Soroepidemiologia da infecção pelo vírus da hepatite A em "meninos de/na rua" de Goiânia-Goiás

Um estudo soroepidemiológico, para anticorpos contra o vírus da hepatite A (anti- VHA total - IgM e IgG), foi realizado no período de 1991-1992, em 397 "meninos de/na rua" em Goiânia. Destes, 313 apresentavam vínculo familiar e desmvolviam, em sua maioria, atividades de trabalho informal, eitquanto que 84 não possuíam vínculo familiar e se encontravam na rua ou em Instituições do Governo Estadual. A taxa média de prevalência foi de 90,4%, variando de 80,0% a 92,9%, sem contudo apresentar diferença estatística significante relativa à idade (7-21). Também não se evidenciou qualquer diferença quando este grupo foi estratificado para presença ou ausência de vínculo familiar ou mesmo quando analisado em relação a outras variáveis sócio-demogrãficas. Estes dados sugerem que a hepatite A ê endêmica na população de baixa condição sócio-econômica da região e que nesta faixa etãria a maioria dos indivíduos já adquiriu a infecção. Outras investigações em grupos e camadas sociais diferentes são necessárias a fim de parametrar estratégias vacinais em países subdesenvolvidos

Fatores de risco e prevalência de anticorpos contra o vírus da hepatite A (VHA) em crianças de creche em Goiânia, Brasil

A seroepidemiologic survey about hepatitis A virus (HAV) infection was carried out in a group comprising 310 children, ranging in age from 3 months to 9 years, from day-care centers, in Goiania, a middle sized city in the central region of Brazil. The biomarkers employed in the investigation of previous infection include total IgG and IgM anti-HAV antibodies, and for the detection of more recent infection, IgM anti-HAV antibodies were analyzed. The study was performed in 1991 and 1992. According to the results, 69.7% of the children presented total IgG/IgM anti-HAV antibodies, with 60% of the group in the age range of 1 to 3 years. Among 10 day-care centers analyzed, the prevalence of the biomarker IgM anti-HAV was 3.2%, with an uniform distribution of the cases in the group of children ranging in age from 1 to 4 years. Multi-variate analysis was performed to investigate the sociodemographic factors that could influence the results. It was verified that the risk for the infection increased with the length of the attendance in the day-care centers, i.e., the risk for children with attendance of one year or more was 4.7 times higher, when compared with children with one month attendance (CI 95% 2.3-9.9). According to the results, hepatitis A is an endemic infection in day-care centers in the study area. The length of attendance in the day-care settings was demonstrated to be a risk factor for the HAV infection. Such findings suggest that if hepatits A vaccination becomes available as a routine policy in our region, the target group should be children under one year. Moreover, those children should receive the vaccine before they start to attend the day-care centers.Um estudo soroepidemiológico para o vírus da hepatite A (VHA), investigando os marcadores de infecção passada (anti-VHA total - IgG e IgM) e infecção recente (anti-VHA IgM), foi realizado entre 1991 e 1992, em crianças de creche de Goiânia-Brasil central. Das 310 crianças com idade entre 03 meses e 09 anos, 69,7% mostraram soropositividade ao anti-VHA total, sendo 60%, na faixa etária entre 1 e 3 anos. A prevalência do marcador anti-VHA IgM foi de 3,2%, visto em idade de 1-4 anos e com distribuição uniforme nas 10 creches estudadas. Entre as variáveis sócio-demográficas estudadas, apenas o tempo de freqüência das crianças nas creches, igual ou superior a um ano, mostrou, em análise multivariada ajustada para idade, um risco 4,7 vezes maior quando comparado com o período de um mês (LC 95% 2,3-9,9). De acordo com os resultados, a hepatite A é uma infecção endêmica no tipo populacional estudado e o tempo de freqüência prolongado das crianças, nas creches públicas, constitui um fator de risco para infecção ao VHA. Tais resultados sugerem que, uma vez que a vacina seja instituída na região, as crianças de creche devem recebê-la antes de um ano de idade, ou no mais tardar antes de ingressarem nas creches públicas

Antimicrobial host defense peptides in an arteriviral infection: differential peptide expression and virus inactivation

Antimicrobial host defense peptides (AHDPs) are effective against a wide range of microbes, including viruses. The arteriviral infection caused by porcine reproductive and respiratory syndrome virus (PRRSV) is a devastating pandemic that causes the most economically significant disease of swine. We sought to determine if the expression of AHDPs was influenced by infection with PRRSV, and if porcine AHDPs have direct antiviral activity against PRRSV. Because pulmonary alveolar macrophages (PAMs) are primary targets of PRRSV infection, gene expression of porcine AHDPs was evaluated in lungs from fetal and 2-wk-old congenitally infected pigs. In PRRSV-positive lungs and PAMs, gene expression of most porcine AHDPs showed little upregulation. However, gene expression of porcine β-defensin-1 (pBD-1), pBD-4, pBD-104, pBD-123, and pBD-125 were downregulated more than threefold in 2-wk-old congenitally infected pig lungs. Incubation of PRRSV with pBD-3 or PG-4 significantly inhibited viral infectivity in MARC-145 cells. Using nine protegrin or protegrin-derived peptides, we determined that a cyclic analog of PG-4 increased anti-PRRSV activity, and that substitution of phenylalanine with valine eliminated most PG-4 antiviral activity. In PAMs, pBD-3 and PG-4 at 5–40 μg/mL consistently suppressed PRRSV titers. Collectively, these findings suggest a potential role for some porcine AHDPs as innate antiviral effectors in PRRSV infection. Moreover, modulation of porcine innate immune mechanisms with AHDPs may be one means of limiting the impact of this costly pandemic viral disease

COVID-19 vaccination and breakthrough infections in patients with cancer

Vaccination is an important preventive health measure to protect against symptomatic and severe COVID-19. Impaired immunity secondary to an underlying malignancy or recent receipt of antineoplastic systemic therapies can result in less robust antibody titers following vaccination and possible risk of breakthrough infection. As clinical trials evaluating COVID-19 vaccines largely excluded patients with a history of cancer and those on active immunosuppression (including chemotherapy), limited evidence is available to inform the clinical efficacy of COVID-19 vaccination across the spectrum of patients with cancer. We describe the clinical features of patients with cancer who developed symptomatic COVID-19 following vaccination and compare weighted outcomes with those of contemporary unvaccinated patients, after adjustment for confounders, using data from the multi-institutional COVID-19 and Cancer Consortium (CCC19). Patients with cancer who develop COVID-19 following vaccination have substantial comorbidities and can present with severe and even lethal infection. Patients harboring hematologic malignancies are over-represented among vaccinated patients with cancer who develop symptomatic COVID-19. Vaccination against COVID-19 remains an essential strategy in protecting vulnerable populations, including patients with cancer. Patients with cancer who develop breakthrough infection despite full vaccination, however, remain at risk of severe outcomes. A multilayered public health mitigation approach that includes vaccination of close contacts, boosters, social distancing, and mask-wearing should be continued for the foreseeable future. •Patients with cancer who develop breakthrough COVID-19 following full vaccination remain susceptible to severe outcomes.•Hematologic malignancies are over-represented among vaccinated patients with cancer who develop breakthrough COVID-19.•Vaccination of close contacts, masking, boosters, and social distancing are needed to protect patients with cancer