Rabies infection and specific effect of vaccination in mice selected for high and low immunobiological parameters

Innate and acquired resistance to rabies infection was investigated in mice genetically selected for high (H) or low (L) antibody responsiveness from selections I, III and IV and in mice selected for maximal (AIRmax) or minimal (AIRmin) acute inflammatory reaction. These mouse lines were infected intramuscularly with different virus dilutions and the LD50 was determined. The HIII and HIV mouse lines were more susceptible than the LIII and LIV lines and the HI line showed a discrete but higher resistance than the LI line. Analysis of the interline (H x L) F1 hybrids from selections III and IV indicated different dominance effects on the resistant and susceptible phenotypes when the route of vaccination was changed. No differences were observed between the AIRmax and AIRmin mice, suggesting that inflammation plays a minor role in the resistance to rabies virus. The comparison of LD50 in mice vaccinated by distinct routes showed that the highest interline difference occurred after intramuscular vaccination (250-fold between H and L and 800-fold between F1 and L). These results indicate that different mechanisms may participate in acquired antirabies resistance

Avaliação da qualidade de vida de mulheres com HIV/AIDS através do HAT-QoL

Com objetivo de avaliar qualidade de vida entre mulheres portadoras de HIV/AIDS, aplicou-se o HIV/AIDS ­ Quality of Life test (HAT-QoL), instrumento específico para indivíduos infectados pelo HIV. Compõe-se de 42 questões e divide-se em nove domínios com questões sobre diversos aspectos de vida dos portadores. A escala foi submetida à tradução reversa e pré-teste. Sua forma definitiva foi aplicada entre 73 mulheres com HIV/AIDS. Os resultados, após análise estatística, indicaram que os domínios mais comprometidos foram: Preocupações financeiras, Preocupação com sigilo sobre a infecção, Atividades sexuais e Preocupações com a saúde. Esses resultados foram atribuídos ao fato das mulheres apresentarem, além da infecção, uma situação sócio-econômica precária que, provavelmente, também interferiu negativamente em sua qualidade de vida. Concluímos que a escala HAT-QoL foi adequada para a população de mulheres portadoras de HIV deste estudo, apesar de ser originária de uma cultura diferente da brasileira, já que sua aplicação produziu resultados semelhantes aos da literatura internacional.

Vinte anos de assistência a pessoas vivendo com HIV/AIDS no Brasil: a perspectiva de profissionais da saúde

O objetivo do estudo é descrever os significados atribuídos por profissionais de saúde à sua experiência de cuidar de pessoas com HIV/AIDS. Os dados foram coletados em entrevistas com 10 profissionais da saúde, em diferentes instituições paulistas. Três temas emergiram da análise dos dados: (a) o cenário da assistência ao paciente com HIV/AIDS; (b) relacionamento com o paciente; (c) aspectos éticos nesse cuidado. A despeito dos reconhecidos avanços na assistência a esse paciente, os achados revelam a persistência de comportamentos discriminatórios, relacionados a sentimentos de insegurança e medo do contágio, entre os profissionais nos serviços e hospitais gerais. O preparo específico para atender os pacientes estaria mais voltado aos profissionais dos centros especializados para a assistência ao HIV/AIDS, resultando em dificuldades na integração da assistência a esses pacientes nos demais serviços do SUS. Esses dados remetem aos aspectos da formação profissional na área da saúde como um todo, levando à reflexão sobre as competências que se espera dos profissionais da saúde em cuidar e relacionar-se com pessoas com HIV/AIDS, assim como sobre o impacto dessa realidade na prevenção da doença.

Histórias de vida de mulheres HIV+ ativistas: mudanças e permanências

Nesses anos de seu reconhecimento, a aids tem obrigado a desnaturalizar questões sociais e culturais construídas historicamente e que são parte dos signos, das normas e dos códigos que balizam a estrutura e a organização da sociedade, impondo outros olhares e novas perspectivas para a complexidade de questões relacionadas aos gêneros, aos corpos e à cultura. Considerando essa conjuntura, esta pesquisa foi realizada com quatro mulheres HIV+ ativistas no movimento de aids com o objetivo de apreender suas concepções sobre a doença, os contextos de vulnerabilidade que possibilitaram sua infecção, suas vulnerabilidades à reinfecção e as mudanças e permanências nos campos afetivo-conjugal e da maternidade, a partir da experiência da doença e da militância.

Co-infecção HIV/HCV em pacientes de Botucatu e região

Devido à similaridade nas rotas de transmissão, a co-infecção HIV/HCV é freqüente, afetando em média 30 a 50% dos portadores de HIV. O presente estudo visou avaliar uma possível associação entre os subtipos do HIV e genótipos do HCV em pacientes co-infectados, com base na análise das freqüências em pacientes mono e co-infectados. Para determinação da freqüência dos subtipos HIV e genótipos HCV, foram analisados respectivamente 124 e 496 pacientes mono-infectados. O estudo da co-infecção foi realizado num grupo de 150 pacientes HIV positivos e esteve presente em 22 (14,7%) dos pacientes. A freqüência dos subtipos do HIV-1 em mono-infectados foi: subtipo B (85,5%), subtipo F (12,9%) e recombinante B/F (1,6%), enquanto nos genótipos HCV foi: 1a (25%), 1b (29,4%), 1a/1b (3,6%), 3a (35%), 2 (1,8%) e 5 (0,4%). Nos co-infectados o padrão de distribuição dos subtipos HIV-1 é semelhante aos mono-infectados, ou seja, subtipo B (85,0%), seguido do subtipo F (15,0%). A distribuição de freqüência de genótipos HCV nos co-infectados foi: 1a (36,3%), 1b (27,3%), 1a/1b (9,1%) e 3a (27,3%) mostrando um aumento de 10% na freqüência do genótipo 1, queda de 7,7% no genótipo 3 e ausência de outros genótipos. A análise estatística de associação entre os subtipos HIV e genótipos HCV (Goodman) mostrou que no genótipo 1 (HCV) ocorreu predominância do subtipo B, enquanto no genótipo 3 (HCV) a distribuição dos subtipos B e F (HIV-1) foi casual. Isto aponta para a necessidade de mais estudos desse grupo e um maior valor amostral.

Photodynamic therapy of oral candidiasis hi hiv-positive patients

The conventional treatments for Candidiasis include therapies that promote serious side effects to patients. Recent research indicates the use of red emission laser associated with a blue photosensitizer as a current method for microbial reduction. This study aimed to evaluate the effectiveness of Photodynamic Therapy in the treatment of oral candidiasis in HIV patients. The response to treatment by the photodynamic therapy has been demonstrated successfully in 100% of the total sample, as in the 7th and 21st days, confirmed he complete absence of clinical and cytological lesions. This therapy is enhanced by its easy applicability and no adverse side effects making it an alternative method of effective recommended treatment.

5-Lipoxygenase Deficiency Impairs Innate and Adaptive Immune Responses during Fungal Infection

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Nutritional management and weight changes during hospitalization of Brazilian infants with diarrhoea: Primary reliance on oral feeding or continuous nasogastric drip with locally made, modulated minced chicken formula

The nutritional management of infants admitted with diarrhoea to the University Hospital of Botucatu includes a change from bolus feeding of a modulated minced-chicken formula to a continuous nasogastric drip (NGD) feeding, whenever the required calorie intake is not achieved or the diarrhoea does not subside. To evaluate this approach, the clinical course and weight changes of 63 children, aged 1-20 months, were reviewed; most (81 per cent) were below the third percentile for weight at admission and 76 per cent had a total duration of diarrhoea ≥10 days. Associated infections, mainly systemic, were present at or after admission in 70 per cent of them. Twenty-five survivors needed nutritional support (NS), predominantly NGD, for a median duration of 30 per cent of their admission time, and were compared to 31 survivors managed without NS. Those who necessitated NS lost weight for a significantly longer median time (12x4 days, p<0.005), but their total weight loss was similar (5x4 per cent) as well as diarrhoea's duration (8x7 days). There was a tendency for a longer hospitalization (21x16 days 0.05

Willingness of Brazilian dentists to treat an HIV-infected patient

A study of the willingness of 363 general dental practices in Brazil to accept a patient infected with human immunodeficiency virus for treatment of dental pain and the provision of routine dental care showed only 44% of dental practices to be willing to provide dental care. Willingness was influenced neither by financial factors nor the local prevalence of human immunodeficiency virus disease. © 1994.

HIV attitudes and practices among professors in a Brazilian dental school.

Although there is considerable published research on Acquired Immunodeficiency Syndrome (AIDS), individual biases persist because of lack of information regarding HIV virus transmission. As a result, both infected patients and health care professionals suffer. The objective of this study was to determine if there is prejudice among university professors at the School of Dentistry at Aracatuba's Sao Paulo State University (FOA-UNESP) concerning HIV-positive patients or HIV-positive health care professionals. Out of the seventy-seven professors who responded to the questionnaire, 62.3 percent (forty-eight) stated that they advise their students not to refuse to treat a patient with HIV. Although 96.2 percent (fifty-two) of the fifty-four professors who treat patients have reported that they treat patients who are HIV-positive, only 65.3 percent of them were aware of infection control precautions, and only 32.7 percent reported that they would treat an HIV-positive patient like any other patient. There is also prejudice regarding HIV-positive professionals because only 48.1 percent (thirty-seven) of the professors responded that they would be willing to be treated by an infected professional. It can be concluded that there is prejudice among some of the FOA-UNESP university professors regarding individuals who are HIV-positive.

Kaposi's sarcoma-associated herpesvirus infection and Kaposi's sarcoma in Brazil

Kaposi's sarcoma (KS) became a critical health issue with the emergence of acquired immunodeficiency syndrome (AIDS) in the 1980s. Four clinical-epidemiological forms of KS have been described: classical KS, endemic KS,iatrogenic KS, and AIDS-associated KS. In 1994, Kaposi's sarcoma-associated herpesvirus (KSHV) or human herpesvirus type 8 was identified by Chang and colleagues, and has been detected worldwide at frequencies ranging from 80 to 100%. The aim of the present study was to evaluate the frequency of KSHV infection in KS lesions from HIV-positive and HIV-negative patients in Brazil, as well as to review the current knowledge about KS transmission and detection. For these purposes, DNA from 51 cases of KS was assessed by PCR: 20 (39.2%) cases of classical KS, 29 (56.9%) of AIDS-associated KS and 2 (3.9%) of iatrogenic KS. Most patients were males (7.5:1, M/F), and mean age was 47.9 years (SD = ± 18.7 years). As expected, HIV-positive KS patients were younger than patients with classical KS. On the other hand, patients with AIDS-associated KS have early lesions (patch and plaque) compared to classical KS patients (predominantly nodular lesions). This is assumed to be the result of the early diagnose of KS in the HIV-positive setting. KSHV infection was detected by PCR in almost all cases (48/51; 94.1%), irrespectively of the clinical-epidemiological form of KS. These results show that KSHV is associated with all forms of KS in Brazilian patients, a fact that supports the role of this virus in KS pathogenesis. © 2006 Brazilian Journal of Medical and Biological Research.

Sporotrichosis in an HIV-positive man with oral lesions: A case report

Background: Sporotrichosis is a granulomatous fungal infection caused by Sporothrix schenckii, which frequently causes cutaneous or lymphocutaneous lesions and rarely has oral manifestations. Case: A 38-year-old, white, HIV-positive man complained of a 5.0-cm, symptomatic, ulcerated lesion with thin, superficial granulation in the soft palate extending to the uvula. Exfoliative cytology of this oral lesion showed chronic granulomatous inflammatory alterations and extracellular fungal structures consisting of periodic acid-Schiff-positive budding cells and spherical or elongated (cigar bodies) free spore forms. Conclusion: The clinical and cytologic findings allowed the diagnosis of sporotrichosis, demonstrating the importance of cytodiagnosis in fungal diseases. © The International Academy of Cytology.

Immune response to Mycobacterium bovis-an5 infection in genetically selected mice (selection IV-A)

Mice genetically selected for high (H) and low (L) antibody production (Selection IV-A) were used as murine experimental model. The aim of the present work was to evaluate the macrophagic activity and to characterize the immune response in Mycobacterium bovis-AN5 infected mice (3×10 7 bacteria). The response profile previously observed in such strains was not similar to that obtained during M. bovis infection; however, it corroborated works carried out using Selection I, which is very similar to Selection IV-A regarding infection by M. tuberculosis and Bacillus Calmette-Guérin (BCG). Considering bacterial recovery, LIV-A mice showed higher control of the infectious process in the lungs than in the spleen, whereas HIV-A mice presented more resistance in the spleen. With respect to macrophagic activity, hydrogen peroxide (H2O 2) was probably not involved in the infection control since there was an inhibition in the production of this metabolite. Nitric oxide (NO) and TNF-α production seemed to be important in the control of bacterial replication and varied according to the strain, period and organ. Evaluation of the antibody production indicated that the multi-specific effect commonly observed in these strains was not the same in the response to M. bovis. Antibody concentrations were higher in LIV-A than in HIV-A mice at the beginning of the infection, being similar afterwards. Such data were compared with delayed-type hypersensitivity (DTH), which was more intense in HIV-A than in LIV-A mice, indicating that antibody production is independent of the capability to trigger DTH reactions and that cellular and humoral responses to M. bovis antigens show a polygenic control and an independent quantitative genetic regulation. Differences were observed among organs and metabolites, suggesting that different mechanisms play an important role in this infection in natural heterogeneous populations, indicating that NO, TNF-α and Th1 cytokines are involved in the infection control.

Indices of body fat distribution for assessment of lipodysthrophy in people living with HIV/AIDS

Background: Metabolic and morphological changes associated with excessive abdominal fat, after the introduction of Antiretroviral Therapy, increase the risk of cardiovascular disease in people living with HIV/AIDS(PLWHA). Accurate methods for body composition analysis are expensive and the use of anthropometric indices is an alternative. However the investigations about this subject in PLWHA are rare, making this research very important for clinical purpose and to advance scientific knowledge. The aim of this study is to correlate results of anthropometric indices of evaluation of body fat distribution with the results obtained by Dual-energy X-Ray Absorptiometry(DEXA) , in people living with HIV/AIDS. Methods. The sample was of 67 PLWHA(39 male and 28 female), aged 43.6+7.9 years. Body mass index, conicity index, waist/hip ratio, waist/height ratio and waist/thigh were calculated. Separated by sex, each index/ratio was plotted in a scatter chart with linear regression fit and their respective Pearson correlation coefficients. Analyses were performed using Prism statistical program and significance was set at 5%. Results: The waist/height ratio presented the highest correlation coefficient, for both male (r=0.80, p<0.001) and female (r=0.87, p <001), while the lowest were in the waist/thigh also for both: male group (r=0.58, p<0.001) and female group (r=0.03, p=0.86). The other indices also showed significant positive correlation with DEXA. Conclusion: Anthropometric indices, especially waist/height ratio may be a good alternative way to be used for evaluating the distribution of fat in the abdominal region of adults living with HIV/ADIS. © 2012 Segatto et al.; licensee BioMed Central Ltd.

Gestantes vivendo com HIV/AIDS: Características antropométricas e peso ao nascer dos seus recém-nascidos

PURPOSE: To describe the anthropometric and pregnancy characteristics of women with HIV/AIDS, assisted by the Brazilian National Health System and the birth weight of their newborns. METHODS: The participants were women assisted at public STD/AIDS clinics of the Municipal Health system of São Paulo. The anthropometric characteristics were evaluated by trained nutritionists and other information was obtained from the medical records. For comparison of the survey data to those of the general population, secondary maternal and pregnancy data were obtained from live birth certificates through the Live Birth Information System. Continuous variables were summarized as mean and standard deviation or as the 25th, 50th and 75th percentiles and minimum and maximum values. The other variables are presented as percentages. Means were compared by the Student's t-test or Kruskal-Wallis test depending on the fulfillment of assumptions, with the decision based on the p value. RESULTS: We found the presence of inadequate maternal nutrition according to triceps skinfold (60.9%). The BMI/gestational age showed the presence of underweight (18.5%) and overweight or obesity (40%). There was no association between disease status (HIV or AIDS) and weight, height, and lean or fat mass. Mean newborn birth weight was lower than the value for the general population without infection or disease. The results of this study indicate the need to develop adapted curves to allow a more accurate nutritional assessment of this population group.