Detection and quantification of hepatitis E virus in the absence of IgG and IgM anti-HEV in HIV-positive patients.

AIMS: To improve RT-qPCR with an internal control and a synthetic standard curve to detect HEV in HIV co-infected patients. METHODS AND RESULTS: A single-stranded RNA (ssRNA) and a double-stranded DNA (dsDNA) synthetic curve were designed, compared to the international reference panel for HEV genotypes, and tested to quantify and detect a reference panel for HEV genotypes. The detection limit of the RNA synthetic curve (50 copies per ml) was better than the DNA synthetic curve (100 copies per ml) and the WHO standard curve (250 copies per ml). Then, 280 serum samples from HIV-positive patients were tested for HEV RNA, which was detected in 3·6% of serum samples. The viral load ranged from 2 × 102 copies per ml to 4·78 × 108 copies per ml. HEV IgM/IgG antibodies were not detected in the RNA-positive patients. Sequencing analysis of HEV showed that the virus belongs to genotype 3 (HEV GT3). CONCLUSIONS: Real-time PCR was a useful tool to estimate co-infection with HEV/HIV, even in patients with low viral loads and undetectable anti-HEV IgG and IgM antibodies. SIGNIFICANCE AND IMPACT OF THE STUDY: Hepatitis E virus genotype 3 (HEV GT3) has been associated with silent chronic hepatitis and cirrhosis in HIV-positive subjects worldwide, but there is a lack of data on this co-infection in Brazil.

Soroprevalência da sífilis em gestantes HIV-negativas, obtida de três testes diagnósticos: VDRL, ELISA, TPHA / Syphilis seroprevalwence in HIV-negative pregnant women, using tree diagnostic tests: VDRL, ELISA M and TPHA

A sífilis é uma infecçäo crônica com diversas manifestaçöes clínicas que ocorrem ao longo de estágios variados. Apesar do seu declínio última década, tem sido, novamente, um importante problema de saúde pública. No Brasil, a média de prevalência é de 4 por cento pelo VDRL, em gestantes atendidas em serviços públicos. Na gestaçäo constitui problema importante, pela gravidade das lesöes e pela possiblidade real da profilaxia medicamentosa. É grande a dificuldade de se proceder ao diagóstico nesta fase, e ainda sim, mesmo com tratamento apropriado, durante a gestaçäo a infecçäo fetal poderá ocorrer em mais de 14,0 por cento dos casos. O presente trabalho objetiva determinar a soroprevalência da sífilis por meio da realizaçäo de prova de VDRL confirmada por teste específico