The seroprevalence rates of human immunodeficiency virus (HIV), human T-cell leukemia/lymphoma virus (HTLV), hepatitis B virus (HBV), hepatitis D virus (HDV), and hepatitis C virus (HCV) in Mozambique are poorly documented. The epidemiology of these infections was studied in the Maputo region. All donors attending the blood bank during the study period were interviewed and underwent serological and molecular tests for markers of virus exposure. Thus, 1,578 consecutive replacement blood donors were investigated, as they undergo no selection (other than their relation with a patient needing a transfusion), and may thus provide reliable estimates of the prevalence rates in the general population. The age-standardized prevalence rates among 15- to 49-year-old men and women were, respectively, 12.3 and 15.4% for HIV and 0.9 and 1.2% for HTLV. Low educational status (P = 0.014) and tattooing/scarification (P = 0.023) were predictive of HIV infection in multivariate analysis. The age-adjusted prevalence rates of markers of hepatotropic virus among men and women were, respectively, 10.6 and 4.5% for hepatitis B surface antigen (HBsAg), 1.2 and 1.0% for anti-HCV, and 0 and 0% for anti-HDV. Two percent of donors had viral co-infections, involving most frequently the combination of HIV and HBsAg +. A significant association was found between anti-HIV and anti-HBc (P = 0.012). HBsAg was associated with the place of birth (P = 0.011) and a history of transfusion (P = 0.069). Smokers had higher seroprevalence rates than nonsmokers for HIV (P < 0.0001) and HBsAg (P = 0.045). Genotype A was the most frequent HBV genotype (86.3%) followed by E and D. HCV genotypes were 1a, 1b, 3a, and 5a. These results show that HBV vaccination and HIV-preventive measures need to be reinforced in Mozambique.

No abstract

Background-Non-steroidal anti-inflammatory drugs (NSAIDs) can have severe gastrointestinal eVects and cause peptic ulcers to bleed. Acute bleeding from oesophageal varices is a major complication of cirrhosis of the liver. Aims-To investigate the role, using a casecontrol study, of NSAIDs in first bleeding episodes associated with oesophageal or cardial varices in cirrhotic patients. Patients/Methods-A structured interview was conducted of 125 cirrhotic patients with bleeding mainly related to oesophageal varices and 75 cirrhotic controls with oesophageal varices who had never bled. Results-Cirrhotic patients who were admitted for bleeding related to portal hypertension were more likely to have used NSAIDs during the week before the index day (31 of 125 (25%)) than the cirrhotic controls (eight of 75 (11%); odds ratio = 2.8, p = 0.016). Use of aspirin alone or combined with other NSAIDs was also more prevalent in the cases (21 of 125 (17%)) than in the controls (three of 75 (4%); odds ratio = 4.9, p = 0.007). Logistic regression analysis showed that NSAID use (p = 0.022, odds ratio = 2.9, 95% confidence interval = 1.8 to 4.7) and variceal size (p<0.001, odds ratio = 4.0, 95% confidence interval = 1.4 to 11.5) were the only variables independently associated with the risk of bleeding. Conclusions-Aspirin, used alone or combined with other NSAIDs, was associated with a first variceal bleeding episode in patients with cirrhosis. Given the life threatening nature of this complication, the possible benefit of this treatment should be weighed against the risk shown here. No firm conclusions could be drawn on non-aspirin NSAIDs used alone. (Gut 1999;44:270-273)

In this study, nitroglycerin offered a limited and clinically nonsignificant benefit for the prevention of post-ERC pancreatitis. Its use did not improve the technical success rate of ERC.

No abstract