Mestrado em Doenças Infecciosas
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Navegando Mestrado em Doenças Infecciosas por Autor "Almeida Filho, Gutemberg Leão de"
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- ItemPrevalência da infecção pelo HPV e de alterações citológicas anais e cervicais em transgêneros atendidos em ambulatório especializado no Espírito Santo entre 2018 a 2021(Universidade Federal do Espírito Santo, 2022-07-21) Costa, Franco Luís Salume; Miranda, Angelica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; https://orcid.org/0000-0001-9794-2536; http://lattes.cnpq.br/3810304292186719; Vicente, Creuza Rachel; https://orcid.org/0000-0003-0182-7969; http://lattes.cnpq.br/0530544422426629; Almeida Filho, Gutemberg Leão de; http://lattes.cnpq.br/4359594061441168Introduction: Transgenderism is considered a health’s social determinant for the transgender population. There are access barriers to health services and demographic censuses that makes unfeasible the determination of sexually transmitted infections (STIs) prevalence. It is known that there is an increased risk of acquiring STIs due to risky sexual behavior. HPV infection is the most common STI among adults and data about its prevalence in transgender people is scarce and necessary. Objectives: To determine the prevalence of HPV infection in the transgender population treated at a specialized service at the University Hospital of Espírito Santo and its association with cytological changes. Materials and Methods: This is a cross-section carried out from August 2018 to May 2021, including 110 transgender users. Data collection consisted of survey, search for HPV, chlamydia, gonorrhea, trichomoniasis in samples from anal and cervical region and oncotic cytology survey and blood samples’ screening for HIV, syphilis, hepatitis B and C. Data were stored and processed using SPSS–data entry (Statistical Package for the Social Sciences), 20. Results: Transgender men represented 60.9% of the sample (n = 67), while transgender women were 34.5% (n = 38). The mean age was 27.7 years, with a standard deviation of 9.131. The prevalence of HPV was 58.3%, with 50% among transgender men and 81.25% among transgender women. By anogenital site, positive HPV in the cervical region were 38% and, in the anal region, 25% in transgender men. Transgender women were HPV positive in the anal region 48.1%. Anal cytology was altered in 23.5% of the transgender women, and the cervical cytology among 9.5% in men. Syphilis, trichomoniasis, HIV, genital wart, herpes, chlamydia, and hepatitis B, were found in, respectively, 13.6%, 12.5%, 5.5%, 4.5%, 4.5%, 4.1% e 0.9%. Conclusion: Prevalence studies of HPV, STIs and their clinical-behavioral correlation are still needed to provide comprehensive, inclusive and respectful care to this population. STI and neoplasm screening and prevention policies should be prioritized.
- ItemPrevalência de lesões precursoras de câncer de colo uterino e fatores associados em mulheres atendidas em Hospital Universitário, Vitória-ES(Universidade Federal do Espírito Santo, 2012-04-04) Boldrini, Neide Aparecida Tosato; Spano, Liliana Cruz; Miranda, Angelica Espinosa Barbosa; Musso, Carlos; Almeida Filho, Gutemberg Leão deIntroduction: The squamous cell cervical cancer develops from precancerous lesions well defined which can progress to invasive disease if not earlier diagnosed and treated. Objectives: To determine the prevalence and factors associated with high-grade lesions and cervical cancer among women treated at University Hospital in Vitoria, ES. Methods: A cross-section conducted in women 18-59 years who were referred for outpatient cervical pathology in 2011. Women were invited to participate and were interviewed for collecting demographics, epidemiological and clinical data. After the interview, they were submitted to gynecological examination to collect specimens for cervical cytology, Chlamydia trachomatis and HPV Hybrid Capture tests, and HPV DNA detection by PCR and colposcopic examination. The patients with cervical lesions at cytology and colposcopy were confirmed by histopathology. Results: A total of 291 women participated in the study. The median age was 38 years (DIQ: 30 - 48 years), 74 (25.4%) had completed four years of schooling; 178 (61.2%) were married and 83 (28.5%) had monthly family income up to three minimum wages. When considering histopathological results, the prevalence of high-grade lesions/cervical cancer was 18.2% (95% CI: 13.8% -22.6%), being 48 (16.5%) cases of high-grade lesions (CIN II, CIN IIIca in situ) and 5 (1.7%) cases of invasive carcinoma. One hundred and eight women (37.1%) were smokers; 11 (3.8%) reported using illicit drugs;38 (13.1%) reported their first sexual intercourse before age 15;221 (75 9%) had more than one partner in life; 20 (6.9%) had more than one partner in the last 12 months;220 (75.6%) reported not using condoms;90 (30.2%) reported anal sex practice;46 (15.8%) reported previous STD. In the final logistic regression model, age between 30-49 years [OR = 4.4 (95%:1.01-19.04), history of smoking [OR = 2.43 (95% CI 1.14 to 5 , 18)], practice of anal intercourse [OR = 2.35 (95% CI 1.10 to 5.03)] and have a positive hybrid capture test for high risk HPV positive [OR = 11.23 (95% 4 0.79 to 26, 36)] remained independently associated with high-grade lesion/cervical cancer. Conclusions: The results show high prevalence of precursor lesions of cervical cancer and high prevalence of high risk HPV. The most prevalent HPV was HPV 16 followed by HPV 31. Associated risk factors for HSIL/carcinoma were age between 30-49 years, history of smoking, practice of anal sex and have a positive hybrid capture test for high risk HPV positive. The study emphasizes the importance of prevention and care strategies for the control of cervical cancer.