Laura Massami Sumita

Duality of patterns in hepatitis a epidemiology: A study involving two socioeconomically distinct populations in Campinas, São Paulo state, Brazil

To evaluate the prevalence of antibodies against hepatitis A in two socioeconomically distinct populations, 101 and 82 serum samples from high and low socioeconomic groups, respectively, were analysed for the presence of IgG anti-HAV using a commercial ELISA. The prevalence in low socioeconomic level subjects was 95.0%, whereas in high socioeconomic subjects was only 19.6% (p < 0.001). These data show a duality in Brazil: anti-HAV prevalence in low socioeconomic subjects is similar to that of developing countries, while in high socioeconomic subjects, a pattern typical of developed countries is found. The control of this infection in our country is primarily related to the improvement of sanitation, but especially for high socioeconomic level populations, the use of vaccination against hepatitis A is strongly advisable to avoid the occasional appearance of this disease in adults.

Enzyme-linked immunosorbent assay (ELISA) for measles antibody: a comparison with haemagglutination inhibition, immunofluorescence and plaque neutralization tests

An enzyme-linked immunosorbent assay (ELISA) for measles antibodies was compared with Plaque Neutralization (PRN), Haemagglutination inhibition (HI) and Fluorescent antibody (IFA) tests in 181 sera from vaccinated children and umbilical cord. Of 179 positive samples by the sensitive PRN, only two, with titers of 8, were negative by ELISA (copositivity of 98.9%). IFA and HI presented, respectively, copositivities of 93.3% and 82.7%. The ELISA presented a high sensitivity as well as a good reproducibility and represents an alternative for the time consuming PRN for detection of low measles antibodies.

Infecção perinatal pelo citomegalovírus em hospital público de São Paulo: estudo prospectivo

In order to demonstrate the occurrence of CMV perinatal infection in a middle socioeconomic class population, the authors conducted a 8-month prospective study in 37 children, not infected congenitally, born in a public hospital of São Paulo city, Prevalence of CMV-IgG antibodies in mothers, detected by immunoenzymatic assay (ELISA), was 92.7%. Survival analysis showed that the risk of acquiring CMV perinatal infection diagnosed by virus isolation in human fibroblasts was 30.9%. When the diagnostic method was detection of IgM class antibodies by indirect immunofluorescence the risk was 8.1% (p < 0.05). Milk samples inoculated in human fibroblasts failed to demonstrate the presence of virus. The infected children did not present any signal of disease in a 4-month follow-up.In order to demonstrate the occurrence of CMV perinatal infection in a middle socioeconomic class population, the authors conducted a 8-month prospective study in 37 children, not infected congenitally, born in a public hospital of Sao Paulo city, Prevalence of CMV-IgG antibodies in mothers, detected by immunoenzimatic assay (ELISA), was 92.7%. Survival analysis showed that the risk of acquiring CMV perinatal infection diagnosed by virus isolation in human fibroblasts was 30.9%. When the diagnostic method was detection of IgM class antibodies by indirect immunofluorescence the risk was 8.1% (p < 0.05). Milk samples inoculated in human fibroblasts failed to demonstrate the presence of virus. The infected children did not present any signal of disease in a 4-month follow-up.Com o objetivo de se avaliar a magnitude da infeccao perinatal pelo citomegalovirus em hospital publico do municipio de Sao Paulo, os autores acompanharam prospectivamente 98 recem-nascidos ate o quarto mes de vida. Amostras de urina foram coletadas ao nascimento e posteriormente a cada mes, para inoculacao em tubos contendo fibroblastos humanos. Amostras de sangue foram coletadas ao nascimento, no segundo e quarto mes de vida para pesquisa de anticorpos IgM especificos para o CMV, pelo metodo de imunofluorescencia indireta. Dos 37 recem-nascidos que foram acompanhados ate o quarto mes de vida, 9 se infectaram neste periodo, com diagnostico feito pelo isolamento do CMV. O risco de aquisicao da infeccao pelo citomegalovirus no periodo perinatal estimado pela tabua de sobrevivencia foi de 30,9%. A pesquisa de anticorpos IgM por imunofluorescencia indireta so permitiu tal diagnostico em 2 casos (8,1%). A diferenca observada entre os dois metodos foi estatisticamente significante (p = 0,015). O estudo da prevalencia de anticorpos IgG pelo ensaio imunoenzimatico nas maes das criancas mostrou taxas de 92,7%. Nao se isolou CMV nas amostras de leite materno, coletadas mensalmente ate o terceiro mes de lactacao. O acompanhamento clinico evidenciou que as criancas infectadas apresentaram-se de forma assintomatica e com desenvolvimento neurop-sicomotor normal ate o quarto mes.

Genotypic distribution of HHV-8 in AIDS individuals without and with Kaposi sarcoma: Is genotype B associated with better prognosis of AIDS-KS?

AbstractAIDS-associated Kaposis sarcoma (AIDS-KS) caused by human herpes virus 8 (HHV-8) is the most severe and resistant form of KS tumor. Our aim was to verify whether there is an association between HHV-8 variability and development of AIDS-KS in Brazil by comparing the HHV-8 variability between individuals without and with KS. Saliva samples and blood, when available, were analyzed by polymerase chain reaction (PCR) techniques for detection of the fragments of ORF K1 of HHV-8, which were then genotyped and analyzed regarding the genetic variability. Our study described 106 positive cases for HHV-8 in the saliva from 751 AIDS patients without previous KS. In addition, we performed a phylogenetic analysis of HHV-8 in 34 of the 106 AIDS patients without KS and in 33 of the 37 patients with active KS. The distribution of HHV-8 genotypes A, B, C, and F in AIDS individuals was indistinguishable by comparing non-KS and KS groups, as well as regarding ethnicity. Considering the KS group, genotype B was associated with better prognosis of KS tumor. Interestingly, we found a particular profile of diversity within clade C and 2 recombinant patterns of HHV-8 in the saliva of AIDS individuals without KS. We emphasize the need to achieve standard genotyping protocol for ORF K1 amplification, thus allowing for substantial detection of HHV-8 variants. Our findings can shed light on the role of HHV-8 variability in the pathogenesis of AIDS-KS.

A50 Genotypic distribution of HHV-8 in aids individuals without and with Kaposi sarcoma

Rotaviruses of species A (RVA) are a common cause of diarrhea in children and the young of various other mammals worldwide. Interspecies transmission of RVA may lead to the emergency of novel RVA strains which may potentially affect rotavirus vaccine efficacy. The aim of this study was to investigate for possible interspecies transmission of RVAs in Uganda. Whole-genome sequencing of eighteen human (under-fives with diarrhea) and six animal (one bovine, one caprine, and four porcine) RVA strains identified in Uganda in the same geographical region, between 2012 and 2014 was undertaken using the Illumina HiSeq platform. RotaC version 2, a classification tool for RVAs was used to assign genotypes to all eleven genome segments of each isolate. Phylogenetic analysis was carried out using the maximum likelihood method in MEGA 6.06. Human RVA strains had either a Waor a DS-1-like genetic constellation. One human strain was a Wa-like mono-reassortant containing a DS-1-like VP2 gene of possible animal origin. In addition, three human RVA strains had one or two genes with possible zoonotic origin. All eleven genes of the bovine RVA strain were closely related to those of human RVAs. The caprine strain had a mixed genotype backbone, suggesting that it emerged from multiple re-assortment events involving different host species. Porcine RVA strains had mixed genotype backbones with possible multiple reassortant events with strains of human and bovine origin. Interspecies transmission of RVA strains occurred in this setting. RVA strains causing diarrhea in children are primarily transmitted from person to person. Rotavirus vaccination in children in Uganda will control rotavirus transmission. It is recommended to continue molecular surveillance of RVAs in humans and animals living in the same geographical region to understand the molecular epidemiology and evolution of RVAs in Uganda and other countries.