Adilson José de Almeida

Occult hepatitis B virus infection in HIV-infected patients: Evaluation of biochemical, virological and molecular parameters.

Aim:  To determine the prevalence of occult hepatitis B virus (HBV) infection in a group of human immunodeficiency virus (HIV)‐infected Brazilian patients and to investigate its association with biochemical, virological and molecular features.

Investigação de acidentes biológicos entre profissionais de saúde

Resumen 1Aluna do Curso de Pós-Graduação em Análises Clínicas, Faculdade Redentor, Itaperuna, RJ. Bióloga, Laboratório de Referência Regional de Campos dos Goytacazes, Hospital Geral de Guarus, Campos dos Goytacazes, RJ. Brasil. E-mail: jazevedo_silva@hotmail.com, 2 Pesquisadora em Saúde Pública, Doutora em Ciências. Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ. Brasil. E-mail: vdepaula@ioc.fiocruz.br, 3 Professor Adjunto, Doutor em Ciências. Setor de Hematologia da Clínica Médica “B” do Hospital Universitário Gaffrée e Guinle, Escola de Medicina e Cirurgia, UNIRIO, Rio de Janeiro. Brasil. E-mail:adilsonjoal@ig.com.br, 4 Tecnologista em Saúde Pública, Doutora em Ciências. Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ. Brasil. E-mail: lvillar@ioc.fiocruz.br PESQUISA RESEARCH INVESTIGACIÓN The aims of this study were to identify the major professional category exposed to biological risk and the principal type of accident occurred among health care workers in Campos dos Goytacazes, RJ. Based on the analysis of 183 records filled out by the workers who suffered biohazardous accidents between January 2005 and September 2005, we found the nursing auxiliaries and technicians as the professional category more exposed to biohazardous accidents (54.1%), followed by undergraduate medical and dental students (10.4%). The occurence of acidents with piercing-cutting materials was related to frequent handling of these instruments, and to the behavior of workers who maintain practices providing risks of needlestick injuries, such as inappropriate disposal of piercing-cutting materials.Os objetivos deste trabalho foram identificar a principal categoria profissional exposta a risco biologico e os principais tipos de acidentes ocorridos entre trabalhadores da area de saude, em Campos dos Goytacazes, RJ. A partir da analise das fichas de notificacao de acidentes biologicos dos 183 profissionais acidentados entre janeiro de 2005 e setembro de 2005, observamos que a categoria profissional mais exposta foi a dos auxiliares/tecnicos de enfermagem (54,1%), seguida pela dos academicos de medicina e odontologia (10,4%). A ocorrencia de acidentes com materiais perfurocortantes foi relacionada a manipulacao frequente desses objetos e ao comportamento dos profissionais que utilizam praticas que oferecem riscos de acidentes com agulhas, tais como o descarte inadequado de objetos perfurocortantes.

A percepção ambiental entre os habitantes da região noroeste do estado do Rio de Janeiro

Foi desenvolvido um estudo para avaliar a percepcao ambiental de individuos residentes do Municipio de Itaperuna, localizado na regiao Noroeste do Rio de Janeiro, Brasil. Foram selecionados 243 individuos, entre os meses de julho a outubro de 2005, que responderam sobre questoes que abordavam a relacao individuo/ambiente; acoes individuais em favor da area ambiental; preocupacao com o impacto ambiental e consumo; habitos pessoais e ambiente. Com base na analise das respostas dos individuos, foi observada maior percepcao ambiental em individuos mais velhos em relacao a criancas e jovens. Este resultado demonstra que os programas de educacao ambiental nesta regiao devem ser voltados para criancas e adolescentes, para que os mesmos se tornem adultos conscientes, uma vez que os individuos respondentes apresentaram grande interesse pelos temas ambientais e disposicao para participar de campanhas e acoes de recuperacao ambiental.

The proportion of different IL-17-producing T cell subsets is associated with liver fibrosis in chronic hepatitis C

Studies have suggested the pivotal role of T helper type 1 (Th1) ‐related cytokines on the outcome of hepatitis C virus (HCV) infection. Nevertheless, the role of different interleukin‐17 (IL‐17) ‐secreting T cells on chronic hepatitis C (CHC) is less clear. Here, the in vivo IL‐1β, IL‐6, and IL‐17 levels were positively correlated with both alanine transaminase (ALT) levels and hepatic lesions. When compared with the control group, CHC patients showed a lower proportion of IL‐17‐secreting (CD4+ and CD8+) T cells capable of simultaneously producing IL‐21. Moreover, the percentage of IL‐10‐secreting Th17 cells was also lower in CHC patients. Notably, advanced liver lesions were observed among those patients with lower percentage levels of IL‐17‐producing T cells positive for IL‐21, interferon‐γ (IFN‐γ) and IL‐10. In contrast, the severity of hepatic damage was associated with peripheral single IL‐17+ T cells. The percentage of IL‐17+ IL‐21– IFN‐γ+ (CD4+ and CD8+) T‐cell phenotypes was positively associated with plasma CD14 levels. Finally, elevated levels of circulating CD14 were detected among CHC patients with extensive liver damage. In summary, although preliminary, our results suggest that a balance between different IL‐17‐producing T cells, associated with peripheral levels of CD14, may be a progress marker for liver disease in chronically HCV‐infected patients.

Investigation of biological accidents among health care workers

Resumen 1Aluna do Curso de Pós-Graduação em Análises Clínicas, Faculdade Redentor, Itaperuna, RJ. Bióloga, Laboratório de Referência Regional de Campos dos Goytacazes, Hospital Geral de Guarus, Campos dos Goytacazes, RJ. Brasil. E-mail: jazevedo_silva@hotmail.com, 2 Pesquisadora em Saúde Pública, Doutora em Ciências. Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ. Brasil. E-mail: vdepaula@ioc.fiocruz.br, 3 Professor Adjunto, Doutor em Ciências. Setor de Hematologia da Clínica Médica “B” do Hospital Universitário Gaffrée e Guinle, Escola de Medicina e Cirurgia, UNIRIO, Rio de Janeiro. Brasil. E-mail:adilsonjoal@ig.com.br, 4 Tecnologista em Saúde Pública, Doutora em Ciências. Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ. Brasil. E-mail: lvillar@ioc.fiocruz.br PESQUISA RESEARCH INVESTIGACIÓN The aims of this study were to identify the major professional category exposed to biological risk and the principal type of accident occurred among health care workers in Campos dos Goytacazes, RJ. Based on the analysis of 183 records filled out by the workers who suffered biohazardous accidents between January 2005 and September 2005, we found the nursing auxiliaries and technicians as the professional category more exposed to biohazardous accidents (54.1%), followed by undergraduate medical and dental students (10.4%). The occurence of acidents with piercing-cutting materials was related to frequent handling of these instruments, and to the behavior of workers who maintain practices providing risks of needlestick injuries, such as inappropriate disposal of piercing-cutting materials.Os objetivos deste trabalho foram identificar a principal categoria profissional exposta a risco biologico e os principais tipos de acidentes ocorridos entre trabalhadores da area de saude, em Campos dos Goytacazes, RJ. A partir da analise das fichas de notificacao de acidentes biologicos dos 183 profissionais acidentados entre janeiro de 2005 e setembro de 2005, observamos que a categoria profissional mais exposta foi a dos auxiliares/tecnicos de enfermagem (54,1%), seguida pela dos academicos de medicina e odontologia (10,4%). A ocorrencia de acidentes com materiais perfurocortantes foi relacionada a manipulacao frequente desses objetos e ao comportamento dos profissionais que utilizam praticas que oferecem riscos de acidentes com agulhas, tais como o descarte inadequado de objetos perfurocortantes.

Normal plasma antithrombin activity in patients with relapsing-remitting and secondary progressive multiple sclerosis.

OBJECTIVE Multiple sclerosis (MS) is an inflammatory disease characterized by multifocal areas of central nervous system (CNS) demyelination. Activation of coagulation factors and fibrin deposition are observed around CNS blood vessels in experimental autoimmune encephalomyelitis, an animal model of MS. Antithrombin (AT) is a potent anticoagulant with remarkable anti-inflammatory properties, and its inhibitory effects on coagulation and inflammation may play a role in the pathogenesis and clinical course of MS. We studied the association between plasma AT activity and clinical forms of MS. PATIENTS AND METHODS A total of 69 patients, 37 with relapsing-remitting and 32 with secondary progressive MS, were included in the study. A control group (CG) of 34 normal subjects was also studied. Plasma AT activity (Stachrom ATIII) was quantified using a chromogenic activity assay with normal reference values ranging from 70% to 120% of AT activity. RESULTS We found no difference between plasma AT levels in patients and those in CG. We also found no association of AT levels with activity of disease, duration of disease progression, level of neurological disability, and treatment. CONCLUSION We found no association between plasma AT activity and RRMS or SPMS. It remains to be studied whether exists or not an association between abnormal plasma AT activity and other MS forms.

Cynomolgus monkeys (Macaca fascicularis) experimentally infected with B19V and hepatitis A virus: no evidence of the co-infection as a cause of acute liver failure

This study was conducted to analyse the course and the outcome of the liver disease in the co-infected animals in order to evaluate a possible synergic effect of human parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus monkeys were inoculated with serum obtained from a fatal case of B19V infection and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV and B19V, liver enzyme levels, viraemia, haematological changes, and necroinflammatory liver lesions were used for monitoring the infections. Seroconversion was confirmed in all infected groups. A similar pattern of B19V infection to human disease was observed, which was characterised by high and persistent viraemia in association with reticulocytopenia and mild to moderate anaemia during the period of investigation (59 days). Additionally, the intranuclear inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte counts were more evident in the co-infected group. The present results demonstrated, for the first time, the susceptibility of cynomolgus to B19V infection, but it did not show a worsening of liver histopathology in the co-infected group.

Genotypic Characterization of Herpes Simplex Virus Type 1 Isolates in Immunocompromised Patients in Rio de Janeiro, Brazil

Herpes simplex virus type 1 (HSV-1) is a prevalent human pathogen that causes a variety of diseases, including an increased risk of developing more severe disease in HIV-infected individuals. In Brazil, there is no information about the molecular epidemiology of HSV-1 infection, especially in HIV-infected individuals. The aim of this study was to perform the genotypic characterization of HSV-1 among HIV-infected patients. A total of 214 serum samples from HIV-positive patients without HSV infection symptoms were enrolled in one of two reference hospitals for HIV infection managing in Rio de Janeiro. The gG and gI genes were analyzed by restriction fragment length polymorphism (RFLP) and full nucleotide sequencing of the US8 (1601 bp), UL44 (1996 bp), and UL23 (1244 bp) regions was performed. A total of 38.3% (82/214) and 32.7% (70/214) of the serum samples tested positive for gG and gI genes, respectively. RFLP analysis classified the HSV-1 as belonging to genotype A. Phylogenetic analysis of the Brazilian samples for the US8, UL44, and UL23 regions demonstrated that the nucleotide identity between Brazilian samples was higher than 97% for all genes. No acyclovir mutation was detected in the patients. The shedding of HSV in the serum samples from HIV-positive patients who were asymptomatic for HSV infection was detected in this work. This is the first report of molecular characterization of HSV-1 in Brazilian samples since there is no previous data available in the literature concerning the genotypic classification and stable distribution of Brazilian strains of HSV-1 in Rio de Janeiro, Brazil.

Knowledge and utilization of standard precaution measures by health professionals

O objetivo deste trabalho foi descrever o conhecimento sobre medidas de precaucao-padrao (MPP), bem como analisar a sua utilizacao entre 266 profissionais de saude do Estado do Rio de Janeiro. Foi utilizado um questionario autoaplicavel com tres dominios: A - Identificacao e capacitacao profissional; B - Conhecimento e suporte apos acidente biologico; C - Utilizacao de MPP em atividades profissionais. Na populacao estudada, 174 (65,4%) relataram ter feito nos ultimos dois anos algum curso de atualizacao em sua area, 106 (39,8%) fizeram algum curso contendo temas de biosseguranca, e 31,9% relataram acidente de trabalho anteriormente. Observamos que os acidentados tinham maior mediana de idade e tempo de conclusao de curso. Concluimos que a maioria dos profissionais reconhece e utiliza as principais MPPs, porem uma parcela desta populacao ainda nao utiliza estas medidas. E importante a capacitacao em biosseguranca a fim de minimizar o risco durante a atividade profissional.

Estudo dos transtornos cognitivos decorrentes da infecção pelo HIV-1

Abstract In its early stages, HIV-1 infection involves the Central Nervous System causing neuropsychological manifestations. With the ai m of studyingthe cognitive functions in HIV-1-infected patients, a total of 20 patients infected with HIV-1 with CD4 + lymphocyte count >200 cells/mm 3 were studied in accordance with the Wechsler Adult Intelligence Scale (WAIS-III). The present study comprised 20 patients, 5 (2 5%) male and15 (75%) female, with a mean age of 39.65 and standard deviation of 10.15 years. The mean CD4 + lymphocyte count was 467.20 with astandard deviation of 215.45 cells/mm 3 . Amongst the 14 patients who received highly active anti-retroviral therapy (HAART), we noted 1case in which the performance of the cognitive functions, attention span and learning, was considered to be very low according to WAIS-III,and the remaining (n=13) patients who were treated with HAART demonstrated a perfo rmance that was not considered to be outsideof the WAIS-III mean. By using WAIS-III testing, it was possible to detect performance of the cognitive functions considered to be verylow in HIV-1 infected individuals, even with those receiving HAART.Uniterms