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INTRODUÇÃO: A utilidade da detecção de anticorpos da imunoglobulina da classe M (IgM) no diagnóstico da sífilis tem sido discutida há tempos. OBJETIVO: No presente estudo foi analisada a ocorrência de anticorpo IgM anti-T. pallidum (Tp-IgMAc) nas amostras de pacientes com sífilis recente, na fase de soroconversão e no monitoramento da resposta sorológica pós-tratamento. MÉTODOS: Amostras séricas de 11 indivíduos. RESULTADOS: Na soroconversão, o Tp-IgMAc foi detectado nas amostras de 10 indivíduos, e em um paciente a reatividade IgM ocorreu anteriormente ao Venereal Disease Research Laboratory (VDRL). A sororreversão foi evidenciada nas amostras de três pacientes com sífilis secundária tratada, e em um indivíduo com reinfecção. CONCLUSÃO: A detecção de Tp-IgMAc mostrou ser um potencial marcador diagnóstico de sífilis ativa e o desempenho do ensaio imunoenzimático de captura de IgM (ELISA-IgM) para o monitoramento pós-tratamento foi similar ao da VDRL.
INTRODUCTION: The appropriateness of IgM antibody detection in the diagnosis of syphilis has been extensively discussed. OBJECTIVE: This study aimed at assessing the detection of anti-T. pallidum IgM antibody (TP-IgMAb) in serum samples from patients with recent syphilis in seroconversion and in the monitoring of post-treatment serological response. METHODS: Serum samples from 11 individuals. RESULTS: At seroconversion, positive Tp-IgMAb was detected in 10 samples and IgM reactivity previous to Venereal Disease Research Laboratory (VDRL) was detected in one sample. Seroreversion was found in samples from three treated patients with secondary syphilis and in one individual with reinfection. CONCLUSION: Tp-IgMAb detection proved to be a potential diagnostic marker for active syphilis, and IgM capture enzyme linked immunosorbent assay (ELISA-IgM) performance was similar to VDRL in post-treatment monitoring.
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BACKGROUND: The intrafamilial dynamics of endemic infection with human herpesvirus type 8 (HHV-8) in Amerindian populations is unknown. METHODS: Serum samples were obtained from 517 Amerindians and tested for HHV-8 anti-latent nuclear antigen (anti-LANA) and antilytic antibodies by immunofluorescence assays. Logistic regression and mixed logistic models were used to estimate the odds of being HHV-8 seropositive among intrafamilial pairs. RESULTS: HHV-8 seroprevalence by either assay was 75.4% (95% confidence interval [CI]: 71.5%-79.1%), and it was age-dependent (P(trend) < .001). Familial dependence in HHV-8 seroprevalence by either assay was found between mother-offspring (odds ratio [OR], 5.44; 95% CI: 1.62-18.28) and siblings aged ≥10 years (OR 4.42, 95% CI: 1.70-11.45) or siblings in close age range (<5 years difference) (OR 3.37, 95% CI: 1.21-9.40), or in families with large (>4) number of siblings (OR, 3.20, 95% CI: 1.33-7.67). In separate analyses by serological assay, there was strong dependence in mother-offspring (OR 8.94, 95% CI: 2.94-27.23) and sibling pairs aged ≥10 years (OR, 11.91, 95% CI: 2.23-63.64) measured by LANA but not lytic antibodies. CONCLUSIONS: This pattern of familial dependence suggests that, in this endemic population, HHV-8 transmission mainly occurs from mother to offspring and between close siblings during early childhood, probably via saliva. The mother to offspring dependence was derived chiefly from anti-LANA antibodies.
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Saúde da Família , Infecções por Herpesviridae/transmissão , Herpesvirus Humano 8/classificação , Herpesvirus Humano 8/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , Brasil/epidemiologia , Criança , Pré-Escolar , Doenças Endêmicas , Feminino , Infecções por Herpesviridae/virologia , Herpesvirus Humano 8/genética , Humanos , Indígenas Sul-Americanos , Lactente , Masculino , Pessoa de Meia-Idade , Grupos Populacionais , Soro/imunologia , Adulto JovemRESUMO
Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV), is the etiologic agent of all forms of Kaposi's sarcoma, primary effusion lymphoma and the plasmablastic cell variant of multicentric Castleman disease. In endemic areas of sub-Saharan Africa, blood transfusions have been associated with a substantial risk of HHV-8 transmission. By contrast, several studies among healthy blood donors from North America have failed to detect HHV-8 DNA in samples of seropositive individuals. In this study, using a real-time PCR assay, we investigated the presence of HHV-8 DNA in whole-blood samples of 803 HHV-8 blood donors from three Brazilian states (São Paulo, Amazon, Bahia) who tested positive for HHV-8 antibodies, in a previous multicenter study. HHV-8 DNA was not detected in any sample. Our findings do not support the introduction of routine HHV-8 screening among healthy blood donors in Brazil. (WCâ=â140).
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Doadores de Sangue , DNA Viral/genética , Herpesvirus Humano 8/genética , Herpesvirus Humano 8/imunologia , Sarcoma de Kaposi/virologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Brasil/epidemiologia , DNA Viral/sangue , Ensaio de Imunoadsorção Enzimática , Humanos , Fases de Leitura Aberta/genética , Prevalência , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reprodutibilidade dos Testes , Sarcoma de Kaposi/sangue , Sarcoma de Kaposi/epidemiologiaRESUMO
To determine the epidemiology of human herpesvirus type 8 (HHV-8) among non-Amazonian native populations, we conducted a cross-sectional study in Brazil, Bolivia, and Paraguay. Our data show striking ethnic and geographic variations in the distribution of HHV-8 seroprevalences in Amazonian (77%) and non-Amazonian native populations (range 0%-83%).
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Infecções por Herpesviridae/etnologia , Herpesvirus Humano 8/isolamento & purificação , Indígenas Sul-Americanos , Adolescente , Adulto , Fatores Etários , Idoso , Anticorpos Antivirais/análise , Bolívia/epidemiologia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Doenças Endêmicas , Feminino , Geografia , Infecções por Herpesviridae/virologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Paraguai/epidemiologia , Prevalência , Estudos SoroepidemiológicosRESUMO
Kaposi's sarcoma-associated herpesvirus (KSHV) is endemic in the Amazon and rare in southern regions of Brazil. However, geographical distribution and epidemiological correlates of infection in this large country are still poorly defined. To estimate the seroprevalence of, and risk factors for, KSHV infection in Brazil, a multi-center study was conducted among 3,493 first-time voluntary unpaid blood donors from Salvador, Sao Paulo and Manaus. Antibodies against KSHV were detected using a whole-virus ELISA validated prior to the serosurvey. Antibodies against the latency-associated nuclear antigen (LANA) were detected by immuno-fluorescence assay (IFA) among ELISA-positive sera and a random sample of ELISA-negative sera. Overall, seroprevalence of KSHV by whole-virus ELISA was 21.7% (95% confidence interval (CI): 20-23.4%) in men and 31.7% (95% CI: 29-34.3%) in women (P<0.0001). KSHV antibodies were detected by IFA-LANA in 3% (95% CI: 2-4.3%) of 867 ELISA-positive samples and in none of 365 randomly selected ELISA-negative samples. In multivariate analysis, KSHV seroprevalence by whole-virus ELISA was independently associated with female sex (odds ratio [OR]=1.6, 95% CI: 1.4-1.9); residence in the Amazon (OR=1.4, 95% CI: 1.2-1.8; compared to Salvador); Caucasian ethnicity (OR=1.3, 95% CI: 1.1-1.6) and herpes simplex virus type 2 (HSV-2) infection (OR=1.3, 95% CI: 1.1-1.6). KSHV seroprevalence did not significantly increase with age, nor was it associated with self-reported sexual behavior. KSHV seroprevalence is high among Brazilian blood donors, particularly from the Amazon region. This study supports the co-existence of sexual and non-sexual routes of KSHV transmission in this population.
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Doadores de Sangue , Herpesvirus Humano 8/isolamento & purificação , Sarcoma de Kaposi/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Sarcoma de Kaposi/etiologia , Sarcoma de Kaposi/virologiaRESUMO
Little data are available on the seroprevalence of, and risk factors for hepatitis B and C viruses (HBV and HCV) infection in Latin American countries. A multi-center serosurvey was conducted among 3,598 first-time blood donors (65% men) from Sao Paulo, Salvador and Manaus in Brazil. The gender-specific seroprevalences of antibodies against hepatitis B core antigen (anti-HBc) and of the hepatitis B surface antigen (HBsAg) in anti-HBc-positive sera were measured, and risk factors analyzed by gender. The gender-specific seroprevalences of antibodies against HCV (anti-HCV) were measured, but risk factors for HCV were not determined. Anti-HBc and HBsAg seroprevalences were not significantly different in men [101/2,341 (4.31%) and 4/2,229 (0.18%), respectively] and women [65/1,237 (5.25%) and 8/1,169 (0.68%), respectively], whereas the seroprevalence of anti-HCV was higher in women (12/1,238 [0.97%] vs. 9/2,353 [0.38%]; odds ratio [OR] = 2.49; 95% confidence interval [CI]: 1.0-6.0). No significant difference for HBV infection was found across the three study sites or by ethnic group. The seroprevalence of anti-HBc increased with age, but decreased with education level in both genders. Lifetime number of sexual partners was associated with anti-HBc prevalence among men (OR = 1.95; 95% CI: 1.2-3.1), but not women. The seroprevalence of HBV and HCV was low among Brazilian blood donors, and exposure increased with age in both genders.
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Doadores de Sangue , Anticorpos Anti-Hepatite B/análise , Hepatite B/epidemiologia , Anticorpos Anti-Hepatite C/análise , Hepatite C/epidemiologia , Estudos Soroepidemiológicos , Brasil/epidemiologia , DNA Viral , Feminino , Hepatite B/sangue , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/sangue , Hepatite C/sangue , Hepatite C/imunologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Vigilância da População , Distribuição por Sexo , Parceiros SexuaisRESUMO
BACKGROUND: Human herpesvirus type 8 (HHV-8) is hyperendemic in Amerindian populations, but its modes of transmission are unknown. METHODS: Antibodies against either HHV-8 lytic antigen or HHV-8 latency-associated nuclear antigen (LANA) were detected, by immunofluorescence assays, in 339 Amerindians and 181 non-Amerindians from the Brazilian Amazon. Serological markers of oro-fecal (hepatitis A), parenteral (hepatitis B and C), and sexual (herpes simplex virus type 2 and syphilis) transmission were measured by specific ELISAs. Salivary HHV-8 DNA was detected by use of a nested polymerase chain reaction assay and was sequenced. RESULTS: Antibodies against either lytic antigen or LANA were detected in 79.1% of Amerindians and in 6.1% of non-Amerindians (adjusted seroprevalence ratio [SR], 12.63 [95% confidence interval {CI}, 7.1-22.4]; P<.0001). HHV-8 seroprevalence increased with age among Amerindians (P(Trend) < .001) and already had high prevalence in childhood but was not sex specific in either population. The 2 populations did not differ in seroprevalence of oro-fecal or parenteral markers, but seroprevalence of markers of sexual transmission was lower among Amerindians. HHV-8 DNA in saliva was detected in 47 (23.7%) of 198 HHV-8 seropositive Amerindians. Detection of HHV-8 DNA decreased with age (P(Trend) < .04) and was more common in men (SR, 2.14 [95% CI, 1.3-3.5]; P=.003). A total of 36 (76.6%) of the 47 saliva HHV-8 DNA samples were sequenced, and all clustered as subtype E. CONCLUSION: The data support the hypothesis of early acquisition and horizontal transmission, via saliva, of HHV-8 subtype E in Amerindian populations.
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Infecções por Herpesviridae/epidemiologia , Infecções por Herpesviridae/virologia , Herpesvirus Humano 8/classificação , Herpesvirus Humano 8/isolamento & purificação , Eliminação de Partículas Virais , Adolescente , Adulto , Fatores Etários , Anticorpos Antivirais/sangue , Brasil/epidemiologia , Criança , Pré-Escolar , Análise por Conglomerados , DNA Viral/química , DNA Viral/genética , Feminino , Imunofluorescência , Infecções por Herpesviridae/transmissão , Herpesvirus Humano 8/genética , Humanos , Indígenas Sul-Americanos , Masculino , Filogenia , Reação em Cadeia da Polimerase , População Rural , Saliva/virologia , Análise de Sequência de DNA , Estudos Soroepidemiológicos , Fatores SexuaisRESUMO
A total of 586 serum samples were used to evaluate the performance of type-specific herpes simplex virus type 2 (HSV-2) commercial enzyme-linked immunosorbent assays (ELISAs) by using the monoclonal antibody-blocking enzyme immunoassay (MAb-EIA) and a clinicovirological panel as reference standards. The Kalon and HerpeSelect ELISAs had similar sensitivities (93.5% and 93.8% compared with the results obtained by MAb-EIA, respectively, and 100% for both ELISAs compared with the results obtained with a clinicovirological panel). The Kalon ELISA had a higher specificity (96.5% and 96.8% compared with the results obtained by MAb-EIA and with a clinicovirological panel, respectively) than the HerpeSelect ELISA (86.9% and 94% compared with the results obtained by MAb-EIA and with a clinicovirological panel, respectively). A higher cutoff significantly improved the specificity of the HerpeSelect ELISA.
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Anticorpos Monoclonais/imunologia , Anticorpos Antivirais/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Herpesvirus Humano 2/imunologia , Anticorpos Antivirais/imunologia , Brasil/epidemiologia , Herpes Genital/diagnóstico , Herpes Genital/epidemiologia , Herpes Genital/virologia , Humanos , Kit de Reagentes para Diagnóstico , Sensibilidade e Especificidade , Testes Sorológicos/métodosRESUMO
Accurate determination of infection with Kaposi's sarcoma-associated herpesvirus (KSHV) has been hindered by the lack of a "gold standard" for comparison of serological assays used to estimate KSHV prevalence in serosurveys conducted in different settings. We have evaluated the performance of five in-house (developed at University College London [UCL], United Kingdom, and at the virology laboratory of the Instituto de Medicine Tropical [IMT] in Sao Paulo, Brazil) and two commercial (ABI and DIAVIR) serological assays to detect antibodies to latency-associated nuclear antigen (LANA) and to lytic KSHV antigens. We used a variety of serum samples assembled to represent populations likely to be at high, intermediate, and low risk of KSHV infection in Brazil. Composite reference standard panels were prepared based on clinical and serological parameters, against which assay performances were assessed using conventional Bayesian statistics and latent class analysis (LCA). Against the clinical reference standard, in-house immunofluorescence assays to detect anti-LANA antibodies (IFA-LANA) produced at UCL and IMT had similar performances, with sensitivities of 61% (95% confidence interval [CI], 48% to 74%) and 72% (95% CI, 58% to 83%) and specificities of 99% (95% CI, 94% to 100%) and 100% (95% CI, 96% to 100%), respectively, and only the IMT IFA-LANA was included in LCA, together with the IMT IFA-lytic and four enzyme-linked immunosorbent assays (ELISAs). The LCA indicated that the IMT whole-virus ELISA performed best (sensitivity, 87% [95% CI, 81% to 91%]; and specificity, 100% [95% CI, 98% to 100%]), confirming the results obtained with the conventional statistical approach. Commercially available ELISA-based tests yielded the lowest specificities using a spectrum of serum samples. The evaluation of KSHV serological assays is warranted before planning serosurveys in various settings.
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Anticorpos Antivirais/sangue , Antígenos Virais/imunologia , Infecções por Herpesviridae/diagnóstico , Herpesvirus Humano 8/imunologia , Proteínas Nucleares/imunologia , Kit de Reagentes para Diagnóstico , Sarcoma de Kaposi/diagnóstico , Latência Viral/imunologia , Brasil , Pré-Escolar , Ensaio de Imunoadsorção Enzimática/normas , Imunofluorescência/normas , Infecções por Herpesviridae/imunologia , Infecções por Herpesviridae/virologia , Humanos , Lactente , Masculino , Kit de Reagentes para Diagnóstico/normas , Padrões de Referência , Sarcoma de Kaposi/imunologia , Sarcoma de Kaposi/virologia , Sensibilidade e Especificidade , Reino UnidoRESUMO
DNA/HHV-8 pode ser detectado em amostras de biópsias de Sarcoma de Kaposi (SK) independente da forma clínica. Objetivos: 1. Descrever os subtipos de HHV-8 em pacientes com aids e sarcoma de Kaposi em São Paulo; 2. Construir uma árvore filogenética com os isolados de DNA/HHV-8 obtidos. Pacientes e métodos: Estudo transversal incluindo pacientes com aids e SK atendidos no Instituto de Infectologia Emílio Ribas, São Paulo, Brasil. Fragmentos de DNA/HHV-8 de 420 pb da região ORF K1foram amplificados por PCR "nested". As seqüências de DNA obtidas foram alinhadas no programa clustalW e análise filogenética realizada pela técnica de neighbour-joining. Resultados: Foram analisadas 37 amostras de 33 pacientes. As amostras foram classificadas como subtipos A, B e C. Em relação ao comportamento de risco 7/10 (70 por cento) pacientes com o subtipo C eram heterossexuais e 3/10 (30 por cento) eram homossexuais (p < 0,05). Dos pacientes com o subtipo A, 2/16 (12.5 por cento) eram heterossexuais e 12/16 (75 por cento) eram homossexuais. Conclusões: 1. Os subtipos de HHV-8 em pacientes com SK e aids em São Paulo pertencem aos subgrupos A, B e C. 2. Os subtipos A e C apresentaram associação estatisticamente significante com comportamento sexual de alto risco.HHV-8/DNA has been found in Kaposi`s sarcoma (KS) tumour tissue, regardless its clinical forms. Objectives: 1. To classify HHV-8 strains from AIDS/KS in Brazil. 2. To construct a phylogenetic tree with the HHV-8/DNA isolates obtained. Methods: AIDS/KS patients were recruited in a cross-sectional study at the "Instituto de Infectologia Emílio Ribas" in Sao Paulo, Brazil. HHV-8/DNA fragments were amplified by nested PCR. The DNA sequences were aligned by clustalW and phylogenetic analysis carried out by Neighbor-joining technique. Results: 37 samples from 33 AIDS/KS patients were analyzed. Brazilian patients yielded subtypes A, B and C. The distribution of HHV-8 strains according to risk behaviour for HIV infection, showed that 7/10 (70 per cent) patients with C subtype were heterosexual and 3/10 (30 per cent) were homosexual (p < 0,05). Of the 16 patients with A subtype, 2/16 (12.5 per cent) were heterosexual and 12/16 (75 per cent) were homosexual. Conclusions: 1. Brazilian HHV-8 strains clustered into subtypes A, B and C; 2. HHV 8 subtypes A and C were statistically significant associated with high risk sexual behaviour...
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Humanos , Masculino , Adolescente , Adulto , Herpesvirus Humano 8 , Síndrome da Imunodeficiência Adquirida/complicações , Epidemiologia Molecular , Fatores de Risco , Comportamento Sexual , Sarcoma de Kaposi/epidemiologia , Sequência de Bases/genéticaRESUMO
BACKGROUND: The aims of this study were to evaluate the prevalence of perianal ulcer in AIDS patients with advanced disease, and to investigate risk factors associated with these lesions. METHODS: A cross-sectional study was conducted to determine the prevalence and risk factors associated with the presence of perianal ulcer in AIDS patients. A type-specific polymerase chain reaction (PCR) assay was carried out for detection of herpes simplex virus (HSV) DNA on swabs obtained from the ulcerative lesions. RESULTS: In total, 272 hospitalized AIDS patients were included in the study, for evaluation of the risk factors associated with the lesion. Perianal ulceration was found in 25 of 272 patients (prevalence=9.2%). The presence of HSV DNA was shown by type-specific PCR in 22 of 23 (95.6%) patients. Multivariate analysis revealed that a history of esophageal candidiasis (odds ratio (OR)=15.1; 95% confidence interval (CI)=3.8-59.1) and a history of perianal ulcer (OR=19.2; 95% CI 6.4-58.1) were significant risk factors for the presence of perianal ulcer. CONCLUSION: We conclude that a history of perianal ulcer and a history of esophageal candidiasis were risk factors independently associated with perianal ulcer in AIDS patients with advanced disease.