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      Rotavirus infection in children and adult patients attending in a tertiary Hospital of São Paulo, Brazil

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          Abstract

          During the period of January 2003 to December 2005, 3,768 stool samples were received in the Microbiology Laboratory for rotavirus antigen detection from outpatients and inpatients of Albert Einstein Hospital, SP. Fresh stool samples from children and adults were analyzed by two methodologies: during 2003 and 2004 by latex agglutination (Slidex Rotavirus, Biomerieux) and 2005 by an immunochromatographic assay for the combined detection of rotavirus and adenovirus (Vikia Rota-Adeno, Biomerieux). Rotavirus group A was detected in 755 (20%) samples. The annual prevalence was 19.8% in 2003, 21.7% in 2004, and 18.7% in 2005. Rotavirus was detected every month during the period of the study, with peak of positivity between June and August (>35%). The prevalence in hospitalized patients was 26.1% (352/1,350) and in outpatients was 16.7% (403/2,418). For hospitalized patients most of the rotavirus infections were diagnosed in Pediatric setting, age range of 0 to 10 years (prevalence of 55.3%, 295/534). Overall positivity was up to 30% in patients between six months and five years of age (67% of all positive patients), all other age groups had at least 10% positive tests. Rotavirus infection is common in Sao Paulo, and besides the expected higher frequency in children it is also frequent in adults.

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          Influence of viral hepatitis on HIV infection.

          The natural history of HBV is known to be complicated by HIV-co-infection. In contrast, the effect of HBV on the outcome of patients infected with HIV-1 is controversial. Some cohort studies from the pre-HAART era described a more rapid progression to AIDS in patients carrying antibodies to the core-antigen or having chronic HBV infection, but post-HAART studies did not detect any impact of HBV co-infection on HIV-disease progression. Similarly, studies assessing the impact of HCV on progression of HIV-disease delivered conflicting results. In the Swiss cohort study, the presence of HCV was independently associated with an increased risk of progression to AIDS and death. Subsequent studies, however, did not find any difference in survival. Most interestingly, the EuroSIDA cohort analysis found no difference between HCV-positive and HCV-negative HIV-patients starting HAART in the time needed to decrease viral loads to less than 400 copies as well as in the time needed to increase CD4-counts by 50%. In summary, there are no major differences in HIV-related mortality between hepatitis B or C co-infected individuals and patients infected with HIV alone, particularly if antiretroviral treatment is given. There is, however, an increased risk of liver disease related morbidity and mortality as well as more hepatoxicity under antiretroviral treatment regimens.
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            Epidemiologia das infecções por rotavírus no Brasil e os desafios para o seu controle

            Os rotavírus causam de 600.000 a 870.000 óbitos por ano entre crianças em todo o mundo. Esses vírus foram visualizados pela primeira vez no Brasil em 1976, a partir da microscopia eletrônica das fezes de crianças diarréicas em Belém, Pará. Estudos conduzidos em hospitais registraram prevalência de diarréia por rotavírus de 12% e 42%. A par disso, investigações longitudinais assinalaram taxa média de 0,25 episódio de diarréia por criança/ano. Os tipos G1, G2, G3 e G4 representam cerca de 2/3 das amostras circulantes, porém, sustenta-se que o genótipo P[8], G5 associa-se a, no mínimo, 10% das diarréias. Estudos sobre a imunidade natural para rotavírus revelaram que 70% das crianças adquirem anticorpos já aos 4-5 anos de idade. A vacina tetravalente, de origem símio-humana (RRV-TV) conferiu proteção de 35% após dois anos de estudo; contudo, o nível protetor alcançou 60% no primeiro ano de vida. A RRV-TV, no norte do Brasil, revelou eficácia de 75% frente às diarréias graves. Há poucos meses interrompeu-se o uso dessa vacina nos EUA devido à ocorrência de intussuscepção como efeito colateral. É provável que futuros experimentos no Brasil contemplem outras "candidatas" a vacina contra rotavírus, que não a RRV-TV.
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              Rotavirus infection in Brazil: epidemiology, immunity, and potential vaccination

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                bjid
                Brazilian Journal of Infectious Diseases
                Braz J Infect Dis
                Brazilian Society of Infectious Diseases (Salvador )
                1678-4391
                February 2008
                : 12
                : 1
                : 44-46
                Affiliations
                [1 ] Universidade Federal de São Paulo Brazil
                [2 ] Albert Einstein Hospital Brazil
                Article
                S1413-86702008000100010
                10.1590/S1413-86702008000100010
                18553013
                8fccbf29-788d-45a3-9c1d-55c5c5eb4057

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1413-8670&lng=en
                Categories
                INFECTIOUS DISEASES

                Infectious disease & Microbiology
                Rotavirus,gastroenteritis
                Infectious disease & Microbiology
                Rotavirus, gastroenteritis

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