Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia

Background: HIV infection leads to a decreasing immune response, thereby facilitating the appearance of other infections, one of the most important ones being HPV. However, studies are needed for determining associations between immunodeficiency caused by HIV and/or the presence of HPV during the course of cervical lesions and their degree of malignancy. This study describes the cytological findings revealed by the Papanicolaou test, laboratory characteristics and HPV molecular profile in women with and without HIV infection. Methods: A total of 216 HIV-positive and 1,159 HIV-negative women were invited to participate in the study; PCR was used for the molecular detection of HPV in cervical samples. Statistical analysis (such as percentages, Chi-square test and Fisher's exact test when applicable) determined human papillomavirus (HPV) infection frequency (single and multiple) and the distribution of six types of high-risk-HPV in women with and without HIV infection. Likewise, a logistic regression model was run to evaluate the relationship between HIV-HPV infection and different risk factors. Results: An association was found between the frequency of HPV infection and infection involving 2 or more HPV types (also known as multiple HPV infection) in HIV-positive women (69.0% and 54.2%, respectively); such frequency was greater than that found in HIV-negative women (44.3% and 22.7%, respectively). Statistically significant differences were observed between both groups (p = 0.001) regarding HPV presence (both in infection and multiple HPV infection). HPV-16 was the most prevalent type in the population being studied (p = 0.001); other viral types had variable distribution in both groups (HIV-positive and HIV-negative). HPV detection was associated with <500 cell/mm(3) CD4-count (p = 0.004) and higher HIV-viral-load (p = 0.001). HPV-DNA detection, <200 cell/mm(3) CD4-count (p = 0.001), and higher HIV-viral-load (p = 0.001) were associated with abnormal cytological findings. Conclusions: The HIV-1 positive population in this study had high multiple HPV infection prevalence. The results for this population group also suggested a greater association between HPV-DNA presence and cytological findings. HPV detection, together with low CD4 count, could represent useful tools for identifying HIV-positive women at risk of developing cervical lesions.

Efectos de cambios impositivos en un modelo de equilibrio general aplicado: un análisis de la reforma de 1995

En este trabajo se analizan los efectos de una disminución de los tipos de las cotizaciones sociales, compensada con un incremento en los tipos del impuesto sobre el valor añadido, como la que tuvo lugar en España en 1995. Para ello se utiliza un modelo de equilibrio general aplicado a la economía española, que se presenta en dos versiones: una donde los sectores productivos se modelizan en competencia perfecta, y otra donde los mismos sectores se modelizan como oligopolistas a la Cournot, lo cual nos permite analizar la influencia del supuesto de competencia imperfecta sobre los resultados. Se ha realizado asimismo una simulación adicional aplicando un supuesto de equal yield por el que el déficit público y el nivel de bienestar del sector público se mantienen constantes tras la aplicación de la nueva política, con objeto de aislar los efectos secundarios que se podrían derivar de un cambio en el comportamiento del sector público.