RESUMO
INTRODUCTION: A cross sectional study was conducted from 2002-2004 to record the evolution of HIV-1 infection in Puerto Rico by monitoring the expression of antiretroviral resistance-associated mutations. METHODS: Samples were analyzed by using the TRUGENE HIV-1 Genotyping Kit and the OpenGene DNA Sequencing System. RESULTS: Mutations in the HIV-1 virus were detected in 92.7% of men and 94.8% of women. Of these, 75.1% of men and 72.4% of women had HIV-1 with resistance to at least one medication. The average number of HIV mutations was 6.1 in men and 5.3 in women. In 2002 and 2003, strains were most frequently resistant to the antiretroviral drugs zalcitabine, lamivudine and didanosine, while in 2004, strains were most frequently resistant to zalcitabine, lamivudine, and efavirenz. The most prevalent mutations in the reverse transcriptase gene were M184V, K103N, T215Y, and M41L. The most prevalent mutations in the protease gene were L63P, M361, L90M, A71V, and L101. CONCLUSIONS: Significant differences between men and women were recorded in the levels of HIV-1 expressed mutations and resistance. When comparing these results with data from 2000 and 2001, results indicate that expression of resistant mutations has remained constant.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Farmacorresistência Viral , HIV-1/efeitos dos fármacos , HIV-1/genética , Distribuição de Qui-Quadrado , Estudos Transversais , Análise Mutacional de DNA , Feminino , Humanos , Masculino , Mutação/efeitos dos fármacos , Prevalência , Porto Rico/epidemiologiaRESUMO
Partial immune restoration may be obtained with highly active antiretroviral therapy (HAART), but specific anti-HIV-1 immune responses do not appear to improve substantially. We have demonstrated that a soluble factor(s) induced by a mixture of inactivated influenza and bacterial vaccines called polyantigenic immunomodulator (PAI), possesses strong immunoregulatory and anti-HIV-1 activities. In the present study, we show that culture fluids from both PAI-stimulated peripheral blood mononuclear cells (PBMC) and CD8+ T-cells of HIV-1 infected patients were able to suppress HIV-1 replication in an MHC-unrestricted fashion. The PAI-induced antiviral activity was eliminated when culture fluids were pre-heated at 100°C for 10 min. and it is associated with induction of IFN-γ, MIP-1α, MIP-1ß, and RANTES production, but inhibition of IL-10. Furthermore, this induction is dependent on the immunological status (CD4:CD8 ratio) of the HIV-1 infected patient. Taken together, our results suggest that the MHC-unrestricted HIV-1 suppression that is induced by culture fluids from PAI-stimulated PBMC may result from the stimulation of immune cell subpopulations to produce a heat-labile antiviral soluble factor(s), which in turn modulate cytokine and ß-chemokine production. The identification of this PAI-induced soluble factor(s) may have major therapeutic potential.
RESUMO
HIV infection usually results in a gradual deterioration of the immune system. It is evident that early recognition of progression markers during HIV infection from asymptomatic to symptomatic state is needed. In the present cross-sectional study, peripheral blood lymphocytes from 63 HIV-infected Puerto Rican individuals were analyzed by two-color flow cytometry to study the co-expression CD45RA and CD45RO on both CD4+ and CD8+ T-cells and its correlation with age, gender, CD4 count, CD4:CD8 ratio, anti-retroviral therapy, clinical status, and viral load. Measurement of T-cell subsets in these patients showed an excessive increase of CD3+CD8+, CD8+CD45RA+, and CD8+CD45RO+ T-cells as disease progresses. In contrast, it was also observed a significant decrease in CD3+CD4+, CD4+CD45RA+ and CD4+CD45RO+ T-cells. The distribution of CD8+CD45RA+ T-cells did not change significantly between HIV and AIDS cases suggesting that this T-cell subset is not a good progression marker. Interestingly, CD4+CD45RA+ T-cells were significantly difference between genders, and CD44+CD45RA+ and CD8+CD45RO+ T-cells were influenced by age. In conclusion, the distribution of naïve/memory CD4+ T-cells and memory CD8+ T-cells significantly correlate with HIV infection in disease progression. It is also important to mention that these T-cell subpopulations may be influenced by both gender and age. Overall, these results suggest that a loss in the generation of new immune response and function may be occurring during disease progression. This study open new windows of understanding that will be beneficial for future studies on immunopathogenesis, diagnosis, prognosis, and treatment monitoring for HIV/AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/imunologia , Infecções por HIV/imunologia , Antígenos Comuns de Leucócito/imunologia , Linfócitos T/imunologia , Síndrome da Imunodeficiência Adquirida/sangue , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Fatores Etários , Terapia Antirretroviral de Alta Atividade/estatística & dados numéricos , Relação CD4-CD8 , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Estudos Transversais , Progressão da Doença , Feminino , Citometria de Fluxo , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Porto Rico/epidemiologia , Fatores SexuaisRESUMO
HIV infection usually results in a gradual deterioration of the immune system. It is evident that early recognition of progression markers during HIV infection from asymptomatic to symptomatic state is needed. In the present cross-sectional study, peripheral blood lymphocytes from 63 HIV-infected Puerto Rican individuals were analyzed by two-color flow cytometry to study the co-expression CD45RA and CD45RO on both CD4+ and CD8+ T-cells and its correlation with age, gender, CD4 count, CD4:CD8 ratio, anti-retroviral therapy, clinical status, and viral load. Measurement of T-cell subsets in these patients showed an excessive increase of CD3+CD8+, CD8+CD45RA+, and CD8+CD45RO+ T-cells as disease progresses. In contrast, it was also observed a significant decrease in CD3+CD4+, CD4+CD45RA+ and CD4+CD45RO+ T-cells. The distribution of CD8+CD45RA+ T-cells did not change significantly between HIV and AIDS cases suggesting that this T-cell subset is not a good progression marker. Interestingly, CD4+CD45RA+ T-cells were significantly difference between genders, and CD44+CD45RA+ and CD8+CD45RO+ T-cells were influenced by age. In conclusion, the distribution of naïve/memory CD4+ T-cells and memory CD8+ T-cells significantly correlate with HIV infection in disease progression. It is also important to mention that these T-cell subpopulations may be influenced by both gender and age. Overall, these results suggest that a loss in the generation of new immune response and function may be occurring during disease progression. This study open new windows of understanding that will be beneficial for future studies on immunopathogenesis, diagnosis, prognosis, and treatment monitoring for HIV/AIDS.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , /imunologia , Infecções por HIV/imunologia , Síndrome da Imunodeficiência Adquirida/imunologia , Linfócitos T , Fatores Etários , Terapia Antirretroviral de Alta Atividade , Progressão da Doença , Linfócitos T CD4-Positivos , Linfócitos T CD8-Positivos , Estudos Transversais , Citometria de Fluxo , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Porto Rico , Fatores Sexuais , Síndrome da Imunodeficiência Adquirida/sangue , Síndrome da Imunodeficiência Adquirida/epidemiologiaRESUMO
En el presente trabajo, analizamos los distintos tratamientos quirúrgicos que se llevaron a cabo en 6 casos de angiofibroma nasofaríngeo juvenil (ANJ). Las vías quirúrgicas que se utilizaron fueron la nasal paralateral, la transpalatina, de Rouge-Denker, y la vía natural oral. Analizamos el criterio actual sobre la preparación prequirúrgica, la utilización de las distintas técnicas actuales, haciendo mención especial del "degloving". Se hace referencia a la relación entre los diferentes estadios del tumor: tamaño y localización, y consecuentemente las distintas técnicas a emplear