The Virological and Immunological Characteristics of the HIV-1-Infected Population in Brazil: From Initial Diagnosis to Impact of Antiretroviral Use.

BACKGROUND: Immunological and virological status of HIV-infected individuals entering the Brazilian public system over time was analyzed. We evaluated the impact of ART on virological, immunological and antiretroviral resistance over time. METHODS: CD4+ T cell counts, viral loads and genotypes from patients over 13 years old from 2001-2011 were analyzed according to demographic data. We compared groups using parametric t-tests and linear regression analysis in the R statistical software language. RESULTS: Mean baseline CD4+ T cell counts varied from 348 (2003) to 389 (2009) and was higher among women (p = 1.1 x 10(-8)), lower in older patients (p< 1 x 10(-8)) and lower in less developed regions (p = 1.864 x 10(-5)). Percentage of treated patients with undetectable viral loads increased linearly from 46% (2001) to 77% (2011), was lower among women (p = 2.851 x 10(-6)), younger ages (p = 1 x 10(-3)), and in less developed regions (p = 1.782 x 10(-4)). NRTI acquired resistance was 86% in 2001-3 and decreased over time. NNRTI resistance increased from 2001-3(50%) to 2006-9 (60%), PI resistance decreased from 2001-3 (60%) to 2009 (40%), and 3-class resistance was stable over time around 25%. Subtype prevalence comprised B (75.3%), B/F recombinants (12.2%), C (5.7%), F (5.3%) and B/C recombinants (1.5%), with regional variations. Three-class resistance was 26.5% among Bs, 22.4% among Fs and 17.2% among Cs. CONCLUSIONS: HIV diagnosis occurs late, especially among elderly Brazilians. Younger individuals need special attention due to poor virological response to treatment. Antiretroviral Resistance profile is subtype related.

Human enterovirus infection in stray dogs: some aspects of interest to public health

Foram estudados 212 caes errantes, capturados em areas perifericas no municipio de Sao Paulo, com o objetivo de investigar o possivel papel desses animais como reservatorios de enterovirus humanos. Os animais capturados foram divididos em 19 grupos compostos por 10 a 20 animais cada um. Foram efetuadas tentativas de isolamento em amostras de fezes em 126/212 caes, obtendo-se resultados positivos em 12 deles, assim distribuidos: poliovirus tipo 1 (dois caes), poliovirus tipo 3 (um cao), echovirus tipo 7 (oito caes) e echovirus tipo 15 (um cao). Dos 12 animais infectados, quatro apresentaram anticorpos neutralizantes homotipicos com titulos>-16. Todos os 212 caes foram submetidos a pesquisa de anticorpos neutralizantes contra enterovirus humanos...

An exanthematic disease epidemic associated with coxsackievirus B3 infection in a day care center

E descrita uma epidemia de doenca exantematica em uma creche, acometendo 10 criancas de 7 a 13 meses de idade. O quadro exantematico caracterizou-se por lesoes maculo ou maculopapulares nao confluentes, que atingiam a face, tronco e pernas. 50 por cento das criancas infectadas apresentaram febre de ate 39 graus C, no inicio da doenca. Foi isolado das fezes de uma crianca doente o coxsackievirus B3 (CB3). Foram examinados soros pareados de 8 das 10 criancas doentes e em 6 delas demonstrou-se soroconversao para CB3...