IFCC interim guidelines on rapid point-of-care antigen testing for SARS-CoV-2 detection in asymptomatic and symptomatic individuals.

With an almost unremittent progression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections all around the world, there is a compelling need to introduce rapid, reliable, and high-throughput testing to allow appropriate clinical management and/or timely isolation of infected individuals. Although nucleic acid amplification testing (NAAT) remains the gold standard for detecting and theoretically quantifying SARS-CoV-2 mRNA in various specimen types, antigen assays may be considered a suitable alternative, under specific circumstances. Rapid antigen tests are meant to detect viral antigen proteins in biological specimens (e.g. nasal, nasopharyngeal, saliva), to indicate current SARS-CoV-2 infection. The available assay methodology includes rapid chromatographic immunoassays, used at the point-of-care, which carries some advantages and drawbacks compared to more conventional, instrumentation-based, laboratory immunoassays. Therefore, this document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 aims to summarize available data on the performance of currently available SARS-CoV-2 antigen rapid detection tests (Ag-RDTs), providing interim guidance on clinical indications and target populations, assay selection, and evaluation, test interpretation and limitations, as well as on pre-analytical considerations. This document is hence mainly aimed to assist laboratory and regulated health professionals in selecting, validating, and implementing regulatory approved Ag-RDTs.

IFCC Interim Guidelines on Molecular Testing of SARS-CoV-2 Infection.

The diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection globally has relied extensively on molecular testing, contributing vitally to case identification, isolation, contact tracing, and rationalization of infection control measures during the coronavirus disease 2019 (COVID-19) pandemic. Clinical laboratories have thus needed to verify newly developed molecular tests and increase testing capacity at an unprecedented rate. As the COVID-19 pandemic continues to pose a global health threat, laboratories continue to encounter challenges in the selection, verification, and interpretation of these tests. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay verification, and (D) test interpretation and limitations for molecular testing of SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide and highlight the continued importance of laboratory medicine in our collective pandemic response.

IFCC Interim Guidelines on Serological Testing of Antibodies against SARS-CoV-2.

Serological testing for the detection of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as an important component of the clinical management of patients with coronavirus disease 2019 (COVID-19) as well as the epidemiological assessment of SARS-CoV-2 exposure worldwide. In addition to molecular testing for the detection of SARS-CoV-2 infection, clinical laboratories have also needed to increase testing capacity to include serological evaluation of patients with suspected or known COVID-19. While regulatory approved serological immunoassays are now widely available from diagnostic manufacturers globally, there is significant debate regarding the clinical utility of these tests, as well as their clinical and analytical performance requirements prior to application. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay evaluation, and (D) test interpretation and limitations for serological testing of antibodies against SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories in the selection, verification, and implementation of serological assays and are of the utmost importance as we expand our pandemic response from initial case tracing and containment to mitigation strategies to minimize resurgence and further morbidity and mortality.

IFCC Interim Guidelines on Biochemical/Hematological Monitoring of COVID-19 Patients.

Routine biochemical and hematological tests have been reported to be useful in the stratification and prognostication of pediatric and adult patients with diagnosed coronavirus disease (COVID-19), correlating with poor outcomes such as the need for mechanical ventilation or intensive care, progression to multisystem organ failure, and/or death. While these tests are already well established in most clinical laboratories, there is still debate regarding their clinical value in the management of COVID-19, particularly in pediatrics, as well as the value of composite clinical risk scores in COVID-19 prognostication. This document by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications for testing, (B) recommendations for test selection and interpretation, (C) considerations in test interpretation, and (D) current limitations of biochemical/hematological monitoring of COVID-19 patients. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide, underscoring the contribution of biochemical and hematological testing to our collective pandemic response.

Prevalence of HPV infection and cervical intraepithelial lesions in HIV positive and negative women in the city of Florianopolis / Prevalência da infecção pelo HPV e lesões intraepiteliais cervicais em mulheres HIV positivas e negativas na cidade de Florianópolis

Introduction: HPV infection is the most frequent sexually transmitted infection in women. The high oncogenic risk HPV, associated with others factors, there are a risk of progressing to a precancerous lesion of the cervix and even cancer. This evolution is related to the persistence of the infection and other factors, mainly those that interfere with the woman's immunity. The immunosuppression caused by HIV infection is an important factor for viral persistence and the appearance of these lesions. Objectives: To compare the prevalence of HPV infection and cervical intraepithelial lesions in HIV-positive and negative women and describe the possible associated risk factors. Methods: The sample consisted of 50 HIV positive women (study group) and 50 HIV negative women (control group) recruited from the public health system of Florianópolis during the months of January to April 2022. Cervical samples were collected for cytological analysis and for detection of high-risk oncogenic HPV DNA by polymerase chain reaction (PCR). Categorical variables were compared using the chi-square test, with a significance level set at 5% Results: HPV infection was more prevalent in the control group, however, HIV positive women had a higher frequency of intraepithelial lesions diagnosed on cytology. Factors such as greater number of sexual partners, depression and smoking were more frequent in the group of HIV positive women. The number of CD4 T cells less than 200 cels/mm3 was associated with a higher number of altered Pap smears and a positive HPV DNA test. The use of combination antiretroviral therapy and undetectable viral load were associated with a greater number of normal cytology and undetected HPV DNA. Conclusion: The prevalence of cervical intraepithelial lesions in HIV-infected women is higher than in women without infection. The presence of HIV infection was the most important risk factor associated with the development of cervical lesions. (AU)

Introdução: O Papilomavírus Humano (HPV) é a infecção de transmissão sexual mais frequente na mulher. O HPV de alto risco oncogênico, associado a outros fatores, apresenta risco de evoluir para uma lesão pré-cancerosa do colo de útero e até mesmo para o câncer. Essa evolução está relacionada à persistência da infecção e outros fatores, principalmente os que interferem na imunidade da mulher. A imunossupressão causada pela infecção HIV é um fator importante para a persistência viral e o aparecimento destas lesões. Objetivos: Comparar a prevalência da infecção pelo HPV e das lesões intraepiteliais do colo de útero em mulheres HIV positivas e negativas, e descrever os possíveis fatores de risco associados. Métodos: A amostra foi composta por 50 mulheres HIV positivas (grupo de estudo) e 50 mulheres HIV negativas (grupo controle) recrutadas no sistema público de saúde de Florianópolis durante os meses de janeiro a abril de 2022. Foram coletadas amostras cervicais para análise citológica e para detecção do DNA HPV de alto risco oncogênico por reação em cadeia da polimerase (PCR). As variáveis categóricas foram comparadas pelo teste qui-quadrado, com nível de significância estabelecido em 5%. Resultados: A infecção pelo HPV foi mais prevalente no grupo controle, entretanto, as mulheres HIV positivas tiveram uma maior frequência de lesões intraepiteliais diagnosticadas na citologia. Os fatores como maior número de parceiros sexuais, depressão e tabagismo foram mais frequentes no grupo de mulheres HIV positivas. O número de células TCD4 inferior a 200 células/mm3 esteve associado a maior número de colpocitologias alteradas e teste DNA HPV positivo. O uso da terapia antirretroviral combinada e a carga viral indetectável estiveram associadas a um número elevado de citologias normais e DNA HPV não detectado. Conclusão: A prevalência de lesões intraepiteliais do colo do útero em mulheres infectadas pelo HIV foi maior que em mulheres soronegativas. A presença de infecção pelo HIV foi o fator de risco mais importante associado ao desenvolvimento de lesões cervicais.Palavras-chave: HPV. HIV. coinfecção. lesões intraepiteliais escamosas cervicais. prevalência.. (AU)

Implementation of the External Quality Assessment Program in Brazil.

The External Quality Assessment (EQA) in Brazil is performed by the National Health Ministry for diseases that are under supervision of Public Health Department. In addition to the government program, the Brazilian Society of Clinical Analysis and the Brazilian Society of Medical Pathology are allowed to provide their programs under the Supervision of National Agency for Sanitary Surveillance (ANVISA) that regulates laboratories to perform EQA programs.

Genital infection by Human Papillomavirus (HPV) in women from Santa Catarina/Brazil / Infecção genital pelo Papilomavírus Humano (HPV) em mulheres de Santa Catarina/Brasil

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in women. About 80% of sexually active women will have contact with this virus at some point in their lives. Most infections will be transient, but when the infection becomes persistent and associated with a high oncogenic risk of Human Papillomavirus, there may be progression to cancer, especially cervical cancer. The best way to prevent Human Papillomavirus infection is through the use of vaccines, which have been available to the public in Brazil since 2014. Objective: This study aimed to assess the most prevalent types of Human Papillomavirus in the state of Santa Catarina, Brazil, and its mesoregions and if the majority of diagnosed types are contained in the Human Papillomavirus vaccines currently available on the market. Methods: A total of 20,000 Human Papillomavirus tests were evaluated for the diagnosis of genital Human Papillomavirus infection in women from the state of Santa Catarina, Brazil. The prevalence of infection was evaluated according to age and the city of origin of the exams. Human Papillomavirus detection was performed using molecular biology tests, such as hybrid capture (for diagnosis of the Human Papillomavirus group, high or low oncogenic risk) and polymerase chain reaction (viral genotyping) techniques. Results: The diagnosis of Human Papillomavirus infection was performed on women between 1 and 102 years of age. The age with the highest Human Papillomavirus positivity, as expected, was 20­25 years (45.6%) and the lowest after 70 years (7.1%). The highest Human Papillomavirus positivity of the exams was observed in the Serrana region of Santa Catarina state (58.9% of the exams). A high-oncogenic-risk Human Papillomavirus was detected in 93% of positive samples and was the most frequent in all age groups. Mixed infection (high- and low-risk Human Papillomavirus) was more prevalent in the 66­70 age group (29.3%) and in the Southern Region of Santa Catarina (26.4%). The most frequent genotypes in the state of Santa Catarina were non-16/18 high oncogenic risk Human Papillomavirus (76.9% of positive cases). Human Papillomavirus 16 was found in 17.1% of positive cases and Human Papillomavirus 18 in 6.6%. Conclusion: The most prevalent types of Human Papillomavirus in the state of Santa Catarina in the past 6 years are the non-16/18 high oncogenic risk Human Papillomavirus types, which are viral types not covered by the current Human Papillomavirus vaccines available in Brazil.

A infecção por Papilomavírus Humano é a infecção sexualmente transmissível mais frequente na mulher. Cerca de 80% das mulheres sexualmente ativas entrarão em contato com esse vírus em algum momento. A maioria das infecções será transitória, mas quando ela é persistente, associada aos Papilomavírus Humano de alto risco oncogênico, poderá progredir para câncer, principalmente de colo de útero. A melhor forma de se prevenir da contaminação pelo vírus é por meio de vacina, disponível no sistema público do Brasil desde 2014. Objetivo: Avaliar os tipos de Papilomavírus Humano mais prevalentes no estado de Santa Catarina e suas mesorregiões, e se a maioria dos tipos diagnosticados estão contidos nas vacinas contra o Papilomavírus Humano atualmente disponíveis no mercado. Métodos: Foram avaliados 20 mil exames para diagnóstico da infecção genital pelo Papilomavírus Humano em mulheres de todo o estado. A prevalência da infecção foi comparada de acordo com a idade e a procedência dos exames. A detecção do Papilomavírus Humano deu-se pelos exames de biologia molecular pelas técnicas de captura híbrida (para diagnóstico do grupo de Papilomavírus Humano, alto ou baixo riscos oncogênicos) e de PCR (genotipagem viral). Resultados: Foram avaliados exames para diagnóstico da infecção de mulheres entre um e 102 anos de idade. A faixa etária de maior positividade, como era de ser esperado, foi dos 20 aos 25 anos (45.6%) e a menor depois dos 70 anos (7.1%). A maior positividade dos exames foi observada na região Serrana do estado (58.9% dos exames). O Papilomavírus Humano de alto risco oncogênico foi detectado em 93% dos casos positivos e foi o mais frequente em todas as faixas etárias. A infecção mista (Papilomavírus Humano de alto e baixo riscos) foi mais prevalente na faixa etária dos 66 aos 70 anos (29.3%) e na região Sul Catarinense (26.4%). Os genótipos mais frequentes no estado foram os Papilomavírus Humano de alto risco oncogênico não 16/18 (76.9% dos casos positivos). O Papilomavírus Humano 16 foi encontrado em 17.1% dos casos positivos e o Papilomavírus Humano 18 em 6.6%. Conclusão:Os tipos de Papilomavírus Humano mais prevalentes no estado de Santa Catarina, nos últimos seis anos, são os Papilomavírus Humano de alto risco oncogênico não 16/18, tipos virais não cobertos pelas atuais vacinas contra o Papilomavírus Humano disponíveis no Brasil.

Diagnóstico laboratorial do SARS-CoV-2 por transcrição reversa seguida de reação em cadeia da polimerase em tempo real (RT-PCR) / Laboratory diagnosis of SARS-CoV-2 by real time reverse transcriptase-polymerase chain reaction (RT-PCR)

O diagnóstico da COVID-19 está alicerçado na clínica do paciente, nos exames de imagem e no diagnóstico laboratorial. O exame de detecção do ácido nucleico viral por transcrição reversa (RT) seguido da reação em cadeia da polimerase em tempo real (PCR) foi rapidamente o primeiro método de diagnóstico laboratorial estabelecido e permanece como o padrão ouro. Esta narrativa descritiva é resultado de uma busca referenciada onde o ponto focal foi descrever o diagnóstico laboratorial do SARS-CoV-2 por RT-PCR. O diagnóstico laboratorial do SARS-CoV-2 por RT-PCR envolve as etapas de extração do RNA, transcrição reversa para obtenção do DNA complementar e a reação em cadeia da polimerase. A detecção da amplificação do material genético é realizada pela medida de fluorescência emitida. Entre as várias amostras biológicas que podem ser utilizadas, aquela que tem apresentado mais praticidade e precisão é a de swab da nasofaringe. A coleta da amostra deve ser, idealmente, realizada até sete dias a partir do início dos sintomas. Quando o SARS-CoV-2 é detectado na RT-PCR, o diagnóstico de COVID-19 é confirmado. No entanto, um único resultado de SARS-CoV-2 não detectado em paciente sintomático não exclui o diagnóstico. O exame não tem apresentado reações cruzadas com outros patógenos respiratórios. Contudo, o exame é caro e demorado, e pode resultar em falso negativo devido ao momento inadequado da coleta da amostra, coleta e manuseio impróprio de amostras e material genético viral insuficiente no sítio de coleta. Lacunas diagnósticas ainda permanecem na triagem de assintomáticos e na detecção de vírus vivos na convalescença.

The diagnosis of COVID-19 is based on the patient's clinic, imaging tests and laboratory diagnosis. The detection of viral nucleic acid by reverse transcription (RT) followed by real-time polymerase chain reaction (PCR) was quickly the first established laboratory diagnosis method and remains the gold standard. This descriptive narrative is a result of a referenced search where the focal point was to describe the laboratory diagnosis of SARS-CoV-2 by RT-PCR. The laboratory diagnosis of SARS-CoV-2 by RT-PCR involves the RNA extraction, reverse transcription to obtain complementary DNA, and the polymerase chain reaction steps. The detection of genetic material amplification is carried out by measuring the emitted fluorescence. Among the various biological samples that can be used, the one that has shown the most practicality and precision is the nasopharyngeal swab. Sample collection should be performed, ideally, within 7 days from the symptoms onset. When SARS-CoV-2 is detected by RTPCR, the diagnosis of COVID-19 is confirmed. However, a single result of undetected SARS-CoV-2 in a symptomatic patient does not exclude the diagnosis. The test has not shown cross-reactions with common respiratory pathogens. However, the test is costly and timeconsuming, a false-negative result may arise due to inadequate sample collection time, improper samples collection and handling, and insufficient viral genetic material at the collection site. Diagnostic gaps remain on asymptomatic patients screening, and in the detection of live viruses in convalescence.

15 STR loci frequencies in the population from Santa Catarina, Southern Brazil.

Allele frequencies for 15 short tandem repeats (STR) loci were determined with a sample of 3000 unrelated individuals from the population of Santa Catarina, Southern Brazil. The loci are most commonly used in forensic and paternity testing, being analyzed by the Powerplex 16 (Promega) commercial kit. The data shows that most polymorphic loci were Penta E and FGA. The distributions of the genotypes in the evaluated loci are in Hardy-Weinberg equilibrium. Comparative analyses between our population data and other Brazilian populations are presented. The calculated forensic parameters showed that the loci are useful for the solution of forensic problems in Brazilian Southern region.

High proportion of hepatitis C virus genotypes 1 and 3 in a large cohort of patients from Southern Brazil.

Hepatitis C virus (HCV) isolates have been divided into six genotypes (1 to 6). The duration of hepatitis C standard treatment is 48 weeks for patients infected with HCV genotype 1 vs 24 weeks for those infected with genotypes 2 and 3. A total of 1544 HCV isolates from chronic patients living in the southern Brazilian states of Rio Grande do Sul (RS, n=627) and Santa Catarina (SC, n=917) were genotyped by restriction fragment length polymorphism (RFLP) of polymerase chain reaction (PCR) products. In RS, 338 (53.9%; 95% CI 50.0-57.8%), 34 (5.4%; 95% CI 3.8-7.4%) and, 255 (40.7%; 95% CI 36.9-44.6%) samples were from genotypes 1, 2, and 3, respectively. In SC, 468 (51%; 95% CI 47.8-54.2%), 26 (2.9%; 95% CI 1.9-4.1%) and, 423 (46.1%; 95% CI 42.9-49.3%) samples were from genotypes 1, 2, and 3, respectively. Genotyping results were confirmed by direct nucleotide sequencing of PCR products derived from 68 samples, without any discrepancy between PCR-RFLP and nucleotide sequencing methods. In conclusion, almost half of the hepatitis C patients from South of Brazil are infected by genotypes 2 and 3 and, these results have important consequential therapeutic implications as they can be treated for only 24 weeks, not 48.

Infecção pelo papilomavírus humano (HPV) em mulheres HIV-positivo de Florianópolis, Santa Catarina / Human papillomavirus (HPV) infection in HIV positive women of Florianópolis, Santa Catarina

A infecção por HPV é a doença sexualmente transmissível mais prevalente no mundo todo. A doença induzida por este vírus está na dependência de vários outros fatores que afetam o hospedeiro. O principal fator é a imunossupressão, principalmente associada à infecção pelo HIV. Objetivo: pesquisara presença da infecção pelo HPV em um grupo de mulheres HIV-positivo e comparar com as mulheres HIV-negativo, avaliar as prevalências dos grupos virais de alto e baixo risco oncogênico, a relação destes achados com características socioeconômicas, demográficas e comportamentais, além de variáveis relacionadas ao HIV, como níveis de CD4, CV e TARVC. Métodos: trata-se de estudo transversal, descritivo, onde foram analisadas amostras genitais de 20 mulheres HIV-positivo e 99 HIV-negativo para o DNA-HPV, através do método da captura híbrida. Foram coletados, ainda, dados de prontuário e de questionário aplicado às participantes. Resultados: a prevalência do HPV foi de 70% entre as mulheres HIV-positivo e de 21,2% entre as HIV-negativo.O HPV de alto risco oncogênico esteve presente em 71,4% dos casos HPV-positivo em ambos os grupos, e ambos os tipos virais em 35,7% das mulheres HIV-positivo. A infecção pelo HPV foi associada a idade acima de 35 anos, baixo nível de escolaridade, CD4 entre 200 e 500 células/mm3 e uso de TARVC entre as mulheres HIV-positivo. As demais variáveis não se mostraram associadas à infecção pelo HPV. Conclusão: a prevalência da infecção pelo HPV nas mulheres HIV-positivo foi cerca de 3,3 vezes maior que nas HIV-negativo, sendo a maioria do grupo de alto risco oncogênico.

Prevalência de infecção por Chlamydia tracomatis em amostras oculares de pacientes com conjuntivite em laboratório de genética e biologia molecular na região metropolitana de Florianópolis / Prevalence of infection by chlamydia trachomatis in ocular samples of patients with conjunctivitis in genetic and molecular biology laboratory from metropolitan area of Florianópolis, Brazil

Objetivo: Conhecer a prevalência de infecção ocular em amostras de raspado conjuntival causada por C. trachomatis, no período de janeiro de 2004 a junho de 2007 em laboratório de Genética e Biologia Molecular da região metropolitana de Florianópolis, SC. Métodos: Realizou-se um estudo transversal e descritivo, envolvendo todos os casos de conjuntivite registrados no banco de dados do Laboratório de Genética e Biologia Molecular (DNAnálise) de janeiro de 2004 a junho de 2007. Foi observada a positividade de C. tracomatis nas amostras coletadas de raspado ocular. Resultados: Dos 660 exames realizados foram detectados 359 casos positivos (54,4%), sendo a maior parte do sexo feminino (66,3%). A prevalência foi maior na faixa etária de zero a 15 anos em pacientes de ambos os sexos, sendo 55,8% para o sexo masculino e 62,5% para o sexo feminino. Verificou-se um grande aumento de casos positivos no primeiro semestre do ano de 2006, representando 79,2% de todos os pacientes analisados. Conclusão: Houve um aumento no número de casos de conjuntivite na região metropolitana de Florianópolis no ano de 2006, causada pela C. trachomatis no laboratório de Genética e Biologia Molecular. O grande aumento de casos verificados sugere a necessidade da intensificação das ações de vigilância epidemiológica do tracoma nessa região para confirmar clinicamente o aumento da prevalência do tracoma.

Objective: To estimate the prevalence of ocular infection by Chlamydia trachomatis in conjuctival material, from january 2004 to june 2007 at Genetic and Molecular Biology Laboratory from Florianópolis Metropolitan area, SC. Methods: A cross-sectional and descriptive study involving all cases of conjunctivitis using the database of Genetic and Molecular biology Laboratory (DNAanálises) recorded in the period from january 2004 to june 2007 was carried out. The positivity to C. trachomatis in conjunctival material was observed. Results: A total of 660 exams to the detection of C. trachomatis in ocular samples were observed 359 (54,4%) positive cases which the most part of them were from female patients (66,3%). The majority of the cases were observed at the female group (66.3%). The highest prevalence was between one to 15 years old in both sex groups, being 55.8% in the male and 62.5% in the female group. We observed an increased number of cases between january and june of 2006 representing 79.2% of the total positive cases. Conclusion: There was an increased number of conjunctivitis at Florianópolis Metropolitan area at the year of 2006, caused by Chlamydia trachomatis detected at Genetic and Molecular Biology Laboratory. The great number of cases detected in the studied area suggests the need for strengthening epidemiological surveillance activities at the region to confirm clinically the increased prevalence of trachoma.

Infecção pelo Papilomavírus humano (HPV) em mulheres de Florianópolis, Santa Catarina / Human Papillomavirus (HPV) infection in women of Florianópolis, Santa Catarina, Brazil

Introdução: a infecção pelo papilomavírus humano (HPV) é a doença sexualmente transmissível mais frequente no mundo e apresenta um amploespectro de manifestações, desde a infecção assintomática até o carcinoma invasivo. Estima-se que pelo menos 50% das pessoas sexualmente ativas venham a adquirir esta infecção em algum momento de suas vidas. Objetivo: determinar a prevalência da infecção pelo HPV e identificar a frequência dos grupos virais de baixo e alto risco oncogênico em mulheres atendidas para consulta ginecológica de rotina em Florianópolis, bem como verificar a associação entre a presença do vírus e alguns fatores de risco. Métodos: trata-se de estudo transversal, de caráter descritivo. Foram avaliadas 100 mulheres atendidas em ambulatório para consulta ginecológica de rotina, selecionadas aleatoriamente. Todas tiveram amostra cervical submetida ao teste de DNA-HPV pelo método de Captura Híbrida II® e responderam a um questionário sobre fatores de risco. Resultados: das 100 mulheres analisadas, 21 (21%) apresentaram positividade para o DNA-HPV. O HPV de alto risco oncogênico esteve presente em 71% e o de baixo risco em 52% das amostras positivas, incluindo as infecções mistas. A infecção pelo vírus de alto risco foi associada às pacientes com início de atividade sexual precoce. Outros fatores avaliados como idade, escolaridade, número de parceiros sexuais, paridade, uso de anticoncepcionais orais, doença sexualmente transmissível e tabagismo não mostraram relação com a infecção pelo HPV. Conclusão: a prevalência de HPV na população estudada foi de 21%, com 71% para vírus de alto risco e 52% para vírus de baixo risco oncogênico, incluindo infecções mistas. A detecção do vírus de alto risco foi associada ao início precoce de atividade sexual.

Introduction: the Human Papillomavirus (HPV) infection is the most frequent sexually transmitted disease in the world and has many clinical manifestations,from asymptomatic infection to invasive carcinoma. At least 50% of sexually active people will have this infection in their life. Objective:to determine the prevalence of HPV and identify the frequency of high risk and low risk virus groups in women attending gynecologic routine as wellas evaluate the association between the presence of these viruses and some risk factors. Methods: this is a cross-sectional study. A hundred randomized selected women who attended the gynecologic service for routine test were evaluated. All of them had cervical specimens tested for DNA-HPV by the Hybrid Capture II assay and answered a questionnaire to acess risk factors. Results: twenty-one (21%) out of 100 analyzed women showed positivity for DNA-HPV. High risk HPV was detected in 71% and low risk HPV in 52% of positive specimens, including mixed infections. Infection with high risk types was associated with younger age at first sexual intercourse. Other evaluated risk factors such as age, level of education, number of sexual partners, parity, use of oral contraceptives, sexually transmitted disease and smoking did not show relation to HPV infection. Conclusion: the prevalence of HPV in the studied population was 21%, with 71% of high risk virus and 52% of low risk types, including mixed infections. High risk HPV detection was associated with younger age at first sexual intercourse.

Prevalência de HPV de baixo e alto risco pela técnica de biologia molecular (Captura Hibrida II) em Santa Catarina / Prevalence of HPV of low and high-risk technique of molecular biology (Hybrid captures II) in Santa Catarina

O Papilomavirus Humano (HPV) vem sendo intensamente pesquisado em virtude da sua grande ocorrência na população mundial e da íntima relação com a carcinogênese cervical. Baseado neste fato, o presente estudo tem por objetivo verificar a prevalência e a incidência de HPV de baixo e alto risco oncogênico pela técnica de biologia molecular (Captura Híbrida II®), bem como a faixa etária mais acometida. Foram analisados 12.211 exames do Estado de Santa Catarina coletados a partir do banco de dados do setor de doenças infecciosas do Laboratório de Análise e Pesquisa do Gene – NAnálise, sediado na cidade de Florianópolis-SC, no período de 2001-2005. Os resultados obtidos apontam a grande incidência de HPV na população estudada, apresentando 53,8 de positividade, onde, destes, 66,4 foi HPV de alto risco. No entanto, quando comparada à prevalência de HPV de baixo e a de alto risco em relação à faixa etária, o HPV de baixo risco teve uma maior incidência na população abaixo dos 25 anos (48) e até os 35 anos(33). Já na faixa etária de 36 a 45 anos (22), e acima de 45 (8) a maior incidência foi de HPV de alto risco. Isso demonstra a importância da realização de exame específico, por metodologias mais sensíveis, como testes de biologia molecular (Captura Híbrida), para garantir o diagnóstico precoce, deste que vem sendo considerado o maior agente causador de câncer cervical.

High proportion of hepatitis C virus genotypes 1 and 3 in a large cohort of patients from Southern Brazil

Hepatitis C virus (HCV) isolates have been divided into six genotypes (1 to 6). The duration of hepatitis C standard treatment is 48 weeks for patients infected with HCV genotype 1 vs 24 weeks for those infected with genotypes 2 and 3. A total of 1544 HCV isolates from chronic patients living in the southern Brazilian states of Rio Grande do Sul (RS, n = 627) and Santa Catarina (SC, n = 917) were genotyped by restriction fragment length polymorphism (RFLP) of polymerase chain reaction (PCR) products. In RS, 338 (53.9 percent; 95 percent CI 50.0 - 57.8 percent), 34 (5.4 percent; 95 percent CI 3.8 - 7.4 percent) and, 255 (40.7 percent; 95 percent CI 36.9 - 44.6 percent) samples were from genotypes 1, 2, and 3, respectively. In SC, 468 (51 percent; 95 percent CI 47.8 - 54.2 percent), 26 (2.9 percent; 95 percent CI 1.9 - 4.1 percent) and, 423 (46.1 percent; 95 percent CI 42.9 - 49.3 percent) samples were from genotypes 1, 2, and 3, respectively. Genotyping results were confirmed by direct nucleotide sequencing of PCR products derived from 68 samples, without any discrepancy between PCR-RFLP and nucleotide sequencing methods. In conclusion, almost half of the hepatitis C patients from South of Brazil are infected by genotypes 2 and 3 and, these results have important consequential therapeutic implications as they can be treated for only 24 weeks, not 48.

Chlamydia pneumoniae e aterosclerose: identificaçäo do DNA bacteriano na parede arterial / Chlamydia pneumoniae and atherosclerosis: identification of bacterial DNA in the arterial wall

OBJECTIVE : The intracellular Gram-negative bacterium Chlamydia pneumoniae has been associated with atherosclerosis. The presence of Chlamydia pneumoniae has been investigated in fragments of the arterial. METHODS: Arterial fragments obtained from vascular surgical procedures in 58 patients were analyzed. From these patients, 39 were males and the mean age was 65ñ6 years. The polymerase chain reaction was used to identify the bacterial DNA with a pair of primers that codify the major outer membrane protein (MOMP) of Chlamydia pneumoniae. The amplified product was visualized by electrophoresis in the 2 porcento agarose gel stained with ethidium bromide, and it was considered positive when migrating in the band of molecular weight of the positive controls. RESULTS: Seven (12 per cent) out of the 58 patients showed positive results for Chlamydia pneumoniae. CONCLUSION: DNA from Chlamydia pneumoniae was identified in the arterial wall of a substantial number of patients with atherosclerosis. This association, which has already been described in other countries, corroborates the evidence favoring a role played by Chlamydia pneumoniae in therogenesis.