IPTSP - Instituto de Patologia Tropical e Saúde Pública

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    Mpox e Mpox em PVHA: um estudo transversal
    (Universidade Federal de Goiás, 2024-11-08) Coutinho, João Victor Soares Coriolano; Siqueira Júnior, João Bosco; http://lattes.cnpq.br/3644529827602550; Siqueira Júnior, João Bosco; Araújo Filho, João Alves de; Soares, Renata de Bastos Ascenço
    Introduction: The Mpox virus was discovered in 1958 in non-human primates and later identified in a 9-year-old child in the Democratic Republic of Congo, remaining restricted to the African continent and primarily affecting children. In 2022, it crossed borders and was associated with outbreaks in different countries, with a different clinical and epidemiological profile than what had been observed, this time affecting Men Who Have Sex with Men (MSM), with genital and anal lesions and disproportionately affecting People Who Live with HIV (PLHIV). The main objective of this study was to compare the epidemiological and clinical characteristics of patients coinfected with Mpox/HIV/AIDS with those infected only with Mpox. Methods: This is a retrospective and cross-sectional study. All confirmed cases of Mpox from patients residing in Goiânia, Goiás, Brazil, between the months of June 2022 and June 2023 were included for analysis. The patients were divided into 3 groups, those with only Mpox, those with Mpox and HIV, and those with Mpox and AIDS, subsequently comparing the epidemiological and clinical characteristics. Results: Of a total of 398 confirmed cases, 223 (52%) were in PLHIV, of these 14 (6%) were in the AIDS phase. There were 175 cases in patients with only Mpox and of these, only 37 (21.14%) were using PrEP for HIV. Different clinical characteristics were identified between the groups, with statistical significance for Localized Lymphadenopathy found more frequently in the group with only Mpox and Genital Lesions being observed more commonly in cases with Mpox/AIDS. The presence of coinfection with another STI occurred more frequently in Mpox/HIV, with syphilis being the most common STI. Finally, all cases evolved to cure. Conclusions: The Mpox outbreak affected PLHIV in Goiânia more frequently, who more commonly presented another STI, greater genital involvement, and a lower proportion of localized lymphadenopathy and among the patients infected with only Mpox a very low proportion was using PrEP for the HIV virus, differing from what is found in developed countries.
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    Prevalência das infecções por Papilomavírus humano e soropositividade de Chlamydia trachomatis em mulheres portadoras de neoplasias cervicais na região central do Brasil
    (Universidade Federal de Goiás, 2009-11-24) Guimarães, Narriman Kennia da Silva Barros; Carneiro, Megmar Aparecida Santos; http://lattes.cnpq.br/8398563469665169; Santos, Silvia Helena Rabelo do; http://lattes.cnpq.br/4994826511439492; Santos , Silvia Helena Rabelo do; Alves, Rosane Ribeiro Figueiredo; Alves, Maria de Fátima Costa
    High-risk papillomavirus (HPV) is the etiological agent for cervical neoplasia. However, the presence of singly HPV infection is unlikely to be sufficient for cervical carcinogenesis, and other sexually transmitted infections (STI) may increase the risk of cervical neoplasia. The significance of the association between the human papillomavirus (HPV) and other sexually transmitted infections in the development of cervical neoplasias has been investigated and the more consistent data have pointed to an association with Chlamydia trachomatis (C. trachomatis). However, the exact relationship between C. trachomatis and HPV infection remains not completely understood. It is possible that C. trachomatis infection may be an independent factor or cofactor for HPV in the development of cervical neoplasia. Objective: The objective of this study was to evaluate the seropositivity for Chlamydia trachomatis in HPV-positive women correlating with the severity of cervical neoplasia in central area of Brazil. Methodology: A total of 131 women referred to colposcopic clinic, in Goiás, Brazil because of an abnormal cervical smear were included in the study. HPV DNA was detected by polymerase chain reaction using PGMY09/PGMY11 primers, and genotyping was performed by reverse dot blot hybridization. Seropositivity for C. trachomatis was evaluated using ELISA for the detection of IgG antibodies. Results: The total prevalence of HPV infection was 86.3% (113/131). Seropositivity for C. trachomatis was 26% (34/131). Thirty one women (27.4%; 31/113) tested simultaneously positive for C. trachomatis and HPV. Of these, 12.9% (4/31) tested negative at histology, while 87.1% (27/31) tested positive for CIN and invasive carcinomas. The most prevalent HPV type in the C. trachomatis seropositive women was HPV 16 (51.6%; 16/31) and in these women, this type was present in 50% (2/4) of cases negative, 33.3% (3/9) of cases CIN1, 53.3% (8/15) of cases CIN2/CIN3 and 100% (3/3) of cases invasive carcinoma. Taking as reference cases negative for HPV/ C. trachomatis, the positivity for HPV/ C. trachomatis was significantly associated with CIN 2 or worse diagnostic, especially the types 16 and 18. A borderline significance was observed when the reference was HPV positive and C. trachomatis negative cases. There was a borderline significance between other types of HPV and positivity for C. trachomatis with neoplastic diagnosis considering as reference HPV/ C. trachomatis negative cases. Conclusions: C. trachomatis seropositivity was associated with severity of cervical neoplasia in women HPV positives. Then, it may be important to screen for the simultaneous presence of C. trachomatis which may have synergistic pathological effects.
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    Associação entre tipos específicos de HPV e carga viral com a gravidade da neoplasia cervical
    (Universidade Federal de Goiás, 2012-12-20) Guimarães, Narriman Kennia da Silva Barros; Santos, Silvia Helena Rabelo do; http://lattes.cnpq.br/4994826511439492; Santos, Silvia Helena rabelo dos; Miranda, Angélica Espinosa; Val, Isabel Cristina Chulvis do; Souza, Menira Borges de Lima Dias e; Lino Júnior, Ruy de Souza
    Introduction: Cervical cancer is a rare consequence and developed long term from a infection by specific types of human papillomavirus (HPV). There are factors related to the acquisition of infection and its persistence that increase the risk of developing cervical neoplasia. The type-specific viral infection and higher viral loads values appear to be related to persistence of virus and progression of neoplasia and therefore with the severity of cervical neoplasia. Objectives: To identify the specific types of HPV in different age groups as well as the importance of viral load of HPV 16 with the severity of cervical neoplasia. Methods: This cross-sectional study conducted in Goiânia, Goiás, included women referred to the Hospitals Santa Casa de Misericórdia de Goiânia and Hospital Mother and Child, by presenting changes in routine cytological examination. HPV DNA was detected by polymerase chain reaction (PCR) and HPV genotyping was performed by reverse hybridization assay. A total of 331 women with cytological diagnosis were selected, 238 of them with histological diagnosis. After PCR for HPV, 58 women were excluded for being HPV negative. In the 273 HPV-positive women an analysis of the association between HPV types and risk of severity of cytological diagnosis by age group was carried out in the following categorization: <30 years, 30-39 years, 40-49 years and ≥ 50 years. To evaluate the association between viral load values with severity of cytological and histological diagnosis, 77 women HPV 16 positive by PCR in real time were selected. Results: The overall prevalence of HPV infection was 82.5%. HPV 16 was the most prevalent type representing 44.7% of cases. Infections by HPV 16 and / or 18 were significantly associated with both the cytological diagnosis of HSIL or more severe lesions (OR: 2.12 95% CI 0.98 to 4.59) and either with the histological diagnosis of CIN 2 or more severe (OR: 3.21 95% CI 1.21 to 8.59) lesions in women younger than 30 years. The cytological diagnosis of HSIL or more severe lesions (OR 4.59, 95% CI: 1.4 to 15.49, p = 0.004) and histological diagnosis of high-grade neoplasia (≥ CIN 2) (OR 6.51; 95% CI: 2.9 to 20.92, p = 0.0002) were significantly associated with higher viral load values in women infected with HPV 16. Conclusions: These results support the hypothesis that infection with HPV 16 and / or 18 in young women can quickly lead to the formation of more severe lesions and high viral loads resulting from infection by HPV 16 are associated with the severity of cervical neoplasia.