Prevalence of hepatitis C virus and human immunodeficiency virus in a group of patients newly diagnosed with active tuberculosis in Porto Alegre, Southern Brazil

BACKGROUND Porto Alegre is the Brazilian state capital with second highest incidence of tuberculosis (TB) and the highest proportion of people infected with human immunodeficiency virus (HIV) among patients with TB. Hepatitis C virus (HCV) infection increases the risk of anti-TB drug-induced hepatotoxicity, which may result in discontinuation of the therapy. OBJECTIVES The aim of this study was (i) to estimate prevalence of HCV and HIV in a group of patients newly diagnosed with active TB in a public reference hospital in Porto Alegre and (ii) to compare demographic, behavioural, and clinical characteristics of patients in relation to their HCV infection status. METHODS One hundred and thirty-eight patients with TB were tested for anti-HCV antibody, HCV RNA, and anti-HIV1/2 antibody markers. HCV RNA from real-time polymerase chain reaction (PCR)-positive samples was submitted to reverse transcription and PCR amplification. The 5′ non-coding region of the HCV genome was sequenced, and genotypes of HCV isolates were determined. FINDINGS Anti-HCV antibody, HCV RNA, and anti-HIV antibodies were detected in 27 [20%; 95% confidence interval (CI), 13-26%], 17 (12%; 95% CI, 7-18%), and 34 (25%; 95% CI, 17-32%) patients, respectively. HCV isolates belonged to genotypes 1 (n = 12) and 3 (n = 4). Some characteristics were significantly more frequent in patients infected with HCV. Among them, non-white individuals, alcoholics, users of illicit drugs, imprisoned individuals, and those with history of previous TB episode were more commonly infected with HCV (p < 0.05). MAIN CONCLUSIONS HCV screening, including detection of anti-HCV antibody and HCV RNA, will be important to improving the management of co-infected patients, given their increased risk of developing TB treatment-related hepatotoxicity.

Serological profile of candidates for corneal donation / Perfil sorológico de candidatos a doação de córneas

Objetive: The purpose of this study is to map the serological profile of candidates to corneal donation at Irmandade Santa Casa de Misericórdia de Porto Alegre, identifying the percentage of disposal by serology and the marker involved. Methods: There have been analised – retrospectively – the results of serology of all corneal donors, made between the period of 1st january 2006 and 31st december 2012. Data analised were related to age, gender and the results of serology pertinent to viral markers (HBsAg, anti-HBc, anti-HCV and anti-HIV), these, determined by immunosorbent tests (ELISA). Results: In the period of the study, there were 2476 corneal donors at the institution, with a major incidence on the male gender, on an average of 58.7 years old. 23% of retention because of serological unfitness was also identified, that is, 570 samples were non-negative to any of the used tests. The marker anti- HBc was the most prevalent on the studied population, followed by the Hepatitis C virus (HCV) and by the Human Immunodeficiency Virus (HIV). Conclusion: From the data found through this study, it is essential to have the participation of an efficient service on the serological evaluation of the candidates to corneal donation, once the security of the receptor must be taken into consideration in a population of donors with 23% of unfitness prevalence, in which the most prevalent marker is the one of Hepatits B. .

Objetivo: O intento deste desígnio é mapear o perfil sorológico dos candidatos a doação de córneas na Irmandade Santa Casa de Misericórdia de Porto Alegre, identificando o percentual de descarte por sorologia e o marcador envolvido. Métodos: Foram analisados – retrospectivamente – os resultados da sorologia de todos os doadores de córneas compreendidos entre 01 de janeiro de 2006 a 31 de dezembro de 2012. Foram avaliados os dados de idade, sexo e os resultados da sorologia pertinentes aos marcadores virais (HBsAg, anti-HBc, anti-HCV e anti-HIV) determinados por testes imunoenzimáticos (ELISA). Resultados: No período coberto pelo estudo, houve 2476 doadores de córneas na instituição, com maior ocorrência do sexo masculino e média de 58,7 anos de idade. Foram verificados 23,0% de retenção por inaptidão sorológica, ou seja, 570 amostras mostraram-se não-negativas para qualquer dos testes empregados. O marcador anti-HBc foi o mais prevalente na população aferida, seguido pelo vírus da hepatite C (HCV) e pelo vírus da imunodeficiência humana (HIV). Conclusão: Diante dos dados encontrados por este estudo, torna-se decisiva a participação de um serviço eficaz no tangente à avaliação sorológica dos candidatos à doação de córnea, uma vez que a segurança do receptor deve ser considerada numa população de doadores com prevalência de retenção por inaptidão sorológica de 23,0%, donde o marcador mais prevalente é o de hepatite B. .

Soroprevalência e fatores associados ao Vírus da Imunodeficiência Humana (HIV) e sífilis em presidiários do Estado de Pernambuco, Brasil / Seroprevalence and factors associated with human immunodeficiency virus (HIV) and syphilis in inmates in the state of Pernambuco, Brazil

Os detentos apresentam maior vulnerabilidade ao HIV e outras Infecções Sexualmente Transmissíveis (IST) devido a fatores de risco como: compartilhamento de seringas e sexo desprotegido. O objetivo do presente trabalho foi determinar a soroprevalência e fatores de risco para o HIV-1/2 e sífilis entre presidiários do sexo masculino em Caruaru, Pernambuco, Brasil. Foi realizado um corte transversal no período de maio a julho de 2011, no qual 1097 detentos de uma penitenciária de Caruaru foram avaliados, por meio de entrevista e coleta de amostra de sangue para realização dos testes. A prevalência de infecção pelo HIV foi de 1,19% e de sífilis 3,92%. A associação com a infecção pelo HIV mostrou-se estatisticamente significante com uso de drogas injetáveis, homossexualismo e condição de transfusão (p < 0,05). Em relação à soropositividade para sífilis, fatores relacionados à vida sexual mostraram-se estatisticamente significante (p < 0,05). A população carcerária constitui um grupo de alto risco para as doenças pesquisadas. As taxas de prevalência aqui identificadas indicam a necessidade de implantação de programas de prevenção para que as mesmas não venham a se disseminar no âmbito desta população.

Prison inmates are more vulnerable to HIV and other Sexually Transmitted Infections (STIs) due to risk factors such as needle sharing and unprotected sex with homosexuals. The aim of this work was to determine the seroprevalence and risk factors associated with the human immunodeficiency virus (HIV-1/2) and syphilis among male inmates in Caruaru, State of Pernambuco, Brazil. A cross-sectional study was performed between May and July 2011, when 1,097 inmates at a prison in Caruaru were assessed by means of interviews and blood sample collection for performing the respective tests. The prevalence was 1.19% for HIV infection and 3.92% for syphilis. HIV infection showed a statistically significant association (p <0.05), with injected drug use, homosexuality and blood transfusions. With respect to HIV status and syphilis, factors related to sex life were statistically significant (p <0.05). The prison population is a high risk group for the diseases investigated. The prevalence rates identified indicate the need to implement prevention programs, helping to contain such diseases in this particular population group.

Reduction of the HIV Seroconversion Window Period and False Positive Rate by Using ADVIA Centaur HIV Antigen/Antibody Combo Assay

BACKGROUND: Early diagnosis of HIV infection reduces morbidity and mortality. Fourth-generation HIV detection assays are more sensitive because they can detect p24 antigen as well as anti-HIV antibodies. In this study, we evaluated the performance of a new fourth-generation ADVIA Centaur HIV antigen/antibody combo (CHIV) assay (Siemens Healthcare Diagnostics Inc., USA) for early detection of HIV infection and reduction of false positive rate. METHODS: Four seroconversion panels were included. The third-generation ADVIA Centaur HIV 1/O/2 enhanced (EHIV) assay (Siemens Healthcare Diagnostics Inc., USA) and fourth-generation CHIV assay were used to test each panel for HIV infection. The presence of antigen was confirmed using HIV p24 antigen assay. To evaluate false-positivity and specificity, 54 HIV false-positive and HIV-negative serum samples from 100 hospitalized patients and 600 healthy subjects were included. RESULTS: Compared to the EHIV assay, the CHIV assay had a shorter window for three of the seroconversion panels: a difference of 10 days and two bleeds in one panel, and 4 days and one bleed in the other two panels. Only 34 of the 54 (63%) samples known to yield false-positive results by EHIV assay had repeatedly yielded reactive results in the CHIV assay. One of the 600 healthy subjects had a false-positive result with the CHIV assay; thus, the specificity was 99.85% (699/700). CHIV accurately determined the reactive results for the HIV-confirmed serum samples from known HIV patients and Korea Food & Drug Administration (KFDA) panels. CONCLUSIONS: The new fourth-generation ADVIA Centaur HIV assay is a sensitive and specific assay that shortens the serological window period and allows early diagnosis of HIV infection.

Evaluation of rapid tests for human immunodeficiency virus as a tool to detect recent seroconversion

The identification of recent HIV infection is important for epidemiological studies and to monitor the epidemic. The objective of this study was to evaluate two rapid tests that are easily available to the Brazilian scientific community for using as markers of recent HIV infection. The Rapid Test - HIV-1/2 Bio-Manguinhos (Bio-Manguinhos/Fiocruz, Brazil) and the Rapid Check HIV 1&2 (NDI-UFES, Center for Infectious Diseases, Universidade Federal do Espírito Santo) were tested, using 489 samples with HIV positive serology, from blood donors, previously classified as recent or long-term infection by serological testing algorithm for recent HIV seroconversion (STARHS) or LS-HIV Vitros assay methods. The samples were diluted prior to testing (1:50 and 1:100 for the Rapid Test - HIV-1/2 Bio-Manguinhos, and 1:500 and 1:600 for the Rapid Check HIV 1&2). Negative samples were considered recent infection, whereas those showing any color intensity were associated with long-term infection. The best dilutions were 1:100 for HIV-1/2 Bio-Manguinhos test (Kappa = 0.840; overall agreement = 0.93), and 1:500 for the Rapid Check HIV 1&2 (Kappa = 0.867; overall agreement = 0.94). The results suggest that both rapid tests can be used to detect recent seroconversion.

Comportamiento de marcadores serológicos en donantes de sangre del territorio de Colón, 1998-2007 / Behavior of the serologic markers in blood donors in the territory of Colon, 1998-2007

En el laboratorio de Sistema Ultra-Micro-Analítico, del banco de sangre del Hospital Territorial Universitario Dr Mario Muñoz Monroy, del municipio Colón, provincia Matanzas, se realizó un estudio descriptivo prospectivo longitudinal, sobre el comportamiento de marcadores serológicos, donde se determinó la incidencia y prevalencia del antígeno de superficie del virus de la hepatitis B (VHB, HBsAg) y de los anticuerpos contra los virus de la hepatitis C (VHC, anti-VHC) y de la inmunodeficiencia humana 1 y 2 (VIH 1 y 2, anti-VIH 1+2), en donantes de sangre del territorio, y el estimado de infección potencial no detectada transmisible por sangre o riesgo residual (RR) en la sangre donada, en el tiempo comprendido del 1 de enero de 1998 al 31 de diciembre de 2007. La investigación se realizó con todo el universo de donantes útiles y sus respectivas donaciones de sangre, y quedó constituido por 49 749 donantes y 84 932 bolsas de sangre. Los índices de prevalencia (x 100 000 donantes), incidencia (x 100 000 donantes), y estimado de riesgo residual (x 1 000 000 de unidades de sangre donada) en el citado período de tiempo fueron: para el VHB 0,81; 0,17 y 0,20; para el VHC 0,55; 0,12 y 0,23; y para los VIH 1y2 0,005; 0,01x10-2 y 0,02 x10-3, respectivamente, índices bajos según la clasificación internacional; pero no para Cuba con respecto al HBsAg.

We carried out a prospective descriptive longitudinal study on the behavior of the serologic markers in the Ultra-Micro-Analytic System laboratory, of the blood bank of the territorial university hospital Dr Mario Muñoz Monroy, of the municipality of Colon, province of Matanzas. We determined the incidence and prevalence of the surface Hepatitis B virus antigen (HBV, HBsAg) and of the antibodies against the Hepatitis C (HCV, anti HCV) and the human immunodeficiency virus 1 and 2 (HIV 1 and 2, anti-HIV 1+2) in blood donors of the territory, and the estimate of non-detected potential infection transmissible by blood or residual risk (RR) in the donated blood, in the period from January 1st 1998 to December 31st 2007. The research was made with all the universe of utile donors and their respective blood donations, and was formed by 49 749 donors and 84 932 blood bags. The prevalence rates (x 100 000 donors), incidence (x 100 000 donors), and estimated residual risk (x 1 000 000 units of donated blood) in the quoted time period were: for the HBV 0,81; 0,17 and 0,20; for the HCV 0,55; 0,12 and 0,23, and for the HIV 1 and 2 0,005; 0,01x10-2 and 0,02x10-3 respectively, low rates according to the international classification, but not for Cuba with respect of the HBsAg.

Magnetic bead technology for viral RNA extraction from serum in blood bank screening

Nucleic acid amplification testing (NAT) was recently recommended by Brazilian legislation and has been implemented at some blood banks in the city of São Paulo, Brazil, in an attempt to reduce blood-born transmission of human immunodeficiency virus (HIV) and hepatitis C virus. OBJECTIVE: Manual magnetic particle-based extraction methods for HIV and HCV viral nucleic acids were evaluated in combination with detection by reverse transcriptase - polymerase chain reaction (RT-PCR) one-step. METHODS: Blood donor samples were collected from January 2010 to September 2010, and minipools of them were submitted to testing. ELISA was used for the analysis of anti-HCV/HIV antibodies. Detection and amplification of viral RNA was performed using real-time PCR. RESULTS: Out of 20.808 samples screened, 53 samples (29 for HCV and 24 for HIV) were confirmed as positive by serological and NAT methods. CONCLUSION: The manual magnetic bead-based extraction in combination with real-time PCR detection can be used to routinely screen blood donation for viremic donors to further increase the safety of blood products.

Marcadores serológicos de hepatitis B y C, y VIH en La Calera y Cuambio, Guerrero, México

OBJETIVO: Determinar la prevalencia de hepatitis B, C, y VIH en una muestra ampliada de dos de las comunidades rurales en las que se registró la mayor prevalencia de anticuerpos anti-core del virus de la hepatitis (anti-HBc) en la Encuesta Nacional de Salud 2000 (ENSA 2000). MATERIAL Y MÉTODOS: Se realizó un estudio transversal en las comunidades de La Calera y Cuambio, dos poblaciones rurales adyacentes del municipio de Zirándaro, Guerrero, seleccionadas por mostrar muy alta prevalencia de anti-HBc en la ENSA 2000. Se determinó la prevalencia de marcadores séricos de hepatitis B y C, y VIH, así como factores sociodemográficos asociados entre los habitantes mayores de 10 años. RESULTADOS: Se confirmó una muy alta prevalencia de marcadores de hepatitis B, asociada con la edad, baja escolaridad y relaciones con trabajadoras sexuales en Estados Unidos, mientras que la prevalencia de hepatitis C fue baja y no se detectó ningún caso de VIH. CONCLUSIONES: Existen en México comunidades rurales con alta endemicidad de hepatitis B, en las cuales es conveniente profundizar la investigación de determinantes de la transmisión de este virus. Estas comunidades son identificadas con certeza por las encuestas nacionales de salud.

OBJECTIVE: To perform a hepatitis B, C, and HIV survey in an enhanced sample from two rural communities with the highest anti-HBc prevalence found in ENSA 2000. MATERIALS AND METHODS: This was a cross-sectional study.We studied the communities of La Calera and Cuambio, two adjacent rural towns of the district of Zirándaro, Guerrero, targeted because of the high prevalence of anti-HBc shown in ENSA 2000.We assessed the prevalence of hepatitis B and C, and HIV serological markers and associated factors among inhabitants older than 10 years. RESULTS: A very high prevalence of hepatitis B markers associated with socioeconomic factors was confirmed, while hepatitis C prevalence was low and HIV absent in the two communities addressed. CONCLUSIONS: National serosurveys are an accurate tool for identifying communities with hepatitis B high endemicity where focused research and control measures are needed.

HBV, HCV and HIV seroprevalence among blood donors in Istanbul, Turkey: how effective are the changes in the national blood transfusion policies?

The national blood transfusion policies have been changed significantly in recent years in Turkey. The purpose of this study was to determine the prevalence of HBV, HCV, and HIV in blood donors at the Red Crescent Center in Istanbul and to evaluate the effect of changes in the national blood transfusion policies on the prevalence of these infections. The screening results of 72695 blood donations at the Red Crescent Center in Istanbul between January and December 2007 were evaluated retrospectively. HBsAg, anti-HCV, and anti-HIV-1/2 were screened by microparticle enzyme immunoassay (MEIA) method. Samples found to be positive for anti-HIV 1/2 and anti-HCV were confirmed by Inno-Lia HCV Ab III and Inno-Lia HIV I/II Score, respectively. The seropositivity rates for HBsAg, anti-HCV, and anti-HIV-1/2 were determined as 1.76 percent, 0.07 percent, and 0.008 percent, respectively. Compared to the previously published data from Red Crescent Centers in Turkey, it was found that HBV and HCV seroprevalances decreased and HIV seroprevalance increased in recent years. In conclusion, we believe that the drop in HBV and HCV prevalence rates are likely multifactorial and may have resulted from more diligent donor questioning upon screening, a higher level of public awareness on viral hepatitis as well as the expansion of HBV vaccination coverage in Turkey. Another factor to contribute to the decreased prevalence of HCV stems from the use of more sensitive confirmation testing on all reactive results, thereby eliminating a fair amount of false positive cases. Despite similar transmission routes, the increase in HIV prevalence in contrast to HBV and HCV may be linked to the increase in AIDS cases in Turkey in recent years.

Prevalence of HIV, syphilis, hepatitis B and C among adults with mental illness: a multicenter study in Brazil / Prevalência de HIV, sífilis, hepatites B e C entre adultos com transtornos mentais: um estudo multicêntrico no Brasil

OBJECTIVE: There is evidence that patients with mental illness have increased prevalence of sexually transmitted infections, but data in Brazil are scarce. The objective of this study was to determine the prevalence of HIV, hepatitis C and B, and syphilis among patients with mental illness in Brazil. METHOD: A multicenter representative sample of adults with mental illness was randomly selected from 26 mental health institutions throughout Brazil. Sociodemographic, sexual behavior and clinical data were obtained from person-to-person interviews and blood was collected for serology testing. Seroprevalence with 95 percent confidence limits were obtained correcting for sampling scheme. RESULTS: Of the 2,475 patients interviewed, 2,238 had blood collected. Most participants were sexually active ever (88.8 percent) or in the last 6 months (61.6 percent), female (51.9 percent), and single (66.6 percent). Half of the sample had less than 5 years of schooling and the mean monthly individual income was low (US$ 210.00). Condom use was very low either during lifetime (8 percent) or in the last 6 months (16 percent). Overall seroprevalence were 1.12 percent, 0.80 percent, 1.64 percent, 14.7 percent and 2.63 percent for, respectively, syphilis, HIV, HBsAg, anti-HBc and anti-HCV. CONCLUSIONS: Seroprevalences found were higher than other populations with representative studies in Brazil, with high rates of sexual risk behavior. This is of public health concern, and prevention and care strategies for sexually transmitted infections among psychiatric patients should urgently be implemented by health authorities.

OBJETIVO: Evidências indicam que pacientes com transtornos mentais têm elevada prevalência de infecções sexualmente transmissíveis, mas dados brasileiros são escassos. O objetivo deste estudo foi determinar a prevalência do HIV, hepatites C e B, e sífilis entre pacientes com transtornos mentais no Brasil. MÉTODO: Uma amostra representativa de pacientes adultos com transtornos mentais foi aleatoriamente selecionada de instituições públicas de saúde mental no Brasil. Dados sociodemográficos, comportamentais e clínicos foram obtidos por entrevista face-a-face e sangue foi coletado para exames sorológicos. Soroprevalências com intervalo de 95 por cento de confiança foram obtidas com correção para o esquema amostral. RESULTADOS: Dos 2.475 pacientes entrevistados, 2.238 tiveram sangue coletado. A maioria era sexualmente ativa ao longo da vida (88,8 por cento) ou nos últimos seis meses (61,4 por cento), do gênero feminino (51,9 por cento), solteira (66,6 por cento), com metade dos participantes com menos de cinco anos de escolaridade e renda média mensal baixa individual (US$210). Uso de preservativo foi baixo em toda a vida (8 por cento) ou nos últimos seis (16 por cento). As soroprevalências gerais foram 1,12 por cento, 0,80 por cento, 1,64 por cento, 14,7 por cento e 2,63 por cento para, respectivamente, sífilis, HIV, HBsAg, anti-HBc e anti-HCV. CONCLUSÕES: As soroprevalências encontradas são maiores do que outros estudos com populações representativas no Brasil, com altos índices de comportamento sexual de risco. Isto é preocupante e estratégias de prevenção e cuidado para as infecções sexualmente transmissíveis entre pacientes psiquiátricos devem ser urgentemente implementadas pelos serviços de saúde.

Meta-Analysis for the Pooled Sensitivity and Specificity of anti-Human Immunodeficiency Virus Ab Rapid Tests / 대한진단검사의학회지

BACKGROUND: Many immunochromatography (ICA) kits for anti-human immunodeficiency virus type (HIV) antibody (Ab) have been introduced to improve the accessibility of HIV Ab tests. However, qualified evaluation reports for HIV rapid tests are not enough to validate their performances. Metaanalysis for the performances of the HIV Ab rapid tests was performed in this study. METHODS: PubMed database was searched with combination of search terms, 'human immunodeficiency virus', 'HIV Ab', 'rapid test', 'immunochromatography', 'performance', 'sensitivity', and 'specificity'. Criteria of inclusion were performance studies for HIV ICA kits with serum or EDTA whole blood. Methodological qualities were evaluated with standards for reporting of diagnostic accuracy studies (STARD) checklists by two investigators. Homogeneity among selected studies was evaluated and then pooled sensitivity and specificity were calculated. Positive and negative predictive values were simulated with presumed HIV prevalence in Korea. RESULTS: Twenty-three studies were selected from 12 high-qualified papers with STARD checklists. The performance of 23 studies were found to be heterogeneous (P<0.1) and random effect model was used. Pooled sensitivity was 99.71% (95% CI: 99.45-99.97%) and pooled specificity was 99.27% (95% CI: 98.83-99.70%). With HIV prevalence of 0.03%, positive and negative predictive values were presumed to be 3.936% and 99.999%, respectively. CONCLUSIONS: This meta-analysis for HIV ICA rapid tests showed good performance. In consideration of low positive predictive values of HIV rapid tests, confirmation by enzyme immunoassay or Western blot is still needed. This study would be helpful in evaluating and establishing proper performance guideline for those kits not fully evaluated.

An unusual seroconversion profile in a pregnant woman infected with the human immunodeficiency virus-1: need for using later generations HIV screening assays.

The first HIV-1 marker that appears in blood following infection is HIV-1 RNA and usually the load is in millions of copies/ ml preceding seroconversion. A 24-year-old pregnant woman, gravida 2, parity 1 was tested for HIV as part of antenatal screening. Three samples were collected and tested from this individual over a period 70 days. The HIV-1 RNA level during seroconversion phase was very low, contrary to the well understood natural history of HIV infection. The reactivity rate in the ELISA and the Western Blot profile showed a gradual increase over the 70 days with a weak reactivity in a second generation assay (detects IgG only) for the third sample. This case illustrates the uncertainties regarding the serological window period in HIV infection and the need to use at least a third generation assay in testing centres for early detection of HIV infection.

Evaluation of the human immunodeficiency virus type 1 and 2 antibodies detection in dried whole blood spots (dbs) samples / Pesquisa de anticorpos contra o vírus da imunodeficiência humana tipos 1 e 2 em amostras de sangue seco coletadas em papel filtro

Human Immunodeficiency Vírus Type 1 and 2 antibodies detection was performed in 457 dried whole blood spots samples (S&S 903). Q-Preven HIV 1+2 was the screening test used. The results were compared with the gold standard serum tests by ELISA (Cobas Core e Axsym HIV1/2 gO) and imunofluorescence was the definitive confirmatory test. The samples were obtained from the Hospital Nossa Senhora da Conceição in Porto Alegre, RS - Brazil, through whole blood transfer to filter paper card and sent to Caxias do Sul, RS - Brazil where the tests were performed. The dried whole blood spot stability was evaluated with two different panels. The first one was composed of five negative and five positive samples stored at room temperature, 4 ºC, -20 ºC and -70 ºC, while the second was composed of two negative and three positive samples stored at 37 ºC (humidity <50 percent). Each sample was screened every week for six weeks. These measurement results didn't show variation during the study period. The detected sensibility was 100 percent, specificity was 99.6 percent, the positive predictive value was 99.5 percent and negative predictive values were 100 percent. The results demonstrated high performance characteristics, opening a new perspective of dried whole blood spot utilization in HIV screening diagnosis.

Foram realizados 457 testes para detectar anticorpos contra o Vírus da Imunodeficiência Humana tipos 1 e 2, em amostras de sangue total seco coletadas em papel filtro (S&S 903), com o teste de triagem Q-Preven HIV 1+2, comparando-se com os resultados dos testes de triagem no soro (Cobas Core e Axsym HIV1/2 gO), sendo a imunofluorescência indireta o teste confirmatório. As amostras foram obtidas no Hospital Conceição em Porto Alegre, pela transferência de sangue total para cartão de papel filtro e encaminhadas para Caxias do Sul para a realização dos testes. Foi analisada a estabilidade da amostra em papel filtro com a utilização de dois painéis: o primeiro com cinco amostras negativas e cinco positivas armazenadas por seis semanas à temperatura ambiente, 4 ºC, -20 ºC e -70 ºC; o segundo com duas negativas e três positivas armazenadas por seis semanas com avaliações semanais a 37 ºC (umidade <50 por cento). Os resultados de todas as amostras testadas foram mantidos. A sensibilidade foi de 100 por cento, a especificidade de 99,6 por cento, o valor preditivo positivo de 99,5 por cento e o valor preditivo negativo de 100 por cento. O excelente desempenho observado na análise da utilização de sangue seco em papel filtro, abre uma nova perspectiva no diagnóstico da infecção pelo HIV.

Human immunodeficiency virus infection in women undergoing treatment for cervical neoplasia: prevalence and the feasibility of routine screening.

This study was undertaken to evaluate the prevalence of human immunodeficiency virus (HIV) infection and the feasibility of routine HIV screening in women undergoing various treatment of cervical neoplasia at Chiang Mai University Hospital between October 2004 and October 2006. Four hundred and ninety five women were recruited for HIV screening with the opt-out approach performed. In this study, thirty-seven (7.47%) women had a previous diagnosis of HIV infection with a mean duration 4.16 years (range: 1-15 years). The remaining 458 women consented to have an HIV test. Six women (1.31%) were newly identified as HIV seropositive, giving an overall prevalence of 8.69%. In conclusion, the prevalence of HIV infection in this study was considerably high and routine HIV screening is feasible because of the high acceptance rate.

Seroprevalence of human immunodeficiency virus-2 in and around Amritsar.

A total of 14555 serum samples collected between January, 2001 to April, 2006 were screened for HIV infection. Antibodies to HIV-1/ HIV-2 were present in 985 (6.76%) of which 964 (97.86%) and 2 (0.22%) were positive for HIV-1 and HIV-2 alone respectively and 19 (1.92 %) for both HIV-1 and HIV-2. Of the 21 in whom HIV-2 infection was detected (alone and dual), 19 (90.5%) were in the age group of 21-40 years and 2 were children below the age of 11 years. Predominantly mode of transmission in them was heterosexual (85.71%) while the 2 children (9.53%) had most probably got the infection through perinatal route. Nine (42.85%) were asymptomatic and 12 (57.15%) clinically presented with chronic diarrhoea (5), prolonged fever (4) and symptoms related to sexually transmitted diseases (3). Opportunistic infections like Oral candidiasis was observed in 3 and pulmonary tuberculosis in 2.

HIV prevalence and risk factors in a Brazilian penitentiary

A infecção pelo HIV em presidiários alcança uma das maiores prevalências entre subgrupos populacionais específicos, com taxas de até 17 por cento, já tendo sido descritas no Brasil e no mundo. Esta pesquisa objetivou estimar a prevalência do marcador do HIV e fatores de risco para essa infecção na população masculina carcerária da Penitenciária de Ribeirão Preto, São Paulo, Brasil, no período de maio a agosto de 2003. Do total de 1.030 presidiários, foram sorteados 333 participantes por amostragem aleatória simples, os quais foram submetidos à aplicação de um questionário padronizado e coleta de sangue. Para diagnóstico sorológico do HIV foi utilizado o ensaio imunoenzimático (ELISA) e reação de imunofluorescência indireta. A prevalência global do HIV nos presidiários foi de 5,7 por cento (IC95 por cento: 3,2-8,2). Todas as variáveis que mostraram associação com presença do anti-HIV, por meio de análise univariada, foram submetidas a modelo multivariado de regressão logística não condicional. As variáveis que se mostraram preditoras de forma independente da infecção pelo HIV foram: tempo total da pena a ser cumprida inferior a cinco anos e compartilhamento de agulhas e seringas.

HIV infection among prison inmates shows one of the highest prevalence rates for specific population subgroups, reaching as high as 17 percent in Brazil and elsewhere in the world. The present study aimed to estimate HIV antibody prevalence and risk factors for infection in male inmates at the Ribeirão Preto Penitentiary, São Paulo State, Brazil, from May to August 2003. Using simple random sampling, 333 participants were selected, answered a standardized questionnaire, and had blood samples collected. Enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence were used for HIV serological diagnosis. Overall HIV prevalence among inmates was 5.7 percent (95 percentCI: 3.2-8.2). All variables associated with HIV antibodies in the univariate analysis were submitted to unconditional multivariate logistic regression. Independent predictors of HIV infection were: total prison sentence less than five years and sharing needles and syringes.