ABSTRACT OBJECTIVE: Viral hepatitis and sexually transmitted infections disproportionally affect men who have sex with men (MSM) and transgender women (TGW). However, only a few studies have evaluated the prevalence of hepatitis in these populations, especially in youths and adolescents. This study aimed to estimate the prevalence of biomarkers for hepatitis A, B, and C among young and adolescent MSM and TGW in three Brazilian municipalities. METHODS: Baseline data were collected from a combination of HIV prevention cohort of young and adolescent MSM (AMSM) and TGW (ATGW) aged 15-19 years in three Brazilian municipalities. A social behavioral questionnaire was applied, and immunoassays were performed to detect antibodies against hepatitis A (anti- HAV IgG and IgM), hepatitis B (anti-HBc and anti-HBs), and hepatitis C virus (anti-HCV); testing for the active hepatitis B marker, HBsAg, was also performed. The prevalence of reactive tests and 95% confidence interval (CI) for proportions were measured. RESULTS: The prevalence of naturally or artificially acquired immunity for hepatitis A totaled 17.7% (95%CI: 15.4-20.4), whereas that of acute infection, 0.4% (95%CI: 0.2-1.2). For hepatitis B and C, prevalence rates totaled 2.8% (95%CI: 1.8-4.4) and 0.2% (95%CI: 0.1-1.1), respectively. About 25.7% (95%CI: 22.4-29.4) of participants were non-reactive for anti-HBc and reactive for anti-HBs, the latter being a vaccine marker for hepatitis B. CONCLUSIONS: The investigation of viral hepatitis biomarkers among vulnerable populations enables the early identification of infections, the provision of timely treatment, and an opportunity to point out the need to expand vaccination coverage.

ABSTRACT OBJECTIVE: Viral hepatitis and sexually transmitted infections disproportionally affect men who have sex with men (MSM) and transgender women (TGW). However, only a few studies have evaluated the prevalence of hepatitis in these populations, especially in youths and adolescents. This study aimed to estimate the prevalence of biomarkers for hepatitis A, B, and C among young and adolescent MSM and TGW in three Brazilian municipalities. METHODS: Baseline data were collected from a combination of HIV prevention cohort of young and adolescent MSM (AMSM) and TGW (ATGW) aged 15-19 years in three Brazilian municipalities. A social behavioral questionnaire was applied, and immunoassays were performed to detect antibodies against hepatitis A (anti- HAV IgG and IgM), hepatitis B (anti-HBc and anti-HBs), and hepatitis C virus (anti-HCV); testing for the active hepatitis B marker, HBsAg, was also performed. The prevalence of reactive tests and 95% confidence interval (CI) for proportions were measured. RESULTS: The prevalence of naturally or artificially acquired immunity for hepatitis A totaled 17.7% (95%CI: 15.4-20.4), whereas that of acute infection, 0.4% (95%CI: 0.2-1.2). For hepatitis B and C, prevalence rates totaled 2.8% (95%CI: 1.8-4.4) and 0.2% (95%CI: 0.1-1.1), respectively. About 25.7% (95%CI: 22.4-29.4) of participants were non-reactive for anti-HBc and reactive for anti-HBs, the latter being a vaccine marker for hepatitis B. CONCLUSIONS: The investigation of viral hepatitis biomarkers among vulnerable populations enables the early identification of infections, the provision of timely treatment, and an opportunity to point out the need to expand vaccination coverage. OBJECTIVE (MSM TGW. . (TGW) However adolescents municipalities METHODS AMSM (AMSM ATGW (ATGW 1519 15 19 15-1 applied anti (anti IgM, IgM , IgM) antiHBc HBc antiHBs, antiHBs HBs anti-HBs) antiHCV HCV (anti-HCV) HBsAg 95 CI (CI measured RESULTS 177 17 7 17.7 95%CI 95CI (95%CI 15.420.4, 154204 15.4 20.4 4 20 15.4-20.4) infection 04 0 0.4 0.21.2. 0212 0.2 1.2 2 1 0.2-1.2) 28 8 2.8 1.84.4 1844 1.8 4.4 1.8-4.4 02 0.11.1, 0111 0.1 1.1 0.1-1.1) respectively 257 25 25.7 22.429.4 224294 22.4 29.4 22 29 22.4-29.4 nonreactive non HBs, anti-HBs CONCLUSIONS treatment coverage (TGW 151 15- (anti-HCV 9 17. 420 15.420.4 15420 154 15. 204 20. 15.4-20.4 0. 21 0.21.2 021 12 1. 0.2-1.2 2. 84 1.84. 184 18 44 4. 1.8-4. 11 0.11.1 011 01 0.1-1.1 25. 429 22.429. 22429 224 22. 294 29. 22.4-29. 42 15.420. 1542 15.4-20. 0.21. 0.2-1. 1.84 1.8-4 0.11. 0.1-1. 22.429 2242 22.4-29 15.420 15.4-20 0.21 0.2-1 1.8- 0.11 0.1-1 22.42 22.4-2 15.42 15.4-2 0.2- 0.1- 22.4- 15.4-

ABSTRACT Maternal Toxoplasma gondii (T. gondii) infection can lead to spontaneous abortion, fetal malformation, and numerous sequelae in the newborn, including visual and hearing impairment. T. gondii serology was determined in pregnant women and their newborns who were referred to Climério de Oliveira Maternity, Federal University of Bahia, and the possible associations with the risk factors for maternal infection were investigated. This cross-sectional study was conducted from January to December 2014 and included 712 pregnant women, aged 15 to 49 years, and 235 newborns. Seroprevalence was determined by the detection of T. gondii-specific immunoglobulin (Ig) M (IgM) and IgG antibodies using enzyme-linked immunoassay. In addition, mothers completed a questionnaire that focused on socioeconomic aspects, and survey data were tabulated using the SPSS statistical software program (version 21.0 for Windows). The seroprevalence rate for specific IgG antibodies was 51% (362) among mothers and 93% (219) among neonates. All the mothers and their newborns were negative for specific-IgM antibodies. Higher age group and lower maternal education were the only risk factors statistically associated with the presence of specific IgG. In summary, high levels of specific IgG antibodies were observed in pregnant women. The knowledge of risk factors for toxoplasmosis can help in the orientation of newly pregnant women.

Cytomegalovirus is related to high rates of morbidity and mortality after hematopoietic stem cell transplantation. This report highlights the importance of adequate monitoring and management of this infection. We report on two cases of patients with late subclinical cytomegalovirus infection. These patients were monitored for antigenemia by indirect immunofluorescence assay. Active cytomegalovirus infection is most common in the first three months after transplantation however the cases reported herein show the importance of monitoring for active infection after Day +100 post-transplantation. Early detection of active infection enables quick preemptive therapy. In conclusion, we emphasize that patients with risk factors for developing severe or late cytomegalovirus disease should be monitored for more than 100 post-transplant days as late active infection is a reality.

INTRODUÇÃO: O vírus linfotrópico da célula T humana (HTLV) é um retrovírus de prevalência elevada em Salvador, Bahia, quando comparado a outras capitais brasileiras. O estudo de seus fatores de risco é muito importante para se entender a dinâmica da infecção no município. OBJETIVO: Avaliar a soroprevalência e alguns fatores de risco para a infecção por HTLV-I/II em indivíduos assistidos pelo Programa Saúde da Família (PSF) no município de Salvador, Bahia, Brasil. MATERIAIS E MÉTODOS: Amostras biológicas foram obtidas em postos do PSF do município de Salvador. Foram realizados imunoensaios do tipo ELISA para a detecção de anticorpos anti-HTLV-I/II. Dados retrospectivos sobre alguns fatores de risco para a infecção pelo HTLV foram obtidos por meio de questionário. RESULTADOS: Foram testadas 765 amostras, 529 (69,2%) do sexo feminino e 236 (30,8%) do masculino. A soroprevalência geral para HTLV-I/II foi de 1,96%, aumentando de acordo com a idade. Observou-se soroprevalência de 2,16% e 1,89% para os sexos masculino e feminino, respectivamente (p = 0,833). Entre os indivíduos com idade inferior a 30 anos (n = 161), não houve soropositivos para HTLV-I/II. Entre os soropositivos, 84,6% relataram ter parceiro sexual fixo e 61,5% não utilizam preservativo com frequência em suas relações sexuais, semelhante ao observado entre os soronegativos, com 76,5% e 67,4%, respectivamente. CONCLUSÃO: A soroprevalência encontrada é considerada alta em comparação a outros municípios brasileiros. Os fatores de risco analisados não foram estatisticamente diferentes entre os grupos soronegativos e soropositivos para HTLV-I/II. A transmissão vertical não se mostrou como importante fator na manutenção do vírus.

INTRODUCTION: HTLV is a retrovirus with high prevalence in Salvador, Bahia, when compared to other Brazilian capitals. The study of its risk factors is very important in order to understand the infection dynamics in the municipality. OBJECTIVE: To assess the prevalence and some risk factors for HTLV-I/II infection among people assisted by the Family Health Program (FHP) in Salvador, Bahia, Brazil. MATERIALS AND METHODS: Biological samples were obtained from FHP health centers in Salvador city. Immunoassays were performed by ELISA method for HTLV antibody detection. Retrospective data about potential risk factors to HTLV infection were obtained through questionnaire. RESULTS: 765 samples were tested, 529 (69.2%) females and 236 (30.8%) males. The overall HTLV-I/II seroprevalence was 1.96%, increasing according to age. HTLV-I/II seroprevalence was 2.16% and 1.89% for males and females, respectively (p = 0.833). Among seropositive individuals, 84.6% reported having a steady sexual partner and 61.5% do not use condoms frequently in their sexual intercourses, what similarly was observed among seronegative with 76.5% and 67.4%, respectively. CONCLUSION: The seroprevalence found is considered high compared to other Brazilian municipalities. The analyzed risk factors were not statistically different between HTLV-I/II seronegative and seropositive groups. The vertical transmission was not an important factor for virus maintenance.

O HTLV-I foi descoberto no início dos anos 1980 e associado a leucemia/linfoma de células T (LLTA) e paraparesia espástica tropical (PET). O HTLV pertence à família Retroviridae e tem um genoma de RNA de fita simples com uma estrutura genética similar à dos demais retrovírus, possuindo os genes gag, pol, env e pX. Este último contém os genes reguladores tax e rex. Tax e Rex são as principais proteínas reguladoras do genoma viral, sendo que Tax regula a transcrição do genoma proviral indiretamente ao interagir com diferentes proteínas regulatórias celulares, principalmente genes de citocinas e protoncogenes, e Rex atua como um regulador pós-transcricional do genoma do HTLV-I ao controlar o processamento (splicing) do RNAm viral. Essa infecção é endêmica em diversas regiões do mundo, tais como Japão, vários países da África, Caribe e América do Sul. No Brasil, Salvador é a cidade de maior prevalência, atingindo 1,7% da população geral. A maioria dos indivíduos infectados pelo HTLV-I permanece assintomática no decorrer de suas vidas, correspondendo a aproximadamente 95%. Dos indivíduos sintomáticos, alguns desenvolvem PET e outros, LLTA, sem que suas fisiopatogenias estejam perfeitamente esclarecidas. O diagnóstico rotineiro da infecção causada pelo HTLV-I baseia-se na detecção sorológica de anticorpos específicos para antígenos das diferentes porções do vírus ou através da pesquisa de seqüências genômicas provirais em células mononucleares periféricas. Ainda não existe nenhum estudo epidemiológico com bases populacionais e com metodologias adequadas sobre a infecção pelo HTLV-I que permita conhecer sua real prevalência no Brasil.

Human T-cell lymphotropic virus type I (HTLV-I) has been identified as the causative agent of both adult T-cell leukemia (ATL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Similar to other retroviruses, HTLV-I has a positive strand RNA diploid genome consisting of four genes: gag, pol, env and pX. The pX region codes for the two regulatory proteins tax and rex. Tax protein is essential for efficient virus expression and plays an important role for activation of cellular genes, such as cytokine genes and protooncogenes. Rex protein induces the expression of unspliced and single spliced mRNAs and regulates a fine balance between the levels of expression of the viral proteins. HTLV-I is widely spread throughout the world. It is endemic in Japan, Africa, the Caribbean and South America. In Brazil, Salvador city shows the highest HTLV-I prevalence rate (1.7%) of the country. It has been established that a vast majority (nearly 95%) of HTLV-I-infected individuals will remain asymptomatic throughout their life. The mechanisms by which HTLV-I causes diseases are not fully elucidated. The HTLV-I diagnosis is based on serologic detection of specific antibodies against several antigens of the virus or through amplification of proviral sequences in the peripheral blood mononuclear cells. However, there is not an epidemiological study with populational bases and suitable methodology in order to estimate its real prevalence in Brazil.