CLARISSE MARTINS MACHADO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina
LIM/52 - Laboratório de Virologia, Hospital das Clínicas, Faculdade de Medicina
LIM/52 - Laboratório de Virologia, Hospital das Clínicas, Faculdade de Medicina
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article 12 Citação(ões) na Scopus Human polyomaviruses JC and BK in the urine of Brazilian children and adolescents vertically infected by HIV(2011) MACHADO, Daisy Maria; FINK, Maria Cristina; PANNUTI, Claudio Sergio; SUCCI, Regina Celia de Menezes; MACHADO, Alessandra Aparecida; CARMO, Fabiana Bononi do; GOUVEA, Aida de Fatima Barbosa; URBANO, Paulo Roberto; BELTRAO, Suenia Vasconcelos; SANTOS, Isabel Cristina Lopes dos; MACHADO, Clarisse MartinsThe aim of this study was to characterize the urinary excretion of the BK (BKV) and JC (JCV) human polyomaviruses in a cohort of human immunodeficiency virus (HIV)-infected children and adolescents. One hundred and fifty-six patients were enrolled: Group I included 116 HIV-infected children and adolescents [median age = 11.4 years (y); range 1-22 y]; Group II included 40 non-HIV-infected healthy controls (median age = 11.37 y; range 7-16 y). Single urine samples from both groups were screened for the presence of JCV and BKV DNA by polymerase chain reaction at enrolment. The overall rate of JCV and BKV urinary excretion was found to be 24.4% and 40.4%, respectively (n = 156). Group I had urinary excretion of JCV and BKV in 27.6% and 54.3% of subjects, respectively. In contrast, Group II showed positive results for JCV in 17.5% of subjects and for BKV in 12.5% of subjects (p Pearson JCV = 0.20; p Pearson BKV < 0.0001). In Group I, there was no association between JCV/BKV shedding and age, gender or CD4 values. Patients with an HIV viral load < 50 copies/mL had a lower excretion of BKV (p < 0.001) and a trend of lower JCV excretion (p = 0.07). One patient in Group I (1/116, 0.9%) showed clinical and radiological features consistent with progressive multifocal leukoencephalopathy, suggesting that children with HIV/polyomavirus coinfection should be kept under surveillance.- Fighting Misconceptions to Improve Compliance with Influenza Vaccination among Health Care Workers: An Educational Project(2012) COUTO, Carla R.; PANNUTI, Claudio S.; PAZ JR., Jose P.; FINK, Maria C. D.; MACHADO, Alessandra A.; MARCHI, Michela de; MACHADO, Clarisse M.The compliance with influenza vaccination is poor among health care workers (HCWs) due to misconceptions about safety and effectiveness of influenza vaccine. We proposed an educational prospective study to demonstrate to HCWs that influenza vaccine is safe and that other respiratory viruses (RV) are the cause of respiratory symptoms in the months following influenza vaccination. 398 HCWs were surveyed for adverse events (AE) occurring within 48 h of vaccination. AE were reported by 30% of the HCWs. No severe AE was observed. A subset of 337 HCWs was followed up during four months, twice a week, for the detection of respiratory symptoms. RV was diagnosed by direct immunofluorescent assay (DFA) and real time PCR in symptomatic HCWs. Influenza A was detected in five episodes of respiratory symptoms (5.3%) and other RV in 26 (27.9%) episodes. The incidence density of influenza and other RV was 4.3 and 10.8 episodes per 100 HCW-month, respectively. The educational nature of the present study may persuade HCWs to develop a more positive attitude to influenza vaccination.
- Oral shedding of human herpesviruses in patients undergoing radiotherapy/chemotherapy treatment for head and neck squamous cell carcinoma(2017) PALMIERI, Michelle; MARTINS, Victor Adriano de Oliveira; SUMITA, Laura Masami; TOZETTO-MENDOZA, Tania Regina; ROMANO, Bruna Baraldi; MACHADO, Clarisse Martins; PANNUTI, Claudio Sergio; BRANDAO, Thais Bianca; RIBEIRO, Ana Carolina Prado; CORREA, Luciana; BRAZ-SILVA, Paulo HenriqueOpportunistic infections may affect the oral mucosa of patients undergoing radio/chemotherapy through exacerbation of oral mucositis. The aim of this study is to evaluate the oral shedding of all eight human herpesviruses and its possible association with oral mucositis. In this prospective cohort study, we analyzed oral rinse samples, collected weekly, from 20 patients during radiotherapy treatment. Serologic status to HSV1 and HSV2, EBV, CMV, and VZV in three different periods was performed by ELISA assay. PCR and enzymatic digestion was performed to detect HSV1, HSV2, EBV, CMV, VZV, HHV6, HHV7, and HHV8. Oral mucositis was evaluated according to the WHO criteria. Oral shedding of EBV, HHV6, and HHV7 was observed in all weeks of radiotherapy. Considering the episodes of shedding, the highest frequency was found in patients with EBV excretion (55.0%). No virus reactivation was observed by serological analysis. EBV oral shedding frequency was significantly higher than that of other viruses and showing a positive correlation with oral mucositis grade >= 2. There was a positive correlation between EBV oral shedding and oral mucositis grade >= 2, particularly after 3 weeks of radiotherapy, a period in which the severity of mucositis was statistically higher. These findings allow us to infer that the local inflammatory environment in mucositis grade >= 2 is more favorable for EBV replication. Mucositis is a frequent and important side effect of radio/chemotherapy treatment. Understanding the possible participation of viruses in the mechanism of this condition is important to develop strategies for treatment and prevention.
- Influenza A and B in a cohort of outpatient children and adolescent with influenza like-illness during two consecutive influenza seasons(2020) MACHADO, Clarisse M.; SOUZA, Ana Carolina Mamana Fernandes de; ROMANO, Camila Malta; FREIRE, Wilton dos Santos; COSTA, Angela Aparecida; FIGUEIREDO, Walter Manso; PANNUTI, Claudio S.; LUNA, Expedito J. A.Introduction: Influenza is an important cause of morbimortality worldwide. Although people at the extremes of age have a greater risk of complications, influenza has been more frequently investigated in the elderly than in children, and inpatients than outpatients. Yearly vaccination with trivalent or quadrivalent vaccines is the main strategy to control influenza. Objectives: Determine the clinical and molecular characteristics of influenza A and B infections in children and adolescents with influenza-like illness (ILI). Methods: A cohort of outpatient children and adolescents with ILI was followed for 20 months. Influenza was diagnosed with commercial multiplex PCR platforms. Results: 179 patients had 277 episodes of ILI, being 79 episodes of influenza A and 20 episodes of influenza B. Influenza A and B cases were mild and had similar presentation. Phylogenetic tree of influenza B viruses showed that 91.6% belonged to the B/Yamagata lineage, which is not included in trivalent vaccines. Conclusions: Influenza A and B are often detected in children and adolescents with ILI episodes, with similar and mild presentation in outpatients. The mismatch between the circulating influenza viruses and the trivalent vaccine offered in Brazil may have contributed to the high frequency of influenza A and B in this population. (C) 2020 Sociedade Brasileira de Infectologia.
- A Double-Blinded, Prospective Study to Define Antigenemia and Quantitative Real-Time Polymerase Chain Reaction Cutoffs to Start Preemptive Therapy in Low-Risk, Seropositive, Renal Transplanted Recipients(2014) DAVID-NETO, Elias; TRIBONI, Ana H. K.; PAULA, Flavio J.; BOAS, Lucy S. Vilas; MACHADO, Clarisse M.; AGENA, Fabiana; LATIF, Acram Z. A.; ALENCAR, Cecilia S.; PIERROTTI, Ligia C.; NAHAS, William C.; CAIAFFA-FILHO, Helio H.; PANNUTI, Claudio S.Background. Cytomegalovirus (CMV) disease occurs in 16% to 20% of low-risk, CMV-positive renal transplant recipients. The cutoffs for quantitative real-time polymerase chain reaction (qPCR) or phosphoprotein (pp65) antigenemia (pp65emia) for starting preemptive therapy have not been well established. Methods. We measured qPCR and pp65emia weekly from day 7 to day 120 after transplantation, in anti-CMV immunoglobulin GYpositive donor and recipient pairs. Patients and physicians were blinded to the test results. Suspicion of CMV disease led to the order of new tests. In asymptomatic viremic patients, the highest pp65emia and qPCR values were used, whereas we considered the last value before diagnosis in those with CMV disease. Results. We collected a total of 1,481 blood samples from 102 adult patients. Seventeen patients developed CMV disease, 54 presented at least one episode of viremia that cleared spontaneously, and 31 never presented viremia. Five patients developed CMV disease after the end of the study period. The median (95% confidence interval) pp65emia and qPCR values were higher before CMV disease than during asymptomatic viremia (6 [9-82] vs. 3 [1-14] cells/10(6) cells; P<0.001 and 3,080 [1,263-15,605] vs. 258 [258-1,679] copies/mL; P=0.008, respectively). The receiver operating characteristic curve showed that pp65emia 4 cells/10(6) cells or greater showed a sensitivity and specificity to predict CMV disease of 69% and 81%, respectively (area, 0.769; P=0.001), with a positive predictive value of 37% and a negative predictive value of 93%. For qPCR 2,000 copies/mL or higher, the positive predictive value and negative predictive value were 57% and 91%, respectively (receiver operating characteristic area, 0.782; P=0.000). Conclusion. With these cutoffs, both methods are appropriate for detecting CMV disease.