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Zhao F.-H.,Peking Union Medical College | Varanasi A.P.,Health Studies Sector | Cunningham C.A.,New York University | Graubard B.I.,U.S. National Institutes of Health | And 5 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2011

The study was embedded in Shanxi Province Cervical Cancer Screening Study II with the aim of examining the association between history of diagnosed tuberculosis or cervical inflammation and oncogenic human papillomavirus (HPV) infection, persistent oncogenic HPV infection, cervical intraepithelial neoplasia grade 3 or cervical cancer (CIN3+) in an isolated rural population of China. A total of 8,798 women were recruited for cervical cancer screening and an interviewer-administered questionnaire. Of the women in the study, 2.7% and 34% reported a diagnosis of tuberculosis and cervical inflammation, respectively. In the model for HPV infection, HPV persistence and CIN3+, we show an increasing magnitude of effect of tuberculosis with increasing severity of disease, as demonstrated by the increasing odds ratios from 1.68 for HPV positivity, to 1.75 for persistent HPV and then 2.08 for CIN3+. Women reporting a diagnosis of tuberculosis, cervical inflammation or both tuberculosis and cervical inflammation were at 75%, 22% and 113% higher odds of persistent HPV infection, respectively. One percent of the study population was diagnosed with tuberculosis and cervical inflammation, placing them at 90% and 113% higher odds of infection with HPV and persistent HPV, respectively. Tuberculosis and oncogenic HPV are identified for the first time as co-infections in rural unscreened women in Shanxi Province, China, highlighting the importance of infection history in assessing an individual's risk for HPV infection, persistence and CIN3+. Source

Greenberg L.,Health Studies Sector | Willard N.,Johns Hopkins University | Korelitz J.,Health Studies Sector | Kapogiannis B.G.,U.S. National Institutes of Health | And 6 more authors.
JAMA Pediatrics | Year: 2015

Importance: With the emphasis on structural-level interventions that target social determinants of human immunodeficiency virus (HIV) transmission to curb the HIV epidemic, there is a need to develop evaluation models that can detect changes in individual factors associated with HIV-related structural changes.Objective: To describe whether structural changes developed and achieved by community coalitions are associated with an effect on individual factors associated with the risk of contracting HIV.Design, Setting, And Participants: In this serial cross-sectional survey design, datawere collected from 8 cities during 4 rounds of annual surveys from March 13, 2007, through July 29, 2010. Study recruitment took place at venues where the population of focus was known to congregate, such as clubs, bars, community centers, and low-income housing. The convenience sample of at-risk youth (persons aged 12-24 years) included 5337 individuals approached about the survey and 3142 (58.9%) who were screened for eligibility. Of the 2607 eligible participants, 2559 (98.2%) ultimately agreed to participate.Interventions: Achievement of locally identified structural changes that targeted public and private entities (eg, federal agencies, homeless shelters, and school systems) with the goal of fostering changes in policy and practice to ultimately facilitate positive behavioral changes aimed at preventing HIV.Main Outcomes And Measures: Number of sexual partners, partner characteristics, condom use, and history of sexually transmitted infections and HIV testing.Results: Exposure to structural changes was not statistically significantly associated with any of the outcome measures, although some results were in the direction of a positive structural change effect (eg, a 10-unit increase in a structural change score had an odds ratio of 0.88 [95%CI, 0.76-1.03; P = .11] for having an older sexual partner and an odds ratio of 0.91 [95% CI, 0.60-1.39; P= .39] for using a condom half the time or less with a casual partner).Conclusions And Relevance This study evaluated a broad representation of at-risk individuals and assessed the effect of numerous structural changes related to various HIV risk factors. No structural changes as measured in this study were associated with a statistically significant reduction in risk behaviors. These null findings underscore the need for a long-term approach in evaluating structural interventions and the development of more nuanced methods of quantifying and comparing structural-change initiatives and determining the appropriate strategies for evaluating effect. © 2015 American Medical Association. All rights reserved. Source

Stoszek S.K.,Health Studies Sector | Duarte G.,University of Sao Paulo | Hance L.F.,Health Studies Sector | Pinto J.,Federal University of Minas Gerais | And 7 more authors.
International Journal of Gynecology and Obstetrics | Year: 2013

Objective To describe temporal management and outcome trends among HIV-1-infected pregnant women and their infants enrolled in the NISDI Perinatal and LILAC cohorts. Methods A prospective cohort of 1548 HIV-1-infected pregnant women and their 1481 singleton live-born infants was analyzed. Participants were enrolled at 24 Latin American and Caribbean sites and followed-up for at least 6 months postpartum. Variables were compared by 2-year enrollment periods from September 27, 2002, to June 30, 2009, using logistic and linear regression modeling. Results Antiretroviral (ARV) use during pregnancy remained high (99.0%). ARVs became increasingly used for treatment (P < 0.001). Regimens containing 2 nucleoside reverse transcriptase inhibitors plus a protease inhibitor became more common in later years (P < 0.001). The proportion of women with viral loads below 1000 copies/mL at hospital discharge after delivery (HD) increased over time (P = 0.0031). Median CD4 lymphocyte counts also rose at HD, from 441 cell/mm3 to 515 cells/mm3 (P < 0.05). Elective cesarean deliveries increased from 30.5% to 42.0% (P = 0.018). Most infants received ARV prophylaxis (99.7%). Few infants were breastfed (0.5%) or became infected with HIV-1 (1.2%). Conclusion The results indicate that national HIV-1 treatment and transmission prevention policies are effective among patients with healthcare access in the region. © 2013 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics. Source

Hamilton C.D.,Global Health | Hamilton C.D.,Duke University | Swaminathan S.,National Institute for Research in Tuberculosis | Christopher D.J.,Christian Medical College | And 10 more authors.
Clinical Infectious Diseases | Year: 2015

Progress in tuberculosis clinical research is hampered by a lack of reliable biomarkers that predict progression from latent to active tuberculosis, and subsequent cure, relapse, or failure. Regional Prospective Observational Research in Tuberculosis (RePORT) International represents a consortium of regional cohorts (RePORT India, RePORT Brazil, and RePORT Indonesia) that are linked through the implementation of a Common Protocol for data and specimen collection, and are poised to address this critical research need. Each RePORT network is designed to support local, in-country tuberculosis-specific data and specimen biorepositories, and associated research. Taken together, the expected results include greater global clinical research capacity in high-burden settings, and increased local access to quality data and specimens for members of each network and their domestic and international collaborators. Additional networks are expected to be added, helping to spur tuberculosis treatment and prevention research around the world. © 2015 The Author. Source

Cerhan J.R.,Mayo Medical School | Berndt S.I.,U.S. National Cancer Institute | Vijai J.,Sloan Kettering Cancer Center | Ghesquieres H.,Center Leon Berard | And 135 more authors.
Nature Genetics | Year: 2014

Diffuse large B cell lymphoma (DLBCL) is the most common lymphoma subtype and is clinically aggressive. To identify genetic susceptibility loci for DLBCL, we conducted a meta-analysis of 3 new genome-wide association studies (GWAS) and 1 previous scan, totaling 3,857 cases and 7,666 controls of European ancestry, with additional genotyping of 9 promising SNPs in 1,359 cases and 4,557 controls. In our multi-stage analysis, five independent SNPs in four loci achieved genome-wide significance marked by rs116446171 at 6p25.3 (EXOC2; P = 2.33 × 10 '21), rs2523607 at 6p21.33 (HLA-B; P = 2.40 × 10 '10), rs79480871 at 2p23.3 (NCOA1; P = 4.23 × 10 '8) and two independent SNPs, rs13255292 and rs4733601, at 8q24.21 (PVT1; P = 9.98 × 10 '13 and 3.63 × 10 '11, respectively). These data provide substantial new evidence for genetic susceptibility to this B cell malignancy and point to pathways involved in immune recognition and immune function in the pathogenesis of DLBCL. © 2014 Nature America, Inc. All rights reserved. Source

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