{"title":"巴西亚马孙地区高流行病亚马孙州献血者中的艾滋病毒急性感染和长期未披露的艾滋病毒感染状况。","authors":"","doi":"10.1016/j.bjid.2024.103848","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The Amazonas state/AM and Manaus rank among the highest AIDS detection rates in Brazil. High proportion of HIV infected blood donors and transmission clusters of multidrug antiretroviral/ARV resistant viruses were described in HEMOAM blood donors, a main Amazonas public blood bank. Recent and long-term infections among previously genotyped donors are reported.</p></div><div><h3>Methods/materials</h3><p>The recency immunoassay Lag Avidity EIA (Maxim, USA) was employed. Clinical/CD4/viral load medical file data of the main local HIV management center (FMT-HVD) and ARV treatment/ART data were reviewed.</p></div><div><h3>Results</h3><p>Among 142 HIV-blood donors, chronic infection predominated (<em>n</em> = 87; 61.3 %), 79 based on LAg EIA and 8 undisclosed HIV identified in FMT-HVD records, mostly young adult, single males, 4 repeat donors, all ART-naive. Recent infections represented 30.3 % (<em>n</em> = 43), 39 identified by LAg EIA and 4 immunologic windows (antibody negative/NAT/RNA positive). The overall profile of recent and long-term infections was similar, including moderate rate of transmitted drug resistance/TDR, however with multiple resistance mutations to more than one ARV-class, suggesting ART/failure.</p></div><div><h3>Discussion</h3><p>Recent/acute and undisclosed/long-term HIV infections represent blood safety alerts suggesting test-seeking behavior of at-risk populations. Early ART use in Brazil, can turn HIV diagnosis more challenging representing a blood transfusion risk in the highly endemic Brazilian Amazon.</p></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1413867024001314/pdfft?md5=a94fe5bb30ff37c0ad781c84e8b965b1&pid=1-s2.0-S1413867024001314-main.pdf","citationCount":"0","resultStr":"{\"title\":\"HIV acute infection and long-term undisclosed HIV status among blood donors from the highly endemic Amazonas state, located in the Brazilian Amazon\",\"authors\":\"\",\"doi\":\"10.1016/j.bjid.2024.103848\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The Amazonas state/AM and Manaus rank among the highest AIDS detection rates in Brazil. High proportion of HIV infected blood donors and transmission clusters of multidrug antiretroviral/ARV resistant viruses were described in HEMOAM blood donors, a main Amazonas public blood bank. Recent and long-term infections among previously genotyped donors are reported.</p></div><div><h3>Methods/materials</h3><p>The recency immunoassay Lag Avidity EIA (Maxim, USA) was employed. Clinical/CD4/viral load medical file data of the main local HIV management center (FMT-HVD) and ARV treatment/ART data were reviewed.</p></div><div><h3>Results</h3><p>Among 142 HIV-blood donors, chronic infection predominated (<em>n</em> = 87; 61.3 %), 79 based on LAg EIA and 8 undisclosed HIV identified in FMT-HVD records, mostly young adult, single males, 4 repeat donors, all ART-naive. Recent infections represented 30.3 % (<em>n</em> = 43), 39 identified by LAg EIA and 4 immunologic windows (antibody negative/NAT/RNA positive). The overall profile of recent and long-term infections was similar, including moderate rate of transmitted drug resistance/TDR, however with multiple resistance mutations to more than one ARV-class, suggesting ART/failure.</p></div><div><h3>Discussion</h3><p>Recent/acute and undisclosed/long-term HIV infections represent blood safety alerts suggesting test-seeking behavior of at-risk populations. Early ART use in Brazil, can turn HIV diagnosis more challenging representing a blood transfusion risk in the highly endemic Brazilian Amazon.</p></div>\",\"PeriodicalId\":56327,\"journal\":{\"name\":\"Brazilian Journal of Infectious Diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1413867024001314/pdfft?md5=a94fe5bb30ff37c0ad781c84e8b965b1&pid=1-s2.0-S1413867024001314-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brazilian Journal of Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1413867024001314\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brazilian Journal of Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1413867024001314","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
摘要
背景:亚马孙州和马瑙斯是巴西艾滋病发现率最高的地区之一。亚马孙州主要的公共血库 HEMOAM 的献血者中,感染 HIV 的献血者比例很高,并且出现了耐多药抗逆转录病毒/ARV 病毒的传播集群。方法/材料:方法/材料:采用 Lag Avidity EIA(美国 Maxim 公司)的近期免疫测定法。对当地主要 HIV 管理中心(FMT-HVD)的临床/CD4/病毒载量医疗档案数据和抗逆转录病毒治疗/ART 数据进行了审查:在 142 名 HIV 献血者中,慢性感染者占多数(n = 87;61.3%),其中 79 人是根据 LAg EIA 感染的,8 人是在 FMT-HVD 的记录中发现的未披露的 HIV 感染者,他们大多是年轻的成年单身男性,4 人是重复献血者,都是抗逆转录病毒疗法无效者。近期感染者占 30.3%(n = 43),其中 39 人通过 LAg EIA 确定,4 人通过免疫学窗口(抗体阴性/NAT/RNA 阳性)确定。近期感染和长期感染的总体情况相似,包括中度的传播耐药性/TDR,但对一种以上的抗逆转录病毒药物有多种耐药性突变,表明抗逆转录病毒疗法/失败:讨论:近期/急性和未披露/长期艾滋病毒感染是血液安全警报,表明高危人群有寻求检测的行为。在巴西,早期使用抗逆转录病毒疗法会使艾滋病诊断变得更具挑战性,这意味着在高流行率的巴西亚马逊地区存在输血风险。
HIV acute infection and long-term undisclosed HIV status among blood donors from the highly endemic Amazonas state, located in the Brazilian Amazon
Background
The Amazonas state/AM and Manaus rank among the highest AIDS detection rates in Brazil. High proportion of HIV infected blood donors and transmission clusters of multidrug antiretroviral/ARV resistant viruses were described in HEMOAM blood donors, a main Amazonas public blood bank. Recent and long-term infections among previously genotyped donors are reported.
Methods/materials
The recency immunoassay Lag Avidity EIA (Maxim, USA) was employed. Clinical/CD4/viral load medical file data of the main local HIV management center (FMT-HVD) and ARV treatment/ART data were reviewed.
Results
Among 142 HIV-blood donors, chronic infection predominated (n = 87; 61.3 %), 79 based on LAg EIA and 8 undisclosed HIV identified in FMT-HVD records, mostly young adult, single males, 4 repeat donors, all ART-naive. Recent infections represented 30.3 % (n = 43), 39 identified by LAg EIA and 4 immunologic windows (antibody negative/NAT/RNA positive). The overall profile of recent and long-term infections was similar, including moderate rate of transmitted drug resistance/TDR, however with multiple resistance mutations to more than one ARV-class, suggesting ART/failure.
Discussion
Recent/acute and undisclosed/long-term HIV infections represent blood safety alerts suggesting test-seeking behavior of at-risk populations. Early ART use in Brazil, can turn HIV diagnosis more challenging representing a blood transfusion risk in the highly endemic Brazilian Amazon.
期刊介绍:
The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents.
The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor, since its inception it has garnered a growing share of the publishing market.