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1.
Viruses ; 14(11)2022 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-36366437

RESUMO

(1) Background: Tropical spastic paraparesis (TSP/HAM) associated with the T cell lymphotropic virus in type I humans (HTLV-1) is a slow, chronic, and progressive disease that causes balance changes. TSP/HAM diagnosis can be classified as probable, possible, and definite. We compared the static balance control of HTLV-1-infected patients with different TSP/HAM diagnosis. (2) Methods: Our sample consisted of 13 participants infected with HTLV-1 and 16 healthy participants. The center of pressure was recorded using a force platform with open and closed eyes. We divided the recordings into three intervals, period T1 (corresponds to the first 10 s); period T2 (from 10 to 45 s); period T3 (from 45 to 55 s). (3) Results: Eight participants infected with HTLV-1 were classified as probable TSP/HAM and five participants infected with HTLV-1 were classified as definite TSP/HAM. There was a significant increase in postural instability in patients with definite PET/MAH considering the structural and global variables of body sway compared to the control and the probable TSP/HAM. (4) Conclusions: We concluded that the severity of balance is directly related to the degree of signs and symptoms of TSP/HAM.


Assuntos
Infecções por HTLV-I , Vírus Linfotrópico T Tipo 1 Humano , Paraparesia Espástica Tropical , Humanos , Paraparesia Espástica Tropical/diagnóstico , Diagnóstico Diferencial , Voluntários Saudáveis
2.
Viruses ; 14(2)2022 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-35215762

RESUMO

BACKGROUND: The aim of the present study was to evaluate the immunological profile of adult HIV-1+ patients coinfected with primary Epstein-Barr virus (EBV) infection who were free of antiretroviral drugs and inhabitants of the Brazilian Amazon region. MATERIALS AND METHODS: Primary EBV infection was screened by the semiquantitative detection of IgM and IgG anti-VCA. Genotypes were determined by conventional PCR. EBV and HIV viral load (VL) were quantified by real-time PCR. Cytokine dosage and cell quantification were performed by cytometry. RESULTS: Only HIV-1+ individuals had primary EBV infection (7.12%). The EBV-1 genotype was the most prevalent (47.37%). The VL of HIV-1 was lower in the HIV/EBV-2 group. CD4+ T lymphocytes were inversely proportional to the VL of EBV in HIV/EBV-1/2 multi-infected patients. The HIV/EBV-2 group had the lowest cytokine levels, especially IFN-γ and IL-4. Different correlations were proposed for each coinfection. The late search for specific care related to HIV infection directly affected the cytokine profile and the number of CD8+ T lymphocytes. Symptoms were associated with the increase in VL of both viruses and cytokine profile. CONCLUSIONS: Different immunological profiles were associated with EBV genotypes in primary infection, with EBV-2 being more frequent in patients with low levels of HIV viral load. With late infection monitoring and consequent delay in the initiation of HAART, clinical changes and effects on the maintenance of the immune response were observed.


Assuntos
Infecções por Vírus Epstein-Barr/virologia , Infecções por HIV/imunologia , HIV-1/imunologia , Herpesvirus Humano 4/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Coinfecção , Estudos Transversais , Infecções por Vírus Epstein-Barr/imunologia , Infecções por Vírus Epstein-Barr/patologia , Feminino , Genótipo , Infecções por HIV/virologia , Soropositividade para HIV , Herpesvirus Humano 4/imunologia , Humanos , Imunidade , Masculino , Pessoa de Meia-Idade , Carga Viral , Adulto Jovem
3.
PLoS One ; 16(12): e0261864, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34965281

RESUMO

Previous observational studies have demonstrated the development of pulmonary impairments in human T-lymphotropic virus type 1 (HTLV-1) infected individuals. The main observed lesions due to chronic inflammation of viral infection in situ are bronchiectasis and lung-scarring injuries. This lung inflammation may be the causal agent of restrictive and obstructive lung diseases, primarily in tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP-HAM) patients. We conducted a prospective cohort study to compare spirometry and high-resolution computed tomography (HRCT) findings among 28 HTLV-1-carrier patients over the course of 6 years (2014-2019) (male/female: 7/21; mean age: 54.7 ± 9.5, range: 41-68 years). Chest HRCT exams revealed the development and evolution of lung lesions related to TSP-HAM: including centrilobular nodules, parenchymal bands, lung cysts, bronchiectasis, ground-glass opacity, mosaic attenuation, and pleural thickening. Spirometry exams showed maintenance of respiratory function, with few alterations in parameters suggestive of obstructive and restrictive disorders primarily in individuals with lung lesions and TSP-HAM. The findings of the present study indicate that pulmonary disease related to HTLV-1 is a progressive disease, with development of new lung lesions, mainly in individuals with TSP-HAM. To improve clinical management of these individuals, we recommend that individuals diagnosed with PET-MAH undergo pulmonary evaluation.


Assuntos
Infecções por HTLV-I/diagnóstico por imagem , Lesão Pulmonar/diagnóstico por imagem , Pneumonia/diagnóstico por imagem , Adulto , Idoso , Estudos de Coortes , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
4.
Immunobiology ; 226(1): 152050, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33338979

RESUMO

Human T-lymphocytic virus 1 (HTLV-1) is mainly associated with adult T-cell leukemia/lymphoma (ATLL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Patients with HAM/TSP exhibit significant changes in their immune response, and HTLV-1 infection can interfere in cytokine production and perhaps in T cell production. The aims of this study were to evaluate thymic function in HAM/TSP patients and HTLV-1 healthy carriers (HCs) and correlate it to age and interleukin 7 (IL-7) gene expression. Thymic function in 21 HAM/TSP patients and 12 HCs was evaluated by quantifying T cell receptor rearrangement excision circle (TREC) particles and IL-7 gene expression, both measured by quantitative polymerase chain reaction. HAM/TSP patients presented lower TREC particle counts (p = 0.0112) and lower IL-7 expression (p = 0.0102) than HCs. Both TREC particles and IL-7 gene expression were separately analyzed in two age groups: ≤ 59 years and ≥60 years, The ≤59-year-old HAM/TSP patients had a lower TREC count compared with the ≤59-year-old HCs (p = 0.0476). In conclusion, HAM/TSP development could interfere with thymic function because the results showed TREC particle reduction in HAM/TSP patients in relation to HCs, and it could be associated with a concomitant reduction in IL-7 expression.


Assuntos
Infecções por HTLV-I/imunologia , Vírus Linfotrópico T Tipo 1 Humano/fisiologia , Paraparesia Espástica Tropical/imunologia , Linfócitos T/imunologia , Timo/imunologia , Adolescente , Adulto , Idoso , Progressão da Doença , Feminino , Regulação da Expressão Gênica , Humanos , Interleucina-7/metabolismo , Ativação Linfocitária , Masculino , Pessoa de Meia-Idade , Receptores de Antígenos de Linfócitos T/genética , Adulto Jovem
5.
Braz J Infect Dis ; 24(4): 322-329, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32619403

RESUMO

Two types of Epstein Barr virus (EBV1/EBV2) have been shown to infect humans. Although their genomes are similar, the regions containing the EBNA genes differ. This study aimed to characterize the EBV genotypes of infectious mononucleosis (IM) cases in the metropolitan region of Belém, Brazil, from 2005 to 2016. A total of 8295 suspected cases with symptoms/signs of IM were investigated by infectious disease physicians at Evandro Chagas Institute, Health Care Service, from January 2005 to December 2016. Out of the total, 1645 (19.8%) samples had positive results for EBV by enzyme immunoassay and 251 (15.3%) were submitted to polymerase chain reaction (PCR) technique, using the EBNA3C region, in order to determine the type of EBV. Biochemical testing involving aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase were also performed. EBV type was identified by PCR in 30.3% (76/251) of individuals; of those, 71.1% (54/76) were classified as EBV1, 17.1% (13/76) as EBV2, and 11.8% (9/76) as EBV1 + EBV2. The main symptoms/signs observed with EBV1 infection were cervical lymphadenopathy (64.8%, 35/54), fever (63%, 34/54), headache (20.4%, 11/54), arthralgia (20.4%, 11/54), and exanthema (18.5%, 10/54). EBV2 infection was detected in all but two age groups, with an average age of 24 years. The most common signs/symptoms of EBV2 were fever (76.9%, 10/13), average duration of 18 days, and lymphadenopathy (69.2%, 9/13). In contrast, EBV1 + EBV2 coinfections were more frequent in those aged five years or less (20.0%, 2/10). The symptoms of EBV1 + EBV2 coinfection included fever (66.7%, 6/9), and cervical lymphadenopathy and headache (33.3%, 3/9) each. The mean values of hepatic enzymes according to type of EBV was significantly different (p < 0.05) in those EBV1 infected over 14 years of age. Thus, this pioneering study, using molecular methods, identified the EBV genotypes in 30.3% of the samples, with circulation of EBV1, EBV2, and EBV1 + EBV2 co-infection in cases of infectious mononucleosis in the northern region of Brazil.


Assuntos
Infecções por Vírus Epstein-Barr/epidemiologia , Herpesvirus Humano 4/genética , Mononucleose Infecciosa/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Pré-Escolar , Genótipo , Humanos , Adulto Jovem
6.
Life Sci ; 256: 117979, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32553930

RESUMO

This study analyzed the relationship between infection by human T-cell lymphotropic virus type 1 (HTLV-1) and changes in the pulmonary system. Cohort and case-control study models that analyzed a causal association between HTLV-1 and changes in the pulmonary system were considered. There were no restrictions on language and publication period. The study was registered in the PROSPERO systematic analysis database (Protocol No. CRD42017078236) and was prepared according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The following databases were used: PubMed, BVS Regional Portal, Embase, CINAHL and Web of Science. We utilized the Newcastle-Ottawa Scale to assess the methodological quality of published studies and the Kappa coefficient to assess the agreement level between two reviewers. Of the total 1156 studies retrieved by the search strategy, 28 were considered potentially eligible (Kappa test = 0.928). Of the 28 studies, three fully met the inclusion criteria. These indicated that pulmonary lesions, such as bronchiectasis and bronchitis/bronchiolitis, were observed in patients with HTLV-1, with high-resolution computed tomography of the chest being the main method of diagnostic investigation. The analyzed cohort and case-control studies indicated an etiological relationship between HTLV-1 infection and the presence of lung lesions, with emphasis on bronchiectasis in the presence of high viral loads, as well as a higher mortality in these individuals compared with the general population.


Assuntos
Infecções por HTLV-I/diagnóstico por imagem , Vírus Linfotrópico T Tipo 1 Humano , Pneumopatias/diagnóstico por imagem , Animais , Estudos de Casos e Controles , Estudos de Coortes , Infecções por HTLV-I/fisiopatologia , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Humanos , Pneumopatias/fisiopatologia , Infecções Respiratórias/diagnóstico por imagem , Infecções Respiratórias/fisiopatologia
7.
Rev. Soc. Bras. Med. Trop ; 51(2): 141-145, Mar.-Apr. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-897064

RESUMO

Abstract INTRODUCTION: Human cytomegalovirus is one of the causes of opportunist infections in immunocompromised patients, and is triggered by factors such as state of viral latency, weakened immune responses, and development of antiviral resistance to ganciclovir, the only drug offered by the public health system in Brazil to treat the infection. The goal of this study was to identify mutations that may be associated with antiviral resistance in immunocompromised patients. METHODS: Molecular analysis was performed in 82 blood samples and subjected to genomic DNA extraction by a silica-based method. Three sequences of the HCMV UL97 gene, which encodes a phosphotransferase protein required for activation of ganciclovir, were amplified by polymerase chain reaction. Pyrosequencing methods were applied to one external 2096-bp segment DNA and two internal sequences between nucleotides 1087 to 1828 to detect mutations in this gene. RESULTS: Approximately 10% of sequences contained mutations between nucleotides 377 and 594, in conserved regions of the UL97 gene, leading to amino acid changes. Eleven coding mutations were identified, including changes leading to amino acid substitutions, E596K and S604F, which were observed in 100% of samples and are described for the first time in Brazil. In addition, one mutation (A594V) that is associated with ganciclovir resistance was detected in a kidney transplant patient. CONCLUSIONS: Further studies to detect mutations associated with HCMV resistance to antiviral drugs are required to demonstrate the need to increase the variety and availability of drugs used to treat viral infections in the public health care system in Brazil.


Assuntos
Humanos , Antivirais/uso terapêutico , Fosfotransferases/genética , Hospedeiro Imunocomprometido , Infecções por Citomegalovirus/tratamento farmacológico , Citomegalovirus/enzimologia , Farmacorresistência Viral/genética , Mutação/genética , Antivirais/farmacologia , Estudos de Casos e Controles , Reação em Cadeia da Polimerase , Estudos Transversais , Citomegalovirus/efeitos dos fármacos , Citomegalovirus/genética , Farmacorresistência Viral/efeitos dos fármacos , Genótipo
8.
PLoS One ; 13(3): e0194184, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29558516

RESUMO

The Human T-cell Lymphotropic Virus (HTLV-1) is a Deltaretrovírus that was first isolated in the 1970s, and associated with Adult T-cell Leucemia-Lymphoma (ATLL), and subsequently to Tropical Spastic Paraparesis-Myelopathy (TSP/HAM). The genetic diversity of the virus varies among geographic regions, although its mutation rate is very low (approximately 1% per thousand years) in comparison with other viruses. The present study determined the genetic diversity of HTLV-1 in the metropolitan region of Belém, in northern Brazil. Blood samples were obtained from patients at the UFPA Tropical Medicine Nucleus between January 2010 and December 2013. The DNA was extracted and the PX region of the HTLV was amplified using nested PCR. The positive samples were then digested using the Taq1 enzyme for the identification and differentiation of the HTLV-1 and HTLV-2. The 5'LTR region of the positive HTLV-1 samples were amplified by nested PCR, and then sequenced genetically. The phylogenetic analysis of the samples was based on the maximum likelihood method and the evolutionary profile was analyzed by the Bayesian approach. Overall, 78 samples tested positive for HTLV-1, and 44 were analyzed here. The aA (cosmopolitan-transcontinental) subtype was recorded in all the samples. The following evolutionary rates were recorded for the different subtypes-a: 2.10-3, b: 2.69. 10-2, c: 6.23. 10-2, d: 3.08. 10-2, e: 6. 10-2, f: 1.78. 10-3, g: 2.2. 10-2 mutations per site per year. The positive HTLV-1 samples tested in the present study were characterized by their low genetic diversity and high degree of stability.


Assuntos
Variação Genética , Vírus Linfotrópico T Tipo 1 Humano/genética , Leucemia-Linfoma de Células T do Adulto/genética , Sequências Repetidas Terminais , Adulto , Brasil/epidemiologia , Feminino , Humanos , Leucemia-Linfoma de Células T do Adulto/enzimologia , Masculino
9.
Cytokine ; 77: 79-87, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26546777

RESUMO

The present study is the first investigation of the association between single nucleotide polymorphisms (SNPs - rs8099917, rs12979860 and rs8103142) of the IL28B gene and the development of human T-lymphotropic virus (HTLV)-associated arthropathy (HAA). Individuals with HAA exhibited low interleukin (IL) 6 (p<0.05) and high IL-10 (p<0.05) levels compared with asymptomatic patients. TNF-α/CD4(+) T cell count, TNF-α/CD8(+) T cell count and IFN-γ/proviral load positively correlated in asymptomatic patients. The allelic and genotypic frequencies did not differ between patients with HAA and asymptomatic patients. Seven haplotypes were detected in the investigated population, with haplotype CCT (p<0.05) being the most frequent among the HTLV-infected individuals, while haplotype TTG (p<0.05) was detected in the group with HAA only. Compared with asymptomatic patients, individuals with HAA and genotype TT (rs8099917) exhibited larger numbers of CD8(+) T cells (p<0.05) and higher proviral load levels (p<0.05). Those patients with HAA and genotypes CC (rs12979860) and TT (rs8103142) exhibited high TNF-ß (p<0.05) and IFN-γ (p<0.05) levels. Those patients with HAA and genotype CT/TT (rs12979860) exhibited high IL-10 levels (p<0.05). These results suggest that haplotypes CCT and TTG might be associated with susceptibility to HTLV infection and progression to HAA, respectively. Genotype TT (rs8099917) might be a risk factor for elevation of the proviral load and CD8(+) T cell count. In addition, genotypes CC (rs12979860) and TT (rs8103142) seem to be associated with increased TNF-ß and IFN-γ levels.


Assuntos
Artrite Infecciosa/virologia , Citocinas/metabolismo , Infecções por Deltaretrovirus/virologia , Deltaretrovirus/fisiologia , Interleucinas/genética , Polimorfismo de Nucleotídeo Único , Alelos , Artrite Infecciosa/genética , Artrite Infecciosa/metabolismo , Linfócitos T CD4-Positivos/metabolismo , Linfócitos T CD8-Positivos/metabolismo , Infecções por Deltaretrovirus/genética , Infecções por Deltaretrovirus/metabolismo , Feminino , Frequência do Gene , Genótipo , Haplótipos , Interações Hospedeiro-Patógeno , Humanos , Interferon gama/metabolismo , Interferons , Interleucina-10/metabolismo , Interleucina-6/metabolismo , Contagem de Linfócitos , Masculino , Células Th1/metabolismo , Células Th2/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Carga Viral
10.
Microb Pathog ; 92: 72-75, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26626960

RESUMO

HTLV-1 infects principally CD4+ T cells that are the main reservoirs of the virus in vivo, which play an important role in the immunological response. Most of the infected patients are asymptomatic. However, 2-3% of patients will develop HAM/TSP or Adult T lymphoma. HAM/TSP is a chronic inflammatory disease of the central nervous system, which is characterized by unremitting myelopathic symptoms. Studies have shown that cytokines levels alterations (IFN-γ and TNF-α) were associated with tissue injury in HAM/TSP. The aims of this study were to compare the gene expression of IFN-γ, IL-4 and IL-10 of asymptomatic and HAM/TSP HTLV-1 infected patients, and to correlate the gene expression with those of clinical symptoms. 28 subjects were included, 20 asymptomatic HTLV-1 and 8 with HAM/TSP. Spasticity was evaluated using the Modified Ashworth Scale and the degree of walking aid was classified on a progressive scale. The relative gene expression of IFN-γ, IL-4, and IL-10 was measured by Real-Time PCR. Results showed high gene expression of IFN-γ for all patients, but it was higher among HAM/TSP. A significant correlation was observed between IFN-γ gene expression and the degree of walking aid, and IFN-γ gene expression was higher among wheelchair users compared to non-wheelchair users. No association was found with IL-4 and IL-10. These findings indicate that HAM/TSP patients express higher amounts of IFN-γ than asymptomatic patients, and more importantly, the expression of this cytokine was strongly correlated with the need of walking aid.


Assuntos
Vírus Linfotrópico T Tipo 1 Humano/imunologia , Imunidade , Paraparesia Espástica Tropical/diagnóstico , Paraparesia Espástica Tropical/etiologia , Adulto , Idoso , Citocinas/genética , Citocinas/metabolismo , Progressão da Doença , Feminino , Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade
11.
Rev. Soc. Bras. Med. Trop ; 47(6): 810-813, Nov-Dec/2014. graf
Artigo em Inglês | LILACS | ID: lil-732983

RESUMO

Malaria remains a major public health problem in Brazil where Plasmodium vivax is the predominant species, responsible for 82% of registered cases in 2013. Though benign, P. vivax infection may sometimes evolve with complications and a fatal outcome. Here, we report a severe case of P. vivax malaria in a 35-year-old Brazilian man from a malaria endemic area, who presented with reversible myocarditis.


Assuntos
Adulto , Humanos , Masculino , Malária Vivax/complicações , Miocardite/parasitologia , Malária Vivax/diagnóstico , Miocardite/diagnóstico
12.
Rev Soc Bras Med Trop ; 47(1): 90-2, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24553802

RESUMO

INTRODUCTION: The genomic heterogeneity of hepatitis C virus (HCV) influences liver disorders. This study aimed to determine the prevalence of HCV genotypes and to investigate the influence of these genotypes on disease progression. METHODS: Blood samples and liver biopsies were collected from HCV-seropositive patients for serological analysis, biochemical marker measurements, HCV genotyping and histopathological evaluation. RESULTS: Hepatitis C virus-ribonucleic acid (HCV-RNA) was detected in 107 patients (90.6% with genotype 1 and 9.4% with genotype 3). Patients infected with genotype 1 exhibited higher mean necroinflammatory activity and fibrosis. CONCLUSIONS: HCV genotype 1 was the most prevalent and was associated with greater liver dysfunction.


Assuntos
Hepacivirus/genética , Hepatite C Crônica/virologia , Cirrose Hepática/virologia , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biópsia , Progressão da Doença , Feminino , Genótipo , Hepatite C Crônica/enzimologia , Hepatite C Crônica/patologia , Humanos , Cirrose Hepática/patologia , Masculino , RNA Viral/sangue , gama-Glutamiltransferase/sangue
13.
Rev. Soc. Bras. Med. Trop ; 47(1): 90-92, Jan-Feb/2014. tab
Artigo em Inglês | LILACS | ID: lil-703154

RESUMO

Introduction: The genomic heterogeneity of hepatitis C virus (HCV) influences liver disorders. This study aimed to determine the prevalence of HCV genotypes and to investigate the influence of these genotypes on disease progression. Methods: Blood samples and liver biopsies were collected from HCV-seropositive patients for serological analysis, biochemical marker measurements, HCV genotyping and histopathological evaluation. Results: Hepatitis C virus-ribonucleic acid (HCV-RNA) was detected in 107 patients (90.6% with genotype 1 and 9.4% with genotype 3). Patients infected with genotype 1 exhibited higher mean necroinflammatory activity and fibrosis. Conclusions: HCV genotype 1 was the most prevalent and was associated with greater liver dysfunction. .


Assuntos
Adulto , Feminino , Humanos , Masculino , Hepacivirus/genética , Hepatite C Crônica/virologia , Cirrose Hepática/virologia , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biópsia , Progressão da Doença , Genótipo , Hepatite C Crônica/enzimologia , Hepatite C Crônica/patologia , Cirrose Hepática/patologia , RNA Viral/sangue , gama-Glutamiltransferase/sangue
14.
PLoS Negl Trop Dis ; 7(6): e2272, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23785534

RESUMO

BACKGROUND: HTLV-1 is a retrovirus that causes lymphoproliferative disorders and inflammatory and degenerative diseases of the central nervous system in humans. The prevalence of this infection is high in parts of Brazil and there is a general lack of public health care programs. As a consequence, official data on the transmission routes of this virus are scarce. OBJECTIVE: To demonstrate familial aggregation of HTLV infections in the metropolitan region of Belém, Pará, Brazil. METHOD: A cross-sectional study involving 85 HTLV carriers treated at an outpatient clinic and other family members. The subjects were tested by ELISA and molecular methods between February 2007 and December 2010. RESULTS: The prevalence of HTLV was 43.5% (37/85) for families and 25.6% (58/227) for the family members tested (95% CI: 1.33 to 3.79, P = 0.0033). Sexual and vertical transmission was likely in 38.3% (23/60) and 20.4% (29/142) of pairs, respectively (95% CI: 1.25 to 4.69, P = 0.0130). Positivity was 51.3% (20/39) and 14.3% (3/21) in wives and husbands, respectively (95% CI: 0.04 to 0.63, P = 0.0057). By age group, seropositivity was 8.0% (7/88) in subjects <30 years of age and 36.7% (51/139) in those of over 30 years (95% CI: 0.06 to 0.34, P<0.0001). Positivity was 24.1% (7/29) in the children of patients infected with HTLV-2, as against only 5.8% (4/69) of those infected with HTLV-1 (95% CI: 0.05 to 0.72, P = 0.0143). CONCLUSION: The results of this study indicate the existence of familial aggregations of HTLV characterized by a higher prevalence of infection among wives and subjects older than 30 years. Horizontal transmission between spouses was more frequent than vertical transmission. The higher rate of infection in children of HTLV-2 carriers suggests an increase in the prevalence of this virus type in the metropolitan region of Belém.


Assuntos
Infecções por Deltaretrovirus/epidemiologia , Saúde da Família , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Vírus Linfotrópico T Tipo 2 Humano/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/transmissão , Estudos Transversais , Infecções por Deltaretrovirus/transmissão , Transmissão de Doença Infecciosa , Feminino , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/epidemiologia , Estudos Soroepidemiológicos , Adulto Jovem
15.
Rev. para. med ; 26(1)jan.-mar. 2012. tab
Artigo em Português | LILACS-Express | LILACS | ID: lil-652216

RESUMO

Objetivo: descrever as características espirométricas e clínicas dos pacientes com fibrose císticacolonizados por Pseudomonas aeruginosa atendidos no Hospital Universitário João de BarrosBarreto (HUJBB), no estado do Pará, Brasil. Método: estudo retrospectivo nos prontuários de 44pacientes, período de 1997-2007, que atenderam aos critérios de inclusão, sendo 14 colonizadospor P. aeruginosa. Resultados: no grupo colonizado 10 eram do sexo feminino; a idade média dossintomas iniciais foi de 0.3±0.6 anos, com diferença significativa quando comparado com pacientesnão colonizados (p<0.05). A idade média ao diagnóstico foi de 13.1±10.8 nos colonizados, todosapresentando sintomas respiratórios persistentes ao diagnóstico. A média dos valores percentuaispreditos das espirometrias, referentes à avaliação inicial e final, do grupo colonizado foiVEF1(60.0± 25.0%) e (47,82±16.1%) e FEF25-75%(42.5± 22.9%) e (26,5±17.9%) e no grupo nãocolonizado foi VEF1(79.2± 21.0%) e (79,6±18.0%) e FEF25-75%(69.2± 26.7%) e (68,9±26.8%),respectivamente (p<0.005). A média do escore de Shwachman inicial nos colonizados foi de42.9±13.5 e nos não colonizados foi de 68.4±15.1(p<0.0001) e na avaliação final foi de 36.6±18.7 e73.6±12.3 (p<0.0001), respectivamente. Os fatores relacionados aos óbitos foram: colonização porP. aeruginosa, estado nutricional deficiente e VEF1 reduzido. Conclusões: o comprometimento dafunção pulmonar foi maior entre os pacientes com fibrose cística colonizados por P. aeruginosa,apresentando idade média mais elevada ao diagnóstico do que em outros estados brasileiros. Hánecessidade de ações para diagnóstico precoce no estado do Pará, propiciando abordagemterapêutica eficaz com aumento da sobrevida e qualidade de vida destes indivíduos.


Objective: to evaluate spirometric and clinic characteristics of patients who present cystic fibrosisand who are attended at João de Barros Barreto University Hospital (HUJBB), in the State of Pará,Brazil. Methods: a retrospective study was performed with 44 patient records that were attended atHUJBB during the 1997 to 2007; these patients fit into inclusion criteria, in which 14 presented P.aeruginosa bacteria colony. Results: within the group, who was colonized by P. aeruginosa, tenpatients were women and the median age for their initial symptoms was of 0.3 ± 0.6 year which wassignificantly different when compared with patients who didn?t present the bacteria colony (p?0.05). The median age for diagnosis was of 13.1 ± 10.8 in colonized patients and all of thempresented respiratory symptoms pertaining to the diagnosis. The median of the predicted percentagevalues of spirometries for initial and final evaluation of the colonized group was VEF1 (60.0 ±25.0%) and (47,82 ± 16.1%) and FEF 25-75% (42.5 ± 22.9%) and (26.5 ± 17.9%), and in the noncolonizedgroup, the median was VEF1 (79.2 ± 21.0%) and (79,6 ± 18.0%) and FEF 25-75% (69.2± 26.7%) and (68.9 ± 26.8%), respectively (p? 0.005). The median initial Shwachman score in thecolonized patients was 42.9 ± 13.5 and in the non-colonized patients it was 68.4 ± 15.1 (p? 0.0001),and at the final evaluation the median was 36.6 ± 18.7 and 73.6 ± 12.3 (p? 0.0001), respectively.Factors related to deaths found in the study were related to P. aeruginosa colonization, inadequatenutritional status and reduced VEF1. Conclusions: in the studied casuistry, a larger damage torespiratory function in P. aeruginosa colonized group and older median age for diagnosis werefound in the State of Pará when compared to other Brazilian States. There is the need for actiontowards precocious diagnosis in the State of Pará so that an efficient therapeutic approach is put intopractice guiding to survival increase and quality of life for these individuals.

16.
Rev. Pan-Amazônica Saúde (Online) ; 1(2): 23-26, 2010. tab
Artigo em Português | ColecionaSUS | ID: biblio-945902

RESUMO

INTRODUÇÃO: Com o advento da terapia antirretroviral de alta atividade em 1996, a doença hepática tornou-se causa importante de morbidade e mortalidade em pessoas infectadas pelo vírus da imunodeficiência humana-1 (HIV-1). OBJETIVO: Descrever os aspectos demográficos e laboratoriais de 62 pacientes coinfectados com o vírus da imunodeficiência humana e da hepatite C (HIV-1/HCV). MÉTODO: Estudo transversal, incluindo pacientes portadores do HIV, confirmados sorologicamente (ELISA + Imunofluorescência indireta ou Western Blot), com anti-HCV positivos pelo teste de ELISA confirmados por RT-PCR, atendidos no ambulatório de fígado da Fundação Santa Casa de Misericórdia do Pará no período de agosto de 2004 até abril de 2008. RESULTADOS: Foram atendidos 49 (79 por cento) indivíduos do gênero masculino e 13 indivíduos do gênero feminino, com mediana de idade de 42,6 anos, solteiros (66, por cento. n = 41), heterossexuais (59,7 por cento, n = 37), bissexuais (27,4 por cento, n = 17), homem que faz sexo com homem HSH (12,9 por cento. n = 8); contagem de linfócitos T CD4+ com mediana de 327 células/mm3, carga viral plasmática do HIV com mediana de 2,54 log10 HIV-RNA cópias/mL, carga viral do HCV (HCV-RNA) de 5,90 log10 UI/mL. O genótipo 1 do HCV foi encontrado em 60,87 por cento. A biópsia hepática foi realizada em 41 (66,12 por cento) pacientes, tendo sido observada a seguinte classificação METAVIR: F0 (12 por cento), F1 (24,4 por cento), F2 (32 por cento), F3 (17 por cento) e F4 (14,6 por cento). CONCLUSÃO: Os pacientes eram predominantemente solteiros,com carga viral do HCV elevada, apresentavam fibrose de moderada a severa em mais de 50 por cento dos casos sem alterações laboratoriais significativas...


INTRODUCTION: Since highly active antiretroviral therapy was developed in 1996, liver injury has become an important cause of morbidity and mortality in individuals infected by the human immunodeficiency virus-1 (HIV-1). OBJECTIVE: To report the demographic and laboratory findings of 62 patients coinfected with HIV-1/HCV. METHODS: This cross-sectional study analyzed HIV patients, confirmed serologically by ELISA and indirect immunofluorescence or Western Blot, with positive anti-HCV by ELISA and confirmed by RT-PCR. These patiens were treated at the Liver Department of the Fundação Santa Casa de Misericórdia do Pará from August 2004 to April 2008. RESULTS: A total of 49 (79 per cent) male and 13 female patients were analyzed. Their age median was 42.6 years and they were single (66.1 per cent n=41), heterosexual (59.7 per cent, n = 37), bisexual (27.4 per cent, n = 17), man who have sex with man MSM (12.9 per cent, n = 8); the lymphocytes T CD4+ count median was 327 cells/mm3, HIV serum viral load median was 2.54 log10 HIV RNA copies/mL, HCV viral load (RNA-HCV) was 5.9 log10 UI/mL. The HCV genotype 1 was found in 60.87 per cent of the patients. Forty-one (66.12 per cent) patients were submitted to liver biopsies and the histopathology results according to METAVIR were F0 (12 per cent), F1 (24.4 per cent), F3 (17 per cent), F4 (14.6 per cent). CONCLUSION: Patients were predominantly single, with high viral load. They presented with moderate to severe fibrosis in more than 50 per cet of cases without significant changes in their laboratory findings...


Assuntos
Masculino , Feminino , Humanos , HIV , Estudos Transversais , Ensaio de Imunoadsorção Enzimática/métodos , Hepacivirus/patogenicidade , Hepatite C Crônica
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