NATALIA BARROS CERQUEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
4 resultados
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- Interpreting HIV diagnostic histories into infection time estimates: analytical framework and online tool(2019) GREBE, Eduard; FACENTE, Shelley N.; BINGHAM, Jeremy; PILCHER, Christopher D.; POWRIE, Andrew; GERBER, Jarryd; PRIEDE, Gareth; CHIBAWARA, Trust; BUSCH, Michael P.; MURPHY, Gary; KASSANJEE, Reshma; WELTE, Alex; WELTE, Alex; SEMPA, Joseph; MATTEN, David; BRAND, Hilmarie; CHIBAWARA, Trust; MURPHY, Gary; HALL, Jake; MCKINNEY, Elaine; BUSCH, Michael P.; GREBE, Eduard; FACENTE, Shelley; HAMPTON, Dylan; KEATING, Sheila; LEBEDEVA, Mila; PILCHER, Christopher D.; MARSON, Kara; KASSANJEE, Reshma; LAEYENDECKER, Oliver; QUINN, Thomas; BURNS, David; LITTLE, Susan; SANDS, Anita; HALLETT, Tim; OWEN, Sherry Michele; PAREKH, Bharat; SEXTON, Connie; PRICE, Matthew; KAMALI, Anatoli; LOEB, Lisa; MARTIN, Jeffrey; DEEKS, Steven G.; HOH, Rebecca; BARTOLOMEI, Zelinda; SANTOS, Breno; ZABTOSKI, Kellin; LIRA, Rita de Cassia Alves; SPERHACKE, Rosa Dea; MOTTA, Leonardo R.; PAGANELLA, Machline; KALLAS, Esper; TOMIYAMA, Helena; TOMIYAMA, Claudia; COSTA, Priscilla; NUNES, Maria A.; REIS, Gisele; SAUER, Mariana M.; CERQUEIRA, Natalia; NAKAGAWA, Zelinda; FERRARI, Lilian; AMARAL, Ana P.; MILANI, Karine; KARIM, Salim S. Abdool; KARIM, Quarraisha Abdool; NDUNGU, Thumbi; MAJOLA, Nelisile; SAMSUNDER, Natasha; NANICHE, Denise; MANDOMANDO, Inacio; MACETE, Eusebio V.; SANCHEZ, Jorge; LAMA, Javier; DUERR, Ann; CAPOBIANCHI, Maria R.; SULIGOI, Barbara; STRAMER, Susan; WILLIAMSON, Phillip; VERMEULEN, Marion; SABINO, EsterBackground It is frequently of epidemiological and/or clinical interest to estimate the date of HIV infection or time-since-infection of individuals. Yet, for over 15 years, the only widely-referenced infection dating algorithm that utilises diagnostic testing data to estimate time-since-infection has been the 'Fiebig staging' system. This defines a number of stages of early HIV infection through various standard combinations of contemporaneous discordant diagnostic results using tests of different sensitivity. To develop a new, more nuanced infection dating algorithm, we generalised the Fiebig approach to accommodate positive and negative diagnostic results generated on the same or different dates, and arbitrary current or future tests - as long as the test sensitivity is known. For this purpose, test sensitivity is the probability of a positive result as a function of time since infection. Methods The present work outlines the analytical framework for infection date estimation using subject-level diagnostic testing histories, and data on test sensitivity. We introduce a publicly-available online HIV infection dating tool that implements this estimation method, bringing together 1) curatorship of HIV test performance data, and 2) infection date estimation functionality, to calculate plausible intervals within which infection likely became detectable for each individual. The midpoints of these intervals are interpreted as infection time 'point estimates' and referred to as Estimated Dates of Detectable Infection (EDDIs). The tool is designed for easy bulk processing of information (as may be appropriate for research studies) but can also be used for individual patients (such as in clinical practice). Results In many settings, including most research studies, detailed diagnostic testing data are routinely recorded, and can provide reasonably precise estimates of the timing of HIV infection. We present a simple logic to the interpretation of diagnostic testing histories into infection time estimates, either as a point estimate (EDDI) or an interval (earliest plausible to latest plausible dates of detectable infection), along with a publicly-accessible online tool that supports wide application of this logic. Conclusions This tool, available at , is readily updatable as test technology evolves, given the simple architecture of the system and its nature as an open source project.
- Asymptomatic anorectal Chlamydia trachomatis and Neisseria gonorrhoeae infections are associated with systemic CD8(+) T-cell activation(2017) VIEIRA, Vinicius A.; AVELINO-SILVA, Vivian I.; CERQUEIRA, Natalia B.; COSTA, Dayane A.; COSTA, Priscilla R.; VASCONCELOS, Ricardo P.; MADRUGA, Valdez R.; MOREIRA, Ronaldo I.; HOAGLAND, Brenda; VELOSO, Valdilea G.; GRINSZTEJN, Beatriz; KALLAS, Esper G.Background: Oral preexposure prophylaxis (PrEP) has been established as a pivotal strategy in HIV prevention. However, bacterial sexually transmitted infections (STIs), such as Chlamydia trachomatis and Neisseria gonorrhoeae, are also highly prevalent. Although the presence of STI-related mucosal lesions is a known risk factor for HIV acquisition, the potential increase in risk associated with asymptomatic STIs is not completely understood. Recent data demonstrated higher T-cell activation is a risk factor for sexually acquired HIV-1 infection. We examined the effect of asymptomatic C. trachomatis and N. gonorrhoeae anorectal infection on systemic immune activation, potentially increasing the risk of HIV acquisition. Methods: We analyzed samples from participants of PrEP Brasil, a demonstration study of daily oral emtricitabine/tenofovir disoproxil fumarate HIV PrEP among healthy MSM, for T-cell activation by flow cytometry. We included 34 asymptomatic participants with anorectal swab for C. trachomatis and/or N. gonorrhoeae infection, whereas negative for other STIs, and 35 controls. Results: We found a higher frequency of human leukocyte antigen DR(+)CD3(+)CD8(+)T cells (1.5 vs. 0.9%, P<0.005) and with memory phenotype in the group with asymptomatic C. trachomatis and/or N. gonorrhoeae infection. Exhaustion and senescence markers were also significant higher in this group. No difference was observed in the soluble CD14 levels. Conclusion: Our findings suggest asymptomatic anorectal C. trachomatis and/or N. gonorrhoeae increase systemic immune activation, potentially increasing the risk of HIV acquisition. Regular screening and treatment of asymptomatic STIs should be explored as adjuvant tools for HIV prevention.
- Beyond HIV prevention: Assessment of the benefits of pre-exposure prophylaxis for sexual quality of life(2024) BERTEVELLO, Daniel A.; VASCONCELOS, Ricardo; CERQUEIRA, Natalia B.; FREITAS, Angela C.; CUNHA, Ana; I, Vivian Avelino-SilvaBackground: Pre-exposure prophylaxis (PrEP) may favor sexual satisfaction by reducing the fear of HIV and promoting less restrictive sexual practices. These benefits may be even higher among PrEP users with mental health issues. Methods: We invited adult PrEP users to answer a questionnaire including demographics, questions on the sexual experience compared to the period before PrEP use, and the Hospital Anxiety and Depression Scale. Factors associated with improvements in the sexual experience were investigated using modified Poisson models. Results: We included 221 participants; most were white males. A large percentage of participants reported improvements in quality of sex after PrEP initiation; the composite outcome ""PrEP-associated improvement in the quality of sex"" was observed in 92 (42%), whereas the outcome ""PrEP-associated improvement in the fear of HIV acquisition"" was observed in 120 participants (54%). Demographics and depression/anxiety were not significantly associated with the outcomes. Conclusion: PrEP has positive effects beyond HIV prevention, improving several aspects of sexual quality of life. These benefits are valid incentives for PrEP use and prescription.
- Immune effects ofLactobacillus caseiShirota in treated HIV-infected patients with poor CD4+T-cell recovery(2020) TENORE, Simone de Barros; AVELINO-SILVA, Vivian Iida; COSTA, Priscilla Ramos; FRANCO, Lucas M.; SABINO, Ester Cerdeira; KALIL, Jorge; CERQUEIRA, Natalia Barros; NAKAGAWA, Zelinda; KALLAS, Esper GeorgesBackground: HIV infection leads to depletion of intestinal CD4+ T cells, mucosal barrier dysfunction, increased gut permeability and microbial translocation even among patients on suppressive ART. Previous studies suggest probiotics may help restore intestinal function. Methods: In this double-blind, placebo-controlled pilot study, we enrolled HIV-infected patients on suppressive ART with poor CD4+ recovery to address the effect of daily oral use ofLactobacillus caseiShirota (LcS) on CD4+ T-cell count and CD4+/CD8+ ratio at 6 and 12 weeks after treatment initiation; immune activation and intestinal microbiome composition were addressed as secondary outcomes. Results: From January 2015 to July 2016, 48 patients were randomized (1 : 1) to active intervention or placebo. Groups had comparable demographic and clinical characteristics; only CD4+ T-cell nadir was statistically different between groups. All participants were virologically suppressed under ART. At week 6, the increment in CD4+ T-cell count was 17 cells/mu l [interquartile range (IQR) -33 to 74] in the active intervention arm and 4 cells/mu l (IQR -43 to 51) in the placebo arm (P = 0.291); at week 12, the change in CD4+ T-cell count was 8 cells//mu l (IQR -30 to 70) in the active arm and 10 cells//mu l (IQR -50 to 33) among participants allocated to placebo (P = 0.495). Median change in CD4+/CD8+ ratio at week 6 compared with baseline was 0 (IQR -0.04 to 0.05) in the active intervention arm and -0.01 in the placebo arm (IQR -0.06 to 0.03;P = 0.671). At week 12, the change in CD4+/CD8+ ratio was higher in the active product group compared with placebo (respectively 0.07 and 0.01), but this difference failed to reach statistical significance (P = 0.171). We found no significant effects of LcS on immune activation markers, CD4+ and CD8+ subpopulations, sCD14 levels or NK cells at week 12. Finally, we found no statistically significant differences between groups in the change of enteric microbiome at week 12. Conclusion: In this pilot study, we found no statistically significant effect of LcS probiotic on CD4+ T-cell counts, CD4+/CD8+ ratio, immune activation or intestinal microbiome among HIV-infected patients on suppressive ART with poor CD4+ recovery.