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1.
Rev Clin Esp (Barc) ; 223(1): 32-39, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36341988

RESUMO

Viral infections during pregnancy have been one of the leading causes associated with significant perinatal problems, such as congenital defects, fetal neurological syndromes, stillbirths, and adverse pregnancy outcomes. The mpox virus infection, caused by an Orthopoxvirus related to the human smallpox virus, was declared a global health emergency by the World Health Organization in July 2022 due to the large number of cases emerging outside the usual endemic area in Africa. There is little information on the impact of mpox virus infection during pregnancy, although the limited evidence available shows a high rate of fetal harm. This review addresses the problem of mpox virus infection in pregnant women and provides indications for its prevention, diagnosis, and treatment.


Assuntos
Mpox , Doenças Negligenciadas , Complicações Infecciosas na Gravidez , Feminino , Humanos , Gravidez , África , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez , Mpox/epidemiologia
2.
DST j. bras. doenças sex. transm ; 33: 1-7, dez.30, 2021.
Artigo em Inglês | LILACS | ID: biblio-1368556

RESUMO

Introduction: Human Immunodeficiency Virus infection is a prevalent infection occurring during pregnancy. The implementation of a program to screen and prevent vertical transmission is highly important in Public Healthcare. Pregnant crack users could face difficulties to test and adhere to the Highly Active Antiretroviral Therapy. Objective: The purpose of this research paper was to investigate whether crack cocaine abuse increases Human Immunodeficiency Virus perinatal transmission rates, as well as to evaluate the risk factors associated with such an increase. Methods: Design: A retrospective study. Setting: Department of Obstetrics and Gynecology, General Hospital of Universidade Federal do Paraná. Population: pregnancies of Human Immunodeficiency Virus-positive women who were using crack cocaine (n=64) were compared with that of non-users (n=826) from 2005 to 2013. Prenatal medical records, delivery records, and newborn records were analyzed. Main Outcome Measures: The vertical transmission of Human Immunodeficiency Virus in the group of crack cocaine users was 9.37% (6) versus 2.54% (21) among non-users (p=0.009744). Results: Over the years of the study, there was a decrease in the vertical transmission rate in non-users, while this number remained constant in the group of users. When analyzing the cases of perinatal transmission, it was found that 83.34% (5) had inadequate prenatal care, and 100% (6) had inadequate Human Immunodeficiency Virus treatment, compared to the group in which there was no vertical transmission, where 65.52% (38) had inadequate prenatal care and 70.86% (41) had inadequate treatment. Conclusion: Vertical transmission is higher among crack cocaine users and did not decrease over the years of the study, as occurred among non-users. Trends that explain this increase were non-adherence to adequate prenatal care, Human Immunodeficiency Virus diagnosis during pregnancy, irregular treatment, absence of intrapartum antiretroviral prophylaxis, and vaginal delivery route.


A contaminação pelo vírus da imunodeficiência humana é uma infecção prevalente ocorrida na gravidez. A implantação de um programa de rastreamento e prevenção da transmissão vertical é um campo tão importante na saúde pública. Neste caso, a gestante, usuária de crack, pode estar com alguma dificuldade de testagem e adesão à administração da terapia antirretroviral altamente ativa. Objetivo: Analisar os casos de gestantes vírus da imunodeficiência humana positivas e usuárias de crack atendidas na maternidade do Hospital de Clínicas da Universidade Federal do Paraná entre 2005 e 2013. Propõe-se avaliar se o uso de crack aumenta a transmissão vertical do vírus da imunodeficiência humana e, caso isso ocorra, quais seriam os possíveis fatores que explicariam esse aumento. Métodos: Trata-se de um estudo retrospectivo e descritivo, com análise de prontuários da obstetrícia (prénatal), do atendimento ao parto, da ficha de avaliação do recém-nascido e do prontuário de evolução do recém-nato. Foi comparada a taxa de transmissão perinatal de vírus da imunodeficiência humana de usuárias (n=64) e não usuárias de crack (n=826) no período de 2005 a 2013. Posteriormente, analisando apenas os casos de uso de crack, foram pareados os grupos com e sem transmissão vertical, avaliando condições sociais, condições do recém-nato, tratamento adequado para o vírus da imunodeficiência humana durante a gestação, entre outras variáveis. Resultados: A transmissão vertical de vírus da imunodeficiência humana foi de 9,37% em usuárias de crack e de 2,54% em não usuárias, com alta significância estatística (p=0,009744). Ao longo dos anos do estudo, houve um decréscimo da taxa de transmissão vertical em não usuárias de crack, enquanto nas usuárias esse número permaneceu constante. Nos casos de transmissão vertical, 83,34% das pacientes tiveram um pré-natal inadequado e em 100% o tratamento para o vírus da imunodeficiência humana na gestação foi inadequado em comparação com o grupo no qual não houve transmissão vertical, em que o pré-natal inadequado foi de 65,52% e o tratamento inadequado foi de 70,86%. O uso de adequada profilaxia antirretroviral intraparto se mostrou um dos principais fatores diretamente associados com a proteção contra a transmissão vertical (p=0,065). Conclusão: A transmissão vertical de vírus da imunodeficiência humana é maior em usuárias de crack e não se mostrou em queda ao longo dos anos do estudo, como ocorreu nas não usuárias. Foram encontradas tendências que explicam esse aumento, por exemplo não adesão ao pré-natal adequado, diagnóstico do vírus da imunodeficiência humana durante a gestação, tratamento irregular, ausência de profilaxia antirretroviral intraparto e via de parto vaginal. Prematuridade e baixo peso ao nascer foram maiores nos recém-natos das usuárias em relação aos índices encontrados na literatura do país. Fica evidenciada a necessidade de atendimento diferenciado para essas gestantes, visto que elas não obedecem às medidas adotadas até o momento para o controle da transmissão vertical.


Assuntos
Humanos , HIV , Cocaína Crack , Gestantes , Cuidado Pré-Natal , Transmissão Vertical de Doenças Infecciosas , Obstetrícia
3.
Front Glob Womens Health ; 2: 602572, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34816177

RESUMO

The new coronavirus (SARS-Cov-2) was first identified in late 2019 as the new RNA virus in the coronaviridae family responsible for causing COVID-19 in the residents of China's Hubei province. In mid-March 2020 WHO declared the pandemic caused by this virus as a result of thousands of people infected all over the world. Epidemiological evidence obtained from other pandemics, such as influenza and ebola, suggest that pregnant women are more susceptible to serious complications and death from viral infection. Physiological changes in the anatomical structure of the respiratory system as well as in the immune system during the pregnancy-puerperal period seem to contribute to this greater risk. Thus, pregnant women are more susceptible to be infected by the SARS-COV-2 or other viruses and to have serious COVID-19 disease. In fact, COVID-19 can alter immune responses at the maternal-fetal interface, affecting the well-being of both mother and her fetus. There is still no sufficient evidence in the literature to support the occurrence of vertical transmission and through breastfeeding, but the prevalence of prematurity was high among pregnant women infected by SARS-Cov-2. In this review, the changes in the immune system that may increase susceptibility to SARS-Cov-2 are discussed as well as the possible mechanisms involved in the transmission of the virus to the fetus by vertical transmission and during breastfeeding.

4.
Medwave ; 21(7): e8454, 2021 Aug 30.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-34519722

RESUMO

INTRODUCTION: COVID-19 disease can affect women at any stage of pregnancy, and newborns could become infected with SARS-CoV-2 through vertical or horizontal transmission. OBJECTIVE: To determine clinical and epidemiological characteristics of mothers with COVID-19, associated neonatal outcomes, and to evaluate SARS-CoV-2 vertical transmission. METHODS: We conducted an observational, descriptive, cross-sectional study. We included all mothers with positive serology for SARS-CoV-2 and their newborns at the Hospital Regional Docente de Trujillo from April 18 to September 30, 2020. Variables were collected from the medical records, and descriptive statistics were used for the analysis. RESULTS: A total of 647 mothers and 656 neonates were enrolled. Of all live births, 85.3% and 14.7% were term and preterm neonates, respectively. We found 1.7% (11/656) of newborns with positive RT-PCR for SARS-CoV-2; and that 27.3% (3/11) of these neonates required hospitalization. Neonatal mortality was 4/656 (0.6%), and no case was attributed to COVID-19. Of all mothers affected with COVID-19, 95.7% were asymptomatic, and 4.3% presented clinical symptoms attributed to COVID-19, most of which were mild. The most frequent obstetric complications were preeclampsia-eclampsia, prelabour rupture of membranes, and acute fetal distress. All the mothers were discharged. CONCLUSION: We found 1.7% of newborns with positive RT-PCR test for SARS-CoV-2; and that 20.1% of these neonates were hospitalized. The most frequent morbidity was neonatal sepsis and prematurity. The infection was mild among newborns, showing a 0.6% overall mortality, with no cases attributed to COVID-19. We found that only 5% of mothers presented symptoms, most of which were mild to moderate symptoms. There was no record of maternal mortality in this study group. It is not possible to conclude whether vertical transmission or intrapartum-acquired infection is responsible for neonatal COVID-19 infections.


INTRODUCCIÓN: La enfermedad de COVID-19 puede afectar a gestantes en cualquier trimestre del embarazo. Por su parte, los neonatos podrían infectarse con SARS-CoV-2 por transmisión vertical u horizontal. OBJETIVO: Determinar las características clínicas y epidemiológicas de madres con COVID-19, de sus neonatos y la transmisión vertical del SARS-CoV-2. MÉTODOS: Estudio observacional, descriptivo, transversal. Se incluyeron todas las madres con serología positiva para SARS-CoV-2 y sus neonatos nacidos en el Hospital Regional Docente de Trujillo desde el 18 de abril hasta el 30 de septiembre de 2020. La información para las variables se recogió de las historias clínicas. Para el análisis se usó estadística descriptiva. RESULTADOS: Participaron 647 madres y 656 neonatos. El 85,3% de los neonatos nació de término y el 14,7% fue prematuro. El 1,7% (11/656) tuvieron PCR-RT positivos para SARS-CoV-2, y de ellos el 27,3% (3/11) requirió hospitalizados. La mortalidad fue de 4/656 (0,6%), no atribuida a COVID-19. De las madres afectadas con COVID-19, 95,7% fue asintomática, el 4,3% presentó sintomatología clínica atribuida a COVID-19, siendo en su mayoría casos leves. Las complicaciones obstétricas más frecuentes fueron preeclampsia, eclampsia, rotura prematura de las membranas y sufrimiento fetal agudo. Todas las madres fueron dadas de alta. CONCLUSIÓN: De los neonatos estudiados, el 1,7% presentó prueba PCR-RT para SARS-CoV-2 positiva. El 20,1% fue hospitalizado. La morbilidad más frecuente fue sepsis neonatal y prematuridad. La mortalidad fue de 0,6%, ningún caso atribuido a COVID-19. El cuadro clínico de esta patología fue leve en los neonatos. El 95% de las madres con COVID-19 fueron asintomáticas. De las gestantes que presentaron cuadro clínico, tuvieron sintomatología leve a moderada. No se tuvo registro de mortalidad materna en el grupo de estudio. No se puede concluir si se trata de casos de transmisión vertical del SARS-CoV-2 o estamos frente a casos de posible infección neonatal adquirida intraparto.


Assuntos
COVID-19/diagnóstico , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Mães/psicologia , Complicações Infecciosas na Gravidez/epidemiologia , SARS-CoV-2/isolamento & purificação , Adulto , Teste de Ácido Nucleico para COVID-19 , Teste Sorológico para COVID-19 , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Resultado da Gravidez/epidemiologia , SARS-CoV-2/genética
5.
Biochim Biophys Acta Mol Basis Dis ; 1867(10): 166182, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34058350

RESUMO

Pregnancy is a unique immunological condition in which an "immune-diplomatic" dialogue between trophoblasts and maternal immune cells is established to protect the fetus from rejection, to create a privileged environment in the uterus and to simultaneously be alert to any infectious challenge. The maternal-placental-fetal interface (MPFI) performs an essential role in this immunological defense. In this review, we will address the MPFI as an active immuno-mechanical barrier that protects against viral infections. We will describe the main viral infections affecting the placenta and trophoblasts and present their structure, mechanisms of immunocompetence and defensive responses to viral infections in pregnancy. In particular, we will analyze infection routes in the placenta and trophoblasts and the maternal-fetal outcomes in both. Finally, we will focus on the cellular targets of the antiviral microRNAs from the C19MC cluster, and their effects at both the intra- and extracellular level.


Assuntos
MicroRNAs/genética , Placenta/fisiologia , Viroses/genética , Viroses/fisiopatologia , Feminino , Feto/fisiopatologia , Humanos , Troca Materno-Fetal/genética , Troca Materno-Fetal/fisiologia , Gravidez , Trofoblastos/fisiologia
6.
Int J Gynaecol Obstet ; 154(3): 474-480, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33404080

RESUMO

OBJECTIVE: To compare ultrasound growth measurements of fetuses with and without microcephaly in suspected Zika virus infection. METHODS: A retrospective cohort study included pregnant women with suspected Zika virus infection to evaluate 110 fetuses with and without microcephaly. The women had been admitted to the fetal medicine unit between October 2015 and August 2016. Cases of fetal microcephaly resulting from other causes were excluded. Variables evaluated were the ultrasound measurements taken at fetal biometry. The relation between each fetal biometry measurement and gestational age was analyzed using fractional polynomials in random-effects regression models. To evaluate fetal growth, curves of the mean fetal biometric parameters were constructed as a function of gestational age. RESULTS: Mean biparietal diameter and mean head circumference increased in both groups as a function of gestational age. In the group with fetal microcephaly, mean head circumference was significantly larger in the 13th and 14th weeks of pregnancy, becoming smaller compared with the group without microcephaly from the 20th week onwards, with the difference increasing with gestational age. CONCLUSION: Fetal head circumference continues to increase until birth, even after a diagnosis of microcephaly, with a reduction only in the pace of growth. Growth decelerates as the pregnancy approaches term.


Assuntos
Microcefalia , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Zika virus , Feminino , Feto , Idade Gestacional , Humanos , Microcefalia/diagnóstico por imagem , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Gestantes , Estudos Retrospectivos , Ultrassonografia Pré-Natal , Infecção por Zika virus/diagnóstico por imagem
7.
Rev. Soc. Bras. Med. Trop ; Rev. Soc. Bras. Med. Trop;53: e20190560, 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1101445

RESUMO

Abstract INTRODUCTION: Congenital transmission (CT) of Trypanosoma cruzi has led to globalization of Chagas disease and its growing relevance as a public health problem. Although the occurrence of CT has been associated with several factors, its mechanisms are still unknown. This study aimed to analyze the geographical and familiar variables of mothers and their association with CT of Chagas disease in a population living in non-endemic areas of Argentina for the last decades. METHODS: We developed a retrospective cohort study in a sample of 2120 mother-child pairs who attended three reference centers in the cities of Buenos Aires, Santa Fe, and Salta between 2002 and 2015. RESULTS: The highest CT rates were observed in children born to Argentinean mothers (10.7%) and in children born to mothers from Buenos Aires (11.7%). Considering the areas of origin of the mothers, those from areas of null-low risk for vector-borne infection had higher CT rates than those from areas of medium-high risk (11.1% vs 8.2%). We also observed a significant intra-familiar "cluster effect," with CT rates of 35.9% in children with an infected sibling, compared to 8.2% in children without infected siblings (RR=4.4 95% CI 2.3-8.4). CONCLUSIONS: The associations observed suggest a higher CT rate in children born to mothers who acquired the infection congenitally, with familiar antecedents, and from areas without the presence of vectors. These observations are considered new epidemiological evidence about Chagas disease in a contemporary urban population, which may contribute to the study of CT and may also be an interesting finding for healthcare professionals.


Assuntos
Humanos , Animais , Masculino , Feminino , Gravidez , Recém-Nascido , Adolescente , Adulto , Adulto Jovem , Doença de Chagas/transmissão , Doença de Chagas/epidemiologia , Complicações Parasitárias na Gravidez/epidemiologia , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Argentina/epidemiologia , População Urbana , Estudos Retrospectivos , Fatores de Risco , Pessoa de Meia-Idade
8.
Vector Borne Zoonotic Dis ; 18(4): 231-233, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29485942

RESUMO

Fourteen pools of Aedes aegypti larvae collected within the urban area of Culiacán, Sinaloa, were analyzed by RT-PCR. The results demonstrate, for the first time, the vertical infection of serotype-2 dengue virus (DENV-2) in Sinaloa, Mexico, suggesting that Ae. aegypti acts as a natural reservoir of DENV-2 in this region.


Assuntos
Aedes/virologia , Vírus da Dengue , Dengue/transmissão , Transmissão Vertical de Doenças Infecciosas , Aedes/crescimento & desenvolvimento , Animais , Larva/virologia , México , RNA Viral
9.
DST j. bras. doenças sex. transm ; 29(3): 79-84, 20171111.
Artigo em Português | LILACS | ID: biblio-879058

RESUMO

Na faixa etária de 0 a 5 anos, considera-se a transmissão vertical o indicador da infecção pelo vírus da imunodeficiência humana (HIV). A principal via de exposição pós-natal ocorre pelo aleitamento materno. Quando a infecção aguda materna se dá no período puerperal, há maior risco de infecção infantil, devido à elevada carga viral materna. Objetivo: Avaliar as formas de infecção pediátrica pelo HIV no serviço de Infectologia Pediátrica do Complexo do Hospital de Clínicas da Universidade Federal do Paraná (UFPR), com ênfase na transmissão vertical tardia via aleitamento materno. Métodos: Estudo transversal e analítico, com coleta de dados retrospectiva, avaliando pacientes de 0 a 16 anos infectados pelo vírus HIV, acompanhados de 2010 a 2015. Realizada análise da categoria de exposição por protocolo geral, seguida de protocolo específico para casos sugestivos de transmissão vertical tardia via aleitamento materno, objetivando compreender as características maternas e pediátricas. Resultados: Dos 122 pacientes incluídos, 95,0% foram infectados via transmissão vertical. Desses, 11 (9,5%) casos foram de infecção tardia ­ possível ou confirmada ­ via aleitamento materno. Ao diagnóstico da criança, 72,7% apresentaram sintomas decorrentes da infecção pelo HIV. Em 45,4% desses casos, mães e filhos foram diagnosticados concomitantemente e 72,7% das mães apresentaram categoria de exposição sexual. Conclusão: A transmissão vertical confirmou-se como a principal forma de contaminação pelo vírus HIV, com importante prevalência da infecção tardia pelo aleitamento materno. Essa observação, a gravidade dos sintomas pediátricos, o momento do diagnóstico e categoria de exposição maternos destacam a importância da busca de medidas profiláticas e avanços científicos que objetivem a redução da transmissão do HIV via leite materno


Vertical transmission is considered an indication of human immunodeficiency virus (HIV) infection in children aged below five years. The main postnatal category of exposure is through breastfeeding. When maternal infection occurs in early postnatal period, the risk of infant infection is even higher, due to a high maternal viral rate in this period. Objective: To evaluate HIV infection in infants assisted by the Pediatric Infectology Service of Hospital de Clínicas da Universidade Federal do Paraná, emphasizing the cases where vertical transmission occurred postnatally through breastfeeding. Methods: Transversal, analytical and descriptive study, with quantitative and qualitative approach, analyzing all HIV-infected patients aged 0 to 16 years, assisted between 2010 and 2015. The analysis of category of exposure was carried out by a general protocol, followed by a specific protocol for cases where transmission was suspected to have occurred due to late postnatal transmission through breastfeeding, aiming at understanding pediatric and maternal characteristics. Results: Records from 122 patients were analyzed, with 95.0% of mother-to-child-transmission cases. Between these cases, 11 (9.5%) were considered possible or confirmed late postnatal transmission through breastfeeding, having the presence of breastfeeding as a requirement. By the time of diagnosis, 72.7% presented symptoms of HIV infection. In 45.4% of these cases, mother and children were diagnosed at the same time, and 72.7% of mothers were infected sexually. Conclusion: Mother­to­childtransmission was the main responsible for infant infection and there was a significant prevalence of late postnatal transmission through breastfeeding in our sample. Moreover, the severity of infant symptoms, the moment of diagnosis and mother's category of exposure highlight a gap on HIV prevention, and the importance of finding prophylactic measures and scientific improvement in order to reduce HIV transmission through breastfeeding


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Aleitamento Materno , Infecções por HIV , Transmissão Vertical de Doenças Infecciosas , Gravidez , Estudos Transversais
10.
Artigo em Inglês | MEDLINE | ID: mdl-27338425

RESUMO

Our objective was to describe viral suppression and antiretroviral (ARV) resistance mutations in an ongoing cohort of perinatally-infected HIV+ (PHIV+) pregnant women. Descriptive analysis was performed using SPSS 18.0. From 2011 to 2014, we followed 22 PHIV+ pregnant women. Median age at prenatal entry was 19 years (Interquartile range (IQR) 17.6-21.0); 86% had an AIDS diagnosis; 81% had disclosed their HIV status to partner 11. The median age at HIV diagnosis was 8.3 y (IQR 4.0-13.6), the median age at sexual debut was 16 years (IQR 14-18). At the time of prenatal care initiation, four (18%) were on their first antiretroviral treatment (ART), eight (36%) in their second regimen and nine (41%) in their third regimen or beyond, and one had no data. Seventeen of 22 (77%) had HIV-viral load (VL) > 50 copies/mL at prenatal care entry, 16 had a genotyping exam performed. Seventeen of 22 PHIV+ had VL results near delivery: 7/17 (41%) had VL < 50 copies/mL. Among those who had genotyping at prenatal entry, 11/16 (69%) had mutations associated with ARV resistance. The most frequent major mutations were K103N, M184V, T215, M41L, D67N at reverse transcriptase gene and M46, I54V and V82A at protease gene. No vertical transmissions occurred. Management of pregnancy among PHIV+ is challenging. Individualized ART are needed to achieve viral suppression in a highly ART-exposed subpopulation.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Resistência à Doença/genética , Infecções por HIV/tratamento farmacológico , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Assistência Perinatal/métodos , Complicações Infecciosas na Gravidez/tratamento farmacológico , Carga Viral/efeitos dos fármacos , Adulto , Brasil , Estudos de Coortes , Feminino , Genótipo , Humanos , Recém-Nascido , Mutação , Gravidez , Complicações Infecciosas na Gravidez/virologia , Adulto Jovem
11.
J. pediatr. (Rio J.) ; J. pediatr. (Rio J.);91(6): 523-528, nov.-dez. 2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-769791

RESUMO

Resumo Objetivo Comparar a prevalência e os fatores associados à transmissão vertical de HIV-1 entre grávidas tratadas de 1998-2004 e de 2005-2011 em um serviço de referência de cuidado de pacientes com HIV no sul do Brasil. Métodos Estudo descritivo e analítico que usou as bases de dados de laboratórios da Rede Nacional de Laboratórios de CD4 e Carga Viral de DST/Aids do Ministério da Saúde. As grávidas com HIV-1 foram selecionadas em uma pesquisa ativa de informações clínicas e dados obstétricos e neonatais em seus prontuários médicos entre 1998-2011. Resultados Foram analisadas 102 grávidas entre 1998 e 2004 e 251 entre 2005-2011, no total 353 crianças nascidas de grávidas com HIV-1. Observou-se que a transmissão vertical foi de 11,8% entre 1998 e 2004 e de 3,2% entre 2005-2011 (p < 0,001). O maior uso de medicamentos antirretrovirais (p = 0,02), a redução na carga viral (p < 0,001) e o tempo de ruptura de membranas menor do que quatro horas (p < 0,001) foram associados à redução nos fatores de transmissão vertical quando os dois períodos são comparados. Conclusão Observou-se uma redução na taxa de transmissão vertical nos últimos anos. De acordo com as variáveis estudadas, sugere-se que os fatores de risco de transmissão vertical de HIV-1 foram ausência de terapia antirretroviral, alta carga viral das grávidas e tempo de ruptura maior do que quatro horas.


Abstract Objective To compare the prevalence and factors associated with vertical transmission of human immunodeficiency virus 1 (HIV-1) among pregnant women treated in the periods of 1998-2004 and 2005-2011 in a reference service for the care of HIV-infected patients in southern Brazil. Methods This was a descriptive and analytical study that used the databases of laboratories from the CD4 and STDs/AIDS Viral Load National Laboratory Network of the Brazilian Ministry of Health. HIV-1-infected pregnant women were selected after an active search for clinical information and obstetric and neonatal data from their medical records between the years of 1998 and 2011. Results 102 pregnant women were analyzed between 1998 and 2004 and 251 in the period between 2005 and 2011, totaling 353 children born to pregnant women with HIV-1. It was observed that the vertical transmission rate was 11.8% between 1998 and 2004 and 3.2% between 2005 and 2011 (p < 0.001). The increased use of antiretroviral drugs (p = 0.02), the decrease in viral load (p < 0.001), and time of membrane rupture lower than 4 h (p < 0.001) were associated with the decrease of vertical transmission factors when comparing the two periods. Conclusion It was observed a decrease in the rate of vertical transmission in recent years. According to the studied variables, is suggested that the risk factors for vertical transmission of HIV-1 were absence of antiretroviral therapy, high viral load in the pregnant women, and membrane rupture time >4 h.


Assuntos
Feminino , Humanos , Recém-Nascido , Gravidez , Infecções por HIV/transmissão , HIV-1 , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Cuidado Pré-Natal , Brasil/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Prevalência , Fatores de Risco , Carga Viral
12.
J Pediatr (Rio J) ; 91(6): 523-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26126701

RESUMO

OBJECTIVE: To compare the prevalence and factors associated with vertical transmission of human immunodeficiency virus 1 (HIV-1) among pregnant women treated in the periods of 1998-2004 and 2005-2011 in a reference service for the care of HIV-infected patients in southern Brazil. METHODS: This was a descriptive and analytical study that used the databases of laboratories from the CD4 and STDs/AIDS Viral Load National Laboratory Network of the Brazilian Ministry of Health. HIV-1-infected pregnant women were selected after an active search for clinical information and obstetric and neonatal data from their medical records between the years of 1998 and 2011. RESULTS: 102 pregnant women were analyzed between 1998 and 2004 and 251 in the period between 2005 and 2011, totaling 353 children born to pregnant women with HIV-1. It was observed that the vertical transmission rate was 11.8% between 1998 and 2004 and 3.2% between 2005 and 2011 (p<0.001). The increased use of antiretroviral drugs (p=0.02), the decrease in viral load (p<0.001), and time of membrane rupture lower than 4h (p<0.001) were associated with the decrease of vertical transmission factors when comparing the two periods. CONCLUSION: It was observed a decrease in the rate of vertical transmission in recent years. According to the studied variables, is suggested that the risk factors for vertical transmission of HIV-1 were absence of antiretroviral therapy, high viral load in the pregnant women, and membrane rupture time >4h.


Assuntos
Infecções por HIV/transmissão , HIV-1 , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Cuidado Pré-Natal , Brasil/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Gravidez , Prevalência , Fatores de Risco , Carga Viral
13.
Arq. bras. med. vet. zootec ; Arq. bras. med. vet. zootec. (Online);60(5): 1110-1117, out. 2008. tab
Artigo em Português | LILACS | ID: lil-500077

RESUMO

Avaliou-se a infecção experimental por Salmonella Enteritidis fagotipo 4 (SEpt4) em embriões de frango de corte para averiguar a habilidade de penetração através da casca e o efeito da inoculação no albúmen, considerando-se a mortalidade, a eclodibilidade e a colonização intestinal dos pintos eclodidos. Foram realizados dois experimentos, distribuídos em quatro tratamentos (T) cada, com 200 e 194 ovos incubáveis das linhagens Ross e ISA Label, respectivamente. Utilizaram-se ovos não sanitizados e inoculados na casca com Salmonella Enteritidis (T1) ou com placebo (T2); ou inoculados no albúmen com Salmonella Enteritidis (T3) ou com placebo (T4). Imediatamente após a inoculação, os ovos foram incubados, e a mortalidade embrionária avaliada após 96, 432 e 528 horas. Salmonella Enteritidis inoculada na casca manteve-se viável na casca e nas membranas durante todo o período de incubação e migrou para o interior dos ovos, entretanto não afetou os parâmetros de incubação. O patógeno inoculado no albúmen determinou mortalidade embrionária tardia nas linhagens Ross, 17,0 por cento, e ISA Label, 13,0 por cento, e originou pintos com maior freqüência de colonização intestinal por Salmonella Enteritidis, 76,7 por cento e 26,7 por cento para Ross e ISA Label, respectivamente.


The experimental infection of Salmonella Enteritidis phagotype 4 (SEpt4) was evaluated in broilers embryos to verify the ability of penetration through eggshell and the effect of albumen inoculation considering embryo mortality, hatchability, and intestinal colonization of hatched chicks. Two trials were conducted using in four treatments each, totaling 200 and 194 fertile eggs of Ross and ISA Label lineages, respectively. Non-sanitized eggs were inoculated on the shell with Salmonella Enteritidis (Treatment 1) or placebo (Treatment 2); and eggs were inoculated in albumen with Salmonella Enteritidis (Treatment 3) or placebo (Treatment 4). Immediately after inoculation, the eggs were incubated and embryo mortality was evaluated after 96, 432, and 528 hours. The results showed that Salmonella Enteritidis inoculated on egg shell remained active there and in shell membranes during all incubation period and migrated to the interior of the eggs; however, it did not affect the incubation parameters. It was observed that Salmonella Enteritidis inoculated in albumen caused late embryo mortality in Ross (17.0 percent) and ISA Label (13.0 percent) lineages, and originated chicks with high frequency of intestinal colonization by Salmonella Enteritidis, being 76.7 percent and 26.7 percent for Ross and ISA Label, respectively.


Assuntos
Animais , Embrião de Mamíferos , Infecções por Salmonella/induzido quimicamente , Aves Domésticas , Salmonella enterica/isolamento & purificação
14.
Arq. bras. med. vet. zootec ; 60(5): 1110-1117, out. 2008. tab
Artigo em Português | VETINDEX | ID: vti-6579

RESUMO

Avaliou-se a infecção experimental por Salmonella Enteritidis fagotipo 4 (SEpt4) em embriões de frango de corte para averiguar a habilidade de penetração através da casca e o efeito da inoculação no albúmen, considerando-se a mortalidade, a eclodibilidade e a colonização intestinal dos pintos eclodidos. Foram realizados dois experimentos, distribuídos em quatro tratamentos (T) cada, com 200 e 194 ovos incubáveis das linhagens Ross e ISA Label, respectivamente. Utilizaram-se ovos não sanitizados e inoculados na casca com Salmonella Enteritidis (T1) ou com placebo (T2); ou inoculados no albúmen com Salmonella Enteritidis (T3) ou com placebo (T4). Imediatamente após a inoculação, os ovos foram incubados, e a mortalidade embrionária avaliada após 96, 432 e 528 horas. Salmonella Enteritidis inoculada na casca manteve-se viável na casca e nas membranas durante todo o período de incubação e migrou para o interior dos ovos, entretanto não afetou os parâmetros de incubação. O patógeno inoculado no albúmen determinou mortalidade embrionária tardia nas linhagens Ross, 17,0 por cento, e ISA Label, 13,0 por cento, e originou pintos com maior freqüência de colonização intestinal por Salmonella Enteritidis, 76,7 por cento e 26,7 por cento para Ross e ISA Label, respectivamente.(AU)


The experimental infection of Salmonella Enteritidis phagotype 4 (SEpt4) was evaluated in broilers embryos to verify the ability of penetration through eggshell and the effect of albumen inoculation considering embryo mortality, hatchability, and intestinal colonization of hatched chicks. Two trials were conducted using in four treatments each, totaling 200 and 194 fertile eggs of Ross and ISA Label lineages, respectively. Non-sanitized eggs were inoculated on the shell with Salmonella Enteritidis (Treatment 1) or placebo (Treatment 2); and eggs were inoculated in albumen with Salmonella Enteritidis (Treatment 3) or placebo (Treatment 4). Immediately after inoculation, the eggs were incubated and embryo mortality was evaluated after 96, 432, and 528 hours. The results showed that Salmonella Enteritidis inoculated on egg shell remained active there and in shell membranes during all incubation period and migrated to the interior of the eggs; however, it did not affect the incubation parameters. It was observed that Salmonella Enteritidis inoculated in albumen caused late embryo mortality in Ross (17.0 percent) and ISA Label (13.0 percent) lineages, and originated chicks with high frequency of intestinal colonization by Salmonella Enteritidis, being 76.7 percent and 26.7 percent for Ross and ISA Label, respectively.(AU)


Assuntos
Animais , Salmonella enterica/isolamento & purificação , Embrião de Mamíferos , Infecções por Salmonella/induzido quimicamente , Aves Domésticas
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