Overt and occult hepatitis B virus infection among treatment-naïve HIV-infected patients in Brazil.

Although hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection is common, only few data are available on HBV among HIV patients including occult hepatitis B infection (OBI), regardless of serological markers. This study aims to determine the prevalence of OBI and overall HBV infection, associated factors, HBV genotypes, and surface (S) gene mutations in a population of treatment-naïve HIV-infected patients in Brazil. A cross-sectional study was conducted in treatment-naïve HIV-infected patients in Central Brazil. All samples were tested for HBV serological markers and HBV DNA. Sequence analysis of the S gene and overlapping polymerase gene was preformed. Overall, 25.1% (127/505) of the patients had markers of current or previous HBV infection, which was associated with age over 40 years, history of injection drug use, and homosexual sex. The hepatitis B surface antigen (HBsAg) seroprevalence was 4.9% (25/505). HBV DNA was detected in 39 out of 505 patients: 20 of them were HBsAg-positive and 19 were HBsAg-negative, resulting in an OBI prevalence of 3.8%. Patients with OBI had significantly higher HCV seropositivity rate compared to HBsAg-positive patients. Sequencing of the S gene revealed Y100C, T131N, and D144A mutations. One patient had the M204I and L180M drug-resistance mutations (polymerase). HBV genotypes A (A1, A2), D (D2, D3), and F (F2) were identified. In conclusion, OBI represented almost half of all HBV infections with detectable HBV DNA, suggesting that hepatitis B diagnosis in HIV patients should include in addition to serological markers the detection of HBV DNA.

Endocervical component in conventional cervical smears: influence on detection of squamous cytologic abnormalities.

The objective of this study was to correlate the number of endocervical cells and the number of atypical cells in cervical smears with cytological abnormalities to verify if a higher number of endocervical cells would implicate in a higher number of squamous atypical cells. In this cross sectional study, it was made a blinded review of 294 conventional cervical smears. The consensus diagnoses reached by the blinded review by three observers included 213 low-grade squamous intraepithelial lesions (LSILs) and 81 high-grade squamous intraepithelial lesions (HSILs). In each cervical smear were computed the number of endocervical cells and the number of squamous atypical cells, and it was established the following score: one (0-5 cells); two (6-10 cells); three (11-25 cells); four (26-50 cells); and five (more than 50 cells). Compared to the smears with an account of endocervical cells classified in score 1 (0-5 cells), an account of more than 50 endocervical cells was significantly associated to the presence of at least 10 squamous atypical cells in the cervical smears (OR 2.87 95% CI 1.54-5.35). Data from this study suggest that there is a positive association between the number of endocervical cells and the number of squamous atypical cells suggestive of SIL.

Neoplasias intraepiteliais cervicais: faixa etária no momento do diagnóstico citológico / Cervical intraepithelial neoplasia: age group in the moment of the cytological diagnosis

Objetivo: Avaliar a distribuição dos diagnósticos citológicos de NIC (neoplasia intraepitelial cervical), considerando a idade das mulheres incluídas. Material e Métodos: Os resultados citológicos de mulheres com NIC 1 (721), NIC 2(218) e NIC 3 (84) foram analisados em um modelo estratificado por faixa etária. Resultados e Conclusão: As prevalências encontradas foram de 70,48%(721/1023) para NIC 1, 21,31% (218/1023) para NIC 2 e 8,21% (84/1023) para NIC 3. Os diagnósticos citológicos de NIC 1 foram observados com maior frequência em mulheres com menos de 40 anos (88,35% 637/721). Os diagnósticos citológicos de NIC 2também foram mais frequentes em mulheres com menos de 40 anos com uma prevalência de 43,6% (95/218) observada na faixa etária de 20-30 anos e de 22,5% (49/218) em mulheres de 31-40 anos. Os diagnósticos de NIC 3 foram mais frequentes em mulherescom mais de 30 anos (83,3% 70/84). Há uma maior prevalência de NIC 1 e NIC 2 em mulheres na faixa etária de 20 a 30 anos enquanto NIC 3 tem prevalência maior em mulheres com mais de 30 anos. É possível que a história natural da NIC 2 seja mais próxima à de NIC 1 quando comparada à de NIC 3.

Objective: To evaluate the distribution of the cytological diagnoses of CIN (cervical intraepithelial neoplasia) consideringthe included women's age group. Material and Methods: The cytological results of woman with CIN 1 (721), CIN 2(218) and CIN 3 (84) were analyzed in a stratified model by age group. Results and Conclusion: The total prevalences founded were 70.48% (721/1023) for CIN 1, 21.31% (218/1023) for CIN 2 and 8.21% (84/1023) for CIN 3. The cytologic diagnosis of CIN 1 were observed more frequently in women under the age of 40 (88.35% 637/721). The cytologic diagnosis of CIN 2 were also more frequent in womenunder 40 years of age with a prevalence of 43.6% (95/218) observed in the age group of 20-30 years and 22.5% (49/218) in women of 31-40 years. The diagnosis of CIN 3 were more frequent in women over 30 years (83.3% 70/84). There is a higher prevalence ofCIN 1 and CIN 2 in women aged 20 to 30 years while CIN 3 prevalence is higher in women over 30 years. It is possible that the natural history of CIN 2 is closer to CIN 1 when compared to CIN 3.

Neoplasias intraepiteliais cervicais: faixa etária no momento do diagnóstico citológico / Cervical intraepithelial neoplasia: age group in the moment of the cytological diagnosis

Objetivo: Avaliar a distribuição de diagnósticos citológicos de neoplasia intraepitelial cervical (NIC), considerando a idade das mulheres incluídas. Material e Métodos: Osresultados citológicos de mulheres com NIC 1 (721), NIC 2(218) e NIC 3 (84) foram analisados em um modelo estratificado por faixa etária. Resultados e Conclusão: As prevalências encontradas foram de 70,48% (721/1023) para NIC 1, 21,31% (218/1023) para NIC 2 e 8,21% (84/1023) para NIC 3. Os diagnósticos citológicos de NIC 1 foram observados com maior frequência em mulheres com menos de 40 anos (88,35%; 637/721). Os diagnósticos citológicos de NIC 2 também foram mais frequentes emmulheres com menos de 40 anos, com uma prevalência de 43,6% (95/218), observada na faixa etária de 20-30 anos, e de 22,5% (49/218) em mulheres de 31-40 anos. Osdiagnósticos de NIC 3 foram mais frequentes em mulheres com mais de 30 anos (83,3%; 70/84). Houve uma maior prevalência de NIC 1 e NIC 2 em mulheres na faixa etária de 20 a 30 anos, enquanto que NIC 3 teve prevalência maior em mulheres com mais de 30 anos. É possível que a história natural da NIC 2 seja mais próxima a de NIC 1, quando comparadaà de NIC 3.

Objective: To evaluate the distribution of the cytological diagnosesof cervical intraepithelial neoplasia (CIN) considering the includedwomen's age group. Material and Methods: The cytological resultsof woman with CIN 1 (721), CIN 2(218) and CIN 3 (84) were analyzedin a stratified model by age group. Results and Conclusion: Thetotal prevalences founded were 70.48% (721/1023) for CIN 1, 21.31%(218/1023) for CIN 2 and 8.21% (84/1023) for CIN 3. The cytologicdiagnosis of CIN 1 were observed more frequently in women underthe age of 40 (88.35% 637/721). The cytologic diagnosis of CIN 2were also more frequent in women under 40 years of age with aprevalence of 43.6% (95/218) observed in the age group of 20-30years and 22.5% (49/218) in women of 31-40 years. The diagnosis ofCIN 3 were more frequent in women over 30 years (83.3% 70/84).There is a higher prevalence of CIN 1 and CIN 2 in women aged 20to 30 years while CIN 3 prevalence is higher in women over 30 years.It is possible that the natural history of CIN 2 is closer to CIN 1 whencompared to CIN 3.