Transmisión sexual del virus SARS-CoV-2 y su rol en la propagación de COVID-19: protocolo de una revisión sistemática viva / Sexual transmission of SARS-CoV-2 virus and its role in the spread of COVID-19: a living systematic review protocol

Objetivo Proporcionar una revisión de la literatura sobre la presencia de SARS-CoV-2 en los fluidos sexuales de pacientes con COVID-19 y su posible transmisión sexual de manera oportuna, rigurosa y continuamente actualizada. Fuentes de datos Realizaremos búsquedas en PubMed / Medline, Embase, Registro Cochrane Central de Ensayos Controlados (CENTRAL), literatura gris y en un repositorio centralizado en L · OVE (Living OVerview of Evidence). L · OVE es una plataforma que mapea las preguntas PICO a la evidencia de la base de datos Epistemonikos. En respuesta a la emergencia de COVID-19, L · OVE se adaptó para ampliar el rango de evidencia que cubre y se personalizó para agrupar todas las pruebas de COVID-19 en un solo lugar. La búsqueda cubrirá el período hasta el día anterior al envío a una revista. Criterios de elegibilidad para la selección de estudios y métodos Adaptamos un protocolo común ya publicado para múltiples revisiones sistemáticas paralelas a las especificidades de esta pregunta. Incluiremos ensayos aleatorios que evalúen la transmisión sexual del virus SARS-CoV-2. Se buscarán ensayos aleatorizados que evalúen la transmisión sexual de otros coronavirus, como MERS-CoV y SARS-CoV, y estudios no aleatorizados en COVID-19 en caso de que no se encuentre evidencia directa de ensayos aleatorizados, o si la evidencia directa proporciona una - o certeza muy baja para resultados críticos. Dos revisores evaluarán de forma independiente la elegibilidad de cada estudio, extraerán datos y evaluarán el riesgo de sesgo. Realizaremos metanálisis de efectos aleatorios y utilizaremos GRADE para evaluar la certeza de la evidencia para cada resultado. Una versión viva basada en la web de esta revisión estará disponible abiertamente durante la pandemia de COVID-19. Lo volveremos a enviar si las conclusiones cambian o hay actualizaciones sustanciales Registro PROSPERO (CRD42020189368).

Zika: an ongoing threat to women and infants / Zika: uma ameaça permanente para mulheres e crianças / Zika: una amenaza permanente para mujeres y niños

Recent data from the municipality of Rio de Janeiro, Brazil, shows a sharp drop in the number of reported occurrences of Zika during the summer of 2016/2017, compared to the previous summer. There is still a much higher incidence among women than men, almost certainly due to sexual transmission. An unexpected feature of the new data is that there are proportionally far more cases affecting children under 15 months than older age classes. By comparing incidence rates in 2016/2017 and 2015/2016, we were able to deduce the proportion of reported cases affecting men and women, and verify that gender disparity is still present. Women and children are still risk groups for Zika infection, even during non-epidemic seasons.

Dados recentes do Município de Rio de Janeiro, Brasil, mostram uma queda importante na notificação de casos de Zika no verão de 2016/2017, comparado ao verão anterior. A incidência ainda é muito mais alta em mulheres do que em homens, quase certamente em função da transmissão sexual. Uma característica inesperada dos novos dados é que, proporcionalmente, há muito mais casos em crianças abaixo dos 15 meses de idade, quando comparadas àquelas das faixas mais velhas. Ao comparar as taxas de incidência em 2016/2017 e 2015/2016, conseguimos deduzir a proporção de casos notificados em homens e mulheres e confirmar que a disparidade de gênero ainda existe. As mulheres e crianças ainda são grupos de risco para a infecção pelo vírus Zika, mesmo durante períodos não epidêmicos.

Datos recientes del municipio de Río de Janeiro, Brasil, muestran un descenso importante en la notificación de casos de Zika durante el verano de 2016/2017, comparado con el verano anterior. La incidencia todavía es mucho más alta en mujeres que en hombres, casi con seguridad debido a la transmisión sexual. Una característica inesperada de los nuevos datos es que, proporcionalmente, hay muchos más casos en niños por debajo de los 15 meses de edad, cuando se comparan con aquellas franjas con edad superior. Al comparar las tasas de incidencia en 2016/2017 y 2015/2016, conseguimos deducir la proporción de casos notificados en hombres y mujeres y confirmar que la disparidad de género todavía existe. Las mujeres y niños todavía son grupos de riesgo para la infección por el virus Zika, incluso durante períodos no epidémicos.

Epidemiología de la infección oral por VPH en sujetos jóvenes sanos / Epidemiology of oral HPV infection in young healthy individuals

Resumen Introducción: La infección por VPH es la infección viral de transmisión sexual más frecuente, y se encuentra asociada a diversas neoplasias. Objetivo: Describir la epidemiología, historia natural y factores de riesgo asociados a la infección oral por VPH en adultos jóvenes asintomáticos. Métodos: Se realizó un estudio prospectivo de corte longitudinal, que incluyó sujetos sin patología oral, a los que se les tomó una muestra de la mucosa bucal. A todos los sujetos con resultados positivos se les realizó un nuevo muestreo seis meses después. Se identificó la presencia del virus por RPC; los datos demográficos y de conducta sexual fueron obtenidos con una encuesta que respondieron sin intervención del investigador. Resultados: Se recolectaron 102 muestras de sujetos de 18-26 años de edad, 60 (58,8%) correspondieron al sexo masculino. La prevalencia del virus fue de 6,9%; todos los sujetos positivos tenían vida sexual. Las relaciones sexuales entre personas del mismo sexo fue la única variable asociada a la presencia del virus (p < 0,05). A los seis meses, todos los sujetos habían eliminado al virus. Conclusión: La infección oral por VPH es transitoria y está asociada a relaciones sexuales entre personas del mismo sexo, principalmente mujeres que tienen sexo con mujeres.

Background: HPV infection is the most common sexually transmitted viral infection, and is associated with several neoplasms. Aim: To describe the epidemiology, natural history and risk factors associated with oral HPV infection in asymptomatic young adults. Methods: A prospective and longitudinal study was conducted, including subjects without oral pathology, who were sampled from the oral mucosa. All subjects with positive results were re-sampled 6 months later. The presence of HPV was identified by PCR. Demographic and sexual behavior data were obtained with a survey that was responded without the intervention of the researcher. Results: 102 samples were collected from subject of 18-26 years old, 60 (58.8%) were male. The prevalence of the virus was 6.9%; all positive subjects had active sexual life. Same-gender relationships were the only variable associated with the presence of the virus (p < 0.05). At six months all subjects had eliminated the virus. Conclusion: Oral HPV infection is transient and is associated to same-gender relationships, mainly women who have sex with women.

Sexual transmission of human T-cell lymphotropic virus type 1

Human T-cell lymphotropic virus type 1 (HTLV-1) is endemic in many parts of the world and is primarily transmitted through sexual intercourse or from mother to child. Sexual transmission occurs more efficiently from men to women than women to men and might be enhanced by sexually transmitted diseases that cause ulcers and result in mucosal ruptures, such as syphilis, herpes simplex type 2 (HSV-2), and chancroid. Other sexually transmitted diseases might result in the recruitment of inflammatory cells and could increase the risk of HTLV-1 acquisition and transmission. Additionally, factors that are associated with higher transmission risks include the presence of antibodies against the viral oncoprotein Tax (anti-Tax), a higher proviral load in peripheral blood lymphocytes, and increased cervicovaginal or seminal secretions. Seminal fluid has been reported to increase HTLV replication and transmission, whereas male circumcision and neutralizing antibodies might have a protective effect. Recently, free virions were discovered in plasma, which reveals a possible new mode of HTLV replication. It is unclear how this discovery might affect the routes of HTLV transmission, particularly sexual transmission, because HTLV transmission rates are significantly higher from men to women than women to men.

[High-risk behaviors of HIV positive individuals referred to behavioral counseling centers of universities of medical sciences in Tehran]

Development of effective antiretroviral therapies [ART] has reduced mortality and increased life expectancy among individuals with HIV infection. Antiretroviral therapy regiments have improved symptoms and quality of life among these patients, whose sexual and reproductive needs, have, therefore, increased as well. In 2010, 20.8% of HIV-infected Iranians acquired the disease through sexual relations. The objective of this study was to define high-risk sexual behaviors among individuals infected with HIV referred to the Triangular Clinics of Universities of Medical Sciences in Tehran. This cross-sectional interview-based survey included 400 HIV-positive individuals selected by consequential sampling. The majority [60%] of the subjects was males, and 44.2% of men and 51.3% of women with HIV were in the age group 34-25 years. On the whole, 15.6% of the women and 49.6% of the men had high-risk sexual behaviors after diagnosis of HIV infection. Further analysis of the data showed that 62.5% of HIV-positive individuals were not aware of the risks of unsafe sexual relationship [using no condom] for HIV-positive transmission.. Based on the logistic regression module, it was found that factors strongly associated with high-risk sexual behavior were being male, being single, under high school diploma/graduate degree, alcohol intake and use of hormonal and permanent methods of family planning [p<0.05]. The findings of this study confirm previous reports showing common high-risk sexual behaviour after diagnosis in HIV-positive populations. Providing suitable health services and advice on fertility and sexual health will result in no- or low-risk sexual life for couples

Hepatitis C virus: molecular and epidemiological evidence of male-to-female transmission

INTRODUCTION: There is general consensus that hepatitis C virus is efficiently transmitted by the parenteral route, whereas data on viral transmission by sexual or non-sexual intrafamilial contact are conflicting. OBJECTIVE AND METHOD: The aim of this study was to investigate the transmission of hepatitis C virus in nine heterosexual couples. RESULT: The mean age of the couples was 43.7 years. When interviewed, all of the women denied the presence of risk factors for acquisition of the infection, whereas the cause of infection in the nine husbands could be attributed to blood transfusions in two of them (22.2 percent), use of intravenous and inhaled drugs in six (66.7 percent), acupuncture in one (11.1 percent), and tattooing in one (11.1 percent). All men and none of the women reported sexual relations with sex professionals. The mean homology score (Non Structural 5b-hepatitis C virus) was 98.4 percent. Among the nine couples with matching subtypes, one (11.1 percent) was infected with subtype 1a, three (33.3 percent) with subtype 1b, and five (55.5 percent) with subtype 3a. Shared personal hygiene items showed a much higher correlation with the possible route of transmission and were better supported by the sequence homology data than the other associated risk factors. Three (33.3 percent) couples shared toothbrushes, seven (77.8 percent) shared razor blades, eight (88.8 percent) shared nail clippers, and six (66.7 percent) shared manicure cutters. CONCLUSION: Sharing of personal hygiene items was a confounding factor in the discussion of sexual hepatitis C virus transmission and the hypothesis of male-to-female transmission was supported in this study.

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

Objetivo: Estudiar los factores asociados a la presencia de anticuerpos contra el virus del herpes simplex tipo 1 (HSV-1), así como identificar éste en muestras genitales. Métodos: Los estudiantes universitarios contestaron un cuestionario y proporcionaron muestras biológicas (sangre y exudado genital). La detección de anticuerpos clase IgG e IgM contra HSV-1 se realizó mediante ELISA. A partir de las muestras positivas a IgM se buscó su muestra genital, se extrajo ADN y se identificaron betaglobina humana así como HSV-1. Resultados: Participaron 815 estudiantes, la seroprevalencia de IgG-HSV-1 fue de 56.7 %; la infección se asoció con el número de parejas sexuales, intercambiar sexo por dinero, relaciones con personas del mismo sexo y parejas ocasionales. La seroprevalencia de IgM-HSV-1 fue de 18.2 %; a partir de estas muestras se buscó infección genital por HSV-1; 91 muestras fueron positivas a betaglobina pero en ninguna se detectó HSV-1. Conclusiones: Los datos epidemiológicos sugieren que el HSV-1 puede ser una infección de transmisión sexual en la población universitaria analizada, sin embargo, en ninguno de los individuos se corroboró presencia genital del HSV-1. Es necesario estudiar esta infección en otras poblaciones susceptibles o incrementar el tamaño de la muestra.

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.

Determinación del VPH en cavidad oral: por técnica del hisopo / HPV determination in oral cavity: by hyssop technique

En este estudio nos proponemos determinar la presencia del VPH en cavidad oral por técnica de hisopado. Se utilizó una muestra de 85 pacientes que por medio de exámenes clínicos y cito-histopatológico se determinó la presencia de la infección por VPH en extendidos de Papanicolaou en la cavidad bucal a través de tomas de hisopado faríngeo. De los 85 pacientes estudiados, 49 eran de sexo femenino y 36 masculinos. En el diagnóstico microscópico 7 pacientes resultaron positivos para VPH de los cuales eran 6 mujeres (6 por ciento) y 1 hombre (1 por ciento). La mayor presencia del VPH en nuestro estudio por sexo fue en el femenino con un 6 por ciento, siendo pacientes que presentaban más de 3 a 5 parejas por año, ubicándose entre los 23 y 48 años de edad en la población estudiada, de los cuales el 100 por ciento de ellos refirió inicio precoz de relaciones sexuales antes de los 20 años. La aplicación del tratamiento estadístico de Alfa de Crombach reportó un 71 por ciento de significancia, concluyendo que la técnica de determinación de VPH por hisopado es un exámen fácil, manejo rápido, económico y que puede ser empleado como protocolo para la determinación precoz de lesiones de cavidad oral y su correlación con VPH genital. Esta técnica se podrá incluir como método de pesquisa en población a riesgo a infección de VPH y por ende hacer diagnóstico en etapas premalignas de la enfermedad.

The objective of this study is to determine the presence of the HPV in oral cavity by hyssop technique. We used a sample of 85 patients who by means of clinical examinations and cytology pathology determined the presence of the infection by HVP in extended of Papanicolaou in the oral cavity through takings of hyssop pharyngeal. Of the 85 studied patients, 49 were of feminine sex and 36 masculine ones. In the microscopic diagnosis 7 patients were positive for HVP from which they were 6 women (6 %) and 1 man (1 %). The greater presence of the HVP in our study by sex was in the feminine one with a 6 %, being patient that presented of 3 to 5 pairs per year, being located enters the 23 and 48 years of age in the studied population, of which the 100 % of them referred precocious beginning of sexual relations before the 20 years, the application of the statistical treatment of Alpha of Crombach reported a 71 % of significance, concluding that the technique of hyssop determination of HVP is an easy examination handling, express, economic and that can be used as a protocol for the precocious determination of injuries in oral cavity and its correlation with genital VPH. This technique could be included as method of screening program to VPH infection and therefore at risk be made diagnosis in premalignant stages of the disease.

Sexual transmission of hepatitis C

It is generally agreed that the hepatitis C virus (HCV) can be efficiently transmitted parenterally, although data on viral transmission by sexual or non-sexual intrafamilial contact are conflicting. Since data collection began in 1989, the first study dealt with the risk of sexual transmission among multiple sex partners. Other investigations followed, emphasizing that risk increases in specific groups such as patients co-infected with HIV and HBV, sex workers, homosexuals, illicit drug users and patients attended at sexually transmittable disease clinics. The question arises as to what might be the risk for monogamous heterosexuals in the general population, in which one of the partners has HCV? The literature provides overall rates that vary from zero to 27 percent; however, most studies affirm that the chances of sexual transmission are low or almost null, with rates for this mode fluctuating from zero to 3 percent. Intrafamilial transmission is strongly considered but inconclusive, since when mentioning transmission between sex partners within the same household, specific situations also should be considered, such as the sharing of personal hygiene items, like razorblades, toothbrushes, nail clippers and manicure pliers, which are important risk factors in HCV transmission. In this review, we discuss the hypotheses of sexual and/or intrafamilial transmission.

A eficiência da transmissão parenteral da hepatite C é consenso, porém dados na literatura sobre transmissão sexual e intrafamiliar são conflitantes. Data de 1989 o primeiro trabalho que relaciona o risco de transmissão sexual a múltiplos parceiros sexuais, na seqüência, outros estudos também reforçam que os riscos aumentam em populações específicas como co-infectados HIV, HBV, profissionais do sexo, homossexuais, usuários de drogas ilícitas e populações de clínicas de doenças sexualmente transmissíveis. Agora, na população geral qual seria o risco para casais monogâmicos heterossexuais onde um dos cônjuges apresenta a infecção pelo HCV? A literatura apresenta números que vão de zero a 27 por cento, porém a maioria dos trabalhos afirma que as chances de transmissão são baixas ou quase nulas e aqui as porcentagens oscilam entre 0 por cento e 3 por cento. A transmissão intradomiciliar é fortemente considerada e mencionada como fator de confusão quando se menciona transmissão entre casais, pois se deve considerar que o compartilhamento de utensílios de higiene pessoal como lâmina de barbear, escova de dente, alicates de manicure e cortadores de unhas atuam como fator de risco importante para a transmissão do HCV dentro do domicílio. Transmissão sexual e/ou transmissão intrafamiliar, esta revisão trás à tona ambas hipóteses discutidas em diversos trabalhos pelo mundo.

Localization of Porcine Reproductive and Respiratory Syndrome Virus Infection in Boars by In Situ Riboprobe Hybridization

The capability of porcine reproductive and respiratory syndrome virus (PRRSV) to be shed in semen for extended periods of time has been suggested to be a principal factor for viral transmission via insemination. In attempts to gain insights into the mechanism of PRRSV persistence in boars, tissue distribution and sites of viral infection were investigated by in situ hybridization (ISH) using digoxigenin-labeled RNA probe and the ISH results were compared with those of reverse transcription-nested polymerase chain reaction (RT-nested PCR). Animals were intranasally inoculated with 104 median tissue culture infectious dose of PRRSV VR-2332 and tissues collected at different times were examined. At day 7 postinfection, limited number of hybridization positive signals was observed in cells within or between seminiferous tubules in the testis sections while relatively abundant hybridization positive signals were observed in the brain stem and tracheobronchial lymph node. At later days of infection, hybridization positive signals were observed in cells within seminiferous tubules with much reduced frequency. Lack of agreement with the RT-nested PCR assay results in testis tissues obtained at days 14, 28, and 59 postinfection suggested that PRRSV infection in the testis may be extremely restricted, and may not necessarily constitute a major viral source in semen during extended periods of seminal shedding.