Detection of Plasmodium spp. in asymptomatic blood donors by the new Brazilian NAT PLUS HIV/HBV/HCV/Malaria Bio-Manguinhos kit.

BACKGROUND: Transfusion-transmitted malaria (TTM) is a public health problem in endemic and nonendemic areas. The Brazilian Ministry of Health (MH) requested the development of a nucleic acid amplification test (NAT) for the detection of Plasmodium spp. in public blood centers to increase blood safety. STUDY DESIGN AND METHODS: The new Brazilian NAT kit named NAT PLUS HIV/HBV/HCV/Malaria Bio-Manguinhos was first implemented in HEMORIO, a public blood center in the city of Rio de Janeiro. Since October 1, 2022, this blood center has been testing all its blood donations for malaria in a pool of six plasma samples to detect Plasmodium spp. by real-time polymerase chain reaction (PCR). RESULTS: Since the implementation of the NAT PLUS platform until February 2023, HEMORIO has successfully received and tested 200,277 donations. The platform detected two asymptomatic donors in the city of Rio de Janeiro, which is a nonendemic region for malaria. Our analyses suggested a malaria from the Amazon region caused by Plasmodium vivax, in the first case, while an autochthonous transmission case by Plasmodium malariae was identified in the rural area of Rio de Janeiro state. DISCUSSION: The NAT PLUS platform detects Plasmodium spp. in plasma samples with sensitivity capable of detecting subpatent infections. This is the first time worldwide that a group developed and implemented molecular diagnosis for Plasmodium spp. to be used by public blood centers to avoid TTM.

A straightforward one-step strategy for SARS-CoV-2 diagnosis and screening of variants of concern: a multicentre study.

BACKGROUND: The prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) has changed unevenly over time around the world. Although whole genome sequencing is the gold standard for virus characterisation, the discovery of alpha VOC causing spike gene target failure (SGTF) result, when tested using an reverse transcription real-time polymerase chain reaction (RT-qPCR) assay, has provided a simple tool for tracking the frequencies of variants. OBJECTIVES: The aim of this study was to investigate if a multiplex RT-qPCR assay (BioM 4Plex VOC) could be used to detect SARS-CoV-2 and to perform a VOC screening test in a single reaction tube. Here, we present the multicentre study evaluating this assay. METHODS: Twelve laboratories have participated in the multicentre study. The BioM 4Plex VOC was distributed to them with detailed instructions of how to perform the test. They were asked to test the BioM 4Plex VOC in parallel with their routine Commercial SARS-CoV-2 diagnostic assay. Additionally, they were requested to select SARS-CoV-2-positive samples with genome sequenced and lineage definition according to PANGO lineage classification. FINDINGS: The BioM 4Plex VOC and commercial RT-PCR assay are equally effective in detecting SARS-CoV-2. Results revealed a specificity of 96.5-100% [95% confidence interval (CI)], a sensitivity of 99.8-100% (95% CI), and an accuracy of 99.8-100% (95% CI). A 99% concordance rate was found between results from the BioM 4Plex VOC and that from available genome sequencing data. MAIN CONCLUSIONS: The BioM 4Plex VOC provides an effective solution to detect SARS-CoV-2 infections and screening for VOCs in a single reaction. It is a straightforward method to help us monitor the frequency and distribution of VOCs and develop strategies to better cope with the pandemics.

A straightforward one-step strategy for SARS-CoV-2 diagnosis and screening of variants of concern: a multicentre study

BACKGROUND The prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) has changed unevenly over time around the world. Although whole genome sequencing is the gold standard for virus characterisation, the discovery of alpha VOC causing spike gene target failure (SGTF) result, when tested using an reverse transcription real-time polymerase chain reaction (RT-qPCR) assay, has provided a simple tool for tracking the frequencies of variants. OBJECTIVES The aim of this study was to investigate if a multiplex RT-qPCR assay (BioM 4Plex VOC) could be used to detect SARS-CoV-2 and to perform a VOC screening test in a single reaction tube. Here, we present the multicentre study evaluating this assay. METHODS Twelve laboratories have participated in the multicentre study. The BioM 4Plex VOC was distributed to them with detailed instructions of how to perform the test. They were asked to test the BioM 4Plex VOC in parallel with their routine Commercial SARS-CoV-2 diagnostic assay. Additionally, they were requested to select SARS-CoV-2-positive samples with genome sequenced and lineage definition according to PANGO lineage classification. FINDINGS The BioM 4Plex VOC and commercial RT-PCR assay are equally effective in detecting SARS-CoV-2. Results revealed a specificity of 96.5-100% [95% confidence interval (CI)], a sensitivity of 99.8-100% (95% CI), and an accuracy of 99.8-100% (95% CI). A 99% concordance rate was found between results from the BioM 4Plex VOC and that from available genome sequencing data. MAIN CONCLUSIONS The BioM 4Plex VOC provides an effective solution to detect SARS-CoV-2 infections and screening for VOCs in a single reaction. It is a straightforward method to help us monitor the frequency and distribution of VOCs and develop strategies to better cope with the pandemics.

A straightforward one-step strategy for SARS-CoV-2 diagnosis and screening of variants of concern: a multicentre study

BACKGROUND The prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) has changed unevenly over time around the world. Although whole genome sequencing is the gold standard for virus characterisation, the discovery of alpha VOC causing spike gene target failure (SGTF) result, when tested using an reverse transcription real-time polymerase chain reaction (RT-qPCR) assay, has provided a simple tool for tracking the frequencies of variants. OBJECTIVES The aim of this study was to investigate if a multiplex RT-qPCR assay (BioM 4Plex VOC) could be used to detect SARS-CoV-2 and to perform a VOC screening test in a single reaction tube. Here, we present the multicentre study evaluating this assay. METHODS Twelve laboratories have participated in the multicentre study. The BioM 4Plex VOC was distributed to them with detailed instructions of how to perform the test. They were asked to test the BioM 4Plex VOC in parallel with their routine Commercial SARS-CoV-2 diagnostic assay. Additionally, they were requested to select SARS-CoV-2-positive samples with genome sequenced and lineage definition according to PANGO lineage classification. FINDINGS The BioM 4Plex VOC and commercial RT-PCR assay are equally effective in detecting SARS-CoV-2. Results revealed a specificity of 96.5-100% [95% confidence interval (CI)], a sensitivity of 99.8-100% (95% CI), and an accuracy of 99.8-100% (95% CI). A 99% concordance rate was found between results from the BioM 4Plex VOC and that from available genome sequencing data. MAIN CONCLUSIONS The BioM 4Plex VOC provides an effective solution to detect SARS-CoV-2 infections and screening for VOCs in a single reaction. It is a straightforward method to help us monitor the frequency and distribution of VOCs and develop strategies to better cope with the pandemics.

Promoção da saúde de estudantes universitários: a influência das habilidades sociais / Health promotion of university students: the influence of social skills

O presente estudo objetivou analisar a influência das Habilidades Sociais na qualidade de vida do estudante universitário (n = 923) de uma instituição de ensino superior na capital paulista. Como método, realizou-se um estudo exploratório, de caráter descritivo e natureza quantitativa. Para coleta de dados, foram aplicados questionário sociodemográfico, Inventário de Habilidades Sociais (IHS-Del-Prette) e WHOQOL-Bref. Foram realizadas análises estatísticas com GraphPadPrism. Os resultados mostraram que houve predomínio de jovens (80,04%), mulheres (63,2%); e foi encontrada correlação significante entre os escores de qualidade de vida e de habilidades sociais. Concluiu-se que, quanto maiores os índices de habilidades sociais, maior a qualidade de vida dos estudantes universitários. Isso remete ao potencial de construção de ambientes saudáveis que fomentem o desenvolvimento de habilidades sociais, geradoras de universidades promotoras de saúde.

The present study aimed to analyze the influence of Social Skills on the quality of life of university students (n=923) of a Higher Education Institution in the capital of São Paulo. As a method, an exploratory study was carried out, with a descriptive and quantitative nature. For data collection, a sociodemographic questionnaire, Social Skills Inventory (IHS-Del-Prette) and WHOQOL-BREF were applied. Statistical analyzes were performed with GraphPadPrism. The results showed that there was a predominance of young people (80.04%) women (63.2%) and a significant correlation was found between the scores of quality of life and social skills. It was concluded that the higher the social skills index, the higher the quality of life of university students. This refers to the potential for building healthy environments that foster the development of social skills, which generate health-promoting universities.

Information, control and health promotion in the Brazilian context of the pandemic.

This article discusses how preventive and promotional discourses have been incorporated by the Brazilian population in the context of the coronavirus pandemic. It analyzes materials posted on the internet and social after the first case of COVID 19-related death in Brazil that are related health promotion and COVID-19 aimed at orienting society's response to the pandemic. The analysis considers two key factors: the mismanagement of the pandemic by the Brazilian government and infodemic. There is complex use of scientific information with recommendations that focus on what people should do (intervention) and in transforming individuals' behaviors, based on an ideal model of healthy behaviors. Narratives aimed to delegate to the population and specific groups the task of taking care of themselves have been reinforced, removing from the State the responsibility to offer conditions for the population to address the situation. There is a sophistication of strategies that blame individual practices, personal organization and that are disconnected from the collective, especially for those who live in situation of extreme vulnerability. Concomitantly, there are also discourses based on notions of solidarity and renewed social connections, which are empowering and consistent with the practice of health promotion as it attributes meanings to the subjects and their ways of life. We conclude that greatest advocacy in the field of health promotion at this moment is political and could be directed toward reaffirming health promotion principles, supporting permanent mobilization against setbacks in the public sphere and defending a new, democratic, inclusive and collective vision of society.

Postdonation information during dengue outbreaks at a single blood center in Brazil: An ally against transfusion-transmitted infections.

BACKGROUND: Brazilian blood banks encourage donors to report postdonation information (PDI) regarding conditions that would lead to deferral in an attempt to retrieve distributed nonconforming blood. OBJECTIVES: This study evaluated the profile of donors reporting PDI, the impact on transfusion safety, and the possible impact on the discard of blood products. SUBJECTS AND METHODS: We analyzed 115 consecutive PDIs between May 2014 and July 2015, a period comprising two dengue-like syndrome (DLS) outbreaks. RESULTS: These PDIs accounted for 87,780 blood donations. The average time for PDIs since donation was 4 (0-23) days and 190 blood components were discarded. DLS accounted for 21.7% of the PDIs analyzed; 11 of the 23 samples tested were nucleic acid test (NAT) positive for dengue and 2 positive for Zika virus (ZIKV). Six of these PDIs were reported after blood components have been transfused: After NAT testing, one of these recipients was diagnosed with dengue and another one with ZIKV infection, both possible transfusions transmitted but without clinical consequences. CONCLUSION: The high number of recovered blood components due to PDI suggests that PDI remains a great ally in the fight against transfusion-transmitted infections and may be particularly useful during outbreaks of emerging potentially blood-borne pathogens.

Percepção de pacientes hipertensos sobre a doença e motivação para mudança de hábitos / Perception of hypertensive patients about the disease and motivation to change habits

O objetivo deste estudo foi conhecer as percepções de pacientes hipertensos sobre a doença e a influência de uma intervenção educativa na adoção de hábitos saudáveis relacionados aos "Oito Remédios Naturais". Estudo desenvolvido em abordagem qualitativa por meio de entrevistas semiestruturadas com oito participantes que vivenciarem uma intervenção educativa que aplicou oficinas sobre hábitos saudáveis relacionados aos "Oito Remédios Naturais". Para análise utilizou-se a técnica do Discurso do Sujeito Coletivo, fundamentada na Teoria da Representação Social, que permitiu a representação de 15 Ideias Centrais, entre as quais se destacam: "Antes das oficinas a qualidade de vida era ruim"; "Conscientização dos riscos da hipertensão e motivação para adotar hábitos saudáveis"; "Percepção de benefícios físicos, emocionais e espirituais após as oficinas"; "Ingestão de mais água, devido ao incentivo nas oficinas"; "Dificuldade quanto à temperança e o sono, pela complexidade em romper velhos hábitos"; "A motivação foi aprender sobre os remédios naturais" e "A confiança em Deus aumenta a motivação para se cuidar". Os participantes reconheceram os riscos da hipertensão, demonstrando compreender a influência da adoção de hábitos saudáveis no controle e prevenção de suas complicações. Reconheceram também a complexidade dos determinantes sociais implicados neste contexto.

The objective of this study was to know the perceptions of hypertensive patients about the disease and the influence of an educational intervention in the adoption of healthy habits related to the "Eight Natural Remedies." The study developed was a qualitative approach through semi-structured interviews with eight participants who experienced an educational intervention that applied workshops on healthy habits related to the "Eight Natural Remedies." For analysis, the Collective Subject Discourse technique was used, based on the Social Representation Theory, which allowed the representation of 15 Central Ideas, among which the following stand out: "Before the workshops, the quality of life was poor"; "Awareness of the risks of hypertension and motivation to adopt healthy habits"; "Perception of physical, emotional and spiritual benefits after the workshops"; "Ingestion of more water, due to the incentive in the workshops"; "Difficulty intemperance and sleep, due to the complexity of breaking old habits"; "The motivation was to learn about natural remedies" and "Trust in God increases the motivation to take care of yourself." The participants recognized the risks of hypertension, demonstrating an understanding that adopting healthy habits influences in the control and prevention of its complications. They also recognized the complexity of the social determinants involved in this context.

Interferon-lambda 3 and 4 Polymorphisms Increase Sustained Virological Responses and Regulate Innate Immunity in Antiviral Therapy With Pegylated Interferon-Alpha.

Sustained virologic response (SVR) in chronic hepatitis C (CHC) treatment denotes that the host genetics controls the immune response and unequivocally contribute to viral clearance or disease severity. In this context, single nucleotide polymorphisms (SNPs) in the locus of interferon lambda 3 and 4 genes (IFNL3/4) have been important genetic markers of responsiveness to CHC as prognostic markers for the pegylated-Interferon-alpha/ribavirin (Peg-IFN-α/RBV). Here, we analyzed 12 SNPs at the IFNL3/4 region in 740 treatment-naïve patients with CHC infected with hepatitis C virus (HCV) genotypes 1, 2, or 3 treated with Peg-IFN-α/RBV. Individually, rs12979860-CC, rs8109886-CC, or rs8099917-TT were predictive markers of SVR, while rs12979860-CC demonstrated the stronger effect. Besides, the genotypic combination of these three predictors' genotypes, CC/CC/TT, increased the rate of SVR. Serum levels of cytokines and gene expression analysis on the genes IFNL3, IFNL4, IFNA1, and some of the IFN-stimulated genes (ISGs) were measured in a subgroup of 24 treated patients and 24 healthy volunteers. An antagonist effect was highlighted between the expression of IFNL3/4 and IFNA1 mRNA among patients. Besides, a prominent production of the pro-inflammatory chemokines CCL4 and CXCL10 was observed at a 12-week treatment follow-up. Lower serum levels of these chemokines were detected in patients with an rs12979860-CC genotype associated with the better treatment outcome. Also, lower expression levels of the IFI6, IFI16, IRF9 genes were observed among rs12979860-CC individuals. In conclusion, a combination of the genotypes at the IFNL3/4 locus can act as a better marker for the prognosis for virological responses in an admixed Brazilian population presenting the modulating effect over innate immunity and inflammation that are controlling the outcome of the viral infection, but also other infectious diseases. This study is registered on the ClinicalTrials.gov platform (accession number NCT01889849 and NCT01623336).

Analytical and clinical performance of molecular assay used by the Brazilian public laboratory network to detect and discriminate Zika, Dengue and Chikungunya viruses in blood.

In response to the Zika epidemics in Brazil, the ZDC molecular assay (Bio-Manguinhos) was developed and registered at the Brazilian Regulatory Agency of Health Surveillance - ANVISA. The circulation of Zika (ZIKV) Dengue (DENV) and Chikungunya (CHIKV) viruses and their clinical similarities are challenges to correctly diagnose these viruses. The simultaneous detection of ZIKV, DENV and CHIKV is an important tool for diagnosis and surveillance. Here, we present the analytical and clinical performance evaluation of ZDC molecular assay (Bio-Manguinhos) at the public health laboratories three years after its registration at ANVISA. The clinical performance demonstrates the ZDC molecular assay (Bio-Manguinhos) has 100% sensitivity and 100% specificity to detect and discriminate ZIKV, CHIKV, and DENV from clinical plasma samples. The ZDC molecular assay (Bio-Manguinhos) results were highly reproducible and no cross-reactivity was seen during testing with a panel of other infectious agents. In conclusion, the ZDC molecular assay (Bio-Manguinhos) is an accurate and reliable tool to monitor Zika, dengue and chikungunya infections in countries like Brazil with simultaneous circulation of the three viruses.

Analytical and clinical performance of molecular assay used by the Brazilian public laboratory network to detect and discriminate Zika, Dengue and Chikungunya viruses in blood

ABSTRACT In response to the Zika epidemics in Brazil, the ZDC molecular assay (Bio-Manguinhos) was developed and registered at the Brazilian Regulatory Agency of Health Surveillance - ANVISA. The circulation of Zika (ZIKV) Dengue (DENV) and Chikungunya (CHIKV) viruses and their clinical similarities are challenges to correctly diagnose these viruses. The simultaneous detection of ZIKV, DENV and CHIKV is an important tool for diagnosis and surveillance. Here, we present the analytical and clinical performance evaluation of ZDC molecular assay (Bio-Manguinhos) at the public health laboratories three years after its registration at ANVISA. The clinical performance demonstrates the ZDC molecular assay (Bio-Manguinhos) has 100% sensitivity and 100% specificity to detect and discriminate ZIKV, CHIKV, and DENV from clinical plasma samples. The ZDC molecular assay (Bio-Manguinhos) results were highly reproducible and no cross-reactivity was seen during testing with a panel of other infectious agents. In conclusion, the ZDC molecular assay (Bio-Manguinhos) is an accurate and reliable tool to monitor Zika, dengue and chikungunya infections in countries like Brazil with simultaneous circulation of the three viruses.

Pain, disability and catastrophizing in individuals with knee osteoarthritis / Dor, incapacidade e catastrofização em indivíduos com osteoartrite do joelho

ABSTRACT BACKGROUND AND OBJECTIVES: Knee osteoarthritis is among the leading sources of chronic disability and may lead to depression, anxiety and pain catastrophizing, enhancing perceived pain. This study aimed at investigating the influence of pain catastrophizing on attitudes and perception of pain, and in the functionality of individuals with knee osteoarthritis. METHODS: This observational study involved 18 patients, who were assessed for weight and height, and completed the Pain-related Catastrophizing Thoughts Scale (PCTS), Survey of Pain Attitudes (SPA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analog scale (VAS). Symptoms and disability were assessed by the Lequesne Index, functional mobility was evaluated by the Timed Up and Go (TUG) test. Pressure pain tolerance thresholds (PPT) were assessed by a digital algometer. RESULTS: Mean body mass index of the sample was classified as obese (32,2±4,3). When split by the median of PCTS, differences were observed in most domains of SPA. Patients with more catastrophic thoughts took longer to perform TUG and presented more pain, joint stiffness and worse functionality (WOMAC). Despite the tendency to report more pain (VAS) in patients above the median score of PCTS, no differences were observed between groups with higher or lower catastrophizing regarding PPT. Positive and significant associations between the Rumination factor of PCTS and WOMAC outcomes were observed, as well as between the Hopelessness factor and TUG, Lequesne and WOMAC. CONCLUSION: The higher the presence of catastrophic thoughts, the worse the attitudes towards pain and the physical functionality of knee osteoarthritis patients.

RESUMO JUSTIFICATIVA E OBJETIVOS: A osteoartrite do joelho está entre as principais causas de incapacidade crônica e pode levar à depressão, ansiedade e catastrofização, intensificando a percepção da dor. Este estudo teve como objetivo investigar a influência da catastrofização da dor nas atitudes e na percepção da dor e a funcionalidade de indivíduos com osteoartrite do joelho. MÉTODOS: Dezoito pacientes foram avaliados quanto ao peso e à estatura, e completaram a Escala de Pensamentos Catastróficos Sobre a Dor (EPCD), Inventário de Atitudes frente à Dor (IAD), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) e escala analógica visual (EAV). Os sintomas e a incapacidade foram avaliados pelo Índice de Lequesne, a mobilidade funcional foi avaliada pelo teste Timed Up and Go (TUG). Os limiares de tolerância à dor à pressão (LTDP) foram avaliados por um algômetro digital. RESULTADOS: A média do índice de massa corporal da amostra foi classificado como obesa (32,2±4,3). Quando divididas pela mediana do EPCD, foram observadas diferenças na maioria dos domínios do IAD. Pacientes com pensamentos mais catastróficos demoraram mais para realizar o TUG e apresentaram mais dor, rigidez articular e pior funcionalidade (WOMAC). Apesar da tendência de relatar mais dor (EAV) em pacientes acima do escore mediano do EPCD, não foram observadas diferenças entre os grupos com maior ou menor catastrofização em relação aos LTDP. Foram observadas associações positivas e significantes entre o fator ruminação da EPCD e o WOMAC, bem como entre o fator Desesperança e TUG, Lequesne e WOMAC. CONCLUSÃO: Quanto maior a presença de pensamentos catastróficos, piores as atitudes em relação à dor e funcionalidade física dos pacientes com osteoartrite do joelho.

Efficacy of an exercise program combined with lifestyle education in patients with knee osteoarthritis.

Therapeutic exercise and lifestyle changes (LS) are usually recommended for the treatment of knee osteoarthritis (OA). OBJECTIVES: to compare the impact of an exercise program vs. exercise program plus LS education in individuals with knee OA. MATERIALS AND METHODS: Single-blind randomized clinical trial with individuals of both sexes with clinical and radiological diagnosis of knee OA. Participants received the treatment 2 times/week for 8 weeks. Therapeutic exercise involved warm-up, flexibility, muscle strengthening, balance and proprioception. The exercise plus lifestyle education group (ELG) also participated in 8 sessions of lectures and discussion on disease self-management and healthy LS. Participants were assessed for pain intensity (visual analog scale), lifestyle, symptoms and physical disability (WOMAC) and pressure pain tolerance threshold (PPT). RESULTS: Sample consisted of 39 participants, divided into exercise group (EG, n=17) and ELG (n=22). Groups were homogeneous regarding regarding age, weight, height, initial pain perception (VAS) and gender predominance age and body mass index. After the interventions, reduction in pain perception and increase in PPT was observed in both groups. Despite the improvement in LS of both groups, only ELG exhibited a significant reduction in pain assessed by WOMAC. Therapeutic exercise programs may produce pain relief, but no improvements were observed in joint stiffness and funcionality.

Correction to: Use of a NAT-based assay to improve the surveillance system and prevent transfusion-transmitted malaria in blood banks.

An amendment to this paper has been published and can be accessed via the original article.

Use of a NAT-based assay to improve the surveillance system and prevent transfusion-transmitted malaria in blood banks.

BACKGROUND: Malaria can be transmitted by blood transfusion through donations collected from asymptomatic donors. Transfusion-transmitted malaria (TTM) poses a great risk to blood services worldwide. A good screening tool for Plasmodium spp. detection in blood banks must have a high sensitivity for prevention of TTM. However, in Brazilian blood banks, screening for malaria still relies on microscopy. METHODS: In Brazil, screening for human immunodeficiency virus type 1 (HIV), RNA/DNA for hepatitis C (HCV) and hepatitis B (HBV) viruses is mandatory for every blood donation and uses nucleic acid amplification testing (NAT). The aim of this study was to evaluate the inclusion of an assay for malaria to identify Plasmodium sp. from total nucleic acid (TNA; DNA/RNA) by targeting the 18S rRNA gene of the parasite. RESULTS: Considering the limitations of microscopy and the wide availability of the Brazilian NAT platform in the screening of blood units for HIV, HCV, and HBV, a molecular diagnostic tool was validated for detection of Plasmodium sp. in blood banks; a pilot study showed that using this novel NAT assay could reduce the risk of TTM. CONCLUSION: The prototype HIV/HCV/HBV/malaria NAT assay was effective in detecting infected candidate donors and has good prospects to be applied in routine screening for preventing TTM.

Resistance mutations of NS3 and NS5b in treatment-naïve patients infected with hepatitis C virus in Santa Catarina and Rio Grande do Sul states, Brazil.

Hepatitis C virus (HCV) infection is a worldwide health problem. Nowadays, direct-acting antiviral agents (DAAs) are the main treatment for HCV; however, the high level of virus variability leads to the development of resistance-associated variants (RAVs). Thus, assessing RAVs in infected patients is important for monitoring treatment efficacy. The aim of our study was to investigate the presence of naturally occurring resistance mutations in HCV NS3 and NS5 regions in treatment-naïve patients. Ninety-six anti-HCV positive serum samples from blood donors at the Center of Hematology and Hemotherapy of Santa Catarina State (HEMOSC) were collected retrospectively in 2013 and evaluated in this study. HCV 1a (37.9%), 1b (25.3%), and 3a (36.8%) subtypes were found. The frequency of patients with RAVs in our study was 6.9%. The HCV NS5b sequencing reveled 1 sample with L320F mutation and 4 samples with the C316N/R polymorphism. The analysis of the NS3 region revealed the D168A/G/T (3.45%), S122G (1.15%), and V55A (2.3%) mutations. All samples from genotype 3a (36.8%) presented the V170 I/V non-synonymous mutation. In conclusion, we have shown that mutations in NS3 and NS5b genes are present in Brazilian isolates from therapy-naïve HCV patients.

Percepções de psicólogos sobre as dinâmicas territoriais na construção de ações promotoras da saúde / Psychologists' perceptions of the territorial dynamics in the construction of health promotion actions / Percepciones de psicólogos sobre las dinámicas territoriales para la construcción de acciones de promoción de la salud

Objetivo: Analisar potencialidades, desafios e limitações de um território para a construção de ações de promoção da saúde, a partir da percepção dos psicólogos que trabalham em uma região. Métodos: Pesquisa qualitativa, realizada em maio de 2018, com 15 psicólogos que trabalham no território da região Sul de São Paulo, Brasil. A coleta de dados ocorreu através de quatro grupos focais. Os dados foram analisados pela análise de conteúdo, emergindo três categorias temáticas: Potencialidades do território para ações de promoção da saúde; Desafios e limitações para desenvolver ações de promoção da saúde no território; A psicologia promotora de saúde no território. Resultados: Como potencialidades destacam-se a diversidade cultural e a possibilidade de atuação via arte. Os desafios e limitações destacados foram a atuação em rede e a falta de suporte na atuação. Há a necessidade de atuação ampliada e contextualizada, além da constante capacitação. Conclusão: Reconhecer a potencialidade no território engloba o profissional ampliar seus horizontes de atuação e constituir espaços de produção subjetiva e coletiva. Incide também reconhecer as limitações do local, com dificuldades de oferta e articulação de serviços e descaso aos direitos básicos daquela comunidade. Assim, sugere-se uma visão voltada para a capacitação continuada e a legitimidade de seu trabalho nesse contexto da atenção primaria. (AU)

Zika Virus and the Safety of Blood Supply in Brazil: A Retrospective Epidemiological Evaluation.

The potential for transfusion transmission of dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) has raised concerns about the safety of the blood supply in endemic areas. In this study, nucleic acid testing (NAT) for ZIKV, DENV, and CHIKV RNA was performed in asymptomatic blood donor samples in the city of Campinas, located in the southeast region of Brazil (1962 in 2015 and 1775 in 2016). The prevalence of reactive NAT was 0.15% in 2015 and 0.62% in 2016 for dengue, 0.05% in 2015 and 0.17% in 2016 for Zika, and 0% in both years for chikungunya. These results demonstrate the weakness of the clinical interview in screening these blood donors. Furthermore, positivity for ZIKV was detected in March 2015, 1 year before the first reported cases in the region. These data attest the feasibility of using donor samples held in library as a tool for retrospective epidemiological evaluation, which is particularly interesting considering emerging pathogens, for which data on their spread and penetrance are initially scarce.

One-step real-time PCR assay for detection and quantification of RNA HCV to monitor patients under treatment in Brazil

ABSTRACT The Brazilian Public Health Service provides freely αPEG-IFN to treat patients infected with HCV. The primary goal of HCV therapy is the long-term elimination of HCV from the blood to reduce the risk of HCV associated complications and death. Patient viremia affects the treatment duration and response, thus influencing clinical decisions. We developed a high-throughput method to perform the quantification of RNA hepatitis C virus (HCV) virus load in plasma samples to monitor patients under treatment. The method is based on a duplex detection, in a one-step real-time RT-PCR assay and it has been validated according to the rules established by the official Brazilian regulatory agency (ANVISA). This new method was compared to a commercial kit (Cobas/Taqman HCV Test v2.0 - Roche), showing virus load results with significant correlation between them (p= 0,012) using commercial and clinical panels. In addition, 611 samples from patients treated with peguilated alfa-interferon (αPEG-IFN) from different regions of Brazil were analyzed. Our one-step real-time RT-PCR assay demonstrated good performance in viral load measurement and in treatment course monitoring, with acceptable sensitivity and specificity values.

One-step real-time PCR assay for detection and quantification of RNA HCV to monitor patients under treatment in Brazil.

The Brazilian Public Health Service provides freely αPEG-IFN to treat patients infected with HCV. The primary goal of HCV therapy is the long-term elimination of HCV from the blood to reduce the risk of HCV associated complications and death. Patient viremia affects the treatment duration and response, thus influencing clinical decisions. We developed a high-throughput method to perform the quantification of RNA hepatitis C virus (HCV) virus load in plasma samples to monitor patients under treatment. The method is based on a duplex detection, in a one-step real-time RT-PCR assay and it has been validated according to the rules established by the official Brazilian regulatory agency (ANVISA). This new method was compared to a commercial kit (Cobas/Taqman HCV Test v2.0 - Roche), showing virus load results with significant correlation between them (p = 0,012) using commercial and clinical panels. In addition, 611 samples from patients treated with peguilated alfa-interferon (αPEG-IFN) from different regions of Brazil were analyzed. Our one-step real-time RT-PCR assay demonstrated good performance in viral load measurement and in treatment course monitoring, with acceptable sensitivity and specificity values.