15 research outputs found
Evidence of New Endemic Clusters of Human T-Cell Leukemia Virus (HTLV) Infection in Bahia, Brazil
BackgroundSalvador, Bahia (northeastern Brazil), has been identified as the epicenter of Human T-cell leukemia virus Human T-cell leukemia virus (HTLV) type 1 infection in the country. This study aims to estimate the rate of HTLV infection and the geographical distribution of this virus in this state.MethodsAll HTLV tests (chemiluminescence/ELISA assays/Western Blotting) performed in the Central Laboratory of Public Health of Bahia (LACEN) from 2004 to 2013 were included. Data was extracted from LACEN’s database using high volume extract, transformation and load throughput. Infection rate was expressed as the number of infected individuals per 100,000 inhabitants considering municipalities grouped in microregions and/or mesoregions as the unit of analysis.ResultsA total of 233,876 individuals were evaluated. Individuals were from 394 out of 417 municipalities of Bahia (94.5%). HTLV chemiluminescence/ELISA assay was found to be reactive for 3,138 individuals from whom 2,323 had WB results (1,978 positives, 62 negative and 282 indeterminate). Out of 1978 reactive samples, 1,813 (91.7%) were positive for HTLV-1, 58 (2.9%) for HTLV-2 and 107 (5.4%) were for both HTLV-1 and HTLV-2. The cumulative mean rate of HTLV-positive cases in Bahia was 14.4 per 100,000 inhabitants. Three microregions presented rates >20 HTLV-positive cases/100,000 inhabitants: Barreiras (24.83 cases per 100,000 inhabitants), Salvador (22.90 cases per 100,000 inhabitants), and Ilhéus-Itabuna (22.60 cases per 100,000 inhabitants).ConclusionHTLV infection is disseminated in the state of Bahia, with an overall moderate rate of infection. Further studies should be conducted to characterize the epidemiological and clinical profile of HTLV-infected individuals better and to propose effective prevention measures
Taxa de infecção do vírus linfotrópico de células humanas (HTLV), vírus da hepatite C (HCV), coinfecção HTLV/HCV no Estado da Bahia e impacto da coinfecção HTLV/HCV no perfil de citocinas
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Previous issue date: 2019O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) – Código de Financiamento 001Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.INTRODUÇAO: Os vírus linfotrópico de células T humanas (HTLV) e vírus da hepatite C (HCV) são endêmicos no Brasil. Ambos causam uma infecção persistente, assintomática em alguns casos, sendo o diagnóstico tardio. Estes vírus compartilham algumas vias de transmissão, o que pode favorecer a coinfecção. OBJETIVOS: Determinar a taxa de infecção do HTLV, HCV e coinfecção HTLV/HCV no estado da Bahia. Descrever o perfil de citocinas inflamatórias nos indivíduos coinfectados com HTLV/HCV. MÉTODOS: Um estudo retrospectivo ecológico foi conduzido usando o banco de dados do LACEN – Bahia. Todos os testes sorológicos para HTLV e HCV foram selecionados entre as 32 microrregiões da Bahia, no período de 2004 a 2013, constituindo um banco com 602.908 registros únicos. Para a avaliação imune, foram selecionados prospectivamente amostras de 31 indivíduos coinfectados HTLV/HCV e de 27 indivíduos monoinfectados com HCV, recebidas no LACEN para quantificar a carga viral do HCV no período de 2014 a 2016. Foram analisadas as citocinas IFN-γ, TNF-α, IL-10, IL-8 e IL-1. O grupo controle foi formado por 30 indivíduos sadios.
RESULTADOS: Foram avaliadas 233.876 amostras para o diagnóstico laboratorial do HTLV. Destas, 1.813 (91,7%) foram positivas para HTLV-1 (prevalência de 0,78%), 58 (2,9%) para HTLV-2 (prevalência de 0,025%) e 107 (5,4%) foram positivas para ambos HTLV-1 e HTLV-2 (prevalência de 0,05%). A taxa de infecção na Bahia foi 0,84% (14,4 casos /100.000 habitantes). A infecção pelo HTLV foi predominante em mulheres (75%) com média de idade de 46 anos. Foram identificados três novos clusters do HTLV, localizados nas regiões Sul, Central e Oeste do estado. Amostras de 247.837 indivíduos foram avaliadas para o diagnóstico laboratorial do HCV. A taxa de infecção do HCV foi de 1,3% que corresponde a 21,2 casos/ 100.000 habitantes. Os homens com idade acima de 55 anos foram os mais acometidos. A cidade de Ipiaú apresentou a maior taxa de infecção para o HCV (112,04 casos/100.000 habitantes). Os genótipos 1 e 3 foram mais prevalentes, seguidos dos genótipos 2, 4 e 5. Para determinar a taxa de coinfecção entre HTLV e HCV amostras de 120.192 indivíduos foram avaliados. A taxa de infecção do HTLV/HCV foi de 14,3% que equivale a 2,8 casos/100.000 habitantes. Os casos de coinfecção HTLV/HCV predominou em homens com média de idade de 59 anos. As maiores taxas foram encontradas em três microrregiões: Salvador, Ilhéus-Itabuna e Porto Seguro. Quanto ao perfil de citocinas, o grupo coinfectados HTLV/HCV teve uma maior tendência a produzir IFN-γ, comparado ao grupo monoinfectado HCV. Houve uma correlação positiva entre os pares IL-1 e IL-8 no grupo coinfectado pelo HTLV/HCV e entre os pares IL-8 - IL10 e INF-γ - IL-10 no grupo monoinfectado pelo HCV. CONCLUSÕES: As infecções pelo HTLV e HCV estão disseminadas nas microrregiões do estado Bahia, no entanto a coinfecção HTLV/HCV está concentrada em apenas três microrregiões. A coinfecção HTLV/HCV está associada à produção de IFN-γ, enquanto indivíduos infectados pelo HCV apresentaram correlação positiva entre as citocinas inflamatórias (IL-8 e IFN-γ) e a citocina reguladora IL-10.BACKGROUND: The human T-lymphotropic virus (HTLV) and hepatitis C virus (HCV) are endemic in Brazil. Both cause a persistent infection, asymptomatic in some cases, with a late diagnosis. These viruses share some of the routes of transmission, which may favor co-infection. AIMS: To determine the infection rate of HTLV, HCV and HTLV / HCV coinfection in the state of Bahia. Describe the profile of inflammatory cytokines in HTLV/HCV coinfected subjects. METHODS: A retrospective ecological study was conducted using data obtained from the Central Laboratory of Public Health of Bahia (LACEN-BA). All serological tests for HTLV and HCV were selected among the 32 Bahia microregions from 2004 to 2013, constituting a database of 602,908 unique records. To the immune evaluation, samples from 31 HTLV/HCV-coinfected individuals and 27 HCV-monoinfected individuals were prospectively selected from 2014 to 2016. These samples were sent to LACEN in order to quantify HCV viral load. The cytokines IFN-γ, TNF-α, IL-10, IL-8 and IL-1 were analyzed. The control group consisted of 30 healthy individuals. RESULTS: A total of 233,876 samples were evaluated for laboratory diagnosis of HTLV. 1,813 (91.7%) were found to be positive for HTLV-1 (prevalence of 0.78%), 58 (2.9%) for HTLV-2 (prevalence 0.025%) and 107 (5.4%) were positive for both HTLV-1 and HTLV-2 (prevalence of 0.05%). The infection rate in the state was 0.84% (14.4 cases / 100,000 inhabitants). The HTLV infection was predominant in women (75%) with a mean age of 46 years. Three new HTLV clusters were identified located in the southern, central and western regions of the state. Samples of 247,837 individuals were evaluated for laboratory diagnosis of HCV. The rate of HCV infection was 1.3%, which corresponds to 21.2 cases/100,000 inhabitants. Men older than 55 years were the most affected. The city of Ipiaú had the highest infection rate for HCV (112.04 cases / 100,000 inhabitants). Genotypes 1 and 3 were the most prevalent, followed by genotypes 2, 4 and 5. To determine the rate of HTLV/HCV coinfection, samples from 120,192 individuals were evaluated. The HTLV/HCV infection rate in the state of Bahia was 14.3% (2.8 cases/100,000 inhabitants.) The cases of HTLV/HCV coinfection was predominant in men with a mean age of 59 years. The highest rates were found in three microregions of Bahia: Salvador, Ilhéus-Itabuna and Porto Seguro. Regarding the cytokine profile, the HTLV/HCV-coinfected group had tendency for higher IFN-γ production compared with the HCV-monoinfected group. There was a positive correlation between IL-1 and IL-8 pairs in the HTLV/HCV-coinfected group and between the IL-8 - IL10 and INF-γ - IL-10 pairs in the HCV-monoinfected group. CONCLUSIONS: HTLV and HCV infections are widespread in the microregions of the state of Bahia; however, HTLV/HCV coinfection is concentrated in only three microregions. HTLV/HCV coinfection is associated with IFN-γ production, while HCV monoinfected individuals presented a positive correlation between both inflammatory cytokines (IL-8 and IFN- γ) and the regulatory cytokine IL-10
Avaliação da utilização do teste immunoblot recombinanre (RIBA) no diagnóstico da infecção pelo vírus da hepatite C (VHC) em doadores de sangue com anti-VHC reagente
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Previous issue date: 2011Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilA infecção pelo vírus da hepatite C (VHC) é comumente assintomática e apresenta
uma elevada taxa de cronicidade, podendo evoluir para cirrose e carcinoma
hepatocelular. O diagnóstico da hepatite C é realizado através da pesquisa de
anticorpos pelo teste de ELISA (Enzyme Linked Immunosorbent Assay) e
confirmado por testes suplementares, tais como o RIBA (Recombinant Immunoblot
Assay) e westernblot e teste confirmatório, como a pesquisa do VHC-RNA. O
objetivo deste trabalho foi avaliar a eficácia do RIBA no diagnóstico da infecção
pelo VHC em doadores de sangue com anti-VHC reagente. Foram analisadas 102
amostras com resultado de anti-VHC reagente na HEMOBA, utilizando-se o teste
anti-VHC Architect Abbott por quimioluminescência para detecção dos anticorpos
anti-VHC, o RIBA III (CHIRON) como teste suplementar para as amostras anti-VHC
reagentes e indeterminadas e a Reação em Cadeia da Polimerase (RT-PCR)
convencional ou em tempo real (Amplicor Roche) para detecção do VHC-RNA. As
amostras com VHC-RNA detectável foram genotipadas por hibridização reversa
(LIPA; SIEMENS). Das 102 amostras analisadas no LACEN, 38,2% (39/102) foram
reagentes, 57,8% (59/102) foram não reagentes e 3,9% (4/102) foram
indeterminadas para o anti-VHC. Os resultados do RIBA foram 58,1% (25/43)
positivos, 9,3% (4/43) negativos e 32,6% (14/43) indeterminados. Todas as
amostras com resultado de RIBA indeterminado tiveram carga viral indetectável. As
bandas predominantes nas amostras indeterminadas foram c33 e c22. Das
amostras indeterminadas no RIBA, repetidas após seis meses com nova coleta,
20% (2/10) negativaram e 71,4% (10/14) permaneceram RIBA indeterminado.
Destas, (8/10) continuaram indeterminadas com o mesmo padrão de bandas. O
VHC-RNA foi realizado em todas as amostras do estudo (102) e foi detectável em
apenas 22,5% (23/102). Todas as amostras com VHC-RNA detectável foram RIBA
positivo e tinham índex maior que cinco na relação S/CO. Em apenas duas
amostras que tiveram resultado de RIBA positivo, o VHC-RNA não foi detectado.
As 23 amostras com VHC-RNA detectável foram genotipadas, sendo 78,3%
(18/23) do genótipo 1, 17,4% (4/23) do genótipo 3 e 4,3% (1/23) do genótipo 2. A
positividade do anti-VHC associou-se com o uso de droga intranasal (< 0,001), com
drogas injetáveis (< 0,001)) e ocorrência de DST (< 0,05). Diante dos resultados
encontrados, observa-se que o RIBA apresenta um elevado número de resultados
indeterminados, sendo necessária a realização do VHC-RNA para a confirmação
da infecção pelo VHC. Indivíduos com resultado de anti-VHC índex menor que
cinco e resultado de RIBA indeterminado têm grande probabilidade de não
apresentarem o VHC-RNA detectável e portanto, de não estarem infectados pelo
VHC, mas devem ser acompanhados sorologicamente, de acordo com o critério
médico.The hepatitis C virus (HCV) infection is usually asymptomatic and has a high rate of
chronicity, which may progress to cirrhosis and hepatocellular carcinoma. The
hepatitis C diagnosis is realized by antibodies research using ELISA test (Enzyme
Linked Immunosorbent Assay) and confirmed by additional serological tests, such
as RIBA (Recombinant Immunoblot Assay) and westernblot, and confirmatory test,
like HCV-RNA research. The objective of this study was to evaluate the RIBA
efficacy in the diagnosis of HCV infection in blood donors with anti-HCV reagent.
Were analyzed 102 samples with anti-HCV reagent in HEMOBA using the anti-HCV
test Abbott Architect chemiluminescence for detection of anti-HCV antibodies, the
RIBA III (Chiron) as a supplemental test for anti-HCV reactive and indeterminate
samples and the Polymerase Chain Reaction test (RT-PCR) conventional or realtime
(Roche Amplicor) for HCV-RNA detection. Samples with HCV-RNA detectable
were genotyped by reverse hybridization (LIPA SIEMENS). Of the 102 samples
analyzed in LACEN 38.2% (39/102) were positive, 57.8% (59/102) were negative
and 3.9% (4 / 102) were indeterminate for anti-HCV. The RIBA results were 58.1%
(25/43) positive, 9.3% (4 / 43) negative and 32.6% (14/43) indeterminate. All
samples with indeterminate RIBA results had undetectable viral load. The
predominant bands in the indeterminate RIBA samples were c33 and c22. Of the
RIBA indeterminate samples, repeated after six months with a new collection, 20%
(2 / 10) became negative and 71.4% (10/14) remained indeterminate. Of these, (8 /
10) remained undetermined with the same banding pattern. HCV-RNA was
performed in all study samples (102) and was detectable in only 22.5% (23/102). All
samples with detectable HCV-RNA were RIBA positive and had more than five in
the ratio index S / CO. Only two samples had RIBA positive results with HCV-RNA
not detected. The 23 samples with detectable HCV-RNA were genotyped, and
78.3% (18/23) were genotype 1, 17.4% (4 / 23) genotype 3 and 4.3% (1 / 23)
genotype 2 . The anti-HCV positivity was associated with intranasal drug use
(p<0.001), injectable drugs (p<0.001)) and STDs (p<0.05). Given the results, it is
noted that the RIBA has a high number of indeterminate results, requiring the HCVRNA
detection for HCV infection confirmation. Individuals with anti-HCV index
below five, and indeterminate RIBA results are likely undetectable HCV-RNA and
therefore are not infected with HCV, but must be serologically accompanied,
according to medical criteria
Indeterminate RIBA results were associated with the absence of hepatitis C virus RNA (HCV-RNA) in blood donors
Introduction: Hepatitis C virus (HCV) infection is diagnosed by the presence of antibodies and is supplemented by confirmatory testing methods, such as recombinant immunoblot assay (RIBA) and HCV-RNA detection. This study aimed to evaluate the efficacy of RIBA testing to diagnose HCV infection in blood donors positive for anti-HCV antibodies. Methods: A total of 102 subjects positive for anti-HCV determined by enzyme-linked immunosorbent assay (ELISA) at the Hematology and Hemotherapy Foundation of Bahia (HEMOBA) were later assessed with new samples using the Abbott Architect anti-HCV test (Abbott Diagnostics, Wiesbaden, Germany), the RIBA III test (Chiron RIBA HCV 3.0 SIA, Chiron Corp., Emeryville, CA, USA), the polymerase chain reaction (PCR; COBAS® AMPLICOR HCV Roche Diagnostics Corp., Indianapolis, IN, USA) and line probe assay (LiPA - Siemens, Tarrytown, NY, USA) genotyping for HCV diagnosis. Results: Of these new samples, 38.2% (39/102) were positive, 57.8% (59/102) were negative and 3.9% (4/102) were indeterminate for anti-HCV; HCV-RNA was detected in 22.5% (23/102) of the samples. RIBA results were positive in 58.1% (25/43), negative in 9.3% (4/43) and indeterminate in 32.6% (14/43) of the samples. The prevailing genotypes were 1 (78.3%, 18/23), 3 (17.4%, 4/23) and 2 (4.3%, 1/23). All 14 samples with indeterminate RIBA results had undetectable viral loads (detection limit ≤50 IU/mL). Of these samples, 71.4% (10/14) were reevaluated six months later. Eighty percent (8/10) of these samples remained indeterminate by RIBA, and 20% (2/10) were negative. Conclusions: In this study, individuals with indeterminate RIBA results had no detectable HCV-RNA
Distribution of Human T-Lymphotropic Virus (HTLV) and Hepatitis C Co-infection in Bahia, Brazil.
Both Human T-lymphotropic virus type 1 (HTLV-1) and hepatitis C virus (HCV) are endemic in Brazil. In Salvador, the capital of the state of Bahia, 2% and 1.5% of the general population is infected with HTLV-1 or HCV. This study aimed to estimate the prevalence and the distribution of HTLV/HCV coinfection in Bahia. This cross-sectional study was conducted at the Central Laboratory of Public Health for the state of Bahia (LACEN-BA). All samples in the LACEN database submitted to serological testing for anti-HCV (chemiluminescence) and anti-HTLV-1/2 (chemiluminescence/ELISA and Western blot) from 2004 to 2013 were included. Infection rate was expressed as the number of infected individuals per 100,000 inhabitants in a given municipality; municipalities were grouped by microregion for further analysis. A total of 120,192 samples originating from 358 of the 417 municipalities in Bahia (85.8%) were evaluated. The overall HCV coinfection rate in HTLV-positive was 14.31% [2.8 (ranging from 0.4 to 8.0) per 100,000 inhabitants.] Twenty-one (5%) of the municipalities reported at least one case of HTLV/HCV coinfection. Most cases (87%) were concentrated in three microregions (Salvador: 79%, Ilhéus/Itabuna: 5%, Porto Seguro: 3%). Coinfection occurred more frequently in males (51%) with a mean age of 59 [(IQR): 46-59] years. HTLV/HCV coinfection in the state of Bahia was more frequently found among males living in the microregions of Salvador, Ilhéus/Itabuna and Porto Seguro, all of which are known to be endemic for HTLV infection
Evidence of New Endemic Clusters of Human T-Cell Leukemia Virus (HTLV) Infection in Bahia, Brazil
Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2019-05-17T13:17:37Z
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Previous issue date: 2019National Council for
Scientific and Technological Development (Conselho Nacional
de Desenvolvimento Científico e Tecnológico-CNPq), the
National Foundation for the Development of Higher Education
(Fundação Nacional para o Desenvolvimento do Ensino
Superior-FUNDADESP), and the Foundation for Research
Support of the State of Bahia (Fundação de Amparo à Pesquisa do
Estado da Bahia-FAPESB). This study was financed in part by the
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior –
Brasil (CAPES) – Finance Code 001.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil / Secretaria da Saúde do Estado da Bahia. Laboratório Central de Saúde Pública Prof. Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Epidemiologia Molecular e Bioestatística. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil.Background: Salvador, Bahia (northeastern Brazil), has been identified as the epicenter of Human T-cell leukemia virus Human T-cell leukemia virus (HTLV) type 1 infection in the country. This study aims to estimate the rate of HTLV infection and the geographical distribution of this virus in this state. Methods: All HTLV tests (chemiluminescence/ELISA assays/Western Blotting) performed in the Central Laboratory of Public Health of Bahia (LACEN) from 2004 to 2013 were included. Data was extracted from LACEN’s database using high volume extract, transformation and load throughput. Infection rate was expressed as
the number of infected individuals per 100,000 inhabitants considering municipalities grouped in microregions and/or mesoregions as the unit of analysis. Results: A total of 233,876 individuals were evaluated. Individuals were from 394 out of 417 municipalities of Bahia (94.5%). HTLV chemiluminescence/ELISA assay was found to be reactive for 3,138 individuals from whom 2,323 had WB results (1,978 positives, 62 negative and 282 indeterminate). Out of 1978 reactive samples, 1,813 (91.7%) were positive for HTLV-1, 58 (2.9%) for HTLV-2 and 107 (5.4%) were for
both HTLV-1 and HTLV-2. The cumulative mean rate of HTLV-positive cases in Bahia was 14.4 per 100,000 inhabitants. Three microregions presented rates >20 HTLVpositive cases/100,000 inhabitants: Barreiras (24.83 cases per 100,000 inhabitants), Salvador (22.90 cases per 100,000 inhabitants), and Ilhéus-Itabuna (22.60 cases per 100,000 inhabitants).
Conclusion: HTLV infection is disseminated in the state of Bahia, with an overall moderate rate of infection. Further studies should be conducted to characterize the epidemiological and clinical profile of HTLV-infected individuals better and to propose effective prevention measures
Performance of commercially available serological screening tests for human T-cell lymphotropic virus infection in Brazil
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Previous issue date: 2018Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq (473667/2012-6 and 311054/2014-5), Fundação de Amparo à Pesquisa do Estado da Bahia - FAPESB (2574/2013), and Fundação Nacional para o Desenvolvimento do Ensino Superior - FUNDADESP (9600113).Bahiana School of Medicine and Public Health. Integrated and Multidisciplinary HTLV Center. Salvador, BA, Brazil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil.Bahiana School of Medicine and Public Health. Integrated and Multidisciplinary HTLV Center. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil.Bahiana School of Medicine and Public Health. Integrated and Multidisciplinary HTLV Center. Salvador, BA, Brazil.Bahiana School of Medicine and Public Health. Integrated and Multidisciplinary HTLV Center. Salvador, BA, Brazil.Gonçalo Moniz Public Health Central Laboratory. Bahia State Department of Health. Salvador, BA, Brazil.Bahiana School of Medicine and Public Health. Integrated and Multidisciplinary HTLV Center. Salvador, BA, Brazil.Bahiana School of Medicine and Public Health. Integrated and Multidisciplinary HTLV Center. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil.Adolfo Lutz Institute. São Paulo, SP, Brazil.Bahiana School of Medicine and Public Health. Integrated and Multidisciplinary HTLV Center. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil.Serological screening for HTLV-1 is usually performed using enzyme-linked immunosorbent assay, particle agglutination or chemiluminescence assay kits. Due to antigen matrix improvement entailing the use of new HTLV-antigens and changes in the format of HTLV screening tests, as well as newly introduced CLIAs, a systematic evaluation of the accuracy of currently available commercial tests is warranted. We aimed to assess the performance of commercially available screening tests for HTLV diagnosis. A diagnostic accuracy study was conducted on a panel of 397 plasma samples: 200 HTLV-negative, 170 HTLV-positive and 27 indeterminate under Western blotting analysis. WB-indeterminate samples (i.e. those yielding no specific bands for HTLV-1 and/or HTLV-2) were assessed by PCR and results were used to compare agreement among the commercially available ELISA screening tests. For performance analysis, WB-indeterminate samples were excluded, resulting in a final study panel of 370 samples. Three ELISA kits (Murex HTLV-1/2, anti-HTLV-1/2 SYM Solution and Gold ELISA HTLV-1/2) and one CLIA kit (Architect r-HTLV-1/2) were evaluated. All screening tests demonstrated 100% sensitivity. Concerning the HTLV-negative samples, SYM Solution and Gold ELISA kits had specificity values >99.5%, while the Architect r-HTLV-1/2 test presented 98.1% specificity, followed by Murex (92.0%). Regarding the 27 samples with WB-indeterminate results, after PCR confirmation, all ELISA kits showed 100% sensitivity, but low specificity. Accuracy findings were corroborated by Cohen's Kappa, which evidenced slight and fair agreement between PCR analysis and ELISA tests for HTLV diagnosis. Based on the data, we believe that all evaluated tests can be safely used for HTLV-infection screening
Return of the founder Chikungunya virus to its place of introduction into Brazil is revealed by genomic characterization of exanthematic disease cases
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Previous issue date: 2019Laboratório Central de Saúde Pública. Departamento de Virologia, Salvador, BA, Brasil.Laboratório Central de Saúde Pública. Departamento de Virologia, Salvador, BA, Brasil.Ministério da Saúde. Coordenação Geral de Vigilância de Arboviroses (CGARB). Brasília, DF, BrasilUniversidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Laboratório de Genética Celular e Molecular. Belo Horizonte, MG, Brasil / University of KwaZulu- Natal, Durban. College of Health Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform. Durban, South Africa.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Laboratório de Patologia Experimental. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.Laboratório Central de Saúde Pública. Departamento de Virologia, Salvador, BA, Brasil.Universidade Estadual de Feira de Santana. Feira de Santana, BA, Brasil / Secretaria de Saúde de Feira de Santana. Feira de Santana, BA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Coordenação Geral dos Laboratórios de Saúde Pública. Brasília, DF, Brasil.Organização Pan-Americana da Saúde/Organização Mundial da Saúde. Brasília, DF, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Brasília, DF, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância de Doenças Transmissíveis. Brasília, DF, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.Universidade Federal do Mato Grosso do Sul. MS, Brasil / Fundação Oswaldo Cruz. Coordenação de Saúde Laboratórios de Vigilância e Referência. Rio de Janeiro, RJ, Brasil.University of Oxford. Oxford, UK.University of KwaZulu- Natal, Durban. College of Health Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform. Durban, South Africa.University of Oxford. Oxford, UK.University of KwaZulu- Natal, Durban. College of Health Sciences. KwaZulu-Natal Research Innovation and Sequencing Platform. Durban, South Africa / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, Brasil.University of Oxford. Department of Zoology. Oxford, UK.Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Laboratório de Genética Celular e Molecular. Belo Horizonte, MG, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, BrasilMinistério da Saúde. Coordenação Geral de Vigilância de Arboviroses (CGARB). Brasília, DF, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Flavivírus. Rio de Janeiro, RJ, BrasilBetween June 2017 and August 2018, several municipalities located in Bahia state (Brazil) reported a large increase in the number of patients presenting with febrile illness similar to that of arboviral infections. Using a combination of portable whole genome sequencing, molecular clock and epidemiological analyses, we revealed the return of the CHIKV-ECSA genotype into Bahia. Our results show local persistence of lineages in some municipalities and the re-introduction of new epidemiological strains from different Brazilian regions, highlighting a complex dynamic of transmission between epidemic seasons and sampled locations. Estimated climate-driven transmission potential of CHIKV remained at similar levels throughout the years, such that large reductions in the total number of confirmed cases suggests a slow, but gradual accumulation of herd-immunity over the 4 years of the epidemic in Bahia after its introduction in 2014. Bahia remains a reservoir of the genetic diversity of CHIKV in the Americas, and genomic surveillance strategies are essential to assist in monitoring and understanding arboviral transmission and persistence both locally and over large distances
Low prevalence of influenza A strains with resistance markers in Brazil during 2017–2019 seasons
This project was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES); Programa Estratégico de Apoio à Pesquisa em Saúde (PAPES), Fundação Oswaldo Cruz, CNPq, and Coordenação Geral de Laboratórios de Saúde Pública (CGLAB) from the Brazilian Ministry of Health.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Laboratório Central de Saúde Pública de Sergipe. Aracaju, SE, Brazil.Laboratório Central de Saúde Pública de Sergipe. Aracaju, SE, Brazil.Laboratório Central do Estado do Paraná. Curitiba, PR, Brazil.Laboratório Central do Estado do Paraná. Curitiba, PR, Brazil.Secretaria de Saúde do Estado do Espírito Santo. Laboratório de Saúde Pública do Estado do Espírito Santo. Vitória, ES, Brazil / Universidade Federal do Espírito Santo. Núcleo de Doenças Infecciosas. Vitória, ES, Brazil.Secretaria de Saúde do Estado do Espírito Santo. Laboratório de Saúde Pública do Estado do Espírito Santo. Vitória, ES, Brazil / Universidade Federal do Espírito Santo. Núcleo de Doenças Infecciosas. Vitória, ES, Brazil.Laboratório Central de Saúde Pública do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Laboratório Central de Saúde Pública do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Secretaria de Saúde do estado do Rio Grande do Sul. Laboratório Central de Saúde Pública. Porto Alegre, RS, Brazil.Secretaria de Saúde do estado do Rio Grande do Sul. Laboratório Central de Saúde Pública. Porto Alegre, RS, Brazil.Fundação Ezequiel Dias. Laboratório Central de Saúde Pública de Minas Gerais. Belo Horizonte, MG, Brazil.Fundação Ezequiel Dias. Laboratório Central de Saúde Pública de Minas Gerais. Belo Horizonte, MG, Brazil.Laboratório Central da Saúde Pública do estado da Bahia. Salvador, BA, Brazil.Laboratório Central da Saúde Pública do estado da Bahia. Salvador, BA, Brazil.Laboratório Central de Santa Catarina. Florianópolis, SC, Brazil.Laboratório Central de Santa Catarina. Florianópolis, SC, Brazil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA. Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA. Brasil.Instituto Adolfo Lutz. Laboratório Central de Saúde Pública do Estado de São Paulo. São Paulo, SP, Brazil.Instituto Adolfo Lutz. Laboratório Central de Saúde Pública do Estado de São Paulo. São Paulo, SP, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Imunização e Doenças Transmissíveis. Brasília, DF, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Imunização e Doenças Transmissíveis. Brasília, DF, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.Fiocruz Fundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.The influenza A virus (IAV) is of a major public health concern as it causes annual epidemics and has the potential to cause pandemics. At present, the neuraminidase inhibitors (NAIs) are the most widely used anti-influenza drugs, but, more recently, the drug baloxavir marboxil (BXM), a polymerase inhibitor, has also been licensed in some countries. Mutations in the viral genes that encode the antiviral targets can lead to treatment resistance. Worldwide, a low prevalence of antiviral resistant strains has been reported. Despite that, this situation can change rapidly, and resistant strain surveillance is a priority. Thus, the aim of this was to evaluate Brazilian IAVs antiviral resistance from 2017 to 2019 through the identification of viral mutations associated with reduced inhibition of the drugs and by testing the susceptibility of IAV isolates to oseltamivir (OST), the most widely used NAI drug in the country. Initially, we analyzed 282 influenza A(H1N1)pdm09 and 455 A(H3N2) genetic sequences available on GISAID. The amino acid substitution (AAS) NA:S247N was detected in one A(H1N1)pdm09 strain. We also identified NA:I222V (n = 6) and NA:N329K (n = 1) in A(H3N2) strains. In addition, we performed a molecular screening for NA:H275Y in 437 A(H1N1)pdm09 samples, by pyrosequencing, which revealed a single virus harboring this mutation. Furthermore, the determination of OST IC50 values for 222 A(H1N1)pdm09 and 83 A(H3N2) isolates revealed that all isolates presented a normal susceptibility profile to the drug. Interestingly, we detected one A(H3N2) virus presenting with PA:E119D AAS. Moreover, the majority of the IAV sequences had the M2:S31N adamantanes resistant marker. In conclusion, we show a low prevalence of Brazilian IAV strains with NAI resistance markers, in accordance with what is reported worldwide, indicating that NAIs still remain an option for the treatment of influenza infections in Brazil. However, surveillance of influenza resistance should be strengthened in the country for improving the representativeness of investigated viruses and the robustness of the analysis
Persistence of chikungunya ECSA genotype and local outbreak in an upper medium class neighborhood in Northeast Brazil.
The chikungunya East/Central/South/Africa virus lineage (CHIKV-ECSA) was first detected in Brazil in the municipality of Feira de Santana (FS) by mid 2014. Following that, a large number of CHIKV cases have been notified in FS, which is the second-most populous city in Bahia state, northeastern Brazil, and plays an important role on the spread to other Brazilian states due to climate conditions and the abundance of competent vectors. To better understand CHIKV dynamics in Bahia state, we generated 5 complete genome sequences from a local outbreak raised in Serraria Brasil, a neighbourhood in FS, by next-generation sequencing using Illumina approach. Phylogenetic reconstructions revealed that the new FS genomes belongs to the ECSA genotype and falls within a single strongly supported monophyletic clade that includes other older CHIKV sequences from the same location, suggesting the persistence of the virus during distinct epidemic seasons. We also performed minor variants analysis and found a small number of SNPs per sample (b_29L and e_45SR = 16 SNPs, c_29SR = 29 and d_45PL and f_45FL = 21 SNPs). Out of the 93 SNPs found, 71 are synonymous, 21 are non-synonymous and one generated a stop codon. Although those mutations are not related to the increase of virus replication and/or infectivity, some SNPs were found in non-structural proteins which may have an effect on viral evasion from the mammal immunological system. These findings reinforce the needing of further studies on those variants and of continued genomic surveillance strategies to track viral adaptations and to monitor CHIKV epidemics for improved public health control