HIV-1 Molecular Epidemiology, Transmission Clusters and Transmitted Drug Resistance Mutations in Central Brazil

We aimed to characterize HIV-1 molecular epidemiology and transmission clusters among heterosexual (HET) and men who have sex with men (MSM) individuals, as well as transmitted drug resistance mutations (TDRM) in Central-Western Brazil. This cross-sectional survey was conducted among 190 antiretroviral naïve HIV-1 infected individuals. Proviral DNA was extracted, and nested PCR amplified partial polymerase gene (PR/RT). After sequencing, subtypes were assigned, and the sequences were analyzed for the occurrence of possible transmission networks. Calibrated Population Resistance (CPR) tool from Stanford HIV Database was used to investigate the presence of TDRM. Among 150 individuals whose samples were successfully sequenced, the most prevalent HIV-1 subtype was B, followed by recombinant forms. The occurrence of twenty transmission clusters composed by at least two sequences was verified, suggesting the existence of transmission clusters among individuals from the same or distinct sexual orientations. Intermediate level of TDRM (12%) was found in the study population, and almost half of the subjects with TDRM had more than one resistance mutation. No correlations between sexual orientation and the presence of TDRM, HIV-1 subtypes/recombinants forms were verified. Taken together, the necessity of the continuous monitoring of the TDRM to verify the importance of pre-genotyping and to delineate future strategies in primary antiretroviral therapy. Likewise, the knowledge of the HIV-1 transmission networks in Brazil would allow the implementation of effective HIV-1 prevention strategies in local settings

Surtos de doenças infectocontagiosas notificados no estado de Mato Grosso do Sul de 2020 a 2022: Vigil Sanit Debate, Rio de Janeiro, 2023, v.11: e02152 | Publicado em: 09/10/2023

Introduction: Due to the importance of infectious diseases for global public health, the investigation of disease outbreaks that can be prevented and controlled by health services is essential. Objective: Describe outbreaks reported in the state of Mato Grosso do Sul, Brazil, in 2020 and 2022, to demonstrate the importance of surveillance in situations of disease outbreaks and/or public health problems. Method: This is a cross-sectional, descriptive, retrospective, qualitative-quantitative epidemiological study with temporal secondary data collected from the outbreak notification system developed by the team at the Strategic Health Surveillance Information Center (CIEVS/Estadual) of Mato Grosso do Sul. Results: In the period, 599 outbreaks were reported, involving 8.076 suspected and 5.191 confirmed individuals. Among the outbreaks, 569 (95%) were caused by Sars-CoV-2, at 32 municipalities, most occurring in industries and hospital. Twenty-six deaths occurred in the period, of which 15 were caused by SARS-CoV-2 outbreaks. Conclusions: The use of tools for the notification of outbreaks is effective and helps in quick decision-making when applied efficiently.Introdução: Devido à importância das doenças infectocontagiosas para a saúde pública mundial, a investigação de surtos de doença passível de prevenção e controle pelos serviços de saúde é fundamental. Objetivo: Descrever os surtos notificados no estado de Mato Grosso do Sul, nos anos de 2020 a 2022, e demonstrar a  importância da vigilância em situações de surtos de doenças e/ou agravos de saúde pública. Método: Trata-se de um estudo epidemiológico transversal, descritivo, retrospectivo, qualiquantitativo com dados secundários temporais coletados do sistema de notificação de surtos criado pela equipe do Centro de Informações Estratégicas de Vigilância em Saúde (CIEVS/Estadual) de Mato Grosso do Sul. Resultados: No período foram notificados 599 surtos, envolvendo 8.076 indivíduos suspeitos e 5.191 confirmados. Dentre os surtos, 569 (95%) foram provocados pelo SARS-CoV-2, notificados por 32 municípios, e a maioria ocorreu em indústrias e hospitais. Ocorreram 26 óbitos no período, e destes 15 foram provenientes dos surtos por SARS-CoV-2. Conclusões: As utilizações de ferramentas para notificação de surtos são efetivas e auxiliam na tomada rápida de decisão quando aplicadas de maneira eficiente

Atenção primária à saúde no Brasil: adolescência, desinformação e infecções sexualmente transmissíveis

Introdução: As infecções sexualmente transmissíveis (IST), principalmente na população jovem, apresentam-se como um problema de saúde pública a nível mundial. Objetivo: Identificar o conhecimento de adolescentes escolares sobre IST e acessibilidade ao serviço de saúde. Método: Trata-se de um estudo descritivo, qualitativo, desenvolvido com 13 adolescentes, estudantes de uma escola municipal de uma capital da região centro-oeste, Brasil. Resultados: A análise das entrevistas proporcionou a identificação de três categorias temáticas: conhecimento e desconhecimento sobre o assunto; a importância da educação sexual na busca de respostas e o elo inexistente com o sistema de saúde. Conclusão: Evidenciou-se que os participantes apresentaram algum conhecimento sobre a prevenção de IST, porém a maioria desconhece a sintomatologia e formas de transmissão destas infecções

Standardization and Prevalence of the Booster Phenomenon: Evaluation Using a Two-Step Skin Test with 43 kDa Glycoprotein in Individuals from an Endemic Region of Paracoccidioidomycosis

Background We estimated the occurrence rate of the booster phenomenon by using an intradermal test with 43 kDa glycoprotein in an endemic area of paracoccidioidomycosis in the central-west region of Brazil. Methods Individuals who had a negative result on a survey performed by using an intradermal test with 43 kDa glycoprotein in an endemic area of paracoccidioidomycosis underwent a second intradermal test after 10–15 days to determine the presence or absence of the booster phenomenon. Statistical analyses were performed using the Chi-square test, Chi-square for linear trend test, Student’s t test, and binomial test; p < 0.05 was considered significant. Results For the first time, we reported the occurrence of the booster phenomenon to an intradermal reaction caused by 43 kDa glycoprotein at a rate of 5.8–8.4%, depending on the test’s cutoff point. This suggests that a cutoff point should be considered for the booster phenomenon in intradermal tests with 43 kDa glycoprotein: a difference of 6–7 mm between readings according to the first and second tests, depending on the purpose of the evaluation. Conclusion The results indicate that the prevalence of paracoccidioidal infection in endemic areas is underestimated, as the booster phenomenon has not been considered in epidemiological surveys for this infection.Health Department of the Municipality of Jaraguari (Mato Grosso do Sul, Brazil)Post-Graduation Program for Health and Development of the Central-West Region BrazilUniv Fed Mato Grosso do Sul, Fac Med, Cidade Univ S-N, BR-79070900 Campo Grande, BrazilFundacao Oswaldo Cruz, Evandro Chagas Clin Res Inst, Lab Immunol & Immunogenet, BR-21040360 Rio De Janeiro, BrazilUniv Fed Sao Paulo, Fac Med, Clin Hosp, Med Mycol Lab, BR-04023062 Sao Paulo, BrazilUniv Estadual Paulista, Fac Med Botucatu, Dept Trop Dis, Botucatu, SP, BrazilUniv Fed Sao Paulo, Fac Med, Clin Hosp, Med Mycol Lab, BR-04023062 Sao Paulo, BrazilWeb of Scienc

Molecular Epidemiology of HIV-1 among Prisoners in Central Brazil and Evidence of Transmission Clusters

Higher rates of human immunodeficiency virus (HIV) infection have been detected in prisoners when compared with the general population, but research into HIV molecular epidemiology and its transmission network has been lacking among them. Thus, this study aimed to verify potential HIV molecular transmission networks among prisoners. In addition, we aimed to describe the mutations related to antiretroviral resistance in these isolates. Thus, we conducted a cross-sectional survey from 2013 to 2018 in prisons in Central-Western Brazil, and the final sampling composed of 84 prisoners. Proviral DNA was extracted from each whole blood sample followed by amplification of the partial polymerase gene and sequencing. Forty-nine sequences (58.3%) were classified as subtype B, followed by C (14.3%), D, and F1 (2.4% each). A complex and dynamic HIV-1 epidemic is observed in the prisons, as 25% of the sequences were recombinant forms. We detected 15 HIV transmission clusters composed of at least two sequences, that included not only prisoners but also individuals from the general population from the same State with a variety of risk behaviors. Thirty-two percent (32.0%) of treatment-experienced prisoners had at least one drug resistance mutation (DRM), while transmitted DRMs were found in 5.9% of the prisoners. We highlight the urgent need for routine surveillance of HIV-1 infection including resistance genotypic tests considering the high disease burden, risky behaviors inside prisons, and the dynamic relationship of prisoners with the outside community

Human T cell lymphotropic virus type 1 infection among men who have sex with men in Central Brazil

ABSTRACT Human T cell lymphotropic virus type 1 (HTLV-1) was the first retrovirus discovered in humans and is endemic in several parts of the world. Because of risk behaviors, mainly sexual, men who have sex with men (MSM) are at high risk of acquiring HTLV-1 infection. A cross-sectional study was performed to estimate the prevalence of HTLV-1 infection, to characterize genetically HTLV-1 sequences and to identify risk behaviors associated with this infection among MSM in Central Brazil. A total of 430 MSM were enrolled in this study and three were shown to be HTLV-1 infected, prevalence of 0.7% (95% confidence interval: 0.4-0.9). Phylogenetic analysis showed that all HTLV-1 positive samples belonged to Cosmopolitan subtype Transcontinental subgroup A. Although the prevalence rate of HTLV-1 infection found in this study was similar to that observed among Brazilian blood donors, additional HTLV-1 preventive interventions need to be further implemented because this population is engaged in high-risk sexual behavior

High-risk behaviors for hepatitis B and C infections among female sex workers

Abstract INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance

Screening for HBV, HCV, HIV and syphilis infections among bacteriologically confirmed tuberculosis prisoners: An urgent action required.

Viral hepatitis, syphilis, HIV, and tuberculosis infections in prisons have been identified globally as a public health problem. Tuberculosis (TB) and viral hepatitis co-infection may increase the risk of anti-tuberculosis treatment-induced hepatotoxicity, leading to the frequent cause of discontinuation of the first-line anti-tuberculosis drugs. Therefore, the aim of this cross-sectional study was to investigate the epidemiological features of HCV, HBV, syphilis and HIV infections among bacteriologically confirmed tuberculosis prisoners in Campo Grande (MS), Central Brazil. The participants who agreed to participate (n = 279) were interviewed and tested for the presence of active or current HCV, HBV, syphilis and HIV infections. The prevalence of HCV exposure was 4.7% (13/279; 95% CI 2.2-7.1). HCV RNA was detected in 84.6% (11/13) of anti-HCV positive samples. Out of 279 participants, 19 (6.8%; 95% CI 4.4-10.4) were HIV co-infected, 1.4% (4/279, 95% CI 0.5-3.8) had chronic hepatitis B virus (HBsAg positive) and 9.3% (26/279, 95% CI 6.4-13.4) had serological marker of exposure to hepatitis B virus (total anti-HBc positive). The prevalence of lifetime syphilis infection (anti-T. pallidum positive) was 10% (28/279, 95% CI 7.0-14.2) and active syphilis (VDRL ≥ 1/8 titre) was 5% (14/279, 95% CI 2.9-8.3). The prevalence of TB/HCV co-infection among prisoners with HIV (15.8%) was higher than among HIV-non-infected prisoners (3.8%; P<0.05). These results highlight the importance of hepatitis testing among prisoners with bacteriologically confirmed case of TB who can be more effectively and safely treated in order to reduce the side effects of hepatotoxic anti-TB drugs

Prevalence and Incidence of HCV Infection among Prisoners in Central Brazil

Submitted by Sandra Infurna ([email protected]) on 2017-05-04T13:09:43Z No. of bitstreams: 1 barbara_lago_etal_IOC_2017.pdf: 2294511 bytes, checksum: d3e34b2cddbbe7813fed3a35ecb9cb2e (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-05-04T13:22:45Z (GMT) No. of bitstreams: 1 barbara_lago_etal_IOC_2017.pdf: 2294511 bytes, checksum: d3e34b2cddbbe7813fed3a35ecb9cb2e (MD5)Made available in DSpace on 2017-05-04T13:22:45Z (GMT). No. of bitstreams: 1 barbara_lago_etal_IOC_2017.pdf: 2294511 bytes, checksum: d3e34b2cddbbe7813fed3a35ecb9cb2e (MD5) Previous issue date: 2017Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Mato Grosso do Sul, MS. Brasil / Universidade Federal do Grande Dourados. Mato Grosso do Sul, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal de Goiás. Escola de Enfermagem. Goiânia, GO, Brasil.Universidade Federal do Grande Dourados.. Mato Grosso do Sul, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Universidade Federal do Mato Grosso do Sul. Campo Grande, MS, Brasil / Fundação Oswaldo Cruz. Mato Grosso do Sul, MS, Brasil.The aim of this multicenter, cross sectional study was to assess the prevalence, incidence and associated risk factors among incarcerated populations from twelve Brazilian prisons. The total of 3,368 individuals from twelve prisons was randomly recruited between March 2013 and March 2014. Participants were interviewed, and provided blood samples which were tested for antibodies to Hepatitis C (HCV ab). One year after the first investigation, a cohort study was conducted with 1,656 inmates who participated the cross sectional study. Positive samples were tested for the presence of HCV RNA. Out of 3,368 inmates, 520 (15.4%) were females, and 2,848 (84.6%) were males. The overall prevalence of HCV was 2.4% (95% CI: 1.9 to 2.9), with 0.6% (95% CI: 0.4 to 0.8) in females, and 2.7% (95% CI: 2.1 to 3.3) in males (p<0.01). HCV RNA was detected in 51/80 (63.7%) samples. Among men prisoners, multivariate analysis of associated factors showed independent associations between HCV exposure and increasing age, inject drug use, length of incarceration, smoking hashish, sharing needle and syringe and HIV positivity. During the cohort study, 7/1,656 new cases of HCV infection were detected, and the incidence rate was 0.4/100 person-year. Once high frequency rates of specific HCV risk behaviors and new HCV infections have been identified inside prisons, effective interventions strategies such as screening, clinical evaluation and treatment to reduce the spread of HCV infection are essential