ABSTRACT
BACKGROUND: The co-circulation of Chikungunya (CHIKV), Dengue (DENV) and Zika (ZIKV) viruses increased the risk of outbreaks and coinfections among them. Here, we report cases of coinfection in clinical samples from state of Tocantins, Brazil. METHODS: In 2017, the Central Public Health Laboratory (LACEN) received samples of patients who consulted health units with symptoms compatible with arboviral infections. A total of 102 samples were sent to the Retrovirology Laboratory at the Federal University of São Paulo, where they were tested by RT-qPCR to confirm DENV, ZIKV and CHIKV infections and to detect coinfected patients. RESULTS: We identified with CHIKV monoinfection (52), DENV serotypes 1 (28) and serotypes 2 (22). We did not detect ZIKV. Five patients were characterized with coinfection involving CHIKV and DENV serotype 2. CONCLUSIONS: The presence of co-circulating arboviruses increases the chance of coinfection and demonstrates the importance of differential diagnosis and vector control.
Subject(s)
Chikungunya Fever/epidemiology , Coinfection/epidemiology , Dengue/epidemiology , Zika Virus Infection/epidemiology , Adolescent , Adult , Brazil/epidemiology , Chikungunya Fever/blood , Chikungunya Fever/diagnosis , Chikungunya Fever/genetics , Chikungunya virus/isolation & purification , Child , Coinfection/diagnosis , Cross-Sectional Studies , Dengue/blood , Dengue/diagnosis , Dengue/genetics , Dengue Virus/isolation & purification , Female , Humans , Male , Middle Aged , RNA, Viral , Reverse Transcriptase Polymerase Chain Reaction , Serogroup , Young Adult , Zika Virus/isolation & purification , Zika Virus Infection/bloodABSTRACT
The resurgence of cases of Zika virus (ZIKV) infection, accompanied by epidemic of microcephaly in Brazil, has aroused worldwide interest in understanding the biological mechanisms of the virus that allow patient management and the viral dissemination control. Colostrum and human milk are possible sources of virus spread. Therefore, the objective of this study was to analyze the repercussions of ZIKV infection on rheological parameters and inflammatory cytokines of colostrum. The prospective cohort study included 40 puerperal donors of colostrum, divided into 2 groups: control (without ZIKV infection, n = 20) and a group infected with ZIKV during the gestational period (n = 20). Analyses were performed for the detection of ZIKV by polymerase chain reaction (PCR). In addition to obtaining the rheological parameters and quantification of IL-10 and IL-6 cytokines by flow cytometry, ZIKV and other flaviviruses were not detected in colostrum. However, maternal infection reflected increased viscosity, decreased levels of IL-10, and elevated levels of IL-6. The higher viscosity may represent a mechanical barrier that hinders the spread of the virus. The lower levels of anti-inflammatory mediators and higher inflammatory cytokines may possibly alter the viscosity, and it seems the higher viscosity represents a possible mechanism of adaptation of breastfeeding against a response to ZIKV.
Subject(s)
Colostrum/immunology , Host-Pathogen Interactions/immunology , Interleukin-10/immunology , Interleukin-6/immunology , Pregnancy Complications, Infectious/immunology , Zika Virus Infection/immunology , Zika Virus/pathogenicity , Adult , Case-Control Studies , Colostrum/chemistry , Female , Gene Expression , Humans , Interleukin-10/genetics , Interleukin-6/genetics , Postpartum Period/immunology , Pregnancy , Pregnancy Complications, Infectious/genetics , Pregnancy Complications, Infectious/virology , Rheology , Viscosity , Zika Virus/immunology , Zika Virus Infection/genetics , Zika Virus Infection/virologyABSTRACT
Despite all the efforts to contain the HIV/AIDS epidemics, there still are individuals of unknown diagnosis. These present high risk of mortality and after diagnosis respond very poorly to treatment. Late testing also represents a reduced opportunity in controlling the transmission of HIV and causes an indirect increase in the transmission rates of other diseases, such as tuberculosis. In European countries, as well as in the United States, a great number of people, represented especially by illegal immigrants, black individuals, and women, markedly present at a later state of infection. In 1996, Brazil was the very first developing country to offer free and universal access to antiretroviral therapy, as well as easy access to HIV testing and care. Nonetheless, there is still a significant number of young and adult subjects who look for HIV/AIDS services and hospitals at later stage of infection by HIV (late presenters). Here we discuss important aspects related to the late diagnosis of HIV in Brazil and worldwide.
Subject(s)
Delayed Diagnosis/statistics & numerical data , Ethnicity/statistics & numerical data , HIV Infections/diagnosis , Patient Acceptance of Health Care/statistics & numerical data , Brazil/epidemiology , Global Health , HIV Infections/epidemiology , Health Education , Humans , Policy Making , Risk Factors , Social Stigma , Time-to-Treatment/statistics & numerical dataABSTRACT
The impact of Structured Treatment Interruption (STI) in peripheral blood mononuclear cell (PBMC) proviral reservoirs in 41 highly active antiretroviral therapy (HAART)-treated viremic individuals at baseline and 12 weeks after STI was determined using quantitative PCR (qPCR). Viral load increased 0.7 log(10) and CD4 decreased 97.5 cells/mm(3) after 12 weeks. A total of 28 of the 41 individuals showed an increased proviral load, 19 with a statistically significant increase above 10%. An increase in active viral replication is an important factor in the replenishment of the proviral reservoir even for short time periods.
