MARCELLO MIHAILENKO CHAVES MAGRI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/48 - Laboratório de Imunologia, Hospital das Clínicas, Faculdade de Medicina
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina

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Autor: MAGRI, Marcello M. C. ×

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  • article 1 Citação(ões) na Scopus
    AIDS incidence and survival in a hospital-based cohort of HIV-positive patients from Sao Paulo, Brazil: The role of IFN-lambda 4 polymorphisms
    (2021) PRATES, Gabriela da Silva; MALTA, Fernanda M.; GONCALVES, Fernanda de Toledo; MONTEIRO, Mariana A.; FONSECA, Luiz Augusto M.; VEIGA, Ana Paula R.; MAGRI, Marcello M. C.; DUARTE, Alberto J. S.; CASSEB, Jorge; ASSONE, Tatiane
    Few studies have reported the prognosis of human immunodeficiency virus (HIV)-positive patients followed for a long time in Brazil, particularly those including pre and post-HAART eras. The polymorphisms of interferon (IFN)-lambda 4 have been postulated as possibly associated with the pathogenesis of HIV infection. The aim of this study was to describe the incidence and mortality from a cohort of HIV-positive patients as well as whether IFN-lambda 4 gene polymorphisms (SNP rs8099917 and SNP rs12979860) were associated with HIV/acquired immune deficiency syndrome (AIDS) progression. We followed 402 patients for up to 30 years; 347 of them began follow-up asymptomatic, without any AIDS-defining opportunistic disease and/or a lymphocytes T CD4+ count of 350 cells/mm(3)or lower. We determined the probability of the asymptomatic subjects to remain AIDS-free, and the risk of death for those entering the study already with an AIDS diagnosis, as well as for subjects developing AIDS during follow-up. We compared the prognosis of patients with two different polymorphisms for the genes encoding for IFN-lambda 4, variants rs8099917 and rs12979860. The follow-up time of the 347 asymptomatic-at-entry subjects was 3687 person-years. IFN-lambda 4 rs8099917 polymorphisms were not associated with AIDS progression, but IFN-lambda 4 rs12979860 wild type genotype (CC) was associated with higher mortality compared to CT and TT, with an increased probability of death from AIDS (P = .01). In conclusion, genetic variations in IFN-lambda 4 on rs12979860 polymorphisms in HIV-infected patients may drive mortality risk.
  • article 0 Citação(ões) na Scopus
    Prevalence of Antiretroviral Drug Resistance Mutations in HIV Seropositive Patients from an Outpatient Clinic of a Large University Hospital from Sao Paulo, Brazil
    (2020) CONSTANTINOV, Ericka Oliveira; BRIGIDO, Luis Fernando de Macedo; FONSECA, Luiz Augusto M.; CASSEB, Jorge; VEIGA, Ana Paula R.; MAGRI, Marcello M. C.; MONTEIRO, Mariana A.; ROCHA, Rosana C.; GASCON, Maria R. P.; FERREIRA, Mauricio D.; POLIS, Thales J. B.; NASCIMENTO, Najara A. de Lima; LIMONGELLI, Isadora Id; OLIVEIRA, Caro S.; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.
    Drug resistance mutations (DRMs) can affect the success of the therapy and compromise new prevention strategies. Increasing rates of resistance to antiretroviral (ARV) drugs have been reported in some areas. This study evaluated the DRMs prevalence among patients at Hospital das Clinicas (Sao Paulo). Among treatment-naive patients, the prevalence of transmitted DRMs (Stanford Calibrated Population Resistance) was 8.4% (21/249), with 69% (75/109) of acquired resistance among treatment-experienced patients. Rates of transmitted DRM showed an increase (6.6% in 2002-2009 vs. 15.1% in 2010-2015, p = .05), from the first to the second decade, mainly due to mutations to the NNRTI (non-nucleoside reverse transcriptase inhibitor) class. Among treatment-experienced cases, a nonsignificant decrease overall, significant for the protease inhibitors (PIs) class, was documented. Subtype B predominated in both groups (78%), followed by subtype F, BF recombinants, and subtype C. Our results add to the growing evidence of an increase in transmitted DRM, document extensive DRM among experienced patients, and a decrease in resistance to PIs class that may reflect the increased use of boosted PIs and newer ARV classes in more recent years.
  • article 0 Citação(ões) na Scopus
    SARS-CoV-2/COVID-19: Clinical Course Among Subjects HIV-1-Infected in Sao Paulo
    (2022) MONTEIRO, Mariana A. A.; PRATES, Gabriela S. S.; NASCIMENTO, Najara A. A. de Lima; VEIGA, Ana Paula R.; MAGRI, Marcello M. C.; POLIS, Thales J. B.; GASCON, Maria R. P.; FERREIRA, Mauricio D. D.; TIBERTO, Larissa; PEREIRA, Luisa O. O.; ALVES, Wagner; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.; CASSEB, Jorge
    Introduction: People living with Human Immunodeficiency Virus (HIV) are under risk for co-infection with SARS-CoV-2. This population may be more prone to complications from COVID-19 due to persistent inflammation caused by HIV and higher incidence of metabolic syndromes, cardiovascular diseases, and malignancies, as well as being considered elderly at 50 years of age. The objective of this study was to report SARS-CoV-2 infection frequency, clinical evolution, and mortality in HIV-positive patients on antiretroviral therapy. Methods: The period of inquiry ranged from January to September 2020. Due to the social distance and the suspension of in-person medical care during the time of the investigation, we sent electronic questions about demographic, epidemiological, and clinical data to 403 HIV-infected patients. Results: Among 260 patients who answered the questionnaire, thirty-nine patients (15%) had suggestive symptoms and were tested for SARS-CoV-2 infection. Of this, 11 had positive results (32.4%) and no patient died of COVID-19 complications. Nine were male (3.4%), and the mean age of the patients with positive results was 43.2 years (+/- 9.6). 107 patients (41.1%) were over 50 years of age and their mean T-CD4(+) cell count was 768. Eleven patients (4.2%) had a detectable HIV RNA viral load and 127 (48.8%) had comorbidities. These variables were not associated with an increased risk for infection. Conclusion: The frequency of SARS-COV2 infection among HIV-infected is similar to the general population, and the clinical course is associated with the presence of comorbidities and not due to the HIV infection. However, new studies should be done to assess if this vulnerable population could answer the vaccine anti-SARS-Cov2.
  • article 1 Citação(ões) na Scopus
    Performance of a Real-Time PCR Assay for the Detection of Five Candida Species in Blood Samples from ICU Patients at Risk of Candidemia
    (2023) FELIX, Gabriel N.; FREITAS, Vera L. T. de; SILVA JUNIOR, Afonso R. da; MAGRI, Marcello M. C.; ROSSI, Flavia; SEJAS, Odeli N. E.; ABDALA, Edson; MALBOUISSON, Luiz M. S.; GUIMARAES, Thais; BENARD, Gil; NEGRO, Gilda M. B. Del
    The gold standard for diagnosing invasive candidiasis still relies on blood cultures, which are inefficient and time-consuming to analyze. We developed an in-house qPCR assay to identify the 5 major Candida species in 78 peripheral blood (PB) samples from ICU patients at risk of candidemia. Blood cultures and (1,3)-beta-D-glucan (BDG) testing were performed concurrently to evaluate the performance of the qPCR. The qPCR was positive for DNA samples from all 20 patients with proven candidemia (positive PB cultures), showing complete concordance with Candida species identification in blood cultures, except for detection of dual candidemia in 4 patients, which was missed by blood cultures. Additionally, the qPCR detected Candida species in six DNA samples from patients with positive central venous catheters blood (CB) but negative PB cultures. BDG values were similarly high in these six samples and the ones with proven candidemia, strongly suggesting the diagnosis of a true candidemia episode despite the negative PB cultures. Samples from patients neither infected nor colonized yielded negative results in both the qPCR and BDG testing. Our qPCR assay was at least as sensitive as blood cultures, but with a shorter turnaround time. Furthermore, negative results from the qPCR provided strong evidence for the absence of candidemia caused by the five major Candida species.
  • article 3 Citação(ões) na Scopus
    Fighting HIV/AIDS in a developing country: lessons from a small cohort from the largest Brazilian city
    (2020) CASSEB, Jorge; VEIGA, Ana Paula R.; MAGRI, Marcello M. C.; MONTEIRO, Mariana A.; ROCHA, Rosana C.; GASCON, Maria Rita P.; DOMINGUES-FERREIRA, Mauricio; POLIS, Thales J. B.; NASCIMENTO, Najara A. de Lima; LIMONGELLI, Isadora; OLIVEIRA, Icaro S.; PRANDI, Gabriela Caetano; COSTA, Livia M. C. B. Villares; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.
  • article 2 Citação(ões) na Scopus
    Evaluation of the Sensititre YeastOne and Etest in Comparison with CLSI M38-A2 for Antifungal Susceptibility Testing of Three Azoles, Amphotericin B, Caspofungin, and Anidulafungin, against Aspergillus fumigatus and Other Species, Using New Clinical Breakpoints and Epidemiological Cutoff Values
    (2022) MELHEM, Marcia S. C.; COELHO, Vivian C.; FONSECA, Claudia A.; OLIVEIRA, Lidiane de; BONFIETTI, Lucas X.; SZESZS, Maria W.; MAGRI, Marcello M. C.; DORNELES, Francine S.; TAGUCHI, Hideaki; MOREIRA, Daniel V. S.; MOTTA, Adriana L.; V, Marjorie Batista; KAMEI, Katsuhiko; SHIKANAI-YASUDA, Maria A.
    Aspergillosis is an invasive fungal disease associated with high mortality. Antifungal susceptibility testing (AFST) is receiving increasing consideration for managing patients, as well as for surveilling emerging drug resistance, despite having time-consuming and technically complex reference methodologies. The Sensititre YeastOne (SYO) and Etest methods are widely utilized for yeasts but have not been extensively evaluated for Aspergillus isolates. We obtained Posaconazole (POS), Voriconazole (VCZ), Itraconazole (ITC), Amphotericin B (AMB), Caspofungin (CAS), and Anidulafungin (AND) minimum inhibitory concentrations (MICs) for both the Etest (n = 330) and SYO (n = 339) methods for 106 sequenced clinical strains. For 84 A. fumigatus, we analyzed the performance of both commercial methods in comparison with the CLSI-AFST, using available cutoff values. An excellent correlation could be demonstrated for Etest-AMB and Etest-VCZ (p < 0.01). SYO-MICs of AMB, VCZ, and POS resulted in excellent essential agreement (>93%), and >80% for AMB, VCZ, and ITC Etest-MICs. High categoric agreement was found for AMB, ITC, and CAS Etest-MICs (>85%) and AMB SYO-MICs (>90%). The considerable number of major/very major errors found using Etest and SYO, possibly related to the proposed cutoffs and associated with the less time-consuming processes, support the need for the improvement of commercial methods for Aspergillus strains.