FAMED – Faculdade de Medicina
URI permanente desta comunidadehttps://rihomolog.furg.br/handle/1/2422
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10 resultados
Resultados da Pesquisa
- ItemHIV-1 vertical transmission in Rio Grande, Southern Brazil(2010) Tornatore, Michele; Vitolla, Carla Gonçalves; Sassi, Raul Andrés Mendonza; Silveira, Jussara Maria; D'Ávila, Nildo Eli Marques; Maas, Claudia Gautério; Bianchi, Mônica Steigleder; Pinheiro, Elaine Miranda; Machado, Elizabeth Stankiewicz; Soares, Marcelo Alves; Martinez, Ana Maria Barral deThe aim of this study was to determine the rate and risk factors of HIV-1 mother-to-child transmission (MTCT), the timing of transmission and the transmitted subtype in a population where subtypes B and C co-circulates. One hundred and fortyfour babies born to HIV-1-infected mothers were studied. Subtype and timing of transmission was determined by a nested polymerase chain reaction of gp41 gene. Seven children were infected (4.9%): four were infected intrautero and one intrapartum. The higher frequency of intrautero transmission was statistically significant (P ¼ 0.001). Use of antiretrovirals (ARVs) in the three stages of gestation was a protective risk factor for MTCT (PR ¼ 0.42; CI: 0.21–0.83; P ¼ 0.013). A higher HIV viral load at delivery was the only independent risk factor for MTCT. Early and universal access to ARVs during pregnancy is the most important measure to decrease vertical HIV-1 transmission even in areas where HIV clade distribution differs.
- ItemRisk factors of hiv-1 vertical transmission (vt) and the influence of antiretroviral therapy (art) in pregnancy outcome(2014) Barral, Maria Fernanda Martínez; Oliveira, Gisele Rodrigues de; Lobato, Rubens Caurio; Sassi, Raul Andrés Mendonza; Martinez, Ana Maria Blanco; Gonçalves, Carla VitolaIn the absence of intervention, the rate of vertical transmission of HIV can range from 15-45%. With the inclusion of antiretroviral drugs during pregnancy and the choice of delivery route this amounts to less than 2%. However ARV use during pregnancy has generated several questions regarding the adverse effects of the gestational and neonatal outcome. This study aims to analyze the risk factors for vertical transmission of HIV-1 seropositive pregnant women living in Rio Grande and the influence of the use of ARVs in pregnancy outcome. Among the 262 pregnant women studied the rate of vertical transmission of HIV was found to be 3.8%. Regarding the VT, there was a lower risk of transmission when antiretroviral drugs were used and prenatal care was conducted at the referral service. However, the use of ART did not influence the outcome of pregnancy. However, initiation of prenatal care after the first trimester had an influence on low birth weight, as well as performance of less than six visits increased the risk of prematurity. Therefore, the risk factors analyzed in this study appear to be related to the realization of inadequate pre-natal and maternal behavior.
- ItemRisk factors of HIV-1 vertical transmission (VT) and the influence of antiretroviral therapy (ART) in pregnancy outcome(2014) Barral, Maria Fernanda Martínez; Oliveira, Gisele Rodrigues de; Lobato, Rubens Caurio; Sassi, Raul Andrés Mendonza; Martinez, Ana Maria Barral de; Goinçalves, Carla VitolaIn the absence of intervention, the rate of vertical transmission of HIV can range from 15-45%. With the inclusion of antiretroviral drugs during pregnancy and the choice of delivery route this amounts to less than 2%. However ARV use during pregnancy has generated several questions regarding the adverse effects of the gestational and neonatal outcome. This study aims to analyze the risk factors for vertical transmission of HIV-1 seropositive pregnant women living in Rio Grande and the influence of the use of ARVs in pregnancy outcome. Among the 262 pregnant women studied the rate of vertical transmission of HIV was found to be 3.8%. Regarding the VT, there was a lower risk of transmission when antiretroviral drugs were used and prenatal care was conducted at the referral service. However, the use of ART did not influence the outcome of pregnancy. However, initiation of prenatal care after the first trimester had an influence on low birth weight, as well as performance of less than six visits increased the risk of prematurity. Therefore, the risk factors analyzed in this study appear to be related to the realization of inadequate pre-natal and maternal behavior.
- ItemPapilomavírus humano: prevalência e genótipos encontrados em mulheres HIV positivas e negativas, em um centro de referência no extremo Sul do Brasil(2010) Entiauspe, Ludmila Gonçalves; Teixeira, Lisiane Ortiz; Sassi, Raul Andrés Mendonza; Gonçalves, Carla Vitola; Gonçalves, Paulo; Martinez, Ana Maria Barral deIntrodução: O objetivo deste estudo foi detectar a presença do papilomavírus humano e verificar a prevalência e distribuição dos genótipos HPV-6, -11, -16 e -18 em mulheres HIV-1 positivas e negativas. Métodos: Analisou-se amostras de secreção cervical de 98 mulheres por reação em cadeia da polimerase nested para presença do HPV e tipo-específica para detecção dos genótipos, sendo estes confirmados por análise dos fragmentos de restrição. Realizou-se os testes do qui-quadrado e Fisher para a análise estatística. Resultados: O DNA-HPV foi observado em 66,3% das amostras analisadas, 76,4% no grupo HIV positivo e 60% no grupo HIV negativo (p=0,1). Uma prevalência maior de infecção viral por genótipos oncogênicos foi observada no grupo de pacientes HIV positivo (65,2%) quando comparado ao grupo HIV negativo (28,6%), (p=0,006), sendo HPV-16 foi o mais frequente nos dois grupos, seguido pelo HPV-18. Conclusões: Sugere-se que mulheres HIV positivas apresentam maior probabilidade de se infectar por genótipos oncogênicos de HPV, ressaltando a importância de um programa de rastreamento e diagnóstico diferenciado para este grupo.
- ItemDeterminats of HIV-1 mother- to- child transmission in Southern Brazil(2006) Martinez, Ana Maria Barral de; Hora, Vanusa Pousada da; Santos, Adriana Lopes dos; Sassi, Raul Andrés Mendonza; Groll, Andrea Von; Soares, Esmeralda Augusta Jardim Machado; D'Ávila, Nildo Eli Marques; Silveira, Jussara Maria; Leal, Renata Gonçalves; Tanuri, Amilcar; Soares, Marcelo AlvesDifferent human immunodeficiency virus type 1 (HIV-1) subtypes may have distinct biological, immunological and pathogenic properties. Efficiency of mother-to-child transmission (MTCT) may be among those properties, but few and controversial results have been described so far. In this study, 102 children born from HIV-1-infected mothers between 1998 and 2004 in the city of Rio Grande, Brazil were analyzed for potential risk factors associated with MTCT. That geographic region is characterized by a high proportion of subtype C-infected subjects, and it allowed comparison between subtypes B and C and their influence on MTCT. The analysis also included clinical, obstetric and immunological parameters. Multivariate regression analyses were conducted to evaluate the influence of the parameters on MTCT, and prevalence ratios (PR)and 95% confidence intervals (CI95) were also calculated. A surprisingly high prevalence of subtype C of over 70% was found. Only the HIV viral load and the use of ACTG 076 protocol were predictive of MTCT.HIV subtype and CD4 T-cell counts were not associated with increased risk of transmission. Although a clear expansion of subtype C is evident in southern Brazil, it does not seem to correlate with increased risk of vertical transmission.
- ItemAlta prevalência de usuários que não retornam ao centro de testagem e aconselhamento (CTA) para o conhecimento do seu status sorológico - Rio Grande, RS, Brasil(2008) Germano, Fabiana Nunes; Silva, Tânia Maria Gonçalves da; Sassi, Raul Andrés Mendonza; Martinez, Ana Maria BlancoThe Testing and Counseling Centers are important sources of epidemiological information. This study describes a research conducted with the users of the Testing and Counseling Center of Rio Grande-RS submitted to anti-HIV test during the period 2001-2004. Demographic and behavioral factors of individuals attended in the service were analyzed using the database SISCTA- 2002/RG. HIV-1 seropositivity between 2001 and 2004 was of 1,1%; 2,4%; 2,3% and 1,7%, respectively. In 2003 and 2004, 37,7% and 36% of the HIV-1 positive patients did not return to the Testing and Counseling Center for getting the result of their serological anti-HIV or confirmatory tests. These results seem to reflect some tendencies of the HIV epidemic in Rio Grande and in Brazil. It is important to emphasize the high percentage of HIV-1 positive patients who do not return for getting the result of their test. In terms of public health this risk behavior may jeopardize the efforts for controlling the epidemic.
- ItemPapilomavírus humano: prevalência e genótipos encontrados em mulheres HIV positivas e negativas, em um centro de referência no extremo Sul do Brasil(2010) Entiauspe, Ludmila Gonçalves; Teixeira, Lisiane Ortiz; Sassi, Raul Andrés Mendonza; Gonçalves, Carla Vitola; Gonçalves, Paulo; Martinez, Ana Maria Barral deIntrodução: O objetivo deste estudo foi detectar a presença do papilomavírus humano e verificar a prevalência e distribuição dos genótipos HPV-6, -11, -16 e -18 em mulheres HIV-1 positivas e negativas. Métodos: Analisou-se amostras de secreção cervical de 98 mulheres por reação em cadeia da polimerase nested para presença do HPV e tipo-específica para detecção dos genótipos, sendo estes confirmados por análise dos fragmentos de restrição. Realizou-se os testes do qui-quadrado e Fisher para a análise estatística. Resultados: O DNA-HPV foi observado em 66,3% das amostras analisadas, 76,4% no grupo HIV positivo e 60% no grupo HIV negativo (p=0,1). Uma prevalência maior de infecção viral por genótipos oncogênicos foi observada no grupo de pacientes HIV positivo (65,2%) quando comparado ao grupo HIV negativo (28,6%), (p=0,006), sendo HPV-16 foi o mais frequente nos dois grupos, seguido pelo HPV-18. Conclusões: Sugere-se que mulheres HIV positivas apresentam maior probabilidade de se infectar por genótipos oncogênicos de HPV, ressaltando a importância de um programa de rastreamento e diagnóstico diferenciado para este grupo.
- ItemPrevalência e fatores associados às manifestações bucais em pacientes HIV positivos atendidos em cidade sul-brasileira(2009) Gasparin, Adriano Baraciol; Ferreira, Fabiana Vargas; Danesi, Cristiane Cademartori; Sassi, Raul Andrés Mendonza; Silveira, Jussara Maria; Martinez, Ana Maria Barral de; Zhang, Linjie; Cesar, Juraci AlmeidaThe aim of the study was to assess the prevalence of oral lesions in AIDS patients and identify associated factors. A cross-sectional study collected data from interviews, clinical examination, and a review of medical records for adult patients treated at the HIV/AIDS clinic in the University Hospital of the Federal University in Rio Grande, Rio Grande do Sul State, Brazil, focusing on socio- demographic, immune status, and treatment factors. Poisson regression was used in a hierarchical analytical model. From April 2006 to January 2007, 300 patients were observed (51% males; mean age 40 years). Of the total, 39% presented oral lesions, with candidiasis as the most frequent (59.1%), followed by hairy leukoplakia (19.5%). Women showed a lower risk of oral lesions, and there was an inverse association with CD4 count. Increased risk was associated with lower schooling, low income, smoking, alcohol addiction, time since HIV seroconversion, and higher viral load. The data confirm the increased prevalence of opportunistic oral lesions and show their relationship to socioeconomic conditions and modifiable habits and customs.
- ItemEffect of combined polymorphims in chemokines and chemokine receptors on the clinical course of HIV-1 infection in a brazilian population(2011) Vieira, Valdimara Corrêa; Barral, Maria Fernanda Martínez; Sassi, Raul Andrés Mendonza; Silveira, Jussara Maria; Soares, Marcelo Alves; Martinez, Ana Maria Barral dePolymorphisms in genes that encode chemokines or their receptors can modulate susceptibility to human immunodeficiency virus (HIV) infection and disease progression. The objective of this study was to assess the frequency of polymorphisms CCR5-Δ32, CCR2-64I, CCR5-59029A and SDF1-3’A and their role in the course of HIV infection in a southern Brazilian population. Clinical data were obtained from 249 patients for an average period of 6.4 years and genotypes were determined by standard polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism. Survival analyses were conducted for three outcomes: CD4+ T-cell counts below 200 cells/ μl, acquired immune deficiency syndrome (AIDS) or death. The frequency of the polymorphisms CCR5-Δ32, CCR2- 64I, CCR5-59029A and SDF1-3’A were 0.024, 0.113, 0.487 and 0.207, respectively. CCR5-Δ32 was associated with a reduction in the risk for CD4+ T-cell depletion and with an increased risk for death after AIDS diagnosis. CCR2-64I was associated with a reduction in the risk for developing AIDS. SDF1-3’A was also associated with decreased risk for AIDS, but its effect was only evident when CCR2-64I was present as well. These results highlight the possibility of using these markers as indicators for the prognosis of disease progression and provide evidence for the importance of analysing the effects of gene polymorphisms in a combined fashion.
- ItemDeterminants of HIV-1 mother-to-child transmission in southern Brazil(2006) Martinez, Ana Maria Barral de; Hora, Vanusa Pousada da; Santos, Adriana Lopes dos; Sassi, Raul Andrés Mendonza; Groll, Andrea Von; Soares, Esmeralda Augusta Jardim Machado; D'Ávila, Nildo Eli Marques; Silveira, Jussara Maria; Leal, Renata Gonçalves; Tanuri, Amilcar; Soares, Marcelo AlvesDifferent human immunodeficiency virus type 1 (HIV-1) subtypes may have distinct biological, immuno- logical and pathogenic properties. Efficiency of mother-to-child transmission (MTCT) may be among those properties, but few and controversial results have been described so far. In this study, 102 children born from HIV-1-infected mothers between 1998 and 2004 in the city of Rio Grande, Brazil were analyzed for potential risk factors associated with MTCT. That geographic region is characterized by a high proportion of subtype C-infected subjects, and it allowed comparison between subtypes B and C and their influence on MTCT. The analysis also included clinical, obstetric and immunological parameters. Multivariate regression analyses were conducted to evaluate the influence of the parameters on MTCT, and prevalence ratios (PR) and 95% confidence intervals (CI95) were also calculated. A surprisingly high prevalence of subtype C of over 70% was found. Only the HIV viral load and the use of ACTG 076 protocol were predictive of MTCT. HIV subtype and CD4 T-cell counts were not associated with increased risk of transmission. Although a clear expansion of subtype C is evident in southern Brazil, it does not seem to correlate with increased risk of vertical transmission.