60 resultados para viral load (VL)


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Background: Immunity plays an important role in controlling human papillomavirus (HPV) infection and associated lesions. Unlike infections caused by other viruses, natural HPV infection does not always result in a protective antibody response. Therefore, HPV antibodies are also considered markers of cumulative exposure. The aim of this study was to identify determinants of HPV16 seroreactivity at enrollment among women from the Ludwig-McGill cohort, a natural history study of HPV infection and risk of cervical neoplasia.Methods: HPV16 serology was assessed by ELISA for L1 and L2 capsid antigens, while HPV typing and viral load measurements were performed by PCR-based methods. The associations were analyzed by unconditional logistic regression.Results: Of 2049 subjects, 425 (20.7%) were strongly seropositive for HPV16. In multivariate analysis, seroreactivity was positively correlated with age, lifetime number of sexual partners, frequency of sex, and HPV16 viral load, and negatively associated with duration of smoking.Conclusions: HPV16 seroreactivity is determined by factors that reflect viral exposure.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Background &aims: Selenium is an essential mineral for immunological function, performing crucial functions at the cellular level. This micronutrient has been determined to be frequently deficient in HIV infected patients, with correlations between reduced immunological function and greater susceptibility to opportunistic infections. Our aim was to evaluate the influence of time of exposure to antiretroviral therapy (ART) on the biochemical profile of selenium in HIV-infected patients.Methods: We performed a cross-sectional study on 50 HIV-positive men with different quantitations of viral load and CD4+ T cells, who were either receiving or not receiving ART. Dual energy X-ray absorptiometry (DXA) to determine body composition, biochemical analysis of selenium and albumin, anthropometric measurements were performed. The subjects were divided into groups according to the use of ART or not: The Control Group (CG) was 10 treatment-nave volunteers, Group G < 2 was 20 volunteers on ART for less than 2 years, and Group G > 2 was 20 volunteers on ART for >2 years.Results: The body mass index showed that all subjects were of normal weight. The group with a longer time of exposure to ART (G > 2) had undetectable viremia and a higher CD4+ T cell count: 593.1 +/- 234.6 mm(3). Selenium values (mu g/L) were 55.9 +/- 11.9 for CG, 52.1 +/- 10.5 for G < 2, and 66.9 +/- 20.8 for G > 2, with a significant difference between groups G < 2 and G > 2 (p < 0.05), and only G > 2 showed normal selenium values.Conclusions: Most of the men studied showed selenium deficiency, except for the subjects with a longer exposure to antiretroviral treatment. Thus, an adequate selenium concentration is related to better control of virology and of immunologic function. (C) 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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The Epstein-Barr virus (EBV) and Kaposi's sarcoma associated herpesvirus (KSHV) are consistently associated with lymphoproliferative diseases and cancers in humans, notably in patients with HIV. Our aim was to evaluate whether EBV and/or KSHV viral loads regularly assessed in peripheral blood mononuclear cells (PBMC) correlate with clinical or laboratorial parameters retrieved for patients living with HIV. This was a longitudinal study with a cohort of 157 HIV positive patients attending an academic HIV outpatient clinic in São Paulo State, Brazil. For each patient, up to four blood samples were collected over a 1 year clinical follow-up: on enrolment into the study, and after 4, 8 and 12 months. Total DNA was extracted from PBMC, and EBV and KSHV viral loads were assessed by real time quantitative PCR. Higher viral loads for EBV were significantly associated with high HIV viraemia, a greater number of circulating T CD8+ cells and lack of virological response to the antiretroviral treatment. KSHV viral load was undetectable in virtually all samples. EBV viral load in PBMC correlated with the number of circulating T CD8+ lymphocytes and the response to the antiretroviral therapy in HIV infected patients. In contrast, KSHV was undetectable in PBMC, presumably an effect of the antiretroviral treatment. Therefore, either KSHV infection in the population studied was absent or viral load in PBMC was beyond the analytical limit of the assay.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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The practice of pharmaceutical care (PC) is recent in Brazil and little is known about its impact on the health system or patients. The aim of this review was thus to identify the clinical, humanistic and economic outcomes achieved by the practice of PC in Brazil. In order to assess those outcomes, data published in studies from 1997 to 2011 were collected from Lilacs and MEDLINE databases, using the technique of content analysis. Original studies on PC that included pharmacotherapeutic follow-up were considered eligible for this descriptive review. A total of 306 articles were identified through the chosen descriptors. Of those, ten studies were eligible for this review and only two did not report significant results. The others reported increased adherence to pharmacotherapy, resolution of pharmacotherapeutic issues and control of clinical parameters of diseases (such as maintenance or reduction of blood pressure, reduction in HIV viral load and increase in lymphocyte count), promoting improvements in the general state of health and behavioral changes. However, economic impact was not assessed in any article analyzed, nor was a direct measurement of life quality performed. Although there are few studies on the outcomes of pharmaceutical care services in Brazil, it is demonstrated in this review that positive results were obtained when the pharmacist acted as a provider of optimized pharmacotherapy. This may be considered a result of the actions that followed the Brazilian Pharmaceutical Care Consensus of 2002, such as the restructuring of the curricular basis of pharmacy courses. From this point on, Brazilian researchers and pharmacists should think of a strategy to expand the offer of pharmaceutical care beyond academia and reach people in general who need this type of health care.

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Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

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