ALBERTO JOSE DA SILVA DUARTE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- DETERMINATION OF VIRAL TROPISM BY GENOTYPING AND PHENOTYPING ASSAYS IN BRAZILIAN HIV-1-INFECTED PATIENTS(2014) ARRUDA, Lia Barbara; ARAUJO, Marilia Ladeira de; MARTINEZ, Maira Luccia; GONSALEZ, Claudio Roberto; DUARTE, Alberto Jose da Silva; COAKLEY, Eoin; LIE, Yolanda; CASSEB, JorgeThe clinical application of CCR5 antagonists involves first determining the coreceptor usage by the infecting viral strain. Bioinformatics programs that predict coreceptor usage could provide an alternative method to screen candidates for treatment with CCR5 antagonists, particularly in countries with limited financial resources. Thus, the present study aims to identify the best approach using bioinformatics tools for determining HIV-1 coreceptor usage in clinical practice. Proviral DNA sequences and Trofile results from 99 HIV-1-infected subjects under clinical monitoring were analyzed in this study. Based on the Trofile results, the viral variants present were 81.1% R5, 21.4% R5X4 and 1.8% X4. Determination of tropism using a Geno2pheno([coreceptor]) analysis with a false positive rate of 10% gave the most suitable performance in this sampling: the R5 and X4 strains were found at frequencies of 78.5% and 28.4%, respectively, and there was 78.6% concordance between the phenotypic and genotypic results. Further studies are needed to clarify how genetic diversity amongst virus strains affects bioinformatics-driven approaches for determining tropism. Although this strategy could be useful for screening patients in developing countries, some limitations remain that restrict the wider application of coreceptor usage tests in clinical practice.
- Low bone mineral density among HIV-infected patients in Brazil(2017) CHABA, Daniela Cardeal da Silva; SOARES, Lismeia R.; PEREIRA, Rosa M. R.; RUTHERFORD, George W.; ASSONE, Tatiane; TAKAYAMA, Liliam; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.; CASSEB, JorgeDecrease in bone mineral density (BMD) has been a complication among people living with HIV/AIDS. To investigate the prevalence of osteopenia/osteoporosis among HIV-infected people living in Sao Paulo city, we studied 108 HIV-infected patients (79 men and 29 women). We extracted data from patients' medical records and BMD was measured by dual-energy X-ray absorptiometry (DXA). Median age of participants was 42 years (interquartile range [IQR] 36-48 years), and the median time since HIV diagnosis was 4.01 years (IQR 2-11 years). Patients had acquired HIV primarily by the sexual route (men who have sex with men 44%, heterosexual 49%). Median age, duration of HIV infection, duration of ART and CD4 nadir were similar for men and women. Plasma viral load was undetectable for 53 patients (49%). Median CD4 T cell count was 399 cells/mu L (IQR 247 - 568). Twenty five patients (23%) had LBMD, and there was no statistically significant difference between men and women (<-1). The associated risk factors for LBMD were older age (>= 50 years old) and smoking with a RR of 3.87 and 2.80, respectively. Thus, despite the lack of statistically significant relationship between the use of ART and LBMD or between duration of ART and LBMD, these factors should be addressed in larger studies.
- Incomplete recovery of the CD4+/CD8+ratio is associated with the late introduction of antiretroviral therapy among people living with HIV infection(2024) PRATES, Gabriela da Silva; MONTEIRO, Mariana Amelia; OLIVEIRA, Ericka Constantinov; NASCIMENTO, Najara Ataide de Lima; VEIGA, Ana Paula Rocha; FERREIRA, Mauricio Domingues; POLIS, Thales Jose Bueno; CAETANO, Gabriela Prandi; SOARES, Beatriz Rodrigues Pellegrina; MAGRI, Marcello Mihailenko Chaves; PEREIRA, Luisa Oliveira; FONSECA, Luiz Augusto Marcondes; ALVES, Wagner Silva; DUARTE, Alberto Jose da Silva; CASSEB, Jorge Simao do RosarioDespite being subject to lower AIDS-related mortality rates and having a higher life expectancy, patients with HIV are more prone to develop non-AIDS events. A low CD4+/CD8+ ratio during antiretroviral therapy identifies people with heightened immune senescence and increased risk of mortality. In clinical practice, finding determinants of a low CD4+/CD8+ ratio may be useful for identifying patients who require close monitoring due to an increased risk of comorbidities and death. We performed a prospective study on the evolution of the CD4(+)/CD8(+) ratio in 60 patients infected with HIV (80% males), who were subjected to two different antiretroviral regimens: early and deferred therapy. The initial CD4(+)/CD8(+) ratio was <= 1 for 70% of the patients in both groups. Older age, CD4(+) cell count at inclusion, Nadir CD8(+)T-cell count, and Initial CD4(+)/CD8(+) ratio <= 1 were risk factors for lack of ratio recovery. In the multivariate analysis, a CD4(+)/CD8(+) ratio > 1 at the start of the treatment was found to be a determinant factor in maintaining a CD4(+)/CD8(+) ratio > 1. The nadir CD4(+)T-cell count was lower in the deferred therapy group (p=0.004), and the last CD4(+)/CD8(+) ratio <= 1 was not associated with comorbidities. Ratio recovery was not associated with the duration of HIV infection, time without therapy, or absence of AIDS incidence. A greater improvement was observed in patients treated early (p=0.003). In contrast, the slope of increase was slower in patients who deferred treatment. In conclusion, the increase in the CD4+/CD8+ ratio occurred mostly for patients undergoing early strategy treatment and its extension did not seem to be related to previous HIV-related factors.
- TUBERCULOSIS AMONG HIV-1-INFECTED SUBJECTS IN A TERTIARY OUT-PATIENT SERVICE IN SAO PAULO CITY, BRAZIL(2012) CASSEB, Jorge; FONSECA, Luiz Augusto M.; MEDEIROS, Lucas A.; GONSALEZ, Claudio R.; LAGONEGRO, Eduardo R.; VEIGA, Ana Paula Rocha; SILVA, Daniela C. Da; MENDONCA, Marcelo; DUARTE, Alberto J. S.TB is currently considered to be the most important infectious disease among HIV-1-infected subjects in developing countries, such as Brazil. A retrospective analysis of TB cases was performed, occurring from January 1995 to December 2010 in our cohort of 599 HIV positive patients. The primary outcome was the occurrence of active TB. Forty-one TB cases were diagnosed over this period of 16 years, among 599 HIV positive patients in an open cohort setting in the city of Sao Paulo, Brazil. All-time lowest mean CD4 T cell count at the time of TB diagnosis was 146 and 186 cells/mm(3), respectively. The mean HIV viral load was 5.19 log(10) copies/mL, and 59% of the patients were on HAART. TB incidence was 1.47 per 100 person-years, for a total follow-up time of 2775 person-years. The probability of surviving up to 10 years after diagnosis was 75% for TB patients as opposed to 96% for patients with other, non-TB opportunistic diseases (p = 0.03). TB can be considered a public health problem among people living with HIV in Brazil despite of the widespread use of antiretrovirals for the treatment of HIV infection/AIDS.
- Fighting HIV/AIDS in a developing country: lessons from a small cohort from the largest Brazilian city(2020) CASSEB, Jorge; VEIGA, Ana Paula R.; MAGRI, Marcello M. C.; MONTEIRO, Mariana A.; ROCHA, Rosana C.; GASCON, Maria Rita P.; DOMINGUES-FERREIRA, Mauricio; POLIS, Thales J. B.; NASCIMENTO, Najara A. de Lima; LIMONGELLI, Isadora; OLIVEIRA, Icaro S.; PRANDI, Gabriela Caetano; COSTA, Livia M. C. B. Villares; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.
- DISCORDANCE BETWEEN BODY MASS INDEX AND ANTHROPOMETRIC MEASUREMENTS AMONG HIV-1-INFECTED PATIENTS ON ANTIRETROVIRAL THERAPY AND WITH LIPOATROPHY/LIPOHYPERTROPHY SYNDROME(2015) SOARES, Lismeia Raimundo; SILVA, Daniela Cardeal da; GONSALEZ, Claudio R.; BATISTA, Felipe G.; FONSECA, Luiz Augusto M.; DUARTE, Alberto J. S.; CASSEB, JorgeIntroduction: Highly Active Antiretroviral Therapy (HAART) has improved and extended the lives of thousands of people living with HIV/AIDS around the world. However, this treatment can lead to the development of adverse reactions such as lipoatrophy/lipohypertrophy syndrome (LLS) and its associated risks. Objective: This study was designed to assess the prevalence of self-reported lipodystrophy and nutritional status by anthropometric measurements in patients with HIV/AIDS. Methods: An observational study of 227 adult patients in the Secondary Immunodeficiencies Outpatient Department of Dermatology, Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo (3002 ADEE-HCFMUSP). The sample was divided into three groups; Group 1 = 92 patients on HAART and with self-reported lipodystrophy, Group 2 = 70 patients on HAART without self-reported lipodystrophy and Group 3 = 65 patients not taking HAART. The nutritional status of individuals in the study sample was determined by body mass index (BMI) and percentage of body fat (% BF). The cardiovascular risk and diseases associated with abdominal obesity were determined by waist/hip ratio (WHR) and waist circumference (WC). Results: The prevalence of self-reported lipoatrophy/lipohypertrophy syndrome was 33% among women and 59% among men. Anthropometry showed depletion of fat mass in the evaluation of the triceps (TSF) in the treatment groups with HAART and was statistically independent of gender; for men p = 0.001, and for women p = 0.007. Similar results were found in the measurement of skin folds of the upper and lower body (p = 0.001 and p = 0.003 respectively). In assessing the nutritional status of groups by BMI and % BF, excess weight and body fat were more prevalent among women compared to men (p = 0.726). The WHR and WC revealed risks for cardiovascular and other diseases associated with abdominal obesity for women on HAART and with self-reported LLS (p = 0.005) and (p = 0.011). Conclusions: Anthropometric measurements were useful in the confirmation of the prevalence of LLS. BMI alone does not appear to be a good parameter for assessing the nutritional status of HIV-infected patients on HAART and with LLS. Other anthropometric measurements are needed to evaluate patients with the lipoatrophy/lipohypertrophy syndrome.
- Prevalence of anti-SARS-CoV-2 antibodies in outpatients of a large public university hospital in Sao Paulo, Brazil(2020) OLIVEIRA, Luanda Mara da Silva; TIYO, Bruna Tiaki; SILVA, Lais Teodoro da; FONSECA, Luiz Augusto Marcondes; ROCHA, Rosana Coura; SANTOS, Vera Aparecida dos; CENEVIVA, Carina; BEDIN, Anderson Aparecido; ALMEIDA, Alexandre de; DUARTE, Alberto Jose da Silva; OSHIRO, Telma MiyukiCoronavirus disease 19 (COVID-19) is caused by SARS-Cov-2 and the manifestations of this infection range from an absence of symptoms all the way up to severe disease leading to death. To estimate the prevalence of past infection in a population, the most readily available method is the detection of antibodies against the virus. This study has investigated the prevalence of anti-SARS-CoV-2 antibodies in outpatients of the Hospital das Clinicas, in Sao Paulo city (Brazil), which is a large university hospital belonging to the public health system that cares for patients with complex diseases who need tertiary or quaternary medical care. Our serological inquiry was carried out for 6 weeks, with once-a-week blood sampling and included 439 patients from several outpatient services. Overall, 61 patients tested positive for anti-SARS-CoV-2 IgG (13.9%); 56.1 % of the patients live in Sao Paulo city, with the remaining living in other towns of the metropolitan area; 32.8% of the patients testing positive for IgG antibodies to SARS-CoV-2 were asymptomatic, 55.7% developed mild or moderate disease and 11.5% had to be hospitalized. The prevalence of SARS-CoV-2 positive serology was lower among patients who had received the seasonal influenza vaccine compared to the ones who did not. These findings may indicate that those individuals care more about health issues, and/or that they have a better access to health care and/or a better quality of health care service. The large proportion of patients who were unaware of having had contact with SARS-CoV-2 deserves attention, reflecting the scarcity of tests performed in the population.