Frequency of antibodies against E4 and E7 from human papillomavirus type 16 in Mexican soldiers.

The high prevalence of HPV in men's genitalia and the low frequency of virus-associated lesions gave rise to questions on the influence of infection-site on the HPV antibody profile. In a cross-sectional study, HPV infection in penis and urethra, and serum antibodies against HPV-16 E4 and E7 proteins were evaluated in 288 Mexican soldiers. The results showed that HPV prevalence was 31% (51% in penis, 11% in urethra and 38% in both sites), while 47% were multiple infections. Overall, seroprevalence was 13% for anti-E4 antibodies and 6% for anti-E7. However, the highest prevalence of anti-E4 antibodies was observed in men with HPV infection in urethra (30%), while for E7 antibodies, the highest prevalence (10%) was found in men who tested positive for HPV in penis. The prevalence of IgG and IgA anti-E4 was related to HPV-16 urethral infection, while detection of HPV-16 in penis was related to IgG anti-E7 prevalence. In conclusion, the high-risk sexual behavior observed in this population might be responsible for high HPV prevalence and multiple infections. However, the seroprevalence of E4 and E7 was similar to that observed in healthy Mexican women. These results suggest that the humoral immune response against HPV infection in men differs, depending on the site of infection.

Analysis of herpes simplex virus 1 and 2 infection in women with high risk sexual behaviour in Mexico.

BACKGROUND: This paper describes the seroprevalence and risk factors of Herpes simplex virus (HSV) infection in a group of female prostitutes from Mexico City. METHODS: Women who consented to participate in the study voluntarily attended a sexually transmitted disease (STD) clinic during 1992. A standardized questionnaire was administered and a blood sample was obtained from each participant. Type-specific Western blot serology was performed to determine the serostatus of HSV-1 and HSV-2 for participants. Bivariate and multivariate analyses were applied to identify variables associated with an increased risk for HSV infection. RESULTS: Prevalences of infection among the 997 prostitutes studied were 93.9% for HSV-1 and 60.8% for HSV-2. Only 1.8% of the women were seronegative for both viruses. The only variable associated with HSV-1 seropositivity was crowding index. The following variables were associated with an increased risk for infection with HSV-2: age, level of education, working site, born outside Mexico City and increasing time as a prostitute. CONCLUSIONS: This is the first assessment of HSV infection in Mexico and may be useful for the development and application of control and preventive measures among the prostitute population at risk of acquiring and transmitting human immunodeficiency virus (HIV) and other STD.

Hepatitis B markers in men seeking human immunodeficiency virus antibody testing in Mexico City.

OBJECTIVES: To estimate the prevalence and associated risk factors of hepatitis B virus (HBV) serologic markers in 1,377 men with high-risk sexual behavior attending a center for human immunodeficiency virus (HIV) detection in Mexico City. METHODS: The study population consisted of all men who were tested for HIV from March to September, 1992. Study participants responded to a standardized questionnaire and provided a blood sample for serology. RESULTS: A total of 1.9% of the population were hepatitis B surface antigen (HBsAg) carriers, and there was a significant difference in HBsAg prevalence between HIV-negative (0.8%) and HIV-positive individuals (7.9%). Sexual preference was associated with HBsAg prevalence; only 0.3% of men who had female sexual partners exclusively were HBsAg carriers, compared with 4.8% of men who had male sexual partners exclusively. Prevalence of antibodies to hepatitis B core antigen (anti-HBc) was 15.4%. However, men who reported only female partners had a 4.6% prevalence, whereas men who had only male partners had a 30.4% prevalence. Logistic regression analysis demonstrated an association of anti-HBc prevalence with age, marital status, sexual preference, seropositivity for HIV, and antibodies to herpes simplex virus type 2. CONCLUSIONS: These data demonstrate that coinfection with HBV is common in the HIV-positive men studied. The highest prevalences of HBsAg and anti-HBc were observed among homosexual men. These results highlight the need to intensify safe-sex education campaigns and to promote hepatitis B vaccination especially among this population group.

[Prevalence of antibodies against cytomegalovirus in women of reproductive age]. / Prevalencia de anticuerpos contra citomegalovirus en mujeres en edad reproductiva.

In order to know the prevalence of antibodies to cytomegalovirus in healthy women, we conducted a seroimmunological survey among 1,885 women, ages 13 to 44 years old, living in a suburban area of Cuernavaca City. Overall, 91.6 per cent of women were seropositive and 8.4 per cent seronegative. The prevalence was not significantly different among women of different ages. Nine out of 10 persons already had antibodies at age 14. One out of ten 15-20 years old women represent the maximum risk of primary infection and, at the same time they represent the population with greatest possibilities of getting pregnant. We found a strong relationship of low education, low income, promiscuity, house without public services and early onset of sexual activity with the presence of antibodies to cytomegalovirus. The risk of exposure to primary infection decreases as these epidemiological markers improve.

[Presence of human Herpes simplex virus-2 (HSV-2) in women attending a clinic for cervico-uterine cancer control]. / Presencia del virus herpes simple-2 (HSV-2) en mujeres que asisten a una clínica de control de cáncer cervicouterino.

For this prospective study, 284 women were recruited who attended a cancer detection (Papanicolaou testing) program and appeared to be healthy. The objective was to obtain cervicovaginal samples from this group and culture them on human foreskin fibroblasts to isolate and identify Herpes simplex virus by immunofluorescence with monoclonal antibodies. A total of 12 women (4.2%) were positive for the virus; upon comparison of various sociodemographic factors in positive and negative culture patients, it was possible to establish certain associations as follows: The presence of Herpes simplex virus type 2 was related to age, start of sexual life, number of sex partners, lower education and minimum income. Other markers observed in infected women were mucopurulent cervicitis, typical and non-typical confluent ulcerations and minor disruptions of the epithelium. The knowledge of this subclinical or somewhat asymptomatic Herpes prevalence should be considered to prevent further spread among couples and also to avoid the risk of reactivation in pregnant women.

[The prevention of urinary infection during pregnancy in patients with asymptomatic bacteriuria]. / Prevención de la infección urinaria durante la gestación en pacientes con bacteriuria asintomática.

A prospective study was carried out in which quantitative clean-voided urine cultures, were obtained at the first clinic visit from 986 consecutive pregnant women, followed to delivery to assess the maternal and pediatric finding associated with maternal asymptomatic bacteriuria. Patients to be evaluated were divided in two groups: Treatment group (TG) with 42/46 patients that were treated with nitrofurantoin 100 mg a day during 10 days, and control group (CG) with 45/46 patients that were not treated. Patients who failed were given a second course of nitrofurantoin. The patients who remained infected were given further treatment (cephalexin). Primary treatment was successful in 85%, 10% more with the second course and 5% were failure treatment. There was a highly significant difference in the incidence of symptomatic bacteriuria (pyelonephritis), premature deliver, prematurity and other perinatal events in patients with persistent infection. Eradication of asymptomatic bacteriuria reduced the risk of pre-term deliveries and lower infant birth weights for gestational age.

[Acute cystourethritis during pregnancy]. / Cistouretritis aguda durante la gestación.

A prospective study was carried out in 103/863 obstetric patients with cystitis characterized by urinary urgency and frequency, dysuria, pyuria and suprapubic discomfort in the absence of systemic symptoms such as fever and costovertebral angle tenderness. The association of symptomatic lower urinary tract infection with low-count bacteriuria (10(2)-10(5) UFC/mL of urine) was present in all the patients. The incidence of cystourethritis was about 12%, most of the infections occurred at the first trimester. To learn whether a multiple-dose of nitrofurantoin or ampicillin is safe and effective therapy for acute uncomplicated urinary tract infections, 103 symptomatic pregnant women were randomly grouped to receive oral nitrofurantoin (100 mg t.i.d.) or ampicillin (500 mg t.i.d.) for five days. Seventeen patient were excluded since they did not return for follow-up. Escherichia coli was isolated in 67% of infections. Overall cure varied from 87% to 89%, without any great differences between the regimens. Nine patients had asymptomatic bacteriuria in the course of pregnancy, four developed acute pyelonephritis and one of them had abnormal intravenous pyelogram.

[Detection of endocervical chlamydia infections by comparing the Papanicolaou staining test and direct immunofluorescence]. / Detección de infección endocervical por clamidia comparando la tinción de Papanicolaou con inmunofluorescencia directa.

The association of infection with Chlamydia trachomatis and cytologic changes on Papanicolaou smear was examined in 453 sexually active postmenarcal female subjects attending the cytology service for routine Papanicolaou smear. We described inflammatory and epithelial cell patterns that permit the detection of group of women with and without cervicitis at high risk for cervical chlamydial infection. We confirmed the infection by direct immunofluorescence using monoclonal antibodies. Ninety-five of 453 women had cervicitis (20.9%) chlamydial inclusions were noted by Papanicolaou in 26 patients with cervicitis and in 61 without cervicitis. Direct stain with fluorescein-conjugated monoclonal antibodies demonstrated elementary bodies of C. trachomatis in 42/453 women, 24 had cervicitis and 18 without cervicitis. One of two patients with cervical smears with chlamydial inclusions as "changes suggestive of chlamydial infection" by Papanicolaou was confirmed by inmmunofluorescence. We calculated the efficay of the Papanicolaou smear as a diagnostic technique: the sensitivity was 0.27, the specificity was 0.80, the predictive value of o positive test was 0.29. In order to compare the efficiency with immunofluorescence the sensitivity was 0.25, specificity 0.94 and the positive predictive value was 0.57. Using the epithelial changes interpreted as inflammatory, we had the highest sensitivity with both tests, 0.76 to Papanicolaou and 0.90 to immunofluorescence, specificity is near 100% for both tests, cytology tended to be more efficient in identifying women without infection than in identifying those with infection.