HIV knowledge and its correlation with the Undetectable = Untransmittable slogan in Brazil

ABSTRACT Knowledge about HIV transmission and prevention is a necessary step for adopting preventive behaviors. We assessed HIV knowledge and its correlation with the perceived accuracy of the "Undetectable = Untransmittable" (U=U) slogan in an online sample with 401 adult Brazilians. Overall, 28% of participants showed high HIV knowledge level. The perceived accuracy of the U=U slogan significantly correlated with HIV knowledge. Younger participants, those reporting lower income or lower education, or who had never tested for HIV showed poorer HIV knowledge. Filling gaps of knowledge among specific populations is urgent in order to increase preventive behaviors and decrease HIV stigma.

Hepatitis B virus infection confirmation and infection status identification in blood donors without serological markers / 中国输血杂志

【Objective】 To confirm Hepatitis B virus (HBV) infections and identify infection status by excluding false positive in blood donors reactive to nucleic acid testing (NAT) but without serological markers (Seroneg-NAT). 【Methods】 Seroneg-NAT yields were selected among blood donors in Dalian Blood Center from November 1, 2010 to February 28, 2021, and their HBV DNA was further confirmed with TaqMan HBV DNA quantification or virions concentration by polyethylene glycol (PEG) precipitation combined with in-house nested PCR targeting the S, BCP, PreS/S and Precore/core regions of the viral genome, and follow-up test was carried out, including blood routine screening and HBsAg, anti-HBs and anti-HBc testing. HBV infection was confirmed by HBV DNA yielding and anti-HBs/anti-HBc seroconversion in follow-up testing, and HBV DNA was further sequenced if necessary. 【Results】 During the period of 10 years and 4 months, 0.03% (126/466 911) Seroneg-NAT yields were selected, of which 46.8% (59/126) were HBV DNA+ and 53.2% (67/126) were unconfirmed. Among 126 Seroneg-NAT yields, 40.5% (51/126) were involved in follow-up test, of which 28 were HBV DNA+ and 23 were unconfirmed. HBV infections were confirmed in 48% (60/126) of Seroneg-NAT yields. Of follow-up donors, 54.9% (28/51) were identified as early infection before seroconversion, 2.0% (1/51) seronegative occult HBV infection (OBI), and 37.3% (19/51) NAT false positive. There were still 5.9% (3/51) classified as the indetermination. 【Conclusion】 Nearly half Seroneg-NAT yields in Dalian blood donors were infected with HBV and more than 50% were early infections before seroconversion. The majority of HBV DNA unconfirmed without serological markers were false positives.

Seroprevalence of Rubella in a Subfertility Clinic of a Semi Urban Tertiary Care Private Hospital of Eastern India

Introduction: Primary maternal rubella virus infectionduring the first trimester of pregnancy carries a high risk fordevelopment of congenital rubella syndrome. According tothe estimate of World Health Organization, worldwide morethan 100,000 children are born with CRS each year. Mostof these children are born in developing countries. Severalguidelines suggest routine rubella serology testing in womentrying for pregnancy. Objectives: This study was conductedto assess immunity (seroprevalence) to rubella among Indianwomen of childbearing age attending subfertility clinic and toobserve the trend over the years.Material and methods: Women attending subfertility clinichad serum sample tested to determine the seropositivityas part of subfertility work up. Rubella seropositivity wasdetermined by estimating IgG antibodies to rubella virus usingCLIA method.Results: The study period was from January 2011 to December2018. Three hundred and seventy seven women were testedfor estimation of Rubella IgG. Overall seronegativity was29.4%. Interestingly this seronegativity rate was very similarover the study period, demonstrating overall nearly one-thirdof the subfertile women were susceptible to rubella.Conclusion: These observations indicate high rubellasusceptibility among women in the childbearing age grouptrying for pregnancy. There is a need for detection ofseroprevalence in subfertile population in Eastern India; sothat appropriate vaccination can prevent this preventabletragedy of perinatal / neonatal morbidity. Further study isneeded to determine the magnitude of problem in other settings(Government hospital, rural population, low socioeconomicstatus).

Goma sifilítica intracraneal en un paciente adolescente VIH seronegativo: reporte de un caso / Intracranial syphilitic gummain an HIV negative adolescent patient: a case report

La sífilis es una enfermedad sistémica causada por la espiroqueta Treponema pallidum que compromete al sistema nervioso central en cualquier etapa y cuyas presentaciones clínicas se modificaron en las últimas décadas. Se presenta el caso de un varón de 16 años con antecedentes de conducta sexual de riesgo y sífilis hace 3 años, sin recibir tratamiento. Acude por cefalea y disminución de visión hace 4 meses. Evaluación inicial objetiva hemianopsia homónima derecha, edema papilar bilateral y retinopatía exudativa izquierda. Pruebas serológicas de sífilis reactivas, VIH: no reactivo. Resonancia magnética de encéfalo: proceso expansivo en lóbulo occipital izquierdo captador de contraste. Recibió tratamiento para sífilis por 3 días y por sospecha inicial de proceso neoproliferativo se realizó biopsia que evidenció proceso granulomatosocrónico sifilítico. En su reingreso, mostró mayor compromiso de agudeza y defecto del campo visual. Potenciales evocados visuales: ausente en ambos ojos. Se inició Penicilina G sódica por 4 semanas (por evidencia de mejoría imagenológica) asociado a corticoides, encontrando disminución serológica y discreta mejoría clínica al término del tratamiento. La neurosífilis gomatosa esuna presentación infrecuente de la sífilis terciaria debiéndose considerar como diagnóstico diferencial en lesiones expansivas intracraneales en individuos VIHseronegativos con serología de sífilis reactiva.

Syphilis is a systemic disease caused by the spirochete Treponema pallidum which can compromise the central nervous system at any stage and whose clinical presentations have been modified in recent decades. Were port the case of a 16 years old male with a 3-years history of sexual risk behavior and syphilis with no treatment who experienced headache and decreased vision for four months. Initial assessment showed right homonymous hemianopia, bilateral papilledema and left exudative retinopathy. Serological tests for syphilis: reactive HIV: non-reactive. Brain MRI revealed a single irregularly enhancing lesion in the left occipital lobe. He received treatment for syphilis for three days, and stereotactic biopsies were performed by the initial suspicion of brain tumour. Histological examination showed a chronic granulomatous consistent with neurosyphilis. In his read mission, greater affectation of acuity and visual field defect was evident. Visual evoked potentials: absent in both eyes. Penicillin G sodium was initiated for 4weeks (for evidence of improvement imagenological)associated with corticosteroids, showing serological and discrete clinical improvement at the end of treatment decreased. The gummatous neurosyphilisis a rare form of tertiary syphilis which ever considered as differential expansive intracranial lesions in HIV-seronegative individuals with reactive syphilis serology.

Outcome of Disseminated Intravascular Coagulation without Documented Antiphospholipid Antibody Successfully Treated with Rituximab

Catastrophic antiphospholipid syndrome (APS) is defined as a rare, life-threatening autoimmune disorder leading to multiorgan failure. Probable APS, with clinical manifestations similar to APS without antiphospholipid antibodies, was suggested to be seronegative catastrophic APS. The triggering factors of catastrophic APS are various, including infection, trauma, malignancy, and surgery. In approximately 40% of patients, catastrophic APS develops from an unknown cause. We report a case of seronegative catastrophic APS due to an unknown origin. A 20-year-old man presented with cough, abdominal pain, skin lesions, tunnel vision, and watery diarrhea without fever. His symptoms and laboratory test suggested disseminated intravascular coagulation. Considering seronegative catastrophic APS, we treated with intravenous steroid and intravenous immunoglobulin, but the effects were limited. After weekly treatment with rituximab, an immune-modulating agent, his laboratory findings including thrombocytopenia and coagulation tests, returned to normal. We conclude that rituximab can be an effective treatment for seronegative catastrophic APS.

Narrativas únicas de vida: pessoas vivendo em situação de sorodiscordância frente ao desejo de reprodução / Unique narratives of life: people living in situations of sorodiscordance against the desire of reproduction

Este estudo pretendeu conhecer e analisar a história de vida de casais sorodiscordantes para o HIV frente ao desejo de reprodução. Desta forma , nossos objetivos nesta pesquisa foram: Identificar quais os sentimentos que emergem em pessoas em situação de sorodiscordância para o HIV frente ao desejo de reprodução; Analisar o desejo de reprodução das pessoas em situação de sorodiscordância para o HIV; Discutir o conhecimento das pessoas em situação de sorodiscordância para o HIV sobre os métodos reprodutivos. A metodologia utilizada neste estudo foi uma pesquisa qualitativa, descritiva, usando a técnica de história de vida, onde o entrevistado foi convidado a contar sua história a partir de uma questão norteadora. Os entrevistados foram estimulados a falarem o que viesse à sua mente, como resposta à questão norteadora. O cenário foi um ambulatório de HIV/AIDS de um Hospital Universitário do Estado do Rio de Janeiro. Os sujeitos foram pacientes do ambulatório, a maioria frequentadora de um grupo ,com reuniões realizadas quinzenalmente pela enfermeira do setor. Foram entrevistados 19 pacientes. As entrevistas foram realizadas individualmente, na sala onde o grupo acontecia, gravadas em MP4 e depois transcritas na íntegra. Para análise e discussão dos conteúdos duas categorias foram construídas. Na primeira categoria aparecem os depoimentos e discussão sobre a gestação, o desejo de ter ou não ter filhos. Na segunda categoria os depoimentos sobre as técnicas reprodutivas e os direitos reprodutivos dos casais sorodiscordantes foram agrupados e discutidos. Através do estudo a autora pode observar que a formação de novos casais sorodiscordantes vem aumentando , juntamente com a cronicidade da doença , com a potencialidade do aumento da expectativa e da qualidade de vida que os portadores do vírus passaram a ter, após o advento dos tratamentos antiretrovirais. Estes casais, em sua maioria em idade reprodutiva, verbalizam seu desejo de reprodução,. E entendem que o atendimento a esse desejo seja possível . Entretanto, diante do HIV, compreendem esse processo de forma complexa principalmente para o psicológico e para o social. Dificuldades com as relações familiares, com amigos, e com revelação ou não de sua soropositividade para o parceiro é frequente, e remetem à persistência do estigma da doença. A dificuldade com o uso da camisinha, método contraceptivo e de barreira ao avanço do vírus, também aparece. Os profissionais de saúde, por falta de capacidade técnica apropriada, têm dificuldade em lidar com as questões relacionadas a sexualidade e, consequentemente, de construir em conjunto com os usuários formas de negociação e erotização do preservativo, que podem tornar seu uso mais frequente, prazeroso e eficaz. O diálogo deve ser horizontal, buscando conhecer as necessidades e dificuldades dos casais, para que as informações sejam fornecidas de maneira clara e precisa. Nos últimos anos, o Brasil foi um dos países com maior número de novos casos de infectados pelo HIV. O país apresenta cenário epidemiológico semelhante ao do resto do mundo, no qual aproximadamente 80% das pessoas com HIV estão em idade reprodutiva. Mesmo assim há dificuldades em encontrar literatura sobre o assunto, principalmente em português, pois pouco se produz sobre o tema no Brasil. Esta pesquisa pretende contribuir para construção desse conhecimento, discutindo o desejo de reprodução entre casais sorodiscordantes para o HIV

This study sought to understand and analyze the life history of serodiscordant couples facing the desire to reproduce. Thus, our goals in this research were: Identifying the feelings that emerge in people suffering from HIV serodiscordance who desire to reproduce; Analyzing the desire to reproduce of serodiscordant people; Discussing the knowledge of people who suffer from HIV serodiscordance about reproductive methods. The methodology used in this study was a qualitative, descriptive research, using the life history technique, where the respondent was asked to tell their story after a guiding question. Those interviewed were encouraged to talk about whatever came to mind, in response to the guiding question. The setting was an outpatient unit for HIV / AIDS at the University Hospital of the State of Rio de Janeiro. The subjects were outpatients, the majority attending a group, with fortnightly meetings held by the sector's nurse. 19 patients were interviewed. The interviews were conducted individually, in the room where the group gathered, recorded in MP4 and then transcribed verbatim. For analysis and discussion of the content, two categories were constructed. In the first category, there is the testimonies and discussions about pregnancy and the desire to have or not have children. In the second category, the testimonies on reproductive techniques and reproductive rights of serodiscordant couples were grouped together and discussed. Through the study the author can observe that the number of new serodiscordant couples is increasing along with the chronic nature of the disease, with the potential of increasing life espectancy and life quality that carriers of the virus have been given after the advent of antiretroviral treatments. These couples, mostly of reproductive age, verbalize their desire to reproduce. And understand that the fulfillment of this desire is possible. However, in the face of HIV, have a complex understanding of the process, especially considering the psychological and social aspects. Difficulties with family relationships, with friends, and with or without revealing their HIV positive status to the partner is common, and refer to the persistence of the stigma of the disease. The difficulty with the use of condoms, a contraceptive method and barrier to the advance of the virus, also appears. Health professionals, due to lack of appropriate technical capabilities, have difficulty in dealing with issues related to sexuality and, consequently, in building together with the users forms of negotiation and eroticization of condoms, which can make its use more frequent, enjoyable and effective. The dialogue should be horizontal, seeking to know the needs and difficulties of couples, so that the information is provided in a clear and precise manner. In recent years, Brazil was one of the countries with the highest number of new incidences of HIV. The country features an epidemiological situation similar to the rest of the world, in which approximately 80% of people with HIV are of reproductive age. Yet it is difficult to find literature on the subject, especially in Portuguese, for little is written about the subject in Brazil. This research aims to contribute in building this knowledge, discussing the desire of reproduction among serodiscordant couples

Primary Classic Kaposi's Sarcoma of the Penis in an HIV-Negative Patient

Kaposi's sarcoma (KS) is a multifocal hemorrhagic sarcoma that occurs primarily on the extremities. KS limited to the penis is rare and a well-recognized manifestation of acquired immune deficiency syndrome (AIDS). However, KS confined to the penis is extraordinary in human immunodeficiency virus (HIV)-negative patients. We present the case of a 68-year-old man with a dark reddish ulcerated nodule on the penile skin, which was reported as a nodular stage of KS. We detected no evidence of immunosuppression or AIDS or systemic involvements in further evaluations. In his past medical history, the patient had undergone three transurethral resections of bladder tumors due to urothelial cell carcinoma since 2000 and total gastrectomy, splenectomy, and adjuvant fluorouracil/cisplatin chemotherapy for 7 months due to advanced gastric carcinoma in 2005. The patient was circumcised and has had no recurrence for 2 years.