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Autor: MENDRONE-JUNIOR, Alfredo ×

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  • article 0 Citação(ões) na Scopus
    Prevalence and clinical consequences of Hepatitis C virus infection in patients undergoing hematopoietic stem cell transplantation
    (2024) DIAZ, Ana Claudia Marques Barbosa; WITKIN, Steven Sol; ALMEIDA-NETO, Cesar de; MENDRONE-JUNIOR, Alfredo; ROCHA, Vanderson; COSTA, Silvia Figueiredo; RAMOS, Jessica Fernandes; MENDES-CORREA, Maria Cassia
    Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality among hematopoietic stem cell transplant (HCT) recipients. In Brazil, its occurrence in HCT recipients remains undetermined. We now report on HCV prevalence in HCT recipients and its clinical consequences. The medical records of all HCT recipients seen at Hospital das Clinicas, Sao Paulo University Medical School, from January 2010 to January 2020 were reviewed to determine HCV serostatus. A retrospective analysis of medical charts was undertaken on all seropositive cases to determine HCV genotype, presence of liver fibrosis, co-infections with other viruses, previous treatments, and clinical evolution of liver pathology after HCT. Of the 1,293 HCT recipients included in the study, seven (0.54%) were HCV antibody-positive and five (0.39%) were also viremic for HCV-RNA. Four of these individuals had moderate to severe liver fibrosis (METAVIR F2/F3) and one was cirrhotic. Two of the viremic patients developed acute liver dysfunction following transplantation. All patients had their acute episode of liver dysfunction resolved with no further complications. Four of the viremic patients were treated for HCV infection with direct acting agents (DAA). Information regarding HCV treatment was lacking for one of the viremic HCV patients due to loss of follow up. Sustained anti-virologic responses were observed in three cases after the use of DAA. The detection of HCV in hematological adults undergoing HCT and its successful treatment with DAA highlight the necessity of testing for HCV both prior to and following transplantation.
  • article 17 Citação(ões) na Scopus
    Demographic characteristics and prevalence of serologic markers among blood donors who use confidential unit exclusion (CUE) in Sao Paulo, Brazil: implications for modification of CUE polices in Brazil
    (2011) ALMEIDA-NETO, Cesar de; LIU, Jing; WRIGHT, David J.; MENDRONE-JUNIOR, Alfredo; TAKECIAN, Pedro L.; SUN, Yu; FERREIRA, Joao Eduardo; CHAMONE, Dalton de Alencar Fischer; BUSCH, Michael P.; SABINO, Ester Cerdeira
    BACKGROUND: This study evaluated demographic profiles and prevalence of serologic markers among donors who used confidential unit exclusion (CUE) to assess the effectiveness of CUE and guide public policies regarding the use of CUE for enhancing safety versus jeopardizing the blood supply by dropping CUE. STUDY DESIGN AND METHODS: We conducted a cross-sectional analysis of whole blood donations at a large public blood center in Sao Paulo from July 2007 through June 2009, compared demographic data, and confirmed serologic results among donors who used and who have never used CUE (CUE never). RESULTS: There were 265,550 whole blood units collected from 181,418 donors from July 2007 through June 2009. A total of 9658 (3.6%) units were discarded, 2973 (1.1%) because CUE was used at the current donation (CUE now) and 6685 (2.5%) because CUE was used in the past (CUE past). The CUE rate was highest among donors with less than 8 years of education (odds ratio [OR], 2.78; 95% confidence interval [CI], 2.51-3.08). CUE now donations were associated with higher positive infectious disease marker rates than CUE never donations (OR, 1.41; CI, 1.13-1.77), whereas CUE past donations were not (OR, 1.04; CI, 0.75-1.45). CONCLUSION: The CUE process results in a high rate of unit discard. CUE use on an individual donation appears predictive of a high-risk marker-positive donation and, thus, appears to contribute modestly to blood safety. The policy of discarding units from donors who have previously CUE-positive donations does not improve safety and should be discontinued.
  • article 9 Citação(ões) na Scopus
    Molecular characterization of viruses associated with encephalitis in Sao Paulo, Brazil
    (2019) FERREIRA, Jerenice E.; FERREIRA, Suzete C.; ALMEIDA-NETO, Cesar; NISHIYA, Anna S.; ALENCAR, Cecilia S.; GOUVEIA, Gisele R.; CAIAFFA-FILHO, Helio; GOMES, Helio; SANTOSID, Raimunda Telma de Macedo; WITKIN, Steven S.; MENDRONE-JUNIOR, Alfredo; SABINO, Ester C.
    The objective of this study was to characterize the prevalence of viral encephalitis due to arbovirus infection of the Togaviridae and Flaviviridae families in Sao Paulo, Brazil. A total of 500 cerebrospinal fluid (CSF) samples collected between August 2012 and January 2013, from patients with symptoms of acute encephalitis were analyzed. Findings suggestive of viral encephalitis-elevations in cell concentration, glucose and total protein-were observed in 234 (46.8%) samples, designated as Group 1. The remaining 266 samples comprised Group 2. All samples were tested for Flaviviruses (dengue virus 1, 2, 3 and 4, yellow fever virus and West Nile virus), Alphavirus (NS5 region) and enterovirus by RT-PCR and for herpesviruses and enteroviruses using CLART(-)Entherpex. A presumptive viral etiological agent was detected in 26 samples (5.2%), 18 (8.0%) in Group 1 and 8 (3.0%) in Group 2. In Group 1 human herpesviruses were detected in 9 cases, enteroviruses in 7 cases, dengue viruses (DENV) in 2 CSFs and St. Louis encephalitis virus (SLEV) in one case. In Group 2 there were 3 CSFs positive for human herpesviruses, 2 for enteroviruses, 2 for DENV and 1 for SLEV. Detection of arboviruses, even though present in a minority of infected patients, identifies these viruses as a probable etiological agent of encephalitis. This is of special concern in regions where this class of viruses is endemic and has been linked to other recent epidemics.
  • article 15 Citação(ões) na Scopus
    Number of recent sexual partners among blood donors in Brazil: associations with donor demographics, donation characteristics, and infectious disease markers
    (2012) PATAVINO, Giuseppina Maria; ALMEIDA-NETO, Cesar de; LIU, Jing; WRIGHT, David J.; MENDRONE-JUNIOR, Alfredo; FERREIRA, Maria Ines Lopes; CARNEIRO, Anna Barbara de Freitas; CUSTER, Brian; FERREIRA, Joao Eduardo; BUSCH, Michael P.; SABINO, Ester Cerdeira
    BACKGROUND: Brazilian blood centers ask candidate blood donors about the number of sexual partners in the past 12 months. Candidates who report a number over the limit are deferred. We studied the implications of this practice on blood safety. STUDY DESIGN AND METHODS: We analyzed demographic characteristics, number of heterosexual partners, and disease marker rates among 689,868 donations from three Brazilian centers between July 2007 and December 2009. Donors were grouped based on maximum number of partners allowed in the past 12 months for each center. Chi-square and logistic regression analysis were conducted to examine associations between demographic characteristics, number of sex partners, and individual and overall positive markers rates for human immunodeficiency virus (HIV), human T-lymphotropic virus Types 1 and 2, hepatitis B virus, hepatitis C virus, and syphilis. RESULTS: First-time, younger, and more educated donors were associated with a higher number of recent sexual partners, as was male sex in Sao Paulo and Recife (p < 0.001). Serologic markers for HIV and syphilis and overall were associated with multiple partners in Sao Paulo and Recife (p < 0.001), but not in Belo Horizonte (p = 0.05, p = 0.94, and p = 0.75, respectively). In logistic regression analysis, number of recent sexual partners was associated with positive serologic markers (adjusted odds ratio [AOR], 1.2-1.5), especially HIV (AOR, 1.9-4.4). CONCLUSIONS: Number of recent heterosexual partners was associated with HIV positivity and overall rates of serologic markers of sexually transmitted infections. The association was not consistent across centers, making it difficult to define the best cutoff value. These findings suggest the use of recent heterosexual contacts as a potentially important deferral criterion to improve blood safety in Brazil.
  • article 6 Citação(ões) na Scopus
    10-year analysis of human immunodeficiency virus incidence in first-time and repeat donors in Brazil
    (2021) MATEOS, Sheila de Oliveira Garcia; PREISS, Liliana; GONCALEZ, Thelma T.; OLIVEIRA, Claudia Di Lorenzo; GREBE, Eduard; GERMANIO, Clara Di; STONE, Mars; AMORIM FILHO, Luiz; PROIETTI, Anna Barbara Carneiro; BELISARIO, Andre Rolim; ALMEIDA-NETO, Cesar de; MENDRONE-JUNIOR, Alfredo; LOUREIRO, Paula; BUSCH, Michael P.; CUSTER, Brian; SABINO, Ester Cerdeira
    Background and objectives Incidence in first-time and repeat blood donors is an important measure of transfusion-transmitted HIV infection (TT-HIV) risk. This study assessed HIV incidence over time at four large blood centres in Brazil. Materials and methods Donations were screened and confirmed using serological assays for HIV from 2007 to 2016, and additionally screened by nucleic acid testing from 2011 forward. Limiting antigen (LAg) avidity testing was conducted on HIV seroreactive samples from first-time donors to classify whether an infection was recently acquired. We calculated incidence in first-time donors using the mean duration of recent infection and in repeat donors using classical methods. Time and demographic trends were assessed using Poisson regression. Results Over the 10-year period, HIV incidence in first-time donors was highest in Recife (45 center dot 1/100 000 person-years (10(5)py)) followed by Sao Paulo (32 center dot 2/10(5)py) and then Belo Horizonte (23 center dot 3/10(5)py), and in repeat donors was highest in Recife (33 center dot 2/10(5)py), Belo Horizonte (27 center dot 5/10(5)py) and Sao Paulo (17 center dot 0/10(5)py). Results from Rio de Janeiro were available from 2013 to 2016 with incidence in first-time donors of 35 center dot 9/10(5)py and repeat donors from 2011 to 2016 of 29 center dot 2/10(5)py. Incidence varied by other donor demographics. When incidence was considered in 2-year intervals, no significant trend was evident. Overall residual risk of TT-HIV was 5 center dot 46 and 7 center dot 41 per million units of pRBC and FFP transfused, respectively. Conclusion HIV incidence in both first-time and repeat donors varied by region in Brazil. Clear secular trends were not evident.
  • article 4 Citação(ões) na Scopus
    SARS-CoV-2 antibody dynamics in blood donors and COVID-19 epidemiology in eight Brazilian state capitals: A serial cross-sectional study
    (2022) PRETE JR., Carlos A.; BUSS, Lewis F.; WHITTAKER, Charles; SALOMON, Tassila; OIKAWA, Marcio K.; PEREIRA, Rafael H. M.; MOURA, Isabel C. G.; DELERINO, Lucas; BARRAL-NETTO, Manoel; TAVARES, Natalia M.; FRANCA, Rafael F. O.; BOAVENTURA, Viviane S.; MIYAJIMA, Fabio; MENDRONE-JUNIOR, Alfredo; ALMEIDA-NETO, Cesar De; SALLES, Nanci A.; FERREIRA, Suzete C.; FLADZINSKI, Karine A.; SOUZA, Luana M. de; SCHIER, Luciane K.; INOUE, Patricia M.; XABREGAS, Lilyane A.; CRISPIM, Myuki A. E.; FRAIJI, Nelson; V, Fernando L. Araujo; CARLOS, Luciana M. B.; PESSOA, Veridiana; RIBEIRO, Maisa A.; SOUZA, Rosenvaldo E. de; SILVA, Sonia M. N. da; CAVALCANTE, Anna F.; VALENCA, Maria I. B.; V, Maria da Silva; LOPES, Esther; FILHO, Luiz A.; MATEOS, Sheila O. G.; NUNES, Gabrielle T.; SILVA-JUNIOR, Alexander L.; BUSCH, Michael P.; CASTRO, Marcia C.; DYE, Christopher; RATMANN, Oliver; FARIA, Nuno R.; NASCIMENTO, Vitor H.; SABINO, Ester C.
    Background: The COVID-19 situation in Brazil is complex due to large differences in the shape and size of regional epidemics. Understanding these patterns is crucial to understand future outbreaks of SARS-CoV-2 or other respiratory pathogens in the country. Methods: We tested 97,950 blood donation samples for IgG antibodies from March 2020 to March 2021 in 8 of Brazil's most populous cities. Residential postal codes were used to obtain representative samples. Weekly age- and sex-specific seroprevalence were estimated by correcting the crude seroprevalence by test sensitivity, specificity, and antibody waning. Results: The inferred attack rate of SARS-CoV-2 in December 2020, before the Gamma variant of concern (VOC) was dominant, ranged from 19.3% (95% credible interval [CrI] 17.5-21.2%) in Curitiba to 75.0% (95% CrI 70.8-80.3%) in Manaus. Seroprevalence was consistently smaller in women and donors older than 55 years. The age-specific infection fatality rate (IFR) differed between cities and consistently increased with age. The infection hospitalisation rate increased significantly during the Gamma-dominated second wave in Manaus, suggesting increased morbidity of the Gamma VOC compared to previous variants circulating in Manaus. The higher disease penetrance associated with the health system's collapse increased the overall IFR by a minimum factor of 2.91 (95% CrI 2.43-3.53). Conclusions: These results highlight the utility of blood donor serosurveillance to track epidemic maturity and demonstrate demographic and spatial heterogeneity in SARS-CoV-2 spread.
  • article 5 Citação(ões) na Scopus
    Contribution of the Retrovirus Epidemiology Donor Study (REDS) to research on blood transfusion safety in Brazil
    (2014) LOUREIRO, Paula; ALMEIDA-NETO, Cesar de; PROIETTI, Anna Bárbara Carneiro; CAPUANI, Ligia; GONÇALEZ, Thelma Terezinha; OLIVEIRA, Claudia Di Lorenzo de; LEÃO, Silvana Carneiro; LOPES, Maria Inês; SAMPAIO, Divaldo; PATAVINO, Giuseppina Maria; FERREIRA, João Eduardo; BLATYTA, Paula Fraiman; LOPES, Maria Esther Duarte; MENDRONE-JUNIOR, Alfredo; SALLES, Nanci Alves; KING, Melissa; MURPHY, Edward; BUSCH, Michael; CUSTER, Brian; SABINO, Ester Cerdeira
    The Retrovirus Epidemiology Donor Study (REDS) program was established in the United States in 1989 with the purpose of increasing blood transfusion safety in the context of the HIV/AIDS and human T-lymphotropic virus epidemics. REDS and its successor, REDS-II were at first conducted in the US, then expanded in 2006 to include international partnerships with Brazil and China. In 2011, a third wave of REDS renamed the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) was launched. This seven-year research program focuses on both blood banking and transfusion medicine research in the United States of America, Brazil, China, and South Africa. The main goal of the international programs is to reduce and prevent the transmission of HIV/AIDS and other known and emerging infectious agents through transfusion, and to address research questions aimed at understanding global issues related to the availability of safe blood. This article describes the contribution of REDS-II to transfusion safety in Brazil. Articles published from 2010 to 2013 are summarized, including database analyses to characterize blood donors, deferral rates, and prevalence, incidence and residual risk of the main blood-borne infections. Specific studies were developed to understand donor motivation, the impact of the deferral questions, risk factors and molecular surveillance among HIV-positive donors, and the natural history of Chagas disease. The purpose of this review is to disseminate the acquired knowledge and briefly summarize the findings of the REDS-II studies conducted in Brazil as well as to introduce the scope of the REDS-III program that is now in progress and will continue through 2018.
  • article 39 Citação(ões) na Scopus
    Correlation between SARS-COV-2 antibody screening by immunoassay and neutralizing antibody testing
    (2021) MENDRONE-JUNIOR, Alfredo; DINARDO, Carla Luana; FERREIRA, Suzete Cleuza; NISHYA, Anna; SALLES, Nanci Alves; ALMEIDA NETO, Cesar de; HAMASAKI, Debora Toshei; FACINCANI, Tila; ALVES, Lucas Bassolli de Oliveira; MACHADO, Rafael Rahal Guaragna; ARAUJO, Danielle Bastos; DURIGON, Edison Luiz; ROCHA, Vanderson; SABINO, Ester Cerdeira
    Background The efficacy of convalescent plasma (CP), an alternative for the treatment of COVID-19, depends on high titers of neutralizing antibodies (nAbs), but assays for quantifying nAbs are not widely available. Our goal was to develop a strategy to predict high titers of nAbs based on the results of anti-SARS-CoV-2 immunoassays and the clinical characteristics of CP donors. Study Design and Methods A total of 214 CP donors were enrolled and tested for the presence of anti-SARS-CoV-2 antibodies (IgG) using two commercial immunoassays: EUROIMMUN (ELISA) and Abbott (Chemiluminescence). Quantification of nAbs was performed using the Cytopathic Effect-based Virus Neutralization test. Three criteria for identifying donors with nAbs >= 1:160 were tested: - C1: Curve ROC; - C2: Conditional decision tree considering only the IA results and - C3: Conditional decision tree including both the IA results and the clinical variables. Results The performance of the immunoassays was similar referring to both S/CO and predictive value for identifying nAbs titers >= 1:160. Regarding the studied criteria for identifying CP donors with high nAbs titers: (a) C1 showed 76.1% accuracy if S/CO = 4.65, (b) C2 presented 76.1% accuracy if S/CO >= 4.57 and (c) C3 had 71.6% accuracy if S/CO was >= 4.57 or if S/CO was between 2.68-4.57 and the last COVID-19-related symptoms were recent (within 19 days). Conclusion SARS-CoV-2 IgG immunoassays (S/CO) can be used to predict high anti-SARS-CoV-2 nAbs titers. This study has proposed different criteria for identifying donors with >= 1:160 nAbs titers, all with high efficacy.
  • article 0 Citação(ões) na Scopus
    The impact of immediate adverse donation reactions on the return of volunteers undergoing platelet apheresis
    (2022) FARIAS, Cassio Lins Gil de; BASSOLLI, Lucas; MENDRONE-JUNIOR, Alfredo; ARRAIS, Cyntia de Araujo; DURAN, Amanda; ROCHA, Vanderson; ALMEIDA-NETO, Cesar de
    Introduction: Immediate adverse reactions experienced during donation decrease return rates among whole-blood donors, but little is known about this effect among platelet apheresis donors. We investigated the impact of immediate adverse reactions on the return rates of volunteer apheresis platelet donors. Methods: In a sample of 4108 consecutive platelet apheresis donors seen from August 2016 through June 2019, we evaluated whether immediate adverse reactions were associated with returning for a subsequent platelet apheresis donation within a 12-month period. We used propensity score matching to compare donors with and without adverse reactions. Results: An immediate adverse reaction occurred in 312 (7.6%) donors; 98.5% were mild, and 0.3% were severe. Of the original 4108 platelet apheresis donors, only 3211 (72.3%) returned for a subsequent donation within 12 months. Experiencing an immediate adverse reaction during the donation process significantly decreased the return rate for a subsequent donation [HR= 0.74 (0.63-0.87)], especially among female donors [HR= 0.70 (0.53-0.93)], donors aged < 30 years [HR= 0.71 (0.54-0.94)], with a high school educational level [0.63 (0.49-0.81)], donors donating for the first time [HR= 0.73 (0.59-0.90)], and repeat donors with a previous platelet apheresis donation more than 180 days prior [HR= 0.68 (0.50-0.93)]. Conclusion: Even mild adverse events reduce the return rates for a subsequent donation among platelet apheresis donors. Female donors, younger donors, and first-time donors are at higher risk of not returning after an im-mediate adverse reaction. Preventing the incidence of immediate adverse reactions during platelet apheresis donation may increase the rate of donor retention.
  • article 0 Citação(ões) na Scopus
    Are different motivations and social capital score associated with return behaviour among Brazilian voluntary non-remunerated blood donors?
    (2020) ESTRADA, Fernanda G. M. D.; OLIVEIRA, Claudia D. L.; SABINO, Ester C.; CUSTER, Brian; GONCALEZ, Thelma T.; MURPHY, Edward L.; TELES, Dahra; MENDRONE-JUNIOR, Alfredo; WITKIN, Steve S.; ALMEIDA-NETO, Cesar de
    Background We examined the association between social capital score, motivator factors and demographic and donation characteristics and donor return at three Brazilian blood centres in Recife, Sao Paulo and Belo Horizonte. Material and methods A total of 5974 donors were interviewed about motivation factors to donate and cognitive and structural social capital just before an effective donation in three Brazilians blood centres in 2009. We assessed the return to a new donation within 2 years for each of these donors. Demographic and donation characteristics, motivators and scores of social capital and their association with donors' return were assessed. Results Overall, 3123 (52.3%) of the study subjects returned for a blood donation at least once. Predictors of donors' return were male gender (adjusted odds ratio [AOR] = 1.6, 1.3-1.9, for replacement and AOR = 1.3, 1.2-1.6, for community donors), previous donation (AOR = 2.7, 2.3-3.3, for replacement and AOR = 2.9, 2.5-3.5, for community donors) and high altruism (AOR = 1.3, 1.1-1.7, for replacement and AOR = 1.2, 1.0-1.5, for community donors). Altruism was the only motivator associated with return behaviour. Donors from Recife and Sao Paulo were more likely to return for replacement and/or for community donations than donors from Belo Horizonte. There was no association between social capital score and donor return behaviour. Conclusion The likelihood to return for a subsequent blood donation is dependent upon characteristics of individual donors and also varies in different regions of Brazil. However, social capital was not associated with the likelihood of return behaviour. A better understanding of altruistic categories and appeals may help to improve donor recruitment and retention.