Brazilian Journal of Sexually Transmitted Diseases https://bjstd.org/revista Sociedade Brasileira de Doenças Sexualmente Transmissíveis en-US Brazilian Journal of Sexually Transmitted Diseases 2177-8264 HIV, Hepatitis B, Hepatitis C, and Syphilis: prevalence and serodiscordance between women and their partners https://bjstd.org/revista/article/view/1194 <p><strong><em>Introduction:</em> </strong>The prevention of vertical transmission of sexually transmitted diseases is the object of research by several authors, who reinforce the importance of knowing the serological status of a woman’s sexual partner.<strong> <em>Objective:</em></strong> To evaluate the prevalence and serodiscordance of HIV, hepatitis B, hepatitis C, and syphilis infections among women admitted to a maternity hospital in southern Brazil and their partners. <strong><em>Methods:</em></strong> 350 women and their partners were interviewed in a service-based cross-sectional study conducted from August 16 to November 23, 2018. <strong><em>Results:</em></strong> 4.0% of the women and 4.3% of the men had one of the infections studied. Among women, 2.0% already knew they were HIV positive, 2.0% had a positive rapid test for syphilis and there was no positive result for hepatitis B or C. A total of 299 (85.4%) partners were located. Of these, 293 (98.0%) agreed to answer the study questionnaire. Of all men interviewed, 281 (95.9%) agreed to undergo an rapid test. Among men, 1.4% already knew they were HIV positive and 0.4% had chronic hepatitis B disease. There was a similar percentage of men with a positive rapid test for syphilis and hepatitis C (1.4%). Regarding couples, 6.8% had some positive test. Most of the positive test subjects were in a serodiscordant relationship (16 serodiscordant couples and 3 positive concordant couples). <strong><em>Conclusion:</em></strong> These results reinforce the importance of testing men to prevent the infection of a negative partner and the vertical transmission of sexually transmitted infections. The high acceptance, by men, to undergo an rapid test at the time of the woman’s hospitalization demonstrated the viability of this strategy in the maternity ward.</p> Aline Scherer Mariângela Freitas da Silveira Bruno Pereira Nunes Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-08-02 2022-08-02 34 10.5327/DST-2177-8264-2022341194 Seasonality of the demand for nontreponemal test in a private laboratory in the city of Niterói - RJ https://bjstd.org/revista/article/view/1192 <p><strong>Introduction:</strong> Syphilis is a systemic, chronic, curable, and unique bacterial infection in humans, transmitted sexually, mainly. When untreated, it evolves to stages that range in severity and can affect different body organs and systems. <strong>Objective:</strong> To delineate whether or not there are significant changes in the demand and positivity of the nontreponemal test (VDRL), after Carnival or at other times in the analyzed years, from January 2014 to December 2019, in a laboratory in the private health network of Niteroi. <strong>Methods:</strong> A retrospective, quantitative and descriptive study was carried out aiming at defining the profiles of the population that seeks a particular laboratory to undergo the VDRL from 2014 to 2019. Data collection was carried out through documental analysis of the results, with an authorization from the laboratory, preserving the confidentiality of patients. The seasonal decomposition, which is a monthly time series, was performed to assess the trend and exponential trend using the additive model. <strong>Results:</strong> A total of 34,817 tests were performed, with 1,637 positive VDRL results in the analyzed years, using the SPSS program. There was an increase in the number of exams in 2019 (6,488), maintaining the distribution during this year. <strong>Conclusion:</strong> Both the demand and the positivity of VDRL tests have increased significantly over the years, finding no seasonality in relation to reactive VDRL tests.</p> <p> </p> Vania Maria de Almeida Gomes Susana Cristina Aidé Viviani Fialho Julia Sampaio de Souza Morais Angélica Espinosa Miranda Ricardo de Souza Carvalho André Cerqueira Clóvis Ozenil de Souza Júnior Vinicius Machado Christina Thereza Machado Bittar Mauro Romero Leal Passos Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-08-31 2022-08-31 34 10.5327/DST-2177-8264-20221192 Lactobacillus crispatus dominance in the vaginal microbiome reduces the occurrence of spontaneous preterm birth in women with a short cervical length https://bjstd.org/revista/article/view/1198 <p>Introduction: The majority of pregnant women with a short cervix will deliver at term and, thus, may unnecessarily receive advanced monitoring and<br>treatment. It is still necessary to define more accurately which sub-population of women with a short cervix is at elevated risk for early delivery. Objective:<br>To determine if vaginal microbiome composition influenced the rate of spontaneous preterm birth in women with a short cervical length. Methods: In an<br>exploratory, observational prospective study, vaginal secretions were obtained from 591 women at 21–24 week gestation. Vaginal microbiome composition<br>was determined by analyzing the V1–V3 region of the bacterial 16S ribosomal RNA gene. Results: Lactobacillus crispatus was numerically dominant in<br>the vagina in 41.7% of subjects, followed by L. iners in 32% and Gardnerella vaginalis in 12%. In women whose cervix was ≤25mm, the sensitivity to<br>predict an spontaneous preterm birth was 11.8%. However, when L. crispatus was not the dominant vaginal bacterium, this sensitivity increased to 81.8%.<br>Similarly, in women with a cervical length ≤30mm, the sensitivity to predict an spontaneous preterm birth increased from 21.7 to 78.3% when L. crispatus<br>was not the dominant vaginal bacterium. In women with a prior spontaneous preterm birth and a cervix ≤25 or ≤30mm, L. crispatus dominance was also<br>associated with a reduced rate of spontaneous preterm birth in the current pregnancy (p&lt;0.001). Conclusion: In pregnant women with a cervix ≤25mm or<br>≤30mm, the risk for an spontaneous preterm birth is increased if L. crispatus is not dominant in the vagina.</p> Antonio Fernandes Moron Steven Sol Witkin Iara Moreno Linhares Alan Roberto Hatanaka Stéphanno Gomes Pereira Sarmento Marcelo Santucci França Francisco Herlânio Costa Carvalho Rosiane Mattar Larry Jay Forney Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-05-19 2022-05-19 34 10.5327/DST-2177-8264-20223407 Lipohypertrophy and nutritional profile among people living with HIV in Southern Brazil https://bjstd.org/revista/article/view/1195 <p><strong>ABSTRACT: </strong><strong>Introduction:</strong> People living with the human immunodeficiency virus (HIV) are generally overweight or have an altered body composition as compared to healthy individuals, showing a change in nutritional profile over time. <strong>Objective: </strong>The aim of the study was to characterize the nutritional status, estimate the prevalence of lipodystrophy, and examine the association between lipohypertrophy and lipid profile alterations, and other clinical data of HIV-infected individuals. <strong>Methods:</strong> This was a cross-sectional study on male and female subjects living with HIV, treated at a specialized outpatient clinic, aged 18 years old and over, whether using the antiretroviral therapy or not. <strong>Results:</strong> The sample consisted of 420 people with a mean age of 43.8 years (standard deviation 11.7). The length of time of the HIV infection averaged 74.6 months, and 91% of the respondents were on antiretroviral therapy. Lipodystrophy prevalence was 35.7%. Of these, 82 (54.7%) presented lipohypertrophy, 61 (40.7%) had lipoatrophy and 7 (4.6%) had a mixed syndrome. Female gender, body mass index, fat percentage, waist circumference and waist-hip ratio were positively associated with the presence of lipohypertrophy (p&lt;0.001). High mean total cholesterol (p=0.015) and LDL fraction (p=0.028) also showed a statistically significant association with lipohypertrophy. The sampled participants had a nutritional profile compatible with overweight or obesity. No association was found between lipohypertrophy and ART and the therapy duration. <strong>Conclusion:</strong> Considering the consequences of overweight as a cause of various pathological conditions, preventive measures and interventions are highly recommended for this population.</p> Fabiana Schuelter-Trevisol Helena Caetano Gonçalves e Silva Maricele Almeida da Silva Chaiana Esmeraldino Mendes Marcon Richard Ferreira Sene Daisson José Trevisol Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-07-25 2022-07-25 34 10.5327/DST-2177-8264-2022341195 Epidemiological analysis of human immunodeficiency virus [HIV] disease between 2010 and 2019 https://bjstd.org/revista/article/view/1171 <p><strong>Introduction</strong>: Human immunodeficiency virus (HIV) had its history changed due to new technologies and drugs that made it possible to increase the life expectancy of infected patients. However, it is possible to raise the hypothesis that the inequalities of the public networks of each Brazilian state can affect the treatment of this disease, leading to a greater mortality. <strong>Objective</strong>: Analyzing the evolution of hospitalizations and deaths in Brazilian regions in relation to HIV between 2010 and 2019. <strong>Methods</strong>: literature review (qualitative type) and observational, quantitative, descriptive and transversal collection, carried out from information contained in Datasus. The bibliographic study was carried out in the Scielo and Pubmed depositories, finding 68 studies and selecting 15 for the discussions proposed herein. <strong>Results</strong>: These studies showed, as a result, that the rate of transmission, hospitalization and death from HIV in Brazil is still very high, especially in the Southeast and Northeast regions, with deaths remaining very stable despite existing treatment. These data showed to be convergent with bibliographic information from the studies discussed herein. <strong>Conclusion</strong>: despite the great possibilities of treatments for HIV, there are significant differences in each state, due to sociocultural issues and access to health care.</p> Bruna Fernandez Sebastião Jorge da Cunha Gonçalves Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-11-01 2022-11-01 34 10.5327/DST-2177-8264-2022341171 Anal cancer: an essay on etiology, risk conditions, vulnerability, and care of carriers https://bjstd.org/revista/article/view/1210 <p><strong>&nbsp;</strong><strong><em>Introduction</em></strong><strong>:</strong> The incidence of anal cancer is influenced by individual factors and socially determined conditions of vulnerability. In Brazil, it has increased in recent decades. A probable explanation for the growing incidence is the low coverage of screening and prevention programs. <strong><em>Objective</em></strong><strong>:</strong> The aim of this study was to reflect on risk factors, the need for early diagnosis, and care of people with anal cancer and to associate social vulnerability in the understanding of illness and care in the Unified Health System (SUS). <strong><em>Methods</em></strong><strong>:</strong> This is a systematic literature review with consultations carried out in open electronic databases: SciELO, Digital Library of Theses and Dissertations, and CAPES Publications Portal. The descriptors used were “anal cancer,” “anal cytology,” “anal cancer precursor lesions,” “primary prevention,” “integrality in health,” and “public health policies.” <strong><em>Results</em></strong><strong>: </strong>Ensuring access to services is a common guideline in the literature. Based on the recovered references, two axes of analysis were built: in the first, ideas to reflect on care with collective health approaches were systematized, mainly on the etiology, biological risk factors, and conditions of vulnerability for cancer development to which the subjects are exposed. In the second, ideas to propose care technologies are put forward, with evidence from similar protocols and policies, especially the “Cervical Cancer Control Program,” which deals with a pathology with cytohistological and etiological similarities, risk factors, diagnostic techniques, and skilled health professionals. <strong><em>Conclusion</em></strong><strong>:</strong> The reviewed sources point to the possibility of incorporating, as a SUS policy, large-scale actions of prevention, screening, and early diagnosis, to qualify and expand the initiatives of promotion and care. The professional cytotechnologist can be a decisive factor in the implementation of the care policy, expanding assistance to the population and qualifying the services.</p> William Pereira Santos Nathália Barbosa do Espírito Santo Mendes Alcindo Antônio Ferla Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-07-04 2022-07-04 34 10.5327/DST-2177-8264-20223409 The fight against sexually transmitted infections cannot stop in the COVID-19 era: a brazilian experience in online training for sexually transmitted infections guidelines https://bjstd.org/revista/article/view/1193 <p><strong><em>Introduction</em></strong><strong>:</strong> The Brazilian Ministry of Health had planned face-to-face workshops for professional training about the Clinical Protocols and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections for the year 2020. Due to the COVID-19 pandemic, the workshops were cancelled, and a new strategy was adopted: virtual meetings, called Webinars—Clinical Protocols and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections 2020. <strong><em>Objective</em></strong><strong>:</strong> To report the experience at the Ministry of Health in online training about the clinical protocol and therapeutic guidelines for comprehensive care for people sexually transmitted infections for health professionals in 2020. <strong><em>Methods</em></strong><strong>:</strong> The webinars were held in partnership with the Brazilian Society of Sexually Transmitted Diseases and the Pan American Health Organization. Each chapter of the Clinical Protocols and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections—2020 was converted into a webinar, with the participation of at least three experts, two speakers, and a moderator. <strong><em>Results</em></strong><strong>:</strong> In total, 16 webinars were presented, covering topics such as sexually transmitted infections surveillance, prevention, diagnosis, treatment, public policies, and sexual violence. The initiative had more than 77,000 hits, with an average of 4,900 hits per webinar and the topic “syphilis” being the most accessed. The event reached all 27 federative units of Brazil, as well as 27 other countries. About 500 questions were received from the audience and answered during the sessions and/or through a document published later on by the Ministry of Health. <strong><em>Conclusion</em></strong><strong>:</strong> Given the high number of hits and inquiries received, we can conclude that health professionals remained engaged in the topic of sexually transmitted infections during the pandemic. This experience shows the great potential of innovative methods for distance learning to promote continuing education, including a series of webinars aimed at strengthening the fight against sexually transmitted infections.</p> <p>&nbsp;</p> Pâmela Cristina Gaspar Adriano Santiago Dias dos Santos Lutigardes Bastos Santana Mayra Gonçalves Aragón Nádia Maria da Silva Machado Miguel Angel Aragón López Mauro Romero Leal Passos Gerson Fernando Mendes Pereira Angélica Espinosa Miranda Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-05-04 2022-05-04 34 10.5327/DST-2177-8264-20223404 Cost utility of penicillin use in primary care for the prevention of complications associated with syphilis https://bjstd.org/revista/article/view/1207 <p>Introduction: Despite penicillin being the drug of choice for the treatment of syphilis, many pregnant women who test positive for syphilis do not receive the drug as recommended by the Ministry of Health, contributing to the increase in costs associated with congenital syphilis. Objective: This study aims to estimate the incremental cost-effectiveness ratio of administering at least one dose of 2.4 million IU of benzathine penicillin in the first trimester of pregnancy as soon as the result of a positive rapid treponemal test performed during antenatal care in primary care units of the Brazilian National Health System. Methods: An analytical model was proposed based on a decision tree. The perspective of the analysis was the one used in The Brazilian National Health System. The clinical outcomes were abortion, prematurity, neonatal death, stillbirth, and congenital syphilis, estimated in terms of disability-adjusted life-years. Only direct costs were considered. Deterministic and probabilistic sensitivity analyses were performed. Results: The model predicted that the most efficient strategy is the one that includes the administration of penicillin in primary care for cases of gestational syphilis. This strategy is more effective, although more costly. The cost per disability-adjusted life-years averted with the use of this strategy was estimated at R$49.79 (US$ 10.67).<br>Conclusion: The prenatal strategy in primary care units that includes the administration of penicillin to pregnant women with syphilis during the first trimester of pregnancy has the greatest potential to be cost-effective.</p> Roberto Carlos Lyra da Silva Antonio Augusto de Freitas Peregrino Regina Rocco Lilian Reinaldi Ribeiro Daniel Aragão Machado Carlos Roberto Lyra da Silva Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-06-13 2022-06-13 34 10.5327/DST-2177-8264-20223408 Time trend and causes of HIV/AIDS mortality in the state of Santa Catarina, 2010–2019 https://bjstd.org/revista/article/view/1186 <p><strong>Introduction:</strong> Although the acquired immunodeficiency syndrome (AIDS) has no cure, antiretroviral treatment has considerably increased the survival of people living with the disease or with the human immunodeficiency virus (HIV), reducing the incidence of opportunistic infections in these patients. Thus, this treatment changed mortality rates and diversified the causes of death, including reasons related to increased longevity, such as chronic non-communicable diseases, common in the uninfected population. Therefore, the current epidemiological transition motivated us to study the death profile of people with HIV/AIDS in the state of Santa Catarina. <strong>Objective:</strong> To investigate case characteristics, as well as the time trend and distribution of deaths, among people with HIV/AIDS in Santa Catarina between 2010 and 2019. <strong>Methods:</strong> In this ecological, epidemiological study, we consulted all death records from the Santa Catarina Mortality Information System that had HIV/AIDS among the causes and occurred between 2010 and 2019. <strong>Results: </strong>A total of 5,174 death records were analyzed. In the period, the mean mortality rate among people with HIV/AIDS was 7.64 deaths per 100 thousand inhabitants (95% confidence interval — 95%CI 6.61–8.67) — 8.99 in 2010 and 6.06 in 2019 —, showing a downward trend of 0.38% per year. <strong>Conclusion:</strong> We identified a downward trend in mortality. Deaths were concentrated on the coast, in more populous cities. Furthermore, the finding of improper completion of the death certificate points to the need to invest in improving the training of professionals responsible for this document.</p> Braulio Sambaquy Escobar Escobar Ilda Vaica Armando Cunga Cunga Gabriel Oscar Cremona Parma Parma Betine Pinto Moehlecke Iser Iser Fabiana Schuelter-Trevisol Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-07-25 2022-07-25 34 10.5327/DST-2177-8264-2022341186 Um Bacterial vaginosis, cervical Human Papillomavirus infection and cervical cytological abnormalities in adult women in Central Brazil: A cross-sectional study https://bjstd.org/revista/article/view/1216 <p><strong>Introduction</strong>: Bacterial vaginosis is the most common cause of vaginal discharge and occurs when there is an imbalance in the vaginal microbiota, predominantly composed of <em>Lactobacillus spp.</em> Human Papillomavirus is the most common sexually transmitted virus in the world. Persistent infection with high-risk Human Papillomavirus genotypes is the main cause of the development of cervical intraepithelial neoplasia and cervical cancer.<strong> Objective:</strong> To investigate the association between bacterial vaginosis and cervical Human Papillomavirus infection and between bacterial vaginosis and cervical cytological abnormalities in adult women. <strong>Methods:</strong> Cross-sectional study carried out in a gynecology outpatient clinic of the public health network. A total of 202 women were included in the study and underwent gynecological examination with cervical specimen collection. Cervical cytopathological examinations and bacterioscopy by the Nugent method were performed to identify bacterial vaginosis, and PCR and reverse hybridization were carried out for Human Papillomavirus detection and genotyping. Bivariate analysis was performed to investigate the association between bacterial vaginosis and cervical Human Papillomavirus infection, and between bacterial vaginosis and cervical cytological abnormalities. The odds ratio was calculated, with the respective 95% confidence intervals (95%CI) and 5% significance level (p≤0.05). <strong>Results:</strong> The prevalence of bacterial vaginosis was 33.2% (67/202), the prevalence of cervical Human Papillomavirus infection was 38.6% (78/202) and the prevalence of cervical cytological abnormalities was 6.0% (12/202). Bivariate analysis showed no significant association between bacterial vaginosis and cervical Human Papillomavirus infection (OR 0.69; 95% CI 0.37–1.27; p=0.23), or between bacterial vaginosis and cervical cytological abnormalities (OR 0.65; 95%CI 0.17–2.50; p=0.54). <strong>Conclusion:</strong> In this study, bacterial vaginosis did not represent a risk factor for cervical Human Papillomavirus infection or for the presence of cervical cytological abnormalities in the investigated adult women.</p> Bruno César Teodoro Martins Kélvia Cristina de Camargo Jamila Pimentel Lima Jéssica Enocêncio Porto Ramos Camila Lemes de Souza Sílvia Helena Rabelo dos Santos Vera Aparecida Saddi Rosane Ribeiro Figueiredo Alves Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-11-22 2022-11-22 34 10.5327/DST-2177-8264-20221216 Limitation of cytology and the impact on reduction of cervical cancer https://bjstd.org/revista/article/view/1197 <p>Introduction: Cervical cancer is the third most common malignant tumor in the female population and the fourth cause of death from cancer in women in<br>Brazil. The squamocolumnar junction and the transformation zone concentrate 90% of pre-invasive and invasive cervical lesions. Objective: To evaluate<br>the prevalence of cytology without cells of the squamocolumnar junction and feasibility of active search. Methods: Cross-sectional study at a university<br>hospital between 2017 and 2018. The prevalence of cytology without squamocolumnar junction cells was calculated. A convenience sample was obtained<br>and mean age and relationship with presence of transformation zone cells were calculated. An active search was performed and cytology collected, with<br>estrogen preparation if indicated. Medical records of the other women were analyzed. Results: Squamocolumnar junction cells were not found in 28.84%<br>of samples. Mean age was 53 years, without association with presence of squamocolumnar junction cells (p=0.409). Seventy-six women returned, 36 of<br>which (47.37%) used estrogen. Level 2 or 3 cervical intraepithelial neoplasia, microinvasive carcinoma or cancer was not identified. A total of 134 medical<br>records were analyzed; only 36 women (26.87%) completed screening. Conclusions: The presence of squamocolumnar junction cells indicates quality of<br>cytology; the use of es</p> Daniela da Silva Alves Monteiro Isabel Cristina Chulvis do Val Guimarães Susana Cristina Aidé Viviani Fialho Caroline Alves de Oliveira Martins Luis Guillermo Coca Velarde Priscila Loyola Campos Izabel Cristina dos Santos Teixeira Julia Sampaio de Souza Morais Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-05-16 2022-05-16 34 10.5327/DST-2177-8264-20223405 Genital infection by Human papillomavirus (HPV) in women from Santa Catarina/Brazil https://bjstd.org/revista/article/view/1212 <p><strong>Introduction:</strong> Human papillomavirus (HPV) infection is the most common sexually transmitted infection in women. About 80% of sexually active women will have contact with this virus at some point in their lives. Most infections will be transient, but when the infection becomes persistent and associated with a high oncogenic risk of Human papillomavirus, there may be progression to cancer, especially cervical cancer. The best way to prevent Human papillomavirus infection is through the use of vaccines, which have been available to the public in Brazil since 2014. <strong>Objective:</strong> This study aimed to assess the most prevalent types of Human papillomavirus in the state of Santa Catarina, Brazil, and its mesoregions and if the majority of diagnosed types are contained in the Human papillomavirus vaccines currently available on the market. <strong>Methods:</strong> A total of 20,000 Human papillomavirus tests were evaluated for the diagnosis of genital Human papillomavirus infection in women from the state of Santa Catarina, Brazil. The prevalence of infection was evaluated according to age and the city of origin of the exams. Human papillomavirus detection was performed using molecular biology tests, such as hybrid capture (for diagnosis of the Human papillomavirus group, high or low oncogenic risk) and polymerase chain reaction (viral genotyping) techniques. <strong>Results:</strong> The diagnosis of Human papillomavirus infection was performed on women between 1 and 102 years of age. The age with the highest Human papillomavirus positivity, as expected, was 20–25 years (45.6%) and the lowest after 70 years (7.1%). The highest Human papillomavirus positivity of the exams was observed in the Serrana region of Santa Catarina state (58.9% of the exams). A high-oncogenic-risk Human papillomavirus was detected in 93% of positive samples and was the most frequent in all age groups. Mixed infection (high- and low-risk Human papillomavirus) was more prevalent in the 66–70 age group (29.3%) and in the Southern Region of Santa Catarina (26.4%). The most frequent genotypes in the state of Santa Catarina were non-16/18 high oncogenic risk Human papillomavirus (76.9% of positive cases). Human papillomavirus 16 was found in 17.1% of positive cases and Human papillomavirus 18 in 6.6%. <strong>Conclusion:</strong> The most prevalent types of Human papillomavirus in the state of Santa Catarina in the past 6 years are the non-16/18 high oncogenic risk Human papillomavirus types, which are viral types not covered by the current Human papillomavirus vaccines available in Brazil.</p> Edison Natal Fedrizzi Sérgio Murilo Steffens Maria Elizabeth Menezes José Eduardo Levi Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-12-07 2022-12-07 34 10.5327/DST-2177-8264-20221212 HIV diagnosis in Brazil: the impact of the COVID-19 pandemic https://bjstd.org/revista/article/view/1170 <p>Letter to the editors</p> Nelson Pereira Marques Nádia Carolina Teixeira Marques Daniella Reis Barbosa Martelli Edson Gomes de Lucena Eduardo Araújo de Oliveira Hercílio Martelli Júnior Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-02-22 2022-02-22 34 10.5327/DST-2177-8264-20223401 Eulogy to Dr. Gisela del Pino: …To hold my teacher in this art equal to my own parents https://bjstd.org/revista/article/view/1189 <p>As the article is a letter to the editor, it does not have an abstract.</p> MAURO RAMOS Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-06-20 2022-06-20 34 10.5327/DST-2177-8264-20221189 Dear fellow readers of the scientific journal Jornal Brasileiro de DST https://bjstd.org/revista/article/view/1184 <p>Letther to the editor</p> Miguel Tilli Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-03-31 2022-03-31 34 10.5327/DST-2177-8264-20223403 Anal cancer and its similarities with cervical cancer – the rescue of forgotten studies https://bjstd.org/revista/article/view/1190 <p>Letter to the editor</p> José Eleutério Junior Luciano Silveira Pinheiro Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-04-25 2022-04-25 34 10.5327/DST-2177-8264-20223406 Monkeypox: A New Epidemic Threat with Behavioral Components of Physical Intimacy? https://bjstd.org/revista/article/view/1205 <p>Given the context of a possible epidemic and the possibility of a pandemic caused by monkeypox, this may be a pathology related to sexual transmission. It is relevant to question and demand from national and international health authorities which measures to adopt to contain the disease and not repeat the mistakes of previous situations.</p> Julia Sampaio de Souza Morais Roberto de Souza Salles Ivo Castelo Branco Coêlho Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-06-10 2022-06-10 34 10.5327/DST-2177-8264-2022341205 Prevalence and epidemiologic transition of sexually transmitted infections in a Brazilian dermatologic clinic (2012-2019) https://bjstd.org/revista/article/view/1183 <p>LETTERS TO THE EDITOR</p> Vítor Cercal de Oliveira Arthur Cesar dos Santos Minato Mariana Mathias Morita Júlia Ferreira de Oliveira Letícia Yumi Ishimoto Bianca Latance da Cruz Maria Vitória Yuka Messias Nakata Lais Gonçalves Moreira Hélio Amante Miot Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-03-31 2022-03-31 34 10.5327/DST-2177-8264-20223402 Chlamydia infection resembling ulcerative colitis: Case report https://bjstd.org/revista/article/view/1208 <p><strong>Introduction</strong>: The diagnosis of ulcerative colitis is relatively complex because the symptoms are similar to those seen in several other diseases. <strong>Objective</strong>: To report a case of rectal chlamydial infection whose initial symptoms resembled ulcerative colitis. <strong>Case report</strong>: A 50-year-old male patient presented with diarrhea, blood and mucus in the stools, and an ulcer in the rectum. The histopathological exam pointed to chronic, unspecified inflammation. After a broad serological screening, with Immunoglobulin M positive for <em>Chlamydia</em> and a high titer of immunoglobulin G, the patient was treated with antibiotics and is clinically cured. Later, he remained Immunoglobulin M positive, but the titers of immunoglobulin G lowered considerably. <em>Chlamydia</em> has been shown to live in the gut microbiota, which could explain the case. <strong>Conclusion</strong>: It is important to search for chlamydial infection as a differential diagnosis of ulcerative colitis.</p> Dario Palhares Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-09-28 2022-09-28 34 10.5327/DST-2177-8264-2022341208 Severe monkeypox case associated with recent laboratory diagnosis of HIV: case report https://bjstd.org/revista/article/view/1215 <p><strong>Introduction:</strong> Monkeypox is a zoonosis caused by the smallpox virus.</p> <p>The first confirmed human case was in 1970, when the virus was isolated from a child in the Democratic Republic of the Congo. Since the beginning of May 2022, a large and unexpected outbreak has been documented globally, with the first cases initially described in the UK reaching around 70 countries today. The causes of this explosive increase in patients are not well understood, but exceed more than ten thousand10,000 infected by the third week of July 2022. Clinical and epidemiological presentations have been distinct from endemic cases and from small outbreaks previously described in non- endemic areas. <strong>Objective:</strong> The aim of this study was to describe the evolutionary and epidemiological, clinical characteristics of Monkeypox and human immunodeficiency virus co-infection in a patient treated at an STI/AIDS Reference Service in São Paulo, Brazil. <strong>Methods: </strong>information contained in this study was obtained through a review of the medical records, interviews with the patient, photographic record of the diagnostic methods, to which the patient was submitted and review of the literature. <strong>Results:</strong> A Brazilian man, with no epidemiological history of travel who was diagnosed with Monkeypox virus through polymerase chain reaction. At the same time of this diagnosis, he received a laboratory diagnosis of human immunodeficiency virus, Chlamydia Urethritis, and Late Latent Syphilis. <strong>Conclusion:</strong> To reduce the risk of the dissemination of Monkeypox, strategies at the public health level are necessary, with the dissemination of information and the development of prevention projects with targeted information and recommendations for vulnerable populations, especially men who have sex with men, with great prudence, seeking not to favor the development of stigmas as already experienced at the beginning of the human immunodeficiency virus epidemic.</p> Mateus Ettori Cardoso Álvaro Furtado da Costa Claudia Afonso Binelli Layana Guedes Carvalhal Roberto José Carvalho da Silva Rosangela Rodrigues Roberta Schiavon Nogueira Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-11-21 2022-11-21 34 10.5327/DST-2177-8264-2022341215 Disseminated dermatophytosis and acquired immunodeficiency syndrome:literature review and presentation of clinical experience https://bjstd.org/revista/article/view/1206 <p><strong>Introduction:</strong> Dermatophytosis are very common fungal infections caused by the fungal species <em>Microsporum, Epidermophyton</em> or <em>Trichophyton</em>, which mostly affect the skin, the interdigital region, groin and scalp. Although they do not cause serious diseases, in patients with the human immunodeficiency virus the infection manifests itself and evolves exuberantly, usually with extensive and disseminated lesions. <strong>Objective:</strong> To review the literature on dermatophytosis in people living with human immunodeficiency virus and to present the experience in clinical care in a patient living with human immunodeficiency virus with extensive and disseminated dermatophytosis. <strong>Methods:</strong> A literature review on the topic was carried out in the PubMed/National Library of Medicine – USA databases, using the keywords dermatophytosis, or dermatophytosis associated with the words AIDS, human immunodeficiency virus or immunodeficiency, from 1988–2022. The clinical experience showed a patient living with human immunodeficiency virus developing AIDS and presenting with disseminated skin lesions. Samples of the lesion were collected by scraping, which were submitted to culture and there was growth of fungi of the <em>Trichophyton sp </em>genus<em>.</em> A biopsy of the lesion was also performed using the Grocott-Gomori's Methenamine Silver stain. <strong>Results:</strong> We found 1,014 articles, of which only 34 presented a direct correlation with our paper, and were used to discuss the main themes narrated in this article. We present clinical experience in the management of a patient with human immunodeficiency virus/AIDS and low adherence to antiretroviral treatment, showing extensive and disseminated erythematous-squamous lesions with a clinical diagnosis of tinea corporis, manifesting with a clinical picture usually not found in immunocompetent patients. The diagnosis was confirmed by laboratory tests with isolation of the <em>Trichophyton sp </em>fungus. The patient was treated with oral fluconazole, with complete remission of the clinical picture after two months. She was also thoroughly encouraged to use the prescribed antiretroviral medication correctly. <strong>Conclusion:</strong> Dermatophytosis in patients living with human immunodeficiency virus can present extensive and disseminated forms. The antifungal treatment is quite effective, with remission of the condition. Antiretroviral therapy is an important adjuvant for better recovery of the sickness.</p> Vanessa Knauf Lopes Ivan Mauricio Herrera Garzon Paloma Marianni Suazo Encarnacion Carlos José Martins Ricardo Barbosa Lima Rogerio Neves Motta Fernando Raphael de Almeida Ferry Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-11-01 2022-11-01 34 10.5327/DST-2177-8264-2022341206 How far can syphilis go? https://bjstd.org/revista/article/view/1222 <p>I have been in medicine for over 40 years. In all these years I have seen many, many people sick with syphilis. Each case different from the other. Nothing repeated.<br />However, on August 9, 2022, I received a WhatsApp message from a hematologist. It was about a young man with very aggressive lymphoma. Just an allogeneic transplant.<br />A donor was identified. But because the person had syphilis, the transplant was delayed.</p> Mauro Romero Leal Passos Copyright (c) 2022 Brazilian Journal of Sexually Transmitted Diseases 2022-10-12 2022-10-12 34 10.5327/DST-2177-8264-20221222