CLARISSE MARTINS MACHADO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina
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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bookPart 0 Citação(ões) na Scopus Transplant infections in developing countries(2012) MACHADO, C. M.- Clinical impact of multiple DNA virus infections in nondepleted haploidentical and unrelated allogeneic hematopoietic stem cell transplantation(2021) KERBAUY, M. N.; RIBEIRO, A. A. F.; ARCURI, L. J.; KERBAUY, L. N.; SILVA, C. C. da; CAMARGO, L. F. A.; MACHADO, C. M.; HAMERSCHLAK, N.Few studies have compared the clinical impact of multiple DNA-virus infections in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with posttransplant cyclophosphamide (PTCy) and unrelated donor allogeneic hematopoietic stem cell transplantation (UD-HSCT) with thymoglobulin, so we retrospectively analyzed viral infections in the first 6 mo posttransplant in these scenarios. Fifty-nine patients underwent to haplo-HSCT, and 68 to UD-HSCT. The most frequent infection was cytomegalovirus (CMV) (76.3% in haplo-HSCT and 69.1% in UD-HSCT) (P =.878) and in the group of patients with CMV reactivation, maximal CMV viral load over 2500 UI/ml correlated with worse overall survival-hazard ratio (HR) 1.93 (95% confidence interval [CI] 1.04-3.59) P =.03. The cumulative incidence of multiple DNA virus within 180 d of posttransplant was 78.7% for one virus and 28.4% for two or more viruses with no difference regarding the type of transplant. Viral infections, age, and acute graft versus host disease (GVHD) grades II–IV were risk factors for worse overall survival in multivariate analyses: one virus HR 2.53 (95% CI 1.03-6.17) P =.04, two or more viruses HR 3.51 (95% CI 1.37-9) P <.01, age HR 1.03 (95% CI 1.02-1.05) P <.01 and acute GVHD II–IV HR 1.97 (95% CI 1.13-3.43) P =.01. Also, age over 50 y HR 4.25 (95% CI 2.01-8.97) P <.001, second CMV reactivation or having both CMV and BK polyomavirus (BKV) HR 2.65 (95% CI 1.26-5.56) P =.01 and acute GVHD grades II–IV HR 2.23 (95% CI 1.12-4.43) P =.022 were risk factors for nonrelapse mortality in the multivariate analyses. In conclusion, multiple DNA-virus infections are frequent in both haplo-HSCT and UD-HSCT and a risk factor for worse overall survival. © 2021 Wiley Periodicals LLC.
- Evaluation of pretransplant influenza vaccination in hematopoietic SCT: a randomized prospective study(2015) AMBATI, A.; BOAS, L. S. V.; LJUNGMAN, P.; TESTA, L.; OLIVEIRA, J. F. de; AOUN, M.; COLTURATO, V.; MAEURER, M.; MACHADO, C. M.Pretransplant influenza vaccination of the donor or allogeneic hematopoietic SCT (HSCT) candidate was evaluated in a randomized study. One hundred and twenty-two HSCT recipients and their donors were assigned to three randomization groups: no pretransplant vaccination (n = 38), donor pretransplant vaccination (n = 44) or recipient pretransplant vaccination (n = 40). Specific IgG was assessed by both hemagglutinin inhibition (HI) and, in 57 patients, by an indirect influenza-specific ELISA at specified times after HSCT. Vaccinated donors had seroprotective HI titers for Ags H1 and H3 (P<0.001) compared with the other groups at the time of donation. The titers against H1 (P = 0.028) and H3 (P<0.001) were highest in the pretransplant recipient vaccination group until day 180 after transplantation. A significant difference was found in the specific Ig levels against pandemic H1N1 at 6 months after SCT (P = 0.02). The mean IgG levels against pandemic H1N1 and generic H1N1 and H3N2 were highest in the pretransplant recipient vaccination group. We conclude that pretransplant recipient vaccination improved the influenza-specific seroprotection rates.
- Antibody response to the non-adjuvanted and adjuvanted influenza A H1N1/09 monovalent vaccines in renal transplant recipients(2012) SALLES, M. J. C.; SENS, Y. A. S.; MALAFRONTE, P.; SOUZA, J. F.; BOAS, L. S. Vilas; MACHADO, C. M.Background The 2009 pandemic influenza A (H1N1) virus spread rapidly throughout Brazil. Non-adjuvanted and the adjuvanted influenza A H1N1/09 monovalent vaccine were recommended as a single dose to persons at risk including renal transplant recipients (RTR). We analyzed the safety and the immune response of 2 influenza A H1N1/09 monovalent vaccines in RTR, and identified factors influencing the immune response. Methods A total of 78 RTR received a single dose of either influenza A H1N1 2009 monovalent AS03-adjuvanted vaccine or a non-adjuvanted vaccine, and 58 healthy controls received a single dose of non-adjuvanted vaccine. Antibody responses to influenza A H1N1 were measured by hemagglutination inhibition assay and were compared between groups on the day of vaccination and 2130 days thereafter, using geometric mean titer (GMT), and seroprotection (SP) and seroconversion (SC) rates. Results Among RTR, after adjuvanted and non-adjuvanted H1N1 vaccination, the SP rate increased from 16.7% to 61.7% (P < 0.001) and to 50% (P < 0.001), and SC rates were 61.7% and 50%, respectively. For healthy controls, SP rate increased from 25.8% to 89.7% (P < 0.001), and SC rate was 87.9% after vaccination. Pre-vaccination GMT for the adjuvanted and non-adjuvanted RTR vaccine groups and healthy controls was 9.7 (95% confidence interval [CI] 7.313.1), 8.9 (95% CI 5.414.7), and 12.5 (95% CI8.718.2), and significantly increased to 49.8 (95% CI 31.379.4, P < 0.001), 43.2 (95% CI 16.3114.4, P < 0.001), and 323.8 (95% CI 213.9490.2, P < 0.001), respectively. Deceased-donor type transplant significantly reduced SP (odds ratio [OR] = 4.62, 95% CI 1.3615.69, P = 0.014) and SC (OR = 6.29, 95% CI 1.8920.98, P = 0.003) rates, and younger age positively affected SP (OR = 0.11; 95% CI 0.030.04, P = 0.001). Adverse events were mild, and renal function showed no change post vaccination. Conclusion RTR vaccinated with either an adjuvanted or non-adjuvanted monovalent influenza vaccine presented poor response compared with healthy controls. Post-vaccination adverse events were mild, and no rejection episode or renal dysfunction was observed.
- Community incidence of pandemic influenza (A/H1N1, 2009) in Sao Paulo, Brazil, 2009(2012) GATTAS, V. L.; MONDINI, G.; MACHADO, C. M.; LUNA, E.
conferenceObject Clinical Assessment of Cytomegalovirus Specific Cell Mediated Immunity in a Prospective Cohort of Lung Transplant Recipients(2017) CAMPOS, S. V.; SAMANO, M. N.; PEGO-FERNANDES, P. M.; TEIXEIRA, R. O.; CARRARO, R. M.; AFONSO-JUNIOR, J. E.; COSTA, A. N.; MACHADO, C. M.; SOUZA, A. C.; PEREIRA, B. B.; FERNANDES, L. M.; ABDALLA, L.conferenceObject QuantiFeron-CMV in the evaluation of CMV-specific immunity after autologous and allogeneic HSCT(2017) MORENO, J.; TESTA, L.; ZANETTI, L.; SERRA, L.; PEREIRA, B.; SOUZA, M.; SOUZA, A. Carolina; SOUZA, M. P.; COLTURATO, V. R.; MACHADO, C. M.conferenceObject Assessment of CMV Specific T-Cell Immunity by the Quantiferon-CMV Assay in Lung Transplant Recipients: Brazilian Pilot Study(2016) CAMPOS, S. V.; MAMANA, A.; SAMANO, M. N.; PEGO-FERNANDES, P. M.; MACHADO, C. M.