RESUMO
Because HTLV-I, HTLV-2, and HIV share identical modes of transmission, simultaneous or subsequent infections with these retroviruses are to be expected. The population of Santos, the largest port in Latin America, includes large numbers of female commercial sex workers and intravenous drug users, presumably having been exposed to retroviral infection. To evaluate the seroprevalence of HTLV infection and their associated risk factors, a cross-sectional survey was carried out in 499 HIV-infected individuals from Santos, Brazil. HTLV testing consisted of enzyme immunoassays for serologic screening and confirmatory Western blot testing. Overall HTLV-I and HTLV-2 seroprevalences were 6.0% (95% confidence interval [CI], 3.9-8.1) and 7.4% (95% CI, 5.1-9.7), respectively. Multivariate logistic regression for statistical analysis revealed HTLV-I infection to be independently associated with: intravenous drug use (IDU) (odds ratio [OR]. 2.99; 95% CI, 1.09-8.20), seropositivity to hepatitis C virus (HCV) (OR, 3.03; 95% CI, 1.02-9.01) and < 3 years of education (OR, 4.73; 95% CI, 1.56-14.41). HTLV-2 infection was associated with: IDU (OR, 3.22; 95% CI, 1.33-7.84), HCV seropositivity (OR, 5.40; 95% CI, 1.86-15.66) and nonwhite race (OR, 3.32; 95% CI, 1.58-7.00). Results indicate that HIV-infected individuals living in Santos are at similarly high risk of being exposed to HTLV-1 and HTLV-2. IDU constitutes the main risk factor for HTLV acquisition in this population, and there is no significant risk associated with sexual practice.
Assuntos
Infecções por HIV/complicações , Infecções por HTLV-I/complicações , Infecções por HTLV-II/complicações , Vírus Linfotrópico T Tipo 1 Humano , Vírus Linfotrópico T Tipo 2 Humano , Adolescente , Adulto , Anticorpos Antivirais/sangue , Brasil/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-II/epidemiologia , Hepatite C/complicações , Hepatite C/epidemiologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Razão de Chances , Análise de Regressão , Fatores de Risco , Estudos Soroepidemiológicos , Fatores Socioeconômicos , Abuso de Substâncias por Via Intravenosa/complicaçõesRESUMO
Laparoscopic surgery for cancer has led to the unwelcome occurrence of malignant seeding of port sites. It is hypothesized that this seeding may be a result of aerosolization and forced egress of cells from the peritoneum as a result of pneumoperitoneum. The purpose of this study was to develop a model that would allow for future investigations of cellular aerosolization. Six swine were anesthetized, intubated, and ventilated. A port was placed in the midline and the abdomen insufflated. After insufflation a 14-gauge angiocath was placed in the abdomen through a separate site and attached to a closed system that allowed escaping air to bubble through 3 ml of saline. Intraabdominal pressure was serially increased at 30-min intervals to 8, 10, 12, 14, 16, and 18 mm Hg, and separate saline samples were collected at each interval. Saline samples were centrifuged, and epithelial cells were counted by direct vision and Giemsa staining. Epithelial cells were recovered at all levels of pneumoperitoneum. There was a moderate correlation between the level of pneumoperitoneum and the number of cells collected (r = 0.61, p < 0.19). Results of this study suggest that during pneumoperitoneum there is an ongoing egress of aerosolized cells from the abdomen. Application of this model may aid in future study of aerosolization of cancer cells during laparoscopic surgery.
