Historia natural de la infección por el virus del papiloma humano en una cohorte de Bogotá, D.C., Colombia
Palabras clave:
papillomavirus humano, Chlamydia trachomatis, Colombia, estudios de seguimiento, historia natural, estudios de cohortesResumen
Objetivo: Describir la prevalencia, incidencia y persistencia de infecciones cervicales por virus del papiloma humanó'(VPH), C. trachomatis y sus factores de riesgo en mujeres de una cohorte en Bogotá, Colombia.
Materiales y métodos: Se revisaron 6 artículos publicados de una cohorte de 1.845 mujeres bogotanas con edades entre13 y 85 años, con citología normal y seguimiento de 5 años.
Resultados: La prevalencia de infección por VPH fue 14,9%. Los virus de alto riesgo fueron tres veces más comunes que los de bajo riesgo (9,0%/3,2%). La mayor prevalencia se observó en menores de 20 años (26%). Para tipos de bajo riesgo, la mayor prevalencia fue en mayores de 55 años (7,6%). La incidencia de infección por VPH fue de 6,2 por 100 mujeres-año, 5,0 para los de alto riesgo y 2,0 para los de bajo riesgo. Siete por ciento de las infecciones prevalentes e incidentes aún estaban presentes a los 5 años de seguimiento.
La eliminación de la infección por VPH 16 fue más lenta que la de tipos de bajo riesgo (RR=0,47; IC95%, 0,32 a 0,72) e infecciones por uno o múltiples tipos virales tuvieron tasas de eliminación similares.
La prevalencia de infección por C. trachomatis fue 5,5%, con un pico en mujeres menores de 20 años (8,1%). Su principal factor de riesgo fueron infecciones múltiples por VPH (OR=2,8; IC95%, 1,2 a 6,0). 94% de las mujeres habían eliminado la infección a los 4 años de seguimiento. Las serovariantes del grupo B y el C tuvieron tasas de eliminación más lentas que el grupo intermedio (RR=0,4; IC95%, 0,1 a 0,9).
Conclusión: El estudio de la historia natural de la Infección por VPH y C. trachomatis en un país en desarrollo contribuye significativamente al conocimiento biológico, clínico y epidemiológico de estos agentes. La prevalencia y la incidencia de VPH por tipos específicos y por edad es información necesaria para plantear nuevas estrategias de prevención del cáncer cervicouterino mediante el desarrollo de vacunas contra VPH, las cuales se encuentran en fase de evaluación en Colombia y otros países.
Biografía del autor/a
Monica Molano, Instituto Nacional de Cancerología E.S.E.
Instituto Nacional de Cancerología E.S.E.
Subdirección de Investigaciones
Grupo de Investigación en Biología del Cáncer
Bogotá, D.C.
Colombia
Héctor Posso, Instituto Nacional de Cancerología E.S.E.
Instituto Nacional de Cancerología E.S.E.
Subdirección de Investigaciones
Grupo de Investigación en Biología del Cáncer
Bogotá, D.C.
Colombia
Fabián Méndez, Instituto Nacional de Cancerología E.S.E.
Instituto Nacional de Cancerología E.S.E.
Subdirección de Investigaciones
Grupo de Investigación en Biología del Cáncer
Bogotá, D.C.
Colombia
Raúl Murillo, Instituto Nacional de Cancerología E.S.E.
Instituto Nacional de Cancerología E.S.E.
Subdirección de Investigaciones
Grupo de Investigación en Biología del Cáncer
Bogotá, D.C.
Colombia
Adriaan Van den Brule, Vrije Universiteit Medical Center
Vrije Universiteit Medical Center
Department of Pathology
Amsterdam
The Netherlands
Adriaan Van den Brule, Vrije Universiteit Medical Center
Vrije Universiteit Medical Center
Department of Pathology
Amsterdam
The Netherlands
Margarita Ronderos, Instituto Nacional de Cancerología E.S.E.
Instituto Nacional de Cancerología E.S.E.
Subdirección de Investigaciones
Grupo de Investigación en Biología del Cáncer
Bogotá, D.C.
Colombia
Alvaro Muñoz, Instituto Nacional de Cancerología E.S.E.
Instituto Nacional de Cancerología E.S.E.
Subdirección de Investigaciones
Grupo de Investigación en Biología del Cáncer
Bogotá, D.C.
Colombia
Chris Meijer, Vrije Universiteit Medical Center
Vrije Universiteit Medical Center
Department of Pathology
Amsterdam
The Netherlands
Nubia Muñoz, Instituto Nacional de Cancerología E.S.E.
Instituto Nacional de Cancerología E.S.E.
Subdirección de Investigaciones
Grupo de Investigación en Biología del Cáncer
Bogotá, D.C.
Colombia
Grupo de estudio del VPH, Instituto Nacional de Cancerología E.S.E.
Instituto Nacional de Cancerología E.S.E.
Subdirección de Investigaciones
Grupo de Investigación en Biología del Cáncer
Bogotá, D.C.
Colombia
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