Este estudo teve por objetivo avaliar o número de linfócitos T CD4 + e carga viral em pacientes infectados com HIV, atendidos em laboratório de referência em Goiânia, Goiás. Trata-se de pesquisa  observacional, longitudinal e retrospectiva. Foram avaliados prontuários eletrônicos de pacientes submetidos ao exame de contagem de linfócitos T CD4 + e carga viral, no período de janeiro de 2015 a dezembro de 2017. Dos 14 pacientes avaliados, 35,7% (n=5/14) obtiveram, no primeiro exame, resultados abaixo de 200 células/mm³ e a quantificação da carga víral foi expressiva. Na quantificação de linfócitos T CD4+, 85,7% (n=12/14) dos pacientes possuíam valores abaixo do valor de referência (VR) mínimo, quando fizeram o primeiro exame, após o diagnóstico, e todos estes tiveram a carga de RNA viral acima do valor mínimo quantificável (VR: 560 células/mm³ a 2700 células/mm³). Foi constatado que, dos 12 dos pacientes que no início apresentaram valores abaixo do normal, 4 deles (33,3%) conseguiram atingir valores normais de linfócitos T CD4+, após o tratamento, e 50,0% (n=6/12) dos pacientes alcançaram níveis indetectáveis de carga viral. O monitoramento imune, feito pela citometria de fluxo, aliado a quantificação da carga viral de RNA, ganha notoriedade, pois, por meio destas ferramentas, pode-se determinar o grau de comprometimento imunológico dos pacientes e a eficácia do tratamento com antirretroviral.

No abstract

BACKGROUND: Helicobacter pylori colonizes approximately half of the world’s human population. Its presence in the gastric mucosa is associated with an increased risk of gastric adenocarcinoma, gastric lymphoma, and peptic ulcer disease. In Brazil, the high prevalence of H. pylori infection is a serious health problem. H. pylori virulence factors are associated with an increased risk of serious gastrointestinal disorders. The cagA gene encodes a cytotoxin-A-associated antigen (CagA) that is involved in bacterial pathogenicity. H. pylori strains carrying the cag pathogenicity island (cag-PAI) are significantly associated with severe clinical outcomes and histopathological changes. OBJECTIVE: The present study aims to investigate the prevalence of the cagA gene among H. pylori isolates from patients with different gastric pathologies. Further, the study hopes to verify its association with clinical outcomes. In addition, phylogenetic analysis was performed on cagA-positive H. pylori strains from patients with severe and non-severe diseases. METHODS: Gastric specimens were collected through a biopsy from 117 patients with different esogastroduodenal diseases. DNA was extracted from these gastric specimens and the polymerase chain reaction was performed to amplify the gene fragments corresponding to the 16S ribosomal RNA and cagA genes using specific primers. The polymerase chain reaction products of selected samples positive for cagA were sequenced. The sequences were aligned with reference sequences from the National Center for Biotechnology Information (NCBI) (Bethesda/USA), and a phylogenetic tree was constructed. RESULTS: H. pylori was detected in 65.9% (77/117) of Brazilian patients with different gastroduodenal disorders. Overall, 80.5% (62/77) of the strains were cagA-positive. The ages of patients with cagA-positive strains (15 males and 47 females) ranged from 18 to 74 years. The lesions were categorized as non-severe and severe according to the endoscopic and histopathological reports the most prevalent non-severe esogastroduodenal lesion was gastritis 54/77 (70.12%), followed by esophagitis 12/77 (15.58%) and duodenitis 12/77 (15.58%). In contrast, the most prevalent severe lesions were atrophy 7/77 (9.09%), followed by metaplasia 3/77 (3.86%) and gastric adenocarcinoma 2/77 (2.59%). Phylogenetic analyses performed with the partial sequences of the cagA gene obtained from local strains were grouped in the same clade. No differences in phylogenetic distribution was detected between severe and non-severe diseases. CONCLUSION: The cagA gene is highly prevalent among H. pylori isolates from gastric lesions in Brazilian patients. The presence of the cagA gene was not considered a marker of the severity of esogastroduodenal lesions in the present study. This is the first study to investigate the phylogenetic population structure of H. pylori strains in a Brazilian capital, which may improve our understanding of the clinical outcome of H. pylori infection.

No abstract

The history of muscle biopsy dates back to 1860, when Duchenne first performed a biopsy on a patient with symptoms of myopathy (1) . Since then, the basic and clinical science of muscle and muscle disease has gone through three stages of development: the classical period, the modern stage and the molecular era.