RESUMO
To evaluate the possible role of parasitemia on Chagas' disease reactivation in Chagas' disease/human immunodeficiency virus (HIV) coinfection cases and the impact of HIV coinfection on Trypanosoma cruzi genetic diversity, 71 patients with Chagas' disease (34 HIV+ and 37 HIV-) were surveyed. Moreover, 92 T. cruzi stocks from 47 chronic chagasic patients (29 HIV+ and 18 HIV-) were isolated and analyzed by multilocus enzyme electrophoresis and a random amplified polymorphic DNA procedure. High parasitemia appeared to play a major role in cases of Chagas' disease reactivation. In HIV+ patients, the genetic diversity and population structure (clonality) of T. cruzi was similar to that previously observed in HIV- patients, which indicates that immunodepression does not modify drastically genotype repartition of the parasite. There was no apparent association between given T. cruzi genotypes and specific clinical forms of Chagas' disease/HIV associations.
Assuntos
Doença de Chagas/parasitologia , Infecções por HIV/parasitologia , Trypanosoma cruzi/genética , Adulto , Idoso , Animais , Brasil/epidemiologia , Doença de Chagas/complicações , Doença de Chagas/epidemiologia , Eletroforese em Acetato de Celulose , Ensaio de Imunoadsorção Enzimática , Variação Genética , Genótipo , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Isoenzimas/isolamento & purificação , Pessoa de Meia-Idade , Técnica de Amplificação ao Acaso de DNA Polimórfico , Trypanosoma cruzi/classificação , Trypanosoma cruzi/isolamento & purificaçãoRESUMO
Listeriosis is a not uncommon infection in humans, usually associated with immunodeficient states and with newborns. However, relatively few cases have been reported in HIV-infected patients. This scarcity of reported cases has aroused interest in the association of listeriosis and AIDS. In this paper we present a case of meningitis and septicemia caused by Listeria monocytogenes in a female patient with AIDS. A review of recent medical literature indicates that association of listeriosis and AIDS may be more common than it seems. Recent research in host-parasite interaction in listerial infection suggests an important role for tumor necrosis factor (TNF) and for integralin, a bacterial protein, in modulating listerial disease in AIDS patients. Inadequate diagnosis may be in part responsible for the scarcity of reports.