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Streptococcus equi subspecies zooepidemicus: an emergent cause of meningoencephalitis in Northeastern Brazil. 马链球菌亚种动物园流行病:巴西东北部脑膜脑炎的新病因。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466051
Luis Arthur Brasil Gadelha Farias, Marcos Maciel Sousa, Karene Ferreira Cavalcante, Marina Pinheiro Catunda Jucá, Aldenise de Olinda Castro, Liana Perdigão Mello, Rafael Ferreira Mesquita, Silviane Praciano Bandeira, Ana Paula Marchi, Tânia Mara Silva Coelho, Antônio Silva Lima Neto, Érico Antonio Gomes de Arruda, Silvia Figueiredo Costa, Maura Salaroli de Oliveira, Lauro Vieira Perdigão Neto

This study describes an outbreak of Streptococcus equi subspecies zooepidemicus infections that caused meningoencephalitis and bacteremia related to unpasteurized milk consumption in northeastern Brazil. Epidemiological investigations and a brief literature review were conducted. Strains with possible neurotropism had not been identified in Brazil before these cases; however, in 2023, another case of meningoencephalitis caused by Streptococcus equi sp. zooepidemicus was described, revealing the need to maintain surveillance and highlighting that these neurotropic strains continue to circulate in the environment.

本研究描述了在巴西东北部爆发的马链球菌亚种动物流行病感染,该感染引起的脑膜脑炎和菌血症与饮用未经巴氏消毒的牛奶有关。我们进行了流行病学调查和简要的文献综述。在发生这些病例之前,巴西尚未发现可能具有神经传导性的菌株;但在 2023 年,又出现了一例由马链球菌动物流行亚种引起的脑膜脑炎病例,这表明有必要继续进行监测,并强调这些具有神经传导性的菌株仍在环境中流通。
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引用次数: 0
Novel approaches for HTLV-1 therapy: innovative applications of CRISPR-Cas9. 治疗 HTLV-1 的新方法:CRISPR-Cas9 的创新应用。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466048
Wilson Domingues, Victor Ângelo Folgosi, Sabri Saeed Sanabani, Pedro Domingos Leite Junior, Tatiane Assone, Jorge Casseb

The human T-cell lymphotropic virus type 1 (HTLV-1) is a single-stranded positive-sense RNA virus that belongs to the Retroviridae family, genus Deltaretro, and infects approximately five to 10 million people worldwide. Although a significant number of individuals living with HTLV-1 remain asymptomatic throughout their lives, some develop one or more severe clinical conditions, such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a progressive and debilitating disease, and/or a subtype of non-Hodgkin's lymphoma with a more threatening course known as adult T-cell leukemia/lymphoma (ATLL). Moreover, current therapeutic options are limited and focus primarily on treating symptoms and controlling viral latency. CRISPR-Cas9 gene editing is proposed as a promising tool to address the intricate links associated with HTLV-1. By targeting or silencing key genes during initial infection and dysregulating immune signaling pathways, CRISPR-Cas9 offers potential intervention opportunities. In this review, we address the therapeutic potential of CRISPR-Cas9 gene editing, as well as examine the primary mechanisms involved in editing potential target genes and discuss the existing evidence in the current scientific literature.

人类 T 细胞淋巴细胞病毒 1 型(HTLV-1)是一种单链正义 RNA 病毒,属于逆转录病毒科 Deltaretro 属,全球约有 500 万到 1000 万人感染该病毒。虽然相当多的 HTLV-1 感染者终生无症状,但有些人却会出现一种或多种严重的临床症状,如 HTLV-1 相关性脊髓病/热带痉挛性截瘫(HAM/TSP)(一种进行性衰弱性疾病)和/或非霍奇金淋巴瘤的一种亚型,即成人 T 细胞白血病/淋巴瘤(ATLL),其病程更具威胁性。此外,目前的治疗方案有限,主要集中在治疗症状和控制病毒潜伏期。CRISPR-Cas9基因编辑被认为是解决与HTLV-1相关的错综复杂联系的一种有前途的工具。通过靶向或沉默初始感染期间的关键基因以及失调的免疫信号通路,CRISPR-Cas9 提供了潜在的干预机会。在这篇综述中,我们将探讨 CRISPR-Cas9 基因编辑的治疗潜力,研究编辑潜在靶基因所涉及的主要机制,并讨论当前科学文献中的现有证据。
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引用次数: 0
Unveiling microbial worlds: exploring viral metagenomics among waste pickers at Latin America's largest dumpsite. 揭开微生物世界的神秘面纱:探索拉丁美洲最大垃圾场拾荒者的病毒元基因组学。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466049
Vanessa Resende Nogueira Cruvinel, Eneas de Carvalho, Daiani Cristina Cilião Alves, Carla Pintas Marques, Rafael Dos Santos Bezerra, Marta Giovanetti, Sandra Coccuzzo Sampaio, Maria Carolina Elias, Wildo Navegantes de Araújo, Rodrigo Haddad, Svetoslav Nanev Slavov

Waste pickers constitute a marginalized demographic engaged in the collection of refuse, facing considerable occupational hazards that heighten their susceptibility to contract infectious diseases. Moreover, waste pickers contend with societal stigmatization and encounter barriers to accessing healthcare services. To explore the viral profile of waste pickers potentially linked to their occupational environment, we conducted a metagenomic analysis on 120 plasma specimens sampled from individuals employed at the Cidade Estrutural dumpsite in Brasilia city, Brazil. In total, 60 blood donors served as a comparative control group. Specimens were pooled and subjected to Illumina NextSeq 2000 sequencing. Viral abundance among waste pickers revealed the presence of significant pathogens, including HIV, HCV, and Chikungunya, which were not detected in the control group. Additionally, elevated levels of anelloviruses and Human pegivirus-1 were noted, with a comparable incidence in the control group. These findings underscore the utility of metagenomics in identifying clinically relevant viral agents within underserved populations. The implications of this study extend to informing public health policies aimed at surveilling infectious diseases among individuals facing socioeconomic disparities and limited access to healthcare resources.

拾荒者是从事垃圾收集工作的边缘化人群,他们面临着相当大的职业危害,更容易感染传染病。此外,拾荒者还受到社会的鄙视,在获得医疗保健服务方面遇到障碍。为了探索拾荒者的病毒特征与其职业环境的潜在联系,我们对巴西巴西利亚市 Cidade Estrutural 垃圾场的 120 份血浆样本进行了元基因组分析。共有 60 名献血者作为对比对照组。标本集中后进行了 Illumina NextSeq 2000 测序。结果表明,在拾荒者中发现了大量病原体,包括艾滋病毒、丙型肝炎病毒和基孔肯雅病毒,而这些病原体在对照组中均未检测到。此外,还发现anelloviruses和人类pegivirus-1的水平升高,而对照组的发病率与之相当。这些发现凸显了元基因组学在未得到充分服务的人群中识别临床相关病毒病原体的实用性。这项研究的意义还在于为公共卫生政策提供信息,以便在面临社会经济差异和医疗资源有限的人群中调查传染病。
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引用次数: 0
Fatal viscerotropic and neurotropic disease after yellow fever vaccine: a rare manifestation leading to diagnosis of severe combined immunodeficiency in an infant. 接种黄热病疫苗后出现致命的粘液性和神经性疾病:一种罕见的表现,导致婴儿被诊断为重症联合免疫缺陷症。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466050
Lara Jhullian Tolentino Vieira, Gabriela Assunção Goebel, Yuri Barcelos, Luciana Oliveira Cunha, Luisa Teles Melo Santos, Roberta Maia de Castro Romanelli, Fernanda Gontijo Minafra, Andrea Lucchesi de Carvalho, Luiz Fernando Andrade de Carvalho, Lilian Martins Oliveira Diniz

Yellow fever vaccine (YFV) is a live attenuated vaccine that can cause a mild infection in immunocompetent patients. However, it may not be self-limiting in patients with inborn errors of immunity (IEI) and may be the first and most severe presentation in these patients. A 10-month-old female infant sought emergency care presenting fever for three days and diffuse exanthema. She was a previous healthy child of consanguineous parents. The child had received YFV 28 days before the onset of symptoms. Upon hospital admission, petechial rash on the limbs and hepatosplenomegaly were noted on physical exam. Laboratory tests showed thrombocytopenia, increased serum aminotransferases and elevated gamma-glutamyl transferase (GGT) and alkaline phosphatase levels. During hospitalization she developed hypoactivity, drowsiness, and hypotonia. The possibility of viscerotropic and neurotropic vaccine associated disease was suspected and a possible primary immunodeficiency disease considered. The patient was tested for antibodies against the yellow fever virus (MAC ELISA) on serum and cerebrospinal fluid (CSF) samples, showing positive IgM results. Immunophenotyping showed low levels of lymphocytes and absence of T-cell receptor excision circles (TREC), leading to diagnose of severe combined immunodeficiency disease (SCID). Despite treatment, after 35 days of hospitalization, she evolved to cardiorespiratory arrest and death. Serious adverse events after administration of the YFV are rare and associated with neurological or visceral involvement in most cases. The unfavorable outcome highlights the importance of neonatal screening for SCID and the clinical suspicion of primary immunodeficiencies in infants who have serious adverse events to live virus vaccines.

黄热病疫苗(YFV)是一种减毒活疫苗,可引起免疫力低下患者的轻度感染。但是,对于先天性免疫错误(IEI)患者来说,黄热病可能不会自限,而且可能是这些患者的首发症状,也是最严重的症状。一名 10 个月大的女婴因发烧三天并伴有弥漫性红斑而急诊就医。她以前是一个健康的孩子,父母是近亲。孩子在发病前28天接受了YFV治疗。入院时,体格检查发现患儿四肢出现瘀点状皮疹,肝脾肿大。实验室检查显示血小板减少、血清转氨酶升高、γ-谷氨酰转移酶(GGT)和碱性磷酸酶水平升高。住院期间,她出现了活动不足、嗜睡和肌张力减退。医生怀疑可能是粘液性和神经性疫苗相关疾病,并考虑可能是原发性免疫缺陷病。对患者的血清和脑脊液样本进行了黄热病病毒抗体(MAC ELISA)检测,结果显示 IgM 阳性。免疫分型显示淋巴细胞水平较低,T细胞受体切割圈(TREC)缺失,因此诊断为重症联合免疫缺陷病(SCID)。尽管进行了治疗,但在住院 35 天后,她还是发展为心肺功能骤停并死亡。使用 YFV 后发生严重不良反应的情况很少见,大多数情况下与神经系统或内脏受累有关。这一不利的结果突显了新生儿 SCID 筛查的重要性,以及临床上对接种活病毒疫苗后出现严重不良反应的婴儿原发性免疫缺陷的怀疑。
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引用次数: 0
Hepatic endotheliitis in Golden Syrian hamsters (Mesocricetus auratus) experimentally infected with SARS-CoV-2. 实验性感染 SARS-CoV-2 的金色叙利亚仓鼠(Mesocricetus auratus)的肝脏内皮细胞炎。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466044
Alex Junior Souza de Souza, Antônio Francisco de Souza Filho, Cristina Kraemer Zimpel, Marina Caçador Ayupe, Marcelo Valdemir de Araújo, Rafael Rahal Guaragna Machado, Erika Salles, Caio Loureiro Salgado, Mariana Silva Tavares, Taiana Tainá Silva-Pereira, Paula Carolina de Souza, Edison Luiz Durigon, Marcos Bryan Heinemann, Paulo Eduardo Brandão, Denise Morais da Fonseca, Ana Marcia de Sá Guimarães, Lilian Rose Marques de Sá

Hepatic injuries in COVID-19 are not yet fully understood and indirect pathways (without viral replication in the liver) have been associated with the activation of vascular mechanisms of liver injury in humans infected with SARS-CoV-2. Golden Syrian hamsters are an effective model for experimental reproduction of moderate and self-limiting lung disease during SARS-CoV-2 infection. As observed in humans, this experimental model reproduces lesions of bronchointerstitial pneumonia and pulmonary vascular lesions, including endotheliitis (attachment of lymphoid cells to the luminal surface of endothelium). Extrapulmonary vascular lesions are well documented in COVID-19, but such extrapulmonary vascular lesions have not yet been described in the Golden Syrian hamster model of SARS-CoV-2 infection. The study aimed to evaluate microscopic liver lesions in Golden Syrian hamsters experimentally infected with SARS-CoV-2. In total, 38 conventional Golden Syrian hamsters, divided into infected group (n=24) and mock-infected group (n=14), were euthanized at 2-, 3-, 4-, 5-, 7-, 14-, and 15-days post infection with SARS-CoV-2. Liver fragments were evaluated by histopathology and immunohistochemical detection of SARS-CoV-2 Spike S2 antigens. The frequencies of portal vein endotheliitis, lobular activity, hepatocellular degeneration, and lobular vascular changes were higher among SARS-CoV-2-infected animals. Spike S2 antigen was not detected in liver. The main results indicate that SARS-CoV-2 infection exacerbated vascular and inflammatory lesions in the liver of hamsters with pre-existing hepatitis of unknown origin. A potential application of this animal model in studies of the pathogenesis and evolution of liver lesions associated with SARS-CoV-2 infection still needs further evaluation.

COVID-19 对肝脏的损伤尚未完全明了,在感染 SARS-CoV-2 的人类中,间接途径(肝脏中没有病毒复制)与激活肝脏损伤的血管机制有关。金色叙利亚仓鼠是实验再现 SARS-CoV-2 感染期间中度和自限性肺部疾病的有效模型。与在人类身上观察到的一样,这种实验模型可再现支气管间质性肺炎病变和肺血管病变,包括内皮细胞炎(淋巴细胞附着在内皮细胞的管腔表面)。在 COVID-19 中,肺外血管病变已被充分记录,但在 SARS-CoV-2 感染的金色叙利亚仓鼠模型中,这种肺外血管病变尚未被描述。本研究旨在评估实验性感染 SARS-CoV-2 的金色叙利亚仓鼠肝脏的显微病变。总共有 38 只常规金色叙利亚仓鼠,分为感染组(n=24)和模拟感染组(n=14),分别在感染 SARS-CoV-2 后 2、3、4、5、7、14 和 15 天安乐死。通过组织病理学和 SARS-CoV-2 Spike S2 抗原的免疫组化检测对肝脏碎片进行评估。在感染了SARS-CoV-2的动物中,门静脉内皮炎、肝小叶活动、肝细胞变性和肝小叶血管变化的频率较高。肝脏中未检测到 Spike S2 抗原。主要结果表明,SARS-CoV-2 感染加剧了原有不明原因肝炎仓鼠肝脏的血管和炎症病变。这种动物模型在研究与 SARS-CoV-2 感染相关的肝脏病变的发病机制和演变过程中的潜在应用仍需进一步评估。
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引用次数: 0
Antibacterial activity of Nocardia spp. and Streptomyces sp. on multidrug-resistant pathogens causing neonatal sepsis. 诺卡氏菌属和链霉菌属对导致新生儿败血症的耐多药病原体的抗菌活性。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466042
Janette Berenice González-Nava, Gauddy Lizeth Manzanares-Leal, Luis Ángel Zapi-Colín, Sonia Dávila-Ramos, Horacio Sandoval-Trujillo, Ninfa Ramírez-Durán

Neonatal sepsis leads to severe morbidity and occasionally death among neonates within the first week following birth, particularly in low- and middle-income countries. Empirical therapy includes antibiotics recommended by WHO. However, these have been ineffective against antimicrobial multidrug-resistant bacterial strains such as Klebsiella spp, Escherichia coli, and Staphylococcus aureus species. To counter this problem, new molecules and alternative sources of compounds with antibacterial activity are sought as options. Actinobacteria, particularly pathogenic strains, have revealed a biotechnological potential still underexplored. This study aimed to determine the presence of biosynthetic gene clusters and the antimicrobial activity of actinobacterial strains isolated from clinical cases against multidrug-resistant bacteria implicated in neonatal sepsis. In total, 15 strains isolated from clinical cases of actinomycetoma were used. PCR screening for the PKS-I, PKS-II, NRPS-I, and NRPS-II biosynthetic systems determined their secondary metabolite-producing potential. The strains were subsequently assayed for antimicrobial activity by the perpendicular cross streak method against Escherichia fergusonii Sec 23, Klebsiella pneumoniae subsp. pneumoniae H1064, Klebsiella variicola H776, Klebsiella oxytoca H793, and Klebsiella pneumoniae subsp. ozaenae H7595, previously classified as multidrug-resistant. Finally, the strains were identified by 16S rRNA gene sequence analysis. It was found that 100% of the actinobacteria had biosynthetic systems. The most frequent biosynthetic system was NRPS-I (100%), and the most frequent combination was NRPS-I and PKS-II (27%). All 15 strains showed antimicrobial activity. The strain with the highest antimicrobial activity was Streptomyces albus 94.1572, as it inhibited the growth of the five multidrug-resistant bacteria evaluated.

新生儿败血症会导致新生儿在出生后一周内严重发病,有时甚至死亡,尤其是在中低收入国家。经验疗法包括世界卫生组织推荐的抗生素。然而,这些抗生素对克雷伯氏菌属、大肠埃希氏菌和金黄色葡萄球菌等抗菌性多药耐药菌株无效。为了解决这一问题,人们正在寻找具有抗菌活性的新分子和替代化合物来源。放线菌,尤其是致病菌株,揭示了一种尚未被充分开发的生物技术潜力。本研究旨在确定从临床病例中分离的放线菌菌株是否存在生物合成基因簇,以及它们对新生儿败血症中涉及的多重耐药菌的抗菌活性。共使用了 15 株从放线菌瘤临床病例中分离出来的菌株。通过对 PKS-I、PKS-II、NRPS-I 和 NRPS-II 生物合成系统进行 PCR 筛选,确定了它们产生次级代谢产物的潜力。随后,采用垂直交叉条纹法对这些菌株进行了抗菌活性检测,检测对象包括 Fergusonii Sec 23 埃希氏菌、肺炎克雷伯氏菌亚种 H1064、变异克雷伯氏菌 H776、氧乐氏克雷伯氏菌 H793 和肺炎克雷伯氏菌亚种 ozaenae H7595,这些菌株之前被归类为耐多药菌株。最后,通过 16S rRNA 基因序列分析对菌株进行了鉴定。结果发现,100% 的放线菌都有生物合成系统。最常见的生物合成系统是 NRPS-I(100%),最常见的组合是 NRPS-I 和 PKS-II(27%)。所有 15 株菌株都具有抗菌活性。抗菌活性最高的菌株是白链霉菌(Streptomyces albus)94.1572,因为它抑制了五种耐多药细菌的生长。
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引用次数: 0
Stenotrophomonas maltophilia outbreak in a university hospital: epidemiological investigation and literature review of an emerging healthcare-associated infection. 一家大学医院爆发嗜麦芽血单胞菌感染:一种新出现的医疗保健相关感染的流行病学调查和文献综述。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466046
Mehmet Erinmez, Feyza Nur Aşkın, Yasemin Zer

Stenotrophomonas maltophilia was considered to be a low-virulence organism. But it has emerged as a prominent opportunistic pathogen in patients with certain risk factors. This study aimed to describe an outbreak experienced in our hospital with all dynamics while evaluating previous S. maltophilia outbreak reports. S. maltophilia isolates were obtained from a university hospital in Türkiye in a seven-months period. Antimicrobial resistance, type of infections, predisposing factors of infected patients, antibiotic therapy, outcome of infections, and outbreak source were investigated. Also, S. maltophilia outbreaks in the literature were reviewed. In the 12 months prior to the outbreak, prevalence rate of clinical samples including S. maltophilia was 7/1,000 patient per day, opposed to 113/1,000 patient per day during the outbreak. Although a large number of cases were observed in a short seven-month period, a source of contamination could not be detected. Stable mortality rates (or remaining close to the average) during outbreaks can be attributed to the careful attention paid by laboratory and clinic physicians during procedures. S. maltophilia has potential to spread outbreaks and infect patients in operating rooms and intensive care units during invasive procedures.

嗜麦芽血单胞菌被认为是一种低毒性生物。但在具有某些危险因素的患者中,它已成为一种突出的机会性病原体。本研究旨在描述我院爆发的嗜麦芽糖单胞菌疫情的所有动态变化,同时对以前的嗜麦芽糖单胞菌疫情报告进行评估。嗜麦芽汁酵母菌分离株来自土耳其的一家大学医院,为期七个月。对抗菌药耐药性、感染类型、感染患者的易感因素、抗生素治疗、感染结果和疫情爆发源进行了调查。此外,还查阅了有关嗜麦芽糖酵母菌爆发的文献。在疫情爆发前的 12 个月中,包括嗜麦芽糖酵母菌在内的临床样本的流行率为每天 7/1,000 名患者,而在疫情爆发期间则为每天 113/1,000 名患者。虽然在短短七个月的时间内观察到大量病例,但却无法发现污染源。在疫情爆发期间,死亡率保持稳定(或接近平均水平),这可归功于实验室和诊所医生在操作过程中的细心观察。嗜麦芽梭菌有可能在侵入性手术过程中传播疫情并感染手术室和重症监护室的病人。
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引用次数: 0
Interventions to prevent mother-to-child transmission in breastfeeding mothers with HIV: a systematic review and meta-analysis of randomized controlled trials. 预防感染艾滋病毒的母乳喂养母亲母婴传播的干预措施:随机对照试验的系统回顾和荟萃分析。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466045
Fangping Xu, Ying Xiong, Min Gu, Lingling Wan, Yun Wang

This study aimed to systematically review interventions to prevent mother-to-child transmission of HIV during breastfeeding. We conducted a systematic review and meta-analysis using specific criteria to identify randomized controlled trials that focused on pregnant and breastfeeding women living with HIV and their children from birth to 2 years of age. We extensively searched electronic databases, including Web of Science, Scopus, PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar up to October 24, 2023. After screening 3,110 titles and abstracts, we reviewed 306 full texts. Of these, we assessed the quality and risk of bias of fifty-five articles, ultimately identifying seven studies. Four of these studies, which focused on antiretroviral therapy (ART), were included in the meta-analysis. There was little heterogeneity in study methodology and pooled estimates. The postnatal HIV transmission rate was found to be 0.01 (95%CI: 0.00 - 0.02). Therefore, the risk of mother-to-child transmission among breastfeeding mothers with HIV was significantly lower in the intervention groups than in the placebo groups. Analysis of funnel plots and Egger's test (p = 0.589) showed no evidence of publication bias. In addition to the four articles, two studies compared different ART regimens and one study compared the administration of high-dose vitamin A to the mother or the child. The results suggest that the use of ART significantly reduces the risk of postnatal HIV transmission compared with placebo. However, the effectiveness of different ART regimens or other therapies, including high-dose vitamin A, is unclear.

本研究旨在系统回顾预防母乳喂养期间母婴传播艾滋病的干预措施。我们采用特定的标准进行了系统性回顾和荟萃分析,以确定针对感染 HIV 的孕妇和哺乳期妇女及其从出生到 2 岁的孩子的随机对照试验。我们广泛检索了电子数据库,包括截至 2023 年 10 月 24 日的 Web of Science、Scopus、PubMed、MEDLINE、EMBASE、Cochrane Central Register of Controlled Trials 和 Google Scholar。在筛选了 3,110 篇标题和摘要后,我们审阅了 306 篇全文。其中,我们评估了 55 篇文章的质量和偏倚风险,最终确定了 7 项研究。其中四项研究侧重于抗逆转录病毒疗法(ART),被纳入荟萃分析。在研究方法和汇总估计值方面几乎不存在异质性。产后 HIV 传播率为 0.01(95%CI:0.00 - 0.02)。因此,干预组感染艾滋病毒的母乳喂养母亲的母婴传播风险明显低于安慰剂组。漏斗图分析和 Egger 检验(P = 0.589)显示,没有证据表明存在发表偏倚。除了这四篇文章外,还有两项研究对不同的抗逆转录病毒疗法进行了比较,一项研究对母亲或儿童服用大剂量维生素 A 进行了比较。研究结果表明,与安慰剂相比,抗逆转录病毒疗法能显著降低产后艾滋病传播的风险。然而,不同抗逆转录病毒疗法或其他疗法(包括大剂量维生素 A)的有效性尚不清楚。
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引用次数: 0
Evaluation of different cut-off points for IgG avidity and IgM in the diagnosis of acute toxoplasmosis in pregnant women participating in a congenital toxoplasmosis screening program. 评估先天性弓形虫病筛查项目中孕妇急性弓形虫病诊断中 IgG 阳性和 IgM 的不同临界点。
IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466043
Michelle Costa Laguardia, Ericka Viana Machado Carellos, Glaucia Manzan Queiroz Andrade, Mariângela Carneiro, José Nélio Januário, Ricardo Wagner de Almeida Vitor

The main social impact of toxoplasmosis stems from its ability to be vertically transmitted. Postnatally acquired infection is generally asymptomatic in approximately 70-90% of cases, making diagnosis often dependent on laboratory tests using serological methods to search for anti-T. gondii antibodies. This study aimed to investigate the ability of the VIDAS TOXO IgG avidity and VIDAS TOXO IgM assays to confirm recent toxoplasmosis. In total, 341 pregnant women with suspected acute toxoplasmosis were systematically monitored in the Program for Control of Congenital Toxoplasmosis in Minas Gerais State, Brazil. We conducted an observational analytical-descriptive cross-sectional study and grouped according to clinical and laboratory criteria as having acute or chronic toxoplasmosis. The VIDAS TOXO IgG avidity and VIDAS TOXO IgM assays were evaluated to investigate the capacity to identify acute infection. IgG avidity showed good performance in identifying acute toxoplasmosis when the IgG avidity index was lower than or equal to 0.1. Values greater than or equal to 3.16 according to the TOXO IgM kit were associated with a greater chance of acute infection. These results may contribute to a more adequate diagnosis of acute gestational toxoplasmosis and, consequently, the avoidance of inadequate or unnecessary treatments.

弓形虫病的主要社会影响源于其垂直传播的能力。出生后感染的病例中约有 70%-90% 通常没有症状,因此诊断通常依赖于使用血清学方法寻找抗弓形虫抗体的实验室检测。本研究旨在探讨 VIDAS TOXO IgG 反应性和 VIDAS TOXO IgM 检测法确认近期弓形虫病的能力。巴西米纳斯吉拉斯州的先天性弓形虫病控制项目共对 341 名疑似急性弓形虫病孕妇进行了系统监测。我们进行了一项观察性分析描述横断面研究,并根据临床和实验室标准将其分为急性和慢性弓形虫病。我们对 VIDAS TOXO IgG 反应性和 VIDAS TOXO IgM 检测法进行了评估,以研究其识别急性感染的能力。当 IgG 阳性指数低于或等于 0.1 时,IgG 阳性在识别急性弓形虫病方面表现良好。根据 TOXO IgM 试剂盒的检测结果,如果数值大于或等于 3.16,则急性感染的几率更大。这些结果可能有助于更充分地诊断急性妊娠弓形虫病,从而避免不适当或不必要的治疗。
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引用次数: 0
Human papillomavirus in women infected with human immunodeficiency virus: association with viral load and lymphocyte count. 感染人类免疫缺陷病毒的妇女体内的人类乳头瘤病毒:与病毒载量和淋巴细胞计数的关系。
IF 1.9 4区 医学 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-07 eCollection Date: 2024-01-01 DOI: 10.1590/S1678-9946202466036
Ana Cléa Cutrim Diniz de Morais, Alice de Sá Ferreira, Carla Déa Trindade Barbosa, Maria Fernanda Bezerra Lima, Karina Donato Fook, Mônika Machado de Carvalho, Alessandra Costa de Sales Muniz, Deborah Rocha de Araújo, Pablo de Matos Monteiro, Maria José Abigail Mendes Araújo, Sally Cristina Moutinho Monteiro, Fernanda Ferreira Lopes

Women living with human immunodeficiency virus are at an increased risk of developing cancers related to human papillomavirus (HPV). Thus, it is important to combine clinical assessments, serological screening, and HPV data for planning prevention policies. This study aimed to identify HPV and its specific types in the cervical, anal, and oral mucosa of HIV-seropositive women, associating it with viral load and lymphocyte count. Sociodemographic characteristics, health data (CD4+ and CD8+ T cell counts and viral load), and biological samples (cervical, anal, and oral) were collected from 86 HIV-positive women undergoing antiretroviral therapy. Data were classified according to the presence or absence of HPV-DNA, HPV-DNA presence at one or more anatomic sites, and level of oncogenic risk, considering low- and high-risk oncogenic HPV-DNA groups. The presence of HPV in the cervicovaginal site was 65.9%, 63.8% in anal canal, and 4.2% in oral mucosa. A viral load ≥75 HIV copies/mL was associated with the presence of HPV-DNA. There was an association between viral load and the low-risk HPV or high-risk HPV groups. We found a high prevalence of HPV infection in HIV-seropositive women, particularly in the cervical and anal mucosa, with viral load ≥75 HIV copies/mL being associated with HPV-DNA presence.

感染人类免疫缺陷病毒的妇女罹患与人类乳头瘤病毒(HPV)相关的癌症的风险更高。因此,结合临床评估、血清学筛查和 HPV 数据来规划预防政策非常重要。本研究旨在确定 HIV 血清阳性女性宫颈、肛门和口腔黏膜中的 HPV 及其特定类型,并将其与病毒载量和淋巴细胞计数联系起来。研究人员收集了 86 名接受抗逆转录病毒治疗的 HIV 阳性女性的社会人口学特征、健康数据(CD4+ 和 CD8+ T 细胞计数和病毒载量)以及生物样本(宫颈、肛门和口腔)。根据是否存在 HPV-DNA、HPV-DNA 是否存在于一个或多个解剖部位以及致癌风险水平(考虑低风险和高风险致癌 HPV-DNA 组)对数据进行了分类。宫颈阴道部位的 HPV 感染率为 65.9%,肛管感染率为 63.8%,口腔粘膜感染率为 4.2%。病毒载量≥75 HIV拷贝/毫升与HPV-DNA的存在有关。病毒载量与低风险 HPV 或高风险 HPV 组之间存在关联。我们发现,HPV 感染在 HIV 血清呈阳性的妇女中发病率很高,尤其是在宫颈和肛门粘膜,病毒载量≥75 HIV 拷贝/毫升与 HPV-DNA 的存在有关。
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引用次数: 0
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Revista Do Instituto De Medicina Tropical De Sao Paulo
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