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1.
Infectio ; 25(4): 276-283, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1286722

ABSTRACT

Resumen Objetivo: Describir la supervivencia a siete años y los principales factores asociados a esta, en las personas con VIH que fueron atendidas en el sistema de salud colombiano entre 2011 a 2018. Métodos: Análisis de supervivencia de una cohorte de 64 039 personas diagnosticadas con VIH en Colombia. Se aplicó el método de Kaplan-Meier para estimar la probabilidad de supervivencia a partir de la fecha del diagnóstico. Se ajustó un modelo de supervivencia paramétrico flexible de Royston Parmar. Resultados: La estimación de la supervivencia global a 7 años fue de 94,8% (IC 95%: 94,5-95,2). El mayor riesgo de muerte se presentó en los hombres (HR: 1,2; IC 95%: 1,1-1,4; p: 0,010); en personas ≥50 años de edad (HR: 3,1; IC 95%: 1,6-6,3; p: 0,002); en el régimen subsidiado (HR: 2,2; IC 95%: 1,9-2,5; p: <0,001); en la etapa sida (HR: 2,8; IC 95%: 2,1-3,7; p: <0,001); en quienes presentaron la última carga viral detectable (HR: 7,1; IC 95%: 6,0-8,3; p: <0,001); y en quienes mostraron conteo de linfocitos T CD4+ <350 células/μL (HR: 1,9; IC 95%: 1,4-2,4; p: <0,001). Conclusión: La probabilidad de la supervivencia de las personas que viven con VIH aumenta al ser diagnosticados en edades jóvenes, en quienes presenten un recuento de linfocitos T CD4+ ≥350 células/μL, una carga viral indetectable (< 50 copias/mL) y no se encuentren en etapa sida.


Summary Objective: to describe the seven-year survival and predictors of mortality among people with HIV who were treated in the Colombian health system between 2011 and 2018. Methods: 64 039 people diagnosed with HIV in Colombia were included. Kaplan-Meier analysis estimated the probability of survival from the date of diagnosis. A Royston Parmar flexible parametric survival model was fitted. Results: The overall survival at 7 years was 94.8% (95% CI: 94.5-95.2). Survival was related to sex (men, HR: 1.2; 95% CI: 1.1-1.4; p: 0.010); people ≥50 years of age (HR: 3.1; 95% CI: 1.6-6.3; p: 0.002); subsidized regime (HR: 2.2; 95% CI: 1.9-2.5; p: <0.001); AIDS stage (HR: 2.8; 95% CI: 2.1-3.7; p: <0.001); a detectable viral load (HR: 7.1; 95% CI: 6.0-8.3; p: <0.001); and a CD4+ Lymphocyte count <350 cells/μL (HR: 1.9; 95% CI: 1.4-2.4; p: <0.001). Conclusion: The probability of survival of people living with HIV increases when they are diagnosed at a young age, in those with a CD4+ T Lymphocyte count ≥350 cells/μL, an undetectable viral load (<50 copies/mL) and are not in the AIDS stage.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Survival Analysis , Acquired Immunodeficiency Syndrome , Sex , T-Lymphocytes , Probability , HIV , Colombia , Lymphocyte Count , Viral Load , Survivorship
2.
Infectio ; 25(3): 163-168, jul.-set. 2021. tab, graf
Article in English | LILACS | ID: biblio-1250087

ABSTRACT

Abstract Aim: To assess the epidemiological situation of people living with HIV and AIDS (PLWHA) in the municipalities and regions of Colombia in 2018. Materials and methods: A cross-sectional study was conducted with secondary data from the High-Cost Diseases Fund from February 1st, 2018 to January 31st, 2019. We included sociodemographic, clinical variables, and related to geographic location. We calculated incidence, prevalence, and mortality according to the Colombian geographical regions, department and municipality of residence. Crude and age-standardized rates were estimated. Results: By 2018, 10,930 new cases of PLWHA were reported, being more frequent in males, aged between 25 to 49 years. 39.32% were reported with AIDS and 35.27% had undetectable HIV viral load. During 2018, there are 109,056 PLWHA in Colombia. The highest age-standardized incidence and prevalence were reported in Florencia (Cauca) (354.28 per 100,000 and 3.32 per 100people, respectively). The age-standardized incidence rate was 22.12 per 100,000 population (95% CI 21.71-22.54). Age-standardized prevalence and mortality were 0.23 per 100 population (95% CI 0.22-0.23) and 3.78 per 100,000 population (95% CI 3.61-3.96), respectively. Conclusion: Different strategies should be implemented to improve the identification of risk factors in the population, especially in some regions of Colombia and prevent transmission.


Resumen Objetivo: Evaluar la situación epidemiológica de las personas que viven con el VIH y el SIDA (PVVS) en los municipios y regiones de Colombia en 2018. Materiales y métodos: Se realizó un estudio transversal con datos secundarios del Fondo Colombiano de Enfermedades de Alto Costo entre febrero 1 de 2018 al 31 de enero de 2019. Incluimos variables sociodemográficas, clínicas y relacionadas con la ubicación geográfica. Calculamos la incidencia, prevalencia y mortalidad según la región geográfica colombiana, el departamento de residencia y el municipio. Se estimaron tasas crudas y estandarizadas por edad. Resultados: Para el 2018, 10.930 nuevos casos de PVVS fueron reportados, siendo más frecuentes en hombres, en edades entre 25 a 49 años. 39.32% fueron reportados con SIDA y 35.27% tuvieron una carga viral de VIH indetectable. 109,056 PVVS en Colombia. Las incidencia y prevalencia ajustadas por edad más altas se informaron en Florencia (Cauca) (354.28 por 100,000 y 3.32 por 100 personas, respectivamente). La tasa de incidencia estandarizada por edad fue de 22.12 por 100,000 habitantes (IC 95% 21.71-22.54). La prevalencia y mortalidad ajustadas por edad fueron 0.23 por 100 habitantes (IC 95% 0.22-0.23) y 3.78 por 100.000 habitantes (IC 95% 3.61-3.96), respectivamente. Se deben implementar diferentes estrategias para mejorar la identificación de los factores de riesgo en la población, especialmente en algunas regiones geográficas de Colombia y prevenir la transmisión.


Subject(s)
Humans , Male , Adult , Health Systems , Acquired Immunodeficiency Syndrome , HIV , Risk , Cross-Sectional Studies , Mortality , Health Strategies , Colombia , Viral Load
3.
Actual. SIDA. infectol ; 29(106): 64-71, jul 2021. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1348867

ABSTRACT

Introducción: Se estima que en Argentina son 129 mil las personas que poseen el virus de inmunodeficiencia humana, aunque un 20% de ellas lo desconoce. El 20% de 5800 nuevos casos por año en el país corresponden a CABA. No hay datos sobre la situación de pacientes que se atienden en hospitales públicos de CABA con respecto a objetivos de la OMS. Objetivo: Analizar esquemas antirretrovirales y situación virológica e inmunológica de las personas con VIH (PcVIH) en TAR que se asisten hospitales públicos de CABA. Métodos: Estudio descriptivo y retrospectivo, bajo muestreo por conveniencia. Análisis de datos obtenidos del Sistema de Administración de Pacientes VIH (SVIH), activos a junio de 2018. Es dable aclarar que la primera parte se refiere a la fuente de información, y que sean activos a junio de 2018 se refiere a criterio de inclusión y periodo de análisis respectivamente. Variables analizadas: sexo, edad, distribución de TAR, CV y CD4 utilizando el programa SPSS 20. Resultados: 6878 PcVIH en TAR, 66,6% hombres. 79% con al menos 1 CV. De ellas, con CV indetectables (<40 copias) 62% (78% del total de PcVIH con CV). Datos de CD4 en 56% PcVIH: 65% con >500. En primera línea de TAR 88,3%: 42% IP potenciados, 45% INNTI, 13% INSTI. De CV indetectables (<40 copias), 92% en primera línea de TAR (significativo) y de las detectables, 80%. INNTI como tercera droga, significativo para CV indetectable (<40 copias). 45% de PcVIH en TAR sin CV y/o CD4. Discusión: La muestra representa la mitad de las PcV1 de CABA atendidas en el sistema público. Más de la mitad de la población estudiada se encuentra indetectable (<40 copias). INNTI siguen siendo las terceras drogas más utilizadas. Alto % de PcVIH en TAR sin CV y/o CD4. Insuficientes laboratorios (CV y CD4), baja disponibilidad de datos y lejanía del objetivo de OMS indican deficiencias del sistema de salud. Mejoras en acceso a TAR, a determinaciones de laboratorio, y en la calidad de los datos son necesarios.


Introduction: HIV infection is significant in Buenos Aires City. 20% of 5800 new cases/year in the country are from this region. There ́s no data about PLwHIV treated in public hospitals of Buenos Aires City about WHO objectivesObjetives: To know and analyze the situation PLwHIV treated in p ublic hospitals of Buenos Aires City about treatment, and virological and immunological responses.Methods: Descriptive and retrospective study. Data obtained from the Administration System of HIV Patients actives in June 2018. Variables analyzed: gender, age, ART distribution, VL and CD4 counts, with SPSS 20 ProgramResults: 6878 PLwHIV on ART, 66,6% male. 79% with at least 1 VL. Of them, 62% with undetectable VL (78% of all PLwHIV with VL). CD4 data in 56% PLwHIV: 65% >500: In 1st line of TAR 88,3%: 42% boosted IPs, 45% NNRTIs, 13% INIs. Of PLwHIV with undetectable VL, 92% in 1st line of ART (significant). NNRTIs significant for undetectable VL.Discussion:Our cohort represents 50% de los PLwHIV of Buenos Aires City. 62% currently with undetectable VL. NNRTIs still the more used 3rd antiretroviral. High % of PLwHIV on ART without VL and/or CD4 count. Not enough laboratory determinations (VLs and CD4 counts), low data ava ilability and remoteness of WHO ́s goals for 2020, show health system ́s weakness. Improvements in Access to ART and laboratory determinations and in the data availability andquality are necessary.


Subject(s)
Humans , Patients , CD4 Antigens , Epidemiology, Descriptive , Retrospective Studies , HIV/immunology , Viral Load , Antiretroviral Therapy, Highly Active , Hospitals, Public/statistics & numerical data
4.
Rev. ADM ; 78(3): 167-175, mayo-jun. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1254949

ABSTRACT

La actual pandemia de COVID-19 provocada por el virus SARS-CoV-2 es un problema de salud que afecta a la población globalmente. Su desarrollo puede ser asintomático o exhibir manifestaciones clínicas moderadas o severas dependiendo en gran medida de la respuesta inmune de quien la padece. Esta enfermedad afecta principalmente a los pulmones a través del desarrollo del síndrome respiratorio agudo severo (SRAS), tanto como por la «tormenta de citocinas¼, una respuesta inflamatoria exacerbada que podría provocar una falla multisistémica y, en casos severos, la muerte. Se conoce que la enzima convertidora de angiotensina 2 (ECA-2), presente en diversos tejidos del cuerpo, actúa como receptor funcional del virus SARS-CoV-2 facilitando la entrada de éste a las células. Se ha demostrado la presencia de dicho receptor en varios tejidos orales, por lo que se puede considerar a la cavidad bucal como una vía latente de infección por dicho coronavirus, ya que su mecanismo de transmisión es a través de la inhalación de partículas virales, ya sea por vía nasal u oral. Así mismo, la presencia de carga vírica en la saliva y algunos de los síntomas de la COVID-19, por ejemplo la ageusia, pueden indicar la presencia de contagio viral en etapas tempranas. La presente revisión muestra evidencia que sugiere que diversos tejidos en la cavidad oral podrían ser considerados sitios potenciales de contagio por el SARS-CoV-2, teniendo un papel importante en el mecanismo de transmisión y en el desarrollo de coinfecciones (AU)


The COVID-19 pandemic caused by the SARS-CoV-2 virus is currently a global healthcare problem. The onset of this disease can exhibit several clinical manifestations ranging from mild to severe symptoms, depending on the individual's immune response. COVID-19 primarily affects the lungs by developing the Severe Acute Respiratory Syndrome (SARS) and the «cytokine storm¼, an exacerbated inflammatory reaction that can lead to multiorgan failure and consequently death. The angiotensin-converting enzyme 2 (ACE-2), present in several tissues in the human body, is known to act as the functional receptor of the SARS-CoV-2 germ facilitating its entrance into the cells. Such receptor is also present in diverse oral cavity tissues, indicating a latent route of infection due to its influence in the transmission mechanism by inhalation, either oral or nasal, of virus particles. Also, viral load in saliva and taste disorder symptoms like ageusia could indicate a viral infection in its early stages. This article presents evidence suggesting that several tissues in the oral cavity can be considered potential sites of SARS-CoV-2 infection, thus playing an essential role in the transmission mechanism and development of co-infections (AU)


Subject(s)
Humans , SARS-CoV-2 , COVID-19 , Mouth Mucosa/pathology , Oral Manifestations , Signs and Symptoms , Taste Disorders , Peptidyl-Dipeptidase A , Viral Load , Inflammation
5.
Infectio ; 25(2): 79-83, abr.-jun. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1250071

ABSTRACT

Abstract Objective: To evaluate the relationship between tobacco use and viral load and CD4+ T cell count in HIV patients. Results: The research conducted was a descriptive study of 317 patients on highly active antiretroviral therapy (HAART), 18 years old and above, who attended the "Unidad de Atención Integral" (UAI) at the Hospital Regional Universitario José María Cabral y Báez, in Santiago, Dominican Republic. Of those 317 patients, 172 were included in the data analysis. It was found that a 77.3% of smokers had a CD4+ T cell count equal to or below 250 cells/mm3. 75% of smokers had a viral load equal to or greater than 400 copies/ml. In addition, 82.9% of nonsmokers presented with a viral load below 400 copies/ml. The smokers were more likely to have a viral load equal to or greater than 400 copies/ml (OR = 6.285, P < 0.001), in comparison with nonsmokers. Patients younger than 45 years old were more likely to have a viral load equal to or above 400 copies/ml compared to older patients (OR = 3.313, P = 0.024).


Resumen Objetivo: Evaluar la relación entre el consumo de tabaco, la carga viral y el recuento de linfocitos T CD4+ en pacientes con VIH. Resultados: La investigación fue realizada mediante un estudio descriptivo a 317 pacientes en terapia antirretroviral de alta actividad (TARGA), de 18 años o ma yores, que asistían a la Unidad de Atención Integral (UAI) del Hospital Regional Universitario José María Cabral y Báez, en Santiago, República Dominicana. De esos 317 pacientes, 172 se incluyeron en el análisis de datos. Se encontró que un 77,3% de los fumadores tenían un recuento de células T CD4 + igual o inferior a 250 células / mm3. El 75% de los fumadores tenían una carga viral igual o superior a 400 copias / ml. Además, el 82,9% de los no fumadores presentaba una carga viral inferior a 400 copias / ml. Los fumadores tenían más probabilidades de tener una carga viral igual o superior a 400 copias / ml (OR = 6.285, P <0.001), en comparación con los no fumadores. Los pacientes menores de 45 años tenían más probabilidades de tener una carga viral igual o superior a 400 copias / ml en comparación con los pacientes mayores (OR = 3,313, P = 0,024).


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tobacco Use Disorder , CD4 Antigens , HIV , Viral Load , Antiretroviral Therapy, Highly Active , Dominican Republic , Tobacco Use , Smokers
6.
Säo Paulo med. j ; 139(2): 99-106, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1290233

ABSTRACT

ABSTRACT BACKGROUND: High prevalence of human immunodeficiency virus (HIV) infection and occurrence of drug-resistant strains have been recorded in northern Brazil. Abandonment of treatment and insufficient and inadequate adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been recorded in the metropolitan area of Belém, the capital of the state of Pará. OBJECTIVES: To identify the sociodemographic profile and level of adherence to ART among women seen at a referral unit in the interior of Pará, northern Brazil. DESIGN AND SETTING: Cross-sectional study at a referral unit for care for PLWHA. METHODS: We included 86 women living with HIV/AIDS (WLWHA) in the Rio Caeté integrated region, northeastern Pará. Social, demographic and behavioral information, as well as the ART level, were obtained using forms that have been described in the scientific literature. Logistic regression models were used to assess associations of variables with ART. RESULTS: Most WLWHA were single (52.4%), young (47.7%) and heterosexual (97.7%), had low levels of education (63.0%), were unemployed (69.8%), had one sexual partner (75.7%), used condoms (46.7%) and were not using either licit drugs (68.7%) or illicit drugs (89.6%). Their adherence level was classified as insufficient , and only their viral load showed an association with ART. CONCLUSIONS: The participants' low level of education and poor socioeconomic conditions may have been interfering with their adherence to ART. Such influences can be minimized through multiprofessional interventions that take the individuality of women served by the healthcare service into consideration.


Subject(s)
Humans , Female , HIV Infections/drug therapy , HIV Infections/epidemiology , Medication Adherence , Brazil/epidemiology , Cross-Sectional Studies , Viral Load
7.
ABCS health sci ; 46: e021201, 09 fev. 2021. tab
Article in English | LILACS | ID: biblio-1147201

ABSTRACT

INTRODUCTION: The city of Santarém, the regional healthcare center in the western Pará State, lacks studies on the epidemic of the human immunodeficiency virus (HIV), in particular, on the causes of death. OBJECTIVE: To characterize the sociodemographic and clinical profile related to the evolution of HIV infection to death. METHODS: The sample consisted of 94 medical records of patients from a reference center in the city of Santarém-PA, who died between 2010-2018. Data were collected on the sociodemographic profile, immunological and clinical characteristics of the patients. Data were analyzed using descriptive and inferential statistics, adopting p<0.05. RESULTS: Most deaths were male (67%), aged between 15-29 years (39%) and diagnosed between 30-44 years (41%), single (54%), mixed race (91.5%), from Santarém (77%) and with sexual intercourse being the main type of exposure (95.7%). Most patients were not being treated at the moment of death (56.4%), the main cause of death was respiratory failure (5%), in which, these individuals had, at the moment of death, TCD4+ lymphocytes <200 cell/mm3 (26%) and detectable viral load (29%). CONCLUSION: The lifetime from diagnosis to death was 48.45±50,30 months, and immunosuppression in the diagnosis was positively associated with the shortest survival time. However, sex was not associated with the immunological profile, age at the time of diagnosis, and death. There was only a tendency for women towards immunosuppression and detectable viral load.


INTRODUÇÃO: A cidade de Santarém, o polo assistencial da região oeste do Pará, carece de estudos sobre a epidemia do vírus da imunodeficiência humana (HIV), especialmente, sobre as causas de óbitos. OBJETIVO: Caracterizar o perfil sociodemográfico e clínico relacionado à evolução da infecção pelo HIV até a morte. MÉTODO: A amostra foi de 94 prontuários de pacientes de um centro de referência do município de Santarém-PA, que evoluíram a óbito entre os anos de 2010-2018. Foram levantados os dados sobre o perfil sociodemográfico, características imunológicas e clínicas dos pacientes. Os dados foram analisados por estatística descritiva e inferencial, adotando-se p<0,05. RESULTADOS: A maioria dos óbitos foi de indivíduos do sexo masculino (67%), com faixa etária do diagnóstico entre 15-29 anos (39%) e de falecimento entre 30-44 anos (41%), solteiros (54%), pardos (91,5%), procedentes de Santarém (77%) e com a relação sexual sendo o principal tipo de exposição (95,7%). A maioria dos pacientes não estava em tratamento no momento do óbito (56,4%), a principal causa de morte foi por insuficiência respiratória (5%), no qual, esses indivíduos apresentavam, no momento da morte, linfócitos TCD4+ <200 cél/mm3 (26%) e carga viral detectável (29%). CONCLUSÃO: O tempo de vida do diagnóstico ao óbito foi de 48,45±50,30 meses e a presença de imunossupressão no diagnóstico associou-se positivamente com o menor tempo de sobrevida. Contudo, o sexo não apresentou associação com o perfil imunológico, a idade no momento do diagnóstico e do óbito, apenas notou-se uma tendência das mulheres para a imunossupressão e carga viral detectável.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Health Profile , Demography , Acquired Immunodeficiency Syndrome/mortality , Acquired Immunodeficiency Syndrome/epidemiology , CD4-Positive T-Lymphocytes , Health Centers , Acquired Immunodeficiency Syndrome/diagnosis , Viral Load
8.
Arch. med ; 21(1): 13-23, 2021/01/03.
Article in English | LILACS | ID: biblio-1148352

ABSTRACT

Objective: to evaluate factors associated with inadequate control of viral load in individuals with Human Immunodeficiency Virus (HIV) in the The Center for Assistance to Sexually Transmitted Infections/SIDA/Viral Hepatitis (CAP) of Itajubá, MG, Brazil. The acquired immunodeficiency syndrome remains a health challenge in Brazil. Therapeutic failures, characterized by detectable viral load, must have their causes evaluated. Among the most relevant reasons is the lack of adherence to treatment. Materials and methods: this is an observational, cross-sectional and documentary study of 261 medical records. The variables analyzed were socio-epidemiological characteristics and laboratory tests for viral load and CD4+ T lymphocytes, poor adherence in history or currently, duration of antiretroviral therapy (ART) use, depression and/or anxiety, use of illicit drugs, follow-up time at the CAP. Results: among the patients, 90.42% had an undetectable viral load and 64.37% had a CD4+ T count ≥500 in the last available test. Some characteristics were related to detectable viral load in the last exam: history of poor adherence during treatment (p<0,0001), inconsistent use of ART (p<0,0001) and use of illicit drugs (p=0,0155). Anxiety and/or depression were not statistically significant (p=0,3321). Conclusion: history of poor adherence, inconsistent use of ART and use of illicit drugs were associated with an increased risk of virologic failure. Early identification of groups at risk of poor adherence to treatment can support the development of intervention strategies in an transdisciplinary way to improve adherence and generate better results in the control of HIV infection..Au


Objetivo: evaluar los factores asociados con el control inadecuado de la carga viral en individuos con virus de inmunodeficiencia humana (VIH) en el Centro de Asistencia para Infecciones de Transmisión Sexual/SIDA/Hepatitis Viral (CAP) de Itajubá, MG, Brazil. El síndrome de inmunodeficiencia adquirida sigue siendo un desafío para la salud en Brasil. Las fallas terapéuticas, caracterizadas por una carga viral detectable, deben tener sus causas evaluadas. Entre las razones más relevantes está la falta de adherencia al tratamiento. Materiales y métodos: estudio observacional, transversal y documental con 261 registros médicos. Las variables analizadas fueron características socioepidemiológicas y pruebas de laboratorio para carga viral y linfocitos T CD4+, pobre adherencia en la historia o en la actualidad, duración del uso de terapia antirretroviral (ARTE), depresión. y/o ansiedad, uso de drogas ilícitas, tiempo de seguimiento en el CAP. Resultados: de los pacientes, el 90.42% tenía una carga viral indetectable y el 64.37% tenía un recuento de CD4 + T ≥500 en la última prueba disponible. Fueron evidenciadas características relacionadas con la carga viral detectable en el último examen: antecedentes de mala adherencia durante el tratamiento (p <0,0001), uso inestable de ARTE (p <0,0001) y uso de drogas ilícitas (p = 0 , 0155). La ansiedad y / o depresión no fue estadísticamente significativa (p = 0.3321). Conclusión: el historial de adherencia deficiente, el uso inconsistente de ART y el uso de drogas ilícitas se asociaron con un mayor riesgo de falla virológica. La identificación de grupos en riesgo de mala adherencia al tratamiento puede ayudar a desarrollar estrategias de intervención de manera temprana y entre disciplinas para mejorar la adherencia y generar mejores resultados en el control de la infección por VIH..Au


Subject(s)
Humans , HIV , Viral Load
9.
Univ. salud ; 23(1): 64-70, ene.-abr. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1157010

ABSTRACT

Resumen Introducción: Las manifestaciones clínicas más frecuentes causadas por el Herpes Virus Humano Tipo 6 (HHV-6) ocurren en niños menores de 2 años, presentan lesiones en piel tipo roséola o exantema súbito. En adultos, las manifestaciones clínicas relacionadas a HHV-6 son muy variables, y pueden sobreponerse con otras afecciones. Objetivo: Presentar una serie de casos de pacientes diagnosticados con infección activa por HHV-6, quienes mostraban manifestaciones neurológicas, dermatológicas y de fatiga crónica. Materiales y métodos: Se realizó análisis de historias clínicas de 6 pacientes que fueron diagnosticados con infección activa por HHV-6, a través de métodos moleculares. Resultados: Se reportan 6 pacientes que fueron diagnosticados con infección activa por HHV-6 mediante métodos moleculares, quienes presentaron manifestaciones clínicas comunes tales como: fiebre, cefalea, depresión, decaimiento, pérdida de memoria y concentración, dolor fibromuscular, dolor poliarticular, sueño no reparador, exantema, nevus rubí, liquen plano y parestesias. Conclusiones: A través de esta serie de casos se espera resaltar la importancia de identificar la infección activa por HHV-6 a través de métodos moleculares, y sensibilizar a la comunidad médica sobre el papel que juega el virus en la evolución de diversas patologías.


Abstract Introduction: The most frequent clinical manifestations of Human Herpesvirus 6 (HHV-6) in children under 2 years of age are roseola-like skin lesions and sudden rash. In adults, the clinical manifestations associated with HHV-6 are highly variable and can overlap with other conditions. Objective: To present a case series of patients diagnosed with active HHV-6 infection, who showed neurological, dermatological and chronic fatigue manifestations. Materials and methods: An analysis of medical records of 6 patients who were diagnosed with active HHV-6 infection through molecular methods was performed. Results: 6 patients were diagnosed with active HHV-6 infection using molecular methods, who had common clinical manifestations such as fever, headache, depression, tiredness, loss of memory and concentration, fibromuscular pain, polyarticular pain, nonrestorative sleep, rash, ruby nevus, lichen planus and paresthesia. Conclusions: This case series highlights the importance of identifying active HHV-6 infection through molecular methods and creating awareness in the medical community of the role that the virus plays on the development of diverse pathologies.


Subject(s)
Herpesvirus 6, Human , Skin Diseases , Fatigue Syndrome, Chronic , Viral Load
10.
Article in English | WPRIM | ID: wpr-880733

ABSTRACT

Epidemiological evidence suggests that patients with hypertension infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at increased risk of acute lung injury. However, it is still not clear whether this increased risk is related to the usage of renin-angiotensin system (RAS) blockers. We collected medical records of coronavirus disease 2019 (COVID-19) patients from the First Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China), and evaluated the potential impact of an angiotensin II receptor blocker (ARB) on the clinical outcomes of COVID-19 patients with hypertension. A total of 30 hypertensive COVID-19 patients were enrolled, of which 17 were classified as non-ARB group and the remaining 13 as ARB group based on the antihypertensive therapies they received. Compared with the non-ARB group, patients in the ARB group had a lower proportion of severe cases and intensive care unit (ICU) admission as well as shortened length of hospital stay, and manifested favorable results in most of the laboratory testing. Viral loads in the ARB group were lower than those in the non-ARB group throughout the disease course. No significant difference in the time of seroconversion or antibody levels was observed between the two groups. The median levels of soluble angiotensin-converting enzyme 2 (sACE2) in serum and urine samples were similar in both groups, and there were no significant correlations between serum sACE2 and biomarkers of disease severity. Transcriptional analysis showed 125 differentially expressed genes which mainly were enriched in oxygen transport, bicarbonate transport, and blood coagulation. Our results suggest that ARB usage is not associated with aggravation of COVID-19. These findings support the maintenance of ARB treatment in hypertensive patients diagnosed with COVID-19.


Subject(s)
Aged , Aged, 80 and over , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme 2/blood , Antibodies, Viral/blood , Antihypertensive Agents/therapeutic use , Biomarkers , COVID-19/complications , China , Female , Humans , Hypertension/drug therapy , Intensive Care Units , Length of Stay , Male , Middle Aged , Retrospective Studies , Transcriptome , Viral Load
11.
Article in English | WPRIM | ID: wpr-880732

ABSTRACT

With the number of cases of coronavirus disease-2019 (COVID-19) increasing rapidly, the World Health Organization (WHO) has recommended that patients with mild or moderate symptoms could be released from quarantine without nucleic acid retesting, and self-isolate in the community. This may pose a potential virus transmission risk. We aimed to develop a nomogram to predict the duration of viral shedding for individual COVID-19 patients. This retrospective multicentric study enrolled 135 patients as a training cohort and 102 patients as a validation cohort. Significant factors associated with the duration of viral shedding were identified by multivariate Cox modeling in the training cohort and combined to develop a nomogram to predict the probability of viral shedding at 9, 13, 17, and 21 d after admission. The nomogram was validated in the validation cohort and evaluated by concordance index (C-index), area under the curve (AUC), and calibration curve. A higher absolute lymphocyte count (


Subject(s)
Aged , Aged, 80 and over , Antibodies, Viral/blood , Area Under Curve , COVID-19/virology , Female , Humans , Lymphocyte Count , Male , Middle Aged , Nomograms , Proportional Hazards Models , Retrospective Studies , Viral Load , Virus Shedding
12.
Article in English | WPRIM | ID: wpr-880731

ABSTRACT

Since December 2019, the novel coronavirus (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) has spread to many countries around the world, developing into a global pandemic with increasing numbers of deaths reported worldwide. To data, although some vaccines have been developed, there are no ideal drugs to treat novel coronavirus pneumonia (coronavirus disease 2019 (COVID-19)). By examining the structure of the coronavirus and briefly describing its possible pathogenesis based on recent autopsy reports conducted by various teams worldwide, this review analyzes the possible structural and functional changes of the human body upon infection with SARS-CoV-2. We observed that the most prominent pathological changes in COVID-19 patients are diffuse alveolar damage (DAD) of the lungs and microthrombus formation, resulting in an imbalance of the ventilation/perfusion ratio and respiratory failure. Although direct evidence of viral infection can also be found in other organs and tissues, the viral load is relatively small. The conclusion that the injuries of the extra-pulmonary organs are directly caused by the virus needs further investigation.


Subject(s)
COVID-19/physiopathology , Human Body , Humans , Immune Evasion , Lung/virology , Viral Load
13.
Rev. méd. Minas Gerais ; 31: 31101, 2021.
Article in Portuguese | LILACS | ID: biblio-1291243

ABSTRACT

A terapia antirretroviral (TARV) promoveu reduções drásticas na morbidade e mortalidade de pessoas vivendo com HIV (PVH). A utilização adequada da TARV requer monitoramento contínuo para avaliar a resposta terapêutica e identificar eventos adversos relacionados à administração a longo prazo. Trata-se de um estudo de coorte, realizado em centro de referência em doenças infecciosas, Belo Horizonte, Minas Gerais, com o objetivo de avaliar a efetividade da TARV entre 2012 e 2018. A população do estudo foi composta por 82 PVH que tiveram indicação para início da TARV entre janeiro a dezembro de 2012. A efetividade da TARV, definida como carga viral < 50 cópias/mL, foi de 75,6% e 80,5% após 12 e 66 meses de seu início, respectivamente. Os casos de falha terapêutica continham em prontuário informações sobre má-adesão e/ou abandono. Apesar da introdução tardia da TARV, a resposta terapêutica foi melhor às estimadas pelo Ministério da Saúde e semelhante a estudos de eficácia, demonstrando efetividade da TARV nos períodos analisados. Estes dados ratificam que a política brasileira de enfrentamento da epidemia de HIV/ Aids, de distribuição universal, é exitosa e deve ser mantida e aprimorada para evitar eventuais falhas terapêuticas.


The antiretroviral therapy (ART) has caused a significant reduction in morbidity and mortality in people living with HIV (PLH). The appropriate use of the ART demands continuous monitoring in order to assess the therapeutic response and identify adverse events related to medium and long-term ART exposure. The aim of this study is to evaluate the effectiveness of ART between 2012 and 2018. It is a prospective cohort study carried out at a reference centre of infectious diseases in Belo Horizonte, Minas Gerais - Brazil. The population of this study was composed of 82 PLH who had indication for the beginning of ART between January and December 2012. The effectiveness of ART, defined as viral load < 50 copies/mL, was of 75.6% and 80.5% after 12 and 66 months, respectively. The cases of treatment failure registered in medical records had information of poor adhesion and abandonment of treatment. In spite of the late introduction of ART in this population, the therapeutic response was better than the values described by Ministry of Health and similar to efficacy studies. These data ratify that the Brazilian public policies of combating HIV/AIDS epidemic, of universal distribution, have been successful and must be kept and improved to avoid possible treatment failures.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Effectiveness , Antiretroviral Therapy, Highly Active , Anti-Retroviral Agents/therapeutic use , Communicable Diseases , HIV , Viral Load
14.
Cad. Saúde Pública (Online) ; 37(9): e00143520, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345635

ABSTRACT

Immune recovery reflects health conditions. Our goal was to estimate the time it takes to achieve immune recovery and its associated factors, in people living with HIV (PLHIV), after antiretroviral therapy (ART) initiation. A historical cohort study was performed among PLHIV (> 18 years-old) in Minas Gerais State, Brazil, using data from healthcare databases. Patients initiating ART between 2009-2018, with T-CD4+ lymphocytes and viral load recorded before and after antiretroviral therapy were included. The outcome is achievement of immune recovery, defined as the first T-CD4+ > 500 cells/µL after ART initiation. Explanatory variables were age, gender, place of residence, year of ART initiation, baseline viral load and T-CD4+, viral load status, and adherence to ART at follow-up. Descriptive analysis, cumulative, and person-time incidences of immune recovery were estimated. Median-time to immune recovery was estimated using Kaplan-Meier method. Factors associated with immune recovery were assessed by Cox regression. Among 26,430 PLHIV, 8,014 (30%) were eligible. Most were male (67%), mean age 38.7 years, resided in non-central region, median-baseline T-CD4+ = 228 cells/µL (< 200 cells/µL = 43%) and viral load median-baseline = 4.7 log10 copies/mL (detectable viral load = 99%). Follow-up time = 15,872 person-years. Cumulative and incidence rate were 58% (95%CI: 57-58) (n = 4,678) and 29.47 cases/100 person-years, respectively. Median-time to immune recovery was of 22.8 months (95%CI: 21.9-24.0). Women living with HIV, younger than 38 years of age, with T-CD4+ baseline > 200 cells/µL, detectable viral load (baseline), antiretroviral therapy-adherence and undetectable viral load (follow-up) were independently associated with immune recovery. Time to immune recovery remains long and depends on early treatment and antiretroviral therapy-adherence.


A recuperação imunológica reflete condições de saúde. Nosso objetivo foi estimar o tempo até a recuperação imunológica e fatores associados em pessoas vivendo com HIV (PVHIV) após de iniciar a terapia antirretroviral (TARV). Foi conduzida uma coorte histórica de PVHIV (> 18 anos) no Estado de Minas Gerais, Brasil, usando bancos de serviços públicos de saúde. Foram incluídos pacientes que iniciaram a TARV entre 2009 e 2018, com linfócitos T-CD4+ e carga viral registrados antes e depois do início da TARV. O desfecho foi a recuperação imunológica, definida como a primeira contagem de T-CD4+ > 500 cel/µL após o início da TARV. As variáveis explanatórias foram idade, sexo, local de residência, ano de início de TARV, carga viral basal, T-CD4+ na linha de base e carga viral e adesão à TARV no seguimento. Foi realizada uma análise descritiva com estimativa de incidência acumulada e taxa de incidência (pessoa-ano). O tempo mediano até a recuperação imunológica foi estimado pelo método Kaplan-Meier. Fatores associados à recuperação imune foram avaliados por meio de regressão de Cox. Entre as 26.430 PVHIV, 8.014 (30%) foram elegíveis. A maioria era do sexo masculino (67%), com média de idade = 38,7 anos, residência em regiões fora da região metropolitana, mediana de T-CD4+ baseline = 228 células/µL (< 200 células/µL = 43%) e mediana de carga viral baseline = 4,7 log10 cópias/mL (carga viral detectável = 99%). Tempo de seguimento = 15.872 pessoas-ano. A incidência acumulativa e a taxa de incidência foram foram 58% (IC95%: 57-58) (n = 4.678) e 29,47 casos/100 pessoas-ano, respectivamente. Tempo mediano até recuperação imune = 22,8 meses (IC95%: 21,9-24,0). Os fatores independentemente associados com recuperação imunológica foram sexo feminino, idade < 38 anos, T-CD4+ basal > 200 células/µL, carga viral detectável (linha de base), adesão à TARV e carga viral indetectável (no seguimento). O tempo até a recuperação imunológica ainda é longo e impactado pelo tratamento precoce e da adesão à TARV.


La recuperación inmunológica refleja condiciones de salud. Nuestra meta fue estimar el tiempo y los factores asociados a la recuperación inmunológica en personas que viven con VIH (PVVIH), tras iniciar una terapia antirretroviral (TAR). Se realizó sobre una cohorte histórica entre PVVIH (> 18 años de edad) en Minas Gerais, Brasil, usando datos de las bases de datos del sistema de salud. Se incluyeron a pacientes que comenzaron una TAR entre 2009-2018, con T-CD4+ linfocitos y carga viral, registrada antes/después de TAR. El resultado fue el logro de recuperación inmunológica, definida como la primera T-CD4+ > 500 células/µL tras la iniciación TAR. Las variables explicatorias fueron: edad, género, lugar de residencia, año de iniciación TAR, base de referencia de carga viral, base de referencia de T-CD4+ y estatus de la carga viral y adherencia al TAR en el seguimiento. Se estimó: análisis descriptivo, acumulativo e incidencias persona-tiempo de recuperación inmunológica. La media de tiempo para la recuperación inmunológica se estimó usando el método Kaplan-Meier. Los factores asociados con la recuperación inmunológica se evaluaron mediante la regresión de Cox. Entre las 26.430 PVVIH, 8.014 (30%) fueron elegibles. La mayoría eran hombres (67%), media de edad = 38,7 años, residentes en una región no central, media de base de referencia T-CD4+ = 228 células/µL (< 200 células/µL = 43%) y carga viral media de base de referencia = 4,7 log10 copias/mL (carga viral detectable = 99%). El tiempo de seguimiento = 15.872 persona-años. La tasa acumulativa y de incidencia fue 58% (95%CI: 57-58) (n = 4.678) y 29,47 casos/100 persona-años, respectivamente. El tiempo de media para la recuperación inmunológica = 22,8 meses (95%CI: 21,9-24,0). Género femenino, PVVIH < 38 años de edad, T-CD4+ base de referencia > 200 células/µL, carga viral detectable (base de referencia), adherencia al TAR e carga viral indetectable (seguimiento) estuvieron independientemente asociadas con la recuperación inmunológica. El tiempo para la recuperación inmunológica sigue siendo largo y depende de un tratamiento temprano y de adherencia a la TAR.


Subject(s)
Humans , Male , Female , Adolescent , Adult , HIV Infections/drug therapy , Anti-HIV Agents/therapeutic use , Brazil , Cohort Studies , Viral Load , Antiretroviral Therapy, Highly Active
15.
Arq. odontol ; 57: 114-121, jan.-dez. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1343366

ABSTRACT

Objetivo: Diante da importância do fluido salivar no contexto da odontologia, este trabalho objetivou realizar uma revisão de literatura sobre a relação da saliva e a COVID-19, bem como as suas principais implicações na Odontologia. Métodos: Foi realizada a busca eletrônica de publicações nas bases de dados SciELO, PubMed, Scopus, EMBASE e Cochrane Central Register of Controlled Trials, utilizando os seguintes descritores: "Saliva", "oral cavity", "oral mucosa", "oral lesions", "Dentistry", e o operador booleano "AND" entre todas as palavras-chave citadas individualmente com o termo "COVID-19". Os estudos foram publicados no período de dezembro de 2019 a setembro de 2020. Resultados: Os estudos demonstraram que a saliva representa um importante meio de transmissão do SARS-CoV-2, o que torna necessário o cumprimento de medidas de biossegurança pelos cirurgiões-dentistas a fim de reduzir a possibilidade de infecção pelo SARS-CoV-2. Ao mesmo tempo, a alta carga viral encontrada na saliva possibilita que a mesma possa ser utilizada como um meio para diagnóstico da COVID-19. Pesquisas têm demonstrado eficácia similar da análise da saliva quando comparada a outras técnicas convencionais. Por sua vez, mais investigações precisam ser realizadas a fim de validar a metodologia aplicada nos estudos atuais. Conclusão: A detecção do SARS-CoV-2 através da saliva é bastante promissora e apresenta vantagens em comparação a outros fluidos biológicos, pois a coleta deste fluido não envolve uma intervenção invasiva, facilitando o manejo pelos profissionais e pacientes.


Aim: Due to the importance of the salivary fluid in dentistry, this study aimed to carry out a literature review on the relationship between saliva and COVID-19, as well as its main implications in Dentistry. Methods: An electronic search for publications was performed in the SciELO, PubMed, Scopus, EMBASE, and Cochrane Central Register of Controlled Trials databases using the following descriptors: "Saliva", "oral cavity", "oral mucosa", "oral lesions ", and "Dentistry", using the Boolean operator "AND" between all keywords cited individually with the term "COVID-19". The studies were published from December 2019 to September 2020.Results: The studies have shown that saliva represents an important means of transmission of SARS-CoV-2, which makes it necessary for dentists to comply with biosafety measures in order to reduce the possibility of SARS-CoV-2 infection. Likewise, the high viral load found in saliva allows it to be used as a path to COVID-19 diagnosis. Investigations have shown similar effectiveness in the saliva analysis compared to other conventional techniques. In this regard, more investigations need to be carried out to validate the methodology applied in current studies. Conclusion: The detection of SARS-CoV-2 through saliva is very promising and has advantages in comparison to other biological fluids, as the collection of this fluid does not involve an invasive intervention, thus facilitating management by professionals and patients.


Subject(s)
Saliva , Coronavirus Infections , Containment of Biohazards , Dentists , COVID-19 , Review , Viral Load , Diagnosis
16.
Mem. Inst. Oswaldo Cruz ; 116: e210018, 2021. tab, graf
Article in English | LILACS | ID: biblio-1287340

ABSTRACT

BACKGROUND Coronavirus disease 2019 (COVID-19) is highly infectious causing millions of deaths worldwide. Nasopharyngeal swabs are the primary sample of choice for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), thus, to decrease the exposure to potentially infected samples through the collection is a key point to reduce the risk of infection in healthcare workers. OBJECTIVES This study aimed to evaluate the sensitivity and viral load of saliva specimens by days of symptoms onset comparing to nasopharyngeal swabs in subjects with mild symptoms. METHODS Saliva and nasopharyngeal swabs samples were collected from São Paulo Hospital workers presenting mild symptoms, such as fever, cough, sore throat, rhinorrhea, myalgia, headaches, anosmia, ageusia, and fatigue. To understand the positivity and viral load, reverse transcription-polymerase chain reaction (RT-PCR) was performed. FINDINGS Saliva specimens presented a sensitivity of 98.6% compared to nasopharyngeal swabs. Overall, saliva showed lower viral load compared to nasopharyngeal swabs, regarding days of symptoms onset on diagnosis, the first four days had significant changes in viral load and no significant difference was reported in the days five to nine. MAIN CONCLUSIONS Although RT-PCR of saliva has presented a lower viral load compared to nasopharyngeal swabs, saliva specimens are a potential and reliable candidate for COVID-19 diagnosis through RT-PCR.


Subject(s)
Humans , RNA, Viral , COVID-19 , Saliva , Nasopharynx , Viral Load , COVID-19 Testing , SARS-CoV-2
17.
Babcock Univ. Med. J ; 4(1): 8-13, 2021.
Article in English | AIM | ID: biblio-1291975

ABSTRACT

Objectives: Human Immunodeficiency Virus (HIV) remains a public health issue with more than 25 million deaths since 1990. As of 2019, Nigeria has a national prevalence of 1.4% among 15-49 years and about 1.9 million people living with HIV, according to the Joint United Nations Programme on HIV/AIDS. This study assessed the factors responsible for unsuppressed viral load among patients accessing care at Federal Medical Centre HIV Clinic in Abeokuta, southwest Nigeria.Methods: The study design was descriptive cross-sectional. Data was collected using the qualitative method; an In-depth interview was conducted among 20 virally unsuppressed HIV patients currently on Antiretroviral Therapy (ART) at Federal Medical Centre Abeokuta. The participants were purposively selected. The data were analyzed using thematic analysis.Results: Although almost all the participants were aware of HIV, their knowledge of HIV was inadequate. Non-adherence to drugs, side effects of medications, the psychological effects of the disease, forgetfulness, and combination of anti-retroviral drugs with local herbs and alcohol were the associated factors of viral non-suppression among the patients.Conclusion: Scaling up psychological care services using Short Message Services (SMS) to improve viral suppression is, therefore, strongly recommended.


Subject(s)
Humans , Male , Female , HIV Infections , Viral Load , Antiretroviral Therapy, Highly Active , Patient Compliance
18.
Pesqui. vet. bras ; 41: e06782, 2021. tab, graf
Article in English | ID: biblio-1340352

ABSTRACT

This research reports the use of different diagnostic tests in cattle, naturally infected by Rabies lyssavirus (RABV), and correlates the positivity of the tests with the clinical moment of euthanasia, the intensity of the inflammatory lesion and viral load. It also highlights the possibility of euthanasia in early stages of the disease as a way to improve animal welfare. For that, samples of 34 bovine brains were collected for analysis, preserved in 10% buffered formaline and refrigerated with subsequent freezing. The samples were subjected to direct immunofluorescence antibody technique (DFAT) tests, viral isolation in cell culture (VICC), histopathology with hematoxylin and eosin staining (HE), immunohistochemistry (IHC), Shorr stainied neural tissue smears (DSS), Reverse transcription polymerase chain reaction (RT-PCR) and polymerase chain reaction by quantitative reverse transcriptase (qRT-PCR). The areas used for analysis were the cerebellum, parietal telencephalon and thalamus. Samples with Negri bodies (NBs) or immunostaining in at least one of the analyzed areas were considered positive. For the study of the intensity of histological lesions, the lesions were classified into grades 0, 1, 2 and 3 and the positivity of the test in the presence or absence of NBs in one of the three areas analyzed. To verify the influence of the disease clinical evolution, 4-four groups of analysis were created according to the animal's clinical status at moment of the euthanasia, being: M1 = animal euthanized while standing, M2 = euthanized when in sternal recumbence, M3 = euthanized when in lateral recumbence, M4 = animal with natural death. Of the 34 brains evaluated, IHC was positive in 100% of cases, DFAT was positive in 97.05% of them, and in this negative sample the presence of RABV was confirmed by VICC. NBs ere seen in 88.23% of the cases, and the DSS test was positive in 82.35% of them. All diagnostic techniques showed positive cases in all groups analyzed. Each case was positive in at least two diagnostic methods. All cases that contained NBs were positive for rabies in the other tests. In this study, it was observed that the variables analyzed (intensity of injury and clinical evolution at the moment of euthanasia) had an influence only on HE and DSS techniques, which are based on NB research to form the diagnosis, but did not interfere with the effectiveness of the diagnosis performed by detecting the viral antigen performed by DFAT and IHC. All isolated RABV samples included in the present study have a genetic lineage characteristic of hematophagous bats Desmodus rotundus. The evaluation of qRT-PCR showed that the amount of virus did not interfere in the positivity of the tests. This work shows that IHC and DFAT are safe diagnostic techniques. They are capable of detecting RABV even in euthanized animals in the early stages of clinical evolution with mild intensities of histological lesions.(AU)


Esta pesquisa relata a utilização de diferentes testes de diagnóstico em bovinos, naturalmente infectados pelo Rabies lyssavirus (RABV), e correlaciona a positividade dos testes com o momento clínico da eutanásia, a intensidade da lesão inflamatória, e a carga viral. Salienta também a possibilidade da eutanásia em estágios precoces da doença como forma de melhorar o bem-estar animal. Para isso amostras de 34 encéfalos bovinos foram coletados para análise, conservadas em formol tamponado 10% e sob refrigeração com posterior congelamento. As amostras foram submetidas aos testes de imunofluorescência direta (IFD), isolamento viral em cultivo de células (IVCC), histopatologia com coloração de hematoxilina e eosina (HE), imuno-histoquímica (IHQ), esfregaço direto com coloração de Shorr (EDS), reação da polimerase em cadeia por transcriptase reversa (RT-PCR) e reação da polimerase em cadeia por transcriptase reversa quantitativo (qRT-PCR). As áreas utilizadas para análise foram o cerebelo, telencéfalo parietal e tálamo. Foram consideradas positivas as amostras que apresentaram Corpúsculo de Negri (CNs) ou imuno-marcação em ao menos uma das áreas analisadas. Para o estudo da intensidade das lesões histológicas, as lesões foram classificadas em graus 0, 1, 2 e 3 e a positividade do teste na presença ou ausência de CN em uma das três áreas analisadas. Para verificar a influência da evolução clínica da doença foram criados 4 grupos de análise conforme o estado clínico do animal no momento da eutanásia, sendo: M1 = animal eutanasiado em estação, M2 = eutanasiado em decúbito esternal, M3 = eutanasiado em decúbito lateral, M4 = animal com morte natural. Dos 34 encéfalos avaliados a IHQ foi positiva em 100% dos casos, a IFD foi positiva em 97,05%, sendo que na amostra negativa a presença de RABV foi confirmada por IVCC. A histologia com HE, através da visualização das CNs, foi positiva em 88,23 % dos casos, e o teste de EDS, foi positivo em 82,35%. Todas as técnicas de diagnóstico apresentaram casos positivos em todos os grupos analisados. Cada caso foi positivo em, pelo menos, dois métodos de diagnóstico. Todos os casos que continham CN foram positivos para raiva nos demais testes. Nesse estudo observou-se que as variáveis analisadas intensidade de lesão e evolução clínica no momento da eutanásia tiveram influência somente nas técnicas de HE e EDS, que se baseiam na pesquisa do CN para formação do diagnóstico, mas não interferiram na eficácia do diagnóstico realizado através da detecção do antígeno viral realizado por IFD e IHQ. Todas as amostras RABV isoladas incluídas no presente estudo apresentam linhagem genética característica de morcegos hematófagos Desmodus rotundus. A avaliação de qRT-PCR demostrou que a quantidade de vírus não interferiu na positividade dos testes. Esse trabalho mostra que a IHQ e a IFD são técnicas seguras de diagnóstico e que mesmo em animais eutanasiados em estágios iniciais de evolução clínica com intensidades leve de lesões histológicas, são capazes de detectar o RABV.(AU)


Subject(s)
Animals , Cattle , Cattle/injuries , Euthanasia , Viral Load/veterinary , Rabies virus , Wounds and Injuries/diagnosis , Encephalitis
19.
Int. j. odontostomatol. (Print) ; 14(4): 544-547, dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1134535

ABSTRACT

RESUMEN: La utilización de enjuagues antisépticos previo a la atención odontológica favorecería la disminución del virus en la cavidad oral. Se ha planteado el uso de peróxido de hidrógeno preconsulta dental. Se revisaron las bases de datos PubMed, Cochrane y Elsevier publicados desde Enero 2019 a junio 2020. Los estudios que cumplieron los criterios de inclusión fueron revisados por 2 autores individualmente. Se realizó una revisión cualitativa de los datos. No existen ensayos controlados aleatorios o estudios de observación clínica sobre el efecto curativo o preventivo del peróxido de hidrógeno contra el COVID-19, pero si protocolos de ensayos clínicos que están en proceso de reclutamiento. El enjuague bucal con peróxido de hidrógeno podría ser una solución viable pre consulta dental que debe ser estudiada para reducir la carga viral del COVID-19.


ABSTRACT: The use of antiseptic rinses prior to dental care would favor the reduction of the virus in the oral cavity. The use of hydrogen peroxide prior to dental consultation has been proposed. PubMed, Cochrane and Elsevier databases published from January 2019 to June 2020 were reviewed. Studies that met the inclusion criteria were reviewed by 2 authors individually. A qualitative review of the data was performed. There are no randomized controlled trials or clinical observation studies on the curative or preventive effect of hydrogen peroxide against COVID-19, but there are clinical trial protocols that are in the process of recruitment. Hydrogen peroxide mouthwash could be a viable solution prior to dental consultation that should be studied, to reduce COVID-19 viral load.


Subject(s)
Humans , Coronavirus Infections/prevention & control , Hydrogen Peroxide/therapeutic use , Dental Care , Viral Load , Hydrogen Peroxide/administration & dosage , Mouthwashes/therapeutic use
20.
Rev. chil. infectol ; 37(5): 550-554, nov. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144249

ABSTRACT

Resumen Introducción: Cargas virales (CV) entre 20-200 copias/mL se consideran cargas virales de bajo grado (CVBG). Su implicancia clínica y manejo no han sido definidos. Objetivo: Evaluar el impacto de CVBG en el riesgo de desarrollo posterior de fallo virológico (FV). Pacientes y Métodos: Se incluyeron pacientes ≥ 18 años, desde enero de 2009 a diciembre de 2019, con infección por VIH-1 con CV< 20 copias/mL, por un mínimo de seis meses y/o en dos muestras consecutivas bajo tratamiento anti-retroviral . Se realizó seguimiento de las CV estrati ficándolas: CV < 20 copias/mL, CVBG (20-50 copias/mL y 51-200 copias/mL) y FV. Mediana de seguimiento 25 meses (IQR 15-31). Resultados: Fueron incluidos 1.416 pacientes con CV < 20 copias/ mL bajo TARV. De ellos, 797 permanecieron con CV< 20 copias/mL durante el seguimiento, 144 presentaron CV entre 20-50 copias/mL, 384 entre 51-200 copias/mL y 91 presentaron FV sin CVBG previa. De los 528 pacientes que tuvieron CVBG, 110 (20,1%) fallaron, riesgo 3,45 veces superior respecto a los que no tuvieron CVBG previa. El riesgo de FV fue 3,27 mayor para aquellos que tuvieron CVBG entre 51-200 copias/mL vs 20-50 copias/mL. Discusión: El estudio permite relacionar la CVBG con el FV posterior, siendo el mayor riesgo CVBG entre 51-200 copias/mL.


Abstract Background: Viral loads (VL) between 20-200 copies/mL are considered low-grade viral loads (LGVL). Its clinical implications and management have not been defined. Aim: To evaluate the impact of LGVL on the risk of subsequent development of virological failure (VF). Methods: Patients ≥ 18 years, with HIV-1 infection who had VL < 20 copies/mL for at least six months and/or in two consecutive samples under antiretroviral therapy (ART) were included, between January 1st, 2009 and December 31, 2019. Follow-up of the VLs was carried out stratifying them in VL < 20 copies/mL, LGVL (20-50 copies/mL and 51-200 copies/mL) and VF. Median follow-up 25 months (IQR 15-31). Results: 1,416 patients were included who reached VL < 20 copies/ml under ART, 797 patients remained with CV < 20 copies/mL during follow-up, 144 patients had VL between 21-50 copies/mL, 384 between 51-200 copies/mL and 91 had VF without previous LGVL. Out of 528 patients who had LGVL, 110 failed, risk 3.45 times higher than those who had no previous LGVL. Risk 3.27 times higher of VF for those who had LGVL between 51-200 copies/mL compared to 20-50 copies/mL. Discussion: The study allows to relate the LGVL with VF. This association was observed more frequently with LGVL between 51-200 copies/mL


Subject(s)
Humans , Viremia/etiology , HIV Infections/complications , HIV Infections/drug therapy , HIV-1 , Treatment Failure , Anti-HIV Agents/therapeutic use , Viral Load , Antiretroviral Therapy, Highly Active
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