Amalia Castro

Detection of high risk human papillomavirus cervical infections by the hybrid capture in Asunción, Paraguay

Cervical cancer is the most frequent malignant tumour of women in Latin America being human papillomavirus (HPV) the main cause. The aim of this study was to increase the knowledge about the cervical infections with oncogenic HPV types (HR-HPV) in Asuncion, Paraguay. Two hundred and seventy-two cervical samples were analyzed using hybrid capture II assay (HCA II) for HR-HPV. The frequency of HR-HPV in the study group was 44%. HR-HPV was detected in 25% of the women negative for squamous intraepithelial lesions (NSIL), 72% with atypical squamous cells of undetermined significance (ASCUS), 68% with low SIL and 78% with high SIL. A moderate concordance was observed between HCA II assay and cytology (kappa: 0.43 IC(95% 0.3-0.5)). It was detected a high frequency of HR-HPV in women from 11 to 30 years old and in those over 60 years old. The data obtained in this study showed a high frequency of HR-HPV in woman with NSIL and ASCUS, which corroborate that the use of cytology together with HCA II assay for HR-HPV could improve remarkably the efficiency of screening programs of cervical cancer in Paraguay. Furthermore, these findings point out the need for the periodical follow-up of HR-HPV infections in older women.

Distribution of human papillomavirus (HPV) genotypes and bacterial vaginosis presence in cervical samples from Paraguayan indigenous

OBJECTIVE To determine the frequency of human papillomavirus (HPV) types and to assess bacterial vaginosis (BV) possible associations with cervical infections in indigenous Paraguayan women of the Department of Presidente Hayes. METHODS This study included 181 sexually active women without cervical lesions. HPV typing was performed by polymerase chain reaction with primers PGMY 09/11 followed by reverse line hybridization. BV was diagnosed by the Nugent criteria using the results from a Gram stain smear. RESULTS Sixteen percent of women were positive for at least one high risk HPV type (HR-HPV). The most frequent genotypes were HPV 16 (4.4%), followed by HPV 58 (3.3%), HPV 45 (3.3%), HPV 53 (2.8%) and HPV 11 (2.8%). A significant association between HR-HPV and BV was observed (p=0.01). In addition, women with BV had a higher frequency of Chlamydia trachomatis (p=0.0007), Trichomonas vaginalis (p=0.00009), Mycoplasma hominis (p=0.001). CONCLUSIONS A large variety of HPV genotypes was detected and showed a slightly different pattern from previous studies on urban women in Paraguay, with the predominance of HR-HPV. Furthermore, the information of co-infections involved in BV could be useful for the improvement of national prevention programs, as well as for laboratory surveillance of these genital infections.

Deteccion del virus del papiloma humano de alto riesgo por captura hibrida II segun hallazgos citologicos en mujeres tratadas por lesiones escamosas intraepiteliales de cuello uterino, periodo 2006/2010

OBJECTIVE: To determinate the frequency of high risk human papillomavirus (HR-HPV) by hybrid capture II (r) (CH II(r)), according cytology results in women treated for squamous intraepithelial lesions of the cervix (SIL). MATERIAL AND METHODS: A descriptive cross-sectional study of a series of cases that included 122 women treated, 79 (75%) for low grade SIL (LSIL) and 43 (35%) for high grade SIL (HSIL) attending at the HPV Laboratory at the Health Sciences Research Institute (IICS), National University of Asuncion (UNA), for post-treatment control during period 2006/2010. RESULTS: A total of 28% (34/122) of women treated for SIL were positive for HR-HPV, detecting viral infection in 20% of women with no SIL (NSIL) (22/108), in 83% of women with LSIL (10/12) and in 100% of women with HSIL (2/2). Of 34 women positive for HR-HPV, 10 women (29%) had high values (100 pg / mL or more) of relative viral load, detecting an increase of positive cases with severity of the lesion (28% NSIL, 30% LSIL, 50% HSIL). CONCLUSION: HR-HPV detection by CH II(r) and high relative viral load values especially in women with NSIL could help to identify treated women at risk of developing recurrence, thereby contributing to strengthening the cervical cancer prevention program.

Anemia y deficiencia de hierro en mujeres indígenas del Departamento de Presidente Hayes, Paraguay, 2010-2011

Segun datos de la UNICEF, entre 4 mil y 5 mil millones de personas en el mundo padecen carencia de hierro, y se calcula que 2 mil millones sufren de anemia. La mujer puede presentar diversos tipos de anemia, ya sea por menstruaciones abundantes o por deficiencia de aporte de hierro. El objetivo de este trabajo fue evaluar los parametros hematologicos e indicadores quimicos de la anemia y carencia de hierro en las mujeres indigenas del Departamento de Presidente Hayes, Paraguay, realizado de octubre de 2010 a octubre de 2011. En este estudio observacional descriptivo de corte transverso, se incluyeron 222 mujeres de 12 a 60 anos de edad de las etnias maka, nivacle, sanapana, enxet y tobaqom. Se determino la concentracion de la hemoglobina e indices hematimetricos: VCM, HCM y CHCM mediante un contador hematologico. El hierro serico y transferrina se determino por metodo enzimatico colorimetrico y la saturacion de la transferrina por calculo manual. En el 40% (88/222) de las mujeres se observo hemoglobina por debajo de 12 g/dL. Con respecto a los indices hematimetricos, presentaron valores inferiores al punto de corte, siendo el 33% para VCM, 22% HCM y el 16% para CHCM. Estos resultados indican una deficiencia de hierro en diferentes fases, lo que tendria consecuencias negativas como la anemia, baja resistencia a infecciones, retraso en el desarrollo psicomotor y funcion cognoscitiva de los ninos, bajo rendimiento academico, fatiga, entre otras patologias en una poblacion vulnerable donde la mayoria de las mujeres estudiadas son de edad fertil.