High Incidence, Reinfections, and Active Syphilis in Populations Attending a Specialized HIV Clinic in Mexico, a Dynamic Cohort Study.

Syphilis, a sexually transmitted infection, has reemerged in many vulnerable groups around the world. The objective of the current study was to determine the prevalence and incidence of syphilis among people who attended a specialized HIV clinic in Mexico from 2011 to 2015. Databases from the laboratory were analyzed, and the following four groups were formed: people seeking HIV-1 voluntary counseling and testing (VCT), people in prison (PPr), people living with HIV (PLWH), and patients from primary care clinics (others). The diagnosis of syphilis was made using the reverse algorithm; antibody titers were examined to determine the stage of infection. Baseline data were analyzed and, with follow-up information, a retrospective dynamic cohort was formed. Factors associated with the seroprevalence of syphilis and active syphilis were evaluated by the chi-square test. Moreover, risk factors for the incidence of syphilis were described. A total of 81,863 baseline individuals were analyzed. The seroprevalence of syphilis was 9.9% in the VCT group, 8.2% in the PPr group, 37.0% in the PLWH group, and 8.7% in the others group; the prevalence of active syphilis was 1.7-13.1%. A total of 11,124 people were followed up. The incidence (cases per 100 person-years) was 3.5 among the VCT group, 16.0 among the PLWH group, and < 0.1 among both the PPr and others groups, respectively; moreover, the frequency of reinfections was 11.1-24.4%. The high prevalence and incidence of syphilis, active syphilis, and reinfections among men, transgender people, individuals aged 20-39 years, and people with a history of HIV or hepatitis B suggest that it is critical to improve prevention, diagnosis, and treatment measures to stop the reemergence of syphilis. There are also new factors such as methamphetamine use, group sex, or contacting partners over the internet that are associated with syphilis. In addition, HIV preexposure prophylaxis could contribute to the increased incidence of syphilis by providing false security in the prevention of STIs, thereby increasing risky sexual behaviors.

[High seroprevalence of syphilis and genital herpes in migrants in transit in Chiapas, MexicoAlta soroprevalência de sífilis e herpes genital em migrantes em trânsito por Chiapas, México]. / Alta seroprevalencia de sífilis y herpes genital en migrantes en tránsito en Chiapas, México.

Objectives: To determine the prevalence of antibodies against Treponema pallidum and herpes simplex virus type 2 (HSV-2), and to identify the factors associated with these infections among migrants in transit in Chiapas, Mexico. Methods: Cross-sectional study conducted during 2021-2022, in three migrant shelters in Chiapas, Mexico. Participants answered a questionnaire and provided a blood sample to detect antibodies against Treponema pallidum and HSV-2. The study calculated seroprevalence and assessed associated factors using Chi-square (χ2) tests and odds ratios. Results: A total of 462 migrants participated, with an average age of 31.2 years; 56.9% were women, and 41.1% came from Honduras. The seroprevalence of HSV-2 was 29.9%; for syphilis it was 4.5%, and it was higher in men (8.0%) than in women (1.9%). Among pregnant women, 15.4% had antibodies against syphilis. Notable variables associated with syphilis include being male, having a history of genital lesions, having same-sex partners, and seropositivity to HSV-2. Regarding HSV-2, factors associated with infection included being female, age, schooling, sleeping in the street, a history of HIV testing, early sexual debut, number of sexual partners, and syphilis. Conclusions: A high prevalence of syphilis and HSV-2 was found among the migrant population evaluated. Syphilis is confirmed as a re-emerging infection, even in women. Migrants have vulnerabilities associated with sexual behavior, so prevention, diagnosis, and treatment measures should be focused on this population group.

Objetivos: Determinar a prevalência de anticorpos contra Treponema pallidum e vírus herpes simples tipo 2 (HSV-2) e identificar os fatores associados a essas infecções entre migrantes em trânsito por Chiapas, México. Métodos: Estudo transversal realizado nos anos de 2021 e 2022 em três abrigos de migrantes em Chiapas, México. Os participantes preencheram um questionário e forneceram uma amostra de sangue para a detecção de anticorpos contra Treponema pallidum e HSV-2. Calculou-se a soroprevalência e avaliaram-se os fatores associados usando testes de χ2 e razões de chances. Resultados: O estudou incluiu 462 migrantes com idade média de 31,2 anos, dos quais 56,9% eram mulheres e 41,1% vinham de Honduras. A soroprevalência do HSV-2 foi de 29,9%. A soroprevalência de sífilis, por sua vez, foi de 4,5%, sendo mais alta nos homens (8,0%) do que nas mulheres (1,9%). Os anticorpos contra a sífilis estavam presentes em 15,4% das mulheres grávidas. As principais variáveis associadas à sífilis foram sexo masculino e história de lesões genitais, além de parceiros do mesmo sexo e soropositividade para HSV-2. Com relação ao HSV-2, fatores como sexo feminino, idade, escolaridade, dormir na rua, história de teste de HIV, iniciação sexual precoce, número de parceiros sexuais e sífilis estavam associados a infecção. Conclusões: A população migrante avaliada apresenta alta prevalência de sífilis e HSV-2. Confirmou-se que a sífilis é uma infecção reemergente, inclusive em mulheres. Os migrantes apresentam vulnerabilidades associadas ao comportamento sexual; portanto, é preciso concentrar medidas de prevenção, diagnóstico e tratamento nesse grupo populacional.

Prevalence of anti-SARS-CoV-2 antibodies and associated factors in healthcare workers of a Mexican Covid-19 hospital

OBJECTIVE: To determine the prevalence of SARS-CoV-2 antibodies among healthcare workers (HCW) and to identify factors associated with infection. Materials and meth-ods. A cross-sectional study was conducted in a Covid-19 hospital in Morelos, Mexico. Antibodies against SARS-CoV-2 spike and nucleocapsid proteins were detected by ELISA. A bivariate and multivariable Poisson regression model were performed to identify factors associated with infection. RESULTS: Among all participants, 31% had anti-SARS-CoV-2 antibodies, while only 13.1% had reported a history of positive RT-PCR. Individuals who reported cohabiting with someone with Covid-19, and those who had a previous RT-PCR test, were more likely to be seropositive. Laboratory personnel had the lowest seroprevalence (12.0%), while social workers had the highest (35.7%). CONCLUSIONS: The results of this study show the seroprevalence of SARS-CoV-2 antibodies among HCW in a hospital in Mexico, and underline the importance of serological tests for a better estimate of prevalence in health systems where only symptomatic cases are recorded.

Re-emergence of syphilis in women of reproductive age and its association with the increase in congenital syphilis in Mexico during 2010-2019: an ecological study.

BACKGROUND: Syphilis is a sexually transmitted infection that is re-emerging in different parts of the world. This infection can be transmitted during pregnancy, causing neonatal syphilis. The objective of this study was to examine trend in syphilis, congenital syphilis, and neonatal deaths among the Mexican population during 2010-2019. METHODS: An ecological study was carried out to collect information about the incidence of syphilis, the incidence of congenital syphilis, and the incidence of neonatal death from congenital syphilis. The variables were described considering age, sex, Mexican state, and year. Trends across time (calendar year) were analyzed using linear regression, increases were estimated with 95% confidence intervals, and p < 0.05 was considered statistically significant. RESULTS: The incidence of syphilis increased by an average of 0.336 cases/100,000 per year and was higher among women aged 15-19 years (0.693 cases). Cases of congenital syphilis increased from 62 cases in 2010 to 372 cases in 2019; furthermore, the increase in syphilis cases among women aged 20 to 24 years was associated with an increase in cases of congenital syphilis. In 2010, 50% of Mexican states did not report cases of congenital syphilis, but in 2018, only 10% did not report cases of congenital syphilis. Between 2010 and 2018, 83 neonatal deaths were reported, with the highest incidence in 2018 (0.88 deaths/100,000 newborns). CONCLUSION: The incidence of congenital syphilis is increasing in Mexico. As a consequence of the reemergence of syphilis among the population of reproductive age, it is necessary to address and treat syphilis in various population groups.

Congenital syphilis in Mexico. Analysis of national and international standards from the perspective of laboratory diagnosis.

INTRODUCTION: Congenital syphilis continues to be a public health problem in Mexico. OBJECTIVE: To assess the similarities and differences between national standards, guidelines and international documents related to the detection of syphilis in pregnant women and congenital syphilis. METHOD: Two algorithms were developed based on the standard of female care during pregnancy and on the standard for prevention and control of sexually transmitted infections. Based on the Centers for Disease Control (CDC) guidelines, algorithms were developed for syphilis during pregnancy, syphilis in the newborn and sexual contacts. RESULTS: The standard for pregnancy mentions that syphilis testing should be carried out in every pregnant woman on her first contact or at delivery, without diagnostic tests being specified. The Official Mexican Standard (NOM) on sexually transmitted infections mentions the traditional algorithm for syphilis detection, treatment follow-up, coinfection with human immunodeficiency virus and congenital syphilis criteria. The CDC recommend reverse algorithm, antibody titer, treatment and follow-up as part of diagnosis. CONCLUSIONS: The elimination of mother-to-child transmission of syphilis requires NOMs updating and homogenizing, as well as the study of stillbirths and neonates born to mothers with syphilis.

Sífilis congénita en México. Análisis de las normas nacionales e internacionales desde la perspectiva del diagnóstico de laboratorio.

INTRODUCTION: Congenital syphilis continues to be a public health problem in Mexico. OBJECTIVE: To assess the similarities and differences between national standards, guidelines and international documents related to the detection of syphilis in pregnant women and congenital syphilis. METHOD: Two algorithms were developed based on the standard of female care during pregnancy and on the standard for prevention and control of sexually transmitted infections. Based on the Centers for Disease Control (CDC) guidelines, algorithms were developed for syphilis during pregnancy, syphilis in the newborn and sexual contacts. RESULTS: The standard for pregnancy mentions that syphilis testing should be carried out in every pregnant woman on her first contact or at delivery, without diagnostic tests being specified. The Official Mexican Standard (NOM) on sexually transmitted infections mentions the traditional algorithm for syphilis detection, treatment follow-up, coinfection with human immunodeficiency virus and congenital syphilis criteria. The CDC recommend reverse algorithm, antibody titer, treatment and follow-up as part of diagnosis. CONCLUSIONS: The elimination of mother-to-child transmission of syphilis requires NOMs updating and homogenizing, as well as the study of stillbirths and neonates born to mothers with syphilis.

INTRODUCCIÓN: La sífilis congénita continúa siendo un problema de salud pública en México. OBJETIVO: Evaluar las similitudes y diferencias entre normas nacionales, guías y documentos internacionales relacionados con la detección de sífilis en embarazadas y sífilis congénita. MÉTODO: Se elaboraron dos algoritmos basados en las normas sobre atención de la mujer durante el embarazo y sobre prevención y control de infecciones de transmisión sexual. A partir de la guía de Centers for Disease Control and Prevention (CDC) se realizaron algoritmos sobre sífilis durante el embarazo, sífilis en recién nacido y contactos sexuales. RESULTADOS: La norma sobre embarazo menciona que la prueba de sífilis debe efectuarse a toda mujer embarazada en su primer contacto o durante el parto, sin especificar pruebas diagnósticas. La norma oficial mexicana (NOM) sobre infecciones de transmisión sexual menciona el algoritmo tradicional para detección de sífilis, seguimiento al tratamiento, coinfección con virus de inmunodeficiencia humana y criterios de sífilis congénita. CDC recomienda algoritmo reverso, título de anticuerpos, tratamiento y seguimiento como parte del diagnóstico. CONCLUSIONES: La eliminación de la transmisión maternoinfantil de sífilis requiere actualizar y homogeneizar las NOM, así como el estudio de mortinatos y de recién nacidos de madres con sífilis.

Heterogeneity of Herpes Simplex Virus Type 2 Seroprevalence From a National Probability Survey In Mexico, 2012.

BACKGROUND: Herpes simplex virus type 2 (HSV-2) seroprevalence and associated infection risk factors show differences by regions and countries. The aims of the study were to determine the HSV-2 seroprevalence and to evaluate the risk factors for HSV-2 in a national representative survey among adolescents and adults in Mexico. METHODS: A cross-sectional study was carried out in Mexico on the basis of the National Health and Nutrition Survey 2012, a national representative survey. Demographic, sexual behavior, reproductive health, and lifestyles indicators were considered in the current study. Participants provided biological samples-dried blood spots-to test for HSV-2 antibodies using enzyme-linked immunosorbent assay and Western blot. Bivariate and multivariate analyses were performed to identify variables associated with HSV-2 infections analyzed by sex. RESULTS: National HSV-2 seroprevalence was 9.9%, 2.4% among adolescents and 11.7% among adults with HSV-2 seroprevalence heterogeneous across the country. Women had 12.2% of antibodies against HSV-2 and men had 7.5%. The factors associated with HSV-2 infection among women were age (45-49 years; odds ratio [OR], 19.8), region (southwest; OR, 3.0), urbanization (urban; OR, 1.9), age at sexual debut (≤14 years; OR, 3.4), education level (any; OR, 3.0), and previous abortion (≥2 abortion; OR, 2.1). Among men, age (45-49 years; OR, 11.7), region (southwest; OR, 3.0), urbanization (urban, odds ratio [OR], 1.7), and HIV care (OR, 7.1) were associated with the infection. CONCLUSIONS: Approximately 10% of Mexicans aged 15 to 49 years had HSV-2 antibodies, with differences by sex, region, education level, urbanization, HIV care, and childbirth, highlighting the relevance of health inequalities in the country: social inequalities seem to matter in terms of the probability of HSV-2 infections.

The hidden burden of Chikungunya in central Mexico: results of a small-scale serosurvey.

OBJECTIVE: To estimate the seroprevalence of CHKV antibodies and assess correlates of seropositivity at a small geographical scale. MATERIALS AND METHODS: A community-based serosurvey of 387 households in Puente de Ixtla, Morelos (central Mexico). Serum IgG antibodies to CHKV were detected by immunoassay. RESULTS: From 27 April to 29 May 2016, we interviewed and collected blood samples from 387 individuals at the same number of households. A total of 114 (29.5%) participants were seropositive to CHK, 36 (31.6%) of them reported no symptoms of CHKV infection within 12 months before the survey. CONCLUSIONS: The estimated seroprevalence to CHKV antibodies was higher than expected by the small number of confirmed cases of CHKV infection reported in Mexico by the National Surveillance System.

Risk factors for anal HPV-16/18 infection in Mexican HIV-infected men who have sex with men.

OBJECTIVE: To describe the prevalence of specific HPV types among HIV-positive men who have sex with men (MSM), particularly the presence of HPV-16 and/or -18, and to determine the factors associated with anal HPV-16/18 infections. METHODS: This is a cross-sectional study from a baseline cohort of 525 HIV-positive MSM, who attended an HIV Clinic in Mexico City. Socio-demographic characteristics, sexual behaviors and HIV-related parameters were assessed. Anal samples were tested for HPV DNA using the Linear Array HPV genotyping assay. RESULTS: The overall prevalence of any HPV type in the anal canal among 446 participants was 93.1%. At least one oncogenic HPV type was detected in 72.2% of the subjects and HPV-16 and/or18 were detected in 30.7%. Additionally, 76.9% of patients were infected with multiple HPV types. Having more than 10 receptive sexual partners in the last 6months (OR=2.30; 95% CI 1.12-4.74) and a CD4 cell count ≤350cells/µL (OR=1.97; 95% CI 1.26-3.09) were factors positively associated with HPV-16/18 infection in the anal canal. CONCLUSION: Co-infection with HPV-16/18 and other oncogenic types are predominant in this group of HIV-positive MSM. The recognition of infection with specific oncogenic types will be of aid in designing future preventive strategies that target this high-risk population.

Avidity of antibodies against HSV-2 and risk to neonatal transmission among Mexican pregnant women.

OBJECTIVE: To determine HSV-2 seroprevalence, risk factors, and antibody avidity among a sample of Mexican pregnant women. MATERIAL AND METHODS: The avidity test was standardized with different urea concentrations and incubation times; the cut-off point was calculated to determine the low avidity (early infection). IgG antibodies against HSV-2 were detected from pregnant and postpartum women from Morelos, Mexico, and the avidity test was performed to positive samples. Multivariate regression logistic analysis was employed to evaluate demographic and sexual behavior characteristics associated with HSV-2 infection. RESULTS: HSV-2 seroprevalence among Mexican women analyzed was 14.5% (333/2300), demographic factors (location of General Hospital, age, education level, and civil status), and risky sexual behaviors (STI self-report and number of sexual partners during last year) were associated with HSV-2 infection. Seventeen women were detected with low avidity antibodies (early infection) with a cut-off point of 66.1%. CONCLUSIONS: HSV-2 infection was common among this group of women from Mexico; the avidity test detected women with recent infections, and these women were more likely to transmit HSV-2 to their neonates. Neonatal herpes has no epidemiological surveillance, the disease could be overlooked, and so more studies are needed to estimate the magnitude of neonatal infection.

[Knowledge about herpes simplex virus type 2 and human papillomavirus, and risk perception to acquire infections among college students]. / Conocimiento sobre el virus herpes simple tipo 2 y virus del papiloma humano, y percepción de riesgo a adquirir las infecciones entre estudiantes universitarios.

INTRODUCTION: herpes simplex virus type 2 (HSV-2) and human papillomavirus (HPV) are the most frequent sexually transmitted infections (STI) among college students 18-24 years old. Educational interventions for STI prevention can help to decrease viral STI prevalence among students. OBJECTIVE: to know the change in knowledge, perception of risk and sexual behavior among 182 students of the Autonomous University of the State of Morelos. MATERIAL AND METHOD: a community intervention trial (before-after) was carried out, using brochures for prevention of HSV-2 and HPV, including information about these STI, with emphasis on the risk factors identified in students of the same university. RESULTS: we found a change in the perception of STI risk during the intervention (56.5 before vs. 67.7% after intervention), possibly the brochures assisted students to learn more about their own risk behaviors. Likewise, there was an increase in knowledge in both HPV and HSV-2. CONCLUSIONS: it is necessary to increase the sample size in future interventions to assess further the change in knowledge, sexual behaviors and the prevalence of infections.

High Prevalence of Syphilis and Syphilis/HIV Coinfection among Men Who Have Sex with Men Who Attend Meeting Places in Mexico.

Men who have sex with men (MSM) are disproportionately affected by syphilis, HIV, and syphilis/HIV coinfection. Antiretroviral therapy (ART) prevents HIV transmission but does not impede the spread or acquisition of syphilis. Information about syphilis/HIV coinfection among MSM is scarce. We aimed to determine the prevalence of syphilis/HIV coinfection in a national sample of MSM who attend meeting places (such as movies, clubs, gay bars, saunas, shopping malls, and others referred to by the same MSM participants of the study) in Mexico to evaluate factors associated with syphilis, and to compare the prevalence rates of syphilis between the current survey and DGE data. We performed a laboratory diagnosis to determine the rates of syphilis and HIV among the included MSM. The national and regional prevalence of syphilis was calculated. HIV and coinfection prevalence were determined only for the survey. All prevalence rates included 95%CIs. Descriptive, bivariate, and multivariate analyses were performed. The national prevalence rates of syphilis, HIV, and coinfection were 15.2%, 10.2%, and 5.7%, respectively. The region with the highest prevalence rate was Mexico City (39.4%). The center region, minimal "goods" (i.e., a minimal number of material possessions such as a car or dryer, etc., which served as a proxy for low economic income level), use of "inhalant drugs", "HIV infection", "sexual intercourse" only with men, "rewarded sex", and "youngest age at first sexual encounter or debut" were risk factors for syphilis. In general, regional prevalence of syphilis was higher in the survey (2013) and DGE data from 2019 than in the DGE data from 2013. Similar to other countries, Mexico needs to assess elements around not only syphilis and HIV infections but also syphilis/HIV coinfection, and preventive measures focusing on MSM are needed.

Seroprevalence and Vaginal Shedding of Herpes Simplex Virus Type 2 in Pregnant Adolescents and Young Women from Morelos, Mexico.

Adolescents and young people are particularly vulnerable to contracting STIs, including HSV-2; furthermore, vaginal shedding of HSV-2 during pregnancy can cause vertical transmission and neonatal herpes. To evaluate the seroprevalence of HSV-2 and vaginal HSV-2 shedding in adolescent and young pregnant women, a cross-sectional study was carried out in 496 pregnant women-adolescents and young women. Venous blood and vaginal exudate samples were taken. The seroprevalence of HSV-2 was determined by ELISA and Western blot. Vaginal HSV-2 shedding was assessed by qPCR of the HSV-2 UL30 gene. The seroprevalence of HSV-2 in the study population was 8.5% (95% CI 6-11), of which 38.1% had vaginal HSV-2 shedding (95% CI 22-53). Young women presented a higher seroprevalence of HSV-2 (12.1%) than adolescents (4.3%), OR = 3.4, 95% CI 1.59-7.23. Frequent alcohol consumption was significantly associated with HSV-2 seroprevalence, OR = 2.9, 95% CI 1.27-6.99. Vaginal HSV-2 shedding is highest in the third trimester of pregnancy, but this difference is not significant. The seroprevalence of HSV-2 in adolescents and young women is similar to that previously reported in other studies. However, the proportion of women with vaginal shedding of HSV-2 is higher during the third trimester of pregnancy, increasing the risk of vertical transmission.

Syphilis as Re-Emerging Disease, Antibiotic Resistance, and Vulnerable Population: Global Systematic Review and Meta-Analysis.

Syphilis is a sexually transmitted disease that has become a public health problem, especially in vulnerable populations. A systematic review and time-free meta-analysis of the publications on the molecular detection of syphilis and mutations associated with antibiotic resistance, CORE group, and syphilis genotypes in PubMed databases, Scielo, and Cochrane was performed, and the last search was conducted in June 2022. Proportions were calculated, and standard errors and confidence intervals were reported for all results of interest. We included 41 articles for quantitative extraction and data synthesis. An increase was observed in the proportion of subjects diagnosed with syphilis and the presence of the A2058G mutation during the 2018−2021 period compared to 2006 (70% 95%CI 50−87 vs. 58% 95%CI 12−78), and we observed that the greater the proportion of the population participating in men who have sex with men (MSM) (<50% and >50%) syphilis increased (78% 95%CI 65−90 vs. 33% 95%CI 19−49). In conclusion, we suggest that there are a set of characteristics that are contributing to the resurgence of syphilis and the selective pressure of bacteria. The MSM population could be a vulnerable factor for this scenario and the global presence of A2058G and A2059G mutations that confer resistance to macrolides.

IL-10 and IL-17 as Progression Markers of Syphilis in People Living with HIV: A Systematic Review.

Much is known about the natural history of syphilis; however, less is known about the immune response against it, and even less is known about people living with HIV (PLWH). Due to the lack of an animal model to study host-pathogen interactions, it remains unclear how the host eliminates the bacteria. Here, we attempt to elucidate the immune response against infection by summarizing all the reported data in a systematic review. We found that only seven papers included PLWH, and they did not accurately describe the immune response against Treponema pallidum since only lymphopenia was reported upon coinfection. On the other hand, at least sixteen papers described the host-pathogen interaction in individual cell populations. Using this information, we established the kinetics of the immune response against syphilis and hypothesized how CD4+ T cells, such as Th17 and T rex cells, worsen the progression of the disease in PLWH through their hallmark cytokines, IL-10 and IL-17, and how these two cytokines may play important roles as biomarkers.

[Serological markers of hepatitis B and C, and HIV in La Calera and Cuambio, Guerrero, México]. / Marcadores serológicos de hepatitis B y C, y VIH en La Calera y Cuambio, Guerrero, México.

OBJECTIVE: To perform a hepatitis B, C, and HIV survey in an enhanced sample from two rural communities with the highest anti-HBc prevalence found in ENSA 2000. MATERIALS AND METHODS: This was a cross-sectional study.We studied the communities of La Calera and Cuambio, two adjacent rural towns of the district of Zirándaro, Guerrero, targeted because of the high prevalence of anti-HBc shown in ENSA 2000.We assessed the prevalence of hepatitis B and C, and HIV serological markers and associated factors among inhabitants older than 10 years. RESULTS: A very high prevalence of hepatitis B markers associated with socioeconomic factors was confirmed, while hepatitis C prevalence was low and HIV absent in the two communities addressed. CONCLUSIONS: National serosurveys are an accurate tool for identifying communities with hepatitis B high endemicity where focused research and control measures are needed.

HSV-2 seroincidence among Mexican college students: the delay of sexual debut is not enough to avoid risky sexual behaviours and virus transmission.

OBJECTIVES: Early sexual debut is a behaviour that has been associated with acquiring sexually transmitted infections. Higher schooling may delay sexual debut, thus the university population is categorised with low-risk sexual behaviours. The rate ratio of herpes simplex virus type 2 (HSV-2) seroincidence according to demographic characteristics and sexual behaviour was estimated for a cohort of university students. METHODS: A dynamic cohort of university students was followed at the Autonomous University of Morelos, in central Mexico, during the years 2001-5. After obtaining informed consent, information was gathered annually regarding demographic characteristics and sexual behaviour and blood samples were obtained to determine HSV-2 antibodies. Seroincidence was estimated and the incidence rate ratio was evaluated using the Poisson regression model. RESULTS: A total of 404 students participated, with 669.2 person-years of follow-up. An incidence of 4.2 cases per 100 person-years was estimated. The variables delayed sexual debut (≥18 years) and multiple sexual partners (two or more sexual partners during the past year) had a rate ratio of 4.1 (95% CI 1.2 to 14.3) and 2.5 (95% CI 1.1 to 5.6), respectively. Incidence for students with delayed sexual debut and multiple partners is estimated to be 10.3 cases per 100 person-years. CONCLUSIONS: Delayed sexual debut was a risk factor for acquiring HSV-2, due to a subgroup with sexual debut at 18 years of age or older that had multiple sexual partners; therefore, in the university population that tends to delay sexual debut, it is necessary to implement prevention programmes to promote the decrease of other risky sexual behaviours, as well as the promotion of the consistent use of condoms.

[Herpes simplex virus type 1: a possible sexually transmitted agent among college students]. / Virus del herpes simplex tipo 1: un posible agente de transmisión sexual en población universitaria.

OBJECTIVE: To study the factors associated with the presence of antibodies against herpes simplex virus type 1 (HSV-1) and to screen for HSV-1 in genital samples. MATERIALS AND METHODS: Students answered a survey and provided biological samples (blood and genital discharge). The detection of IgG and IgM antibodies against HSV-1 was performed by an ELISA test. From IgM positive samples we sought and extracted genital DNA and identified a beta-globulin gene and HSV-1. RESULTS: Eight hundred and fifteen students participated. IgG/HSV-1 seroprevalence was 56.7%, HSV-1 infection was associated with number of sexual partners, exchanging sex for money, same sex relationships and occasional partners. IgM/HSV-1 seroprevalence was 18.2%, 91 samples were positive for human beta-globuline but none for HSV-1 DNA. CONCLUSIONS: Epidemiological evidence suggests that HSV-1 could be transmitted by sexual contact among college students; however, HSV-1 was not detected in any of the genital samples analyzed. To further test our hypothesis we need to study HSV-1 among high risk groups or increase our sample size.

Hepatitis B seroprevalence in 10-25-year-olds in Mexico - the 2012 national health and nutrition survey (ENSANUT) results.

OBJECTIVES: To estimate hepatitis B virus (HBV) seroprevalence from natural infection or vaccination in 10-25-year-olds in Mexico, using the 2012 National Health and Nutrition Survey (ENSANUT). METHODS: Randomly selected serum samples (1,581) from adolescents and young adults, representative of 38,924,584 Mexicans, were analyzed to detect hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc). Weighted HBV seroprevalence in the Mexican population and association with sociodemographic variables were calculated. RESULTS: Overall weighted seroprevalence from natural infection (positive for anti-HBs and anti-HBc) was 0.23% (95% confidence interval [95% CI] 0.10-0.52). No HBsAg was detected, indicating no acute or chronic infection. Vaccine-derived immunity (positive ≥ 10.0 mIU/ml for anti-HBs and negative to anti-HBc) was 44.7% (95% CI: 40.2-49.4) overall; lower in persons aged 20-25 years (40.83%) than in persons aged 10-19 years (47.7%). Among the population analyzed, 54.2% (95% CI: 49.6-58.8) were seronegative to HBV (negative for all three markers) and no sociodemographic risk factors were identified. CONCLUSIONS: HBV seroprevalence from natural infection was low. Vaccination-induced immunity was higher among Mexican adolescents than young adults, possibly due to vaccination policies since 1999.

Analysis of self-reported adverse reactions to efavirenz and drug interactions in a population with HIV in Mexico.

OBJECTIVE: To analyse the most frequent self-reported adverse reactions (ARs), the durability and the causes of antiretrovirals (ARVs) regimens change, concomitant treatments and drug interactions related to the use of ARVs in a group of people living with HIV in Cuernavaca, Morelos, Mexico. MATERIALS AND METHODS: Cross-sectional study conducted in a clinic specialising in HIV 'CAPASITS-Cuernavaca' in Mexico from February to June 2015. People who wanted to participate were given a questionnaire on demographic characteristics, adherence, concomitant treatments and ARs. To understand the clinical variables, the clinical records were reviewed. Quantitative variables were compared using Student's t-test for normal data and the Mann-Whitney U test for non-normal data. For comparisons between categorical variables, the χ2 test was used. All tests used a significance level of 0.05. RESULTS: A total of 96 people participated, and 218 ARs (mean= 2.3±1.9) were found. The most frequently encountered ARs were dizziness (53.1%), insomnia (21.9%) and lucid dreams (17.7%). Twenty-three people (24%) were polymedicated, and 18 potential interactions were detected in 12 people. CONCLUSIONS: The results suggest that a thorough analysis of the possible drug interactions should be performed for polymedicated people on ARV treatment and that a protocol should be designed for the monitoring and management of AR to ensure a good adherence to ARV treatment.