C González

Instituto de Salud Carlos III, Madrid, Madrid, Spain

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Publications (6)16.1 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We estimated the effect of sexual behavior, age and immunodeficiency on the number of High-Risk Human-Papillomavirus (HR-HPV) in the anal canal among HIV-positive men who have sex with men (MSM). Anal samples were genotyped with Linear Array and risk factors were investigated with Poisson regression. Of 586 MSM, 69% were Spanish, 25.6% Latin-Americans, median age 34.9 years (IQR: 30.1-40.8). Median number recent sexual partners was 6 (IQR: 2-24), median CD4-cell count was 531.5 cells/mm(3) (IQR: 403-701). Prevalence of any and multiple HR-HPV infections was 83.4% and 60.5%, respectively. Commonest types were HPV-16 (42%), HPV-51 (24%), HPV-39 (23.7%) and HPV-59 (23.5%). Age had a non-linear association with number of types, with the highest value around 35 years (p< 0.001); so did the number of recent sexual partners (p=0.033), which showed a fairly linear effect on the log-scale. The high prevalence of HR-HPV types is associated with recent sexual behavior and age.
    The Journal of Infectious Diseases 01/2013; · 5.85 Impact Factor
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    ABSTRACT: There are no data on the incidence and persistence of high-risk human papillomavirus (HR-HPV) infections in female sex workers (FSWs). We aimed to describe and compare the rates of incidence and persistence of HR-HPV infections in FSWs and women from the general population (WGP) who attended healthcare facilities between May 2003 and December 2006 in Alicante, Spain. Women with an established HR-HPV infection at study entry were evaluated for the analysis of HR-HPV persistence, and those testing negative for HR-HPV infection at entry were evaluated for the analysis of incidence. HR-HPV infection was determined by the Digene HC2 HR HPV DNA Test. A total of 736 women - 592 WGP and 144 FSWs - were followed for a median of 16.8 months. Global incidence and persistence rates were 3.98 per 100 woman-years (95% confidence interval (CI) 2.91-5.45) and 26.81 per 100 woman-years (95% CI 20.08-35.79), respectively. In the multivariate analysis, only commercial sex work was associated with a statistically significant higher incidence (relative risk (RR) 4.72, 95% CI 2.45-9.09) and persistence (RR 1.93, 95% CI 1.08-3.46) of HR-HPV infection. Our data show that FSWs have both a higher incidence and a higher persistence of HR-HPV than WGP and should be prioritized in HPV-related cancer screening programs.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 07/2011; 15(10):e688-94. · 2.17 Impact Factor
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    ABSTRACT: The aim of the study was to estimate the prevalence and risk factors associated with infection by high-risk human papillomavirus (HR-HPV) in cervix and squamous intra-epithelial lesions (SIL) in imprisoned women. This was done by a cross-sectional study of imprisoned women attending the gynaecological clinic in Foncalent prison in Alicante, Spain. The study period was from May 2003 to December 2005. HR-HPV infection was determined through Digene HPV Test, Hybrid Capture II (HC-II). HPV typing was determined by multiplex nested PCR assay combining degenerate E6/E7 consensus primers. Multiple logistic regression modelling was used for the analysis of associations between variables where some were considered possible confounders after checking for interactions. A total of 219 women were studied. HR-HPV prevalence was 27.4% and prevalence of SIL was 13.3%. HIV prevalence was 18%, higher in Spaniards than in migrant women (24.6% vs. 14.3%, P<0.05). In multivariate analyses, risk factors for HPV infection were younger age (P for trend=0.001) and tobacco use (OR 2.62, 95% CI 1.01-6.73). HPV infection (OR 4.8, 95% CI 1.7-13.8) and HIV infection were associated with SIL (OR 4.8, 95% CI 1.6-14.1). The commonest HPV types were HPV16 (29.4%), HPV18 (17.6%), HPV39 (17.6%) and HPV68 (17.6%). The prevalence of both HR-HPV infection and SIL in imprisoned women found in this study is high. Determinants for each of the outcomes studied were different. HPV infection is the most important determinant for SIL. A strong effect of HIV co-infection on the prevalence of SIL has been detected. Our findings reinforce the need to support gynaecological clinics in the prison setting.
    Epidemiology and Infection 02/2008; 136(2):215-21. · 2.87 Impact Factor
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    ABSTRACT: To estimate prevalence and determinants of high risk (HR) human papillomavirus (HPV) by country of origin in women attending a family planning centre (FPC) in Alicante, Spain. Cross sectional study of all women attending a FPC from May 2003 to January 2004. An ad hoc questionnaire was designed and data were collected prospectively. HR HPV infection was determined through the Digene HPV test, Hybrid Capture II, and positive samples for PCR were directly sequenced. Data were analysed through multiple logistic regression. HR HPV prevalence in 1011 women was 10% (95% CI: 8.2 to 12). Compared to Spaniards (prevalence 8.2%) HR HPV prevalence in Colombians was 27.5% (OR: 4.24 95% CI: 2.03 to 8.86), 23.1% in Ecuadoreans (OR: 3.35 95% CI: 1.30 to 8.63), and 22.73% in women from other Latin American countries (OR: 3.29 95% CI: 1.17 to 9.19). Women with more than three lifetime sexual partners had an increased risk of HR HPV infection (OR 3.21 95% CI: 2.02 to 5.10). The higher risk of HR HPV infection was maintained in Latin American women in multivariate analyses that adjusted for age, number of lifetime sexual partners, and reason for consultation. The commonest HPV types in women with normal cervical smears were HPV-18 (20%), HPV-16 (14%) and HPV-33 (11%). Prevalence of HR HPV is more than three times higher in Latin Americans than in Spaniards. Latin American women's HPV prevalence resembles more that of their countries of origin. It is essential that health service providers identify these women as a priority group in current cervical screening programmes.
    Sexually Transmitted Infections 07/2006; 82(3):260-2. · 2.61 Impact Factor
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    ABSTRACT: To estimate the prevalence and risk factors of high risk human papillomavirus (HPV) infection in migrant female sex workers (FSW) according to age and geographical origin. Cross sectional study of migrant FSW attending a sexually transmitted infection (STI) clinic in Madrid during 2002. Information on sociodemographic characteristics, reproductive and sexual health, smoking, time in commercial sex work, history of STIs, HIV, hepatitis B, hepatitis C, syphilis, and genitourinary infections was collected. High risk HPV Infection was determined through the Digene HPV Test, Hybrid Capture II. Data were analysed through multiple logistic regression. 734 women were studied. Overall HPV prevalence was 39%; 61% in eastern Europeans, 42% in Ecuadorians, 39% in Colombians, 29% in sub-Saharan Africans, and 24% in Caribbeans (p = 0.057). HPV prevalence showed a decreasing trend by age; 49% under 20 years, 35% in 21-25 years,14% over 36 years% (p<0.005). In multivariate analyses, area of origin (p = 0.07), hormonal contraception in women not using condoms (OR 19.45 95% CI: 2.45 to 154.27), smoking, age, and an interaction between these last two variables (p = 0.039) had statistically significant associations with HPV prevalence. STI prevalence was 11% and was not related to age or geographical origin. High risk HPV prevalence in migrant FSW is elevated and related to age, area of origin, and use of oral contraceptives in women not using condoms. These data support the role of acquired immunity in the epidemiology of HPV infection and identifies migrant FSW as a priority group for sexual health promotion.
    Sexually Transmitted Infections 03/2005; 81(1):79-84. · 2.61 Impact Factor
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    ABSTRACT: RESUMEN El equipo que propone esta comunicación, preocupado por abordar y mejorar los diferentes ámbitos de nuestra docencia en el nuevo marco europeo, ha acordado, en este curso académico 2011-2012, ahondar en las prácticas tanto en su planificación y desarrollo como en su evaluación; interés suscitado por varios motivos. En primer lugar, deseamos optimizar un trabajo que, no por obligatorio, resulta complicado dado el elevado número de alumnos matriculados en Historia del Arte en la USAL que desarrollan prácticas de campo y en el aula con un único profesor. Ello explica que queramos fortalecer nuestras capacidades y habilidades al respecto. En segundo lugar existe una preocupación derivada del peso que las prácticas tienen en los Grados de Historia del Arte, tal como ocurre en otras titulaciones adecuadas al EEES. Y, en tercer lugar, deseamos dar un enfoque renovado y adecuado a la realidad tecnológica actual a unas prácticas que, en ciertos casos, estaban ancladas en otros tiempos. Las conclusiones de esta reflexión y de su puesta en funcionamiento son la base de esta propuesta, con la que esperamos colaborar en la adaptación a la nueva realidad educativa en la que los docentes universitarios estamos inmersos.

Publication Stats

80 Citations
16.10 Total Impact Points

Institutions

  • 2011
    • Instituto de Salud Carlos III
      Madrid, Madrid, Spain
  • 2006–2008
    • Universidad Miguel Hernández de Elche
      • Department of Public Health, History of Science and Gynecology
      Elx, Valencia, Spain