RESUMO
To identify risk factors for death from pandemic (H1N1) 2009, we obtained data for 157 hospitalized patients with confirmed cases of this disease. Multivariate analysis showed that diabetes and class III obesity were associated with death. These findings helped define priority vaccination groups in Brazil.
Assuntos
Complicações do Diabetes/mortalidade , Influenza Humana/complicações , Influenza Humana/mortalidade , Obesidade/mortalidade , Pandemias , Brasil/epidemiologia , Pré-Escolar , Complicações do Diabetes/epidemiologia , Feminino , Hospitalização , Humanos , Vírus da Influenza A Subtipo H1N1/patogenicidade , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Obesidade/complicações , Obesidade/epidemiologia , Gravidez , Fatores de Risco , VacinaçãoRESUMO
OBJECTIVE: The objective of the study was to identify epidemiological correlates for persistence and clearance of human papillomavirus (HPV) infection. STUDY DESIGN: Cervical smears collected in a prospective cohort study to perform Papanicoloau cytology and HPV deoxyribonucleic acid (DNA) detection at baseline and during the follow-up. Outcomes analyzed were: (1) persistence of HPV DNA; (2) conversion; and (3) clearance of HPV. RESULTS: Among 501 women the incidence of HPV was 12.3%. Thirty-four women were persistently infected with HPV, which was associated with age below 21 years at first intercourse and 4 or more sexual partners during their lifetime. In a median of 19 months, 80.7% of women had clearance of HPV, which was associated with black race, coinfection with Chlamydia trachomatis at baseline, and a history of previous Papanicoloau smear. CONCLUSION: Strategies for sexual orientation may modify the rates of HPV persistence. The association of HPV clearance with a history of previous Papanicolaou smear screening highlights the importance of improving cervical screening programs. Further studies on the association of gynecological infections with HPV clearance are needed.