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HIV/Aids and COVID-19 in Brazil: in four decades, two antithetical approaches to face serious pandemics
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Galvão-Castro, Bernardo

; Grassi, Maria Fernanda Rios

; Castilho, Euclides Ayres de

; Greco, Dirceu Bartolomeu

Memórias do Instituto Oswaldo Cruz

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2021, Volume 116 elocation e210071

Resumo: En | Texto: En | PDF: En

In the space of four decades, Brazil has faced two serious pandemics: human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and Coronavirus disease 2019 (COVID-19). The country’s response to HIV/AIDS was coordinated by several stakeholders and recognised the importance of scientific evidence in guiding decision-making, and a network offering monitoring and antiretroviral treatment was provided through coordinated efforts by the country’s universal health system. Conversely, the lack of a centrally coordinated strategy and misalignment between government ministries regarding the COVID-19 pandemic response, together with the denial of scientific evidence, promotion of ineffective treatments and insufficient vaccination efforts, have all led to the uncontrolled spread of infection, the near-total collapse of the health system and excess deaths.

https://doi.org/10.1590/0074-02760210071 446 downloads

Clinical and laboratory findings of acute Zika virus infection in patients from Salvador during the first Brazilian epidemic
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Bandeira, Antonio Carlos

; Gois, Luana Leandro

; Campos, Gubio Soares

; Sardi, Silvia

; Yssel, Hans

; Vieillard, Vincent

; Autran, Brigitte

; Grassi, Maria Fernanda Rios

Brazilian Journal of Infectious Diseases

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Out 2020, Volume 24 Nº 5 Páginas 405 - 411

Resumo: En | Texto: En | PDF: En

Abstract Several major epidemics of Zika fever, caused by the ZIKA virus (ZIKV), have emerged in Brazil since early 2015, eventually spreading to other countries on the South American continent. The present study describes the clinical manifestations and laboratory findings of patients with confirmed acute ZIKV infection during the first epidemic that occurred in Salvador, Brazil. All included patients were seen at the emergency room of a private tertiary hospital located in Salvador, Brazil from 2015 through 2017. Patients were considered eligible if signs of systemic viral febrile disease were present. All individuals were tested for ZIKV and Chikungunya infection using PCR, while rapid test was used to detect Dengue virus antibodies or, alternatively, the NS1 antigen. A diagnosis of acute ZIKV infection was confirmed in 78/434 (18%) individuals with systemic viral febrile illness. Positivity was mainly observed in blood, followed by saliva and urine. Coinfection with Chikungunya and/or Dengue virus was detected in 5% of the ZIKV-infected patients. The most frequent clinical findings were myalgia, arthralgia and low-grade fever. Laboratory analysis demonstrated normal levels of hematocrit, platelets and liver enzymes. In summary, in acute settings where molecular testing remains unavailable, clinicians face difficulties to confirm the diagnosis of ZIKV infection, as they rely only on clinical examinations and conventional laboratory tests.

https://doi.org/10.1016/j.bjid.2020.08.005 446 downloads

Revisiting Keratoconjunctivitis sicca associated with Human T-Cell Lymphotropic Virus Type 1: prevalence, clinical aspects and proviral load
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Rathsam-Pinheiro, Regina Helena

; Boa-Sorte, Ney

; Grassi, Maria Fernanda Rios

; Copello, Úrsula Cury

; Rios, Karla Tayrine Silva Guimarães

; Araújo, Thessika

; Galvão-Castro, Bernardo

Brazilian Journal of Infectious Diseases

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Mar 2019, Volume 23 Nº 2 Páginas 95 - 101

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: The prevalence of keratoconjunctivitis sicca (KCS) associated with Human T-Cell Lymphotropic Virus Type 1 (HTLV-1) (HTLV-1/KCS) has been estimated at around 37%, but its clinical manifestations are poorly described. Purpose: To determine the prevalence and associated factors of HTLV-1/KCS in a large cohort of HTLV-1-infected individuals living in Salvador, Brazil. Methods: A cross-sectional study was conducted between June 2004 and September 2017 at the Integrative and Multidisciplinary Center for HTLV in Salvador, Bahia-Brazil. Data from 758 HTLV-1-infected patients was collected. A complete ophthalmologic examination was performed in both eyes. Lacrimal function was evaluated by breakup time, Rose Bengal and Schirmer I Tests. KCS diagnosis was considered in the presence of at least two out of three positive tests. HTLV-1 proviral load Crude and Adjusted Prevalence Rates (PR) with 95% Confidence Intervals (95% CI) were estimated using multivariate Poisson Regression with robust error variance. Results: The overall prevalence of KCS was 31.7%, with higher rates observed in HTLV-1-associated myelopathy/tropical spastic paraparesis patients (crude PR: 1.84; CI95%: 1.50-2.26) even after adjusting for age, sex, time of HTLV-1 diagnosis and schooling (adjusted PR: 1.63; CI95%: 1.31-2.02). Proviral load, low corrected visual acuity, burning and/or pain and itching were all significantly higher in patients with KCS. Conclusion: Burning and/or pain and itching and low corrected visual acuity were the most common alterations of HTLV-1/KCS. High Proviral load was found to be associated with the presence of KCS. It is strongly recommended that HTLV-1 patients undergo periodic ophthalmologic examination to promote the early diagnosis of KCS and prevent the consequences associated with dry eye disease.

https://doi.org/10.1016/j.bjid.2019.04.002 501 downloads

Evaluation of the cervicovaginal environment in asymptomatic Human T-cell lymphotropic virus type 1 infected women
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Firmino, Alisson de Aquino

; Martins, Adenilda Lima Lopes

; Gois, Luana Leandro

; Paixão, Taiane Silva

; Batista, Everton da Silva

; Galvão-Castro, Bernardo

; Grassi, Maria Fernanda Rios

Brazilian Journal of Infectious Diseases

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Jan 2019, Volume 23 Nº 1 Páginas 27 - 33

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: Human T-cell lymphotropic virus type 1 (HTLV-1) is sexually transmitted and causes persistent infection. This virus induces activation of the immune system and production of inflammatory cytokines. This study aimed to assess the cytokine profile and cytopathological findings in the cervicovaginal fluid of asymptomatic HTLV-1-infected women. Methods: HTLV-1-infected and uninfected women were selected at the Centro de Atendimento ao Portador de HTLV in Salvador-Brazil. None of the included HTLV-1-infected women reported any HTLV-1-associated diseases. All volunteers underwent gynecological examination to collect cervicovaginal fluid. Cytokine quantification was performed using the Cytometric Bead Array (CBA) Human Th1/Th2/Th17 kit. Light microscopy was used to evaluate cervicovaginal cytopathology. In addition, proviral load in cervicovaginal fluid and peripheral blood was measured by real-time quantitative polymerase chain reaction. Results: 112 women (63 HTLV-1-infected and 49 uninfected) were evaluated. No differences were found with respect to cytopathological cervicovaginal findings between the groups. IL-2, TNF, IL-4, IL-10, and IL-17 levels were significantly higher in cervicovaginal fluid of the HTLV-1-infected women than in uninfected women (p < 0.05). Conversely, IFN-γ was found to be lower in the HTLV-1-infected women (p < 0.001) compared to uninfected individuals. Cervicovaginal proviral load was detectable in 53% of the HTLV-1-infected women and was found to be consistently lower than the proviral load in peripheral blood. Conclusions: HTLV-1 infection induces immune activation in cervicovaginal environment, characterized by elevated concentrations of Th1, Th2, and IL17 in the cervicovaginal fluid.

https://doi.org/10.1016/j.bjid.2019.02.001 503 downloads

Increasing awareness of human T-lymphotropic virus type-1 infection: a serious, invisible, and neglected health problem in Brazil
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Puccioni-Sohler, Marzia

; Grassi, Maria Fernanda Rios

; Galvão-Castro, Bernardo

; Caterino, Adele

; Proietti, Anna Bárbara de Freitas Carneiro

; Vicente, Ana Carolina Paulo

; Galvão-Castro, Ana Verena

; Vallinoto, Antonio Carlos

; Paiva, Arthur

; Penalva, Augusto

; Rosadas, Carolina

; Miyashiro, Denis

; Barbosa, Edel Figueiredo

; Carvalho, Edgar Marcelino de

; Batista, Everton da Silva

; Smid, Jerusa

; Casseb, Jorge

; Vidal, Jose

; Sousa, Maisa Silva

; Viana, Maria Graça de Castro

; Bastos, Michele de Souza

; Lírio, Monique

; Boa-Sorte, Ney

; Ferreira Jr, Orlando C.

; Takayanagui, Osvaldo

; Moura, Patrícia

; Rocco, Regina

; Cunha, Rodrigo Guimaraes

; Haddad, Simone Kashima

; Assone, Tatiane

; Araújo, Thessika Hialla Almeida

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20190343

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/0037-8682-0343-2019 953 downloads

Algorithm for dry eye disease diagnosis in individuals infected with human T-cell lymphotropic virus type 1
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Castro-Lima-Vargens, Cristina

; Grassi, Maria Fernanda Rios

; Boa-Sorte, Ney

; Rathsam-Pinheiro, Regina Helena

; Almeida, Paula Caroline Matos

; Galvão-Castro, Bernardo

Arquivos Brasileiros de Oftalmologia

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Dez 2017, Volume 80 Nº 6 Páginas 369 - 372

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Avaliar a precisão da propedêutica do filme lacrimal e propor um algoritmo para o diagnóstico da doença do olho seco em indivíduos infectados com Vírus linfotrópico de células-T humanas tipo 1. Métodos: Noventa e seis pacientes infectados com o vírus linfotrópico de células T humana tipo 1 foram incluídos no estudo. Para avaliar sintomatologia, os pacientes responderam o questionário Índice para Doenças da Superfície Ocular. A fim de avaliar a qualidade do filme lacrimal, os pacientes foram submetidos ao teste de ruptura do filme lacrimal, teste de Schirmer I e coloração com Rosa Bengala. A doença do olho seco foi diagnosticada quando, pelo menos, dois dos testes ruptura do filme lacrimal, teste de Schirmer I e coloração com Rosa Bengala) eram anormais. Foram determinados sensibilidade, especificidade, valor preditivo positivo e negativo e acurácia do questionário e de cada teste sozinho e combinados em paralelo e em série. Resultados: O teste de ruptura do filme lacrimal foi o mais sensível (98%) e o teste de Schirmer I foi o mais específico (100%). A maior acurácia foi encontrada no teste de coloração com Rosa Bengala (88,64%), enquanto sintomas avaliados usando o questionário Índice para Doenças da Superfície Ocular teve a menor acurácia geral (62,65%). O teste de ruptura do filme lacrimal, teste de Schirmer I e Questionário de Doença da Superfície Ocular quando combinados em paralelo mostraram um aumento da sensibilidade e uma diminuição na especificidade de todos os testes. Por outro lado, combinados em série, teste de ruptura do filme lacrimal, Schirmer I e questionário Índice para Doenças da Superfície Ocular tiveram um aumento na especificidade e sensibilidade diminuída. Conclusão: Este estudo apontou a necessidade de utilizar mais do que um teste para avaliar a qualidade do filme lacrimal, bem como utilizar um questionário de sintomas como parte do algoritmo de diagnóstico para doença do olho seco.

ABSTRACT Purpose: To evaluate the accuracy of lacrimal film tests and propose an algorithm for the diagnosis of dry eye disease in individuals infected with human T-cell lymphotropic virus type 1. Methods: Ninety-six patients infected with human T-cell lymphotropic virus type 1 were enrolled in the study. To assess clinical complaints, patients completed the Ocular Surface Disease Index questionnaire. To evaluate lacrimal film quality, patients underwent the tear breakup time test, Schirmer I test, and Rose Bengal staining. Dry eye disease was diagnosed when at least two of the three test results were abnormal. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of the questionnaire as well as of each test alone and combined in parallel and in series were determined. Results: The most sensitive test was the tear breakup time test (98%), whereas the most specific was the Schirmer I test (100%). Rose Bengal staining had the highest overall accuracy (88.64%), whereas the Ocular Surface Disease Index had the lowest overall accuracy (62.65%). The tear breakup time test, Schirmer I test, and Ocular Surface Disease Index combined in parallel showed increased sensitivity and decreased specificity for all tests. In contrast, when combined in series, these tests demonstrated increased specificity and decreased sensitivity. Conclusion: This study shows the need to use multiple tests to evaluate tear film quality and include a symptom questionnaire as part of the diagnostic algorithm for dry eye disease.

https://doi.org/10.5935/0004-2749.20170090 897 downloads

Completeness of tuberculosis reporting forms for disease control in individuals with HIV/AIDS in priority cities of Bahia state
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Lírio, Monique

; Santos, Normeide Pedreira dos

; Passos, Louran Andrade Reis

; Kritski, Afrânio

; Galvão-Castro, Bernardo

; Grassi, Maria Fernanda Rios

Ciência & Saúde Coletiva

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Abr 2015, Volume 20 Nº 4 Páginas 1143 - 1148

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

O controle da coinfecção HIV/Tuberculose (TB) ainda representa um desafio para a saúde pública. Ambas as doenças são de notificação obrigatória e o Sistema Nacional de Agravos de Notificação (SINAN) é o órgão responsável pela coleta e processamento das fichas individuais de notificação e acompanhamento. O preenchimento adequado dos campos destas fichas (completude) é essencial para acompanhar a dinâmica da doença e definir prioridades de intervenção. O objetivo deste estudo foi avaliar a completude das fichas de notificações de tuberculose nos municípios prioritários da Bahia (Camaçari, Feira de Santana, Ilhéus, Itabuna, Jequié, Lauro de Freitas, Porto Seguro, Teixeira de Freitas, Paulo Afonso, Barreiras e Salvador), para controle da doença em indivíduos com HIV/AIDS, através dos relatórios de tabulação do Sinan, no período de 2001 a 2010. Os resultados demonstraram que, apesar da completude do campo HIV estar acima de 50%, mais da metade das fichas estavam preenchidas como "não realizado" ou "em andamento", em todos os municípios avaliados no período. A baixa completude das fichas de notificação pode comprometer a qualidade de vigilância dos casos de TB. Os resultados sugerem a necessidade de maior disponibilidade de teste para HIV nesses indivíduos.

The control of HIV / Tuberculosis (TB) co -infection remains a challenge for public health. Notification is mandatory for both diseases and the National Case Registry Database (Sinan) is responsible for the collection and processing of individual forms of reporting and monitoring. The adequate fulfillment of these fields chips (completeness) is essential to follow the dynamics of the disease and set priorities for intervention. The aim of this study was to evaluate the completeness of the notification forms of tuberculosis in the priority municipalities of Bahia (Camaçari , Feira de Santana , Ilhéus , Itabuna, Jequié, Lauro de Freitas , Porto Seguro , Teixeira de Freitas , Paulo Afonso, Barreiras and Salvador) to control the disease in individuals with HIV/AIDS using tabulations obtained from the Sinan in the period from 2001 to 2010. The results showed that despite the completeness of the field HIV be above 50 %, more than half the cases were met as "undone" or "being processed" in all municipalities assessed in the period. The low completeness of reporting forms may compromise the quality of surveillance of TB cases. The results suggest the need for greater availability of HIV testing in these individuals.

https://doi.org/10.1590/1413-81232015204.00672014 1444 downloads

Completeness of tuberculosis reporting forms for disease control in individuals with HIV/AIDS in priority cities of Bahia state
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Lírio, Monique

; Santos, Normeide Pedreira dos

; Passos, Louran Andrade Reis

; Kritski, Afrânio

; Galvão-Castro, Bernardo

; Grassi, Maria Fernanda Rios

Ciência & Saúde Coletiva

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Abr 2015, Volume 20 Nº 4 Páginas 1143 - 1148

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232015204.00672014 3035 downloads

Mycobacterium tuberculosis epitope-specific interferon-g production in healthy Brazilians reactive and non-reactive to tuberculin skin test
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Silva, Bosco Christiano Maciel da

; Grassi, Maria Fernanda Rios

; Coutinho, Raimundo

; Mascarenhas, Rita Elizabeth Moreira

; Olavarria, Viviana Nilla

; Coutinho-Borgo, Adriana

; Kalil, Jorge

; Cunha Neto, Edecio

; Fonseca, Simone Gonçalves

Memórias do Instituto Oswaldo Cruz

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Dez 2014, Volume 109 Nº 8 Páginas 999 - 1004

Resumo: En | Texto: En | PDF: En

The interferon (IFN)-γ response to peptides can be a useful diagnostic marker of Mycobacterium tuberculosis (MTB) latent infection. We identified promiscuous and potentially protective CD4+ T-cell epitopes from the most conserved regions of MTB antigenic proteins by scanning the MTB antigenic proteins GroEL2, phosphate-binding protein 1 precursor and 19 kDa antigen with the TEPITOPE algorithm. Seven peptide sequences predicted to bind to multiple human leukocyte antigen (HLA)-DR molecules were synthesised and tested with IFN-γ enzyme-linked immunospot (ELISPOT) assays using peripheral blood mononuclear cells (PBMCs) from 16 Mantoux tuberculin skin test (TST)-positive and 16 TST-negative healthy donors. Eighty-eight percent of TST-positive donors responded to at least one of the peptides, compared to 25% of TST-negative donors. Each individual peptide induced IFN-γ production by PBMCs from at least 31% of the TST-positive donors. The magnitude of the response against all peptides was 182 ± 230 x 106 IFN-γ spot forming cells (SFC) among TST-positive donors and 36 ± 62 x 106 SFC among TST-negative donors (p = 0.007). The response to GroEL2 (463-477) was only observed in the TST-positive group. This combination of novel MTB CD4 T-cell epitopes should be tested in a larger cohort of individuals with latent tuberculosis (TB) to evaluate its potential to diagnose latent TB and it may be included in ELISPOT-based IFN-γ assays to identify individuals with this condition.

https://doi.org/10.1590/0074-0276140193 1367 downloads

10.

Microbiology of the middle meatus compared to sputum in young patients with cystic fibrosis from Bahia - Brazil
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Tunes, Alessandro

; Reis, Joice Neves

; Terse, Regina

; Santana, Maria Angélica

; Diniz, Ana Lúcia

; Barros, Tânia Fraga

; Leal, Ana Karina Souza

; Paixão, Vilma

; Grassi, Maria Fernanda Rios

Brazilian Journal of Infectious Diseases

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Abr 2014, Volume 18 Nº 2 Páginas 215 - 219

Resumo: En | Texto: En | PDF: En

Lower airway infection is a major cause of morbidity and mortality in patients with cystic fibrosis. It is currently unknown if the infection of the upper airway can cause exacerbation of lower respiratory tract infection. This study aimed to determine the microbiological profile of the anterior paranasal sinuses outflow tract (middle meatus) of cystic fibrosis outpatients. The microbiological profile was defined using endoscopically directed middle meatal cultures. Paired middle meatal and sputum specimens were collected from 56 outpatients for aerobic cultures. A semi-quantitative leukocyte count of the middle meatal samples was performed. The median age of patients was nine years (3-20 years). Staphylococcus aureus (37%), Staphylococcuscoagulase-negative (25%), Neisseriac (14%), Pseudomonas aeruginosa (11%), andStreptococcus pneumoniae (7%) were the most prevalent microorganisms in the middle meatal cultures. Using the middle meatal leukocyte count, 16 out of 54 patients (29.6%) presented sinus infection. The most frequently identified pathogens in patients with sinus infections wereStaphylococcus aureus (10 patients), Pseudomonas aeruginosa (4 patients), andStreptococcus pneumoniae (3 patients). Agreement of paired middle meatal and sputum cultures was significantly higher among patients with infection in middle meatal (69%). The most common middle meatal pathogens were the typical cystic fibrosis spectrum. This suggests the potential for participating in post-nasal lower airway seeding.

https://doi.org/10.1016/j.bjid.2013.07.006 1241 downloads

11.

Decreased memory T-cell response and function in human immunodeficiency virus-infected patients with tegumentary leishmaniasis
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Gois, Luana Leandro

; Mehta, Sanjay

; Rodrigues, Maria Zilma Andrade

; Schooley, Robert T

; Badaró, Roberto

; Grassi, Maria Fernanda Rios

Memórias do Instituto Oswaldo Cruz

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Fev 2014, Volume 109 Nº 1 Páginas 9 - 14

Resumo: En | Texto: En | PDF: En

The effects of human immunodeficiency virus (HIV) on the immune response in patients with cutaneous leishmaniasis have not yet been fully delineated. This study quantified and evaluated the function of memory T-cell subsets in response to soluble Leishmania antigens (SLA) from patients coinfected with HIV and Leishmania with tegumentary leishmaniasis (TL). Eight TL/HIV coinfected subjects and 10 HIV seronegative subjects with TL were evaluated. The proliferative response of CD4+and CD8+T-cells and naïve, central memory (CM) and effector memory (EM) CD4+T-cells in response to SLA were quantified using flow cytometry. The median cell division indices for CD4+and CD8+T-cells of coinfected patients in response to SLA were significantly lower than those in patients with Leishmania monoinfection (p < 0.05). The proportions of CM and EM CD4+T-cells in response to SLA were similar between the coinfected patients and patients with Leishmania monoinfection. However, the median CM and EM CD4+T-cell counts from coinfected patients were significantly lower (p < 0.05). The reduction in the lymphoproliferative response to Leishmaniaantigens coincides with the decrease in the absolute numbers of both EM and CM CD4+T-cells in response to Leishmania antigens in patients coinfected with HIV/Leishmania.

https://doi.org/10.1590/0074-0276130174 1499 downloads

12.

Completeness of tuberculosis reporting forms in five Brazilian capitals with a high incidence of the disease
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Santos, Normeide Pedreira dos

; Lírio, Monique

; Passos, Louran Andrade Reis

; Dias, Juarez Pereira

; Kritski, Afrânio Lineu

; Galvão-Castro, Bernardo

; Grassi, Maria Fernanda Rios

Jornal Brasileiro de Pneumologia

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Abr 2013, Volume 39 Nº 2 Páginas 221 - 225

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

O objetivo deste estudo foi avaliar a completude das fichas de notificações de tuberculose de cinco capitais brasileiras com alta incidência regional de tuberculose em 2010 - Salvador, Rio de Janeiro, Cuiabá, Porto Alegre e Belém - através dos relatórios de tabulação do Sistema Nacional de Informação de Agravos e Notificações. Porto Alegre e Cuiabá apresentaram os melhores resultados, enquanto o Rio de Janeiro, capital com o maior número de notificações de tuberculose no país, apresentou o pior. A baixa completude desses formulários pode comprometer a qualidade do Programa Nacional de Controle da Tuberculose e repercutir na assistência e nos processos decisórios.

The aim of this study was to evaluate the completeness of tuberculosis reporting forms in the greater metropolitan areas of five Brazilian capitals where the incidence of tuberculosis was high in 2010-Salvador, Rio de Janeiro, Cuiabá, Porto Alegre, and Belém-using tabulations obtained from the Sistema Nacional de Informação de Agravos de Notificação (National Case Registry Database). The degree of completeness was highest in Porto Alegre and Cuiabá, whereas it was lowest in Rio de Janeiro, where there are more reported cases of tuberculosis than in any other Brazilian capital. A low degree of completeness of these forms can affect the quality of the Brazilian National Tuberculosis Control Program, which will have negative consequences for health care and decision-making processes.

https://doi.org/10.1590/S1806-37132013000200014 815 downloads

13.

Evolution of HTLV-1 proviral load in patients from Salvador, Brazil
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Olavarria, Viviana Nilla

; Gomes, Alline do Nascimento

; Kruschewsky, Ramon de Almeida

; Galvão-Castro, Bernardo

; Grassi, Maria Fernanda Rios

Brazilian Journal of Infectious Diseases

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Ago 2012, Volume 16 Nº 4 Páginas 357 - 360

Resumo: En | Texto: En | PDF: En

INTRODUCTION: Variations in human T cell lymphotropic virus type 1 (HTLV-1) proviral load (PVL) in infected individuals over time are not well understood. Objective: To evaluate the evolution of proviral load in asymptomatic individuals and HAM/TSP patients in order to help determine periodicity for measuring proviral load. METHODS: A group of 104 HTLV-1 infected patients, followed at the HTLV reference center in Salvador, Brazil, were included in the study (70 asymptomatic and 34 HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients). HTLV-1 PVL was measured using real-time polymerase chain reaction (PCR) at baseline and again at another point, either < 12 months, between 12-24 months, or > 24 months. RESULTS: HAM/TSP patients had higher PVL (ranging from 11,041 to 317,009 copies/10(6) PBMC) when compared to asymptomatic individuals (ranging from 0 to 68,228 copies/10(6) PBMC). No statistically significant differences were observed in the medians of PVL in HAM/TSP patients or asymptomatic individuals over time. However, in asymptomatic individuals with a PVL below 50,000 copies/10(6) PBMC, a statistically significant two-fold increase was observed over time. CONCLUSION: HTLV-1-PVL remained stable in both asymptomatic individuals and HAM/TSP patients over time. Frequent monitoring of asymptomatic individuals with low PVLs is recommended and further studies should be conducted to assess the course of PVL in these patients over extended periods of time.

https://doi.org/10.1016/j.bjid.2012.06.022 1853 downloads

14.

Evidence of a higher prevalence of HPV infection in HTLV-1-infected women: a cross-sectional study
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Lôpo, Sônia Sampaio

; Oliveira, Paula Matos

; Santana, Iuri Usêda

; Pena, Geisa Barbosa

; Torrales, Maria Betânia

; Mascarenhas, Rita Elizabeth

; Galvão-Castro, Bernardo

; Grassi, Maria Fernanda Rios

Revista da Sociedade Brasileira de Medicina Tropical

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Jun 2012, Volume 45 Nº 3 Páginas 305 - 308

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

INTRODUÇÃO:A infecção pelo HTLV-1 aumenta a susceptibilidade para outras infecções. Poucos estudos avaliaram a co-infecção entre HPV/HTLV-1 e a resposta imune envolvida nesta interação. O objetivo deste trabalho é determinar a prevalência de infecção cervical pelo HPV em mulheres infectadas pelo HTLV-1 e estabelecer os fatores de risco envolvidos nesta co-infecção. MÉTODOS: Um estudo de corte transversal foi conduzido em Salvador, Brasil, entre setembro de 2005 e dezembro de 2008, envolvendo 50 mulheres infectadas pelo HTLV-1, acompanhadas no Centro de Referência de HTLV e 40 mulheres não infectadas, acompanhadas no Serviço de Ginecologia, ambos na Escola Bahiana de Medicina. A infecção pelo HPV foi confirmada pela Captura Híbrida. A carga proviral do HTLV-1 foi quantificada pelo PCR em tempo real. RESULTADOS: A média de idade das mulheres infectadas pelo HTLV-1 (38±10 anos) foi semelhante ao do grupo controle (36±13 anos). A prevalência de infecção pelo HPV foi 44% nas mulheres infectadas pelo HTLV-1 e de 22,5% no grupo controle (p=0,03). Mulheres infectadas pelo HTLV-1 informaram menor idade de início de vida sexual (17±3 anos versus 19±3 anos; p=0,03) e maior número de parceiros sexuais, em relação ao grupo controle (4±3 versus 2±1; p<0,01). No grupo de mulheres infectadas pelo HTLV-1, não se observou diferença entre a carga proviral do HTLV-1 entre as mulheres infectadas pelo HPV e as não infectadas. CONCLUSÕES: A prevalência de infecção pelo HPV foi maior em mulheres infectadas pelo HTLV-1. Novos estudos devem ser realizados para avaliar a progressão desta co-infecção.

INTRODUCTION:HTLV-1 infection increases susceptibility to other infections. Few studies have addressed the co-infection between HPV and HTLV-1 and the immune response involved in this interaction. The aim of this study was to determine the prevalence of cervical HPV infection in HTLV-1-infected women and to establish the risk factors involved in this co-infection. METHODS: A cross-sectional study was carried out in Salvador, Brazil, between September 2005 and December 2008, involving 50 HTLV-1-infected women from the HTLV Reference Center and 40 uninfected patients from gynecological clinic, both at the Bahiana School of Medicine. HPV infection was assessed using hybrid capture. HTLV-1 proviral load was quantified using real-time polymerase chain reaction (PCR). RESULTS: The mean age of HTLV-1-infected women (38 ± 10 years) was similar to that of the control group (36 ± 13 years). The prevalence of HPV infection was 44% in the HTLV-1-infected group and 22.5% in uninfected women (p = 0.03). HTLV-1-infected women had lower mean age at onset of sexual life (17 ± 3 years versus 19 ± 3 years; p = 0.03) and greater number of lifetime partners compared with the control group (4 ± 3 versus 2 ± 1; p < 0.01). In the group of HTLV-1-infected patients, there was neither difference in HTLV-1 proviral load between HPV-infected women and the uninfected. CONCLUSIONS: The prevalence of HPV infection was higher in HTLV-1-infected women. Further studies should be performed to evaluate the progression of this co-infection.

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15.

Prevalence of cervical Chlamydia trachomatis infection in sexually active adolescents from Salvador, Brazil
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Machado, Márcia Sacramento Cunha

; Silva, Bruno Fernando Borges da Costa e

; Gomes, Igor Logetto Caetité

; Santana, Iuri Usêda

; Grassi, Maria Fernanda Rios

Brazilian Journal of Infectious Diseases

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Abr 2012, Volume 16 Nº 2 Páginas 188 - 191

Resumo: En | Texto: En | PDF: En

The incidence of sexually transmitted diseases among adolescents is increasing worldwide. Genital Chlamydia trachomatis infection is one of the most prevalent sexually transmitted diseases in young women, and undetected disease is highly associated with long-term complications in women. Our goal was to determine the prevalence of cervical Chlamydia trachomatis infection in a sexually active population of female adolescents from Salvador, Brazil, and to describe their socio-demographic, behavioral, and clinical characteristics. 100 sexually active adolescents (10-19 years) were included in this study, between 2008 and 2010. Endocervical samples were obtained during gynecological examination. Inhouse polymerase chain reaction of cervical specimens was used for Chlamydia trachomatis detection. The overall prevalence of cervical Chlamydia trachomatis infection was 31% (95% CI 22-40). There were no statistically significant differences in the age at first sexual intercourse, number of sexual partners, and frequency of condom use between Chlamydia infected and uninfected adolescents. The prevalence of cervical Chlamydia trachomatis infection among adolescents from Salvador was the highest in Brazil up to the present date. These results demonstrate an urgent need for continued and comprehensive prevention strategies along with proper screening for Chlamydia in high-risk populations in order to decrease the rates of infection.

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