Gerardo Deluca

Chlamydia trachomatis as a probable cofactor in human papillomavirus infection in aboriginal women from northeastern Argentina

OBJECTIVES High-risk types of human papillomavirus (HPV) are strongly associated with cervical cancer (CC), and Chlamydia trachomatis (CT), the most frequent sexually transmitted bacterial infection (STBI) worldwide, seems to be a risk factor for HPV infection and for CC. It is also known that both agents are more prevalent in vulnerable communities where lack of adequate primary health care is a cause for concern. The aim of this work was to determine the impact of CT and HPV infections in women belonging to an isolated aboriginal population (Pilaga community) from a poor region in Northern Argentina (province of Formosa). For this purpose, a cross-sectional study was performed in all sexually active Pilaga women, who attended a local community-based gynecological health screening project. The polymerase chain reaction (PCR) method on a cervical brush specimen was used to detect both agents. RESULTS A total of 227 women (20% of the total female population of the Pilaga community) were studied and the overall prevalence was 26.4% for CT, 46.7% for HPV and 16.3% for concurrent infection. CT infection was higher in HPV DNA positive (34.2%) than in HPV DNA negative women (19%; OR: 2.22/95% CI = 1.16-4.28 / p = 0.009) and the most prevalent HPV types were HPV-16 (19.4%), 6 and 18 (5.3%), 58 (3.5%) and 33 (3.1%). CONCLUSIONS The prevalence of CT and HPV observed in Pilaga women are among the worst registered in Latin America. Also, data collected suggest that chlamydial infection may play an important role in the natural history of HPV infection. On this respect, we propose that the association between these two agents seems to be more related to a mutual potentiation than to the fact that they share a common route of transmission.

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.

Human papillomavirus detection in Corrientes, Argentina: High prevalence of type 58 and its phylodynamics.

Human papillomavirus (HPV) has the highest mortality rate due to cervical cancer in Northeastern Argentina. The aim of this work was to detect and characterize HPV in samples from the Province of Corrientes, Argentina. HPV detection and typing was performed using PCR-RFLP on samples with different cervical lesions (n=255). Seventeen viruses typified as HPV-58 were sequenced (E6 and E7 genes) and mutations were analyzed. HPV DNA was detected in 56.1% of the cervical lesions (143/255). Twenty-two different HPV types were detected. The type most frequently found among the total number of samples and HPV-positive samples was HPV-16 (14.5% and 25.9%, respectively), followed by HPV-58 (8.2%/14.7%, respectively), which is also considered a high-risk viral type. Increased severity of the cytological status was associated with greater rates of HPV detection and, especially, with the detection of greater rates of high-risk types. In addition, the evolutionary dynamics of the alpha-9 species group and HPV-58 was studied. All HPV-58 viruses reported in this work belonged to lineage A, sublineage A2. The phylodynamic analysis indicated that diversification of main groups within lineage A might have accompanied or preceded human migrations across the globe. Given that the most prevalent viruses found belonged to high-risk HPV types, some concerns might arise about the extent of cross protection of the vaccines against the types not included in their design.

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.