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Objetivo. Estimar la prevalencia de infección por el virus del papiloma humano (VPH) en estudiantes universitarios y utilizar dicha frecuencia como un marcador biológico para evaluar el comportamiento sexual. Material y métodos. Se realizó un estudio transversal, en estudiantes de la Universidad Autónoma del estado de Morelos, México, durante el periodo 2000-2001. Se aplicó un cuestionario y se colectaron muestras genitales para detectar ADN de los VPH oncogénicos. Los datos se analizaron utilizando pruebas de Ji cuadrada y razones de momios. Resultados. La prevalencia global del VPH en 194 estudiantes fue de 14.4%. Las mujeres con dos o más parejas sexuales durante el último año presentaron mayor riesgo de infección por el VPH (RM 6.0 IC 1.7-21.1), al igual que las que utilizaron anticonceptivos hormonales y espermicidas en su última relación sexual (RM 3.0 IC 1.0-8.7). Los hombres que consumieron cocaína tuvieron más riesgo de infección por el VPH (RM 7.6 IC 1.3-45.1). Conclusiones. La prevalencia del VPH es relativamente alta. La utilización del VPH como un marcador biológico de comportamientos sexuales en mujeres es pertinente; en hombres, es necesario ampliar la muestra.

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. To measure hepatitis C virus (HCV) sero-prevalence, prevalence, hepatitis risk characteristics frequency, and genotype correlation with viral load among clients attending health care clinics. Material and Methods. Venous blood samples from 112 226 consecutive consenting adults were collected from January 2006 through December 2009. HCV antibodies were detected by immunoassay. HCV RNA was detected by qRT-PCR and viral genotype was performed by PCR and LIPA test. Results. The HCV seroprevalence observed was 1.5 % (C.I. 95% 1.3-1.7), from seropositive individuals 60.9 % reported previous blood transfusion, 28.3% declared to have relatives with cirrhosis, 25.2% had tattoos or piercings, and 6.9% referred to have used drugs. Male gender and transfusion (p<0.001) were the most frequent hepatitis risk characteristics in the HCV seropositive group. Among seropositive subjects 48.3% presented HCV RNA. The most frequent genotype detected in all geographic areas of Mexico was 1 (subtype 1A, 33%; subtype 1B, 21.4%) followed by genotype 2 (subtype 2A, 8.50%). Subjects with genotype 1 had a significant correlation with the highest viral load. Conclusions. Our results show that nearly half of seropositive individuals are chronically infected. HCV infection has been shown in this study to be an emerging health problem in Mexico. [ABSTRACT FROM AUTHOR]

Objective. To measure for the first time in a population based study the prevalence of antibodies against Treponema pallidum among the Mexican adult population and correlates of infection. Materials and Methods. This study was derived from the Mexican National Health Survey carried out in 2000. Anti-T. pallidum seroprevalence was determined according to an algorithm based on a set of treponemic and non-treponemic serological tests for 12 010 sera randomly selected from participating women and men 20 years and older. A statistical analysis was applied to identify seropositivity associated variables. Results. Anti-T. pallidum seroprevalence was 3.1% (CI95% 2.5-3.7). Population characteristics significantly related to infection exposure were: older age (OR 3.3), being male (OR 1.3), inhabiting the southern region of the country (OR 1.7), having a regular partner not being married (OR 2.7) or being a widow (OR 1.8), early age at sexual debut (OR 6.3), and for women, having had still births (OR 1.8) and not using the condom as a contraceptive measure (OR 14.1). Conclusions. Results obtained show that exposure to T. pallidum infection among Mexican adults is at present a true public health problem, unknown until now. Factors associated with seropositivity were those expected considering the epidemiology of sexually transmitted infections. Health authorities must reinforce the surveillance and diagnosis of syphilis in Mexico to help prevent and control the transmission of the etiologic agent. [ABSTRACT FROM AUTHOR]

Objective. To estimate the prevalence of chronic hepatitis B infection and carrier status in Mexico; to analyze the frequency and distribution of hepatitis B markers in relation to the demographic and geographic variables and to identify risk factors. Materials and Methods. A total of 12 014 sera samples from the 2000 National Health Survey that were randomly selected for Anti-HBc and HBsAg were studied. The sera were collected between November 1999 and June 2000 on a national level. Results. Seroprevalence for anti-HBc and HBsAg were 3.3% (CI 95%: 2.8-3.9) and 0.21% (0.11-0.37), respectively. Odds ratios adjusted by age for anti-HBc were: 15.3 for subjects 50 to 59 years old as compared with adults less than 29 years of age; 2.6 for residents in the southern region of the country as compared with residents in the central region; 4.6 for laborers as compared with business owners; 2.1 for women having had stillbirths; and 1.7 for adults having initiated sexual relations before 25 years of age. Conclusion. The epidemiological pattern for hepatitis B in Mexico is lower than the data worldwide. Nevertheless, it is of concern that 1.7 million Mexicans have suffered from the infection caused by this virus and 107 000 suffer from a chronic carrier status. [ABSTRACT FROM AUTHOR]

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To estimate seroprevalence of hepatitis C virus (HCV) among 15-49 years old Mexicans living in households and to describe the profile of seroreactive individuals., Materials and Methods: Cross-sectional study implemented in 2012 using a national probabilistic sample with behavioral data from face-to-face interviews at households and HCV antibodies screening using capillary blood from same individuals., Results: HCV seroprevalence in Mexico was estimated at 0.27% (IC95% 0.12-0.60), representing 161 000 persons. Seroprevalence was significantly higher among males (0.45% CI95% 0.01-0.89) than females (0.10% CI95% 0.00-0.22). Multivariate analysis suggests a higher possibility of HCV reactivity among men, increasing with age and higher among those sexually active, and lower for higher socioeconomic level., Conclusion: HCV seroprevalence in Mexico by 2012 seems significantly lower than the estimation from 2000 of 1.2% for the same age-group. Evidence of infection among individuals 15-19 years old suggests the need to strength preventive actions, particularly in subjects with risky behaviors.

Objective: To estimate the HIV seroprevalence among Mexicans aged 15 to 49 years old and living in households, and to describe the profile of serorreactive individuals., Materials and Methods: Cross-sectional study with a national probabilistic sample of individuals aged 15 to 49 years with behavioral data from direct interview (face-to-face) at households and HIV screening using capillary blood collected from the same individuals., Results: A seroprevalence of 0.15% (95%CI 0.09-0.21) was estimated for Mexicans aged 15 to 49; seroprevalence among women was 0.07% (95%CI 0.03-0.11) and 0.24% (95%CI 0.11-0.36) for men. HIV serorreactive population is composed of younger men, with a higher socioeconomic level compared to the general population, and with a higher insurance coverage-social protection on health in general and social security in particular. Only 50% of the serorreactive individuals may be aware of their status as living with HIV., Conclusions: The estimated HIV seroprevalence in the NHNS 2012 suggests a stable pattern since 2000. The estimated prevalence among individuals 15 to 49 years was adjusted both for selection bias correction and to include MSM estimations (under the assumption that MSM is a population hard to reach in a household survey), resulting in a total seroprevalence of 0.23% and an estimated number of people with HIV of 140,000.

Patients with hepatitis C virus (HCV) infection are detected by testing for the presence of antibodies to HCV (Anti-HCV). A positive Anti-HCV test represents a true positive result only in a variable proportion of subjects (35 to 95%). The qualitative interpretation as positive or negative Anti-HCV report is associated with a general lack of understanding regarding the interpretation of results, when more specific testing should be performed, and which tests should be considered for this purpose. Therefore, a substantial variation in supplemental testing practices exists among laboratories and physicians. This guideline was developed on the basis of the best available evidence to classify positive antibody in two (low and high) or three levels (very low, low and high) according to the signal to cutoff (S/CO) ratio: the very low level of the Anti-HCV identifies false-positive results and further diagnostic testing is not necessary. The low antibody level is frequently related with false-positive results and testing with Immunoblot is recommended; only Immunoblot-positive subjects require HCV RNA testing because of a low possibility of being viremic. The high Anti-HCV level is an accurate serological marker for predicting viremia and denotes the need of routine HCV RNA testing in order to efficiently confirm hepatitis C. Cost-effectiveness analysis, based on the Anti-HCV level, recommends the use of the two or three-levels to choose the confirmatory test of positive antibody. This approach can be implemented without increasing test costs because the S/CO ratio is automatically generated in most laboratory analyzers and would provide health care professionals with useful information for counseling and evaluating patients, to eliminate unwarranted notifications in cases of false antibody reactivity, and correctly identifying those Anti-HCV-positive patients who are infected and need antiviral treatment. The written report should include the antibody level (S/CO ratio), the type of the immunoassay applied and interpretation guideline. Anti-HCV testing is performed in multiple settings including blood banks or health department facilities; adoption of this Guideline for interpretation and report of the antibody to hepatitis C virus by laboratories and its implementation by clinicians will improve the accuracy for interpreting antibody result to determine the next step on hepatitis C diagnosis.

Objective: Assess frequencies of maternal and congenital syphilis, mother-child transmission and variables associated with syphilis in six urban hospitals in Bolivia., Material and Methods: A cross-sectional study was performed between May and September 2004. We administered the Abbot Determine-TP rapid test and quantitative RPR to postpartum women without prior RPR. Sociodemographic variables and prior prenatal care visits were studied. Newborns of syphilis positive mothers were studied with Western Blot IgM p47 and ELISA IgM. Serum samples were analyzed at the Central Reference Laboratory (INLASA). Statistical analysis included bivariate and multivariate analyses to establish association with positive diagnosis of T. pallidum., Results: Syphilis prevalence among 1 594 postpartum women was 7.2%. Mother to child transmission was 15.7%. Congenital syphilis prevalence by serology was 1.1% and 94% of these newborns displayed no symptoms. Despite 70.5% prenatal care coverage in Bolivia some women still go directly to a facility to give birth without prior routine tests for syphilis. Low education levels in both parents (< 8 years) and failure to attend prenatal care were strong predictors of congenital syphilis., Conclusions: Rapid syphilis tests constitute an important tool to strengthen early diagnosis of syphilis during pregnancy. Preventing congenital and maternal syphilis in Bolivia remains a public health priority.

Objective: To estimate the prevalence of maternal and neonatal syphilis, to assess the usefulness of a rapid treponemic diagnostic test, and to evaluate the frequency of screening for syphilis during prenatal care in Mexican women., Material and Methods: This was a cross-sectional study that included 1,322 women interviewed in two hospitals (Hospital General in Cuernavaca, Morelos, and Hospital de la Mujer in Mexico City). Women answered a questionnaire on reproductive background, exposure to sexually transmitted infections and prenatal care. In order to diagnose syphilis, a rapid Determine TP test and a latex-VDRL test were used among all participating women. Positive cases were confirmed using FTA-ABS test., Results: Prevalence of serologically active syphilis was 0.3% (4/1322). Using as comparison standard a combination of VDRL and FTA-ABS tests, the Determine TP test had a sensitivity and specificity of 100%. Two newborns with positive FTA-ABS IgM, one negative with FTA-ABS IgM and one first-trimester abortion were found from seropositive women. Prenatal serum screening for syphilis was conducted in only 6.9% of women included in the study., Conclusions: Although the prevalence of maternal syphilis is relatively low, results show that if the situation found in the hospitals studied is shared by other hospitals in Mexico, a systematic screening for maternal syphilis would help to diagnose more cases of this infection than the number reported in official figures. Screening of syphilis in pregnant women using rapid tests may help in the prevention of congenital syphilis.

Objective: To compare the mechanisms of HIV/AIDS transmission reported by the epidemiological surveillance system information of the Chiapas State and those referred by HIV positive men interviewed in the Soconusco's region from the same state., Methods: Databases containing information about the HIV/AIDS cases registered in the State of Chiapas and in the Soconusco's region were used. Additionally, 32 men previously detected as HIVpositive by the regional surveillance system answered a questionnaire about their sexual behavior and some socio-demographic characteristics. All participants provided a blood sample to identify antibodies against HIVusing two screening tests, ELISA and microagglutination, and one confirmatory test by Western blot., Results: While the heterosexual transmission was predominant among HIV/AIDS cases reported by the epidemiological surveillance of Chiapas State and the Soconusco's (50.4% and 69. 40%, respectively), heterosexual transmission among the interviewed individuals was 36.7%., Conclusions: Contrary to the proposal about a process of "heterosexualization" of HIV/AIDS epidemic in Chiapas State and particularly in the Soconusco's region, the present study suggest that homosexual and bisexual behavior continue to be the main routes of HIV transmission among men. These results also suggest the presence of a methodological limitation in the evaluation of sexual behavior among HIV-seropositive individuals in the region. A gender analysis about masculinity, would allow a better understanding ofthe social and cultural aspects of sexuality that are not evident when only the sexual practices are evaluated.

Objective: To assess the frequency of HSV-2 and Treponema pallidum markers and their relationship with characteristics of women during gynecological outpatient visits., Material and Methods: In 1994 and 1995, two populations of 388 and 448 women were studied in two hospitals; one in Cuernavaca, Morelos, México, and the other in Mexico City. Participants provided a blood specimen for detection of antibodies against HSV-2 and T pallidum using the Western blot technique and the VDRL and FTA-ABS tests. Also, participants answered a questionnaire on their sociodemographic characteristics and sexual behavior. The data were analyzed with the SPSS and EGRET statistical packages., Results: The frequencies of HSV-2 antibodies were 28.3% in women from the first hospital, and 18.1% for those in the second. The frequencies of T pallidum antibodies were 2.3% and 1.1%, respectively. Age, marital status, education level, and number of sexual partners were associated with HSV-2 infection., Conclusions: Low frequencies were found for infection by the microorganisms studied in both groups. HSV-2 infection was associated to exposure periods, sexual behavior, and socioeconomic level. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

Objective: To determine the seroprevalence of type 2 herpes simplex virus (HSV-2) infection and risk factors in three female population groups in Mexico City., Material and Methods: A cross-sectional study was carried out in 2000, among a sample population of women living in Mexico City, diagnosed with breast or cervical cancer, and women with negative Pap test results from the general population. Informed consent was obtained from all participants to answer a sociodemographic and sex life questionnaire and draw a blood specimen. The presence of antibodies against type 2 herpes simplex virus was determined using the type-specific Western blot technique. Crude and adjusted statistical analyses were performed on the associations between survey data and infection outcomes., Results: Women with cervical cancer had a seroprevalence of HSV-2 infection of 46.8% (191/408); that of women from the general population who were Pap negative was 29.3% (214/730). For women with breast cancer, the seroprevalence was 22.6% (29/128). Variables significantly associated with seropositivity against HSV-2 infection were older age, more sexual partners, having cervical cancer, and, among cervical cancer patients, beginning sexual activity before 21 years of age and being divorced or separated., Conclusions: Study findings showed statistically significant differences in the prevalence of viral infection by population groups. The overall frequency of viral infection among study subjects shows that this is an intermediate risk population, as compared with other population groups in Mexico at high (sexual workers) and low (college students) risk. The main characteristics associated with exposure to type 2 herpes simplex virus for the subpopulations corresponded, as expected, to sexual behavior and to the probability of infection with older age. The English version of this paper is available too at:http://www.insp.mx/salud/index.html.

Objective: To estimate the prevalence of Human papillomavirus (HPV) among university students and to use it as a biological marker to assess sexual behavior., Material and Methods: A cross-sectional study was carried out between 2000 and 2001 among 194 students at Universidad Autónoma del Estado de Morelos, Mexico. A data collection instrument was applied and genital samples were taken to detect oncogenic HPV DNA. Data were analyzed using the chi-squared test and odds ratios., Results: Overall HPV prevalence was 14.4%. Women who had had two or more sexual partners during the previous year showed a greater risk of HPV infection (OR 6.0, 95% CI 1.7-21.1), as did women who had used oral contraceptives and spermicides at their latest intercourse (OR 3.0, 95% CI 1.0-8.7). Males who consumed cocaine were at a greater risk of HPV infection (OR 7.6, 95% CI 1.3-45.1)., Conclusions: HPV prevalence is relatively high. HPV is a reliable biological marker of sexual behavior among females. A greater sample size may be needed to assess its reliability among men.