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Chen GH, Dai YC, Hsieh SC, Tsai JJ, Sy AK, Jiz M, Pedroso C, Brites C, Netto EM, Kanki PJ, Saunders DRD, Vanlandingham DL, Higgs S, Huang YJS, Wang WK. Detection of anti-premembrane antibody as a specific marker of four flavivirus serocomplexes and its application to serosurveillance in endemic regions. Emerg Microbes Infect 2024; 13:2301666. [PMID: 38163752 PMCID: PMC10810658 DOI: 10.1080/22221751.2023.2301666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/30/2023] [Indexed: 01/03/2024]
Abstract
In the past few decades, several emerging/re-emerging mosquito-borne flaviviruses have resulted in disease outbreaks of public health concern in the tropics and subtropics. Due to cross-reactivities of antibodies recognizing the envelope protein of different flaviviruses, serosurveillance remains a challenge. Previously we reported that anti-premembrane (prM) antibody can discriminate between three flavivirus infections by Western blot analysis. In this study, we aimed to develop a serological assay that can discriminate infection or exposure with flaviviruses from four serocomplexes, including dengue (DENV), Zika (ZIKV), West Nile (WNV) and yellow fever (YFV) viruses, and explore its application for serosurveillance in flavivirus-endemic countries. We employed Western blot analysis including antigens of six flaviviruses (DENV1, 2 and 4, WNV, ZIKV and YFV) from four serocomplexes. We tested serum samples from YF-17D vaccinees, and from DENV, ZIKV and WNV panels that had been confirmed by RT-PCR or by neutralization assays. The overall sensitivity/specificity of anti-prM antibodies for DENV, ZIKV, WNV, and YFV infections/exposure were 91.7%/96.4%, 91.7%/99.2%, 88.9%/98.3%, and 91.3%/92.5%, respectively. When testing 48 samples from Brazil, we identified multiple flavivirus infections/exposure including DENV and ZIKV, DENV and YFV, and DENV, ZIKV and YFV. When testing 50 samples from the Philippines, we detected DENV, ZIKV, and DENV and ZIKV infections with a ZIKV seroprevalence rate of 10%, which was consistent with reports of low-level circulation of ZIKV in Asia. Together, these findings suggest that anti-prM antibody is a flavivirus serocomplex-specific marker and can be employed to delineate four flavivirus infections/exposure in regions where multiple flaviviruses co-circulate.
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Affiliation(s)
- Guan-Hua Chen
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yu-Ching Dai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Szu-Chia Hsieh
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ava Kristy Sy
- National Reference Laboratory for Dengue and Other Arbovirus, Virology Department, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Mario Jiz
- Immunology Department, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Celia Pedroso
- LAPI-Laboratório de Pesquisa em Infectologia-School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Carlos Brites
- LAPI-Laboratório de Pesquisa em Infectologia-School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Eduardo Martins Netto
- LAPI-Laboratório de Pesquisa em Infectologia-School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Phyllis J. Kanki
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Dana L. Vanlandingham
- Biosecurity Research Institute and Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Stephen Higgs
- Biosecurity Research Institute and Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Yan-Jang S. Huang
- Biosecurity Research Institute and Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Wei-Kung Wang
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
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Vechi HT, Bay MB, de Freitas CHS, de Sant’anna JGFC, Brites C, de Lima KC. Factors associated with hepatitis A susceptibility among men who have sex with men using HIV pre-exposure prophylaxis in Northeastern Brazil: A cross-sectional study. PLoS One 2024; 19:e0301397. [PMID: 38547222 PMCID: PMC10977755 DOI: 10.1371/journal.pone.0301397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/11/2024] [Indexed: 04/02/2024] Open
Abstract
Hepatitis A virus (HAV) infection has disproportionately affected more men who have sex with men (MSM), occurring in outbreaks, despite being vaccine-preventable. We determined the prevalence and factors associated with HAV susceptibility among cisgender MSM on HIV pre-exposure prophylaxis (PrEP) in Northeastern Brazil. From September 30, 2021 to June 19, 2023, 282 cisgender MSM receiving HIV PrEP were enrolled into this cross-sectional study. Sociodemographic and clinical information were collected. Blood samples were collected for screening of sexually transmitted infections (STIs) and serum samples were tested for IgM and total anti-HAV antibodies. Non-reactive results for total anti-HAV antibodies were found in 106 of 282 (37.6%) participants. Factors associated with HAV susceptibility included age <30 years (prevalence ratio [PR]: 2.02; 95% confidence interval [95% CI]: 1.61-2.53), having health insurance (PR: 1.39; 95% CI: 1.19-1.64), sex only with cisgender men (PR: 1.52; 95% CI: 1.23-1.89), non-steady partner (PR: 1.20; 95% CI: 1.01-1.43) and no lifetime history of STIs (PR: 1.25; 95% CI: 1.03-1.53). Identifying clinical correlates of HAV susceptibility in key populations is a fundamental step towards development of public policy focused on prevention, especially following the recent hepatitis A outbreak in Brazil.
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Affiliation(s)
- Hareton Teixeira Vechi
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Multicampi School of Medical Sciences, Federal University of Rio Grande do Norte, Caicó, Rio Grande do Norte, Brazil
| | - Mônica Baumgardt Bay
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Cláudio Henrique Silva de Freitas
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Carlos Brites
- Hospital Universitário Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Kenio Costa de Lima
- Department of Odontology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Oliveira RC, Souza JSMD, Alcântara LCJ, Guimarães ML, Brites C, Monteiro-Cunha JP. Molecular and Phylogenetic Analysis of HIV-1 Subtype C in Bahia State, Northeastern Brazil. AIDS Res Hum Retroviruses 2024; 40:37-41. [PMID: 37312563 DOI: 10.1089/aid.2023.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
HIV-1 subtype C is associated with more than half of infections in southern Brazil and has been increasing in other regions of the country. In a previous study carried out in northeastern Brazil, we found a prevalence of 4.1% of subtype C. This work investigates the origin of subtype C in the state of Bahia based on five new viral sequences. The phylogenetic analysis showed that subtype C viruses found in Bahia descend from the main lineage that circulates in other Brazilian regions.
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Affiliation(s)
- Rodrigo Cunha Oliveira
- Departamento de Bioquímica e Biofísica, Núcleo de Bioinformática, Universidade Federal da Bahia, Salvador, Brasil
| | | | | | | | - Carlos Brites
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brasil
| | - Joana Paixão Monteiro-Cunha
- Departamento de Bioquímica e Biofísica, Núcleo de Bioinformática, Universidade Federal da Bahia, Salvador, Brasil
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Tosta BR, de Almeida IM, da Cruz Pena L, Dos Santos Silva H, Reis-Goes FS, Silva NN, Cruz JVA, Dos Anjos Silva M, de Araújo JF, Rodrigues JL, Oliveira G, Figueiredo RG, Vaz SN, Montaño-Castellón I, Santana D, de Lima Beltrão FE, Carneiro VL, Campos GS, Brites C, Fortuna V, Figueiredo CA, Trindade SC, Ramos HE, Costa RDS. MTOR gene variants are associated with severe COVID-19 outcomes: A multicenter study. Int Immunopharmacol 2023; 125:111155. [PMID: 37951192 DOI: 10.1016/j.intimp.2023.111155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/13/2023]
Abstract
BACKGROUND The worst outcomes linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been attributed to the cytokine storm, which contributes significantly to the immunopathogenesis of the disease. The mammalian target of rapamycin (mTOR) pathway is essential for orchestrating innate immune cell defense including cytokine production and is dysregulated in severe Coronavirus Disease 2019 (COVID-19) individuals. The individual genetic background might play a role in the exacerbated immune response. OBJECTIVE In this study, we aimed to investigate the association between MTOR genetic variants and COVID-19 outcomes. METHODS This study enrolled groups of individuals with severe (n = 285) and mild (n = 207) COVID-19 from Brazilian states. The MTOR variants, rs1057079 and rs2536, were genotyped. A logistic regression analysis and Kaplan-Meier survival curves were performed. We applied a genotyping risk score to estimate the cumulative contribution of the risk alleles. Tumor necrosis factor (TNF) and interleukin-6 (IL-6) plasma levels were also measured. RESULTS The T allele of the MTOR rs1057079 variant was associated with a higher likelihood of developing the most severe form of COVID-19. In addition, higher levels of IL-6 and COVID-19 death was linked to the T allele of the rs2536 variant. These variants exhibited a cumulative risk when inherited collectively. CONCLUSIONS These results show a potential pathogenetic role of MTOR gene variants and may be useful for predicting severe outcomes following COVID-19 infection, resulting in a more effective allocation of health resources.
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Affiliation(s)
- Bruna Ramos Tosta
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Ingrid Marins de Almeida
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Laiane da Cruz Pena
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Hatilla Dos Santos Silva
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Fabiane S Reis-Goes
- Laboratório de Imunologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Nívia N Silva
- Laboratório de Imunologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - João Victor Andrade Cruz
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Mailane Dos Anjos Silva
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Jéssica Francisco de Araújo
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Juliana Lopes Rodrigues
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | | | | | - Sara Nunes Vaz
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil
| | - Iris Montaño-Castellón
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil
| | - Daniele Santana
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil
| | | | | | - Gubio Soares Campos
- Laboratório de Virologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Carlos Brites
- Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil
| | - Vitor Fortuna
- Laboratório de Imunologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Camila Alexandrina Figueiredo
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil
| | - Soraya Castro Trindade
- Laboratório de Imunologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil; Universidade Estadual de Feira de Santana, Bahia, Brazil
| | - Helton Estrela Ramos
- Programa de Pós-Graduação em Processos Interativos de Órgãos e Sistema, Instituto de Saúde e Ciência, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Ryan Dos Santos Costa
- Laboratório de Imunofarmacologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil.
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Luz I, Vinhaes E, Cruz I, Travassos AG, Luz E, Netto EM, Brites C. High Prevalence of Anal Sexually Transmitted Infections among Men Who Have Sex with Men and Transgender Women Attending a Clinic for Prevention of Anal Cancer in Salvador, Brazil. Pathogens 2023; 12:1297. [PMID: 38003762 PMCID: PMC10675476 DOI: 10.3390/pathogens12111297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Men who have sex with men (MSM) and transgender women (TGW) are highly vulnerable to anal sexually transmitted infections (STIs). Objectives-to evaluate the prevalence of anal STIs among MSM and TGW attending a referral clinic for anal cancer prevention. Methods-MSM and TGW attending a medical visit for high-resolution anoscopy in Salvador, Brazil, from February 2021 to June 2022 were screened for HPV, gonorrhea, and chlamydial infection by PCR of anal swab and by serum VDRL titration for syphilis screening. They also responded to a questionnaire on sociodemographic characteristics and sexual behavior. Results-we evaluated 141 participants: 117 (82.9%) MSM, 9 (6.4%) bisexual men (BSM), and 15 (10.6%) TGW. Most (111/141, 78.7%) were older than 30 years, 89 (63.1%) had over 12 years of education, and 124 (87.9%) had a family income of up to five minimum wages. At least one STI was detected in 112 (79.4%) of the participants (86.7% among TGW). HIV infection was detected in 102 (72.3%) participants; HIV frequency was higher in BSM (7/9, 88.9%) and in MSM (89/116, 76.1%) than in TGW (5/15, 33.3%). A lower income (p = 0.004) was predictive of anal STIs, while syphilis was significantly more frequent among participants with HIV (29.1% vs. 5,3%, for HIV positive and negative, respectively, p = 0.002). Presenting at least one active STI was also associated with having had group sex in the last year (p = 0.03) and with use of sexualized drugs (p = 0.02). Conclusions-MSM and TGW present a high vulnerability to anal STIs. Number of sexual partners, use of sexualized drugs, and lower income are predictive of a higher risk of acquiring an STI in such populations.
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Affiliation(s)
- Ivana Luz
- Fundação Bahiana de Infectologia, Salvador 40110-060, Brazil; (I.L.); (E.V.); (E.L.); (E.M.N.)
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Eda Vinhaes
- Fundação Bahiana de Infectologia, Salvador 40110-060, Brazil; (I.L.); (E.V.); (E.L.); (E.M.N.)
| | - Isabela Cruz
- Hospital Universitário Professor Edgard Santos, UFBA-EBSERH, Salvador 40110-060, Brazil;
| | | | - Estela Luz
- Fundação Bahiana de Infectologia, Salvador 40110-060, Brazil; (I.L.); (E.V.); (E.L.); (E.M.N.)
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Eduardo Martins Netto
- Fundação Bahiana de Infectologia, Salvador 40110-060, Brazil; (I.L.); (E.V.); (E.L.); (E.M.N.)
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Carlos Brites
- Fundação Bahiana de Infectologia, Salvador 40110-060, Brazil; (I.L.); (E.V.); (E.L.); (E.M.N.)
- Hospital Universitário Professor Edgard Santos, UFBA-EBSERH, Salvador 40110-060, Brazil;
- School of Medicine, Universidade Federal da Bahia, Salvador 40110-060, Brazil
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Patiño Escarcina JE, Netto EM, Brites C. Long-term outcomes of highly experienced people with HIV undergoing salvage therapy with raltegravir. Medicine (Baltimore) 2023; 102:e35407. [PMID: 37800823 PMCID: PMC10553021 DOI: 10.1097/md.0000000000035407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023] Open
Abstract
Raltegravir and other third-line drugs have shown promise in improving outcomes in treatment-experienced patients. However, the efficacy and tolerability of these agents vary. This study assessed real-life virologic success, long-term survival, and adverse events in patients receiving raltegravir or other third-line drugs as salvage regimens. This retrospective cohort study included adults who experienced treatment failure (human immunodeficiency syndrome-1 RNA plasma viral load >1000 copies/mL) and subsequently initiated raltegravir or other third-line drugs (darunavir/ritonavir, maraviroc, or etravirine). Propensity score matching methods were employed to account for differences at the time of switching from failing antiretroviral therapy regimens. The matched subset was analyzed using the Kaplan-Meier method and Generalized Wilcoxon tests to evaluate the probability of achieving virologic suppression (plasma viral load <50 copies/mL). Mortality rates, toxicity, treatment interruption, virologic failure, and loss to follow-up were determined using Poisson regression. One hundred and sixty-eight patients initiating salvage regimens were included, with 123 receiving raltegravir and 45 other third-line drugs. Propensity score matching resulted in a subset of 90 patients, 45 in each group. During the follow-up period, there were no significant differences observed between the groups in terms of virologic suppression (77.8% vs 82.2%, P = .73), mortality rates (4.04 vs 6.18 persons per 100 person-years [p-y]; P = .67), drug toxicity (0.00 vs 2.06 persons per 100 p-y; P = .49), treatment interruption (8.07 vs 0.00 persons per 100 p-y; P = .06), virologic failure (2.02 vs 4.12 persons per 100 p-y; P = .61), and loss of follow-up (6.05 vs 4.12 persons per 100 p-y; P = .70). Our findings indicate comparable survival and virological success rates between raltegravir and other drugs used in salvage regimens. Similar rates of drug toxicity, treatment interruption, virologic failure, and loss of follow-up were also observed. These results suggest that raltegravir may be a viable option for salvage therapy, demonstrating outcomes comparable to other third-line drugs in real life.
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Affiliation(s)
| | - Eduardo Martins Netto
- LAPI - Infectious Disease Research Laboratory, Complexo Hospitalar Universitário Profesor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Carlos Brites
- Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
- LAPI - Infectious Disease Research Laboratory, Complexo Hospitalar Universitário Profesor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
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De Castro N, Chazallon C, Brites C, Messou E, Khosa C, Laureillard D, Chau GD, Pilotto JH, Eholié S, Delaugerre C, Molina JM, Wittkop L, Grinsztejn B, Marcy O. Virologic response to antiretroviral therapy in people with HIV and tuberculosis in high tuberculosis burden countries. AIDS 2023; 37:1837-1842. [PMID: 36928120 DOI: 10.1097/qad.0000000000003521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE We sought to compare virologic outcomes on antiretroviral therapy (ART) between people with HIV (PWH) also treated for tuberculosis in the different countries who participated to two randomized trials. DESIGN Pooled analysis of two randomized clinical trials. METHODS In the phase II Reflate TB and phase III Reflate TB2 trials conducted in Brazil, Côte d'Ivoire, Mozambique and Vietnam, ART-naïve PWH treated for tuberculosis were randomized to receive raltegravir or efavirenz. We assessed country differences in baseline characteristic using Wilcoxon tests and chi-square, or Fisher's exact test. We used logistic regression to analyze determinants of virologic success, defined as week-48 plasma HIV-1 RNA <50 copies/ml. RESULTS Of 550 participants (140 from Brazil, 170 from Côte d'Ivoire, 129 from Mozambique and 111 from Vietnam) with median baseline HIV-1 RNA of 5.4 log 10 copies/ml, 362 (65.8%) achieved virologic success at week 48. Virologic success rates were: 105/140 (75.0%) in Brazil, 99/170 (58.2%) in Côte d'Ivoire, 84/129 (65.1%) in Mozambique and 74/111 (66.7%) in Vietnam ( P = 0.0233). Baseline HIV-1 RNA, but not the country, was independently associated with virologic success: baseline HIV-1 RNA ≥500 000 copies/ml (reference), HIV RNA <100 000 copies/ml odds ratio 3.12 [95% confidence interval (CI) 1.94; 5.01] and HIV-1 RNA 100 000-499 999 copies/ml odds ratio: 1.80 (95% CI 1.19; 2.73). Overall, 177/277 (63.9%) patients treated with raltegravir and 185/273 (67.9%) patients treated with efavirenz had a plasma HIV-1 RNA <50 copies/ml at week 48. CONCLUSIONS Virologic response to antiretroviral therapy in PWH with TB varied across countries but was mainly driven by levels of pretreatment HIV-1 RNA.
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Affiliation(s)
- Nathalie De Castro
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
- Infectious Diseases Department, AP-HP-Hôpital Saint-Louis Lariboisière, Paris, France
| | - Corine Chazallon
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
| | - Carlos Brites
- Laboratório de Pesquisa em Doenças Infecciosas, Hospital Universitário Prof Edgar Santos, Bahia, Brazil
| | - Eugène Messou
- Programme PACCI/ANRS Research Center
- Centre de Prise en Charge de Recherche et de Formation, CePReF-Aconda-VS, Abidjan, Cote D'Ivoire
- Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Cote d'Ivoire
| | - Celso Khosa
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Didier Laureillard
- Department of Infectious and Tropical Diseases, Nimes University Hospital, Nimes
- Research Unit 1058, Pathogenesis and Control Chronical Infections, INSERM, French Blood Center, University of Montpellier, Montpellier, France
| | - Giang D Chau
- Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam
| | - José H Pilotto
- Laboratorio de AIDS e Imunologia Molecular-IOC/Fiocruz, Rio de Janeiro, Brazil
| | - Serge Eholié
- Programme PACCI/ANRS Research Center
- Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Cote d'Ivoire
| | - Constance Delaugerre
- Virology department, APHP-Hôpital Saint-Louis
- INSERM U944
- Université Paris Cité, Paris
| | - Jean-Michel Molina
- Infectious Diseases Department, AP-HP-Hôpital Saint-Louis Lariboisière, Paris, France
- INSERM U944
- Université Paris Cité, Paris
| | - Linda Wittkop
- University Bordeaux, INSERM, Institut Bergonié, Bordeaux
- INRIA SISTM team, Talence
- CHU de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, Bordeaux, France
| | - Beatriz Grinsztejn
- National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Olivier Marcy
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
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Postigo-Hidalgo I, Jo WK, Pedroso C, Brites C, Drexler JF. Introduction of chikungunya virus in coastal northeast Brazil. Lancet Microbe 2023; 4:e764. [PMID: 37385284 DOI: 10.1016/s2666-5247(23)00176-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 07/01/2023]
Affiliation(s)
- Ignacio Postigo-Hidalgo
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, 10117 Berlin, Germany
| | - Wendy K Jo
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, 10117 Berlin, Germany
| | - Celia Pedroso
- Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | - Carlos Brites
- Hospital Universitário Professor Edgard Santos, Universidade Federal de Bahia, Salvador, Brazil
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, 10117 Berlin, Germany; German Centre for Infection Research (DZIF), associated partner Charité-Universitätsmedizin Berlin, Berlin, Germany.
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da Silva ACG, Lins-Kusterer L, Luz E, Brites C. Development and Validation of a Transgender Health Care Humanization Scale. Transgend Health 2023; 8:444-449. [PMID: 37810935 PMCID: PMC10551756 DOI: 10.1089/trgh.2021.0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose Stigma and discrimination against transgender people can lead to their segregation. Fighting stigma and discrimination is a crucial strategy to expand access to health services. The goals of the present study were to develop and validate a transgender health care humanization scale (THcH scale) to evaluate the perception of humanization in health care for transgender individuals. Methods This cross-sectional study included 340 health care providers aged ≥18 years. Participants answered a structured questionnaire when attending HIV/AIDS scientific meetings or at their place of work. An exploratory factor analysis was conducted, using a polychoric matrix and robust diagonally weighted least squares extraction method. The number of retained factors was defined through the parallel analysis technique, with random permutation of the observed data and the use of Robust Promin rotation. Results The interpretability of correlation matrix items was suggested by the Bartlett's sphericity tests (1633.7, df=91; p<0.001) and Kaiser-Meyer-Olkin Test (0.875). The factor structure showed adequate adjustment indices (χ2=44,200, df=52; root mean square error of approximation p<0.05; comparative fit index=0.968; Tucker-Lewis index=0.945; goodness-of-fit index = 0.995). Only one factor was retained by parallel analysis, explained by 54.17% of the variance of the construct and confirmed by the following indices: unidimensional congruence=0.902, explained common variance=0.828, and mean of item residual absolute loadings=0.279. Good reliability was confirmed by Cronbach's alpha test (0.899). Conclusion The THcH scale showed good psychometric properties. This self-report questionnaire, which can be completed in 5 min, may be useful in scientific research and could guide health care providers in expansion of a Health Humanization Policy and in deconstructing prejudice against transgender people in health care settings.
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Affiliation(s)
- Ana Clara Guimarães da Silva
- LAPI-Laboratório de Pesquisa em Infectologia, Federal University of Bahia, Hospital Universitário Professor Edgard Santos, Salvador, Brazil
- Post-Graduation Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Liliane Lins-Kusterer
- LAPI-Laboratório de Pesquisa em Infectologia, Federal University of Bahia, Hospital Universitário Professor Edgard Santos, Salvador, Brazil
- Post-Graduation Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Estela Luz
- LAPI-Laboratório de Pesquisa em Infectologia, Federal University of Bahia, Hospital Universitário Professor Edgard Santos, Salvador, Brazil
- Post-Graduation Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Carlos Brites
- LAPI-Laboratório de Pesquisa em Infectologia, Federal University of Bahia, Hospital Universitário Professor Edgard Santos, Salvador, Brazil
- Post-Graduation Program in Medicine and Health, School of Medicine, Federal University of Bahia, Salvador, Brazil
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10
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Chen GH, Dai YC, Hsieh SC, Tsai JJ, Sy AK, Jiz M, Pedroso C, Brites C, Netto EM, Kanki PJ, Saunders DRD, Vanlandingham DL, Higgs S, Huang YJS, Wang WK. Detection of anti-premembrane antibody as a specific marker of four flavivirus serocomplexes and its application to serosurveillance in endemic regions. medRxiv 2023:2023.09.21.23295701. [PMID: 37808865 PMCID: PMC10557774 DOI: 10.1101/2023.09.21.23295701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
In the past few decades, several emerging/re-emerging mosquito-borne flaviviruses have resulted in disease outbreaks of public health concern in the tropics and subtropics. Due to cross-reactivities of antibodies recognizing the envelope protein of different flaviviruses, serosurveillance remains a challenge. Previously we reported that anti-premembrane (prM) antibody can discriminate between three flavivirus infections by Western blot analysis. In this study, we aimed to develop a serological assay that can discriminate infection or exposure with flaviviruses from four serocomplexes, including dengue (DENV), Zika (ZIKV), West Nile (WNV) and yellow fever (YFV) viruses, and explore its application for serosurveillance in flavivirus-endemic countries. We employed Western blot analysis including antigens of six flaviviruses (DENV1, 2 and 4, WNV, ZIKV and YFV) from four serocomplexes. We tested serum samples from YF-17D vaccinees, and from DENV, ZIKV and WNV panels that had been confirmed by RT-PCR or by neutralization assays. The overall sensitivity/specificity of anti-prM antibodies for DENV, ZIKV, WNV, and YFV infections/exposure were 91.7%/96.4%, 91.7%/99.2%, 88.9%/98.3%, and 91.3%/92.5%, respectively. When testing 48 samples from Brazil, we identified multiple flavivirus infections/exposure including DENV and ZIKV, DENV and YFV, and DENV, ZIKV and YFV. When testing 50 samples from the Philippines, we detected DENV, ZIKV, and DENV and ZIKV infections with a ZIKV seroprevalence rate of 10%, which was consistent with reports of low-level circulation of ZIKV in Asia. Together, these findings suggest that anti-prM antibody is a flavivirus serocomplex-specific marker and can be employed to delineate four flavivirus infections/exposure in regions where multiple flaviviruses co-circulate.
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11
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de Santana DS, Netto EM, Vaz SN, Dantas PH, Brites C. Seroprevalence and indexes of IgG antibodies for SARS-CoV-2 infection among People Living With HIV, tuberculosis patients and healthcare workers, in Salvador, Brazil. Braz J Infect Dis 2023; 27:102811. [PMID: 37813359 PMCID: PMC10582833 DOI: 10.1016/j.bjid.2023.102811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/13/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023] Open
Abstract
INTRODUCTION COVID-19 can trigger different clinical presentations in distinct population groups, some of which are considered at higher risk of SARS-CoV-2 infection. Little is known about the susceptibility of certain populations to the infection. OBJECTIVES We aimed to determine the prevalence of COVID-19 among People Living With HIV/AIDS (PLWH) attending a tertiary public hospital in Salvador, Brazil, patients with active pulmonary tuberculosis and Hospital's Healthcare Workers (HCW), and to compare their SARS-CoV-2 antibody levels. METHODS In this observational study we included 2294 participants from June 9, 2020 to August 10, 2021. IgG SARS-CoV-2 antibodies from all participants (275 PLWH, 42 with active tuberculosis and 1977 healthcare workers) were measured. Prevalence of COVID-19 and antibodies indexes were compared across groups. RESULTS We detected a higher prevalence of COVID-19 in patients with active tuberculosis (42.9%) than in PLWH (22.5%) or HCW (11.7%). Previously vaccinated participants with a COVID-19 history had median higher IgG antibody indexes (8.2; IQR: 5.5‒10) than those vaccinated who did not have COVID-19 until the time of this study (4.1; IQR: 1.6‒6.2, p < 0.001). CONCLUSION Prevalence of previous SARS-CoV-2 infection was higher among tuberculosis patients than that found in HCW and PLWH, but antibodies levels were similar across groups.
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Affiliation(s)
- Daniele Souza de Santana
- Universidade Federal da Bahia (UFBA/EBSERH), Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia, Salvador, BA, Brazil
| | - Eduardo Martins Netto
- Universidade Federal da Bahia (UFBA/EBSERH), Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia, Salvador, BA, Brazil; Fundação Bahiana de Infectologia, Salvador, BA, Brazil
| | - Sara Nunes Vaz
- Universidade Federal da Bahia (UFBA/EBSERH), Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia, Salvador, BA, Brazil; Fundação Bahiana de Infectologia, Salvador, BA, Brazil
| | - Paulo Henrique Dantas
- Universidade Federal da Bahia (UFBA/EBSERH), Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia, Salvador, BA, Brazil
| | - Carlos Brites
- Universidade Federal da Bahia (UFBA/EBSERH), Hospital Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia, Salvador, BA, Brazil; Fundação Bahiana de Infectologia, Salvador, BA, Brazil.
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12
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Cardoso-Neto ÉC, Netto EM, Brites C. Weight gain in patients starting Dolutegravir-based ART according to baseline CD4 count after 48 weeks of follow up. Braz J Infect Dis 2023; 27:102807. [PMID: 37788801 PMCID: PMC10569987 DOI: 10.1016/j.bjid.2023.102807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/28/2023] [Accepted: 09/14/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Excessive weight gain is a current concern among People Living with HIV (PLHIV) starting ART. OBJECTIVES To evaluate the weight gain after 48-weeks of ART in naive patients, according with baseline CD4 count. METHODS PLHIV starting 3TC + TDF + DTG with at least 48-weeks of follow up in two AIDS referral centers were stratified by baseline CD4 count (lower or higher than 200 cells/mm3). Data on CD4 count, HIV viral load, weight/Body Mass Index (BMI), lipids and glucose levels were collected at baseline, 24 and 48 weeks of treatment. For analysis purpose, patients were categorized according to their BMI progression. RESULTS A total of 270 patients were included in the study. Mean CD4 count were 78.3 ± 61.7 and 536.7 ± 273 cells/mm3 for low and high CD4 count groups, respectively (p < 0.001). Baseline BMI was significantly lower in low CD4 group (21.7 vs. 23.6 Kg/m2, p < 0.001). Patients in low CD4 group gained more weight than those in high CD4 group (11.2 ± 8.5 kg vs. 2.2 ± 4.2 Kg, p = 0.004). Overall weight gain was higher in women, regardless group (13.1 ± 7.9 Kg vs. 1.4 ± 3.6 Kg for women and men, respectively, p < 0.001). The proportion of overweight/obesity significantly increased in low CD4 group. Viral suppression rate was high for both groups. At week 48 the overall proportion of overweight/obesity was like that reported for the Brazilian population. CONCLUSIONS Weight gain in the present study indicates a "return to health" phenomenon. Excessive weight gain was more frequent in women.
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Affiliation(s)
| | | | - Carlos Brites
- Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BA, Brazil; Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil.
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13
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Tsai JJ, Tsai CY, Lin PC, Chen CH, Tsai WY, Dai YC, Lin YC, Pedroso C, Brites C, Wang WK. Correction to: Comparing the performance of dengue virus IgG and IgG-capture enzyme-linked immunosorbent assays in seroprevalence study. BMC Infect Dis 2023; 23:401. [PMID: 37312023 DOI: 10.1186/s12879-023-08360-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ping-Chang Lin
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, Zhunan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Wen-Yang Tsai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yu-Ching Dai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yen-Chia Lin
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Celia Pedroso
- LAPI-Laboratório de Pesquisa em Infectologia-School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Carlos Brites
- LAPI-Laboratório de Pesquisa em Infectologia-School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Wei-Kung Wang
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
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14
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de Oliveira Almeida K, Nogueira Alves IG, de Queiroz RS, de Castro MR, Gomes VA, Santos Fontoura FC, Brites C, Neto MG. A systematic review on physical function, activities of daily living and health-related quality of life in COVID-19 survivors. Chronic Illn 2023; 19:279-303. [PMID: 35404175 PMCID: PMC9006095 DOI: 10.1177/17423953221089309] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To analyze the published studies that investigated the physical function, activities of daily living and health-related quality of life in COVID-19 survivors. DESIGN Systematic review. METHODS We searched MEDLINE/PubMed, Scopus, SciELO, and Cochrane Library for studies that evaluated the physical function, activities of daily living and health-related quality of life after COVID-19 from the earliest date available to July 2021. Two independent reviewers screened and selected the studies. The Newcastle Ottawa Scale was used to evaluate methodological quality. RESULTS We included 35 studies in this systematic review. Of the 35 studies included, 28 were cohort, and 7 cross-sectional studies The studies demonstrated that COVID-19 survivors had reduced levels of physical function, activities of daily living, and health-related quality of life. Furthermore, incomplete recovery of physical function, and performance in activities of daily living were observed 1 to 6 months post-infection. DISCUSSION Physical disability and reduction in health-related quality of life is a common condition in post-COVID-19 and impairments may persist up to 1 to 6 months. Researchers and clinicians can use these findings to understand the potential disabilities and rehabilitation needs of people recovering from the COVID-19.
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Affiliation(s)
- Katna de Oliveira Almeida
- 28111Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Iura Gonzalez Nogueira Alves
- Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Department of Medicine, Bahiana School of Medicine and Public Health (BSMPH), Salvador, Bahia, Brazil
| | - Rodrigo Santos de Queiroz
- 28111Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Marcela Rodrigues de Castro
- Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Educação Física, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Vinicius Afonso Gomes
- Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Hospital Especializado Octávio Mangabeira, Salvador, Bahia, Brazil
| | - Fabiane Costa Santos Fontoura
- Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Hospital Especializado Octávio Mangabeira, Salvador, Bahia, Brazil
| | - Carlos Brites
- 28111Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Mansueto Gomes Neto
- 28111Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
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15
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Tsai JJ, Tsai CY, Lin PC, Chen CH, Tsai WY, Dai YC, Lin YC, Pedroso C, Brites C, Wang WK. Comparing the performance of dengue virus IgG and IgG-capture enzyme-linked immunosorbent assays in seroprevalence study. BMC Infect Dis 2023; 23:301. [PMID: 37158835 PMCID: PMC10165301 DOI: 10.1186/s12879-023-08307-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/05/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Dengue virus (DENV) is the leading cause of arboviral diseases in humans worldwide. Currently Dengvaxia, the first dengue vaccine licensed in 20 countries, was recommended for DENV seropositive individuals aged 9-45 years. Studying dengue seroprevalence can improve our understanding of the epidemiology and transmission dynamics of DENV, and facilitate future intervention strategies and assessment of vaccine efficacy. Several DENV envelope protein-based serological tests including IgG and IgG-capture enzyme-linked immunosorbent assays (ELISAs) have been employed in seroprevalence studies. Previously DENV IgG-capture ELISA was reported to distinguish primary and secondary DENV infections during early convalescence, however, its performance over time and in seroprevalence study remains understudied. METHODS In this study, we used well-documented neutralization test- or reverse-transcription-polymerase-chain reaction-confirmed serum/plasma samples including DENV-naïve, primary and secondary DENV, primary West Nile virus, primary Zika virus, and Zika with previous DENV infection panels to compare the performance of three ELISAs. RESULTS The sensitivity of the InBios IgG ELISA was higher than that of InBios IgG-capture and SD IgG-capture ELISAs. The sensitivity of IgG-capture ELISAs was higher for secondary than primary DENV infection panel. Within the secondary DENV infection panel, the sensitivity of InBios IgG-capture ELISA decreased from 77.8% at < 6 months to 41.7% at 1-1.5 years, 28.6% at 2-15 years and 0% at > 20 years (p < 0.001, Cochran-Armitage test for trend), whereas that of IgG ELISA remains 100%. A similar trend was observed for SD IgG-capture ELISA. CONCLUSIONS Our findings demonstrate higher sensitivity of DENV IgG ELISA than IgG-capture ELISA in seroprevalence study and interpretation of DENV IgG-capture ELISA should take sampling time and primary or secondary DENV infection into consideration.
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Affiliation(s)
- Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ping-Chang Lin
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, Zhunan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Wen-Yang Tsai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yu-Ching Dai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yen-Chia Lin
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Celia Pedroso
- LAPI-Laboratório de Pesquisa em Infectologia-School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Carlos Brites
- LAPI-Laboratório de Pesquisa em Infectologia-School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Wei-Kung Wang
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
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16
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Lundgren JD, Babiker AG, Sharma S, Grund B, Phillips AN, Matthews G, Kan VL, Aagaard B, Abo I, Alston B, Arenas-Pinto A, Avihingsanon A, Badal-Faesen S, Brites C, Carey C, Casseb J, Clarke A, Collins S, Corbelli GM, Dao S, Denning ET, Emery S, Eriobu N, Florence E, Furrer H, Fätkenheuer G, Gerstoft J, Gisslén M, Goodall K, Henry K, Horban A, Hoy J, Hudson F, Azwa RISR, Kedem E, Kelleher A, Kityo C, Klingman K, Rosa AL, Leturque N, Lifson AR, Losso M, Lutaakome J, Madero JS, Mallon P, Mansinho K, Filali KME, Molina JM, Murray DD, Nagalingeswaran K, Nozza S, Ormaasen V, Paredes R, Peireira LC, Pillay S, Polizzotto MN, Raben D, Rieger A, Sanchez A, Schechter M, Sedlacek D, Staub T, Touloumi G, Turner M, Madruga JV, Vjecha M, Wolff M, Wood R, Zilmer K, Lane HC, Neaton JD. Long-Term Benefits from Early Antiretroviral Therapy Initiation in HIV Infection. NEJM Evid 2023; 2:10.1056/evidoa2200302. [PMID: 37213438 PMCID: PMC10194271 DOI: 10.1056/evidoa2200302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND For people with HIV and CD4+ counts >500 cells/mm3, early initiation of antiretroviral therapy (ART) reduces serious AIDS and serious non-AIDS (SNA) risk compared with deferral of treatment until CD4+ counts are <350 cells/mm3. Whether excess risk of AIDS and SNA persists once ART is initiated for those who defer treatment is uncertain. METHODS The Strategic Timing of AntiRetroviral Treatment (START) trial, as previously reported, randomly assigned 4684 ART-naive HIV-positive adults with CD4+ counts .500 cells/mm3 to immediate treatment initiation after random assignment (n = 2325) or deferred treatment (n= 2359). In 2015, a 57% lower risk of the primary end point (AIDS, SNA, or death) for the immediate group was reported, and the deferred group was offered ART. This article reports the follow-up that continued to December 31, 2021. Cox proportional-hazards models were used to compare hazard ratios for the primary end point from randomization through December 31, 2015, versus January 1, 2016, through December 31, 2021. RESULTS Through December 31, 2015, approximately 7 months after the cutoff date from the previous report, the median CD4+ count was 648 and 460 cells/mm3 in the immediate and deferred groups, respectively, at treatment initiation. The percentage of follow-up time spent taking ART was 95% and 36% for the immediate and deferred groups, respectively, and the time-averaged CD4+ difference was 199 cells/mm3. After January 1, 2016, the percentage of follow-up time on treatment was 97.2% and 94.1% for the immediate and deferred groups, respectively, and the CD4+ count difference was 155 cells/mm3. After January 1, 2016, a total of 89 immediate and 113 deferred group participants experienced a primary end point (hazard ratio of 0.79 [95% confidence interval, 0.60 to 1.04] versus hazard ratio of 0.47 [95% confidence interval, 0.34 to 0.65; P<0.001]) before 2016 (P=0.02 for hazard ratio difference). CONCLUSIONS Among adults with CD4+ counts >500 cells/mm3, excess risk of AIDS and SNA associated with delaying treatment initiation was diminished after ART initiation, but persistent excess risk remained. (Funded by the National Institute of Allergy and Infectious Diseases and others.).
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Affiliation(s)
- Jens D Lundgren
- CHIP Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, Copenhagen
| | - Abdel G Babiker
- Medical Research Council Clinical Trials Unit, University College London, London
| | - Shweta Sharma
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis
| | - Birgit Grund
- School of Statistics, University of Minnesota, Minneapolis
| | | | | | | | - Bitten Aagaard
- CHIP Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, Copenhagen
| | - Inka Abo
- Helsinki University Central Hospital, Helsinki
| | - Beverly Alston
- Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, MD
| | | | | | - Sharlaa Badal-Faesen
- Clinical HIV Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Carlos Brites
- Hospital Universitario Professor Edgard Santos, School of Medicine, Federal University of Bahia, Salvador, Brazil
| | | | - Jorge Casseb
- Laboratory of Medical Investigation - LIM56, Faculty of Medicine, Department of Dermatology, University of São Paulo, São Paulo
| | - Amanda Clarke
- Royal Sussex County Hospital, Brighton, United Kingdom
| | | | | | - Sounkalo Dao
- Mali-National Institute of Allergy and Infectious Diseases HIV Research Initiative, Bamako, Mali
| | - Eileen T Denning
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis
| | | | | | | | - Hansjakob Furrer
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Gerd Fätkenheuer
- Klinik I für Innere Medizin der Universität zu Köln, Cologne, Germany
| | - Jan Gerstoft
- Rigshospitalet, Infektionsmedicinsk ambulatorium 8622, Copenhagen
| | | | - Katharine Goodall
- Medical Research Council Clinical Trials Unit, University College London, London
| | - Keith Henry
- Hennepin Health Research Institute, Minneapolis
| | | | - Jennifer Hoy
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, VIC, Australia
| | - Fleur Hudson
- Medical Research Council Clinical Trials Unit, University College London, London
| | | | | | | | - Cissy Kityo
- Joint Clinical Research Centre, Kampala, Uganda
| | - Karin Klingman
- Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, MD
| | | | | | | | - Marcelo Losso
- Hospital General de Agudos J.M. Ramos Mejia, Buenos Aires
| | | | - Juan Sierra Madero
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City
| | - Patrick Mallon
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin
| | | | | | | | - Daniel D Murray
- CHIP Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, Copenhagen
| | - Kumarasamy Nagalingeswaran
- Voluntary Health Services, Infectious Diseases Medical Centre, Chennai Antiviral Research and Treatment, Clinical Research Site, Chennai, India
| | | | | | - Roger Paredes
- Hospital Universitari Germans Trias i Pujol, Barcelona
| | | | - Sandy Pillay
- Durban International Clinical Research Site, Durban, South Africa
| | - Mark N Polizzotto
- Clinical Hub for Interventional Research, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Dorthe Raben
- CHIP Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, Copenhagen
| | | | | | | | | | | | - Giota Touloumi
- Medical School, National and Kapodistrian University of Athens, Athens
| | | | | | | | - Marcelo Wolff
- Hospital Clínico San Borja Arriarán, Fundación Arriarán, Santiago, Chile
| | - Robin Wood
- Desmond Tutu Health Foundation, Cape Town, South Africa
| | - Kai Zilmer
- West Tallinn Central Hospital Infectious Diseases, Tallinn, Estonia
| | - H Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, MD
| | - James D Neaton
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis
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17
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Llibre JM, Brites C, Cheng CY, Osiyemi O, Galera C, Hocqueloux L, Maggiolo F, Degen O, Taylor S, Blair E, Man C, Wynne B, Oyee J, Underwood M, Curtis L, Bontempo G, van Wyk J. Efficacy and Safety of Switching to the 2-Drug Regimen Dolutegravir/Lamivudine Versus Continuing a 3- or 4-Drug Regimen for Maintaining Virologic Suppression in Adults Living With Human Immunodeficiency Virus 1 (HIV-1): Week 48 Results From the Phase 3, Noninferiority SALSA Randomized Trial. Clin Infect Dis 2023; 76:720-729. [PMID: 35235656 PMCID: PMC10021070 DOI: 10.1093/cid/ciac130] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In TANGO, switching to dolutegravir/lamivudine (DTG/3TC) demonstrated long-term noninferior efficacy vs continuing tenofovir alafenamide-based regimens in treatment-experienced adults with HIV-1. The phase 3 SALSA study evaluated efficacy and safety of switching to DTG/3TC compared with continuing various 3-/4-drug current antiretroviral regimens (CARs). METHODS Adults with HIV-1 RNA <50 copies/mL and no previous virologic failure were randomized (1:1, stratified by baseline third agent class) to switch to once-daily fixed-dose combination DTG/3TC or continue CAR (primary endpoint: proportion of participants with HIV-1 RNA ≥50 copies/mL at week 48; Snapshot, intention-to-treat-exposed population, 5% noninferiority margin). RESULTS Overall, 493 adults (39% women; 39% aged ≥50 years; 19% African American/African heritage; 14% Asian) were randomized to switch to DTG/3TC (n = 246) or continue CAR (n = 247). At week 48, 1 (0.4%) participant in the DTG/3TC group and 3 (1.2%) in the CAR group had HIV-1 RNA ≥50 copies/mL (Snapshot), demonstrating noninferiority (adjusted difference, -0.8%; 95% CI, -2.4%, .8%). Zero participants met confirmed virologic withdrawal criteria; therefore, no resistance testing was performed. Drug-related adverse events were more frequent with DTG/3TC (20%) than CAR (6%) through week 48 but comparable post-week 24 (5% vs 2%, respectively). Proximal tubular renal function and bone turnover biomarkers improved with DTG/3TC. Both groups had generally minimal changes in lipids and inflammatory biomarkers. CONCLUSIONS Switching to DTG/3TC was noninferior to continuing CAR for maintaining virologic suppression at week 48 with no observed resistance, supporting the efficacy, good safety, and high barrier to resistance of DTG/3TC. CLINICAL TRIALS REGISTRATION www.clinicaltrials.gov, NCT04021290.
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Affiliation(s)
- Josep M Llibre
- Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | | | - Chien-Yu Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- Institute of Public Health, School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Olayemi Osiyemi
- Triple O Research Institute PA, West Palm Beach, Florida, USA
| | - Carlos Galera
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | - Olaf Degen
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Stephen Taylor
- Birmingham Heartlands Hospital, Birmingham, United Kingdom
- University of Birmingham, Birmingham, United Kingdom
| | | | - Choy Man
- ViiV Healthcare, Durham, North Carolina, USA
| | - Brian Wynne
- ViiV Healthcare, Durham, North Carolina, USA
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18
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Silva GPSA, Oliveira RC, de Souza JSM, Giovanetti M, Guimarães ML, Brites C, Monteiro-Cunha JP. Tracing the relationship among HIV-1 sub-subtype F1 strains: a phylodynamic perspective. Mem Inst Oswaldo Cruz 2023; 117:e220109. [PMID: 36700579 PMCID: PMC9870255 DOI: 10.1590/0074-02760220109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/17/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The human immunodeficiency virus type 1, F1 sub-subtype (HIV-1 F1) circulates in three continents: Africa, Europe, and South America. In Brazil, this sub-subtype co-circulates with subtypes B and C and several recombinant forms, mainly BF1 variants. OBJECTIVES This study aimed to reconstruct the dynamic history of HIV-1 F1 in Brazil. METHODS HIV-1 near full-length genome and pol gene nucleotide sequences available in public databases were assembled in two datasets (POL671 and NFLG53) to cover the largest number of F1 sub-subtype sequences. Phylodynamic and temporal analyses were performed. FINDINGS Two main strains of the F1 sub-subtype are circulating worldwide. The first (F1.I) was found among Brazilian samples (75%) and the second (F1.II) among Romanian (62%) and other European and African isolates. The F1 subtype epidemic in Brazil originated from a single entry into the country around 1970. This ancestral sample is related to samples isolated in European countries (France, Finland, and Belgium), which are possibly of African origin. Moreover, further migration (1998 CI: 1994-2003) of strains from Brazil to Europe (Spain and the UK) was observed. Interestingly, all different recombinant BF patterns found, even those from outside Brazil, present the same F1 lineage (F1.I) as an ancestor, which could be related to the acquisition of adaptive advantages for the recombinant progenies. MAIN CONCLUSIONS These findings are important for the understanding of the origin and dynamics of the F1 sub-subtype and a consequent better and greater understanding of the HIV-1 F1 and BF epidemic that still spreads from Brazil to other countries.
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Affiliation(s)
| | - Rodrigo Cunha Oliveira
- Universidade Federal da Bahia, Departamento de Bioquímica e Biofísica, Salvador, BA, Brasil
| | | | - Marta Giovanetti
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Laboratório de Genética Celular e Molecular, Belo Horizonte, MG, Brasil
| | - Monick Lindenmeyer Guimarães
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de AIDS e Imunologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil
| | - Joana Paixão Monteiro-Cunha
- Universidade Federal da Bahia, Departamento de Bioquímica e Biofísica, Salvador, BA, Brasil,+ Corresponding author:
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19
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Aguiar IL, Carvalho FM, Santos-Lins LS, Brasil-Oliveira R, Brites C, Cotrim HP, Bouquot JE, Lins-Kusterer L. Oral health related-quality of life before and during the COVID-19 pandemic in patients with non-alcoholic fatty liver disease. Med Oral Patol Oral Cir Bucal 2023:25731. [PMID: 36641744 DOI: 10.4317/medoral.25731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/16/2022] [Indexed: 01/16/2023]
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, the number of medical appointments and the offer and use of oral health services have decreased sharply with the lockdown period. Restriction to regular dental care can increase the risk of oral diseases, capable of affecting general health and oral health-related quality of life, particularly among medically compromised patients. This study aimed to assess health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) of patients with non-alcoholic liver disease (NAFLD) before and during the COVID-19 pandemic. MATERIAL AND METHODS Prospective cohort of 58 patients with NAFLD followed up from March 2020 (before the pandemic) to December 2021 (during the pandemic). RAND 36-Item Health Survey and Oral Health Impact Profile 14 (OHIP-14) questionnaires were used to assess HRQoL and OHRQoL, respectively, in the two points of time. RESULTS The scores of all scales HRQoL and of the question about health change in the last year decreased substantially with the advent of the pandemic. Large (>0.50) effect sizes were estimated for the scales Role functioning/physical, Pain, General health, and Energy/fatigue. Patients who had COVID-19 presented better HRQoL and OHIP-14 mean scores than those who did not have the disease. The OHIP-14 total score increased 3.6 points with the advent of the pandemic, representing a large effect size (0.62). Patients presented high probability (84.3%) of increasing OHIP14 score during the pandemic. CONCLUSIONS The HRQoL and the OHRQoL scores of NAFLD patients decreased substantially with the advent of the pandemic. However, these decreases were not associated with the COVID-19 disease by itself, but probably to other factors related to the deep social changes brought by the social isolation measures to combat the pandemic.
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Affiliation(s)
- I-L Aguiar
- Programa de Pós-Graduação em Medicina e Saúde Faculdade de Medicina da Bahia, Universidade Federal da Bahia Rua Doutor Augusto Viana, s/n 40110-060, Canela, Salvador - BA, Brazil
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20
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Herrera BB, Mayoral R, Brites C. Development and Validation of a Rapid Screening Test for HTLV-I IgG Antibodies. Viruses 2022; 15:129. [PMID: 36680167 PMCID: PMC9862416 DOI: 10.3390/v15010129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Initial diagnosis of human T cell lymphotropic virus (HTLV) infections is mainly based by detecting antibodies in plasma or serum using laboratory-based methods. The aim of this study was to develop and evaluate a rapid screening test for HTLV-I antibodies. Our rapid screening test uses HTLV-I p24 antigen conjugated to gold nanoparticles and an anti-human IgG antibody immobilized to a nitrocellulose strip to detect human HTLV-I p24-specific IgG antibodies via immunochromatography. Performance of the rapid screening test for HTLV-I was conducted on a total of 118 serum specimens collected in Salvador, Bahia, the epicenter for HTLV-1 infection in Brazil. Using a Western blot test as the comparator, 55 serum specimens were HTLV-I positive, 5 were HTLV-I and HTLV-II positive, and 58 were negative. The sensitivity of the rapid screening test for HTLV-1 was 96.7% and the specificity was 100%. The rapid screening test did not show cross-reaction with serum specimens from individuals with potentially interfering infections including those caused by HTLV-II, HIV-I, HIV-II, hepatitis A virus, hepatitis B virus, hepatitis C virus, herpes simplex virus, Epstein-Barr virus, SARS-CoV-2, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Toxoplasma gondii, and Plasmodium falciparum. The rapid screening test also did not show cross-reaction with potentially interfering substances. Strategies for HTLV diagnosis in non- and high-endemic areas can be improved with low-cost, rapid screening tests.
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Affiliation(s)
- Bobby Brooke Herrera
- Division of Allergy, Immunology, Infectious Diseases, Department of Medicine, Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
- Rutgers Global Health Institute, Rutgers University, New Brunswick, NJ 08901, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | | | - Carlos Brites
- Universidade Federal da Bahia, Salvador 40170-110, Brazil
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21
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Lins-Kusterer L, de Azevedo CF, Netto EM, Menezes MS, Aguiar CVN, de Azevedo RA, Cavalcante WC, Sarmento VA, Brites C. Impact of Anxiety on Health-Related Quality of Life and Symptoms of Burnout in Multi-Professional Residents in Brazil During the COVID-19 Pandemic. Appl Res Qual Life 2022; 18:229-247. [PMID: 36405034 PMCID: PMC9651893 DOI: 10.1007/s11482-022-10117-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 02/05/2022] [Indexed: 06/16/2023]
Abstract
We aimed to determine the prevalence of anxiety and to identify associated factors among multi-professional residents in Brazil during the early days of the COVID-19 pandemic. A cross-sectional study included a sample of 752 multi-professional residents selected by snowball technique. Symptoms of anxiety were measured by the Beck anxiety inventory scale (≥ 16 cut-off). We used WHOQOL-BREF to access the health-related quality of life and the Maslach Burnout Inventory to measure the burnout syndrome. PR and respective 95% confidence intervals (CI) were calculated using the Poisson regression model. The prevalence of anxiety was 41.2% (310/752). Some variables were strongly associated with anxiety: afraid of getting COVID-19; extra work demand during COVID-19 pandemic; sweating/wheezing/increased heart rate during work; feeling safe when using personal protective equipment at work, and psychological support from residence preceptors. Residents with symptoms of anxiety showed high emotional exhaustion at work (36.6 ± 9.6 vs. 24.7 ± 10.7, P = 0.001) and depersonalization (8.9 ± 6.0 vs. 5.6 ± 4.9, P = 0.001). Correlations coefficients between emotional exhaustion versus Physical WHOQOL-BREF and between emotional exhaustion versus Psychological WHOQOL-BREF were significantly lower among residents without anxiety (P = 0.027 and P = 0,03, respectively). The prevalence of anxiety was high and strongly associated with several variables, particularly with being afraid of getting COVID-19, the perception of workload, somatization (sweating, wheezing and increased heart rate during work), feeling unsafe when using personal protective equipment, and lack of psychological support from residence preceptors. Anxiety was associated with increased emotional exhaustion and depersonalization and low health-related quality of life during the COVID-19 pandemic in Brazil. Low WHOQOL-BREF environment domain, and high emotional exhaustion MBI domain increased the chances of presenting symptoms of anxiety.
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Affiliation(s)
- Liliane Lins-Kusterer
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Avenida Reitor Miguel Calmon s/n, CEP 40110-100 Salvador, Bahia Brazil
| | - Carolina Franco de Azevedo
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Avenida Reitor Miguel Calmon s/n, CEP 40110-100 Salvador, Bahia Brazil
| | - Eduardo Martins Netto
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Avenida Reitor Miguel Calmon s/n, CEP 40110-100 Salvador, Bahia Brazil
| | | | | | | | | | | | - Carlos Brites
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Avenida Reitor Miguel Calmon s/n, CEP 40110-100 Salvador, Bahia Brazil
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22
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Nascimento L, Improta-Caria AC, Brites C. Mortality in hospitalized HIV-infected patients in a referral center in Bahia, Brazil. Braz J Infect Dis 2022; 26:102716. [PMID: 36356643 PMCID: PMC9661378 DOI: 10.1016/j.bjid.2022.102716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/10/2022] [Accepted: 10/06/2022] [Indexed: 11/09/2022] Open
Abstract
The number of people living with HIV / AIDS in the world has increased and, in Salvador, Brazil, the mortality rate is above the state and national rates. This study sought to describe the characteristics of HIV patients who died in a referral hospital. This is a retrospective cohort study between 2012 and 2017 conducted at the, Federal University of Bahia´s Hospital, involving patients who died during hospitalization. There were 62 deaths among the 461 hospitalized patients with a predominance of males, blacks, and residents of Salvador. Mean age was 41.4 years. Most patients had at least one associated infection and 13% had a malignant neoplasm. The main reported cause of death was septic shock / HIV-associated infections. About 6.4% had an undetectable viral load and in-hospital survival was longer in this group. The lowest in-hospital survival was seen in patients presenting with pneumonia. Although the HIV / AIDS mortality rate at this center reflects the complexity of the country's epidemiological scenario poor adherence and therapeutic failure play a key role in the risk of death.
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Affiliation(s)
- Luca Nascimento
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Salvador, BA, Brazil,Corresponding author.
| | - Alex Cleber Improta-Caria
- Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde (PPGMS), Salvador, BA, Brazil
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Salvador, BA, Brazil,Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde (PPGMS), Salvador, BA, Brazil
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23
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Carvalho A, Longo E, Nascimento-Carvalho C, Argollo N, Coelho KE, Sampaio A, Brites C, Lucena R. Do Children With Congenital Zika Syndrome Have Cerebral Palsy? Glob Health Sci Pract 2022; 10:GHSP-D-21-00575. [PMID: 36316149 PMCID: PMC9622294 DOI: 10.9745/ghsp-d-21-00575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 09/20/2022] [Indexed: 01/25/2023]
Abstract
As researchers and practitioners, we have an important role in educating families of children with brain damage caused by Zika virus infection on how a cerebral palsy diagnosis can empower them with more information and enable better access to care and intervention services.
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Affiliation(s)
- Alessandra Carvalho
- SARAH Network of Rehabilitation Hospitals, Salvador, Bahia, Brazil.,Correspondence to Alessandra Carvalho ()
| | - Egmar Longo
- Trairi Health Sciences Faculty (FACISA), Federal University of Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | | | | | | | - Aline Sampaio
- Federal University of Bahia, Salvador, Bahia, Brazil
| | - Carlos Brites
- Federal University of Bahia, Salvador, Bahia, Brazil
| | - Rita Lucena
- Federal University of Bahia, Salvador, Bahia, Brazil
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24
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Deminco F, Vaz SN, Santana DS, Pedroso C, Tadeu J, Stoecker A, Vieira SM, Netto E, Brites C. A Simplified Sanger Sequencing Method for Detection of Relevant SARS-CoV-2 Variants. Diagnostics (Basel) 2022; 12:2609. [PMID: 36359452 PMCID: PMC9689870 DOI: 10.3390/diagnostics12112609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 08/26/2023] Open
Abstract
Molecular surveillance of the new coronavirus through new genomic sequencing technologies revealed the circulation of important variants of SARS-CoV-2. Sanger sequencing has been useful in identifying important variants of SARS-CoV-2 without the need for whole-genome sequencing. A sequencing protocol was constructed to cover a region of 1000 base pairs, from a 1120 bp product generated after a two-step RT-PCR assay in samples positive for SARS-CoV-2. Consensus sequence construction and mutation identification were performed. Of all 103 samples sequenced, 69 contained relevant variants represented by 20 BA.1, 13 delta, 22 gamma, and 14 zeta, identified between June 2020 and February 2022. All sequences found were aligned with representative sequences of the variants. Using the Sanger sequencing methodology, we were able to develop a more accessible protocol to assist viral surveillance with a more accessible platform.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Carlos Brites
- Laboratório de Pesquisa em Infectologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia (UFBA)/EBSERH, Salvador 40170-110, Bahia, Brazil
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25
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Luz E, Marques M, Netto EM, Campos LM, Amaral S, Santana I, Marques EL, Brites C. HIV, HTLV, and Hepatitis B and C Infection in Blood Donors in Bahia, Brazil from 2008 to 2017. Viruses 2022; 14:v14112323. [PMID: 36366422 PMCID: PMC9692744 DOI: 10.3390/v14112323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Although blood transfusion is an important therapeutic resource, transfusion-transmitted infections (TTIs) are still a cause for concern. Measures to mitigate this risk involve improvement of donor screening criteria and improvements in laboratory tests, especially the use of nucleic acid test (NAT). In this retrospective study we evaluated HIV, HTLV, HCV and HBV infection rates in blood donors of the Hematology and Hemotherapy Foundation of Bahia (Hemoba), Brazil, through serological and NAT results and the characteristics of donors. From February/2008 to December/2017, 777,446 blood donations were made. Most donors were male, aged 25-44 years, black and mixed race, and single or divorced. The density-type incidence (DTI; per 100,000) for each virus was 91.1 for HBV; 66.5 for HCV; 54.3 for HIV; and 33.9 for HTLV, with a decreasing trend observed over the period studied, except in the last biennium. NAT detected only 1 donor in immunological window for HIV (0.46/100,000 donations) and 3 donors in immunological window for HBV (1.8/100,000 donations). Serological positivity for all viruses studied was higher in the metropolitan region of Salvador, the state capital. Conclusion: DTI rates show a decreasing trend over the years studied, with a predominance of HBV infection. NAT allowed the detection of donors in immunological window periods, having an important role in improving transfusion safety.
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Affiliation(s)
- Estela Luz
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
- Laboratório de Pesquisa em Infectologia, Hospital Universitário Professor Edgard Santos, Salvador 40110-060, BA, Brazil
- Fundação Bahiana de Infectologia, Salvador 40110-160, BA, Brazil
| | - Marinho Marques
- Fundação de Hematologia e Hemoterapia da Bahia, Salvador 40286-240, BA, Brazil
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador 41180-045, BA, Brazil
| | - Eduardo Martins Netto
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
- Laboratório de Pesquisa em Infectologia, Hospital Universitário Professor Edgard Santos, Salvador 40110-060, BA, Brazil
- Fundação Bahiana de Infectologia, Salvador 40110-160, BA, Brazil
| | | | - Sávio Amaral
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
- Laboratório de Pesquisa em Infectologia, Hospital Universitário Professor Edgard Santos, Salvador 40110-060, BA, Brazil
- Fundação Bahiana de Infectologia, Salvador 40110-160, BA, Brazil
| | - Iraildes Santana
- Fundação de Hematologia e Hemoterapia da Bahia, Salvador 40286-240, BA, Brazil
| | | | - Carlos Brites
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
- Laboratório de Pesquisa em Infectologia, Hospital Universitário Professor Edgard Santos, Salvador 40110-060, BA, Brazil
- Fundação Bahiana de Infectologia, Salvador 40110-160, BA, Brazil
- Correspondence:
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26
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Schindler S, Magalhães RA, Costa ELF, Brites C. Genital Cytokines in HIV/Human Papillomavirus Co-Infection: A Systematic Review. AIDS Res Hum Retroviruses 2022; 38:683-691. [PMID: 35435746 DOI: 10.1089/aid.2021.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Cervical cancer is the fourth cancer in incidence and the third in mortality among women worldwide. Women living with HIV have a significantly increased risk of cervical cancer. The immune response of the host is crucial to determine the course of the human papillomavirus (HPV) infection and cytokines play an important role modulating viral multiplication and concentrating the immune response in the Th1 or Th2 pattern. The aim of this study is to evaluate the available evidence on the concentration of genital cytokines and their role in HPV infection in HIV-infected women. A systematic search of the literature was performed using MEDLINE by PubMed, Embase, Cochrane, LILACS, Scopus, Science direct, and Web of Science databases on November, 2020, in which the following clusters of terms were applied: HIV infection, HPV infection, and cytokine. Initially, 728 articles were selected, but only 17 were eligible for full-text review, and among them, 9 were included in the qualitative analysis. No restriction was applied in language, publication date, or status. The most studied cytokines in the articles included in this review were interferon (IFN)-γ and interleukin (IL)-10 (six articles), tumor necrosis factor (TNF) and IL-6 (five articles), and macrophage inflammatory protein (four articles). The main findings show that there is a reduction in the number of cells expressing IFN-γ (p = .02) and TNF-α (p = .01), in the cervices of HIV-HPV co-infected women compared with those infected only by HPV. In addition, levels of IL-6 (p = .039) and IL-10 (p = .02) are increased in the cervical secretions of HIV-positive women compared to seronegative patients. Despite these findings, there is a clear need of larger studies to understand the role of these immune factors in HPV-induced cervical neoplasia of women co-infected with HIV.
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Affiliation(s)
- Sandra Schindler
- Postgraduate Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil.,Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | | | | | - Carlos Brites
- Postgraduate Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil.,Faculty of Medicine, Federal University of Bahia, Salvador, Brazil.,Infectology Research Laboratory (LAPI), University Hospital Prof. Edgard Santos (HUPES), Federal University of Bahia, Salvador, Brazil
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27
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Costa DA, Carvalho FM, Vieira NM, Falcão GGSC, Sarmento VA, Brites C, Lins-Kusterer L. Work ability and associated factors in people living with human T-cell leukemia virus type 1. Rev Soc Bras Med Trop 2022; 55:e0111. [PMID: 35946625 PMCID: PMC9344948 DOI: 10.1590/0037-8682-0111-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Infection with the human T-lymphotropic virus type 1 (HTLV-1) affects an
estimated 10-15 million people worldwide. However, knowledge of the impact
of HTLV-1 infection on work ability is lacking. This study aimed to measure
the frequency and identify factors associated with poor work ability in
patients living with HTLV-1. Methods: This cross-sectional study included 207 individuals infected with HTLV-1 who
attended the University Hospital in Salvador, Bahia, Brazil. HTLV-1
antibodies were detected in the participants’ blood by enzyme-linked
immunosorbent assay (ELISA) and confirmed by western blotting. Participants
answered a questionnaire on sociodemographic data, personal habits, clinical
data, health-related quality of life, and work ability, evaluated using the
work ability index questionnaire. A Poisson regression model with a robust
variance estimate was used to identify the factors associated with the
prevalence of poor work ability. Results: Patients mean age was 55.2, ranging from 19 to 84 years, 73.0% were females,
100% had monthly family income less than US$ 394, and 33.8% presented HTLV-1
associated myelopathy/tropical spastic paraparesis (HAM/TSP). No individual
was classified as having excellent work ability. Poor work ability
prevalence was strongly associated (prevalence ratio; 95% confidence
interval [CI]) with sedentarism (1.30; 1.03-1.65), neurological symptoms
(1.25; 1.02-1.52), and low physical (0.95; 0.94-0.96) and mental (0.98;
0.97-0.99) component summaries of health-related quality of life. Conclusions: Poor work ability among people living with HTLV-1 is associated with
sedentarism, neurologic symptoms, and low health-related quality of
life.
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Affiliation(s)
- Dayana Alves Costa
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | | | - Nicolle Melo Vieira
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | | | | | - Carlos Brites
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | - Liliane Lins-Kusterer
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
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Montaño-Castellón I, Lins-Kusterer L, Luz E, Pedroso C, Paz M, Brites C. SARS-CoV-2 Incidence, signs and symptoms and main risk factors for COVID-19 infection in Health Care Workers: A hospital-wide survey in Salvador, Brazil. Braz J Infect Dis 2022; 26:102387. [PMID: 35905929 PMCID: PMC9300588 DOI: 10.1016/j.bjid.2022.102387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/17/2022] [Accepted: 07/03/2022] [Indexed: 11/25/2022] Open
Abstract
Background Brazil is the third country most affected by Coronavirus Disease 2019 (COVID-19) in the world. Health care workers (HCWs) are at higher risk of infection. Despite the increasing numbers of studies on the topic, There are gaps in the knowledge of characteristics and risk factors for infection of HCWS. This information is important to design preventive strategies and to mitigate the disease impact. The objective of this study was to estimate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, to identify factors associated, and to describe symptoms reported by healthcare workers at a tertiary hospital in Salvador, Brazil. Methods All HCWs were evaluated in a cross-sectional study conducted between May and September 2020, using self-administered questionnaires, and screening all participants for SARS-COV-2 IgG and IgM antibodies by rapid tests. Reactive IgG samples were retested by ELISA and IgM-positive test had a saliva sample retest by RT-PCR. Univariate associations were estimated by a non-adjusted incidence proportion ratio. Variables associated with COVID-19 incidence at p < 0.20 were selected for inclusion in a binary logistic regression model. Results A total of 2083 HCWs were included, mean age 41±10 years, 71.8% women, and 77.8% non-white. Of these, 271 (13.0%) and 25 (1.2%) HCWs tested positive for IgG and IgM SARS-CoV-2 antibodies, respectively, and three had a positive RT-PCR. Ancillary work [Odds Ratio (OR): 4.96], elementary education (OR: 2.91), high school education (OR: 2.89), and catholic religion (OR: 2.16) were associated with an increased likelihood of a positive IgG antibodies against SARS-CoV-2. Anosmia [Incidence Proportion Ratio (IPR): 7.41] and ageusia (IPR:8.51) were the most frequent associated symptoms. Conclusion HCWs with low mean family income, lower level of schooling, ancillary workor being black had a significantly higher likelihood of testing positive for SARS-CoV-2 antibodies. Social vulnerability was an important risk factor for COVID-19 infection.
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Narváez M, Lins-Kusterer L, Valdelamar-Jiménez J, Brites C. Quality of Life and Antiretroviral Therapy Adherence: A Cross-Sectional Study in Colombia. AIDS Res Hum Retroviruses 2022; 38:660-669. [PMID: 35459414 DOI: 10.1089/aid.2021.0233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The introduction of highly active combined antiretroviral therapy (cART) has changed the management of HIV/AIDS, which is recognized as a chronic disease with relevant aspects, such as adherence and quality of life. This study aimed to compare clinical and demographic characteristics and health-related quality of life in people with adherence and non-adherence to cART. A cross-sectional study was carried out with 200 participants. The instruments used were the Adherence Follow-up Questionnaire, the Beck Depression Inventory-II, the 36-Item Short Form Health Survey and the WHOQOL-HIV BREF. Poisson regression was applied to obtain estimates of adjusted prevalence ratios (PRadj). Individuals lacking therapeutic support were more likely to be non-adherent than those with proper support (PR: 1.79). The health-related quality of life of individuals with non-adherence was 4% lower (PR = 0.96) in the general health domain than individuals with adherence. Non-adherence to cART was associated with lower quality of life in the general health domain and no therapeutic support.
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Affiliation(s)
- Mónica Narváez
- Post Graduation Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil
- Research Laboratory in Infectious Diseases (LAPI), University Hospital Complex Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Liliane Lins-Kusterer
- Post Graduation Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil
- Research Laboratory in Infectious Diseases (LAPI), University Hospital Complex Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Juliet Valdelamar-Jiménez
- Post Graduation Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil
- Research Laboratory in Infectious Diseases (LAPI), University Hospital Complex Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Carlos Brites
- Post Graduation Program in Medicine and Health (PPgMS), Federal University of Bahia, Salvador, Brazil
- Research Laboratory in Infectious Diseases (LAPI), University Hospital Complex Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
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de Oliveira-Filho EF, de Carvalho OV, Carneiro IO, Fernandes FD, Vaz SN, Pedroso C, Gonzalez-Auza L, Urbieta VC, Kühne A, Mayoral R, Jo WK, Moreira-Soto A, Reusken CBEM, Drosten C, Brites C, Osterrieder K, Netto EM, Ristow LE, Maia RDC, Vogel FSF, de Almeida NR, Franke CR, Drexler JF. Frequent Infection of Cats With SARS-CoV-2 Irrespective of Pre-Existing Enzootic Coronavirus Immunity, Brazil 2020. Front Immunol 2022; 13:857322. [PMID: 35450070 PMCID: PMC9016337 DOI: 10.3389/fimmu.2022.857322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Carnivores such as cats and minks are highly susceptible to SARS-CoV-2. Brazil is a global COVID-19 hot spot and several cases of human-to-cat transmission have been documented. We investigated the spread of SARS-CoV-2 by testing 547 domestic cats sampled between July-November 2020 from seven states in southern, southeastern, and northeastern Brazil. Moreover, we investigated whether immune responses elicited by enzootic coronaviruses affect SARS-CoV-2 infection in cats. We found infection with significantly higher neutralizing antibody titers against the Gamma variant of concern, endemic in Brazil during 2020, than against an early SARS-CoV-2 B.1 isolate (p<0.0001), validating the use of Gamma for further testing. The overall SARS-CoV-2 seroprevalence in Brazilian cats during late 2020 validated by plaque reduction neutralization test (PRNT90) was 7.3% (95% CI, 5.3-9.8). There was no significant difference in SARS-CoV-2 seroprevalence in cats between Brazilian states, suggesting homogeneous infection levels ranging from 4.6% (95% CI, 2.2-8.4) to 11.4% (95% CI, 6.7-17.4; p=0.4438). Seroprevalence of the prototypic cat coronavirus Feline coronavirus (FCoV) in a PRNT90 was high at 33.3% (95% CI, 24.9-42.5) and seroprevalence of Bovine coronavirus (BCoV) was low at 1.7% (95% CI, 0.2-5.9) in a PRNT90. Neutralizing antibody titers were significantly lower for FCoV than for SARS-CoV-2 (p=0.0001), consistent with relatively more recent infection of cats with SARS-CoV-2. Neither the magnitude of SARS-CoV-2 antibody titers (p=0.6390), nor SARS-CoV-2 infection status were affected by FCoV serostatus (p=0.8863). Our data suggest that pre-existing immunity against enzootic coronaviruses neither prevents, nor enhances SARS-CoV-2 infection in cats. High SARS-CoV-2 seroprevalence already during the first year of the pandemic substantiates frequent infection of domestic cats and raises concerns on potential SARS-CoV-2 mutations escaping human immunity upon spillback.
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Affiliation(s)
- Edmilson F de Oliveira-Filho
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Ianei O Carneiro
- School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | | | - Sara Nunes Vaz
- Disease Research Laboratory, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Célia Pedroso
- Disease Research Laboratory, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Lilian Gonzalez-Auza
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Victor Carvalho Urbieta
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Arne Kühne
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rafaela Mayoral
- School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Wendy K Jo
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andrés Moreira-Soto
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Chantal B E M Reusken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carlos Brites
- Disease Research Laboratory, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | - Eduardo Martins Netto
- Disease Research Laboratory, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | - Rita de Cassia Maia
- Veterinary Medicine Department, Federal Rural University of Pernambuco, Recife, Brazil
| | | | - Nadia Rossi de Almeida
- School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Carlos Roberto Franke
- School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Jan Felix Drexler
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Centre for Infection Research (DZIF), Associated Partner Site Charité, Berlin, Germany
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31
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Montaño-Castellón I, Marconi CSC, Saffe C, Brites C. Clinical and Laboratory Outcomes in HIV-1 and HTLV-1/2 Coinfection: A Systematic Review. Front Public Health 2022; 10:820727. [PMID: 35359787 PMCID: PMC8963803 DOI: 10.3389/fpubh.2022.820727] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/04/2022] [Indexed: 01/06/2023] Open
Abstract
Aim To perform a systematic review to describe the available findings on clinical outcomes in HIV-1 and HTLV-1/HTLV-2 co-infected individuals since 1995. Design This Systematic Review used PECO criteria follow by PRISMA reporting guidelines and registered as CRD42021279062 (Prospero database). The Newcastle-Ottawa Scale assessed the methodological quality of included studies. Data Collection and Analysis A systematical search in PubMed/MEDLINE, Embase, Web of Sciences databases for cross-sectional, case-control, or cohort studies design to identify clinical and laboratorial outcomes related to HIV-1 and HTLV-1/2 coinfection. Search strategy: [(“HIV-1” AND “HTLV-1” OR “HTLV-2”) AND (“Coinfection”) AND (1990/01/01:2021/12/31[Date- Publication])]. Results A total of 15 articles were included on this systematic review describing data of 2,566 mono and coinfected patients, 58% male, with mean age was 35.7 ± 5.7 years. HIV-1 and HTLV-1 coinfected patients were more likely to had shorter survival and faster progression to death or mortality than monoinfected ones. Coinfected had higher CD4 cell counts and less likelihood of ART use. In addition, higher frequency of diseases like ichthyosis (22.2 vs. 6.8%), scabies (18.6 vs. 0%), candidiasis (42 vs. 12%), Strongyloidiasis (15.4 vs. 2%) and neurological manifestations like encephalopathy, peripheral neuropathy and HAM/TSP were more frequently reported in coinfected patients. Conclusions HIV-1 and HTLV-1 coinfection and HIV-1 and HTLV-1 /2 triple coinfection were related to shorter survival, higher mortality rate, and faster progression to death, while coinfection by HIV-1/HTLV-2 seems to have neutral association with longer survival, slower AIDS progression, and lower mortality rate. The available evidence indicates an urgent need for prevention and control measures, including screening, diagnosis, and treatment of HIV-1 and HTLV-1/2 coinfected patients. Test-and-treat strategy for patients living with HIV in areas endemic for HTLV infection is mandatory, to avoid the risks of delayed therapy and death for coinfected patients. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42021279062.
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Affiliation(s)
- Iris Montaño-Castellón
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Professor Edgard Santos (HUPES), Salvador, Brazil.,Programa de Pós Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Cleyde Sheyla Chachaqui Marconi
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Professor Edgard Santos (HUPES), Salvador, Brazil.,Programa de Pós Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Clara Saffe
- Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | - Carlos Brites
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Professor Edgard Santos (HUPES), Salvador, Brazil.,Programa de Pós Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia (UFBA), Salvador, Brazil.,Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
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Lins-Kusterer L, Aguiar I, Santos-Lins LS, Lins-Rocha M, Aguiar CVN, Menezes MS, Sampaio AS, Quarantini LC, Cotrim HP, Brites C. Validation of the RAND 36-Item Health Survey questionnaire in Brazil. Arq Gastroenterol 2022; 59:193-197. [PMID: 35830028 DOI: 10.1590/s0004-2803.202202000-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/07/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Health-related quality of life is frequently used as an outcome measure that improves the quality of care. The SF-36 and RAND-36 were derived from the Medical Outcomes Study. OBJECTIVE The present study aimed to validate the RAND-36 in Brazil, in healthy individuals and patients with liver disease. METHODS Confirmatory factor analysis (CFA) was conducted by using JASP Software. The parameters of the items were estimated using the Robust Diagonally Weighted Least Squares (RDWLS) approach. Comparative fit index (CFI), Goodness-of-fit index (GFI), Tucker-Lewis Index (TLI) and the root mean square error of approximation (RMSEA) were evaluated. Internal consistency was measured using the Composite reliability index. Convergent validity between RAND-36 domains and Work Ability Index (WAI) was conducted. RESULTS This validation study included 763 individuals, 400 (52.4%) with chronic liver disease. The most prevalent liver diseases were hepatitis C (13.9%), alcoholic liver disease (11.8%), and steatosis (12.1%). The measurement model tested using the CFA obtained the following adjustment indicators: X2 (df): 599.65 (498); CFI: 0.998; GFI: 0.998; TLI: 0.998; RMSEA: 0.016 (90%CI: 0.011-.021). Convergent validity of RAND-36 and total WAI ranged from medium to large correlation. CONCLUSION The RAND-36 is effective in measuring the perception of health-related quality of life in individuals with and without chronic liver disease. The results of our study support the developer's claims for the reliability of the RAND-36 version 1 as a measure of health-related quality of life. The evidence for the construct validity of the RAND-36 was substantial.
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Affiliation(s)
- Liliane Lins-Kusterer
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | - Inácio Aguiar
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | - Larissa Souza Santos-Lins
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | - Matheus Lins-Rocha
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | | | | | - Aline Santos Sampaio
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Salvador, BA, Brasil
| | - Lucas C Quarantini
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Salvador, BA, Brasil
| | - Helma P Cotrim
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
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Brown D, Kaplan R, Losso M, Brites C, Wang R, Underwood M, Hopking J, Aboud M, Sievers J. Efficacy of second-line dolutegravir plus 2 nucleoside reverse transcriptase inhibitors by baseline nucleoside reverse transcriptase inhibitor resistance and nucleoside reverse transcriptase inhibitor use in the DAWNING study. Antivir Ther 2022. [DOI: 10.1177/13596535221077487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background In the DAWNING study, dolutegravir + 2 nucleoside reverse transcriptase inhibitors (NRTIs) demonstrated superior efficacy at Week 48 and a favourable safety profile compared with lopinavir/ritonavir + 2 NRTIs in adults with HIV-1 failing first-line therapy of a non-nucleoside reverse transcriptase inhibitor + 2 NRTIs. Methods Participants at 58 centres in 13 countries were randomised (1:1) to 52 weeks of open-label treatment with dolutegravir or lopinavir/ritonavir combined with 2 investigator-selected NRTIs, including at least one fully active NRTI based on screening resistance testing. The primary endpoint was the proportion of participants achieving HIV-1 RNA <50 copies/ml at Week 48 (Snapshot algorithm). Post-hoc efficacy analyses were performed based on baseline NRTI resistance profile and second-line NRTI use. Results Of 624 participants randomised and treated, 499 (80%) received <2 active NRTIs at Baseline. NRTI resistance was present in 561 participants (90%). Among participants receiving lamivudine or emtricitabine in the presence of M184V/I, 85% (187/220) of participants on dolutegravir versus 72% (152/210) on lopinavir/ritonavir had HIV-1 RNA <50 copies/ml at Week 48 (difference, 12.6%; 95% CI: 4.9–20.3%). High responses were also observed in the dolutegravir group, when zidovudine or tenofovir disoproxil fumarate were included in the background regimen in the presence of thymidine analogue mutations or K65R, respectively; however, participant numbers in these subgroups were small. Conclusions Response rates were high in participants receiving dolutegravir + 2 NRTIs as second-line treatment regardless of pre-existing resistance to one of the NRTIs, including in participants using lamivudine or emtricitabine in the presence of M184V/I.
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Affiliation(s)
- Dannae Brown
- Global Medical Sciences, ViiV Healthcare, Abbotsford, Australia
| | | | - Marcelo Losso
- HIV Unit, Hospital JM Ramos Mejia, Buenos Aires, Argentina
| | - Carlos Brites
- Infectious Diseases, School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Ruolan Wang
- Clinical Virology, ViiV Healthcare, Research Triangle Park, NC, USA
| | - Mark Underwood
- Clinical Virology, ViiV Healthcare, Research Triangle Park, NC, USA
| | | | - Michael Aboud
- Global Franchise Medical, ViiV Healthcare, Brentford, UK
| | - Jörg Sievers
- Clinical Development, ViiV Healthcare, Brentford, UK
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34
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Amaral S, Brites C, Sprinz E. Integrase Inhibitors Use for HIV Infection in Pregnancy. Curr Infect Dis Rep 2022. [DOI: 10.1007/s11908-022-00774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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35
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Araujo RA, Amaral S, Tolentino A, Zeballos D, Montaño I, Souza LS, Lins-Kusterer L, Brites C. Low Quality of Life, Falls, and Pre-Frailty are Associated with Depressive Symptoms in Virologically Suppressed PLWHIV in Salvador, Brazil. AIDS Behav 2022; 26:397-406. [PMID: 34312738 DOI: 10.1007/s10461-021-03393-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2021] [Indexed: 11/25/2022]
Abstract
Depression is the leading cause of years lived with disability worldwide and PLWHIV present a higher risk of developing depressive symptoms. We aimed to evaluate depressive symptoms and their predictors in virologically suppressed PLWHIV. We conducted a cross-sectional study with 200 PLWHIV. Depressive symptoms were defined as scoring ≥ 14 points in the Beck Depression Inventory II. Most of the participants (58.5%) were men, with a median age of 54 years (IQR: 46.25-59.00). Depressive symptoms' prevalence was 19.5% and they were associated with being divorced/widowed (aOR: 2.93, CI 95%: 1.17-7.37), recurrent falls (aOR: 4.24, CI 95%: 1.07-16.85), pre-frailty (aOR: 3.55, CI 95%: 1.47-8.57), and lower scores in all HRQoL dimensions. Although virologically suppressed PLWHIV presented lower prevalence of depressive symptoms than reported in previous studies in Brazil and South America, they were associated with falls and frailty, highlighting the need for screening.
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Affiliation(s)
- Rafael Antonius Araujo
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Sávio Amaral
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil.
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil.
| | - Arthur Tolentino
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Diana Zeballos
- Programa de Pós-graduação em Saúde Coletiva (PPgSC), Universidade Federal da Bahia, Salvador, Brazil
| | - Iris Montaño
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Lucca S Souza
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Liliane Lins-Kusterer
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
| | - Carlos Brites
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Dr. Augusto Viana Street, Salvador, BA, 40.110-060, Brazil
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Costa DD, Brites C, Vaz SN, de Santana DS, Dos Santos JN, Cury PR. Chlorhexidine mouthwash reduces the salivary viral load of SARS-CoV-2: A randomized clinical trial. Oral Dis 2021; 28 Suppl 2:2500-2508. [PMID: 34837305 DOI: 10.1111/odi.14086] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/25/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to evaluate the effect of 0.12% chlorhexidine gluconate on the salivary load of SARS-CoV-2. MATERIALS AND METHODS A randomized, double-blind, placebo-controlled trial was performed on 100 participants positive for SARS-CoV-2. In the test group (n = 50), volunteers gargled with a mouthwash containing 15 ml of 0.12% chlorhexidine gluconate for 1 min, while the control group (n = 50) used a placebo. Saliva samples were obtained before (baseline) and 5 and 60 min after using the solutions. Real-time reverse transcription polymerase chain reaction assays (qRT-PCR) were carried out and the cycle threshold (Ct) was computed. The chi-square test and t-test were used for group comparison (p ≤ 0.05). RESULTS The differences in Ct values between the 5-min evaluation and baseline (test group: 2.19 ± 4.30; control: -0.40 ± 3.87, p = 0.002) and between 60 min and baseline (test group: 2.45 ± 3.88; control: 0.76 ± 4.41, p = 0.05) were significantly greater in the test group, revealing a reduction of viral load. Furthermore, there was a reduction in the load of SARS-CoV-2 in 72% of the volunteers using chlorhexidine versus 30% in the control group (p = 0.001). CONCLUSIONS Chlorhexidine gluconate (0.12%) was effective in reducing salivary SARS-CoV-2 load for at least 60 min.
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Affiliation(s)
- Denis Damião Costa
- Postgraduate Program in Dentistry and Health, Federal University of Bahia, Salvador, Brazil
| | - Carlos Brites
- Infectious Diseases Research Laboratory, Professor Edgard Santos Hospital, Federal University of Bahia, Salvador, Brazil.,Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | - Sara Nunes Vaz
- Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | | | - Jean Nunes Dos Santos
- Postgraduate Program in Dentistry and Health, Federal University of Bahia, Salvador, Brazil.,Department of Oral Pathology, School of Dentistry, Federal University of Bahia, Salvador, Brazil
| | - Patricia Ramos Cury
- Postgraduate Program in Dentistry and Health, Federal University of Bahia, Salvador, Brazil.,Department of Periodontology, School of Dentistry, Federal University of Bahia, Salvador, Brazil
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Falcão GGVSC, Sarmento VA, Dutra BS, Russoni B, de Oliveira LS, Costa DA, Brites C, Bouqout JE, Lins-Kusterer L. Oral health and quality of life of people living with human T-cell leukemia virus-1 in Salvador, Brazil: a cross-sectional study. Clin Oral Investig 2021; 26:2565-2573. [PMID: 34665340 DOI: 10.1007/s00784-021-04226-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/12/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the oral health status and oral health-related quality of life (OHRQoL) in symptomatic and asymptomatic patients with human T-cell leukemia virus-1 (HTLV-1). MATERIAL AND METHODS This cross-sectional study included 204 seropositive patients, classified into two groups, symptomatic and asymptomatic. The first group included patients with neurological symptoms associated with HTLV-1 (n = 69), and the second group, asymptomatic HTLV-1 carriers (n = 135). We evaluated the total unstimulated saliva flow, oral mucosa, the Decayed, Missing, Filled Teeth (DMFT) index, and Periodontal Screening and Recording (PSR). The Oral Health Impact Profile (OHIP14) measured the oral health-related quality of life. General health-related quality of life was measured by the 36-Item Short-Form Health Survey (SF-36). Variables with a value of p < 0.25 in bivariate analysis were selected, together with SF-36 summaries' scores and total OHIP-14, for composing a logistic regression model that had symptomatology as the dependent variable. RESULTS The OHIP-14 total score was poor in symptomatic and asymptomatic groups, but with no marked difference between them. Symptomatic patients showed significantly lower SF-36 scores (P ≤ 0.05) compared to asymptomatic ones, except for mental component summary (MCS). Family income (1-2.99 minimal wages), reduced salivary flow, flossing, and lower physical component summary (PCS) were associated (P ≤ 0.05) with symptomatology. CONCLUSIONS Symptomatic individuals living with HTLV-1 showed lower HRQoL and poorer OHRQoL compared to asymptomatic ones. Family income, flossing, reduced salivary flow, and lower PCS were associated with symptomatic HTLV-1 individuals. CLINICAL RELEVANCE In the present study, symptomatic individuals with HTLV-1 showed higher family income, poorer oral health status, lower salivary flow, poorer OHRQoL, and lower HRQoL compared to asymptomatic ones.
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Affiliation(s)
| | | | - Brenda Soares Dutra
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - Bruno Russoni
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil
| | | | - Dayana Alves Costa
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - Carlos Brites
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - Jerry E Bouqout
- Department of Diagnostic Sciences, School of Dentistry, University of Texas, Houston, TX, USA
| | - Liliane Lins-Kusterer
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil. .,Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Rua Doutor Augusto Viana, s/n - Canela, Salvador, BA, 40110-060, Brazil.
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Brites C, Borges ÁH, Sprinz E, Page K. Editorial: HIV and Viral Co-infections. Front Microbiol 2021; 12:731337. [PMID: 34531845 PMCID: PMC8439274 DOI: 10.3389/fmicb.2021.731337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - Eduardo Sprinz
- Universidade Federal do Rio Grande do SUL, Porto Alegre, Brazil
| | - Kimberly Page
- University of New Mexico, Albuquerque, NM, United States
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Pedroso C, Vaz S, Netto EM, Souza D, Deminco F, Mayoral R, Menezes E, da Cunha APA, Moreira-Soto A, Drexler JF, Brites C. Self-prescribed Ivermectin use is associated with a lower rate of seroconversion in health care workers diagnosed with COVID, in a dose-dependent response. Braz J Infect Dis 2021; 25:101603. [PMID: 34390646 PMCID: PMC8358133 DOI: 10.1016/j.bjid.2021.101603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/27/2021] [Accepted: 07/05/2021] [Indexed: 12/02/2022] Open
Abstract
Background Over-the-counter use of ivermectin amongst other drugs as SARS-CoV-2 treatment has been increasingly common, despite the lack of evidence on its clinical efficacy. Objective To evaluate the effect of ivermectin use on production of antibodies against SARS-CoV-2 in health care workers (HCW) diagnosed with COVID-19 and of Th1/Th2 cytokines by stimulated peripheral blood mononuclear cells of the same cohort (PBMCs). Methods This cross-sectional study evaluated seroconversion and neutralizing antibodies production in HCW at Complexo Hospitalar Universitário Professor Edgard Santos (Salvador, Brazil), diagnosed with COVID-19 from May to July, 2020, as well as in vitro production of antibody against SARS-CoV-2 and Th1/Th2 cytokines. Analyses were performed between December 2020 and February 2021. Participants were stratified according to the use of ivermectin (≤ 1 dose vs. multiple doses) for treatment of COVID-19. Results 45 HCW were included (62% women). Mean age was 39 years, and disease severity was similar across groups. Neutralizing antibodies were detected less frequently in multiple doses (70%) vs. ≤ 1 dose (97%) groups, p = 0.02). PBMCs of patients in multiple doses group also were less likely to produce antibodies against SARS-CoV-2 following in vitro stimulation with purified spike protein in comparison with patients in ≤ 1 dose group (p < 0.001). PBMC´s production of Th1/Th2 cytokines levels was similar across groups. Abdominal pain (15% vs 46%, p = 0.04), diarrhea (21% vs. 55%, p = 0.05) and taste perversion (0% vs. 18%, p = 0.05) were more frequently reported by participants that used multiple doses of ivermectin. Conclusions Although there was no evidence for differential disease severity upon ivermectin use for treatment of COVID-19 it was associated with more gastro-intestinal side-effects and impairment of anti-SARS-CoV2 antibodies production, in a dose dependent manner. This potentially impacts the effectiveness of immune response and the risk of reinfection and warrants additional studies for clarifying the mechanisms and consequences of such immunomodulatory effects.
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Affiliation(s)
- Célia Pedroso
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil
| | - Sara Vaz
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil
| | - Eduardo Martins Netto
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil
| | - Daniele Souza
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil
| | - Felice Deminco
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil
| | - Rafaela Mayoral
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil
| | - Eliana Menezes
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil
| | - Ana Patricia Amancio da Cunha
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil
| | - Andres Moreira-Soto
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; German Centre for Infection Research, Berlin, Germany
| | - Carlos Brites
- Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil.
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Brites C, Grassi MF, Quaresma JAS, Ishak R, Vallinoto ACR. Pathogenesis of HTLV-1 infection and progression biomarkers: An overview. Braz J Infect Dis 2021; 25:101594. [PMID: 34256025 PMCID: PMC9392164 DOI: 10.1016/j.bjid.2021.101594] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/12/2021] [Accepted: 06/03/2021] [Indexed: 12/12/2022] Open
Abstract
Infection by human T-cell lymphotropic virus type 1 (HTLV-1) occurs in lymphocytes, which travel throughout the body, thus affecting several target organs and causing varied clinical outcomes, particularly in populations that are underserved and do not have access to healthcare. However, the mechanism of pathogenesis is not yet fully understood. The TAX and HTLV-1 basic leucine zipper factor (HBZ) proteins maintain viral persistence and affect pathogenesis through cell proliferation and immune and inflammatory responses that accompany each clinical manifestation. TAX expression leads to inhibition of transcription error control, OX40 overexpression, and cell proliferation in adult T-cell leukemia (ATL). OX40 levels are elevated in the central nervous system (CNS), and the expression of TAX in the CNS causes neuronal damage and loss of immune reactivity among patients with HTLV-1-associated myelopathy (HAM). HBZ reduces viral replication and suppresses the immune response. Its cell compartmentalization has been associated with the pathogenesis of HAM (cytoplasmic localization) and ATL (nuclear localization). TAX and HBZ seem to act antagonistically in immune responses, affecting the pathogenesis of HTLV-1 infection. The progression from HTLV-1 infection to disease is a consequence of HTLV-1 replication in CD4+ T and CD8+ T lymphocytes and the imbalance between proinflammatory and anti-inflammatory cytokines. The compartmentalization of HBZ suggests that this protein may be an additional tool for assessing immune and inflammatory responses, in addition to those already recognized as potential biomarkers associated with progression from infection to disease (including human leukocyte antigen (HLA), killer immunoglobulin-like receptors (KIR), interleukin (IL)-6, IL-10, IL-28, Fas, Fas ligand, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and mannose-binding lectin).
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Affiliation(s)
- Carlos Brites
- Federal University of Bahia (UFBA), Professor Edgard Santos University Hospital Complex, Laboratory of Infectious Diseases Research, Salvador, BA, Brazil
| | | | | | - Ricardo Ishak
- Federal University of Pará (UFPA), Institute of Biological Sciences, Laboratory of Virology, Belém, PA, Brazil
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Gomes-Neto M, Saquetto MB, Alves IG, Martinez BP, Vieira JPB, Brites C. Effects of Exercise Interventions on Aerobic Capacity and Health-Related Quality of Life in People Living With HIV/AIDS: Systematic Review and Network Meta-Analysis. Phys Ther 2021; 101:6166193. [PMID: 33704496 DOI: 10.1093/ptj/pzab092] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/29/2020] [Accepted: 02/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Exercise is a recommended component of care for people living with HIV/AIDS; however, it is unclear which type of exercise is most effective. The purpose of this study was to investigate the relative effects of different types of exercise interventions on aerobic capacity measured by peak oxygen consumption (peak VO2) and health-related quality of life (HRQoL) in this population. METHODS For this systematic review and indirect-comparisons meta-analysis (network meta-analysis), different electronic databases were searched up to February 2020 for randomized controlled trials that evaluated the effects of different types of exercise interventions on peak VO2 and HRQoL of people living with HIV/AIDS. Mean differences, standardized mean difference (SMD), and 95% CI were calculated. Fixed- and random-effects Bayesian network meta-analysis were used to compare the relative effectiveness of the different exercise interventions. RESULTS Forty studies met the study criteria, reporting on a total of 1518 patients. When comparing the exercise interventions with usual care (control group) for the peak VO2 outcome, combined aerobic and resistance exercise was the highest ranked exercise intervention with an SMD of 4.2 (95% CI = 2.5 to 5.9), followed by aerobic exercise (SMD = 3.1; 95% CI = 1.4 to 5.1). Compared with aerobic exercise, resistance training, and yoga, combined aerobic and resistance exercise was the best exercise intervention to promote improvement on physical function, general health, mental health, and energy/vitality domains HRQoL. CONCLUSION The combined aerobic and resistance exercise was the highest ranked exercise intervention to improve peak VO2 and HRQoL. Combined aerobic and resistance exercise should be considered as a component of care for people living with HIV/AIDS.
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Affiliation(s)
- Mansueto Gomes-Neto
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Micheli Bernardone Saquetto
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Iura Gonzalez Alves
- Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Bruno Prata Martinez
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - João Paulo B Vieira
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Carlos Brites
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
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Valdelamar-Jiménez J, Lins-Kusterer L, de Jesus STG, Netto EM, Brites C. Comparison of Three Health-Related Quality of Life Instruments to Evaluate Symptoms of Depression in HIV Patients in Brazil. J Clin Psychol Med Settings 2021; 27:643-650. [PMID: 31456126 DOI: 10.1007/s10880-019-09657-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The evaluation of quality of life could be a useful indicator of depression in HIV patients. We compared the performance of three health-related quality of life (HRQoL) instruments for detecting depression. This nested case-control study included 200 HIV patients attended at an AIDS referral center. Depression was measured by Beck Depression Inventory (BDI). We accessed HRQoL by SF-36v2, HAT-QoL, and WHOQOL-HIV Bref. The depression diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curve analysis. SF-36v2 presented negative correlation with BDI score (- 0.72 to - 0.40), and HAT-QoL (- 0.66 to 0.05) and WHOQoL-HIV Bref (- 0.67 to 0.32) domains presented negative and positive correlations. Mental Health (r = - .71) and Mental Component Summary (r = - .72) showed high negative correlation with BDI. SF-36v2 showed excellent measure by the ROC curve analysis in four factors, and high correlation in Mental Health and MCS. Sf-36 may represent a useful tool for screening of depressive symptoms in HIV patients.
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Affiliation(s)
- Juliet Valdelamar-Jiménez
- LAPI - Infectious Diseases Research Laboratory, Edgard Santos Federal University Hospital, Rua Augusto Viana, S/n, Canela, Salvador, Bahia, CEP-40110060, Brazil
| | - Liliane Lins-Kusterer
- LAPI - Infectious Diseases Research Laboratory, Edgard Santos Federal University Hospital, Rua Augusto Viana, S/n, Canela, Salvador, Bahia, CEP-40110060, Brazil.
| | | | - Eduardo Martins Netto
- LAPI - Infectious Diseases Research Laboratory, Edgard Santos Federal University Hospital, Rua Augusto Viana, S/n, Canela, Salvador, Bahia, CEP-40110060, Brazil
| | - Carlos Brites
- LAPI - Infectious Diseases Research Laboratory, Edgard Santos Federal University Hospital, Rua Augusto Viana, S/n, Canela, Salvador, Bahia, CEP-40110060, Brazil
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Rosadas C, Brites C, Arakaki-Sanchez D, Casseb J, Ishak R. Brazilian Protocol for Sexually Transmitted Infections 2020: human T-cell lymphotropic virus (HTLV) infection. Rev Soc Bras Med Trop 2021; 54:e2020605. [PMID: 34008723 PMCID: PMC8210483 DOI: 10.1590/0037-8682-605-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 12/26/2022] Open
Abstract
This article addresses the Human T-lymphotropic virus (HTLV). This subject comprises the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. HTLV-1/2 infection is a public health problem globally, and Brazil has the largest number of individuals living with the virus. HTLV-1 causes several clinical manifestations of neoplasm (adult T-cell leukemia/lymphoma) and inflammatory nature, such as HTLV-1-associated myelopathy and other manifestations such as uveitis, arthritis, and infective dermatitis. These pathologies have high morbidity and mortality and negatively impact the quality of life of infected individuals. This review includes relevant information for health authorities professionals regarding viral transmission, diagnosis, treatment, and monitoring of individuals living with HTLV-1 and 2 in Brazil. HTLV-1/2 transmission can occur through blood transfusion and derivatives, injectable drug use, organ transplantation, unprotected sexual intercourse, and vertical transmission.
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Affiliation(s)
- Carolina Rosadas
- Imperial College London, Department of Infectious Disease, London, United Kingdom
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil
| | | | - Jorge Casseb
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brasil
| | - Ricardo Ishak
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brasil
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Montaño-Castellón I, Zeballos D, Gutiérrez-Peredo G, Netto E, Brites C. High Prevalence of Frailty and Prefrailty Status in Brazilian Patients Living with HIV. AIDS Res Hum Retroviruses 2021; 37:335-342. [PMID: 33353458 DOI: 10.1089/aid.2020.0113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Frailty is associated with an increased probability of serious adverse health outcomes in the geriatric general population. People living with HIV have a higher prevalence of frailty. However, the magnitude of this problem in younger patients in South America is unknown. We aimed to determine the prevalence and factors associated with frailty. This is a cross-sectional study from the Brazilian cohort HIV-AIDS (CoBRA) developed between March and November of 2018, on patients ≥18 years of age. Frailty phenotype was assessed by original Fried criteria. The results were analyzed using descriptive statistics, while identification of factors related to frailty was assessed by using multivariate logistic regression. We enrolled 231 patients; all, but 2 were on antiretroviral therapy (ART). Median age was 45.6 interquartile range (36.7-52.1) years, 136 (58.9%) were male, and 86.7% self-identified as non-white. Mean CD4 count was 660 (±345) cells/mm3 and 83.5% had undetectable HIV plasma viral load (<50 copies/mL). Prevalence of frailty and prefrailty was 10.4% and 52.4%, respectively. A CD4 count <200 cells/mm3, depression, low income, and use of third-line ART were variables significantly associated with a greater risk to present frail or prefrail status. Frailty prevalence increases with age and is an important health problem to health care in HIV aging patients. It requires proper strategies to its early detection, prevention, and management.
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Affiliation(s)
- Iris Montaño-Castellón
- Post-graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil
- LAPI—Research Laboratory of Infectious Diseases, University Hospital Professor Edgard Santos, School of Medicine, Salvador, Bahia, Brazil
| | - Diana Zeballos
- Post-graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Gabriel Gutiérrez-Peredo
- Post-graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Eduardo Netto
- Post-graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil
- LAPI—Research Laboratory of Infectious Diseases, University Hospital Professor Edgard Santos, School of Medicine, Salvador, Bahia, Brazil
| | - Carlos Brites
- Post-graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil
- LAPI—Research Laboratory of Infectious Diseases, University Hospital Professor Edgard Santos, School of Medicine, Salvador, Bahia, Brazil
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Tolentino A, Amaral S, S Souza L, Zeballos D, Brites C. Frequency of Falls and Associated Risk Factors in People Living With HIV: A Systematic Review With Meta-Analysis and Meta-Regression. J Acquir Immune Defic Syndr 2021; 86:616-625. [PMID: 33351527 DOI: 10.1097/qai.0000000000002600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/07/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Falls are considered as a predictive marker of poorer outcomes for people living with HIV (PLWHIV). However, the available evidences on the predictive value of falls are controversial. Our aim is to summarize the existing data about falls in PLWHIV. METHODS A literature search was conducted using electronic databases (MEDLINE, Embase, and LILACS) for original observational studies. The primary outcome was any and recurrent falls' frequency in PLWHIV, and secondary outcomes were factors associated with falls. We conducted a random-effects meta-analysis with meta-regression to obtain a summary frequency of falls and recurrent falls. RESULTS The pooled frequency for any fall was 26% [95% confidence interval (CI): 19% to 34%], compared with 14% for recurrent falls (95% CI: 9% to 22%). In studies comparing PLWHIV and people without HIV, we found no difference for any (pooled odds ratio 1.03, 95% CI: 0.90 to 1.17) or recurrent falls (pooled odds ratio 1.08, 95% CI: 0.92 to 1.27) between groups, but falls in middle-aged PLWHIV might be more associated with subjacent clinical conditions such as cognitive impairment, polypharmacy, use of medications with action in the central nervous system, and frailty, classic risk factors for falls in the elderly. CONCLUSIONS The overall frequency of falls in PLWHIV seems to be lower than that presented by some initial studies, and several factors associated with falls are shared with elderly adults. Although both PLWHIV and people without HIV presented similar frequency of falls, we found that these events might be qualitatively different; therefore, an appropriate method to evaluate falls in this population to prevent adverse outcomes is warranted.
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Affiliation(s)
- Arthur Tolentino
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Salvador, Brazil
| | - Sávio Amaral
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil; and
| | - Lucca S Souza
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Diana Zeballos
- Programa de Pós-graduação em Saúde Coletiva (PPgSC), Universidade Federal da Bahia, Salvador, Brazil
| | - Carlos Brites
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Laboratório de Pesquisa em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Salvador, Brazil
- Programa de Pós-graduação em Medicina e Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Brazil; and
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Marconi CSC, Lins-Kusterer L, Brites C, Gomes-Neto M. Comparison of functioning and health-related quality of life among patients with HTLV-1, HIV, and HIV-HTLV-1-coinfection. Rev Soc Bras Med Trop 2021; 54:e0759-2020. [PMID: 33759928 PMCID: PMC8008869 DOI: 10.1590/0037-8682-0759-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/19/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION: Human immunodeficiency virus (HIV) and human T-cell leukemia virus-1 (HTLV-1) viruses are associated with a high global burden of disease, and coinfection is a frequently reported event. We aimed to compare the functioning and health-related quality of life (HRQoL) of patients infected with HTLV-1, HIV, and HIV-HTLV-1. METHODS: We conducted a cross-sectional study of patients older than 18 years who had an HTLV-1 infection (Group A), HIV infection (Group B), or HIV-HTLV-1 coinfection (Group C). The functioning profiles were evaluated using handgrip strength, Berg balance scale (BBS), timed “up and go” (TUG) test, and 5-m walk test (m/s). We used the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire to measure disability. The HRQoL was evaluated using a 36-item short-form health survey. For data with parametric and non-parametric distribution, we used analysis of variance with Bonferroni correction and the Kruskal-Wallis test, followed by Dunn’s pairwise tests with Bonferroni correction. RESULTS: We enrolled 68 patients in Group A, 39 in Group B, and 29 in Group C. The scores for handgrip strength, BBS, TUG test, all the WHODAS domains, and HRQoL were poorer for Groups A and C than for Group B. CONCLUSIONS: Compared to patients with HIV infection, those with HIV-HTLV-1 coinfection and HTLV-1 infection had poor functioning and HRQoL scores. HTLV-1 infection was associated with reduced functioning and HRQoL in patients with a single HTLV-1 infection and HIV-HTLV-1 coinfection.
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Affiliation(s)
- Cleyde Sheyla Chachaqui Marconi
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil.,Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brasil
| | - Liliane Lins-Kusterer
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil.,Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brasil.,Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Doenças Infecciosas, Salvador, BA, Brasil
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil.,Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brasil.,Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Doenças Infecciosas, Salvador, BA, Brasil
| | - Mansueto Gomes-Neto
- Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brasil.,Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Doenças Infecciosas, Salvador, BA, Brasil.,Universidade Federal da Bahia, Departamento de Fisioterapia, Salvador, BA, Brasil
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Rosadas C, Brites C, Arakaki-Sánchez D, Casseb J, Ishak R. [Brazilian Protocol for Sexually Transmitted Infections 2020: human T cell lymphotropic virus (HTLV) infection]. ACTA ACUST UNITED AC 2021; 30:e2020605. [PMID: 33729406 DOI: 10.1590/s1679-497420200006000015.esp1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/07/2020] [Indexed: 11/22/2022]
Abstract
This manuscript is related to the chapter about human T-cell lymphotropic virus (HTLV) that is part of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Health Ministry. HTLV-1/2 infection is a worldwide public health problem and Brazil has the largest number of individuals living with the virus. HTLV-1 causes a variety of clinical manifestations of a neoplastic nature, such as adult leukemia/T-cell lymphoma, and also of an inflammatory nature, such as HTLV-1-associated myelopathy, as well as other manifestations such as uveitis, arthritis and infective dermatitis. These pathologies have high morbidity and mortality and negatively impact the quality of life of infected individuals. This review includes relevant information for health service managers and workers regarding virus transmission modes, diagnosis, treatment and monitoring of individuals living with HTLV-1 and 2 in Brazil.
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Affiliation(s)
- Carolina Rosadas
- Imperial College London, Department of Infectious Disease, Londres, Reino Unido
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil
| | | | - Jorge Casseb
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brasil
| | - Ricardo Ishak
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brasil
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Brites C, Miranda F, Luz E, Netto EM. Early and Successful Combination Antiretroviral Therapy Normalizes Survival Time in Patients Coinfected With Human Immunodeficiency Virus and Human T-cell Lymphotrophic Virus Type 1. Clin Infect Dis 2021; 71:196-200. [PMID: 31406994 DOI: 10.1093/cid/ciz756] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Coinfection with human T-cell lymphotrophic virus type 1 (HTLV-1) is associated with shorter survival for adults and children infected with human immunodeficiency virus (HIV), although the reasons remain a matter of debate. We evaluated the factors associated with survival time in a large cohort of HIV/HTLV-1-coinfected and HIV-monoinfected individuals on combination antiretroviral therapy (cART). METHODS In a nested, retrospective case-control study (1:1), we reviewed medical records of people with HIV infection on cART in a referral AIDS center in Salvador, Brazil. We matched 149 patients coinfected with HTLV-1 (cases) by age at HIV diagnosis and sex, to an equal number of HTLV-uninfected persons (controls). Death rates, survival time, baseline and current CD4 cell count, last HIV-1 RNA plasma viral load (pVL), and causes of death were compared between groups. RESULTS The overall mortality rate was 2.1 person-years (76 deaths, 53 among coinfected patients). Survival time for cases (16.7 ± 0.7 years) was significantly shorter than for controls (18.1 ± 0.4 years; P = .001). Among patients with pVL >50 copies/mL, coinfected patients had a shorter survival time (8.4 ± 0.8 years) than monoinfected ones (12.9 ± 1.4 years; P = .02), regardless of pVL magnitude. However, survival time did not differ for HIV-monoinfected (19.0 ± 0.4 years) or coinfected patients (20.2 ± 0.6 years) presenting with pVL <50 copies/mL (P = .5). Deceased coinfected patients had higher initial CD4 count (417 ± 219 cells) than monoinfected ones with the same outcome (177 ± 160 cells; P = .004), while survivors had similar CD4 cell count at baseline, regardless of HTLV status. CONCLUSIONS Successful cART is able to normalize survival for coinfected patients and should be introduced for all coinfected patients, regardless of CD4 cell count.HIV/human T-cell lymphotrophic virus type 1 coinfection is believed to decrease survival of coinfected patients. In this case-control study, we demonstrate that successful combination antiretroviral therapy (last HIV viral load <50 copies/mL) is able to improve survival of coinfected patients to levels observed for those monoinfected.
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Affiliation(s)
- Carlos Brites
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil
| | - Fernanda Miranda
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil
| | - Estela Luz
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil
| | - Eduardo Martins Netto
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil
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Castilho JL, Kim A, Jenkins CA, Grinsztejn B, Gotuzzo E, Fink V, Padgett D, Belaunzaran‐Zamudio PF, Crabtree‐Ramírez B, Escuder MM, Souza RA, Tenore SB, Pimentel SR, Ikeda MLR, de Alencastro PR, Tupinanbas U, Brites C, Luz E, Netto J, Cortes CP, Grangeiro A, Shepherd BE, McGowan CC. Antiretroviral therapy and Kaposi's sarcoma trends and outcomes among adults with HIV in Latin America. J Int AIDS Soc 2021; 24:e25658. [PMID: 33405281 PMCID: PMC7787071 DOI: 10.1002/jia2.25658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Kaposi's sarcoma (KS) remains the most frequent malignancy in persons living with HIV (PWH) in Latin America. We examined KS trends and outcomes from Latin American clinical sites in the era of increased access to antiretroviral therapy (ART). METHODS Cohorts in Brazil, Peru, Mexico, Honduras, Argentina and Chile contributed clinical data of PWH ≥16 years old from 2000 to 2017, excluding patients with KS diagnosed before clinic enrolment. We compared KS incidence over time using multivariable incidence rate ratios. Predictors of KS before/at or after ART initiation and of mortality after KS were examined using Cox regression. RESULTS Of 25 981 PWH, 481 had incident KS, including 200 ART-naïve and 281 ART-treated patients. From 2000 to 2017, the incidence of KS decreased from 55.1 to 3.0 per 1000 person-years. In models adjusting for CD4 and other factors, the relative risk for KS decreased from 2000 to 2008. Since 2010, the adjusted risk of KS increased in the periods before and ≤90 days after ART initiation but decreased >90 days after ART. In addition to low CD4 and male-to-male sex, KS risk after ART was associated with age and history of other AIDS-defining illnesses. Mortality after KS (approximately 25% after five years) was not associated with either year of KS diagnosis nor timing of diagnosis relative to ART initiation. CONCLUSIONS KS incidence in Latin America has remained stable in recent years and risk is highest before and shortly after ART initiation. Early diagnosis of HIV and ART initiation remain critical priorities in the region.
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Affiliation(s)
- Jessica L Castilho
- Division of Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
| | - Ahra Kim
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTNUSA
| | - Cathy A Jenkins
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTNUSA
| | | | - Eduardo Gotuzzo
- Universidad Peruana Cayetano HerediaInstituto de Medicina Tropical Alexander von HumboldtLimaPeru
| | - Valeria Fink
- Fundación HuéspedInvestigaciones ClínicasBuenos AiresArgentina
| | - Denis Padgett
- Instituto Hondureño de Seguridad Social and Hospital Escuela UniversitarioTegucigalpaHonduras
| | - Pablo F Belaunzaran‐Zamudio
- Deparatmento de InfectologiaInstituto Nacional de Ciencias Médicas y NutriciónSalvador Zubirán. Mexico CityMexico
| | - Brenda Crabtree‐Ramírez
- Deparatmento de InfectologiaInstituto Nacional de Ciencias Médicas y NutriciónSalvador Zubirán. Mexico CityMexico
| | | | - Rosa Alencar Souza
- São Paulo State Department of HealthAIDS Reference and Training CenterSão PauloBrazil
| | - Simone B Tenore
- São Paulo State Department of HealthAIDS Reference and Training CenterSão PauloBrazil
| | - Sidnei R Pimentel
- São Paulo State Department of HealthAIDS Reference and Training CenterSão PauloBrazil
| | - Maria Letícia Rodrigues Ikeda
- Care and Treatment Clinic of the Partenon SanatoriumRio Grande do Sul State Department of HealthPorto AlegreBrazil
- University of Vale do Rio dos SinosSão LeopoldoBrazil
| | - Paulo R de Alencastro
- Care and Treatment Clinic of the Partenon SanatoriumRio Grande do Sul State Department of HealthPorto AlegreBrazil
| | - Unai Tupinanbas
- Medical SchoolFederal University of Minas GeraisBelo HorizonteBrazil
| | - Carlos Brites
- Edgar Santos University Hospital ComplexFederal University of BahiaSalvadorBrazil
| | - Estela Luz
- Edgar Santos University Hospital ComplexFederal University of BahiaSalvadorBrazil
| | - Juliana Netto
- Instituto Nacional de Infectiologia Evandro ChagasFiocruzBrazil
| | - Claudia P Cortes
- Fundaciòn Arriaran and University of Chile School of MedicineSantiagoChile
| | - Alexandre Grangeiro
- Department of Preventive MedicineUniversity of São Paulo School of MedicineSão PauloBrazil
| | - Bryan E Shepherd
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTNUSA
| | - Catherine C McGowan
- Division of Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
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Carvalho A, Sales HF, Ventura P, Gnoatto-Medeiros M, Brites C, Lucena R. The neurodevelopmental spectrum of congenital Zika infection: a scoping review. Dev Med Child Neurol 2020; 62:1356-1362. [PMID: 32931050 DOI: 10.1111/dmcn.14675] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 01/26/2023]
Abstract
AIM To describe the standardized neurodevelopmental outcomes after the first year of life in children with congenital Zika syndrome (CZS) and those exposed to Zika virus (ZIKV) during fetal life, but without microcephaly at birth. METHOD This scoping review included observational studies about the standardized neurodevelopmental outcome in children with CZS or exposed to ZIKV, but without microcephaly, assessed after 12 months of age. The databases searched were MEDLINE/Pubmed, LILACS, Scielo, Scopus, PsycINFO, CINAHL, and Embase. Risk of bias was assessed with the Joanna Briggs Institute Critical Appraisal Checklists. RESULTS Seventeen papers were included: 12 focused on children with CZS, four on children born without microcephaly, and one described both. Only one of the studies about CZS reported a child with microcephaly and typical development; the remainder described a severe pattern of global developmental delay and cerebral palsy. The prevalence of epilepsy was 74.6%. In the reports about children born without microcephaly, 6.9% to 8.7% had some domain with a score below -2 SD, and three children developed autism spectrum disorder. INTERPRETATION CZS is associated with severe global developmental delay and cerebral palsy after 1 year of age. In children born without microcephaly, although most have typical development, some may be at risk for impairments.
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Affiliation(s)
- Alessandra Carvalho
- SARAH Network of Rehabilitation Hospitals, Salvador, Brazil.,Post Graduation Program in Medicine and Health, Bahia Medical School, Federal University of Bahia, Salvador, Brazil
| | - Henrique F Sales
- Bahia Medical School, Federal University of Bahia, Salvador, Brazil
| | - Paloma Ventura
- SARAH Network of Rehabilitation Hospitals, Salvador, Brazil
| | | | - Carlos Brites
- Post Graduation Program in Medicine and Health, Bahia Medical School, Federal University of Bahia, Salvador, Brazil
| | - Rita Lucena
- Post Graduation Program in Medicine and Health, Bahia Medical School, Federal University of Bahia, Salvador, Brazil
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