Late-stage diagnosis of HIV infection in Brazilian children: evidence from two national cohort studies

This study analyzed data from two consecutive retrospective cohort samples (1983 to 1998 and 1999 to 2002) of Brazilian children with AIDS (N = 1,758) through mother-to-child-transmission. Late-stage diagnosis (CDC category C) was investigated in relation to the following variables: year of birth, year of HIV diagnosis, and time periods related to changes in government treatment guidelines. Late-stage diagnosis occurred in 731 (41.6%) of cases and was more prevalent in infants under 12 months of age. The rate of late-stage diagnosis decreased from 48% to 36% between the two periods studied. We also observed a reduction in the proportion of late-stage diagnoses and the time lapse between HIV diagnosis and ART initiation. A significant association was found between timely diagnosis and having been born in recent years (OR = 0.62; p = 0.009) and year of HIV diagnosis (OR = 0.72; p = 0.002/OR = 0.62; p < 0.001). Infants under the age of 12 months were more likely to be diagnosed at a late stage than older children (OR = 1.70; p = 0.004). Despite advances, there is a need to improve the effectiveness of policies and programs focused on improving early diagnosis and management of HIV/AIDS

Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

<p>Abstract</p> <p>Background</p> <p>HAART has significantly reduced AIDS-related morbidity in children. However, limited evidence is available from developing countries regarding patterns of opportunistic illnesses. We describe these events and their associated factors in children with AIDS in Brazil.</p> <p>Methods</p> <p>This study is based on two representative retrospective multi-center cohorts including a total 1,859 children with AIDS, infected via mother-to-child transmission (MTCT), between 1983-2002. Opportunistic illnesses were described and analyzed over time. The association of demographic, clinical and operational data with the occurrence of opportunistic diseases was assessed.</p> <p>Results</p> <p>In total, 1,218 (65.5%) had at least one event of an opportunistic disease. Variables significantly associated with occurrence of these events included: region of residence (OR 2.68-11.33, as compared to the Northern region), age < 1 year at diagnosis (OR 2.56, 95% CI 1.81-3.61, p < 0.001), and non-performance of MTCT prevention measures (OR 1.58, 95% CI 1.21-2.07, p < 0.001). Protective factors included year of HIV diagnosis in the HAART era (OR 0.34, 95% CI 0.15-0.76, p = 0.009) and ART use (OR 0.58, 95% CI 0.44-0.77, p < 0.001). In both periods bacterial infections represented the most common opportunistic events (58.6 vs. 34.7%; p < 0.001), followed by <it>Pneumocystis jirovecii </it>pneumonia (21.9 vs. 13.2%; p < 0.001), and bacterial meningitis/sepsis (16.8 vs. 7.4%; p < 0.001).</p> <p>Conclusions</p> <p>Despite the significant reduction in recent years, opportunistic illnesses are still common in Brazilian children with AIDS in the HAART era, especially bacterial diseases. The data reinforce the need for scaling up prevention of MTCT, early diagnosis of infection, and improvement of comprehensive pediatric care.</p

Variabilidade genética de acessos da cultivar 'BRS Bela' de Stylosanthes guianensis usando marcadores moleculares RAPD.

Taxonomicamente, Stylosanthes guianensis está dividida em quatro variedades botânicas: var. guianensis, var. pauciflora, var. canescens e var. microcephala. A cultivar ?BRS Bela? é uma das duas cultivares dessa leguminosa forrageira registradas no Brasil e é composta por uma mistura física de sementes de quatro acessos pertencentes a variedades botânicas ainda desconhecidas. O objetivo deste trabalho foi caracterizar a variabilidade genética entre os quatro acessos que compõem esta cultivar e determinar suas inter-relações com acessos de variedades botânicas conhecidas, usando a técnica de polimorfismos de DNA amplificados ao acaso (RAPD). Foram analisados 10 primers decâmeros em 36 acessos, do banco de germoplasma da Embrapa gado de Corte, de S. guianensis: 14 da variedade botânica pauciflora, 11 da var. guianensis, quatro da var. canescens, três da var. microcephala e os quatro acessos da cultivar 'BRS Bela'. As bandas amplificadas foram analisadas como dados binários e uma matriz de similaridade genética foi gerada, usando coeficiente de Jaccard. Com base na dissimilaridade genética, os acessos foram agrupados pelos métodos de ligação média entre grupos (UPGMA) e Tocher. A média de similaridade genética dentro das variedades botânicas foi de 0,72 para var. pauciflora, 0,63 para var. microcephala, 0,62 para var. canescens e 0,46 para var. guianensis. Entre os quatro acessos da cultivar ?BRS Bela?, esta média foi de 0,62. Ambos os métodos de agrupamento geraram resultados similares e tenderam a agrupar os acessos da mesma variedade botânica. Os acessos da cultivar ?BRS Bela? foram agrupados com acessos var. guianensis. Os resultados mostram que há variabilidade genética dentro das variedades botânicas de S. guianensis e entre os acessos da cultivar ?BRS Bela? e que existe uma tendência ao agrupamento por variedade botânica

Aplicação de espectrometria de massas MALDI-TOF para identificação de candidatos a marcadores moleculares de Scrapie.

O trabalho aqui apresentado busca identificar marcadores moleculares para diagnóstico de Scrapie em amostras de sangue de animais acometidos por PrPSc