TAK-875 This study demonstrated that HIV serostatus was the most important

This study demonstrated that HIV serostatus was the most important attributor to oncogenic HPV infection in female illicit drug users. Many studies have also reported high rates of persistence of detectable oncogenic HPV DNA in women who were infected with HIV. The study findings indicated that HIV-related immunocompromised status would contribute to the persistence of HPV infection. However, the mechanisms by which immunosuppression contributes to the increased risks of HPV-related diseases is not well understood. CD4+ T-cell levels were used as a marker of immunosuppression, but the markers for HPV-specific immunity were not known.
In Taiwan, the general prevalence of HPV alone and oncogenic HPV infection in adult women is 19.85% and 11.1%, respectively. In this study, higher rates of HPV infections were observed in incarcerated HIV-negative women (47.4%) in comparison with the general TAK-875 (19.85%). Therefore, the characteristics of illicit drug users, including low number of years of education, unstable marital status, low rate of condom usage, and high numbers of sexual partners, were considered risk factors for HPV infection among female drug users.
The median duration of incarceration for these women inmates was approximately 1 year in both groups in this study, so the detected HPV infections implicated possible persistent infections. Previous studies had demonstrated HPV infections would not abate for a median of 8 months; thus, this point prevalence rate would approximate the rate of persistent infection, considered to be the major risk factor in the development of precancerous and cancer lesions.
HPV types 52, 51, and 58 were the most commonly encountered oncogenic types in this study. Research has also demonstrated that HPV types 52 and 58 were the most prevalent oncogenic types in Taiwan. Distribution of different HPV types may vary across areas. For example, in the United States, HPV types 53, 52, and 59 were the most commonly encountered oncogenic HPV genotypes. HPV type 16 was the most commonly detected type in Brazil, type 52 in Uganda, and type 33 in Zimbabwe. HPV types included in available HPV vaccines (types 6, 11, 16, and 18) comprised only 5.4% of the total infections in this study; therefore, these HPV vaccines may not provide enough protection for female drug users in Taiwan.
Previous studies had confirmed that immunosuppression may accelerate the progression of HPV-associated precursor lesions, and HIV-positive patients with CD4+ T-cell counts less than 100 cells/μL were reported to have a twofold relative risk of developing cervical cancer. However, because the patients in this study were young and not in a severe immunosuppressive status, and the number of cases was small, an association between cervical dysplasia and CD4+ cell counts could not be established.
There are several limitations of this study. First, this study focused on the incarcerated female population, and hence, no generalizations could be made. Second, this cross-sectional study did not reveal the outcome of HPV infection, for which longitudinal follow-up would be necessary. Third, the general women population was not enrolled in this study. However, the prevalence of HPV infection in the general population and patient demographics has already been reported in previous large-scale studies in Taiwan; the value of this study could not be neglected despite the limitations.

The authors thank Taoyuan Women\’s Prison for the assistance with research. This study was supported by grants FEMH-96-C-028 from the Far Eastern Memorial Hospital, Pan-Chiao, New Taipei City, and PTH-97S1 from the Taoyuan General Hospital, Department of Health, Taoyuan, Taiwan.

Juvenile idiopathic arthritis (JIA) is not a single disease and comprises—as an “umbrella” term—all chronic arthritides of unknown etiology persisting for at least 6 weeks with a clinical onset before 16 years of age. The disease spectrum spans from self-limited monoarthritis to ongoing multiple joints destruction, and may involve severe systemic manifestations or sight-threatening uveitis. In order to provide a better quality on medical treatment and follow-up, updated knowledge of the epidemiology, clinical features, and course of JIA is essential. In the last decade, our study group proposed the clinical features of juvenile rheumatoid arthritis based on the American College of Rheumatology system. To find a more homogenous disease classification suitable for aetiopathogenetic studies, the International League of Associations for Rheumatology (ILAR) developed a new set of classification criteria for childhood-onset idiopathic inflammatory arthritis and called it JIA. The system was revised several times to improve its usefulness. First proposed in 1994 (Santiago criteria), the classification system was twice revised: in 1997 (Durban) and in 2001 (Edmonton). The distribution of JIA categories in the Chinese population according to the ILAR system, however, is lacking.