RESUMO
OBJECTIVES: Puerto Rico (PR), is the fifth highest jurisdiction of the United States of America (US) with respect to HIV prevalence and the leading in cervical cancer incidence. This cross-sectional study describes the prevalence and correlates of cervical HPV infection among a clinic-based sample of 302 women living with HIV/AIDS in PR. METHODS: Data collection included questionnaires, blood and cervical samples. Multivariable logistic regression models were used to estimate the magnitude of association (adjusted Prevalence odds ratio [aPOR]) between HPV cervical infection and other covariates. RESULTS: Mean age of participants was 40.3 years (± 10.3SD). The prevalence of HPV infection was 50.3%; 41.1% for low-risk types and 29.5% for high-risk types. Having ≥ 10 lifetime sexual partners (aPOR = 2.10, 95% CI:1.02-4.29), an abnormal Pap (aPOR = 3.58, 95% CI:1.93-6.62), active genital warts (aPOR = 3.45, 95% CI:1.60-7.42), and CD4 counts ≤ 200 (aPOR = 4.24, 95% CI: 1.67-10.78) were positively associated with any cervical HPV infection. Similar results were observed for HR HPV infection. CONCLUSIONS: A high burden of HPV co-infection exists among women living with HIV/AIDS in this population. Given the high incidence of HIV in PR and the higher risk of cervical cancer among women living with HIV/AIDS, HPV vaccination should be promoted in this population.
Assuntos
Colo do Útero/virologia , Coinfecção/epidemiologia , Infecções por HIV/epidemiologia , Hispânico ou Latino , Infecções por Papillomavirus/etnologia , Infecções por Papillomavirus/epidemiologia , Adulto , Coinfecção/virologia , Condiloma Acuminado/epidemiologia , Condiloma Acuminado/etiologia , Condiloma Acuminado/virologia , Efeitos Psicossociais da Doença , Estudos Transversais , DNA Viral , Feminino , Infecções por HIV/complicações , Infecções por HIV/virologia , Humanos , Modelos Logísticos , Razão de Chances , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Prevalência , Porto Rico/epidemiologia , Fatores de Risco , Parceiros Sexuais , Inquéritos e Questionários , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/etiologia , Neoplasias do Colo do Útero/virologiaRESUMO
AIM: Acupuncture and moxibustion are 2 therapeutic methods used in Traditional Chinese Medicine. The aim of this study is to evaluate the effect of acupuncture and moxibustion in physical performance by an ergospirometry test. METHODS: Thirty-one subjects, sedentary, were randomized into 3 groups: Group I (Acupuncture); Group II (AcupunctureSham) and Group III (Control). They were submitted to anamnesis and an ergospirometry test. The subjects from Groups I and II were submitted to 10 acupuncture and moxibustion sessions, twice a week, for 5 weeks. The differences between the groups were that in Group I the acupuncture and moxibustion sessions were performed in acupoints and Group II in non acupoints. After this, the ergospirometry test was performed again. RESULTS: The acupuncture and moxibustion sessions did not increase maximum oxygen uptake (VO2max) significantly. Other variables presented a significant increasing: oxygen uptake in anaerobic threshold (VO2La); velocity in anaerobic threshold (Vel LA); caloric consumption (Gast Cal). The heart rate decreased when compared to velocity pre and post-treatment. The results show peripheral, afferent stimulation (acupuncture and moxibustion) could alter the functions of structures or internal organs. The decrease in heart rate and the significant improvement in oxygen uptake in anaerobic threshold are similar to adaptations to physical training. Probably, the autonomic nervous system (mainly sympathetic system) is engaged in the acupuncture and moxibustion mechanism of action. CONCLUSIONS: Acupuncture and moxibustion decreased the heart rate during the ergospirometry test; the oxygen uptake in anaerobic threshold (VO2La); velocity in anaerobic threshold (Vel LA) and caloric consumption (Gast Cal) had significantly increased.
Assuntos
Terapia por Acupuntura , Fadiga/terapia , Moxibustão , Resistência Física/fisiologia , Adulto , Limiar Anaeróbio , Índice de Massa Corporal , Teste de Esforço , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio/fisiologia , Espirometria , Estatísticas não ParamétricasRESUMO
There is increasing evidence that male or female genital tract represent a distinct replication compartment for human immunodeficiency virus type 1 (HIV-1) and that such compartments may serve as a virus reservoir. Forty-four paired plasma and vaginal samples from HIV-infected females undergoing HAART were collected to examine the viral responses to antiretroviral therapy and to assess the possible role of the vaginal tract as a reservoir for drug-resistant variants. Twenty-one females had detectable viral RNA both in plasma and vaginal fluid, whereas 14 females had detectable virus only in plasma. Twelve paired samples were used to analyze HIV-1 pol sequences for the presence of drug resistance-associated mutations. Nine of the twelve paired samples exhibited discordant drug resistance mutation patterns. The other three females showed identical drug resistance-associated mutations. However, further examination of protease and RT showed numerous non-drug-associated mutations that corresponded to predefined CTL epitopes. These non-drug-associated mutations were different between plasma and vaginal viruses, suggesting that evolution of HIV-1 was independent in these two compartments.
Assuntos
Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral/genética , Infecções por HIV/virologia , HIV-1/genética , Mutação , Adulto , Sequência de Aminoácidos , Terapia Antirretroviral de Alta Atividade , Transmissão de Doença Infecciosa , Feminino , Genes pol/genética , Infecções por HIV/sangue , Infecções por HIV/transmissão , Protease de HIV/genética , Transcriptase Reversa do HIV/genética , HIV-1/efeitos dos fármacos , Humanos , Transmissão Vertical de Doenças Infecciosas , Dados de Sequência Molecular , RNA Viral/análise , RNA Viral/sangue , Alinhamento de Sequência , Vagina/virologiaRESUMO
In order to investigate the existing notion that the human immunodeficiency virus type 1 (HIV-1) infection in Puerto Rico (PR) was imported from the continental United States of America (USA) we sequenced and analyzed 900 bases of the HIV-1 pol sequence from individuals in PR for comparison with pol sequences from the USA mainland. The sequences were derived by direct sequencing of reverse transcription-polymerase chain reaction products generated from plasma virus. The products were sequenced in both directions and the complementary strands were compared prior to analysis. These processed sequences and GenBank sequences from the continental USA were subjected to phylogenetic analyses. The PR and USA sequences did not form independent clusters, indicating a shared HIV-1 infection. This may be due to the continuous human traffic or, less likely, may indicate a similar evolution of a common source virus. Analysis of drug resistance mutations, fairly similar in frequency in the PR and USA sequences analyzed here, supports human traffic as a rationale for the common infection. This work indicates that an efficacious vaccine developed for use in the USA mainland will also be effective in prevention in PR and perhaps the other countries of the Caribbean region.
Assuntos
Produtos do Gene pol/genética , HIV-1/genética , Filogenia , Farmacorresistência Viral/genética , Evolução Molecular , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Porto Rico/epidemiologia , Alinhamento de Sequência , Análise de Sequência de RNA , Estados Unidos/epidemiologiaRESUMO
Despite its ancient use as a therapeutic tool to treat several ailments, acupuncture still faces the challenge of scrutiny by Western science both in terms of its efficacy and in terms of the characterization of its effects and mechanisms of actions underlying these effects. We investigated under well-controlled and carefully characterized conditions the influence of electrical stimulation of acupuncture points ST-36 (Zusanli) and SP-6 (Sanyinjiao) on the myoelectric activity of the small intestine of 38 adult male Wistar rats. Electrical recordings obtained by means of four electrodes chronically implanted in the small intestine were used to assess the effects of acupuncture (electroacupuncture stimulation set at 2 Hz, intermittent stimulation, 1 V, for 30 min). Immobilization of the animals was associated with a consistent decrease (-8 +/- 7%) in the myoelectric activity of the small intestine as measured by means of the root mean square. Conversely, acupuncture was able to significantly increase (overshoot) this activity compared to baseline (+44 +/- 7%). In contrast, immobilized animals subjected to sham acupuncture had only modest (nonsignificant) increases in myoelectric activity (+9 +/- 6%). Using carefully controlled conditions we confirmed previous noncontrolled studies on the ability of acupuncture to alter intestinal motility. The characterization of the topographic and temporal profiles of the effects observed here represents a basis for future dissection of the physiological and pharmacological systems underlying these effects.
Assuntos
Pontos de Acupuntura , Motilidade Gastrointestinal/fisiologia , Intestino Delgado/fisiologia , Animais , Estimulação Elétrica , Eletromiografia , Masculino , Ratos , Ratos WistarRESUMO
Despite its ancient use as a therapeutic tool to treat several ailments, acupuncture still faces the challenge of scrutiny by Western science both in terms of its efficacy and in terms of the characterization of its effects and mechanisms of actions underlying these effects. We investigated under well-controlled and carefully characterized conditions the influence of electrical stimulation of acupuncture points ST-36 (Zusanli) and SP-6 (Sanyinjiao) on the myoelectric activity of the small intestine of 38 adult male Wistar rats. Electrical recordings obtained by means of four electrodes chronically implanted in the small intestine were used to assess the effects of acupuncture (electroacupuncture stimulation set at 2 Hz, intermittent stimulation, 1 V, for 30 min). Immobilization of the animals was associated with a consistent decrease (-8 ± 7 percent) in the myoelectric activity of the small intestine as measured by means of the root mean square. Conversely, acupuncture was able to significantly increase (overshoot) this activity compared to baseline (+44 ± 7 percent). In contrast, immobilized animals subjected to sham acupuncture had only modest (nonsignificant) increases in myoelectric activity (+9 ± 6 percent). Using carefully controlled conditions we confirmed previous noncontrolled studies on the ability of acupuncture to alter intestinal motility. The characterization of the topographic and temporal profiles of the effects observed here represents a basis for future dissection of the physiological and pharmacological systems underlying these effects
Assuntos
Animais , Masculino , Ratos , Pontos de Acupuntura , Motilidade Gastrointestinal , Intestino Delgado , Estimulação Elétrica , Eletromiografia , Ratos WistarRESUMO
The roots of the Hispanic populations of the Caribbean Islands and Central and South America go back to three continents of the Old World. In Puerto Rico major genetic contributions have come from (1) Asians in the form of the aboriginal Taino population, an Arawak tribe, present when Columbus arrived on the Island, (2) Europeans, largely Spanish explorers, settlers, government administrators, and soldiers, and (3) Africans who came as part of the slave trade. Since JC virus (JCV) genotypes characteristic of Asia, Europe, and Africa have been identified, and excretion of JCV in urine has been proposed as a marker for human migrations, we sought to characterize the JCV strains present in a Caribbean Hispanic population. We found that the strains of JCV present today in Puerto Rico are those derived from the Old World populations represented there: Types 1B and 4 from Spain, Types 3A, 3B, and 6 from Africa, and Type 2A from Asia. The Type 2A genotype represents the indigenous Taino people. This JCV genotype was represented much more frequently (61%) than would be predicted by the trihybrid model of genetic admixture. This might be attributable to characteristics of JCV Type 2A itself, as well as to the nature of the early relationships between Spanish men and native women. These findings indicate that the JCV strains carried by the Taino Indians can be found in today's Puerto Rican population despite the apparent demise of these people more than two centuries ago. Therefore, molecular characterization of JCV provides a tool to supplement genetic techniques for reconstructing population histories including admixed populations.
Assuntos
Genética Populacional , Hispânico ou Latino/genética , Vírus JC/genética , Adulto , África , Feminino , Pool Gênico , Genótipo , Humanos , Indígenas Centro-Americanos/genética , Masculino , Pessoa de Meia-Idade , Filogenia , Porto Rico , EspanhaRESUMO
Direct percutaneous exposure is the main route of HCV transmission. In Puerto Rico half of people infected with HIV use illicit drugs. The effects of HCV in the course of HIV infection and vice versa have been extensively studied, but remain highly controversial. This may be due to HCV genetic heterogeneity. Therefore, a complex classification into genotypes has emerged that prompted us to determined how this impacts a population of intravenous drug users (IDUs) co-infected with HIV-1. Using Inno-LiPa II technique, we analyzed samples from 171 HCV-HIV-1-co-infected IDUs and 375 from a general HCV population of unknown HIV or source of infection status. Similar HCV genotype distribution was detected in these populations. HCV genotype 1a was the most frequently in IDUs-co-infected with HIV-1, followed by 1b and 3a. Twenty mixed infections and 5 undetermined genotypes were reported. A reduced HCV viral load was observed in HIV-1 positives with wasting syndrome. Individuals with a high HIV-1 viral load presented a low HCV viral load. There were no correlation between HCV genotypes and AIDS-related event. Patients with genotype 1b showed a higher HCV viral load. Males presented higher HCV viral load than females. Females were predominantly affected by genotype 1a, and men by 1a and 1b. Neither the HCV viral load nor the frequency of genotypes were influenced by the antiretroviral modality. The importance of continuous genotype monitoring is stressed.
Assuntos
Infecções por HIV/complicações , Hepacivirus/genética , Hepatite C/virologia , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Frequência do Gene , Genótipo , Infecções por HIV/virologia , HIV-1 , Hepacivirus/isolamento & purificação , Hepatite C/complicações , Hepatite C/imunologia , Humanos , Masculino , Porto Rico , RNA Viral/sangue , Carga ViralAssuntos
Infecções por HIV/virologia , HIV-1/classificação , HIV-1/genética , DNA Viral/análise , Feminino , Variação Genética , Protease de HIV/genética , Humanos , Dados de Sequência Molecular , América do Norte , Polimorfismo de Fragmento de Restrição , Porto Rico , Vigilância de Evento Sentinela , Trabalho SexualRESUMO
Ponce School of Medicine AIDS Research Program conducted a large scale viral load assessment of Puerto Ricans who are infected by human immunodeficiency virus type 1 (HIV-1) during the summer of 1996 through the Roche ACCESS program before general implementation of combination therapy. Since January 1997, it has monitored those HIV-1 patients who are under treatments at most HIV-1 health care clinics, including both public and private. The present study was conducted to evaluate how the new treatment has generally impacted on the HIV-1 disease status of HIV-1 infected population in the eight Immunology Clinics. Assessment was made by consecutively monitoring the changes in HIV-1 viral load profiles of the population from January to September, 1997. A large majority of samples were delivered for viral load assessment without information of their treatment status, and only a small number of samples were identifiable either as baseline or followup. Despite the paucity of individual information, remarkable improvements of HIV-1 (+) population at large were evident. For example, in the summer of 1996 (ACCESS), population median viral load was 51,842; only 9% of the population had viral load less than 500 viral RNA copies/ml plasma and 72% had over 10,000 copies/ml. By July-September, 1997, the population median dropped to 8,679 (83%); 23% were below 500 copies/ml (+156%) and the proportion of patients who had over 10,000 copies/ml was reduced to 48% (-33%). The group of individuals who were positively identified as "follow-up" (i.e., under active treatment) had a median of 37128 copies/ml (-94%); 28% were below 500 copies/ml (+211%) and only 40% had more than 10,000 copies/ml (-44%). It is obvious that the implementation of triple combination therapy by PASET in 1997, has very markedly improve the HIV-1 disease status of HIV-1 (+) population in Puerto Rico.