Abstract The persistence of serum-specific anti-chikungunya IgM antibodies (CHIKV-IgM) can vary after chikungunya fever (CHIK) infection. However, the factors related to its production are not yet known. We described a case series drawn up from data collected from 57 patients between 12 and 36 months after the acute phase of CHIK infection in Northeastern Brazil. CHIKV-IgM was detectable in 7/57 (12.3%) patients after 28.3 months of infection. No frequency differences in chronic musculoskeletal manifestations and underlying conditions were detected between patients with or without CHIKV-IgM. CHIKV-IgM was detected for up to 35 months in Brazilian patients after CHIK infection.

Abstract INTRODUCTION: Apart from masking the diagnosis of AIDS in patients with HIV/AIDS, human T-cell lymphotropic virus (HTLV), when present, also increases the risk of myelopathies and neurological disease in these patients. METHODS: Disease prevalence was estimated by ELISA and confirmed by Western blot. RESULTS: The coinfection rate was 1.5% (11/720); 10 of 11 patients had HTLV-1, and the remaining one had HTLV-2. The majority were male, over 40 years old, and of pardo color (ethnicity). CONCLUSIONS: There was no association between the risk factors examined and HTLV/HIV coinfection. This is the first study to report the occurrence of HTLV-2 in Pernambuco.

Abstract INTRODUCTION: We evaluated the associations between interleukin-10 (IL-10) gene polymorphisms -G1082A/-C819T/-C592A and periportal fibrosis regression after specific treatment for schistosomiasis. METHODS: This retrospective cohort study involved 125 Brazilian patients infected with Schistosomiasis mansoni, who were followed up for 2 years after specific treatment to estimate the probability of periportal fibrosis regression. RESULTS: There was no evidence of associations between IL-10 polymorphisms and periportal fibrosis regression after treatment. CONCLUSIONS: There was no evidence of associations between gene promoter polymorphisms of IL-10 and the regression of periportal fibrosis in this Brazilian population.

INTRODUCTION : We hypothesized higher mannose-binding lectin level and classic factors (i.e., age, sex, alcohol consumption, exposure, and specific treatment) are associated with the severity of periportal fibrosis in schistosomiasis. METHODS : This cross-sectional study involved 79 patients infected with Schistosoma mansoni with severe or mild/moderate periportal fibrosis. Serum concentrations of mannose-binding lectin were obtained by enzyme-linked immunosorbent assay (ELISA). RESULTS: Higher serum level of mannose-binding lectin was significantly associated with advanced periportal fibrosis. CONCLUSIONS: Mannose-binding lectin may contribute to liver pathology in schistosomiasis and may represent a risk factor for advanced periportal fibrosis in the Brazilian population studied.

The aims of this study were to investigate the genotypes of hepatitis B virus and to identify the precore G1896A and basal core promoter A1762T/G1764A mutations in HBsAg and anti-HBc-positive patients. Eighty-three asymptomatic individuals, three with acute hepatitis B and 33 with chronic hepatitis B referred to viral hepatitis centers in the State of Alagoas, Brazil were analyzed according to their viral load, HBeAg/anti-HBe profile and alanine aminotransferase serum level. The genotypes identified were: A (92.5%), C (5%), D (1.25%) and F (1.25%). The precore mutation was detected in 3.8% of sequences and basal core promoter mutation in 52.4%. These were identified in 45.45% of the asymptomatic individuals and 54.55% of the patients with chronic hepatitis, irrespective of viral load and alanine aminotransferase serum level. In genotype C, only the basal core promoter mutation was identified and no mutations were identified in genotypes D and F.

CONTEXTO: A transfusão sanguínea destaca-se entre os fatores de risco implicados na transmissão dos vírus das hepatites B (VHB) e C (VHC); entretanto não há relatos da transmissão endoscópica destes vírus em pacientes com esquistossomose na forma hepatoesplênica. OBJETIVO: Estimar a prevalência dos marcadores sorológicos do VHB e VHC em pacientes com esquistossomose hepatoesplênica e avaliar os possíveis fatores de risco associados a essas infecções. MÉTODOS: Estudo do tipo transversal, com 230 pacientes com esquistossomose hepatoesplênica atendidos em um Hospital Universitário de Recife, PE, Brasil, no período de fevereiro a agosto de 2008. Os pacientes responderam a um questionário padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HBc total, o anti-HBs, o HBsAg e o anti-VHC por ensaio imunoenzimático. As análises estatísticas utilizadas foram a univariada e a regressão logística múltipla. RESULTADOS: Encontrou-se prevalencia de 30% para anti-HBc total e/ou HBsAg e 7,4% para o anti-VHC. Houve maior frequencia de pacientes positivos do sexo feminino e idade .50 anos para os marcadores analisados. Verificou-se associação significativa entre a presenca do anti-HCV e a categoria de seis ou mais transfusões. Nao foi constatada associação do antecedente e numero de endoscopias digestivas com os marcadores sorologicos analisados. CONCLUSÕES: Constatou-se maior prevalência de marcadores sorológicos do VHB e menor prevalência para o anti-VHC. Evidenciou-se o sexo feminino e paciente de idade avançada como as categorias mais atingidas e maior probabilidade da infecção pelo VHC em pacientes politransfundidos.

CONTEXT: Blood transfusion is one of the major risk factors for the transmission of the hepatitis B (HBV) and C (HCV) viruses. However, there are no reports describing the endoscopic transmission of these viruses in patients with the hepatosplenic form of schistosomiasis. OBJECTIVE: To estimate the prevalence of serological markers of HBV and HCV in patients with the hepatosplenic form of schistosomiasis and evaluate the possible risk factors associated with these infections. METHODS: A cross-sectional study was conducted on 230 patients with hepatosplenic form of schistosomiasis who attended a university hospital in Recife, Northeastern Brazil, from February to August 2008. The patients answered a standardized questionnaire about risk factors. Serum samples were analyzed for anti-HBc total, anti-HBs, HBsAg, and anti-HCV using enzyme-linked immunosorbent assays. Univariate analysis and multiple logistic regression were performed. RESULTS: The prevalence was 30% for anti-HBc total and/or HBsAg and 7.4% for anti-HCV. There was a higher frequency of the serological markers in females and in patients aged .50 years. A significant association was detected between the presence of anti-HCV and the receipt of six or more blood transfusions. There was no association of history and number of digestive endoscopies with the serological markers analyzed. CONCLUSIONS: We observed a higher prevalence of serological markers for HBV and a lower prevalence of anti-HCV. Our results indicate that females and patients of an advanced age are the most affected categories and that patients that received multiple transfusions are at a higher probability of HCV infection.

OBJETIVO: Estimar a prevalência do vírus da hepatite C (HCV) e fatores de risco associados com a co-infecção em pessoas soropositivas para HIV. MÉTODOS: Estudo do tipo transversal, descritivo e analítico, com 343 portadores do HIV atendidos em um hospital universitário de Recife (PE), no período de março a dezembro de 2003. Os pacientes foram submetidos a um questionário padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HCV pelo ELISA, o HCV-RNA por meio da RT-PCR e a identificação dos genótipos foi realizada no equipamento ABI377 (PE Biosystems®). As análises estatísticas utilizadas foram a univariada, a multivariada e a regressão logística múltipla. RESULTADOS: A prevalência encontrada para o HCV foi de 4,1% (14/343) pelo ELISA e de 3,2 % (11/343) quando utilizada a RT-PCR. Os genótipos mais freqüentes foram 1b (45%), 3 (33%) e 1a (22%). A faixa etária com maior proporção de co-infectados foi a de 30 a 39 anos, com predomínio do sexo masculino (64,3%). Após regressão logística múltipla, apenas a variável transfusão sangüínea permaneceu como fator de risco para o HCV (OR=4,28; IC 95%: 1,44;12,73). CONCLUSÕES: A prevalência da co-infecção HIV/HCV foi baixa, a transfusão sangüínea foi um fator de risco e o genótipo 1b do HCV foi o mais freqüente.

OBJECTIVE: To estimate the prevalence of hepatitis C virus (HCV) infection and risks factors associated with coinfection in HIV-positive individuals. METHODS: A cross-sectional descriptive study was conducted with 343 HIV patients attended at a university hospital in Recife, Northeastern Brazil, from March to December 2003. A standardized questionnaire about risk factors was administered. Serum samples were analyzed for anti-HCV antibodies using enzyme-linked immunosorbent assay (ELISA), HCV-RNA using reverse transcription-polymerase chain reaction (RT-PCR), and genotyping using the ABI 377 (PE Biosystems®). Univariate and multivariate analyses and multiple logistic regression were performed. RESULTS: HCV prevalence was 4.1% (14/343) using ELISA and 3.2% (11/343) using RT-PCR. The most common genotypes were 1b (45%), 3 (33%) and 1a (22%). Co-infection was higher among those aged 30 to 39 years, and predominantly in males (64.3 %). In the multiple logistic regression, the variable blood transfusion was the single remaining risk factor for HCV (OR=4.28; 95% CI 1.44;12.73). CONCLUSIONS: The prevalence of HIV/HCV coinfection was low. Blood transfusion was a risk factor and HCV genotype 1b was the most frequently found.

OBJETIVO: Estimar la prevalencia de virus de hepatitis C (HCV) y factores de riesgo asociados con la coinfección en personas seropositivas para HIV. MÉTODOS: Estudio de tipo transversal, descriptivo y analítico, con 343 portadores de HIV atendidos en un hospital universitario de Recife (Noreste de Brasil), en el período de marzo a diciembre de 2003. Los pacientes fueron sometidos a un cuestionario estandarizado sobre los factores de riesgo. En las muestras de suero fueron pesquisados el anti-HCV por ELISA, el HCV-RNA por medio de la RT-PCR y la identificación de los genotipos fue realizada en el equipo ABI377 (PE Biosystems®). Los análisis estadísticos utilizados fueron la univariada, la multivariada y la regresión logística múltiple. RESULTADOS: La prevalencia encontrada para el HCV fue de 4,1% (14/343) por ELISA y de 3,2% (11/343) por RT-PCR. Los genotipos mas frecuentes fueron 1b (45%), 3 (33%) y 1a (22%). El rango de edad con mayor proporción de coinfectados fue la de 30-39 años, con predominio del sexo masculino (64,3%). Posterior a la regresión logística múltiple, sólo la variable transfusión sanguínea permaneció como factor de riesgo para el HCV (OR=4,28; IC 95%: 1,44; 12,73). CONCLUSIONES: La prevalencia de la coinfección HIV/HCV fue baja, la transfusión sanguínea fue un factor de riesgo y el genotipo 1b de HCV fue el más frecuente.

OBJETIVO: Estimar a prevalência do vírus da hepatite C (HCV) e fatores de risco associados com a co-infecção em pessoas soropositivas para HIV. MÉTODOS: Estudo do tipo transversal, descritivo e analítico, com 343 portadores do HIV atendidos em um hospital universitário de Recife (PE), no período de março a dezembro de 2003. Os pacientes foram submetidos a um questionário padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HCV pelo ELISA, o HCV-RNA por meio da RT-PCR e a identificação dos genótipos foi realizada no equipamento ABI377 (PE Biosystems®). As análises estatísticas utilizadas foram a univariada, a multivariada e a regressão logística múltipla. RESULTADOS: A prevalência encontrada para o HCV foi de 4,1% (14/343) pelo ELISA e de 3,2 % (11/343) quando utilizada a RT-PCR. Os genótipos mais freqüentes foram 1b (45%), 3 (33%) e 1a (22%). A faixa etária com maior proporção de co-infectados foi a de 30 a 39 anos, com predomínio do sexo masculino (64,3%). Após regressão logística múltipla, apenas a variável transfusão sangüínea permaneceu como fator de risco para o HCV (OR=4,28; IC 95%: 1,44;12,73). CONCLUSÕES: A prevalência da co-infecção HIV/HCV foi baixa, a transfusão sangüínea foi um fator de risco e o genótipo 1b do HCV foi o mais freqüente.

OBJECTIVE: To estimate the prevalence of hepatitis C virus (HCV) infection and risks factors associated with coinfection in HIV-positive individuals. METHODS: A cross-sectional descriptive study was conducted with 343 HIV patients attended at a university hospital in Recife, Northeastern Brazil, from March to December 2003. A standardized questionnaire about risk factors was administered. Serum samples were analyzed for anti-HCV antibodies using enzyme-linked immunosorbent assay (ELISA), HCV-RNA using reverse transcription-polymerase chain reaction (RT-PCR), and genotyping using the ABI 377 (PE Biosystems®). Univariate and multivariate analyses and multiple logistic regression were performed. RESULTS: HCV prevalence was 4.1% (14/343) using ELISA and 3.2% (11/343) using RT-PCR. The most common genotypes were 1b (45%), 3 (33%) and 1a (22%). Co-infection was higher among those aged 30 to 39 years, and predominantly in males (64.3 %). In the multiple logistic regression, the variable blood transfusion was the single remaining risk factor for HCV (OR=4.28; 95% CI 1.44;12.73). CONCLUSIONS: The prevalence of HIV/HCV coinfection was low. Blood transfusion was a risk factor and HCV genotype 1b was the most frequently found.

OBJETIVO: Estimar la prevalencia de virus de hepatitis C (HCV) y factores de riesgo asociados con la coinfección en personas seropositivas para HIV. MÉTODOS: Estudio de tipo transversal, descriptivo y analítico, con 343 portadores de HIV atendidos en un hospital universitario de Recife (Noreste de Brasil), en el período de marzo a diciembre de 2003. Los pacientes fueron sometidos a un cuestionario estandarizado sobre los factores de riesgo. En las muestras de suero fueron pesquisados el anti-HCV por ELISA, el HCV-RNA por medio de la RT-PCR y la identificación de los genotipos fue realizada en el equipo ABI377 (PE Biosystems®). Los análisis estadísticos utilizados fueron la univariada, la multivariada y la regresión logística múltiple. RESULTADOS: La prevalencia encontrada para el HCV fue de 4,1% (14/343) por ELISA y de 3,2% (11/343) por RT-PCR. Los genotipos mas frecuentes fueron 1b (45%), 3 (33%) y 1a (22%). El rango de edad con mayor proporción de coinfectados fue la de 30-39 años, con predominio del sexo masculino (64,3%). Posterior a la regresión logística múltiple, sólo la variable transfusión sanguínea permaneció como factor de riesgo para el HCV (OR=4,28; IC 95%: 1,44; 12,73). CONCLUSIONES: La prevalencia de la coinfección HIV/HCV fue baja, la transfusión sanguínea fue un factor de riesgo y el genotipo 1b de HCV fue el más frecuente.

OBJETIVO: Verificar a associação entre a atividade do lúpus eritematoso sistêmico (LES) e a avidez das imunoglobulinas IgG anti-EBV. MÉTODOS: Analisou-se o sangue periférico de 66 pacientes distribuídos em dois grupos: 22 pacientes com LES em atividade e 44 pacientes com doença inativa. A presença e o índice de avidez de anticorpos IgG anti-EBV foram determinados pela técnica ELISA. (Enzygnost anti-EBV - Dade Behring). RESULTADOS: Identificou-se positividade no teste de detecção de IgG para EBV em 21 (95,5%) pacientes do grupo LES ativo e em 40 (90,9%) do grupo LES inativo. O índice de avidez alcançou valores 40 em 54 (88,5%) pacientes, sendo 34 (85%) do grupo LES inativo e 20 (95,2%) do grupo LES ativo; em cinco (12,5%) pacientes do grupo LES inativo, este índice ficou entre 20 e 40 e foi inferior a 20 em dois (3,3%) pacientes. Adotando-se 20, 30 ou 40 como ponto de corte do índice de avidez, para diagnóstico de reativação da infecção por EBV, foram classificados como infecção reativada, nos grupos LES ativo e inativo, respectivamente: 1 (4,8%) x 5 (12,5%) pacientes, 1 (4,8%) x 4 (10%) pacientes e 1 (4,8%) x 5 (12,5%) pacientes. CONCLUSÃO: No presente estudo, não foi demonstrada associação entre a atividade do LES e a reativação do EBV. Esse fato parece indicar que a não eliminação dos linfócitos B infectados se deve à falha no mecanismo de apoptose ou à ação de linfócitos T citotóxicos, permitindo assim a progressão do LES.

OBJECTIVE: To verify the association of SLE activity to the avidity of IgG anti-EBV immune globulins. METHODS: Peripheral blood of 66 patients was analyzed, 22 had active SLE and 44 had inactive SLE. Presence and avidity index of IgG anti-EBV antibodies were determined by the ELISA method (Enzygnost® anti-EBV/IgG - Dade Behring). RESULTS: IgG anti-EBV test was positive for 21 (95.5%) patients in the active SLE group and 40 (90.9%) in the inactive group. The avidity index was 40 for 54 (88.5%) patients of which 34 (85%) belonged to the inactive SLE group and 20 (95.2%) to the active group. For 5 (12.5%) inactive SLE patients, the avidity index reached values ranging from 20 to 40; while for only 2 (3.3%) patients this index was lower than 20. Adopting 20, 30 or 40 as a cutoff point of the avidity index for diagnosis of reactivation of the EBV infection, the author classified as having reactivated infection, for active and inactive SLE groups, respectively: 1 (4.8%) x 1 (2.5%) patient; 1 (4.8%) x 4 (10%) patients and 1 (4.8%) x 5 (12.5%) patients. CONCLUSION: Association between EBV activity and SLE was not demonstrated. This appears to indicate that persistence of infected B lymphocytes may be due to failure in the apopotosis mechanism or to the action of T cytotoxic lymphocytes, permitting evolution of SLE.