Mulheres Reclusas e Vulnerabilidade ao Vírus Hiv/Aids

O presente trabalho teve como objetivos a identificação do perfil sociodemográfico e dos fatores determinantes da vulnerabilidade à  infecção pelo vírus HIV em mulheres reclusas, cujos parceiros sexuais são detentos da Agência Goiana do Sistema Prisional. Os resultados indicaram que 41% das detentas mantinham relacionamentos afetivos dentro do sistema prisional goiano, levando-as a conviver com um fator de risco aumentado em 40% de contrair a infecção pelo vírus HIV. As características gerais desta população são mulheres advindas de famílias numerosas, decorrentes de áreas urbanas, que já viveram na rua em algum período de suas vidas, com história de desestruturação familiar e violência

PREVALÊNCIA DO HIV E HCV EM PRESÍDIO DE APARECIDA DE GOIÂNIA, GOIÁS

Introdução: A infecção pelo vírus da Imunodeficiência humana (HIV) e hepatite C (HCV) é considerada um importante problema de saúde pública, afetando milhões de pessoas em todo o mundo. Na atualidade, os detentos são considerados grupo de risco para ambos os vírus. Torna-se imprescindível uma maior atenção a doenças e promoção da saúde de encarcerados, não somente pelos maiores riscos presentes no ambiente prisional, mas pela falta de ações educativas e preventivas oferecidas. Objetivo: Identificar prevalência das infecções pelo HIV e coinfecção pelo HCV, bem como os comportamentos de risco associados a essas infecções. Metodologia: Estudo transversal, de caráter descritivo e de abordagem qualitativa. A amostra foi composta por detentos de ambos os sexos da Agência Goiana do Sistema Prisional. Os participantes foram submetidos à punção venosa e pesquisa dos marcadores sorológicos anti-HIV e anti-HCV. Resultados: Entre os 870 indivíduos privados de liberdade a prevalência do HIV foi de 0,57% (5/870), já a prevalência da coinfecção com o marcador anti-HCV foi de 40% (2/5). Conclusão: A elevada prevalência da infecção pelo HIV e coinfecção com o HCV evidencia a necessidade de programas de conscientização para esclarecer e orientar a respeito das formas de contaminação e de prevenção é de extrema necessidade. Evitando-se que um número maior de pessoas sejam infectadas

Prevalence of hepatitis B and C infection and associated factors in people living with HIV in Midwestern Brazil

This study aimed to estimate the prevalence of infection by the hepatitis B virus (HBV) and hepatitis C virus (HCV) in people infected by the human immunodeficiency virus (HIV) and analyze sociodemographic and behavioral factors associated with such co-infection. A cross-section study was performed in 495 individuals treated at a public center in the city of Goiânia. Participants were interviewed and blood collected for evaluation of serological and molecular markers for HBV and HCV. The rate of exposure to HBV was 33.5% (95% CI 29.4-37.9). Nineteen patients (3.8%) were diagnosed as HBV carriers, of whom 68.4% were HBV DNA positive. The prevalence of anti-HCV was 9.7% (95% CI 7.3-12.7). Genotype 1a was identified in 72.7% of the PCR samples positive for HCV. Co-infection by all three viruses was 4.4% (95% CI 2.9-6.8). Being, male, aged ≥40 years, history of sexually transmitted disease (STD), and having homosexual practices were independently associated with the presence of markers of HBV exposure. A history of injectable drugs use and STDs showed association with HCV seropositivity. Approximately 50% of participants were not aware of their HBV and HCV serostatus. The results obtained may contribute to assess the burden of viral hepatitis in people living with HIV and to guiding preventive measures for more vulnerable groups

Epidemiological and environmental aspects of visceral leishmaniasis in children under 15 years of age between 2007 and 2012 in the City of Araguaína, State of Tocantins, Brazil

Introduction Visceral leishmaniasis (VL) stands out as a zoonosis observed on four continents and also in urban expansion zones in several regions of Brazil. Methods A cross-sectional epidemiological study of VL cases in children under 15 years of age in the period from 2007 to 2012. Clinical data were gathered from medical reports; meteorological data were obtained at the Meteorological Measurement Department of UFT. Environmental variables were divided into two periods, rainy and dry. Results The study revealed no difference by gender (p=0.67) among the 821 patients. However, the most affected age group was between one and five years of age (58.6%; p<0.01); the highest prevalence of the disease (99.03%; p<0.01) occurred in urban zones; and the most affected ethnic group (85.5%; p<0.01) was mixed race. The highest incidence coefficients in this population occurred in 2007 and 2008 (578.39/100,000 inhabitants; 18.5/100,000 inhabitants, respectively), whereas the highest lethality coefficients occurred in 2008 and 2011 (0.85/100 deaths). There was no significant correlation between average rainfall and the number of VL cases. The correlation between temperature and number of VL cases was negative (r = -0.4039; p<0.01). Conclusions In Aragua&#237;na, visceral leishmaniasis in children under 15 years is an urban-based endemic disease distributed across all districts of the city wherein temperature as an environmental factor, a higher prevalence in mixed race children between one and five years of age, and a high incidence coefficient all strongly contribute to child mortality

Acute Zika Virus Infection in an Endemic Area Shows Modest Proinflammatory Systemic Immunoactivation and Cytokine-Symptom Associations

An early immune response to Zika virus (ZIKV) infection may determine its clinical manifestation and outcome, including neurological effects. However, low-grade and transient viremia limits the prompt diagnosis of acute ZIKV infection. We have investigated the plasma cytokine, chemokine, and growth factor profiles of 36 individuals from an endemic area displaying different symptoms such as exanthema, headache, myalgia, arthralgia, fever, hyperemia, swelling, itching, and nausea during early-phase infection. These profiles were then associated with symptoms, revealing important aspects of the immunopathophysiology of ZIKV infection. The levels of some cytokines/chemokines were significantly higher in acute ZIKV-infected individuals compared to healthy donors, including interferon (IFN) gamma-induced protein 10 (IP-10), regulated on activation, normal T cell expressed and secreted (RANTES), IFN-γ, interleukin (IL)-9, IL-7, IL-5, and IL-1ra, including some with predominantly immunoregulatory activity. Of note, we found that higher levels of IP-10 and IL-5 in ZIKV-infected individuals were strongly associated with exanthema and headache, respectively. Also, higher levels of IL-1ra were associated with subjects with arthralgia, whereas those with fever showed lower levels of granulocyte-colony stimulating factor (G-CSF). No correlation was observed between the number of symptoms and ZIKV viral load. Interestingly, only IP-10 showed significantly decreased levels in the recovery phase. In conclusion, our results indicate that acute ZIKV infection in a larger cohort resident to an endemic area displays a modest systemic immune activation profile, involving both proinflammatory and immunoregulatory cytokines and chemokines that could participate of virus control. In addition, we showed that differential cytokine/chemokine levels are related to specific clinical symptoms, suggesting their participation in underlying mechanisms

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<p>An early immune response to Zika virus (ZIKV) infection may determine its clinical manifestation and outcome, including neurological effects. However, low-grade and transient viremia limits the prompt diagnosis of acute ZIKV infection. We have investigated the plasma cytokine, chemokine, and growth factor profiles of 36 individuals from an endemic area displaying different symptoms such as exanthema, headache, myalgia, arthralgia, fever, hyperemia, swelling, itching, and nausea during early-phase infection. These profiles were then associated with symptoms, revealing important aspects of the immunopathophysiology of ZIKV infection. The levels of some cytokines/chemokines were significantly higher in acute ZIKV-infected individuals compared to healthy donors, including interferon (IFN) gamma-induced protein 10 (IP-10), regulated on activation, normal T cell expressed and secreted (RANTES), IFN-γ, interleukin (IL)-9, IL-7, IL-5, and IL-1ra, including some with predominantly immunoregulatory activity. Of note, we found that higher levels of IP-10 and IL-5 in ZIKV-infected individuals were strongly associated with exanthema and headache, respectively. Also, higher levels of IL-1ra were associated with subjects with arthralgia, whereas those with fever showed lower levels of granulocyte-colony stimulating factor (G-CSF). No correlation was observed between the number of symptoms and ZIKV viral load. Interestingly, only IP-10 showed significantly decreased levels in the recovery phase. In conclusion, our results indicate that acute ZIKV infection in a larger cohort resident to an endemic area displays a modest systemic immune activation profile, involving both proinflammatory and immunoregulatory cytokines and chemokines that could participate of virus control. In addition, we showed that differential cytokine/chemokine levels are related to specific clinical symptoms, suggesting their participation in underlying mechanisms.</p