Leyde Daiane de Peder

CÂNCER DE PRÓSTATA: EPIDEMIOLOGIA E ASSOCIAÇÃO COM INFECÇÃO URINÁRIA

O câncer (CA) de prostata e o segundo câncer mais comum entre os homens no Brasil e afeta principalmente individuos com idade superior a 65 anos de idade. O objetivo do presente trabalho foi determinar as caracteristicas epidemiologicas de pacientes portadores de câncer de prostata, bem como a prevalencia de infeccoes urinarias nestes pacientes. Pesquisa de carater descritivo e quantitativo realizada em prontuarios, de pacientes adultos atendidos no periodo de janeiro de 2015 a janeiro de 2016, em um hospital de referencia em câncer, situado em Cascavel, Parana (PR). Foram analisados 503 prontuarios de pacientes com idade superior a 30 anos. Destes, 46% possuiam acima de 70 anos, 76% eram de etnia branca, 96% nao possuiam ensino superior e 91% realizou tratamento pelo SUS. Infeccao urinaria foi observada em 29% dos pacientes em tratamento para câncer de prostata sendo que o principal antimicrobiano prescrito foi o Ciprofloxacino (28%). Verificou-se que o numero de casos de câncer de prostata vem aumentando gradativamente na populacao estudada, tornando-se cada vez mais comum em homens principalmente acima de 50 anos, e que a infeccao urinaria pode estar relacionada com o câncer de prostata devido as alteracoes celulares e posterior risco de mutacao.

Seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected patients in an HBV endemic area in Brazil

Background Hepatitis B virus (HBV) and hepatitis C virus (HCV) are a common cause of complications in liver disease and immunological impairment among human immunodeficiency virus (HIV)-infected patients. The aim of this study was to assess the seroprevalence of HBV and HCV and their correlation with CD4+ T-cells among HIV-infected patients in an HBV endemic area. Methods A cross-sectional observational and retrospective study was carried out in a reference center in Southern Brazil between January 2005 and December 2016. Socio-demographic data were collected by using a structured questionnaire. Serological tests and analysis of CD4+ T-cell count levels were performed using standard procedures. Results The seroprevalence of HIV-HBV, HIV-HCV, and HIV-HBV-HCV coinfections was 3.10%, 3.10%, and 0.16%, respectively. At baseline, anti-hepatitis B surface and anti-hepatitis B core antigens were detected in 46.27% and 16.74% of HIV-monoinfected patients and in 31.25% and 21.86% of the HIV-HCV coinfected patients, respectively. The median CD4+ T-cell count at baseline in the HIV-monoinfected group was higher than that in the HIV-coinfected groups, but without statistical significance. The median CD4+ T-cell count and the CD4/CD8 ratio were significantly higher in HIV-HBV and HIV-HCV groups after 24 months of combination antiretroviral therapy (cART) compared to the pre-cART values. When comparing patients with HIV-HBV and HIV-HCV on cART, CD4+ T-cell recovery was more rapid for HIV-HBV patients. Conclusion Although the analyzed region was endemic for HBV, the prevalence of HIV-HBV and HIV-HCV coinfection was lower than the rate found in the general population of Brazil. HBV and HCV had no significant impact on CD4+ T-cell counts among HIV-infected patients at baseline.

Association between Human Papillomavirus and Non-cervical Genital Cancers in Brazil: A Systematic Review and Meta-Analysis

Background: Human papillomavirus (HPV) infection is associated with cervical cancer; however, it is controversial whether it is involved in non-cervical genital cancers. Objective: This study aimed to evaluate articles on the prevalence of HPV in penile cancer, vulvar cancer, colorectal cancer, prostate cancer and anal canal cancer in studies conducted in Brazil. Methods: The study was conducted in accordance with the Preferred Reporting of Systematic Reviews and Meta-Analysis Statement. Comprehensive searches for HPV and cancer for the years 2006 to 2016 were conducted in two databases (PubMed and Web of Knowledge) and Google Scholar system. We also tracked the references of all eligible articles to identify additional non-captured publications through online surveys. Results: Eighteen studies, with a combined sample size of 1,552 patients were analyzed. The overall prevalence of HPV was 43% (95% CI: 36–51%; p < 0.001). The pooled prevalence of HPV in penile cancer was 42% (95% CI: 32–55%; p < 0.001), in colorectal cancer it was 67% (95% CI: 64–70%; p < 0.001) and in vulvar cancer 43% (95% CI: 34–55%; p < 0.001). HPV 16 was the most prevalent in all sites evaluated, with prevalence estimated at 54% (95% CI: 44–66%; p < 0.001), followed by genotypes 33 (21%; 95% CI: 17–28; p < 0.001), 6 (15%; 95% CI: 8–26%; p < 0.001), 11 (13%; 95% CI: 5–32%; p < 0.001) and 18 (12%; 95% CI: 7–22%; p < 0.001), respectively. The pooled prevalence of single infection was 82% and infection by multiple genotypes of HPV was 22%. Conclusion: Our study demonstrated a high prevalence of HPV in non-cervical genital cancers in Brazil, with predominance of genotype 16, providing evidence for the need for preventive and control measures to avoid future harm to the population.

TOXOPLASMA GONDII – SOROPREVALÊNCIA EM PACIENTES HIV NO SUL DO BRASIL

The objective of this study was to estimate the seroprevalence of Toxoplasma gondii and its association with predictors in HIV-infected patients. A cross-sectional study with HIV-infected patients attended at a referral center in Southern Brazil between 2005 and 2014. The seroprevalence of T. gondii was 57.90%, being significantly higher in patients belonging to 30-49 years (Odds Ratio (OR) 5.2, 95% CI 1.57-17.10, p=0.007) and ≥ 50 years (OR 4.1, 95% CI 1.22-13.77, p=0,02, female (OR 3.3, 95% CI 1.33-7.32, p <0.0001) and with ≤ 8 years of education (OR 2.2, 95% CI 1.62-2, 93, p <0.0001). Single patients with HIV diagnosis time ≤ 1 year had a protective factor (OR 0.5, 95% CI 0.25-0.99, p = 0.04) and (OR 0.5, CI 0.37 -0.73, p <0.0001), respectively. The findings report high seroprevalence for T. gondii in HIV-infected patients.