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BACKGROUND: Safety data on the yellow fever vaccine 17DD in People Living with HIV (PLWH) are limited. This study explored the occurrence of post-vaccination 17DD viremia and the kinetics of hematological and liver laboratorial parameters in PLWH and HIV-uninfected participants [HIV(-) controls]. METHODS: We conducted a secondary analysis of a longitudinal interventional trial (NCT03132311) study that enrolled PLWH and HIV(-) controls to receive a single 17DD dose and were followed at 5, 30 and 365 days after vaccination in Rio de Janeiro, Brazil. 17DD viremia (obtained throughreal-time PCR and plaque forming units' assays), hematological (neutrophils, lymphocytes and platelets counts) and liver enzymes (ALT and AST) results were assessed at baseline and Days 5 and 30 post-vaccination. Logistic regression models explored factors associated with the odds of having positive 17DD viremia. Linear regression models explored variables associated with hematological and liver enzymes results at Day 5. RESULTS: A total of 202 PLWH with CD4 ≥ 200 cells/µL and 68 HIV(-) controls were included in the analyses. 17DD viremia was found in 20.0 % of the participants and was twice more frequent in PLWH than in HIV(-) controls (22.8% vs. 11.8 %, p-value < 0.001). Neutrophils, lymphocytes and platelets counts dropped at Day 5 and returned to baseline values at Day 30. 17DD viremia was associated with lower nadir of lymphocytes and platelets at Day 5. ALT levels did not increase post-vaccination and were not associated with 17DD viremia. CONCLUSIONS: 17DD was safe and well-tolerated in PLWH with CD4 ≥ 200 cells/µL. Post-vaccination viremia was more frequent in PLWH than in controls. Transient and self-limited decreases in lymphocytes and neutrophils occurred early after vaccination. 17DD viremia was associated with lower lymphocytes and platelets nadir after vaccination. We did not observe elevations in ALT after 17DD vaccination.
Asunto(s)
Infecciones por VIH , Vacuna contra la Fiebre Amarilla , Fiebre Amarilla , Humanos , Vacuna contra la Fiebre Amarilla/efectos adversos , Fiebre Amarilla/prevención & control , Estudios Longitudinales , Viremia , Anticuerpos Antivirales , Brasil , Vacunación/métodos , HígadoRESUMEN
OBJECTIVE: To evaluate immunogenicity and reactogenicity of yellow fever (YF) vaccine in people with HIV (PWH) compared to HIV-uninfected controls. DESIGN: In this longitudinal interventional trial (NCT03132311), PWH with CD4 + cell count ≥200âcells/µl and controls, aged 18-59, without a previous history of YF vaccination received a single standard dose of YF vaccine (17DD) and were followed at Days 5, 30 and Year 1. METHODS: YF-neutralization titers were measured at Days 0, 30 and Year 1 and geometric mean titers (GMT) were calculated. Adverse events (AE) and YF virus detection were measured at Days 5 and 30. Linear regression evaluated factors associated with YF-neutralization titers. RESULTS: Two hundred and eighteen PWH and 82 controls were included. At baseline, all PWH were using antiretroviral therapy; 92.6% had undetectable HIV viral load (VL) and median CD4 + cell count was 630âcells/µl [interquartile range (IQR) 463-888]. YF vaccine was safe and there were no serious AEs. At Day 30, seroconversion was observed in 98.6% of PWH [95% confidence interval (CI): 95.6-99.6] and in 100% of controls (95% CI: 93.9-100); at Year 1, 94.0% of PWH (95% CI: 89.6-96.7) and 98.4% of controls (95% CI 90.3-99.9) were seropositive. PWH had lower GMTs than controls at Day 30 and Year 1. Baseline VL >1000âcopies/ml, low CD4 + cell count and low CD4 + /CD8 + ratio were associated with lower YF-neutralization titers. CONCLUSIONS: YF vaccine is safe in PWH with CD4 + cell count ≥200âcells/µl. YF vaccine immunogenicity is impaired in PWH, particularly among those with high VL, low CD4 + cell count and low CD4 + /CD8 + ratio at vaccination and YF-neutralization titers decays over time.
Asunto(s)
Infecciones por VIH , Vacuna contra la Fiebre Amarilla , Fiebre Amarilla , Humanos , Fiebre Amarilla/prevención & control , Anticuerpos Neutralizantes , Infecciones por VIH/complicaciones , Vacunación/efectos adversos , Anticuerpos AntiviralesRESUMEN
ABSTRACT Background: Safety data on the yellow fever vaccine 17DD in People Living with HIV (PLWH) are limited. This study explored the occurrence of post-vaccination 17DD viremia and the kinetics of hematological and liver laboratorial parameters in PLWH and HIV-uninfected participants [HIV(-) controls]. Methods: We conducted a secondary analysis of a longitudinal interventional trial (NCT03132311) study that enrolled PLWH and HIV(-) controls to receive a single 17DD dose and were followed at 5, 30 and 365 days after vaccination in Rio de Janeiro, Brazil. 17DD viremia (obtained throughreal-time PCR and plaque forming units' assays), hematological (neutrophils, lymphocytes and platelets counts) and liver enzymes (ALT and AST) results were assessed at baseline and Days 5 and 30 post-vaccination. Logistic regression models explored factors associated with the odds of having positive 17DD viremia. Linear regression models explored variables associated with hematological and liver enzymes results at Day 5. Results: A total of 202 PLWH with CD4 > 200 cells/μL and 68 HIV(-) controls were included in the analyses. 17DD viremia was found in 20.0 % of the participants and was twice more frequent in PLWH than in HIV(-) controls (22.8% vs. 11.8 %, p-value < 0.001). Neutrophils, lymphocytes and platelets counts dropped at Day 5 and returned to baseline values at Day 30. 17DD viremia was associated with lower nadir of lymphocytes and platelets at Day 5. ALT levels did not increase post-vaccination and were not associated with 17DD viremia. Conclusions: 17DD was safe and well-tolerated in PLWH with CD4 > 200 cells/μL. Post-vaccination viremia was more frequent in PLWH than in controls. Transient and self-limited decreases in lymphocytes and neutrophils occurred early after vaccination. 17DD viremia was associated with lower lymphocytes and platelets nadir after vaccination. We did not observe elevations in ALT after 17DD vaccination.
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Foi realizado um levantamento do tipo "estado da arte" nas dissertações publicadas entre 2005 e 2010, no Programa de Pós-Graduação em Psicologia Aplicada - Mestrado, na Universidade Federal de Uberlândia (UFU), do eixo Psicologia do desenvolvimento humano e da aprendizagem, elaborando um panorama a respeito das pesquisas realizadas em termos de temáticas, palavras-chave, metodologia e autores referenciados. Das 132 dissertações defendidas, 24 eram desse eixo. A maioria dos trabalhos tratava de temas ligados à Psicologia escolar e educacional, assim como as palavras-chave. Há uma hegemonia da teoria histórico-cultural e da metodologia qualitativa de pesquisa. Verificou-se uma contradição entre os títulos e o conteúdo revelado nas palavras-chave; nomes clássicos da Psicologia do desenvolvimento e da aprendizagem foram privilegiados, em detrimento daqueles da área da Psicologia escolar e educacional. A produção se mostra atualizada perante as demandas sociais; embora a maioria dos trabalhos tenha feito referência à Psicologia escolar e educacional e não à Psicologia do desenvolvimento humano e da aprendizagem, como consta do título do eixo.
A survey, "state of the art", was conducted with the papers being published between 2005 and 2010 in the Graduate Program in Applied Psychology - Masters degree at the Federal University of Uberlandia (UFU), Human Development and Learning Psychology axis, developing an overview about the researches carried out in terms of themes, keywords, methodology and authors referenced. Of the 132 dissertations, 24 were from that axis. Most of the papers dealt with issues related to school and educational psychology, as well as the keywords. There is a dominance of historical-cultural theory and qualitative research methodology. A contradiction was verified between the titles and the content revealed in the keywords; classical names of the Learning and Development Psychology have been privileged detrimentally to those from the area of School and Educational Psychology. The production seems refreshed in respect to social demand, although most of the works have indicated that school psychology and not the Psychology of Human Development and Learning, as stated in the title of the axis.
Se realizó un inventario del "estado del arte" en los trabajos publicados entre los años 2005 y 2010 en el Programa de Postgrado en Psicología Aplicada - Maestría de la Universidad Federal de Uberlândia (UFU), del eje Psicología del Desarrollo Humano y del Aprendizaje, elaborando un panorama sobre los estudios realizados en términos de temas, palabras clave, metodología y autores citados. De las 132 tesis defendidas, 24 eran de este eje. La mayoría de los trabajos trataba sobre temas relacionados con la Psicología escolar y educacional, así como palabras clave. Hay un predominio de la teoría histórico-cultural y de la metodología de investigación cualitativa. Hay una contradicción entre el título y el contenido que se revela en las palabras clave. Se han privilegiado nombres clásicos de la Psicología del desarrollo y del aprendizaje en detrimento de los de la Psicología escolar y educacional. La producción se muestra actualizada de acuerdo con las demandas sociales, aunque la mayoría de los trabajos se haya referido a la Psicología escolar y educacional y no a la Psicología del Desarrollo Humano y del Aprendizaje, como se indica en el título del eje.
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Tesis Académicas como Asunto , Psicología Educacional , InvestigaciónRESUMEN
O presente trabalho relata as experiências vivenciadas em um estágio de Psicologia escolar realizado no Curso de Psicologia da Universidade Federal de Uberlândia (UFU). O estágio, pautado na Psicologia histórico-cultural, estava vinculado à organização e ao desenvolvimento de uma disciplina intitulada Psicologia: Ciência e Profissão, voltada para os alunos que ingressavam no referido curso. A ementa dessa disciplina vai ao encontro da necessidade de desenvolvimento de uma visão crítica e socialmente comprometida em relação à Psicologia, o que permite a constituição de um espaço de possibilidades de se considerar essa ciência e profissão de um modo mais amplo. As atividades desenvolvidas nos encontros buscavam instigar reflexões acerca da Universidade, da Psicologia como ciência e profissão e da vida acadêmica. Para embasar essas discussões, a Arte (cinema, pintura, teatro, literatura, música) foi utilizada como mote para a apropriação e a construção do próprio conhecimento. Descrevemos aqui a trajetória desse estágio e as suas repercussões na formação pessoal e profissional dos futuros psicólogos, dando destaque para as contribuições desencadeadas a partir do contato com a Arte tanto para os estagiários como para a supervisora...
This paper describes the experience acquired during a school psychology internship in the psychology course in the Federal University of Uberlândia (UFU). The internship, based on the culturalhistorical psychology, was linked to the organization and development of a course titled Psychology: Science and Profession, which is oriented towards freshmen students. The program of this course meets the need to develop a socially involved and critical vision of psychology, which allows the creation of a space of possibilities to think about this science and profession more broadly. The activities developed in the meetings sought to engage reflections about the University, about psychology as a science and profession and about the academic life. To serve as base for discussion, Art (cinema, painting, theatre, literature, music) was used as a theme for ownership and construction of self knowledge. We describe the results of the internship and its impact on the personal and professional education of future psychologists, highlighting the contributions triggered by the contact with Art...
El presente trabajo relata las experiencias vividas en una pasantía de Psicología escolar realizada en el Curso de Psicología de la Universidad Federal de Uberlândia (UFU). La pasantía, pautada en la Psicología histórico-cultural, estaba vinculada a la organización y al desarrollo de una disciplina titulada Psicología: Ciencia y Profesión, volcada a los alumnos que ingresaban en el referido curso. El contenido programático de esa disciplina va al encuentro de la necesidad de desarrollo de una visión crítica y socialmente comprometida con relación a la Psicología, lo que permite la constitución de un espacio de posibilidades de considerarse esa ciencia y profesión de un modo más amplio. Las actividades desarrolladas en los encuentros buscaban incitar reflexiones acerca de la Universidad, de la Psicología como ciencia y profesión y de la vida académica. Para la base esas discusiones, el Arte (cine, pintura, teatro, literatura, música) fue utilizado como recurso para la apropiación y la construcción del propio conocimiento. Describimos aquí la trayectoria de esa pasantía y sus repercusiones en la formación personal y profesional de los futuros psicólogos, dando destaque para las contribuciones desencadenadas desde el contacto con el Arte tanto para los practicantes como para la supervisora...
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Arte , Prácticas Clínicas , PsicologíaRESUMEN
Fever and a petechial rash are strongly associated with meningococcal disease in the city of Rio de Janeiro. Early antibiotic therapy is indicated and, consequently, a reduction of confirmed cases by culture, Gram stain, and latex agglutination test is expected. We evaluated a multiplex PCR assay to identify Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae in biological samples from cases of non-culture proven meningitis with a petechial rash at presentation. To detect DNA in cerebrospinal fluid (n = 71) or blood (n = 5), a PCR screen was performed, based on the crgA, ply and bexA targets, respectively. Of the total, 70 CSF and 3 blood samples (96%) were positive by PCR for the presence of N. meningitidis DNA. Another PCR assay predicted in 82% of these samples N. meningitidis serogroups A (2%), B (60%), C (7%), X (3%), Y (2%), 29E (2%) or W135 (24%). In non-culture proven meningitis, PCR was found to be a valuable adjunct for the demonstration of meningococcal aetiology.