Cervical human papillomavirus (HPV) infection may increase HIV risk. Since other genital infections enhance HIV susceptibility by inducing inflammation, we assessed the impact of HPV infection and ...clearance on genital immunology and the cervico-vaginal microbiome. Genital samples were collected from 65 women for HPV testing, immune studies and microbiota assessment; repeat HPV testing was performed after 6 months. All participants were HIV-uninfected and free of bacterial STIs. Cytobrush-derived T cell and dendritic cell subsets were assessed by multiparameter flow cytometry. Undiluted cervico-vaginal secretions were used to determine cytokine levels by multiplex ELISA, and to assess bacterial community composition and structure by 16S rRNA gene sequence analysis. Neither HPV infection nor clearance were associated with broad differences in cervical T cell subsets or cytokines, although HPV clearance was associated with increased Langerhans cells and HPV infection with elevated IP-10 and MIG. Individuals with HPV more frequently had a high diversity cervico-vaginal microbiome (community state type IV) and were less likely to have an L. gasseri predominant microbiome. In summary, HPV infection and/or subsequent clearance was not associated with inflammation or altered cervical T cell subsets, but associations with increased Langerhans cells and the composition of the vaginal microbiome warrant further exploration.
Background. Genital inflammation is a key determinant of human immunodeficiency virus (HIV) transmission, and may increase HIV-susceptible target cells and alter epithelial integrity. Several genital ...conditions that increase HIV risk are more prevalent in African, Caribbean, and other black (ACB) women, including bacterial vaginosis and herpes simplex virus type-2 (HSV-2) infection. Therefore, we assessed the impact of the genital microbiota on mucosal immunology in ACB women and microbiome-HSV-2 interactions. Methods. Cervicovaginal secretions and endocervical cells were collected by cytobrush and Instead Softcup, respectively. T cells and dendritic cells were assessed by flow cytometry, cytokines by multiplex enzyme-linked immunosorbent assay (ELISA), and the microbiota by 16S ribosomal ribonucleic acid gene sequencing. Results. The cervicovaginal microbiota of 51 participants were composed of community state types (CSTs) showing diversity (20/51; 39%) or predominated by Lactobacillus iners (22/51; 42%), L. crispatus (7/51; 14%), or L. gasseri (2/51; 4%). High-diversity CSTs and specific bacterial phyla (Gardnerella vaginalis and Prevotella bivia) were strongly associated with cervicovaginal inflammatory cytokines, but not with altered endocervical immune cells. However, cervical CD4+ T-cell number was associated with HSV-2 infection and a distinct cytokine profile. Conclusions. This suggests that the genital microbiota and HSV-2 infection may influence HIV susceptibility through independent biological mechanisms.
To estimate the prevalence of hepatitis B viral markers.
A sero-epidemiological community-based cross-sectional study.
All nine provinces of Zimbabwe.
From April 1989 to December 1991 serum samples ...were collected from 1,461 males and 1,933 females in the age group 10-61 years, the majority in the younger age groups.
Sera were tested for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), antibody to HBs-Ag (anti-HBs), antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B e antigen (anti-HBe). All sera were tested for HBsAg, anti-HBs and anti-HBc but for the detection of HBeAg and anti-HBe, only samples positive for HBsAg were examined.
The male-to-female ratio in rural and urban settings was 0.82 and 0.66 respectively. The median age for males and females in rural areas was 21 and 22 years and 28 and 26 years respectively in urban areas. The overall prevalence of HBsAg was 15.4% (males 16.8%, females 14.3%). The difference between sexes was consistent in all age groups and statistically significant (P < 0.05). The prevalences in urban and rural areas were almost identical (15.7% v. 15.3%). However, the prevalence was significantly higher among males in the age group 40-49 years in urban areas compared with rural areas (P < 0.0001). Using the case-referent approach, with HbsAg-positive patients as cases and HBsAg-negative ones as referents, the crude odds ratio for rural areas compared with urban areas was 0,97. However, standardisation for year of data collection and province resulted in a relative risk of 2.0, i.e. the risk of being HBsAg-positive in rural areas is twice as high as in urban areas. Similarly, the crude odds ratio for females compared with males was 0.83, and was reduced significantly to 0.7 when standardised for year of data collection and province. The prevalences of HBeAg, anti-HBe, anti-HBs and anti-HBc were 25%, 25%, 45% and 36% respectively. The prevalences of anti-HBs and anti-HBc increased continuously with age and were about 70% higher in the age group 50 years and above compared with those under 20 years. The prevalence of any of the HBV markers-HBsAg, or anti-HBc -was 66% in males and 61% in females.
The results indicate that hepatitis B is hyperendemic in both rural and urban areas of Zimbabwe.
The Kingdom and the Glory Agamben, Giorgio; Chiesa, Lorenzo; Mandarini, Matteo
2011, 2011-09-13
eBook
Arguing that Western power is both "government" and "glory," this book reveals the "theological-economic" paradigm at the origin of several of the most important components of modern politics and ...illuminates the function of consent and the media in today's democracies.
Background and Objectives: In Zimbabwe, sexually transmitted diseases are highly prevalent and represent a significant amount of the workload for physicians. Goal of This Study: To estimate the ...prevalence of sexually transmitted diseases and human immunodeficiency virus as well as symptoms related to sexually transmitted diseases. Study Design: This was a cross-sectional study of 500 volunteers (285 women and 215 men) attending an sexually transmitted disease clinic in the Murewa District, 100 km northeast of the capital, Harare. Information on background characteristics and symptoms were obtained with a standardized questionnaire, and samples were collected and immediately transported to the laboratory for examination. Results: The majority of the patients were 20-29 years old. Half of the men and 12% of the women had never been married, and 7.9% of the men and 12% of the women were divorced. Genital ulcers and dysuria were the most prevalent symptoms in men (64% and 62%, respectively). In women, the most prevalent symptoms were lower vaginal discharge and lower abdominal pain (91% and 79%, respectively). Almost 50% of the men and women were positive for human immunodeficiency virus-1 antibodies. The prevalence of Treponema pallidum and Neisseria gonorrhoeae was 15% and 18%, respectively, in men and 19% and 10%, respectively, in women. Chlamydia trachomatis showed the lowest prevalence (8%) in both sexes. No relationship was found between human immunodeficiency virus and other sexually transmitted diseases. Conclusion: Women who enter a sexually transmitted disease clinic with vaginal discharge or lower abdominal pain should be tested for several sexually transmitted diseases and human immunodeficiency virus. Men with dysuria or urethral discharge who enter such clinics should at least be tested for Neisseria gonorrhoeae.
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