RESUMO
Epidemiological studies conducted in endemic areas of human herpesvirus 8 (HHV-8) infection have shown iatrogenic Kaposi's sarcoma in renal transplant recipients. Hemodialysis has not yet been demonstrated to be a route of virus transmission/acquisition, although recently blood transfusion has been suggested as a vehicle of HHV-8 transmission. The present study searching HHV-8 antibodies among serum samples from 70 hemodialysis patients disclosed a high prevalence of infection (22.9%). There was an association between HHV-8 seroreactivity and previous transfusions and transplantation, as well as with a black/pardum ethnic background of patients. These results emphasized that chronic renal patients are at risk of developing HHV-8-related diseases.
Assuntos
Infecções por Herpesviridae/complicações , Herpesvirus Humano 8 , Diálise Renal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Feminino , Infecções por Herpesviridae/epidemiologia , Infecções por Herpesviridae/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Reação Transfusional , Latência ViralRESUMO
Desde a descoberta do herpes vírus humano tipo 8 (HHV-8) como o agente etiológico do sarcoma de Kaposi (SK) nas suas diferentes formas clínico-epidemiológicas, vários estudos vêm sendo conduzidos com o intuito de determinar as vias de transmissão desse vírus em populações endêmicas e de risco epidemiológico. Em regiões endêmicas, a transmissão viral foi relacionada à transmissão horizontal de mães para filhos e entre irmãos e a sexual principalmente, nos casos de SK/aids. Com o objetivo de determinar segmentos do genoma viral em fluídos biológicos e consequentemente seu potencial infectante foi conduzido o presente trabalho. Foram avaliados quanto à presença de segmentos localizados em posições estratégicas do genoma do HHV-8 em sangue, saliva e urina de 76 pacientes com SK/aids, 19 pacientes com HIV/aids, 4 casos de SK clássico e 11 indivíduos sadios (HIV-soronegativos, sem SK). Foram utilizadas as técnicas de PCR "nested" para as ORF K1, ORF 25, ORF 26, ORF K8.1 e ORF 73 em DNA extraído de material de biópsia de lesão de SK (controle positivo), células do sangue periférico, saliva e urina. Os resultados de PCR positivo para o HHV-8 foram analisados quanto a variáveis epidemiológicas, clínicas e laboratoriais. Foram consideradas como variáveis: sexo, cor, origem étnica, tempo de infecção por HIV e de acompanhamento do SK, terapia ARV e para SK, contagem de células CD4+ e sorol
RESUMO
Human herpesvirus 8 (HHV-8) seroprevalences were determined in two isolated Amazon Amerindian tribes, according to age, gender and familial aggregation. Plasma and serum samples obtained from 982 Amazon Amerindians (664 Tiriyó and 318 Waiampi) were tested for antibodies against lytic and latent HHV-8 antigens by using 'in-house' immunofluorescence assays. Overall, HHV-8 seroprevalence was 56.8 % (57.4 % in the Tiriyó tribe and 55.7 % in the Waiampi tribe). Seroprevalence was independent of gender and increased linearly with age: it was 35.0 % among children aged 2-9 years, 51.4 % in adolescents (10-19 years), 72.9 % in adults and 82.3 % in adults aged >50 years. Interestingly, 44.4 % of children under 2 years of age were HHV-8-seropositive. No significant differences in seroprevalence between tribes and age groups were detected. It is concluded that HHV-8 is hyperendemic in Brazilian Amazon Amerindians, with vertical and horizontal transmission during childhood, familial transmission and sexual contact in adulthood contributing to this high prevalence in these isolated populations.
Assuntos
Anticorpos Antivirais/sangue , Doenças Endêmicas , Infecções por Herpesviridae/etnologia , Infecções por Herpesviridae/epidemiologia , Herpesvirus Humano 8/imunologia , Indígenas Sul-Americanos , Adolescente , Adulto , Distribuição por Idade , Antígenos Virais/imunologia , Brasil/epidemiologia , Criança , Pré-Escolar , Etnicidade , Feminino , Infecções por Herpesviridae/virologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Distribuição por SexoRESUMO
Desde a descoberta do herpes vírus humano tipo 8 (HHV-8) como o agente etiológico do sarcoma de Kaposi (SK) nas suas diferentes formas clínico-epidemiológicas, vários estudos vêm sendo conduzidos com o intuito de determinar as vias de transmissão desse vírus em populações endêmicas e de risco epidemiológico. Em regiões endêmicas, a transmissão viral foi relacionada à transmissão horizontal de mães para filhos e entre irmãos e a sexual principalmente, nos casos de SK/aids. Com o objetivo de determinar segmentos do genoma viral em fluídos biológicos e consequentemente seu potencial infectante foi conduzido o presente trabalho. Foram avaliados quanto à presença de segmentos localizados em posições estratégicas do genoma do HHV-8 em sangue, saliva e urina de 76 pacientes com SK/aids, 19 pacientes com HIV/aids, 4 casos de SK clássico e 11 indivíduos sadios (HIV-soronegativos, sem SK). Foram utilizadas as técnicas de PCR "nested" para as ORF K1, ORF 25, ORF 26, ORF K8.1 e ORF 73 em DNA extraído de material de biópsia de lesão de SK (controle positivo), células do sangue periférico, saliva e urina. Os resultados de PCR positivo para o HHV-8 foram analisados quanto a variáveis epidemiológicas, clínicas e laboratoriais. Foram consideradas como variáveis: sexo, cor, origem étnica, tempo de infecção por HIV e de acompanhamento do SK, terapia ARV e para SK, contagem de células CD4+ e sorol
RESUMO
A malakoplakia-like lesion was detected in a pleural biopsy from an AIDS patient presenting clinical and radiologic features of pneumonia. Cultures of bronchoalveolar lavage and pleural fluid evidenced Rhodococcus equi as the causative agent of pleuro-pulmonary infection. Immunochemical characterization of the R. equi isolate showed the presence of a strain similar to the ATCC 33704 reference strain presenting the capsular antigen of serotype 4, and the intermediate virulence-associated antigen of 20-kDa. Histopathology of the patient's pleural biopsy showed plaques of macrophages interspersed with lymphocytes, and intracytoplasmic cocci and bacilli in macrophages, which were variably acid-fast positive. Immunohistochemistry of cocci, bacilli and their degradation products resulted strongly positive when stained with a mouse monoclonal antibody (MAb) produced against the 20-kDa antigen. This finding could have important implications for the pathogenicity of R. equi for human beings, since we do not know yet all the factors involved in the formation of malakoplakia. Indeed, the results obtained in the present study, taken together with the results obtained for pigs inoculated with R. equi strains of intermediate virulence (Madarame et al. 1998), raise the possibility that most strains presenting the 20-kDa antigen may be capable of inducing malakoplakia. If this hypothesis is confirmed by immunohistochemical analysis of human pulmonary malakoplakia cases due to R. equi, the detection of this antigen may be extremely helpful in the diagnosis and treatment of such patients. This is the first report of R. equi infection in human beings that suggests a relationship between pleural malakoplakia and the virulence-associated antigen of 20-kDa.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Infecções por Actinomycetales/microbiologia , Antígenos de Bactérias/análise , Malacoplasia/microbiologia , Doenças Pleurais/microbiologia , Rhodococcus equi/imunologia , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/patologia , Infecções por Actinomycetales/imunologia , Infecções por Actinomycetales/patologia , Adulto , Animais , Anticorpos Monoclonais , Humanos , Técnicas Imunoenzimáticas , Macrófagos Alveolares/microbiologia , Macrófagos Alveolares/patologia , Malacoplasia/imunologia , Malacoplasia/patologia , Masculino , Camundongos , Peso Molecular , Doenças Pleurais/imunologia , Doenças Pleurais/patologia , Rhodococcus equi/patogenicidade , Abuso de Substâncias por Via Intravenosa , Virulência/imunologiaRESUMO
A serological survey for HTLV infection identified an AIDS patient with HTLV-I/HTLV-II dual seroreactivity. Two further sequential blood samples were collected (samples A and B) for PCR, restriction fragment length polymorphism (RFLP), and sequence analyses of HTLV-I and HTLV-II strains. PCR analyses confirmed dual infection in both samples. Restriction digests of the env region amplified from sample A showed the presence of an HTLV-IIa subtype; the HTLV-II provirus was found to be defective in the pol and env regions in the second sample from this patient. RFLP analysis of the HTLV-II LTR region of both samples confirmed this finding and identified an a5/bzl restriction type. Nucleotide sequence analyses revealed full homology in the HTLV-I env and LTR regions and in the HTLV-II LTR region between the two samples. These findings document the first case of an HTLV-I/HTLV-II coinfection that was fully confirmed and characterized by means of molecular analyses.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Infecções por HTLV-I/complicações , Infecções por HTLV-II/complicações , Adulto , Brasil , Infecções por HTLV-I/virologia , Infecções por HTLV-II/virologia , Vírus Linfotrópico T Tipo 1 Humano/genética , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Vírus Linfotrópico T Tipo 2 Humano/genética , Vírus Linfotrópico T Tipo 2 Humano/isolamento & purificação , Humanos , Masculino , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Análise de Sequência de DNARESUMO
Diversity of virulence-associated antigens of Rhodococcus equi was detected among thirteen strains isolated from AIDS patients on two continents. One out of four Brazilian isolates presented the virulence-associated antigen of 15- to 17-kDa, and the other three isolates had the 20-kDa virulence-associated antigen. In contrast, only three out of nine Italian isolates were positive for virulence-associated antigens - two for the 15- to 17-kDa antigen and one for the 20-kDa antigen. In four other Italian strains, one or more other low-molecular-weight antigens were identified. Because of R. equi variability and host immune dysfunction, no characteristic antibody profile was detected among patients, although the presence of specific antibodies in serum samples suggested prognostic value: good patient outcome and recovery from pneumonia were correlated with R. equi antibody detection, whereas the lack or disappearance of specific antibodies, mainly those to low-molecular-weight antigens, was correlated with disease progression and patient death. These results confirmed the nonobligatory presence of the well-known virulence-associated antigens for the pathogenicity of R. equi in humans, and also the diversity of R. equi strains isolated from AIDS patients, which may be related to the geographic origin of the isolates or may be a consequence of the route of R. equi transmission in different countries. Some mechanisms underlying the results obtained are discussed, suggesting immune complex formation during the progress of the disease.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções por Actinomycetales/diagnóstico , Infecções por Actinomycetales/imunologia , Anticorpos Antibacterianos/sangue , Rhodococcus equi/imunologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Infecções por Actinomycetales/microbiologia , Infecções por Actinomycetales/veterinária , Animais , Antígenos de Bactérias/imunologia , Eletroforese em Gel de Poliacrilamida , Doenças dos Cavalos/imunologia , Doenças dos Cavalos/microbiologia , Cavalos , Humanos , Immunoblotting , Rhodococcus equi/classificação , Rhodococcus equi/genética , Rhodococcus equi/patogenicidade , VirulênciaRESUMO
One hundred and seven plasma specimens obtained from children born to HIV-1 infected mothers were tested for the presence of antibody to human T-cell lymphotropic virus types I and II (HTLV-I and -II) to determine perinatal transmission of these agents. None of the children in this study were breastfed. Fifty-five specimens were from HIV-1 infected children, 28 from HIV-1 non-infected children, and in 24 cases the HIV-1 status could not be defined. In these series, when ELISA screening tests were employed, HTLV antibodies were detected in 54.5, 17.9, and 37.5 per cent of cases, respectively, given an overall ratio of 41.1 per cent. Western blot analysis disclosed 17 specimens with some HTLV reactivity: three were classified as HTLV-I/II, two confirmed as having a HTLV-I Western blot profile, and the last 12 samples showed reactivity to only one of the protein (gag or env) components. In 11 out of 17 cases molecular approaches were used to confirm HTLV infection in children; no case of HTLV-I or -II was detected. In contrast, when 13 specimens of mother-child pairs were analysed, three mothers' plasma samples which were seropositive were confirmed to have HTLV infection by PCR analysis; one case of HTLV-I and two cases of HTLV-II infections were detected. Taking into account the age of the children and their Western blot profiles, passive maternal antibodies could be detected until the age of 15 months. Indeed, after the age of 18 months seroreactivity amongst the children, with ELISA and Western blot assays, suggests the presence of maternal antibodies that resist degradation and/or antibodies that cross-react with rgp21 or p19 antigens from HTLV, or alternatively, with components of the HIV-1. These results emphasize the lack of HTLV-I and -II vertical transmission in children at high risk who are not breastfed.
Assuntos
Infecções por HIV/complicações , HIV-1 , Infecções por HTLV-I/transmissão , Infecções por HTLV-II/transmissão , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/virologia , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/virologia , Infecções por HTLV-II/epidemiologia , Infecções por HTLV-II/virologia , Humanos , Lactente , Recém-Nascido , Masculino , GravidezRESUMO
Rhodococcus equi (formerly Corynebacterium equi) are known to be highly virulent, intermediate in virulence, or avirulent correlated with specific virulence-associated antigens identified immunochemically by different molecular weights. The association of virulence antigens with infection of AIDS patients by this organism has not been sufficiently evaluated in Brazil or Italy. The objective of the present study was to search for virulence-associated antigens of 15-to 17-kD and 20-kD in Rhodococcus equi strains isolated from patients with rhodococcal infection and AIDS. Four Brazilian and 9 Italian strains were studied. All isolates were analyzed by gel electrophoresis followed by immunoblotting using specific monoclonal antibodies to identify virulence-associated antigens. The results obtained on gel electrophoresis analyses showed complexing of R. equi components with proteins of molecular weights ranging from 10-to 150-kD. By immunoblotting, a wide diversity in R. equi virulence-associated antigens was detected: 1 of the 4 Brazilian isolates and 2 Italian isolates had the 15-to 17-kD virulence-associated antigen, 3 Brazilian isolates and 1 Italian isolate had the 20-kD virulence-associated antigen, and the other Italian isolates had no virulence-associated antigens. These results indicate that the pathogenicity of R. equi strains for humans does not depend only on the presence of these well established virulence-associated antigens.