Prevalence and correlates of HIV infection among female sex workers in 2 Mexico-US border cities

BACKGROUND: We examined human immunodeficiency virus (HIV) prevalence and correlates among female sex workers (FSWs) in Tijuana and Ciudad Juarez, 2 large cities on the Mexico-US border. METHODS: FSWs aged > or =18 years underwent interviews and testing for HIV, syphilis, gonorrhea, and chlamydia. Logistic regression identified factors associated with HIV infection. RESULTS: In 924 FSWs, the prevalence of HIV, gonorrhea, chlamydia, and syphilis titers > or =1:8 was 6%, 6.4%, 13%, and 14.2%, respectively. Factors independently associated with HIV were the injection of cocaine (odds ratio [OR], 2.96); the smoking, snorting, or inhalation of methamphetamine (OR, 3.32); and syphilis titers > or =1:8 (OR, 4.16). CONCLUSIONS: Culturally appropriate interventions are needed to identify and treat ulcerative sexually transmitted infections and reduce HIV risks associated with stimulants among FSWs in the Mexico-US border region.     

Experimental demonstration of pathogenic potential of Anisakis physeteris and Anisakis paggiae in Wistar rats

Anisakis morphotype I is the principal etiologic agent of human anisakiasis, with differences in pathogenicity found between the Anisakis simplex s.s. and A. pegreffii species; however, the role of morphotype II larvae in this illness is not well understood. The purpose of this study is to verify the ability of morphotype II larvae to invade tissues via the experimental infection of Wistar rats, an animal model which simulates infection in humans. In the in vivo assay, 7.1 % (4/56 L3 morphotype II) showed pathogenic potential, defined as the capacity of the larvae to cause lesions, attach to the gastrointestinal wall or penetrate it. Two of these larvae, one of A. physeteris and one of A. paggiae, penetrated the stomach wall and were found within the abdominal cavity, with the first one producing a small lesion with blood vessel breakage. The majority of the L3 larvae of morphotype II were found in the intestine (51.8 %; 29/56) with the caecum being the least frequent location (8.9 %; 5/56). In contrast, 44.0 % (11/25) of the morphotype I larvae demonstrated pathogenic potential. Isoenzyme electrophoresis, PCR-RFLP of ITS1-5.8 s-ITS2 and PCR-sequencing of the cox2 mitochondrial gene were used to identify these larvae as A. physeteris (42.9 %), A. paggiae (30.3 %) and A. brevispiculata (1.8 %). Although the morphotype II larvae of A. physeteris and A. paggiae have lower pathogenic potential than morphotype I larvae of A. simplex s.s. (93 and 91 % lower, respectively), they may still be implicated in human anisakiasis, as they are capable of attaching to and penetrating the gastrointestinal wall of animals, demonstrating a similar pathogenicity to that of A. pegreffii. The techniques used for the identification of species reveal a great genetic heterogeneity of A. paggiae and A. physeteris, suggesting the existence of sibling species.     

Transplantation of kidneys from hepatitis C‐positive donors into hepatitis C virus‐infected recipients followed by early initiation of direct acting antiviral therapy: a single‐center retrospective study

The availability of direct acting antiviral agents (DAA) has transformed the treatment of hepatitis C virus (HCV) infection. The current study is a case series that reports the outcomes from a cohort of twenty‐five HCV‐infected ESRD patients who received a kidney from an anti‐HCV‐positive deceased organ donor followed by treatment with DAAs in the early post‐transplant period. Time to transplantation and the efficacy of DAA therapy as measured by sustained viral response at 12 weeks were assessed. The median waiting time from original date of activation on the United Network Organ Sharing (UNOS) waiting list until transplantation was 427 days; however, the median time from entering the patient into UNet^sm for a HCV‐positive offer until transplantation was only 58 days. The 25 patients were started on antiviral treatment early post‐transplant (median 125 days) and 24 of 25 (96%) achieved a sustained virologic response at 12 weeks. Tacrolimus dose adjustments were required during antiviral treatment in 13 patients to maintain therapeutic levels. Accepting a kidney from an anti‐HCV‐positive deceased donor shortened the waiting time for HCV‐infected kidney transplant candidates. We recommend that kidneys from anti‐HCV‐positive donors should be considered for transplant into HCV‐infected recipients followed by early post‐transplant treatment with DAA agents.