RESUMEN
AIM: This study compared lactoferrin (LF) levels in the gingival crevicular fluid (GCF) and saliva between HIV-infected and noninfected patients with chronic periodontitis. METHODS: For each subject, LF levels were analyzed in one shallow site (SS; PD ≤3 mm), one deep site (DS; PD >5 mm) and in resting whole saliva. Two groups, 28 HIV-infected and 10 noninfected, were selected. RESULTS: Although the salivary LF levels were higher in HIV-infected than in noninfected individuals, especially in AIDS patients, this was not statistically significant (P > 0.05). Subgingival LF levels for SS and DS were lower among HIV-infected individuals, although AIDS patients showed the lowest levels. Age, smoking, gender, T CD4 lymphocytes levels and viral load did not influence subgingival LF levels, neither for SS nor for DP. Positive fungal culture was observed in 24 HIV-infected patients, but only observed in one in the control group. Overall, LF concentration was significantly higher in DS than SS, both in HIV-infected and noninfected individuals (P < 0.05) and salivary LF levels were always higher than GCF levels. CONCLUSION: The data indicate that LF levels in the GCF and saliva are not different between HIV-infected and noninfected patients with chronic periodontitis.
Asunto(s)
Periodontitis Crónica/metabolismo , Líquido del Surco Gingival/química , Infecciones por VIH/metabolismo , Lactoferrina/análisis , Saliva/química , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/metabolismo , Adolescente , Adulto , Factores de Edad , Recuento de Linfocito CD4 , Candida albicans/aislamiento & purificación , Periodontitis Crónica/complicaciones , Índice de Placa Dental , Femenino , Infecciones por VIH/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Mucosa Bucal/microbiología , Pérdida de la Inserción Periodontal/complicaciones , Pérdida de la Inserción Periodontal/metabolismo , Índice Periodontal , Bolsa Periodontal/complicaciones , Bolsa Periodontal/metabolismo , Factores Sexuales , Fumar/metabolismo , Lengua/microbiología , Carga Viral , Adulto JovenRESUMEN
BACKGROUND: Antiretroviral therapy is provided by the Brazilian Ministry of Health to eligible HIV-infected individuals. Based on clinical and immunological classification, the Brazilian guidelines recommend dual or triple therapy for children. However, the development of drug-resistant strains or poor adherence to therapy could impact the efficacy of this approach. OBJECTIVES: We examined relationships between RNA levels, CD4+ T-cell counts, treatment history, and the prevalence of drug-resistant variants in a cohort of HIV-1-infected children in Rio de Janeiro, Brazil. STUDY DESIGN: Direct sequencing of reverse transcriptase and protease genes from plasma was performed. Virologic and CD4+ T-cell counts responses to therapy were assessed by changes in HIV-1 RNA levels and CD4+ T-cell counts from baseline. RESULTS: Thirty-seven patients were receiving dual therapy and 38 were on triple therapy at enrollment, segregated by antiretroviral history. Both groups had a higher increase in CD4+ T cell counts and a lower viral load in pre-treatment antiretroviral-naïve subjects. Notably, there was a direct correlation between the higher frequencies of drug-resistance mutations and cross-resistance with previous usage of antiretroviral (ARV) therapy in both groups. Non-B subtypes isolates were found in 21.3% of samples. A smaller increase in CD4+ T cell counts was found between non-B subtypes when compared to B-subtypes. CONCLUSIONS: These results suggest that less immunological recovery and a higher number of mutations related to drug resistance were associated with previous usage of ARV and consequent higher time under drug selective pressure in these HIV-infected Brazilian children. These facts suggest the preferential use of triple drug combination as first line regimen in children.
Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Farmacorresistencia Viral/genética , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , VIH-1/genética , Adolescente , Fármacos Anti-VIH/farmacología , Brasil , Recuento de Linfocito CD4 , Niño , Preescolar , ADN Complementario/química , ADN Complementario/aislamiento & purificación , Quimioterapia Combinada , Evolución Molecular , Femenino , Infecciones por VIH/inmunología , Proteasa del VIH/genética , Transcriptasa Inversa del VIH/genética , VIH-1/efectos de los fármacos , VIH-1/aislamiento & purificación , Humanos , Lactante , Masculino , Datos de Secuencia Molecular , Mutación Missense , ARN Viral/sangre , ARN Viral/aislamiento & purificación , Selección Genética , Análisis de Secuencia de ADN , Carga Viral , ViremiaRESUMEN
The Mycobacterium tuberculosis-specific ESAT-6 antigen induces highly potent T-cell responses and production of gamma interferon (IFN-gamma), which play a critical role in protective cell-mediated immunity against tuberculosis (TB). In the present study, IFN-gamma secretion by peripheral blood mononuclear cells (PBMCs) in response to M. tuberculosis ESAT-6 in Brazilian TB patients was investigated in relation to clinical disease types, such as pleurisy and cavitary pulmonary TB. Leprosy patients, patients with pulmonary diseases other than TB, and healthy donors were assayed as control groups. Sixty percent of the TB patients indeed recognized M. tuberculosis ESAT-6, as did 50% of the leprosy patients and 60% of the non-TB controls. Nevertheless, the levels of IFN-gamma in response to the antigen ESAT, but not to antigen 85B (Ag85B) and purified protein derivative (PPD), were significantly lower in controls than in patients with treated TB or pleural or cavitary TB. Moreover, according to Mycobacterium bovis BCG vaccination status, only 59% of the vaccinated TB patients responded to ESAT in vitro, whereas 100% of them responded to PPD. Both CD4 and CD8 T cells were able to release IFN-gamma in response to ESAT. The present data demonstrate the specificity of ESAT-6 of M. tuberculosis and its ability to discriminate TB patients from controls, including leprosy patients. However, to obtain specificity, it is necessary to include quantitative IFN-gamma production in response to the antigen as well, and this might limit the use of ESAT-6-based immunodiagnosis of M. tuberculosis infection in an area of TB endemicity.
Asunto(s)
Antígenos Bacterianos/inmunología , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Mycobacterium tuberculosis/inmunología , Tuberculosis Pleural/inmunología , Tuberculosis Pulmonar/inmunología , Antígenos Bacterianos/genética , Proteínas Bacterianas , Brasil , Femenino , Humanos , Interferón gamma/biosíntesis , Masculino , Proteínas Recombinantes/inmunología , Tuberculina/inmunología , Tuberculosis Pleural/diagnóstico , Tuberculosis Pleural/microbiología , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/microbiologíaRESUMEN
Objetivo: relatar a ocorrência de uma deficiência funcional de neutrófilos rara, com quadro clínico e laboratorial semelhante ao da doença granulomatosa crônica. Métodos: relato de caso de paciente com deficiência acentuada da glicose-6-fosfato desidrogenase e infecções de repetição. Realizada pesquisa bibliográfica utilizando as bases de dados Medline e Lilacs abrangendo o período de 1972 a 2000. Resultados: paciente com nível da glicose-6-fosfato desidrogenase extremamente reduzido e quadro de infecções graves com melhora clínica após uso de cotrimoxazol contínuo. Os leucócitos do paciente apresentam defeito no metabolismo oxidativo, similar ao da doença granulomatosa crônica. Conclusões: o diagnóstico da deficiência da glicose-6-fosfato desidrogenase em neutrófilos deve ser considerado em qualquer paciente com anemia hemolítica não esferocítica congênita no qual o nível da glicose-6-fosfato desidrogenase esteja anormalmente baixo ou apresente infecções de repetição. É diagnóstico diferencial da doença granulomatosa crônica
Asunto(s)
Humanos , Masculino , Preescolar , Enfermedad del Almacenamiento de Glucógeno Tipo I , Anemia Hemolítica CongénitaRESUMEN
The aim of this case series was to describe the clinical, laboratory and epidemiological characteristics and the presentation of bacillary angiomatosis cases (and/or parenchymal bacillary peliosis) that were identified in five public hospitals of Rio de Janeiro state between 1990 and 1997; these cases were compared with those previously described in the medical literature. Thirteen case-patients were enrolled in the study; the median age was 39 years and all patients were male. All patients were human immunodeficiency virus type 1 (HIV-1) infected and they had previous or concomitant HIV-associated opportunistic infections or malignancies diagnosed at the time bacillary angiomatosis was diagnosed. Median T4 helper lymphocyte counts of patients was 96 cells per mmÝ. Cutaneous involvement was the most common clinical manifestation of bacillary angiomatosis in this study. Clinical remission following appropriate treatment was more common in our case series than that reported in the medical literature, while the incidence of relapse was similar. The frequency of bacillary angiomatosis in HIV patients calculated from two of the hospitals included in our study was 1.42 cases per 1000 patients, similar to the frequencies reported in the medical literature. Bacillary angiomatosis is an unusual opportunistic pathogen in our setting
Asunto(s)
Humanos , Adulto , Masculino , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Angiomatosis Bacilar/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/patología , Angiomatosis Bacilar/patología , Angiomatosis Bacilar/terapia , Recurrencia , Estudios RetrospectivosRESUMEN
Aspectos epidemiológicos da doença meningocócica registrados a partir da segunda metade da década de 80 impulsionaram as autoridades de saúde pública a discutirem as medidas de controle disponíveis. A ocorrência da doença entre adolescentes e o registro de surtos envolvendo escolas säo os dois pontos que mais pressionaram uma revisäo das medidas de controle disponíveis. O uso das vacinas antimeningocócicas polissacarídeas e as recomendaçöes para o controle de surtos localizados (clusters) säo outros aspectos que mereceram atençäo recentemente. Objetivou, assim, apresentar um panorama atual de alguns aspectos da epidemiologia e do controle dos casos secundários da doença meningocócica
Asunto(s)
Humanos , Masculino , Femenino , Neisseria meningitidis , Meningitis Meningocócica/epidemiología , Quimioprevención , Vacunas , Transmisión de Enfermedad Infecciosa , Brotes de EnfermedadesAsunto(s)
Humanos , Recién Nacido , Niño , Preescolar , Lactante , Infecciones por VIH/terapia , Transmisión Vertical de Enfermedad Infecciosa , Síndrome de Inmunodeficiencia Adquirida/terapia , Infecciones por VIH/diagnóstico , Infecciones por VIH/etiología , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/etiologíaRESUMEN
Trata especificamente dos problemas obstétricos de mulheres infectadas pelo HIV. Reflete a urgência de enfrentar a atual realidade mundial da epidemiologia e clínica da infecçäo pelo HIV
Asunto(s)
Vías Clínicas , Obstetricia , Complicaciones Infecciosas del Embarazo , Síndrome de Inmunodeficiencia Adquirida/embriología , Salud de la Mujer , Manual de ReferenciaRESUMEN
Apresentaçäo de um caso de paracoccidioidomicose com comprometimento do sistema nervoso central, manifestando-se por movimento involuntário do tipo tremor rubral. Säo discutidas, ainda, as outras formas de apresentaçäo desta afecçäo relatadas na literatura