Estudo prospectivo de infecção por calicivírus (norovírus e sapovírus) em pacientes submetidos a transplante alogênico de células progenitoras hematopoiéticas

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dc.contributor.advisor1Souza, Menira Borges de Lima Dias e
dc.contributor.advisor1Latteshttp://lattes.cnpq.br/0054562567103606por
dc.contributor.referee1Souza, Menira Borges de Lima Dias e
dc.contributor.referee2Fiaccadori, Fabíola Souza
dc.contributor.referee3Leite, José Paulo Gagliardi
dc.creatorLemes, Lucianna Gonçalves Nepomuceno
dc.creator.Latteshttp://lattes.cnpq.br/0816025025526987por
dc.date.accessioned2014-09-26T11:31:18Z
dc.date.issued2013-12-20
dc.description.abstractThe calicivirus (norovirus and sapovirus) are important etiologic agents of acute gastroenteritis. Recent studies show that in immunocompromised patients such as those undergoing allogeneic hematopoietic stem cell transplantation (HSCT), norovirus infection can lead to worsening of symptoms and be confused with clinical symptoms of graft versus host disease (GVHD). However, calicivirus screening is not performed, routinely, as part of the patients’ follow-up laboratory exams. The main objective of this study was to evaluate the occurrence of norovirus (NoV) and sapovirus (SaV) in patients who underwent HSCT, and to conduct the molecular characterization of the samples positive for these viruses. Fecal samples were collected weekly, and serum samples were obtained every two weeks of ten patients who underwent HSCT, for a minimum period of five months and a maximum of one year. The secretor status was determined by an enzyme immunoassay and the detection of calicivirus was performed by RT-PCR using primers specific for a partial region of the gene encoding the NoV genogroup I and II (GI and GII) and SaV capsid protein. The genomic sequencing was performed for positive samples. The results showed that from ten patients participating in the study, eight had diarrhea. Among these, six (60%) had positive samples for NoV, and all of them had a secretor phenotype. The duration of NoV excretion in feces ranged from five to 143 days. Viral RNA was also detected in serum specimens, ranging from 29 to 36 days in the five patients infected with NoV. Three of the six patients had acute intestinal GVHD. Through genomic sequencing and phylogenetic analysis all NoV-positive samples were characterized as genotype GI.3, and because they had a high nucleotide identity, they were all characterized as a single haplotype. The data highlight the urgent need of the inclusion of calicivirus screening in the routine testing performed before transplantation and during follow-up of these patients. This is the first report of the occurrence of NoV in patients undergoing HSCT in Brazil.eng
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dc.description.resumoOs calicivírus (norovírus e sapovírus) são importantes agentes etiológicos da gastroenterite aguda. Estudos recentes mostram que em pacientes imunocomprometidos, como os submetidos a transplante alogênico de células progenitoras hematopoiéticas (TACPH), a infecção por norovírus pode levar ao agravamento dos sintomas e ser confundida com quadro clínico da doença do enxerto contra o hospedeiro (DECH). Entretanto, a triagem para calicivírus não é realizada, rotineiramente, como parte dos exames laboratoriais de acompanhamento destes pacientes. O principal objetivo deste estudo foi avaliar a ocorrência de norovírus (NoV) e sapovírus (SaV) em pacientes que foram submetidos ao TACPH e proceder à caracterização molecular das amostras positivas para estes vírus. Foram obtidas amostras de fezes, coletadas semanalmente, e de soro, a cada quinze dias, de dez pacientes que realizaram o TACPH, por um período mínimo de cinco meses e máximo de um ano. O fenótipo secretor dos pacientes foi determinado utilizando um teste imunoenzimático e a pesquisa de calicivírus foi realizada pela RT-PCR, utilizando-se iniciadores específicos para uma região parcial do gene codificante para a proteína dos capsídeos dos NoV do genogrupo I e II (GI e GII) e dos SaV. Os amplicons das amostras positivas foram submetidos ao sequenciamento genômico e análise filogenética. Os resultados obtidos revelaram que de dez pacientes participantes do estudo, oito apresentaram diarreia e vômito. Dentre esses, seis (60%) apresentaram amostras positivas para NoV, sendo que todos foram identificados como secretores. O período de excreção de NoV nas fezes variou de cinco a 143 dias. Foi também detectado RNA viral nas amostras de soro, variando de 29 a 36 dias, em cinco pacientes infectados por NoV. Três, dos seis pacientes, apresentaram DECH aguda intestinal. Através do sequenciamento genômico e análise filogenética, todas as amostras positivas para NoV, de todos os pacientes, foram caracterizadas como genótipo GI.3 dos NoV, e como foi comprovada elevada identidade nucleotídica entre elas, foram caracterizadas como um único haplótipo. Os dados obtidos ressaltam a urgente necessidade da inclusão da pesquisa de calicivírus na rotina de exames realizados antes do transplante, bem como durante o acompanhamento destes pacientes. Este é o primeiro relato da ocorrência de NoV em pacientes submetidos ao TACPH no Brasil.por
dc.formatapplication/pdf*
dc.identifier.citationLEMES, Lucianna Gonçalves Nepomuceno. Estudo prospectivo de infecção por calicivírus (norovírus e sapovírus) em pacientes submetidos a transplante alogênico de células progenitoras hematopoiéticas. 2013. 80 f. Dissertação (Mestrado em Biologia das Relações Parasito-Hospedeiro) - Universidade Federal de Goiás, Goiânia, 2013.por
dc.identifier.urihttp://repositorio.bc.ufg.br/tede/handle/tede/3177
dc.languageporpor
dc.publisherUniversidade Federal de Goiáspor
dc.publisher.countryBrasilpor
dc.publisher.departmentInstituto de Ciências Biológicas - ICB (RG)por
dc.publisher.initialsUFGpor
dc.publisher.programPrograma de Pós-graduação em Biologia das Interações PH (IPTSP)por
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dc.rightsAcesso Abertopor
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectCaliciviruspor
dc.subjectNoroviruspor
dc.subjectSapoviruspor
dc.subjectTransplante alogênico de células progenitoras hematopoiéticaspor
dc.subjectDoença do enxerto contra hospedeiropor
dc.subjectAllogeneic hematopoietic stem cell transplantationeng
dc.subjectGraft versus host diseaseeng
dc.subject.cnpqMICROBIOLOGIA::MICROBIOLOGIA APLICADApor
dc.thumbnail.urlhttp://repositorio.bc.ufg.br/tede/retrieve/8794/Disserta%c3%a7%c3%a3o_Lucianna%20G.%20N.%20Lemes.pdf.jpg*
dc.titleEstudo prospectivo de infecção por calicivírus (norovírus e sapovírus) em pacientes submetidos a transplante alogênico de células progenitoras hematopoiéticaspor
dc.title.alternativeProspective study of calicivirus infection (norovirus and sapovirus) in patients undergoing allogeneic hematopoietic stem cell transplantationeng
dc.typeDissertaçãopor

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Mestrado em Biologia da Relação Parasito-Hospedeiro (IPTSP)