Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
HIV Seropositivity: HELP
Articles from Miscellaneous cities in Brazil
Based on 37 articles published since 2008

These are the 37 published articles about HIV Seropositivity that originated from Miscellaneous cities in Brazil during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2
1 Review HIV, reproductive aging, and health implications in women: a literature review. 2009

Conde, Délio Marques / Silva, Emanuela T / Amaral, Waldemar N / Finotti, Marta F / Ferreira, Rui G / Costa-Paiva, Lúcia / Pinto-Neto, Aarão M. ·Department of Gynecology and Obstetrics, Universidade Federal de Goiás, Goiânia, Brazil. condedelio@uol.com.br ·Menopause · Pubmed #18800017.

ABSTRACT: Infection by the human immunodeficiency virus (HIV) is increasing among women. After the advent of highly active antiretroviral therapy (HAART), a decrease occurred in the mortality rate, which now seems to have stabilized. One of the consequences of this current situation is that more and more HIV-infected women are now reaching menopause. Therefore, factors often investigated in seronegative women need to be evaluated in middle-aged, HIV-positive women. In midlife, HIV-positive women will experience the onset of menopause, while concomitantly they may also be affected by metabolic complications related to the HIV infection and to HAART. This literature review was therefore carried out to identify studies dealing with conditions related to middle-aged women with HIV with the aim of providing data on age at menopause, menopausal symptoms, reproductive hormones, cognitive function, bone mineral density, cardiovascular disease, and lipid and glucose metabolism in middle-aged women with HIV and discussing these issues. Some of these factors may be aggravated by the HIV infection and by HAART. The prevention and treatment of these conditions in middle-aged, HIV-positive women are discussed in the light of current knowledge.

2 Article From Pill to Condom, or Nothing at all: HIV Diagnosis and Discontinuation of Highly Effective Contraceptives Among Women in Northeast Brazil. 2018

Stifani, Bianca M / MacCarthy, Sarah / Nunn, Amy / Benfield, Nerys / Dourado, Inês. ·Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY, 10461, USA. Bianca.stifani@gmail.com. · RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA. · School of Public Health of Brown University, 121 South Main Street, Suite 810, Providence, RI, 02912, USA. · Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY, 10461, USA. · Institute of Collective Health, Federal University of Bahia (UFBA), Rua Basílio da Gama, s/n - Campus Universitário Canela, Salvador, Bahia, 40110-040, Brazil. ·AIDS Behav · Pubmed #28688030.

ABSTRACT: This is a cross-sectional study examining highly effective contraceptive (HEC) use among HIV-positive women in Salvador, Brazil. We used multivariate logistic regression to look for predictors of alternative contraceptive choices among women who discontinued HEC after HIV diagnosis. Of 914 participants surveyed, 38.5% of participants used HEC before but not after diagnosis. Of these, 65.9% used condoms alone; 19.3% used no protection; and 14.8% reported abstinence. Use of condoms alone was associated with a history of other sexually transmitted infections (AOR 2.18, 95% CI 1.09-4.66, p = 0.029). Abstinence was associated with recent diagnosis (AOR 8.48, 95% CI 2.20-32.64, p = 0.002). Using no method was associated with age below 25 (AOR 5.13, 95% CI 1.46-18.00, p = 0.011); income below minimum wage (AOR 2.54, 95% CI 1.31-4.92, p = 0.006); HIV-positive partner status (AOR 2.69, 95% CI 1.03-7.02, p = 0.043); and unknown partner status (AOR 2.90, 95% CI 1.04-8.05, p = 0.042). Improved contraceptive counseling is needed after HIV diagnosis. Continuation of HEC should be encouraged for women wishing to prevent pregnancy, and may increase contraceptive coverage among HIV-positive women.

3 Article Lymphocyte CD4+ cell count, strength improvements, heart rate and body composition of HIV-positive patients during a 3-month strength training program. 2017

Bessa, Artur / Lopez, Jorge C / DI Masi, Fabrízio / Ferry, Fernando / Costa E Silva, Gabriel / Martins Dantas, Estélio H. ·Faculty of Physical Education, Federal University of Mato Grosso (UFMT), Cuiabá, Brazil. · University of Playa Ancha, Valparaíso, Chile. · Rural Federal University of Rio de Janeiro (UFRRJ), Rio de Janeiro, Brazil. · Federal University of Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil. · Rural Federal University of Rio de Janeiro (UFRRJ), Rio de Janeiro, Brazil - gabriel_bill04@hotmail.com. · Faculty of Medicine, Federal University of ABC, Santo André, Brazil. · Universidade Tiradentes (LABMH/UNIT), Aracaju, Brazil. ·J Sports Med Phys Fitness · Pubmed #27433932.

ABSTRACT: BACKGROUND: There is a lack of information regarding the positive effects of different types of physical training on HIV-positive patient immune function, body composition and physical fitness. The goal of this study was two-fold: 1) to determine the effects of a three-month progressive strength training program on lymphocyte CD4+ cell counts in HIV-positive patients; and 2) to measure strength improvements, body composition and cardiovascular alterations in HIV-positive patients after a strength training program. METHODS: Sixteen HIV-positive male subjects participated in a strength-training program. CD4+ cell count, heart rate body composition and strength measurements were acquired at rest two days before and two days after the program. RESULTS: The average CD4+ cell count was increased (%=23%, P=0.0005), and all strength tests also showed improvement (%=95%, P=0,0001). Patient resting heart rate decreased (%=9%, P=0.0042), as did the skinfold sum (%=16%, P=0.002). Limb circumference sum and body weight did not change. CONCLUSIONS: Considering that a decrease in CD4+ cell count, muscle mass and overall physical fitness are expected results of HIV infection, the strength training protocol described here is an effective and safe way to improve immune function, body composition and cardiovascular fitness in HIV-positive patients. The results provided an important evidence for the effectiveness of a 3-month progressive resistance exercise training program at increasing immune function and physical fitness, strongly recommending its inclusion in the standardized treatment plan of HIV-positive patients.

4 Article Incidence of Cervical Human Papillomavirus and Cervical Intraepithelial Neoplasia in Women with Positive and Negative HIV Status. 2016

Ceccato Junior, Benito Pio Vitorio / Guimarães, Mark Drew Crosland / Lopes, Ana Paula Ceccato / Nascimento, Lorena Fiorini / Novaes, Luísa Magalhães / Del Castillo, Dora Méndez / Melo, Victor Hugo. ·Department of Gynecology and Obstetrics, Faculdade de Ciencias Médicas de Minas Gerais - FCCMG, Belo Horizonte, Minas Gerais, Brazil. · Department of Preventive and Social Medicine, Faculdade de Medicina, UFMG, Belo Horizonte, Minas Gerais, Brazil. · Faculdade de Medicina de Barbacena, Barbacena, Minas Gerais, Brazil. · Faculdade de Ciencias Médicas de Minas Gerais - FCCMG, Belo Horizonte, Minas Gerais, Brazil. · Center for Action and Research in Support Diagnostics, UFMG, Belo Horizonte, Minas Gerais, Brazil. · Department of Gynecology and Obstetrics, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, Minas Gerais, Brazil. ·Rev Bras Ginecol Obstet · Pubmed #27123772.

ABSTRACT: Objectives To evaluate the incidence and factors associated with cervical intraepithelial neoplasia (CIN) and cervical infection by human papillomavirus (HPV) among HIV-positive and HIV-negative women. Methods A cohort of 103 HIV positive and 113 HIV negative women were monitored between October 2008 and February 2012, for at least one year. Procedures included cervical cytology, DNA/HPV detection by polymerase chain reaction, colposcopy with biopsy if necessary, followed by an interview for exposure characteristics data. CIN was based on the histopathological results. Results The incidence of CIN was of 8.8 and 4.6 cases/100 women-years in HIV-positive and HIV-negative women, respectively. HIV-positive women presented a hazard ratio (HR) of 2.8 for CIN and developed lesions earlier (0.86 year) than HIV-negative women (2 years) (p = 0.01). The risk of developing CIN decreased with age (HR = 0.9) and marital status (HR = 0.4). HPV patients presented a higher incidence of CIN when compared HIV-positive and HIV-negative women (p = 0.01). The incidence of HPV cervical infection was 18.1 and 11.4 cases/100 women-years in HIV-positive and HIV-negative women, respectively. Those HIV-positive presented earlier HPV infection(p = 0.002). The risk of developing HPV infection decreased with age and was higher among HIV-positive women. HPV 16 was the most common type in HIV-positive women, and also the type most closely associated with CIN in HIV-negative women. Conclusions HIV-positive women had a greater incidence of HPV and CIN, and in a shorter time interval. More rigorous and timely clinical control is required for this group.

5 Article Incident and long-term HIV-1 infection among pregnant women in Brazil: Transmitted drug resistance and mother-to-child transmission. 2016

Lima, Yanna Andressa Ramos / Cardoso, Ludimila Paula Vaz / Reis, Mônica Nogueira da Guarda / Stefani, Mariane Martins Araújo. ·Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Goiás, Brazil. · Department of Medicine, Federal University of Goiás, Jataí, Goiás, Brazil. ·J Med Virol · Pubmed #27037910.

ABSTRACT: Primary infection, seroconversion, and transmitted drug resistance (TDR) during pregnancy may influence the risk of mother-to-child-transmission (MTCT) of HIV-1 infection. This study estimated recent seroconversion, TDR rates, HIV-1 subtypes and pregnancy outcomes among 95 recently diagnosed, antiretroviral (ARV)-naïve pregnant women recruited during antenatal care in central western Brazil. Recent seroconversion was defined by BED-capture enzyme immunoassay (<155 days) and ambiguous nucleotides base calls (<1 year) in pol sequences (protease-PR and reverse transcriptase-RT regions). TDR was evaluated by the Calibrated Population Resistance tool. HIV-1 subtypes were defined by REGA and phylogenetic analyses. The median age of participants was 25 years; the median gestational age at diagnosis was 20.5 weeks. Based on serology and sequence polymorphism, recent infection was identified in 11.6% (11/95) and, 9 of them (82%), probably seroconverted during pregnancy; one MTCT case was observed among them. Three cases of stillbirth were observed among chronic infected patients (3.6%; 3/84). Moderate rate of TDR was observed (9/90, 10%, CI95% 4.7-18.1%). Subtype B was 60% (54/90), 13.3% (12/90) was subtype C, 6.7% (6/90) was subtype F1. Recombinant B(PR) /F1(RT) and F1(PR) /B(RT) viruses comprised 15.5% (14/90); B(PR) /C(RT) mosaics represented 4.4% (4/90). Seroconversion during pregnancy, late presentation to antenatal care and moderate TDR identified in this study represent significant challenges for the MTCT elimination. J. Med. Virol. 88:1936-1943, 2016. © 2016 Wiley Periodicals, Inc.

6 Article Evaluation of T, B and natural killer lymphocyte in the cervical stroma of HIV-positive and negative patients with cervical intraepithelial neoplasia. 2016

Lucena, Adriana A S / Guimarães, Mírian Viviane M B / Michelin, Márcia A / Lodi, Cláudia T C / Lima, Maria Inês M / Murta, Eddie Fernando Candido / Melo, Victor Hugo. ·Holy House of Mercy Hospital of Belo Horizonte, Santa Casa de Belo Horizonte, Minas Gerais, Brazil. · Research Institute of Oncology, Discipline of Gynecology and Obstetrics, Federal University of Triângulo Mineiro (Universidade Federal do Triângulo Mineiro), Brazil. Electronic address: michelinimuno@icbn.uftm.edu.br. · Minas Gerais School of Medical Sciences, (Faculdade de Ciências Médicas de Minas Gerais), Brazil. · Research Institute of Oncology, Discipline of Gynecology and Obstetrics, Federal University of Triângulo Mineiro (Universidade Federal do Triângulo Mineiro), Brazil. · School of Medicine - Federal University of Minas Gerais (Faculdade de Medicina da Universidade Federal de Minas Gerais), Brazil. ·Immunol Lett · Pubmed #26545568.

ABSTRACT: Cervical intraepithelial neoplasias (CIN) are closely associated with oncogenic subtypes of the human papillomavirus (HPV). In the presence of this virus, it is known that the activation or suppression of immune system is the key to the development, progression and/or regression of cervical lesions. Therefore, the objective of this study is to compare the local immune response among HIV-seropositive and seronegative patients with cervical intraepithelial neoplasia regarding the expression of T lymphocytes (CD3+, CD4+ and CD8+), B lymphocytes (CD20+) and natural killers cells (CD56+) in the cervical stroma. A cross-sectional study of paraffin blocks containing cervical tissue after conization by the Loop Electrosurgical Excision Procedure (LEEP) from 47 HIV-seropositive and 38 seronegative patients with CIN. Cervical stroma immunohistochemistry was performed in the CIN area. The Fisher's exact test was used for the statistical analysis. When HIV-seropositive and seronegative women were compared, the seropositive women had a higher count of CD8+ T lymphocytes (52.1% versus 28.9%, P<0.04). Considering CIN degree (CIN 1 and CIN 2/3), the HIV-seronegative patients with CIN 1 had a low count of CD20+B-lymphocytes (7.1%) in comparison with CIN 1 HIV seropositive and with CIN 2/3 HIV-seronegative patients, respectively 50% (P<0.018) and 54.5% (P<0.0048). The HIV infection and degree of CIN influenced the cytotoxic lymphocytes inducing an increase in the number of cells high count of CD20+ lymphocytes with CIN 1.

7 Article [Prevalence of cervical infection by human papillomavirus and cervical intraepithelial neoplasia in HIV-positive and negative women]. 2015

Ceccato Junior, Benito Pio Vitorio / Lopes, Ana Paula Ceccato / Nascimento, Lorena Fiorini / Novaes, Luísa Magalhães / Melo, Victor Hugo. ·Departamento de Ginecologia, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brasil. · Faculdade de Medicina de Barbacena, Barbacena, MG, Brasil. · Programa de Pós-Graduação em Saúde da Mulher, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. ·Rev Bras Ginecol Obstet · Pubmed #25992501.

ABSTRACT: PURPOSE: To conduct a comparative study between two groups of women (HIV positive and negative) analyzing: the prevalence of cervical intraepithelial neoplasia (CIN) and cervical HPV infection; viral risk and relationship with development of CIN; and sociodemographic and behavioral parameters that influence cervical HPV infection and the development of CIN. METHODS: A cross-sectional study in which 202 HIV-positive women and 164 HIV-negative women were analyzed to assess the prevalence of CIN and 171 HIV-positive women and 160 HIV-negative women were analyzed to assess the prevalence of cervical HPV infection. The following procedures were performed on the occasion of each medical visit: collection of cervical samples for cytology and polymerase chain reaction (PCR) to detect HPV DNA; colposcopy; standardized questionnaire to collect demographic and behavioral data; and biopsy of all colposcopic changes. Histopathology was the gold standard for the diagnosis of CIN. RESULTS: The prevalence of CIN was 2.4 and 15.3% (p<0.001) and the prevalence of cervical HPV infection was 37.1 and 55.5% (p=0.002), respectively, among HIV-negative and -positive women. HIV-positive women had a higher risk of HPV infection (35.7 and 23.6%) (p=0.02). HPV 16 was the most prevalent virus type, occurring in 11.3 and 10.2% of HIV-positive and negative women and was also more prevalent among women presenting CIN in both groups. Factors associated with the development of CIN were: HIV infection (HT=4.64; 95%CI 2.23-9.65), age (HT=0.95; 95%CI 0.93-0.98 for each year of life) and marital status (HT=0.49; 95%CI 0.30-0.80). Associated factors for HPV infection were: HIV presence (HT=2.72; 95%CI 1.77-4.17), greater number of sexual partners (HT=1.87; 95%CI 1.23-2.84), age (HT=0.97; 95%CI 0.95-0.99 for each year of life) and marital status (HT=0.65; 95%CI 0.42-1.0 for stable union/widows). CONCLUSION: The prevalence of CIN and cervical HPV infection was higher in HIV-positive women, who also presented a higher risk of HPV infections and multiple viral types. Type 16 was predominant in both groups and in women with CIN. Older women and women with stable union/widows were less likely to acquire cervical HPV infection and CIN.

8 Article Unprotected sexual practices among men who have sex with women and men who have sex with men living with HIV/AIDS in Rio de Janeiro. 2015

Julio, Renata Siqueira / Friedman, Ruth Khalili / Cunha, Cynthia B / De Boni, Raquel Brandini / Cardoso, Sandra Wagner / Torres, Thiago / Alves, Carla Almeida / Castro, Cristiane / Fernandes, Nilo Martinez / Veloso, Valdilea G / Grinsztejn, Beatriz. ·Superintendência Regional de Saúde de Varginha/Centro Universitário do Sul de Minas, Varginha, Minas Gerais, Brazil. ·Arch Sex Behav · Pubmed #25318623.

ABSTRACT: Combined antiretroviral therapy is now acknowledged for preventing new HIV infections, besides decreasing mortality and morbidity. However, in many Latin America countries the epidemic is still driven by unprotected sexual intercourse. This study aims to describe sexual practices related to HIV/STD and to evaluate factors associated to unprotected sex among men who have sex with women (MSW) and men who have sex with men (MSM) under care at a reference center for HIV in Rio de Janeiro, Brazil. A cross-sectional study, nested in a Brazilian clinical cohort, evaluated the sexual practices of 404 sexually active HIV-positive MSW and men who have MSM. Approximately 30 % of them reported unprotected sexual practices during the 6 months prior to the interview. Most frequent risky practices reported were unprotected vaginal sex among MSW and unprotected receptive anal sex among MSM. Factors increasing the chance of unprotected sexual practices among MSW were the partner's desire of becoming pregnant (OR 2.81; CI 95 %: 1.36-5.95). To have received comments about excessive consumption of alcohol (OR 2.43; CI 95 %: 1.01-5.83), illicit drug use (OR 4.41; CI 95 %: 1.75-11.60) and lived in marital situation (OR 2.10; CI 95 %: 1.09-4.08) were significantly associated with unsafe sexual practices among MSM. The results highlight that health care of men living with HIV, as well as the prevention strategies, must consider the particularities of sexual behavior practiced by people who differ in sexual orientation.

9 Article Proposed ratios and cutoffs for the assessment of lipodystrophy in HIV-seropositive individuals. 2015

Beraldo, R A / Vassimon, H S / Aragon, D C / Navarro, A M / Albuquerque de Paula, F J / Foss-Freitas, M C. ·Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, Brazil. · Health Promotion Program, University of Franca, Franca, Brazil. · Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. ·Eur J Clin Nutr · Pubmed #25074393.

ABSTRACT: OBJECTIVES: To propose objective ratios using anthropometry and dual-energy X-ray absorptiometry (DXA) and to suggest cutoff points for them in order to classify lipodystrophy in male patients. METHODS: It is a cross-sectional study. DXA was applied and anthropometric measurements were performed in 100 men on highly active antiretroviral therapy. Receiver operating characteristic curves were used to propose cutoffs. Individuals were divided in without (lipo-) or with (lipo+) lipodystrophy and their metabolic parameters were compared. RESULTS: The following ratios were proposed: fat mass ratio by DXA (FMR), waist thigh ratio (WTR), waist calf ratio (WCR), and arm to trunk ratio (ATR). The best cutoffs observed for FMR, WTR and ATR were 1.26, 1.74 and 2.08, respectively. Using the proposed cutoff for FMR, we observed worse metabolic profile, with increased tryglicerides, fasting serum glucose and more hypercholesterolemia in the lipo+ group. WTR and ATR showed a significant correlation with FMR. CONCLUSIONS: Anthropometric ratios (WTR/ATR) and FMR can be used to aid the diagnosis of lipodystrophy in order to contribute to a more accurate and earlier diagnosis permitting intervention and even preventing metabolic disturbances.

10 Article Immunological profile of periapical endodontic infections from HIV- and HIV+ patients. 2015

de Brito, L C N / Teles, F R / Teles, R P / Nogueira, P M / Vieira, L Q / Ribeiro Sobrinho, A P. ·Faculdade de Odontologia, Universidade de Itaúna, Itaúna, Brazil. · Departament of Applied Oral Sciences, The Forsyth Institute, Boston, MA, USA. · Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA. · Departamento de Odontologia Restauradora, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Departamento de Bioquímica e Imunologia Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Nucleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Brazil. ·Int Endod J · Pubmed #25069888.

ABSTRACT: AIM: To evaluate CD4(+) CD28(+) and CD8(+) T-cell genes and the gene expression of IFN-γ, TNF-α, IL-1-β, IL-17A, IL-10, CCL-2/MCP-1, CCL-4, CCL-5 (RANTES), CXCR4, CCR5 and RANKL from cells in the periapical interstitial fluid from root canal infections in healthy patients (HIV-) and HIV-positive individuals (HIV+). METHODOLOGY: Subjects included 20 HIV- and 23 HIV+ patients referred to the School of Dentistry at the Universidade Federal de Minas Gerais (Belo Horizonte, MG, Brazil). Almost all HIV+ patients were undergoing highly active antiretroviral therapy (HAART). Clinical samples were taken from teeth with pulp necrosis, and no patients had acute periapical symptoms at the time of the appointments. After cleaning and drying, 3 paper points were introduced into the root canal, passing passively through the root apex (2 mm) into the periapical tissues for 1 min. The samples were collected immediately after root canal cleaning and 7 days later (restrained root canal bacterial load) to characterize those gene expressions using real-time PCR. RESULTS: Significantly higher levels of CD4(+) CD28(+) and CD8(+) T cells in teeth with restrained bacterial loads (second collection) compared with the first collection were observed in both HIV- and HIV+ samples. In HIV- patients, an increase in IL-10 and CXCR4 expression was demonstrated as well as a decrease in pro-inflammatory cytokines such as RANKL, IFN-γ, IL1-β and CCL5. However, in HIV+ patients an increase in cytokines IFN-γ, IL-1-β, TNF-α and IL-17A, and chemokines CCL-2, CXCR4 and CCR5 were observed. The chemokine CCL-5 was not detected in HIV+ individuals. CONCLUSIONS: These findings suggest that after reducing the root canal bacterial load in HIV- individuals an anti-inflammatory response is generated whilst in HIV+ patients a pro-inflammatory response is sustained in the periapical area.

11 Article Risk factors associated with HIV infection among male homosexuals and bisexuals followed in an open cohort study: Project Horizonte, Brazil (1994-2010). 2014

Silva, Ana Paula / Greco, Marília / Fausto, Maria Arlene / Greco, Dirceu B / Carneiro, Mariângela. ·Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Project Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Project Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Departamento de Alimentos, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Brazil. · Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Project Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. ·PLoS One · Pubmed #25279670.

ABSTRACT: BACKGROUND: There has recently been an increase in HIV infection rates among men who have sex with men (MSM). This study aimed at investigating risk factors associated with incident HIV infection in a MSM cohort-Project Horizonte, Belo Horizonte, Minas Gerais, Brazil. METHODOLOGY: This is a nested case-control study in an ongoing open cohort of homosexual and bisexual men, carried out in 1994-2010, during which 1,085 volunteers were enrolled. Each HIV seroconverted volunteer (case) was compared with three randomly selected HIV negative controls, matched by admission date and age (±3 years). During follow-up, 93 volunteers seroconverted and were compared with 279 controls. PRINCIPAL FINDINGS: The risk factors associated with HIV seroconversion were: contact with partner's blood during sexual relations (OR 3.7; 95% CI 1.2-11.6), attendance at gay saunas in search for sexual partners (OR 2.6; 95% CI 1.3-5.4), occasional intake of alcohol when flirting and engaging in sexual activity (OR 2.5; 95% CI 1.3-5.1), inconsistent use of condoms in receptive anal sex (OR 2.4; 95% CI 1.1-5.4), little interest to look up information about AIDS (OR 2.6; 95% CI 1.0-6.7) particularly in newspapers (OR 3.4; 95% CI 1.4-8.1). CONCLUSIONS: This study shows that MSM are still engaging in risk behavior, such as unprotected anal intercourse, despite taking part in a cohort study on various preventive measures. New preventive strategies in touch with the epidemic's development and the specificities of this particular population are needed.

12 Article Acroangiodermatitis (pseudo-Kaposi's sarcoma) in an HIV sero-positive patient with syphilis and hepatitis C virus coinfection: clinical and dermatopathological features. 2014

Bernardes Filho, Fred / Martins, Gustavo / Nery, José Augusto da Costa / Andrade, Cecília Vianna de / Kac, Bernard Kawa. ·Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. · Private clinic, Ituiutaba, MG, Brazil. · Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. ·An Bras Dermatol · Pubmed #25184919.

ABSTRACT: Acroangiodermatitis is an angioproliferative disease usually related to chronic venous insufficiency, and it is considered a clinical and histological simulator of Kaposi's sarcoma (KS). Immunohistochemistry is the suitable method to differentiate between these two entities. It reveals the following immunostaining profile: immunopositivity with anti-CD34 antibody is restricted to the vascular endothelium in acroangiodermatitis, and diffuse in the KS (endothelial cells and perivascular spindle cells); immunopositivity with anti-HHV-8 only in KS cases. We report the case of an HIV seropositive patient without apparent vascular disease, who presented violaceous and brownish erythematous lesions on the feet, and whose histopathology and immunohistochemistry indicated the diagnosis of acroangiodermatitis.

13 Article Community-acquired diarrhea associated with Clostridium difficile in an HIV-positive cancer patient: first case report in Latin America. 2014

Costa, Cecília L / Quesada-Gómez, Carlos / de Carvalho, Cibele B Mano / González, Rafael H / Gifoni, Markus A / Ribeiro, Ronaldo A / de Castro Brito, Gerly Anne. ·Laboratory of Bacteriology, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo 1315, Rodolfo Teófilo, CEP 60430-275, Fortaleza, Brazil. Electronic address: cecilialcosta@hotmail.com. · Laboratorio de Investigación en Bacteriología Anaerobia, Facultad de Microbiología and Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San José, Costa Rica. · Laboratory of Bacteriology, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo 1315, Rodolfo Teófilo, CEP 60430-275, Fortaleza, Brazil. · Haroldo Juaçaba Hospital, Cancer Institute of Ceará, Fortaleza, Brazil. · Laboratory of Pharmacology of Inflammation and Cancer (LAFICA), Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, Brazil. · Núcleo de Microscopia e Processamento de Imagens (NEMPI), Department of Morphology, Federal University of Ceará, Fortaleza, Brazil. ·Int J Infect Dis · Pubmed #25066118.

ABSTRACT: Clostridium difficile is the most important cause of nosocomial diarrhea, mainly associated with antibiotic use and immunodeficiency. Although, an increased incidence of community-acquired C. difficile infection (CA-CDI) has been reported worldwide, this infection has been under-diagnosed in Latin America. This is the first report of a CA-CDI case in Latin America, in an HIV-positive patient with cancer.

14 Article Detection of the B"-GWGR variant in the southernmost region of Brazil: unveiling the complexity of the human immunodeficiency virus-1 subtype B epidemic. 2013

Junqueira, Dennis Maletich / Medeiros, Rúbia Marília de / Leite, Thaysse Cristina Neiva Ferreira / Guimarães, Monick Lindenmeyer / Gräf, Tiago / Pinto, Aguinaldo Roberto / Almeida, Sabrina Esteves de Matos. ·Centro de Desenvolvimento Científico e Tecnológico, Fundação Estadual de Produção e Pesquisa em Saúde,, Porto AlegreRS, Brasil. ·Mem Inst Oswaldo Cruz · Pubmed #24037196.

ABSTRACT: Typical human immunodeficiency virus-1 subtype B (HIV-1B) sequences present a GPGR signature at the tip of the variable region 3 (V3) loop; however, unusual motifs harbouring a GWGR signature have also been isolated. Although epidemiological studies have detected this variant in approximately 17-50% of the total infections in Brazil, the prevalence of B"-GWGR in the southernmost region of Brazil is not yet clear. This study aimed to investigate the C2-V3 molecular diversity of the HIV-1B epidemic in southernmost Brazil. HIV-1 seropositive patients were ana-lysed at two distinct time points in the state of Rio Grande do Sul (RS98 and RS08) and at one time point in the state of Santa Catarina (SC08). Phylogenetic analysis classified 46 individuals in the RS98 group as HIV-1B and their molecular signatures were as follows: 26% B"-GWGR, 54% B-GPGR and 20% other motifs. In the RS08 group, HIV-1B was present in 32 samples: 22% B"-GWGR, 59% B-GPGR and 19% other motifs. In the SC08 group, 32 HIV-1B samples were found: 28% B"-GWGR, 59% B-GPGR and 13% other motifs. No association could be established between the HIV-1B V3 signatures and exposure categories in the HIV-1B epidemic in RS. However, B-GPGR seemed to be related to heterosexual individuals in the SC08 group. Our results suggest that the established B"-GWGR epidemics in both cities have similar patterns, which is likely due to their geographical proximity and cultural relationship.

15 Article Maternal ability to take care of children exposed to HIV. 2013

Freitas, Julyana Gomes / Barroso, Léa Maria Moura / Galvão, Marli Teresinha Gimeniz. ·Universidade de Fortaleza, Fortaleza, CE, Brazil. ·Rev Lat Am Enfermagem · Pubmed #23970235.

ABSTRACT: OBJECTIVE: to assess the ability of mothers to take care of children exposed to HIV, using the Assessment Scale of Care Skills for Children Exposed to HIV at Birth and to check the association between the scale dimensions and maternal characteristics. METHOD: this cross-sectional study involved 62 HIV+ mothers whose children of up to one year old had been exposed to the virus at birth. The Assessment Scale of Care Skills for Children Exposed to HIV at Birth consists of 52 items and five dimensions, indicating high, moderate or low care ability. RESULTS: 72.7% of the mothers appropriately offered zidovudine syrup; 86.0% were highly skilled to prepare and administer milk formula; 44.4% were moderately able to prepare and administer complementary feeding; 76.5% revealed high ability to administer prophylactic treatment against pneumonia and 95.3% demonstrated high abilities for clinical monitoring and immunization. Significant associations were found between some maternal variables and the scale dimensions. CONCLUSION: the scale permits the assessment of maternal care delivery to these children and the accomplishment of specific child health interventions.

16 Article Serum cytokines associated with severity and complications of kala-azar. 2013

Costa, Dorcas L / Rocha, Regina L / Carvalho, Rayssa M A / Lima-Neto, Adelino S / Harhay, Michael O / Costa, Carlos Henrique N / Barral-Neto, Manoel / Barral, Aldina P. ·Maternal and Childhood Department, Federal University of Piauí, Brazil. ·Pathog Glob Health · Pubmed #23683334.

ABSTRACT: OBJECTIVES: Recent clinical data suggest that severe kala-azar (or visceral leishmaniasis) is an exaggerated innate immune response mediated by inflammatory cytokines, leading to a systemic inflammatory syndrome similar to what is observed in malaria, sepsis and other diseases. We tested this hypothesis by measuring serum cytokines in individuals with kala-azar. METHODS: We compared patients with severe kala-azar (i.e. hemorrhagic manifestations, n = 38) with patients without evidence of hemorrhage (n = 96). We conducted a detailed clinical and laboratory evaluation, measuring serum IL-1beta, IL-6, IL-8, IL-10, IL-12, interferon-gamma, and TNF-alpha, and markers of disseminated intravascular coagulation (DIC). RESULTS: Infants had higher levels of inflammatory cytokines, while HIV-infected patients had lower concentrations of IL-10 and interferon-gamma. Higher levels of IL-6, interferon-gamma, and IL-8 were found among deceased patients. IL-8 and interferon-gamma were independently associated with bleeding. Several cytokines were associated with different signs of severe clinical and laboratory manifestations, including DIC. IL-6 was highly positively and independently associated with IL-1beta, IL-8, IL-10, and negatively associated with TNF-alpha. IL-1beta and TNF-alpha were also highly independently associated with disease severity. CONCLUSION: In its severe form, kala-azar, a neglected tropical disease, initiates a systemic inflammatory response that leads to DIC and other manifestations. Children may have higher risk of death due to the more intense cytokine release. The data supports the notion that IL-6 is the central cytokine that is associated with lethal disease, but interferon-gamma, IL1beta, IL-8, and TNF-alpha are also involved with disease severity. Inhibition of IL-6 is a potential target of adjuvant therapy for severe or pediatric forms of this disease.

17 Article HIV among MSM in a large middle-income country. 2013

Kerr, Ligia R F S / Mota, Rosa S / Kendall, Carl / Pinho, Adriana de A / Mello, Maeve B / Guimarães, Mark D C / Dourado, Inês / de Brito, Ana M / Benzaken, Adele / McFarland, Willi / Rutherford, George / Anonymous3250746. ·Departamento de Saúde Comunitária, Universidade Federal do Ceará, Fortaleza, Ceara, Brazil. ·AIDS · Pubmed #23291540.

ABSTRACT: OBJECTIVE: To conduct the first national biological and behavioral surveillance survey for HIV among MSM in Brazil. DESIGN: A cross-sectional surveillance study utilizing Respondent Driven Sampling (RDS) in 10 cities, following formative research. Planned sample: 350 MSM reporting sex with another man in the last 12 months, at least 18 years of age, and residing in the city of the study. METHODS: Conventional RDS recruitment. Results were calculated for each city using RDSAT 5.6. For the national estimate, a new individual weight using a novel method was calculated. The 10 cities were aggregated, treated as strata and analyzed using STATA11.0. Self-reported HIV status and logistic regression was used to impute missing values for serostatus, an important issue for RDSAT. RESULTS: A total of 3859 MSM were interviewed. Sample was diverse, most self-identified as mulatto or black, were social class C or below, and had relatively low levels of education. More than 80% reported more than one partner in the last 6 months. Only 49% had ever tested for HIV. HIV prevalence among MSM ranged from 5.2 to 23.7% in the 10 cities (3.7-16.5% without imputation) and was 14.2% for all cities combined with imputation. The overall prevalence was two and three times higher than that estimated for female sex workers and drug users, respectively, in Brazil. Half of those who tested HIV positive were not aware of their infection. CONCLUSION: The AIDS epidemic in Brazil is disproportionately concentrated among MSM, as has been found in other countries. Renewed efforts to encourage testing, prevention and treatment are required.

18 Article Acute encephalitis as initial presentation of primary HIV infection. 2012

Nzwalo, Hipólito / Añón, Rosário Pazos / Àguas, Maria João. ·Neurology Department, Faro Hospital, Faro, Portugal. hipnzwalo@yahoo.com.br ·BMJ Case Rep · Pubmed #22761210.

ABSTRACT: Acute encephalitis is a life-threatening condition. A wide variety of infectious agents are implicated and in many patients no cause is found. HIV acute seroconversion illness can rarely present as acute encephalitis. Although most experts agree in starting antiretroviral treatment in severe acute HIV infection, the evidence of the benefits are still lacking. The authors report a case of severe acute encephalitis as a primary presentation of HIV infection in which introduction of highly active antiretroviral treatment resulted in clinical recovery. This case highlights the need to consider HIV infection in the differential diagnosis of treatable viral encephalitis.

19 Article Eosinophilic acute appendicitis caused by Strongyloides stercoralis and Enterobius vermicularis in an HIV-positive patient. 2012

Cruz, Dennis Baroni / Friedrisch, Bruno Kras / Fontanive Junior, Vilmar / da Rocha, Vívian Wünderlich. ·Medicina, UNISC-Universidade de Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil. debaroni@gmail.com ·BMJ Case Rep · Pubmed #22605801.

ABSTRACT: A 29 year old female HIV-positive patient presented in emergency with acute right lower quadrant abdominal pain, fever, tenderness and positive Blumberg sign. Laboratorial tests revealed eosinophilia, anaemia and leukocytosis. She underwent exploratory laparotomy followed by appendectomy. The pathological analysis of the appendix revealed acute appendicitis, accentuated eosinophilia and infestation by Strongyloides stercoralis and Enterobius vermicularis. She did well after surgery and adequate treatment. To the authors' knowledge, this is the first case of eosinophilic acute appendicitis caused by these two parasitic worms reported in the medical literature.

20 Article [Hope in HIV-positive women]. 2012

Galvão, Marli Teresinha Gimeniz / Bonfim, Danuta Yelena Goiana / Gir, Elucir / de Lima Carvalho, Carolina Maria / de Almeida, Paulo Cesar / Balsanelli, Alessandra Cristina Sartore. ·Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brasil. marligalvao@gmail.com ·Rev Esc Enferm USP · Pubmed #22441263.

ABSTRACT: The objective of this study was to assess the hope in the lives of HIV-positive women, using the Herth Hope Scale (HHS). Participants were 111 HIV-positive women who attended a referral outpatient clinic in Fortaleza-CE. From January to May 2009, interviews were held to collect biopsychosocial variables, and the HHS was applied. Data were analyzed using SPSS-8.0 and revealed an average hope index of 34.86, indicating that these women have little hope in life in view of their diagnosis of HIV. The scale item with the highest score was faith. This probably derives from the fact that Aids is incurable, transmissible and generates negative stigma, in addition to its relation with the idea of imminent death. In conclusion, measuring hope among HIV patients through the use of an instrument permits intervention assessment and planning, promoting assistance and motivation to live better and maintain a hopeful attitude.

21 Article High occurrence of HIV-positive siblings due to repeated mother-to-child transmission in Brazil. 2012

Ramos, Alberto N / Matida, Luiza H / Hearst, Norman / Oliveira, Fabíola Araújo / Heukelbach, Jorg. ·Department of Community Health, Federal University of Ceará, Fortaleza, Brazil. novaes@ufc.br ·AIDS Care · Pubmed #22148871.

ABSTRACT: Pregnancies in women without knowledge of their HIV-positive status increase the risk of mother-to-child transmission, and of disease progression. This study aimed to characterize the frequency of multiple pregnancies and of HIV-positive children in the family, during HAART era. We analyzed data of a national multicenter cohort study among Brazilian children with AIDS diagnosed between 1999 and 2002. In total, 945 children and their 928 mothers were included. Five hundred and ninety (64.6%) women had a history of multiple pregnancies, and 49.5% attended prenatal care (mean: 3.5 consultations; SD 3.6). In 483 child cases, HIV status of the sibling was known; 130 (26.9%) of these were infected with HIV. In 38.5% of cases, the child with AIDS included in the cohort study was the first case in the family. Despite the overall positive results of the Brazilian control policy of HIV/AIDS, our study shows that HIV infection in pregnant women was often undetected and that consequently there was a high frequency of repeated HIV-infected children. There is a need to improve comprehensive prenatal and postnatal care of Brazilian women. HIV-affected families are most vulnerable and should be targeted by specific control programs, preventing additional HIV infections in other children.

22 Article Abandonment of antiretroviral therapy among HIV-positive patients attended at the reference center for HIV/AIDS in Vitória, Brazil. 2012

Zago, Adriana Marchon / Morelato, Paola / Endringer, Emmanuele de Angeli / Dan, Germano de Freitas / Ribeiro, Evanira Mendes / Miranda, Angelica Espinosa. ·1Centro de Referencia em DST/AIDS, Secretaria de Saúde de Vitória, Vitória, Brazil. ·J Int Assoc Physicians AIDS Care (Chic) · Pubmed #21876214.

ABSTRACT: This study evaluates the risk factors for the abandonment of antiretroviral therapy (ART) among patients receiving care in an AIDS clinic in Vitória, Brazil. We conducted a case-control study of patients with AIDS attending a reference center for sexually transmitted disease (STD)/AIDS. A total of 62 patients, who abandoned therapy in 2008, and 188 HIV-infected patients answered an interview including demographic, social, and clinical characteristics. Risk factors associated with abandon in univariate analysis were entered into logistic regression models. A total of 250 patients were included in the study. Groups were similar regarding age, gender, and monthly income. In the final multivariate model, illicit drug use (adjusted odds ratio [AOR], 2.3; 95% confidence interval [CI], 1.03-5.07), previous abandon of medication (AOR 38.6; 95% CI 10.49-142.25), last CD4 count <200 cells/mm(3) (AOR 1.5; 95% CI 1.03-2.10), and viral load higher than 1000 copies/mL (AOR 2.0 (95% CI 1.34-3.09) were independent predictors of abandonment of ART. In addition to the clinical indicators, behavioral factors remained important throughout the multivariate analysis in our study.

23 Article IL28B polymorphism associated with spontaneous clearance of hepatitis C infection in a Southern Brazilian HIV type 1 population. 2012

Lunge, Vagner Ricardo / da Rocha, Daniel Bedinote / Béria, Jorge Umberto / Tietzmann, Daniela Cardoso / Stein, Airton Tetelbom / Simon, Daniel. ·Programa de Pós-Graduação em Diagnóstico Genético e Molecular, Universidade Luterana do Brasil, Canoas, RS, Brazil. ·AIDS Res Hum Retroviruses · Pubmed #21790472.

ABSTRACT: About one-third of people infected with human immunodeficiency virus-1 (HIV-1) are coinfected with hepatitis C virus (HCV) because of shared transmission routes. Studies report that HIV-1 complicates hepatitis C infection by increasing HCV viral load and reducing spontaneous clearance. Single nucleotide polymorphisms (SNPs) upstream of the IL28B gene have been associated with spontaneous and treatment-induced clearance of HCV infection. The aim of this study was to evaluate the association between the SNP rs12979860 of the IL28B gene and spontaneous clearance of HCV infection in a Brazilian HIV-1 population. The SNP was analyzed by polymerase chain reaction (PCR) followed by restriction digestion in 138 anti-HCV-positive patients. Spontaneous clearance was observed in 34 subjects (24.6%). Genotype distribution was significantly different between spontaneous clearance and HCV chronic patients. The CT/TT genotypes conferred a nearly 3-fold increased odds to chronic HCV infection relative to the CC genotype (odds ratio, 2.78; 95% confidence interval, 1.16-6.64; p=0.011). In conclusion, the rs12979860 polymorphism is associated with spontaneous clearance of HCV in HIV-1 Brazilian infected patients.

24 Article HIV type 1 molecular epidemiology in pol and gp41 genes among naive patients from Mato Grosso do Sul State, central western Brazil. 2012

da Silveira, Alexsander Augusto / Cardoso, Ludimila Paula Vaz / Francisco, Roberta Barbosa Lopes / de Araújo Stefani, Mariane Martins. ·Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia City/Goiás State, Brazil. ·AIDS Res Hum Retroviruses · Pubmed #21790471.

ABSTRACT: Antiretroviral naive patients (n=49) were recruited in central western Brazil (Campo Grande City/Mato Grosso do Sul State, located across the Bolivia and Paraguay borders). HIV-1 protease (PR), reverse transcriptase (RT), and env gp41 HR1 fragments were sequenced. Genetic diversity was analyzed by REGA/phylogenetic analyses. Intersubtype recombinants were identified by SimPlot/phylogenetic trees. PR/RT resistance was analyzed by Calibrated Population Resistance/Stanford databases. T-20 resistance in gp41 was assessed by Stanford, Los Alamos, and other sources. Of HIV-1 subtypes 65.3% were B(PR)B(RT), 10.2% were C(PR)C(RT), and 8.2% were F1(PR)F1(RT). Intersubtype recombinants were 16.3%: four B/F1 and four B/C (two were "CRF31_BC-like"). The Pol-RT V75M mutation was detected in two homosexual partners; one patient had the T215S revertant mutation. T-20/gp41 resistance mutations were L44M (n=2) and V38A (n=1). The high percentage of non-B isolates (∼35%) highlights the importance of molecular surveillance studies in settings distant from the origin of the epidemic. Our data help elaborate the molecular epidemiological map of HIV-1 in Brazil.

25 Article [Experiences to cope with HIV among infected women]. 2011

Galvão, Marli Teresinha Gimeniz / Paiva, Simone de Sousa. ·Universidade Federal do Ceará, Departamento de Enfermagem, Pesquisadora do CNPq, Fortaleza-CE, Brasil. marligalvao@gmail.com ·Rev Bras Enferm · Pubmed #22664599.

ABSTRACT: The study aimed to describe HIV-positive women's reports and experiences in coping with the infection. A qualitative study was carried out in the context of a specialized care service in Fortaleza-CE in 2007. Participants were 14 women diagnosed with HIV infection, who participated in tape recorded interviews. The analysis of interviews contents revealed the category Motivations for coping with HIV/AIDS and the subcategories religiosity, social and family support, presence of children and professional complicity as positive factors for coping with the infection. In conclusion, these women need professional and family care and support to remain stimulated in the care process.