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
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Monitoring for HHV-6 Infection After Renal Transplantation: Evaluation of Risk Factors for Sustained Viral Replication(2013) LUIZ, Claudia R.; MACHADO, Clarisse M.; CANTO, Cynthia L. M.; CHRIST, Silvia C. C.; PESTANA, Jose O. M.; KOTTON, Camille N.; CAMARGO, Luis F. A.Background. Human herpesvirus-6 (HHV-6) is known to reactivate after renal transplantation and has been associated with several clinical manifestations. Risk factors for sustained viral replication, however, remain unclear. Methods. Thirty consecutive kidney transplant patients were prospectively followed for HHV-6 replication between February 2007 and February 2008. Plasma samples for DNA detection were collected from the donor and the recipient before transplantation and from the recipient weekly for the first 2 months after transplantation and then every 2 weeks for 2 additional months. HHV-6 active infection was defined as detection of viral DNA in plasma, by polymerase chain reaction, in at least two consecutive samples over an interval of at least 1 week. Results. Active viral infection was detected in 25% of the recipients before transplantation and 27% (8 of 30) of the patients after transplantation. The mean time to onset of viral replication was 28.1 days after transplantation and 7 of 8 (87.5%) were asymptomatic. Risk factors associated with active HHV-6 infection were receiving an organ from a living donor (P=0.028), recipients with IgM antibodies detected before transplantation (P=0.005), and pretransplantation recipient HHV-6 viral load more than 10,000 copies/mL plasma (P=0.034). Conclusions. Active HHV-6 infection occurs early after renal transplantation and is mostly asymptomatic. Donor or recipient infection may occur at the time of transplantation and are related to higher rates of posttransplantation infections.
conferenceObject Epidemiology of Cytomegalovirus Infection and Disease in Hematopoietic Stem Cell Transplant Recipients in Selected Countries Outside of North America and Europe: A Systematic Review(2022) MACHADO, Clarisse M.; CHO, Sung-Yeon; SLAVIN, Monica; SINGH, Inderjeet; SANDHU, Anudeep; DEMUTH, Dirk; WU, Depei- Cut-Off of COBAS (R) Ampliprep/COBAS (R) Taqman (R) CMV Test in Transplant Recipients Receiving Intermittent Ganciclovir (GCV) Prophylaxis(2018) CAMPOS, Silvia Vidal; SOUZA, Ana Carolina M.; MELLO, Liliane S.; PEREIRA, Barbara B. S.; MACHADO, Clarisse M.
conferenceObject Real-World Treatment Patterns and Outcomes For Cytomegalovirus Infection and Disease in Hematopoietic Stem Cell Transplant Recipients in Selected Countries Outside of North America and Europe: A Systematic Review(2022) CHO, Sung-Yeon; WU, Depei; MACHADO, Clarisse; SINGH, Inderjeet; SANDHU, Anudeep; DEMUTH, Dirk; SLAVIN, Monica- 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.