PAULO HENRIQUE BRAZ DA SILVA
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ODE, FO - Docente
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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- Oral shedding of herpesviruses and clinical outcomes in hematopoietic stem cell transplant patients(2023) MIRANDA-SILVA, Wanessa; MOLLA, Vinicius Campos de; KNEBEL, Franciele Hinterholz; TOZETTO-MENDOZA, Tania Regina; ARRAIS-RODRIGUES, Celso; CAMARGO, Anamaria Aranha; BRAZ-SILVA, Paulo Henrique; FREGNANI, Eduardo RodriguesObjectives To characterize the oral shedding of herpes viruses in patients who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT) and investigate its relationship with clinical outcomes. Materials and Methods Polymerase chain reaction and enzymatic digestion were performed to identify the oral shedding of the members of the Herpesviridae family in 31 patients. The samples were collected from the oral cavity at five timestamps. Results The presence of each herpesvirus in the oral cavity was observed in 3.2%, 12.9%, 19.3%, 32.2%, 54.8% and 93.5% patients for human herpesvirus (HHV)-6A, herpes simplex virus-1, HHV-6B, cytomegalovirus (CMV), Epstein-Barr virus (EBV) and HHV-7, respectively. Oral shedding of herpes virus was not uncommon after alloHSCT. There was a statistically significant association between the EBV and CMV oral shedding at C1 and the cumulative incidence of acute graft-versus-host disease (aGVHD). The results suggested that the presence of HSV-1 at C2 was related to a relapse. The HHV-7 oral shedding at C2 suggests a possible link between relapse, progression-free survival and overall survival of the patients. Conclusions Patients who developed aGVHD showed higher CMV and EBV shedding in the oral cavity at aplasia, suggesting modifications to the pattern of immune cell response and inflammatory microenvironment.
- Periodontal disease and detection of human herpesviruses in saliva and gingival crevicular fluid of chronic kidney disease patients(2020) PALLOS, Debora; RUIVO, Gilson F.; FERRARI-JUNIOR, Sabino H.; PANNUTI, Claudio S.; PEROZINI, Caroline; SARMENTO, Dmitry J. S.; PALMIERI, Michelle; SOUZA, Ana C. M. F.; TOZETTO-MENDOZA, Tania R.; DOGLIO, Alain; BRAZ-SILVA, Paulo H.Background Patients with chronic kidney disease (CKD) have inability to maintain the normal levels of protein metabolism products, blood pressure and hematocrit. Periodontal disease involves an inflammatory destructive process. Identification of opportunistic viruses is extremely important as they are associated with co-morbidities. The objective of this study was to analyse the presence of human herpesviruses in saliva and gingival crevicular fluid (GCF) from patients with CKD. Methods One hundred and thirty one individuals were divided depending on the stage of CKD: Group 1 (clearance of creatinine > 75 mL/min) patients with no renal disease (n = 24); Group 2 (clearance of creatinine of 11-75 mL/min) patients with renal disease (n = 67); Group 3 (clearance of creatinine < 10 mL/min) patients on hemodialysis (n = 40). The parameters of periodontal disease were evaluated. The viral detection was assessed by PCR. Results considering the three groups, the prevalence of herpes simplex virus 1 (HSV-1) were 9% in saliva and 5% in GCF; Epstein-Barr virus 36% in saliva and 39% in GCF; human cytomegalovirus (HCMV) 11% in GCF; varicella zoster virus 6% in saliva and 3% in GCF; of human herpesvirus-6 (HHV-6) 6% in saliva and 2% in GCF; and HHV-7 44% in saliva and 8% in GCF. Of these patients, 46.48% presented with severe periodontitis. A statistically significant association between HSV-1 and HCMV was found in hemodialysis patients and severe periodontitis was also more frequent among them. Conclusion These findings show the importance of evaluating the periodontal disease and detecting herpesviruses in patients with CKD as the inflammatory process observed in these clinical conditions may worsen the course of both periodontal disease and CKD.
article 5 Citação(ões) na Scopus Oral lesions as an important marker for HIV progression(2017) BRAZ-SILVA, P. H.; SCHUSSEL, J. L.; ORTEGA, K. L.; GALLOTTINI, M.Background: Oral hairy leukoplakia (OHL) is a benign lesion caused by Epstein-Barr virus (EBV) replication in the oral epithelium affecting the borders of the tongue. It is strongly associated with immunosuppression, especially in HIV+ adults but is uncommon in pediatric population. The aim of the study is to show the importance of the correct diagnosis of OHL and its influence on HIV treatment. We report two cases of HIV+ adolescent patients that presented with leukoplakic lesions on the border of the tongue, suggestive of OHL. OHL diagnosis was confirmed in only one case through EBV in situ hybridization. After confirmation of the diagnosis, the patient with OHL was referred to an infectious disease specialist with the decision to start antiretroviral therapy. Conclusion: OHL definitive diagnosis can help clinical management of pediatric HIV+ patients. © 2017 by the article author(s).- Unusual multiple dentigerous cysts evaluated by cone beam computed tomography: a case report on a non-syndromic patient(2021) BERGAMINI, Mariana Lobo; SANCHES, Guilherme Trafani; PINA, Paulo Sergio Souza; D'AVILA, Ricardo Pimenta; CANTO, Alan Motta do; OGAWA, Celso Massahiro; BRAZ-SILVA, Paulo Henrique; COSTA, Andre Luiz Ferreira
- Unusual presentation of a disseminated oral HPV infection after combined antiretroviral therapy initiation(2019) VALE, Daniela Assis do; FERRACINI, Lais Magda Araujo; BUENO, Marcus Vinicius da Silva Rodrigues; SOUZA, Ana Carolina Mamana Fernandes; BRAZ-SILVA, Paulo Henrique; ORTEGA, Karem LopezHPV clinical manifestations have their characteristics modified by the use of combined antiretroviral therapy (cART), although its incidence is unaffected by cART. We report an unusual presentation of oral HPV infection and discuss an effective treatment for disseminated HPV lesions. A 52-year-old male of Asian-origin, HIV-seropositive, presented with extensive nodular lesions throughout the oral mucosa extending to the oropharyngeal region. Biopsy followed by histopathological examination and HPV genotyping were performed. The treatment was initiated with topical application of podophyllin and trichloroacetic acid. HPV lesions in oral mucosa are generally easy to handle. Extensive lesions can make it difficult to choose an effective treatment that meets the patient's particularities and medication availability.
- Unusual giant complex odontoma: A case report(2020) BUENO, N. P.; BERGAMINI, M. L.; ELIAS, F. M.; BRAZ-SILVA, P. H.; FERRAZ, E. P.Odontomas are benign, non-aggressive, and the most common odontogenic tumor of the jaws. Composed of dental tissues, it can be classified as compound or complex odontomas depending on their radiological and histological features. Among them, complex odontomas are less common and usually is presented as a small and asymptomatic radiopaque mass surrounded by a radiolucent halo, found on routine radiographic examination. Although benign tumors, odontomas can reach large sizes leading to facial asymmetry and decreasing bone strength, which predisposes fractures and infection. Our aim was to present a case report of an unusual giant mandibular odontoma on the left mandibular angle and ramus successfully treated by surgical excision and highlight the importance of the earlier diagnostic to minimize damages.
- Introduction of human gammaherpesvirus 8 genotypes A, B, and C into Brazil from multiple geographic regions(2020) LOPES, Amanda de Oliveira; SPITZ, Natalia; MARTINELLI, Katrini Guidolini; PAULA, Anderson Vicente de; TOSCANO, Ana Luiza de Castro Conde; BRAZ-SILVA, Paulo Henrique; BARBOSA NETTO, Juliana dos Santos; TOZETTO-MENDOZA, Tania Regina; PAULA, Vanessa Salete deVariations in the open reading frame (ORF) K1 gene sequence of human gammaherpesvirus 8 (HHV-8) has led to the identification of 6 major genotypic clades (A, B, C, D, E, and F) in specimens isolated from around the world. These clades exhibit clear clustering among individuals in different ethnic groups and from different geographic regions. The human population of Brazil varies greatly in ethnicity because of multiple immigration events from Africa, Europe, Asia, and indigenous communities. However, there is scant information about the HHV-8 genotypes currently circulating in Brazil. Here, we describe HHV-8 genotypic diversity in isolates from Brazilian HIV-infected patients living with Kaposi's sarcoma (KS) by analysis of the complete ORF-K1 region. We also identified the most likely geographic origins of these different Brazilian genotypes. We extracted HHV-8 DNA (24 positive samples) from individuals with HIV/KS from the states of Sao Paulo and Rio de Janeiro, amplified the ORF-K1 gene using nested PCR (about 870 base pairs), performed sequencing and phylogenetic analysis, and then calculated the mean genetic distances of Brazilian sequences from sequences in other regions of the world (523 sequences analyzed). Phylogenetic analysis showed that genotypes C, A, and B were present in 45.8 %, 29.2% and 25 % of the isolates from Brazil, respectively. These isolates grouped into separate clades, rather than a single monophyletic cluster. Mean genetic distance analyses suggested that these genotypes were introduced into the Brazil multiple times from different geographical regions. HHV-8/A isolates appear to be from Ukraine, Russia, and the Tartar ethnic group; HHV-8/B isolates appear to be from Congo and Democratic Republic of the Congo; and HHV-8/C isolates appear to be from Australia, Algeria, England, and French Guiana. These results contribute to a better understanding of the genetic diversity and origins of HHV-8 strains circulating in Brazil, and will provide a foundation for further epidemiological and evolutionary studies of HHV-8.
- High-risk human papillomavirus in patients with oral leukoplakia and oral squamous cell carcinoma-A multi-centre study in Sweden, Brazil and Romania(2021) SUNDBERG, Jonas; OHMAN, Jenny; KORYTOWSKA, Magdalena; WALLSTROM, Mats; KJELLER, Goran; ANDERSSON, Maria; HORAL, Peter; LINDH, Magnus; GIGLIO, Daniel; KOVACS, Aniko; SAND, Lars; HIRSCH, Jan-Michael; FERRACINI, Lais Magda Araujo; SOUZA, Ana Carolina Mamana Fernandes de; PARLATESCU, Ioanina; DOBRE, Maria; HINESCU, Mihail-Eugen; BRAZ-SILVA, Paulo Henrique; TOVARU, Serban; HASSEUS, BengtObjectives Although causal associations between oral leukoplakia (OL), oral squamous cell carcinoma (OSCC) and high-risk human papillomavirus (HR-HPV) have been speculated upon in several reports, conclusive evidence has not been presented. This study investigates whether the number of cases of HR-HPV in OL has increased over time and whether the prevalence of HR-HPV-positive OL differs in various parts of the world. Patients and Methods A total of 432 patients with OL from Sweden, Brazil and Romania were analysed. Patients were divided into historical (1992-2002) and contemporary (2011-2017) cohorts from the respective countries. Seventeen patients with OL developed oral squamous cell carcinoma (OSCC). A real-time PCR assay, targeting HPV sub-types 6,11,16,18,31,33,35,39,45,52,56,58 and 59, was performed to detect HR-HPV in patients with OL. Results In the Swedish and Romanian cohorts, none of the investigated HPV sub-types were detected. In the Brazilian cohorts, five patients with OL (3%) were positive for HR-HPV, including four patients from the contemporary cohort (HPV 16, 31, 33) and one from the historical cohort (HPV 11). All the cases of OL that transformed into OSCC were HR-HPV-negative, as were the corresponding tumours. Conclusions In summary, the prevalence of HR-HPV in OL is low in all the tested countries, and the incidence has not changed over time. HR-HPV in OL does not seem to be a driver of oncogenesis.
- Evaluation of photodynamic therapy in pericoronitis Protocol of randomized, controlled, double-blind study(2019) SCHALCH, Tania Oppido; PALMIERI, Michelle; LONGO, Priscila Larcher; BRAZ-SILVA, Paulo Henrique; TORTAMANO, Isabel Peixoto; MICHEL-CROSATO, Edgard; MAYER, Marcia Pinto Alves; JORGE, Waldyr Antonio; BUSSADORI, Sandra Kalil; PAVANI, Christiane; NEGREIROS, Renata Matalon; HORLIANA, Anna Carolina Ratto TempestiniIntroduction: Pericoronitis is a common disease in the eruption phase of third molars, sometimes debilitating, with an impact on the quality of life. The most indicated treatment in the initial phase is the irrigation for cleanliness of the region. In order to reduce the chances of systemic dissemination of the infection and antibiotics use, it is mandatory to test effective treatments in the initial phase of pericoronitis avoiding the evolution of the infectious disease. Photodynamic therapy (PDT) is an interesting alternative because it is an effective antimicrobial treatment that is easy to perform and does not select bacterial resistance. The methylene blue (MB) used in PDT has been studied in an oral formulation, which optimizes the formation of monomers increasing its antimicrobial action. Objective: The aim of this study is to evaluate the effectiveness of PDT with MB in an astringent vehicle in pericoronitis on the initial phase in healthy patients through microbiological, clinical, and immune response. The impact of pericoronitis on oral health-related quality of life (OHRQoL) of these patients will also be evaluated. Method: In this randomized, controlled, double-blind clinical bioequivalence protocol, 64 healthy patients with pericoronitis will be evaluated. Patients will be randomized into the positive control group (G1) (n=32): irrigation with sterile saline and PDT (conventional MB at 0.005% concentration and irradiation with low intensity laser lambda=660nm, 9J per point and radiant exposure of 318J/cm(2)), and the experimental group (G2) (n=32): treatment identical to G1, however, MB will be delivered in a new formulation for oral use. Microbiological analysis will be performed by RT-PCR for the bacterium Tannerella forsythia. Gingival crevicular fluid and saliva will be collected to evaluate cytokines by Luminex assay (Luminex Corporation, Austin, TX). The pain (visual analogue scale), swelling and buccal opening (digital caliper), and OHRQoL will also be evaluated through the OHIP-14 questionnaire. The variables will be evaluated in T1 (baseline), T2 (immediately after PDT), and T3 (4th day after PDT). Registration: clinicaltrials.gov NCT 03576105. Registered in July 2018.
- BK virus salivary shedding and viremia in renal transplant recipients(2019) SARMENTO, Dmitry Jose de Santana; PALMIERI, Michelle; GALVAO, Gustavo Souza; TOZETTO-MENDOZA, Tania Regina; CANTO, Cynthia Motta do; PIERROTTI, Ligia Camera; DAVID-NETO, Elias; AGENA, Fabiana; GALLOTTINI, Marina; PANNUTI, Claudio Sergio; FINK, Maria Cristina Domingues; BRAZ-SILVA, Paulo HenriqueObjectives: This study aimed to verify the presence of polyomavirus BK (BKPyV) in the saliva of kidney transplant recipients and to correlate it with blood viremia. Material and Methods: We have conducted a cross-sectional study with a sample involving 126 renal transplant recipients. 126 samples of saliva and 52 samples of blood were collected from these patients. Detection and quantification of BKPyV were performed using a real-time PCR. To compare the presence of BKPyV in blood and saliva, the binomial proportion test was used. To verify associations between salivary shedding BKPyV and post-transplant periods (in months), the Mann-Whitney test was used. Spearman's correlation was used to correlate the viral load in the saliva with blood of kidney transplant recipients. Results: The mean age of the study group was 51.11 +/- 12.45 years old, and 69 participants (54.8%) were female, with a mean post-transplantation time of 4.80 +/- 6.04 months. BKPyV was quantified in several samples of saliva and blood, with medians of 1,108 cp/mL and 1,255 cp/mL, respectively. Only 16/52 (30.8%) participants presented BKPyV in blood, and 59/126 (46.8%) excreted the virus in saliva (p=0.004). BKPyV shedding was found in patients at a shorter post-transplantation period (3.86 +/- 5.25, p=0.100). A weak correlation was observed between viral quantification in saliva and blood (Spearman's correlation coefficient=0.193). Conclusion: The results of this study suggested that, although saliva excretes more BKPyV than blood, there is no reliable correlation between salivary shedding and blood viremia, showing two independent compartments of viral replication.