Outcomes of Elective and Non-elective Fenestrated-branched Endovascular Aortic Repair for Treatment of Thoracoabdominal Aortic Aneurysms.

OBJECTIVE: To describe outcomes after elective and non-elective fenestrated-branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aortic aneurysms (TAAAs). BACKGROUND: FB-EVAR has been increasingly utilized to treat TAAAs; however, outcomes after non-elective versus elective repair are not well described. METHODS: Clinical data of consecutive patients undergoing FB-EVAR for TAAAs at 24 centers (2006-2021) were reviewed. Endpoints including early mortality and major adverse events (MAEs), all-cause mortality, and aortic-related mortality (ARM), were analyzed and compared in patients who had non-elective versus elective repair. RESULTS: A total of 2603 patients (69% males; mean age 72±10 year old) underwent FB-EVAR for TAAAs. Elective repair was performed in 2187 patients (84%) and non-elective repair in 416 patients [16%; 268 (64%) symptomatic, 148 (36%) ruptured]. Non-elective FB-EVAR was associated with higher early mortality (17% vs 5%, P <0.001) and rates of MAEs (34% vs 20%, P <0.001). Median follow-up was 15 months (interquartile range, 7-37 months). Survival and cumulative incidence of ARM at 3 years were both lower for non-elective versus elective patients (50±4% vs 70±1% and 21±3% vs 7±1%, P <0.001). On multivariable analysis, non-elective repair was associated with increased risk of all-cause mortality (hazard ratio, 1.92; 95% CI] 1.50-2.44; P <0.001) and ARM (hazard ratio, 2.43; 95% CI, 1.63-3.62; P <0.001). CONCLUSIONS: Non-elective FB-EVAR of symptomatic or ruptured TAAAs is feasible, but carries higher incidence of early MAEs and increased all-cause mortality and ARM than elective repair. Long-term follow-up is warranted to justify the treatment.

Comparison of single- and multistage strategies during fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms.

OBJECTIVE: The aim of this study was to compare outcomes of single or multistage approach during fenestrated-branched endovascular aortic repair (FB-EVAR) of extensive thoracoabdominal aortic aneurysms (TAAAs). METHODS: We reviewed the clinical data of consecutive patients treated by FB-EVAR for extent I to III TAAAs in 24 centers (2006-2021). All patients received a single brand manufactured patient-specific or off-the-shelf fenestrated-branched stent grafts. Staging strategies included proximal thoracic aortic repair, minimally invasive segmental artery coil embolization, temporary aneurysm sac perfusion and combinations of these techniques. Endpoints were analyzed for elective repair in patients who had a single- or multistage approach before and after propensity score adjustment for baseline differences, including the composite 30-day/in-hospital mortality and/or permanent paraplegia, major adverse event, patient survival, and freedom from aortic-related mortality. RESULTS: A total of 1947 patients (65% male; mean age, 71 ± 8 years) underwent FB-EVAR of 155 extent I (10%), 729 extent II (46%), and 713 extent III TAAAs (44%). A single-stage approach was used in 939 patients (48%) and a multistage approach in 1008 patients (52%). A multistage approach was more frequently used in patients undergoing elective compared with non-elective repair (55% vs 35%; P < .001). Staging strategies were proximal thoracic aortic repair in 743 patients (74%), temporary aneurysm sac perfusion in 128 (13%), minimally invasive segmental artery coil embolization in 10 (1%), and combinations in 127 (12%). Among patients undergoing elective repair (n = 1597), the composite endpoint of 30-day/in-hospital mortality and/or permanent paraplegia rate occurred in 14% of single-stage and 6% of multistage approach patients (P < .001). After adjustment with a propensity score, multistage approach was associated with lower rates of 30-day/in-hospital mortality and/or permanent paraplegia (odds ratio, 0.466; 95% confidence interval, 0.271-0.801; P = .006) and higher patient survival at 1 year (86.9±1.3% vs 79.6±1.7%) and 3 years (72.7±2.1% vs 64.2±2.3%; adjusted hazard ratio, 0.714; 95% confidence interval, 0.528-0.966; P = .029), compared with a single stage approach. CONCLUSIONS: Staging elective FB-EVAR of extent I to III TAAAs was associated with decreased risk of mortality and/or permanent paraplegia at 30 days or within hospital stay, and with higher patient survival at 1 and 3 years.

A One Welfare approach to identify socioeconomic vulnerability in families during investigations into companion animal abuse in Pinhais, Brazil.

A One Welfare approach allows intervention to resolve problems related to the human-animal-environment interface. However, in Brazil and many other countries, there is poor communication between human and animal welfare services. In this research we considered a One Welfare approach in cases of abuse involving dogs and cats. When investigating pet abuse, professionals from the Animal Welfare Division of Pinhais, Brazil, can enter the home environment. During routine animal abuse investigations, the demographic profile of pet owners and their socioeconomic vulnerability was also recorded. Results from forty-five cases with (n = 30) and without (n = 15) suspicion of socioeconomic vulnerability were sent to the Department of Social Assistance of Pinhais, Brazil for confirmation. Socioeconomic vulnerability was suspected if socioeconomic problems were reported by the pet owners under investigation or their neighbours, as well by assessment of the socioeconomic environment of the families during home visits. Economic disadvantage was the most prevalent socioeconomic vulnerability. Cohen's Kappa coefficients support the ability of animal welfare service professionals to detect socioeconomic vulnerability. Almost half of all families considered to have socioeconomic vulnerability had not previously participated in social programmes. In all cases involving families already being assisted by the Department of Social Assistance, pets were found to be suffering abuse. Families with socioeconomic vulnerability confirmed were included in the social programmes. These results support the need for a multi-disciplinary approach to improve the well-being of families with dogs and cats. This study can help guide the development of an interdisciplinary approach to address animal abuse cases.

Veterinary Forensics, Animal Welfare and Animal Abuse: Perceptions and Knowledge of Brazilian and Colombian Veterinary Students.

Veterinarians have a fundamental role to play in the detection of animal abuse and domestic violence cases. Therefore, it is essential that veterinary colleges provide appropriate training in animal welfare and veterinary forensics. The aim of this article is to characterize the perception and knowledge of veterinary students about training in veterinary forensics, animal welfare and the association between animal abuse and human violence. An online survey was made available to veterinary students at 227 veterinary colleges in Brazil and 22 in Colombia. The Chi-square test of independence was performed to compare responses of Brazilian and Colombian students for categorical survey items. Most of the surveyed students indicated that their college offered animal welfare training. However, only 21.8% (47/216) of the Colombian and 43.1% (216/523) of the Brazilian students mentioned that their veterinary colleges offered veterinary forensics training. Deficits in training in identification of non-accidental traumas, reporting of animal abuse and awareness of the association between interpersonal violence and animal abuse were identified in both countries. Despite this, more than 90% of students were aware of the relationship between these two crimes and in the importance of receiving compulsory training in animal abuse and veterinary forensics. Likewise, most of the respondents recognized that animal abuse includes both physical and mental abuse. The results highlight the need to improve education in animal welfare, animal abuse, human violence and veterinary forensics in veterinary colleges in Brazil and Colombia.

Efficacy of Albumin Treatment for Patients with Cirrhosis and Infections Unrelated to Spontaneous Bacterial Peritonitis.

BACKGROUND & AIMS: We performed a randomized trial to determine whether albumin should be administered to patients with infections unrelated to spontaneous bacterial peritonitis (SBP). METHODS: We performed a multicenter, open-label trial in which 118 patients with cirrhosis, non-SBP infections, and additional risk factors for poor outcome were randomly assigned to receive antibiotics plus albumin (study group; n = 61) or antibiotics alone (control group; n = 57). The primary outcome was in-hospital mortality; secondary outcomes were effect of albumin on disease course. RESULTS: There were no significant differences at baseline between groups in results from standard laboratory tests, serum markers of inflammation, circulatory dysfunction, or liver severity scores. However, the combined prevalence of acute on chronic liver failure (ACLF) and kidney dysfunction was significantly higher in the study group (44.3% vs 24.6% in the control group; P = .02), indicating greater baseline overall severity. There was no significant difference in the primary outcome between groups (13.1% in the study group vs 10.5% in the control group; P = .66). Circulatory and renal functions improved in only the study group. A significantly higher proportion of patients in the study group had resolution of ACLF (82.3% vs 33.3% in the control group; P = .03). A significantly lower proportion of patients in the study group developed nosocomial infections (6.6% vs 24.6% in the control group; P = .007). CONCLUSIONS: In a randomized trial of patients with advanced cirrhosis and non-SBP infections, in-hospital mortality was similar between those who received albumin plus antibiotics vs those who received only antibiotics (controls). However, patients given albumin were sicker at baseline and, during the follow-up period, a higher proportion had ACLF resolution and a lower proportion had nosocomial infections. ClinicalTrials.gov no: NCT02034279.

Global warming implications from increased forest biomass utilization for bioenergy in a supply-constrained context.

This article analyzes different forest management strategies to meet the increasing demand of biomass for bioenergy and assesses the resulting global warming implications. Applied to maritime pine forest plantations in Portugal, the assessed strategies are: full harvest of residues (FULL); sustainable and proactive management (SMART); expansion of forest plantations on abandoned farmland (EXP); and biomass import (IMP). A dynamic CO2 inventory was obtained for each scenario using a parametric stand-level C-flux model adapted to Portuguese conditions, which was then extended to the landscape-level and coupled to a dynamic climate model. The time-adjusted absolute global warming potential (AGWP) was then calculated at both stand and landscape levels, considering the timing of all CO2 emissions and uptakes (both fossil and biogenic). To test the robustness of the findings, a sensitivity analysis was performed. Results show that, in a supply-constrained context like Portugal, SMART and EXP management strategies can provide important global warming mitigation benefits (GWPbio < 0), although their supply-response is slow (long-term strategies). On the other hand, FULL and IMP management strategies show moderate to null AGWP reduction potential (0 < GWPbio < 1), while involving other possible risks (e.g., exacerbated soil erosion, nutrient depletion or uncertain impacts abroad), but their supply-response is fast (short-term strategies). National forest regulations and energy policies should be revised to address the drawbacks related to all management strategies and to unleash the multiple environmental benefits they can provide in the short- and long-term.

TRAP1 regulates autophagy in lung cancer cells.

BACKGROUND: Expression of TRAP1, a member of the HSP90 chaperone family, has been implicated in tumour protective effects, based on its differential mitochondrial localization and function. DESIGN: This work was designed to provide new insights into the pathways involved in TRAP1-provided cytoprotection on NSCLC. For this, TRAP1-depleted A549 human NSCLC cells and MRC-5 normal lung fibroblasts were produced using a siRNA approach and main cellular quality control mechanisms were investigated. RESULTS: TRAP1-depleted A549 cells displayed decreased cell viability likely due to impaired mitochondrial function including decreased ATP/AMP ratio, oxygen consumption and membrane potential, as well as increased apoptotic indicators. Furthermore, the negative impact of TRAP1 depletion on mitochondrial function was not observed in normal MRC-5 lung cells, which might be due to the differential intracellular localization of the chaperone in tumour versus normal cells. Additionally, A549 TRAP1-depleted cells showed increased autophagic flux. Functionally, autophagy inhibition resulted in decreased cell viability in both TRAP1-expressing and TRAP1-depleted tumour cells with minor effects on MRC-5 cells. Conversely, autophagy stimulation decreased cell viability of both A549 and MRC-5 TRAP1-expressing cells while in A549 TRAP1-depleted cells, increased autophagy augmented viability. CONCLUSIONS: Our results show that even though TRAP1 depletion affects both normal MRC-5 and tumour A549 cell proliferation, inhibition of autophagy per se led to a decrease in tumour cell mass, while having a reduced effect on the normal cell line. The strategy of targeting TRAP1 in NSCLC shows future potential therapeutic applications.

Brazil starts to ban animal use in higher education: A positive and progressive development.

The Brazilian government has published a resolution that bans animal use in some practical classes within undergraduate and high school technical education from April 2019. Resolution No. 38/2018, issued by the National Council for the Control of Animal Experimentation (CONCEA), bans the killing of animals for dissection purposes and animal experiments in practical classes that do not involve the acquisition of new skills. The initial call for the ban was by the Brazilian Network for Humane Education (RedEH), an independent body comprising Brazilian professors and international collaborators dedicated to the implementation of replacement alternatives in education. The call was supported by InterNICHE, and many professors and other international organisations. The Brazilian Council of Veterinary Medicine, which is responsible for regulating the veterinary profession in Brazil, also stated its support for humane education and for the ban. The call was the first formal request, and it eventually led to the first legal resolution for the replacement of animal use in education in Brazil. This represents an important historic landmark in the advancement of science education.

Chemoselective tarantula toxins report voltage activation of wild-type ion channels in live cells.

Electrically excitable cells, such as neurons, exhibit tremendous diversity in their firing patterns, a consequence of the complex collection of ion channels present in any specific cell. Although numerous methods are capable of measuring cellular electrical signals, understanding which types of ion channels give rise to these signals remains a significant challenge. Here, we describe exogenous probes which use a novel mechanism to report activity of voltage-gated channels. We have synthesized chemoselective derivatives of the tarantula toxin guangxitoxin-1E (GxTX), an inhibitory cystine knot peptide that binds selectively to Kv2-type voltage gated potassium channels. We find that voltage activation of Kv2.1 channels triggers GxTX dissociation, and thus GxTX binding dynamically marks Kv2 activation. We identify GxTX residues that can be replaced by thiol- or alkyne-bearing amino acids, without disrupting toxin folding or activity, and chemoselectively ligate fluorophores or affinity probes to these sites. We find that GxTX-fluorophore conjugates colocalize with Kv2.1 clusters in live cells and are released from channels activated by voltage stimuli. Kv2.1 activation can be detected with concentrations of probe that have a trivial impact on cellular currents. Chemoselective GxTX mutants conjugated to dendrimeric beads likewise bind live cells expressing Kv2.1, and the beads are released by channel activation. These optical sensors of conformational change are prototype probes that can indicate when ion channels contribute to electrical signaling.

On the journey toward humane education in Brazil: First request for a total ban of harmful animal use in professional and higher education.

The Brazilian Network for Humane Education (RedEH( is an independent and self-managed group comprised of academics from ten different Brazilian states and a number of international collaborators. In 2016, in a concerted effort to change the educational field in Brazil and propagate humane education, RedEH sent a request to the Brazilian National Council for the Control of Animal Experimentation (CONCEA(, asking that harmful animal use in education in professional and undergraduate courses be banned. This was the first formal request for a total replacement of harmful animal use in education in Brazil, and represented a major historic landmark in the advancement of Brazilian science education. This paper presents the full text of the request, as well as outlining its national and international repercussions. The request was supported by InterNICHE and representatives of 18 other international organisations. A major national impact of the request was its recognition by the Federal Council of Veterinary Medicine. With this action, academics and researchers took a potentially revolutionary step in the Brazilian education arena, with regard to advancing and supporting a higher quality, ethical and democratic educational system.

Molecular Engineering of the Peptoid Nanosheet Hydrophobic Core.

The relationship between the structure of sequence-defined peptoid polymers and their ability to assemble into well-defined nanostructures is important to the creation of new bioinspired platforms with sophisticated functionality. Here, the hydrophobic N-(2-phenylethyl)glycine (Npe) monomers of the standard nanosheet-forming peptoid sequence were modified in an effort to (1) produce nanosheets from relatively short peptoids, (2) inhibit the aggregation of peptoids in bulk solution, (3) increase nanosheet stability by promoting packing interactions within the hydrophobic core, and (4) produce nanosheets with a nonaromatic hydrophobic core. Fluorescence and optical microscopy of individual nanosheets reveal that certain modifications to the hydrophobic core were well tolerated, whereas others resulted in instability or aggregation or prevented assembly. Importantly, we demonstrate that substitution at the meta and para positions of the Npe aromatic ring are well tolerated, enabling significant opportunities to tune the functional properties of peptoid nanosheets. We also found that N-aryl glycine monomers inhibit nanosheet formation, whereas branched aliphatic monomers have the ability to form nanosheets. An analysis of the crystal structures of several N,N'-disubstituted diketopiperazines (DKPs), a simple model system, revealed that the preferred solid-state packing arrangement of the hydrophobic groups can directly inform the assembly of stable peptoid nanosheets.

Cynomolgus monkeys (Macaca fascicularis) experimentally infected with B19V and hepatitis A virus: no evidence of the co-infection as a cause of acute liver failure.

This study was conducted to analyse the course and the outcome of the liver disease in the co-infected animals in order to evaluate a possible synergic effect of human parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus monkeys were inoculated with serum obtained from a fatal case of B19V infection and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV and B19V, liver enzyme levels, viraemia, haematological changes, and necroinflammatory liver lesions were used for monitoring the infections. Seroconversion was confirmed in all infected groups. A similar pattern of B19V infection to human disease was observed, which was characterised by high and persistent viraemia in association with reticulocytopenia and mild to moderate anaemia during the period of investigation (59 days). Additionally, the intranuclear inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte counts were more evident in the co-infected group. The present results demonstrated, for the first time, the susceptibility of cynomolgus to B19V infection, but it did not show a worsening of liver histopathology in the co-infected group.

Medicina Veterinaria Forense, Bienestar y Maltrato Animal: Percepciones y Conocimiento de Estudiantes de Medicina Veterinaria Colombianos y Brasileños.

Los médicos veterinarios juegan un papel fundamental en la detección de casos de maltrato animal y violencia doméstica. Por lo tanto, es esencial que las escuelas de medicina veterinaria brinden una formación adecuada en bienestar animal y medicina veterinaria forense. El objetivo del presente artículo es caracterizar la percepción y el conocimiento de los estudiantes de medicina veterinaria sobre la formación en medicina veterinaria forense, bienestar animal y la asociación entre maltrato animal y violencia humana. Un cuestionario online fue distribuido a los estudiantes de las 227 y 22 facultades de medicina veterinaria en Brasil y Colombia, respectivamente. Pruebas de chi-cuadrado fueron realizadas para comparar las respuestas de las variables categóricas entre los estudiantes de Brasil y Colombia. La mayoría de los estudiantes encuestados indicaron que su escuela ofrecía capacitación en bienestar animal. Sin embargo, solo el 21.8% (47/216) de los estudiantes colombianos y el 43.1% (216/523) de los brasileños mencionaron que su facultad ofrecía formación en medicina veterinaria forense. En ambos países fueron identificadas deficiencias en la capacitación sobre la identificación de traumas no accidentales, denuncia de maltrato animal y el conocimiento sobre la asociación entre maltrato animal y violencia interpersonal. A pesar de esto, más del 90% de los estudiantes relataron ser conscientes de la relación que existe entre estos dos crímenes y la importancia de recibir capacitación obligatoria sobre maltrato animal y medicina veterinaria forense. Adicionalmente, la mayoría de los encuestados reconocieron que el maltrato animal incluye tanto el abuso físico como el mental. Nuestros resultados destacan la necesidad de mejorar la educación en bienestar animal, maltrato animal, violencia humana y medicina veterinaria forense en las facultades de medicina veterinaria de Brasil y Colombia.

Humane Education in Brazil: Organisation, Challenges and Opportunities.

Humane education and the debate on alternatives to harmful animal use for training is a relatively recent issue in Brazil. While animal use in secondary education has been illegal since the late 1970s, animal use in higher science education is widespread. However, alternatives to animal experiments in research and testing have recently received attention from the Government, especially after the first legislation on animal experiments was passed, in 2008. This article proposes that higher science education should be based on a critical and humane approach. It outlines the recent establishment of the Brazilian Network for Humane Education (RedEH), as a result of the project, Mapping Animal Use for Undergraduate Education in Brazil, which was recognised by the 2014 Lush Prize. The network aims to create a platform to promote change in science education in Brazil, starting by quantitatively and qualitatively understanding animal use, developing new approaches adapted to the current needs in Brazil and Latin America, and communicating these initiatives nationally. This paper explores the trajectory of alternatives and replacement methods to harmful animal use in training and education, as well as the status of humane education in Brazil, from the point of view of educators and researchers engaged with the network.

Doxorubicin-induced cardiotoxicity: from bioenergetic failure and cell death to cardiomyopathy.

Doxorubicin (DOX) is an anticancer anthracycline that presents a dose-dependent and cumulative cardiotoxicity as one of the most serious side effects. Several hypotheses have been advanced to explain DOX cardiac side effects, which culminate in the development of life-threatening cardiomyopathy. One of the most studied mechanisms involves the activation of DOX molecule into a more reactive semiquinone by mitochondrial Complex I, resulting in increased oxidative stress. The present review describes and critically discusses what is known about some of the potential mechanisms of DOX-induced cardiotoxicity including mitochondrial oxidative damage and loss of cardiomyocytes. We also discuss alterations of mitochondrial metabolism and the unique characteristics of DOX delayed toxicity, which can also interfere on how the cardiac muscle handles a "second-hit stress." We also present pharmaceutical and nonpharmaceutical approaches that may decrease DOX cardiac alterations in animal models and humans and discuss the limitations of each strategy.

Clinical features and laboratory findings of human parvovirus B19 in human immunodeficiency virus-infected patients.

Immunocompromised patients may develop severe chronic anaemia when infected by human parvovirus B19 (B19V). However, this is not the case in human immunodeficiency virus (HIV)-infected patients with good adherence to highly active antiretroviral treatment (HAART). In this study, we investigated the clinical evolution of five HIV-infected patients receiving HAART who had B19V infections confirmed by serum polymerase chain reaction. Four of the patients were infected with genotype 1a strains and the remaining patient was infected with a genotype 3b strain. Anaemia was detected in three of the patients, but all patients recovered without requiring immunoglobulin and/or blood transfusions. In all cases, the attending physicians did not suspect the B19V infections. There was no apparent relationship between the infecting genotype and the clinical course. In the HAART era, B19V infections in HIV-positive patients may be limited, subtle or unapparent.

Genetic characterization of the parvovirus full-length VP2 gene in domestic cats in Brazil.

Feline parvovirus (FPV) and canine parvovirus (CPV) are over 98% identical in their DNA sequences, and the new variants of CPV (2a/2b/2c) have gained the ability to infect and replicate in cats. The aim of this study was to determine the genetic diversity in the VP2 gene of parvovirus strains circulating in domestic cats in Brazil during a 10-year period (2008-2017). For parvovirus screening, specific PCR was performed, and 25 (34.7%) of 72 cats tested positive. The PCR-positive samples were further subjected to full-length VP2 sequencing (1755 bp), and eight sequences (36%) were characterized as FPV, seven (28%) as CPV-2a and (32%) nine (36%) as CPV-2b. One sequence (RJ1085/11) showing typical CPV amino acid (aa) at residues 80 R, 93 N, 103 A, 232 I, and 323 N could not be characterized at this time. The sequences in this study displayed aa changes previously described for FPV (A14T, A91S, I101T, N564S, and A568G) from cats and CPV-2a/2b (S297N and Y324L) from dogs. However, the Y324L mutation has not yet been reported in any CPV-2a/2b strains from cats. Phylogenetic analysis supported the division of these sequences into two well-defined clades, clade 1 for FPV and clade 2 for CPV2a/2b. Unusually, the sequence RJ1085/11 was grouped separately. Two recombination breakpoints were detected by Bootscan and 3Seq methods implemented in the RDP4. This study is the first report of CPV-2a/2b in cats in Brazil. The detection of FPV strains with mutations characteristic of CPV indicates that Brazilian FPV strains have undergone genetic changes.

Clinical, hematological, and biochemical findings in puppies with coronavirus and parvovirus enteritis.

The clinical and laboratory findings in puppies naturally infected with canine coronavirus (CCoV) and/or canine parvovirus (CPV) were compared with findings in uninfected puppies. Lymphopenia was the only parameter related to CCoV infection that was statistically significant; vomiting, anorexia, lethargy, hemorrhagic fluid diarrhea, leukopenia, lymphopenia, thrombocytopenia, hypoglycemia, and hypoproteinemia were correlated with CPV infection.

Résultats cliniques, hématologiques et biochimiques chez des chiots atteints de l'entérite à coronavirus et à parvovirus. Les résultats cliniques et de laboratoire chez des chiots naturellement infectés par le coronavirus canin (CoVC) et/ou le parvovirus canin (PVC) ont été comparés aux résultats des chiots non infectés. La lymphopénie était le seul paramètre statistiquement significatif associé à l'infection par le CoVC; les vomissements, l'anorexie, la léthargie, la diarrhée liquide hémorragique, la leucopénie, la lymphopénie, la thrombocytopénie, l'hypoglycémie et l'hypoprotéinémie étaient tous associés à l'infection par le PVC.(Traduit par Isabelle Vallières).

Parvovirus B19 seroconversion in a cohort of human immunodeficiency virus-infected patients.

Erythrovirus B19 (B19V) infection may cause red cell aplasia in patients infected with human immunodeficiency virus (HIV). The introduction of highly active antiretroviral therapy (HAART) has improved the immune function of these patients by modifying the course of B19V infection. The purpose of this study was to estimate the frequency of B19 seroconversion in a cohort of HIV-infected patients and evaluate the occurrence of B19V-related anaemia during the seroconversion period. Adult HIV-infected patients were studied at a public hospital in Niterói, state of Rio de Janeiro, Brazil. IgG and IgM antibodies against B19V were detected by an enzyme-linked immunosorbent assay and B19 viraemia was assayed by polymerase chain reaction. Medical records were reviewed for any clinical evaluation of anaemia. Seroconversion was detected in 31.8% of the 88 individuals who began the study as anti-B19V IgG-negative. No clinical manifestations of B19V infection were detected during the period of seroconversion. Patients who seroconverted were 5.40 times more likely to have anaemia than those who did not [odds ratio 5.40 (95% confidence interval: 1.33-22.93)]. Anaemia was detected in eight patients. All patients recovered from anaemia by either beginning or continuing HAART, without requiring blood transfusions. In the HAART era, B19V infection may only be associated with a course of disease characterised by less severe chronic anaemia. This milder course of B19V-associated disease is likely due to the increased immune function of HAART-treated patients.