RESUMO
Here we determined the relative expression of HERV-K and W proviruses in HIV infected and non-infected mothers as well as their respective babies up to 1 year-old. HIV-infected mothers, their babies and uninfected control groups presented expression of both HERV-K and HERV-W with relatively high frequency. While the level of HERV-K expression was similar among groups, the level of HERV-W expression in HIV-infected mothers was four-fold higher than the uninfected mothers from the control group (p < 0.01). HERV-W was down regulated in HIV-exposed babies in comparison to non-exposed babies. To our knowledge, this is the first report of HERV transcriptional activity in babies from 0-1 year-old.
Assuntos
Retrovirus Endógenos/isolamento & purificação , Infecções por HIV/transmissão , Infecções por HIV/virologia , HIV-1/isolamento & purificação , Doenças do Recém-Nascido/virologia , Adulto , Retrovirus Endógenos/classificação , Retrovirus Endógenos/genética , Feminino , HIV-1/classificação , HIV-1/genética , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Masculino , Transcrição GênicaRESUMO
The objective of this work was to report the tomographic findings in five cases of intrathoracic textilomas. The CT scans of five patients presenting with textilomas after being submitted to thoracotomy for myocardial revascularisation were reviewed retrospectively. Two chest radiologists studied the scans independently, and decisions concerning the CT findings were made by consensus. In each of the five cases, the imaging findings were similar and showed lesions resembling an extrapulmonary mass and well-defined contours situated at the marginal posterior pleural surface. In four of the five cases, a low-density centre and peripheral rim-like enhancement were observed after administration of contrast media. The suspicion of textiloma should be raised when a patient with a history of previous myocardial revascularisation surgery presents with an extrapulmonary mass in close contact with the posterior pleural surface.
Assuntos
Corpos Estranhos/diagnóstico por imagem , Granuloma de Corpo Estranho/diagnóstico por imagem , Revascularização Miocárdica , Cavidade Pleural/diagnóstico por imagem , Biópsia por Agulha Fina , Meios de Contraste , Tosse/etiologia , Diagnóstico Diferencial , Feminino , Corpos Estranhos/patologia , Granuloma de Corpo Estranho/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Pleural/patologia , Estudos Retrospectivos , Tampões de Gaze Cirúrgicos , Toracotomia , Tomografia Computadorizada por Raios XRESUMO
The immune consequences of in utero HIV exposure to uninfected children whose mothers were submitted to highly active antiretroviral therapy (HAART) during gestation are not well defined. We evaluated 45 HIV-exposed uninfected (ENI) neonates and 45 healthy unexposed control (CT) neonates. All HIV-infected mothers received HAART during pregnancy, and the viral load at delivery was <50 copies/mL for 56.8%. Twenty-three ENI neonates were further evaluated after 12 months and compared to 23 unexposed healthy age-matched infants. Immunophenotyping was performed by flow cytometry in cord and peripheral blood. Cord blood lymphocyte numbers did not differ between groups. However, ENI neonates had a lower percentage of naive T cells than CT neonates (CD4+, 76.6 vs 83.1%, P < 0.001; CD8+, 70.9 vs 79.6%, P = 0.003) and higher percentages of central memory T cells than CT neonates (CD4+, 13.9 vs 8.7%, P < 0.001; CD8+, 8.6 vs 4.8%, P = 0.001). CD38 mean fluorescence intensity of T cells was higher in ENI neonates (CD4+, 62.2 vs 52.1, P = 0.007; CD8+, 47.7 vs 35.3, P < 0.001). At 12 months, ENI infants still had higher mean fluorescence intensity of CD38 on T cells (CD4+, 34.2 vs 23.3, P < 0.001; CD8+, 26.8 vs 19.4, P = 0.035). Despite effective maternal virologic control at delivery, HIV-exposed uninfected children were born with lower levels of naive T cells. Immune activation was present at birth and remained until at least 12 months of age, suggesting that in utero exposure to HIV causes subtle immune abnormalities.
Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , HIV-1/imunologia , Memória Imunológica/imunologia , Linfócitos T/imunologia , Adolescente , Adulto , Contagem de Células Sanguíneas , Estudos de Casos e Controles , Feminino , Sangue Fetal , Citometria de Fluxo , Infecções por HIV/prevenção & controle , Humanos , Memória Imunológica/efeitos dos fármacos , Imunofenotipagem , Lactente , Ativação Linfocitária/imunologia , Masculino , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal/imunologia , Carga Viral , Adulto JovemRESUMO
The immune consequences of in utero HIV exposure to uninfected children whose mothers were submitted to highly active antiretroviral therapy (HAART) during gestation are not well defined. We evaluated 45 HIV-exposed uninfected (ENI) neonates and 45 healthy unexposed control (CT) neonates. All HIV-infected mothers received HAART during pregnancy, and the viral load at delivery was <50 copies/mL for 56.8 percent. Twenty-three ENI neonates were further evaluated after 12 months and compared to 23 unexposed healthy age-matched infants. Immunophenotyping was performed by flow cytometry in cord and peripheral blood. Cord blood lymphocyte numbers did not differ between groups. However, ENI neonates had a lower percentage of naive T cells than CT neonates (CD4+, 76.6 vs 83.1 percent, P < 0.001; CD8+, 70.9 vs 79.6 percent, P = 0.003) and higher percentages of central memory T cells than CT neonates (CD4+, 13.9 vs 8.7 percent, P < 0.001; CD8+, 8.6 vs 4.8 percent, P = 0.001). CD38 mean fluorescence intensity of T cells was higher in ENI neonates (CD4+, 62.2 vs 52.1, P = 0.007; CD8+, 47.7 vs 35.3, P < 0.001). At 12 months, ENI infants still had higher mean fluorescence intensity of CD38 on T cells (CD4+, 34.2 vs 23.3, P < 0.001; CD8+, 26.8 vs 19.4, P = 0.035). Despite effective maternal virologic control at delivery, HIV-exposed uninfected children were born with lower levels of naive T cells. Immune activation was present at birth and remained until at least 12 months of age, suggesting that in utero exposure to HIV causes subtle immune abnormalities.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Lactente , Masculino , Gravidez , Adulto Jovem , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , HIV-1 , Memória Imunológica/imunologia , Linfócitos T/imunologia , Contagem de Células Sanguíneas , Estudos de Casos e Controles , Sangue Fetal , Citometria de Fluxo , Infecções por HIV/prevenção & controle , Imunofenotipagem , Memória Imunológica/efeitos dos fármacos , Ativação Linfocitária/imunologia , Complicações Infecciosas na Gravidez/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal/imunologia , Carga Viral , Adulto JovemRESUMO
The immunogenicity and tolerability of hepatitis A virus vaccine was evaluated in a group of 32 children with human immunodeficiency virus (HIV) infection and 27 children with seroreversion. After 2 doses of vaccine, 100% of children experienced seroconversion with good toleration of the vaccine. There were no differences in variation of virus load between immunized HIV-positive children and a group of 31 nonimmunized HIV-positive children with similar characteristics.
Assuntos
Infecções por HIV/imunologia , Anticorpos Anti-Hepatite A/biossíntese , Vacinas contra Hepatite A/imunologia , Tolerância Imunológica , Terapia Antirretroviral de Alta Atividade , Criança , Infecções por HIV/tratamento farmacológico , Anticorpos Anti-Hepatite A/sangue , Vacinas contra Hepatite A/administração & dosagem , HumanosRESUMO
Human herpesvirus-8 (HHV-8) appears to be transmitted mainly by sexual contact. However, several studies suggest that in developing countries the infection may be acquired early in life by routes other than sexual transmission. The present study estimated the seroprevalence of HHV-8 in Brazilian children born to HIV-1-infected mothers. The serum samples were collected in a cross-sectional cohort study from 99 children born to HIV-infected mothers (median age 3.27 years; range 1.5-13.8 years) attending the outpatient clinic of the Federal University of Sao Paulo. IgG antibodies to HHV-8 latency-associated nuclear antigen and lytic phase antigens were detected by immunofluorescence assays. The samples tested were collected from children aged 12 months or older to exclude the possibility of cross-placental antibody transport. The total prevalence of anti-lytic antibodies in this population (5/99; 5%) reveals that HHV-8 infection can occur during childhood. Children aged 1.5 to 2 years had a seroprevalence of 2% (1/50) and children aged 3.25 to 13.8 years had a seroprevalence of 8% (4/49). This difference was not statistically significant, probably because of the small size of the sample, but it suggests that HHV-8 infection occurs more commonly late in infancy. Further prospective studies are necessary to evaluate the timing and risk factors for primary HHV-8 infection in the pediatric population.
Assuntos
Infecções por HIV/complicações , HIV-1/imunologia , Infecções por Herpesviridae/epidemiologia , Herpesvirus Humano 8/imunologia , Complicações Infecciosas na Gravidez/virologia , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Métodos Epidemiológicos , Feminino , Técnica Direta de Fluorescência para Anticorpo , Anticorpos Anti-HIV/sangue , Infecções por Herpesviridae/diagnóstico , Infecções por Herpesviridae/transmissão , Infecções por Herpesviridae/virologia , Humanos , Imunoglobulina G/sangue , Lactente , Transmissão Vertical de Doenças Infecciosas , Masculino , GravidezRESUMO
Human herpesvirus-8 (HHV-8) appears to be transmitted mainly by sexual contact. However, several studies suggest that in developing countries the infection may be acquired early in life by routes other than sexual transmission. The present study estimated the seroprevalence of HHV-8 in Brazilian children born to HIV-1-infected mothers. The serum samples were collected in a cross-sectional cohort study from 99 children born to HIV-infected mothers (median age 3.27 years; range 1.5-13.8 years) attending the outpatient clinic of the Federal University of São Paulo. IgG antibodies to HHV-8 latency-associated nuclear antigen and lytic phase antigens were detected by immunofluorescence assays. The samples tested were collected from children aged 12 months or older to exclude the possibility of cross-placental antibody transport. The total prevalence of anti-lytic antibodies in this population (5/99; 5 percent) reveals that HHV-8 infection can occur during childhood. Children aged 1.5 to 2 years had a seroprevalence of 2 percent (1/50) and children aged 3.25 to 13.8 years had a seroprevalence of 8 percent (4/49). This difference was not statistically significant, probably because of the small size of the sample, but it suggests that HHV-8 infection occurs more commonly late in infancy. Further prospective studies are necessary to evaluate the timing and risk factors for primary HHV-8 infection in the pediatric population.
Assuntos
Humanos , Masculino , Feminino , Gravidez , Lactente , Pré-Escolar , Criança , Adolescente , Infecções por HIV/complicações , HIV-1 , Infecções por Herpesviridae/epidemiologia , /imunologia , Complicações Infecciosas na Gravidez/virologia , Brasil/epidemiologia , Estudos de Coortes , Estudos Transversais , Técnica Direta de Fluorescência para Anticorpo , Anticorpos Anti-HIV/sangue , Infecções por Herpesviridae/diagnóstico , Infecções por Herpesviridae/transmissão , Infecções por Herpesviridae/virologia , Transmissão Vertical de Doenças Infecciosas , Imunoglobulina G/sangue , Sensibilidade e Especificidade , Estudos SoroepidemiológicosRESUMO
OBJECTIVE: To review recent knowledge about Acquired Immunodeficiency Syndrome in children to help pediatricians provide care for these patients.METHOD: We reviewed the most recent papers about pathogenesis, prognostic markers and treatment of the HIV- infected child.RESULTS: We present the main HIV features that may interfere in the pathogenesis of this syndrome and that should be taken into consideration when the antiretroviral therapy starts.CONCLUSIONS: Viral replication in children is very intense, and the persistence of high levels of viral load may be a sign of immunological immaturity. Viral load measurement and CD4+ lymphocytes count are important markers of the disease progression. At least two drugs should be administered as antiretroviral therapy, which should aim at reducing the viral load to undetectable levels. This will slow down the progression of the disease and the emergence of resistant viral strains.