Graciano Lopez - Academia.edu (original) (raw)

Papers by Graciano Lopez

Salud Pública de México, 1998

Objective. To determine the prevalence of tuberculosis infection in school children from Tijuana,... more Objective. To determine the prevalence of tuberculosis infection in school children from Tijuana, Mexico. Materials and methods. A study sample was randomly chosen from the municipal school registry and 1 131 elementary and high school children were included. All received one dosis of PPD 5 TU (Mantoux). Subjects with induration ≥ 10 mm were considered positive reactors. Results.The overall prevalence of positive reactors was 57%. The proportion of positive reactors was significantly higher among BCGimmunized subjects than in non-immunized individuals (59.7 vs 45.6 % ; p<0.001). Correlation was not significant between age of immunization with BCG and diameter of induration. Conclusions. The prevalence of tuberculosis infection in Tijuana is extremely high; this fact has important implications in the control of tuberculosis in this region.

than 8.7 million people of Mexican origin resided in Cal-ifornia, with economic and social factor... more than 8.7 million people of Mexican origin resided in Cal-ifornia, with economic and social factors being the driving force for migration.[1] Baja California is a leading point of entry to the United States, with the Tijuana-San Diego border crossing being the busiest land port of entry in the world, with more than 131,000 legal border crossings daily. Therefore, Tijuana offers a unique opportunity to study the risk factors for HIV acquisition and migration patterns at the Mexico-US border.

The Pediatric infectious disease journal, 2017

Diagnosis of latent tuberculosis infection (LTBI) is facilitated by tuberculin skin testing (TST)... more Diagnosis of latent tuberculosis infection (LTBI) is facilitated by tuberculin skin testing (TST) or interferon-gamma release assays such as the QuantiFERON TB Gold In-Tube (QTF-GIT) assays. Limited data exist on the utility of interferon-gamma release assays in HIV-infected children, which may be falsely negative due to immunosuppression. A cross-sectional study comparing TST to QTF-GIT for the diagnosis of suspected LTBI was performed in children in Tijuana, Mexico, and in San Diego, California. Concordance between TST (≥5 mm for HIV infected and ≥10 mm for HIV uninfected) and QTF-GIT was evaluated utilizing kappa coefficients. Multivariate logistic regression assessed factors influencing the results. One hundred sixty-five children (70 HIV infected and 95 HIV uninfected) were evaluated (median age, 8.0 years). Among HIV-infected children, the median CD4 cell count was 913 cells/μL, with 92.9% of subjects on antiretroviral treatment and 80.0% with an HIV RNA load <400 copies/mL...

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

To describe the morbidity and mortality associated with tuberculosis (TB) in human immunodeficien... more To describe the morbidity and mortality associated with tuberculosis (TB) in human immunodeficiency virus (HIV) infected children in Baja California, Mexico. Retrospective review of the medical records of all children with perinatally acquired HIV infection evaluated at Tijuana General Hospital with a diagnosis of TB between 1998 and 2007. The Stegen-Toledo (ST) clinical criteria for the diagnosis of TB were used. A total of 73 HIV-infected children were followed during the study period. Thirteen (18%) children were diagnosed with TB; one was confirmed by culture to be positive. Among these children, the mean ages at HIV and TB diagnosis were respectively 3.6 and 5.3 years. The mean ST score was 8.1; 10/13 had a score of >or=7, or highly probable TB. There were a cumulative 29 hospital admissions prior to TB diagnosis; 24 of these were due to pneumonia. The mean duration of symptoms at TB diagnosis was 73 days. The most common symptoms were cough (92%) and anorexia (85%). Seven p...

Journal of the International Association of Physicians in AIDS Care, 2011

This study characterizes temporal trends in HIV disease progression among perinatally infected ch... more This study characterizes temporal trends in HIV disease progression among perinatally infected children at a clinic in Baja California, Mexico. A total of 73 children were followed, 52% were categorized under US Centers for Disease Control and Prevention (CDC) classification group C with a mean age of 2.3 years (SD ± 3.16) at HIV diagnosis. For the years 1998 to 2001, 2002 to 2003, 2004 to 2005, and 2006 to 2007, highly active antiretroviral therapy (HAART) use increased to 60%, 75%, 83%, and 94% ( P < .001) as did mean CD4 percentage of 23.4%, 23.2%, 26.9%, and 29.0%, respectively ( P = .009), while HIV plasma RNA log10 decreased significantly (4.49, 4.23, 4.00, and 3.79, respectively; P = .019). Overall mortality was 31% (23 of 73), with pneumonia being the most common cause of death (43% of all deaths) followed by tuberculosis (22%). Mortality rates declined from 30.4% to 25%, 8.9%, and 9.3% ( p = 0.035) for the years 1998 to 2001, 2002 to 2003, 2004 to 2005, and 2006 to 2007,...

Journal of the International Association of Physicians in AIDS Care, 2010

This study evaluated an obstetrical program using rapid HIV testing for the prevention of mother-... more This study evaluated an obstetrical program using rapid HIV testing for the prevention of mother-to-child HIV transmission (MTCT) in Baja California, Mexico. Between 2003 and 2005, 45 women in labor and 17 prenatal care women were HIV infected. Among labor patients, 14 (31%) delivered by cesarean section compared with 17 (100%) prenatal care patients (P < .001). Intravenous maternal zidovudine (ZDV) and infant oral ZDV were more frequently administered in prenatal care compared to labor patients: 94% versus 33% (P < .001) and 100% versus 79% (P < .001), respectively. All prenatal care women received combination therapy. All 10 HIV-infected infants were in the labor group, resulting in a MTCT rate of 23% (95% confidence interval [CI] 9.5-34.8) compared to 0% (95% CI 0-1.8; P < .001) among the prenatal care group. Five (50%) of the HIV-infected infants had an AIDS diagnosis and 2 (20%) died within 18 months of birth. Women diagnosed during labor had a high HIV MTCT and poo...

Journal of the International AIDS Society, 2005

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2006

To evaluate the acceptance of counseling and rapid HIV testing and to determine the associated ri... more To evaluate the acceptance of counseling and rapid HIV testing and to determine the associated risk factors for HIV infection in pregnant women in Baja California, Mexico. Pregnant women attending Tijuana General Hospital who consented to participate in the study had blood drawn for a rapid HIV test (Determine HIV-1/2; Abbott Diagnostics, North Chicago, IL). A confirmatory enzyme immunoassay and Western blot were performed and demographic and risk factor data were obtained. From March to November 2003, 1529 (92.5%) of 1653 women who sought prenatal care and 1068 (95.2%) of 1122 women in labor consented to participate. HIV seroprevalence was significantly higher among women screened during labor (12/1068, 1.12%) compared with those seeking prenatal care (5/1529, 0.33%). HIV-infected women were significantly more likely to use injection drugs (12% vs. 1%, P = 0.02), &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;other&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; drugs, including methamphetamine, marijuana, and cocaine (65% vs. 6%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), to have more sex partners (3.6 vs. 2.6, P = 0.0002), to not have received prenatal care (41% vs. 13%, P = 0.03), and to have a spouse/partner who used injection drugs (36% vs. 4%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;other&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; drugs (73% vs. 23%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). In multivariate regression analysis, use of methamphetamine (adjusted odds ratio, 17.8, 95% CI, 5.6-56) was independently associated with the risk of HIV infection. These findings indicate a wide acceptance of HIV counseling and testing and document a higher HIV seroprevalence among pregnant women delivering at Tijuana General Hospital than current established estimates in Mexico.

AIDS, 2003

It has been well known since HIV first surfaced in Mexico that the epidemic is driven by men who ... more It has been well known since HIV first surfaced in Mexico that the epidemic is driven by men who have sex with men, with an HIV prevalence rate of 14.2% [ 2 ]. A high percentage of Mexican men who have sex with men also engage in high-risk sex with women, as a study at the ...

Annals of Epidemiology, 2013