Characteristics of HIV-positive patients infected by vertical transmission, Campo Grande, MS, Brazil, 1993–2009

Matos, Vanessa Terezinha Gubert de; Oliveira, Ana Lúcia Lyrio de; Souza, Albert Schiaveto de; Fabbro, Márcia Maria Ferrairo Janini Dal

doi:10.1136/sextrans-2011-050457

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…gattii infection has been described in children [68], our results also confirm the rarity of cryptococcosis due to C . neoformans in pediatric cases [69, 70] with the youngest patient presenting at age 18.…”

Section: Discussionmentioning

confidence: 99%

MLST-Based Population Genetic Analysis in a Global Context Reveals Clonality amongst Cryptococcus neoformans var. grubii VNI Isolates from HIV Patients in Southeastern Brazil

et al. 2017

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Cryptococcosis is an important fungal infection in immunocompromised individuals, especially those infected with HIV. In Brazil, despite the free availability of antiretroviral therapy (ART) in the public health system, the mortality rate due to Cryptococcus neoformans meningitis is still high. To obtain a more detailed picture of the population genetic structure of this species in southeast Brazil, we studied 108 clinical isolates from 101 patients and 35 environmental isolates. Among the patients, 59% had a fatal outcome mainly in HIV-positive male patients. All the isolates were found to be C. neoformans var. grubii major molecular type VNI and mating type locus alpha. Twelve were identified as diploid by flow cytometry, being homozygous (AαAα) for the mating type and by PCR screening of the STE20, GPA1, and PAK1 genes. Using the ISHAM consensus multilocus sequence typing (MLST) scheme, 13 sequence types (ST) were identified, with one being newly described. ST93 was identified from 81 (75%) of the clinical isolates, while ST77 and ST93 were identified from 19 (54%) and 10 (29%) environmental isolates, respectively. The southeastern Brazilian isolates had an overwhelming clonal population structure. When compared with populations from different continents based on data extracted from the ISHAM-MLST database (mlst.mycologylab.org) they showed less genetic variability. Two main clusters within C. neoformans var. grubii VNI were identified that diverged from VNB around 0.58 to 4.8 million years ago.

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Section: Discussionmentioning

confidence: 99%

MLST-Based Population Genetic Analysis in a Global Context Reveals Clonality amongst Cryptococcus neoformans var. grubii VNI Isolates from HIV Patients in Southeastern Brazil

et al. 2017

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“…Of these, 143 studies were included in the data analysis (Tables, references, Supplemental Digital Contents 1, http://links.lww.com/INF/F353; 2, http://links.lww.com/INF/F354) and 25 did not meet the inclusion criteria. 8,13,15,17–38 A total of 1048 children were included in the data analysis. The 103 case reports of pediatric cryptococcal disease are summarized in Table, Supplemental Digital Content 1, http://links.lww.com/INF/F353.…”

Section: Resultsmentioning

confidence: 99%

Pediatric Cryptococcosis

Gifford,

Jayawardena,

Carlesse

et al. 2024

Pediatric Infectious Disease Journal

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Background: Seroprevalence studies have shown that 70% of children are exposed to Cryptococcus, the most common cause of meningitis in people living with human immunodeficiency virus (HIV), but reported pediatric disease prevalence is much lower than in adults. Methods: PubMed and Ovid Global Health databases were searched with the terms “cryptococcosis,” “cryptococcal meningitis,” “Cryptococcus neoformans” or “Cryptococcus gattii.” All studies reporting pediatric specific data in the English language from 1980 up until December 2022 were included. Results: One hundred sixty-eight publications were reviewed totaling 1469 children, with the majority reported from Africa (54.2%). Sixty-five percent (961) were HIV positive, 10% (147) were non-HIV immunocompromised and 19% (281) were immunocompetent. Clinical signs and symptoms were only reported for 458 children, with fever (64%), headache (55%) and vomiting (39%) being the most common. Most children (80%) suffered from meningoencephalitis. Lung involvement was rarely described in HIV-positive children (1%), but significantly more common in the non-HIV immunocompromised (36%) and immunocompetent (40%) groups (P < 0.0001). Only 22% received the recommended antifungal combination therapy, which was significantly higher in immunocompetent children than those with HIV (39% vs. 6.8%; P < 0.0001). Overall mortality was 23%. A significant higher mortality was observed in children with HIV compared with immunocompetent children (32% vs. 16%; P < 0.001), but not compared with children with non-HIV immunosuppression (25). Conclusions: This is the largest review of pediatric cryptococcosis with new observations on differences in clinical presentation and outcome depending on the underlying condition. The lack of granular clinical data urges prospective clinical epidemiological studies for improved insight in the epidemiology, management and outcome of cryptococcosis in children.

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“…HIV-1 infection in the pediatric population has a distinct pattern of disease progression, ranging from a fast progression to AIDS and high mortality in the first two years of life to an intermediate and a slow progression. 2,28 Currently, pediatricians are providing care to a higher number of HIV-1 children at risk of acquiring HIV, then infected by HIV. In this analysis, seven (8.6%) patients were diagnosed by the age of 10 or later, all of them were symptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…38,39 The association of subtype C and R5 tropism, considering all patients have been infected for an extensive period of time, is also previously reported that indicates the occurrence of X4 or dual tropic virus appears to be rare in this clade. 17–43 A conserved nature of HIV-1 C subtype V3 sequence may reduce the possibility of coreceptor switch in these viruses, which may explain the low prevalence of X4-tropic in this population. 44 Nevertheless, a study conducted in India, which included only HIV-1 subtype C perinatally-infected patients, showed a higher prevalence of X4 tropic strains in an older population.…”

Section: Discussionmentioning

confidence: 99%

Young adults HIV-1 infected by vertical transmission in southern Brazil – Clinical, demographic, and virological features

et al. 2017

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Combination antiretroviral therapy promotes longer life expectancy, making it possible for perinatally HIV-infected patients to achieve adulthood. Past therapy was not always optimized, suggesting that virological and host features may also play a role in survival. The aim of this study is to describe characteristics of HIV disease progression associated with virological features in adolescents perinatally that were HIV infected. A case series was conducted including 81 patients that were in follow-up at Hospital de Clínicas/Universidade Federal do Paraná, Curitiba, Brazil. Venous blood was collected to conduct tropism and viral subtype assays. The median age was 19 years old (interquartile range 18-21), and a majority of patients were female (54.3%). Viral subtype was obtained for 66 (82%) patients, and subtypes B and C were found in 34% and 59%, respectively. Tropism assay was conducted in 55 (67%) patients: 71% were R5 and 29% X4. Distribution of viral tropism and subtype shows a significant association of subtype C with R5 tropism. Subtype C is more prevalent in southern Brazil and also in the population infected with HIV by vertical transmission. Both R5 tropism and subtype C are associated with slower progression to AIDS. The survival of these patients may be related to virological features present in a benign pattern of disease progression.

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Characteristics of HIV-positive patients infected by vertical transmission, Campo Grande, MS, Brazil, 1993–2009

Abstract: Despite the availability of drugs and appropriate laboratory tests, a significant number of paediatric patients were failing ARV therapy due to non-adherence. Further interventions to enhance adherence in this population are needed.

Cited by 6 publications

References 8 publications

MLST-Based Population Genetic Analysis in a Global Context Reveals Clonality amongst Cryptococcus neoformans var. grubii VNI Isolates from HIV Patients in Southeastern Brazil

MLST-Based Population Genetic Analysis in a Global Context Reveals Clonality amongst Cryptococcus neoformans var. grubii VNI Isolates from HIV Patients in Southeastern Brazil

Pediatric Cryptococcosis

Young adults HIV-1 infected by vertical transmission in southern Brazil – Clinical, demographic, and virological features

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