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J. Health Biol. Sci. (Online) ; 8(1): 1-4, 01/01/2020. ilus
Article in English | LILACS (Americas) | ID: biblio-1103710


Introduction: IL-6 is a cytokine that participates in the systemic inflammatory process in Kala-azar, its plasma levels are high during active disease and especially in patients with severe clinical condition. Case reports: Three patients from different age groups, clinical score of severe disease and different plasma levels of IL-6 were reported. Conclusion: The results suggest that only the clinical severity score does not present sensitivity to classify, among critically ill patients, those with imminent risk of death. The IL-6 concentration seems to allow this differentiation, considering that the only fatal case, HBV/Leishmania coinfection, presented an expressively higher plasma level.

Introdução: IL-6 é uma citocina que participa do processo inflamatório sistêmico no calazar. Seus níveis plasmáticos estão elevados durante doença ativa e, principalmente, em pacientes com quadro clínico grave. Relato de casos: foram reportados três pacientes em diferentes faixas etárias, escore clínico de doença grave e diferentes níveis plasmáticos de IL-6. Conclusão: os resultados sugerem que apenas o escore clínico não apresenta sensibilidade para classificar, entre os doentes graves, aquele com risco iminente de óbito. A concentração de IL-6 parece permitir essa diferenciação, considerando que o único caso fatal, coinfecção HBV/Leishmania, mostrou nível plasmático expressivamente mais elevado.

Coinfection , Interleukin-6 , Hepatitis B , Leishmaniasis, Visceral
Article in English | WPRIM (Western Pacific) | ID: wprim-782497


From December 2006 to December 2016, 1093 human immunodeficiency virus (HIV) individuals < 70 years enrolled in Korea human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) cohort were analyzed to investigate the prevalence of HIV/HBV co-infection rate and hepatitis B virus surface antibody (HBsAb) positive rate based on birth year. The HBV co-infection prevalence rate was the highest (8.8%) in patients born between 1960 and 1964 and the lowest (0%) among those born between 1995 and 1999. A decreasing linear trend of HBV co-infection rate was observed according to the 5-year interval changes. HBsAb-positive rate was only 58.1% in our study. The national HBV vaccination programs have effectively lowered the HBV co-infection rate in HIV population. However, it is identified that the HIV population has low HBsAb positive rate. Further evidences supporting efficacy of booster immunization for HBsAb negative HIV patients are required and efforts should be made to increase HBsAb positive rates among HIV patients to prevent horizontal transmission.

Cohort Studies , Coinfection , Hepatitis B virus , HIV Infections , HIV , Humans , Immunization, Secondary , Korea , Parturition , Prevalence , Vaccination
Article in English | WPRIM (Western Pacific) | ID: wprim-782217


BACKGROUND: The aim of this study was to investigate the effectiveness of intravenous isoniazid (H) and ethambutol (E) administered in patients with new sputum positive drug-susceptible pulmonary tuberculosis (TB) with tuberculous meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment.METHODS: Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method.RESULTS: A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%) in group 2 (p=0.023).CONCLUSION: In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.

Coinfection , Ethambutol , HIV Infections , HIV , Humans , Isoniazid , Meningoencephalitis , Methods , Mortality , Mycobacterium tuberculosis , Pyrazinamide , Rifampin , Serum , Sputum , Tuberculosis , Tuberculosis, Meningeal , Tuberculosis, Pulmonary
Rev. bras. parasitol. vet ; 29(1): e016319, 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1058011


Abstract Leishmania infantum is a trypanosomatid that causes parasitic dermatopathy in dogs. Trypanosoma caninum is another trypanosomatid, which infects the skin of dogs, although cutaneous abnormalities are absent. This study aimed to investigate the occurrence of T. caninum infection and its associated cutaneous and histological changes and compare it with the occurrence of L. infantum infection in dogs. The study included 150 dogs, of which T. caninum infection was identified in 3 (2%) and L. infantum infection in 15 (10%) of them, with no association (p>0.05) of these infections with the breed, gender, age, or cutaneous abnormalities. The cutaneous abnormalities were based on 1 (4.8%) and 12 (57.1%) dogs infected by T. caninum and L. infantum, respectively. The dermatohistopathological abnormalities in the dogs infected with T. caninum included mild perivascular lymphohistioplasmacytic infiltrates in the clinically asymptomatic ones, while in those with dermatological abnormalities, acanthosis, epidermal orthokeratotic hyperkeratosis, melanomacrophages, and co-infection with Microsporum sp. and Trichophyton sp. were observed. InL. infantum infected, the histopathological findings included chronic granulomatous inflammatory infiltrates and structures compatible with amastigotes. Despite the low frequency of T. caninum infection, our findings suggest that this trypanosomatid, unlike L. infantum, does not cause any macroscopic skin abnormalities.

Resumo Leishmania infantum é um tripanosomatídeo que causa dermatopatia parasitária em cães. Trypanosoma caninum é outro tripanosomatídeo, que infecta a pele de cães, embora anormalidades cutâneas sejam ausentes. Este estudo teve como objetivo investigar a ocorrência da infecção por T. caninum e suas alterações cutâneas e histológicas associadas e compará-las com a ocorrência da infecção por L. infantum em cães. O estudo incluiu 150 cães, dos quais a infecção por T. caninum foi identificada em 3 (2%) e a infecção por L. infantum em 15 (10%) deles, sem associação (p>0,05) dessas infecções com a raça, sexo, idade ou anormalidades cutâneas. As alterações cutâneas foram observadas em 1 (4,8%) e 12 (57,1%) cães infectados por T. caninum e L. infantum, respectivamente. As anormalidades dermato-histopatológicas nos cães infectados por T. caninum incluíram infiltrados linfo-histioplasmocitários perivasculares leves nos clinicamente assintomáticos, enquanto naqueles com anormalidades dermatológicas, foram observados acantose, hiperqueratose ortoqueratótica epidermal e melanomacrófagos e co-infecção por Microsporum sp. e Trichophyton sp. Nos cães infectados por L. infantum, os achados histopatológicos incluíram infiltrados inflamatórios granulomatosos crônicos e estruturas compatíveis com amastigotas. A despeito da baixa frequência da infecção por T. caninum, nossos achados sugerem que esse tripanosomatídeo, diferentemente de L. infantum, não causa anormalidades macroscópicas na pele.

Animals , Dogs , Trypanosoma/genetics , Trypanosomiasis/veterinary , Leishmania infantum/genetics , Dog Diseases/pathology , Leishmaniasis, Visceral/veterinary , Trypanosomiasis/pathology , Trypanosomiasis/epidemiology , Brazil/epidemiology , Polymerase Chain Reaction , Prevalence , DNA, Protozoan/genetics , Dog Diseases/epidemiology , Coinfection , Leishmaniasis, Visceral/pathology , Leishmaniasis, Visceral/epidemiology
South African Medical Journal ; 110(6), p.473-475, 2020
Article in English | AIM (Africa) | ID: afr-201888


The first critically ill patient admitted to our hospital in Cape Town, South Africa, during the COVID-19 pandemic was co-infected with HIV and SARS-CoV-2. Pneumocystis jirovecii pneumonia (PCP) and other respiratory opportunistic infections share many clinical features with severe COVID-19. Our understanding of the nuances of co-management of HIV and COVID-19 is evolving. We describe the diagnostic and therapeutic challenges presented by this case.

Coronavirus Infections , HIV , Infections , Coinfection , Diagnosis , Africa
An. bras. dermatol ; 94(4): 446-448, July-Aug. 2019. graf
Article in English | LILACS (Americas) | ID: biblio-1038296


Abstract: Necrolytic acral erythema is a distinct erythema that has been described as an extrahepatic manifestation of hepatitis C virus infection. Most reported cases have been in Africa, especially Egypt. We report the first case (to the best of our knowledge) of necrolytic acral erythema in a Chinese patient with HCV and HBV coinfection. We aim to increase awareness for recognizing this condition in the Chinese population.

Humans , Male , Adult , Hepatitis C/complications , Erythema/pathology , Erythema/virology , Coinfection/complications , Hepatitis B/complications , China , Hepatitis C/pathology , Extremities/pathology , Coinfection/pathology , Hepatitis B/pathology , Necrosis/virology
Med. UIS ; 32(2): 41-46, mayo-ago. 2019. graf
Article in Spanish | LILACS (Americas) | ID: biblio-1114966


Resumen La circuncisión es un procedimiento quirúrgico de baja complejidad; el riesgo de complicaciones oscila entre el 0,2 a 5%, siendo la miasis un hecho poco frecuente. Para su tratamiento, principalmente se extraen las larvas, y se administran antiparasitarios y antibióticos para prevenir la infección secundaria. El objetivo del artículo es reportar el caso de un adulto masculino, quien presentó miasis genital posterior a una circuncisión y biopsia. En la mayoría de los casos, la miasis es accidental en humanos, y su verdadera incidencia es difícil de establecer debido al subregistro. La mala higiene, el bajo nivel socioeconómico y el hacinamiento son factores de riesgo importantes para adquirirla, además de la excesiva exposición del hospedero potencial a las moscas. Es fundamental realizar un correcto tratamiento de heridas y un seguimiento estricto del paciente que recibe manejo quirúrgico. MÉD.UIS.2019;32(2):41-6

Abstract Circumcision is a non complex surgical procedure, but is not a harmless option. Risk of complications may fluctuate between 0,2% and 5%, being myiasis a low often situation, for its treatment mainly the larvae are extracted, antiparasitics and antibiotics are administered to prevent secondary infection. The objective of the article is to report the case of a male adult, who presented genital myiasis after a circumcision and biopsy. In most of cases myiasis is accidental in humans and its true incidence is very hard to establish due to underreporting. Poor hygiene, low socio-economic level and overcrowding, are risk factors to obtain it, besides an excessive exposure to flies. A right wounds treatment and a strict monitoring of patient in surgical management is essential. MÉD.UIS.2019;32(2):41-6

Humans , Male , Middle Aged , Phimosis , Myiasis , Social Class , Surgical Procedures, Operative , Therapeutics , Wounds and Injuries , Humans , Hygiene , Risk , Circumcision, Male , Aftercare , Adult , Coinfection , Genitalia , Infections , Larva , Anti-Bacterial Agents , Antiparasitic Agents
Pesqui. vet. bras ; 39(8): 630-634, Aug. 2019. tab
Article in English | LILACS (Americas), VETINDEX | ID: biblio-1040734


This study carried out a survey about enteropathogenic agents in domestic cats' shelter as a stage of investigation for the intermittent chronic diarrhea. Individual fecal samples from 39 cats with free access to the external environment were submitted to parasitological examination, parvovirus, and coronavirus by PCR, and Cryptosporidium spp., Giardia spp. and Tritrichomonas foetus by real-time PCR. From the cats evaluated, 30 (76.9%) were positive for one or more enteric agents, and coinfections were observed in 11 cats samples (28.2%). Helminth eggs were observed in 48.7% of cats (19/30), 16 (41%) were positive for parvovirus or coronavirus and 25.6% (10/30) were infected by protozoa. From the positives for protozoa, five cats were positive to T. foetus (12.82%). The first finding of this protozoan through PCR was in the southern Brazil, and the second was in the whole country. Chronic diarrhea in cats may be multifactorial in shelter animals where the population density is high and the control of parasitic, and viral infections are deficient. Moreover, it is due to poor hygiene conditions in these shelters. The factors associated with the proliferation of infectious diseases in shelters are correlated with new pathogens infections such as T. foetus.(AU)

Uma pesquisa de agentes enteropatogênicos em gatos domésticos de um abrigo foi realizado como etapa da investigação das causas de diarreias crônicas intermitentes. Amostras fecais individuais de 39 gatos, com livre acesso ao ambiente externo, foram obtidas para pesquisa de helmintos através do exame parasitológico, investigação de parvovírus e coronavírus e de Cryptosporidium spp., Giardia spp. e Tritrichomonas foetus através de PCR em tempo real. Dos gatos avaliados, 30 (76,9%) foram positivos para algum ou mais de um destes agentes entéricos. Desses, 11 (28,2%) apresentaram co-infecções parasitárias. Ovos de helmintos foram observados em 48,7% dos gatos (19/30), 16 felinos (41%) foram positivos para parvovírus ou coronavírus e 25,6% (10/30) estavam infectados por protozoários. Dos positivos para protozoários, cinco apresentaram Tritrichomonas foetus (12,82%), um organismo pouco relatado no Brasil, sendo este o primeiro relato de detecção deste protozoário através de PCR em fezes de gatos no Sul do Brasil e o segundo no país. A diarreia crônica em gatos pode ser multifatorial em animais de abrigo onde a densidade populacional é elevada e os meios de controle parasitário e viral são deficitários, além das condições de higiene precárias. Os fatores associados à proliferação de doenças infecciosas em abrigos promovem o surgimento de infecções por novos patógenos como o Tritrichomonas foetus, até então pouco relatado no Brasil.(AU)

Animals , Cats , Parasitic Diseases, Animal/diagnosis , Tritrichomonas foetus , Diarrhea/etiology , Diarrhea/veterinary , Brazil , Polymerase Chain Reaction/veterinary , Coinfection/veterinary , Housing, Animal
Rev. bras. parasitol. vet ; 28(3): 499-503, July-Sept. 2019. graf
Article in English | LILACS (Americas) | ID: biblio-1042529


Abstract A juvenile subantarctic fur seal (Arctocephalus tropicalis) found dead in Santa Catarina state, southern Brazil, presented with disseminated verminous pneumonia due to Parafilaroides sp. A concomitant infection with two different gammaherpesviruses was identified by PCR in different tissues; one of them possibly a novel species (tentatively named Otariid herpesvirus 7). Sarcocystis sp. DNA was identified molecularly in skeletal muscle samples with intrasarcoplasmic bradyzoites and no apparent tissue response. All analyzed samples (mandibular, laryngeal, tracheal, and mesenteric lymph nodes, and lung) were PCR-negative for Brucella spp. The most likely cause of death was severe pulmonary parafilaroidiasis. The pathogenic role of the gammaherpesviruses in several of the tissues was not evident. This study describes the pathogenicity of Parafilaroides sp. in a subantarctic fur seal, widens the host range of herpesvirus in pinnipeds, and reports the first molecular identification of Sarcocystis sp. in this species.

Resumo Um lobo-marinho-subantártico (Arctocephalus tropicalis) juvenil foi achado morto no Estado de Santa Catarina, sul do Brasil, apresentando pneumonia parasitária disseminada por Parafilaroides sp. Infecção concomitante por dois gammaherpesvírus diferentes foi identificada pela PCR em diversos tecidos, um desses herpesvírus possivelmente uma nova espécie (denominada provisoriamente Otariid herpesvirus 7). DNA de Sarcocystis sp. foi identificado molecularmente em amostras de músculo esquelético que apresentavam bradizoítos intra-sarcoplasmáticos sem aparente resposta tecidual. Todas as amostras analisadas (linfonodo mandibular, laríngeo, traqueal e mesentérico, e pulmão) pela PCR para Brucella spp. foram negativas. A causa mais provável da morte do animal foi parafilaroidose pulmonar severa. O papel patogénico dos gammaherpesvírus em vários tecidos não foi evidente. Este estudo descreve a patogenicidade de Parafilaroides sp. em um lobo-marinho-subantártico, amplia a variedade de hospedeiros de herpesvírus em pinípedes e reporta a primeira identificação molecular de Sarcocystis sp. para essa espécie.

Animals , Male , Sarcocystis/genetics , Sarcocystosis/veterinary , Gammaherpesvirinae/genetics , Herpesviridae Infections/veterinary , Fur Seals/parasitology , Fur Seals/virology , Lung Diseases/veterinary , Sarcocystosis/diagnosis , Fatal Outcome , Herpesviridae Infections/diagnosis , Herpesviridae Infections/virology , Coinfection , Lung Diseases/parasitology , Lung Diseases/virology
REME rev. min. enferm ; 23: e-1211, jan.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1051564


OBJETIVO: analisar os fatores associados a HIV/AIDS em pacientes com tuberculose (TB) em Minas Gerais entre os anos de 2006 e 2015. MÉTODOS: trata-se de estudo transversal realizado a partir dos casos de tuberculose notificados no estado de Minas Gerais entre 2006 e 2015 na base de dados do Sistema de Informação de Agravos de Notificação (SINAN). Calculou-se a prevalência de clientes TB/HIV/AIDS associada a cada variável explicativa, sendo utilizada regressão logística múltipla com p ≤ 0,05 e testes qui-quadrado de Pearson e exato de Fisher com nível de significância de 5%. RESULTADOS: a prevalência de coinfecção TB/HIV/AIDS no período estudado foi de 9,4%, sendo associada a: sexo; idade; escolaridade; área de residência; uso de álcool; forma clínica; agravos associados (diabetes e doença mental); exames diagnósticos (Raios-X, baviloscopia e cultura de escarro); e situação de encerramento dos indivíduos. Valores ignorados nas variáveis área de residência, escolaridade e uso de álcool foram mais frequentes em indivíduos com coinfecção TB/HIV/AIDS. CONCLUSÃO: os fatores associados à coinfecção TB/HIV/AIDS incluem aspectos socioeconômicos, clínicos, do diagnóstico e acompanhamento de casos. O reconhecimento desses fatores pode contribuir para o desenvolvimento de estratégias para evitar ou postergar prognósticos indesejáveis nessa população.(AU)

Objective: To analyze the factors associated with HIV/AIDS in patients with tuberculosis (TB) in Minas Gerais between 2006 and 2015. Methods: This is a cross-sectional study based on tuberculosis cases reported in the state of Minas Gerais between 2006 and 2015 in the database of the Sistema de Informação de Agravos de Notificação (SINAN). The prevalence of TB/HIV/AIDS patients associated with each explanatory variable was calculated, using multiple logistic regression with p ≤ 0.05, and Pearson's chi-square and Fisher's exact tests with a significance level of 5%. Results: The prevalence of TB/HIV/AIDS co-infection during the study period was 9.4%, being associated with the following: gender; age; schooling; area of residence; alcohol consumption; clinical manifestation; associated disorders (diabetes and mental illness); diagnostic tests (X-Rays, sputum smear and sputum culture); and final status of individuals. Unknown values in the variables "area of residence", "schooling" and "alcohol consumption" were more frequent in individuals with TB/HIV/AIDS co-infection. Conclusion: The factors associated with TB/HIV/AIDS coinfection include socio-economic, clinical, diagnostic, and follow-up factors. Recognizing these factors may contribute to new strategies to avoid or delay undesirable prognoses in this population.(AU)

Objetivo: analizar los factores asociados al VIH/SIDA en pacientes con tuberculosis (TB) en el Estado de Minas Gerais entre 2006 y 2015. Método: se trata de un estudio transversal basado en casos de tuberculosis reportados en el estado de Minas Geraisentre 2006 y 2015 en la base de datos del sistema de información de enfermedades de reporte obligatorio (SINAN). Se calculó la prevalencia de clientes TB/VIH/SIDA asociada con cada variable explicativa, utilizando regresión logística múltiple con ≤ 0,05 y chi-cuadrado de Pearson y pruebas exactas de Fischer con un nivel de significancia del 5%. Resultados: la prevalencia de coinfección TB/VIH/SIDA durante el período de estudio fue del 9,4% asociada a sexo, edad, escolaridad, área de residencia, consumo de alcohol, forma clínica, trastornos asociados (diabetes y enfermedad mental), pruebas de diagnóstico (radiografía, baviloscopía y cultivo de esputo) y situación de clausura de los individuos. Los valores ignorados en las variables zona de residencia, escolaridad y consumo de alcohol fueron más frecuentes en individuos con coinfección TB/VIH/SIDA. Conclusión: los factores asociados con la coinfección TB/VIH/SIDA incluyen aspectos socioeconómicos, clínicos, de diagnóstico y seguimiento de casos. El reconocimiento de estos factores puede contribuir al desarrollo de estrategias para evitar o postergar pronósticos no deseados en esta población.(AU)

Humans , Tuberculosis , Risk Factors , HIV , Diagnosis , Coinfection/prevention & control , Socioeconomic Factors
Rev. epidemiol. controle infecç ; 9(3): 212-219, 2019. ilus
Article in Portuguese | LILACS (Americas) | ID: biblio-1046897


Justificativa e Objetivos: A coinfecção tuberculose-HIV (TB/HIV) tem figurado uma importante causa de óbitos e de atendimento médico-hospitalar-ambulatorial nos serviços de saúde em todo o mundo. Por isso, o objetivo deste estudo foi avaliar comportamento da coinfecção TB/HIV no estado de Alagoas. Métodos: Trata-se de estudo ecológico, de séries temporais, que analisou indicadores de coinfecção TB/HIV no período de 2001 a 2016. A área de estudo foi o estado de Alagoas, Brasil, e suas divisões administrativas de referência para o setor de saúde. A análise da evolução temporal empregou a variação percentual e o teste de Mann-Kendall. Resultados: No período de 2001 a 2016, foram notificados 996 casos novos de coinfecção TB/HIV no estado de Alagoas, correspondendo a 5,6% do total de casos de TB. O percentual de coinfecção TB-HIV elevou-se de 1,4% em 2001 a 14,6% em 2016, com variação e tendência positiva de 1180% (p<0,05). A incidência da coinfecção TB/HIV nesse mesmo período passou de 0,6% em 2001 a 2,0% em 2016, com variação e tendência positiva de 290% (p<0,05). Conclusão: As séries temporais da proporção e incidência de coinfecção TB/HIV apresentaram tendência crescente significativa para o estado de Alagoas no período de 2001 a 2016, associando a presença do HIV à ocorrência da TB na população.(AU)

Background and Objectives: Tuberculosis-HIV co-infection (TB/HIV) has been an important cause of death and medical-hospital-outpatient care in health services worldwide. Thus, the objective of this study was to evaluate the behavior of TB/HIV coinfection in the state of Alagoas, Brazil. Methods: This is an ecological, time-series study that analyzed indicators of TB/HIV co-infection between 2001 and 2016. The study area was the state of Alagoas, Brazil, and its administrative divisions of reference for the health sector. The analysis of the temporal evolution used percent variance and the Mann-Kendall trend test. Results: In the period from 2001 to 2016, 996 new cases of TB/HIV coinfection were reported in Alagoas, corresponding to 5.6% of the total TB cases. The percentage of TB/HIV coinfection increased from 1.4% in 2001 to 14.6% in 2016, with 1180% (p<0.05) variance and positive trend. The incidence of TB/HIV coinfection in the same period increased from 0.6% in 2001 to 2.0% in 2016, with 290% (p<0.05) variance and positive trend. Conclusion: The time series of the proportion and incidence of TB/HIV co-infection showed a significant increase in the state of Alagoas between 2001 and 2016, emphasizing the importance of HIV as a factor for the occurrence of TB in the population.(AU)

Justificación y Objetivos: La coinfección tuberculosis-VIH (TB/VIH) ha sido una causa importante de muerte y de atención médica-hospitalaria-ambulatoria en servicios de salud por todo el mundo. Por lo tanto, el objetivo de este estudio fue evaluar el comportamiento de la coinfección TB/VIH en el estado de Alagoas (Brasil). Métodos: Se trata de un estudio ecológico de series de tiempo en que analizó los indicadores de coinfección TB/VIH en el periodo de 2001 a 2016. El área de estudio fue el estado de Alagoas, Brasil, y sus divisiones administrativas de referencia para el sector de la salud. El análisis de la evolución temporal utilizó la variación porcentual y la prueba de Mann-Kendall. Resultados: En el período comprendido entre 2001 y 2016, se notificaron 996 nuevos casos de coinfección TB/VIH en el estado de Alagoas, lo que corresponde al 5,6% del total de casos de TB. El porcentaje de coinfección TB-VIH aumentó de 1,4% en 2001 a 14,6% en 2016, con una variación y una tendencia positiva del 1180% (p<0,05). La incidencia de coinfección TB/VIH en el mismo período aumentó de 0,6% en 2001 a 2,0% en 2016, con una tendencia positiva y una variación del 290% (p<0,05). Conclusión: Las series temporales de la proporción e incidencia de coinfección TB/VIH revelan un aumento significativo en el estado de Alagoas desde 2001 hasta 2016, lo que destaca la influencia del VIH como factor para la ocurrencia de TB en la población.(AU)

Humans , Tuberculosis , Epidemiology , HIV , Coinfection
Rev. gaúch. enferm ; 40: e20180033, 2019. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1004082


Resumo OBJETIVO Analisar como o pertencimento a certos grupos sociais contribui para a constituição das vulnerabilidades associadas ao adoecimento pela coinfecção tuberculose/HIV/aids. METODOLOGIA Pesquisa qualitativa realizada em Porto Alegre-RS, em regiões de alta vulnerabilidade social. Foram entrevistadas 20 pessoas coinfectadas em serviços especializados de saúde, entre agosto e dezembro de 2016. A análise teve como aporte os referenciais The Sound of Silence e Vulnerabilidade e Direitos Humanos. RESULTADOS Condições socioeconômicas foram decisivas para constituição das condições de vulnerabilidade. Processos de invisibilização das pessoas e silenciamento de suas vozes, em um cenário marcado por desigualdades econômicas, raciais e de gênero contribuíam para que suas necessidades de saúde não fossem compreendidas e efetivamente levadas em consideração nas ações dos serviços. CONSIDERAÇÕES FINAIS Quanto mais efetivas forem as estratégias para legitimar as vozes e compreender as necessidades das pessoas afetadas pela coinfecção, maiores serão as chances de que as respostas programáticas para o problema sejam exitosas.

Resumen OBJETIVO Analizar cómo la pertenencia a ciertos grupos sociales contribuye a la constitución de las vulnerabilidades asociadas al padecimiento de coinfección tuberculosis/VIH/SIDA. METODOLOGÍA Investigación cualitativa realizada en Porto Alegre-RS/Brasil, en zonas de alta vulnerabilidad social. Fueron entrevistadas 20 personas coinfectadas en servicios especializados de salud, entre agosto y diciembre de 2016. Análisis con aporte de referenciales The Sound of Silence y Vulnerabilidad y Derechos Humanos. RESULTADOS Las condiciones socioeconómicas resultaron decisivas para constituir las condiciones de vulnerabilidad. Los procesos de invisibilización de las personas y el silenciamiento de sus voces contribuían a que sus necesidades de salud no fuesen comprendidas y efectivamente consideradas en las acciones de los servicios. CONSIDERACIONES FINALES Cuanto más efectivas sean las estrategias para legitimar las voces y comprender las necesidades de los afectados por la coinfección, mayores serán las posibilidades para que las respuestas programáticas al problema resulten exitosas.

Abstract OBJECTIVE To analyze how belonging to certain social groups contributes to constituting the vulnerabilities associated with illnesses due to tuberculosis/HIV/AIDS coinfection. METHODOLOGYThis is a qualitative study carried out in the city of Porto Alegre, state of Rio Grande do Sul, in regions of high social vulnerability. Twenty coinfected people were interviewed in specialized health services between August and December 2016. The analysis was based on the frameworks The Sound of Silence and Vulnerability and Human Rights. RESULTS Socioeconomic conditions were decisive for the constitution of the vulnerability conditions. Processes of people invisibilization, and the silencing of their voices, in a scenario marked by economic, racial and gender inequalities, contributed for their health needs not to be understood and effectively taken into account in the services actions. FINAL CONSIDERATIONS The more effective strategies are to legitimize voices and to understand the needs of those affected by coinfection, the greater the chances that programmatic responses to the problem will be successful.

Humans , Male , Female , Adult , Social Class , Tuberculosis, Pulmonary/epidemiology , HIV Infections/epidemiology , Vulnerable Populations/statistics & numerical data , Coinfection/epidemiology , Socioeconomic Factors , Tuberculosis, Pulmonary/therapy , Brazil , HIV Infections/therapy , Acquired Immunodeficiency Syndrome/therapy , Acquired Immunodeficiency Syndrome/epidemiology , Needs Assessment , Qualitative Research , Middle Aged
Rio de Janeiro; s.n; 2019. 134 p. ilus.
Thesis in Portuguese | LILACS (Americas) | ID: biblio-1050350


A coinfecção por diferentes parasitos é comumente observada na natureza e representa um complexo desafio para o entendimento do seu curso e consequências, em termos da resposta imune e desfecho clínico, no hospedeiro humano. A malária e leishmaniose são doenças negligenciadas, coendêmicas em diversas regiões do mundo, inclusive no Brasil. Atualmente, existem poucos estudos a respeito das coinfecções por Plasmodium spp. e Leishmania spp. no Brasil e no mundo, apesar da sua sobreposição geográfica. Neste contexto, o objetivo deste estudo foi avaliar os impactos que uma infecção pode ter sobre a resposta imune e a evolução clínica da outra. Para tal, dois desenhos experimentais foram desenvolvidos: (A) camundongos C57BL/6 foram infectados com Plasmodium berghei ANKA e posteriormente coinfectados com Leishmania major e (B) camundongos C57BL/6 foram infectados primeiro com L. major e posteriormente coinfectados com P. berghei ANKA. Avaliamos o curso clínico de ambas as doenças por parâmetros como sobrevida, peso, temperatura, parasitemia e o aparecimento de lesões (por L. major) na orelha dos animais

O perfil de recrutamento de células do sistema imune foi determinado por citometria de fluxo e a dosagem sistêmica de citocinas foi avaliada pelo Kit Cytometric Bead Array. Para o desenho experimental A observamos que a coinfecção com L. major não altera o curso clínico da infecção malárica. Embora tenhamos observado diferenças no percentual e total de células linfoides e/ou mieloides no baço entre os grupos. Ao avaliarmos a carga parasitária (por L. major) do linfonodo drenante da lesão dos animais coinfectados, observamos uma redução na mesma. Esta redução está relacionada à maior concentração de citocinas do perfil Th1 detectadas no soro dos animais coinfectados em relação aos animais infectados apenas com L. major. Assim, observamos que a progressão da infecção por Leishmania é diferente daquela vista durante a coinfecção e, portanto, a infecção com o Plasmodium poderia exercer uma influência no controle da proliferação do parasito L. major

Já no desenho experimental B, a coinfecção com o P. berghei ANKA apresenta um efeito benéfico no desenvolvimento da leishmaniose cutânea causada por L. major, diminuindo o tamanho da lesão causada por este parasito. Esta redução foi acompanhada por uma diminuição na carga parasitária das lesões e aumento no nível de citocinas séricas em animais coinfectados, os quais apresentaram um perfil mais pró-inflamatório (quando comparado à infecção somente com L. major), mediado por citocinas como IFN-γ e TNF-α. Foi verificada ainda uma redução no número total de células T (CD4+ e CD8+) e células mieloides no baço dos animais coinfectados quando comparado aos animas infectados apenas com Plasmodium, e que o recrutamento de linfócitos para a orelha diminui nos animais coinfectados em relação aos camundongos infectados apenas com Leishmania. Nossos dados sugerem que a coinfecção com Plasmodium ativa uma resposta imune que consegue controlar a proliferação de L. major em camundongos C57BL/6 resultando em uma menor carga parasitaria e lesões menores nos animais coinfectados. (AU)

Humans , Animals , Malaria, Cerebral , Leishmaniasis, Cutaneous , Coinfection
Korean Journal of Radiology ; : 1226-1235, 2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-760278


OBJECTIVE: Human bocavirus (HBoV) is a newly identified pathogen that can cause upper and lower respiratory infections usually in children; however, its clinical characteristics and significance in respiratory infections in adults have not been well known. Our objective was to evaluate the clinical features of respiratory HBoV infection and to describe the CT findings of HBoV pneumonia in adults. MATERIALS AND METHODS: A total of 185 adult patients diagnosed with HBoV infection at a tertiary referral center between January 2010 and December 2017 were retrospectively evaluated with respect to the clinical characteristics of HBoV infection and its risk factors for pneumonia. Chest CT findings for 34 patients with HBoV pneumonia without co-infection were analyzed and compared between immunocompetent (n = 18) and immunocompromised (n = 16) patients. RESULTS: HBoV infections were predominantly noted between February and June. Among the 185 patients with HBoV infection, 119 (64.3%) had community-acquired infections and 110 (59.5%) had pneumonia. In multivariable analysis, older age (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00–1.04; p = 0.045) and nosocomial infection (OR, 2.07; 95% CI, 1.05–4.10; p = 0.037) were associated with HBoV pneumonia. The main CT findings were bilateral consolidation (70.6%) and/or ground-glass opacities (64.7%); centrilobular nodules (14.7%) were found less frequently. The pattern of CT findings were not significantly different between immunocompetent and immunocompromised patients (all, p > 0.05). CONCLUSION: HBoV infection can be a potential respiratory tract infection in adults. The most frequent CT findings of HBoV pneumonia were bilateral consolidation and/or ground-glass opacities.

Adult , Child , Coinfection , Community-Acquired Infections , Cross Infection , Human bocavirus , Humans , Immunocompromised Host , Pneumonia , Respiratory Tract Infections , Retrospective Studies , Risk Factors , Tertiary Care Centers , Tomography, X-Ray Computed
Article in Korean | WPRIM (Western Pacific) | ID: wprim-739514


PURPOSE: Multiple virus infections may affect clinical severity. We investigated the effect of coinfection of respiratory syncytial virus (RSV) and influenza virus with other respiratory viruses on clinical severity. METHODS: Data from 634 samples of a single tertiary hospital between September 2014 and April 2015 were analyzed for clinical characteristics (fever duration and O2 need, steroid use, and ICU care) between single infection and coinfection of RSV (n=290) and influenza virus (n=74) with 16 common respiratory viruses from hospitalized children. RESULTS: The RSV coinfection group (n=109) (3.1±2.7 days) showed significantly longer fever duration than the RSV single infection group (n=181) (2.6±2.6 days) (P=0.04), while there was no difference in O2 need, steroid use or ICU care in the 2 groups. The influenza coinfection group (n=38) showed significantly higher O2 need than the influenza single infection group (n=36) (21.1% vs. 5.6%, P=0.05), while there was no difference in fever duration between the 2 groups. CONCLUSION: The results indicate that RSV and Influenza coinfections can increase clinical severity and that the severity may be influenced by the nature of coinfecting viruses.

Child , Child, Hospitalized , Coinfection , Dyspnea , Fever , Humans , Influenza, Human , Orthomyxoviridae , Respiratory Syncytial Viruses , Tertiary Care Centers
Article in English | WPRIM (Western Pacific) | ID: wprim-738992


Chest pain in kidney transplant patients is usually caused by cardiac or pulmonary problems. However, it may be rarely caused by opportunistic esophageal infections. A 66-year-old female kidney transplant recipient was admitted because of chest pain. She had been treated with high-dose steroid and immunosuppressants for acute T-cell-mediated rejection. Cardiologic and pulmonary evaluations had normal results. Endoscopic examination revealed three clear ulcerative lesions in the esophagus. Histological and immunohistochemical staining of the endoscopic biopsy specimens revealed coinfection of herpes simplex virus and cytomegalovirus. The patient was treated with intravenous ganciclovir for 2 weeks. Her symptoms completely resolved, and follow-up endoscopy revealed complete healing of the previous ulcers. Viral esophagitis should be considered in the differential diagnosis in kidney transplant recipients presenting with chest pain.

Aged , Biopsy , Chest Pain , Coinfection , Cytomegalovirus , Diagnosis, Differential , Endoscopy , Esophagitis , Esophagus , Female , Follow-Up Studies , Ganciclovir , Herpes Simplex , Humans , Immunosuppressive Agents , Kidney , Kidney Transplantation , Simplexvirus , Thorax , Transplant Recipients , Ulcer
Rev. pesqui. cuid. fundam. (Online) ; 11(2, n. esp): 358-362, jan. 2019.
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-969295


Objetivo: Estimar a prevalência de coinfecção HIV/TB em pacientes submetidos a tratamento de TBMR em um hospital de referência do Rio de Janeiro. Método: Uma investigação transversal, cuja população foi composta por 40 pacientes em tratamento para TBMR, no período de março a dezembro de 2016. Para análise estatística utilizou-se o programa estatístico SPSS. Resultados: No período em estudo foram diagnosticados 40 casos de TBMR, dos quais 9 mostraram sorologia positiva para HIV, o que representou uma taxa de coinfecção de 22,5%. Nesse grupo predominou o sexo masculino (85,29%) e a média 37,5 anos. O diagnóstico de TB nos coinfectados prevaleceu a forma clínica pulmonar (80%). No teste do esfregaço, (66,6%) apresentaram resultado positivo, (74,9%) radiologia sugestiva e 100% dos pacientes apresentaram resistência a rifampicina no teste do Gene Xpert. Conclusão: As drogas que apresentaram-se mais resistentes neste grupo foram rifampicina, isoniazida e estreptomicina (87,5%)

Objective: The study's purpose has been to estimate the prevalence of HIV/TB coinfection in patients submitted to treatment of multidrug-resistant tuberculosis (MDR-TB) at a referral hospital in Rio de Janeiro city. Methods: It is a cross-sectional study that was carried out over the period from March to December 2016, whose population was composed of 40 patients undergoing treatment for MDR-TB. Statistical analysis was performed using the SPSS statistical program. Results: During the study time frame, 40 cases of MDR-TB were diagnosed, out of which 9 cases showed positive serology for HIV, representing a coinfection rate of 22.5%. In this group, the male gender predominated (85.29%) and with average age of 37.5 years old. The diagnosis of TB in coinfected patients occurred in the pulmonary clinical form (80%). In the smear test, (66.6%) presented a positive result, (74.9%) suggestive radiology and 100% of the patients presented resistance to rifampicin in the GeneXpert TB test. Conclusion: The drugs that presented the most resistance in this group were rifampicin, isoniazid and streptomycin (87.5%)

Objetivo: Estimar la prevalencia de coinfección VIH/TB en pacientes sometidos a tratamiento de TBMR en un hospital de referencia de Río de Janeiro. Método: Una investigación transversal, cuya población fue compuesta por 40 pacientes en tratamiento para TBMR, en el período de marzo a diciembre de 2016. Para análisis estadístico se utilizó el programa estadístico SPSS. Resultados: En el período en estudio se diagnosticaron 40 casos de TBMR, de los cuales 9 mostraron serología positiva para el VIH, lo que representó una tasa de coinfección del 22,5%. En ese grupo predominó el sexo masculino (85,29%) y la media 37,5 años. El diagnóstico de TB en los coinfectados prevaleció la forma clínica pulmonar (80%). En la prueba del frotis, (66,6%) presentaron un resultado positivo, (74,9%) radiología sugestiva y el 100% de los pacientes presentaron resistencia a rifampicina en la prueba del Gene Xpert. Conclusión: Las drogas que se presentaron más resistentes en este grupo fueron rifampicina, isoniazida y estreptomicina (87,5%)

Humans , Male , Female , Adolescent , Adult , Middle Aged , Tuberculosis , HIV Infections/diagnosis , HIV Infections/therapy , HIV Infections/epidemiology , Coinfection/diagnosis
Cogitare enferm ; 24: e66775, 2019. tab, graf
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1055971


RESUMO Objetivo: analisar a cobertura do tratamento diretamente observado segundo o risco de coinfecção tuberculose/vírus da imunodeficiência humana e desfechos desfavoráveis. Método: estudo ecológico com dados secundários relacionados aos 10.389 casos novos de coinfecção notificados no estado de São Paulo de 2010 a 2015. Dados analisados pelo Índice Local de Moran, estatística de varredura espacial e Modelos Bayesianos Hierárquicos. Resultados: região metropolitana de São Paulo e Baixada Santista concentraram maior incidência de coinfecção e abandono ao tratamento. Baixa cobertura de tratamento diretamente observado esteve associada aos territórios em risco para a coinfecção e maior risco de abandono. Município de São Paulo, região litorânea e região de Ribeirão Preto apresentaram maior incidência de óbito, o qual não apresentou relação com a cobertura do tratamento diretamente observado. Conclusão: baixa cobertura de tratamento diretamente observado apresentou associação com maior risco de coinfecção e abandono do tratamento.

RESUMEN Objetivo: Analizar la cobertura del tratamiento directamente observado según el riesgo de coinfección tuberculosis/virus de la inmunodeficiencia humana y desenlaces desfavorables. Método: Estudio ecológico con datos secundarios relacionados con los 10.389 nuevos casos de coinfección informados en el estado de São Paulo de 2010 a 2015. Datos analizados mediante Índice Local de Moran, estadística de muestreo espacial y Modelos Bayesianos Jerárquicos. Resultados: La región metropolitana de São Paulo y Baixada Santista concentraron mayor incidencia de coinfección y abandono del tratamiento. La baja cobertura de tratamiento directamente observado estuvo asociada a las áreas con riesgo de coinfección y mayor grado de abandono. El Municipio de São Paulo, la región litoral y el área de Ribeirão Preto expresaron mayor incidencia de decesos, no relacionándose ello con la cobertura del tratamiento directamente observado. Conclusión: La baja cobertura de tratamiento directamente observado mostró asociación com mayor riesgo de coinfección y abandono del tratamiento.

ABSTRACT Objective: To analyze the coverage of directly observed treatment according to the risk of tuberculosis/human immunodeficiency virus coinfection and unfavorable outcomes. Methods: Ecological study with secondary data related to 10,389 new cases of coinfection notified in the state of São Paulo, Brazil, from 2010 to 2015. They were analyzed by applying local Moran's index, spatial scan statistics, and hierarchical Bayesian models. Results: The São Paulo metropolitan area and Baixada Santista concentrate the highest incidence of coinfection and treatment default. Low coverage of directly observed treatment was associated with areas at risk for the coinfection and higher withdrawal risk. The city of São Paulo, the coastal region, and the Ribeirão Preto area showed a higher incidence of deaths, which did not show an association with the coverage of directly observed treatment. Conclusion: Low coverage of directly observed treatment was associated with a higher risk of coinfection and treatment default.

Humans , Tuberculosis , Acquired Immunodeficiency Syndrome , Coinfection , Operations Research , Health Services Research
South African Family Practice ; 62(2), p.65–68,tab., fig., 2019
Article in English | AIM (Africa) | ID: afr-200453


Background: HIV/HBV co-infection remains a global threat to HIV management despite the available effective hepatitis B vaccine and hepatitis B covering antiretroviral therapy. Many studies done in South Africa and internationally showed high prevalence of HIV/hepatitis B co-infection, which mandated routine screening for both infections before initiating HAARTFewer studies have highlighted the prevalence of hepatitis B susceptibility in the general population starting HAART and most of them were limited to children and high-risk groups. The aim of this study was to demonstrate the extent ofhepatitis B susceptibility, hepatitis B/HIV co-infections and hepatitis B immunity in general HIV-infected patients.Method: This was a retrospective review of 1 066 randomly sampled files of patients initiated on HAART between January 2012 and December 2014 at two Durban hospitals. Data collection included demographic characteristic, CD4 counts and hepatitis B serology. Data were analysed for the prevalence of hepatitis B susceptibility, HIV/HBV co-infection and hepatitis B immunity, while correlations between age, CD4 count and these three groups were demonstrated. Statistical analysis was performed using SAS version 9.3.Results: Total prevalence of HBV susceptibility was 69.7%, HBV immunity was 26.9% and true chronic HIV/HBV co-infection was 3.4%, while HBVsAg positivity accounted for 8.4% of the participants. Adults were more susceptible to HBV than children, with a median age of 36 years. Stratified for age, children were more immune (90%) to HBV than adults. Conclusion: This study demonstrated a significantly high number of HIV-infected persons who were susceptible to hepatitis B infection in Durban, South Africa, where both HIV and HBV are endemic, co-infection is high, and safe and effective HBV vaccine is available. Hepatitis B vaccination of the hepatitis B susceptible patients initiating HAART in South Africa is recommended to prevent further HIV/HBV co-infection.

Disease , Hepatitis , HIV , Coinfection , Vaccination , Africa