Sexual Abuse and Sexually-Transmitted HIV/AIDS in Jamaican Children and Adolescents Aged 6-19 Years.

INTRODUCTION: Risk factors and outcomes of sexually-acquired human immunodeficiency virus infection were characterized in Jamaican children and adolescents. METHODOLOGY: Management was carried out by multidisciplinary teams in Infectious Diseases clinics during August 2003 through February 2019 using modified World Health Organization HIV criteria. RESULTS: There were 78 clients, aged 6 to 19 years, with females:males = 4:1 (p < 0.05). Sexual-initiation occurred in 60%, 47 before < 16 years (median 13 years, with four < 10 years; females:males = 7:1). Sexual-initiation preceded HIV diagnosis in all cases (median 2 years). Secondary education 93% (69/77) and living with non-parental relatives 17% (13/78) were associated with early sexual-initiation (p < 0.042); as was later imprisonment in 6% (3/52). Other sexually transmitted infections 36% (19/53) were associated with sexual-initiation ≥ 16 years (p < 0.01). Risks for ongoing HIV-transmission included infrequent condom use 74% (39/53), body-piercings 50% (24/48), illicit drug use 37% (28/76), tattoos 36% (19/52), transactional sex 14% (7/53) and pregnancy 56% of girls. 77% (59/77) had Centres for Diseases Control's Category A HIV infection; 82% (61/75) initiated anti-retroviral therapy; 75% (56/75) had first-line drugs, with helper T lymphocyte counts ≥ 500 cells/µL in 61% (48/78) and HIV viral load of < 1,000 copies/µL in 63% (40/64). Complications included dermatological 39% (20/52), respiratory 25% (13/52) and neurological 15% (8/52). Early sexual initiation was associated with depression 43% (33/76; p < 0.004) and suicidal attempt or ideation 23% (18/77; p < 0.096). Four (5%) died. CONCLUSIONS: Sexually transmitted HIV/AIDS in children and adolescents should preempt prompt medical, legal and psychosocial interventions.

Interplay among Vaginal Microbiome, Immune Response and Sexually Transmitted Viral Infections.

The vaginal ecosystem is important for women's health and for a successful reproductive life, and an optimal host-microbial interaction is required for the maintenance of eubiosis. The vaginal microbiota is dominated by Lactobacillus species in the majority of women. Loss of Lactobacillus dominance promotes the colonization by anaerobic bacterial species with an increase in microbial diversity. Vaginal dysbiosis is a very frequent condition which affects the immune homeostasis, inducing a rupture in the epithelial barrier and favoring infection by sexually transmitted pathogens. In this review, we describe the known interactions among immune cells and microbial commensals which govern health or disease status. Particular attention is given to microbiota compositions which, through interplay with immune cells, facilitate the establishment of viral infections, such as Human Immunodeficiency Virus (HIV), Human Papilloma Virus (HPV), Herpes Simplex Virus 2 (HSV2).

Possible sexual transmission of Crimean-Congo hemorrhagic fever.

Three cases of family transmission of laboratory-confirmed Crimean-Congo hemorrhagic fever (CCHF) among spouses are reported. These spouses had sexual contact at the end of the incubation period or during the early stage of the mild form of CCHF, without any hemorrhagic symptoms in the first infected spouse. This report demonstrates that sexual contact may represent a real risk of CCHF transmission, even if the patient only experiences mild symptoms.

[WEIGHT GAIN DURING PREGNANCY AND PERINATAL OUTCOMES IN PREGNANT ADOLESCENTS WITH A HISTORY OF SEXUAL ABUSE]. / GANANCIA DE PESO DURANTE LA GESTACIÓN Y RESULTADOS PERINATALES EN ADOLESCENTES EMBARAZADAS CON ANTECEDENTE DE ABUSO SEXUAL.

OBJECTIVE: the purpose of the present study was to describe some perinatal outcomes in two groups of pregnant adolescents: one group with history of sexual abuse and one group without sexual abuse antecedent. METHODS: we designed an observational, retrolective study. Participants were primigravid adolescents between 10 to 16 years, with a singleton pregnancy, and at least three prenatal medical evaluations. Participants were grouped according to sexual abuse antecedent: 55 adolescents had sexual abuse antecedent, and 110 participants had not sexual abuse antecedent. We obtained the clinical data from medical records: socio-demographic characteristics, sexually transmitted infections, illicit drugs use, pre-gestational body mass index, gestational weight gain, and newborn weight. The data were analyzed using association tests and mean comparisons. RESULTS: the adolescents with sexual abuse history had higher prevalence of human papilloma virus infection. The newborns weight of mothers without sexual abuse antecedent was about 200 grams higher than the newborns of mothers with sexual abuse antecedent (p = 0.002); while the length of the first group was 2 centimeters longer than the length of the newborns on the second group (p = 0.001). Gestational weight increase was 5 kilograms lower in adolescents with sexual abuse antecedent compared to adolescent without the antecedent (p = 0.005). Illicit drug use was similar in the two groups and it was associated to low newborn weight. CONCLUSIONS: the sexual abuse antecedent in pregnant adolescents was associated to higher frequency of human papilloma virus infections, lower newborn weight, and lower gestational weight increase on pregnant adolescents.

Introducción: la mayoría de las adolescentes con antecedente de abuso sexual inician su control prenatal tardíamente, incrementando el riesgo de eventos perinatales adversos. Objetivo: analizar la ganancia de peso gestacional materna, peso y longitud neonatales de adolescentes con y sin el antecedente de abuso sexual. Métodos: estudio observacional, retrolectivo con adolescentes embarazadas, entre 10 y 16 años, primigestas, con embarazo único y con al menos tres consultas prenatales. Las adolescentes fueron divididas en dos grupos: 55 casos con antecedente de abuso sexual (AAS) y 110 sin antecedente de abuso sexual (SAAS). Se obtuvieron datos: sociodemográficos, presencia de infecciones de transmisión sexual, toxicomanías, índice de masa corporal pregestacional y ganancia de peso gestacional maternos, así como peso y longitud del neonato. Se calcularon pruebas de asociación y comparación de medias. Resultados: las adolescentes con AAS tuvieron mayor prevalencia de virus del papiloma humano. El peso y longitud de los neonatos del grupo SAAS fue mayor, con cerca de 200 g (p = 0,002) y 2 cm (p = 0,001) que el grupo con AAS. El aumento de peso gestacional fue 5 kg inferior en las adolescentes con AAS (p = 0,005). El consumo de drogas ilegales fue similar en ambos grupos y se asoció con menor peso de los recién nacidos. Conclusiones: el antecedente de abuso sexual en adolescentes embarazadas se asoció con mayor frecuencia al virus del papiloma humano, menor peso y longitud en los recién nacidos y menor aumento de peso gestacional en la madre. El uso de drogas ilícitas fue similar en ambos grupos y se asoció con menor peso al nacer.

Human papillomavirus and oropharyngeal cancer in Greenland in 1994-2010.

BACKGROUND: Oropharyngeal squamous cell carcinoma (OPSCC) is associated with the sexually transmitted human papillomavirus (HPV), smoking and alcohol. In Greenland, a high rate of HPV-induced cervical cancer and venereal diseases are found, which exposes the population for high risk of HPV infection. In Greenland, only girls are included in the mandatory HPV vaccination program. OBJECTIVE: To investigate the annual incidence of OPSCC and the proportion of HPV-associated OPSCC (HPV+ OPSCC) in Greenland in 1994-2010. DESIGN: At Rigshospitalet, University of Copenhagen, we identified all Greenlandic patients diagnosed and treated for OPSCC from 1994 to 2010. Sections were cut from the patient's paraffin-embedded tissue blocks and investigated for p16 expression by immunohistochemistry. HPV analyses were performed with 2 sets of general HPV primers and 1 set of HPV16-specific primer. HPV+ OPSCC was defined as both >75% p16+ cells and PCR positive for HPV. RESULTS: Of 26 Greenlandic patients diagnosed with OPSCC, 17 were males and 9 were females. The proportion of HPV+ OPSCC in the total study period was 22%, without significant changes in the population in Greenland. We found an increase in the proportion of HPV+ OPSCC from 14% in 1994-2001 to 25% in 2002-2010 (p=0.51). Among males from 20 to 27% (p=0.63) and in females from 0 to 20% (p=0.71). The annual OPSCC incidence increased from 2.3/100,000 (CI=1.2-4.2) in 1994-2001 to 3.8/100,000 (CI=2.4-6.2) in 2002-2010: among males from 2.4/100,000 (CI=1.0-5.7) to 5.0/100,000 (CI=2.9-8.9). CONCLUSION: Even though the population is at high risk of HPV infection, the proportion of 22% HPV+ OPSCC in the total study period is low compared to Europe and the United States. This might be explained by our small study size and/or by ethnic, geographical, sexual and cultural differences. Continuing observations of the OPSCC incidence and the proportion of HPV+ OPSCC in Greenland are needed.

[Semen-derived enhancer of viral infection--a key factor in sexual transmission of HIV].

Semen-derived enhancer of viral infection(SEVI) is a peptide fragment (PAP248-286) from prostatic acid phosphatase(PAP), which can enhance human immunodeficiency virus infection. The mechanisms of SEVI include: (1) SEVI with several cationic amino acid residues reduced electrostatic repulsion between HIV virus and the target cells; (2) The disorder state of SEVI in the human body fluids was helpful to the interaction between virus and the target cell membranes; (3) SEVI could capture HIV particles directly and speed the velocity of virus on the surface of the target cells and improve adsorption and fusion. Currently, the substances of inhibiting SEVI activity include: EGCG from green tea, small molecule compound of aminoquinoline Surfen, ThT analogs BTA-EG6. Those compounds might block the combination of HIV and SEVI or prevent the formation of amyloid fibers, and then reduce the enhancement of SEVI. The studies on the biological characteristics and mechanisms of SEVI have a big benefit for the prevention and treatment of HIV infection.

Human papillomavirus vaccine intention among college men: what's oral sex got to do with it?

OBJECTIVE: To identify associations between engaging in oral sex and perceived risk of oral cancer among college men. Also, to identify associations, and their moderating factors, between oral sex and human papillomavirus (HPV) vaccine acceptance. METHODS: Young men were recruited from 2 university campuses in the South (N = 150). Men completed an audio computer-assisted self-administered interview. RESULTS: With the exception of receiving fellatio, each measure of oral sex behavior was significantly associated with greater perceived risk of oral cancer. Four oral sex behaviors evidenced significant associations with vaccine acceptance. Men engaging in recent oral sex or reporting oral sex behaviors with more than 2 partners were more likely to indicate vaccine intent. African American/black race, communication with parents about sex-related topics, and HPV-related stigma/shame were identified as moderating factors. CONCLUSION: Young college men giving or receiving oral sex with multiple partners may be predisposed to HPV vaccination.

Human papillomavirus infection and reinfection in adult women: the role of sexual activity and natural immunity.

There is a paucity of data on whether or not women can be reinfected with human papillomavirus (HPV) types to which they were exposed to earlier in life and on the role of natural immunity. The observation of HPV infection at older ages may be explained by the reactivation of a latent infection or new exposure from sexual activity. Our objective was to analyze the association between reinfection and sexual activity. We analyzed data from 2,462 women enrolled in the Ludwig-McGill cohort and followed every 4 to 6 months for up to 10 years. We performed HPV typing and viral load measurements via PCR and determined HPV-16 seroreactivity at enrollment. Incidence of infection and reinfection were estimated for individual types. Adjusted relative risks (RR) for the association between infection/reinfection and new sexual partners were calculated using Cox regression. Rates of initial infection and reinfection postclearance were statistically comparable. RRs of initial infection or reinfection were consistently associated with new sexual partners [2.4 (95% confidence intervals; 95% CI, 2.0-3.1) for first infection, 3.7 (1.1-13.8) for reinfection with the same type, and 2.3 (1.5-3.7) for reinfection with a different type]. Reinfection in older women was also associated with new sexual partners (RR, 2.8; 95% CI, 1.4-5.3) as were new infections with HPV-16 among women with serologic evidence of prior HPV-16 exposure (RR, 3.0; 95% CI, 1.6-5.3). Viral loads at initial infection and at reinfection were comparable. HPV infection and reinfection were strongly associated with sexual activity. This study suggests that natural immunity does not play a role in controlling the extent of reinfections.

A survey of knowledge of sexually transmitted infections among patients at a public hospital in Pulau Pinang, Malaysia.

OBJECTIVE: The aim of this study was to assess the patients' knowledge and awareness of sexually transmitted infections (STIs). SUBJECTS AND METHODS: A face-to-face interview was conducted among the patients visiting the Venereal Diseases Outpatient Department of the General Hospital of Pulau Pinang (Malaysia). A 19-item questionnaire was used. A total of 116 patients participated in the study and 107 patients had valid responses. The reliability and internal consistency of the questionnaire tool was estimated on the basis of Cronbach's alpha (= 0.81). The Statistical Package for Social Sciences (SPSS 13.0(R)) was used for data analysis. Student's t test and analysis of variance were used to analyse the knowledge differences among the groups. RESULTS: Of the 107 patients, 82 (76.6%) were diagnosed with syphilis; AIDS was the most commonly known STI among the patients. Of the 107 patients, 35 were sexually active and of these 23 (65.7%) had more than 1 sexual partner. The most popular source of knowledge was newspapers (51 patients, 47.7%), with hospitals (3 patients, 2.8%) being the least popular one. Overall mean score on knowledge questions was 12.21 out of the maximum of 33 points. Knowledge about causative organisms, risk groups, transmission, symptoms, prevention and treatment of STIs was inadequate. The knowledge level was significantly related to gender (p = 0.03), religion (p = 0.005), educational level (p = 0.000), marital status (p = 0.000) and income level (p = 0.036). CONCLUSION: This study demonstrated evidence of poor knowledge of STIs amongst the patients attending an STI service in the General Hospital of Pulau Pinang (Malaysia). Hence there is an immediate need for efforts towards improving patient knowledge of STIs.

Virus Papiloma Humano (HPV): Parte II - Clínica y terapéutica / Human Papilloma Virus (HPV). Part II – Clinic and therapeutics

Los virus papiloma humano (HPV) pertenecen a la familia de los Papovaviridae y están ampliamente distribuidos en la naturaleza. Se han identificado más de 130 tipos. Pueden comprometer la piel y mucosas provocando lesiones benignas llamadas verrugas. Algunos tipos se asocian con el desarrollo de procesos malignos epiteliales. La respuesta inmune del huésped cumple un rol importante en el control de la infección. El diagnóstico es esencialmente clínico, pero a veces se recurre al estudio histopatológico de las lesiones o al empleo de técnicas de biología molecular. Existe una variedad de opciones terapéuticas, la mayoría destinada a destruir las lesiones. Últimamente se han desarrollado vacunas preventivas para algunos tipos de HPV y se encuentran en experimentación las vacunas terapéuticas.

The human papillomavirus belongs to the family of the Papillomaviridae. This virus is widely distributed in the nature. More than 130 types have been indentifi ed; they can compromise the skin and mucous membranes provoking benign injuries called warts. Some types of virus are said to be involved in the development of precancerous skin lesions. The host immune response has an important role on controlling the infection. The diagnosis is essentially clinic, nevertheless, sometimes histopathologic study of lesions or molecular biology techniques are needed in order to reach an accurate diagnosis. There is a great variety of treatment options; most of them aim to destroy the lesion. Lately some vaccines have been being developed; these are only for some types of HPV and are still under experimental designs (Dermatol Argent 2010;16(2):102-109).

Sexually transmitted papillomavirus infections: epidemiology pathogenesis, clinic, morphology, important differential diagnostic aspects, current diagnostic and treatment options.

The family of human papilloma viruses (HPV) comprises more than 100 genotypes. Approximately 30 of the genotypes are responsible for infections in the human anogenital area. A precisely defined algorithm with the goal of diagnosing and removing HPV for a prolonged or indefinite length of time, as well as to protect the patient from any malignant ransformation, does not currently exist. The identification of HPV strains by PCR or DNA hybridization in lesional tissue provides higher security for the patients. In high-risk patients additional colposcopy, rectoscopy, and rethroscopy/cystoscopy increase the probability of proper diagnosis and the application of a reliable therapeutic strategy. Removal of lesions by means of invasive methods, such as electrodessication, cryosurgery, and/or laser therapy, may be successful and could be combined pre- and postoperatively with the local application of podophyllotoxin, Trichloroacetic acid, 5-fluorouracil epinephrine gel, imiquimod, cidofovir or interferon. The administration of vaccine to young patients prevents to a significant extent the clinical manifestation of the most frequent viral strains, being HPV-6,-11 and -18. The different therapeutic methods must be applied in accordance with the clinical picture, taking into account the patient's general status, the presence of concomitant diseases, as well as the local and systematic compatibility of the side effects of each remedy. The review focuses on the diagnosis and treatment options of sexually transmitted HPV-infections and includes synopsis of the most recent literature regarding new data of epidemiology, pathogenesis, ifferential diagnosis and morphology of HPV infections in humans.

Infección por VIH en la Ciudad Autónoma de Buenos Aires: situación actual y tendencias / Trends and epidemiological pattern of HIV infection in Buenos Aires City

La epidemia de VIH en Argentina sigue siendo concentrada - es decir, con una prevalencia en la población general menor al 1% y superior al 5% en alguna población específica - y predominantemente urbana. En este artículo presentamos un análisis de los datos epidemiológicos de la población de residentes de la Ciudad Autónoma de Buenos Aires (CABA), diagnosticados durante el período 2003-2008 y notificados a la Coordinación Sida del Ministerio de Salud de la Ciudad. Los resultados muestran que la vía sexual sigue siendo la forma principal de transmisión, con predominio del grupo de hombres que tienen sexo con hombres (HSH) en la población masculina. La universalización del testeo en embarazadas y una mayor accesibilidad de las mujeres a los servicios de salud podrían haber impactado en el llamado proceso de feminización de la epidemia. El mayor porcentaje de diagnósticos tardíos en la población masculina se observa particularmente en mayores de 50 años y con menor nivel de instrucción, lo que plantea la necesidad de fortalecer las estrategias preventivas y de accesibilidad al testeo en esta población.

Argentina HIV epidemic is a contained and urban epidemic, with a relative slow and stable prevalence. In this paper we analyzed the epidemic profile about Buenos Aires residents for which diagnosis of HIV infection was made between 2003 an 2008 and were notified to the AIDS Programme of the Ministry of Health. Most infections were adquired by sexual transmissions with predominance of men who have sex eith men in the masculine popultaion. Universal HIV testing in pregnancy and facilitate access of women to health services could explain the process of feminization of the epidemy. Predominance of delayed diagnosis in the male population, elder than fifty and with lowest instruction level, suggests the need of enhacing preventive strategies and access to testing in this setting.

Infección por VIH en la Ciudad Autónoma de Buenos Aires: situación actual y tendencias / Trends and epidemiological pattern of HIV infection in Buenos Aires City

La epidemia de VIH en Argentina sigue siendo concentrada - es decir, con una prevalencia en la población general menor al 1% y superior al 5% en alguna población específica - y predominantemente urbana. En este artículo presentamos un análisis de los datos epidemiológicos de la población de residentes de la Ciudad Autónoma de Buenos Aires (CABA), diagnosticados durante el período 2003-2008 y notificados a la Coordinación Sida del Ministerio de Salud de la Ciudad. Los resultados muestran que la vía sexual sigue siendo la forma principal de transmisión, con predominio del grupo de hombres que tienen sexo con hombres (HSH) en la población masculina. La universalización del testeo en embarazadas y una mayor accesibilidad de las mujeres a los servicios de salud podrían haber impactado en el llamado proceso de feminización de la epidemia. El mayor porcentaje de diagnósticos tardíos en la población masculina se observa particularmente en mayores de 50 años y con menor nivel de instrucción, lo que plantea la necesidad de fortalecer las estrategias preventivas y de accesibilidad al testeo en esta población.(AU)

Argentina HIV epidemic is a contained and urban epidemic, with a relative slow and stable prevalence. In this paper we analyzed the epidemic profile about Buenos Aires residents for which diagnosis of HIV infection was made between 2003 an 2008 and were notified to the AIDS Programme of the Ministry of Health. Most infections were adquired by sexual transmissions with predominance of men who have sex eith men in the masculine popultaion. Universal HIV testing in pregnancy and facilitate access of women to health services could explain the process of feminization of the epidemy. Predominance of delayed diagnosis in the male population, elder than fifty and with lowest instruction level, suggests the need of enhacing preventive strategies and access to testing in this setting.(AU)

Advances in sexually transmitted infections of the gastrointestinal tract.

The gastrointestinal mucosa is a target of many sexually transmitted infections, and major advances have increased our understanding of the consequences of such infections within the gastrointestinal system. HIV-1 is associated with a marked loss of mucosal CD4(+) T cells that express CC-chemokine receptor 5. This process seems to be more rapid and more severe in mucosa-associated lymphoid tissue than in the peripheral blood. Mechanistic insights into the underlying cause of acute and chronic gastrointestinal damage with HIV infection-microbial translocation, defects in intestinal epithelial barrier function and activation of a systemic immune response-have also been achieved. Increased understanding of the pathogenesis of mucosal HIV-1 infection may identify therapeutic targets to restore immunological function and the integrity of the intestinal mucosal epithelial barrier. The increasing prevalence of lymphogranuloma venereum in Europe, mostly in HIV-positive men who have sex with men, suggests a change in the epidemiology of what was previously considered to be a 'tropical' disease. The increasing incidence of acute HCV infection transmitted via sexual contact has also been fueled by high-risk sexual behaviors among men who have sex with men, many of whom are also HIV-positive. The first part of this Review discusses the pathogenesis and gastrointestinal complications of HIV infection, and the second part summarizes advances in our understanding of other sexually transmitted infections of the gastrointestinal system.

Sexually transmitted papillomavirus infections: epidemiology pathogenesis, clinic, morphology, important differential diagnostic aspects, current diagnostic and treatment options: [review] / Infecções por papilomavírus sexualmente transmitida: epidemiologia, patogênese, clínica, morfologia, aspectos importantes do diagnóstico diferencial, diagnóstico atual e opções de tratamento: [revisão]

The family of human papilloma viruses (HPV) comprises more than 100 genotypes. Approximately 30 of the genotypes are responsible for infections in the human anogenital area. A precisely defined algorithm with the goal of diagnosing and removing HPV for a prolonged or indefinite length of time, as well as to protect the patient from any malignant ransformation, does not currently exist. The identification of HPV strains by PCR or DNA hybridization in lesional tissue provides higher security for the patients. In high-risk patients additional colposcopy, rectoscopy, and rethroscopy/cystoscopy increase the probability of proper diagnosis and the application of a reliable therapeutic strategy. Removal of lesions by means of invasive methods, such as electrodessication, cryosurgery, and/or laser therapy, may be successful and could be combined pre- and postoperatively with the local application of podophyllotoxin, Trichloroacetic acid, 5-fluorouracil epinephrine gel, imiquimod, cidofovir or interferon. The administration of vaccine to young patients prevents to a significant extent the clinical manifestation of the most frequent viral strains, being HPV-6,-11 and -18. The different therapeutic methods must be applied in accordance with the clinical picture, taking into account the patient's general status, the presence of concomitant diseases, as well as the local and systematic compatibility of the side effects of each remedy. The review focuses on the diagnosis and treatment options of sexually transmitted HPV-infections and includes synopsis of the most recent literature regarding new data of epidemiology, pathogenesis, ifferential diagnosis and morphology of HPV infections in humans.

A família de papiloma vírus humano (HPV) compreende mais de 100 genótipos. Aproximadamente 30 dos genótipos são responsáveis pelas infecções na área anogenital em humanos. Não dispomos no momento de um algoritmo precisamente definido tendo como meta o diagnóstico e a remoção de HPV por períodos de tempo prolongados ou indefinidos, nem para proteção do paciente contra transformação maligna. A identificação das cepas de HPV por PCR ou hibridização de DNA em tecido lesional oferece maior segurança para os pacientes. Em pacientes de alto risco realiza-se ainda colposcopia, rectoscopia e uretroscopia/ cistoscopia, aumentando a probabilidade do diagnóstico correto e a aplicação de estratégia terapêutica confiável. A remoção das lesões por meio de métodos invasivos, como a eletrodissecção, criocirurgia, e/ou terapia com laser, pode ser bem sucedida e combinada no pré e no pós-operatório com a aplicação local de toxina podofílica, ácido tricloroacético, gel de epinefrina 5-fluorouracil, imiquimod, cidofovir ou interferon. A administração da vacina em pacientes jovens é capaz de previnir as manifestações clínicas das cepas virais mais frequentes, que são HPV-6, -11 e -18. Os diferentes métodos terapêuticos devem ser aplicados de acordo com o quadro clínico, levando em consideração o estado de saúde geral do paciente, a presença de doenças concomitantes, assim como a compatibilidade local e sistêmica dos efeitos adversos em cada remédio. A revisão foca o diagnóstico e as opções de tratamento de infecções por HPV sexualmente transmitidas e inclui uma sinopse da literatura mais recente no que diz respeito aos dados de epidemiologia, patogênese, diagnóstico diferencial e morfologia de infecções por HPV em humanos.

Infección por molusco contagioso en pezón: a propósito de un caso / Molluscum contagiosum infection: a purpose of a case

El molusco contagioso es una infección viral que produce lesiones en piel y mucosas características más frecuentes en niños, sin embargo, en el adulto su aparición en el área genital y sitios inusuales, lo cataloga como enfermedad de transmisión sexual. Paciente femenino de 25 años, acude a la consulta por nódulo doloroso en pezón de mama derecha de tres meses de evolución. Antecedentes familiares: dos tías paternas diagnosticadas con cáncer de mama. Al examen físico: área descamativa en areola entre R11-R1 y nódulo doloroso de 4 mm ha dicho nivel, sin signos de flogosis. La ecografía mamaria no reporta lesión. Se realizó la exéresis de nódulo 6 mm blanquecino a través de incisión en base de pezón cuya biopsia reportó infección por molusco contagioso. El molusco contagioso es un virus DNA de la familia de los poxvirus, transmitido por medio de fómites o contacto directo con piel infectada. La lesión típica en piel forma pápulas con umbilicación central de 3 mm a 5 mm de diámetro en tronco, cara y extremidades en los niños, en los adultos en el área genital. Las principales lesiones del pezón son: estructurales, eccematosas, quistes sebáceos e infrecuente los adenomas. Las infecciones del pezón por molusco contagioso son extremadamente raras, así lo demuestra la revisión de casos. La importancia del diagnóstico radica en el control local para reducir contagiosidad, sin embargo, en individuos inmunocompetentes tiene un curso auto limitado.

The molluscum contagiosum is viral infection that produces characteristics papular eruptions in skin and in the mucous membranes. Is more prevalent in children’s although in the adults can infected the genital area, for that reason is knows as a sexual transmitted disease. A 25 years old female patient who referred us painful nodule in her right nipple, the apparition of this nodule was observed three months ago. The familiar antecedents in this patient were: Two paternal aunties with diagnosis of breast cancer. In the physical examination we found: In the scale area between radial 11 and 1 of the areola a 4 mm size painful nodule at the same level. The breast ultrasound study was normal. The lesion excision was made through nipple incision and the biopsy reports: Molluscum contagiosum infection. The molluscum contagiosum is a DNA virus of the poxvirus family; the transmission requires a direct contact with infected hosts or for the contaminated fomites. The common lesion found is self limited 3 mm to 5 mm with papular eruptions in the skin with central umbilicated surface in face, body and in the extremities in children’s and in genitalia in the adults patients. The main nipple lesions are: Structural abnormalities, eczema, sebaceous cysts and uncommon adenomas. The nipple molluscum contagiosum infections are extremely rare. It is important make the diagnosis for the reduction of the transmissibility, and although is self limited in immunocompetents individuals.

Seroepidemiology of human papillomavirus type 11 in the United States: results from the third National Health And Nutrition Examination Survey, 1991--1994.

OBJECTIVES: The national seroprevalence of the nononcogenic human papillomavirus (HPV) type 11, one of the types targeted by the quadrivalent HPV vaccine, has not been evaluated in the United States. The objectives of this study were to estimate the national seroprevalence and evaluate predictors of HPV-11 seropositivity. STUDY DESIGN: We tested serum samples for HPV-11 antibodies and analyzed questionnaire data from the second phase of the National Health and Nutrition Examination Survey III, 1991--1994. Seroprevalence estimates were weighted to represent the US population. RESULTS: : Overall seroprevalence of HPV-11 infection was 4.7%. Seroprevalence was significantly higher among females (5.7%) than among males (3.6%). Independent predictors of HPV-11 seropositivity included sex, race/ethnicity, lifetime number of sex partners, education, and HPV-16 seropositivity. CONCLUSION: This study represents the most comprehensive picture of HPV-11 infection in the United States to date, and provides baseline data on the prevalence of HPV-11 before availability of the quadrivalent HPV vaccine.

HPV knowledge and behaviors of black college students at a historically black university.

UNLABELLED: College students are at high risk for human papillomavirus (HPV) infection, yet their knowledge and self-protective behaviors appear inadequate. Researchers who have measured HPV-related knowledge and behaviors in evaluating college intervention efforts pay secondary attention to black college students because this group generally represents only a small subset of samples of the broader college population. OBJECTIVE AND PARTICIPANTS: The authors' purpose in this study was to examine HPV-related knowledge and behaviors in 351 black undergraduates attending a historically black southeastern university in the spring of 2003. METHODS: Voluntary and anonymous student participation was solicited in randomly selected undergraduate classes. RESULTS: Results indicated that most students lacked HPV awareness (64%), became aware of HPV largely after infection, and gained their HPV knowledge from a health-care provider or college class. The authors performed an analysis by gender and found that women were more knowledgeable about HPV than were men. Observed HPV-related knowledge and behaviors were similar to samples of the broader US college population. CONCLUSIONS: Findings suggest a greater need for HPV intervention efforts for all college students, including those at black colleges.