Depressão, desesperança e percepção de suporte familiar em pacientes com HTLV-1 / Depression, hopeless and family support in HTLV-1

Doenças crônicas e sem cura podem provocar sofrimento psíquico e insatisfatória qualidade de vida. Nesta pesquisa, foram abordados pacientes com infecção para HTLV-1 (vírus linfotrópico da célula humana do tipo 1), vírus sem cura que pode causar paresia ou plegia dos membros inferiores e leucemia/linfoma de células T do adulto (ATLL). Buscou-se compreender se o sofrimento psíquico (depressão e/ou desesperança) e a percepção da qualidade de vida destes pacientes poderiam fazer diferença na percepção de suporte familiar e ainda, se haveriam diferenças significativas entre os pacientes sintomáticos e assintomáticos, nos quesitos, depressão, desesperança, qualidade de vida e suporte familiar percebido. A coleta de dados aconteceu no ambulatório de HTLV do Instituto de Infectologia Emílio Ribas. A amostragem foi constituída por 59 pacientes, sendo que 31 eram sintomáticos e 28 assintomáticos para HAM/TSP (paraparesia espástica tropical), 43 (72,9%) eram do sexo feminino, as idades variaram entre 19 e 73 anos e a média foi de 50 anos. Os dados foram coletados por meio de 5 instrumentos: Questionário Sociodemográfico, Escala Beck de Depressão (BDI), Escala Beck de Desesperança (BHS), Inventário de Percepção de Suporte Familiar (IPSF) e Escala de Qualidade de Vida (SF-36). Para análise dos dados foram feitas análises descritivas teste t-student, coeficiente de correlação de Pearson e avaliação da diferença entre os grupos, através do d de Cohen. Os resultados apontaram os pacientes sintomáticos com maior grau de depressão, o grau de desesperança encontrado foi mínimo para ambos os grupos, a média de percepção de qualidade de vida tanto para assintomáticos, quanto para sintomáticos foi satisfatória, exceto no fator que avalia a Adaptação Familiar, que apresentou média-baixa. Foram encontradas correlações negativas e significativas somente entre desesperança e fator 1 do IPSF para os pacientes sintomáticos e entre desesperança e todos os fatores do IPSF, para os pacientes assintomáticos. Entre depressão e os fatores do IPSF verificou-se correlação negativa significativa para os sintomáticos somente com o fator 1 e para os pacientes assintomáticos somente entre o valor total e o fator 1. Entre os domínios de qualidade de vida e o IPSF verificou-se correlação com o valor total e o fator 1 e os domínios Capacidade Funcional e Aspectos Sociais. Conclui-se que pacientes sintomáticos e assintomáticos, participantes desta pesquisa, diferem-se nos níveis de depressão, em todos os domínios de qualidade de vida e no fator 3 do IPSF, referente a autonomia familiar. (AU)

Incurable chronic diseases can lead to psychological distress and poor quality oflife. This study has addressed patients with HTLV-1.....We sought to find out whether psychological distress (depression and/or hopelessness) andperceived quality of life could influence these patients’ perceived family support,and whether there would be significant differences between symptomatic andasymptomatic patients in term..... The sample consisted of 59patients: 31 were symptomatic; 28, asymptomatic for HAM/TSP (tropical spasticparaparesis); 43 (72.9%) were female, between 19-73 years old, and themedian age was 50. Five instruments were used for collecting data:Sociodemographic Questionnaire, Beck Depression Inventory (BDI), BeckHopelessness Scale (BHS), Inventory of Perceived Family Support (IPFS), andQuality of Life Scale (QOLS-36)...Symptomatic patients showed mid-low scores on perceived Family support, except the factor that evaluates Consistent Affective Aspects, whichs Yet, asymptomatic patients had medium-high scores in almost all categories, except the factor that evaluates Family Adjustment, which showed medium-low. We found negative, significant correlation betweenhopelessness and IPFS factor 1 for symptomatic patients, and betweenhopelessness and the overall total, factor 1, fator 2 and factor 3, forasymptomatic patients. We found negative, significant correlation betweendepression/IPFS factors for symptomatic patients and factor 1; for theasymptomatic patients, the same was found only between the overall total andfactor 1. We found correlation between quality of life and IPFS and the overalltotal and factor 1 and Functional Capacity and Social Aspects. We conclude that the participants in this study, both symptomatic and asymptomatic patients,show different levels of depression in all aspects of quality of life and in IPFSfactor 3, regarding family autonomy (AU).

Re-mapping the molecular features of the human immunodeficiency virus type 1 and human T-cell lymphotropic virus type 1 Brazilian sequences using a bioinformatics unit established in Salvador, Bahia, Brazil, to give support to the viral epidemiology studies

The analysis of genetic data for human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus type 1 (HTLV-1) is essential to improve treatment and public health strategies as well as to select strains for vaccine programs. However, the analysis of large quantities of genetic data requires collaborative efforts in bioinformatics, computer biology, molecular biology, evolution, and medical science. The objective of this study was to review and improve the molecular epidemiology of HIV-1 and HTLV-1 viruses isolated in Brazil using bioinformatic tools available in the Laboratório Avançado de Sáude Pública (Lasp) bioinformatics unit. The analysis of HIV-1 isolates confirmed a heterogeneous distribution of the viral genotypes circulating in the country. The Brazilian HIV-1 epidemic is characterized by the presence of multiple subtypes (B, F1, C) and B/F1 recombinant virus while, on the other hand, most of the HTLV-1 sequences were classified as Transcontinental subgroup of the Cosmopolitan subtype. Despite the high variation among HIV-1 subtypes, protein glycosylation and phosphorylation domains were conserved in the pol, gag, and env genes of the Brazilian HIV-1 strains suggesting constraints in the HIV-1 evolution process. As expected, the functional protein sites were highly conservative in the HTLV-1 env gene sequences. Furthermore, the presence of these functional sites in HIV-1 and HTLV-1 strains could help in the development of vaccines that pre-empt the viral escape process.

A unique seroepidemiological pattern of HBV, HCV and HTLV-I in Nenets and Komi in northwestern Russia.

An epidemiological study of hepatitis viruses type B (HBV) and type C (HCV) and human T-cell leukemia virus type I (HTLV-I) was carried out among 105 residents (male:female=19:86) regarded as Nenets partly mixed with Komi, in the region of Krasnoe, the Nenets Autonomous District of the Arkhangelsk Region, in northwestern Russia in 2004. Blood was drawn from apparently healthy volunteers at ages of 41.6+/-16.5 (range 14-85) years. HBsAg, HBsAb, HBcAb, HBeAb and HCV Ab were measured by microparticle enzyme-immunoassay, and HTLV-I Ab was measured by particle agglutination. Prevalences of HBsAg(+), HBsAb(+), HBcAb(+) and HBeAb(+) were 0.0%, 29.5.%, 20.0% and 7.6%, respectively. The overall HBV infection rate (positive HBsAb or HBcAb) was 34.3%, while no positive HCV or HTLV-I Abs could be detected. A serological subgroup with positive HBsAb and negative HBcAb, consisting of 15(14.3%) females, contrasted sharply to other serological subgroups in sex, age, parent's ethnicity, positive HBeAb rate, and HBcAb inhibition%. We conclude that HBV is prevalent with unique serological patterns among the Nenets, while HCV and HTLV-I infections are negligible.

Paraparesia espastica tropical asociada al HTLV-I en Santander / Tropical spastic paraparesis associated with HTLV-I in Santander

La paraparesia espastica tropical (PET) ha sido descrita como una enfermedad neurologica, endemica cronica, restringida a grupos raciales de ancestro africano en comunidades tropicales costeras. Recientemente se ha establecido que es causada por un Retrovirus denominado HTLV-I y que afecta diversos grupos raciales con descripciones cada vez mas numerosas en diversos paises, incluyendo zonas no tropicales. La OMS ha recomendado el nombre de PET/HAM (paraparesia espastica tropical/mielopatia asociada a HTLV-I) para destacar no solo el compromiso anatomico principal sino su etiologia. En Colombia la mayoria de los casos se han informado en la zona sur-occidental y es nuestro proposito presentar dos casos de PET con anticuerpos positivos contra el HTLV-I en suero y LCR, en hombres residentes en el oriente colombiano uno de ellos de raza negra y otro mestizo. Se actualizan algunos conceptos sobre la PET