RESUMO
To explore sexually transmitted diseases and sexual behavior as risk factors for cervical cancer, we analyzed data from a population-based case-control study of breast and cervical cancer in Costa Rica. Data from 415 cases of cervical carcinoma in situ, 149 cases of invasive cervical cancer, and 764 controls were included in the analysis. Multivariate analysis showed that lifetime number of sex partners, first intercourse before age 15 years, number of livebirths, herpes simplex virus type 2 seropositivity, and serologic evidence of previous chlamydial infection were predictors of carcinoma in situ. Serologic evidence of previous syphilis was not associated with carcinoma in situ. Predictors for invasive cervical cancer included lifetime number of sex partners, first intercourse before age 15 years, number of livebirths, serologic evidence of previous syphilis, herpes simplex type 2 infection, and chlamydial infection. Cigarette smoking, socioeconomic status, self-reported history of sexually transmitted diseases, and douching were not associated with either carcinoma in situ or invasive cervical cancer.
Assuntos
Comportamento Sexual , Infecções Sexualmente Transmissíveis/complicações , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/etiologia , Adulto , Distribuição por Idade , Análise de Variância , Carcinoma in Situ/epidemiologia , Carcinoma in Situ/etiologia , Estudos de Casos e Controles , Costa Rica/epidemiologia , Feminino , Humanos , Incidência , Modelos Logísticos , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco , Infecções Sexualmente Transmissíveis/epidemiologia , Fumar , Fatores SocioeconômicosRESUMO
Thirteen children with human immunodeficiency virus infection acquired perinatally and with varicella were identified. Clinical and epidemiologic information, including the use of varicella immune globulin and acyclovir, was obtained and testing for antibodies to varicella-zoster virus was done. The 13 children infected with human immunodeficiency virus had an uncomplicated clinical course, and many had a significant antibody response to varicella-zoster virus.
Assuntos
Varicela/etiologia , Infecções por HIV/complicações , Aciclovir/uso terapêutico , Anticorpos Antivirais/sangue , Varicela/tratamento farmacológico , Varicela/imunologia , Criança , Pré-Escolar , Infecções por HIV/transmissão , Herpesvirus Humano 3/imunologia , Humanos , LactenteRESUMO
The development of quantitative single-cell immunoassays has provided a novel opportunity to demonstrate the isotype-specific immunoglobulin responses in normal and infected neonates. The reverse enzyme-linked immunospot assay was used to determine the number of immunoglobulin-secreting cells (IgSCs) in peripheral blood. Baseline numbers of IgSCs were established in 69 uninfected term and preterm infants within 5 days of birth; values above the 99th percentile were considered elevated. The IgSCs were also measured in 266 infants with proved or suspected infections or congenital anomalies. A subset of newborn infants was retested weekly. Few IgSCs (mostly IgMSCs) were detected within 5 days of birth in uninfected neonates, but by 1 month 77% had increased numbers of IgSCs, primarily IgASCs. Sixty-three (24%) of 266 study infants had increased IgSCs on initial sampling (predominantly IgMSCs); these included infants as immature as 25 to 27 weeks of gestational age; elevations in IgSCs were most frequent in infants with intrauterine infections. Increased numbers of IgSCs were uncommon in infants with early-onset sepsis in the first 5 days but were frequent by the second week, consistent with acquisition of infection near the time of delivery. We conclude that the presence of elevated numbers of IgSCs soon after birth may be a useful surrogate marker of untreated intrauterine infection. The development of predominantly IgASCs in the first month of life suggests postnatal exposure to common mucosal antigens.
Assuntos
Imunoglobulinas/biossíntese , Doenças do Recém-Nascido/imunologia , Recém-Nascido/imunologia , Infecções/imunologia , Células Produtoras de Anticorpos , Feminino , Humanos , Recém-Nascido Prematuro/imunologia , MasculinoRESUMO
Antibodies to herpes simplex virus type 2 (HSV-2), antibodies to hepatitis B virus (HBV) core antigen (anti-HBc), and VDRL antibodies (serologic evidence of syphilis) were evaluated in women known to be infected with human immunodeficiency virus type 1 (HIV-1) (n = 95) or human T lymphotropic virus type I (HTLV-I) (n = 45) and controls (n = 89). HIV-1-seropositive women were more likely than controls to have antibodies to HSV-2 (88% vs. 54%; P less than .001), anti-HBc (67% vs. 43%; P = .008), and VDRL antibodies (21% vs. 8%; P = .02). Similarly, HTLV-I-seropositive women were more likely than controls to have antibodies to HSV-2 (82% vs. 54%; P = .003) and anti-HBc (67% vs. 43%; P = .008). There was no evidence that HIV-1 or HTLV-I predisposed to chronic hepatitis B virus infection. The stronger associations between HIV-1 and HTLV-I with HSV-2 than the associations with syphilis or HBV are consistent with the hypothesis that recurrent disruptions of mucous membranes caused by HSV-2 infections predispose to sexual transmission of HIV-1 and HTLV-I.
Assuntos
Infecções por HIV/complicações , Infecções por HTLV-I/complicações , Hepatite B/epidemiologia , Herpes Simples/epidemiologia , Sífilis/epidemiologia , Adolescente , Adulto , Fatores Etários , Anticorpos Antivirais/sangue , Feminino , Anticorpos Anti-HIV/sangue , HIV-1 , Anticorpos Anti-HTLV-I/sangue , Haiti/epidemiologia , Hepatite B/complicações , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Herpes Simples/complicações , Humanos , Prevalência , Simplexvirus/imunologia , Sífilis/complicações , Sorodiagnóstico da SífilisRESUMO
We studied the prevalence of antibody to Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 766 randomly selected Costa Rican women 25-59 years of age in a national household survey in 1984-1985. Overall, 97.1% were seropositive for HSV-1 and 39.4% for HSV-2. Only 1.1% of HSV-2 seropositive women gave a history of symptomatic genital herpes. HSV-2 virus antibody increased with age and with the number of lifetime sexual partners. HSV-2 seroprevalence among women who reported only 1 lifetime sexual partner was almost twice as high as the prevalence among women who denied sexual experience (30.5% vs. 17.7%) and reached 79.2% among women with greater than or equal to 4 partners. HSV-2 seroprevalence was lower among women whose partners used condoms: 28.9% for those who had used condoms for at least 2 years vs. 44.3% for those who never used condoms.
Assuntos
Anticorpos Antivirais/análise , Parceiros Sexuais , Simplexvirus/imunologia , Adulto , Fatores Etários , Anticorpos Antibacterianos/análise , Chlamydia trachomatis/imunologia , Dispositivos Anticoncepcionais Masculinos , Costa Rica , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , População Rural , Comportamento Sexual , Sorodiagnóstico da Sífilis , População UrbanaRESUMO
All neonates with necrotizing enterocoltis cared for at Grady Memorial Hospital from July, 1977, through February, 1979, were compared with controls matched for birth weight and time of admission to the nursery, to examine risk factors which have been implicated in the etiology of the disease. Data on maternal history, birth history, and hospital course were uniformly collected and contrasted for 35 cases and 98 controls. Low birth weight was associated with an increased incidence of NEC and an increased case fatality rate. All babies 36 weeks or more at birth were diagnosed by seven days. More immature infants developed the disease later in their hospital course. In addition, preterm babies who developed NEC after 2 weeks of age appear to be smaller and sicker. Factors previously thought to predispose an infant to the development of the disease, such as prolonged rupture of membranes, infectious complications of pregnancy, low Apgar scores, patent ductus arteriosus, and use of umbilical catheters, were found with equal frequency in cases and controls and may simply represent the descriptive characteristics of a population of sick premature infants. Feeding history and antibiotic use were examined in depth and were not correlated with the development of NEC.
Assuntos
Enterocolite Pseudomembranosa/etiologia , Doenças do Recém-Nascido/etiologia , Antibacterianos/uso terapêutico , Peso ao Nascer , Enterocolite Pseudomembranosa/mortalidade , Enterocolite Pseudomembranosa/terapia , Métodos Epidemiológicos , Feminino , Georgia , Idade Gestacional , Humanos , Lactente , Alimentos Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Doenças do Prematuro/etiologia , Nutrição Parenteral , GravidezRESUMO
We recently have described destruction of cells infected with herpes simplex virus by the combination of specific antibody and either lymphocytes or monocyte-macrophages. Because of the role of these cells in viral immunity and the severity of HSV in neonates and pregnant women, cord blood from 11 healthy neonates and peripheral blood from seven of their postpartum mothers were analyzed for MP and lymphocyte antibody-dependent cellular cytotoxicity against cells infected with HSV. Cord blood yielded more lymphocytes and maternal blood fewer lymphocytes than did blood from adult female control subjects. Baseline cytotoxicity of cord MP and lymphocytes and maternal lymphocytes was significantly lower than control values. There was no significant difference in MP or lymphocyte ADCC, although maternal ADCC tended to be lower than that of control subjects. Analysis of cord plasma indicated that antibody able to participate in lymphocyte and MP ADCC crosses the placenta. These data demonstrate intact ADCC but possible defects in baseline cytotoxicity with leukocytes obtained from neonates and pregnant women. Further consideration of the use of HSV antibody for prevention and therapy of neonatal HSV infection is suggested.
Assuntos
Anticorpos Antivirais , Citotoxicidade Celular Dependente de Anticorpos , Herpes Simples/imunologia , Macrófagos/imunologia , Monócitos/imunologia , Complicações Infecciosas na Gravidez/imunologia , Testes Imunológicos de Citotoxicidade , Feminino , Sangue Fetal/citologia , Herpes Simples/sangue , Herpes Simples/patologia , Humanos , Recém-Nascido , Linfopenia/diagnóstico , Período Pós-Parto , GravidezRESUMO
The lymphocyte transforming agent, associated with Epstein-Barr virus, was sought in the oropharynx and other clinical sites of 443 individuals in the following groups: premature and term neonates; infants with congenital malformations or with suspected TORCH syndrome; children with various illnesses; pregnant and postpartum women; healthy adults; and patients with infectious mononucleosis. Evidence of intrauterine infection was found in one newborn infant and LTA was demonstrated in a 16-day-old infant who developed transient hepatosplenomegaly. LTA was not detected in 96 other newborn infants and 57 infants with various anomalies or illnesses; nor was it found in the cervix of 125 pregnant or postpartum women. LTA was demonstrated in varying frequency in ill children, healthy adults, and those with infectious mononucleosis. It is suggested that the clinicoepidemiologic patterns of EBV infection in newborn infants and children will best be established by prospective studies.