944 resultados para Arsenic Carcinogenesis


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Problématique: Le virus du papillome humain (VPH) est présent dans près de 50% des cancers de l’oropharynx. Le potentiel oncogénique du VPH est encodé dans les oncoprotéines E6 et E7, qui agissent en modulant différents gènes, dont les gènes suppresseurs de tumeur p53 et pRb. Les cellules VPH positives démontrent une altération au niveau de la signalisation de la réponse aux dommages à l’ADN (RDA), un mécanisme de contrôle dans l’arrêt de la croissance des cellules ayant subit des dommages au niveau de leur ADN. Hypothèse et objectifs : Nous croyons que les défauts au niveau de la RDA des cancers VPH positifs peuvent être exploités afin de sensibiliser préférentiellement les cellules cancéreuses aux traitements de radiothérapie. Cette stratégie de recherche nécessite l’élaboration d’un modèle cellulaire de carcinogenèse isogénique pour le cancer de l’oropharynx que nous proposons de développer et de caractériser. L’étude vise à dériver des lignées isogéniques à partir de kératinocytes primaires et cellules épithéliales de l’oropharynx pour ensuite valider la carcinogenèse de notre modèle in vitro & in vivo Méthodologie : Des lignées cellulaires de kératinocytes primaires et de cellules épithéliales de l’oropharynx ont été successivement modifiées par transduction afin de présenter les mutations associées aux cancers de l’oropharynx induits par le VPH. Les cellules ont été modifiées avec des lentivirus codants pour la télomérase (hTERT), les oncogènes E6, E7 et RasV12. Afin de valider la cancérogenèse in vitro de notre modèle, des études d’invasion en matrigel et de croissance sans ancrage en agar mou ont été réalisées. Les populations cellulaires transformées ont été ensuite introduites dans des souris immunodéficientes afin d’évaluer leur tumorogénicité in vivo. Résultats : À partir des plasmides recombinés construits par méthodes de clonage traditionnelle et de recombinaison « Gateway », nous avons produit des lentivirus codants pour la télomérase humaine (hTERT), les oncogènes viraux E6 et E7 et l’oncogène Ras. Les kératinocytes primaires et cellules épithéliales de l’oropharynx ont été infectés successivement par transduction et sélectionnés. Nous avons validé l’expression de nos transgènes par méthode d’immunofluorescence, de Western Blot et de réaction de polymérisation en chaîne quantitative en temps réel (qRT-PCR). Nous avons établi trois lignées des cellules épithéliales de l’oropharynx (HNOE) à partir d’échantillons tissulaires prélevés lors d’amygdalectomie (HNOE42, HNO45, HNOE46). Les cellules transduites avec le lentivirus exprimant le promoteur fort CMV/TO de l’oncogène RasV12 ont présenté un changement morphologique compatible avec une sénescence prématurée induite par l’oncogène Ras. En exprimant des quantités plus faibles du RasV12 mutant, la lignée cellulaire HEKn hTERT-E6-E7 PGK RasV12 a réussi à échapper à la sénescence induite par l’oncogène Ras. La population cellulaire exprimant HEKn hTERT-E6-E7-PGK RasV12 a présenté un phénotype malin en culture et à l’étude d'invasion, mais n’a pas démontré de résultats positifs à l’étude de croissance sans ancrage en agar mou ni en xénogreffe en souris immunodéficientes. Conclusion : Nos résultats démontrent qu’en présence des oncogènes viraux E6 et E7, il y a un troisième mécanisme suppresseur de tumeur qui médie la sénescence induite par l’oncogène Ras. Nous avons identifié que la présence de E6 seule ne suffit pas à immortaliser les kératinocytes primaires humains (HEKn). Nous n’avons pas réussi à créer un modèle in vitro de carcinogenèse pour les cancers de l’oropharynx induits par le VPH.

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The work is an attempt to understand the role of 5-HT, 5-HT1A and 5-HT2C receptors in the regulation of liver cell proliferation using in vivo and in vitro models. The work also focuses on the brain serotonergic changes associated with hapatocyte proliferation and apoptosis to delineate its regulatory function. The investigation of mechanisms involving different models of hepatocyte proliferation contributes to our knowledge about serotonergic regulation of cell growth, apoptosis and carcinogenesis of liver. The study reveals that the alteration of the 5-HT1A and 5-HT2C receptor function and gene expression in the brain stem, cerebral cortex and hypothalamus play an important role in the sympathetic regulation of cell proliferation, neoplastic transformation and apoptosis. The functional balance between 5-HT1A and 5-HT2C receptor plays an important role in regulating hepatocyte proliferation, neoplastic transformation and hepatic apoptosis. The regulatory role of 5-HT1A and 5-HT2C receptor during neoplastic transformation and apoptosis could lead to possible therapeutic intervention in the treatment of cancers and have immense clinical importance.

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The present thesis is an attempt to understand the role of GABA, GABAA and GABAB receptors in the regulation of liver cell proliferation using in vivo and in vitro models. The work also focuses on the brain GABAergic changes associated with normal and neoplastic cell growth in liver and to delineate its regulatory function. The investigation of mechanisms involving mitogenic models without cell necrosis may contribute our knowledge about both on cell growth, carcinogenesis, liver pathology and treatment. Objectives of the present study are, to induce controlled liver cell proliferation by partial hepatectomy and lead nitrate administration and uncontrolled cell proliferation by N-nitrosodiethylamine treatment in male Wistar rats, the changes in the content of GABA, GABAA,GABAB in various rat brain regions. To study the GABAA and GABAB receptor changes in brain stem, hypothalamus, cerebellum and cerebral cortex during the active cortex during the period of active DNA synthesis in liver of different experimental groups. The changes in GABAA and GABAB receptor function of the brain stem, hypothalamus and cerebellum play an important role sympathetic regulation of cell proliferation and neoplastic growth in liver. The decrease in GABA content in brain stem, hypothalamus and cerebellum during regeneration and neoplasia in liver. The time course of brain GABAergic changes was closely correlated with that of heptic DNA synthesis. The functional significance of these changes was further explored by studying the changes in GABAA and GABAB receptors in brain.

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Brasses are widely used as constructional materials in marine environment due to their anticorrosive,antifouling and mechanical properties.However, its resistance to corrosion and fouling may vary according to local marine environmental condition and the seasons.The dezincification of brass is one of the forms of selective corrosion which has attracted the attention of researchers for the last two decades.Many of the dezincification mechanistic studies have been performed in noncomplex media and hence their conclusions cannot be extended to esturine water,which is of great significance since brass is extensively used in marine environment.Inhibited α brasses are largely immune to dezincication and the effect of tin and arsenic addition to α/beta brasses is not so reliable in controlling the dezincification. There have been many cases of dezincification in duplex brasses in both freshwater and seawater.Though there is some protection methods such as inhibitors,electro deposition and electro polymerization,there is no reliable method of inhibiting the dezincification of two-phase brass.Organic coatings are effectively used for the protection metals due to their capacity to act a physical barrieer between the metal surface and corrosive environment.Hence,pure epoxy coating is selected for this as it has antocorrosiion effect on brass.The dezincification behaviour of brass of the present study has been highlighted in terms of corrosion rate,weight gain/loss,corrosion current and polarization resistence,open circuit potential,dezincification factor. The marine fouling as biomass on brass was assessed and presented in this thesis, The physicochemical properties of estuarine water were correlated with corrosion behaviour of brass.The deterioration of the brass subjected to the effect of estuarine water was also investigated as a measure of loss in mechanical properties such as tensile strength,yield strength,percntage elongation and percentage reduction in area.To validate dezincification data,visual observation,spot analysis,surface morphology before and after removal of corrosion products and corrosion product analysis were performed.The dezincification behavior of epoxy coated brass of the present study has beenhighlighted in terms of corrosion rate ,weight gain/loss,corrosion current and polarization resistance,open circuit potential.dezincification factor.The marine fouling as biomass on epoxy coated brass subjeted to the effect of estuarine water was also investigated as ameasure of loss in mechanical properties such as tensile strength,percentage elongation and percentage reduction in area.The results of dezincification behavior of brass and epoxy coated brass in Cochin estuary water has been presented and discussed.Attempt has been made to correlate the dezincification behavior of brass with epoxy coated brass.

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Microarray data analysis is one of data mining tool which is used to extract meaningful information hidden in biological data. One of the major focuses on microarray data analysis is the reconstruction of gene regulatory network that may be used to provide a broader understanding on the functioning of complex cellular systems. Since cancer is a genetic disease arising from the abnormal gene function, the identification of cancerous genes and the regulatory pathways they control will provide a better platform for understanding the tumor formation and development. The major focus of this thesis is to understand the regulation of genes responsible for the development of cancer, particularly colorectal cancer by analyzing the microarray expression data. In this thesis, four computational algorithms namely fuzzy logic algorithm, modified genetic algorithm, dynamic neural fuzzy network and Takagi Sugeno Kang-type recurrent neural fuzzy network are used to extract cancer specific gene regulatory network from plasma RNA dataset of colorectal cancer patients. Plasma RNA is highly attractive for cancer analysis since it requires a collection of small amount of blood and it can be obtained at any time in repetitive fashion allowing the analysis of disease progression and treatment response.

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Inhibited α brasses are largely immune to dezincification in most water, but the effect of tin and arsenic addition to α/β brasses is not so reliable or predictable in controlling the problem. There have been many cases of dezincification in duplex brasses in both fresh water and seawater. There is no reliable method of inhibiting the dezincification of two-phase brass despite there are some protection methods such as inhibitors, electro deposition and electro polymerization. Organic coatings are effectively used for the protection of metals due to their capacity to act as a physical barrier between the metal surface and corrosive environment. Hence, epoxy coating on brass was applied and effect of this against dezincification in Cochin estuarine water over a period of one year was studied and reported in this paper

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Aktuelle Entwicklungen auf dem Gebiet der zielgerichteten Therapie zur Behandlung maligner Erkrankungen erfordern neuartige Verfahren zur Diagnostik und Selektion geeigneter Patienten. So ist das Ziel der vorliegenden Arbeit die Identifizierung neuer Zielmoleküle, die die Vorhersage eines Therapieerfolges mit targeted drugs ermöglichen. Besondere Aufmerksamkeit gilt dem humanisierten monoklonalen Antikörper Trastuzumab (Herceptin), der zur Therapie Her-2 überexprimierender, metastasierter Mammakarzinome eingesetzt wird. Jüngste Erkenntnisse lassen eine Anwendung dieses Medikamentes in der Behandlung des Hormon-unabhängigen Prostatakarzinoms möglich erscheinen. Therapie-beeinflussende Faktoren werden in der dem Rezeptor nachgeschalteten Signaltransduktion oder Veränderungen des Rezeptors selbst vermutet. Mittels Immunhistochemie wurden die Expressions- und Aktivierungsniveaus verschiedener Proteine der Her-2-assoziierten Signaltransduktion ermittelt; insgesamt wurden 37 molekulare Marker untersucht. In Formalin fixierte und in Paraffin eingebettete korrespondierende Normal- und Tumorgewebe von 118 Mammakarzinom-Patientinnen sowie 78 Patienten mit Prostatakarzinom wurden in TMAs zusammengefasst. Die in Zusammenarbeit mit erfahrenen Pathologen ermittelten Ergebnisse dienten u.a. als Grundlage für zweidimensionales, unsupervised hierarchisches clustering. Ergebnis dieser Analysen war für beide untersuchten Tumorentitäten die Möglichkeit einer Subklassifizierung der untersuchten Populationen nach molekularen Eigenschaften. Hierbei zeigten sich jeweils neue Möglichkeiten zur Anwendung zielgerichteter Therapien, deren Effektivität Inhalt weiterführender Studien sein könnte. Zusätzlich wurden an insgesamt 43 Frischgeweben die möglichen Folgen des sog. shedding untersucht. Western Blot-basierte Untersuchungen zeigten hierbei die Möglichkeit der Selektion von Patienten aufgrund falsch-positiver Befunde in der derzeit als Standard geltenden Diagnostik. Zusätzlich konnte durch Vergleich mit einer Herceptin-sensitiven Zelllinie ein möglicher Zusammenhang eines Therapieerfolges mit dem Phosphorylierungs-/ Aktivierungszustand des Rezeptors ermittelt werden. Fehlende klinische Daten zum Verlauf der Erkrankung und Therapie der untersuchten Patienten lassen keine Aussagen über die tatsächliche Relevanz der ermittelten Befunde zu. Dennoch verdeutlichen die erhaltenen Resultate eindrucksvoll die Komplexität der molekularen Vorgänge, die zu einem Krebsgeschehen führen und damit Auswirkungen auf die Wirksamkeit von targeted drugs haben können. Entwicklungen auf dem Gebiet der zielgerichteten Therapie erfordern Verbesserungen auf dem Gebiet der Diagnostik, die die sichere Selektion geeigneter Patienten erlauben. Die Zukunft der personalisierten, zielgerichteten Behandlung von Tumorerkrankungen wird verstärkt von molekularen Markerprofilen hnlich den hier vorgestellten Daten beeinflusst werden.

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The scope of this work is the fundamental growth, tailoring and characterization of self-organized indium arsenide quantum dots (QDs) and their exploitation as active region for diode lasers emitting in the 1.55 µm range. This wavelength regime is especially interesting for long-haul telecommunications as optical fibers made from silica glass have the lowest optical absorption. Molecular Beam Epitaxy is utilized as fabrication technique for the quantum dots and laser structures. The results presented in this thesis depict the first experimental work for which this reactor was used at the University of Kassel. Most research in the field of self-organized quantum dots has been conducted in the InAs/GaAs material system. It can be seen as the model system of self-organized quantum dots, but is not suitable for the targeted emission wavelength. Light emission from this system at 1.55 µm is hard to accomplish. To stay as close as possible to existing processing technology, the In(AlGa)As/InP (100) material system is deployed. Depending on the epitaxial growth technique and growth parameters this system has the drawback of producing a wide range of nano species besides quantum dots. Best known are the elongated quantum dashes (QDash). Such structures are preferentially formed, if InAs is deposited on InP. This is related to the low lattice-mismatch of 3.2 %, which is less than half of the value in the InAs/GaAs system. The task of creating round-shaped and uniform QDs is rendered more complex considering exchange effects of arsenic and phosphorus as well as anisotropic effects on the surface that do not need to be dealt with in the InAs/GaAs case. While QDash structures haven been studied fundamentally as well as in laser structures, they do not represent the theoretical ideal case of a zero-dimensional material. Creating round-shaped quantum dots on the InP(100) substrate remains a challenging task. Details of the self-organization process are still unknown and the formation of the QDs is not fully understood yet. In the course of the experimental work a novel growth concept was discovered and analyzed that eases the fabrication of QDs. It is based on different crystal growth and ad-atom diffusion processes under supply of different modifications of the arsenic atmosphere in the MBE reactor. The reactor is equipped with special valved cracking effusion cells for arsenic and phosphorus. It represents an all-solid source configuration that does not rely on toxic gas supply. The cracking effusion cell are able to create different species of arsenic and phosphorus. This constitutes the basis of the growth concept. With this method round-shaped QD ensembles with superior optical properties and record-low photoluminescence linewidth were achieved. By systematically varying the growth parameters and working out a detailed analysis of the experimental data a range of parameter values, for which the formation of QDs is favored, was found. A qualitative explanation of the formation characteristics based on the surface migration of In ad-atoms is developed. Such tailored QDs are finally implemented as active region in a self-designed diode laser structure. A basic characterization of the static and temperature-dependent properties was carried out. The QD lasers exceed a reference quantum well laser in terms of inversion conditions and temperature-dependent characteristics. Pulsed output powers of several hundred milli watt were measured at room temperature. In particular, the lasers feature a high modal gain that even allowed cw-emission at room temperature of a processed ridge wave guide device as short as 340 µm with output powers of 17 mW. Modulation experiments performed at the Israel Institute of Technology (Technion) showed a complex behavior of the QDs in the laser cavity. Despite the fact that the laser structure is not fully optimized for a high-speed device, data transmission capabilities of 15 Gb/s combined with low noise were achieved. To the best of the author`s knowledge, this renders the lasers the fastest QD devices operating at 1.55 µm. The thesis starts with an introductory chapter that pronounces the advantages of optical fiber communication in general. Chapter 2 will introduce the fundamental knowledge that is necessary to understand the importance of the active region`s dimensions for the performance of a diode laser. The novel growth concept and its experimental analysis are presented in chapter 3. Chapter 4 finally contains the work on diode lasers.

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In this work investigation of the QDs formation and the fabrication of QD based semiconductor lasers for telecom applications are presented. InAs QDs grown on AlGaInAs lattice matched to InP substrates are used to fabricate lasers operating at 1.55 µm, which is the central wavelength for far distance data transmission. This wavelength is used due to its minimum attenuation in standard glass fibers. The incorporation of QDs in this material system is more complicated in comparison to InAs QDs in the GaAs system. Due to smaller lattice mismatch the formation of circular QDs, elongated QDs and quantum wires is possible. The influence of the different growth conditions, such as the growth temperature, beam equivalent pressure, amount of deposited material on the formation of the QDs is investigated. It was already demonstrated that the formation process of QDs can be changed by the arsenic species. The formation of more round shaped QDs was observed during the growth of QDs with As2, while for As4 dash-like QDs. In this work only As2 was used for the QD growth. Different growth parameters were investigated to optimize the optical properties, like photoluminescence linewidth, and to implement those QD ensembles into laser structures as active medium. By the implementation of those QDs into laser structures a full width at half maximum (FWHM) of 30 meV was achieved. Another part of the research includes the investigation of the influence of the layer design of lasers on its lasing properties. QD lasers were demonstrated with a modal gain of more than 10 cm-1 per QD layer. Another achievement is the large signal modulation with a maximum data rate of 15 Gbit/s. The implementation of optimized QDs in the laser structure allows to increase the modal gain up to 12 cm-1 per QD layer. A reduction of the waveguide layer thickness leads to a shorter transport time of the carriers into the active region and as a result a data rate up to 22 Gbit/s was achieved, which is so far the highest digital modulation rate obtained with any 1.55 µm QD laser. The implementation of etch stop layers into the laser structure provide the possibility to fabricate feedback gratings with well defined geometries for the realization of DFB lasers. These DFB lasers were fabricated by using a combination of dry and wet etching. Single mode operation at 1.55 µm with a high side mode suppression ratio of 50 dB was achieved.

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We present the results of GaInNAs/GaAs quantum dot structures with GaAsN barrier layers grown by solid source molecular beam epitaxy. Extension of the emission wavelength of GaInNAs quantum dots by ~170nm was observed in samples with GaAsN barriers in place of GaAs. However, optimization of the GaAsN barrier layer thickness is necessary to avoid degradation in luminescence intensity and structural property of the GaInNAs dots. Lasers with GaInNAs quantum dots as active layer were fabricated and room-temperature continuous-wave lasing was observed for the first time. Lasing occurs via the ground state at ~1.2μm, with threshold current density of 2.1kA/cm[superscript 2] and maximum output power of 16mW. These results are significantly better than previously reported values for this quantum-dot system.

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La captación de glucosa y su conversión en lactato juega un papel fundamental en el metabolismo tumoral, independientemente de la concentración de oxígeno presente en el tejido (efecto Warburg). Sin embrago, dicha captación varía de un tipo tumoral a otro, y dentro del mismo tumor, situación que podría depender de las características microambientales tumorales (fluctuaciones de oxígeno, presencia de otros tipos celulares) y de factores estresores asociados a los tratamientos. Se estudió el efecto de la hipoxia-reoxigenación (HR) y las radiaciones ionizantes (RI) sobre la captación de glucosa, en cultivos de líneas tumorales MCF-7 y HT-29, cultivadas de forma aislada o en cocultivo con la línea celular EAhy296. Se encontró que la captación de glucosa en HR es diferente para lo descrito en condiciones de hipoxia permanente y que es modificada en el cocultivo. Se identificaron poblaciones celulares dentro de la misma línea celular, de alta y baja captación de glucosa, lo que implicaría una simbiosis metabólica de la célula como respuesta adaptativa a las condiciones tumorales. Se evaluó la expresión de NRF2 y la translocación nuclear de NRF2 y HIF1a, como vías de respuesta a estrés celular e hipoxia. La translocación nuclear de las proteínas evaluadas explicaría el comportamiento metabólico de las células tumorales de seno, pero no de colon, por lo cual deben existir otras vías metabólicas implicadas. Las diferencias en el comportamiento de las células tumorales en HR en relación con hipoxia permitirá realizar planeaciones dosimétricas más dinámicas, que reevalúen las condiciones de oxigenación tumoral constantemente.

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El comportamiento biológico de las células cancerosas es influenciado por el microambiente en el que se desarrollan y en este, factores como la angiogénesis o el estímulo de agentes estresores como la hipoxia, se han considerado críticos para su evolución y manejo terapéutico. Uno de los mecanismos moleculares implicados en la respuesta celular frente a estímulos estresores es la activación de vías de señalización intracelulares; en este estudio, se evaluó el estado de la vía JAK/STAT y en ella la expresión/activación de la proteína STAT3 en la línea tumoral (HeLa) y endotelial (EA.hy926), sometidas a hipoxia física y química con mesilato de deferoxamina durante 2, 6 y 24 horas. Adicionalmente, al considerar la importancia de la hipoxia como un agente modificador de la respuesta en el manejo del cáncer utilizando radiaciones ionizantes, se construyeron curvas de supervivencia celular que permitieron evaluar el comportamiento celular frente a estos estímulos. El presente estudio resalta la importancia de la hipoxia como un estímulo que modifica la activación de la proteína STAT3 y la supervivencia de células irradiadas en las dos líneas estudiadas.

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El cáncer gástrico es una de las enfermedades neoplásicas de más alta incidencia y mortalidad a nivel mundial: es el segundo tipo de cáncer más frecuente en el mundo y la primera causa mundial de mortalidad por esta enfermedad. Por su parte, la apoptosis es un proceso importante de muerte celular programada que se presenta durante la embriogénesis, la regulación del sistema inmune y el mantenimiento de la homeostasis tisular. La evasión de la apoptosis por diferentes mecanismos es uno de los aspectos moleculares más importantes en el desarrollo de cáncer. En este artículo se presenta una revisión exhaustiva de la evidencia del papel de la apoptosis vía Fas/FasL en el desarrollo de la carcinogénesis gástrica, inclusive desde etapas tempranas, como la aparición de lesiones preneoplásicas. Finalmente, se evidencia que el desarrollo de más estudios permitiría esclarecer mejor el papel de la vía Fas/FasL en la carcinogénesis gástrica, en sus diferentes estadios.

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The signaling pathway of phosphatidylinositol 3-kinase (PI3K) is critical in many aspects of growth and cell survival. The path of PI3K is stimulated physiologically as a result of many growth factors and regulatory factors. Several genetic alterations such as amplification, mutation and chromosomal arrangements may compromise the PI3K pathway, generating permanent activation in different cancer types have found evidence of these deleterious genetic modifications. Abnormal activation of the PI3K pathway results in alteration of the control mechanisms of growth and cell survival, which favors the competitive growth, and frequently metastatic capacity, greater resistance to treatment. The aim of this paper is to review matters relating to the operation of the PI3K/Akt signaling pathway and its role in the process of carcinogenesis in humans.

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Introducción: La infección por un tipo de Virus del Papiloma Humano de alto riesgo (VPH-AR), es el factor principal en el desarrollo de Cáncer de Cérvix (CC). La carga viral puede modular esta asociación, por lo que resulta importante su cuantificación y el establecimiento de su relación con lesiones precursoras de CC. Metodología: 60 mujeres con lesiones escamosas intraepiteliales (LEI) y 120 mujeres sin LEI, confirmadas por colposcopia, fueron incluidas en el estudio. Se determinó la carga viral de 6 tipos de VPH-AR, mediante PCR en tiempo real. Se estimaron OR crudos y ajustados para evaluar la asociación entre la carga viral de cada tipo y las lesiones cervicales. Resultados: 93.22% de mujeres con LEI y 91.23% de mujeres negativas, fueron positivas para al menos un tipo de VPH. VPH-18 y VPH-16 fueron los tipos más prevalentes, junto con VPH-31 en mujeres sin LEI. No se encontraron diferencias estadísticamente significativas de las cargas virales entre éstos dos grupos, aunque se observó un mayor carga viral en lesiones para algunos tipos virales. Una mayor frecuencia de lesiones se asoció a infecciones con carga baja de VPH-16 (ORa: 3.53; IC95%: 1.16 – 10.74), en comparación a mujeres con carga alta de VPH-16, (ORa: 2.63; IC95%: 1.09 – 6.36). En infecciones por VPH-31, la presencia de carga viral alta, se asoció con una menor frecuencia de lesiones (ORa: 0.34; IC95%: 0.15 – 0.78). Conclusiones: La prevalencia tipo-específica de VPH se corresponde con las reportadas a nivel mundial. La asociación entre la carga viral del VPH y la frecuencia de LEI es tipo específica y podría depender de la duración de la infección, altas cargas relacionadas con infecciones transitorias, y bajas cargas con persistentes. Este trabajo contribuye al entendimiento del efecto de la carga viral en la historia natural del CC; sin embargo, estudios prospectivos son necesarios para confirmar estos resultados.