Vertical transmission of HIV-1 in the western region of the State of São Paulo / Transmissão vertical do HIV-1 na região oeste do Estado de São Paulo

INTRODUCTION: This study aimed to determine the prevalence of vertical HIV-1 transmission in the western region of the State of São Paulo, Brazil. METHODS: The study analyzed the medical records of HIV-1-infected mothers and infant pairs living in the municipalities of São Paulo Regional Health Departments DRS II (Araçatuba) and DRS XI (Presidente Prudente). From March 2001 to March 2006, blood samples were collected and referred to the Molecular Biology Unit of the Adolfo Lutz Institute (ALI), Presidente Prudente. HIV-1-RNA viral load was determined by bDNA assay. RESULTS: The number of births (109/217, 50.2 percent) and vertical HIV-1 transmissions (6/109, 5.5 percent) that occurred in DRS II was similar to births (108/217, 49.8 percent) and vertical transmissions (7/108, 6.5 percent) in DRS XI (p > 0.05). Although 80 percent (4/5) of the infected children were male in DRS II, while in DRS XI, 75 percent (6/8) were female, no differences between sex regarding infected and noninfected children in the regions of Araçatuba and Presidente Prudente were verified. The overall vertical HIV-1 transmission rate was 6 percent. No consistent reduction in the prevalence of vertical HIV-1 transmission occurred over the years. About 20 percent of mothers did not know the HIV-1 status of their newborns eight months after delivery. CONCLUSIONS: In the present study, MTCT prevalence rates were about 70 percent higher than those previously determined in the State of São Paulo, with noreduction throughout the period.Furthermore, a significant number of mothers did not know the HIV-status of their newborns eight months after delivery.

INTRODUÇÃO: O objetivo desse estudo foi determinar a prevalência da transmissão vertical do HIV-1 na região oeste do Estado de São Paulo, Brasil. MÉTODOS: Foram analisadas as fichas de mães infectadas pelo HIV-1 e recém-nascidos, residindo em municípios das Delegacias Regionais de Saúde (DRS II, Araçatuba) e (DRS XI, Presidente Prudente). Entre março de 2001 e março de 2006 as amostras foram colhidas e enviadas ao Instituto Adolfo Lutz, Presidente Prudente. A carga viral do RNA-HIV-1 foi determinada por bDNA. RESULTADOS: O número de nascimentos, 50,2 por cento (109/217) e a transmissão vertical do HIV-1, 5,5 por cento (6/109) ocorrido na DRS II foi semelhante aos nascimentos, 49,8 por cento (108/217) e a transmissão vertical, 6,5 por cento (7/108) ocorrido na DRS XI, respectivamente. Embora na DRS II, 80 por cento (4/5) das crianças infectadas fossem meninos e na DRS XI, 75 por cento (6/8) meninas, não houve diferença entre sexo em crianças infectadas ou não nas regiões de Presidente Prudente e Araçatuba. A taxa de transmissão vertical para o HIV-1 foi de 6 por cento.Não houve diminuição da taxa de infecção ao longo dos anos. Cerca de 20 por cento das mães não haviam feito exame para HIV-1 de seus filhos oito meses após o nascimento. CONCLUSÕES: A transmissão vertical para HIV-1 foi cerca de 70 por cento maior que a encontrada anteriormente no Estado de São Paulo, sem diminuição ao longo do período. Além disso, um número expressivo de mães não realizou exame de seus filhos oito meses após o nascimento.

Cystic brain metastases radiologically simulating neurocysticercosis / Metástases císticas cerebrais simulando neurocisticercose radiologicamente

CONTEXT: Brain metastases are common complications of cancer. Magnetic resonance imaging (MRI), the main diagnostic imaging method in these cases, rarely shows cystic images. CASE REPORT: The patient was a 45-year-old woman who had had severe headache for a month that was refractory to medication, and had previously had breast cancer, which had been treated. The MRI showed the criteria for neurocysticercosis. Since there was no improvement with clinical treatment, we chose to excise the lesions. Histopathological analysis showed an epithelioid malignant neoplasm. CONCLUSION: From immunohistochemical analysis, it was concluded that this was a metastasis of breast carcinoma. Even when the MRI is not characteristic of cerebral metastasis, this hypothesis needs to be ruled out in patients with a previous history of cancer.

CONTEXTO: Metástases cerebrais são complicações comuns do câncer. A ressonância nuclear magnética (RNM), principal método de diagnóstico por imagem nesses casos, mostra raramente imagens císticas. RELATO DO CASO: A paciente era uma mulher de 45 anos de idade, com cefaleia intensa há um mês, refratária à medicação, e câncer de mama tratado previamente. A RNM apresentava critérios diagnósticos para neurocisticercose. Como não apresentou melhora com tratamento clínico, optou-se pela exérese das lesões. O histopatológico mostrou neoplasia maligna epitelioide. CONCLUSÃO: A imunoistoquímica revelou metástase de carcinoma da mama. Mesmo quando a RNM não é característica de metástase cerebral, esta hipótese precisa ser afastada em pacientes com história prévia de câncer.

Gastroenterite eosinofílica: relato de caso / Eosinophilic gastroenteritis: case report

A gastroenterite eosinofílica é uma doença rara, de etiologia desconhecida, com infiltração eosinofílica da parede gastrintestinal a uma profundidade variável e diversas manifestações gastrintestinais. Relatamos o caso de um homem de 37 anos admitido com queixa aguda de dor abdominal e vômitos biliares. Tratava-se de uma gastroenterite eosinofílica, com infiltração predominante da camada muscular (submucosa e lâmina própria), que respondeu a um curso de corticoide em doses baixas, estando assintomático até o momento em que se relatou o caso.

Eosinophilic gastroenteritis is a rare disease of unknown etiology, with eosinophilic infiltration of the gastrointestinal wall to a depth variable and various gastrointestinal symptoms. We report the case of a 37 year old man admitted with complaints of acute abdominal pain and vomiting bile. It was an eosinophilic gastroenteritis with predominant infiltration of the muscle layer (submucosa and lamina propria), which responded to a course of steroids in low doses, with no symptoms until the time it was reported the case.

Seroprevalence of HBV, HCV and HIV co-infection in selected individuals from state of São Paulo, Brazil

Few studies are available on hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection in populations living in small and medium-sized Brazilian cities. We evaluated the seroprevalence of these viruses in selected individuals from a clinic of infectology, who were referred to the University Regional Hospital of the West Region of state of São Paulo, Brazil. Among a total of 7,021 individuals seen in the clinic following receipt of preliminary ELISA results or having the suggested clinical signs of viral hepatitis or HIV, 1,228 were systematically screened. Isolated or associated HBsAg, HCV and HIV antibodies were found in 44.9 percent of the subjects. Anti-HIV antibodies were found in 24.7 percent of the patients, 20.3 percent of whom had an HIV monoinfection and 4.4 percent of whom were co-infected with hepatitis viruses (HCV: 4 percent; HBV: 0.4 percent). Anti-HCV antibodies were found in 14 percent of the patients and 5.9 percent had anti-HBsAg antibodies. HCV infection affected males more than females (p < 0.05) and individuals > 50-years old had an increased prevalence of anti-HCV compared to HIV (p = 0.0001) or HBV (p = 0.0063). HCV-RNA was detected in 73.5 percent of the samples with a predominance of genotype 1 (72.5 percent). A significant percentage (44.9 percent) of the selected individuals was positive for antibodies against HBV, HCV and/or HIV; these patients would otherwise have remained undiagnosed.