LUIZ AUGUSTO MARCONDES FONSECA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Prevalence of Antiretroviral Drug Resistance Mutations in HIV Seropositive Patients from an Outpatient Clinic of a Large University Hospital from Sao Paulo, Brazil(2020) CONSTANTINOV, Ericka Oliveira; BRIGIDO, Luis Fernando de Macedo; FONSECA, Luiz Augusto M.; CASSEB, Jorge; VEIGA, Ana Paula R.; MAGRI, Marcello M. C.; MONTEIRO, Mariana A.; ROCHA, Rosana C.; GASCON, Maria R. P.; FERREIRA, Mauricio D.; POLIS, Thales J. B.; NASCIMENTO, Najara A. de Lima; LIMONGELLI, Isadora Id; OLIVEIRA, Caro S.; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.Drug resistance mutations (DRMs) can affect the success of the therapy and compromise new prevention strategies. Increasing rates of resistance to antiretroviral (ARV) drugs have been reported in some areas. This study evaluated the DRMs prevalence among patients at Hospital das Clinicas (Sao Paulo). Among treatment-naive patients, the prevalence of transmitted DRMs (Stanford Calibrated Population Resistance) was 8.4% (21/249), with 69% (75/109) of acquired resistance among treatment-experienced patients. Rates of transmitted DRM showed an increase (6.6% in 2002-2009 vs. 15.1% in 2010-2015, p = .05), from the first to the second decade, mainly due to mutations to the NNRTI (non-nucleoside reverse transcriptase inhibitor) class. Among treatment-experienced cases, a nonsignificant decrease overall, significant for the protease inhibitors (PIs) class, was documented. Subtype B predominated in both groups (78%), followed by subtype F, BF recombinants, and subtype C. Our results add to the growing evidence of an increase in transmitted DRM, document extensive DRM among experienced patients, and a decrease in resistance to PIs class that may reflect the increased use of boosted PIs and newer ARV classes in more recent years.
- Short Communication: Is It Possible to Control HIV Infection in a Middle-Income Country Through a Multidisciplinary Approach?(2018) CASSEB, Jorge; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.Despite the difficulties to follow and retain patients for a long time in the public health service, special programs may bring about increased chances of survival and better quality of life, as well as higher rates of retention in care; this is also true for middle-income developing countries such as Brazil. Our relatively small outpatient service (approximate to 500 HIV-infected patients) may not mirror the reality encountered in other settings, including SAo Paulo city, but retention and high quality of care may improve rates of virological success, even in poorer settings. Furthermore, prevention of depression or anxiety, with discussion in groups of patients with the presence of a therapist, regular HIV RNA viral and CD4 cells counts, genotyping tests pre-HAART, and vigilance for drug failure, may explain this successful experience. We should also take into consideration that our cohort consists mostly of asymptomatic at-entry patients referred by the Blood Bank of SAo Paulo, located at the same hospital, implying that they had a better immunological status at start than the more usual HIV population. Besides that, the degree of adherence to treatment in our service, in general, is quite high and the patients have a higher mean educational level: >90% of the patients a high school or college education. Such features make this cohort a very specific and differentiated sample. To extend our findings, we intend to conduct similar studies in other HIV treatment centers, enabling comparisons of populations with different profiles.
- Can Persistent Infections with Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus, and Human T Lymphotropic Virus Type 1 Be Eradicated?(2024) TEIXEIRA, Sandy Vieira; PRATES, Gabriela; FONSECA, Luiz Augusto Marcondes; CASSEB, JorgePersistent viruses are hard to be eradicated, even using effective medications, and can persist for a long time in humans, sometimes regardless of treatment. Hepatitis B virus, hepatitis C virus, human immunodeficiency virus, and human T cell lymphotropic virus infections, the most common in our era, are still a challenge despite the increased knowledge about their biology. Most of them are highly pathogenic, some causing acute disease or, more often, leading to chronic persistent infections, and some of the occult, carrying a high risk of morbidity and mortality. However, if such infections were discovered early, they might be eradicated in the near future with effective medications and/or vaccines. This perspective review points out some specific characteristics of the most important chronic persistent viruses. It seems that in the next few years, these persistent viruses may have control by vaccination, epidemiological strategies, and/or treatment.
- Interferon-gamma Secretion Enzyme-Linked Immunospot Assay Determined Among Human T Cell Lymphotropic Virus Type 1-Infected Subjects: A Potential Laboratory Marker for Early HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis Diagnosis(2020) APOLIANO, Carlos Fernando; ASSONE, Tatiane; SILVA, Bosco Christiano Maciel da; CORRAL, Marcelo Andreetta; OLIVEIRA, Augusto Cesar Penalva de; FONSECA, Luiz Augusto Marcondes; DUARTE, Alberto Jose da Silva; TANG, Yuyang; CASSEB, Jorge