SUMMARYIn São Paulo, Brazil, between November 1980 and July 1982, 1614 newborns of middle socioeconomic background and 1156 newborns of low socioeconomic background were examined for the occurrence of congenital cytomegalovirus (CMV) infection by isolation of virus from urine samples or detection of specific anti-CMV IgM in umbilical cord serum tested by immunofluorescence. In the low socioeconomic population prevalence of CMV complement-fixing antibodies in mothers was 84.4%(151/179) and the incidence of congenital infection assessed by virus isolation 0.98% (5/508), as compared with 0.46% (3/648) in the group of newborns tested by detection of specific anti-CMV IgM in umbilical cord-serum. In middle socioeconomic level population prevalence of CMV complement-fixing antibodies in mothers was 66.5% (284/427) and the incidence of CMV congenital infection was 0.39% (2/518) in the group of newborns screened by virus isolation and 0.18% (2/1096) in the group tested by detection of specific anti-CMV IgM. In the present study none of the 12 congenitally infected newborns presented clinical apparent disease at birth.
A number of epidemiologic variables were investigated in a case-control interview study, conducted in São Paulo, Brazil, of 70 Hodgkin's disease (HD) patients, 70 tumor control subjects matched for age and sex, and 128 siblings of the patients. The major epidemiologic findings were a high percentage of total cases among children, with a high sex ratio, a relative predominance of the mixed cellularity histologic subtype, and a bimodal age-specific incidence curve with the highest rates among young adults and the elderly. When the matched controls were used as the comparison group, high socioeconomic status (SES) was found to be associated with an increased risk for HD (p = 0.001). On the basis of the case-sibling comparison, an association between prior tonsillectomy and risk for HD was found (p = 0.04), and the relative risk for HD among tonsillectomized persons as compared to individuals who had not had the operation was 2.5. Other variables, including sibship size, birth order, marital status, occupational exposure, prior use of amphetamines or diphenylhydantoin, intensity of exposure to children and history of viral illnesses were not found to be determinants of risk for HD in this study.
Sixty-seven cases of Hodgkin's disease (HD) occurring in São Paulo, Brazil, were studied. Males with HD predominated over females 2.3 to 1. Sixty-six percent of the cases occurred in patients under 30 years of age, 31.7% under 20 years of age, and only 7.5% after 50 years of age. Lymphocyte predominance and mixed cellularity histologic types were most common in patients less than 15 years old, and nodular sclerosis was most common in the 15- to 19-year-old group. Sera from all patients had antibody to the viral capsid antigen (VCA) of Epstein-Barr virus (EBV). The geometric mean titer (GMT) of VCA antibody with the use of Jijoye cells as antigen was 1:162, and 31.3% of patients had titers of 1:320 or more; in controls, the GMT was 1:67 and 3.8% had titers of 1:320 or more. Similar results were obtained when EB-3 cells were used as antigen. The highest titers occurred in males, in mixed cellularity and lymphocyte depletion forms, and in stage 2 of illness. EBV-specific IgM antibody and heterophile antibody levels were not elevated, but 20.5% of the HD patients had antibody to the early antigen of EBV present in their sera. Antibody levels for herpes simplex virus, cytomegalovirus, rubella, measles, parainfluenza viruses, and papovavirus were not significantly elevated over those in matched controls.
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