Pregnancy outcomes and mother-to-child transmission rate in HTLV-1/2 infected women attending two public hospitals in the metropolitan area of Rio de Janeiro.

HTLV-1/2 are transmitted sexually, by whole cell blood products and from mother-to-child (MTC), mainly through breastfeeding. HTLV-1/2 prevalence in pregnant women is high in Rio de Janeiro, however there were no local studies addressing the rate of adverse pregnancy outcomes (APO) and MTC transmission. The aim was to study sociodemographic characteristics which may be associated to HTLV-1/2 infection and describe pregnancy outcomes and MTC transmission in HTLV-1/2-positive women. The cross-sectional study screened 1,628 pregnant women in of Rio de Janeiro (2012-2014) and found 12 asymptomatic carrier mothers (prevalence = 0.74%). Pregnancy outcome information was retrieved from medical records. Sociodemographic characteristics were similar between the positive and negative groups except for maternal age, which was higher in carrier mothers. The incidence of adverse pregnancy outcomes was similar in infected and non-infected patients (p = 0.33), however there was a high rate of premature rupture of membranes (PROM) amid infected mothers (3/12). Multilevel logistic regression found that for each additional year of age, the chance of being HTLV-1/2-positive increased 11% and that having another sexually transmitted infection (STI) increased 9 times the chance of being infected. Carrier mothers had more antenatal visits (OR = 5.26). Among the children of HTLV-1/2-positive mothers there was one fetal death, one infant death and one loss of follow-up. After two years of follow-up there was one case of MTC transmission (1/9). The mother reported breastfeeding for one month only. Knowledge about factors associated to HTLV-1/2 infection, its impact on pregnancy outcomes and the MTC transmission rate is important to guide public health policies on antenatal screening and management.

Baseline Circulating Activated TFH and Tissue-Like Exhausted B Cells Negatively Correlate With Meningococcal C Conjugate Vaccine Induced Antibodies in HIV-Infected Individuals.

Since 2006, meningococcal serogroup C (MenC) conjugate (MCC) vaccines have been supplied by the Brazilian government for HIV-infected children under 13 years old. For measuring protection against MenC, the serum bactericidal antibody (SBA) assay is the method of choice. The characterization of T follicular helper cells (TFH) cells has been an area of intensive study because of their significance in multiple human diseases and in vaccinology. The objective of this study was to characterize the phenotype of peripheral TFH cells and B cells and how they associated with each other and with SBA levels induced by vaccination as well as with serum cytokine levels of HIV-infected and non-infected children and adolescents. We found that CD27-IgD-CD21-CD38+ (exhausted B cells) as well as short-lived plasmablasts (CD27+IgD-CD21-CD38+) are increased in cART treated HIV patients and negatively associated with MCC vaccine induced SBA levels. Baseline frequency of activated peripheral TFH cells was a negative correlate for SBA response to MCC vaccine but positively correlated with circulating plasmablast frequency. Baseline IL4-levels positively associated with SBA response but showed a negative correlation with activated peripheral TFH cells frequency. The increased frequency of activated peripheral TFH cells found in non-responders to the vaccine implies that higher activation/differentiation of CD4 T cells within the lymph node is not necessarily associated with induction of vaccine responses.

Prevalence of HTLV-1/2 in pregnant women living in the metropolitan area of Rio de Janeiro.

BACKGROUND: HTLV-1/2 infection can cause severe and disabling diseases in children and adults. The aim of the study was to estimate the prevalence of HTLV-1/2 infection in pregnant women living in the metropolitan area of Rio de Janeiro. METHODOLOGY/PRINCIPAL FINDINGS: 1,204 pregnant women were tested upon hospital admission for delivery in two public hospitals in the cities of Rio de Janeiro and Mesquita, between November, 2012 and April, 2013. The samples were screened by chemiluminescent microparticle immunoassay (CMIA) and reactive ones were confirmed by Western blot (WB). Epi-info software was used for building the database and performing the statistical analysis. Eight patients had confirmed HTLV-1/2 infection (7 HTLV-1, one HTLV-2), equivalent to a prevalence rate of 0.66%. Two further reactive screening tests had negative Western blot results and therefore were considered negative in the statistical analysis. All HTLV-1/2-positive patients were born in Rio de Janeiro, most were non-Caucasian (87.5%), in a stable relationship (62.5%), had at least ten years of formal education (62.5%) and a monthly family income of up to US$600.00 (87.5%). There was only one case of coinfection with syphilis and none with HIV. The mean age of the infected women was 28.4 (SD = 6.3) years and of the seronegative ones was 24.8 (SD = 6.5) (p = 0.10). The median number of pregnancies were 3.0 and 1.0 (p = 0.06) and the median number of sexual partners were 3.5 and 3.0 (p = 0.33) in the seropositive and negative groups, respectively. There were no statistically significant differences between the groups. CONCLUSIONS/SIGNIFICANCE: A significant prevalence of HTLV-1/2 was found in our population. The socio-epidemiological profile of carrier mothers was similar to the controls. Such findings expose the need for a public health policy of routine HTLV-1/2 screening in antenatal care, since counselling and preventive measures are the only strategies currently available to interrupt the chain of transmission and the future development of HTLV-1/2-related diseases.

Prevalence of cytomegalovirus infection in different patient groups of a urban university in Brazil

This study sought for evidence of previous CMV infection in patients of a general hospital serving the low income population of Rio de Janeiro. An enzyme immunoassay was used to detect anti-CMV antibodies in 713 typical hospital patients classified into eight different groups. Positive tests were found in 87 per cent of pregnant women, 85 per cent of newborns, 61 per cent of pediatric patients, 77 per cent of adolescent patients, 81 per cent of adult patients, 87 per cent of dialysed transplant candidates 89 per cent of kidney donors, and 92 per cent of patients after transplantation. Depending of the subgroup studied these results carry different meanings and necessitate different clinical approaches. The risk of congenital disease is probably low in view of the reduced number of pregnant women still susceptible to primary infection. The number of primary infections will also be low in transplant recipients. However, those still susceptible will almost certainly acquire the infection from their donor. Prophylactic CMV matching in kdney transplantation is not a realistic approach due to the low probality of finding pairs of seronegative donors and recipients.

Pós-graduaçäo na área biomédica / Graduation in biomedical area

Relatam-se os resultados das discussöes sobre pós-graduaçäo na área biomédica, com profissionais biomédicos pós-graduados, obtidos a partir de painel e discussöes em grupo. Concluiu-se que há forte condicionamento do biomédico à pós-graduaçäo pela ligaçäo com a carreira do magistério (ensino-pesquisa). Entretanto, parece näo ocorrer bom preparo pedagógico dentro das programaçöes oferecidas nos referidos cursos, surgindo conflito entre formaçäo e exigência profissional, o que eventualmente interfere na relaçäo professor-aluno. Enfatizam-se, outrossim, sugestöes oferecidas anteriormente

Sorologia positiva em doadores voluntários de sangue em área endêmica de doença de Chagas / Positive serology in voluntary blood donors in endemic area of Chagas' disease

Com a finalidade de detectar a prevalência de portadores da doença de Chagas entre doadores de sangue em zona endêmica (município de Piumhy-MG), foram estudados 30 doadores voluntários de sangue (com 1 a 3 doaçöes nos últimos 5 meses). Eram 25 homens e 5 mulheres com idade entre 26 e 52 anos (média 39), todos da raça branca, naturais e residentes no município, assintomáticos e sem contato com "barbeiro" e/ou ter recebido transfusäo sangüínea. Foram realizadas três reaçöes sorológicas: Guerreiro-Machado, Imunofluorescência e Hemaglutinaçäo. As três reaçöes sorológicas foram positivas em 4 doadores (13,3%) e negativas nos demais. Discute-se a importância deste diagnóstico para a prevençäo da disseminaçäo da doença tanto em áreas endêmicas quanto em grandes centros