RESUMEN
BACKGROUND: Information on genital wart incidence in adolescents and young adults before human papillomavirus (HPV) vaccination is important for understanding the impact of the vaccine on the epidemiology of this early outcome of HPV infection. METHODS: The study population included 11- to 29-year-old enrollees of Northern California Kaiser Permanente between July 1, 2000, and July 1, 2005, before the availability of the HPV vaccine. We identified genital warts with an algorithm combining genital wart-specific International Classification of Diseases, Ninth Revision, Clinical Modification codes (078.10, 078.11, and 078.19) with physician-recorded anatomic locations. We calculated sex- and age-specific incidence rates of genital warts and described the specific anatomic location of presentation, as well as recurrences of genital warts. RESULTS: We identified 1,682 cases of genital warts among 181,264 individuals. The incidence rate was highest among women (6.3/1000 person-years) and men (2.9/1000 person-years) aged 20 to 24 years old. Among women (n = 96,792), 63.4% of the 1240 incident genital wart cases occurred on the vulva and 21.1% on the cervix. Among men (n = 84,472), 91.6% of the 442 incident genital wart cases did not have a specific anatomic location recorded. Most people with an incident genital wart diagnosis (87.2%) did not have a recurrence during the observation period. CONCLUSIONS: Our study found that the incidence of genital warts was highest among persons aged 20 to 24 years using a unique method to identify the location of the wart. Information on incidence of genital warts before vaccine use provides baseline data that can be used to measure HPV vaccine impact.
Asunto(s)
Condiloma Acuminado/prevención & control , Papillomaviridae/inmunología , Enfermedades del Pene/prevención & control , Enfermedades Uretrales/prevención & control , Enfermedades del Cuello del Útero/prevención & control , Enfermedades Vaginales/prevención & control , Enfermedades de la Vulva/prevención & control , Adolescente , Adulto , California/epidemiología , Niño , Estudios de Cohortes , Condiloma Acuminado/clasificación , Condiloma Acuminado/epidemiología , Condiloma Acuminado/virología , Prestación Integrada de Atención de Salud , Femenino , Humanos , Incidencia , Masculino , Vacunas contra Papillomavirus , Enfermedades del Pene/clasificación , Enfermedades del Pene/virología , Enfermedades Virales de Transmisión Sexual/clasificación , Enfermedades Virales de Transmisión Sexual/epidemiología , Enfermedades Virales de Transmisión Sexual/prevención & control , Enfermedades Virales de Transmisión Sexual/virología , Enfermedades Uretrales/clasificación , Enfermedades Uretrales/virología , Enfermedades del Cuello del Útero/clasificación , Enfermedades del Cuello del Útero/virología , Vacunación , Enfermedades Vaginales/clasificación , Enfermedades Vaginales/virología , Enfermedades de la Vulva/clasificación , Enfermedades de la Vulva/virología , Adulto JovenRESUMEN
Resveratrol (3,5,4'-trihydroxystilbene) is a natural component of certain foods, such as grapes, that, when topically applied, has been shown to limit HSV-1 lesion formation in the skin of mice [Antiviral Res. 61:19-26, 2004]. To determine if it is active on genital HSV infection, the vagina of mice were infected with HSV-2 or HSV-1 and treated with a cream formulation of resveratrol. Mice were evaluated daily for extravaginal disease and vaginal swabs were taken regularly and assayed for infectious virus. Initial studies demonstrated that 19% resveratrol cream administered intravaginally five times a day for 5 days beginning 1h after infection significantly reduced HSV-2 replication beginning on day 1 of infection and prevented extravaginal disease when compared to animals treated with placebo. When resveratrol was tested at a concentration of 6.25% and 12.5% administered five times a day, 6.25% limited virus replication only on day 1 and delayed development of extravaginal disease by 1 day. However, 12.5% resveratrol inhibited HSV-2 replication beginning on day 1 and abolished extravaginal disease. If the number of applications per day was reduced to three for 5 days, 12.5% resveratrol inhibited HSV-2 replication only on day 1, while 19% resveratrol inhibited it throughout the 9-day assay period. When the animals with three treatments per day were examined for extravaginal disease, it was found that 12.5% resveratrol was ineffective when compared to placebo, while animals treated with 19% resveratrol did not exhibit extravaginal disease. When treatment was delayed 6h, 12.5% resveratrol did not inhibit HSV-2 replication or extravaginal lesion formation, but 19% resveratrol did. When resveratrol was used to treat vaginal HSV-1 infection, it was found that 12.5% resveratrol did not limit replication or prevent extravaginal lesion formation. In contrast, 19% resveratrol did significantly limit vaginal HSV-1 replication and reduced extravaginal lesion formation, but the latter was not significant. Mortality rates in placebo-treated animals was 37%, 6.25% resveratrol-treated animals was 40%, 12.5% resveratrol-treated animals was 24%, and 19% resveratrol-treated animals was 3%. Collectively, these results demonstrate that resveratrol cream inhibits or reduces HSV replication in the vagina of mice and limits extravaginal disease.
Asunto(s)
Antivirales/uso terapéutico , Herpes Genital/tratamiento farmacológico , Herpesvirus Humano 1/efectos de los fármacos , Estilbenos/uso terapéutico , Enfermedades Vaginales/tratamiento farmacológico , Animales , Antivirales/administración & dosificación , Antivirales/farmacología , Evaluación Preclínica de Medicamentos , Femenino , Herpes Genital/patología , Herpes Genital/virología , Herpesvirus Humano 1/fisiología , Herpesvirus Humano 2/efectos de los fármacos , Herpesvirus Humano 2/aislamiento & purificación , Herpesvirus Humano 2/fisiología , Ratones , Placebos , Resveratrol , Estilbenos/administración & dosificación , Estilbenos/farmacología , Análisis de Supervivencia , Enfermedades Vaginales/virología , Ensayo de Placa Viral , Replicación Viral/efectos de los fármacosRESUMEN
This study presents the chemical composition and antiviral activity against herpes simplex virus type 1 (HSV-1) and 2 (HSV-2) of sulfated galactan crude extracts and main fractions obtained from two red seaweeds collected in Brazil, Gymnogongrus griffithsiae and Cryptonemia crenulata. Most of the eighteen tested products, including homogeneous kappa/iota/nu carrageenan and DL-galactan hybrid, exhibited antiherpetic activity with inhibitory concentration 50% (IC50) values in the range 0.5-5.6 microg/ml, as determined in a virus plaque reduction assay in Vero cells. The galactans lacked cytotoxic effects and showed a broad spectrum of antiviral activity against HSV-1 and HSV-2. No direct virus inactivation was observed after virion treatment with the galactans. The mode of action of these compounds could be mainly ascribed to an inhibitory effect on virus adsorption. Most importantly, a significant protection against a murine vaginal infection with HSV-2 was afforded by topical treatment with the sulfated galactans.