ANGELA CARVALHO FREITAS
Projetos de Pesquisa
Unidades Organizacionais
P ICHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina
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article 4 Citação(ões) na Scopus Prevalence and factors associated with darunavir resistance mutations in multi-experienced HIV-1-infected patients failing other protease inhibitors in a referral teaching center in Brazil(2011) VIDAL, Jose E.; FREITAS, Angela C.; SONG, Alice T. W.; CAMPOS, Silvia V.; DALBEN, Mirian; HERNANDEZ, Adrian V.Information about resistance profile of darunavir (DRV) is scarce in Brazil. Our objectives were to estimate the prevalence of DRV resistance mutations in patients failing protease inhibitors (PI) and to identify factors associated with having more DRV resistance mutations. All HIV-infected patients failing PI-based regimens with genotyping performed between 2007 and 2008 in a referral teaching center in Sao Paulo, Brazil, were included. DRV-specific resistance mutations listed by December 2008 IAS-USA panel update were considered. Two Poisson regression models were constructed to assess factors related to the presence of more DRV resistance mutations. A total of 171 HIV-infected patients with available genotyping were included. The number of patients with lopinavir, saquinavir, and amprenavir used in previous regimen were 130 (76%), 83 (49%), and 35 (20%), respectively. The prevalence of major DRV resistance mutations was 50V: 5%; 54M: 1%; 76V: 4%; 84V: 15%. For minor mutations, the rates were 11I: 3%; 32I: 7%; 33F: 23%; 47V: 6%; 54L: 6%; 74P: 3%; 89V: 6%. Only 11 (6%) of the genotypes had >= 3 DRV resistance mutations. In the clinical model, time of HIV infection of > 10 years and use of amprenavir were independently associated with having more DRV resistance mutations. In the genotyping-based model, only total number of PI resistance mutations was associated with our outcome. In conclusion, the prevalence of DRV mutations was low. Time of HIV infection, use of amprenavir and total number of PI resistance mutations were associated with having more DRV mutations.- Erratum in «High rate of virologic supression with darunavir/ritonavir plus optimazed background therapy among highly antiretroviral-experienced HIV-infected patients: results of a prospective cohort study in São Paulo, Brazil»(2013) VIDAL, José Ernesto; SONG, Alice Tung Wan; MATOS, Maria Laura; BARTMANN, Daniel; ANJOS, Guilherme dos; MIRANDA, Érique José Peixoto de; FREITAS, Ângela Carvalho; DALBEN, Mirian de Freitas; SANTANA, Claudinei; SEGURADO, Aluísio Cotrim; BARRETO, Cláudia Cortese; HERNÁNDEZ, Adrián Vladimir
- HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in Sao Paulo city, Brazil(2019) FREITAS, Angela Carvalho; AVELINO-SILVA, Vivian Iida; GUTIERREZ, Eliana Battaggia; MARQUES, Heloisa Helena de Souza; DURIGON, Giuliana Stravinskas; SEGURADO, Aluisio CotrimBackground: HIV-infected children surviving until adulthood have been transitioning to adult outpatient health care service in Brazil since the late 2000's. Deterioration of clinical condition is expected during this period, as reported among youths with non-communicable chronic diseases. Despite their young age, they are long-term hosts of the virus, have prolonged exposure to antiretroviral therapy and have suffered from the social determinants and stigma of HIV infection since early childhood. Objectives: This study aimed to (1) describe demographic and clinical characteristics at the first appointment at adult care service following pediatric care of a cohort of Brazilian youths living with HIV since childhood; and (2) retrospectively address adherence and clinical variables in the last two years of pediatric follow-up. Methods: Descriptive study. Results: 41 consecutive patients referred to adult outpatient care from a pediatric HIV unit were enrolled, median age 19 years, and median lifetime CD4+ nadir 117 cell/mm(3); 89% reported previous AIDS-defining conditions. At first laboratory assessment in adult care, only 46% had undetectable (<400 copies/ml) HIV viral load and the median CD4+ count was 250 cell/mm(3). Conclusion: Youths living with HIV at the transition from pediatric to adult care had poor treatment adherence, low lifetime CD4+ cell nadir, low CD4 cell count and detectable HIV viral load. Health care providers should closely monitor these adolescents in a youth friendly environment, prepared for open communication about all aspects of their health. (C) 2019 Sociedade Brasileira de Infectologia.
- Predictors of treatment adherence and HIV viral load among youths transitioning from pediatric to adult HIV outpatient care in Sao Paulo, Brazil(2018) FREITAS, A.; AVELINO-SILVA, V.; GUTIERREZ, E.; DURIGON, G.; PEREIRA, M. F.; LITIVINOC, N.; MARQUES, H. H.; SEGURADO, A.
bookPart Diarreias Infecciosas e Cólera(2016) ALMEIDA, Maria Cláudia Stockler de; IBRAHIM, Karim Yaqub; FREITAS, Angela de Carvalho; LITVOC, Marcelo- Humoral and cellular immune responses to CoronaVac up to one year after vaccination(2022) COSTA, Priscilla Ramos; CORREIA, Carolina Argondizo; MARMORATO, Mariana Prado; DIAS, Juliana Zanatta de Carvalho; THOMAZELLA, Mateus Vailant; SILVA, Amanda Cabral da; OLIVEIRA, Ana Carolina Soares de; GUSMAO, Arianne Fagotti; FERRARI, Lilian; FREITAS, Angela Carvalho; PATINO, Elizabeth Gonzalez; GRIFONI, Alba; WEISKOPF, Daniela; SETTE, Alessandro; SCHARF, Rami; KALLAS, Esper Georges; SILVEIRA, Cassia Gisele TerrassaniCoronavac is a widely used SARS-CoV-2 inactivated vaccine, but its long-term immune response assessment is still lacking. We evaluated SARS-CoV-2-specific immune responses, including T cell activation markers, antigen-specific cytokine production and antibody response following vaccination in 53 adult and elderly individuals participating in a phase 3 clinical trial. Activated follicular helper T (Tfh), non-Tfh and memory CD4(+) T cells were detected in almost all subjects early after the first vaccine dose. Activated memory CD4(+) T cells were predominantly of central and effector memory T cell phenotypes and were sustained for at least 6 months. We also detected a balanced Th1-, Th2- and Th17/Th22-type cytokine production that was associated with response over time, together with particular cytokine profile linked to poor responses in older vaccinees. SARS-CoV-2-specific IgG levels peaked 14 days after the second dose and were mostly stable over one year. CoronaVac was able to induce a potent and durable antiviral antigen-specific cellular response and the cytokine profiles related to the response over time and impacted by the senescence were defined.
bookPart Estafilococcias e Estreptococcias(2013) LEITE, Olavo Henrique Munhoz; FREITAS, Angela Carvalho; OLIVEIRA, Priscila Rosalba Domingos de; CAMPOS, Silvia Vidal; LEVIN, Anna Sara Shafferman; COSTA, Silvia FigueiredobookPart Infecção pelo Vírus da Imunodeficiência Humana (HIV) e Síndrome da Imunodeficiência Adquirida (Aids)(2016) SEGURADO, Aluísio Augusto Cotrim; FREITAS, Angela Carvalho; ATOMIYA, Angela Naomi; WüNSCH, Celia Torrens; NOVAES, Christina Terra Gallafrio; HIGASHINO, Hermes Ryoiti; BERMUDEZ, Jose Ernesto Vidal; CHAVES NETTO, Lucas; VICENTINE, Margarete Paganotti; BOULOS, Maria Ivete Castro; LOPES, Max Igor Banks Ferreira; VASCONCELOS, Ricardo de Paula; SANTOS, Sigrid de Sousa dos; MELLO, Valéria Antakly de; AVELINO-SILVA, Vivian Helena Iida- Access and adherence to isoniazid preventive therapy and occurrence of active TB in a cohort of people living with HIV: a retrospective cohort study in Sao Paulo, Brazil(2020) PICONE, Camila Melo; FREITAS, Angela Carvalho; GUTIERREZ, Eliana B.; AVELINO-SILVA, Vivian IidaTuberculosis (TB) is still a leading cause of morbidity and mortality among people living with HIV (PLHIV). The diagnosis of latent TB is required for the implementation of prophylactic therapy with isoniazid (PTI). However, low access to diagnosis of latent TB and non-adherence to PTI may hinder potential benefits of this essential intervention. In this study, we addressed the access and adherence to PTI in a cohort of PLHIV with positive tuberculin skin test (TST) in a reference HIV clinic in Sao Paulo, Brazil. We have also analyzed the occurrence of active TB over a median of 131 months after a positive TST among study participants. Our findings revealed that 88.3% of the 238 TST-positive patients had access to PTI, and 196 (93.3%) of those with access adhered to PTI. Active tuberculosis was diagnosed in three of the 196 TST-positive patients who adhered to PTI (1.5%; 95% confidence interval [CI] 0.3-4.4%). whereas seven cases were detected among 42 patients without access or who did not adhere to PTI (16.6%; 95% CI 7.0-31.3%). The apparent beneficial effect of PIT in our cohort is consistent with previous studies including PLHIV, and highlights the importance of reliably delivering each of the steps between screening for latent TB and provision of PTI.
- High rate of virologic suppression with darunavir/ritonavir plus optimized background therapy among highly antiretroviral-experienced HIV-infected patients: results of a prospective cohort study in Sao Paulo, Brazil(2013) VIDAL, Jose Ernesto; SONG, Alice Tung Wan; MATOS, Maria Laura; BARTMANN, Daniel; ANJOS, Guilherme dos; MIRANDA, Erique Jose Peixoto de; FREITAS, Angela Carvalho; DALBEN, Mirian de Freitas; SANTANA, Claudinei; SEGURADO, Aluisio Cotrim; BARRETO, Claudia Cortese; HERNANDEZ, Adrian VladimirObjectives: To assess the virologic and immunological response of darunavir/ritonavir plus optimized background therapy in highly antiretroviral-experienced HIV-infected patients in Brazil. Methods: Prospective cohort study carried out in a tertiary center in Sao Paulo, Brazil. Three-class antiretroviral-experienced patients with confirmed virologic failure began darunavir/ritonavir plus optimized background therapy (nucleoside/tide reverse transcriptase inhibitors +/- raltegravir +/- enfuvirtide +/- maraviroc) after performing a genotypic resistance assay. Clinical evaluation and laboratory tests were collected at baseline and at weeks 12, 24, and 48. Multivariate analysis was performed to identify predictors of virologic response at 48 weeks. Results: Ninety-two patients were included. The median of darunavir resistant mutation was 1 (range 0-6). The median genotypic sensitivity score in the optimized background therapy was 2 (interquartile range 1-2). At week 48, 83% (95% CI: 75-90%) had an HIV RNA level <50 copies/mL and the median CD4 cell count was 301 (interquartile range 224-445) cells/mm(3). Baseline HIV RNA >100 000 copies/mL was inversely associated with virologic success at week 48 (HR: 0.22, 95% CI: 0.06-0.85, p=0.028). Conclusions: Darunavir/ritonavir plus optimized background therapy was a highly effective salvage regimen under clinical routine conditions in a referral center in Brazil, which is similar to the reported in high-income countries.