Resumo O objetivo deste artigo é sintetizar artigos que abordam fake news e hesitação vacinal contra a COVID-19 no contexto de saúde pública. Revisão integrativa que incluiu estudos originais indexados nas bases de dados Literatura Latino Americana e do Caribe em Ciências da Saúde; Medical Literature Analysis and Retrieval System Online; Scopus; Web of Science e Embase, publicados em qualquer idioma, entre 2019 e 2022. A análise crítica foi realizada na forma descritiva, consoante à pergunta de pesquisa e ao objetivo da revisão. Foram selecionados 11 artigos, com predomínio de estudos transversais. Relacionaram-se ao processo de adesão à vacinação: gênero, idade, estado civil, escolaridade, posicionamento político, religião, confiança em autoridades de saúde, percepção de efeitos colaterais e eficácia das vacinas, entre outros. Hesitação e desinformação são os principais entraves para se alcançar a cobertura vacinal em muitos países. Todos os estudos abordam a relação entre baixa intenção de imunização e uso de mídias sociais como fonte de informação sobre o SARS-CoV-2. É necessário aumentar a confiança na segurança e eficácia das vacinas. A melhor compreensão dos benefícios da vacinação para COVID-19 é imprescindível para combater a hesitação e ampliar a adesão vacinal.

Abstract This article aims to synthesize articles addressing fake news and COVID-19 vaccine hesitancy in the context of public health. We conducted an integrative review of articles published in any language between 2019 and 2022 in journals indexed in the following databases: Latin American and the Caribbean Literature on Health Sciences, Medical Literature Analysis and Retrieval System Online, Scopus, Web of Science, and Embase. A critical analysis was performed, guided by the research question and objective of the review. Eleven articles were selected, the overwhelming majority of which were cross-sectional studies. The main factors related to vaccine take-up highlighted by the studies were gender, age, education level, political leanings, religion, trust in health authorities, and perceptions of side-effects and vaccine efficacy. The main obstacles to attaining optimal vaccination coverage were vaccine hesitancy and disinformation. All studies addressed the relationship between low vaccination intention and the use of social media as a source of information about SARS-CoV-2. It is necessary to build public trust in vaccine safety and efficacy. Promoting a better understanding of the benefits of COVID-19 vaccination is essential to combat vaccine hesitancy and improve vaccine take-up.

Abstract This article aims to synthesize articles addressing fake news and COVID-19 vaccine hesitancy in the context of public health. We conducted an integrative review of articles published in any language between 2019 and 2022 in journals indexed in the following databases: Latin American and the Caribbean Literature on Health Sciences, Medical Literature Analysis and Retrieval System Online, Scopus, Web of Science, and Embase. A critical analysis was performed, guided by the research question and objective of the review. Eleven articles were selected, the overwhelming majority of which were cross-sectional studies. The main factors related to vaccine take-up highlighted by the studies were gender, age, education level, political leanings, religion, trust in health authorities, and perceptions of side-effects and vaccine efficacy. The main obstacles to attaining optimal vaccination coverage were vaccine hesitancy and disinformation. All studies addressed the relationship between low vaccination intention and the use of social media as a source of information about SARS-CoV-2. It is necessary to build public trust in vaccine safety and efficacy. Promoting a better understanding of the benefits of COVID-19 vaccination is essential to combat vaccine hesitancy and improve vaccine take-up.

Resumo O objetivo deste artigo é sintetizar artigos que abordam fake news e hesitação vacinal contra a COVID-19 no contexto de saúde pública. Revisão integrativa que incluiu estudos originais indexados nas bases de dados Literatura Latino Americana e do Caribe em Ciências da Saúde; Medical Literature Analysis and Retrieval System Online; Scopus; Web of Science e Embase, publicados em qualquer idioma, entre 2019 e 2022. A análise crítica foi realizada na forma descritiva, consoante à pergunta de pesquisa e ao objetivo da revisão. Foram selecionados 11 artigos, com predomínio de estudos transversais. Relacionaram-se ao processo de adesão à vacinação: gênero, idade, estado civil, escolaridade, posicionamento político, religião, confiança em autoridades de saúde, percepção de efeitos colaterais e eficácia das vacinas, entre outros. Hesitação e desinformação são os principais entraves para se alcançar a cobertura vacinal em muitos países. Todos os estudos abordam a relação entre baixa intenção de imunização e uso de mídias sociais como fonte de informação sobre o SARS-CoV-2. É necessário aumentar a confiança na segurança e eficácia das vacinas. A melhor compreensão dos benefícios da vacinação para COVID-19 é imprescindível para combater a hesitação e ampliar a adesão vacinal.

Resumen Introducción: Ante la necesidad de reestructurar las instituciones de educación en salud a causa de la pandemia por COVID-19, se ha señalado a la educación híbrida como una alternativa para reorganizar las actividades educativas. El objetivo de este estudio es describir el desarrollo de la educación híbrida en la formación de los profesionales en el área de la salud. Materiales y métodos: Revisión sistemática de la literatura basada en las recomendaciones de los elementos de informes preferidos para revisiones sistemáticas y metaanálisis (PRISMA). La búsqueda se realizó por pares entre julio y septiembre de 2020 en cuatro bases de datos electrónicas. Los descriptores utilizados fueron “educación a distancia”, “educación superior”, “aprendizaje”, “salud”, “enfermería”, “medicina”, “odontología”, “fisioterapia” y “educación híbrida”. A su vez, los artículos seleccionados se clasificaron según su nivel de evidencia. Resultados: Se seleccionaron 49 artículos, entre los que se incluyeron estudios cuantitativos, cualitativos y de métodos mixtos. Se identificaron experiencias en el desarrollo de la educación híbrida en diferentes cursos de formación en el área de la salud. Se observó que la educación híbrida se implementó de acuerdo con el modelo de rotación, el modelo a la carta y el modelo Flex. Discusión: La enseñanza híbrida ha venido ganando cada vez más importancia en el escenario académico de la educación en salud. Se observó que, a partir de esta, el estudiante logra destacarse en su aprendizaje, ya que se convierte en el principal gestor de este proceso al aprender de forma activa mediante diversas herramientas educativas guiadas por el docente. Conclusiones: El éxito de la educación híbrida se puede relacionar con su carácter innovador, flexible, con buena relación costo-beneficio y la habilidad de convertir a los estudiantes en protagonistas de su proceso de enseñanza-aprendizaje, lo que influye en su propio rendimiento académico.

Resumo Introdução: A partir da necessidade de reestruturação das instituições de ensino em saúde devido à pandemia da COVID-19, o ensino híbrido vem se destacando como possibilidade de reorganização das atividades educativas. O objetivo: deste estudo foi escrever o desenvolvimento do ensino híbrido na formação de profissionais da área da saúde. Materiais e Métodos: Revisão sis- temática da literatura, baseada nas recomendações da Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A pesquisa foi desenvolvida em pares, entre julho a setembro de 2020, em quatro bases de dados eletrôni- cas. Os descritores foram os termos “Educação a Distância”, “Educação Superior”, “Aprendizagem”, “Saúde”, “Enfermagem”, “Medicina”, “Odontologia” e “Fisiote- rapia” e “Ensino híbrido”. Os artigos foram classificados conforme seu Nível de Evidência. Resultados: 49 artigos foram selecionados, entre estudos quanti- tativos, qualitativos e de método misto. Foram encontradas experiências do desenvolvimento do ensino híbrido nos diferentes cursos de formação na área da saúde. Observou-se aplicação do ensino híbrido segundo o modelo de Ro- tação, modelo à la carte e o modelo Flex. Discussão: o ensino híbrido vem ganhando destaque cada vez maior no cenário da educação acadêmica em saúde. Foi visto que, a partir dele, o aluno destaca-se em sua aprendizagem, pois é o principal gerenciador deste processo, aprendendo ativamente por diversos ins- trumentos educativos a partir da condução do professor. Conclusões: O êxito do ensino híbrido pode estar relacionado ao seu caráter inovador, flexível, com boa relação custo-benefício e capaz de tornar os alunos protagonistas do seu processo de ensino-aprendizagem, influenciando no desempenho acadêmico dos alunos.

Abstract Introduction: Given the need to restructure healthcare education institutions due to the COVID-19 pandemic, hybrid education has been identified as an alternative to reorganize educational activities. The objective of this study is to describe hybrid education development in healthcare education. Materials and Methods: A systematic literature review was conducted based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guideline. A peerreviewed search was conducted across four electronic databases between July and September 2020. Descriptors used were “distance education”, “learning”, “health”, “nursing”, “medicine”, “dentistry”, “physical therapy” and “hybrid education”. Selected articles were classified based on their level of evidence. Results: 49 articles were selected, including quantitative, qualitative and mixed methods studies. Experiences in the development of hybrid education in multiple healthcare courses were found. Hybrid education has been implemented based on the rotation model, a la carte model and Flex model. Discussion: Hybrid education has been gaining more and more importance in the academic scenario of healthcare education. Based on this, students manage to stand out in their learning process as they become the main agent of this process by actively learning using multiple education tools provided by their teachers. Conclusions: Successful hybrid education can be related to its innovative, flexible, cost-effective nature and the ability to turn students into key players in their teaching-learning process, which ends up influencing their own academic performance.

Abstract Zoonotic spillover is a phenomenon characterized by the transfer of pathogens between different animal species. Most human emerging infectious diseases originate from non-human animals, and human-related environmental disturbances are the driving forces of the emergence of new human pathogens. Synthesizing the sequence of basic events involved in the emergence of new human pathogens is important for guiding the understanding, identification, and description of key aspects of human activities that can be changed to prevent new outbreaks, epidemics, and pandemics. This review synthesizes the connections between environmental disturbances and increased risk of spillover events based on the One Health perspective. Anthropogenic disturbances in the environment (e.g., deforestation, habitat fragmentation, biodiversity loss, wildlife exploitation) lead to changes in ecological niches, reduction of the dilution effect, increased contact between humans and other animals, changes in the incidence and load of pathogens in animal populations, and alterations in the abiotic factors of landscapes. These phenomena can increase the risk of spillover events and, potentially, facilitate new infectious disease outbreaks. Using Brazil as a study model, this review brings a discussion concerning anthropogenic activities in the Amazon region and their potential impacts on spillover risk and spread of emerging diseases in this region.

Resumo: O objetivo deste artigo é examinar a dinâmica do debate nas plataformas de redes sociais sob a perspectiva da identidade e da ação coletiva. Mais especificamente, buscamos identificar quem foram os atores centrais no Twitter em torno do debate sobre duas paralisações de entregadores de aplicativo contra o regime e as condições de trabalho durante o período da pandemia (UberEats, iFood, Rappi, etc.) ocorridas a 1 e 25 de julho de 2020 no Brasil. Examinamos, além disso, se os perfis mais influentes protagonizaram a formação de comunidades em torno de sua interpretação sobre esse tema. Para isso, coletamos um total de 535.178 tweets publicados em dois episódios de manifestações dos trabalhadores, ocorridos entre junho e julho de 2020. A partir da análise temporal de clusters, identificamos o momento de entrada de cada comunidade no debate sobre o tema e discutimos como perfis de influenciadores, movimentos sociais, políticos e celebridades desempenharam funções centrais na mobilização de apoiadores e no engajamento público ligado às manifestações nas redes. Os resultados mostram que a mobilização social em ambientes digitais ocorre a partir de interações entre grupos com grande envolvimento com as causas defendidas e perfis de atuação mais efêmeros, cuja participação é fundamental para a promoção e divulgação dos atos.

Abstract: The purpose of this article is to examine the dynamics of the debate on social networking platforms from the perspective of collective identity and collective action concepts. More specifically, we seek to identify who are the central actors on Twitter in the debate about the two delivery app workers’ strike against the work regime and working conditions during the pandemics (UberEats, iFood, Rappi, etc.) occurred on July 1 and 25, 2020, in Brazil. We also examined whether the most influential users played a role in the formation of communities around their interpretation of this topic. To do so, we collected 535,178 tweets published in two periods of workers’ demonstrations, which occurred between June and July 2020. Based on temporal analysis of clusters, we identified the moment of entrance of each community on the debate and discussed how profiles of influencers, social movements, politicians, and celebrities on Twitter played central roles in mobilizing supporters and fostering public engagement linked to acts on the networks. The results show that social mobilization in digital environments occurs from interactions between groups with great involvement with the causes and profiles of more ephemeral performance, whose participation is fundamental for the promotion and dissemination of acts.

Resumo Qualea grandiflora é uma espécie típica da fisionomia cerradão, de importância ecológica, florística e medicinal. No entanto, são pouco os estudos no que se refere a sua fenologia. Diante do exposto, objetivou-se verificar a sazonalidade e influência das variáveis climáticas nos eventos reprodutivos de Qualea grandiflora em cerradão. Marcaram-se 15 indivíduos que foram visitados mensalmente entre julho de 2016 e junho de 2018 para registrar os eventos: botões florais, antese, frutos imaturos e maduros. A intensidade de Fournier e sincronia foram correlacionadas com a precipitação, temperatura máxima, média e mínima através da correlação de Spearman, e a sazonalidade por meio da estatística circular. A espécie produziu botões e flores durante a estação chuvosa, o que resultou em correlação positiva com a precipitação. A formação de frutos ocorreu tanto na época chuvosa quanto na seca, já a maturação dos frutos ocorreu na estação seca. O evento de frutos imaturos foi o único não sazonal devido a sua duração. Os eventos reprodutivos de Qualea grandiflora se correlacionaram com a temperatura e a precipitação, de modo que a espécie utiliza essa influência para potencializar suas chances de reprodução.

Abstract Qualea grandiflora is a typical species of the ‘Cerradão’ physiognomy, of ecological, floristic and medicinal importance. However, there are few studies regarding to its phenology. In view of the above, the objective was to verify the seasonality and the influence of the climatic variables on the reproductive events of Qualea grandiflora in ‘Cerradão’. Fifteen (15) individuals were visited and visited monthly between July 2016 and June 2018 to record the events: flower buds, anthesis, immature and ripe fruits. Fournier's intensity and synchrony were correlated with precipitation, maximum, average and minimum temperature through the Spearman's correlation, and seasonality using circular statistics. The species itself produced buds and flowers during the rainy season, which resulted in a positive correlation with precipitation. The fruit formation occurred both in the rainy and dry season, whereas the fruit ripening occurred in the dry season. The immature fruit event was the only non-seasonal event due to its duration. The reproductive events of Qualea grandiflora correlated with temperature and precipitation, so the species uses this influence to enhance its chances of reproduction.

Abstract Amazonian biodiversity is increasingly threatened due to the weakening of policies for combating deforestation, especially in Brazil. Loss of animal and plant species, many not yet known to science, is just one among many negative consequences of Amazon deforestation. Deforestation affects indigenous communities, riverside as well as urban populations, and even planetary health. Amazonia has a prominent role in regulating the Earth’s climate, with forest loss contributing to rising regional and global temperatures and intensification of extreme weather events. These climatic conditions are important drivers of emerging infectious diseases, and activities associated with deforestation contribute to the spread of disease vectors. This review presents the main impacts of Amazon deforestation on infectious-disease dynamics and public health from a One Health perspective. Because Brazil holds the largest area of Amazon rainforest, emphasis is given to the Brazilian scenario. Finally, potential solutions to mitigate deforestation and emerging infectious diseases are presented from the perspectives of researchers in different fields.

Abstract: Pentacyanidoferrate(II) complexes of aromatic N-heterocycles, such as 4-cyanopyridine, exhibit characteristic colors and strong metallochromism associated with the donor-acceptor interactions of the metal ions with the cyanide ligands. In the presence of transition metal ions insoluble polymeric complexes are formed, displaying bright yellow, red, brown and green colors with zinc(II), nickel(II), copper(II) and iron(III) ions, respectively. Such metallochromic response is better observed on filter paper, allowing applications in analytical spot tests. The effects can be explored visually and probed by means of modern instrumental facilities, including spectrophotometric and resonance Raman techniques. In this way, by using the cyanopyridinepentacyanidoferrates, the Prussian Blue test for ferric ions can be extended to the entire row of transition metal elements, providing a new and modern insight of such classical Feigl’s spot tests.

Magnetic nanohydrometallurgy (NHM) is a new process based on engineered superparamagnetic nanoparticles capable of performing as complexing agents for extracting and recovering strategic metals from mineral sources and urban wastes, as well as for removing hazardous elements from contaminated water. Its principles and application are reviewed in this paper. Typical examples involving copper, silver and mercury processing are here discussed, including the exploitation of a novel nanotechnological strategy for capturing and fractionating rare earth elements.

BACKGROUND The time of progression towards AIDS can vary greatly among seropositive patients, and may be associated with host genetic variation. The NR1I2 (PXR) gene, a ligand-activated transcription factor, regulates the transcription immune pathway genes and can therefore be targets of viral replication mechanisms influencing time of progression to AIDS. OBJECTIVE To verify the association of single nucleotide polymorphisms (SNPs) rs3814057, rs6785049, rs7643645, and rs2461817 in the NR1I2 (PXR) gene with progression to AIDS in HIV-1 infected patients. METHODS Blood samples were obtained from 96 HIV-1 positive individuals following informed consent. DNA was isolated and genotyped through real time polymerase chain reaction (PCR) for the presence of SNPs in the NR1I2. Questionnaires on socio-demographic features and behaviors were answered and time of progression to AIDS was estimated based on medical chart analysis. FINDINGS Patients with the GG genotype for rs7643645 were shown to be related with a more rapid disease progression when compared to GA and AA genotypes. This result was maintained by the Multivariate Cox Regression considering sex, ethnicity, and presence of HLA-B*57, HLA-B*27, and CCR5del32 polymorphisms. MAIN CONCLUSIONS Recent studies reported the expression of the nuclear receptors in T-Lymphocytes, suggesting their possible role in the immune response. In addition, nuclear receptors have been shown to inhibit the HIV replication, although no such mechanism has been thoroughly elucidated to date. This is the first time an association between NR1I2 polymorphism and time of progression to AIDS is reported and supports an apparent relationship between the gene in the immune response and identifies another genetic factor influencing AIDS progression.

Resumo Uma das atividades antrópicas geradoras de resíduos potencialmente tóxicos refere-se àquelas ligadas ao processamento do couro bovino (indústrias curtumeiras). Embora se saiba que essas indústrias ao descartarem incorretamente seus resíduos líquidos no ambiente contribuem para o aparecimento de prejuízos na saúde de diferentes organismos, raros são os estudos que investigaram os efeitos desses resíduos em modelos experimentais mamíferos. Logo, o presente estudo objetivou avaliar os efeitos físicos e neurocomportamentais da exposição de fêmeas de camundongos Swiss a efluente de curtume. Para isso, os animais receberam pela via oral, por um período de 15 dias, concentrações de 5% e 10% de efluente de curtume, diluído em água. O grupo controle recebeu apenas água potável. A massa corpórea dos animais foi avaliada no início e ao final do experimento. Já o consumo de água e ração foi aferido diariamente. Após 15 dias de exposição, os animais foram submetidos ao teste do labirinto em cruz elevado (preditivo de ansiedade) e ao teste do nado forçado (preditivo de depressão). Os resultados demonstram que os tratamentos não provocaram alterações na massa corpórea dos animais, tampouco no comportamento alimentar e no consumo de água. Por outro lado, observou-se nos animais dos grupos 5% e 10% de efluente de curtume efeito ansiolítico dos tratamentos, assim como efeito antidepressivo, quando comparados aos animais do grupo controle. Logo, conclui-se que em fêmeas de camundongos Swiss a exposição a concentrações de 5% e 10% de efluente de curtume diluído em água, embora não tenha causado alterações físicas nos animais, pode causar alterações neurocomportamentais, possivelmente relacionadas à neurotoxicidade desses resíduos.

Abstract Among the anthropic activities generating potentially toxic residues are those involved with bovine hide processing (tannery industries). However, knowledge is scant regarding the damage caused to the health of various organisms by tannery waste and studies are rare, especially in mammalian experimental models. This study therefore aimed to evaluate the physical and behavioral effects of the exposure of female Swiss mice to tannery effluent. To accomplish this, for a period of 15 days the animals were fed tannery effluent diluted with water in the following concentrations: 0% (control group, received only potable water), 5% and 10%. The body mass of the animals was evaluated at the beginning and end of the experiment, as well as the daily consumption of water and food. After 15 days of exposure to the effluent, the animals were submitted to the elevated plus maze (predictive of anxiety) and the forced swim test (predictive of depression). The treatments did not affect the animals' body mass, either in eating behavior or in consumption of water. However, it was found that the animals that ingested tannery effluent concentrations of 5% and 10% exhibited an anxiolytic (lower level of anxiety, greater percentage of time in the open arms, longer time and frequency in the diving behavior, less time of lurks and less frequency of freezing) and an antidepressant effect (more time in climbing behavior and less time of immobility) when compared to the control group. It was concluded that the exposure of female Swiss mice to tannery effluents (5% and 10% diluted with water) causes behavioral changes, possibly related to the neurotoxicity of this waste, without causing physical changes in the animals.

RESUMO Os adenovírus humanos (HAdV) são notavelmente resistentes ao ambiente. Estes agentes podem servir como indicadores efetivos de contaminação fecal, tanto quanto podem atuar como agentes causadores de diferentes doenças em seres humanos. A reação em cadeia da polimerase (PCR) e mais recentemente a PCR quantitativa (qPCR) são amplamente usadas para detecção de agentes virais em matrizes ambientais. No presente estudo, PCR e SYBR(r)Green qPCR foram comparadas para a detecção de HAdV em amostras de água (55) e sedimento (20) provenientes de nascentes, poços, açudes e arroios coletadas em propriedades leiteiras. A metodologia quantitativa detectou HAdV em 87,3% das amostras de água e 80% dos sedimentos, enquanto por PCR convencional a detecção foi de 47,3% e 35%, respectivamente.

SUMMARY Human Adenoviruses (HAdV) are notably resistant in the environment. These agents may serve as effective indicators of fecal contamination, and may act as causative agents of a number of different diseases in human beings. Conventional polymerase chain reaction (PCR) and, more recently, quantitative PCR (qPCR) are widely used for detection of viral agents in environmental matrices. In the present study PCR and SYBR(r)Green qPCR assays were compared for detection of HAdV in water (55) and sediments (20) samples of spring and artesian wells, ponds and streams, collected from dairy farms. By the quantitative methodology HAdV were detected in 87.3% of the water samples and 80% of the sediments, while by the conventional PCR 47.3% and 35% were detected in water samples and sediments, respectively.

INTRODUCTION: Human immunodeficiency virus type 1 (HIV-1) has spread worldwide, with several subtypes and circulating recombinant forms. Brazil has an incidence of 20.5 HIV-1/acquired immunodeficiency syndrome (AIDS) patients per 100,000 inhabitants; however, the Southernmost State of Rio Grande do Sul (RS) has more than twice the number of HIV-1-infected people (41.3/100,000 inhabitants) and a different pattern of subtype frequencies, as previously reported in studies conducted in the capital (Porto Alegre) and its metropolitan region. This study examined HIV-1/AIDS epidemiological and molecular aspects in the countryside of Rio Grande do Sul. METHODS: Socio-demographic, clinical and risk behavioral characteristics were obtained from HIV-1-positive adult patients using a structured questionnaire. HIV-1 subtypes were determined by nested-polymerase chain reaction (PCR) and sequencing of the pol and env genes. RESULTS: The study sample included 149 (55% women) patients with a mean age of 41.8 ± 11.9 years. Most (73.8%) patients had a low education level and reported heterosexual practices as the most (91.9%) probable transmission route. HIV-1 subtypes were detected in 26 patients: 18 (69.2%) infected with subtype C, six (23.1%) infected with subtype B and two (7.7%) infected with BC recombinant forms. CONCLUSIONS: These data highlight the increasing number of HIV-1 subtype C infections in the countryside of South Brazil.

Introdução: Embora a maioria das infecções de HIV-1 no Brasil seja devido ao subtipo B, o Sul do Brasil apresenta uma alta prevalência do subtipo C e formas recombinantes, como CRF31_BC. Este estudo avaliou o impacto da diversidade viral na evolução clínica em uma coorte de pacientes HIV-positivos recém diagnosticados. Métodos: De julho/2004 a dezembro/2005, 135 pacientes anti-HIV reagentes foram recrutados. A região pol parcial foi subtipada por filogenia. Um modelo de equação de estimativa generalizada (GEE) foi utilizado para examinar a relação entre subtipo viral, contagem de células CD4 e níveis de carga viral pré-terapia antirretroviral. Hazard ratio (regressão de Cox) foi utilizada para avaliar os fatores associados à supressão viral (carga viral < 50 cópias/mL em seis meses). Resultados: Os principais subtipos de HIV-1 incluíram B (29,4%), C (28,2%) e CRF31_BC (23,5%). Os subtipos B e C apresentaram uma tendência semelhante no declínio de células CD4. Quando comparados os subtipos não B (C e CRF31_BC) e B, não houve diferença significativa na proporção de pacientes com supressão viral aos seis meses (24 semanas). CD4 mais alto e carga viral mais baixa demonstraram associação independente com supressão viral. Conclusão: Não houve diferença significativa entre os subtipos; entretanto, viremia mais baixa e CD4 mais alto pré-terapia mostraram associação com melhor resposta.

Background: Although most HIV-1 infections in Brazil are due to subtype B, Southern Brazil has a high prevalence of subtype C and recombinant forms, such as CRF31_BC. This study assessed the impact of viral diversity on clinical progression in a cohort of newly diagnosed HIV-positive patients. Methods: From July/2004 to December/2005, 135 HIV-infected patients were recruited. The partial pol region was subtyped by phylogeny. A generalized estimating equation (GEE) model was used to examine the relationship between viral subtype, CD4+ T cell count and viral load levels before antiretroviral therapy. Hazard ratio (Cox regression) was used to evaluate factors associated with viral suppression (viral load < 50 copies/mL at six months). Results: Main HIV-1 subtypes included B (29.4%), C (28.2%), and CRF31_BC (23.5%). Subtypes B and C showed a similar trend in CD4+ T cell decline. Comparison of non-B (C and CRF31_BC) and B subtypes revealed no significant difference in the proportion of patients with viral suppression at six months (week 24). Higher CD4+ T cell count and lower viral load were independently associated with viral suppression. Conclusion: No significant differences were found between subtypes; however, lower viral load and higher CD4+ T cell count before therapy were associated with better response.

The aim of the present study was to investigate the association between HPV-DNA and micronucleus (MN) frequency in women with normal cervical cytology. A total of 158 normal cervical smears were analyzed cytologically. The HPV genome was amplified using the GP5+/bioGP6+ consensus primers. HPV-DNA of high-risk types 16, 18, 31, 33, 39, 45 and 59 were also investigated. Of the 158 samples, 20 (12.7%) and 47 (29.7%) were positive for HPV-DNA and MN, respectively. Evidence for MN was found in 11 out of 20 (55%) HPV-DNA positive samples and in 36 out of 138 (26.1%) HPV-DNA negative ones. MN presence was significantly higher in HPV-DNA positive samples (p = 0.016). On the other hand, the absence of MN observed in a considerable number of HPV-DNA negative samples (102) may be of great value in predicting the absence of HPV. The mean age of HPV-DNA positive women (34.2 ± 12.6) was significantly lower than the mean age of HPV-DNA negative women (43.9 ± 13.7) (p = 0.003). Infection by one or multiple HPV types was found in 11 out of 20 (55.0%) and 9 out of 20 (45.0%) samples, respectively. The evaluation of MN using cervical smears collected for cytology tests could, thus, be used as additional information to monitor a population's exposure to HPV.