ABSTRACT
There have been reports of neurological abnormalities associated with the Zika virus (ZIKV), such as congenital Zika syndrome (CZS) in children born to mothers infected during pregnancy. We investigated how the immune response to ZIKV during pregnancy is primed and conduct a thorough evaluation of the inflammatory and cytotoxic profiles as well as the expression of CCR5 and CX3CR1. We compared the reactivity of T cells to ZIKV peptides in convalescent mothers infected during pregnancy. The child's clinical outcome (i.e., born with or without CZS) was taken to be the variable. The cells were stimulated in vitro with ZIKV peptides and evaluated using the ELISPOT and flow cytometry assays. After in vitro stimulation with ZIKV peptides, we observed a tendency toward a higher Interferon gamma (IFN-γ)-producing T cell responses in mothers who had asymptomatic children and a higher CD107a expression in T cells in mothers who had children with CZS. We found a higher frequency of T cells expressing CD107a+ and co-expressing CX3CR1+CCR5+, which is much clearer in the T cells of mothers who had CZS children. We suggest that this differential profile influenced the clinical outcome of babies. These data need to be further investigated, including the evaluation of other ZIKV peptides and markers and functional assays.
Subject(s)
CX3C Chemokine Receptor 1/metabolism , Pregnancy Complications, Infectious/immunology , Receptors, CCR5/metabolism , T-Lymphocytes/immunology , Zika Virus Infection/immunology , Adult , Cross-Sectional Studies , Cytotoxicity, Immunologic , Female , Humans , Infant , Interferon-gamma/metabolism , Lysosomal Membrane Proteins/metabolism , Pregnancy , Pregnancy Outcome , T-Lymphocytes/metabolism , Young Adult , Zika Virus/immunologyABSTRACT
A triagem e o tratamento das doenças infecciosas em gestantes são de grande importância para o planejamento de ações preventivas e a elaboração de políticas de saúde materno-infantil. Objetivo: Determinar a soroprevalência de toxoplasmose, sífilis, hepatite B, hepatite C, rubéola, citomegalovírus (CMV) e infecção pelo vírus da imunodeficiência humana (HIV) em gestantes acompanhadas no Hospital Universitário Antônio Pedro, Niterói (RJ). Métodos: Foi feito um estudo transversal por meio de revisão de testes sorológicos registrados nos prontuários médicos de gestantes atendidas, de 2008 a 2012, no Ambulatório de Pré-Natal. Resultados: As prevalências encontradas foram: 61,4 (IgG) e 2,4% (IgM) para toxoplasmose; 95,1 (IgG) e 0,5% (IgM) para rubéola; 95,1 (IgG) e 1,2% (IgM) para CMV; 0,9% para hepatite B (HBsAg); 1,6% para hepatite C; 1,5% para sífilis; e 5,8% para infecção pelo HIV. Não houve, entre gestantes infectadas e não infectadas pelo HIV, diferenças estatisticamente significativas nas frequências das infecções estudadas. As taxas de transmissão vertical foram de 4,2% (2/48) para o HIV; 33,3% (5/15) para toxoplasmose; e 22,2% (2/9) para sífilis. Foram detectadas alterações compatíveis com rubéola congênita em 1/5 crianças cuja mãe apresentava IgM e IgG positivas para tal infecção durante a gestação. A coinfecção HIV/toxoplasmose ocorreu em uma criança. Conclusão: O número de gestantes susceptíveis à toxoplasmose (38,8%) e ao vírus da hepatite B (VHB) (66,3%) revela a necessidade de medidas diagnósticas e preventivas da toxoplasmose durante a gestação e vacinação para o VHB, visando diminuir o risco dessas infecções durante a gravidez, melhorando, assim, a saúde materno-infantil.
Screening and treatment of infectious diseases in pregnant women have great importance in planning preventive actions and development of maternal and child health policies. Objective: To evaluate the seroprevalence of toxoplasmosis, syphilis, hepatitis B, hepatitis C, rubella, cytomegalovirosis and human immunodeficiency virus (HIV) infection among pregnant women followed up at a University Hospital of Niterói, RJ. Methods: A cross-sectional study was done by reviewing serological tests recorded in the medical records of pregnant women attending the antenatal service of the Hospital Antônio Pedro, Universidade Federal Fluminense, from 2008 to 2012. Results: The seroprevalences found were 61.4 (IgG) and 2.4% (IgM) for toxoplasmosis; 95.1 (IgG) and 0.5% (IgM) for rubella; 95.1 (IgG) and 1.2% (IgM) for cytomegaloviruosis; 0.9% for hepatitis B surface antigen; 1.6% for hepatitis C virus; 1.5% for syphilis and 5.8% for HIV infection. There were no statistically significant differences between seroprevalences of patients with or without HIV infection. The rates of congenital transmission were 4.2% (2/48) for HIV, 33.3% (5/15) for toxoplasmosis, and 22.2% (2/9) for syphilis. There were congenital abnormalities in 1/5 newborn whose mother was seropositive for rubella IgG and/or IgM in the prenatal routine. Coinfection HIV/toxoplasmosis was found in one newborn. Conclusion: The large proportion of pregnant women susceptible to toxoplasmosis (38.8%) and hepatitis B (66.3%) shows the necessity of diagnostic and preventive measures for toxoplasmosis and HBV vaccination to reduce the risk of vertical transmission of these infections, thus improving the health of mother and newborn.
Subject(s)
Humans , Female , Pregnancy , Cytomegalovirus , Hepatitis B , Hepatitis C , HIV , Measles , Syphilis/transmission , Toxoplasmosis/transmission , Coinfection , Hospitals, University , Infectious Disease Transmission, Vertical , Maternal and Child Health , Prenatal Care , Seroepidemiologic StudiesABSTRACT
BACKGROUND: Serologic immunity studies are necessary to evaluate immunization policies for rubella control and prevention of congenital rubella syndrome (CRS), and serologic data from regular testing for clinical follow-up can be used to complement surveillance information. METHODS: To assess immunity to rubella after an immunization campaign in 12-29-year-old girls and women, we retrospectively reviewed immunoglobulin (Ig) G tests performed from 2000 to 2003 in 9610 serum samples from pregnant subjects in Niterói, Rio de Janeiro, Brazil. Serologic tests for rubella were performed using commercial enzyme immunoassays. RESULTS: Rubella IgG were positive in 83.9% of serum samples collected before the campaign and in 92.5% after the campaign. The proportion of seropositive subjects was inversely related to age (P < .001). The proportion of immune girls or women aged 12-29 years, targeted by the campaign, was significantly increased after the campaign, whereas women aged ≥ 30 years, not targeted by the campaign, had no change in serologic immunity. Geometric mean titers for rubella IgG were significantly higher among pregnant girls and women after the vaccination campaign. CONCLUSIONS: The convenience sample provided evidence of increased population immunity among the girls and women targeted by the campaign, but with a coverage of only 83% there remains a significant population at risk for rubella and thus congenital rubella syndrome.
