Author Interviews, Global Health, Lancet, Methamphetamine, OBGYNE, STD / 29.07.2016

MedicalResearch.com Interview with: N. Saman Wijesooriya Public Health Advisor/Technical Advisor Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: The article Global burden of maternal and congenital syphilis in 2008 and 2012: a health systems modeling study by Wijesooriya, et al published in the August 2016 issue of The Lancet Global Health (Open source - http://dx.doi.org/10.1016/S2214-109X(16)30135-8) estimates the incidence and prevalence of maternal and congenital syphilis for both time periods and identifies gaps antenatal care access and syphilis testing and treatment services to assess progress in the global elimination of congenital syphilis, or mother-to-child transmission of syphilis, as a public health problem. Untreated maternal syphilis is understood to be transmitted from mother-to-child in utero in 50% of cases resulting in tragic adverse pregnancy outcomes, or congenital syphilis infections, including early fetal death, stillbirth, preterm birth, low birthweight, neonatal death, and congenital infections in infants. Since most maternal syphilis infections are asymptomatic, it is recommended that screening for syphilis use a combination of serological tests for pregnant women and treatment of syphilis seropositive women with at least 2.4 million units of benzathine penicillin intramuscularly early in pregnancy to prevent most congenital syphilis infections. In 2007, the World Health Organization responded to estimates indicating 2 million maternal and 1.5 congenital syphilis infections would occur annually without treatment and launched the global initiative for the Elimination of Congenital Syphilis (ECS). The strategy includes reducing the prevalence of syphilis in pregnant women and mother-to-child transmission of syphilis. The objective is for countries to achieve high performing antenatal care systems providing access to antenatal care to more than 95% of pregnant women, syphilis testing for more than 95% of pregnant women, and treatment for more than 95% of seropositive women to attain a congenital syphilis rate of 50 or fewer cases per 100,000 live births. (more…)
Author Interviews, Fertility, HPV, OBGYNE, STD / 12.07.2016

MedicalResearch.com Interview with: Dejan R. Nonato, MD, PhD Institute of Tropical Pathology and Public Health School of Medicine Federal University of Goiás Goiânia, GO, Brazil MedicalResearch.com: What is the background for this study? Response: Human papillomavirus (HPV) and Chlamydia trachomatis (CT) share the same route of sexual transmission and possess similar risk factors, indicating that co-infection may act synergistically in the induction of epithelial cell abnormalities. (more…)
Author Interviews, CDC, Infections, Sexual Health, STD / 28.06.2016

MedicalResearch.com Interview with: Dr. Andrew Amato-Gauci MD Head of the European Centre for Disease Prevention and Control Programme on HIV/AIDS, sexually transmitted infections and viral hepatitis MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our surveillance data (http://bit.ly/1sXdbVv) show that between 2008 and 2014, the overall rate of officially reported gonorrhoea infections has more than doubled across Europe, going up from 8 per 100 000 population to 20 cases per 100 000 persons. In total, 66 413 gonorrhoea cases were reported in 27 countries of the European Union and European Economic Area (EU/EEA) in 2014 – which constitutes an increase of 25% compared with 2013. The majority of gonorrhoea infections were diagnosed among young adults aged 15–24 years who accounted for 38% of cases; followed by the 25–34-year-olds (34%). For the first time since 2010, the number of cases among women was higher than the number of cases among heterosexual men. Given the risk of reproductive tract complications, e.g. pelvic inflammatory disease or, if untreated, infertility, as well as possible transmission from mother to child, this trend among women is of particular concern. (more…)
Author Interviews, Infections, PLoS, Sexual Health, STD / 07.05.2016

MedicalResearch.com Interview with: Charu Kaushic. PhD. Professor OHTN Applied HIV Research Chair Department of Pathology and Mol. Medicine McMaster Immunology Research Center, McMaster University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kaushic: Female sex hormones, estradiol and progesterone have been shown to regulate immune responses in many experimental and clinical studies. We and others have shown previously that these hormones also regulate susceptibility to and outcome of sexually transmitted infections (STIs), including Chlamydia, HSV-2, SIV and HIV-1. Most studies show that progesterone generally increases susceptibility while estradiol generally confers protection against STIs. This has recently gained much more widespread attention because of the controversy surrounding use of injectable hormonal contraceptives in geographical areas where there is high prevalence of HIV-1. The most frequently used injectable contraceptive uses a progestin-based formulation which has been correlated with 2-fold increase in HIV acquisition and transmission in epidemiological studies. Oral contraceptives that contain a combination of estradiol and progesterone do not show similar correlation with increased infection. This is currently a very important women’s health issue, which is being carefully monitored by many public health agencies, including WHO. Many researchers are focusing efforts in understanding how sex hormones can increase or decrease susceptibility of women to STIs. We have published in this area for more than a decade, including a series of papers showing that in a mouse model, the outcome of genital herpes (HSV-2) infection can depend on which hormone we treat the mice with. A few years ago, we showed for the first time that mice that received an HSV-2 vaccine under the influence of estradiol were much better protected and showed less disease pathology (Bhavanam et al, Vaccine 2008). These results were reproduced a year later by another group, using an actual HSV-2 vaccine formulation. Since then, we have been working to understand at a cellular level, the underlying mechanism of estradiol-mediated enhanced protection. In this PLOS Pathogens paper, we report for the first time a cellular mechanism by which estradiol was seen to enhance immune protection against HSV-2 infection in mice. The main findings are that estradiol primes dendritic cells in the vaginal tract to induce enhanced anti-viral T cell responses. Dendritic cells are key immune cells that decide what type of immune responses will be mounted against an infection. Under the influence of estradiol, the dendritic cells in the vaginal tract of mice induced Th17 cells which in turn helped enhance anti-viral T cell responses (Th1), resulting in better protection against genital HSV-2. This regulation of anti-viral immunity was seen only in the reproductive tract. (more…)
Author Interviews, STD / 18.11.2015

MedicalResearch.com Interview with: Dr Pam Sonnenberg  Reader in Infectious Disease Epidemiology Research Department of Infection & Population Health University College London London MedicalResearch: What is the background for this study? What are the main findings? Dr. Sonnenberg:  This study strengthens growing evidence that Mycoplasma genitalium (MG) is a sexually transmitted infection (STI). Analyses of over 4500 of urine samples from Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) showed that MG was prevalent in up to 1% of the general population aged 16-44, who had reported at least one sexual partner. Prevalence was much higher in those who had reported more than four sexual partners in the past year – 5.2% in men and 3.1% in women. Absence of the infection in over 200 16-17 year olds who had not had vaginal, anal, or oral sex provided further evidence that MG is transmitted sexually. The study also analysed risk factors for  Mycoplasma genitalium, such as ethnicity, number of partners, and areas of deprivation. There were strong associations with risky sexual behaviours, with similar behavioural risk factors to other known STIs. The authors found that men of Black ethnicity and those living in the most deprived areas were more likely to test positive for MG. Over 90% of Mycoplasma genitalium in men and over two-thirds of MG cases in women were in those aged 25–44 years; an age group who would not be included in STI prevention measures currently aimed at young people in Britain. Interestingly, the majority of participants who tested positive for MG did not report any STI symptoms in the last month. Over half of women did not report any symptoms, but among those who did, bleeding after sex was most common. Over 90% of MG positive men did not report any symptoms. (more…)
Author Interviews, CDC, Infections, OBGYNE, STD / 13.11.2015

MedicalResearch.com Interview with: Dr. Virginia Bowen PhD Epidemic Intelligence Service Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention,CDC  Medical Research: What is the background for this study? What are the main findings? Dr. Bowen: Congenital syphilis (CS) occurs when a mother infected with syphilis transmits the infection to her child during the course of pregnancy. Our study looked at recent trends in CS between 2008 and 2014. After four years of decline, Congenital syphilis rates increased by 38% from 2012 to 2014. The findings from this report show we are missing opportunities to screen and treat pregnant women for STDs. Syphilis in pregnant women can cause miscarriages, premature births, stillbirths, or death of newborn babies. We have effective tests and treatment for syphilis – there’s no excuse for allowing it to resurge. Every case of CS is one too many. (more…)