RESUMO
BACKGROUND: The incidence of cytomegalovirus infection or reactivation is 8 times more frequent in transplant recipients than in the general population. AIM: To evaluate the prevalence and usefulness of different diagnostic techniques for cytomegalovirus infection in renal transplant recipients. PATIENTS AND METHODS: Twenty nine renal transplant recipients were followed for at least five months. Cytomegalovirus infection was assessed by the presence of serum antibodies against the virus using ELISA and viral detection in urine and lymphocytes, using classical viral isolation, shell vial assay, and detection of viral genome by polymerase chain reaction. RESULTS: Prior to transplantation, 23 of 27 patients had IgG type anti cytomegalovirus antibodies. In 40%, IgM type antibodies were detected in some moment of the follow up. Three of these corresponded to seroconversion. Cytomegalovirus was detected in urine in 41% of patients and it was not detected in lymphocytes. Shell vial assay detected the virus in 5 of 13 urine samples and in 1 of 7 lymphocyte samples. Polymerase chain reaction was positive in 12 of the 29 patients. In six patients, an acute rejection was postulated and there was no relation of rejection episodes with viral detection. In two patients, a disease caused by cytomegalovirus was postulated. One of these patients had a seroconversion during follow up. CONCLUSIONS: The prevalence of positive serum indices of cytomegalovirus infection was similar to that reported in the general population. However, the frequency of reactivation and viral disease was lower than that reported elsewhere. The techniques used in this study can be useful to confirm the suspicion of cytomegalovirus disease. However they do not predict the occurrence or evolution of the disease caused by the virus nor viral reactivation in renal transplant recipients.
Assuntos
Infecções por Citomegalovirus/diagnóstico , Transplante de Rim/imunologia , Infecções Oportunistas/diagnóstico , Adolescente , Adulto , Anticorpos Antivirais/sangue , Criança , Infecções por Citomegalovirus/epidemiologia , Feminino , Seguimentos , Humanos , Imunoglobulina M/sangue , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos ProspectivosRESUMO
Cytomegalovirus is the main agent of congenital viral infections. The aim of this study was to compare the incidence of congenital cytomegalovirus infections of two groups of newborns of differing socioeconomic status. Cytomegalovirus was isolated from urine or oropharingeal secretions in 218 children born in a private clinic and 471 born in a public hospital. Positive viral isolates were confirmed with indirect immunofluorescence using monoclonal antibodies. Infection was detected in 12 children (1.82%), four coming from the private clinic (1.86%) and 8 coming from the public hospital (1.81%). Ninety two percent of infected children were asymptomatic. Urine and oropharingeal secretion samples had the same yield for viral isolation. It is concluded that the incidence of congenital cytomegalovirus infection is similar to that described in developed countries.
Assuntos
Infecções por Citomegalovirus/epidemiologia , Citomegalovirus/isolamento & purificação , Chile/epidemiologia , Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/urina , Feminino , Humanos , Incidência , Recém-Nascido , Masculino , Fatores SocioeconômicosRESUMO
Cytomegalovirus infection is the first cause of viral congenital infections. We studied the incidence of primary cytomegalovirus infection, searching for the presence of antibodies with an ELISA technique, in 939 pregnant women of a low socioeconomic level, attending a public outpatient clinic and 123 pregnant university students, attending a special outpatient clinic for students. The initially seronegative women were tested again during the second and third trimester of pregnancy to identify primary infections. The presence of cytomegalovirus congenital infection in the newborns of infected mothers was investigated isolating the virus in cell cultures from urine samples. There was a higher prevalence of infection among low socioeconomic status women (95 vs 69.9%). Two women (one student and one coming from a low socioeconomic status) had a primary infection and in the newborn of the student, a congenital cytomegalovirus infection was detected. It is concluded that women's socioeconomic condition is not a risk factor for cytomegalovirus primary infection during pregnancy.
Assuntos
Infecções por Citomegalovirus/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Feminino , Humanos , Incidência , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Gravidez , Prevalência , Estudos Prospectivos , Estudos Soroepidemiológicos , Fatores SocioeconômicosRESUMO
The prevalence of the herpes simplex virus infection was investigated in a chilean female population. During 1981 and 1985 a number of 1,003 women were analyzed through serological methods. A 29.1% of the group referred past history of oral herpes and 59.4% of these presented 1 to 2 recurrent episodes a year. The high prevalence of this infection in our population is shown when detecting that a 91.4% of the female population had antiherpes simplex antibodies and the titer of this antibodies were in direct correlation to the antecent of recurrent clinical herpes and to the frequency of these episodes.