JORGE SIMAO DO ROSARIO CASSEB
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Dermatologia, Faculdade de Medicina - Docente
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Prevalence of infection by human T Cell lymphotropic viruses (HTLV-1/2) in adult population in Vitoria-ES(2021) ORLETTI, Maria P. S.; ASSONE, Tatiane; SARNAGLIA, Glenia Daros; MARTINS, Marina Lobato; ROSADAS, Carolina; CASSEB, Jorge; TAYLOR, Graham; FERREIRA-FILHO, Joaquim B.; PEREIRA, Fausto E. L.; MIRANDA, Angelica EspinosaIntroduction: Brazil has a high number of HTLV-1/2 infections which are unequally distributed in the country. Most prevalence studies have focused on specific populations, such as blood donors and pregnant women. Some areas, for example the state of Bahia, have robust information about HTLV-1/2 infection, however there is no information available about this infection in the general population of Vitoria, Espirito Santo, Brazil. Objective: To determine the prevalence of HTLV-1/2 infection in adults from the municipality of Vitoria, ES. Methods: A cross sectional study was performed from September 2010 to December 2011, in individuals of both sexes, aged 18 or older living in Vit = oria-ES. Venous blood samples were collected and tested for anti-HTLV-1/2 antibodies by chemiluminescent immunoassay (CMIA). Individuals with CMIA reactive results were submitted to a new blood collection for retesting by CMIA, followed by PCR to confirm infection and discriminate the viral type. Results: From 1502 tested samples, eight were reactive in CMIA and all were confirmed by PCR. Therefore, the prevalence of HTLV-1/2 was 0.53% (8/1502, 95% CI: 0.2-1.0%). The infection rate was 0.7% in men (5/711, 95% CI: 0.17-1.51%), and 0.38% in women (3/791, 95% CI: 0 - 0.81%). Conclusions: The prevalence of HTLV-1/2 infection was 0.53% (8/1502; 95% CI: 0.2 - 0.9%). Confirmatory test using real-time PCR (qPCR) identified seven individuals positive for HTLV-1 and one for HTLV-2. Considering the risk of infected individuals to develop high morbidity and mortality diseases, it would be important to implement public health policies aimed at stopping transmission of these viruses in this municipality. (C) 2021 Sociedade Brasileira de Infectologia.
- In vitro basal T-cell proliferation among asymptomatic Human T cell Leukemia Virus type 1 patients co-infected with hepatitis C and/or Human Immunodeficiency Virus type 1(2018) ASSONE, Tatiane; KANASHIRO, Tatiana M.; BALDASSIN, Maira P. M.; PAIVA, Arthur; HAZIOT, Michel E.; SMID, Jerusa; OLIVEIRA, Augusto Penalva de; FONSECA, Luiz Augusto M.; NORRIS, Philip J.; CASSEB, JorgeBackground: Infection with Human T cell Leukemia Virus type 1 can be associated with myelopathy/tropical spastic paraparesis (HAM/TSP) and other inflammatory diseases. Lymphocytes from about half of Human T cell Leukemia Virus type 1-infected subjects spontaneously proliferate in vitro, and how this phenomenon relates to symptomatic disease and viral burden is poorly understood. Objective: To evaluate T-cell proliferation in vitro among patients co-infected with Human T cell Leukemia Virus type 1/Hepatitis C Virus/Human Immunodeficiency Virus type 1. Material and methods: From 610 Human T cell Leukemia Virus-infected patients of the Human T cell Leukemia Virus outpatient clinic from Institute of Infectious Diseases ""Emilio Ribas"" in Sao Paulo, 273 agreed to participate: 72 had HAM/TSP (excluded from this analysis) and 201 were asymptomatic, a classification performed during a regular neurological appointment. We selected the subgroup made up only by the 201 asymptomatic subjects to avoid bias by the clinical status as a confounder effect, who had laboratory results of Human T cell Leukemia Virus type 1 proviral load and T-cell proliferation assay in our database. They were further grouped according to their serological status in four categories: 121 Human T cell Leukemia Virus type 1 asymptomatic mono-infected carriers; 32 Human T cell Leukemia Virus type 1/Hepatitis C Virus, 29 Human T cell Leukemia Virus type 1/Human Immunodeficiency Virus type 1, and 19 Human T cell Leukemia Virus type 1/Human Immunodeficiency Virus type 1/Hepatitis C Virus co-infected patients. Clinical data were obtained from medical records and interviews. DNA Human T cell Leukemia Virus type 1 proviral load (PVL) and T-cell proliferation (LPA) assay were performed for all samples. Results: From a total of 273 subjects with Human T cell Leukemia Virus type 1, 80 presented co-infections: 29 had Human Immunodeficiency Virus type 1, 32 had Hepatitis C Virus, and 19 had Human Immunodeficiency Virus type 1 and Hepatitis C Virus. Comparing the groups based on their serological status, independently of being asymptomatic carriers, we observed a significant increase of PVL (p < 0.001) and LPA (p =0.001). However, when groups were stratified according to their clinical and serological status, there was no significant increase in Human T cell Leukemia Virus type 1 PVL and LPA. Conclusion: No significant increase of basal T-cell proliferation among Human T cell Leukemia Virus type 1 co-infected was observed. This interaction may be implicated in liver damage, worsening the prognosis of co-infected patients or, on the contrary, inducing a higher spontaneous clearance of Hepatitis C Virus infection in Human T cell Leukemia Virus type 1 co-infected patients. (C) 2018 Sociedade Brasileira de Infectologia.
article 23 Citação(ões) na Scopus Prevalence of anxiety, depression and quality of life in HTLV-1 infected patients(2011) GASCON, Maria Rita Polo; CAPITAO, Claudio Garcia; CASSEB, Jorge; NOGUEIRA-MARTINS, Maria Cezira Fantini; SMID, Jerusa; OLIVEIRA, Augusto Cesar Penalva deThe HAM/TSP caused by HTLV-1 infection usually affects patients to disabling states, and sometimes can lead them to paraplegia presenting symptoms of depression and anxiety, impacting on quality of life. Objective: The purpose of this study was to evaluate the frequency of depression and anxiety and its impact on quality of life in HTLV-1-infected TSP/HAM patients. Material and Methods: This was a cross-sectional study including 67 asymptomatic (control group) and 63 with TSP/HAM subjects. The instruments used were a demographic questionnaire, scales for anxiety and depression diagnosis (BDI and BAI), questionnaire for the assessment of Quality of Life of the World Health Organization (WHOQOL-Brief) and neurological scale to measure the disability level (Osame's Disability Status Scale). All patients had HTLV-I diagnosis by serological and molecular approaches, monitored at Instituto de Infectologia Emilio Ribas from May 2008 to July 2009. Data were analyzed statistically by frequencies, the Mann-Whitney test and the Spearman correlation test. Data among groups were analyzed and correlated with functional and severity aspects. Results: The results showed that patients with HAM/TSP compared to asymptomatic carriers had higher rates of depression (p < 0.001) and anxiety (p < 0.001), and impairment on quality of life in the areas of: dissatisfaction with health (p < 0.001), physical (p < 0.001) and the environment (p = 0.003). The main factors that correlated with levels of depression and anxiety and the domains of the WHOQOL-brief were: education, family income and social class. Conclusion: A well conducted evaluation and counseling may help in treatment, for a better quality of life of these patients.- Efficacy of vitamin D supplementation among persons living with HIV/AIDS in Sao Paulo city, Brazil(2021) ALMEIDA-AFONSO, Rosa; FINAMOR, Danilo; FONSECA, Luiz Augusto M.; VEIGA, Ana P. Rocha; MONTEIRO, Mariana A.; MAGRI, Marcello; DUARTE, Alberto J. S.; CASSEB, JorgeHypovitaminosis D is now considered a pandemic, especially among more vulnerable populations and in HIV-infected subjects, with 80% presenting levels below 30 ng/mL. As there is no consensus on the more adequate dosage needed to correct such deficiency, the objective of this study was to evaluate 25 (OH) vitamin D supplementation in HIV-1 patients deficient of vitamin D. A total of 73 HIV-1-infected patients were included, drawn from a cohort of 435 patients; 37 patients were randomized to the active group, supplemented once a week with 50,000 UI vitamin D by mouth (group 1) and 36 to the placebo group (group 2). The study period ranged from June 2016 to September 2017. Variables involved in vitamin D metabolism and risk factors associated with hypovitaminosis were evaluated. The mean age was 45 years and 31.5 % were women. Vitamin D supplementation was effective in normalizing serum levels after six months in group 1 (mean 35 ng/mL compared to 21 ng/mL for the placebo group; p = 0.04). No patient reached blood levels considered toxic (>100 UI). Efavirenz use can negatively influence vitamin D levels and supplementation is necessary as a likely adjunct to improving CD4+ T cells, resulting in greater effectiveness of the treatment. A weekly oral dose of 50,000 IU of vitamin D was sufficient to normalize the vitamin deficiency, safely and with good adherence among persons living with HIV/AIDS in Brazil. (C) 2021 Sociedade Brasileira de Infectologia.
- The impact of urinary incontinence on the quality of life and on the sexuality of patients with HAM/TSP(2018) GASCON, Maria Rita Polo; MELLAO, Mirella de Almeida; MELLO, Sandra Helena; NEGRAO, Rosangela Maria; CASSEB, Jorge; OLIVEIRA, Augusto Cesar Penalva deThis study evaluated the impact of urinary incontinence (UI) on sexuality, body image, mood, and quality of life of patients with myyelopathy associated with HTLV-1/tropical spastic paraparesis (HAM/TSP). The sample consisted of 31 HAM/TSP outpatients, of both sexes, followed-up at the Emilio Ribas Infectology Institute. The following instruments were used: sociodemographic questionnaire, Hospital Anxiety and Depression Scale (HAD), Body Image Assessment Scale, Sexual Quotient Female (QS-F) and Male (QS-M) Versions, King's Health Questionnaire (KHQ), and Revised OSAME Motor Disability Score. Data analysis was performed using descriptive statistics and the Mann-Whitney U-test was used for group comparison. The presence of UI was reported by 13 (41.9%) patients. Based on the quality of life questionnaire, patients with UI had a significant impact in the following domains: incontinence impact, daily life activities limitation, physical and social limitations, social relations, emotions, sleep and disposition, and severity measurements. Most participants had no anxiety (21; 67.7%) or depression symptoms (18; 58.1%). Regarding the sexual coefficient, 13 (41.9%) participants had sexual dissatisfaction. Conclusion: UI is common in HTLV-1 patients and may cause serious impairment in quality of life, with social, psychological and hygienic consequences. Nonetheless, there are few studies on this subject and their impact on mood and sexuality. (C) 2018 Sociedade Brasileira de Infectologia.