Background In the Andean Region, HIV and sexually transmitted infections (STI) are most prevalent among men who have sex with men (MSM), but incidence estimates and associated factors have never been prospectively assessed. Methods A cohort of 1056 high-risk HIV-negative MSM in Lima, Peru, was recruited during 1998–2000 (The ALASKA Cohort) and a nested case-control analysis conducted between seroconverters and non-seroconverters, matched 1:3 by age and duration of follow-up for comparison of risk behaviors, acute retroviral symptoms, circumcision, and STI. Results During average follow-up of 335 days, 34 men seroconverted, providing a HIV incidence estimate of 3.5/100 person-years (95% CI: 2.3–4.7). High syphilis (9.2/100 person-years, 95% CI: 6.7–10.1) and HSV-2 infection (10.4/100 person-years, 95% CI: 8.6–11.9) incidence estimates were obtained. HIV seroconverters were more likely than men who remained seronegative to report fever ≥3 days (46% vs. 7%), to seek medical care (62% vs. 27%), and to have ≥1 casual partner (86.2% vs. 74.1%) since their last visit. HIV seroconverters also were more likely to have acquired syphilis or HSV-2 infection (31% vs. 8% among initially HSV-2 seronegative men) while were less likely to be circumcised (4.2% vs. 20.6%, a non-significant difference). In multivariate analysis, incident syphilis or HSV-2 infection (OR: 5.9, 95% CI 1.5–22.7) and sex with any casual partner (OR: 4.8, 95% CI: 0.9–26.2) were associated with HIV seroconversion. Conclusions STI that may cause anogenital ulcers are important risk factors for HIV acquisition among high-risk MSM in Lima, a population with a very high HIV incidence estimate. Synergistic interventions focusing in preventing both HIV and HSV-2, like male circumcision, are warranted to be assessed, especially in MSM populations with low levels of circumcision and high incidence estimates of ulcerative STI.
Fetal teratomas are rare tumors sometimes located in mediastinum. The following case report illustrates a case of fetal mediastinal teratoma treated by immediate postnatal surgical excision.A woman was referred to our University hospital at 21 weeks of gestation for a suspected pleural effusion encountered during her routine midtrimester scan. We performed transabdominal 2D and 3D scan which revealed a mediastinal antero-median unilocular mediatinal cystic mass with irregular borders and incomplete septations ( figure A and B). Fetal MRI was also performed, which confirmed the mass's characteristics and size. Fortnightly scans were performed showing slight but constant increase in the lesion's dimensions and the amniotic fluid. Spontaneous preterm prelabour rupture of membranes occurred at 33 weeks and an urgent caesarean section was performed due to a pathologic fetal heart trace. A female baby weighting 2400g was born. The girl was operated upon 3 hours postnatally via right thoracotomy, showing a well-encapsulated right paramedian mass (figure D), which was completely excised. The postoperative course was regular. The histopathological analysis revealed an immature triphyllic mediastinal teratoma. The baby is now four months old, in good health and thriving well.Supporting information can be found in the online version of this abstract P12.04
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.