Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon.

BACKGROUND: The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality. METHODS: The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1ß, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay. RESULTS: The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal-esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death. CONCLUSIONS: The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients.

Increased levels of reactive oxygen species in platelets and platelet-derived microparticles and the risk of respiratory failure in HIV/AIDS patients.

Respiratory failure (RF) is the main cause of hospital admission in HIV/AIDS patients. This study assessed comorbidities and laboratory parameters in HIV/AIDS inpatients with RF (N = 58) in relation to those without RF (N = 36). Tuberculosis showed a huge relative risk and platelet counts were slightly higher in HIV/AIDS inpatients with RF. A flow cytometry assay for reactive oxygen species (ROS) showed lower levels in platelets of these patients in relation to the healthy subjects. However, when stimulated with adrenaline, ROS levels increased in platelets and platelet-derived microparticles of HIV/AIDS inpatients, which may increase the risk of RF during HIV and tuberculosis (HIV-TB) coinfection.

Increased levels of reactive oxygen species in platelets and platelet-derived microparticles and the risk of respiratory failure in HIV/AIDS patients

Respiratory failure (RF) is the main cause of hospital admission in HIV/AIDS patients. This study assessed comorbidities and laboratory parameters in HIV/AIDS inpatients with RF (N = 58) in relation to those without RF (N = 36). Tuberculosis showed a huge relative risk and platelet counts were slightly higher in HIV/AIDS inpatients with RF. A flow cytometry assay for reactive oxygen species (ROS) showed lower levels in platelets of these patients in relation to the healthy subjects. However, when stimulated with adrenaline, ROS levels increased in platelets and platelet-derived microparticles of HIV/AIDS inpatients, which may increase the risk of RF during HIV and tuberculosis (HIV-TB) coinfection.

Polimorfismo do gene de receptor da leptina e a obesidade / Leptin receptor gene polymorphism and the obesity

Introdução: A obesidade consiste em um complexo conjunto de fatores comportamentais, ambientais e genéticos que se relacionam e se potencializam. Acredita-se que polimorfismos de nucleotídeo único (SNPs) possuam relação com a obesidade e que estejam hiperexpressos nesta condição. Objetivo: Revisar a relação da presença de polimorfismos no gene LEPR com a obesidade em crianças e adolescentes, buscando evidenciar condições e/ou fatores ambientais relacionados. Métodos: Trata-se de um artigo de atualização sobre o tema polimorfismo do LEPR e a associação com a obesidade. Resultados: Os dados levantados mostram a influência de polimorfismos do gene receptor de leptina (LEPR) com o desenvolvimento da obesidade, assim como fatores ambientais, tais como dieta hipercalórica na presença do polimorfismo, potencializam o desenvolvimento dessa condição clínica, resultando em aumento das medidas antropométricas e bioquímicas, na presença da mutação genética.

Introduction: Obesity consists of a complex set of behavioral, environmental and genetic factors that relate to and potentiate. It is believed that single nucleotide polymorphisms (SNPs) have relation with obesity and are hiperexpressos this condition. Objective: Review the relationship between the presence of polymorphisms in LEPR gene with obesity in children and adolescents, to disclosing conditions and / or related environmental factors. Methods: This is an update article on the topic LEPR polymorphism and the association with obesity. Results: The data collected show the influence of polymorphisms of the Leptin receptor gene (LEPR) with the development of obesity as well as environmental factors such as caloric diet in the presence of the polymorphism potentiate the development of this medical condition, resulting in increase of action anthropometric and biochemical in the presence of gene mutation.