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A Leucemia Linfocítica Crônica (LLC) é uma doença linfoproliferativa considerada a doença mais comum nos idosos no mundo ocidental. A citogenética é uma importante ferramenta prognóstica que demonstra as principais alterações cromossômicas predizendo o curso clínico da doença, a sobrevida do paciente e auxilia na escolha do tratamento. O vírus Epstein-Barr (EBV) é um γ ubíquo-herpesvírus que infecta mais de 90% da população mundial. A relação entre EBV e o curso clínico de pacientes com LLC é desconhecida. O objetivo desse trabalho é investigar a infecção do EBV em pacientes portadores de LLC. Foi realizado um estudo transversal de 46 pacientes sob diagnóstico de LLC e tratamento efetivado nos períodos de 2017 a 2019. Os dados foram obtidos pela revisão de prontuários médicos e registrados via formulário eletrônico com aspectos demográficos, clínicos, parâmetros hematológicos e perfil citogenético. Para a detecção do EBV foi utilizado o teste de reação em cadeia da polimerase (PCR). O DNA viral foi extraído com auxílio do kit “QIAamp DNA Mini” (QIAGEN) e submetido à reação de PCR, utilizando o kit comercial Ludwig Biotec, tendo como alvo o gene EBNA-3C. Observou-se que o sinal clínico mais frequente foi esplenomegalia e a linfocitose a alteração laboratorial de mau prognóstico. As alterações citogenéticas foram encontradas em 36,6% da população estuda e 16,67% foram de mau prognóstico (deleção 11q, 17p e tp53). Foram detectados 43,47% dos pacientes com DNA viral do EBV. Ocorrendo um aumento estatístico significativo de complicações e comorbidade e evoluções a óbito nos pacientes EBV positivo (p

EBV-associated gastric cancer accounts for about 10% of all gastric carcinomas worldwide. We aimed to verify the prevalence of EBV in gastric adenocarcinoma samples using FISH and qPCR and comparing the results obtained by both techniques. Gastric cancer samples from 191 cases were analyzed. The FISH assay was performed to detect small EBV RNAs (EBER1) and qPCR was performed to detect the EBV-EBNA-1 gene region. Cohen’s kappa index and the chi-square test were used to compare the methodologies and investigate correlations with the clinical-pathological data of the gastric adenocarcinoma patients. Most of the patients were men, and the average age was 60 years. The intestinal subtype cancer presented more aggressive stages with 90% of patients having a reactive FISH for EBV (EBV+), although the virus infection frequency in epithelial gastric tissue was only 1%. No positive association with clinicopathological features and EBV+ was found by FISH. Using qPCR analysis, the percentage of positive samples was lower (52.4%), and a positive association was found in samples from older patients (> 60 years). Interestingly, 71 qPCR-negative cases were detected by FISH in the presence of non-epithelial cells and in 10 qPCR-positive cases with no evidence of EBV according to FISH. The concordance between the two techniques was low, with only 57.6%. FISH is more informative for associating the gastric carcinoma with EBV positivity in tumor/epithelial cells; however, qPCR can provide relevant information regarding the progression and characteristics of neoplasia.

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The aim of this study is to determine HPV infection prevalence, to perform association of liquid-based cytology (LBC) with DNA molecular analyses of high-risk HPV (HR-HPV) and to verify viral behavior in women who sought diagnostic services of the institution more than once, as well as providing relevant information to medical professionals regarding the primary screening for cervical cancer. The study was observational, descriptive and retrospective. For screening, HR-HPV detection and genotyping were performed by real-time PCR using cobas® HPV Test system. Considering a total of 987 samples, a prevalence of 38.50% of women in the age group between 31 and 40 years was observed, 25.03% with detection of HR-HPV, 5.47% with presence of cellular morphological changes, and 4.25% showed a detectable HR-HPV combination with altered LBC. DNA detection for HR-HPV was shown to be significantly associated with the presence of cellular morphological changes (p < 0.0001), and the relative risk has demonstrated that one in seven women with detectable HR-HPV may present cellular morphological changes. The HR-HPV prevalence decreased with increasing age. The molecular biology test used is shown to be a useful tool in diagnosis and HPV infection monitoring. This is effective as a preventive diagnostic strategy for precursor lesion development and cervical cancer. The recommendation of a new algorithm as an option for primary screening uses high sensitivity and risk stratification of molecular biology, together with high specificity of cytology for an ideal balance in screening for cervical cancer.

Interleukin-6 has been recognized as a major role player in COVID-19 severity, being an important regulator of the cytokine storm. Hence, the evaluation of the influence of polymorphisms in key genes of the IL-6 pathway, namely IL6, IL6R, and IL6ST, may provide valuable prognostic/predictive markers for COVID-19. The present cross-sectional study genotyped three SNPs (rs1800795, rs2228145, and rs7730934) at IL6. IL6R and IL6ST genes, respectively, in 227 COVID-19 patients (132 hospitalized and 95 non-hospitalized). Genotype frequencies were compared between these groups. As a control group, published data on gene and genotype frequencies were gathered from published studies before the pandemic started. Our major results point to an association of the IL6 C allele with COVID-19 severity. Moreover, IL-6 plasmatic levels were higher among IL6 CC genotype carriers. Additionally, the frequency of symptoms was higher at IL6 CC and IL6R CC genotypes. In conclusion, the data suggest an important role of IL6 C allele and IL6R CC genotype on COVID-19 severity, in agreement with indirect evidence from the literature about the association of these genotypes with mortality rates, pneumonia, and heightening of protein plasmatic levels pro-inflammatory driven effects.

IntroductionImmune reconstitution failure after HIV treatment is a multifactorial phenomenon that may also be associated with a single polymorphism of human leukocyte antigen (HLA); however, few reports include patients from the Brazilian Amazon. Our objective was to evaluate the association of the immunogenic profile of the “classical” HLA-I and HLA-II loci with treatment nonresponse in a regional cohort monitored over 24 months since HIV diagnosis.Materials and MethodsTreatment-free participants from reference centers in the state of Pará, Brazil, were enrolled. Infection screening was performed using enzyme immunoassays (Murex AG/AB Combination DiaSorin, UK) and confirmed by immunoblots (Bio-Manguinhos, FIOCRUZ). Plasma viral load was quantified by real-time PCR (ABBOTT, Chicago, Illinois, USA). CD4+/CD8+ T lymphocyte quantification was performed by immunophenotyping and flow cytometry (BD Biosciences, San Jose, CA, USA). Infection was monitored via test and logistics platforms (SISCEL and SICLOM). Therapeutic response failure was inferred based on CD4+ T lymphocyte quantification after 1 year of therapy. Loci A, B and DRB1 were genotyped using PCR-SSO (One Lambda Inc., Canoga Park, CA, USA). Statistical tests were applied using GENEPOP, GraphPad Prism 8.4.3 and BioEstat 5.3.ResultsOf the 270 patients monitored, 134 responded to treatment (CD4+ ≥ 500 cells/µL), and 136 did not respond to treatment (CD4+ < 500 cells/µL). The allele frequencies of the loci were similar to heterogeneous populations. The allelic profile of locus B was statistically associated with treatment nonresponse, and the B*13, B*35 and B*39 alleles had the greatest probabilistic influence. The B*13 allele had the highest risk of treatment nonresponse, and carriers of the allele had a detectable viral load and a CD4+ T lymphocyte count less than 400 cells/µL with up to 2 years of therapy. The B*13 allele was associated with a switch in treatment regimens, preferably to efavirenz (EFZ)-based regimens, and among those who switched regimens, half had a history of coinfection with tuberculosis.ConclusionsThe allelic variants of the B locus are more associated with non-response to therapy in people living with HIV (PLHIV) from a heterogeneous population in the Brazilian Amazon.

The polyomaviruses that infect humans, JC virus (JCV) and BK virus (BKV), can establish persistent infections in the cells that make up the renal system, causing nephritis and BKV-associated nephropathy in up to 10% of renal transplant patients, and of these, 90% lose the graft and return for hemodialysis. This study aimed to determine the prevalence of polyomaviruses (PyV) in the population with chronic kidney disease (CKD), classified into three groups (conservative, dialysis, and transplanted) and a control group. Urine samples were collected from 290 individuals, including 202 patients with CKD and 88 from the control group. PyV screening was performed by PCR amplification of a fragment of the VP1 region, and the JCV and BKV species were distinguished through enzymatic digestion with the restriction endonuclease BamHI from the amplification of a TAg region. All amplification products were visualized on a 3% agarose gel. The prevalence of PyV infection was correlated with clinical-epidemiological variables using the chi-squared and Fisher’s exact tests. In the group with CKD, the prevalence of PyV was 30.2%, a higher rate being observed in conservative patients (36.66%; 22/60), followed by dialysis patients (30.48%; 25/82), and transplanted patients (20%; 12/60). In the control group, the prevalence was 46.59% (41/88). The differentiation between species revealed that JCV was present in 77.8% and BKV in 22.2% of the group with CKD. The prevalence of infection was higher in male patients (59.32%), whose most common pathology was systemic arterial hypertension (35.59%). In the group of transplanted patients, there was a statistically significant association between infection and the use of the immunosuppressant azathioprine (p = 0.015). The prevalence of PyV infection was higher in the control group than in the group with CKD, being predominant in males and in patients with systemic arterial hypertension.

This study aimed to investigate the detection of Epstein-Barr virus (EBV) in oral squamous cell carcinoma (OSCC) and to verify the concordance of EBV-DNA frequency in subgingival sites and in the OSCC.A cross-sectional study with 30 OSCC patients, aged from 44 to 88 years old, was conducted. Samples were collected in subgingival sites and at the OSCC, then submitted to DNA isolation, qPCR, and genotyping. Descriptive statistic was performed to report the frequency of EBV-DNA in all samples, and McNemar test was applied to verify the concordance among the EBV-DNA frequency in both sites.The individuals presented 62 years old in average, and the majority were male (66.6%). EBV-DNA was detected in 56.7% OSCC lesions. Among the subgroup of 19 dentate individuals, high concordance (73.7%) in both EBV-DNA detection and the absence in subgingival sites and OSCC was observed, and it was statistically significant (p 0.05).We report the notable occurrence of EBV-DNA in OSCC; also, the presence of EBV in periodontal sites may contribute to find it in OSCC, although the possible contribution of EBV in the OSCC remains to be investigated.The identification of this easily accessible site of EBV latent infection may help to improve the patient's quality of life by maintenance of oral/periodontal health condition and preventing further possible disorders related to the virus, and also encourages new approaches for investigating EBV, periodontitis, and OSCC.

To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.

Gastric cancer (GC) is a worldwide health problem, making it one of the most common types of cancer, in fifth place of all tumor types, and the third highest cause of cancer deaths in the world. There is a subgroup of GC that consists of tumors infected with the Epstein–Barr virus (EBV) and is characterized mainly by the overexpression of programmed cell death protein-ligand-1 (PD-L1). In the present study, we present histopathological and survival data of a thousand GC patients, associated with EBV status and PD-L1 expression. Of the thousand tumors analyzed, 190 were EBV-positive and the vast majority (86.8%) had a high relative expression of mRNA and PD-L1 protein (p &lt, 0.0001) in relation to non-neoplastic control. On the other hand, in EBV-negative samples, the majority had a low PD-L1 expression of RNA and protein (p &lt, 0.0001). In the Kaplan–Meier analysis, the probability of survival and increased overall survival of EBV-positive GC patients was impacted by the PD-L1 overexpression (p &lt, 0.0001 and p = 0.004, respectively). However, the PD-L1 low expression was correlated with low overall survival in those patients. Patients with GC positive for EBV, presenting PD-L1 overexpression can benefit from immunotherapy treatments and performing the quantification of PD-L1 in gastric neoplasms should be adopted as routine.

Background: Lymphomas are a type of cancer that starts in the lymphatic system. This system is made up of organs, tissues and vessels responsible for immune function. Hodgkin's lymphoma is characterized by giant cells, well differentiated and binucleated. It is divided into two groups: classical hodgkin's lymphoma and hodgkin's lymphoma predominant in nodular lymphocytes. The classic in turn is subdivided into four more histological subtypes: nodular sclerosis, rich in lymphocytes, depleted in lymphocytes and mixed cellularity. This study analyzed the spatial distribution and clinical-epidemiological and Hodgkin's lymphoma characteristics and their histological types in patients diagnosed with the disease at a Reference Hospital in Oncology in the Eastern Amazon between the years 2006 to 2015.Methods: A study was carried out cross-sectional, retrospective, analytical and descriptive study through the analysis of the medical records of 336 patients diagnosed with the disease in that given period and location, the G test was performed to demonstrate the association between the variables. Results: The cases of Hodgkin's Lymphoma came from the following Brazilian states: Pará (318 cases), Amapá (15 cases), Maranhão (2 cases), Piauí (1 case). It affected more men (62%) and young adults (mean age 26 years). The most frequent histological type was nodular sclerosis (65%). The primary location of the tumor was predominant in the cervical lymph nodes (65%). Mostly, patients with no metastases (98%), but the presence of metastases was more frequent in Hodgkin's lymphoma, Nodular Lymphocytic Predominance (18%). Conclusion: The data obtained in this study allow to know some regional peculiarities about Hodgkin's Lymphoma, which can contribute to regional preventive policies, as well as can support comparisons about the disease in other regions, contributing to better understand the heterogeneity of LH.

Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. P?s-gradua??o em Virologia. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Estadual do Par?. Resid?ncia M?dica. Bel?m, PA, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. P?s-gradua??o em Virologia. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Par?. N?cleo de Medicina Tropical. Bel?m, PA, Brazil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. P?s-gradua??o em Virologia. Ananindeua, PA, Brasil. Two types of Epstein Barr virus (EBV1/EBV2) have been shown to infect humans. Although their genomes are similar, the regions containing the EBNA genes differ. This study aimed to characterize the EBV genotypes of infectious mononucleosis (IM) cases in the metropolitan region of Bel?m, Brazil, from 2005 to 2016. A total of 8295 suspected cases with symptoms/signs of IM were investigated by infectious disease physicians at Evandro Chagas Institute, Health Care Service, from January 2005 to December 2016. Out of the total, 1645 (19.8%) samples had positive results for EBV by enzyme immunoassay and 251 (15.3%) were submitted to polymerase chain reaction (PCR) technique, using the EBNA3C region, in order to determine the type of EBV. Biochemical testing involving aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase were also performed. EBV type was identified by PCR in 30.3% (76/251) of individuals; of those, 71.1% (54/76) were classified as EBV1, 17.1% (13/76) as EBV2, and 11.8% (9/76) as EBV1?+?EBV2. The main symptoms/signs observed with EBV1 infection were cervical lymphadenopathy (64.8%, 35/54), fever (63%, 34/54), headache (20.4%, 11/54), arthralgia (20.4%, 11/54), and exanthema (18.5%, 10/54). EBV2 infection was detected in all but two age groups, with an average age of 24 years. The most common signs/symptoms of EBV2 were fever (76.9%, 10/13), average duration of 18 days, and lymphadenopathy (69.2%, 9/13). In contrast, EBV1?+?EBV2 coinfections were more frequent in those aged five years or less (20.0%, 2/10). The symptoms of EBV1?+?EBV2 coinfection included fever (66.7%, 6/9), and cervical lymphadenopathy and headache (33.3%, 3/9) each. The mean values of hepatic enzymes according to type of EBV was significantly different (p?0.05) in those EBV1 infected over 14 years of age. Thus, this pioneering study, using molecular methods, identified the EBV genotypes in 30.3% of the samples, with circulation of EBV1, EBV2, and EBV1?+?EBV2 co-infection in cases of infectious mononucleosis in the northern region of Brazil.

Background: Two types of Epstein Barr virus (EBV1/EBV2) have been shown to infect humans by causing infectious mononucleosis, their genome being very similar, except for regions of the EBNA genes. This study aimed to describe the EBV genotypes in cases of infectious mononucleosis in the metropolitan region of Belém, Brazil, from 2005 to 2016. Methods: A total of 8.295 suspected cases with symptoms/signs of infectious mononucleosis (MI) were investigated by doctors of infectious diseases at the Evandro Chagas Institute Health Care Service from January 2005 to December 2016. In 3.0% (251/8.295) of the cases were positive by enzymatic immunoassay were submitted to PCR for EBNA3C region to detect the types of EBV. Biochemical testing involving aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase were realized. Results: The identification of EBV types by PCR was verified in 30.3% (76/251) of individuals, being 71.1% (54/76) classified as EBV1, 17.1% (13/76) as EBV2 and 11.8% (9/76) as EBV1+EBV2. The number of women infected with EBV1 was higher (61.1% - 33/54) than for men (38.9% - 21/54), most were over 14 years old (66.7%-36/54). The main symptoms/clinical signs observed in EBV1 infection were: cervical lymphadenopathy (64.8%-35/54), fever (63%-34/54), headache (20.3%-11/54), arthralgia (20.3%-11/54) and exanthema (18.5%-10/54). In EBV2 infection, it was also detected in all age groups, with the exception of two groups, with an average age of 24 years. The presence of fever in 76.9% (10/13) with an average duration of 18 days and lymphadenopathy in 53.8 (7/13) were the most relevant signs/symptoms in EBV2. In contrast, EBV1+EBV2 co-infection was more frequent in the £5 year age group, affecting 20.0% (2/10). Women presented 66.7% (6/9) more positive cases. The symptoms involving EBV1+EBV2 co-infection were more related to fever (66.7%-6/9) and cervical lymphadenopathy (55.6% -5/9). The average of enzymatic values according to type of EBV was statistically significant (p

The present study aimed to describe the seroprevalence infection, Epstein-Barr virus (EBV) genotypes, relate the infection’s profile with the epidemiological and corticotherapy data of patients with Autoimmune inflammatory rheumatic diseases (AIRD). A cross-sectional study was carried out with 139 individuals, 92 with systemic lupus erythematosus (SLE), 27 with rheumatoid arthritis (RA) and 20 with other autoimmune diseases, who were undergoing clinical follow-up in Brazil. Serological tests for the detection of EBV anti-VCA IgM and IgG antibodies, as well as the amplification of a segment of the EBV EBNA-3c gene by conventional PCR were performed to identify the infection and the viral subtype. The Epstein–Barr nuclear antigen 3 (EBNA3C) gene participates of maintenance of viral latency and infected B-lymphocytes immortalization by unclear signaling cascades. The association of active/latent EBV infection with EBV infection profile was assessed by Fisher’s exact test and multiple logistic regression. The seroprevalence of EBV anti-VCA IgG was 100%, while that of anti-VCA IgM was 1.43% (2/139). Active-phase infection was confirmed by the presence of EBV DNA in 40.29% of the population evaluated (56/139), with 45.65% (42/92) in SLE, 25.92% (7/27) in the RA and in 35% (7/20) in other autoimmune diseases. It was observed that individuals with SLE had a higher prevalence of active/lytic EBV infection and that oral corticosteroid therapy at a dose lower than 20 mg/day increased the risk of EBV activity by up to 11 times. Only the presence of EBV-1 was identified. Thus, EBV lytic infection was higher in individuals with SLE when compared to other autoimmune diseases with rheumatologic involvement and the lytic activity of the virus precedes corticosteroid-induced immunosuppression.

Background: The aim of the present study was to evaluate the immunological profile of adult HIV-1+ patients coinfected with primary Epstein–Barr virus (EBV) infection who were free of antiretroviral drugs and inhabitants of the Brazilian Amazon region. Materials and methods: Primary EBV infection was screened by the semiquantitative detection of IgM and IgG anti-VCA. Genotypes were determined by conventional PCR. EBV and HIV viral load (VL) were quantified by real-time PCR. Cytokine dosage and cell quantification were performed by cytometry. Results: Only HIV-1+ individuals had primary EBV infection (7.12%). The EBV-1 genotype was the most prevalent (47.37%). The VL of HIV-1 was lower in the HIV/EBV-2 group. CD4+ T lymphocytes were inversely proportional to the VL of EBV in HIV/EBV-1/2 multi-infected patients. The HIV/EBV-2 group had the lowest cytokine levels, especially IFN-γ and IL-4. Different correlations were proposed for each coinfection. The late search for specific care related to HIV infection directly affected the cytokine profile and the number of CD8+ T lymphocytes. Symptoms were associated with the increase in VL of both viruses and cytokine profile. Conclusions: Different immunological profiles were associated with EBV genotypes in primary infection, with EBV-2 being more frequent in patients with low levels of HIV viral load. With late infection monitoring and consequent delay in the initiation of HAART, clinical changes and effects on the maintenance of the immune response were observed.

Introdução/objetivo: O início tardio do monitoramento específico após a aquisição do HIV-1 é multifatorial e está relacionado ao perfil social dos pacientes. Objetivamos identificar os fatores sóciodemográficos associados à apresentação tardia e as consequências clínicas resultantes em uma coorte de pacientes do Pará/Brasil. Métodos: O total de 402 pacientes HIV-1 + foram monitorados por 24 meses, estando todos livres de terapia na coleta inicial. Aspectos sóciodemográficos foram obtidos de prontuários clínicos e questionários epidemiológicos. A carga viral foi quantificada por PCR em tempo real. A concentração de linfócitos e de citocinas foi quantificada por citometria de fluxo. Os dados longitudinais do monitoramento foram obtidos do banco SISCEL. As mutações de resistência foram sequenciadas por Sanger e plataforma 3130Ix1 e analisadas em Standford HIV Drug Resistance Database. Os esquemas terapêuticos foram obtidos do banco SICLOM. Resultados: Cerca de 4% da coorte teve apresentação tardia entre 7 a mais de 12 meses do diagnóstico primário; a procura ocorreu por orientação de terceiros ou início dos sintomas. Renda familiar abaixo de 1 salário e relações com profissionais do sexo foram fatores associados. O atraso resultou em: Três ou mais coinfecções, a maioria viral e bacteriana; Polissintomatologia, com combinação específica de mialgia e febre; Carga viral elevada e CD4 + baixo nos 6 primeiros meses; Manutenção da terapia sem trocas ao longo dos 24 meses, porém, com maior representação de esquemas de 2ª escolha. Na pré-terapia, pacientes tardios tinham altas dosagens de citocinas TH1 e baixa dosagem de citocinas TH2 e TH17; mutações de resistência não foram frequentes. Conclusões: Poucos fatores sóciodemográficos e comportamentais foram associados à apresentação tardia, porém, as consequências deste atraso se mostraram adversas à progressão esperada com o início imediato da terapia, principalmente nos primeiros 6 meses de monitoramento.

Hospital Funda??o Santa Casa de Miseric?rdia do Par?. Departamento Pediatria. Unidade de Terapia Intensiva Pedi?trica. Bel?m, PA, Brasil. Hospital Funda??o Santa Casa de Miseric?rdia do Par?. Departamento Pediatria. Unidade de Terapia Intensiva Pedi?trica. Bel?m, PA, Brasil. Hospital Funda??o Santa Casa de Miseric?rdia do Par?. Departamento Pediatria. Unidade de Terapia Intensiva Pedi?trica. Bel?m, PA, Brasil. Hospital Funda??o Santa Casa de Miseric?rdia do Par?. Departamento Pediatria. Unidade de Terapia Intensiva Pedi?trica. Bel?m, PA, Brasil. Hospital Funda??o Santa Casa de Miseric?rdia do Par?. Departamento Pediatria. Unidade de Terapia Intensiva Pedi?trica. Bel?m, PA, Brasil. Hospital Funda??o Santa Casa de Miseric?rdia do Par?. Departamento Pediatria. Unidade de Terapia Intensiva Pedi?trica. Bel?m, PA, Brasil. Hospital Funda??o Santa Casa de Miseric?rdia do Par?. Departamento Pediatria. Unidade de Terapia Intensiva Pedi?trica. Bel?m, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio Epstein-Barr V?rus. Ananindeua, PA, Brasil. OBJETIVO: Avaliar o desempenho dos escores de mortalidade Pediatric Risk of Mortality (PRISM) e Pediatric Index of Mortality 2 (PIM2) na Unidade de Terapia Intensiva Pedi?trica (UTIP) Terci?ria da Funda??o Santa Casa de Miseric?rdia do Par? (FSCMPA). MATERIAIS E M?TODOS: Estudo de coorte retrospectivo, incluindo pacientes admitidos na UTIP, entre janeiro de 2017 a abril de 2018, com perman?ncia por mais de 8 h. Os crit?rios de exclus?o foram: perman?ncia superior a 90 dias; parada cardiorrespirat?ria sem estabilidade em 12 h; cuidados paliativos; e morte encef?lica. Para calcular os sistemas de escores e desfecho, utilizou-se as vari?veis Standardized Mortality Rate (SMR), calibra??o e discrimina??o, que foram comparadas pelos testes goodness-of-fit e curvas Receiver Operating Characteristic (ROC), respectivamente. RESULTADOS: Entre as 458 interna??es, 429 (93,7%) foram inclu?das. A mortalidade geral foi de 17,5%, sendo que 64,0% eram menores de 2 anos de idade e 58,7% dos que evolu?ram a ?bito foram submetidos ? ventila??o mec?nica por per?odo maior que sete dias. A m?dia de probabilidade de morte estimada do PRISM foi 9,85%, enquanto a m?dia do PIM2 foi de 14,2%. O SMR foi de 1,35 (1,26?1,72) para o PRISM e de 1,23 (1,13?1,58) para o PIM2. A ?rea sob a curva ROC foi de 0,89 (IC 95% 0,81?0,91) para o PRISM e 0,87 (IC 95% 0,83?0,91) para o PIM2. CONCLUS?O: Na UTIP da FSCMPA, o PRISM e o PIM2 tiveram boa calibra??o e bom poder discriminat?rio. O SMR foi superior a um.

Background: Two types of Epstein Barr virus (EBV1 and 2) have been shown to infect humans. This study aimed to detect the types of EBV that cause infectious mononucleosis and correlate these viral types with clinical parameters in the metropolitan region of Belém from 2005 to 2016.Methods: A total of 76 cases of infectious mononucleosis (IM) were processed at the Instituto Evandro Chagas, Ananindeua, Brazil. PCR was used to analyze the EBNA 3C region for the recognition of EBV types. Biochemical testing (aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) was performed by the COBAS INTEGRA clinical biochemistry PLUS 400 / ROCHE automatic analyzer. The data were evaluated using the Statistical Package for Social Science - SPSS 17.0 and GraphPadPrism 7.0 for Windows.Results: EBV1 infection was observed in 71.1% (54/76) of individuals, among whom those > 14 years constituted 66.7% (36/54); the average age was 23 years, and the number of women infected was higher (61.1% [33/54]) than that of men 38.9%[21/54]). The symptoms/clinical signs observed in infection by EBV1 were cervical lymphadenopathy in 64.8% (35/54), fever in 63% (34/54), headache and arthralgia in 20.3% (11/54), and exanthema in 18.5% (10/54). Infection by EBV2 was observed in only 17.1% (13/76) of cases. Coinfections by EBV1 and EBV2, most frequently showing symptoms of fever and cervical lymphadenopathy, occurred in 66.7% (6/9) and 55.6% (5/9) of individuals. Alterations to AST were confirmed in 14.8% (8/54), EBV2 of cases in 7.7% (1/13) in EBV1 infection. Conclusions: EBV1 was predominant in 71% of clinical cases of infectious mononucleosis. The correlation of biochemical parameters in infection by EBV1, EBV2, and coinfections by EBV1/2 revealed a statistically significant difference in mean changes of EBV1 in individuals older than 14 years.

Alcoholic liver disease (ALD) is a highly prevalent spectrum of pathologies caused by alcohol overconsumption. Morbidity and mortality related to ALD are increasing worldwide, thereby demanding strategies for early diagnosis and detection of ALD predisposition. A potential candidate as a marker for ALD susceptibility is the transcription factor nuclear factor erythroid-related factor 2 (Nrf2), codified by the nuclear factor erythroid 2-related factor 2 gene (NFE2L2). Nrf2 regulates expression of proteins that protect against oxidative stress and inflammation caused by alcohol overconsumption. Here, we assessed genetic variants of NFE2L2 for association with ALD. Specimens from patients diagnosed with cirrhosis caused by ALD were genotyped for three NFE2L2 single nucleotide polymorphisms (SNP) (SNPs: rs35652124, rs4893819, and rs6721961). Hematoxylin &amp, eosin and immunohistochemistry were performed to determine the inflammatory score and Nrf2 expression, respectively. SNPs rs4893819 and rs6721961 were not specifically associated with ALD, but analysis of SNP rs35652124 suggested that this polymorphism predisposes to ALD. Furthermore, SNP rs35652124 was associated with a lower level of Nrf2 expression. Moreover, liver samples from ALD patients with this polymorphism displayed more severe inflammatory activity. Together, these findings provide evidence that the SNP rs35652124 variation in the Nrf2-encoding gene NFE2L2 is a potential genetic marker for susceptibility to ALD.

Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Programa de P?s-Gradua??o em Epidemiologia e Vigil?ncia em Sa?de. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Universidade Federal do Par?. N?cleo de Medicina Tropical. Bel?m, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Rotav?rus. Ananindeua, PA, Brasil. Immunosuppressive therapy causes severe impairment of host defense and diarrhea is a frequent complication in renal transplant recipients. This study aimed to describe the occurrence of Rotavirus A (RVA) and Human Bocavirus (HBoV) in fecal samples of immunosuppressed patients submitted to renal transplantation during posttransplant follow?up. A longitudinal study was carried out involving a 25?patient cohort, selected for kidney transplantation. A total of 126 fecal samples were collected between May 2014 and May 2016. Molecular techniques were used to detect and characterize circulating RVA and HBoV genotypes and statistical analysis were applied to verify the association between epidemiological and clinical characteristics. The prevalence of RVA and HBoV was 24% (6/25) and 40% (10/25), respectively. Among RVA and HBoV positive cases, the majority was female; did not conduct water treatment nor had adequate sewage facilities. The most detected genotypes were RVA G3 (62.5%) and HBoV?3 (95%). Phylogenetic analysis of HBoV strains indicated that studied samples were similar to those found in Asian and American countries. The present study point out the circulation of these viral agents among immunosuppressed individuals and these findings will enable the construction of new knowledge and care perspectives on the cause of diarrhea in this population.

Conselho Nacional de Desenvolvimento Cientifico e Tecnologico/Programa de Apoio a Nucleos de Excelencia/Fundacao Amazonia de Amparo a Estudos e Pesquisas do Para (CNPq/PRONEX/FAPESPA) ICAAF092/2010; Pro-reitoria de Pesquisa e Pos-Graduacao-PROPESP/UFPA (PAPQ-2018) Federal University of Par?. Institute of Biological Sciences. Virus Laboratory. Bel?m, PA, Brazil. Federal University of Par?. Institute of Biological Sciences. Virus Laboratory. Bel?m, PA, Brazil. Federal University of Par?. Institute of Biological Sciences. Virus Laboratory. Bel?m, PA, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Portuguese Beneficent Hospital. Cardiology Unit. Bel?m, PA, Brazil. Federal University of Par?. Institute of Biological Sciences. Virus Laboratory. Bel?m, PA, Brazil. Federal University of Par?. Institute of Biological Sciences. Virus Laboratory. Bel?m, PA, Brazil. Atherosclerosis is a progressive disease characterized by chronic inflammation of the arterial walls, associated with genetic and infectious factors. The present study investigated the involvement of Chlamydia trachomatis and Chlamydia pneumoniae infections and immunological markers (C-reactive protein, CRP, TNF-alpha, IL-6, IL-8, and IL-10) in the process of atherosclerosis. The evaluation included 159 patients for surgical revascularization (CAD) and 71 patients for surgical heart valve disease (HVD) at three hospitals in Belem, Brazil. The control group (CG) comprised 300 healthy individuals. Blood samples collected before surgery were used for antibodies detection (enzyme immunoassay), CRP (immunoturbidimetry) and IL-6 levels (enzyme immunoassay). Tissue fragments (atheroma plaque, heart valve and ascending aorta) were collected during surgery and subjected to qPCR for detection of bacterial DNA. Promoter region polymorphisms of eachmarker and relative quantification of TNF-alpha, IL-8, and IL-10 gene expression were performed. Demography and social information were similar to the general population involved with both diseases. Antibody prevalence to C. trachomatis was 30.6, 20.3, and 36.7% (in the CAD, HVD, and CG, respectively) and to C. pneumoniae was 83.6, 84.5, and 80.3% (in the CAD, HVD, and CG, respectively). C. trachomatis cryptic plasmid DNA was detected in 7.4% of the samples. Frequency of IL6-174G > C polymorphism was higher in CAD and HVD than in CG regardless of previous exposure to Chlamydia. Previous C. trachomatis infection showed involvement in HVD and CAD. Significant association between disease and previous C. pneumoniae infection was found only among HVD. GG genotype of IL6-174G > C is apparently a risk factor for heart disease, whereas AT genotype of IL8-251A > T was mainly involved in valvulopathies, including patients with prior exposure to C. pneumoniae.

El lupus eritematoso sistemico (LES) es una enfermedad autoinmune cronica, cuyo desarrollo puede estar asociado a la infeccion por virus, como el virus de Epstein-Barr (VEB), parvovirus B19 y virus linfotropico de celulas T humanas (HTLV). Durante el periodo de junio a setiembre de 2014, se realizo un estudio transversal, incluyendo a 85 pacientes oriundos del Hospital Jean Bitar en la Ciudad de Belem, Estado de Para, Brasil. Se hizo el estudio de anticuerpos especificos contra los agentes virales estudiados, ademas de investigar la presencia del genoma para EBV y HTLV. Se evaluaron tambien, variables clinicas y epidemiologicas. La mayoria de los pacientes era de mujeres, con un promedio de edad de 30 anos y se declararon blancos. Para VEB, se detecto una positividad de 37,6% para IgM, 98,8% para IgG y 2,4% por PCR, con cuantificaciones de 85.028 y 298 copias del genoma/mL de plasma. Para B19, la positividad para IgM fue 0% y para IgG 67,1%. No hubo deteccion serologica o por PCR de HTLV. Se verifico una relacion estadisticamente significante entre la positividad para IgM anti VEB y pacientes mas jovenes. Este hallazgo puede estar relacionado con la mayor eficiencia en la produccion de esa inmunoglobulina en las infecciones primarias agudas, que ocurren generalmente en individuos infantes o adultos jovenes. Adicionalmente, el resultado de IgG anti B19 fue asociado a la edad avanzada de los pacientes, probablemente por un tiempo mayor de exposicion al virus aliado a la persistencia de este marcador luego del contacto. La presencia de los marcadores no estuvo asociada a las variables clinicas y epidemiologicas. Sin embargo, el porcentual de positividad para el marcador de infeccion aguda por VEB puede sugerir que haya una implicacion del virus con el LES

Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico e do Instituto Evandro Chagas Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Par?, Bel?m, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil OBJETIVO: Realizar a detec??o e caracteriza??o das cepas de v?rus respirat?rio sincicial humano (VRSH), nos casos de infec??o respirat?ria aguda (IRA), circulantes nos estados brasileiros do Acre, Amap?, Amazonas, Par? e Roraima, no ano de 2015. MATERIAIS E M?TODOS: Foram coletadas 1.082 amostras de aspirado de nasofaringe e swab combinado narina e garganta de pacientes de diferentes g?neros e faixas et?rias com IRA e submetidas ? qRT-PCR para VRSH. As amostras positivas foram inoculadas em cultura celular HEP-2 e as que apresentaram efeito citop?tico foram submetidas a tr?s etapas: extra??o do RNA viral, amplifica??o do gene G pela RT-PCR e sequenciamento gen?tico. RESULTADOS: Das 1.082 amostras, 57 (5,3%) foram positivas para VRSH, sendo 38 (66,7%) de pacientes de 0 a 4 anos de idade. A circula??o predominou entre mar?o e julho, per?odo de transi??o clim?tica na Regi?o. Apenas no Acre, Amazonas e Par? foram detectadas amostras positivas, 15 (26,3%), 23 (40,4%) e 19 (33,3%), respectivamente. O efeito citop?tico foi avaliado em 45 (78,9%) amostras, nas quais foram identificados os subgrupos: 40 (88,9%) do VRSH-B com gen?tipo BA e cinco (11,1%) do VRSH-A do gen?tipo ON1. CONCLUS?O: Este estudo revelou uma taxa de infec??o viral relevante em crian?as de 0 a 4 anos de idade. A circula??o viral ocorreu no Acre, Amazonas e Par? durante o per?odo de mudan?a clim?tica. Foi not?ria a ocorr?ncia dos gen?tipos BA e ON1, sendo a primeira vez que se comprova a circula??o do ON1 no Par?.

Atherosclerosis is a progressive disease characterized by chronic inflammation of the arterial walls, associated with genetic and infectious factors. The present study investigated the involvement of Chlamydia trachomatis and Chlamydia pneumoniae infections and immunological markers (C-reactive protein, CRP, TNF-α, IL-6, IL-8, and IL-10) in the process of atherosclerosis. The evaluation included 159 patients for surgical revascularization (CAD) and 71 patients for surgical heart valve disease (HVD) at three hospitals in Belém, Brazil. The control group (CG) comprised 300 healthy individuals. Blood samples collected before surgery were used for antibodies detection (enzyme immunoassay), CRP (immunoturbidimetry) and IL-6 levels (enzyme immunoassay). Tissue fragments (atheroma plaque, heart valve and ascending aorta) were collected during surgery and subjected to qPCR for detection of bacterial DNA. Promoter region polymorphisms of each marker and relative quantification of TNF-α, IL-8, and IL-10 gene expression were performed. Demography and social information were similar to the general population involved with both diseases. Antibody prevalence to C. trachomatis was 30.6, 20.3, and 36.7% (in the CAD, HVD, and CG, respectively) and to C. pneumoniae was 83.6, 84.5, and 80.3% (in the CAD, HVD, and CG, respectively). C. trachomatis cryptic plasmid DNA was detected in 7.4% of the samples. Frequency of IL6−174G>C polymorphism was higher in CAD and HVD than in CG regardless of previous exposure to Chlamydia. Previous C. trachomatis infection showed involvement in HVD and CAD. Significant association between disease and previous C. pneumoniae infection was found only among HVD. GG genotype of IL6−174G>C is apparently a risk factor for heart disease, whereas AT genotype of IL8−251A>T was mainly involved in valvulopathies, including patients with prior exposure to C. pneumoniae.

INTRODUCTION: Although control measures of maternal and congenital syphilis are available in Brazil, difficulties exist within the healthcare network in providing a laboratory diagnosis of the infection during the prenatal period. The objective of this study was to confirm the presence of Treponema pallidum by PCR in women with positive VDRL serology and lethal pregnancy outcomes, i.e., abortion, stillbirth and neonatal death. METHODS: A retrospective study was conducted on VDRLseroreactive women with lethal pregnancy outcomes admitted to the Fundação Santa Casa de Misericórdia do Pará (FSCM-PA) between January and July 2004. Serum samples and DNA from whole blood were obtained at the time of screening by the VDRL test. These samples were analyzed by IgG ELISA, IgM FTA-Abs and simple PCR (polA). RESULTS: During the study period, 0.7% (36/4,912) of women with lethal pregnancy outcomes presented a positive VDRL test. The polAgene was amplified in 72.7% (24/33) of these women, with 55.6% (20/36) and 94.4% (34/36) presenting IgM and IgG antibodies against T. pallidum, respectively. Comparison of these results showed a significant difference, with agreement between the PCR and IgM FTA-Abs results, suggesting that maternal syphilis was an active infection. No basic cause of death of the conceptus was reported in 97.2% (35/36) of cases. Among women who were submitted to the VDRL test during the prenatal period, only four of the nine seroreactive patients underwent treatment. CONCLUSIONS: The high frequency of syphilis in the group studied indicates the fragility of the service of infection diagnosis, treatment and monitoring, compromising epidemiological control.INTRODUÇÃO: Apesar das medidas de controle da sífilis materna e congênita estarem disponíveis no Brasil, existem dificuldades da rede em prover o diagnóstico laboratorial da infecção durante o pré-natal. O objetivo deste estudo foi confirmar a presença do Treponema pallidum pela PCR em mulheres com sorologia positiva ao VDRL e com resultado letal da gravidez, isto é, aborto, natimorto e neomorto. MÉTODOS: Estudo retrospectivo realizado em mulheres VDRL-sororeativas com resultado negativo da gravidez, admitidas na Fundação Santa Casa de Misericórdia do Pará FSCM-PA entre janeiro e julho de 2004. As amostras de soro e DNA de sangue total foram obtidas no mesmo período da triagem pelo VDRL. Estas amostras foram analisadas pelo ELISA IgG, FTA-Abs IgM e PCR simples (polA). RESULTADOS: Durante o período de estudo, 0,7% (36/4.912) das mulheres com resultado letal da gravidez apresentaram VDRL positivo. O genepolA foi amplificado em 72,7% (24/33) destas mulheres,com 55,6% (20/36) e 94,4% (34/36) apresentando anticorpos tipo IgG e IgM contra o T. pallidum, respectivamente. A comparação destes resultados mostrou uma diferença estatística significativa, sendo que os resultados da PCR versus FTA-Abs Ig Mmostraram-se concordantes, sugerindo que a sífilis materna era uma infecção ativa. A causa básica de morte dos conceptos não foi relatada em 97,2% (35/36) dos casos. Entre as mulheres que foram submetidas ao VDRL no pré-natal, somente quatro das nove soropositivas receberam tratamento. CONCLUSÕES: A elevada frequência de sífilis no grupo de estudo indica a fragilidade do serviço no diagnóstico, tratamento e monitoramento da infecção, comprometendo o controle epidemiológico.

Universidade Federal do Par?. N?cleo de Medicina Tropical. Bel?m, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Universidade Federal do Par?. N?cleo de Medicina Tropical. Bel?m, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Universidade Federal do Par?. N?cleo de Medicina Tropical. Bel?m, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Este ? um estudo do tipo transversal, em que o crit?rio cl?nico para inclus?o das amostras foi a suspeita cl?nica e/ou aparecimento dos sintomas da varicela ou herpes-zoster para identifica??o dos gen?tipos do v?rus da varicela-zoster (VVZ), por meio das t?cnicas de rea??o em cadeia da polimerase (PCR) e sequenciamento, com posterior pesquisa de polimorfismo de nucleot?deo ?nico (SNP). De novembro de 2008 a mar?o de 2012, foram coletadas 93 amostras (85 casos de varicela e oito de herpes-zoster) de swab nasal, oral e de secre??o de ves?culas rompidas em v?rios s?tios anat?micos (49 de indiv?duos do sexo masculino e 44 do feminino). As estirpes Dumas e Oka parental foram inclu?das como refer?ncia padr?o dos gen?tipos europeu (classe 1 ou 3) e japon?s (classe 2), respectivamente. Estirpes com variabilidade no SNP foram classificadas dentro de um grupo de gen?tipo denominado mosaico (classe 5). As classes 1 ou 3 foram identificadas em 11 amostras do VVZ, nove casos de varicela e dois casos de herpes-zoster, enquanto que duas amostras apresentaram o gen?tipo de classe 5, ambos casos de varicela. O gen?tipo classe 1 ou 3 foi encontrado nos Munic?pios de Ananindeua, Bel?m e Marituba, Estado do Par?, Brasil, sendo que o gen?tipo classe 5 apenas em Ananindeua. A PCR foi sens?vel em 13 amostras de material direto de ves?culas, enquanto que em amostras de saliva n?o se obteve sucesso. This is a cross-sectional study in which the clinical criteria for inclusion of the samples was the clinical suspicion and/or onset of symptoms of chickenpox or shingles in order to genotype varicella-zoster virus (VZV) by the polymerase chain reaction (PCR) and sequencing techniques, with a search of single nucleotide polymorphisms (SNP) subsequently. From November 2008 to March 2012, 93 samples (85 cases of varicella and eight herpes zoster) were collected from oral, nasal swab and secretion of ruptured vesicles in several anatomical sites (49 male and 44 female). Dumas and Oka parental strains were included as European genotypes of the reference standard (class 1 or 3) and Japanese (class 2) genotypes, respectively. Strains with the SNP variability were classified into a group of genotype describe as Mosaic (class 5). Classes 1 or 3 were identified in 11 samples of VZV, nine cases of varicella and two cases of herpes zoster, while two samples showed the class genotype 5, both cases of varicella. The genotype class 1 or 3 was found in the Municipalities of Ananindeua, Bel?m and Marituba, Par? State, Brazil, and genotype class 5 only in Ananindeua. PCR was sensitive in just 13 samples of direct vesicles material, but in saliva samples there were not positive results.

Background Currently, sharing of drug paraphernalia is the main form of HCV transmission worldwide. In South America, consistent findings indicate that shared sniffing equipment is an important factor in the spread of HCV among non-injecting drug users. Epidemiological data on the status of HCV infection in illicit drug users in the Amazon region are scarce, although reports of clinical cases of hepatitis or pathologies associated with HCV infection in other population groups are numerous. Thereby, this study investigated the prevalence, genotype frequency, and epidemiological factors associated with HCV infection in non-injecting drug users in the state of Pará, eastern Amazon. Results During 2008–2011, 300 non-injecting drug users attending drug-treatment centers participated in this study. Most non-injecting drug users were male (63.7%). The mean age was 32.5 years. The non-injecting drugs most consumed were: cannabis (15.6%), cocaine paste (21.3%), and oxi cocaine (25.7%). Tobacco (60.9%) and alcohol (79.4%) were also commonly consumed. One hundred six (35.1%; CI 95%: 29.8 - 41.1) non-injecting drug users presented anti-HCV antibodies by EIA. The HCV-RNA prevalence was 28.0% (95% CI: 20.6 - 35.8). Genotypes 1 (76.9%) and 3 (23.1%) of HCV have been identified. A multivariate analysis demonstrated that HCV infection was independently associated with the following factors: “age (≥ 35 years)”, “tattoos”, “use of a needle or syringe sterilized at home”, “shared use of drug paraphernalia”, “uses drugs for more than 5 years”, and “use of drugs everyday”. Conclusions This study revealed a high prevalence of HCV infection in non-injecting drug users, and most infections are occasioned by genotype 1. Likely, HCV transmission is associated with the tattoos, the use of needle or syringe sterilized at home by people over the age of 35 years, and sharing, time and frequency of use of non-injecting drugs. These findings should serve as an incentive for the establishment of a program of Hepatitis C prevention and control by the local public-health authorities in order to develop effective policies and strategies for contain the spread of HCV infection.

Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Federal University of Par?. Biological Sciences Institute. Laboratory of Human and Medical Genetics. Bel?m, PA, Brazil. Federal University of Par?. Biological Sciences Institute. Laboratory of Human and Medical Genetics. Bel?m, PA, Brazil. Federal University of Par?. Biological Sciences Institute. Laboratory of Human and Medical Genetics. Bel?m, PA, Brazil. Federal University of Par?. Biological Sciences Institute. Laboratory of Human and Medical Genetics. Bel?m, PA, Brazil. Federal University of Par?. Biological Sciences Institute. Human Cytogenetics Laboratory. Bel?m, PA, Brazil. Federal University of Par?. Biological Sciences Institute. Human Cytogenetics Laboratory. Bel?m, PA, Brazil. Federal University of Par?. Biological Sciences Institute. Laboratory of Human and Medical Genetics. Bel?m, PA, Brazil. Federal University of Par?. Biological Sciences Institute. Human Cytogenetics Laboratory. Bel?m, PA, Brazil. Federal University of Par?. Biological Sciences Institute. Laboratory of Human and Medical Genetics. Bel?m, PA, Brazil. Ionizing radiation, such as that emitted by uranium, may cause mutations and consequently lead to neoplasia in human cells. The TP53 gene acts to maintain genomic integrity and constitutes an important biomarker of susceptibility. The present study investigated themain alterations observed in exons 4, 5, 6, 7, and 8 of the TP53 gene and adjacent introns in Amazonian populations exposed to radioactivity. Samples were collected from 163 individuals. Occurrence of the following alterations was observed: (i) a missense exchange in exon 4 (Arg72Pro); (ii) 2 synonymous exchanges, 1 in exon 5 (His179His), and another in exon 6 (Arg213Arg); (iii) 4 intronic exchanges, 3 in intron 7 (C - T at position 13.436; C - T at position 13.491; T - G at position 13.511) and 1in intron 8 (T - G at position 13.958). Alteration of codon 72 was found to be an important risk factor for cancer development (P = 0.024; OR = 6.48; CI: 1.29?C32.64) when adjusted for age and smoking.Thus, TP53 gene may be an important biomarker for carcinogenesis susceptibility in human populations exposed to ionizing radiation.

In this study, the prevalence, genotype frequency, and risk factors for HCV infection in 384 cocaine users were determined. One hundred twenty-four (32.3 %) cocaine users had anti-HCV antibodies and 120 (31.3 %) had HCV-RNA. Genotyping results indicated the predominance of genotypes 1 (73.3 %) and 3 (26.7 %). Multivariate analysis showed an association of HCV infection with tattoos, shared use of paraphernalia, daily cocaine use, and a long history of cocaine use. The epidemiological aspects of HCV infection among cocaine users presented here should serve as an incentive for the establishment of a program of hepatitis C prevention and control by the local public-health authorities in the Amazon.

INTRODUCTION: Although control measures of maternal and congenital syphilis are available in Brazil, difficulties exist within the healthcare network in providing a laboratory diagnosis of the infection during the prenatal period. The objective of this study was to confirm the presence of Treponema pallidum by PCR in women with positive VDRL serology and lethal pregnancy outcomes, i.e., abortion, stillbirth and neonatal death. METHODS: A retrospective study was conducted on VDRLseroreactive women with lethal pregnancy outcomes admitted to the Fundação Santa Casa de Misericórdia do Pará (FSCM-PA) between January and July 2004. Serum samples and DNA from whole blood were obtained at the time of screening by the VDRL test. These samples were analyzed by IgG ELISA, IgM FTA-Abs and simple PCR (polA). RESULTS: During the study period, 0.7% (36/4,912) of women with lethal pregnancy outcomes presented a positive VDRL test. The polAgene was amplified in 72.7% (24/33) of these women, with 55.6% (20/36) and 94.4% (34/36) presenting IgM and IgG antibodies against T. pallidum, respectively. Comparison of these results showed a significant difference, with agreement between the PCR and IgM FTA-Abs results, suggesting that maternal syphilis was an active infection. No basic cause of death of the conceptus was reported in 97.2% (35/36) of cases. Among women who were submitted to the VDRL test during the prenatal period, only four of the nine seroreactive patients underwent treatment. CONCLUSIONS: The high frequency of syphilis in the group studied indicates the fragility of the service of infection diagnosis, treatment and monitoring, compromising epidemiological control.