Dissertações em Doenças Tropicais (Mestrado) - PPGDT/NMT

URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/3559

O Mestrado Acadêmico em Doenças Tropicais iniciou em 2004 e pertence ao Programa de Pós-Graduação em Doenças Tropicais do Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA).

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Análise de polimorfismo na região promotora do gene da Interleucina 18 (-137 G/C e -607 C/A) em pacientes portadores do vírus da hepatite C de Belém, Pará
(Universidade Federal do Pará, 2012-03-23) SANTOS, Kemper Nunes dos; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769
Since its discovery in 1989, the hepatitis C virus (HCV) has been recognized as a major cause of chronic liver disease worldwide. Considered a public health problem worldwide involving between 170 to 350 million people infected. Host genetic factors have been implicated in the persistence of HCV infection. Studies suggest that two single nucleotide polymorphisms at position -607 C/A (rs1946518) and -137 G/C (rs187238) in the region of the gene IL-18 and have been found associated with the transcriptional promoter activity of IL -18, and potentially of IFN-γ, being associated with delayed viral clearance and persistence of the disease. We conducted a cross-sectional analytical study of the city of Belém-PA in 152 blood samples from patients infected with HCV and 188 uninfected controls. The samples were subjected to RT-PCR (Reverse Transcriptase - PCR) for detection of viral RNA and, subsequently, the PCR-RFLP (Restriction Fragment Length Polymorphism) to evaluate the polymorphism in the promoter region of IL-18 gene at positions -137 G/C and -607 C/A. The results showed no significant difference for IL-18 polymorphisms between patients and control group. But showed a significant difference for homozygous genotypes G/G (39.1%) at position -137 (OR = 3.00, CI [95%] = 1.24 – 7.22, p = 0.02), and A/A (21.7 %), position -607 (OR = 3.62, CI [95%] = 1.25 – 10.45, p = 0.03) among women than men (22.6% and 7.6%). The results showed evidence that among women, the presence of the polymorphism homozygous A/A (-607) acts as a protective factor against HCV infection, genotype as the A/A (-607) have been linked in some studies with liver disease and mild viral clearance.
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Análise epidemiológica e caracterização parcial do gene F dos Metapneumovirus Humano detectados a partir de casos de infecção respiratória aguda na Região Norte do Brasil
(Universidade Federal do Pará, 2012-10-30) FERREIRA, Luís Edilson de Azevedo; MELLO, Wyller Alencar de; http://lattes.cnpq.br/1784167608719139; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Diseases of the respiratory tract are the main complaints in health care services, and acute respiratory infections (ARI) the most common manifestations, especially in children under five years of age. In developing countries the ARI are a serious public health problem. Throughout the world is estimated to occur in approximately 2 million deaths each year by ARI. Among the causative agents of ARI, we highlight the human metapneumovirus (HMPV), especially by causing severe illness in children under 5 years. Aiming to generate data on the molecular epidemiology of this virus, we analyzed samples taken from patients with ARI in the period January 2009 to December 2011 arising from the Northern Region (Pará, Amazonas, Acre, Amapá and Roraima). It was used the technique of real time PCR (qRT-PCR) to detect the virus by the N gene and RT-PCR for the gene encoding the F protein, which was then partially sequenced. Within the study period, were tested in 2966 samples, 129 of which were positive for HMPV. The age group of 0-4 years was the one that focused more cases (n = 84, 65.89%) across the North. The identification of viruses was found to co-circulation of subgroups A2 and B2 during the three years of the study. Subgroups A1 and B1 not circulated in the region during the study period. This study represents the first report of data on molecular epidemiology of Human Metapneumovirus in northern Brazil.
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Análise filogenética de genes de provável origem não humana de rotavírus do grupo A em espécimes fecais de crianças com gastrenterite aguda provenientes de Belém, Brasil
(Universidade Federal do Pará, 2012) MAESTRI, Régis Piloni; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435
Rotaviruses (RVs) are the main cause of acute viral gastroenteritis in both humans and young animals of species such as calves, horses, pigs, dogs, cats, and birds. The genetic diversity of RVs is related to a variety of evolutionary mechanisms, including point mutation, genome reassortment, and reassortment. The objective of this study was realized the molecular charaxterization of the genes that encode structural and nonstructural proteins in unusual RV strains. The clinical specimens selected for this study were obtained from children and newborns with RV gastroenteritis, who participated in research projects on viral gastroenteritis conducted at the Evandro Chagas Institute. Structural (VP1-VP4, VP6, and VP7) and nonstructural (NSP1-NSP6) genes were amplified from stool samples by the polymerase chain reaction and subsequently sequenced. Eight unusual RV strains isolated from children and newborns with gastroenteritis were studied. Reassortments between genes of animal origin were observed in 5/8 (62.5%) strains analyzed. These results demonstrate that, although rare, interspecies (animal-human) transmission of RVs occurs in nature, as observed in the present study in strains NB150, HSP034, HSP180, HST327, and RV10109. This study is the first of its kind conducted in the Amazon region and supports previous data showing a close relationship between genes of human and animal origin, representing a challenge to the large-scale introduction of RV vaccines in national immunization programs.
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Características epidemiológicas relativas à doença dental e infecção por Helicobacter pylori na cavidade oral de estudantes em Belém-Pará
(Universidade Federal do Pará, 2009) MATOS, Gyselly de Cássia Bastos de; CORVELO, Tereza Cristina de Oliveira; http://lattes.cnpq.br/7253864056606024
The infection by Helicobacter pylori is one of the most common in humans and despite having tropism by stomach, can be found in the oral cavity, maintaining a commensal relationship with the host, while dental caries is also an infectious disease and results from the metabolism of the bacterial plaque. Both infections are highly prevalent in developing countries, since these populations are more exposed to environmental risk factors, and are usually acquired during childhood. The prevalence of these infections was investigated in the oral cavity of school children with no symptoms of gastric diseases, from a population of Belém-Pa, in relation to some parameters of oral hygiene and health, socioeconomic conditions and genetic susceptibility factors like the ABO and Lewis blood groups. Were investigated 104 patients, with average age of 17 years. Of all the participants were collected saliva samples and dental plaque. Saliva was collected to identify the ABO and Lewis state secretor and estimation of salivary parameters, and both, saliva and plaque samples were collected for molecular analysis of 16S rRNA genes of H. pylori and FUT2. H. pylori was detected in 79.8% of the students, with a frequency of 66.35% in dental plaque and 58.65% in saliva. The caries prevalence was 82.8% in the population studied. The clinical evaluation of oral health showed that the average CPO-D found was 3.53. It was observed that the caries experience tends to increase as in addition to age and the H. pylori infection was higher in early childhood. The education level and number of dentist visits showed significant differences in relation to the presence of H. pylori. The phenotypic distribution of ABO and Lewis blood groups did not differ significantly between infected and uninfected individuals, explaining there is greater genetic susceptibility to infection by H. pylori and dental caries. Throughout this analysis, the high frequencies found prove the need for care and treatment of dental diseases, such as caries and it is suggested that H. pylori in the oral cavity can contribute to infection and re-infection of the stomach after treatment.
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Caracterização antigênica e molecular de amostras de rotavírus do tipo G1, obtidas de crianças participantes de estudos em gastroenterites virais, no período de 1982 a 2003, em Belém, Pará, Brasil
(Universidade Federal do Pará, 2006-07-03) SOARES, Luana da Silva; MASCARENHAS, Joana D'Arc Pereira; http://lattes.cnpq.br/5156164089432435; LINHARES, Alexandre da Costa; http://lattes.cnpq.br/3316632173870389
Infant mortality remains an important problem of public health worldwide, mainly in developing countries. Of more than the 50 etiologic agents implied in this disease, rotavirus causes 111 million episodes of diarrhoea, resulting in more than 600,000 deaths among children less than five years, of which 82% are notified in the poorest countries of the world. This study aimed at the antigenic and molecular characterization of G1 rotavirus strains among children participanting of viral gastroenteritis studies, carried out from 1982 to 2003, in Belém, Pará, Brazil. One hundred and forty-eight specimens of G1 rotavirus were analyzed in the present investigation. Overall, the prevalence of the G1 type was of 41.3%, being that frequencies of this genotype through studies ranged from 11.0% to 67.6%. Eletropherotypes, G serotypes and P genotypes characterization of G1 rotavirus occurred in frequencies of 78.4%, 89.9% and 87.8%, respectively. Three long eletropherotypes varieties were identified, being that the L1 variety was found frequently (79.3%). The G1, G9 and G1+G4 serotypes were detected in 88.0%, 9.8% and 2.2% of the specimens, respectively. Mixed infection by G1+G4 genotype was detected in one sample. The prevalent binary combination was P[8],G1, being responsible for 72.3% of the cases. Mixed infections circulated in percentage of 20.0%, including genotypes P[4]+P[8],G1, P[6]+P[8],G1, P[4]+P[6],G1, P[4]+P[6]+P[8],G1 and P[6]+P[8],G1+G4. The G1 genotype circulated among 2nd to 35th months of age and a highest number of cases was registered between 6 to 16 months of age. Clinical severity differences among G1 and other genotypes of rotavirus were not verified. The present analysis gathers pioneer findings in Brazil, allowing to extend the knowledge concerning the antigenic and molecular diversity of the infections by G1 rotavirus and these results will allow to understand the genetic complexity of such viral agents.
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Caracterização de espécies de Leishmania isoladas de Flebotomíneos sp. de três ecótopos da Serra dos Carajás, Pará, Brasil
(Universidade Federal do Pará, 2008) DIAS JUNIOR, Manoel Guacelis de Sena; ISHIKAWA, Edna Aoba Yassui; http://lattes.cnpq.br/3074963539505872
The American cutaneous leishmaniasis (LTA) is an infectious disease, with a high frequency of zoonosis, endemic in the Amazon region, transmitted by sand flies of generous Psychodopygus and Lutzomyia. Serra dos Carajás, located in southeastern Pará, is widely exploited by extractive companies and as a result, the LTA would be transformed into a major health problem to workers because of the practice of deforestation and construction of roads for drainage of the ore. The purpose of this study is to evaluate the natural infection in the sand fly by Leishmania in the Serra dos Carajás region through the PCR. Catches of sandflies were held in three different areas, Parque Zoobotânico de Quarentena, APA do Gelado and Tapirapé-Aquirí, with CDC-type of light traps and Shannon, during the night from the evening twilight. The sand flies captured were identified according to Young & Duncan, 1994, and frozen in N2. 5.947 sandflies were frozen, being 3.495 females and among these 550 specimens were tested. The extraction of DNA was performed using SDS and KOAc and it was precipitated with ethanol 96%. Subsequently, the PCR was performed by amplifying the mini-exon gene with the primers S1629 (5' GGGAATTCAATAWAGTACAGAAACTG 3') and S1630 (5' GGGAAGCTTCTGTACTWTATTGGTA 3'). The DNA of Leishmania was detected in 36 (6,5%) sand flies, 34 of subgenus Viannia detected in 30 Psychodopygus wellcomei/ complexus, three Lutzomyia whitmani and a Lutzomyia shawi. Two infections by Leishmania amazonensis was detected in Psychodopygus wellcomei/ complexus. Tapirapé - Aquirí, APA do Gelado and Parque Zoobotânico de Quarentena showed high rates of natural infection in sand flies 6.54%, 5.96% and 7.92% respectively. Ps. wellcomei/complexus still presents as Leishmania vector that cause LTA. Studies on the power of vector species Lu. whitmani and Lu. shawi naturally infected by Leishmania in the Serra dos Carajás should be intensified, if these species may be acting in the cycle of transmission of LTA in Serra dos Carajás. Studies that best explain the variation of the prevalence of different sandflies species and knowledge of the rate of infections should be also intensified in Serra dos Carajás.
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Caracterização dos genes codificadores da hemaglutinina e PB2 do vírus Influenza A (H1N1) pandêmico isolado na mesorregião metropolitana de Belém
(Universidade Federal do Pará, 2012-10-26) FERREIRA, Jessylene de Almeida; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539; NUNES, Márcio Roberto Teixeira; http://lattes.cnpq.br/0299116892743368
The recent influenza pandemic of 2009/2010 caused by the Influenzavirus A (H1N1) pandemic showed a severity profile different from seasonal flu due to a significant percentage of severe and fatal cases occurred in young adults without comorbidity. The virulence of Influenzavirus A (H1N1) pandemic is the result of protein interaction complexes and is related essentially some viral genes. The aim of this study was to characterize the genes that encodes for the hemagglutinin (H1) and polymerase basic 2 (PB2) of Influenzavirus A (H1N1) pandemic recovered from patients with flu coming from the metropolitan mesoregion, Belém-PA. The sample size consisted of 87 random samples of both genders, the 0-96 years, with severe acute respiratory syndrome (SARS) without comorbidity reported from May 2009 to August 2010. The samples were isolated in MDCK cell, and analyzed by molecular biology techniques that comprised three main steps: a) viral RNA (vRNA) extraction from supernatant of infected cells; b) amplification of the vRNA by Polymerase Chain Reaction preceded by Reverse Transcription (RT-PCR) technique; c) complete sequencing of genes encoding H1 and PB2. Of 87 strains amplified by RT-PCR in 82 amplicons the acquisition and analysis of sequences for the HA gene was obtained, whereas in 81 amplicons viral sequences were obtained for the PB2 gene. The comparative analysis of the sequences obtained with the sequence of the vaccine strain (A/California/07/2009 (H1N1)) revealed amino acid substitutions in HA (P83S, D97N; S203T, D222G, and I321V Q293H) and PB2 (K340N, and K526R M631L) proteins any changes were, however not associated with hospitalization. At the level of substitution in HA, the D97N alone or associated with the S203T was detected more frequently in the first wave. Furthermore, the level of PB2, a substitution K526R was found in the majority of strains that circulated during the first wave, while the M631L was more evident in the second. The D222G substitution in HA was only found in cases of death. Finally, there was a tendency of changes in HA antigenic sites. Thus, the genetic and antigenic continuous surveillance of Influenzavirus A (H1N1) pdm in circulation, as well as the sharing of information is extremely important for the best possible recommendation for virus which are included in vaccine the composition thus avoiding higher risk of severe epidemics in the future.
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Caracterização genética parcial e completa da nucleoproteína de hantavírus na Amazônia brasileira
(Universidade Federal do Pará, 2011) SIMITH, Darlene de Brito; NUNES, Márcio Roberto Teixeira; http://lattes.cnpq.br/0299116892743368
The Hantavirus Pulmonary Syndrome (HPS) has been diagnosed in the Brazilian Amazon since 1995. Until december 2010 have been diagnosed 289 cases in the Brazilian Amazon, registered in the states of Mato Grosso, Pará, Maranhão, Amazonas and Rondônia. The overall objective of this study was to characterize genetically hantavirus strains circulating in these states. Samples of viscera from wild rodents positive for IgG antibodies against hantavirus caught in ecoepidemiológicos studies, conducted in the municipalities of Itacoatiara/AM, Alto Paraíso/RO and Campo Novo do Parecis/MT, and serum/blood of human cases of HPS from the municipalities in the area of influence of BR-163 in the states of Pará and Mato Grosso, Tomé-Açu/PA, Tangará da Serra/MT, and viscera of a pool of death coming from Anajatuba/MA. The samples were extracted viral RNA, followed by the reactions of RT-Hemi-Nested-PCR for samples from rodents, RT-Nested-PCR for human samples and nucleotide sequencing using the Sanger method and pyrosequencing, and later, scanned for matters such as identity (BLAST search), similarity (Simplot) and nucleotide and aminoacidic homology with other hantaviruses (Clustal W). We obtained partial sequences of hantavirus in five species of rodents Oligoryzomys microtis (n=2 from Itacoatiara/AM; n=3 from Alto Paraíso/RO) and in eight samples from humans (n=1 from Tomé-Açu/PA; n=1 from Altamira/Cachoeira da Serra; n=1 from Novo Progresso/PA; n=1 from Guarantã do Norte/MT; n=1 de Anajatuba/MA and n=3 de Altamira/Castelo dos Sonhos). Using the strategy of pyrosequencing were obtained complete sequences of the gene N, S-RNA of three hantavirus in rodents (n=2 from Alto Paraíso/RO and n=1 from Campo Novo do Parecis/MT) and two human cases (n=1 from Tangará da Serra/MT and n=1 from Novo Progresso/PA). Analysis of complete sequences showed the presence of ORFs for possible NSs protein, as described for other hantaviruses. Phylogenetic analysis of the sequences obtained in this study and other hantaviruses available in GenBank suggests that the virus Castelo dos Sonhos is responsible for cases of HPS in municipalities in the area of influence of BR-163, obtaining for the first time, the complete sequence of this virus in rodent Oligoryzomys utiaritensis, coming from Mato Grosso; confirmed the continued circulation of Laguna Negra-like virus associated with HPS cases in the state of Mato Grosso; the Rio Mamoré-like virus was first time detected in O.microtis rodents, the state of Amazonas and Rondônia, but not associated with human cases; the virus Anajatuba was responsible for a case of death from Maranhão. This work will serve as support for future epidemiological and molecular studies, therefore, provides new data about the spread of hantaviruses in the Brazilian Amazon.
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Caracterização sorológica e detecção molecular do HTLV em amostras de pacientes com distúrbios neurológicos no Estado do Pará, Brasil (1996-2005)
(Universidade Federal do Pará, 2006-07-07) LIMA, Telma Vitorina Ribeiro; LINHARES, Alexandre da Costa; http://lattes.cnpq.br/3316632173870389
Human T-lymphotropic virus tipe 1 is recognized as the etiologic agent of tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM). A very similar clinical disease has been increasingly associated to HTLV-2, whose pathogenicity still requires further assessments. This transversal, retrospective epidemiological survey aimed to determine the prevalence of HTLV among individuals with neurological disturbances and further evaluate cases of inconclusive serology using molecular biology methods. The present study involved patients inhabitants of Pará State and/or admitted at health institutions of the and who were referred to the Virology Section of Instituto Evandro Chagas (IEC) by local doctors between January of 1996 and December 2005, to search for the presence of HTLV-1/2 serum antibodies. Of these patients 353 were selected, with age between 9 months and 79 years, who presented at least one signal or symptom of the Marsh’s Complex (1996), as well as had HTLV-1/2 positive serology at screening and confirmatory ELISA. The overall prevalence of HTLV antibodies by ELISA as 8,8% (31/353), with rates of 10,6% (19/179) and 6,9% (12/174) for female and male patients, respectively. Among HTLV-1/2 the 31 ELISA-positive patients it was noted that 15 (48.4%) of 31 had paresis (n = 8), parestesis (n = 5), and paraplegia (n = 3). Of these 31 HTLV ELISA positive patients, 25 could be submitted to WB for assessment of viral types, which were distributed as follow: 80% (20/25) were HTLV-1, 12% (3/25) were HTLV-2, one case was of HTLV-1+HTLV-2 infection (4%), and serum from one patient yielded an indeterminate profile (4%). Only 14 of these 25 patients could be re-localised for collection of an additional sample for molecular analysis. It was observed that 78.6% of samples typed by WB had the proviral TAX region successfully amplified by nested-PCR. In addition, types were confirmed as based on results obtained from the amplification of the POL region using real-time PCR; this denoted good specificity and sensitivity of the WB used in this study. The sample defined as HTLV-1+HTLV-2 infection by WB was amplified in its TAX region but real time PCR confirmed HTLV-1 infection only. The patient with WB indeterminate profile and one of samples typed as HTLV-2 by WB were amplified by nested-PCR but the real time PCR was negative for HTLV-1 and HTLV-2 in both samples. One patient presenting clinical manifestations of crural myalgia and parestesia with duration of about 7 years reacted HTLV-2-positive by both WB and real-time PCR, a denoting a clear HTLV-2- related chronic myelopathy. This study has identified a case of possible vertical transmission in two distinct situations: a patient whose mother presented antibodies for HTLV-1 by WB and two sisters who reacted HTLV-1-positive by WB and real-time PCR. Although of epidemiological relevance, results from this study warrant further and broader analyses concerning the molecular epidemiology of HTLV types and subtypes HTLV. In addition, a more complete clinical assessment of neurological symptoms should be further performed, in order to better characterise cases of HTLV-related chronic myelopathy in our region.
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Perfil genotípico de resistência do vírus Influenza A (H1N1) pandêmico aos inibidores da neuraminidase em pacientes procedentes da mesorregião de Belém no período de maio de 2009 a maio de 2012
(Universidade Federal do Pará, 2012-10-26) BARBAGELATA, Luana Soares; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Influenza virus is responsible for the flu, a disease that causes millions of hospitalizations and deaths every year. In severe infections, especially in people at risk with comorbidities for complications, antiviral become the main means for clinical management, mainly the neuraminidase inhibitors (INAs). By fact, in the 2009 pandemic episode the World Health Organization (WHO) recommends the use of Oseltamivir for the treatment of patients. However, due to viral genetic evolution emerged strains with mutations in the gene coding for the neuraminidase (NA) responsible for amino acid substitutions that lead to drug resistance INAs. Thus, WHO began recommending surveillance genotypic resistance to influenza viruses. Our study aimed to verify the occurrence of mutations in the NA encoding gene of Influenza virus A (H1N1) pandemic strains that could be related to INAs resistance in the Belém mesoregion from May 2009 to May 2012 and analyze, through modeling of proteins, NA amino acid substitutions that may be altering the protein conformation. During the study period, were received 2619 clinical samples at the Virus Respiratory Lab in Evandro Chagas Institute in Belém – Brazil, from patients presenting signs and symptoms of acute respiratory infection with up to five days from the start of symptoms. For the detection of the viral genome viral RNA extraction was made followed by real time RT- PCR using specific markers for Influenza A H1N1pdm, resulting in 744 (28.4%) positive samples. A portion of the positive samples were then inoculated in MDCK cells and isolated samples were then submitted to a new viral RNA extraction followed by real time RT-PCR and semi-nested reaction (PCR) using primers specific for the NA gene. Subsequent analysis was done in 3130xl ABI Prism automatic sequencer (Applied Biosystems ). Molecular modeling was performed to the NA gene using SWISS-MODEL software, MODELLER 9.10, Procheck, VERIFY3D and PYMOL. The analysis of partial sequences of neuraminidase showed no circulation of the H1N1 pdm with H275Y mutation, the principal involved in resistance to oseltamivir. However in two samples were identified the D199N substitution that has been reported in several studies showing a possible association with increased resistance to oseltamivir. The samples of 2012 showed two substitutions (V241I and N369K) which are relate to a possible role in offsetting the negative effects caused by the H275Y mutation. Molecular modeling shows that the mutation D199N caused a change in protein structure near the NA-antiviral binding site. Phylogenetic analysis revealed that 2012 samples formed an isolated cluster, showing a much more temporal variation than geographic. This represents the first study of drug resistance of influenza virus in H1N1pdm metropolitan mesoregion of Belém - Brazil an important tool for health professionals to adopt more effective strategies for disease management and the development of new anti-influenza drugs.
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Pesquisa e genotipagem do vírus da hepatite C em portadores de doenças renais crônicas submetidos à hemodiálise
(Universidade Federal do Pará, 2012-12-20) FREITAS, Maria de Jesus Rodrigues; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769
Patients with chronic kidney disease are at high risk of acquiring hepatitis C virus (HCV). The prevalence of hepatitis C in hemodialysis units is high. The study aimed to assess the presence of HCV and its different genotypes in patients with chronic kidney disease who underwent hemodialysis in Belém and metropolitan area in the state of Pará, Brazil, determining the prevalence of the virus genotypes and epidemiological characteristics of patients with chronic kidney disease. We conducted cross-sectional study, hemodialysis units in seven cities of Belém and metropolitan area in the period from October 2011 to April 2012. A questionnaire was applied to social data, epidemiological and on the presence of risk factors for viral hepatitis. Biological material was collected from the patients for HCV PCR and ELISA tests. Patients with the presence of viral RNA were evaluated for genotypes. The prevalence of antibodies to HCV between the groups was 8.4%, while 5.4% had viral RNA, with 0.1% among those who were negative. Genotype 1 was the most prevalent, with 86.1%, followed by type 2, with 11.6%. The type 3 was only 2.3%. Whereas epidemiological analysis showed male predominance, age 49, married or in a stable, low education level and family income of up to two minimum wages. The main cause of CKD was diabetes mellitus (34.4%), followed by glomerulonephritis (18.6%) and hypertension (17.1%). The duration of hemodialysis was significantly important risk factor for acquiring HCV (p = 0.012), with the majority of HCV patients who acquired the disease during hemodialysis were above 5 years of treatment (p = 0.0001). Another risk factor associated with HCV was prior organ transplant. We conclude that, in Belém and the metropolitan area, the prevalence of HCV in hemodialysis was high and the most frequent genotype is the same as the general population in northern Brazil.
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Prevalência do papilomavírus humano em mulheres portadoras do vírus da imunodeficiência humana atendidas no serviço de atendimento especializado de Imperatriz-MA
(Universidade Federal do Pará, 2012) CASANOVA, Franciara Batista; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973
This work aims to assess the prevalence of HPV and the risk factors associated to the co-infection HIV HPV. Seventy-eight cervical samples of HIV-positive women attended at the SAE of an STD/ AIDS Program of the city of Imperatriz, Maranhão, Brazil, were analyzed. Cytopathology exams and amplification by PCR were realized. A questionnaire was used as instrument for data collection. The DNA positivity of HPV was 74,36%. In our study, the cytology diagnosed alterations in 16 (20,51%) of the cases. DNA HPV in 71% of the patients with inflammatory cytology was detected, and 93% of cytologies altered. Amongst the alterations we feature ASCUS with 100%; ASCUH 100%; LIE low level 100%; LIE high level 66,6%. By analyzing the social-demographic risk factors of this population in relation to the prevalence of infection by HPV, it was noticed that women who assumed they never had alcohol showed higher prevalence (87,5%), and women who presently use tobacco (84,6%) were infected by HPV. No differences were noticed amongst the variables “marital status”, “education”, “number of partners”, “use of preservatives” and “use of contraceptives”, with similar profile occurring. This study was a pioneer in the city of Imperatriz and confirmed a high prevalence of co-infection. The fight against uterine cancer must be adopted as a priority of public health services since it is a disease with potential to prevention, whose tracking is effective.

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