only variable associated with decreasing AMH levels in women living with HIV was increasing age.
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Infecciones por VIH/prevención & control , Técnicas Reproductivas Asistidas , Femenino , Infecciones por VIH/transmisión , VIH-1 , Humanos , Legislación Médica , Masculino , Técnicas Reproductivas Asistidas/legislación & jurisprudencia , Técnicas Reproductivas Asistidas/normas , Países Escandinavos y NórdicosRESUMEN
The life expectancy in well-treated HIV-infected persons approaches that of the general population, but HIV-infected persons have a greater incidence of fractures and osteoporosis. A decrease in bone mineral density is observed primarily during the first 1-2 years of antiretroviral therapy. Dual X-ray absorptiometry scan should be considered in HIV-infected men ≥ 50 years and postmenopausal women. In case of osteoporosis, bisphosphonate treatment should follow guidelines for the general population. Future research should focus on pathogenesis and prevention of bone density loss in HIV.
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Antirretrovirales/efectos adversos , Densidad Ósea/efectos de los fármacos , Infecciones por VIH/complicaciones , Osteoporosis/inducido químicamente , Absorciometría de Fotón , Anciano , Antirretrovirales/uso terapéutico , Densidad Ósea/fisiología , Femenino , Fracturas Óseas/etiología , Fracturas Óseas/prevención & control , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/diagnóstico por imagen , Osteoporosis/prevención & control , Posmenopausia , Guías de Práctica Clínica como Asunto , Medición de RiesgoRESUMEN
OBJECTIVE: To identify disclosure, stigma and predictors of non-disclosure among women living with HIV in Denmark. METHODS: A questionnaire study of women living with HIV in Denmark was performed. The enrolment period was from February 2013 to March 2014. Logistic regression was used to estimate predictors of non-disclosure. RESULTS: A total of 234 participants were included. The majority (94%) had disclosed their HIV status to at least one person outside their healthcare environment, although 29% had disclosed to fewer than three people. Confidantes were mostly partners (96%), siblings (63%), friends (63%) and children (41%). The primary reason for non-disclosure was a feeling that it did not concern others (55%), although reactions upon disclosure were mainly positive in 53%. Predictors of non-disclosure were being of black or Asian ethnicity. Following their HIV diagnosis, 40% no longer dared to have sex, 40% felt isolated and 23% felt that others were afraid and kept a physical distance. In contrast, after disclosure 75% felt better at taking decisions about life and 50% were in closer contact with family and friends. CONCLUSION: Almost one-third of participants disclosed their HIV diagnosis to fewer than three people and black or Asian ethnicity predicted non-disclosure. HIV-related stigma regarding sex and contact with others is still highly prevalent; however, reactions to disclosure were mainly positive and associated with secondary positive gains. We strongly urge healthcare professionals to initiate a dialogue regarding stigma and disclosure with women living with HIV with a view to increasing disclosure and minimising stigmatisation in this vulnerable population.
RESUMEN
INTRODUCTION: As the human immunodeficiency virus (HIV)-positive population ages, issues concerning sexuality and fertility, among others, are becoming relevant. HIV is still surrounded by stigma and taboos, and there have been few studies conducted in industrialized settings concerning these questions. We therefore wanted to investigate the perception of sexuality and fertility in women living with HIV (WLWH) in an industrialized setting, using a questionnaire. METHODS: WLWH were recruited at their regular outpatient clinic visits, at the major Departments of Infectious Diseases in Denmark and Finland, from January 2012 to October 2013. A questionnaire was developed, study participants were informed of the nature of study and, if they agreed to participate and signed a consent form, they filled in the questionnaire. Demographic information on the participants was obtained from patient files (in Finland) or from a national HIV cohort (in Denmark). Statistical analysis was performed using STATA, version 11. RESULTS: In total, 560 women were included in the study. The median age was 44 years. The majority were of white European origin, with fully suppressed HIV viral load, CD4 cell count >350 µL and mild or no symptoms of their HIV infection. A total of 62% were sexually active, stating condom use as their sole form of contraception. Of the sexually inactive women, one-third were in steady relationships. Eighty percent reported prior pregnancies, of which the majority had one or more children. Most children were born prior to the women's HIV diagnosis and the mode of conception was predominantly natural. One-quarter of the participating women desired pregnancy, while more than half did not. The remaining quarter either stated that they already had the desired number of children or chose not to answer the question. Fourteen percent stated that their HIV diagnosis ended their wish for children; of these women, the median time of diagnosis was between 1995 and 1996. Pregnancy had been attempted unsuccessfully in one-quarter of study participants. The final question inquired what the risk of mother-to-child transmission was, with all precautions taken. Fifteen percent estimated the risk to be above two percent. CONCLUSIONS: In conclusion, the majority of WLWH in industrialized settings in Denmark and Finland have few HIV-related symptoms, are sexually active and have a strong desire for children.