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.

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.

BACKGROUND: Vulvovaginal candidiasis (VVC) is the second most common vaginal infection. HIV-infection is a risk factor for this infection. OBJECTIVE: To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patients, compared to HIV-uninfected women in Salvador, Brazil. METHODS: Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil). RESULTS: Frequency of Candida spp. was higher in HIV-infected women (29.7%) than in HIV-uninfected controls (14.5%) (p = 0.02). The odds ratio value for vulvovaginal candidiasis in HIV-infected patients was 2.6 (95% CI: 1.07 - 6.32 p = 0.03). Candida albicans was the most commonly isolated species in both HIV-infected (52.3%) and uninfected women (85.7%), followed by C. parapsolis in 17.6% and 14.3%, respectively. In HIV-infected women, C. glabrata, C. parapsilosis, and a coinfection of C. albicans and C. glabrata were also identified. There was no significant difference between Candida species isolated from the vaginal mucosa of women with VVC and colonization of the vaginal mucosa of HIV-infected and HIV-uninfected women. One C. glabrata isolate from an HIV-infected patient was resistant to fluconazole and other two isolates exhibited a dose-dependent susceptibility. CONCLUSION: Our results confirm a higher frequency of Candida spp. isolated from the vaginal mucosa of HIV-infected women and a broader spectrum of species involved. Only Candida glabrata isolates showed decreased susceptibility to fluconazole.

OBJETIVO: comparar a freqüência de vulvovaginites em mulheres infectadas pelo vírus da imunodeficiência humana (HIV) com mulheres não infectadas. MÉTODOS: estudo de corte transversal com 64 mulheres infectadas pelo HIV e 76 não infectadas. Foram calculadas as freqüências de vaginose bacteriana, candidíase e tricomoníase, que foram diagnosticadas por critérios de Amsel, cultura e exame a fresco, respectivamente. Para análise dos dados, utilizaram-se o teste do c2, teste exato de Fisher e regressão múltipla para verificar a independência das associações. RESULTADOS: a infecção vaginal foi mais prevalente em pacientes infectadas pelo HIV quando comparadas ao Grupo Controle (59,4 versus 28,9%, p<0,001; Odds Ratio=2,7, IC95%=1,33-5,83, p=0,007). Vaginose bacteriana ocorreu em 26,6% das mulheres HIV positivas; candidíase vaginal, em 29,7% e tricomoníase, em 12,5%. Todas foram significativamente mais freqüentes no grupo de mulheres infectadas pelo HIV (p=0,04, 0,02 e 0,04, respectivamente). CONCLUSÕES: vulvovaginites são mais freqüentes em mulheres infectadas pelo HIV.

PURPOSE: to compare the frequency of vulvovaginitis in women infected with human imunnodeficiency virus (HIV) with the frequency in non-infected women. METHODS: a transversal study including 64 HIV infected women and 76 non-infected ones. The frequencies of bacterial vaginosis, candidiasis and trichomoniasis, diagnosed by Amsel's criteria, culture and fresh exam, respectively, were calculated. Chi-square test, Fisher's exact test and multiple regressions to verify the independence of associations were used to analyze the data. RESULTS: the vaginal infection was more prevalent in HIV infected patients, as compared to the control group (59.4 versus 28.9%, p<0,001; Odds Ratio=2.7, IC95%=1.33-5.83, p=0.007). Bacterial vaginosis occurred in 26.6% of the positive-HIV women; vaginal candidiasis, in 29.7% and trichomoniasis, in 12.5% of them. All the infections were significantly more frequent in the group of HIV infected women (p=0.04, 0.02 e 0.04, respectively). CONCLUSIONS: vulvovaginitis is more frequent in HIV infected women.