GABRIELA DA SILVA PRATES
Projetos de Pesquisa
Unidades Organizacionais
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Incomplete recovery of the CD4+/CD8+ratio is associated with the late introduction of antiretroviral therapy among people living with HIV infection(2024) PRATES, Gabriela da Silva; MONTEIRO, Mariana Amelia; OLIVEIRA, Ericka Constantinov; NASCIMENTO, Najara Ataide de Lima; VEIGA, Ana Paula Rocha; FERREIRA, Mauricio Domingues; POLIS, Thales Jose Bueno; CAETANO, Gabriela Prandi; SOARES, Beatriz Rodrigues Pellegrina; MAGRI, Marcello Mihailenko Chaves; PEREIRA, Luisa Oliveira; FONSECA, Luiz Augusto Marcondes; ALVES, Wagner Silva; DUARTE, Alberto Jose da Silva; CASSEB, Jorge Simao do RosarioDespite being subject to lower AIDS-related mortality rates and having a higher life expectancy, patients with HIV are more prone to develop non-AIDS events. A low CD4+/CD8+ ratio during antiretroviral therapy identifies people with heightened immune senescence and increased risk of mortality. In clinical practice, finding determinants of a low CD4+/CD8+ ratio may be useful for identifying patients who require close monitoring due to an increased risk of comorbidities and death. We performed a prospective study on the evolution of the CD4(+)/CD8(+) ratio in 60 patients infected with HIV (80% males), who were subjected to two different antiretroviral regimens: early and deferred therapy. The initial CD4(+)/CD8(+) ratio was <= 1 for 70% of the patients in both groups. Older age, CD4(+) cell count at inclusion, Nadir CD8(+)T-cell count, and Initial CD4(+)/CD8(+) ratio <= 1 were risk factors for lack of ratio recovery. In the multivariate analysis, a CD4(+)/CD8(+) ratio > 1 at the start of the treatment was found to be a determinant factor in maintaining a CD4(+)/CD8(+) ratio > 1. The nadir CD4(+)T-cell count was lower in the deferred therapy group (p=0.004), and the last CD4(+)/CD8(+) ratio <= 1 was not associated with comorbidities. Ratio recovery was not associated with the duration of HIV infection, time without therapy, or absence of AIDS incidence. A greater improvement was observed in patients treated early (p=0.003). In contrast, the slope of increase was slower in patients who deferred treatment. In conclusion, the increase in the CD4+/CD8+ ratio occurred mostly for patients undergoing early strategy treatment and its extension did not seem to be related to previous HIV-related factors.
- Could Cesarean Delivery Help Prevent Mother-to-Child Transmission of Human T-Lymphotropic Virus Type 1?(2023) PRATES, Gabriela; PAIVA, Arthur; HAZIOT, Michel E.; FONSECA, Luiz Augusto M.; SMID, Jerusa; MARCUSSO, Rosa Maria do N.; ASSONE, Tatiane; OLIVEIRA, Augusto. C. P. de; CASSEB, JorgeBackground. Mother-to-child transmission (MTCT) of human T-lymphotropic virus type 1 (HTLV-1) is an important route of transmission that can cause lifelong infection. There is high morbidity and mortality due to adult T-cell leukemia/lymphoma, HTLV-1-associated myelopathy (HAM), and other inflammatory disorders. These conditions develop in nearly 10% of people with HTLV-1 infection, with a higher risk if infection occurs early in life. Identification of risk factors can inform targeted measures to reduce HTLV-1 MTCT. This study aimed to investigate the potential of cesarean delivery to prevent HTLV-1 MTCT. Methods. We performed a review of the cases of women and their offspring under regular follow-up at the HTLV-1 outpatient clinic at the Institute of Infectious Diseases Emilio Ribas. Results. A total of 177 HTLV-1-infected women and 369 adult offspring were investigated. Overall, 15% of the children were positive for HTLV-1 and 85% were negative. Regarding vertical transmission, we found that a breastfeeding duration of >6 months was associated with MTCT. Moreover, maternal proviral load was not associated with transmission, but high educational level and cesarean delivery were identified as protective factors. Conclusions. HTLV-1 MTCT was associated with mother's age at delivery of >25 years, low educational level, prolonged breastfeeding, and vaginal delivery.
- Can Persistent Infections with Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus, and Human T Lymphotropic Virus Type 1 Be Eradicated?(2024) TEIXEIRA, Sandy Vieira; PRATES, Gabriela; FONSECA, Luiz Augusto Marcondes; CASSEB, JorgePersistent viruses are hard to be eradicated, even using effective medications, and can persist for a long time in humans, sometimes regardless of treatment. Hepatitis B virus, hepatitis C virus, human immunodeficiency virus, and human T cell lymphotropic virus infections, the most common in our era, are still a challenge despite the increased knowledge about their biology. Most of them are highly pathogenic, some causing acute disease or, more often, leading to chronic persistent infections, and some of the occult, carrying a high risk of morbidity and mortality. However, if such infections were discovered early, they might be eradicated in the near future with effective medications and/or vaccines. This perspective review points out some specific characteristics of the most important chronic persistent viruses. It seems that in the next few years, these persistent viruses may have control by vaccination, epidemiological strategies, and/or treatment.