VIVIAN HELENA IIDA AVELINO DA SILVA

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LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina

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Autor: AVELINO-SILVA, Vivian I. ×

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Agora exibindo 1 - 10 de 29
  • article 3 Citação(ões) na Scopus
    Say it right: measuring the impact of different communication strategies on the decision to get vaccinated
    (2023) AVELINO-SILVA, Vivian I.; FERREIRA-SILVA, Sofia Natalia; SOARES, Maria Eduarda Muniz; VASCONCELOS, Ricardo; FUJITA, Luiz; MEDEIROS, Tainah; BARBIERI, Carolina Luisa Alves; COUTO, Marcia Thereza
    BackgroundVaccine hesitancy is a concerning menace to the control of vaccine-preventable diseases. Effective health communication could promote an overall understanding of the importance, risks, and benefits of vaccination and reduce vaccine hesitancy.MethodsIn this survey, four fictitious newspaper articles addressing an emerging bogus disease and its vaccine were randomly assigned to participants. The first version focused on information about the disease; the second was akin to the first, including a case description and image. The third version focused on vaccine safety/efficacy; the fourth version was like the third, including a case description and image. After reading a single version of the article, participants responded if they would take the vaccine and if they would vaccinate their children. We used chi-squared tests for comparisons and investigated interactions with vaccine-hesitant attitudes.ResultsWe included 5233 participants between August/2021 and January/2022; 790 were caregivers of a child <= 5 years old, and 15% had prior vaccine hesitancy. Although most declared intention to take the vaccine, the percentage was highest among those exposed to the newspaper article focusing on the vaccine safety/efficacy with the case description and picture (91%; 95% confidence interval 89-92%), and lowest among participants exposed to the article focusing on the disease with no case description (84%; 95% confidence interval 82-86%). Similar trends were observed in the intention of offspring vaccination. We found evidence of effect modification by vaccine-hesitant attitudes, with a higher impact of communication focusing on vaccine safety/efficacy compared to that focusing on disease characteristics among hesitant participants.ConclusionCommunication strategies focusing on different aspects of the disease-vaccine duet may impact vaccine hesitancy, and storytelling/emotive imagery descriptions may improve risk perception and vaccine uptake. Moreover, the effect of message framing strategies may differ according to previous vaccine hesitant attitudes.
  • article 5 Citação(ões) na Scopus
    Comparison of cumulative viraemia following treatment initiation with different antiretroviral regimens: a real-life study in Brazil
    (2019) PASCOM, Ana R.; PINHO, Rosana E. G. G.; RICK, Fernanda; VERAS, Nazle M. C.; PERINI, Filipe de Barros; MEIRELES, Mariana V.; PEREIRA, Gerson F.; BENZAKEN, Adele S.; AVELINO-SILVA, Vivian I.
    Introduction The relative efficacy of different antiretroviral (ART) regimens has been extensively evaluated in the context of clinical trials, using HIV viral load (VL) measurements at pre-specified timepoints after ART onset. However, data from real-life studies using combined longitudinal measurements of cumulative viraemia are scarce. This study aimed to address the independent effect of different ART regimens on HIV cumulative viraemia over the first 12 months after treatment initiation, using programmatic data from the Ministry of Health of Brazil. Methods Retrospective cohort study analysing cumulative viraemia under the most frequently used ART regimens in Brazil (tenofovir, lamivudine and dolutegravir (regimen 1); tenofovir, lamivudine and efavirenz (regimen 2); tenofovir, lamivudine and ritonavir-boosted atazanavir (regimen 3)). Results and Discussion We included 112,243 patients >12 years old who received their first ART prescription between January 2014 and August 2017. Univariate analysis indicated that cumulative viraemia was significantly lower in patients receiving regimen 1 as compared with those receiving regimens 2 or 3 (p<0.0001 for both pairwise comparisons). In a multivariable analysis adjusted for age, sex, baseline T CD4+ counts and baseline HIV VL, ART regimen persisted with statistically significant effect on 12-month cumulative viraemia. The model predicted a 45-unit increase in log(10) copy-days/mL cumulative viraemia for regimen 2 as compared with regimen 1, and a 70-unit increase in log(10) copy-days/mL cumulative viraemia for regimen 3 as compared with regimen 1 (95%CI 41 to 49 and 61 to 79 respectively; p<0.001 for both comparisons). In models restricted to youths (13 to 24 years old) and female patients, ART regimen had similar effects. ART regimen with dolutegravir in association with a tenofovir-lamivudine backbone was superior to regimens containing efavirenz or boosted atazanavir in reducing HIV VL, as shown by cumulative viraemia over the first 12 months after treatment initiation. The superiority persisted even after adjusting the analysis for potential confounders. Conclusions Our findings could bring direct benefits to patients as suggested by lower viral replication during treatment, lower risk of HIV transmission, and a potential reduction in resistance mutations in the initial 12 months under ART.
  • article 36 Citação(ões) na Scopus
    The Effect of Depressive Symptoms on Adherence to Daily Oral PrEP in Men who have Sex with Men and Transgender Women: A Marginal Structural Model Analysis of The iPrEx OLE Study
    (2016) MEHROTRA, Megha L.; GLIDDEN, David V.; MCMAHAN, Vanessa; AMICO, K. Rivet; HOSEK, Sybil; DEFECHEREUX, Patricia; MAYER, Kenneth H.; VELOSO, Valdilea G.; BEKKER, Linda-Gail; AVELINO-SILVA, Vivian I.; SCHECHTER, Mauro; GRANT, Robert M.
    We assessed the role of depressive symptoms on adherence to daily oral FTC/TDF for HIV PrEP in cis-gender men who have sex with men (MSM) and transgender women who have sex with men (TGW) using data from the iPrEx OLE study. A marginal structural logistic regression model was used to estimate the effect of time-varying CES-D scores on having protective levels of drug concentration, adjusting for confounding by sexual practices over time, prior adherence, and baseline demographic characteristics. We found a non-monotonic relationship between CES-D score and odds of protective FTC/TDF levels in MSM. We found evidence that the effect of depression on adherence varied between MSM and TGW, and that depressive symptoms did not contribute greatly to decreased adherence on a population scale. We recommend that depressive symptoms not preclude the prescription of PrEP, and that MSM and TGW be studied separately.
  • article 2 Citação(ões) na Scopus
    Plasmablast Expansion Following the Tetravalent, Live-Attenuated Dengue Vaccine Butantan-DV in DENV-Naive and DENV-Exposed Individuals in a Brazilian Cohort
    (2022) SILVEIRA, Cassia G. T.; MAGNANI, Diogo M.; COSTA, Priscilla R.; AVELINO-SILVA, Vivian I.; RICCIARDI, Michael J.; TIMENETSKY, Maria do Carmo S. T.; GOULART, Raphaella; CORREIA, Carolina A.; MARMORATO, Mariana P.; FERRARI, Lilian; NAKAGAWA, Zelinda B.; TOMIYAMA, Claudia; TOMIYAMA, Helena; KALIL, Jorge; PALACIOS, Ricardo; PRECIOSO, Alexander R.; WATKINS, David I.; KALLAS, Esper G.
    An effective vaccine against the dengue virus (DENV) should induce a balanced, long-lasting antibody (Ab) response against all four viral serotypes. The burst of plasmablasts in the peripheral blood after vaccination may reflect enriched vaccine-specific Ab secreting cells. Here we characterize the acute plasmablast responses from naive and DENV-exposed individuals following immunization with the live attenuated tetravalent (LAT) Butantan DENV vaccine (Butantan-DV). The frequency of circulating plasmablasts was determined by flow cytometric analysis of fresh whole blood specimens collected from 40 participants enrolled in the Phase II Butantan-DV clinical trial (NCT01696422) before and after (days 6, 12, 15 and 22) vaccination. We observed a peak in the number of circulating plasmablast at day 15 after vaccination in both the DENV naive and the DENV-exposed vaccinees. DENV-exposed vaccinees experienced a significantly higher plasmablast expansion. In the DENV-naive vaccinees, plasmablasts persisted for approximately three weeks longer than among DENV-exposed volunteers. Our findings indicate that the Butantan-DV can induce plasmablast responses in both DENV-naive and DENV-exposed individuals and demonstrate the influence of pre-existing DENV immunity on Butantan DV-induced B-cell responses.
  • conferenceObject
    Sexual health and sexually transmitted infections prevention among people who have sex between vulvas: a Brazilian analysis
    (2024) BARTOLLETI, Flavia; AVELINO-SILVA, Vivian I.; HANITZSCH, Eugenia; SOUZA, Athos
  • article 0 Citação(ões) na Scopus
    Knowledge about clinical presentation, prevention strategies and sexual transmission of Zika virus infection among women of reproductive age in an endemic area
    (2021) MANULI, Erika R.; PEREIRA, Geovana M.; BERNAT, Maria Cristina; NOVAES, Celia R.; SABINO, Ester C.; AVELINO-SILVA, Vivian I.
    Background: The recognition of the causal association between Zika virus (ZIKV) infection during pregnancy and congenital abnormalities including microcephaly underlines the importance of preventing this disease in pregnant women (PW) and women of childbearing age (WCA). Although Brazil and other Latin American countries reported a significant reduction in the number of ZIKV infections in recent years, epidemic waves can recur in settings with previous outbreaks as conditions for transmission remain optimal and susceptible populations are continuously replenished. Methods: In this cross-sectional study, we enrolled 64 PW and 260 non-pregnant WCA attending routine medical appointments in two primary care units in Sao Paulo, Brazil, and assessed knowledge and attitudes about ZIKV infection and prevention. Results: Most women reported knowing that ZIKV is transmitted through the bite of Aedes mosquitos, and most knew that acute symptoms are similar to those seen in Dengue infection. Furthermore, most participants correctly described that ZIKV infection during pregnancy may cause detrimental outcomes for the newborn. However, most ignored that ZIKV infection can be asymptomatic, and only 15% knew about the risk of ZIKV sexual transmission. We found no statistically significant differences between PW and WCA regarding knowledge about ZIKV sexual transmission. Knowledge about ZIKV sexual transmission was significantly associated with education; among participants with <= 12 schooling years, only 9.0% (95%CI 3.4-18.5%) correctly answered that ZIKV can be sexually transmitted, compared to 12.9% (95%CI 8.2-18.8%) among participants with 12-14 schooling years, and to 24.4% (95%CI 15.9-34.9%) of participants with >= 15 schooling years (p = 0.015). Education remained independently associated with knowledge about sexual transmission of ZIKV in a multivariate logistic regression model adjusted for age, race and pregnancy status (p = 0.022). Conclusion: Our findings underscore the urgent need of educational and family planning programs that may help prevent detrimental outcomes of ZIKV infection in an endemic area of Brazil. (c) 2021 Sociedade Brasileira de Infectologia.
  • article 7 Citação(ões) na Scopus
    Prospective study of human herpesvirus 8 oral shedding, viremia, and serological status among human immunodeficiency virus seropositive and seronegative individuals in Sao Paulo, Brazil
    (2017) BRAZ-SILVA, Paulo H.; TOZETTO-MENDOZA, Tania R.; SUMITA, Laura M.; FREIRE, Wilton; PALMIERI, Michelle; CANTO, Alan M. do; AVELINO-SILVA, Vivian I.; GALLOTTINI, Marina; MAYAUD, Philippe; PANNUTI, Claudio S.
    Human herpesvirus 8 (HHV-8) is a gamma-herpesvirus and etiological agent of all forms of Kaposi sarcoma (KS). Saliva may play an important role in HHV-8 transmission in specific populations. Little is known about HHV-8 oral shedding pattern and the possible correlation with the HHV-8 serological profile and viremia. A prospective study was conducted of HHV-8 salivary excretion among human immunodeficiency virus HIV-seronegative (n = 47) and -seropositive (n = 44) homosexual men and HIV-seropositive women (n = 32) over a 6-month period with monthly HHV-8 serologies (immunofluorescence assays to identify antibodies to latent and lytic HHV-8 viral proteins, and a whole-virus HHV-8 enzyme-linked immunosorbent assay [ELISA]), monthly HHV-8 DNA serum/plasma detection, and daily self-collected oral rinses for HHV-8-DNA detection using real-time polymerase chain reaction. HHV-8 seropositivity was 51.1%, 63.6%, and 37.5%, in the three studied groups. There was no case of HHV-8 DNA detection in serum/plasma. Intermittent detection of oral HHV-8 DNA was observed during 5.1% (110/2,160) of visits among 28% (18/64) of HHV-8-seropositive individuals, all of whom were males and HHV-8 ELISA seropositive. In immunologically controlled populations of Brazil, HHV-8 oral shedding was limited to HHV-8-seropositive men, occurred infrequently and intermittently, and was not linked to HHV-8 viremia, suggesting a limited potential for oral or blood transmission.
  • conferenceObject
    Absence of anti-HBc in HIV/HBV coinfected individuals with advanced immunosuppression
    (2012) AVELINO-SILVA, Vivian I.; GOMES-GOUVEA, Michele S.; MIRAGLIA, Joao Luiz; GUASTINI, Cristina; PINHO, Joao R.; MENDES-CORREA, Maria Cassia
    HBV chronic infection is frequent among HIV carriers but serological markers may present atypical profiles among these patients. HBsAg reactivity in anti-HBc negative patients is a rare event that has been described in HIV co-infected patients. This pattern was related to mutations in the coding region of the viral core protein, to aberrant host immune response or to both factors. The aim of this study was to evaluate the occurrence of anti-HBc negative/HBsAg positive profile in HIV/HBV coinfected patients and to identify possible associations with clinical variables and HBV mutations. This is a case control study based in medical reports and laboratorial records from the studied patients. For each anti-HBc negative/HBsAg positive identified case, 2 anti-HBc positive/HBsAg positive controls matched by sex and age were selected. HBVDNA was detected by real time PCR. Patients with detectable viral load were further analyzed by amplification and sequencing of precore/core and S regions for genotyping and identification of mutations possibly involved with this anomalous serological pattern. Our study population was selected from 2412 anti-HIV positive patients. Among them, 120 were HBsAg reactive. Patients were followed up for a mean time of 5 years, utilizing from 1 to 5 samples for serological evaluations. We identified 12 patients (11 male and one female) who were negative for anti-HBc but positive for HBsAg in at least one sample during follow up, Compared with controls, anti-HBc negative / HBsAg positive cases had lower mean count of CD4 + T lymphocytes (349.2 vs. 455 cells/mm3, P = 0.048). There was no correlation between anti-HBc negative/HBsAg positive serological profile and the analyzed clinical variables (time of diagnosis, history of opportunistic infections, nadir CD4 + T cells, use of medications effective against HBV or advanced liver disease). Serum samples from 7 patients were submitted to the HBV viral load detection and HBV DNA was detected in only 3 of these patients, with a mean viral load of 5.67 log. These three cases were infected by HBV subgenotype A1 and the analysis of the precore/core region of these viruses did not identify any mutation that could explain the anomalous serological profile. In our series of HBV/HIV co-infected patients, 10% of them were concomitantly HBsAg reactive but anti-HBc nonreactive. No mutation in the precore/core regions was identified that could explain this profile. As these patients showed a lower mean CD4+T cells count compared to the control group, our findings may suggest that advanced immunosuppression may be involved, determining the loss of anti-HBc at least in detectable levels.
  • article 4 Citação(ões) na Scopus
    Sexual Dysfunctions Among People Living With HIV With Long- Term Treatment With Antiretroviral Therapy
    (2022) SCANAVINO, Marco De Tubino; MORI, Emi; NISIDA, Vera Vichr; AVELINO-SILVA, Vivian I.; AMARAL, Maria Luiza Sant'ana do; MESSINA, Bruna; SEGURADO, Aluisio Cotrim
    Introduction: Sexuality plays an essential role in the psychosocial well-being of people living with HIV (PLHIV) but it is still less assessed by healthcare professionals during treatment. Aim: To investigate the frequency of those screening positive for sexual dysfunction (SD) and associated factors according to gender/sexual orientation in PLHIV under long-term treatment with antiretroviral therapy (ART). Methods: Between September 2013 and October 2016, 234 PLHIV adults in treatment in Sao Paulo were included. Participants were sexually active, did not present sexual orientation disorder or body dysmorphicdisor-der, and did not use sexual hormones. We performed clinical interviews and measured levels of depression, anxiety, and levels of sexual hormones. SD was assessed using a self-report questionnaire. Main Outcome Measures: Proportion of participants screening positive for SD in the International Index of Erectile Function, the Index of Premature Ejaculation, and the Female Sexual Function Index. In the regression analyses, the outcome SD considered any SD presented with disregard to gender. Results: 70% of participants reported consistent adherence to ART and 96% had an undetectable viral load. The median (Md) duration of ART was 198 months (inter quartil range, IQR 111.6-230.4) and the median CD4 was 655 cells/mm(3) (IQR 443-871). Screening positive for erectile dysfunction was 49.7%, premature ejaculation 16.9%, female sexual dysfunction 27.4% and hypoactive desire 45.1%. Lower testosterone and prolactin levels were associated with erectile dysfunction in heterosexual men (n = 58); lower levels of oestradiol and higher levels of follicle stimulating hormone were associated with female sexual dysfunction and hypoactive desire in female participants (n = 63). The multivariable model used included comorbidities and hormonal abnormality and found that age (odds ratio, OR = 1.04, 95% confidence interval, 95%CI 1.00-1.08, P = .026) and the presence of depression/anxiety (OR = 2.96; 95%CI 1.52-5.77; P = .001) were associated with SD. Also, men reporting engaging in sex with other men were associated with screening positive for SD (OR 2.66; 95%CI 1.52-5.77, P = .013). During treatment of PLHIV, it is important to evaluate sexual health and symptoms of depression and anxiety specifically. The strength of this study consists in evaluating PLHIV who have been in long-term treatment with ART and analyzing those screening positive for SD and associated factors for each group (heterosexual men, men reporting engaging in sex with other men, and women). Limitation includes the difficulty to generalize the findings of the study, and not exploring women's sexual orientation. Conclusion: PLHIV in long-term treatment with ART presented alarming rates of depression/anxiety which in turn is correlated with sexual and physical health problems.
  • article 38 Citação(ões) na Scopus
    MAIT cells are activated in acute Dengue virus infection and after in vitro Zika virus infection
    (2018) PAQUIN-PROULX, Dominic; AVELINO-SILVA, Vivian I.; SANTOS, Bianca A. N.; BARSOTTI, Nathalia Silveira; SIROMA, Fabiana; RAMOS, Jessica Fernandes; TONACIO, Adriana Coracini; SONG, Alice; MAESTRI, Alvino; CERQUEIRA, Natalia Barros; FELIX, Alvina Clara; LEVI, Jose Eduardo; GREENSPUN, Benjamin C.; ROUGVIE, Miguel de Mulder; ROSENBERG, Michael G.; NIXON, Douglas F.; KALLAS, Esper G.
    Dengue virus (DENV) and Zika virus (ZIKV) are members of the Flaviviridae and are pre-dominantly transmitted via mosquito bites. Both viruses are responsible for a growing number of infections in tropical and subtropical regions. DENV infection can cause lethargy with severe morbidity and dengue shock syndrome leading to death in some cases. ZIKV is now linked with Guillain-Barre A syndrome and fetal malformations including microcephaly and developmental disorders (congenital Zika syndrome). The protective and pathogenic roles played by the immune response in these infections is unknown. Mucosal-associated invariant T (MAIT) cells are a population of innate T cells with potent anti-bacterial activity. MAIT cells have also been postulated to play a role in the immune response to viral infections. In this study, we evaluated MAIT cell frequency, phenotype, and function in samples from subjects with acute and convalescent DENV infection. We found that in acute DENV infection, MAIT cells had elevated co-expression of the activation markers CD38 and HLA-DR and had a poor IFN gamma response following bacterial stimulation. Furthermore, we found that MAIT cells can produce IFN gamma in response to in vitro infection with ZIKV. This MAIT cell response was independent of MR1, but dependent on IL-12 and IL-18. Our results suggest that MAIT cells may play an important role in the immune response to Flavivirus infections.