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Background: In some countries, HIV infection in pregnancy has become a common complication of pregnancy.Goal: To determine the seroprevalence of HIV, hepatitis B virus, and syphilis among pregnant women, and to assess risk factors for these infections.Study Design: A cross-sectional study was performed.Methods: Pregnant women attending antenatal clinics of Vitória Municipality from March to December 1999 were included in this study after giving written informed consent. The women were systematically interviewed. During the interview, their demographics and patterns of risk behavior were explored. A blood sample was collected for testing HIV, hepatitis B virus, and syphilis.Results: The participants in this study were 1608 pregnant women. The prevalence of HIV infection was 0.8% (95% CI, 0.4-1.2), hepatitis B virus carriers 1.1% (95% CI, 0.8-1.3), and syphilis 3% (95% CI, 2.6-3.5). The potential risk behaviors were found to be a history of STDs (6.5%), condoms never used (52.8%), prostitution (0.5%), noninjection drug use (6.3%), blood transfusion (1.5%), and intravenous drug abuse (0.7%).Conclusion: These results show the necessity of implementing programs aimed at preventing transmission of these infections in women and their children. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted diseases (STDs) have become an important medical problem in prisons.Goal: To determine the prevalence of and risk factors for STDs among female inmates in a Brazilian prison.Study Design: All female prisoners at the Espírito Santo State Prison were offered enrollment in this cross-sectional study. An interview exploring demographics, criminal charges, and risk behavior was conducted. Blood and genital specimens were collected for STD testing.Results: Of 122 eligible women, 121 (99%) agreed to participate. Prevalence rates were: HIV 9.9%, human T-cell lymphotrophic virus type I 4.1%, hepatitis B virus 7.4%, hepatitis C virus 19%, syphilis 16%, gonorrhea 7.6%, chlamydial infection 11%, human papillomavirus-related cytologic changes 9.3%, trichomoniasis 30%, and bacterial vaginosis 15%. Previous or current drug abuse (54%), injection drug use (11%), and blood transfusion (16%) were associated with at least one STD. Condom use was infrequent.Conclusion: The prevalence of STDs and of behaviors leading to ongoing transmission are high among female inmates in Vitória, Brazil, and demonstrate the potential importance of prevention activities targeting this population. [ABSTRACT FROM AUTHOR]

Abstract: Low bone mineral density (BMD) has been described in human immunodeficiency virus (HIV)-infected patients, but data on associated factors are still unclear, and to our knowledge, no reports are available in Brazil. Our goal was to evaluate BMD in HIV patients attending an outpatient clinic in Vitoria, Brazil. A sectional study was performed in 300 HIV-infected patients to measure BMD by dual-energy X-ray absorptiometry (DXA). Age, gender, anthropometric parameters, nadir and current CD4 cell count, HIV viral load, smoking habit, and current antiretroviral therapy (ART) associations were investigated by multivariable analysis. Based on World Health Organization T-score ranges, low BMD (T-score <−1.0 standard deviation [SD] in postmenopausal women and men aged 50 and older or Z-score <− 2.0 SD in premenopausal women and men below the age of 50) was detected in 54.7% (95% confidence interval: 49.1–60.3%) of the 300 enrolled patients. The observed median age was 46 yr (interquartile range: 39–52), 58% were male, 88.5% were on ART, and 21.4% smoked. The following factors were identified, by multiple logistic modeling, as being independently associated with low BMD: (1) male gender (4.6 [1.28–16.39]), (2) body mass index lower than 25 kg/m2 (2.9 [1.31–6.49]), (3) menopause (13.4 [2.53–71.12]), and (4) HIV-1 undetectable viral load (7.9 [1.96–32.25]). Conversely, zidovudine (0.2 [0.04–0.85]) and nevirapine (0.1 [0.02–0.38]) use were inversely associated with low BMD. Low BMD was frequently found in our cohort of about 300 Brazilian HIV-infected subjects. This study upports the need for periodic DXA testing in HIV outpatient clinics. [Copyright &y& Elsevier]

We assessed the prevalence of AIDS among children diagnosed with active tuberculosis (TB) in Espírito Santo State, Brazil, by linking TB and AIDS surveillance databases using Reclink software and SPSS. Among 411 pediatric TB cases from 2000 to 2006, 27 (7%) were co-infected with AIDS. Most children were unable to provide a sputum specimen; co-infected patients were more likely to be smear negative for acid-fast bacilli (83% vs 46%; p = 0.07) and culture positive for Mycobacterium tuberculosis (44% vs 19%; p < 0.001). In all, 57% of co-infected patients did not react to tuberculin skin test compared with 17% of TB patients (p < 0.001). This report emphasizes the significance of AIDS in pediatric TB cases and highlights the importance of evaluating surveillance databases for gaining a better understanding of the burden of co-infection. [ABSTRACT FROM AUTHOR]