Sporotrichosis is a sporadic and rare mycotic infection in most of the developed world. In many parts of the developing world, sporotrichosis is much more commonly recognized, but epidemiological data are generally lacking from these regions. We report epidemiological, clinical, and treatment data from 238 cases of culture-proven sporotrichosis occurring in a relatively remote area of the south central highlands of Peru that were retrospectively collected during 1995-1997. Most cases (60%) occurred in children aged =14 years, and the most commonly affected anatomic site was the face. Disease was clinically confined to the skin and subcutaneous tissue in all patients. The incidence of sporotrichosis in this region ranged from 48 to 60 cases per 100,000 persons and was highest among children aged 7-14 years, approaching 1 case per 1000 persons. Sporotrichosis is a significant mycosis in the rural highlands of Peru, with an incidence exceeding those of other invasive mycoses in individuals without human immunodeficiency virus infection.
Despite the seemingly important role of cytotoxic T-lymphocyte (CTL) responses in human immunodeficiency virus (HIV) disease pathogenesis, their measurement has relied on a variety of different techniques. We utilized three separate methodologies for the detection of CTLs in a cohort of HIV-infected individuals who were also human leukocyte antigen A2 (HLA-A2) positive. Among the different CTL assays, a correlation was seen only when the Gag epitope-specific HLA A*0201-restricted tetramer assay was compared with the ELISPOT assay performed after stimulation with the Gag epitope; however, this correlation was of borderline statistical significance. On average, the tetramer reagent detected a 10-fold-higher number of cells than were seen to produce gamma interferon by the ELISPOT assay. The implications of this CTL assay comparison and the possibility of phenotypic differences in HIV-specific CD8 ؉ T lymphocytes are discussed.
Background: Achieving sustainable economic and social growth through advances in health is crucial in Latin America within the framework of the United Nations Millennium Development Goals.
HIV counseling and testing services are critical for individuals to access HIV prevention and treatment. Unfortunately, the standard HIV testing algorithm is complex and includes the use of a sensitive enzyme immunoassay (EIA), followed by a Western blot if the EIA is positive. This process can take 1 week or longer. Therefore, innovative approaches that incorporate simpler diagnostic algorithms are needed to reach the large number of individuals who are not aware that they are HIV-infected. Currently available rapid HIV tests have demonstrated sensitivities and specificities comparable to those of standard HIV testing without the requirements of sophisticated laboratory resources or highly trained personnel. These rapid HIV tests are increasingly being used in various clinical scenarios to decrease the number of missed opportunities for detection of HIV-infection. Their use is particularly applicable in specific clinical and nonclinical settings; public health settings; labor and delivery wards; in the management of occupational exposures; and in resource-constrained settings. The overarching goals of achieving wide implementation of rapid HIV tests are to increase the number of individuals who are aware of their serostatus, to improve entry of persons with HIV into prevention and care services, and to prevent further HIV transmission.
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