An intervention to address vision loss was carried out in 2008 in Táchira, Venezuela, by health teams of the joint Cuban-Venezuelan initiative known as Misión Milagro. It included active case identification of patients with ophthalmologic conditions and, where warranted, surgery, followup, rehabilitation and medical discharge. From a universe of 345 patients aged ≥18 years with ophthalmologic conditions found, 210 were selected for cataract or pterygium surgery. Of cataract patients, 55.2% recovered optimal vision within three months after surgery, as did 90.9% of those with pterygium; frequency of complications was 15.4% in cataract patients and 41.7% in pterygium patients. The intervention was considered successful, although many patients’ low-income status required premature postoperative return to their jobs and other labors, a factor considered detrimental to optimal recovery.
KEYWORDS Health disparities, medical missions, medical assistance, ophthalmology, cataract/extraction, pterygium/surgery, surgery, Venezuela, Cuba
INTRODUCTION The therapeutic potential of adult stem cells in coronary and peripheral arterial diseases has been proposed in recent years. However, factors possibly predictive of unfavorable angiogenic results have not been clearly identified as yet.
OBJECTIVES Identify candidate predictors of poor angiogenesis, as indicated by need for amputation, after autologous hematopoietic stem cell transplantation for chronic lower limb ischemia.
METHODS A retrospective analytical case-series study was carried out to detect factors possibly associated with hematopoietic stem cell autograft failure due to low angiogenic potential. The study universe was composed of 47 patients (19 women, 28 men) with critical lower limb ischemia in Fontaine stages IIb, III and IV, who received autologous stem cell transplantation at the Dr Gustavo Aldereguía Lima University General Hospital in Cienfuegos, Cuba, from January 2007 through December 2010. Variables studied were sex, age, medical history (high blood pressure, ischemic cardiomyopathy, diabetes mellitus and chronic renal insufficiency), Fontaine ischemia stage, intermittent claudication, pain score on a 1–10 scale, ankle-brachial pressure index in the affected extremity, presence of ulcers, and smoking. Laboratory variables included: blood concentrations of hemoglobin, glucose, creatinine, liver enzymes, cholesterol, triglycerides and LDH; as well as leukocyte and platelet counts, stem cell viability, prothrombin time and erythrocyte sedimentation rate. The main response variable was amputation, an indicator of poor angiogenesis. Using logistic regression, a prognostic score of 1 to 4 was developed for each risk factor and scores added to create a risk prediction scale. Predicted risk for amputation and observed amputation rates were compared for patients in three risk groups: low, 0–4; medium, 5–8; and high, 9–12.
RESULTS Factors identified as possibly predictive of poor angiogenesis were: final leukocyte count <20 x 109/L after mobilization with granulocyte colony stimulating factor; age ≥60 years; pain scale score of 10; glycemia of >6 mmol/L; and triglycerides of >1.8 mmol/L. Patients who scored low on predicted amputation risk scale were spared amputation in 90.9% (10/11) of cases, versus 16.7% (2/12) in patients scoring high.
CONCLUSIONS Five possible prognostic factors for low angiogenic potential in stem cell autotransplantation were identified and a preliminary scale established to predict in which patients autotransplantation would be more likely to be successful.
KEYWORDS Adult stem cells, autologous transplantation, autografting, peripheral occlusive disease, peripheral artery disease, ischemia, prognosis, amputation, risk factor, Cuba
INTRODUCTION Continuous venovenous hemodiafiltration, generally used in patients with acute renal failure, enables elimination of humoral mediators of systemic inflammatory response and sepsis from blood. This effect should improve treatment results in patients with multiple organ dysfunction, but evidence of improved survival is insufficient.
OBJECTIVES Describe the effect of continuous venovenous hemodiaflitration on patients with multiple organ dysfunction syndrome in terms of systemic and brain hemodynamics, oxygenation, metabolism and status on ICU separation.
METHODS An observational case series was done of 18 patients (11 men and 7 women) aged 24–78 years with multiple organ dysfunction syndrome treated with continuous venovenous hemodiafiltration in the Medical-Surgical Research Center’s ICU in Havana. General, systemic and brain hemodynamic, oxygenation and metabolic variables were assessed immediately before and 12 hours after starting the procedure; vital status on separation from intensive care was recorded. For analysis, patients were grouped by whether cause of multiple organ dysfunction syndrome was septic or nonseptic. Variable means before and after treatment were compared using the Wilcoxon matched pairs test. Standardized mortality ratios were calculated for both groups, with survival efficacy defined by a ratio of <0.9.
RESULTS After 12 hours continuous venovenous hemodiafitration, the septic group showed clinical improvement, with statistically significant improvement in all variables except mean arterial pressure and brain hemodynamics. Survival to discharge from ICU was 64%, with a standardized mortality ratio of 0.66. In the nonseptic group, survival was 0% and ratio was 2.13; temperature was the only variable found to improve significantly.
CONCLUSIONS Continuous venovenous hemodiafltration improved clinical parameters and survival in patients with multiple organ dysfunction of septic origin. Further studies are needed with larger numbers of patients to corroborate these results.
KEYWORDS Continuous renal replacement therapy, hemodiafiltration, multiple organ failure, septic shock, acute liver failure, MODS, Cuba
INTRODUCTION One reason given by the South African government for establishing a physician training agreement with Cuba is that the ethical, humanistic and solidarity principles promoted in Cuban medical education are difficult to acquire in other settings. However, Cuba’s general medical training program does not provide all skills needed by a general practitioner in South Africa: other competencies are required, such as management of general and gynecological or obstetrical surgical emergencies, administration of anesthesia and nursing procedures. As long as the desired humanistic values were assured, South African authorities have preferred to complement these competencies. Thus, since 2003, the Medical University of Villa Clara has applied a curricular strategy of 12 complementary courses to develop the requested additional skills, but results have not met expectations.
OBJECTIVE Determine why the complementary curricular strategy has not been entirely successful and identify possible courses of action for improvement.
METHODS A document review was conducted of the curricular strategy applied and of minutes of meetings between Cuban and South African counterparts to identify correspondence between requested professional skills and actions to develop them. In addition, South African students were surveyed and Cuban professors were interviewed in depth. Senior university administrators and key informants were also interviewed. Variables assessed were course quality and satisfaction of students and professors.
RESULTS Some actions originally included in the curricular strategy were not implemented and there were structural weaknesses in complementary courses, primarily in objectives, teaching strategy and evaluation. Students reported insufficient practical activities and lack of relationship between content and the health situation in South Africa. Professors were dissatisfied with student levels of motivation and ability to manage their own learning. Other influencing factors were insufficient academic management and professors’ lack of knowledge about the context where these future professionals would eventually practice.
CONCLUSIONS Curricular strategy deficiencies detected are primarily in academic management; overcoming them could facilitate action in specific directions identified to improve the requested skill levels.
KEYWORDS Evaluation, qualitative evaluation, curriculum, competency-based education, professional competence, medical education, clinical skills, international educational exchange, Cuba, South Africa
INTRODUCTION Health systems and services research by nursing personnel could inform decisionmaking and nursing care, providing evidence concerning quality of and patient satisfaction. Such studies are rather uncommon in Cuban research institutes, where clinical research predominates.
OBJECTIVE Assess the results of a strategy implemented between 2008 and 2011 to develop nursing capacity for health systems and services research in 14 national research institutes based in Havana.
METHODS The study comprised four stages: description of approaches to health systems and services research by nurses worldwide and in Cuba; analysis of current capacities for such research in Cuba; intervention design and implementation; and evaluation. Various techniques were used including: literature review, bibliometric analysis, questionnaire survey, consultation with experts, focus groups, and workshops for participant orientation and design and followup of research projects. Qualitative information reduction and quantitative information summary methods were used. Initially, 32 nursing managers participated; a further 105 nurses from the institutes were involved in research teams formed during intervention implementation.
RESULTS Of all published nursing research articles retrieved, 8.9% (185 of 2081) concerned health systems and services research, of which 26.5% (49 of 185) dealt with quality assessment. At baseline, 75% of Cuban nurses surveyed had poor knowledge of health systems and services research. Orientation, design and followup workshops for all institute teams developed individual and institutional capacity for health systems and services research. Post-intervention, 84.7% (27) of nurses reached good knowledge and 14.3% (5) fair; institutional research teams were formed and maintained in 9 institutes, and 13 projects designed and implemented (11 institutional, 2 addressing
ministerial-level priorities) to research nursing issues at selected centers.
CONCLUSIONS A systematic strategy to build nursing capacity for health systems and services research can be effective in involving nurses in such research and in developing institutional support for it, fostering compliance with Cuban and international professional development priorities for nursing, as well as contributing to quality of patient services.
KEYWORDS Health systems, health services, health services research, evaluation studies, intervention study, nursing education, nursing, capacity building, Cuba
INTRODUCTION Athletes’ kinanthropometric profiles are widely addressed in the scientific literature. Such profiles are particularly important in volleyball because absolute size contributes a significant percentage of total variance associated with athletic success. As in other team sports, volleyball players’ kinanthropometric attributes correlate with the game’s tactical demands. From 1992 through 2000, the Cuban women’s volleyball team achieved top global performance, winning first place in three successive Summer Olympic Games.
OBJECTIVE Describe the kinanthropometric profiles of Cuban women Olympic volleyball champions during 1992–2000 and compare these by position played.
METHODS Measurements were taken of body composition, somatotype, proportionality and several anthropometric indicators in 41 Cuban women volleyball players, grouped by playing position. All were members of the national team that participated in the Summer Olympic Games in Barcelona (1992), Atlanta (1996) and Sydney (2000). Mean and standard deviations were calculated for all study variables. Analysis of variance was used to compare means for different positions for the variables weight; height; percent adipose, muscle and bone mass; body mass index; and muscle-to-bone ratio. Discriminant analysis was performed to identify anthropometric dimensions differentiating playing positions (center, spiker and setter), using p<0.05 as significance threshold. Results were presented in tables and figures.
RESULTS Centers presented greater absolute size and higher average adipose (22.8±1.7 kg) and bone (7.1±0.6 kg) mass. The mean somatotype of all volleyball players was balanced mesomorphic (2.7–3.6–2.9). Classified by position, centers (2.9–3.4–3.4) and spikers (2.8–3.6–2.9) presented an average mesomorphic–ectomorphic somatotype, and setters (2.6–3.7–2.6) were balanced mesomorphic. On assessing Somatotype Attitudinal Mean (SAM), centers and spikers showed more intrapositional homogeneity than that of setters. Centers were significantly taller (187.1±2.5 cm) than players in other positions. Centers’ percent adipose tissue mass (28.9±2.7%) was significantly higher than that of setters (24.3±2.7%), who were leanest of all positions.
CONCLUSIONS The kinanthropometric profile of Cuban women Olympic volleyball champions was defined by considerable muscular-skeletal development, with a predominantly mesomorphic somatotype and low endomorphy. Height and body composition varied significantly by playing position.
KEYWORDS: Body composition, somatotype, volleyball, anthropometry, sports medicine, ectomorph, endomorph, mesomorph, Cuba
INTRODUCTION There is a tendency among women today to delay the age at which they have their first child or subsequent children. This creates a dilemma for couples, since health professionals tend to counsel against pregnancy in women aged ≥40 years without considering their reproductive potential and their ability to and likelihood of conceiving and carrying to term a healthy newborn at little or no risk.
OBJECTIVE Assess hypothalamic-pituitary-gonadal axis function in menopausal women in Havana, to evaluate relevance to reproductive potential.
METHODS A retrospective study was conducted from March 2006 through March 2008 of 230 healthy women aged 40–59 years seen in the Menopause and Osteoporosis Clinic in Havana, Cuba. Chart review yielded data on current age, stage of climacteric and hormone levels expressed in means and standard deviations: serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol and testosterone. Analysis of variance was used for assesment by age group and stage of menopause (eumenorrheic, perimenopausal and postmenopausal), with a p value of <0.05 set as significance level.
RESULTS Mean serum hormone levels in eumenorrheic women were: FSH 6.97 IU/L, LH 4.23 IU/L and estradiol 314 pmol/L; in perimenopausal women: FSH 34.69 IU/L, LH 20.78 IU/L and estradiol 201 pmol/L; and in postmenopausal women: FSH 75.43 IU/L, LH 37.59 IU/L and estradiol 117 pmol/L (p <0.05 for difference between eumenorrheic and postmenopausal women). There was a progressive increase in FSH and LH and a decline in estradiol with older age. There was no significant difference in testosterone levels by age or stage of menopause.
CONCLUSIONS Menstrual cycle and hormonal levels of the hypothalamic-pituitary-gonadal axis should be considered in addition to chronological age when determining reproductive potential in women aged 40–59 years.
KEYWORDS Hormones, hypothalamo-hypophyseal system, luteinizing hormone, follicle stimulating hormone, estradiol, testosterone, sex hormones, infertility, female, middle age, menopause, fertility, climacteric, Cuba
Over 2200 new cases of breast cancer are diagnosed annually in Cuba, and a decade ago I became one of them. Late in 2000, I underwent breast cancer surgery at the National Oncology and Radiology Institute in the Cuban capital. My experience—both with the disease and as a sociologist at the University of Havana studying gender relations—serves as the basis for the following essay. The article characterizes today’s Cuban women, particularly those of us with or at risk of breast cancer, and describes my own and others’ responses to our disease. My aim is to provide insights useful to the physicians, nurses, engineers, physicists, technicians, and service and administrative workers in Cuba’s health services who interact with us, whose increased awareness will make us feel more deeply understood and respected. In this context, I also reflect on the Cuban media’s portrayal of cancer, with recommendations for dismantling the biases of fatalism and even pity often conveyed.
KEYWORDS Cancer, breast cancer, survivorship, physician-patient relations, professional education, Cuba
Translated from the Spanish and reprinted with permission from the Revista Cubana de Medicina Tropical, Vol 64, No 1, Jan–Apr 2012. Original available at: http://bvs.sld.cu/revistas/mtr/vol64_1_12/mtr01112.htm
In 1981, Cuba reported the first hemorrhagic dengue epidemic in the Americas, with 344,203 cases, including 10,312 severe and very severe cases, resulting in 158 deaths. In the 30 years following the epidemic, surveillance, control and research have kept Cuba dengue free; although isolated, interrupted epidemics and transmissions have been reported. In this article, we summarize issues of interest regarding the 1981 epidemic, as well as laboratory surveillance data and various related research results.
KEYWORDS dengue, hemorrhagic dengue, Cuba, 1981 epidemic
The article describes progress and challenges in incorporating a gender perspective into the Cuban health system. Results obtained thus far indicate progress in raising consciousness and in concentration on the interaction between biological and social factors, in particular recognizing gender as a social determinant of health. Weaknesses are also identified, and recommendations made for introduction of a gender perspective in various areas of the health system such as policy making; services planning, organization and delivery; population health assessments; and human resources training and development.
KEYWORDS Gender issues, gender bias, health care systems, delivery of health care, Cuba
Gender identity is a sociocultural construct based (in nearly every society) on a binary norm: female and male. Transsexual individuals suffer from intense family and social discrimination because they express a dissident sexuality incongruent with this norm. They assert they feel trapped in a body that does not belong to them, so they seek help from health professionals to modify their bodies, to “adapt their bodies to their minds.” This essay discusses health care for transsexual persons in Cuba from a human rights perspective that does not pathologize their gender identification.
KEYWORDS Transsexualism, gender identity, sexual health, sexual reassignment surgery, gender role, human rights, prejudice, sexism, Cuba
INTRODUCTION An HIV diagnosis, like that of any another chronic illness, alters family dynamics. Although the whole family is affected, usually only one member is the primary caregiver of the sick person. Children and adolescents with HIV/AIDS need care according to their physical, psychological and social needs, requiring responsible caregivers who maintain adequate physical and mental health.
OBJECTIVE To describe general mental health characteristics of primary caregivers of Cuban children and adolescents from across the country diagnosed with HIV/AIDS at the Pedro Kourí Tropical Medicine Institute.
METHODS A descriptive study was carried out from November 2009 through March 2010. Twenty-six caregivers met inclusion criteria and 13 participated. A psychological assessment was made of each caregiver’s mental health, including both externally evaluated and self reported factors associated with physical or psychological problems. Clinical interview and observation, psychiatric examination and various psychological tests were used. A simple descriptive analysis of caregiver characteristics, qualitative information and test results was made.
RESULTS Most caregivers were women, infected with HIV/AIDS themselves, unemployed and without a partner. They presented symptoms of anxiety but no clinical psychiatric diagnoses. The study group reported dissatisfaction with family functioning and partner relationships, as well as problems related to HIV and poor employment prospects.
CONCLUSIONS Caregivers studied described complex intra- and interpersonal life dynamics influenced by their HIV infection. Their mental health status, evaluated through a combination of objective and subjective factors reveals a complex reality, indicating the need for a more comprehensive and efficient approach to caregivers’ health care, integrating attention to both physical and mental health.
KEYWORDS Mental health, caregivers, family caregivers, HIV/AIDS, Cuba
INTRODUCTION Studies of neuroplasticity have shown that the brain’s neural networks change in the absence of sensory input such as hearing or vision. However, little is known about what happens when both sensory modalities are lost (deaf-blindness). Hence, this study of cortical reorganization in visually-impaired child cochlear implant (CI) candidates.
OBJECTIVE Assess cross-modal plasticity, specifically cortical reorganization for tactile representation in visually-impaired child CI candidates, through study of topography of somatosensory evoked potentials (SEP).
METHODS From April through September 2005, SEP from median and tibial nerve electrical stimulation were studied in 12 visually-impaired child CI candidates aged 3–15 years and 23 healthy controls. Following placement of 19 recording electrodes using the International 10-20 System , SEP were recorded and then processed. Topographic maps were obtained for SEP N20 (median nerve) and SEP P40 (tibial nerve), permitting assessment of cortical reorganization by comparing visually-impaired, deaf children’s maps with those of healthy children by means of visual inspection and statistical comparison using a permutation test.
RESULTS SEP N20 topography was significantly more extensive in visually-impaired child CI candidates than in healthy children. An asymmetrical pattern occurred from the expansion of hand tactile activation into the temporal and occipital regions in the left hemisphere on right median nerve stimulation. This did not occur for SEP P40 on tibial nerve stimulation (right and left). Magnitude of expanded SEP N20 response was related to severity of visual impairment and longer duration of dual sensory loss.
CONCLUSIONS Changes in SEP N20 topography are evidence of cross-modal plasticity in visually-impaired child CI candidates, appearing to result from a complex interaction between severity of visual impairment and duration of multisensory deprivation.
KEYWORDS Somatosensory evoked potentials, deaf-blind, hearing and vision loss, sensorineural hearing loss, cochlear implants, neuroplasticity, neuroimaging, neurophysiology, fMRI, functional magnetic resonance imaging, positron-emission tomography, PET scan, Cuba
The following erratum has been corrected in all versions of this article.
Page 26, in the legend for Figure 2 (both a and b), the second group label should read: “Hearing & vision loss.”
INTRODUCTION Cuba has implemented an effective National Immunization Program since 1962. The schedule, administered primarily to children, comprises 11 vaccines (8 domestically produced) protecting against 13 diseases. In 1999 Cuba launched a national vaccine adverse event surveillance system to monitor and assess the safety of the immunization program, its vaccination procedures and the products administered.
OBJECTIVES Describe adverse events following vaccination reported in children aged <16 years in Cuba from 1999 through 2008.
METHODS A retrospective descriptive study was conducted of adverse events following vaccination reported from January 1999 through December 2008. Variables used: year, number of adverse events, province, type of vaccine, type and severity of adverse events (common minor, rare, severe), vaccination program errors, number of deaths, and final results of investigations of severe events. Percentages and rates per dose administered were calculated. Adverse event rates were calculated per 100,000 doses administered and by percentages of individual effects among events reported.
RESULTS A total of 45,237,532 vaccine doses were administered, and 26,159 vaccine-associated adverse events were reported (overall rate: 57.8 per 100,000 doses). The group aged 0–5 years reported the highest rate of vaccine-associated adverse events (82/100,000 doses). The DTwP vaccine exhibited the highest rate of adverse events. Common minor events were: fever (17,538), reactions at injection site (4470) and systemic side effects (2422). Rare events (by WHO definition) reported were: persistent crying (2666), hypotonic-hyporesponsive episodes (3), encephalopathy (2) and febrile seizures (112). Severe events included: anaphylaxis (2), respiratory distress (1), multiple organ failure (1), sudden death (1), vaccine-associated paralytic poliomyelitis (2), toxic shock syndrome (3), and sepsis (1). The 10 deaths and 3 cases of disability were investigated by an expert commission, which concluded that 8 of the 13 severe events were vaccination-related.
CONCLUSIONS Low rates of severe vaccine-associated adverse events observed in this study underline the low risk of vaccination relative to its demonstrated benefits in Cuba. Decision-making for the continued success of the National Immunization Program is supported by reliable information from comprehensive national surveillance with standarized reporting, along with multidisciplinary expert analysis of rare and severe adverse events and program errors.
KEYWORDS Immunization, immunization programs, vaccines, vaccination, product surveillance, postmarketing, adverse drug event, communicable disease control, Cuba
INTRODUCTION Upper gastrointestinal endoscopy, traditionally performed in Cuba in specialized hospitals, was decentralized to the primary health care level in 2004 to make it more patient-accessible.
OBJECTIVES Describe frequency and distribution of the principal symptomatic diseases of the upper gastrointestinal tract and their relation to the main risk factors associated with each in a sample of urban adults who underwent upper gastrointestinal endoscopy in primary care facilities in Havana in selected months of 2007.
METHODS A multicenter cross-sectional study was conducted, including 3556 patients seen in the primary health care network of Havana from May through November 2007. The endoscopies were performed at the 22 polyclinics (community health centers) providing this service. Diagnostic quality and accuracy were assessed by experienced gastroenterologists using a validated tool. Patients responded to a questionnaire with clinical, epidemiologic, and sociodemographic variables. Univariate and multivariate analyses (unconditional logistical regression) were used to identify associated risk factors. The significance level was set at p < 0.05 (or confidence interval excluding 1.0).
RESULTS The diagnoses were: gastritis (91.6%), duodenitis (57.8%), hiatal hernia (46.5%), esophagitis (25.2%), duodenal ulcer (15.8%), gastric ulcer (6.2%) and malignant-appearing lesions (0.4%). Overall prevalence of Helicobacter pylori infection was 58.4%. The main risk factors for duodenal ulcer were H. pylori infection (OR 2.70, CI 2.17–3.36) and smoking (OR 2.08, CI 1.68–2.58); and for gastric ulcer, H. pylori (OR 1.58, CI 1.17–2.15) and age ≥60 years (OR 1.78, CI 1.28–2.47). H. pylori infection was the main risk factor for gastritis (OR 2.29, CI 1.79–2.95) and duodenitis (OR 1.58, CI 1.38–1.82); and age ≥40 years for hiatal hernia (OR 1.57, CI 1.33–1.84). External evaluation was “very good” or “good” for 99.3% of endoscopic procedures and 97.9% of reports issued.
CONCLUSIONS Gastrointestinal endoscopy performed in primary care yielded high quality results and important information about prevalence of the most common diseases of the upper GI tract and associated risk factors. This study provides a reference for new research and can inform objective recommendations for community-based interventions to prevent and control these diseases. The existence of a network of universally accessible diagnostic endoscopy services at the primary care level, will contribute to conducting further research.
KEYWORDS Endoscopy, gastrointestinal diseases, upper GI tract, prevalence, risk factors, primary care, Cuba
INTRODUCTION Differentiating between HIV-1 and HIV-2 infection is the first step to understanding HIV transmission, epidemiology and pathogenesis in geographical areas where both viruses circulate. In Cuba, positive results in mixed HIV-1/2 screening assays are confirmed by HIV-1 Western blot. Indeterminate results constitute the main limitation of this test and HIV-2 infection is among their possible causes; hence the importance of second-stage screening and confirmatory tests for HIV-2 infection.
OBJECTIVE Investigate the contribution of HIV-2 antibodies to negative or indeterminate HIV-1 Western blot results in serum samples from 2005 through 2008 in Cuba.
METHODS HIV-2 reactivity was studied using the ELISA DAVIH–VIH-2 diagnostic kit (Cuba) in 1723 serum samples with negative or indeterminate results for HIV-1 Western blot from January 2005 through December 2008. Duplicate sera reactive by ELISA were confirmed by HIV-2 Western blot, results interpreted according to WHO criteria. The epidemiological interview established by Cuba’s National Program for Prevention and Control Sexually-Transmitted Diseases and HIV/AIDS was applied to HIV-2 Western blot-positive patients.
RESULTS Among all sera studied, HIV-2 ELISA identified 12 reactive serum samples (0.70%) and 1711 non-reactive (99.30%). Western blot analysis of the 12 ELISA-reactive samples confirmed two positive samples (16.67%), 4 negative (33.33%) and 6 indeterminate (50%). Positive samples reacted against the p16, p26, gp36, p53, p56, p68 and gp105 proteins. All 12 ELISA-reactive samples belonged to the HIV-1 Western blot indeterminate group. The two HIV-2–positive samples showed well defined reactivity to gp160, p53, p55 and p34 of HIV-1. HIV-1 seroconversion was observed in all 10 remaining samples during serological followup.
CONCLUSIONS Two new HIV-2 seropositive cases were diagnosed using DAVIH–VIH-2 and HIV-2 Western blot in indeterminate HIV-1 Western blot samples. Results support the recommendation that HIV-2 Western blot be included in the diagnostic algorithm for HIV-1/2 to followup negative or indeterminate HIV-1 Western blot results.
KEYWORDS Diagnosis, laboratory techniques and procedures, antibodies, HIV-2, Western blot, enzyme-linked immunosorbent assay, algorithm, Cuba
