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Asociación del Virus del Papiloma Humano con la presencia de dos infecciones de transmisión sexual en mujeres colombianas

dc.contributor.advisorPatarroyo, Manuel A.
dc.contributor.advisorSoto De León, Sara Cecilia
dc.creatorCamargo Pinzón, Sandra Milena
dc.creator.degreeDoctor en Ciencias Biomédicas y Biológicasspa
dc.creator.degreetypeFull timespa
dc.date.accessioned2021-01-14T21:54:28Z
dc.date.available2021-01-14T21:54:28Z
dc.date.created2020-11-11
dc.descriptionEfecto del Virus del Papiloma Humano en la infección de Chlamydia trachomatis y el Virus de Inmunodeficiencia Humana. Las Infecciones de Transmisión Sexual (ITS) son una causa importante de morbilidad, generando gran impacto en la salud pública por las secuelas a las que conllevan. La importancia a nivel clínico de éstas radica en que su persistencia ha sido asociada con daño progresivo y continuo de la arquitectura cervical, que conduce al desarrollo de lesiones que pueden progresar a neoplasia cervical. El Virus del Papiloma Humano, es la ITS viral de mayor distribución, siendo ampliamente demostrada su asociación con el desarrollo de Cáncer Cervical (CC). Se ha descrito que factores adicionales, como el comportamiento sexual del hospedero, factores intrínsecos del VPH y la coexistencia de otras ITS, podrían estar desempeñando un rol relevante en el desarrollo de la enfermedad cervical.En este estudio, se analizó la coexistencia entre VPH y dos ITS de amplia distribución, Chlamydia trachomatis y el Virus de Inmunodeficiencia Humana (VIH). Este proyecto de investigación fue diseñado en dos componentes; el primero, de tipo longitudinal, buscó determinar la incidencia de infección por C. trachomatis y su relación con la presencia y carga viral de 6 tipos de VPH de alto riesgo (VPH-AR-16, -18, -31, -33, -45 y -58), en mujeres provenientes de tres ciudades de Colombia. Los resultados mostraron que VPH-18 y -31 fueron los tipos más persistentes, mientras que VPH-16 y -33 se eliminaron en menor tiempo. En cuanto a la carga viral (CV), se encontró que una baja CV de VPH-16 y -31 se asoció con una mayor frecuencia de Lesión Intraepitelial Escamosa (LEI). En cuanto a C. trachomatis, una cuarta parte de las mujeres del estudio iniciaron con infección bacteriana, aumentando su frecuencia de aparición a lo largo de los seguimientos; mujeres con factores como la presencia de múltiples tipos de VPH, mayor número de compañeros sexuales y antecedentes de aborto, presentaron un mayor riesgo de adquirir esta infección bacteriana En cuanto a efecto de la CV en el curso clínico de C. trachomatis, los resultados mostraron que las variaciones en el número de copias virales influyen en el desenlace de las infecciones bacterianas; adicionalmente, estos efectos fueron dependientes del tipo de VPH infectante. El segundo componente, corresponde a un estudio de corte transversal, con el cual se buscó establecer la frecuencia de la infección por VPH en un grupo de mujeres colombianas que conviven con el VIH. Con este estudio, se encontraron elevadas frecuencias de infección y coinfección (definida como la detección simultánea de múltiples tipos de VPH) en mujeres que conviven con VIH; factores como el recuento de células CD4 y la carga viral de VIH, se asociaron positivamente a la infección y coinfección de VPH, mientras que el tratamiento antiretroviral se asoció sólo con las infecciones por VPH. Los resultados de este estudio indican que la infección y coinfección de VPH, se ven influenciadas por un microambiente cervical, en el que factores del hospedero (como el comportamiento sexual) y la presencia de otros patógenos que comparten la misma ruta de transmisión, coexisten e interactúan favoreciendo la permanencia, replicación e integración del VPH en el hospedero, y trayendo como consecuencia la aparición de anormalidad a nivel cervical. La relación causal entre infecciones por VPH y el desarrollo CC ha sido ampliamente demostrada; características propias del VPH influyen en el curso clínico de dichas infecciones. Sin embargo, la infección con VPH por sí sola no es suficiente para que se desarrolle esta neoplasia, por lo que otras características como la coexistencia con otras ITS, constituyen un factor clave. La comprensión del papel que desempeñan las ITS distintas a VPH en el desarrollo de CC resulta, por ende, relevante y plantea nuevos retos en el abordaje e implementación de estrategias acertadas que mejoren y prolonguen la calidad de vida en la población femenina.spa
dc.description.abstractSexually Transmitted Infections (STIs) are an important cause of morbidity, generating a great impact on public health due to the consequences to which they entail. Their persistence has been associated with progressive and continuous damage to the cervical architecture, which leads to the development of lesions that can progress to cervical neoplasia. The Human Papilloma Virus (HPV) is the most widely distributed sexually transmitted infection and associate with the development of Cervical Cancer (CC) being widely demonstrated. It has been described that additional factors, such as the sexual behavior of the host, intrinsic factors of HPV and the coexistence of other STIs, could be playing a relevant role in the development of cervical disease. In this study, the coexistence between HPV and two widely distributed STIs, Chlamydia trachomatis (Ct) and Human Immunodeficiency Virus (HIV), was analyzed. This research project was designed in two components; The first, was a longitudinal study, to determine the incidence of infection of C. trachomatis and its relationship with the presence and viral load of 6 types of high-risk HPV (HPV-AR-16, -18, -31, -33, -45 and -58), in women from three cities in Colombia. The results showed that HPV-18 and -31 were the most persistent types, while HPV-16 and -33 were eliminated in less time. Regarding viral load (VL), it was found that a VL-Low of HPV-16 and -31 was associated with a higher frequency of Squamous Intraepithelial Lesion (LEI). A quarter of the women in the study began with Ct infection, increasing its frequency throughout the follow-ups; women with factors such as the presence of multiple types of HPV, a greater number of sexual partners, and a history of abortion, had a higher risk of acquiring the bacterial infection. Regarding the effect of VL in the Ct infection, the results showed that variations in the number of viral copies influence the outcome of bacterial infections; additionally, the results showed that variations in VL affected bacterial infection outcome and depended on the viral type involved in such infection. The second component, was a cross-sectional study to establish the frequency of HPV infection in a group of Colombian women with and without HIV infection. The results showed in HIV-positive women had higher HPV prevalence and were more commonly infected with multiple HPV types. HPV detection and coinfection were associated with CD4 cell count and HIV viral load, while antiretroviral treatment was associated only with HPV infections. These results indicate that HPV infection and coinfection are influenced by a cervical microenvironment, in which host factors (such as sexual behavior) and the presence of other pathogens that share the same transmission route, coexist and they interact favoring the permanence, replication and integration of HPV in the host, and favouring the appearance of abnormality at the cervical level. The association between HPV and CC has been clearly established and considerable progress has been made in understanding it; however, it remains to be resolved why only a few HPV-infected women develop cervical lesions and the influence that additional factors have on this process. Considering coexistence with other pathogens will contribute towards knowledge regarding interactions at different levels and STI dynamics, posing new challenges concerning the approach to and carrying out control strategies.spa
dc.description.embargo2021-01-14 17:05:01: Script de automatizacion de embargos. Correo recibido: Sandra Milena Camargo Pinzon Mié 2/12/2020 12:41 AM Cordial saludo, Soy Sandra Milena Camargo, estudiante del Doctorado en Ciencias Biomédicas y Biológicas, acabo de subir mi tesis al repositorio y se encuentra en espera de revisión. Por medio del presente correo solicito me sea aprobado el estado de acceso de Restringido, puesto que en la actualidad uno de los productos generados de la tesis corresponde a un artículo científico que se encuentra sometido a revisión en la revista Frontiers in Microbiology (adjunto portada de sometimiento), por lo que hasta que no sea publicado, la información de este producto es de carácter confidencial. Agradezco la atención prestada y quedo en espera de respuesta. Feliz día. - Respuesta: Repositorio Institucional EdocUR Jue 14/01/2021 5:01 PM Respetada doctora Sandra Camargo, reciba un cordial saludo, Hemos realizado la publicación de su documento: Asociación del Virus del Papiloma Humano con la presencia de dos infecciones de transmisión sexual en mujeres colombianas, el cual puede consultar en el siguiente enlace: https://repository.urosario.edu.co/handle/10336/30752 De acuerdo con su solicitud, el documento ha quedado embargado por 2 años hasta el 2023-01-14 en concordancia con las Políticas de Acceso Abierto de la Universidad. Si usted desea dejarlo con acceso abierto antes de finalizar dicho periodo o si por el contrario desea extender el embargo al finalizar este tiempo, puede enviar un correo a esta misma dirección realizando la solicitud. Tenga en cuenta que los documentos en acceso abierto propician una mayor visibilidad de su producción académica. Quedamos atentos a cualquier inquietud o sugerencia
dc.description.embargo2023-01-14 01:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2023-01-13
dc.description.sponsorshipEl Departamento Administrativo de Ciencia, Tecnología e Innovación (COLCIENCIAS) apoyó la formación doctoral de Sandra Milena Camargo Pinzón, en el marco del Programa Nacional de Fomento a la Formación de Investigadores - Convocatoria 617spa
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_30752
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/30752
dc.language.isospaspa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Ciencias Naturales y Matemáticasspa
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programDoctorado en Ciencias Biomédicas y Biológicasspa
dc.rightsAtribución-SinDerivadas 2.5 Colombiaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectVirus del Papiloma Humanospa
dc.subjectChlamydia trachomatisspa
dc.subjectVirus de la Inmunodeficiencia Humanaspa
dc.subjectCáncer de Cérvixspa
dc.subjectInfecciones de Transmisión Sexualspa
dc.subjectFactores de riesgo en mujeres con papilomaspa
dc.subject.ddcIncidencia & prevención de la enfermedadspa
dc.subject.keywordHuman Papillomavirusspa
dc.subject.keywordChlamydia trachomatisspa
dc.subject.keywordHuman Immunodeficiency Virusspa
dc.subject.keywordCervical Cancerspa
dc.subject.keywordSexually-Transmitted Infectionspa
dc.subject.keywordRisk factors in women with papillomaspa
dc.titleAsociación del Virus del Papiloma Humano con la presencia de dos infecciones de transmisión sexual en mujeres colombianasspa
dc.title.TranslatedTitleAssociation of Human Papilloma Virus with the presence of two sexually transmitted infections in Colombian womeneng
dc.title.TranslatedTitleEffect of Human Papilloma Virus on Chlamydia trachomatis and Human Immunodeficiency Virus infectioneng
dc.title.alternativeEfecto del Virus del Papiloma Humano en la infección de Chlamydia trachomatis y el Virus de Inmunodeficiencia Humanaspa
dc.typedoctoralThesiseng
dc.type.documentRevisión sistemáticaspa
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTesis de doctoradospa
local.department.reportEscuela de Medicina y Ciencias de la Saludspa
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Nombre:
CamargoPinzon_SandraMilena.pdf
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10.31 MB
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Descripción:
Documento de tesis presentado como requisito para optar al título de Doctor en Ciencias Biomédicas y Biológicas