Focal epithelial hyperplasia or Heck's disease is a rare contagious disease caused by human papillomavirus types 13 or 32, initially described among Native American populations. This condition is characterized by the occurrence of multiple small papules or nodules in oral cavity, especially on labial and buccal mucosa and tongue. This report describes the diagnosis of focal epithelial hyperplasia in five Central Amazonian Indians who sought treatment at the Amazonas State Foundation of Tropical Medicine (FMT-AM), using clinical criteria, polymerase chain reaction (PCR) and DNA sequencing.

ABSTRACT. Infection by human papillomavirus (HPV) is one of the primary causes of mortality by cancer in northern Brazil. Sexually active women from Manaus, Amazonas, without cytological alterations and women with pre-malignant and malignant cytological alterations were examined for HPV virus, identified via PCR and sequencing. The target region for this study was part of the L1 capsid gene of HPV. Twentythree samples that were PCR-positive were sequenced. Analysis of 336 bp demonstrated a high incidence of high-risk HPV types in the population of Manaus, identified as HPVs 16, 33, 58, 66, 68. HPV type 16 was the most prevalent, presenting two variants similar to the AsianAmerican (AA) and East-Asian type (As) variants. A rare HPV type 13 related to "Heck's disease" was also detected. This preliminary provides important information about the HPV circulating in Amazonas State.

The scarcity of data about the effects of chlamydial infection on pregnancy and neonatal outcomes justified this study. Diagnosing and treating chlamydial infection during the third trimester of pregnancy may prevent neonate infection. Therefore, preventive screening should be seen as a priority for early detection of asymptomatic C. trachomatis infection as part of local public health strategies.

Sexually transmitted infections are an important cause of morbidity among sexually active women worldwide, and have been implicated as cofactors in the pathogenesis of cervical cancer. We investigated the prevalence of human papillomavirus (HPV), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV), and accessed the diversity of HPV in women with normal and abnormal cytology in Manaus, Brazil. We used polymerase chain reaction and HPV genotyping by direct sequencing. The chi-square test was used to calculate the absolute and relative frequencies of the categorical variables, and Fisher's test was used when P < 0.05. The level of significance was set at 5%. All statistical analyses were performed using R 2.9.0. There were statistically significant differences in age (P = 0.0395), education level (P = 0.0131), sexual partners (P = 0.0211), condom use (P = 0.0039), marital status (P < 0.0001), and pregnancy (P = 0.0003) between the normal and abnormal groups. HPV DNA was found in 36.56 and 93.88% of subjects in the normal and abnormal groups, respectively. A total of 19 genotypes were detected; HPV16 was the most common, followed by HPV58. The percentages of TV and CT DNA were 18.04 and 9.02% in the normal group, respectively. The percentages of HPV/TV and HPV/CT coinfection were 12.5% each in women with normal cytology. These findings improve our understanding of HPV, CT, and TV, and the distribution of HPV types, which may be relevant to vaccination strategies for protecting women from the north of Brazil from cervical cancers and precancerous lesions.

Background: We established for the first time the prevalence of Chlamydia trachomatis infection among infertile women in Manaus Amazonas Brazil using the polymerase chain reaction (PCR) technique. Methods: 106 women were studied at a public university hospital fertility clinic for infertility problems correlated with chlamydia infection. Social-economic and clinical information was obtained before medical examination to obtain samples for the amplification of C. trachomatis DNA plasmid. Results: The prevalence of chlamydial infection among infertile women was 52.8, and 51.8% of the positive participants were older than 30 years of age (p = 0.8697). Of the 56 women positive for C. trachomatis, 31 (55.4%) had never given birth, while 9 (16%) had a pregnancy resulting in fetal death. Our findings also revealed that these patients had a low socio-economic status and high unemployment (p = 0.0274), and a significant association of 5% (p < 0.05) of chlamydial infection with family income. Conclusions: Due to the high prevalence of C. trachomatis, concerns about effects on reproductive health and fertility are undertaken. Therefore, we believe it is extremely necessary to implement large-scale PCR-based screening as part of routine clinical detection programs concerning preventive effects of chlamydial infection among this population.

Human papillomavirus (HPV) type 13 is associated with focal epithelial hyperplasia, a benign and self-limited disease of oral mucosa. It is a rare finding, most often seen among young American natives. We carried out a molecular characterization case study of HPV type 13 isolated from a 14-year-old native girl living in Amazonia, in the northern region of Brazil, by describing the E6 and E7 open reading frame (ORF) sequences and comparing them to the only reference sequence in GenBank, which came from a Turkish isolate. The E6 and E7 ORFs were amplified by PCR, and the amplicons were purified and cloned in E. coli using the pCR ® -4 TOPO ® vector. The purified recombinant plasmids were automatically sequenced, showing 98 and 94% similarity to the E6 and E7 ORFs from the reference sequence, respectively. Six mutations were identified in the E6 ORF, but these changed only three amino acids in the final protein. In the E7 ORF, we found three transversions and one deletion of nine base pairs, which led to three amino acid mutations and three amino acid deletions in the final protein. The mutations in E6 ORF gave no predicted changes in the final protein, while the mutations in E7 were predicted to cause changes in the ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 19 (1): gmr18393 C.M. Borborema-Santos et al. 2protein. We conclude that the E6 and E7 ORFs in HPV-13 from the Amazonia and Turkey isolates have a high degree of genetic similarity.

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A microbiota vaginal tem uma importância fundamental na saúde do trato genital feminino. A presença de Ureaplasma spp.  tem sido relatada com frequência em estudos de correlação com o Papilomavírus Humano (HPV). Objetivou-se determinar a prevalência de Ureaplasma parvum (UP) e Ureaplasma urealyticum (UU) em mulheres com Vaginose Bacteriana (VB) e Candidíase Vulvovaginal (CVV) e correlacionar com HPV. Extraiu-se o DNA genômico de 64 amostras cervicais, utilizando o kit comercial QIAamp® DNA Mini Kit. Identificou-se UP e UU por Multiplex PCR convencional e para HPV utilizou-se Nested PCR/ sequenciamento. Verificou-se que a prevalência de UP no grupo de CVV foi de 87,8% (29/33) e no de VB foi de 96,7% (30/31). O UU demonstrou prevalência de 81,8% (27/33) nas amostras de CVV e 67,7% (21/33) nas de VB. Quanto ao HPV, 27,2% (9/33) das amostras de CVV foram positivas para a presença deste patógeno e nas amostras de VB, 35,4% (11/31) das amostras também foram positivas. Observou-se que existe uma tendência de infecção pelo HPV na presença de Ureaplasma spp. em especial o UP. Todavia, tal afirmação não pode ser confirmada neste trabalho por não demonstrar significância estatística.