Artigos e Materiais de Revistas Científicas - FM/MIP

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.


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  • article 7 Citação(ões) na Scopus
    Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories
    (2024) RAZAVI-SHEARER, Devin M.; BUTI, Maria; TACKE, Frank; TERRAULT, Norah A.; ZEUZEM, Stefan; ABBAS, Zaigham; AGHEMO, Alessio; AKARCA, Ulus S.; MASRI, Nasser M. Al; ALALWAN, Abduljaleel M.; BLOME, Marianne Alanko; ALEMAN, Soo; ALGHAMDI, Abdullah S.; ALGHAMDI, Mohammed; ALGHAMDI, Saad; AL-HAMOUDI, Waleed K.; ALI, Ela; ALJUMAH, Abdulrahman A.; ALTRAIF, Ibrahim H.; AMARSANAA, Jazag; ASSELAH, Tarik; BAATARKHUU, Oidov; BABAMETO, Adriana; BEN-ARI, Ziv; BERG, Thomas; BIONDI, Mia J.; BRAGA, Wornei S. M.; BRANDAO-MELLO, Carlos E.; BROWN JR., Robert S.; BRUNETTO, Maurizia R.; CABEZAS, Joaquin; CARDOSO, Mariana; CHAN, Henry Lik Yuen; CHEINQUER, Hugo; CHEN, Chien-Jen; CHEN, Pei-Jer; CHIEN, Cheng-Hung; CHILD, Hailey; CHUANG, Wan-Long; GARZA, Laura E. Cisneros; COCO, Barbara; COFFIN, Carla S.; COPPOLA, Nicola; CORNBERG, Markus; CRAXI, Antonio; CRESPO, Javier; CUKO, Liri; LEDINGHEN, Victor De; DUBERG, Ann-Sofi; ETZION, Ohad; FERRAZ, Maria Lucia G.; FERREIRA, Paulo R. A.; FORNS, Xavier; FOSTER, Graham R.; FUNG, James; GAETA, Giovanni B.; GARCIA-SAMANIEGO, Javier; GENOV, Jordan; GHEORGHE, Liliana S.; GHOLAM, Pierre M.; GISH, Robert G.; GLENN, Jeffrey; GOLDIS, Adrian; HAMID, Saeed S.; HERCUN, Julian; HSU, Yao-Chun; HU, Ching-Chih; HUANG, Jee-Fu; IDILMAN, Ramazan; JAFRI, Wasim S. M.; JANJUA, Naveed; JELEV, Deian; JERKEMAN, Anna; JIA, Jidong; KABERG, Martin; KAITA, Kelly D. E.; KAO, Jia-Horng; KHAN, Aamir G.; KIM, Do Young; KONDILI, Loreta A.; LAGGING, Martin; LAMPERTICO, Pietro; LAZARO, Pablo; V, Jeffrey Lazarus; LEE, Mei-Hsuan; LIM, Young-Suk; LOBATO, Cirley M. O.; MACEDO, Guilherme; MARINHO, Rui T.; MAROTTA, Paul J.; MARTINS, Alexanda; MENDES-CORREA, Maria Cassia; MENDEZ-SANCHEZ, Nahum; NAVAS, Maria-Cristina; NING, Qing; ORMECI, Necati; ORREGO, Mauricio; OSIOWY, Carla; PAN, Calvin Q.; PESSOA, Mario G.; PIRACHA, Zahra Z.; POP, Cora; RAMOS, Jose A. Presa; QURESHI, Huma; RAIMONDO, Giovanni; RAMJI, Alnoor; RAZAVI-SHEARER, Kathryn; RIBEIRO, Sofia; RIOS-HINCAPIE, Cielo Y.; RODRIGUEZ, Manuel; ROSENBERG, William M. C.; ROULOT, Dominique; RYDER, Stephen D.; SAEED, Umar; SAFADI, Rifaat; SANAI, Faisal M.; SANCHEZ-AVILA, Juan F.; SANTANTONIO, Teresa A.; SARRAZIN, Christoph; SETO, Wai-Kay; SHOUVAL, Daniel; SIMONOVA, Marieta Y.; TANAKA, Junko; TERGAST, Tammo L.; TSENDSUREN, Oyunsuren; VALENTE, Cristina; VILLALOBOS-SALCEDO, Juan Miguel; VOELLER, Alexis S.; WAHEED, Yasir; WONG, Grace L-H; WONG, Vincent W-S; WU, Jaw-Ching; I, Hwai- Yang; YIP, Terry C-F; YU, Ming-Lung; YUEN, Man-Fung; YURDAYDIN, Cihan; ZUCKERMAN, Eli; RAZAVI, Homie A.
    Background & Aims: Hepatitis delta virus (HDV) is a satellite RNA virus that requires the hepatitis B virus (HBV) for assembly and propagation. Individuals infected with HDV progress to advanced liver disease faster than HBV-monoinfected individuals. Recent studies have estimated the global prevalence of anti-HDV antibodies among the HBV-infected population to be 5-15%. This study aimed to better understand HDV prevalence at the population level in 25 countries/territories. Methods: We conducted a literature review to determine the prevalence of anti-HDV and HDV RNA in hepatitis B surface antigen (HBsAg)-positive individuals in 25 countries/territories. Virtual meetings were held with experts from each setting to discuss the findings and collect unpublished data. Data were weighted for patient segments and regional heterogeneity to estimate the prevalence in the HBV-infected population. The findings were then combined with The Polaris Observatory HBV data to estimate the anti-HDV and HDV RNA prevalence in each country/territory at the population level. Results: After adjusting for geographical distribution, disease stage and special populations, the anti-HDV prevalence among the HBsAg+ population changed from the literature estimate in 19 countries. The highest anti-HDV prevalence was 60.1% in Mongolia. Once adjusted for the size of the HBsAg+ population and HDV RNA positivity rate, China had the highest absolute number of HDV RNA+ cases. Conclusions: We found substantially lower HDV prevalence than previously reported, as prior meta-analyses primarily focused on studies conducted in groups/regions that have a higher probability of HBV infection: tertiary care centers, specific risk groups or geographical regions. There is large uncertainty in HDV prevalence estimates. The implementation of reflex testing would improve estimates, while also allowing earlier linkage to care for HDV RNA+ individuals. The logistical and economic burden of reflex testing on the health system would be limited, as only HBsAg+ cases would be screened.
  • article 0 Citação(ões) na Scopus
    Guideline Adherence and Outcomes of Patients with Candidemia in Brazil
    (2024) ARAUJO, Jordana Machado; ALMEIDA JUNIOR, Joao Nobrega de; MAGRI, Marcello Mihailenko Chaves; COSTA, Silvia Figueiredo; GUIMARAES, Thais
    Candidemia is a significant cause of mortality among hospitalized patients, both worldwide and in Brazil. Prompt and appropriate treatment are essential to mitigate mortality, and clinical practice guidelines aim to optimize patient care based on the best scientific evidence. This study aims to examine the management of candidemia, assessing adherence to the guidelines of the Brazilian Society of Infectious Diseases in a single center located at S & atilde;o Paulo, Brazil. All adult patients hospitalized from 2016 to 2018 who presented one positive blood culture for Candida spp. were included. Electronic medical records were retrospectively reviewed to collect information relevant to the treatment for candidemia, in order to assess the adherence to the Brazilian guideline for the management of candidemia in relation to nine defined outcomes, and we correlated those findings with 30-day mortality by using uni- and multivariate analyses. A total of 115 patients were included; 68 patients (59.1%) were male, with a mean age of 55 years. C. albicans, C. tropicalis and C. glabrata were the most prevalent species. In total, 80 patients (69.5%) received antifungal treatment. The adherence to Brazilian guideline recommendations was determined as described in the following: initial treatment with echinocandin in 48 (60%); step-down to fluconazole in 21 (26.2%); collection of first control blood culture in 43 (58.9%); collection of second control blood culture, if the first one had been positive, in 14 (73.6%); treatment for 14 days after the first negative blood culture in 53 (65.4%); central venous catheter (CVC) removal in 66 (82.5%); CVC removal if the first control blood culture had been positive in 17 (89.4%); performance of a transthoracic echocardiogram in 51 (63.7%) and performance of a fundoscopy in 59 (73.7%). Univariate analysis showed that CVC removal and initial echinocandin therapy were more prevalent in the surviving group, but with no statistically significant difference. On the other hand, step-down to fluconazole demonstrated higher survival rate in the multivariate analysis OR 0.15 (95% CI 0.03-0.8); p = 0.02. The analysis of these nine recommendations demonstrates that it is necessary to improve adherence to specific recommendations and also disseminate strategies of the initial use of echinocandin as the drug of choice and addressing length of treatment and follow-up and complementary exams. Our study provides reassurance that the step-down to fluconazole is safe and may be recommended, if the preexisting conditions are present.
  • article 0 Citação(ões) na Scopus
    Recurrent acquired ocular toxoplasmosis associated with Kyrieleis plaques and documented allergy to sulfonamide-A treatment proposal for two rare conditions
    (2024) AMATO, Valdir Sabbaga; RIBEIRO, Victoria Stadler Tasca; SILVA, Allan Gomes; GOMES, Andre Marcelo Vieira; TUON, Felipe Francisco
    The aim of this study was to describe a case of a patient with ocular toxoplasmosis, which has resulted in Kyrieleis plaques formation (segmental periarteritis associated with severe inflammation) and later follow-up and alternative treatment due to documented allergy to sulfonamide. A 33 -year -old Brazilian woman diagnosed with acute toxoplasmosis, initially treated with sulfonamide, developed a critical cutaneous rash. Cotrimoxazole was changed to clindamycin and pyrimethamine, and prednisone was started. The medication was maintained for 45 days. Four months later, she developed retinal lesions suggestive of toxoplasmosis with Kyrieleis plaques in the upper temporal vessels. Pyrimethamine, clindamycin, and prednisone were initiated until healing. She presented reactivation months later, and a suppressive treatment with pyrimethamine was instituted for one year. This is the first report to use the combination of clindamycin with pyrimethamine in the treatment and recurrence prophylaxis for OT in a documented allergy to sulfonamide.
  • article 0 Citação(ões) na Scopus
    Epidemiological Assessment and Risk Factors for Mortality of Bloodstream Infections by Candida sp. and the Impact of the COVID-19 Pandemic Era
    (2024) ARAUJO, Jordana Machado; ALMEIDA JUNIOR, Joao Nobrega de; MAGRI, Marcello Mihailenko Chaves; COSTA, Silvia Figueiredo; GUIMARAES, Thais
    Candidemia is one of the healthcare-associated infections that has high mortality. The risk factors that predispose a patient to develop this infection are mostly found in patients of greater severity and COVID-19 contributes to the risk of death. The aim of this study is to evaluate epidemiological characteristics and risk factors for mortality in patients with candidemia before and during the COVID-19 pandemic era. This is a retrospective study conducted at Instituto Central from 2016 to 2020 of patients with candidemia that were evaluated for demographic data, medical history, risk factors, microbiological data, therapeutic measures, complementary exams, device management, and outcome defined by 30-day mortality. A total of 170 episodes were included (58.2% males; mean age of 56 years). The overall incidence density of candidemia per 1000 admissions and per 1000 patient-days was 1.17 and 0.17, respectively, with an increase of 38% in the year 2020. The use of a central venous catheter was the most prevalent (93.5%) condition, followed by the previous use of antibiotics (91.1%). Corticosteroid use ranked seventh (56.4%). C. albicans was responsible for 71 (41.7%) of the isolates, followed by C. tropicalis and C. glabrata, with 34 (20%) isolates each. Echinocandin was prescribed in 60.1% of cases and fluconazole in 37%. Echocardiography resulted in six (5.08%) cases of endocarditis and fundoscopy resulting in two (2.4%) endophthalmitis. The 30-day mortality was 93/170 (54.7%). The risk factors associated with mortality were age (OR 1.03, CI 95% 1.01-1.06), heart disease (OR 7.51, CI 95% 1.48-37.9), hemodialysis (OR 3.68, CI 95% 1.28-10.57), and use of corticosteroids (OR 2.83, CI 95% 1.01-7.92). The COVID-19 pandemic had an impact on the increase incidence of candidemia. The persistently high mortality highlights the need for better management strategies, control of risk factors, and guarantee of adequate treatment.
  • article 0 Citação(ões) na Scopus
    Case Report: In Situ and Systemic Immune Response to Mucosal Leishmaniasis in an HIV-Infected Patient
    (2024) AMATO, Valdir Sabbaga; FRANCO, Lucas Augusto Moyses; SOUZA, Regina Maia de; SILVA, Camila Alves Maia da; RAMUNDO, Mariana Severo; CORTES, Marina Farrel; CORREA-CASTRO, Gabriela; SANTOS-OLIVEIRA, Joanna Reis; DA-CRUZ, Alda M.; PAGLIARI, Carla; GALO, Luciane Kanashiro; TUON, Felipe Francisco
    In situ and systemic evaluations of the immune responses of HIV -infected patients to mucosal leishmaniasis have been poorly described. We describe a recently diagnosed HIV -infected patient with mucosal leishmaniasis who was characterized by a CD4 count of 85 cells/mm3 and nasal septum destruction resulting from pruritic and ulcerated nasal mucosa with crust formation and progression over 2 years. In situ and systemic immune evaluations of T cell activation, memory, and exhaustion were conducted using cytofluorometric assays, and sequencing of the Leishmania species was performed. The immune profile of HIV -infected patient with mucosal leishmaniasis shows a mixed Th1/Th2 pattern and an activated and exhausted status.
  • article 0 Citação(ões) na Scopus
    Immunogenicity of COVID-19 adsorbed inactivated vaccine (CoronaVac) and additional doses of mRNA BNT162b2 vaccine in immunocompromised adults compared with immunocompetent persons
    (2024) IBRAHIM, Karim Yaqub; MOREIRA, Raquel Megale; SANTOS, Carolina Ferreira dos; STRABELLI, Tania Mara Varejao; BELIZARIO, Juliana de Cassia; PINTO, Maria Isabel de Moraes; MARINHO, Ana Karolina Barreto Berselli; PEREIRA, Juliana Marquezi; MELLO, Liliane Saraiva de; ANDO, Mauricio Cesar; SILVA, Vitor Gabriel Lopes da; SATO, Paula Keiko; LIMA, Marcos Alves de; FRANCA, Joao Italo Dias; LOCH, Ana Paula; MIYAJI, Karina Takesaki; INFANTE, Vanessa; PRECIOSO, Alexander Roberto; SARTORI, Ana Marli Christovam
    Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3 rd and 4 th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3 rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups.
  • article 1 Citação(ões) na Scopus
    First report of New Delhi metallo-beta-lactamase-5 (NDM-5)-producing Escherichia coli isolates from water environment in Cameroon
    (2024) MEGUEYA, Armelle Leslie; MAKUETCHE, Kevine; SCACCIA, Nazareno; COSTA, Silvia Figueiredo; FONCESCA, Joyce Vanessa da Silva; KOMURIAN-PRADEL, Florence; TCHATCHOUANG, Serges; SIMO, Pierrette; TCHATCHUENG, Jules; NONO, Arsene Djoko; NGANG, Essia; NGANDJIO, Antoinette; NZOUANKEU, Ariane
  • article 0 Citação(ões) na Scopus
    COVID-19 in hematopoietic stem cell transplant recipients during three years of the pandemic: a multicenter study in Brazil
    (2024) RANDI, Bruno Azevedo; HIGASHINO, Hermes Ryoiti; SILVA, Vinicius Ponzio da; SALOMAO, Matias Chiarastelli; PIGNATARI, Antonio Carlos Campos; ABDALA, Edson; VASQUES, Fabiana; SILVA, Celso Arrais Rodrigues da; SILVA, Roberto Luiz da; LAZARI, Carolina dos Santos; LEVI, Jose Eduardo; XAVIER, Erick Menezes; CORTES, Marina Farrel; LUNA-MUSCHI, Alessandra; ROCHA, Vanderson; COSTA, Silvia Figueiredo
    Hematopoietic stem cell transplant (HSCT) recipients are at -increased risk for severe COVID-19. The aim of this study was to evaluate the burden of COVID-19 in a cohort of HSCT recipients. This retrospective study evaluated a cohort of adult hospitalized HSCT recipients diagnosed with COVID-19 in two large hospitals in Sao Paulo, Brazil postHSCT, from January 2020 to June 2022. The primary outcome was all-cause mortality. Of 49 cases, 63.2% were male with a median age of 47 years. Allogeneic-HSCT (51.2%) and autologous-HSCT (48.9%) patients were included. The median time from HSCT to COVID-19 diagnosis was 398 days (IQR: 1211-134), with 22 (44.8%) cases occurring within 12 months of transplantation. Most cases occurred during the first year of the pandemic, in non-vaccinated patients (n=35; 71.4%). Most patients developed severe (24.4%) or critical (40.8%) disease; 67.3% received some medication for COVID-19, primarily corticosteroids (53.0%). The probable invasive aspergillosis prevalence was 10.2%. All-cause mortality was 40.8%, 51.4% in non-vaccinated patients and 14.2% in patients who received at least one dose of the vaccine. In the multiple regression analyses, the variables mechanical ventilation (OR: 101.01; 95% CI: 8.205 - 1,242.93; p = 0.003) and chest CT involvement at diagnosis >= 50% (OR: 26.61; 95% CI: 1.06 - 664.26; p = 0.04) remained associated with all-cause mortality. Thus, HSCT recipients with COVID-19 experienced high mortality, highlighting the need for full vaccination and infection prevention measures.
  • article 0 Citação(ões) na Scopus
    SARS-CoV-2 shedding, infectivity, and evolution in an immunocompromised adult patient
    (2024) MENDES-CORREA, Maria Cassia; GHILARDI, Fabio de Rose; SALOMAO, Matias Chiarastelli; VILLAS-BOAS, Lucy Santos; PAULA, Anderson Vicente de; PAIAO, Heuder Gustavo Oliveira; COSTA, Antonio Charlys da; TOZETTO-MENDOZA, Tania Regina; FREIRE, Wilton; SALES, Flavia Cristina Silva; CLARO, Ingra Morales; SABINO, Ester Cerdeira; FARIA, Nuno Rodrigues; WITKIN, Steven Sol
    This study aimed to provide further insight into the evolutionary dynamics of SARS-CoV-2 by analyzing the case of a 40 -year -old man who had previously undergone autologous hematopoietic stem cell transplantation due to a diffuse large B -cell lymphoma. He developed a persistent SARS-CoV-2 infection lasting at least 218 days and did not manifest a humoral immune response to the virus during this follow-up period. Whole-genome sequencing and viral cultures confirmed a persistent infection with a replication -positive virus that had undergone genetic variation for at least 196 days after symptom onset.
  • article 2 Citação(ões) na Scopus
    Main autopsyfindings of visceral involvement by fatal mpox in patients with AIDS: necrotising nodular pneumonia, nodular ulcerative colitis, and diffuse vasculopathy
    (2023) DUARTE-NETO, Amaro Nunes; GONCALVES, Ana Maria; ELIODORO, Raissa Heloisa de Araujo; MARTINS, Wilker Dias; CLARO, Ingra Morales; VALENCA, Ian Nunes; PAES, Vitor Ribeiro; TEIXEIRA, Ralcyon; SZTAJNBOK, Jaques; SILVA, Ivan Leonardo Avelino Franca e; LEITE, Luiz Antonio Ferreira; MALAQUE, Ceila Maria Sant'Ana; BORGES, Luciana Marques Sansao; GONZALEZ, Mario Peribanez; BARRA, Luiz Alberto Costa; PEREIRA JUNIOR, Luiz Carlos; MELLO, Claudia Figueiredo; QUEIROZ, Wladimir; ATOMYA, Angela Naomi; FERNEZLIAN, Sandra de Morais; ALVES, Venancio Avancini Ferreira; LEITE, Katia Ramos Moreira; FERREIRA, Cristiane Rubia; SALDIVA, Paulo Hilario Nascimento; MAUAD, Thais; SILVA, Luiz Fernando Ferraz da; FARIA, Nuno R.; CORREA, Maria Cassia Jacinto Mendes; SABINO, Ester Cerdeira; SOTTO, Mirian Nacagami; DOLHNIKOFF, Marisa
  • article 0 Citação(ões) na Scopus
    A spatial case-control study on symptomatic and inapparent primary dengue infections in an endemic city in Brazil
    (2024) FIGUEIREDO, Gerusa; CHIARAVALLOTI, Francisco; CAMPOS, Sergio; PELLINI, Alessandra Cristina Guedes; FELIX, Alvina Clara; LUNA, Expedito
    We conducted a spatial case-control study nested in a dengue incidence cohort to explore the role of the spatial and socioeconomic factors in the proportion of symptomatic (cases) and inapparent primary dengue virus infections (controls). Cohort participants were children and adolescents (2 to 16 years of age) at the beginning of the follow-up. Case definitions were, for symptomatic cases, fever plus a positive lab result for acute dengue (NS1, RT-PCR, ELISA IgM/IgG), and for inapparent infection a positive result for dengue IgG (ELISA) in subjects without symptoms and with a previously negative result at baseline. The covariates included sociodemographic factors, residential location, and socioeconomic context variables of the census tracts of residence of cases and controls. We used principal component analysis to reduce the contextual covariates, with the component values assigned to each one based on their residences. The data were modeled in a Bayesian context, considering the spatial dependence. The final sample consisted of 692 children, 274 cases and 418 controls, from the first year of follow-up (2014-2015). Being male, older age, higher educational level of the head of the family and having a larger number of rooms in the household were associated with a greater chance of presenting dengue symptomatic infection at the individual level. The contextual covariates were not associated with the outcome. Inapparent dengue infection has extensive epidemiological consequences. Relying solely on notifications of symptomatic dengue infections underestimates the number of cases, preserves a silent source of the disease, potentially spreading the virus to unaffected areas.
  • article 1 Citação(ões) na Scopus
    Phylogenetics, Epidemiology and Temporal Patterns of Dengue Virus in Araraquara, São Paulo State
    (2024) SOUZA, Caio Santos de; CALEIRO, Giovana Santos; CLARO, Ingra Morales; JESUS, Jaqueline Goes de; COLETTI, Thais Moura; SILVA, Camila Alves Maia da; COSTA, Angela Aparecida; INENAMI, Marta; RIBEIRO, Andreia C.; FELIX, Alvina Clara; PAULA, Anderson Vicente de; FIGUEIREDO, Walter M.; LUNA, Expedito Jose de Albuquerque; SABINO, Ester C.; ROMANO, Camila M.
    Dengue virus (DENV) is a prominent arbovirus with global spread, causing approximately 390 million infections each year. In Brazil, yearly epidemics follow a well-documented pattern of serotype replacement every three to four years on average. Araraquara, located in the state of Sao Paulo, has faced significant impacts from DENV epidemics since the emergence of DENV-1 in 2010. The municipality then transitioned from low to moderate endemicity in less than 10 years. Yet, there remains an insufficient understanding of virus circulation dynamics, particularly concerning DENV-1, in the region, as well as the genetic characteristics of the virus. To address this, we sequenced 37 complete or partial DENV-1 genomes sampled from 2015 to 2022 in Araraquara. Then, using also Brazilian and worldwide DENV-1 sequences we reconstructed the evolutionary history of DENV-1 in Araraquara and estimated the time to the most recent common ancestor (tMRCA) for serotype 1, for genotype V and its main lineages. Within the last ten years, there have been at least three introductions of genotype V in Araraquara, distributed in two main lineages (L Ia and L Ib, and L II). The tMRCA for the first sampled lineage (2015/2016 epidemics) was approximately 15 years ago (in 2008). Crucially, our analysis challenges existing assumptions regarding the emergence time of the DENV-1 genotypes, suggesting that genotype V might have diverged more recently than previously described. The presence of the two lineages of genotype V in the municipality might have contributed to the extended persistence of DENV-1 in the region.
  • article 0 Citação(ões) na Scopus
    Exploring the combined effects of MTTP gene polymorphisms in chronic hepatitis C patients with hepatic steatosis
    (2024) PRATA, Thamiris Vaz Gago; PAULA, Victoria Goncalves de; PASSOS, Lhays Ozorio; BROGIATO, Vitoria Luiza Batalhoti; FERREIRA, Gustavo Manoel; MANCHIERO, Caroline; DANTAS, Bianca Peixoto; BATTAGLIA, Debora Bignotto Rosane; FIGUEIREDO, Gerusa Maria; TENGAN, Fatima Mitiko; MAGRI, Mariana Cavalheiro
  • article 0 Citação(ões) na Scopus
    Itraconazole Serum Trough Concentrations Using Oral Capsules for the Treatment of Chronic Pulmonary Aspergillosis: What is the Target?
    (2023) OLIVEIRA, Vitor Falcao de; TABORDA, Mariane; ARCIERI, Vitor Ciampone; KRUSCHEWSKY, Wdson Luis Lima; COSTA, Andre Nathan; DUARTE, Nilo Jose Coelho; ROMANO, Paschoalina; EBNER, Persio de Almeida Rezende; MAGRI, Adriana Satie Goncalves Kono; ABDALA, Edson; LEVIN, Anna S. S.; MAGRI, Marcello Mihailenko Chaves
    BackgroundIn regions where there is only itraconazole capsule as a therapeutic option for treatment of chronic pulmonary aspergillosis (CPA), measuring the serum concentrations becomes even more important for therapeutic success.ObjectiveEvaluate the initial itraconazole serum trough concentrations after the administration of oral capsule of itraconazole for the treatment of CPA.MethodsThe measurement was performed at least 7-days after initiation of therapy. The standard treatment at our institution was a 200 mg capsule every 12 h. We defined that an adequate serum trough concentration of itraconazole during treatment was 1-4 mg/L.ResultsThis study recruited 28 patients. The median value was 0.30 mg/L (IQR 0.01-0.70). Only 11% (n = 3) had adequate serum concentrations based on guideline recommendation. All patients with clinical deterioration had itraconazole serum levels <= 0.8 mg/L.ConclusionThe initial serum concentrations of itraconazole after capsule formulation administration were low. Increasing the dose should be considered when the itraconazole concentration is low, especially if it is <= 0.8 mg/L, and the patient presents with clinical deterioration. Larger studies are needed to evaluate the adequate concentrations recommended for CPA.
  • article 1 Citação(ões) na Scopus
    Clinical and epidemiological features of mpox in a Brazilian reference center for HIV and sexually transmitted infections: A cross-sectional study
    (2024) COSTA, Alvaro Furtado; ROCHA, Simone Queiroz; FONSI, Mylva; NOGUEIRA, Roberta Schiavon; KALICHMAN, Artur Olhovetchi; MADRUGA, Jose Valdez Ramalho; GIANNA, Maria Clara; SOUZA, Rosa de Alencar; RODRIGUES, Rosangela; TAYRA, Angela; RAMOS, Lucas Rocker; SILVA, Roberto Jose Carvalho da; SARTORI, Ana Marli Christovam; PRADO, Walkiria Delnero Almeida; ABBUD, Adriano; TANCREDI, Mariza Vono
    Background: The 2022 mpox outbreak has affected disproportionately people living with HIV (PLWH) and pre-exposure prophylaxis (PrEP) users. Methods: We conducted a cross-sectional study to evaluate factors associated with laboratory diagnosis of mpox among suspected cases, and access differences between PrEP users and PLWH with confirmed diagnostic. Results: 394 mpox suspected cases were analyzed, 309 (78.4%) confirmed. Most patients with mpox were PLWH (54.4%) and 99 (32%) PrEP users. Mpox cases were likely to be between 25 and 39 years old (aOR = 2.8; p = 0.042), men who have sex with men/bisexual or transgender women (aOR = 17.2; p < 0.001) and to have fever (aOR = 4.7; p < 0.001), adenomegaly (aOR = 7.2; p < 0.001) and multiple vesicular lesions (aOR = 4.2; p < 0.001). Comparing PrEP users to PLWH with confirmed mpox, PrEP users had lesions predominantly with exclusive genital involvement (p = 0.016); while PLWH had higher extragenital involvement (p = 0.018). Conclusions: PrEP users and PLWHA were the main epidemiological groups in our cohort. Recognizing the differences between vulnerable populations can contribute to the development public policies to control mpox in settings with reduced access to vaccines
  • article 0 Citação(ões) na Scopus
    Evaluation of enterovirus concentration, species identification, and cerebrospinal fluid parameters in patients of different ages with aseptic meningitis in Sao Paulo, Brazil
    (2024) HONORATO, Layla; FERREIRA, Noely Evangelista; DOMINGUES, Renan Barros; SENNE, Carlos; LEITE, Fernando Brunale Vilela de Moura; SANTOS, Marcio Vega dos; FERNANDES, Gustavo Bruniera Peres; PAIAO, Heuder Gustavo Oliveira; BOAS, Lucy Santos Vilas; COSTA, Antonio Charlys da; TOZETTO-MENDOZA, Tania Regina; WITKIN, Steven S.; MENDES-CORREA, Maria Cassia
    Human enteroviruses (EV) are the most common cause of aseptic meningitis worldwide. Data on EV viral load in cerebrospinal fluid (CSF) and related epidemiological studies are scarce in Brazil. This study investigated the influence of EV viral load on CSF parameters, as well as identifying the involved species. CSF samples were collected in 2018-2019 from 140 individuals at The Hospital das Clinicas, Sao Paulo. The EV viral load was determined using real-time quantitative polymerase chain reaction, while EV species were identified by 5 ' UTR region sequencing. Median viral load was 5.72 log10 copies/mL and did not differ by subjects' age and EV species. Pleocytosis was observed in 94.3% of cases, with the highest white blood cell (WBC) counts in younger individuals. Viral load and WBC count were correlated in children (p = 0.0172). Elevated lactate levels were observed in 60% of cases and correlated with the viral load in preteen-teenagers (p = 0.0120) and adults (p = 0.0184). Most individuals had normal total protein levels (70.7%), with higher in preteen-teenagers and adults (p < 0.0001). By sequencing, 8.2% were identified as EV species A and 91.8% as species B. Age-specific variations in CSF characteristics suggest distinct inflammatory responses in each group.
  • article 0 Citação(ões) na Scopus
    Serosurvey of Toxoplasma gondii and Toxocara spp. co-infection in pregnant women in low-income areas of Brazil
    (2024) PEREIRA, Edlayne Larissa Gretter Machado; FERREIRA, Isabella Braghin; VICTORINO, Roberta Brinholi; LESCANO, Susana Angelica Zevallos; GIUFFRIDA, Rogerio; KMETIUK, Louise Bach; BIONDO, Alexander Welker; SANTAREM, Vamilton Alvares
    Introduction: Despite human toxoplasmosis and toxocariasis having been listed among the top six most neglected parasitic zoonoses worldwide, presenting similar associated risk factors and transmission routes, few studies have been conducted in pregnant women and the consequences of concurrent infection remain to be fully established. Accordingly, the present study has serologically assessed the co-infection and associated risk factors for Toxoplasma gondii and Toxocara spp. in pregnant women, assisted by the public Unified National Health System (SUS) in southeastern Brazil. Materials and Methods: Blood samples were collected and tested for IgG antibodies against Toxoplasma gondii by chemiluminescence immunoassay and against Toxocara spp. by enzyme-linked immunosorbent assay (ELISA). An epidemiological questionnaire was applied to gather socioeconomic information to assess the risk factors associated with seropositivity to toxocariasis/toxoplasmosis by univariate analysis followed by logistic regression. Results: Overall, seropositivity was 69/280 (24.6, 95% CI: 19.96-30.01) for T. gondii and 56/280 (20.0, 95% CI: 15.73-25.08) for Toxocara spp. Co-infection was observed in 25/280 (8.9, 95% CI: 6.12-12.85) pregnant women, with increased odds (OR: 3.3, CI 95%: 1.77-6.14, p = 0.0002). Logistic regression revealed that a higher educational level (high school or college) significantly reduced the likelihood of co-infection seropositivity, owning cats increased the odds of toxocariasis, and older pregnant women presented significantly higher T. gondii seropositivity. Conclusion: Co-infection herein highlights the importance of educational programs in the prevention of toxocariasis and toxoplasmosis in pregnant women and other high-risk populations.
  • article 0 Citação(ões) na Scopus
    The decline of measles antibody titers in previously vaccinated adults: a cross-sectional analysis
    (2024) CASTINEIRAS, Anna Carla Pinto; SALES, Amanda Caroline; PICONE, Camila de Melo; DIOGO, Constancia Lima; ROSSI, atila Duque; GALLIEZ, Rafael Mello; JR, Orlando da Costa Ferreira; CASTINEIRAS, Terezinha Marta Pereira Pinto; LOPES, Marta Heloisa; SARTORI, Ana Marli Christovam
    The global reemergence of measles in 2018-2019 reinforces the relevance of high coverage immunization to maintain the disease elimination. During an outbreak in the Sao Paulo State in 2019, several measles cases were reported in individuals who were adequately vaccinated according to the current immunization schedule recommends. This study aimed to assess measles IgG antibody seropositivity and titers in previously vaccinated adults. A cross-sectional study was conducted at CRIE-HC-FMUSP (Sao Paulo, Brazil) in 2019. It included healthy adults who had received two or more Measles-Mumps-Rubella vaccines (MMR) and excluded individuals with immunocompromising conditions. Measles IgG antibodies were measured and compared by ELISA (Euroimmun (R)) and chemiluminescence (LIASON (R)). The association of seropositivity and titers with variables of interest (age, sex, profession, previous measles, number of measles-containing vaccine doses, interval between MMR doses, and time elapsed since the last MMR dose) was analyzed. A total of 162 participants were evaluated, predominantly young (median age 30 years), women (69.8%) and healthcare professionals (61.7%). The median interval between MMR doses was 13.2 years, and the median time since the last dose was 10.4 years. The seropositivity rate was 32.7% by ELISA and 75.3% by CLIA, and a strong positive correlation was found between the tests. Multivariate analyses revealed that age and time since the last dose were independently associated with positivity. Despite being a single-center evaluation, our results suggest that measles seropositivity may be lower than expected in adequately immunized adults. Seropositivity was higher among older individuals and those with a shorter time since the last MMR vaccine dose.
  • article 0 Citação(ões) na Scopus
    Hydroxymethylnitrofurazone lymphatic uptake with nanostructured lipid carrier after oral administration in rats
    (2024) SOUZA, Aline de; SCARIM, Caue Benito; COTRIM, Paulo Cesar; BARBOSA JUNIOR, Fernando; ROCHA, Bruno Alves; CALIXTO, Leandro Augusto; CORREIA, Cristiano Jesus; ARAUJO, Gabriel Lima de Barros; LOBENBERG, Raimar; BOU-CHACRA, Nadia Araci; BREITHAUPT-FALOPPA, Ana Cristina
    Background: Leishmaniasis, caused by the protozoan Leishmania sp., infects phagocyte cells present in lymphatic organs. This study demonstrates the influence of nanostructured lipid carrier-loaded hydroxymethylnitrofurazone (NLC-NFOH) on lymphatic uptake using a chylomicron-blocking flow model in rats. Method: Lymphatic uptake of NFOH was assessed 1 h after oral administration of dimethyl sulfoxide with NFOH or NLC-NFOH with and without cycloheximide pretreatment. Result: Dimethyl sulfoxide with NFOH and NLC-NFOH showed NFOH serum concentrations of 0.0316 and 0.0291 mu g/ml, respectively. After chylomicron blocking, NFOH was not detected. Conclusion: Despite log P below 5, NFOH was successfully taken up by the lymphatic system. Long-chain fatty acids and particle size might be main factors in these findings. NLC-NFOH is a promising and convenient platform for treating leishmaniasis via oral administration.
  • article 2 Citação(ões) na Scopus
    Epidemiology, treatment patterns, and disease burden of cytomegalovirus in hematopoietic cell transplant recipients in selected countries outside of Europe and North America: A systematic review
    (2023) CHO, Sung-Yeon; AR, Muhlis Cem; MACHADO, Clarisse M.; WU, Depei; SINGH, Inderjeet; SANDHU, Anudeep; DEMUTH, Dirk; SLAVIN, Monica
    Background: Cytomegalovirus (CMV) disease impacts morbidity and mortality in hematopoietic cell transplant (HCT) recipients. This systematic review summarized data on the epidemiology, management, and burden of CMV post-HCT outside of Europe and North America.Methods: The MEDLINE, Embase, and Cochrane databases were searched for observational studies and treatment guidelines in HCT recipients across 15 selected countries from Asia-Pacific, Latin America, and Middle East (search period: 1 January 2011-17 September 2021). Outcomes included incidence of CMV infection/disease, recurrence, risk factors, CMV-related mortality, treatments, refractory, resistant CMV, and burden.Results: Of 2708 references identified, 68 were eligible (67 studies and one guideline; 45/67 studies specific to adult allogeneic HCT recipients). The rates of CMV infection and disease within 1 year of allogeneic HCT were 24.9%-61.2% (23 studies) and 2.9%-15.7% (10 studies), respectively. Recurrence occurred in 19.8%-37.9% of cases (11 studies). Up to 10% of HCT recipients died of CMV-related causes. In all countries, first-line treatment for CMV infection/disease involved intravenous ganciclovir or valganciclovir. Conventional treatments were associated with serious adverse events such as myelosuppression (10.0%) or neutropenia only (30.0%, 39.8%) and nephrotoxicity (11.0%) (three studies), frequently leading to treatment discontinuation (up to 13.6%). Refractory CMV was reported in 2.9%, 13.0%, and 28.9% of treated patients (three studies) with resistant CMV diagnosed in 0%-10% of recipients (five studies). Patient-reported outcomes and economic data were scarce.Conclusion: The incidence of CMV infection and disease post-HCT is high outside of North America and Europe. CMV resistance and toxicity highlight a major unmet need with current conventional treatments.