ABSTRACT
RESUMEN El linfoma de Burkitt, se trata de un subtipo poco frecuente del linfoma no Hodgkin, con elevada frecuencia en aquellos pacientes con sida. La hepatoesplenomegalia es un signo clínico de gran importancia para el diagnóstico oportuno de algunas patologías; entre los mecanismos de formación de la hepatoesplenomegalia se encuentra la infiltración celular, ocasionada por la migración de células tumorales. Se presenta por inflamaciones debido a la presencia de infecciones por virus o bacterias las cuales son muy comunes en pacientes con sida. Se presentó un caso de un paciente masculino de 4 años, diagnosticado con VIH positivo, con la configuración correspondiente de criterios clínicos en clasificación C para sida. El cual desarrolló a nivel de cavidad oral un Burkitt primario, que se acompañó de hepatoesplenomegalia. Se pretendió describir la relación y el comportamiento de este tipo de linfoma con la hepatoesplenomegalia, así como la repercusión a nivel del sistema estomatognático, a nivel sistémico y el plan de tratamiento. Por el cuadro clínico e inmunológico del paciente estudiado, se planteó un pronóstico reservado por presentar un cuadro clínico infrecuente, en el que se observó Burkitt; tanto a nivel del sistema estomatognático como a nivel abdominal. Se hizo necesario realizar un diagnóstico oportuno y certero para iniciar el tratamiento a tiempo, se comenzó inmediatamente con tratamiento (AU).
ABSTRACT Burkitt lymphoma (BL) is a rare subtype of non-Hodgkin lymphoma, with high frequency in those patients with AIDS. Hepatosplenomegaly is a clinical sign of great importance for the timely diagnosis of some pathologies; cellular infiltration is found among the mechanisms of hepatosplenomegaly formation; it is caused by the migration of tumor cells. It emerges by inflammations due to the presence of infections by virus or bacteria which are very common in patients with AIDS. The authors present the case of a male patient, aged 4 years, with a positive HIV diagnosis, and the correspondent configuration of clinical criteria in C classification for AIDS, who developed a primary Burkitt lymphoma at the level of oral cavity We present the case of a 4-year-old male patient diagnosed with HIV positive, with the corresponding configuration of clinical criteria in classification C for AIDS; who developed a primary LB at the oral cavity level that was accompanied by hepatosplenomegaly. The authors pretended to describe the relation and behavior of this kind of lymphoma with hepatosplenomegaly, and also the repercussion at the stomatognathic level, at the systemic level and the treatment plan. Due to the clinical and immunological characteristics of the studied patient a reserved prognosis was given because of presenting infrequent clinical characteristics in which a Burkitt was observed both, at the stomatognathic and at the abdominal level. It was necessary to make an opportune and accurate diagnosis to begin the treatment on time (AU).
Subject(s)
Humans , Male , Child , Signs and Symptoms , Child , Burkitt Lymphoma/complications , Splenomegaly/complications , Splenomegaly/diagnosis , Mouth Neoplasms/complications , Mouth Neoplasms/diagnosis , HIV Antigens/therapeutic use , Clinical Diagnosis/diagnosis , HIV/pathogenicity , Hepatomegaly/diagnosisABSTRACT
Resumo A postura do médico em relação a diagnóstico e esclarecimentos ao paciente infectado pelo vírus da imunodeficiência humana baseia-se principalmente na percepção pessoal e experiência humanística. O objetivo deste estudo foi relatar a experiência de estudantes de medicina do sexto período do Centro Universitário Metropolitano da Amazônia, em Belém/PA, durante as aulas do módulo de Habilidades Clínicas (Eixo Infectologia) no Centro de Atenção à Saúde em Doenças Infecciosas Adquiridas. Depois de prestarem atendimentos ambulatoriais e discutirem casos clínicos por cinco meses, os estudantes se deram conta da necessidade de humanização nessa área, considerando questões biopsicossociais. De modo geral, a experiência ampliou os conhecimentos adquiridos nas aulas e permitiu aplicar o cuidado integral ao paciente, além de estimular formação mais humanística e crítica desses profissionais de saúde.
Abstract The physicians's attitude towards diagnosis and clarifications to the patient infected by the human immunodeficiency virus is based mainly on personal perception and humanistic experience. The objective of this study was to report the experience of medical students from the sixth period of the Centro Universitário Metropolitano da Amazônia, in Belém, Pará, Brazil, during classes of the Clinical Skills module (Infectious Axis) at the Center for Attention on Acquired Infectious Diseases. After providing outpatient care and discussing clinical cases for five months and considering biopsychosocial issues, the students realized a need for humanization in this area. The experience expanded the knowledge acquired in class and allowed the delivery of comprehensive care to the patient, in addition to encouraging more humanistic and critical training of these health professionals.
Resumen La actitud del médico respecto al diagnóstico y la aclaración de la condición del paciente infectado por el VIH está relacionada con la percepción personal y la experiencia humanística. El presente estudio tuvo el objetivo de presentar la experiencia de estudiantes de medicina del sexto período del Centro Universitário Metropolitano da Amazônia, en Belém, Pará, Brasil, durante las clases del módulo Habilidades Clínicas (Eje Infectología) en el Centro de Atención de Enfermedades Infecciosas Adquiridas. Los estudiantes ofrecieron atención ambulatoria y tuvieron discusión de casos durante cinco meses y pudieron advertir la necesidad de humanización en esta área debido a problemas biopsicosociales. La experiencia brindó la oportunidad de ampliar los conocimientos adquiridos durante las clases y aplicar una atención integral al paciente, y estimular la capacitación de profesionales de la salud con un perfil humanístico y crítico.
Subject(s)
AIDS Serodiagnosis , HIV Antigens , Education, Medical , Humanization of Assistance , Infectious Disease MedicineABSTRACT
Introdução: O aleitamento materno é o mais simples método de vínculo, proteção e nutrição para a criança. Entretanto, o aleitamento pode ser contraindicado nos casos em que a puérpera possuir soropositividade para o HIV e HTLV. Objetivo: Conhecer a visão da puérpera soropositiva para HIV e HTLV quanto a não amamentação. Método: Descritivo com abordagem qualitativa, pois propicia conhecer a natureza e processo que constitui o objeto de estudo, descrevendo-os e interpretando-os. Enquanto que a abordagem qualitativa possibilitará compreender a realidade estudada. Realizado em um hospital materno-infantil referência em gestação de alto risco. Participaram oito puérperas soropositivas para HIV/HTLV no período de março-abril de 2017. Resultado: Três categorias: entendimento relacionado ao não aleitamento materno; sentimento da puérpera quanto a não amamentação e conhecimento sobre o funcionamento e importância do banco de leite humano. Considerações finais: Pode-se compreender a visão da puérpera sobre o aleitamento materno, falta de conhecimento das participantes advindas do interior e falta de informações quanto ao HTLV, salientando a importância da interação entre a enfermagem e a puérpera a fim de melhor orientá-la.(AU)
Subject(s)
Humans , Female , Breast Feeding , HIV Antigens , HIV Seropositivity , Maternal and Child HealthABSTRACT
To construct an HSV-1 vector vaccine carrying HIV-1 antigens, HIV-1 gp160, gag, protease and the expression elements were chained together, and then inserted into the internal inverted repeat sequence region of HSV-1 by bacterial artificial chromosome technology. Firstly, HIV-1 gp160 (including type B and C), gag and protease genes were cloned into pcDNA3 in series to generate the pcDNA/gBgp and pcDNA/gCgp, then the recombinant plasmids were transfected into 293FT cells, and HIV-1 antigen was detected from transfected cells by Western blotting. Then the expression cassettes from pcDNA/gBgp and pcDNA/gCgp, comprising HIV-1 antigen genes and expression elements, were cloned into pKO5/BN to generate the shuttle plasmids pKO5/BN/gBgp and pKO5/BN/gCgp. The shuttle plasmids were electroporated into E. coli cells that harbor an HSV-BAC, the recombinant bacteria were screened, and the recombinant DNA was extracted and transfected into Vero cells. The recombinant virus was purified through picking plaques, the virus' DNAs were identified by Southern blotting; HIV-1 antigen was detected from the recombinant HSV-1 infected cells by Western blotting, and the virus' replication competent was analyzed. As the results, gp160 and gag proteins were detected from 293FT cells transfected with pcDNA/gBgp and pcDNA/gCgp by Western blotting. The recombinant bacteria were generated from the E. coli electroporated with pKO5/BN/gBgp or pKO5/BN/gCgp. The recombinant HSV was purified from the Vero cells transfected with the recombinant DNA, the unique DNA fragment was detected from the genome of recombination HSV by Southern blotting; gp120 and gp41 were detected from the infected cells by Western blotting, and the recombinant HSV retained replication competent in mammalian cells. The results indicate that the recombinant HSV carrying HIV-1 gp160, gag and protease genes was generated, the virus retains replication competent in mammalian cells, and could be used as a replicated viral vector vaccine.
Subject(s)
Animals , Chlorocebus aethiops , Chromosomes, Artificial, Bacterial , DNA, Recombinant , Genetics , DNA, Viral , Genetics , Escherichia coli , HIV Antigens , Genetics , Allergy and Immunology , HIV Envelope Protein gp160 , Genetics , Allergy and Immunology , HIV Protease , Genetics , Allergy and Immunology , Herpes Simplex Virus Vaccines , Allergy and Immunology , Herpesvirus 1, Human , Physiology , Plasmids , Transfection , Vero Cells , Virus Replication , gag Gene Products, Human Immunodeficiency Virus , Genetics , Allergy and ImmunologyABSTRACT
Ronald Woodroof died of AIDS in September 12, 1992, seven years after he was diagnosed. A lower dose of AZT became widely used in later drug combinations that saved millions of lives". These words end the film Dallas Buyers Club, a recent, highly awarded movie, that tells the true story of a cowboy diagnosed with AIDS in 1985 and illegally receives the firsthand antiviral AZT but, due to the severe side effects that the drug afflicted, begins to experiment with and illicitly distribute among the "Club" non-FDA approved remedies in search of a better treatment for himself and other AIDS patients. Perhaps owing to an artistic strategy, the movie waits until the last couple of lines to do justice to AZT and the impact it had in dealing with AIDS at that day and age
Subject(s)
Humans , HIV Antigens , Zidovudine , Anti-HIV Agents , Anti-Retroviral AgentsABSTRACT
INTRODUÇÃO E OBJETIVOS: Uma fonte secundária e não convencional de peptídeos que se ligam as moléculas MHC de classe I tem sido descrita como responsável por produzir peptídeos crípticos. Esses peptídeos são imunogênicos e portanto, capazes de induzir uma resposta imunológica por células T e assim, contribuir com a resposta total exercida pelas células T CD8+, colaborando na pressão que leva HIV-1 ao processo de mutação, e consequentemente ao escape viral. Alguns pacientes, que correspondem a menos de 5% da população infectada, são capazes de naturalmente controlar a progressão da doença, mantendo a contagem de célula T CD4+ acima de 500 células/uL ou mantendo a carga viral abaixo de 2.000 cópias/mL, por ao menos 12 meses, sem ser submetido a tratamento com antirretrovirais ou esquema HAART. Avaliar a resposta imunológica destes pacientes, controladores da infecção, contra peptídeos crípticos pode nos fornecer informações importantes que colaborem com o desenvolvimento de novas estratégias preventivas. METODOLOGIA: A resposta imunológica contra peptídeos crípticos, estes derivados da transcrição da seqüência consenso e da seqüência inversa do gene do HIV-1, foram avaliados em vários conjuntos (pools), utilizando amostras coletadas de pacientes controladores, tanto avirêmicos, também conhecidos como controladores de elite (carga viral < limite de detecção), bem como virêmicos (carga viral < 2.000 cópias/mL) e, de pacientes progressores. Foi observada que a resposta imunológica contra peptídeos crípticos é mais freqüente, com maior amplitude e magnitude entre os pacientes controladores comparados ao que foi observado entre pacientes progressores. Esta resposta, entretanto, parece inverter ao longo da infecção, como observada utilizando as amostras coletadas em momento tardio da infecção, onde os controladores parecem perder sua capacidade de responder aos peptídeos crípticos, enquanto que os progressores desenvolveram resposta, ressaltando...
BACKGROUND: A second and unconventional source of peptides that bind to MHC class I molecule has been described to produce cryptic peptides, which are immunogenic and are able elicit T cell response, that contributes to total CD8+ T cell immune response and then exert mutation pressure on HIV-1, leading to virus escape. Some rare patients, less than 5% of infected population, are naturally able to control disease progression, either maintaining CD4+ T cells over 500 cells/uL or viral load under 2,000 copies/mL, without being treated with HAART, for at least 12 months. Understanding their immune response to cryptic peptides might be a great value to help on developing better prevention strategies. METHODOLOGY: Immune response to cryptic peptides, derived from sense and antisense transcription of HIV-1, was evaluated in pools using samples from Elite (aviremic) or HIV (viremic, < 2,000 copies/mL) controllers and progressors. Immune response to cryptic peptides are more frequent, with a larger breadth and of greater magnitude in controllers than in progressors, and this response is inversed seen in a later time point, when controllers seems to lose this response, while progressors developed it, showing cryptic peptides immune response to different pools, suggesting that immune response to cryptic peptides might play some role in pressuring the virus mutation escape. CONCLUSIONS AND SIGNIFICANCE: cryptic peptides can elicit immune response and help to explain how some virus selection happens, either by changing expression of crucial HIV-1 proteins or generating defective virus. They can be included in vaccine design for enhancing the magnitude and breadth of T cell immune response and consequently the protection against infection or progression of HIV-1 infection.
Subject(s)
Humans , Female , Adult , Enzyme-Linked Immunospot Assay , HIV Antigens , HIV Infections , HIV-1ABSTRACT
Os medicamentos antirretrovirais têm a finalidade de impedir a replicação viral, mantendo indiretamente a contagem de linfócitos T CD4+ estável, com isso, as infecções oportunistas diminuem, havendo melhora da qualidade de vida do indivíduo infectado pelo HIV, porém, inibidores de proteases e da transcriptase reversa também estão associados a efeitos adversos e risco de desenvolvimento de resistência medicamentosa. Além disso, ainda não está claro o efeito dessas terapias na microbiota bucal. Objetivo: O objetivo desse estudo foi investigar, em biofilme supra e subgengival de pacientes HIV positivos com diferentes condições periodontais e imunológicas, o efeito da terapia antirretroviral sobre microrganismos que podem estar associados a infecções oportunistas locais ou sistêmicas. Materiais e métodos: Foram obtidos dados sobre as condições de saúde, uso antirretrovirais e amostras de biofilme supra e subgengival de 118 pacientes HIV positivos de ambos os sexos divididos em dois grupos (usuários e não usuários de HAART). Essas amostras foram submetidas à detecção de microrganismos por PCR. Cálculos de Odds ratios foram realizados para determinar a relevância de inter-relações entre diferentes microrganismos e a significância dos parâmetros clínicos e microbiológicos foi determinada através de regressão logística multivariada. Resultados: Foram encontrados principalmente Tannerella forsythia, Campylobacter rectus, Acninomyces israelli, Staphylococcus sp, Citomegalovírus e Enterobacteriaceae nos pacientes. Treponema denticola, Fusobacterium nucleatum, Mollicutes, Actinomyces israelli e Staphylococcus sp em biofilme subgengival tiveram correlação significativa com os grupos de antirretrovirais (p < 0,05). Na comparação entre os grupos, somente Enterococcus faecalis e Pseudomonas aeruginosa tiveram significância com maior prevalência para o grupo de não usuários de antirretrovirais. Conclusão: Não houve diferenças significantes entre os grupos...
Introduction: Antiretrovirals are used in order to prevent viral replication while maintaining CD4 + T lymphocytes stable and low viral load, thus the occurrence of opportunistic infections decreases with an improvement in the quality of life of HIV-infected individual. As is known, protease inhibitors and reverse transcriptase are also associated with risk of adverse effects and development of drug resistance, however, it remains unclear the effect of these therapies on oral microbiota. Objective: The aim of this study was to investigate, in biofilm supra and subgingival in HIV - positive patients with different periodontal and immunological conditions, the effect of HAART on microorganisms that may be associated with local or systemic opportunistic infections. Materials and methods: Data on health conditions, use or nonuse of antiretroviral and biofilm samples supra and subgingival of 118 HIV - positive patients of both sexes, divided into two groups (users and nonusers of HAART), were obtained. These samples were subjected to PCR for detection of microorganisms. Odds ratio calculations were performed to determine the relevance of inter - relations between different microorganisms and the significance of clinical and microbiological parameters were determined using multivariate logistic regression. Results: Mainly T. forsythia, C. rectus, A. israelli, Staphylococcus sp and CMV were found. T denticola, F nucleatum, mollicutis, A. israelli and Staphylococcus sp in subgingival biofilm showed significant correlation (p <0.05) with antiretrovirals groups. Only E. faecalis and P. aeruginosa were significant with higher incidence in no HAART users group. Conclusion: There were no significant differences in supra and subgingival biofilm for most microbiota of HAART users and non-users...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , AIDS-Related Opportunistic Infections , Antiretroviral Therapy, Highly Active , HIV Antigens , Microbiota , PeriodontiumABSTRACT
Introdução: Os medicamentos antirretrovirais têm a finalidade de impedir a replicação viral, mantendo indiretamente a contagem de linfócitos T CD4+ estável, com isso, as infecções oportunistas diminuem, havendo melhora da qualidade de vida do indivíduo infectado pelo HIV, porém, inibidores de proteases e da transcriptase reversa também estão associados a efeitos adversos e risco de desenvolvimento de resistência medicamentosa. Além disso, ainda não está claro o efeito dessas terapias na microbiota bucal. Objetivo: O objetivo desse estudo foi investigar, em biofilme supra e subgengival de pacientes HIV positivos com diferentes condições periodontais e imunológicas, o efeito da terapia antirretroviral sobre microrganismos que podem estar associados a infecções oportunistas locais ou sistêmicas. Materiais e métodos: Foram obtidos dados sobre as condições de saúde, uso antirretrovirais e amostras de biofilme supra e subgengival de 118 pacientes HIV positivos de ambos os sexos divididos em dois grupos (usuários e não usuários de HAART). Essas amostras foram submetidas à detecção de microrganismos por PCR. Cálculos de Odds ratios foram realizados para determinar a relevância de inter-relações entre diferentes microrganismos e a significância dos parâmetros clínicos e microbiológicos foi determinada através de regressão logística multivariada. Resultados: Foram encontrados principalmente Tannerella forsythia, Campylobacter rectus, Acninomyces israelli, Staphylococcus sp, Citomegalovírus e Enterobacteriaceae nos pacientes. Treponema denticola, Fusobacterium nucleatum, Mollicutes, Actinomyces israelli e Staphylococcus sp em biofilme subgengival tiveram correlação significativa com os grupos de antirretrovirais (p < 0,05). Na comparação entre os grupos, somente Enterococcus faecalis e Pseudomonas aeruginosa tiveram significância com maior prevalência para o grupo de não usuários de antirretrovirais. Conclusão: Não houve diferenças significantes entre os grupos para a...
Introduction: Antiretrovirals are used in order to prevent viral replication while maintaining CD4 + T lymphocytes stable and low viral load, thus the occurrence of opportunistic infections decreases with an improvement in the quality of life of HIV-infected individual. As is known, protease inhibitors and reverse transcriptase are also associated with risk of adverse effects and development of drug resistance, however, it remains unclear the effect of these therapies on oral microbiota. Objective: The aim of this study was to investigate, in biofilm supra and subgingival in HIV - positive patients with different periodontal and immunological conditions, the effect of HAART on microorganisms that may be associated with local or systemic opportunistic infections. Materials and methods: Data on health conditions, use or nonuse of antiretroviral and biofilm samples supra and subgingival of 118 HIV - positive patients of both sexes, divided into two groups (users and nonusers of HAART), were obtained. These samples were subjected to PCR for detection of microorganisms. Odds ratio calculations were performed to determine the relevance of inter - relations between different microorganisms and the significance of clinical and microbiological parameters were determined using multivariate logistic regression. Results: Mainly T. forsythia, C. rectus, A. israelli, Staphylococcus sp and CMV were found. T denticola, F nucleatum, mollicutis, A. israelli and Staphylococcus sp in subgingival biofilm showed significant correlation (p <0.05) with antiretrovirals groups. Only E. faecalis and P. aeruginosa were significant with higher incidence in no HAART users group. Conclusion: There were no significant differences in supra and subgingival biofilm for most microbiota of HAART users and non-users
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , AIDS-Related Opportunistic Infections , Antiretroviral Therapy, Highly Active , HIV Antigens , Microbiota , PeriodontiumABSTRACT
<p><b>OBJECTIVE</b>To investigate if immunological factors associated with rheumatoid arthritis (RA) affect the result of human immunodeficiency virus (HIV) screening by electrochemiluminescence immunoassay (ECLIA) and enzyme-linked immunosorbent assay (ELISA).</p><p><b>METHODS</b>100 RA cases were enrolled from January 2012 to February 2013 into this study. HIV screening was conducted with ECLIA detecting both HIV-1 p24 antigen, HIV-1 and HIV-2 antibodies, with ELISA and colloidal gold method detecting HIV-1 and HIV-2 antibodies. The samples producing positive results were submitted to the Center for Disease Control for confirmation using Western blotting method. The antibody titers of rheumatoid factors (RF) including RF-IgG, RF-IgM, RF-IgA, and CCP-IgG were analyzed by ELISA.</p><p><b>RESULTS</b>The HIV positive-rate determined by ECLIA was significantly higher than that by ELISA and colloidal gold method (P<0.01). The false-positive rate of HIV screening was associated with antibody titers of RF-IgG, RF-IgM, RF-IgA, and CCP-IgG in RA (P<0.01).</p><p><b>CONCLUSIONS</b>Immunological factors, including RF and anti-CCP antibody, may influence the screening of HIV by ECLIA, producing false-positive result.</p>
Subject(s)
Adult , Aged , Humans , Middle Aged , Arthritis, Rheumatoid , Enzyme-Linked Immunosorbent Assay , False Positive Reactions , HIV Antibodies , Blood , HIV Antigens , Blood , HIV Infections , Diagnosis , Rheumatoid Factor , PhysiologyABSTRACT
Hallazgos recientes en el área de la intensificación de los tratamientos antirretrovirales demuestran que la forma de llegar a una curación para el VIH exige la inclusión de nuevas estrategias de tratamiento como las vacunas terapéuticas. La vacuna terapéutica DermaVir incluye elementos tecnológicos clave en el diseño de una vacuna racional: un único inmunógeno plásmido de ADN (pADN) que expresa a 15 antígenos del VIH, formulación de nanomedicina y una única administración tópica de la vacuna enfocada a las células dendríticas. Luego de su administración tópica sobre la piel preparada, las células epidérmicas de Langerhans activadas transportan la nanomedicina DermaVir a los nódulos linfáticos para expresar a los antígenos del VIH codificados como pADN e inducir a las células T precursoras/de memoria con una alta capacidad de proliferación. Se han demostrdo la seguridad, la inmunogenicidad y la eficacia preliminar de la DermaVir en varios modelos animales y en humanos con infección por VIH. Esta novedosa tecnología de vacunación terapéutica podría constituir un nuevo paradigma en el trtamiento contra el VIH.
Recent findings on the field of antiretroviral treatment intesnsification demonstrate thar the way towards a cure for HIV requires the involvement of novel treatment strategies like therapeutic vaccines. DermaVir therapeutic vaccine includes key technological elements of rational vaccine design: a single plasmid DNA (pDNA) immunogen that expresses 15 HIV antigens, nanomedicine formulation and a unique dendritic cell-targeting topical vaccine administration. Following topical administration on the prepared skin, DermaVir nanomedicine is transported by activated epidermal Langerhans cells to the lymph nodes to express the pDNA-encoded HIV antigens and induce precursor/memory T cells with high proliferation capacity. Safety, immunogenicity and preliminary efficacy of DermaVir have been demonstrated in several animal models and HIV-infected human subjects. This novel therapeutic vaccination technology might offer a new treatment paradigm against HIV.
Subject(s)
Humans , AIDS Vaccines , HIV Antigens/immunology , HIV , Nanomedicine , Treatment OutcomeABSTRACT
No fim da década de 80, muitas mulheres passaram a contrair o vírus HIV e este fato começou a delinear um novo perfil da epidemia da AIDS no Brasil. No entanto, muitos estudos sobre HIV/AIDS são realizados somente com a população adulta e dados sobre a infecção pediátrica ainda são bastante escassos. Este é um estudo transversal que objetiva traçar o perfil da resposta à terapia antirretroviral em uma população formada por crianças e adolescentes. Este trabalho foi desenvolvido por meio da análise dos resultados dos testes de genotipagem - disponíveis no banco de dados do Setor de Biologia Molecular do Laboratório Central do Estado do Rio Grande do Sul (LACEN-RS). Por meio dos testes de genotipagem foi possível observar algumas mutações de resistência aos antirretrovirais. O subtipo B apresentou maior prevalência, seguido pelo subtipo C. As mutações que ocorreram com maior frequência foram D67N e V118I, pertencentes à classe de medicamentos Nucleosídeos Inibidores da Transcriptase Reversa (NRTI). Foi possível observar que alguns medicamentos apresentaram maiores níveis de resistência simples: Zidovudina e Lamivudina. A importância da identificação de mutações de resistência se faz relevante na escolha dos medicamentos que serão utilizados, aumentando assim, as chances de sucesso da terapia.
In the late 80s, many women began to contract the HIV virus; this fact began to change the profile of AIDS epidemic in Brazil. However, many studies of HIV/AIDS are performed only on the adult population and data on pediatric HIV infection are still quite scarce. The aim of this cross-sectional study was to outline the response of the HIV infection to antiretroviral therapy in a population composed of children and adolescents. The work involved analyzing the results of virus genotyping assays, available in the database of the Section of Molecular Biology of the Central State Laboratory of Rio Grande do Sul (LACEN-RS). Subtype B was the most prevalent, followed by subtype C. Through genotyping, it was possible to observe some antiretroviral resistance mutations. The mutations that occurred most frequently were D67N and V118I, which confer resistance to medications of the class of Nucleoside Reverse Transcriptase Inhibitors (NRTI). The highest observed frequencies of resistance were to Zidovudine and Lamivudine. The identification of resistance mutations is of great relevance in the choice of drugs that will be used to treat a particular patient, to maximize the chance of a successful therapy.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Anti-Retroviral Agents , HIV Antigens , MutationABSTRACT
Mycobacterium abscessus is a rapidly growing non-tuberculous mycobacterium that is a common water contaminant, and an exclusive opportunistic pathogen in immunosuppressed patients; however, it occasionally causes lung infections in immunocompetent persons as well. We report two cases of chronic pulmonary infection caused by M abscessus in two young migrant workers; they were nonreactive to HIV antigen, without any history of pulmonary disorders and no evidence of any immunocompromized status. Both were initially suspected as having pulmonary tuberculosis, and antituberculosis drugs were administered. The preliminary culture found the isolate as a rapidly growing nontuberculous mycobacteria and later by advanced molecular genotyping of the isolates revealed it as M abscessus. The patients were treated with multiple drugs including clarithromycin. The symptoms resolved slowly, the smears and culture became negative, and they recovered completely. This is the first case of its type to be reported from Saudi Arabia
Subject(s)
Humans , Male , Mycobacterium/pathogenicity , Immunocompetence , Chronic Disease , HIV Antigens , Genotyping Techniques , Clarithromycin , Molecular Diagnostic Techniques , MalnutritionABSTRACT
So far, recombinant antigens of HIV-1, the etiologic cause of Acquired Immunodeficiency Syndrome [AIDS], have been widely used for the diagnosis and vaccine development. P17 or the matrix protein formed by the proteolytic cleavage of gag is strongly antigenic and is as conserved and immunogenic as p24. In some cases, antibodies to p17 are more prevalent than antibodies to p24 and the decline in the level of p17 antibodies is an earlier prognostic marker for disease progression than decline in the level of antibodies to p24. The aim of this study was to clone and express the gag derived p17 protein in soluble form in E. coli and then assess the immunoreactivity of produced recombinant p17. DNA sequence encoding p17 matrix protein was cloned from PTZ-gag53-IR vector that has the complete gag polyprotein sequence. The T7-promoter-based expression system used in this study was TOPO directional cloning strategy that expressed p17 matrix protein in fusion with thioredoxin in E. Coli. Purification of produced recombinant protein has been done using Ni-NTA nickel chelating agarose beads. Sequencing result of the cloned sequence showed that it belongs to CRF35_AD subtype of HIV-1 which is highly prevalent in Iran and Afghanistan. The immunoreactivity of produced recombinant p17 to sera from infected individuals showed 93.8% sensitivity and 100% specificity
Subject(s)
Humans , HIV Antigens , Thioredoxins , Acquired Immunodeficiency Syndrome , AIDS Vaccines , Cloning, Molecular , Recombinant Fusion ProteinsABSTRACT
The purpose is to screen and identify the specific H-2d restricted T-cell epitopes. These epitopes are used to investigate the cellular immune response of BALB/c (H-2d) mice immunized with a HIV-1 vaccine which expresses six antigens of gp160, gag, pol, rev, tat and nef of HIV subtype B'/C. A replicating DNA vaccine and a non-replicating recombinant vaccinia virus vector, both expressing the six antigens mentioned above, were used to immune BALB/c (H-2d) mice in a prime-boost regiment. The six peptide libraries of HIV B'/C corresponding respectively to the six complete antigens were pooled according to a designed matrix format and used to test for IFN-gamma production from splenocytes of immunized mice by an enzyme-linked immunospot (IFN-gamma ELISPOT) assay. The ELISPOT data indicated that two of seven Gag-specific T-cell epitope peptides were identified to be the novel epitopes. One of three Pol-specific T-cell epitope is unreported. One novel epitope was confirmed in two gp160-specific T-cell epitope peptides. One Nef-specific T-cell epitope was identified. Three Tat-specific T-cell epitope peptides were continuous sequences in Tat peptide library and all contained either complete or partial sequence reported. Rev-specific T-cell epitope was not be found. The specific T-cell epitopes (H-2d restricted) were identified by IFN-7 ELISPOT assay, which could be used to detect the cellular immune response of BALB/c mice immunized with the HIV-1 vaccine expressing six antigens of gp160, gag, pol, rev, tat and nef of HIV subtype B'/C.
Subject(s)
Animals , Female , Humans , Mice , Amino Acid Sequence , Enzyme-Linked Immunospot Assay , Methods , Epitopes, T-Lymphocyte , Chemistry , Genetics , Allergy and Immunology , H-2 Antigens , Chemistry , Genetics , Allergy and Immunology , HIV Antigens , Chemistry , Genetics , Allergy and Immunology , HIV Infections , Allergy and Immunology , Virology , HIV-1 , Classification , Genetics , Allergy and Immunology , Histocompatibility Antigen H-2D , Mice, Inbred BALB C , Molecular Sequence Data , Peptide Mapping , MethodsABSTRACT
<p><b>INTRODUCTION</b>Dried blood spot (DBS) collection is an appealing alternative to whole blood or plasma sampling, as it has technical and economic advantages over the latter.</p><p><b>MATERIALS AND METHODS</b>A prospective cross-sectional study was conducted at a Malaysian tertiary referral hospital from November 2009 to March 2010. One hundred and fifty paired specimens of DBS and plasma were analysed by the standard assays for HIV Ag/Ab, HBsAg, anti-HBS and anti-HCV, separately (total 600 paired specimens). DBS sample titres were then compared to the results of plasma testing, which was used as the gold standard.</p><p><b>RESULTS</b>For the HIV Ag/Ab assay with a cut-off point of 0.35 Relative Light Units (RLUs), the sensitivity and specificity were both 100%. For the HBsAg assay, the sensitivity was 96.5% and the specificity was 97.8%, with a cut-off point of 1.72 RLUs. Sensitivity for the anti-HBs test was 74.2% and the specificity was 86.9%, using a cut-off point of 0.635 RLUs. For the anti-HCV assay, the sensitivity was 97.3% and the specificity was 100%, with a cut-off point of 0.10 RLUs.</p><p><b>CONCLUSION</b>DBS is an ideal choice to be used as a screening tool for the detection of HIV, Hepatitis B and Hepatitis C virus infections. However, different cut-off values need to be used for the validation of test positivity in DBS samples because the small amount of blood in the DBS specimens leads to lower assay titres.</p>
Subject(s)
Humans , Cross-Sectional Studies , Dried Blood Spot Testing , HIV Antibodies , Blood , Allergy and Immunology , HIV Antigens , Blood , Allergy and Immunology , HIV Infections , Diagnosis , Hepacivirus , Hepatitis B , Diagnosis , Hepatitis B Antibodies , Blood , Allergy and Immunology , Hepatitis B Surface Antigens , Blood , Allergy and Immunology , Hepatitis C , Diagnosis , Hepatitis C Antibodies , Blood , Allergy and Immunology , Hepatitis C Antigens , Blood , Allergy and Immunology , Malaysia , Plasma , Virology , Prospective Studies , Referral and Consultation , Sensitivity and Specificity , Specimen HandlingABSTRACT
Desde el modelo de la información-motivación-habilidades conductuales, se propone que el efecto de variablescomo el conocimiento y actitudes hacia el VIH/sida y la vulnerabilidad se ven mediados por la autoeficacia en el usodel preservativo. En este estudio se somete a prueba esta hipótesis con una muestra de adolescentes de Colombia.Los participantes fueron 599 adolescentes colombianos, sexualmente activos, de enseñanza secundaria. El 65.94% eran varones. La edad media fue de 15.58 años (DT = 1.41). Se trata de un estudio que utiliza un diseño ex-postfacto retrospectivo factorial. Los instrumentos utilizados fueron: El Cuestionario VIH/SIDA-65; la adaptación española abreviada del Inventario de Roles Sexuales de Bem(BSRI) y la adaptación española del Cuestionario SOS (Sexual Opinion Survey). Los resultados indican que las variables referidas a los componentes información y motivación tienen un efecto directo sobre el uso del preservativo y, éste no se ve mediado por la autoeficacia.
The Information-Motivation-Behavioral Skills model suggests that the effect of variables such as knowledge and attitudes towards HIV/AIDS and vulnerability are influenced by self-efficacy in condom use. This currentstudy tests this hypothesis with a sample of adolescents in Colombia. The participants were 599 Colombianadolescents sexually active, from Secondary Education. The 65.94% of the sample were males. The averageage was 15.58 years (TD=1.41). We used a factorial retrospective ex-post-facto design. The instrumentsused were HIV/AIDS-65 Questionnaire, the Spanish abbreviated adaptation of Bem Sexual Roles Inventory(BSRI) and the Spanish adaptation of the Sexual Opinion Survey (SOS). The results obtained shows thatthe variables related to information and motivation have a direct effect on condom use, which is not influencedby self-efficacy.
Subject(s)
Humans , HIV Antigens , Self EfficacyABSTRACT
A 35-year-old, human immunodeficiency virus sero-positive male presented with huge mediastinal mass for evaluation. After contrast enhanced computed tomography (CECT) angiogram, aneurysm of arch of aorta was diagnosed. The patient also proved to be co-infected with syphilis, which is the aetiological cause of aneurysm in this case. The present report highlights the need to suspect, diagnose and treat dual infections in individuals with high risk behaviour.
Subject(s)
Adult , Aneurysm, Infected/diagnosis , Aneurysm, Infected/etiology , Aortic Aneurysm/diagnosis , Aortic Aneurysm/etiology , HIV Antibodies/analysis , HIV Antigens/analysis , HIV Seropositivity/complications , HIV Seropositivity/diagnosis , HIV-1/immunology , Humans , Male , Syphilis, Cardiovascular/complications , Syphilis, Cardiovascular/diagnosis , Tomography, X-Ray ComputedABSTRACT
Este artículo presenta la descripción y correlación de las variables psicológicas ansiedad, depresión, Percepción de Control sobre la Salud -PCS- y Percepción de Control sobre Eventos Estresantes de la Vida -PCEEV- en mujeres diagnosticadas con VIH/Sida. La investigación fue de carácter no experimental, de tipo descriptivo-correlacional, con diseño transversal. La muestra estuvo compuesta por 47 mujeres atendidas en instituciones de salud de la ciudad de Cali, Colombia. Como medidas se utilizaron la entrevista de datos sociodemográficos, características biomédicas y psicosociales en mujeres diagnosticadas con VIH/Sida (diseñada por los autores) y una batería de evaluación de variables psicológicas adaptada para mujeres diagnosticadas con VIH/Sida. Los resultados generales muestran que el 23,4 por ciento de la muestra presenta indicadores clínicos de ansiedad, el 10,63 por ciento de depresión, el 6,38 por ciento muestra bajos niveles de PCS y el 100 por ciento de las participantes muestra niveles moderados de PCEEV. Las variables ansiedad y depresión presentaron una correlación positiva, así como la PCEEV con ansiedad y depresión; depresión con PCS y ansiedad con PCS presentaron correlaciones negativas.
Subject(s)
Humans , HIV Antigens , Anxiety/psychology , Women/psychologyABSTRACT
BACKGROUND: Although the overall sensitivity and specificity of the western blot (WB) test for detection of antibodies to various viral proteins is high, there has been a substantial difference in the timing of the appearance of antibody bands and their intensities during different stages of HIV infection. AIMS: Mapping different band patterns of Western blot results and correlating them with stages of HIV infection. METHODS: We performed a retrospective study with 1,467 HIV-1 infected cases confirmed by WB test between January 2002 to July 2005, with the objective of mapping different band patterns of western blot results and determining whether the presence or absence of certain bands was associated with any specific stage of HIV infection. For the interpretation of the WB results in this study, the guidelines recommended by NACO, India were followed. RESULTS: Reactivity with all the bands was the most commonly observed WB pattern, occurring in 92.91% (1363/1467) of cases, whereas the other 7.09% showed uncommon band patterns. Of all individual bands, p31 band was the most frequently missing one, absent in 7.09% cases. On classifying the WB reactive cases by the WHO clinical staging system, 38.45% (564/1467) were in Stage 1, 47.99% (704/1467) in stages 2 and 3 and 13.56% in stage 4. Correlation of CD4 cell counts with the various uncommon band patterns showed that only 5.56% (4/72) had counts in the 200-500 cells/microl range, whereas 45.83% and 48.61% had counts of < 200 and> 500 cells/microl respectively. CONCLUSION: Interpretation of the WB band pattern in combination with clinical features may be occasionally useful in predicting the stage of HIV infection.