Incidence of antiretroviral adverse drug reactions in pregnant women in two referral centers for HIV prevention of mother-to-child-transmission care and research in Rio de Janeiro, Brazil

Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) infection remains an important cause of new HIV infections worldwide, especially in low and middleresource limited countries. Safety data from studies involving pregnant women and prenatal antiretroviral (ARV) exposure are still needed once these studies are often small and with a limited duration to assess adverse drug reactions (ADR). The aim of this study was to estimate the incidence of ADR related to the use of antiretroviral therapy (ART) in pregnant women in two referral centers in Rio de Janeiro State. A prospective study was carried out from February 2005 to May 2006. Women were classified according to their ART status during pregnancy diagnosis: ARV-experienced (ARTexp) or ARV-naïve (ARTn). Two hundred fourteen HIV-infected pregnant women were included: 36 ARTexp and 178 ARTn. ARTexp women have not experienced ADR. Among ARTn, 20.2% presented ADR. Incidence rate of ADR was 70.8 per 1000 person-months and the most common ADRs observed were: gastrointestinal (belly or abdominal cramps, diarrhea, nausea and vomit) in 16.3%, cutaneous (pruritus and rash) in 6.2%, anemia (2.2%) and hepatitis (1.7%). The frequency of obstetrical complications, preterm delivery, low birth weight and birth abnormalities was low in this population. ADRs ranged from mild to moderate intensity, none of them being potentially fatal. Only in a few cases it was necessary to discontinue ART. In conclusion, the high effectiveness of ARV for HIV prevention of MTCT (PMTCT) overcomes the risk of ADR

Neutralization susceptibility of B subtype variant B" primary HIV-1 isolates. The HEC/FIOCRUZ AIDS Clinical Research Group.

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-08-12T13:58:33Z No. of bitstreams: 1 Bongertz V Neutralization....pdf: 117774 bytes, checksum: 3b8595108e205935db0e283bb01847f4 (MD5)Made available in DSpace on 2014-08-12T13:58:33Z (GMT). No. of bitstreams: 1 Bongertz V Neutralization....pdf: 117774 bytes, checksum: 3b8595108e205935db0e283bb01847f4 (MD5) Previous issue date: 1998AIDS & Molecular Immunology Laboratory. Department of Immunology. Rio de Janeiro, RJ, BrasilAIDS & Molecular Immunology Laboratory. Department of Immunology. Rio de Janeiro, RJ, BrasilAIDS & Molecular Immunology Laboratory. Department of Immunology. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Rio de Janeiro, RJ, BrasilServidores do Estado Hospital Rio de Janeiro. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilAIDS & Molecular Immunology Laboratory. Department of Immunology. Rio de Janeiro, RJ, BrasilSusceptibility to autologous and heterologous neutralization of primary human immunodeficiency virus (HIV)-1 isolates belonging to subtype B, to the B"-variant of subtype B or to subtype F from infected individuals residing in Rio de Janeiro was assayed. A lower infectivity of the B"- and F isolates when compared to the classical B-subtype HIV-1 isolates was observed. Comparisons of neutralization susceptibilities were carried out for 19 B-subtype, 11 B"-variant and two F-subtype HIV-1 isolates with plasma from autologous and heterologous samples. Frequency of autologous neutralization was slightly lower for B-subtype isolates in comparison to B"-variant isolates. Heterologous intra-subtype neutralization was significantly lower for B-subtype than for the B"-variant or the F-subtype isolates. While B-subtype isolates were neutralized by most anti-F-subtype plasma, F-subtype isolates, although most susceptible to F-subtype antibodies, were highly susceptible to neutralization by anti-B-subtype antibodies. Cross-neutralization for B"-variant and B-subtype isolates was not as extensive as observed for B- and F-subtype isolates. However, the results presented indicate a quite extensive cross-neutralization between Brazilian HIV-1 isolates

Postmalaria neurological syndrome: a case report

Described here is a case of postmalaria neurological syndrome in a patient who presented infection by Plasmodium falciparum two months earlier. The patient received empiric use of acyclovir for herpetic meningoencephalitis, but neuropsychiatric symptoms improved only after administration of methylprednisolone

A Comparison of the Pharmacokinetics of Standard and Increased Dosage Lopinavir/Ritonavir Co-formulation Tablets in HIV-positive Pregnant Women: a randomized clinical trial

Made available in DSpace on 2015-07-01T12:12:29Z (GMT). No. of bitstreams: 2 license.txt: 1914 bytes, checksum: 7d48279ffeed55da8dfe2f8e81f3b81f (MD5) esau_joaoetal_IOC_2014.pdf: 710059 bytes, checksum: b9e7e1c8a324a8e046c8813a7b6ba2d5 (MD5) Previous issue date: 2014Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Centro de Ciências da Saúde. Faculdade de Farmácia. Laboratório de Farmacometria. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Children's Hospital of Los Angeles. Division of Infectious Diseases. Los Angeles, CA, USA.Universidade Federal do Estado do Rio de Janeiro. Departamento de Matemática. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Departamento de Matemática. Rio de Janeiro, RJ, Brasil.Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Centro de Ciências da Saúde. Faculdade de Farmácia. Laboratório de Farmacometria. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Lopinavir/ritonavir (LPV/r) based regimen is recommended during pregnancy to reduce the risk of HIV mother-to-child transmission, but the appropriate dose is controversial. Wecompared the pharmacokinetics of standard and increased LPV/r doses during pregnancy. This randomized, open-label prospective study enrolled 60 HIV-infected pregnant women 31 between gestational weeks 14 and 30. Participants received either the standard (400/100 mg BID) or increased dose (600/150 mg BID) of LPV/r tablets during pregnancy and the standard dose for six weeks after childbirth. Pharmacokinetic analysis was performed using a high-performance liquid chromatography-tandem mass spectrometry method. Adherent participants who received the standard dose presented minimum LPV concentrations of 4.4, 4.3 and 6.1µg/mL in the second and the third trimesters and postpartum, respectively. The increased dose group exhibited values of 7.9, 6.9 and 9.2 µg/mL at the same timepoints. Although LPV exposure was significantly higher in the increased dose group, the standard 39 dose produced therapeutic levels of LPV against wild-type virus in all adherent participants, except one patient in the third trimester; 50%, 37.5%, 25% and 0%, 15%, 0% of the participants in the standard and increased dose groups, respectively, failed to achieve therapeutic levels against resistant viruses during the second and third trimesters and after childbirth. After 12 weeks of treatment and after childbirth, all adherent participants achieved undetectable HIV viral loads, and their babies (49/54) were uninfected. No serious drug-related adverse events were observed. We conclude that the standard dose is appropriate for use during pregnancy and an increased dose may be necessary for women harboring resistant HIV

Anti-HIV-1 seroreactivity and HIV transmission route[R1]

Made available in DSpace on 2010-08-23T16:58:49Z (GMT). No. of bitstreams: 3 license.txt: 1848 bytes, checksum: 9bb8f65f67107ba6a95f9f2a8ded1f54 (MD5) LANDMANN_BASTOS_Anti-HIV Seroreactivity_1999.pdf: 115488 bytes, checksum: 822ef0044d528414151cf2fc097db530 (MD5) LANDMANN_BASTOS_Anti-HIV Seroreactivity_1999.pdf.txt: 37638 bytes, checksum: c02649157725807b912ca746ee5f1d54 (MD5) Previous issue date: 1999Made available in DSpace on 2010-11-04T14:20:09Z (GMT). No. of bitstreams: 3 LANDMANN_BASTOS_Anti-HIV Seroreactivity_1999.pdf.txt: 37638 bytes, checksum: c02649157725807b912ca746ee5f1d54 (MD5) LANDMANN_BASTOS_Anti-HIV Seroreactivity_1999.pdf: 115488 bytes, checksum: 822ef0044d528414151cf2fc097db530 (MD5) license.txt: 1848 bytes, checksum: 9bb8f65f67107ba6a95f9f2a8ded1f54 (MD5) Previous issue date: 1999Research supported by the FIOCRUZ Integrated AIDS Program PIAF, World Bank 063:94, CNPq 520922:95-6 and CNPq:MRC(Canada).Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro Centro de Informação Cientifica e Tecnológica. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro de Informação Cientifica e Tecnológica Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro de Informação Cientifica e Tecnológica. Rio de Janeiro, RJ, BrasilUniversidade Estadual do Rio de Janeiro. NEPAD. Rio de Janeiro, RJ, BrasilHospital Geral de Nova Iguaçu. Rio de Janeiro, RJ, BrasilHospital dos Servidores do Estado. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, BrasilBackground: antibody binding assays carried out by our group have consistently indicated a higher reactivity of sera from male HIV-1 infected individuals. This study was carried out in order to analyze the importance of gender, route of transmission, disease progression and HIV-1 genotype in seroreactivity assays. Study design: specificity of antibody binding was studied in plasma of 247 HIV-1 seropositive individuals belonging to patient groups of pregnant women, injecting drug users (IDUs) and recent seroconvertors, resident in Rio de Janeiro, RJ. Recognition of synthetic peptides corresponding to antigenically important epitopes in the envelope of HIV-1 (gp41 immunodominant epitope, V3 loop, V2 loop and gp41 735–752 epitope) was determined. Results: the immunodominant gp41 peptide (amino acids 594–613, HIV-1 MN sequence) was recognized by 85% of all plasma tested. Reactivity with the gp41 735–752 peptide and gp120 V2 loop peptides was low but quite variable, being generally more often specific to a Brazilian V2 peptide used than to the HIV-1 MN derived V2 peptide. The overall recognition of the different V3 peptides tested varied from 41 to 76%. Patients with more advanced disease showed a more frequent reactivity with the peptides studied than did asymptomatic patients. Statistically significant differences in peptide recognition were observed by multiple logistic analyses comparing plasma derived from individuals infected by blood or sexual HIV transmission, adjusting for disease progression and gender. Plasma from individuals infected by sexual transmission showed lower peptide recognition than did plasma from individuals infected through HIV positive blood. Association attempts between seroreactivity and genotype indicated that plasma derived from patients infected with HIV-1 of the F subtype showed highest recognition of heterologous V3 peptides, as well as a slightly more frequent recognition of the non-V3 peptides tested. Recognition of homologous peptides was generally higher than recognition of heterologous peptides. Differences were most pronounced between the prototypical HIV-1 B subtype and the Brazilian B′′ variant of this subtype but almost non-existent between the HIV-1 B and F subtypes. Conclusions: individual gender was shown to be a confounder when investigating the relationships of peptide reaction to HIV-1 route of transmission through multivariate statistical methods: patients infected by blood transmission (IDU) present higher frequency of peptide recognition than individuals infected by sexual HIV-1 transmission. Plasma from individuals infected with the B′′ variant (GWG) of B subtype HIV-1 showed lower heterologous peptide recognition than that from HIV-1 B (GPG) or F infected individuals

HIV specific humoral immune response in Rio de Janeiro, Brazil. The HEC/Fiocruz AIDS Clinical Research Group.

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-08-12T16:58:38Z No. of bitstreams: 1 Bongertz V HIV Specific Humoral....pdf: 113169 bytes, checksum: 203f033b0f6c4e306ef1664dc658d0e6 (MD5)Made available in DSpace on 2014-08-12T16:58:39Z (GMT). No. of bitstreams: 1 Bongertz V HIV Specific Humoral....pdf: 113169 bytes, checksum: 203f033b0f6c4e306ef1664dc658d0e6 (MD5) Previous issue date: 1998Instituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular, Departamento de Imunologia. Rio de Janeiro, RJ, BrasilInstituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular, Departamento de Imunologia. Rio de Janeiro, RJ, BrasilInstituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular, Departamento de Imunologia. Rio de Janeiro, RJ, BrasilInstituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular, Departamento de Imunologia. Rio de Janeiro, RJ, BrasilInstituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular, Departamento de Imunologia. Rio de Janeiro, RJ, BrasilInstituto Oswaldo Cruz. Hospital Evandro Chagas. Laboratório de AIDS e Imunologia Molecular, Departamento de Imunologia. Rio de Janeiro, RJ, BrasilCentro de Informações em Ciência e Tecnologia. Fiocruz, RJ, BrasilHospital Geral de Nova Iguaçu. Nova Igaçu, RJ, BrasilHospital dos Servidores do Estado. Rio de Janeiro, RJ, BrasilSecretaria da Saúde e Meio Ambiente. Porto Alegre, RS, BrasilMinistério da Saúde. Programa Nacional DST AIDS. Brasília, DF, BrasilNEPAD. Universidade Estadual do Rio de Janeiro. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilEfforts to characterize HIV-1 polymorphism and anti-HIV immune response are being made in areas where anti-HIV/AIDS vaccines are to be employed. Anti-HIV-1 humoral immune response is being studied in infected individuals residents in Rio de Janeiro, in distinct cohorts involving recent seroconvertors, pregnant women or intravenous drug users (IDU). Comparative analyses of specificity of antibody response towards epitopes important for anti-HIV-1 immune response indicate quantitative differences between cohorts, with an exceptionally strong response in IDUs and weakest response in pregnant women. However, a comparative analysis between pregnant women cohorts from Rio de Janeiro and Rio Grande do Sul indicated an even lower response (with exception of the anti-V3-C clade peptide recognition) for the southern cohort. Studies analysing the immune function of the humoral response indicate a quite elevated occurrence of antibodies capable for neutralizing heterologous primary HIV-1 isolates from Rio de Janeiro. Attempts to correlate seroreactivity with HIV-1 neutralization with respect to HIV-1 polymorphism were not very successful: while the Brazilian B clade B " variant could be recognized by binding assays, no significant distinction of HIV-1 clades/variants was observed in viral neutralization assays