HLA-B*14 allele predicts HIV-1 mother-to-child-transmission, in Salvador, Brazil

ABSTRACT Background: Class I human leukocyte antigens, especially the molecules encoded at the B locus (HLA-B), are associated with AIDS progression risk. Different groups of HLA-B alleles have been associated to a protective effect or increasing susceptibility to HIV infection and are expressed from the earliest stages of gestation. Objective: The aim of this study was to evaluate which variants of HLA-B are associated with the risk of HIV vertical transmission in infected pregnant women and in their offspring, in a referral center in Salvador Bahia. Methods: We performed HLA-B genotyping in 52 HIV-infected mothers and their children exposed to HIV-1 during pregnancy (N = 65) in Salvador, Brazil. We compared the HLA-B alleles frequency in mothers, uninfected and infected children, according to the use of antiretroviral prophylaxis. Results: Absence of antiretroviral antenatal and postnatal prophylaxis was significantly associated with vertical transmission of HIV-1 (p = <0.01, and p = <0.01 respectively). Frequency of HLA-B*14 (29.2%, p = 0.002), HLA-B*18 (16.7%, p = 0.04) or HLA-B*14:1 (20.8%, p = 0.01) alleles subgroups were significantly higher in HIV-1 infected children and persisted (HLA-B*14, p = 0.04) even after adjusting for use of antiretroviral prophylaxis. No significant difference in expression of HLA-B alleles was observed among mothers who transmitted the virus compared to those who did not. Conclusions: Expression of HLA-B*14 allele in children exposed to HIV-1 is predictive of vertical transmission and reinforces the important role of genetics in mother-to-child transmission.

A systematic review on the influence of hla-b polymorphisms on hiv-1 mother-to-child-transmission

ABSTRACT Background: Mother-to-child-transmission (MTCT) is the main route of HIV-1 infection in children. Genetic studies suggest HLA-B alleles play an important role on HIV-1 transmission, progression, and control of HIV-1 infection. Objective: To evaluate which polymorphisms of HLA-B are involved in HIV-1 MTCT. Methods: Two independent reviewers performed a systematic review on search engines PubMed, Europe PMC, Cochrane, Scientific Electronic Library Online (SciELO), and Literatura Latino-americana e do Caribe em Ciências da Saúde (Lilacs), using the following key terms: "HIV infection", "HIV newborn", "HLA polymorphisms", "HLA-B", and "Mother to child transmission". All studies focusing on evaluation of HIV-1 MTCT, HIV infection evolution, and molecular analyses of HLA-B in children were selected. Results: Nine studies fulfilled the inclusion criteria. Sixteen HLA-B alleles groups were associated with HIV-1 infection; seven of them (43.8%) were related to slow disease progression or reduced risk of MTCT, while six (37.5%) alleles groups were linked to a faster progression of HIV infection in children and to increased risk of MTCT. The available evidence suggest that HLA-B*57 group allele is associated with slow disease progression, while HLA-B*35 group allele is associated to increased risk of MTCT and rapid disease progression in infected children. The role of HLA-B*18, B*58 and B*44 are still controversial because they were associated to both, protection against MTCT, and to higher HIV replicative capacity, in different studies. Conclusion: HLA-B*57 group allele can be protective against MTCT while HLA-B*35 groups alleles are consistently associated with HIV-1 MTCT.

Historia de las vasculitis primarias en Latinoamérica / History of primary vasculitis in Latinoamerican

En este artículo se hace una revisión extensa sobre las vasculitis primarias y se recopila la información latinoamericana que aparece referen-ciada en las más importantes bases de datos mundiales en inglés, español y portugués, desde el año 1945 hasta septiembre del año 2007. Igualmente se establecieron varios contactos con reumatólogos o médicos interesados en este tópico. Se realizaron búsquedas secundarias de los estudios que aparecieran citados en los artículos seleccionados y se revisaron manualmente abstracts de congresos.

In this paper an extensive review about primary vasculitis and Latino American information that appears referenced in the most important world wide data bases in English, Spanish and Portuguese from 1945 to september 2007, is compiled. Several contacts with rheumatologist or physician interested in this topic were made. Also secondary searches of the studies that appeared mentioned in selected articles were made and the abstracts of congresses were reviewed manually.

Estandarización de la versión peruana del índice de incapacidad funcional del cuestionario de evaluación de salud (Health Assessment Questionnaire - HAQ) / Standarization for a peruvian version of the functional incapacity index in the health assessment questionnaire (HAQ)

Objetivo: estandarizar la versión peruana del Indice de Incapacidad Funional del Cuestionario de Evaluación de Salud [Health Assessment Questionaire (HAQ)] en pacientes de 3 hospitales de Lima-Perú. Material y métodos: a 41 pacientes con Artritis Reumatoide, según los criiiiterios del Colegio Americano de Reumatología se les aplicó el HAQ, para medir el grado de incapacidad funcional [Incapacidad referida (Ir)] y se comparó con una observación directa de 12 actividades [Incapacidad observada (Io)]. Análisis Estadístico: con el coeficiente de correlación de Pearson entre la Ir y la Io. Resultado: El promedio del cuestionario fue 0,50 (escala de 0-3) rango de 0,00 a 1,87, el resultado promedio de la observación directa fue 0,45(0,00-158, p menor 0,0001). Conclusión: la buena correlación entre lo referido y lo observado, hace que el HAQ-versión peruana deba ser aplicado a un número mayor de pacientes nacionales y por un período más prolongado para confirmar esta validación.