RESUMO
BACKGROUND: Blood screening for hepatitis B virus (HBV) is not universally performed for donor selection in human milk banks. OBJECTIVES: To evaluate the frequency of detection of HBV surface antigen (HBsAg) and HBV-DNA in colostrum of HBV-infected nursing mothers before and after Holder pasteurization. STUDY DESIGN: Forty-two concentrated breast milk samples were obtained within two postnatal weeks from 24 HBsAg-positive women (4 HBeAg-positive and 20 HBeAg-negative, anti-HBe-positive) were tested for the presence of HBsAg and HBV-DNA before and after Holder pasteurization (30min at 62.5 degrees C). RESULTS: Before pasteurization, HBsAg and HBV-DNA were found in 14/24 (58%), and 20/24 (75%) first milk samples, respectively, obtained by 4 days after delivery. At least one marker was detected in 20/24 (83%) milk samples. Both markers were identified in milk of HBeAg-positive mothers, and most mothers with anti-HBe in blood had at least one HBV marker. Once detected, viral markers were frequently found in milk samples subsequently obtained from the same woman. Holder pasteurization did not affect the probability of detecting HBsAg (8/18, 44%), HBV-DNA (12/18, 67%), or at least one of them (15/18, 83%). CONCLUSIONS: Although the biological implications of these findings remain to be determined, considering that HBV is highly contagious and most recipients of banked human milk are preterm infants, these findings should be taken into account when donors are enlisted for human milk banks without serological screening.
Assuntos
DNA Viral/isolamento & purificação , Antígenos de Superfície da Hepatite B/isolamento & purificação , Vírus da Hepatite B/isolamento & purificação , Hepatite B/diagnóstico , Leite Humano/virologia , Adolescente , Adulto , Biomarcadores , Feminino , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Humanos , Adulto JovemRESUMO
We report a severe case of Guillain-Barré syndrome (GBS) characterized by flaccid areflexive tetraplegia and signs of autonomic instability related to acute HIV-1 infection, and the occurrence of relapse episodes coinciding with the detection of HIV-1 RNA in blood during the phase of irregular treatment with antiretroviral agents. The patient has been asymptomatic for 3 years and has an HIV-1 load below the limit of detection. The recurrence of GBS in this case may be related to alterations of the immunologic response caused by disequilibrium in the host-HIV relationship due to the increase in HIV-1 viremia.
Assuntos
Síndrome de Guillain-Barré/virologia , Infecções por HIV/complicações , HIV-1 , Imunoglobulinas Intravenosas/administração & dosagem , Viremia/complicações , Doença Aguda , Adulto , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/terapia , Humanos , Masculino , Recidiva , Índice de Gravidade de Doença , Carga ViralRESUMO
Changes in the natural course of Trypanosoma cruzi infection have been associated with immunosuppression. We report here a case of the reactivation of Chagas' disease in a patient with non-Hodgkin's lymphoma with gastric, oesophageal and laryngeal involvement. This is the first report describing the involvement of the larynx by T. cruzi.
Assuntos
Doença de Chagas/parasitologia , Doenças da Laringe/parasitologia , Linfoma não Hodgkin , Adulto , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Cardiomiopatia Chagásica/parasitologia , Doenças do Esôfago/parasitologia , Feminino , Humanos , Linfoma não Hodgkin/tratamento farmacológico , Recidiva , Gastropatias/parasitologia , Resultado do Tratamento , Trypanosoma cruziRESUMO
PURPOSE: To evaluate the human leucocyte antigen (HLA) class 1 (HLA-A and HLA-B) and HLA class 2 (HLA-DRB1 and HLA-DQB1) allele profiles in the susceptibility to cytomegalovirus retinitis (CMV-R) in patients with AIDS. METHODS: Cytomegalovirus retinitis was clinically diagnosed by indirect binocular ophthalmoscopy. Human leucocyte antigens class 1 were typed using a complement-dependent microlymphocytotoxicity assay, and HLA class 2 alleles were identified using amplified DNA hybridized to sequence-specific oligonucleotide primers. RESULTS: The frequencies of HLA class 1 antigens and HLA class 2 alleles observed in patients and controls were similar; however, HLA-A31 antigen was over-represented in patients with AIDS, independent of the presence of CMV-R. CONCLUSION: There was no association between HLA molecules/alleles and CMV-R in Brazilian patients with AIDS. However, the results support the role of the HLA system in the susceptibility to developing AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/imunologia , Alelos , Retinite por Citomegalovirus/complicações , Frequência do Gene , Antígenos de Histocompatibilidade Classe II/genética , Antígenos de Histocompatibilidade Classe I/genética , Síndrome da Imunodeficiência Adquirida/genética , Adolescente , Adulto , Idoso , Brasil , Criança , Pré-Escolar , Feminino , Predisposição Genética para Doença , Antígenos HLA-A/análise , Humanos , Lactente , Masculino , Pessoa de Meia-IdadeRESUMO
Para avaliar os estados nutricional e de vitamina A, foram realizadas medidas antropométricas e dosagens bioquímicas em indivíduos infectados pelo HIV-I da regiäo de Ribeirao Preto, SP, Brasil. O retinol plasmático foi dosado por HPLC e as reservas hepáticas de vitamina A avaliadas pelo teste do RDR (relative dosis response). Os pacientes com AIDS apresentaram subnutriçäo significativa, com alteraçöes mais marcantes nas medidas antropométricas relacionadas à gordura corporal, com relativa preservaçäo dos parâmetros relacionados com a massa muscular (subnutriçäo marasmática). Valores de retinol plasmático abaixo de 1,05µmol/L foram verificados em 25 por cento dos pacientes com AIDS e em 17,3 por cento dos pacientes infectados pelo HIV. Valores do RDR indicativos de baixa reserva corporal de vitamina A ocorreram em 28 por cento dos indivíduos estudados. Näo houve correlaçäo dos níveis de retinol sérico com o número de linfócitos CD4+, com o tempo de diagnóstico clínico de AIDS, com a PCT e o IGB