Viabilidade celular de linfócitos como auxiliar na instituição da terapia antirretroviral na infecção pelo HIV-1 / Cellular viability of lymphocytes as an auxiliary for the institution of antiretroviral therapy in the human immunodeficiency virus infection

A infecção pelo vírus da imunodeficência humana (HIV) está associada à diminuição progressiva do número de linfócitos T CD4. Além do comprometimento na produção das células T CD4, os altos níveis de apoptose verificados nesses pacientes também são responsáveis pela depleção dessas células. O objetivo deste trabalho foi mostrar a importância da avaliação da viabilidade celular de linfócitos como auxiliar no monitoramento da infecção pelo HIV. Participaram deste estudo 18 voluntários HIV soropositivos com contagem de linfócitos CD4 ≤ 200 células/mm3 e 14 voluntários HIV soropositivos com contagem de linfócitos CD4 ≥ 200 células/mm3. O ensaio de viabilidade celular foi realizado em citômetro de fluxo, modelo FACScalliburTM. A avaliação da viabilidade celular demonstrou níveis elevados de apoptose nos pacientes HIV soropositivos com contagem de linfócitos CD4 ≤ 200 células/mm3 (64,21± 15,26), assim como nos pacientes HIV soropositivos com contagem de linfócitos CD4 ≥ 200 células/mm3 (62,63...

Lipid and acute-phase protein alterations in HIV-1 infected patients in the early stages of infection: correlation with CD4+ lymphocytes.

Lipid and acute-phase protein alterations have been described in various infection diseases, and they have been recorded during the early stages of HIV infection. Lipid and acute-phase protein profiles also have been correlated with cellular immunological abnormalities. To document these correlations during HIV infection, we studied 75 HIV-infected patients and 26 HIV-negative controls. Patients were classified according to the criteria proposed by the Walter Reed Army Institute: as WR-1 (CD4 lymphocytes, 1154 +/- 268/mm3), WR-2 (CD4, 793 +/- 348/mm3) and WR3/4 (CD4, 287+/-75 mm3). Triglycerides, total cholesterol and HDL-cholesterol concentrations were measured by enzymatic methods. Immunoglobulins (IgA and IgG) and acute-phase proteins (haptoglobin, alpha1-acid glycoprotein, C-reactive protein and transferrin) were determined by immunonephelometry. Haptoglobin levels were significantly increased in HIV-positive patients and correlated with the progression of HIV-infection (control

Hepatitis B and hepatitis C prevalence among blood donors and HIV-1 infected patients in Florianópolis--Brazil.

Information is scarce on the prevalence of hepatitis B (HBV) and hepatitis C (HCV) among voluntary blood donors and patients infected with the human immunodeficiency virus (HIV) in Florianópolis, Brazil. A total of 2,678 serum samples from 2,583 blood donors and 95 HIV-infected patients, collected between April, 1994, and March, 1995, were examined for markers of HBV and HCV. All the samples were analyzed to detect HBV and HCV markers (HBsAg, anti-HBc, and anti-HCV). Hepatitis B and C prevalence among the studied blood donors reached 9.3% and 1.0%, respectively; 0.7% being seropositive for HBsAg and 9.2% for anti-HBc. It was also verified that 0.1% of blood donors were seropositive for HBsAg alone, 8.6% seropositive for the anti-HBc alone, and 0.6% presented a positive reaction for both of the HBV markers studied. Among HIV-infected patients, prevalence of 69.5% and 54.7% for hepatitis B and hepatitis C, respectively, were observed. Of these patients, 18.9% were seropositive for HBsAg, and 66.3% for the anti-HBc. The prevalence of a reaction for HBsAg alone, and for anti-HBc alone was 3.1% and 50.5%, respectively, for HIV-infected patients, whereas 15.8% were seropositive for both of the studied markers. HBV and HCV coinfection was 0.1% in blood donors, and 40% of those patients tested seropositive for HIV. Results show prevalence of HBV and HCV infection to be significantly greater among HIV-infected patients than among blood donors. These observations confirm the high frequency of HIV-infected patients exposure to these other viruses.

Decreased antioxidant defence in individuals infected by the human immunodeficiency virus.

BACKGROUND: The oxidative stress associated with HIV infection may be important for the progression of the disease because reactive oxygen species activate the nuclear transcription factor NF-kappaB, which is obligatory for HIV replication. PATIENTS AND METHODS: The activities of the antioxidant enzymes superoxide dismutase (SOD, EC 1.15.1.1) and glutathione peroxidase (GPx, EC 1.11.1.9) of blood plasma and peripheral blood mononuclear cells, as well as the plasma levels of ascorbate, alpha-tocopherol and beta-carotene, were measured in 75 subjects with HIV infection and in 26 controls. The HIV-infected patients were classified according to the Walter Reed Army Institute criteria. RESULTS: The extracellular SOD (EC-SOD) of blood plasma activity was decreased in HIV-infected patients compared to controls, while the SOD activity of mononuclear cells decreased with the HIV-associated disease progression. GPx activities and alpha-tocopherol concentration of HIV-infected patients neither differed as compared to controls nor in relation to disease progression. Lower concentrations of ascorbate and beta-carotene were found in HIV-infected patients than in controls. A positive correlation between CD4 lymphocyte counts and the SOD activities of plasma and mononuclear cells was found. CONCLUSION: These results suggest that abnormalities of antioxidant defence, mainly of SOD activity, are related to the progression of the HIV infection.

Prevalence of Serologic Markers of HBV and HCV Infection in HIV-1 Seropositive Patients in Florianópolis, Brazil.

B and C hepatitis are infections transmitted in ways similar to the human immunodeficiency virus (HIV). The present study was designed to assess the prevalence of hepatitis B (HBV) and hepatitis C (HCV) virus infection in HIV-1-infected patients who lived in the metropolitan areas of Florianópolis, in the State of Santa Catarina. Ninety-three patients seropositive to HIV-1 were identified by using enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence. Patients were assigned to according to HIV-1 transmission risk: homosexuals (n=20), heterosexuals (n=39), and intravenous drug users (IVDU) (N=34). HbsAg, Anti-HBc, Anti-HBc IgM and Anti-HCV measurements were done using ELISA. HBV and HCV prevalence in HIV-1 infected patients was 71% and 53.8%, respectively. In the IVDU group, the prevalence of HBV (85.3%), of HCV (88.2%), and infections by both viruses (76.5%) was greater than that observed in the heterosexual and homosexual groups. Hepatitis B markers (HbsAg and Anti-HBc) for chronic persistent disease were recorded in 24.3% of patients, and for past infection in 71.2% of patients. The evidence of high prevalence of HBV and HCV infections in HIV-1 seropositive patients, mainly among intravenous drug users, should be included in educational programs in an effort to decrease the incidence of multiple infections.

HIV influence on hematopoiesis at the initial stage of infection.

Alterations in the parameters responsible for the characteristic anemic condition of AIDS patients who are at the final stage of infection have already been established. However, the development of these alterations at the initial stage of infection, where no opportunistic infections occur, needs further study. The goal of this study was to verify whether laboratory alterations observed on patients at the final stages of the disease could already be seen at the beginning of HIV infection, or were the result of opportunistic infections. To that end, HIV-seropositive patients identified by the ELISA test and confirmed by immunofluorescence were screened by infectologist doctors and classified as per the Walter Reed Army Institute System. Results showed that thrombocytopenia occurred at an early stage during HIV infection. The number of leukocytes and erythrocytes diminished progressively as the disease advanced, and levels of hemoglobin, transferrin and serum iron were also diminished with the progression of the disease. These results indicate that the laboratory alterations observed in HIV-seropositive patients during the initial stages were, probably, due to virus infection, because these patients did not present opportunistic infections.

Morphofunctional Study of Blood Polymorphonuclear Leucocytes in HIV-Seropositive Individuals.

The impairment of leukocytic functions in AIDS infected individuals, where opportunistic infections are manifested, has been under study since 1985. However, controversy remains concerning leukocyte function during initial stages of HIV infection. In the context of the precarious immunologic and phagocytic defense of persons with AIDS, and the resulting difficulty they have to control microorganism invasion and opportunistic infections, examination of the host defense functions played by leukocytes in seropositive HIV persons is particularly important. To that end, our study sought to assess, during the initial stage of HIV infection, the laboratory parameters associated myeloid cells which are known to be altered during disease stage. Seventy-five (75) persons seropositive to HIV-1 (by the ELISA test, confirmed by immunofluorescence), and twenty-six (26) controls were tested. These individuals were screened by infectologists and their disease severity classified according to the Walter Reed Army Institute System. We observed that myeloperoxidase enzyme activity, superoxide anion production, and fungicidal action in homologous serum were all diminished in patients classified as WR-1, and progressively decreased in WR-2-4. The percent phagocytizing neutrophils and the number of C. albicans phagocytized were normal in WR-1 patients, but diminished in WR-2-4. We conclude that neutrophil function is diminished in HIV-infected persons at the beginning of infection, and that the defects increase as the HIV disease progresses.

Avaliaçäo da contagem diferencial de células sangüíneas por metodologia automatizada e microscopia / Diferential blood cells counting evaluation by automated methodology and optical microscopy

O hemograma é uma importante análise laboratorial de triagem na avaliaçäo dos fatores estimuladores e diferenciadores dos precursores hemopoiéticos medulares. Em condiçöes fisiológicas há equilíbrio entre a produçäo e a destruiçäo das células sangüíneas, realizada através de microscopia óptica e/ou automatizada, pode revelar possíveis variaçöes fisiológicas ou mesmo situaçöes patológicas. O objetivo deste estudo foi comparar os resultados da contagem de células sangüínas, empregando-se metodologia automatizada, com aqueles obtidos através da avaliaçäo diferencial por microscopia óptica. As análises das células sangüíneas de 558 pacientes atendidos no Hospital Universitário foram realizadas no setor de Hematologia do Laboratório de Análises Clínicas. Os resultados deste estudo demonstram que através da metodologia automatizada determinou-se número significamente maior de neutrófilos (p<0,05) e de monócitos (p<0,0001), em relaçäo àqueles determinados por microscopia óptica. Nas determinaçöes de plaquetas, linfócitos, eosinófilos e basófilos, näo foram observadas variaçöes significativas entre os métodos avaliados (p>0,05). Esses dados sugerem que apesar da agilidade dos métodos automatizados, quando o aparelho apresentar alarmes específicos em sua leitura, a análise por microscopia óptica, ainda é indispensável afim de minimizar as limitaçöes na contagem diferencial das células sangüíneas realizadas em aparelhos automatizados, e assim garantir a qualidade do resultado