60 results on '"Arruda MB"'
Search Results
2. Genomic and epidemiological monitoring of yellow fever virus transmission potential
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Faria, NR, Kraemer, MUG, Hill, SC, Goes de Jesus, J, Aguiar, RS, Iani, FCM, Xavier, J, Quick, J, du Plessis, L, Dellicour, S, Thézé, J, Carvalho, RDO, Baele, G, Wu, C-H, Silveira, PP, Arruda, MB, Pereira, MA, Pereira, GC, Lourenço, J, Obolski, U, Abade, L, Vasylyeva, TI, Giovanetti, M, Yi, D, Weiss, DJ, Wint, GRW, Shearer, FM, Funk, S, Nikolay, B, Fonseca, V, Adelino, TER, Oliveira, MAA, Silva, MVF, Sacchetto, L, Figueiredo, PO, Rezende, IM, Mello, EM, Said, RFC, Santos, DA, Ferraz, ML, Brito, MG, Santana, LF, Menezes, MT, Brindeiro, RM, Tanuri, A, Dos Santos, FCP, Cunha, MS, Nogueira, JS, Rocco, IM, da Costa, AC, Komninakis, SCV, Azevedo, V, Chieppe, AO, Araujo, ESM, Mendonça, MCL, Dos Santos, CC, Dos Santos, CD, Mares-Guia, AM, Nogueira, RMR, Sequeira, PC, Abreu, RG, Garcia, MHO, Abreu, AL, Okumoto, O, Kroon, EG, de Albuquerque, CFC, Lewandowski, K, Pullan, ST, Carroll, M, de Oliveira, T, Sabino, EC, Souza, RP, Suchard, MA, Lemey, P, Trindade, GS, Drumond, BP, Filippis, AMB, Loman, NJ, Cauchemez, S, Alcantara, LCJ, and Pybus, OG
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Prevention ,Genetics ,Emerging Infectious Diseases ,Rare Diseases ,Infectious Diseases ,Vaccine Related ,Biodefense ,Aetiology ,2.2 Factors relating to the physical environment ,Infection ,Aedes ,Age Factors ,Animals ,Brazil ,Disease Outbreaks ,Epidemiological Monitoring ,Evolution ,Molecular ,Genomics ,Humans ,Phylogeny ,Polymerase Chain Reaction ,Risk ,Sex Factors ,Spatio-Temporal Analysis ,Yellow Fever ,Yellow fever virus ,General Science & Technology - Abstract
The yellow fever virus (YFV) epidemic in Brazil is the largest in decades. The recent discovery of YFV in Brazilian Aedes species mosquitos highlights a need to monitor the risk of reestablishment of urban YFV transmission in the Americas. We use a suite of epidemiological, spatial, and genomic approaches to characterize YFV transmission. We show that the age and sex distribution of human cases is characteristic of sylvatic transmission. Analysis of YFV cases combined with genomes generated locally reveals an early phase of sylvatic YFV transmission and spatial expansion toward previously YFV-free areas, followed by a rise in viral spillover to humans in late 2016. Our results establish a framework for monitoring YFV transmission in real time that will contribute to a global strategy to eliminate future YFV epidemics.
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- 2018
3. Anomalia de Ebstein em paciente adulto: valvuloplastia modificada para correção de insuficiência tricúspide
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Arruda Mb, Mauro Barbosa Arruda Filho, Sérgio da Costa Rayol, Ana Paola Morais Arruda, Heraldo Maia, Flávia Arruda de Godoy Santos, and Claudia Arruda Buarque de Gusmão
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medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Anomalia de Ebstein ,RD1-811 ,Anomalia de Ebstein/cirurgia ,Cardiopatias congênitas ,Doppler studies ,Heart defects, congenital ,lcsh:Surgery ,Regurgitation (circulation) ,Actuarial survival ,Tricuspid valve ,Internal medicine ,medicine ,Valva tricúspide ,Diseases of the circulatory (Cardiovascular) system ,cardiovascular diseases ,Atrioventricular Septal Defect ,Cardiopatias congênitas/cirurgia ,Normal shape ,Adult patients ,business.industry ,Valva tricúspide/cirurgia ,General Medicine ,lcsh:RD1-811 ,Surgery ,medicine.anatomical_structure ,Ventricle ,lcsh:RC666-701 ,RC666-701 ,Ebstein´s Anomaly ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJETIVOS: Avaliar a correção cirúrgica em pacientes adultos portadores de anomalia de Ebstein, utilizando uma variação técnica para correção da insuficiência tricúspide. CASUÍSTICA E MÉTODOS: Entre janeiro de 1990 e março de 2001, seis pacientes adultos foram submetidos à correção cirúrgica com uma variação da técnica apresentada por Carpentier. A idade variou de 18 a 34 anos. Todos se apresentavam em classe funcional III ou IV (NYHA), com piora da cianose ou arritmias freqüentes. Em quatro pacientes a valva tricúspide era do tipo B e em dois do tipo A (Carpentier), quatro apresentavam comunicação interatrial (CIA) associada. O hematócrito variou de 33% a 68%. O índice cardíaco variou de 0.47 a 0.88. A fração de ejeção do ventrículo esquerdo variou de 50% a 80%. RESULTADOS: Não se registrou óbitos no período hospitalar. Um paciente foi reoperado por sangramento no pós-operatório imediato. Em dois pacientes ocorreram derrames pericárdicos de repetição. Foi registrado um óbito no 14º mês de pós-operatório por morte súbita. Os pacientes foram seguidos por um período de 10 a 108 meses. Quatro encontram-se em classe funcional I e um encontra-se em classe funcional II (NYHA). O ecocardiograma no pós-operatório imediato e na última avaliação mostra insuficiência tricúspide discreta ou moderada em quatro e importante em um paciente. CONCLUSÃO: Apesar do pequeno número de pacientes nesta série, a modificação técnica cumpriu o seu papel, com a melhora clínica e funcional dos pacientes tratados em até nove anos de seguimento. PURPOSE: To value the surgical treatment of adult patients with Ebstein's anomaly, using a Carpentier's modified repair technique. MATERIAL AND METHODS: Between January 1990 and March 2001 six adult patients with Ebstein's anomaly were treated using a modification of Carpentier's repair technique, four were males and two were females, ages ranging from 18 to 34 years (Mean 23.3 years), all were in Functional Class III or IV (NYHA), with increased cyanoses and frequent rhythm disturbance. Four patients had an associated atrioventricular septal defect; in four patients the tricuspid valve was Carpentier's type B and two type A and all were able to benefit from this conservative technique. RESULTS: There were not hospital deaths and one patient died 14º months after surgery in this series. Actuarial survival was 83.3% in 9 years. Four patients are in Functional Class I and one in Functional Class II (NYHA). Echocardiography and Doppler studies demonstrated a normal shape of right ventricle and good tricuspid valve function in four patients and one has moderate tricuspid regurgitation but still in Functional Class II (NYHA). CONCLUSION: Although the small number of patients in this series, the modification of Carpentier's repair technique in adult patients was efficient, reproducible and improved the preoperative status with regard to functional class, tricuspid regurgitation cyanoses and rhythm disturbance.
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- 2002
4. Comportamento da artéria caudal bovina como enxerto biológico vascular alternativo: estudo experimental em cães. (Nota prévia)
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Arruda Mb and Mauro Barbosa Arruda Filho
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Bioprosthesis ,Gynecology ,medicine.medical_specialty ,Bioprótese ,business.industry ,General Medicine ,Materiais biocompatíveis ,Femoral artery ,medicine ,Surgery ,Artéria femoral/cirurgia ,Artéria femoral ,Biocompatible materials ,Cardiology and Cardiovascular Medicine ,business ,Bioprótese/métodos - Abstract
Foram interpostos 20 segmentos de artéria caudal bovina (ACB), tratados com glutaraldeído e formaldeido, nas artérias femorais de 10 cães. O período de seguimento pós-operatório variou de 180 a 297 dias. Foram avaliados: função motora, pulsos (à palpação e ao ultra-sônar), variações das pressões arteriais sistólica, diastólica e média e fluxo através do enxerto, assim como consistência dilatação e coloração quando da retirada. Não houve óbitos, alterações da marcha ou processos inflamatórios nas feridas. Houve trombose total (15%), trombose mural focal (30%), reação linfoplasmocitária focal da adventícia (100%), calcificação unicamente das miocélulas (5%), reendotelização total (60%) e parcial (30%). Por apresentar adequação com diâmetro de pequenas artérias, ter comprimento suficiente para substituir ou atingir diversos segmentos de artérias distais, apresentar rápida endotelização, bem como ausência de rejeição, é demonstrada a receptividade ao uso da ACB como enxerto vascular alternativo. Twenty segments of bovine tail artery treated with glutaraldehyde were interposed into 10 dog's femoral arteries. The post-operative period varied from 183 to 297 days. Motor function, pulses, systolic, diastolic and median blood pressure and blood flow throught the graft, as well as consistence, dilatation and color in the follow-up period were analysed. There were no deaths, motorfunction or inflammatory changes. There were 15% of total thrombosis, focal wall thrombosis (30%), advential focal linfoplasmocitory reaction (100%), myocells calcification (15%), total reendotelization (60%) and partial (30%). Our data show that bovine tail artery has a diameter adequacy with small arteries, is long enough to replace or reach several distal arterial segments, has easy epitelization, and absence of cytological reation, allowding its use as an alternative graft.
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- 1996
5. Cardiac extension of primary mediastinal seminoma compressing the right ventricular outflow tract
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Thiago B. Saraiva, Vital Lira, Saraiva Lr, Arruda Mb, and Djair Brindeiro Fº
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Adult ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,endocrine system diseases ,Heart disease ,Heart Ventricles ,Ventricular Outflow Obstruction ,urologic and male genital diseases ,Anterior mediastinum ,Heart Neoplasms ,Heart neoplasms ,Testicular Neoplasms ,medicine ,Humans ,Ventricular outflow tract ,Antibiotics, Antineoplastic ,Primary seminoma ,Mediastinal Seminoma ,business.industry ,Anatomy ,Seminoma ,medicine.disease ,lcsh:RC666-701 ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
We report the case of a 33-year-old male with primary seminoma of the anterior mediastinum with initial clinical manifestations suggestive of heart disease.
- Published
- 2001
6. Anuloplastia concêntrica do anel mitral, isolada ou associada à ressecção quadrangular, em crianças e jovens
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Ana Paola Morais Arruda, Heraldo Maia e Silva, Mauro Barbosa Arruda Filho, Flávia Arruda de Godoy Santos, Audes D. M. Feitosa, Arruda Mb, Claudia Arruda Buarque de Gusmão, and Sérgio da Costa Rayol
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Gynecology ,Insuficiência da valva mitral ,medicine.medical_specialty ,business.industry ,Valva mitral ,Insuficiência da valva mitral/cirurgia ,Febre reumática ,General Medicine ,Surgery ,Valva mitral/cirurgia ,Valvas cardíacas ,medicine ,Mitral valve ,Febre reumática/complicações ,Rheumatic fever ,Valvas cardíacas/cirurgia ,Cardiology and Cardiovascular Medicine ,business ,Mitral Annuloplasty ,Quadrantectomy ,Heart valve ,Mitral valve insufficiency - Abstract
OBJETIVO: Descrever procedimento cirúrgico de anuloplastia concêntrica do anel mitral sem prótese, isolada ou associada à ressecção quadrangular com plicatura póstero-medial do anel mitral, e analisar os resultados imediatos e tardios obtidos. MÉTODO: Entre fevereiro de 1986 e fevereiro de 2001, realizamos 790 procedimentos abordando a valva mitral, 41 foram realizados em crianças e adolescentes menores de 20 anos (média de 9,7 anos). Vinte (48,7%) pacientes eram do sexo feminino e 21 (51,3%) do masculino. A doença reumática foi responsável pelas lesões em 92,6% dos casos e a degeneração mixomatosa em apenas 7,4%. No período pré-operatório, 22 (53,6%) pacientes estavam em classe funcional III e 19 (46,4%) em classe funcional IV, advindos de repetidos surtos de febre reumática, agravados pela desnutrição. A técnica cirúrgica utilizada foi a anuloplastia concêntrica, aplicada isoladamente ou em associação à ressecção quadrangular com plicatura póstero-medial. O curso do seguimento pós-operatório foi de 7 meses a 15 anos (3/2/1986 a 12/2/2001). RESULTADOS: A mortalidade hospitalar foi de 2,4%. Os pacientes receberam alta sem sopro sistólico de regurgitação mitral. Dois pacientes apresentaram, ao longo dos anos (4 e 11 anos), estenose mitral e necessitaram reoperação, um deles operado com dois anos de idade. Dois doentes foram reoperados para corrigir disfunção aórtica previamente abordada por plastia (12 e 18 meses após a primeira operação), morrendo e contribuindo para mortalidade tardia de 5%. CONCLUSÃO: Consideramos a técnica empregada um procedimento alternativo, válido, de aplicação preferencial em crianças e adolescentes, de fácil reprodução e de baixíssimo custo. OBJECTIVE: To describe the mitral anuloplasty technique either in isolation or associated with posterior quadrantectomy and to analyze the immediate and late results in young patients. METHOD: Between February 1986 and February 2001, 790 mitral valve procedures were performed in our Institution including 41 annuloplaties in patients with ages ranging from 1 to 20 years (Mean age = 9.7 years). 51.7% were males. The main etiologies were rheumatic disease (92.6%) and myxomatous degeneration (7.4%). Twenty-two (53.6%) patients were preoperatively in functional class III (NYHA), and 19 (46.4%) in class IV (NYHA), some in course of rheumatic fever aggravated by malnutrition. The technique employed was concentric mitral annuloplasty either in isolation or associated with posterior quadrantectomy. The follow-up ranged from 7 months to 15 years. RESULTS: The hospital mortality rate was 2.4%. All patients were discharged without mitral regurgitation. Two patients coursed with mitral stenosis (after 4 and 11 years respectively) and valve replacement was needed. Two patients coursed with aortic insufficiency (after 12 and 18 months) and died after aortic valve replacement, contributing to a 5% late mortality rate. CONCLUSION: In conclusion, mitral annuloplasty without ring either in isolation or associated with posterior quadrantectomy is a safe, easily reproducible especially in young patients.
- Published
- 2004
7. Diretrizes da cirúrgia de revascularização miocárdica valvopatias e doenças da aorta
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Alexandre Visconti Brick, Mário Gesteira Costa, Ricardo de Carvalho Lima, José Wanderley Neto, Fernando A. Lucchese, Jorge Ilha Guimarães, José Teles de Mendonça, Domingos Marcolino Braile, Domingos S. R. Souza, Arruda Mb, José Glauco Lobo Filho, Maria do Socorro Duarte Leite, João Nelson Rodrigues Branco, Marcius Vinícius M. Maranhão, Luis Fernando Kubrusly, Maurilio Onofre Deininger, Mozart Escobar, Frederico Pires Vasconcelos Silva, Nery Ac, Nilson Augusto Mendes Ribeiro, Pedro R Salerno, Paulo Roberto Slud Brofman, Sergio Tavares Montenegro, Mauro Barbosa Arruda Filho, Bruno Botelho Pinheiro, Enio Buffolo, and Jorge Augusto Nunes Guimarães
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lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,lcsh:RC666-701 ,business.industry ,Internal medicine ,Cardiology ,medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2004
8. The surgical treatment of traumatic rupture of aortic valve and atrial septum after blunt chest trauma: literature review and presentation of a rare case
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Mauro Barbosa Arruda Filho, Claudia Arruda Buarque de Gusmão, Ana Paola Morais Arruda, Arruda Mb, Ednaldo Fontes Junior, Flávia Arruda de Godoy Santos, Heraldo Maia e Silva, and Sérgio da Costa Rayol
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Aortic valve ,medicine.medical_specialty ,Heart Injury ,business.industry ,Leaflet Disruption ,General Medicine ,medicine.disease ,Intensive care unit ,Heart septum ,law.invention ,Surgery ,medicine.anatomical_structure ,law ,Internal medicine ,Heart failure ,cardiovascular system ,Cardiology ,Medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Hemopneumothorax ,Subcutaneous emphysema - Abstract
The case of a 49-year-old man who suffered a car accident responsible for several chest injuries including fractures of the left ribs, large subcutaneous emphysema and left hemopneumothorax arrived in shock in the Emergency Room of the Real Hospital Portugues de Beneficencia in Pernambuco (RHPBPE). He was hospitalized for 30 days including some time in the intensive care unit and but did not show signs of diastolic murmur or heart failure. He was submitted to an echocardiography examination that diagnosed slight aortic incompetence, good left ventricular function and was discharged after clinical improvement. Three months later he started to feel symptoms of heart failure and returned to cardiac Emergency Room of the same Hospital. He repeated transthoracic and transesophageal echocardiography examinations presenting severe aortic incompetence due to leaflet disruption, rupture of atrial septum with enlargement of the right cardiac chambers and poor left ventricular function. He underwent surgical treatment of these lesions, with direct approach of the atrial septum and the aortic valve was replaced with a mechanical prosthesis, with a good result.
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- 2003
9. Mital valve disease with rheumatic appearance in the presence of left ventricular endomyocardial fibrosis
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Saraiva Lr, Arruda Mb, R W Carneiro, Djair Brindeiro F, and Vital Lira
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Male ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Heart Ventricles ,Endomyocardial fibrosis ,Heart Valve Diseases ,Regurgitation (circulation) ,Disease ,Internal medicine ,Mitral valve ,medicine ,Humans ,Mitral Valve Stenosis ,Child ,business.industry ,Rheumatic Heart Disease ,medicine.disease ,Endomyocardial Fibrosis ,Stenosis ,medicine.anatomical_structure ,Ventricle ,lcsh:RC666-701 ,Cardiology ,Mitral Valve ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
This is a report of a nine-year-old boy with both mitral stenosis and regurgitation and extensive endomyocardial fibrosis of the left ventricle. Focus is given to the singularity of the fibrotic process, with an emphasis on the etiopatho-genic aspects.
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- 1999
10. P16-39. T cell recognition of autologous and non-autologous HIV-1 protease peptides by HIV-1 infected patients undergoing PI therapy
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Moraes, SL, primary, Muller, NG, additional, Paula, MO, additional, Arruda, MB, additional, Brindeiro, RM, additional, Alencar, R, additional, Jamal, L, additional, Kalil, J, additional, and Cunha-Neto, E, additional
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- 2009
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11. Mitral Valve Surgery in Children
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Carlos R. Moraes, Jose Ricardo Lagreca, Gilvan Tompson, Arruda Mb, Ivan Cavalcanti, and Edgar Guimarães Victor
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,medicine ,030212 general & internal medicine ,030204 cardiovascular system & hematology ,Cardiology and Cardiovascular Medicine ,business ,Mitral valve surgery ,Surgery - Published
- 1978
12. Congenital Aneurysm of the Left Atrium
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Edgar Guimarães Victor, Arruda Mb, Ivan Cavalcanti, Gilvan Tompson, and Carlos R. Moraes
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medicine.medical_specialty ,business.industry ,Congenital aneurysm ,Left atrium ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Internal medicine ,Cardiology ,Medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 1978
13. Surgical Experience with Rheumatic Mitral Valve Disease in Children
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Cláudio A Gomes, Carlos R. Moraes, Ivan Cavalcanti, Ricardo de Carvalho Lima, Arruda Mb, Edgar Guimarães Victor, Rodrigues Jv, and Mozart Excobar
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medicine.medical_specialty ,education.field_of_study ,Heart disease ,business.industry ,medicine.medical_treatment ,Population ,Mitral valve replacement ,Disease ,medicine.disease ,medicine.anatomical_structure ,Valve replacement ,Internal medicine ,Mitral valve ,medicine ,Cardiology ,Rheumatic fever ,In patient ,business ,education - Abstract
In developing countries, rheumatic heart disease continues to be a challenging problem. The disease often affects young people from the lower strata of the population in an accelerated and severe form that produces early valve damage, which can be relieved in some patients only by surgery [1–3]. In this paper, we review our experience with surgical management of rheumatic mitral valve disease in patients below the age of 15 years.
- Published
- 1986
14. Ventricular septal defect following nonpenetrating trauma. Case report and review of the surgical literature
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Ivan Cavalcanti, Luciano Raposo, Arruda Mb, Edgar Guimarães Victor, Jose Ricardo Lagreca, José Maria Pereira Gomes, and Carlos R. Moraes
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Heart Septal Defects, Ventricular ,Male ,Heart Injury ,medicine.medical_specialty ,Extracorporeal Circulation ,Injury control ,Poison control ,030204 cardiovascular system & hematology ,Suicide prevention ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,Injury prevention ,medicine ,Humans ,030212 general & internal medicine ,Child ,business.industry ,Extracorporeal circulation ,Accidents, Traffic ,Human factors and ergonomics ,Surgery ,Heart Injuries ,Emergency medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 1973
15. Spontaneous development of paraplegia after repair of coarctation of the aorta
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Ivan Cavalcanti, Mozart Escobar, Arruda Mb, Ricardo de Carvalho Lima, Rodrigues Jv, Carlos R. Moraes, and Edgar Guimarães Victor
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Aorta ,business.industry ,Coarctation of the aorta ,Corrective surgery ,medicine.disease ,nervous system diseases ,Surgery ,medicine.artery ,Anesthesia ,medicine ,Cardiology and Cardiovascular Medicine ,Paraplegia ,business ,Complication - Abstract
This report describes the case of a 19-month-old boy in whom paraplegia developed spontaneously 2 days after a technically uncomplicated coarctation of the aorta repair.
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- 1985
16. Oropouche virus genomic surveillance in Brazil.
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Moreira FRR, Dutra JVR, de Carvalho AHB, Reis CR, Rios JSH, Ribeiro MO, Arruda MB, Alvarez P, Souza RP, Voloch C, Zauli DAG, and Aguiar RS
- Abstract
Competing Interests: We declare no competing interests. All new Oropouche virus genome sequences were deposited on NCBI GenBank under accessions PQ066768 to PQ066785. We acknowledge all authors who submitted Oropouche virus genome sequences to National Center for Biotechnology Information GenBank, making this and other genomic epidemiology efforts possible. A complete list of data contributors is available in the appendix. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.
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- 2024
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17. Differential diagnosis of exanthematous viruses during the 2022 Mpox outbreak in Minas Gerais, Brazil.
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Adelino TÉR, Santos SC, Lima MT, da Costa AVB, Guimarães NR, Tomé LMR, Silva MVF, Pereira AM, Luiz KCM, Lamounier LO, Gomes Júnior AC, Ribeiro AA, Alvarez P, Arruda MB, Kroon EG, Guerra-Duarte C, and Iani FCdM
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- Humans, Brazil epidemiology, Retrospective Studies, Male, Female, Adult, Diagnosis, Differential, Child, Adolescent, Mpox (monkeypox) diagnosis, Mpox (monkeypox) epidemiology, Mpox (monkeypox) virology, Young Adult, Child, Preschool, Middle Aged, Monkeypox virus genetics, Monkeypox virus isolation & purification, Herpesvirus 3, Human genetics, Herpesvirus 3, Human isolation & purification, Infant, Aged, Exanthema virology, Exanthema epidemiology, Real-Time Polymerase Chain Reaction, Disease Outbreaks
- Abstract
The monkeypox virus (MPXV) outbreak, primarily endemic to Africa, has spread globally, with Brazil reporting the second-highest number of cases. The emergence of MPXV in non-endemic areas has raised concerns, particularly due to the co-circulation of other exanthematous viruses such as varicella-zoster virus (VZV) and molluscum contagiosum virus (MOCV). To perform an accurate differential diagnosis of MPXV during the ongoing outbreak in Minas Gerais, Brazil, a 5PLEX qPCR assay targeting orthopoxviruses (OPV), VZV, and MOCV was used to retrospectively analyze all clinical samples that tested negative for MPXV in the initial screening conducted at Funed. In summary, our study analyzed 1,175 clinical samples received from patients suspected of MPXV infection and found a positivity rate of 33.8% (397 samples) for MPXV using the non-variola qPCR assay. Testing the 778 MPXV-negative clinical samples using the 5PLEX qPCR assay revealed that 174 clinical samples (22.36%) tested positive for VZV. MOCV DNA was detected in 13 and other OPV in 3 clinical samples. The sequencing of randomly selected amplified clinical samples confirmed the initial molecular diagnosis. Analysis of patient profiles revealed a significant difference in the median age between groups testing positive for MPXV and VZV and a male predominance in MPXV cases. The geographic distribution of positive cases was concentrated in the most populous mesoregions of Minas Gerais state. This study highlights the challenges posed by emerging infectious diseases. It emphasizes the importance of epidemiological surveillance and accurate diagnosis in enabling timely responses for public health policies and appropriate medical care., Importance: Brazil ranks second in the number of cases during the global monkeypox epidemic. The study, conducted in Minas Gerais, the second most populous state in Brazil with over 20 million inhabitants, utilized differential diagnostics, revealing a significant number of positive cases for other exanthematous viruses and emphasizing the need for accurate diagnoses. During the study, we were able to assess the co-circulation of other viruses alongside monkeypox, including varicella-zoster virus, molluscum contagiosum virus, and other orthopoxviruses. The significance of the research is underscored by the concentration of positive cases in populous areas, highlighting the challenges posed by emerging infectious diseases. This demographic context further amplifies the importance of the research in guiding public health policies and medical interventions, given the substantial population at risk. The study not only addresses a global concern but also holds critical implications for a state with such a large population and geographic expanse within Brazil. Overall, the study emphasizes the pivotal role of surveillance and precise diagnosis in guiding effective public health responses and ensuring appropriate medical interventions., Competing Interests: P.A. and M.B.A. are employees of Bio-Manguinhos (Fundação Oswaldo Cruz/FIOCRUZ), the institution responsible for the development and provision of the Kit Molecular 5PLEX OPXV/MPXV/VZV/MOCV/RP to the BrMoH. However, there was no involvement or interference from this institution in the execution of the experiments or the writing of the manuscript.
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- 2024
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18. Detection of Plasmodium spp. in asymptomatic blood donors by the new Brazilian NAT PLUS HIV/HBV/HCV/Malaria Bio-Manguinhos kit.
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Costa E, Rocha D, Lopes JIF, Andrade E, Cardoso P, Ribeiro M, Fontana-Maurell M, Vicentino ARR, Calazans AR, Arruda MB, Mesquita CA, Ferreira AGP, Amorim Filho L, and Alvarez P
- Subjects
- Humans, Hepatitis B virus, Blood Donors, Brazil epidemiology, Plasmodium malariae, Malaria diagnosis, Malaria epidemiology, HIV Infections diagnosis, HIV Infections epidemiology, Hepatitis C
- Abstract
Background: Transfusion-transmitted malaria (TTM) is a public health problem in endemic and nonendemic areas. The Brazilian Ministry of Health (MH) requested the development of a nucleic acid amplification test (NAT) for the detection of Plasmodium spp. in public blood centers to increase blood safety., Study Design and Methods: The new Brazilian NAT kit named NAT PLUS HIV/HBV/HCV/Malaria Bio-Manguinhos was first implemented in HEMORIO, a public blood center in the city of Rio de Janeiro. Since October 1, 2022, this blood center has been testing all its blood donations for malaria in a pool of six plasma samples to detect Plasmodium spp. by real-time polymerase chain reaction (PCR)., Results: Since the implementation of the NAT PLUS platform until February 2023, HEMORIO has successfully received and tested 200,277 donations. The platform detected two asymptomatic donors in the city of Rio de Janeiro, which is a nonendemic region for malaria. Our analyses suggested a malaria from the Amazon region caused by Plasmodium vivax, in the first case, while an autochthonous transmission case by Plasmodium malariae was identified in the rural area of Rio de Janeiro state., Discussion: The NAT PLUS platform detects Plasmodium spp. in plasma samples with sensitivity capable of detecting subpatent infections. This is the first time worldwide that a group developed and implemented molecular diagnosis for Plasmodium spp. to be used by public blood centers to avoid TTM., (© 2024 AABB.)
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- 2024
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19. Influenza A, like Omicron SARS-CoV-2, Is Similarly Detected in Saliva or Nasopharyngeal Samples via RT-qPCR.
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Abreu H, Royer CA, Poitevin CG, Kohler AF, Rodrigues AC, Raboni SM, Nogueira MB, Cardoso PH, Arruda MB, Baptista PADS, Bonatto AC, Gradia DF, Adamoski D, Maltempi de Souza E, and Carvalho de Oliveira J
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- Humans, COVID-19 Testing, SARS-CoV-2 genetics, Saliva, Nasopharynx, Specimen Handling, Influenza, Human diagnosis, COVID-19 diagnosis
- Abstract
After the Coronavirus pandemic, the importance of virus surveillance was highlighted, reinforcing the constant necessity of discussing and updating the methods for collection and diagnoses, including for other respiratory viruses. Although the nasopharyngeal swab is the gold-standard sample for detecting and genotyping SARS-CoV-2 and Influenza viruses, its collection is uncomfortable and requires specialized teams, which can be costly. During the pandemic, non-invasive saliva samples proved to be a suitable alternative for SARS-CoV-2 diagnosis, but for Influenza virus the use of this sample source is not recognized yet. In addition, most SARS-CoV-2 comparisons were conducted before the Omicron variant emerged. Here, we aimed to compare Influenza A and Omicron RT-qPCR analysis of nasopharyngeal swabs and saliva self-collection in paired samples from 663 individuals. We found that both nasopharyngeal swab and saliva collection are efficient for the diagnosis of Omicron (including sub-lineages) and for Influenza A, with high sensitivity and accuracy (>90%). The kappa index is 0.938 for Influenza A and 0.905 for SARS-CoV-2. These results showed excellent agreement between the two samples reinforcing saliva samples as a reliable source for detecting Omicron and highlighting saliva as a valid sample source for Influenza detection, considering this cheaper and more comfortable alternative.
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- 2023
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20. Epidemiological and genomic investigation of chikungunya virus in Rio de Janeiro state, Brazil, between 2015 and 2018.
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Moreira FRR, Menezes MT, Salgado-Benvindo C, Whittaker C, Cox V, Chandradeva N, Paula HHS, Martins AF, Chagas RRD, Brasil RDV, Cândido DDS, Herlinger AL, Ribeiro MO, Arruda MB, Alvarez P, Tôrres MCP, Dorigatti I, Brady O, Voloch CM, Tanuri A, Iani F, Souza WM, Cardozo SV, Faria NR, and Aguiar RS
- Subjects
- Humans, Brazil epidemiology, Phylogeny, Genomics, Disease Outbreaks, Chikungunya virus genetics, Chikungunya Fever
- Abstract
Since 2014, Brazil has experienced an unprecedented epidemic caused by chikungunya virus (CHIKV), with several waves of East-Central-South-African (ECSA) lineage transmission reported across the country. In 2018, Rio de Janeiro state, the third most populous state in Brazil, reported 41% of all chikungunya cases in the country. Here we use evolutionary and epidemiological analysis to estimate the timescale of CHIKV-ECSA-American lineage and its epidemiological patterns in Rio de Janeiro. We show that the CHIKV-ECSA outbreak in Rio de Janeiro derived from two distinct clades introduced from the Northeast region in mid-2015 (clade RJ1, n = 63/67 genomes from Rio de Janeiro) and mid-2017 (clade RJ2, n = 4/67). We detected evidence for positive selection in non-structural proteins linked with viral replication in the RJ1 clade (clade-defining: nsP4-A481D) and the RJ2 clade (nsP1-D531G). Finally, we estimate the CHIKV-ECSA's basic reproduction number (R0) to be between 1.2 to 1.6 and show that its instantaneous reproduction number (Rt) displays a strong seasonal pattern with peaks in transmission coinciding with periods of high Aedes aegypti transmission potential. Our results highlight the need for continued genomic and epidemiological surveillance of CHIKV in Brazil, particularly during periods of high ecological suitability, and show that selective pressures underline the emergence and evolution of the large urban CHIKV-ECSA outbreak in Rio de Janeiro., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Moreira et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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21. A straightforward one-step strategy for SARS-CoV-2 diagnosis and screening of variants of concern: a multicentre study.
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Fontana-Maurell M, Motta FDC, Arruda MB, Cardoso P, Ribeiro M, Andrade E, Godoy DT, Costa E, Rocha D, Siqueira MAM, Brindeiro R, and Alvarez P
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- Humans, COVID-19 Testing, Biological Assay, Chromosome Mapping, SARS-CoV-2 genetics, COVID-19 diagnosis
- Abstract
Background: The prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) has changed unevenly over time around the world. Although whole genome sequencing is the gold standard for virus characterisation, the discovery of alpha VOC causing spike gene target failure (SGTF) result, when tested using an reverse transcription real-time polymerase chain reaction (RT-qPCR) assay, has provided a simple tool for tracking the frequencies of variants., Objectives: The aim of this study was to investigate if a multiplex RT-qPCR assay (BioM 4Plex VOC) could be used to detect SARS-CoV-2 and to perform a VOC screening test in a single reaction tube. Here, we present the multicentre study evaluating this assay., Methods: Twelve laboratories have participated in the multicentre study. The BioM 4Plex VOC was distributed to them with detailed instructions of how to perform the test. They were asked to test the BioM 4Plex VOC in parallel with their routine Commercial SARS-CoV-2 diagnostic assay. Additionally, they were requested to select SARS-CoV-2-positive samples with genome sequenced and lineage definition according to PANGO lineage classification., Findings: The BioM 4Plex VOC and commercial RT-PCR assay are equally effective in detecting SARS-CoV-2. Results revealed a specificity of 96.5-100% [95% confidence interval (CI)], a sensitivity of 99.8-100% (95% CI), and an accuracy of 99.8-100% (95% CI). A 99% concordance rate was found between results from the BioM 4Plex VOC and that from available genome sequencing data., Main Conclusions: The BioM 4Plex VOC provides an effective solution to detect SARS-CoV-2 infections and screening for VOCs in a single reaction. It is a straightforward method to help us monitor the frequency and distribution of VOCs and develop strategies to better cope with the pandemics.
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- 2023
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22. Monkeypox keratoconjunctivitis with associated Wessley immune ring in an immunocompetent patient.
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Quites TO, Landeira LFL, Santana TGV, Khouri CL, Arruda MB, Baptista PADS, and Barroso SPC
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- Humans, Mpox (monkeypox), Keratoconjunctivitis
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- 2023
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23. COVID-19 cross-sectional study in Maricá, Brazil: The impact of vaccination coverage on viral incidence.
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Frauches TS, Costa CAS, Rodrigues CDS, de Azevedo MCVM, Ferreira MM, Ramos HBVDS, de Souza Junior WR, Costa AR, Camargo AC, Alonso AH, Dos Santos FÁ, Oliveira HDS, Coelho JG, Sobral JFDS, Rodrigues LCDS, Ferreira MMC, Laureano P, da Paz Fernandes RA, Santos RDS, Dos Santos RMC, Milagres S, Dos Santos VCC, Silva JT, da Silva TM, da Rocha MGC, de São Carlos AE, de Araújo Ramos AM, Bastos FMA, Francisco DR, Rosa SDS, Linhares LC, Organista RR, Bastos L, Pinto MMK, do Nascimento JPL, da Silveira JPM, Dos Santos MQ, da Silva NS, Ferreira NCDS, Reis RBR, de Oliveira RF, Sá VO, Hammes TRS, Monteiro JO, Cardoso PH, Arruda MB, Alvarez P, Maia RA, Ribeiro LJ, Ferreira OC Jr, Santos A, de Almeida ACM, Garcia L, Pansera C, and Tanuri A
- Subjects
- Antibodies, Neutralizing, Antibodies, Viral, Brazil epidemiology, Cross-Sectional Studies, Humans, Immunoglobulin G, Incidence, Pandemics, SARS-CoV-2, COVID-19 epidemiology, COVID-19 prevention & control, Vaccination Coverage
- Abstract
Population surveillance in COVID-19 Pandemic is crucial to follow up the pace of disease and its related immunological status. Here we present a cross-sectional study done in Maricá, a seaside town close to the city of Rio de Janeiro, Brazil. Three rounds of study sampling, enrolling a total of 1134 subjects, were performed during May to August 2021. Here we show that the number of individuals carrying detectable IgG antibodies and the neutralizing antibody (NAb) levels were greater in vaccinated groups compared to unvaccinated ones, highlighting the importance of vaccination to attain noticeable levels of populational immunity against SARS-CoV-2. Moreover, we found a decreased incidence of COVID-19 throughout the study, clearly correlated with the level of vaccinated individuals as well as the proportion of individuals with detectable levels of IgG anti-SARS-CoV-2 and NAb. The observed drop occurred even during the introduction of the Delta variant in Maricá, what suggests that the vaccination slowed down the widespread transmission of this variant. Overall, our data clearly support the use of vaccines to drop the incidence associated to SARS-CoV-2., Competing Interests: The authors have declared that no competing interests exist.
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- 2022
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24. Evaluation of the Panbio COVID-19 Antigen Rapid Diagnostic Test in Subjects Infected with Omicron Using Different Specimens.
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Galliez RM, Bomfim L, Mariani D, Leitão IC, Castiñeiras ACP, Gonçalves CCA, Ortiz da Silva B, Cardoso PH, Arruda MB, Alvarez P, Brindeiro R, Ota VA, Rodrigues DGM, da Costa LJ, Ferreira ODC Jr, Castiñeiras TMPP, Faffe DS, and Tanuri A
- Subjects
- COVID-19 Testing, Diagnostic Tests, Routine, Humans, SARS-CoV-2 genetics, Sensitivity and Specificity, COVID-19 diagnosis
- Abstract
Community testing is a crucial tool for the early identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and transmission control. The emergence of the highly mutated Omicron variant (B.1.1.529) raised concerns about its primary site of replication, impacting sample collection and its detectability by rapid antigen tests. We tested the performance of the Panbio antigen rapid diagnostic test (Ag-RDT) using nasal and oral specimens for COVID-19 diagnosis in 192 symptomatic individuals, with quantitative reverse transcription-PCR (RT-qPCR) of nasopharyngeal samples as a control. Variant of concern (VOC) investigation was performed with the 4Plex SARS-CoV-2 screening kit. The SARS-CoV-2 positivity rate was 66.2%, with 99% of the positive samples showing an amplification profile consistent with that of the Omicron variant. Nasal Ag-RDT showed higher sensitivity (89%) than oral (12.6%) Ag-RDT. Our data showed good performance of the Ag-RDT in a pandemic scenario dominated by the Omicron VOC. Furthermore, our data also demonstrated that the Panbio COVID-19 antigen rapid diagnostic test does not provide good sensitivity with oral swabs for Omicron Ag-RDT detection. IMPORTANCE This study showed that the antigen rapid test for COVID19 worked fine using nasal swabs when it was utilized in patients infected with the Omicron variant, showing a concordance with PCR in 93% of patients tested. The nasal swab yielded more reliable results than the oral swab when an antigen rapid diagnosis test (the Panbio COVID-19 antigen rapid diagnostic test) was used in patients infected with the Omicron variant.
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- 2022
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25. HIV-1 molecular diversity in Brazil unveiled by 10 years of sampling by the national genotyping network.
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Gräf T, Bello G, Andrade P, Arantes I, Pereira JM, da Silva ABP, Veiga RV, Mariani D, Boullosa LT, Arruda MB, Fernandez JCC, Dennis AM, Rasmussen DA, and Tanuri A
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- Adolescent, Adult, Brazil epidemiology, Female, Genotype, HIV Infections blood, HIV Infections virology, HIV Seropositivity, Humans, Longitudinal Studies, Male, Middle Aged, Young Adult, HIV Infections epidemiology, HIV-1 classification, HIV-1 genetics, Phylogeny
- Abstract
HIV-1 has diversified into several subtypes and recombinant forms that are heterogeneously spread around the world. Understanding the distribution of viral variants and their temporal dynamics can help to design vaccines and monitor changes in viral transmission patterns. Brazil has one of the largest HIV-1 epidemics in the western-world and the molecular features of the virus circulating in the country are still not completely known. Over 50,000 partial HIV-1 genomes sampled between 2008 and 2017 by the Brazilian genotyping network (RENAGENO) were analyzed. Sequences were filtered by quality, duplicate sequences per patient were removed and subtyping was performed with online tools and molecular phylogeny. Association between patients' demographic data and subtypes were performed by calculating the relative risk in a multinomial analysis and trends in subtype prevalence were tested by Pearson correlation. HIV-1B was found to be the most prevalent subtype throughout the country except in the south, where HIV-1C prevails. An increasing trend in the proportion of HIV-1C and F1 was observed in several regions of the country, while HIV-1B tended to decrease. Men and highly educated individuals were more frequently infected by HIV-1B and non-B variants were more prevalent among women with lower education. Our results suggest that socio-demographic factors partially segregate HIV-1 diversity in Brazil while shaping viral transmission networks. Historical events could explain a preferential circulation of HIV-1B among men who have sex with men (MSM) and non-B variants among heterosexual individuals. In view of an increasing male/female ratio of AIDS cases in Brazil in the last 10-15 years, the decrease of HIV-1B prevalence is surprising and suggests a greater penetrance of non-B subtypes in MSM transmission chains., (© 2021. The Author(s).)
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- 2021
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26. Oral Use of Phenytoin to Reduce Calcification in Bovine Pericardium and Porcine Aortic Leaflets Implants in Rats.
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Arruda MB Filho, Aguiar LD, Marques SRB, Cavalcanti LRP, and Sá MPBO
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- Animals, Aorta, Cattle, Glutaral, Pericardium, Phenytoin pharmacology, Rats, Swine, Bioprosthesis, Calcinosis prevention & control, Heart Valve Prosthesis
- Abstract
Introduction: This study aims to test the effect of phenytoin as an inhibitor of the process of dystrophic calcification in bovine pericardium and porcine leaflets implanted in the subcutaneous tissue of rats., Methods: Isolated segments of biomaterials were implanted subcutaneously in young rats. The study groups received 500 mg phenytoin per kilogram of diet per day. After 90 days, samples were collected and quantitative calcification assessment by optical microscopy, radiological studies with mammography, and atomic emission spectrometry were performed., Results: Inflammatory reaction was a frequent finding in all groups when analyzed by optical microscopy. The calcium level assessed by atomic absorption spectrophotometry was significantly lower in the study groups using phenytoin compared to the control groups (control bovine pericardium group X=0.254±0.280 µg/mg; study bovine pericardium group X=0.063±0.025 µg/mg; control porcine aortic leaflets group X=0.640±0.226 µg/mg; study porcine aortic leaflets group X=0.056±0.021 µg/mg; P<0.05). Radiologic studies revealed a statistically significant difference between the groups treated with and without phenytoin (not only regarding the bovine pericardium but also the porcine leaflets)., Conclusion: The results obtained suggest that phenytoin reduces the calcification process of bovine pericardium segments and porcine aortic leaflets in subdermal implants in rats; also, the incidence of calcification in bovine pericardium grafts was similar to that of porcine aortic leaflets.
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- 2021
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27. Pregnant women co-infected with HIV and Zika: Outcomes and birth defects in infants according to maternal symptomatology.
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João EC, Ferreira ODC Jr, Gouvêa MI, Teixeira MLB, Tanuri A, Higa LM, Costa DA, Mohana-Borges R, Arruda MB, Matos HJ, Cruz ML, Mendes-Silva W, and Read JS
- Subjects
- Adult, Algorithms, Brazil epidemiology, Central Nervous System abnormalities, Chikungunya Fever complications, Chikungunya Fever diagnosis, Chikungunya Fever epidemiology, Cohort Studies, Coinfection diagnosis, Dengue complications, Dengue diagnosis, Dengue epidemiology, Disease Outbreaks, Female, Humans, Infant, Newborn, Male, Pregnancy, Pregnancy Complications, Infectious diagnosis, Pregnancy Outcome, Prevalence, Risk Factors, Young Adult, Zika Virus Infection diagnosis, Coinfection epidemiology, Congenital Abnormalities epidemiology, Congenital Abnormalities etiology, HIV Infections complications, HIV Infections epidemiology, Pregnancy Complications, Infectious epidemiology, Zika Virus Infection complications, Zika Virus Infection epidemiology
- Abstract
Background: Zika virus (ZIKV) was first isolated in Uganda in 1947. In Brazil, the first reported case of ZIKV infection was in May 2015. Additionally, dengue (DENV) is endemic and there has been a recent outbreak of chikungunya (CHIKV). Since the clinical manifestations of different arboviral infections (AI) can be similar, definitive diagnosis requires laboratory testing., Objectives: To determine the prevalence of ZIKV, DENV, and CHIKV infections in a Brazilian cohort of HIV-infected pregnant women, to assess clinical/immunological characteristics and pregnancy outcomes of women with evidence of recent AI., Study Design: Laboratory diagnosis of ZIKV, DENV and CHIKV infections utilized serological assays, RT-PCR and PRNT. The tests were performed at the first visit, 34-36 weeks of gestation and at any time if a woman had symptoms suggestive of AI. Mann-Whitney tests were used for comparison of medians, Chi-square or Fisher's to compare proportions; p< 0.05 was considered statistically significant. Poisson regression was used to analyze risk factors for central nervous system (CNS) malformations in the infant according to maternal symptomatology., Results: Of 219 HIV-infected pregnant women enrolled, 92% were DENV IgG+; 47(22%) had laboratory evidence of recent AI. Of these, 34 (72%) were ZIKV+, nine (19%) CHIKV+, and two (4%) DENV+. Symptoms consistent with AI were observed in 23 (10%) women, of whom 10 (43%) were ZIKV+, eight (35%) CHIKV+. No CNS abnormalities were observed among infants of DENV+ or CHIKV+ women; four infants with CNS abnormalities were born to ZIKV+ women (three symptomatic). Infants born to ZIKV+ women had a higher risk of CNS malformations if the mother was symptomatic (RR = 7.20), albeit not statistically significant (p = 0.066)., Conclusions: Among HIV-infected pregnant women with laboratory evidence of a recent AI, 72% were ZIKV-infected. In this cohort, CNS malformations occurred among infants born to both symptomatic and asymptomatic pregnant women with Zika infection., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2018
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28. Prevalence of IgG Autoantibodies against GD3 Ganglioside in Acute Zika Virus Infection.
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Nico D, Conde L, Rivera-Correa JL, Vasconcelos-Dos-Santos A, Mesentier-Louro L, Freire-de-Lima L, Arruda MB, Freire-de-Lima CG, Ferreira ODC Jr, Lopes Moreira ME, Zin AA, Vasconcelos ZFM, Otero RM, Palatnik-de-Sousa CB, Tanuri A, Todeschini AR, Savino W, Rodriguez A, and Morrot A
- Abstract
Zika virus (ZIKV) disease has become a global health emergency with devastating effects on public health. Recent evidences implicate the virus as an emergent neuropathological agent promoting serious pathologies of the human nervous system, that include destructive and malformation consequences such as development of ocular and fetal brain lesions, microcephaly in neonates, and Guillain-Barré syndrome (GBS) in adults. These neurological disorders of both central and peripheral nervous systems are thought to be associated to the neurotropic properties of the virus that has ability to infect neural stem cells as well as peripheral neurons, a hallmark of its pathogenicity. The presence of autoantibodies against gangliosides plays a pivotal role in the etiogenesis of GBS and a variety of neurological disorders. Gangliosides are a class of galactose-containing cerebrosides mainly expressed in nervous system tissues playing a critical role in the physiology of neural cells and neurogenesis. Herein, our findings indicate that patients at acute phase of ZIKV infection without any neurological signs show increased levels of IgG autoantibody against GD3 gangliosides, a class of glycolipid found to be highly expressed in neural stem cell acting in the maintenance of their self-renewal cellular capacity. It is possible that a pathological threshold of these antibodies is only acquired in secondary or subsequent infections. In the light of these evidences, we propose that the target of GD3 by autoimmune responses may possibly has an effect in the neuropathy and neurogenesis disorder seen during ZIKV infection.
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- 2018
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29. Brazilian network for HIV Drug Resistance Surveillance (HIV-BresNet): a survey of treatment-naive individuals.
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Arruda MB, Boullosa LT, Cardoso CC, da Costa CM, Alves CR, de Lima ST, Kaminski HT, Aleixo AW, Esposito AO, Cavalcanti AM, Riedel M, Couto-Fernandez JC, Ferreira SB, de Oliveira IC, Portal LE, Wolf HH, Fernandes SB, de M C Pardini MI, Feiteiro MV, Tolentino FM, Diaz RS, Lopes GI, Francisco RB, Véras NM, Pires AF, Franchini M, Mesquita F, and Tanuri A
- Subjects
- Adult, Brazil, Drug Resistance, Viral genetics, Female, Genotype, Humans, Male, Middle Aged, Reverse Transcriptase Inhibitors therapeutic use, Anti-HIV Agents therapeutic use, HIV Infections drug therapy
- Abstract
Introduction: In Brazil, more than 487,450 individuals are currently undergoing antiretroviral treatment. In order to monitor the transmission of drug-resistant strains and HIV subtype distribution in the country, this work aimed to estimate its prevalence and to characterize the nationwide pretreatment drug resistance in individuals recently diagnosed with HIV between 2013 and 2015., Methods: The HIV threshold survey methodology (HIV-THS, WHO) targeting antiretroviral-naive individuals with recent HIV diagnosis was utilized, and subjects were selected from 51 highly populated cities in all five Brazilian macroregions. The HIV pol genotypic test was performed by genomic sequencing., Results: We analysed samples from 1568 antiretroviral-naive individuals recently diagnosed with HIV, and the overall transmitted drug resistance (TDR) prevalence was 9.5% (150 sequences). The regional prevalence of resistance according to Brazilian geographical regions was 9.4% in the northeast, 11.2% in the southeast, 6.8% in the central region, 10.2% in the north and 8.8% in the south. The inhibitor-specific TDR prevalence was 3.6% for nucleoside reverse transcriptase inhibitors (NRTIs), 5.8% for non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 1.6% for protease inhibitors (PIs); 1.0% of individuals presented resistance to more than one class of inhibitors. Overall, subtype B was more prevalent in every region except for the southern, where subtype C prevails., Conclusions: To the best of our knowledge, this is the first TDR study conducted in Brazil with nationwide representative sampling. The TDR prevalence revealed a moderate rate in the five Brazilian geographical regions, although some cities presented higher TDR prevalence rates, reaching 14% in São Paulo, for example. These results further illustrate the importance of surveillance studies for designing future strategies in primary antiretroviral therapy, aiming to mitigate TDR, as well as for predicting future trends in other regions of the globe where mass antiretroviral (ARV) treatment was implemented., (© 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.)
- Published
- 2018
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30. Dr. Roimicher, et al , reply.
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Roimicher L, Ferreira OC Jr, Arruda MB, and Tanuri A
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- Humans, Arthritis, Rheumatoid, Zika Virus, Zika Virus Infection
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- 2018
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31. Successful Live Kidney Transplantation After Chikungunya Disease in the Donor.
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Moura-Neto JA, de Souza Moura AF, Souza E, de Carvalho Henriques JL Jr, Arruda MB, Pessoa LS, Boullosa LT, da Costa Ferreira Junior O, and Rocco Suassuna JH
- Published
- 2017
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32. The spectrum of neuropathological changes associated with congenital Zika virus infection.
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Chimelli L, Melo ASO, Avvad-Portari E, Wiley CA, Camacho AHS, Lopes VS, Machado HN, Andrade CV, Dock DCA, Moreira ME, Tovar-Moll F, Oliveira-Szejnfeld PS, Carvalho ACG, Ugarte ON, Batista AGM, Amorim MMR, Melo FO, Ferreira TA, Marinho JRL, Azevedo GS, Leal JIBF, da Costa RFM, Rehen S, Arruda MB, Brindeiro RM, Delvechio R, Aguiar RS, and Tanuri A
- Subjects
- Adolescent, Adult, Brain diagnostic imaging, Eye diagnostic imaging, Eye pathology, Female, Humans, Infant, Newborn, Male, Microcephaly diagnostic imaging, Microcephaly etiology, Muscle, Skeletal pathology, Pituitary Gland diagnostic imaging, Pituitary Gland pathology, Pregnancy, Spinal Cord diagnostic imaging, Young Adult, Zika Virus Infection complications, Zika Virus Infection diagnostic imaging, Brain pathology, Microcephaly pathology, Pregnancy Complications, Infectious, Spinal Cord pathology, Zika Virus Infection congenital, Zika Virus Infection pathology
- Abstract
A major concern associated with ZIKV infection is the increased incidence of microcephaly with frequent calcifications in infants born from infected mothers. To date, postmortem analysis of the central nervous system (CNS) in congenital infection is limited to individual reports or small series. We report a comprehensive neuropathological study in ten newborn babies infected with ZIKV during pregnancy, including the spinal cords and dorsal root ganglia (DRG), and also muscle, pituitaries, eye, systemic organs, and placentas. Using in situ hybridization (ISH) and electron microscopy, we investigated the role of direct viral infection in the pathogenesis of the lesions. Nine women had Zika symptoms between the 4th and 18th and one in the 28th gestational week. Two babies were born at 32, one at 34 and 36 weeks each and six at term. The cephalic perimeter was reduced in four, and normal or enlarged in six patients, although the brain weights were lower than expected. All had arthrogryposis, except the patient infected at 28 weeks gestation. We defined three patterns of CNS lesions, with different patterns of destructive, calcification, hypoplasia, and migration disturbances. Ventriculomegaly was severe in the first pattern due to midbrain damage with aqueduct stenosis/distortion. The second pattern had small brains and mild/moderate (ex-vacuo) ventriculomegaly. The third pattern, a well-formed brain with mild calcification, coincided with late infection. The absence of descending fibres resulted in hypoplastic basis pontis, pyramids, and cortico-spinal tracts. Spinal motor cell loss explained the intrauterine akinesia, arthrogryposis, and neurogenic muscle atrophy. DRG, dorsal nerve roots, and columns were normal. Lympho-histiocytic inflammation was mild. ISH showed meningeal, germinal matrix, and neocortical infection, consistent with neural progenitors death leading to proliferation and migration disorders. A secondary ischemic process may explain the destructive lesions. In conclusion, we characterized the destructive and malformative consequences of ZIKV in the nervous system, as reflected in the topography and severity of lesions, anatomic localization of the virus, and timing of infection during gestation. Our findings indicate a developmental vulnerability of the immature CNS, and shed light on possible mechanisms of brain injury of this newly recognized public health threat.
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- 2017
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33. Zika Virus in the Joint of a Patient with Rheumatoid Arthritis.
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Roimicher L, Ferreira OC Jr, Arruda MB, and Tanuri A
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- Female, Humans, Middle Aged, Zika Virus Infection complications, Zika Virus Infection virology, Arthritis, Rheumatoid complications, Knee Joint virology, Synovial Fluid virology, Zika Virus isolation & purification, Zika Virus Infection diagnosis
- Published
- 2017
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34. Congenital Zika Virus Infection: Beyond Neonatal Microcephaly.
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Melo AS, Aguiar RS, Amorim MM, Arruda MB, Melo FO, Ribeiro ST, Batista AG, Ferreira T, Dos Santos MP, Sampaio VV, Moura SR, Rabello LP, Gonzaga CE, Malinger G, Ximenes R, de Oliveira-Szejnfeld PS, Tovar-Moll F, Chimelli L, Silveira PP, Delvechio R, Higa L, Campanati L, Nogueira RM, Filippis AM, Szejnfeld J, Voloch CM, Ferreira OC Jr, Brindeiro RM, and Tanuri A
- Subjects
- Abnormalities, Multiple etiology, Brazil, Cerebellum pathology, Cerebrum pathology, Female, Follow-Up Studies, Humans, Infant, Infant Death, Infant, Newborn, Lissencephaly etiology, Male, Microcephaly etiology, Perinatal Death, Pregnancy, Zika Virus Infection congenital, Arthrogryposis etiology, Hydrocephalus etiology, Nervous System Malformations etiology, Pregnancy Complications, Infectious, Zika Virus genetics, Zika Virus isolation & purification, Zika Virus pathogenicity, Zika Virus Infection complications
- Abstract
Importance: Recent studies have reported an increase in the number of fetuses and neonates with microcephaly whose mothers were infected with the Zika virus (ZIKV) during pregnancy. To our knowledge, most reports to date have focused on select aspects of the maternal or fetal infection and fetal effects., Objective: To describe the prenatal evolution and perinatal outcomes of 11 neonates who had developmental abnormalities and neurological damage associated with ZIKV infection in Brazil., Design, Setting, and Participants: We observed 11 infants with congenital ZIKV infection from gestation to 6 months in the state of Paraíba, Brazil. Ten of 11 women included in this study presented with symptoms of ZIKV infection during the first half of pregnancy, and all 11 had laboratory evidence of the infection in several tissues by serology or polymerase chain reaction. Brain damage was confirmed through intrauterine ultrasonography and was complemented by magnetic resonance imaging. Histopathological analysis was performed on the placenta and brain tissue from infants who died. The ZIKV genome was investigated in several tissues and sequenced for further phylogenetic analysis., Main Outcomes and Measures: Description of the major lesions caused by ZIKV congenital infection., Results: Of the 11 infants, 7 (63.6%) were female, and the median (SD) maternal age at delivery was 25 (6) years. Three of 11 neonates died, giving a perinatal mortality rate of 27.3%. The median (SD) cephalic perimeter at birth was 31 (3) cm, a value lower than the limit to consider a microcephaly case. In all patients, neurological impairments were identified, including microcephaly, a reduction in cerebral volume, ventriculomegaly, cerebellar hypoplasia, lissencephaly with hydrocephalus, and fetal akinesia deformation sequence (ie, arthrogryposis). Results of limited testing for other causes of microcephaly, such as genetic disorders and viral and bacterial infections, were negative, and the ZIKV genome was found in both maternal and neonatal tissues (eg, amniotic fluid, cord blood, placenta, and brain). Phylogenetic analyses showed an intrahost virus variation with some polymorphisms in envelope genes associated with different tissues., Conclusions and Relevance: Combined findings from clinical, laboratory, imaging, and pathological examinations provided a more complete picture of the severe damage and developmental abnormalities caused by ZIKV infection than has been previously reported. The term congenital Zika syndrome is preferable to refer to these cases, as microcephaly is just one of the clinical signs of this congenital malformation disorder.
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- 2016
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35. Association between KIR genotypes and HLA-B alleles on viral load in Southern Brazilian individuals infected by HIV-1 subtypes B and C.
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Fernandes-Cardoso J, Süffert TA, Correa MDG, Jobim LFJ, Jobim M, Salim PH, Arruda MB, Boullosa LT, Tanuri A, Porto LC, and Ferreira OC Jr
- Subjects
- Adult, Aged, Brazil, Cohort Studies, Female, Follow-Up Studies, Gene Frequency, Genetic Association Studies, Genetic Predisposition to Disease, Genotype, Humans, Male, Middle Aged, Polymorphism, Genetic, Young Adult, HIV Infections genetics, HIV-1 physiology, HLA-B27 Antigen genetics, Receptors, KIR genetics, Viral Load
- Abstract
There is a great variety of HIV-1 subtypes circulating in Brazil, including subtype C, whose prevalence is on the rise, particularly in the southern region. Many host and viral genetic factors may be involved in this trend. We evaluated the influence of human leukocyte antigen (HLA) class I alleles and killer-cell immunoglobulin-like receptor (KIR) genotypes on viral set point and T-CD4(+) parameters in 84 treatment-naïve HIV-1-positive individuals. Frequency data in the infected group were compared to data of 548 healthy control subjects. Individuals with the KIR AA genotype had a higher viral load (VL) than individuals with the KIR Bx genotype. The HIV-1 group was subdivided into three subgroups according to HLA-B allele presence: those with protection to disease alleles (HLA-B(+)), accelerated disease progression alleles (HLA-B(-)), or neither (HLA-B(o)) were grouped. We observed a significant effect of the HLA-B allele presence on VL. The HLA-B(+) group had significantly lower VL than the HLA-B(-) group and trended toward a lower VL than the HLA-B(o) group. There were significant differences between groups expressing extreme VL values: KIR-AA+HLA-B(-) vs. KIR Bx+HLA-B(+) and KIR-AA+HLA-B(o)vs. KIR Bx+HLA-B(+). The relationship of KIR/HLA host genetics with slow HIV disease progression in southern Brazil may be useful for vaccine developers, epidemiologists, and clinicians., (Copyright © 2016 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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36. Single Nucleotide Polymorphisms in Cellular Drug Transporters Are Associated with Intolerance to Antiretroviral Therapy in Brazilian HIV-1 Positive Individuals.
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Arruda MB, Campagnari F, de Almeida TB, Couto-Fernandez JC, Tanuri A, and Cardoso CC
- Subjects
- Alleles, Case-Control Studies, Female, HIV Infections drug therapy, HIV Seropositivity drug therapy, HIV-1, Haplotypes, Humans, Male, Multidrug Resistance-Associated Protein 2, Pharmacogenetics, Anti-HIV Agents therapeutic use, HIV Infections genetics, HIV Seropositivity genetics, Multidrug Resistance-Associated Proteins genetics, Organic Anion Transporters genetics, Polymorphism, Single Nucleotide, Reverse Transcriptase Inhibitors therapeutic use
- Abstract
Adverse reactions are the main cause of treatment discontinuation among HIV+ individuals. Genes related to drug absorption, distribution, metabolism and excretion (ADME) influence drug bioavailability and treatment response. We have investigated the association between single nucleotide polymorphisms (SNPs) in 29 ADME genes and intolerance to therapy in a case-control study including 764 individuals. Results showed that 15 SNPs were associated with intolerance to nucleoside and 11 to non-nucleoside reverse transcriptase inhibitors (NRTIs and NNRTIs), and 8 to protease inhibitors (PIs) containing regimens under alpha = 0.05. After Bonferroni adjustment, two associations remained statistically significant. SNP rs2712816, at SLCO2B1 was associated to intolerance to NRTIs (ORGA/AA = 2.37; p = 0.0001), while rs4148396, at ABCC2, conferred risk of intolerance to PIs containing regimens (ORCT/TT = 2.64; p = 0.00009). Accordingly, haplotypes carrying rs2712816A and rs4148396T alleles were also associated to risk of intolerance to NRTIs and PIs, respectively. Our data reinforce the role of drug transporters in response to HIV therapy and may contribute to a future development of personalized therapies., Competing Interests: Francine Campagnari is employed by Deoxi Biotecnologia. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials. FC has worked in the present study as part of her PhD project.
- Published
- 2016
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37. Evidence for Transmission of Zika Virus by Platelet Transfusion.
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Motta IJ, Spencer BR, Cordeiro da Silva SG, Arruda MB, Dobbin JA, Gonzaga YB, Arcuri IP, Tavares RC, Atta EH, Fernandes RF, Costa DA, Ribeiro LJ, Limonte F, Higa LM, Voloch CM, Brindeiro RM, Tanuri A, and Ferreira OC Jr
- Subjects
- Adolescent, Blood Component Removal, Blood Platelets virology, Brazil, Humans, Middle Aged, Platelet Transfusion adverse effects, Zika Virus, Zika Virus Infection transmission
- Published
- 2016
- Full Text
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38. Lopinavir Resistance Classification with Imbalanced Data Using Probabilistic Neural Networks.
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Raposo LM, Arruda MB, de Brindeiro RM, and Nobre FF
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- Algorithms, Antiviral Agents therapeutic use, HIV Infections drug therapy, Humans, Logistic Models, Lopinavir therapeutic use, Predictive Value of Tests, Software Design, Antiviral Agents pharmacology, Drug Resistance, Viral, Lopinavir pharmacology, Neural Networks, Computer
- Abstract
Resistance to antiretroviral drugs has been a major obstacle for long-lasting treatment of HIV-infected patients. The development of models to predict drug resistance is recognized as useful for helping the decision of the best therapy for each HIV+ individual. The aim of this study was to develop classifiers for predicting resistance to the HIV protease inhibitor lopinavir using a probabilistic neural network (PNN). The data were provided by the Molecular Virology Laboratory of the Health Sciences Center, Federal University of Rio de Janeiro (CCS-UFRJ/Brazil). Using bootstrap and stepwise techniques, ten features were selected by logistic regression (LR) to be used as inputs to the network. Bootstrap and cross-validation were used to define the smoothing parameter of the PNN networks. Four balanced models were designed and evaluated using a separate test set. The accuracies of the classifiers with the test set ranged from 0.89 to 0.94, and the area under the receiver operating characteristic (ROC) curve (AUC) ranged from 0.96 to 0.97. The sensitivity ranged from 0.94 to 1.00, and the specificity was between 0.88 and 0.92. Four classifiers showed performances very close to three existing expert-based interpretation systems, the HIVdb, the Rega and the ANRS algorithms, and to a k-Nearest Neighbor.
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- 2016
- Full Text
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39. Effective surveillance of vector dynamics of Aedes aegypti in a hospital setting in Cuiabá, Mato Grosso, Brazil.
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Leal-Santos FA, Santana MB, de Figueiredo DA, de Oliveira MM, Acel AM, Ribeiro AL, Rodrigues JS, Carvalho-Leandro D, Miyazaki RD, and Leite DP Jr
- Subjects
- Aedes growth & development, Animals, Brazil, Dengue transmission, Epidemiological Monitoring, Hospitals, Oviposition, Population Dynamics, Aedes physiology, Disease Vectors
- Abstract
Introduction: Hospitals are important for vector control of endemic diseases., Methodology: To investigate the presence of dengue vectors, 30 locations at a university hospital in Cuiabá, Mato Grosso, Brazil, were monitored from January to December 2009 for mosquito eggs using ovitraps placed in high-traffic internal and external areas., Results: A total of 2,302 eggs were obtained. Positivity rate at different sites ranged from 50.0% to 0.0%, with the highest indices in external areas. The presence of eggs correlated with increasing humidity (r = 9.81; p = 0.0013)., Discussion: The study aimed to detect and verify the infestation level of the dengue vector and the influence of abiotic factors., Conclusions: The results indicate that this hospital may be considered an environment for the spread of dengue and hence strategic actions, including control measures and programs aimed at preventing the transmission of this vector, must be implemented.
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- 2014
- Full Text
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40. Effects of chin advancement surgery in hyoid bone and tongue positions and in the dimension of the oropharynx.
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Cabral MB, de Freitas AC, de Araújo TM, Pena N, and Brandão Filho RA
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- Adolescent, Adult, Cephalometry, Female, Humans, Male, Middle Aged, Neck Muscles physiology, Organ Size, Statistics, Nonparametric, Treatment Outcome, Young Adult, Chin surgery, Genioplasty, Hyoid Bone physiopathology, Mandibular Advancement, Oropharynx anatomy & histology, Oropharynx pathology, Tongue physiopathology
- Abstract
Introduction: Advancement genioplasty has been increasingly indicated for the correction of anterior mandibular deficiency as it balances the patient's profile and generates functional changes., Objective: Thus, the aim of this study was to assess the effects of advancement genioplasty in the oropharyngeal size and in the position of the hyoid bone and tongue., Methods: The sample comprised 22 lateral cephalometric radiographs of 11 individuals who had undergone advancement genioplasty alone. Eleven of these radiographs depicted the immediate preoperative period (T0) and the other 11 the postoperative period after at least four months (T1). The radiographs were scanned and exported to the Radiocef Studio 2.0® software (Radio Memory Ltda., Belo Horizonte, MG, Brazil). The landmarks were then identified and automatically measured by the program., Results: The results showed statistically significant differences between the horizontal position of the hyoid bone and tongue and in the oropharyngeal size. The hyoid bone and tongue were repositioned anteriorly after surgery (p = 0.01), thereby increasing the dimension of the oropharyngeal airspace (p = 0.01)., Conclusions: The oropharyngeal dimension increased as the tongue base and hyoid bone were repositioned more anteriorly.
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- 2013
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41. Prevalence of etravirine-associated mutations in clinical samples with genotypic resistance to nevirapine and efavirenz in Brazilian clinics.
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Martins AN, Arruda MB, Aleixo AW, Pires AF, Greco DB, de M Brindeiro R, and Tanuri A
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- Alkynes, Antiretroviral Therapy, Highly Active methods, Brazil, Cyclopropanes, HIV genetics, HIV isolation & purification, HIV Infections drug therapy, Humans, Mutation, Missense, Nitriles, Prevalence, Pyrimidines, Anti-HIV Agents pharmacology, Benzoxazines pharmacology, Drug Resistance, Viral, HIV drug effects, HIV Infections virology, Nevirapine pharmacology, Pyridazines pharmacology
- Abstract
Nonnucleoside reverse transcriptase inhibitors (NNRTIs) are potent and well tolerated. In Brazil, the first-generation NNRTI efavirenz is included in the majority of first-line antiretroviral treatment regimens. In this study, we evaluated the effectiveness of etravirine, a new second-generation NNRTI, among patients failing antiretroviral regimens containing first-generation NNRTIs. We assessed single resistance mutations to etravirine as well as complex resistance mutations profile and discuss the potential of introducing etravirine as salvage therapy.
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- 2011
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42. Accumulation of P(T/S)AP late domain duplications in HIV type 1 subtypes B, C, and F derived from individuals failing ARV therapy and ARV drug-naive patients.
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Martins AN, Arruda MB, Pires AF, Tanuri A, and Brindeiro RM
- Subjects
- Genotype, HIV-1 classification, HIV-1 isolation & purification, Humans, Molecular Sequence Data, Selection, Genetic, Sequence Analysis, DNA, Treatment Failure, Amino Acid Motifs, Anti-Retroviral Agents administration & dosage, HIV Infections drug therapy, HIV Infections virology, HIV-1 genetics, gag Gene Products, Human Immunodeficiency Virus genetics
- Abstract
HIV-1 budding requires short peptide motifs in p6(Gag), known as late domains, that promote the release of infectious virions. The primary late domain of HIV-1 is a Pro-(Thr/Ser)-Ala-Pro (hereafter referred to as a PTAP) motif. This motif may be completely or partially duplicated. In this work we analyzed p6(Gag) sequences from 547 isolates from drug-naive patients and 213 isolates from patients failing HAART therapy. Complete duplications within PTAP were selected during HAART therapy in all HIV-1 subtypes analyzed: B (p = 0.0338), F1 (p = 0.0294), and C (p = 0.0001). Nevertheless, the patterns of these duplications were different; subtype C isolates accumulated longer duplications and displayed a higher frequency of duplications in both treated (54%) and drug-naive isolates (23%). Accumulation of PTAP duplications within subtypes B, F1, and C during therapy suggests a potential role of the duplications in antiretroviral drug resistance.
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- 2011
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43. Brazilian Network for HIV Drug Resistance Surveillance: a survey of individuals recently diagnosed with HIV.
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Inocencio LA, Pereira AA, Sucupira MC, Fernandez JC, Jorge CP, Souza DF, Fink HT, Diaz RS, Becker IM, Suffert TA, Arruda MB, Macedo O, Simão MB, and Tanuri A
- Abstract
Use of antiretrovirals is widespread in Brazil, where more than 200,000 individuals are under treatment. Although general prevalence of primary antiretroviral resistance in Brazil is low, systematic sampling in large metropolitan areas has not being performed.The HIV Threshold Survey methodology (HIV-THS, WHO) was utilized, targeting Brazil's four major regions and selecting the six most populated state capitals: Sao Paulo, Rio de Janeiro, Salvador, Porto Alegre, Brasilia and Belem. We were able to sequence samples from 210 individuals with recent HIV diagnosis, 17 of them (8.1%) carrying HIV isolates with primary antiretroviral resistance mutations. Five, nine and four isolates showed mutations related to resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs), respectively. Using HIV-THS, we could find an intermediate level of transmitted resistance (5% to 15%) in Belem/Brasilia, Sao Paulo and Rio de Janeiro. Lower level of transmitted resistance (<5%) were observed in the other areas. Despite the extensive antiretroviral exposure and high rates of virologic antiretroviral failure in Brazil, the general prevalence of primary resistance is still low. However, an intermediate level of primary resistance was found in the four major Brazilian cities, confirming the critical need to start larger sampling surveys to better define the risk factors associated with transmission of resistant HIV.
- Published
- 2009
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44. Enfuvirtide (T-20) resistance-related mutations in HIV type 1 subtypes B, C, and F isolates from Brazilian patients failing HAART.
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Oliveira AC, Martins AN, Pires AF, Arruda MB, Tanuri A, Pereira HS, and Brindeiro RM
- Subjects
- Adult, Amino Acid Sequence, Amino Acid Substitution genetics, Brazil, Enfuvirtide, Genotype, HIV Envelope Protein gp41 genetics, HIV Infections drug therapy, HIV-1 classification, HIV-1 drug effects, HIV-1 isolation & purification, Humans, Middle Aged, Molecular Sequence Data, Sequence Alignment, Sequence Analysis, DNA, Treatment Failure, Young Adult, Antiretroviral Therapy, Highly Active, Drug Resistance, Viral, HIV Envelope Protein gp41 pharmacology, HIV Fusion Inhibitors pharmacology, HIV Infections virology, HIV-1 genetics, Mutation, Missense, Peptide Fragments pharmacology
- Abstract
The synthetic peptide T-20 (enfuvirtide, EFV) represents the first compound approved by the FDA known as entry inhibitors (EIs). The resistance mutations associated with this new class of antiretroviral drug are located in the first heptad repeat (HR1) region of gp41. Amino acid changes in codons G36D/S, I37V, V38A/M/E, Q39H/R, Q40H, N42T, and N43D can confer resistance to EFV. In this work we investigated the presence of resistance mutations that occur in patients never treated with EFV and failing HAART with protease inhibitors (PIs), nucleoside reverse transcriptase (RT) inhibitors (NRTIs), and nonnucleoside RT inhibitors (NNRTIs). This knowledge can reveal whether this salvage therapy can be effective in patients failing HAART. For this, we amplified 65 samples from plasma isolates and than sequenced a fragment of 416 nt encompassing the HR1 and HR2 regions (amino acids 33-170 of gp41). The subtype distribution among the 65 isolates was 45 (69.23%) subtype B, 9 (13.85%) subtype C, 7 (10.77%) subtype F1, and 4 (6.15%) mosaics B/F1, B/C, F1/C, and C/F1/B. We found a high prevalence (7.6%) of EFV-associated mutation G36D in this cohort of patients failing HAART therapy, five isolates from subtype B (11.11% within this group). In contrast, when 1079 sequences from drug-naive patients were analyzed, only one showed the G36D substitution. This finding indicates a strong association between the selected position G36D and HAART therapy (p < 0.0001). The isolates that possess these mutations can develop resistance to EFV more rapidly. Nevertheless, more information about the impact of these mutations in salvage therapy with EFV in patients failing HAART must still be obtained.
- Published
- 2009
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45. Drug resistance mutation profile and accumulation kinetics in human immunodeficiency virus-positive individuals infected with subtypes B and F failing highly active antiretroviral therapy are influenced by different viral codon usage patterns.
- Author
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Waléria-Aleixo A, Martins AN, Arruda MB, Brindeiro RM, Da-Silva RM, Nobre FF, Greco DB, and Tanuri A
- Subjects
- Brazil, CD4 Lymphocyte Count, Female, Genotype, HIV Infections virology, HIV Protease genetics, HIV Reverse Transcriptase genetics, HIV Seropositivity drug therapy, HIV Seropositivity virology, HIV-1 classification, HIV-1 genetics, Humans, Male, RNA, Viral blood, Treatment Failure, Antiretroviral Therapy, Highly Active, Codon genetics, Drug Resistance, Viral genetics, HIV Infections drug therapy, HIV-1 drug effects, Mutation
- Abstract
The major human immunodeficiency virus type 1 subtype circulating in Brazil is B, followed by F and C. We have genotyped 882 samples from Brazilian patients for whom highly active antiretroviral therapy failed, and we found subtype B and the unique recombinant B/F1 forms circulating. Due to codon usage variation, there is a significantly lower incidence of the substitutions L210W, Q151M, and F116Y in subtype F1 isolates than in the subtype B counterparts.
- Published
- 2008
- Full Text
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46. Genotypic and phenotypic characterization of human immunodeficiency virus type 1 isolates circulating in pregnant women from Mozambique.
- Author
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Abreu CM, Brindeiro PA, Martins AN, Arruda MB, Bule E, Stakteas S, Tanuri A, and de Moraes Brindeiro R
- Subjects
- Drug Resistance, Viral, Female, Genotype, HIV Infections epidemiology, HIV-1 classification, Humans, Mozambique epidemiology, Phenotype, Pregnancy, pol Gene Products, Human Immunodeficiency Virus genetics, HIV Infections virology, HIV-1 genetics, HIV-1 isolation & purification
- Abstract
This work evaluated HIV-1 subtypes from different geographic regions and phenotypic data from drug-naïve HIV-positive pregnant women from Mozambique. We analyzed 75 pol sequences from patients and the distribution of the subtypes in three regions of Mozambique and found that the majority of samples analyzed clustered with subtype C. In the northern region, multiple variants were found 5 (approximately 18%) subtype A, 3 (approximately 11%) subtype D and 2 (approximately 7.1%) mosaics (A/C/D and C/D), whereas 18 (64.3%) isolates were subtype C, from a total of 28 samples. Already in the southern region, only one (5%) isolate of 20 samples was subtype D, and the other 19 (95%) isolates were subtype C. All 27 (100%) isolates from the central region grouped within clade C. No primary resistance mutations to IP, NNRTI or NRTI were found. There was no evidence of phenotypic resistance in any of the isolates tested, suggesting that neither the polymorphism in the protease, nor the one found at codon 215 of the RT gene caused an increase in phenotypic resistance. This finding suggests that HAART regimens indicated by WHO will probably be successful in Mozambique.
- Published
- 2008
- Full Text
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47. Biological characterization of human immunodeficiency virus type 1 subtype C protease carrying indinavir drug-resistance mutations.
- Author
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Gonzalez LMF, Aguiar RS, Afonso A, Brindeiro PA, Arruda MB, Soares MA, Brindeiro RM, and Tanuri A
- Subjects
- Drug Resistance, Viral genetics, HIV-1 classification, HIV-1 physiology, Lopinavir, Microbial Sensitivity Tests, Mutation, Nelfinavir pharmacology, Pyrimidinones pharmacology, Species Specificity, Virus Replication, HIV Protease genetics, HIV Protease Inhibitors pharmacology, HIV-1 drug effects, Indinavir pharmacology
- Abstract
Human immunodeficiency virus type 1 subtype C isolates belong to one of the most prevalent strains circulating worldwide and are responsible for the majority of new infections in the sub-Saharan region and other highly populated areas of the globe. In this work, the impact of drug-resistance mutations in the protease gene of subtype C viruses was analysed and compared with that of subtype B counterparts. A series of recombinant subtype C and B viruses was constructed carrying indinavir (IDV)-resistance mutations (M46V, I54V, V82A and L90M) and their susceptibility to six FDA-approved protease inhibitor compounds (amprenavir, indinavir, lopinavir, ritonavir, saquinavir and nelfinavir) was determined. A different impact of these mutations was found when nelfinavir and lopinavir were tested. The IDV drug-resistance mutations in the subtype C protease backbone were retained for a long period in culture without selective pressure when compared with those in subtype B counterparts in washout experiments.
- Published
- 2006
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48. Low accumulation of L90M in protease from subtype F HIV-1 with resistance to protease inhibitors is caused by the L89M polymorphism.
- Author
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Calazans A, Brindeiro R, Brindeiro P, Verli H, Arruda MB, Gonzalez LM, Guimaraes JA, Diaz RS, Antunes OA, and Tanuri A
- Subjects
- Amino Acid Sequence, Animals, Cell Line, Consensus Sequence, Genotype, HIV Protease chemistry, Molecular Sequence Data, Time Factors, Drug Resistance, Viral genetics, HIV Protease genetics, HIV Protease Inhibitors pharmacology, HIV-1 drug effects, HIV-1 genetics, Polymorphism, Genetic
- Abstract
Background: This work evaluates the role of subtype F human immunodeficiency virus type 1 (HIV-1) protease (PR) substitutions L89M and L90M in viral replication and resistance to PR inhibitors (PIs)., Methods: Subtype B and F PR genes were subjected to site-directed mutagenesis, to create and reverse the methionine at positions 89 and 90. Viruses were re-created in cell culture, and their replicative capacity was assessed by fitness assay. Generated viruses were also phenotyped for PI resistance., Results: The subtype F clone (89M90L) showed a replicative capacity comparable to that of the PI-susceptible subtype B clone (89L90L) and was more fit than the L89M mutated subtype B clone (89M90L). Both 89M90M subtype B and F clones presented the lowest fitness s values. The L89M mutation impacted phenotypic resistance to all PIs in half of the subtype F isolates but not in the subtype B isolates. Subtype F isolates presented a phenotypic profile similar to that of subtype B isolates when the M89L mutation was introduced., Conclusion: The L89M mutation in subtype F viruses is a high genetic barrier to the accumulation of the L90M resistance mutation and can function as a resistance mutation, depending on the presence of other polymorphisms in the subtype F PR backbone.
- Published
- 2005
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49. [Guidelines for myocardial revascularization surgery].
- Author
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Lima Rde C, Kubrusly LF, Nery AC, Pinheiro BB, Brick AV, de Souza DS, Braile DM, Buffolo E, Lucchese FA, Silva FP, Branco JN, Lobo Filho JG, de Mendonça JT, Wanderley Neto J, Guimarães JA, Maranhão MV, Leite Mdo S, Costa MG, Deininger MO, Arruda MB, Arruda Filho M, de Escobar MA, Ribeiro NA, Brofman PS, Salerno PR, Montenegro ST, and Guimarães JI
- Subjects
- Anesthesia standards, Extracorporeal Circulation standards, Humans, Male, Minimally Invasive Surgical Procedures standards, Multicenter Studies as Topic, Myocardial Infarction complications, Myocardial Infarction surgery, Postoperative Care, Postoperative Complications, Preoperative Care, Coronary Disease surgery, Myocardial Revascularization standards
- Published
- 2004
50. Cardiac extension of primary mediastinal seminoma compressing the right ventricular outflow tract.
- Author
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Saraiva LR, Brindeiro Filho DB, Saraiva TB, Arruda MB, and Lira V
- Subjects
- Adult, Antibiotics, Antineoplastic therapeutic use, Heart Neoplasms drug therapy, Heart Ventricles ultrastructure, Humans, Male, Seminoma drug therapy, Ventricular Outflow Obstruction drug therapy, Heart Neoplasms secondary, Seminoma secondary, Testicular Neoplasms pathology, Ventricular Outflow Obstruction complications
- Abstract
We report the case of a 33-year-old male with primary seminoma of the anterior mediastinum with initial clinical manifestations suggestive of heart disease.
- Published
- 2001
- Full Text
- View/download PDF
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