Prevalência dos marcadores sorológicos dos vírus da hepatite B e D em crianças das tribos Caiabietxucarramãe do parque indígena do Xingu, Brasil central

O Parque Indígena do Xingu (PIX) está localizado no estado do Mato Grosso, na região de transição de cenado ao sul e da floresta Amazônica ao norte. Dados de literatura mostram que a população adulta apresenta elevada prevalência de marcadores do vírus da hepatite B (HBV). O presente estudo visa determinar a prevalência dos marcadores do HBV e do HDV na população indígena do PIX de zero a 14 anos, e investigar a forma de transmissão do HBV na região. Entre as 17 tribos existentes no PIX escolheu-se os Caiabi e os Txucairamãe que diferem em seus hábitos de vida e habitam a região Norte do parque com características de clima, vegetação e fauna semelhantes ás da região Amazônica. Avaliaram-se 222 crianças (116 Txucarramãe e 106 Caiabi) e 33 mulheres em idade fértil. A pesquisa de marcadores sorológicos para HBV e HDV foi feita por técnica imunoenzimãtica. A prevalência global dos marcadores sorológicos nas crianças foi: HBsAg 4,5%; anti-HBs 39,6%; anti- HBc 44,1%; presença de algum marcador do HBV 47,3% e anti-HDV 0,0%, enquanto que nas mulheres em idade fértil foi: HBsAg 12%, todas anti-HBe positivas. A infecção pelo HBV ocoireu mais precocemente entre os Txucarramãe, quando se considerou algum marcador do HBV (p < 0,001). No PIX, área de alta endemicidadepara infecção pelo HBV, a transmissão do vírus ocorre provavelmente de maneira horizontal e não vertical como seria de se esperar, características culturais, condições de habitação e presença de insetos hematófagos são importantes determinantes na sua transmissão. Apesar de não ter sido detectado nenhum caso com hepatite Delta, o PIX é uma área propícia para a sua disseminação.

Diagnosis of rubella infection by detecting specific immunoglobulin M antibodies in saliva samples: a clinic-based study in Niterói, RJ, Brazil

This study was designed to investigate whether saliva could be a feasible alternative to serum for the diagnosis of recent rubella infection in a clinic setting. Forty-five paired blood and saliva samples collected 1 to 29 days after onset of illness were tested for specific immunoglobulin (Ig) M by antibody-capture radioimmunoassay (MACRIA). Rubella IgM was detected in all serum samples and in 38 (84.4%) saliva specimens. Forty-six serum and saliva samples from other patients with rash diseases were tested by MACRIA for control purposes and two saliva specimens were reactive. The saliva test had specificity of 96%. These results indicate that salivary IgM detection may be a convenient non-invasive alternative to serum for investigation of recent rubella cases, especially for disease surveillance and control programmes.

Hepatite D

O vírus da hepatite D (VHD), também chamado de vírus delta, é um pequeno vírus contendo RNA circular. O VHD causa infecção, quando há coinfecção com o vírus da hepatite B (VHB) em indivíduos normais ou superinfecção em portadores crônicos do VHB. Três genótipos já foram clonados e seqüenciados. A infecção apresenta distribuição mundial, sendo a região ocidental da Amazônia brasileira considerada área de alta endemicidade. Estima-se que 18 milhões de pessoas encontram-se infectadas pelo vírus entre os 350 milhões de portadores crônicos do VHB no mundo. As vias de transmissão do VHD e os fatores de risco mostram-se similares aos da infecção pelo VHB. O diagnóstico se faz pela identificação imuno-histológica do HDAg no fígado e pelo encontro das frações IgM e IgG anti-HD no soro por radioimunoensaio ou ELISA. O curso clínico da infecção pelo VHD mostra-se variável. Os pacientes podem apresentar formas fulminantes de hepatite. As formas crônicas associam-se a achados histopatológicos graves no fígado, com curso rápido e progressivo, evoluindo para cirrose, insuficiência hepática e morte. O interferon alfa constitui a única opção terapêutica com algum efeito benéfico no tratamento da hepatite. O transplante hepático encontra indicação nos casos terminais de cirrose. A profilaxia indireta da infecção pelo VHD tornou-se possível com o advento da vacina contra o vírus da hepatite B.

Infecção pelos vírus das hepatites B e D entre grupos indígenas da Amazônia Brasileira: aspectos epidemiológicos

Entre populações autóctones da América, estudos relatam altos índices de infecção e doença pelos vírus das hepatites B e D. Esta é uma revisão do que já foi descrito entre indígenas da Amazônia brasileira. Em alguns grupos a prevalência do AgHBs é muito baixa, enquanto que outros da mesma região, apresentam padrão de elevada endemicidade, presente inclusive entre menores de 10 anos. O VHD só foi encontrado entre etnias no estado do Amazonas. É descrito a importância da transmissão horizontal familiar, e do contato sexual entre adultos jovens. Fatores socioculturais, genéticos, ecológicos, e a formação histórica desses povos, são apontados como determinantes deste padrão. Entretanto, a origem do VHB e VHD na Amazônia é ainda obscura. Populações indígenas com sua memória genética são, na verdade, o experimento ao vivo, o que demanda investigação abrangente, avaliando a influência dos aspectos históricos, ecológicos, médicos e antropológicos envolvidos, utilizando inclusive técnicas modernas de biologia molecular.

The secretory immunoglobulin A response to Mycobacterium tuberculosis in a childhood population

We report on the measurement of saliva anti-Purified Protein Derivative sIgA and 38kDa antibodies from 127 children, of whom 31 were strong tuberculosis suspects and 96 were healthy contact children. The results concerning the percentage of children with antibody reactivity to PPD and 38kDa antigens showed that, of these 2 antigens, 38kDa induced higher reactivity in patients positive and negative for the Tuberculin Skin Test (28% and 16.6%, respectively) in comparison to controls positive and negative for the TST (11.7% and 7.1%, respectively). There was a statistically significant difference between patients positive and controls negative for the TST. In relation to the Purified Protein Derivative antigen, while 14.2% of patients positive for the TST showed antibody reactivity to the PPD antigen, no patients negative for the TST had reactivity to this antigen. The findings suggest that these two antigens seem be associated with a different development of the mucosal defence mechanisms mediated by sIgA against Mycobacterium tuberculosis.

Low prevalence of hepatitis B virus, hepatitis D virus and hepatitis C virus among patients with human immunodeficiency virus or acquired immunodeficiency syndrome in the Brazilian Amazon basin

Comorbidities in human immunodeficiency virus infection are of great interest due to their association with unfavorable outcomes and failure of antiretroviral therapy. This study evaluated the prevalence of coinfection by human immunodeficiency virus and viral hepatitis in an endemic area for hepatitis B in the Western Amazon basin. Serological markers for hepatitis B virus, hepatitis C virus and hepatitis D virus were tested in a consecutive sample of all patients referred for treatment of human immunodeficiency virus or acquired immunodeficiency syndrome. The variables sex, age, origin and exposure category were obtained from medical records and from the sexually transmitted diseases and acquired immunodeficiency syndrome surveillance database. Among 704 subjects, the prevalence of chronic hepatitis B carriage was 6.4% and past infection 40.2%. The presence of hepatitis B was associated with birth in hyperendemic areas of the Amazon basin, male sex and illegal drug use. The overall prevalence of hepatitis C was 5% and was associated with illegal drug use. The prevalence of hepatitis B and C among human immunodeficiency virus or acquired immunodeficiency syndrome patients in the Western Amazon basin was lower than seen elsewhere and is probably associated with the local epidemiology of these viruses and the degree of overlap of their shared risk factors. An opportunity presents itself to evaluate the prevention of hepatitis C through harm reduction policies and hepatitis B through vaccination programs among human immunodeficiency virus or acquired immunodeficiency syndrome patients.

Seroprevalence and risk factors for canine visceral leishmaniasis in the endemic area of Dias D'Ávila, State of Bahia, Brazil

INTRODUCTION: Visceral leishmaniasis (VL) is an important zoonosis in relation to public health systems. Dogs are the main domestic reservoir. This study aimed to investigate occurrences of canine VL in Dias D'Ávila, State of Bahia, Brazil. METHODS: The prevalence was evaluated by means of clinical and laboratory tests on a population of 312 domestic dogs from 23 localities in this municipality, using indirect immunofluorescence and immunoenzymatic assays. RESULTS: Among the animals examined, 3.2% and 6.7% showed signs of VL, confirmed by indirect immunofluorescence and immunoenzymatic assays, respectively, with a distribution of 29.9% (24 dogs) in the rural zone and 4.9% (288 dogs) in the urban zone (p = 0.001). The clinical evaluation on seropositive dogs showed both asymptomatic animals (2.4%) and symptomatic animals (47.6%), along with other abnormalities (e.g. normocytic and normochromic anemia, with leukocytosis and thrombocytopenia). Observations relating to phenotypic characteristics (e.g. sex, age, breed and hair) did not present statistical significance, although high seropositivity among male, short-haired and mixed-breed dogs was observed. CONCLUSIONS: The findings showed that VL was a predominantly rural zoonosis and that close contact between poultry and domestic dogs significantly increased the risk of canine infection in this region.

Hepatitis D virus infection in the Western Brazilian Amazon - far from a vanishing disease

INTRODUCTION: A decline in hepatitis D virus (HDV) occurrence was described in Europe and Asia. We estimated HDV prevalence in the Brazilian Amazon following hepatitis B vaccination. METHODS: This is a cross-sectional survey of HDV measured by total antibodies to HDV (anti-HD T). RESULTS: HDV prevalence was 41.9% whiting HBsAg carries and was associated with age (PR = 1.96; 95% CI 1.12-3.42; p = 0.01), hepatitis B virus (HBV) infection (PR = 4.38; 95% CI 3.12-6.13; p < 0.001), and clinical hepatitis (PR =1.44; 95% CI 1.03-2.00; p = 0.03). Risk factors were related to HDV biology, clinical or demographic aspects such as underlying HBV infection, clinical hepatitis and age. CONCLUSIONS: Our study demonstrated that HDV infection continues to be an important health issue in the Brazilian Amazon and that the implementation of the HBV vaccination in rural Lábrea had little or no impact on the spread of HDV. This shows that HDV has not yet disappeared from HBV hyperendemic areas and reminding that it is far from being a vanishing disease in the Amazon basin.

Prevalence of hypovitaminosis D and its association with oral lesions in HIV-infected Brazilian adults

Abstract: INTRODUCTION: This study assessed the prevalence of hypovitaminosis D and its association with oral candidiasis and clinical parameters of periodontitis (CPP) in HIV-infected patients. METHODS: Periodontal examinations for the 113 HIV-infected patients were recorded using the Community Periodontal Index. A cytological smear from the lateral borders of the tongue was performed to evaluate candidiasis. RESULTS: The frequency of hypovitaminosis D was 23.9%. In multivariate analysis, only the duration of exposure to HIV was associated with CPP [OR 4.72 (95% CI: 0.97-23.00)]. CONCLUSIONS: The prevalence of hypovitaminosis D was 23.9% and was not related with oral candidiasis or CPP.

Immunoglobulin E-rheumatoid factor in juvenile rheumatoid arthritis

OBJECTIVES: To determine the presence of immunoglobulin E-rheumatoid factor in patients with juvenile rheumatoid arthritis and to correlate it with clinical and laboratory parameters. METHODS: A multicenter prospective study was carried out from January 1993 to January 1999 with the enrollment of 3 centers of pediatric rheumatology. Ninety-one children with juvenile rheumatoid arthritis diagnosed according to the American College of Rheumatology criteria were studied: 38 (42%) with systemic, 28 (31%) with pauciarticular, and 25 (27%) with polyarticular onset. Ages ranged from 2.1 years to 22.6 years (mean 10.5 ± 4.7), with 59 (65%) girls. The control group consisted of 45 healthy children. The detection of immunoglobulin E-rheumatoid factor was carried out utilizing an enzyme-linked immunosorbent assay. Associations of immunoglobulin E-rheumatoid factor with immunoglobulin M-rheumatoid factor (latex agglutination test), total serum immunoglobulin E, erythrocyte sedimentation rate, antinuclear antibody, and functional and radiological classes III or IV were analyzed. RESULTS: Positive immunoglobulin E-rheumatoid factor was found in 15 (16.5%) of the 91 children with juvenile rheumatoid arthritis: 7 (18.5%) with systemic, 5 (18%) with pauciarticular, and 3 (12%) with polyarticular onset. A significant correlation was observed between immunoglobulin E-rheumatoid factor and total serum immunoglobulin E in the juvenile rheumatoid arthritis patients. No correlation was found between immunoglobulin E-rheumatoid factor and positive latex agglutination slide test, erythrocyte sedimentation rate, antinuclear antibody, or the functional and radiological classes III or IV in any disease onset group. In 4 out of 45 control children (8.9%), immunoglobulin E-rheumatoid factor was positive but with no correlation with total serum immunoglobulin E levels. CONCLUSIONS: Immunoglobulin E-rheumatoid factor could be detected in 16.5% of juvenile rheumatoid arthritis patients, particularly in those with high levels of total serum immunoglobulin E, and immunoglobulin E-rheumatoid factor appears not to be associated with disease activity or severity.

Endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris: immunoglobulin G heterogeneity detected by indirect immunofluorescence

Pemphigus are autoimmune intraepidermal blistering diseases in which immunoglobulin G (IgG) autoantibodies are directed against desmosomal glycoproteins. The aim of this study was to determine the IgG subclass profile of endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris utilizing indirect immunofluorescence. PATIENTS AND METHODS: Twenty-five patients with pemphigus vulgaris, 25 with endemic pemphigus foliaceus (fogo selvagem), and 25 healthy controls were analyzed by indirect immunofluorescence for circulating autoantibodies (total IgG and its subclasses). RESULTS: Our data revealed a significant correlation (P <.05) of disease activity and autoantibody levels in both forms of pemphigus, i.e., negative titers related to clinical remission, whereas positive results related to active disease. Immunoglobulin G subclass analysis in fogo selvagem demonstrated that in patients in remission, 56% showed positive immunoglobulin G4; in active disease, immunoglobulin G4 was the predominant subclass (100% positive in all cases). The IgG subclass profile in pemphigus vulgaris showed that in patients in remission, only 10% were positive for immunoglobulin G4; in active disease, positivity for immunoglobulin G4 was present in 78% to 88% of the cases. CONCLUSION: Subclass characterization of immunoglobulin G autoantibodies is a useful tool for pemphigus follow-up, since immunoglobulin G4 (IgG4) is the subclass that is closely related to recognition of pathogenic epitopes, and consequently with disease activity. Careful monitoring should be performed for fogo selvagem in clinical remission with a homogeneous IgG4 response, since this may indicate more frequent relapses.

Desempenho de uma bomba d'água acionada por correnteza de rios

Uma bomba d'água acionada por correntezas de rios mediante um rotor Savonius sub-merso foi. testada. Depois de um ano de uso contínuo a bomba ainda estava em funcionamen to. Porém, certas modificações foram concebidas para diminuir os desgastes dos componen tes. Novos desenhos e uma nova lista de materiais são apresentados. Um gráfico da vazão diária da bomba em função da velocidade da correnteza, mostrou que com correntezas de 0,5 até 1,1 m.s-1 a vazão (y litros/dia) depende Linearmente da corrente ( x m.s-1), sabendo-se a altura (a metros) do bombeamento segundo a equação:y = 7692 x - 1250 - 500 a/3A bomba é considerada prática, econômica, com uma vida útil adequada. Contudo a evolução da tecnologia é limitada pelo fiato de que o rotor fica consideravelmente mais caro quando não se usa um camburão de Óleo para a sua costrução.

Estudos preliminares de cinco cultivares de amendoim em Vilhena e Ouro Preto D'Oeste, Estado de Rondônia

Foram instalados dois ensaios de amendoim (Arachis hipogaea. L.), um no município de Ouro Preto D'Oeste e outro em Vilhena, testando o comportamento de cinco cultivares de tipos diferentes (Tatu, Altika, Makap, Penapolis e VC-42) de procedências diferentes. 0 delineamento utilizado foi o de blocos casualizados com 4 repetições (Ouro Preto D'0es-te) e 5 repetições (Vilhena) . Os resultados mostraram que há viabilidade de cultivo de amendoim do tipo Spanish e Virginia em dois municípios testados, e a sua produtividade foi maior no ensaio de Ouro Prelo D'Oeste (2.235 a 2.677 kg/ha de grãos) em relação a de Vilhena (1.060 a 2.220 kg/ha de grãos), provável conseqüência da melhor fertilidade do solo, devido ao cultivo realizado em capoeira de 3 anos recém-desmaiada.