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1.
Rev. chil. infectol ; Rev. chil. infectol;41(2): 311-315, abr. 2024. ilus, tab
Article in Spanish | LILACS | ID: biblio-1559674

ABSTRACT

El alelo HLA B*57:01 es un marcador genético asociado con la hipersensibilidad al fármaco anti-retroviral abacavir (ABC) y su frecuencia en la población peruana todavía es desconocida. El objetivo fue identificar el alelo HLA B*57:01 en una población militar de Lima, Perú. Se reclutaron 43 personas viviendo con VIH (PVV) quienes aceptaron participar a través de un consentimiento informado. La detección del alelo HLA B*57:01 se realizó mediante RPC en tiempo real (RT-PCR). Asimismo, se determinó la carga viral (CV), el recuento de linfocitos CD4 y la genotipificación del VIH. Se identificaron dos casos positivos al alelo HLA B*57:01 (4,7%). Además, uno de ellos presentó múltiples mutaciones de resistencia a los anti-retrovirales (ARV), incluyendo ABC. Se demostró por primera vez en el Perú la presencia del alelo HLA B*57:01.


The HLA B*57:01 allele is a genetic marker associated with hypersensitivity to the antiretroviral Abacavir (ABC) and its frequency in the Peruvian population is still unknown. The objective was to identify the HLA B*57:01 allele in a military population from Lima, Peru. Forty three people living with HIV (PLWH) were recruited, who agreed to participate through informed consent. Detection of the HLA B*57:01 allele was performed by real-time PCR (RT-PCR). Likewise, viral load (VL), CD4 lymphocyte count and HIV genotyping were determined. Two cases positive for the HLA B*57:01 allele (4.7%) were identified. In addition, one of them had multiple resistance mutations to antiretrovirals (ARVs), including ABC. The presence of the HLA B*57:01 allele was demonstrated for the first time in Peru.


Subject(s)
Humans , Male , Middle Aged , HIV Infections/genetics , Anti-HIV Agents/adverse effects , Drug Hypersensitivity/genetics , Military Personnel , Peru , HLA-B Antigens/genetics , Genetic Markers , HIV Infections/drug therapy , HIV/genetics , CD4 Lymphocyte Count , Viral Load/genetics , Genetic Predisposition to Disease , Cyclopropanes/adverse effects , Drug Hypersensitivity/immunology , Alleles , Real-Time Polymerase Chain Reaction , Genotype
2.
Rev. méd. hered ; 35(2): 91-95, abr.-jun. 2024. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1576617

ABSTRACT

SUMMARY The prompt diagnosis of HIV is a clue for starting anti-retroviral treatment (ART). Viral load determination and other immunologic parameters are essential for evaluating the prognosis and follow-up of these patients. Objective: To evaluate viral load and CD4 cell count determinations in HIV residents of Callao during the COVID-19 pandemic. Methods: a cohort study of 289 adult HIV patients living in Callao was implemented. The student's t-test was used to evaluate paired samples; a p-value<0.05 was considered statistically significant. Results: HIV patients who received ART had a reduction in viral load and an increase in CD4 counts. Conclusion: The management of HIV patients in Callao has been successful.


RESUMEN El diagnóstico del virus de la inmunodeficiencia humana (VIH) es clave para el inicio de la terapia antirretroviral (TAR). Los valores de carga viral (CV) y otros componentes inmunológicos son esenciales para el seguimiento y pronóstico de las personas con VIH. Objetivo: Evaluar el control de la carga viral y la carga linfocitaria en la población residente del Callao con diagnóstico confirmado de VIH, durante la pandemia de la Covid 19. Material y métodos: Estudio prospectivo, en el cual se evaluaron 289 adultos residentes de la región Callao, se realizaron mediciones confirmatorias y post tratamiento TAR. Para la diferencia de medias se calculó la prueba t de Student para muestras pareadas, considerando p<0,05 como estadísticamente significativo. Resultados: Las personas que recibieron TAR mostraron una disminución significativa de los valores de VL y un aumento de CD4+. Conclusión: El manejo y control de la enfermedad de la población infectada por VIH en el Callao ha sido exitoso.

3.
Article | IMSEAR | ID: sea-235427

ABSTRACT

Background: According to the WHO estimation, up to 70 % of patients with an initial high viral load will achieve viral load suppression following an adherence intervention. In Benue State, very limited studies have been done that show viral load suppression following enhanced adherence counselling (EAC). This study assessed viral suppression after enhanced adherence counselling and its predictors among unsuppressed HIV seropositive people in the State, the time to commence EAC after the unsuppressed VL result, and to estimate the time to repeat the viral load test after EAC. Methods: This was a retrospective review of electronic medical records of all HIV-infected people with a viral load greater than 1000 copies/ml after six months on HAART as of December 2022, in Benue State. Patients with VL ? 1000 copies/ml were expected to receive EAC and have a repeat VL after three months of good adherence. Six months following the documented unsuppressed result, we determined: the viral load suppression rate after EAC, the time to commencement of EAC, the time to repeat the viral load test after EAC, and the predictors of viral load suppression among clients with unsuppressed viral load. Result: Of the 234,185 People Living with HIV (PLHIV) on ART between December 2022 and July 2023, up to 210, 514 (89.9%) did viral load testing and 9194 (3.9%) had VL >1000 copies/ml. Of these 9,194 unsuppressed PLHIV, EAC uptake was 90.3% (n=8,307), EAC completion rate was 62.5% (n=5,220), and viral suppression rate following EAC was 93.8% (4897/5220). PLHIV who have been on treatment for less than five years were more likely to achieve viral load suppression. Conclusion: The study demonstrated a post-EAC viral load re-suppression rate of 93.8%, indicating significant effectiveness. Nonetheless, notable deficiencies were observed in both EAC enrollment and completion. It is imperative to identify and address the underlying reasons for these gaps to fully optimize the benefits of Enhanced Adherence Counseling (EAC).

4.
DST j. bras. doenças sex. transm ; 36: e24361401, 15 fev. 2024. tab
Article in English | LILACS | ID: biblio-1580304

ABSTRACT

Introduction: AIDS has become a chronic disease that may not be sexually transmitted as long as people living with HIV take their medications correctly. Therefore, adherence to antiretroviral drugs remains a central issue for therapeutic success. Objective: To describe the prevalence of self-reported missed doses of antiretroviral drugs (MDARV) in people living with HIV and analyze its associated factors. Methods: A cross-sectional study was conducted in a specialized service on STI/HIV/AIDS in the city of São Paulo (SP), Brazil. The data sources used were a self-administered form and the Database of the Laboratory Test Control System of the National Network for CD4+/CD8+ Lymphocyte Count and HIV Viral Load. The dependent variable was the self-report of MDARV by users in the last three days. The independent variables were related to sociodemographic, behavioral, and healthcare-associated characteristics. Poisson regression was used to estimate prevalence ratios and 95% confidence intervals. Results: Among the 510 responding participants, the MDARV prevalence in the last three days was 15.9% (95%CI 12.69­19.06). Factors associated with MDARV were detectable viral load, practicing a religion, change of residence in the last year, use of drugs, and more than 11 years of treatment. Knowing CD4+ T lymphocyte count was associated with protection regarding missed doses.Conclusion: Monitoring MDARV self-report is a simple tool that can improve comprehensive care for people living with HIV/AIDS. (AU)


Introdução: A AIDS se tornou uma doença crônica, e pode não ser sexualmente transmitida desde que as pessoas vivendo com HIV tomem suas medicações corretamente. Desta forma, a adesão aos antirretrovirais permanece uma questão central para a obtenção do sucesso terapêutico. Objetivo: Descrever a prevalência de autorrelato de perda de doses da terapia antirretroviral (PDARV) de pessoas vivendo com HIV e analisar os seus fatores associados. Métodos:Foi conduzido um estudo transversal em serviço especializado em IST/HIV/Aids do município de São Paulo. As fontes de dados utilizadas foram o formulário autoaplicado e o banco de dados do Sistema de Controle de Exames Laboratoriais da Rede Nacional de Contagem de Linfócitos CD4+/CD8+ e Carga Viral do HIV. A variável dependente foi o autorrelato dos usuários sobre a PDARV nos últimos três dias. As variáveis independentes foram relacionadas a questões sociodemográficas, comportamentais e associadas ao serviço de saúde. Empregou-se regressão de Poisson para estimar razões de prevalência e intervalos de confiança de 95%. Resultados: Dentre os 510 participantes, encontrou-se prevalência de PDARV nos últimos três dias: 15,9% (IC95% 12,69­19,06). Os fatores associados à PDARV foram: carga viral detectável; prática religiosa; mudança de residência no último ano; uso de drogas; e mais de 11 anos de tratamento. O conhecimento da contagem de linfócitos T CD+4 foi associado à proteção em relação à perda de doses. Conclusão: O monitoramento do autorrelato de PDARV é uma ferramenta de simples aplicação que pode melhorar o cuidado integral para as pessoas vivendo com HIV/AIDS. (AU)


Subject(s)
Humans , Adult , Middle Aged , HIV , Medication Adherence , Acquired Immunodeficiency Syndrome , Viral Load , Self Report
5.
Article | IMSEAR | ID: sea-227802

ABSTRACT

Background: Suppression of viral load and its maintenance is the necessary condition for reducing mortality linked to HIV infection in children. This study aimed to investigate the factors associated with viral load rebound in children receiving antiretroviral treatment. Methods: This was a cross-sectional study with analytical purposes, running from August 1 to 31, 2023. Were inclusive, all children living with HIV under 15 years of age, with at least two viral load results and whose parents have agreed to participate in the study. Results: A total of 286 children were included in the study. The mean age was 11.5 years (±2.8). More than half (55.2%) of the children were not informed of their HIV status and for the majority (50.3%). Among the 198 children with a suppressed viral load at the first test, 46 (23.2%) experienced a rebound in viral load at the last test. The factors significantly associated with rebound were the low level of education of the parents (p=0.012), the administration of medicines to the children by the parents (p=0.000), the long duration of taking the medicines (p=0.021) and poor compliance with treatment (0.000). Conclusions: The rebound in viral load after suppression is a disastrous reality for children. Efforts must be made to strengthen early therapeutic education for children, training of health workers on the process of announcing results and ongoing dialogue with children and adolescents on compliance are ways to improve the maintenance of viral suppression.

6.
Article in Chinese | WPRIM | ID: wpr-1017727

ABSTRACT

Community acquired pneumonia(CAP)is the leading cause of death in children,and as molecular diagnostic techniques continue to improve,more CAP is found to be caused by viral infections. At present,many factors are known to affect the severity of viral pneumonia,including viral subtypes,viral virulence,host factors,environmental factors,etc. Some studies have found that viral load is related to the severity of viral pneumonia,and different viral load levels have different effects on the severity of viral pneumonia. The correlation with virus type,subtype,site of virus specimen collection,age,sex and co-infection may be also different. This article will review the relationship between viral load and disease severity in pneumonia caused by common respiratory viral infections.

7.
Article in Chinese | WPRIM | ID: wpr-1024979

ABSTRACT

【Objective】 To establish and verify a new nucleic acid extraction method for OBI detection with large volume and high sensitivity, and apply it in the quantitative determination of OBI samples with low viral load. 【Methods】 The method for nucleic acid extraction with large volume was established based on the method of Roche nucleic acid detection kit. HBV standards were configured into 10 000 IU/mL, 1 000 IU/mL, 100 IU/mL, 10 IU/mL and 1 IU/mL respectively, and nucleic acid was extracted from the 10 mL standards by magnetic beads. CT values of each concentration were detected by fluorescence quantitative PCR and each concentration gradient was detected in parallel duplicates. The logarithm of virus concentration was taken as the X-axis and the average CT values of two tests were taken as the Y-axis to construct the fluorescence quantitative standard curve and regression equation. Three repeated experiments were conducted to verify the stability of the method. This method was used to extract nucleic acid from OBI samples with low viral load, and fluorescence quantification was performed. 【Results】 The amplification efficiency of fluorescence quantitative standard curves ranged from 90% to 105%, and the regression equation was greater than 0.99. The variation coefficients of variation of CT values were 0.63%, 0.78%, 1.52%, 1.36% and 0.78%, respectively. This method can extract nucleic acid from OBI samples with viral load of 1 IU/mL for quantification. 【Conclusion】 The detection limit of HBV nucleic acid quantitative detection system can reach 1 IU/mL, and it has strong stability and high sensitivity, which can be used for the quantitative detection of OBI with low viral load.

8.
Journal of Clinical Hepatology ; (12): 483-488, 2024.
Article in Chinese | WPRIM | ID: wpr-1013125

ABSTRACT

ObjectiveTo investigate the significance of high-sensitive polymerase chain reaction (PCR) in detecting hepatitis B virus (HBV) among the population with a very low viral load (HBV DNA 10‍ — ‍99 IU/mL). MethodsThis study was conducted among the chronic hepatitis B (CHB) patients who were treated with nucleos(t)ide analogues for ≥48 weeks in The Fifth Affiliated Hospital of Guangzhou Medical University from September 2019 to February 2022 and had an HBV DNA load below the lower limit of ordinary-sensitivity detection (100 IU/mL). Then high-sensitivity HBV DNA detection was performed for all patients, and according to these results, the patients were divided into very low viral load group (VLVL group with an HBV DNA load of 10‍ — ‍99 IU/mL) and complete virologic response group (CVR group with an HBV DNA load of <10 IU/mL or without HBV DNA detected). The two groups were compared in terms of general characteristics, serum virological indicators, biochemical parameters, and noninvasive fibrosis markers; the value of related serum virological indicators in predicting the results of high-sensitivity HBV DNA above the lower limit of detection were assessed; the influencing factors for failure to achieve CVR were analyzed. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The receiver operating characteristic (ROC) curve was used to investigate the value of related serum virological indicators in predicting the results of high-sensitivity HBV DNA above the lower limit of detection, and a binary logistic regression analysis was used to investigate the influencing factors for failure to achieve CVR. ResultsA total of 106 CHB patients were enrolled, with 24 in the VLVL group and 82 in the CVR group. Compared with the CVR group, the VLVL group had a significantly younger age (P=0.004) and significantly higher quantitative hepatitis B surface antigen (qHBsAg) level (P=0.002), HBeAg positive rate (P=0.002), pgRNA positive rate (P=0.010), and alanine aminotransferase level (P=0.017). The qHBsAg level had an area under the ROC curve of 0.717 (P=0.002) in predicting the results of high-sensitivity HBV DNA above the lower limit of detection (>10 IU/mL), with an optimal cut-off value of 1 214.5 IU/mL, a sensitivity of 95.5%, and a specificity of 53.9%. Positive HBeAg (odds ratio [OR]=3.654, 95% confidence interval [CI]: 1.162‍ —‍ ‍11.489, P=0.027) and qHBsAg (OR=2.985, 95%CI: 1.058‍ — ‍8.422, P=0.039) were independent influencing factors for failure to achieve CVR. ConclusionSome CHB patients have an HBV DNA load of <100 IU/mL by ordinary-sensitivity detection, but with the presence of VLVL determined by high-sensitivity PCR. The VLVL group had significantly higher level of inflammatory damage and positive rates of pgRNA and HBeAg. Positive HBeAg and high qHBsAg level are independent influencing factors for failure to achieve CVR. Clinicians should not ignore the presence of VLVL in CHB patients, and high-sensitivity HBV DNA detection should be performed in a timely manner.

9.
Epidemiol. serv. saúde ; 33(spe1): e2024412, 2024. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1582259

ABSTRACT

ABSTRACT Objective To analyze factors associated with detectable HIV viremia among transgender women/transvestites (TWT) in five Brazilian capitals. Methods : This was a cross-sectional study using data from a sample of TWT with HIV-positive serology and detectable viral load (VL), between 2019 and 2021. The dependent and independent variables were, respectively: viral load measurement, socioeconomic/demographic characteristics; alcohol/drug use; and self-perceived mental health. Poisson regression with robust variance was used. Results : A total of 425 TWT tested positive for HIV and underwent VL measurement, 179 (42.0%) presented detectable viremia. Factors positively associated with detectability were: younger age (PR=2.26; 95%CI 1.13;4.51), poorer housing conditions (PR=2.72; 95%CI 1.30;5.68) and poor/very poor mental health (PR=1.70; 95%CI 1.08;2.66). The use of antiretroviral drugs was a protective factor against detectability (PR=0.29; 95%CI 0.30;0.61). Conclusion The factors associated with unsuppressed viral load highlight vulnerability related to gender identity that have a negative impact, despite the majority of participants being on antiretroviral therapy (ART).


RESUMEN Objetivo Analizar factores asociados a la viremia detectable del VIH entre mujeres transexuales/travestis (MTTr), en cinco capitales brasileñas. Métodos Datos referentes al muestreo MTTr con serología reactiva para VIH y carga viral detectable (CV), en estudio transversal entre 2019-2021. Las variables dependientes e independientes fueron, respectivamente: medición de carga viral, socioeconómicas/demográficas; consumo de alcohol/drogas; y autopercepción de salud mental. Se utilizó la regresión de Poisson con varianza robusta. Resultados Un total de 425 MTTr dieron positivo para el VIH y se sometieron a pruebas CV, siendo 179 (42,0%) detectables. Los factores asociados positivamente con la detectabilidad fueron: ser más joven (RP=2,26; IC95% 1,13;4,51), peores condiciones de vivienda (RP=2,72; IC95% 1,30;5,68) y salud mental mala/muy mala (RP=1,70; IC95% 1,08;2,66). El uso de medicamentos antirretrovirales fue un factor protector para la detectabilidad (RP=0,29; IC95% 0,30;0,61). Conclusión Los factores asociados a la no supresión viral indican vulnerabilidad ligada a identidad de género con efecto negativo, incluso cuando la mayoría utiliza terapia antirretroviral (TARV).


RESUMO Objetivo Analisar fatores associados à viremia detectável de HIV entre mulheres transexuais/travestis (MTTr), em cinco capitais brasileiras. Métodos Dados referentes à amostra de MTTr com sorologia reagente para HIV e carga viral (CV) detectável, em um estudo transversal entre 2019 e 2021. As variáveis dependentes e independentes foram, respectivamente: dosagem da carga viral, características socioeconômicas/demográficas; uso de álcool/drogas; e autopercepção de saúde mental. Foi utilizada a regressão de Poisson com variância robusta. Resultados Um total de 425 MTTr tiveram resultado reagente para HIV e realizaram dosagem de CV, com 179 (42,0%) detectáveis. Os fatores associados positivamente à detectabilidade foram: serem mais novas (RP=2,26; IC95% 1,13;4,51), piores condições de moradia (RP=2,72; IC95% 1,30;5,68) e saúde mental ruim/muito ruim (RP=1,70; IC95% 1,08;2,66). O uso de antirretroviral foi fator protetor à detectabilidade (RP=0,29; IC95% 0,30;0,61). Conclusão Os fatores associados à não supressão viral apontam vulnerabilidade ligada à identidade de gênero com impacto negativo, mesmo com a maioria em uso da terapia antirretroviral (TARV).

10.
Article | IMSEAR | ID: sea-234810

ABSTRACT

HIV is a RNA virus whose hallmark is the reverse transcriptase enzyme which causes transcription of RNA to DNA.It is the etiologic agent of AIDS (acquired immunode?ciency syndrome)The hallmark of HIV disease is profound immunode?ciency due to progressive quantitative and qualitative de?ciency of helper T cells .The helper T cells have a molecule CD4 on its surface which serves as the primary cellular receptor for HIV .The clinical consequences of HIV infection encompass a spectrum ranging from an acute syndrome associated with primary infection to a prolonged asymptomatic state to advanced disease .As the disease progresses CD4 T cells decline and the appearance of an opportunistic infection may be the ?rst manifestation of the disease .An OI (opportunistic infections) is a disease caused by a microbial agent in a person with a compromised host immune system.The threat to the life of a person living with HIV is essentially due to life-threatening OIs, consequent to decline in immunity and not because of HIV per se . Progression of disease can be predicted with decreasing CD4 and increasing viral load

11.
Cambios rev. méd ; 22 (2), 2023;22(2): 921, 16 octubre 2023. ilus., tabs.
Article in Spanish | LILACS | ID: biblio-1526591

ABSTRACT

INTRODUCCIÓN. La nefropatía por poliomavirus BK resulta un problema emergente en el trasplante renal, pues contribuye a la pérdida temprana de los injertos renales. OBJETIVO. Caracterizar clínicamente a los pacientes trasplantados renales con nefropatía por poliomavirus BK. MATERIALES Y MÉTODOS. Estudio observacional, descriptivo, realizado en el Hospital de Especialidades Carlos Andrade Marín en el período 2013-2022, se obtuvo una base de datos anonimizada, 479 pacientes trasplantados renales, de estos se identificaron 37 pacientes que corresponde a un 7,7% con nefropatía por poliomavirus BK, se realizó un análisis con el programa estadístico SPSS v26®. RESULTADOS. La población estuvo caracterizada por pacientes del sexo masculino (56,8%), con una edad media de 48,2 años, el donante cadavérico fue el más frecuente (94,5%), la mayor parte del tratamiento de la nefropatía por poliomavirus BK consistió en cambio de micofenolato sódico a everolimus y se mantuvo con 50% de Tacrolimus y Prednisona (40,5%); al valorar el cambio de los valores de creatinina, los niveles más elevados fueros a los 12 meses cuando la pérdida renal fue temprana (p: 0,042), y de la misma manera a los 12 meses, fueron más elevados los niveles de creatinina cuando el diagnóstico histopatológico fue Nefropatía por Poliomavirus Clase 3 (p: 0,01). DISCUSIÓN. La prevalencia de la nefropatía se mantuvo por debajo del 10% reportado a nivel global, la creatinina empeoró en pacientes con pérdida temprana del injerto renal y con una clase patológica avanzada, hecho reportado en la fisiopatología de la enfermedad. CONCLUSIÓN. La pérdida del injerto renal temprano presentó una creatinina más alta que la tardía. Es recomendable un tamizaje adecuado para la detección temprana del virus BK siendo crucial para prevenir el deterioro de la función renal y limitar la posterior pérdida del injerto.


INTRODUCTION: BK polyomavirus nephropathy is emerging as a significant concern in kidney transplantation, as it contributes to the early loss of renal grafts. OBJECTIVE: The aim of this study was to clinically characterize renal transplant recipients with BK polyomavirus nephropathy. MATERIALS AND METHODS: An observational and descriptive study was conducted at Carlos Andrade Marín Specialties Hospital during the period of 2013 to 2022. An anonymized database comprising 479 renal transplant patients was utilized. Among these, 37 patients, constituting 7.7%, were identified with BK polyomavirus nephropathy. Data analysis was performed using the statistical program SPSS v26®. RESULTS: The study population was predominantly composed of male patients (56.8%) with a mean age of 48.2 years. Deceased donors accounted for the majority (94.5%) of cases. The primary approach for managing BK polyomavirus nephropathy involved transitioning from mycophenolate sodium to everolimus, alongside maintaining a regimen of 50% tacrolimus and 40.5% prednisone. When assessing changes in creatinine values, the highest levels were observed at 12 months, coinciding with early renal loss (p: 0.042). Similarly, at the 12-month mark, elevated creatinine levels were associated with a histopathological diagnosis of Polyomavirus nephropathy Class 3 (p: 0.01). DISCUSSION: The prevalence of nephropathy remained below the globally reported threshold of 10%. Creatinine levels worsened in patients experiencing early graft loss and an advanced pathological classification, aligning with established disease pathophysiology. CONCLUSION: Early renal graft loss was associated with higher creatinine levels compared to delayed loss. Adequate screening for early detection of BK virus is recommended, as it plays a crucial role in preventing renal function deterioration and limiting subsequent graft loss.


Subject(s)
Humans , Male , Female , Middle Aged , Kidney Transplantation , BK Virus , Viral Load , Creatinine , Renal Insufficiency, Chronic , Immunosuppressive Agents , Tissue Donors , Polyomavirus , Ecuador , Kidney Diseases
12.
Article | IMSEAR | ID: sea-233542

ABSTRACT

Background: COVID-19 disease raised global health concerns especially for the pregnant women who are more susceptible to respiratory viral illnesses due to their bodily immunological and physiological changes to accommodate the foetus. The aim of the study is to evaluate the relationship between the SARS-CoV 2 specific RdRp gene Ct values ??and the severity of the COVID-19 disease in SARS-CoV2 positive pregnant women at term. Methods: A retrospective cohort study was conducted in the Department of Microbiology, Government Medical College, Amritsar on a subset of 46 COVID-19 positive, ante natal mothers, who presented in the labour room for delivery from August 2020 to January 2022. Results: A cohort of 4.8% (46/949) women tested positive in the RT-PCR test for viral RNA. Average age of the group was 25.5years and 89.1% were asymptomatic. 10.9% women reported mild symptoms and 95% had no pre-existing co morbidities. Obstetric complications like premature rupture of membranes were 4.3%, pre-term births 17.33%. Miscarriage and IUD was recorded in 4.34% and 2.17% patients respectively. When compared to values seen in symptomatic women with fever (Ct 25.8), dyspnoea (Ct 28.7), and respiratory distress (Ct 29.1), the mean Ct value reported in asymptomatic women (27.49 SD+5.4) was identical. SARS-CoV2 was not present in any newborns. Despite 24% having low birth weights for their gestational ages, 93% of babies were asymptomatic. Conclusions: The severity of the COVID-19 illness did not correspond with the SARS CoV2 virus RdRp gene Ct levels. The presence of SARS-CoV2 did not appear to independently cause poor maternal and new-born outcomes.

13.
Gac. méd. Méx ; Gac. méd. Méx;159(3): 231-237, may.-jun. 2023. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1448281

ABSTRACT

Resumen Antecedentes: La infección por SARS-CoV-2 se confirma con la prueba de reacción en cadena de la polimerasa. Su positividad se determina mediante el tiempo de ciclado (Ct, cycle threshold), el cual es inversamente proporcional a la carga viral. Objetivo: Describir las características clínicas y epidemiológicas de pacientes infectados por SARS-CoV-2 de acuerdo con su carga viral estimada mediante Ct. Material y métodos: Estudio transversal que incluyó 21 110 casos confirmados, los cuales fueron estratificados conforme a su carga viral: baja (Ct > 30), media (Ct 25-30) y alta (Ct < 25). Resultado: 53 % de los casos tuvo una carga viral alta, la hospitalización fue más frecuente en sujetos con carga viral media y las defunciones fueron más prevalentes en aquellos con carga viral alta. La mediana del Ct fue más baja durante los primeros cinco días y aumentó linealmente con los días de evolución clínica. Hubo una mayor prevalencia de defunciones, hospitalizaciones y apoyo ventilatorio en sujetos con infección confirmada por SARS-CoV-2 que presentaron carga viral media y alta. Conclusiones: El valor de Ct, correlacionado con otras características del paciente, puede orientar el pronóstico, así como al diseño de intervenciones que limiten la diseminación poblacional del virus.


Abstract Background: SARS-CoV-2 infection is confirmed with the polymerase chain reaction test. Its positivity is determined by the cycle threshold (Ct), which is inversely proportional to viral load. Objective: To describe clinical and epidemiological characteristics of SARS-CoV-2-infected patients according to their viral load estimated by Ct. Material and methods: Cross-sectional study that included 21,110 confirmed cases, which were stratified according to their viral load: low (Ct > 30), medium (Ct 25-30) and high (Ct < 25). Results: High viral load was identified in 53% of the cases, hospitalization was more common in subjects with medium viral load, and deaths were more prevalent in those with high viral load. Median Ct was lower during the first five days and linearly increased with the days of clinical evolution. There was a higher prevalence of deaths, hospitalizations and ventilatory support in subjects with confirmed SARS-CoV-2 infection who had a medium and high viral load. Conclusions: The Ct value, correlated with other patient characteristics, can guide the prognosis, as well as the design of interventions that limit the spread of the virus within the population.

14.
Rev. argent. microbiol ; Rev. argent. microbiol;55(2): 6-6, jun. 2023.
Article in English | LILACS-Express | LILACS | ID: biblio-1449404

ABSTRACT

Abstract At present, different reports have shown that children reach similar SARS-CoV-2 viral load (VL) levels compared to adults; however, the impact of VL on children remains ambiguous when asymptomatic versus symptomatic cases are compared. Thus, the aim of this study was to assess VL at the time of diagnosis in asymptomatic and symptomatic SARS-CoV-2 infected children. VL analysis was retrospectively carried out from nasopharyngeal swabs on 82 SARS-CoV-2 infected children, from March to October 2020. Of the 82 children, 31 were asymptomatic. Symptomatic patients had significantly higher VL values compared to asymptomatic ones (median = 7.41 vs4.35 log10 copies/ml, respectively). Notwithstanding, 8 out of 31 asymptomatic children had high VL levels, overlapping levels observed above the first quartile in the symptomatic group. Analysis of different age groups revealed that median VL values were higher in the symptomatic groups, although there was only a significant difference in children younger than 5 years of age. On the other hand, there was no significant difference between the VL values from the 82 SARS-CoV-2 infected children according to age, sex, underlying disease, symptoms or severity of COVID-19 related disease. This study emphasizes the importance of VL analysis in SARS-CoV-2 infected children, who could contribute to viral spread in the community. This concern could be extended to healthcare workers, who are in contact with children.


Resumen Diferentes informes han demostrado que los ninos alcanzan niveles de carga viral (CV) de SARS-CoV-2 similares a los de los adultos, pero el impacto de la CV en los niños continua siendo incierto cuando se compara entre aquellos que son asintomáticos y sintomáticos. El objetivo de este estudio fue evaluar la CV al momento del diagnóstico en ninos asintomáticos y sintomáticos infectados por SARS-CoV-2. El análisis de CV se realizó retrospectivamente a partir de muestras de hisopados nasofaríngeos de 82 niños infectados por SARS-CoV-2 entre marzo y octubre de 2020. De ellos, 31 eran asintomáticos. Encontramos que el grupo sintomático tenía valores de CV significativamente más altos en comparación con el grupo asintomático (mediana = 7,41 vs. 4,35 log10 copias/ml, respectivamente). No obstante, 8 de los 31 ninos asintomáticos presentaron valores de CV elevados, equivalentes a los observados por encima del primer cuartil del grupo sintomático. El análisis por grupos de edad reveló que la mediana de CV fue más alta en los niños sintomáticos, aunque esta diferencia fue significativa solamente en los menores de 5 anos. A su vez, los valores de CV obtenidos a partir de los 82 niños infectados por SARS-CoV-2 no mostraron diferencias significativas según el grupo etario, el sexo, la enfermedad de base, los síntomas y la gravedad de la COVID-19. Este estudio enfatiza la necesidad del análisis de la CV en ninos infectados por SARS-CoV-2, quienes podrían contribuir a la propagación del virus en la comunidad. Esta preocupación podría extenderse a los trabajadores de la salud que están en contacto con los ninños.

15.
Rev. obstet. ginecol. Venezuela ; 83(2): 169-185, abr. 2023. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1571153

ABSTRACT

Objetivo: Determinar la incidencia de infección por virus de inmunodeficiencia humana y el efectos sobre el peso del neonato, en embarazadas que acuden al Hospital Universitario de Caracas. Métodos: Se incluyeron las gestantes seropositivas para infección por virus de inmunodeficiencia humana. Se practicó Elisa para infección por virus de inmunodeficiencia humana, Webstern blot, hematología y química, linfocitos CD3, CD4 y CD8 por citometría, carga viral, se registró el peso de 204 neonatos y el esquema de tratamiento recibido. Resultados: La frecuencia de infección por virus de inmunodeficiencia humana en gestantes aumentó desde el año 2000; la mayoría ocurre durante el tercer trimestre. El 68,55 % de las gestantes en segundo y tercer trimestre presentaron hemoglobina mayor a 11 g y el 31,45 % tuvo hemoglobina de 7 a 10 g. La relación CD4/CD8 estuvo disminuida. Los niveles de CD4 del segundo trimestre fueron más bajos en pacientes con hemoglobina entre 7 y 10 gramos. Esta relación no se vio en el tercer trimestre, quizás por el grado de supresión viral por el tratamiento; las madres del 95,7 % de los neonatos con bajo peso al nacer recibieron terapia antirretroviral combinada, no hubo neonatos con bajo peso al nacer hijos de madres que recibieron monoterapia. Conclusión: La prevalencia de infección por virus de inmunodeficiencia humana fue 1,6 %. La prevalencia de anemia fue de 31,45 %. La relación CD4/CD8 estaba disminuida. Hubo 11,3 % de neonatos con bajo peso al nacer, en 95,7 % las madres recibieron terapia antirretroviral combinada(AU)


Objective: To determine the incidence of infection by human immunodeficiency virus and the effects on the weight of the newborn, in pregnant women who attend the University Hospital of Caracas. Methods: Seropositive pregnant women for human immunodeficiency virus infection were included. Elisa was performed for human immunodeficiency virus infection, Websternblot, hematology and chemistry, CD3, CD4 and CD8 lymphocytes by cytometry, viral load, the weight of 204 neonates and the treatment scheme received were recorded. Results: The frequency of infection by human immunodeficiency virus in pregnant women has increased since the year 2000; most occur during the third trimester. 68.55% of pregnant women in the second and third trimester had hemoglobin greater than 11 g and 31.45% had hemoglobin between 7 and 10 g. The CD4/CD8 ratio was decreased. Second trimester CD4 counts were lowest in patients with hemoglobin between 7 and 10 grams. This relationship was not seen in the third trimester, perhaps because of the degree of viral suppression by treatment; mothers of 95.7% of low birth weight infants received combination antiretroviral therapy, there were no low birth weight infants born to mothers who received monotherapy. Conclusion: The prevalence of human immunodeficiency virus infection was 1.6%. The prevalence of anemia was 31.45%. The CD4/CD8 ratio was decreased. There were 11.3% of neonates with low birth weight, in 95.7% the mothers received combination antiretroviral therapy(AU)


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Acquired Immunodeficiency Syndrome , HIV , Antiretroviral Therapy, Highly Active , Pregnant Women , Hematology , Infections , Pregnancy Trimester, Second , Pregnancy Trimester, Third , Infant, Very Low Birth Weight , Viral Load , Anemia
16.
Article | IMSEAR | ID: sea-217396

ABSTRACT

Background: Yoga therapy can be a promising adjunct to antiretroviral therapy. However, evidence on the ef-fectiveness of Yoga therapy is scanty. The proposed trial will estimate the effect of integrated yoga practice for six months on immune parameters (CD4 (cluster of differentiation 4), viral load) among adult people living with HIV (PLWH) and its cost-effectiveness from the healthcare system’s perspective. Methods: In this randomized open-label parallel-group trial, 110 PLWH in stage 2 HIV, between 18 and 49 years in the intervention arm and 220 PLWH in the same stage will be recruited by block randomization. Inte-grated yoga practice will be given for six months in the intervention arm, and health education on yoga prac-tice in the control arm, besides antiretroviral therapy. After six months, the difference in immune parameters, cardio-metabolic indicators and quality of life (QOL) will be assessed. Besides, an economic evaluation will be done with sensitivity analysis. If found useful, the intervention can be tested at large scale for further confir-mation of the outcomes. Irrespective of the study's outcome, the results will be disseminated through peer-reviewed journals.

17.
Rev. estomat. salud ; 31(1): 1-8, 20230123.
Article in English | LILACS-Express | LILACS | ID: biblio-1435269

ABSTRACT

Aim: The aim of this randomised, double-blind, placebo-controlled pilot clinical trial is to evaluate the capacity of a mouthwash to reduce SARS-CoV-2 viral load in the saliva of patients with COVID-19. Methods: Twenty-three symptomatic SARS-CoV-2-positive outpatients were selected andrandomised into two groups and registered at NTC 04563689. Both groups rinsed and gargled for one minute with either distilled water (Placebo) or with 0.05% Cetylpyridinium chloride (CPC) plus 0.12% Chlorhexidine (CHX) mouthwash (PERIOAID Intensive Care). Saliva samples were collected before the use of placebo or mouthwash and after 15 minutes and 1 and 2 hours of either of the above treatment. A saliva sample was also taken five days after regular use of placebo or mouthwash twice daily. The virus was detected by qRT-PCR. Results: A great heterogeneity in the viral load values was observed at baseline in both groups for nasopharyngeal and saliva samples. Most of the patients who used the mouthwash (8/12) had a significant decrease in baseline viral load after 15 min (greater than 99% reduction). This inhibitory effect was maintained for up to two hours in 10 of the 12 patients. At five days, SARS-CoV-2 RNA was detectedin only 1 patient from the mouthwash group and in 5 from the placebo group. Conclusions: This study points out that a CPC mouthwash can reduce the viral load in saliva of COVID-positive patients. This finding may be important in transmission control of SARS-CoV-2. Nevertheless, the clinical relevance of CPC mouthwash-reduction on SARS-CoV-2 shedding in saliva requires further study.


Objetivo: El objetivo de este ensayo clínico piloto aleatorizado, doble ciego y controlado con placebo es evaluar la capacidad de un enjuague bucal para reducir la carga viral del SARS-CoV-2 en la saliva de pacientes con COVID-19. Materiales y métodos:Veintitrés pacientes ambulatorios positivos para SARS-CoV-2 sintomáticos fueron seleccionados y aleatorizados en dos grupos y registrados en el NTC 04563689. Ambos grupos se enjuagaron y hicieron gárgaras durante un minuto con agua destilada (placebo) o con cloruro decetilpiridinio al 0 ,05 % (CPC). ) más enjuague bucal con Clorhexidina (CHX) al 0,12% (PERIOAID Intensive Care). Se recolectaron muestras de saliva antes del uso de placebo o enjuague bucal y después de 15 minutos y 1 y 2 horas de cualquiera de los tratamientos anteriores. También se tomó una muestra de saliva cinco días después del uso regular de placebo o enjuague bucal dos veces al día. El virus fue detectado por qRT-PCR. Resultados:Se demostró una gran heterogeneidad en los valores de carga viral al inicio del estudio en grupos ambos para muestras de nasofaringe y saliva. La mayoría de los pacientes que usaron el enjuague bucal (8/12) tuvieron una disminución significativa en la carga viral inicial después de 15 minutos (reducción superior al 99 %). Este efecto inhibidor se mantuvo hasta dos horas en 10 de los 12 pacientes. A los cinco días, se detectó ARN del SARS-CoV-2 en solo 1 paciente del grupo de enjuague bucal y en 5 del grupo de placebo. Conclusiones:Este señala que un enjuague bucal CPC puedereducir la carga viral en saliva de pacientes COVID positivos. Este hallazgo puede ser importante en el control de la transmisión del SARS-CoV-2. Sin embargo, la relevancia clínica de la reducción del enjuague bucal con CPC en la excreción de SARS-CoV-2 en la saliva requiere más estudios.

18.
Article in English | WPRIM | ID: wpr-988691

ABSTRACT

@#Introduction: Early studies have suggested the role of C-C chemokine receptor type 5 (CCR5) polymorphisms in influencing HIV pathogenesis and phenotypes, including the protection against HIV infection and delaying disease progression to AIDS. This study aimed to further determine the impact of CCR5 variants (CCR5-Δ32 and CCR5- R223Q) on HIV susceptibility, viral load suppression and CD4 recovery during highly active antiretroviral therapy (HAART) among Malaysian HIV patients. Methods: This cross-sectional study involved 182 HIV-infected who were recruited from three out-patient clinics, and 150 non-HIV subjects from Malay, Chinese and Indian ethnicities. CD4 count and viral load data at 4-6 months (t1) and 8-12 months (t2) after starting HAART were gathered from hospital records. Chi-square test was used to analyse the correlation between CCR5 variants with dependent variables. Results: Heterozygous CCR5-Δ32 and CCR5-R223Q occurred in a percentage of 0.5% (1/182) and 1.7% (3/182) among HIV patients respectively, while none of homozygous mutant for CCR5-Δ32 and CCR5-R223Q were found. CCR5-R223Q was found more frequently in non-HIV as compared to the HIV group (P=0.018). However, both polymorphisms were not found to be correlated with CD4 recovery to ≥500 cells/mm3 (P>0.05) and viral load suppression ≤50 copies/mL (P>0.05). Conclusion: CCR5-R223Q and CCR5-Δ32 alleles probably have no modifying effects on HIV susceptibility virological and immunological recoveries in the first 12 months of HAART, partially due to the low prevalence of these mutations in the studied population.

19.
Article in Chinese | WPRIM | ID: wpr-991824

ABSTRACT

Objective:To investigate the relationship between the peak load of Epstein-Barr virus (EPV) and live function damage in children with infectious mononucleosis caused by EPV.Methods:Eighty children with infectious mononucleosis caused by EPV who received treatment in Pingxiang People's Hospital from January 2018 to December 2021 were included in this study. Five mL of venous blood was taken from each child for detecting the peak load of EBV-DNA and liver function indicators. These children were divided into a low-load group ( n = 25, EBV-DNA load < 10 4 copies/mL), a medium-load group ( n = 34, EBV-DNA load of 10 4-10 5 copies/mL), and a high-load group ( n = 21, EBV-DNA load > 10 5 copies/mL) according to the peak EBV-DNA load. The relationships between different peak loads of EBV-DNA and live function, age, and sex were analyzed. Results:The rate of liver dysfunction in the high-load group [85.71% (18/21)] was significantly higher than [38.24% (13/34)] in the medium-load group and [20.00% (5/25)] in the low-load group ( χ2 = 11.90, 19.71, P = 0.001, P < 0.001). Alanine aminotransferase and aspartate aminotransferase levels in the high-load group were (156.24 ± 13.21) U/L and (171.69 ± 13.49) U/L, respectively, which were significantly higher than (125.89 ± 10.54) U/L and (143.26 ± 10.29) U/L in the medium-load group and (89.64 ± 6.75) U/L and (64.89 ± 5.74) U/L] in the low-load group (all P < 0.001). There was no significant difference in the peak load of EBV-DNA between children of different ages and between children of different sexes (both P > 0.05). Conclusion:Children with infectious mononucleosis caused by EPV have a high EBV-DNA peak load. A higher peak load of EVB-DNA indicates a higher risk of liver function damage. More attention should be paid in clinical practice. Effective diagnosis and treatment should be performed in time to control the patient's condition as early as possible.

20.
Zhongguo dangdai erke zazhi ; Zhongguo dangdai erke zazhi;(12): 278-283, 2023.
Article in Chinese | WPRIM | ID: wpr-971073

ABSTRACT

OBJECTIVES@#To study the effect of breastfeeding on immune function in infants with human cytomegalovirus (HCMV) infection.@*METHODS@#A retrospective analysis was performed on the medical data of 135 infants with HCMV infection who were admitted to Children's Hospital Affiliated to Zhengzhou University from January 2021 to May 2022, and all these infants received breastfeeding. According to the results of breast milk HCMV-DNA testing, the infants were divided into two groups: breast milk HCMV positive (n=78) and breast milk HCMV negative (n=57). According to the median breast milk HCMV-DNA load, the infants in the breast milk HCMV positive group were further divided into two subgroups: high viral load and low viral load (n=39 each). Related indicators were compared between the breast milk positive and negative HCMV groups and between the breast milk high viral load and low viral load subgroups, including the percentages of peripheral blood lymphocyte subsets (CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, and CD19+ B cells), CD4+/CD8+ ratio, IgG, IgM, IgA, and urine HCMV-DNA load.@*RESULTS@#There were no significant differences in the percentages of CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, and CD19+ B cells, CD4+/CD8+ ratio, IgG, IgM, IgA, and urine HCMV-DNA load between the breast milk HCMV positive and HCMV negative groups, as well as between the breast milk high viral load and low viral load subgroups (P>0.05).@*CONCLUSIONS@#Breastfeeding with HCMV does not affect the immune function of infants with HCMV infection.


Subject(s)
Female , Child , Humans , Infant , Breast Feeding , Cytomegalovirus Infections , CD8-Positive T-Lymphocytes , Retrospective Studies , Infectious Disease Transmission, Vertical , Milk, Human , Cytomegalovirus , Immunity , Immunoglobulin A , Immunoglobulin G , Immunoglobulin M
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