A dissertation submitted to the Faculty of Medicine, University of the Witwatersrand, in partial fulfilment of the requirements for the degree Master of Medicine (Virology) / This study was undertaken to determine the role of human parvovlrus B19 (B19) in chronic anaemia of HIV infected TB patients. Patlents were selected from an existing databank of 307 patients included in a MRC HIV/TB study. Twenty-nine patients, 15 colnfected with HIV /TB and 14 Infected with TB only, were identified for further evaluation. These patient's era were subjected to serological and DNA detection studies using IgG and IgM ELISA methods and a nested polymerase chain reaction (PCR) assay. The selection of the nested PCR was based on comparative evaluation of a new rapid 99 cycle PCR method recommended for hepatitis B DNA detection and the nested PCR method established for B19. The nested assay was shown to be the more sensitive system in the context of B19 DNA detection. Serological evaluation of these 29 patients suggested that a greater proportion of HIV/TB patients with chronic anaemia had evidence of recent or past exposure to B19 than those not experiencing anaemia. The nested PCR demonstrated the presence of circulating B19 DNA in 2 coinfected individuals with haematological pictures compatible with persistent B19 infection. B19 DNA was also demonstrated in a TB only patient without anaemia; further haematological and serological evidence in this patient suggested recent exposure to B19. The serological and DNA amplification assay results of these 29 patients would suggest a possible role - either causal or co-factorial - for persistent B19 infection in the establishment of chronic anaemia in HIV/TB patients. / Andrew Chakane 2019

A dissertation submitted to the Faculty of Medicine, University of the Witwatersrand, in partial fulfilment of the requirements for the degree Master of Medicine (Virology) / This study was undertaken to determine the role of human parvovirus B19 (B19) in chronic anaemia of HIV infected TB patients. Patlents were selected from an existing databank of 307 patients included ln a MRC HIV/TB study. Twenty-nine patients, 15 colnfected with HIV/TB and 14 Infected with TB only, were identified for further evaluation. These patients' sera were subjected to serological and DNA detection studies using IgG and IgM ELISA methods and a nested polymerase chain reaction (PCR) assay. The selection of the nested PCR was based on comparative evaluation of a new rapid 99 cycle PCR method recommended for hepatitis B DNA detection and the nested PCR method established for B19. The nested assay was shown to be the more sensitive system in the context of B19 DNA detection. Serological evaluation of these 29 patients suggested that a greater proportion of HIV/TB patients with chronic anaemia had evidence of recent or past exposure to B19 than those not experiencing anaemia. The nested PCR demonstrated the presence of circulating B19 DNA in 2 coinfected individuals with haematological pictures compatible with persistent B19 infection. B19 DNA was also demonstrated in a TB only patient without anaemia; further haematological and serological evidence in this patient suggested recent exposure to B19. The serological and DNA amplification assay results of these 29 patients would suggest a possible role - either causal or co-factorial - for persistent B19 infection in the establishment of chronic anaemia in HIV/TB patients. / Andrew Chakane 2019

Reproduction de : Thèse d'exercice : Médecine : Nancy 1 : 2004. / Titre provenant de l'écran-titre.

O eritrovírus humano (parvovírus), gênero Erytrovírus, é o único representante da família Parvoviridae responsável por um amplo espectro de doenças. Estudos recentes têm demonstrado variações entre o eritrovírus e orientam a reclassificação destas variantes em três genótipos distintos: genótipos 1, 2 e 3. O papel do eritrovírus na etiopatogenia de doenças hematológicas em humanos permanece incerto. Este estudo teve como objetivo principal avaliar a relação etiopatogênica dos genótipos do eritrovírus e as citopenias de origem desconhecida. Materiais e Métodos: Participaram do estudo 285 indivíduos procedentes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Destes, 120 apresentavam citopenias de origem desconhecida (grupo 1 Casos), 45 eram doadores de medula óssea (grupo 2 Controles Saudáveis) e 120 eram pacientes com doenças oncohematológicas crônicas (grupo 3 Controles com Neoplasias Hematológicas). A pesquisa do vírus foi realizada pelo método de semi-nested PCR (Reação em Cadeia da Polimerase) em amostras de medula óssea e de sangue periférico. As fitas complementares foram seqüenciadas diretamente do produto da PCR. Amostras de plasma de todos os indivíduos incluídos no estudo foram testadas para presença de anticorpos IgG e IgM específicos contra o eritrovírus por ensaio imunoenzimático. Resultados: Dos 40 indivíduos com resultado positivo na PCR em amostra da medula óssea, o genótipo 1 foi encontrado em 22 (55%), o genótipo 2 em 5 (12,5%), o genótipo 3 em 13 (32,5%). Quando comparadas as freqüências de positividade entre os casos e controles (Grupo 1 VS Grupos 2 e 3), não encontramos diferença significativa com relação ao genótipo 1 (p=0, 192) nem com relação aos genótipos 2 e 3 (p= 0.143). A soroprevalência encontrada na amostra foi de 71%. Conclusão: Concluímos que a infecção isolada pelo eritrovírus, independente do genótipo encontrado, não tem relação etiopatogênica com as citopenias de origem desconhecida, uma vez que o vírus foi encontrado com a mesma freqüência nos casos e nos controles estudados / The human erythrovirus (parvovirus), genus Erytrovirus, is the only representative of the family Parvoviridae responsible for a broad spectrum of diseases. Recent studies have shown variations within the erythrovirus and guide the classification of these variants in three distinct genotypes: genotypes 1, 2 and 3. The role of the erythrovirus in the etiopathogenesis of hematological diseases in humans remains uncertain. This studys main objective was to evaluate the etiopathogenic relationship between the genotypes of the erythrovirus and the cyptopenias of unknown origins. Methods and Materials: 285 individuals coming from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo participated in the study. Of these, 120 represented cytopenias of unknown origins (group one Cases), 45 were bone marrow donors (group two - Healthy Controls), and 120 were patients with chronic oncohematological diseases (group three Controls with Hematological Disorder). The research of the virus was done through the semi-nested PCR method (polymerase chain reaction) in bone marrow and peripheral blood samples. The complementary strands were sequenced directly from the product of the PCR. Plasma samples from all of the individuals included in the study were tested through immunosorbent assay for the presence of lgG and IgM antibodies specific to the eritrovírus. Results: Of the 40 individuals that had positive PCR bone marrow results, the genotype 1 was found in 22 (55%), the genotype 2 in 5 (12.5%), and genotype 3 in 13 (32.5%). When the frequency of positivity was compared between the cases and the controls (Group 1 vs. Groups 2 and 3), we did not find a significant difference in relation to genotype 1 (p=0.192), nor did we find a significant difference in relation to genotypes 2 and 3 (p=0.143). The overall seroprevalence found in the samples was 71%. Conclusion: We conclude that the infection isolated by the erytrovirus, independent of the genotype found, does not have a etiopathogenic relationship with the cytopenias of unknown origins, hence the virus was found with the same frequency in the cases and the controls studied

O eritrovírus humano (parvovírus), gênero Erytrovírus, é o único representante da família Parvoviridae responsável por um amplo espectro de doenças. Estudos recentes têm demonstrado variações entre o eritrovírus e orientam a reclassificação destas variantes em três genótipos distintos: genótipos 1, 2 e 3. O papel do eritrovírus na etiopatogenia de doenças hematológicas em humanos permanece incerto. Este estudo teve como objetivo principal avaliar a relação etiopatogênica dos genótipos do eritrovírus e as citopenias de origem desconhecida. Materiais e Métodos: Participaram do estudo 285 indivíduos procedentes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Destes, 120 apresentavam citopenias de origem desconhecida (grupo 1 Casos), 45 eram doadores de medula óssea (grupo 2 Controles Saudáveis) e 120 eram pacientes com doenças oncohematológicas crônicas (grupo 3 Controles com Neoplasias Hematológicas). A pesquisa do vírus foi realizada pelo método de semi-nested PCR (Reação em Cadeia da Polimerase) em amostras de medula óssea e de sangue periférico. As fitas complementares foram seqüenciadas diretamente do produto da PCR. Amostras de plasma de todos os indivíduos incluídos no estudo foram testadas para presença de anticorpos IgG e IgM específicos contra o eritrovírus por ensaio imunoenzimático. Resultados: Dos 40 indivíduos com resultado positivo na PCR em amostra da medula óssea, o genótipo 1 foi encontrado em 22 (55%), o genótipo 2 em 5 (12,5%), o genótipo 3 em 13 (32,5%). Quando comparadas as freqüências de positividade entre os casos e controles (Grupo 1 VS Grupos 2 e 3), não encontramos diferença significativa com relação ao genótipo 1 (p=0, 192) nem com relação aos genótipos 2 e 3 (p= 0.143). A soroprevalência encontrada na amostra foi de 71%. Conclusão: Concluímos que a infecção isolada pelo eritrovírus, independente do genótipo encontrado, não tem relação etiopatogênica com as citopenias de origem desconhecida, uma vez que o vírus foi encontrado com a mesma freqüência nos casos e nos controles estudados / The human erythrovirus (parvovirus), genus Erytrovirus, is the only representative of the family Parvoviridae responsible for a broad spectrum of diseases. Recent studies have shown variations within the erythrovirus and guide the classification of these variants in three distinct genotypes: genotypes 1, 2 and 3. The role of the erythrovirus in the etiopathogenesis of hematological diseases in humans remains uncertain. This studys main objective was to evaluate the etiopathogenic relationship between the genotypes of the erythrovirus and the cyptopenias of unknown origins. Methods and Materials: 285 individuals coming from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo participated in the study. Of these, 120 represented cytopenias of unknown origins (group one Cases), 45 were bone marrow donors (group two - Healthy Controls), and 120 were patients with chronic oncohematological diseases (group three Controls with Hematological Disorder). The research of the virus was done through the semi-nested PCR method (polymerase chain reaction) in bone marrow and peripheral blood samples. The complementary strands were sequenced directly from the product of the PCR. Plasma samples from all of the individuals included in the study were tested through immunosorbent assay for the presence of lgG and IgM antibodies specific to the eritrovírus. Results: Of the 40 individuals that had positive PCR bone marrow results, the genotype 1 was found in 22 (55%), the genotype 2 in 5 (12.5%), and genotype 3 in 13 (32.5%). When the frequency of positivity was compared between the cases and the controls (Group 1 vs. Groups 2 and 3), we did not find a significant difference in relation to genotype 1 (p=0.192), nor did we find a significant difference in relation to genotypes 2 and 3 (p=0.143). The overall seroprevalence found in the samples was 71%. Conclusion: We conclude that the infection isolated by the erytrovirus, independent of the genotype found, does not have a etiopathogenic relationship with the cytopenias of unknown origins, hence the virus was found with the same frequency in the cases and the controls studied

O parvovírus B19 é o agente causador de eritemas infecciosos em crianças, hidropsia fetal em mulheres gestantes, esse vírus pode causar anemia crônica e crise aplástica transitória respectivamente. A levedura P. pastoris é um sistema de expressão usado na produção de várias proteínas heterólogas. O objetivo deste trabalho foi expressar as proteínas VP1 e VP2 do parvovírus humano B19 em levedura P. pastoris. As seqüências gênicas VP1 e VP2 foram amplificadas por PCR, usando DNA do vírus B19, os produtos obtidos foram inicialmente subclonados no vetor pGEM-TEasy. Os fragmentos de DNA foram digeridos com enzima de restrição EcoRI e NotI , purificados e inseridos no vetor de expressão e excreção pPIC9K de P. pastoris, entre os sítios EcoRI e NotI. Para expressão das proteínas recombinantes VP1 e VP2 de parvovírus humano B19, os transformantes foram crescidos em glicerol e induzidos pela adição de metanol. As expressões dos antígenos recombinantes foram analisadas por SDS-PAGE e atividade biológica foram confirmadas pelos ensaios imunológicos ELISA, Dot-Blot e Western Blot. / Human Parvovirus B19 is the causative agent of erythema infectiosum in children, hydrops fetalis in pregnant women, B19 may cause chronic anemia and aplastic crisis, respectively. The yeast P. pastoris expression system is being used for the production of various recombinant heterologous proteins. The objective of this work was to express the VP1 and VP2 proteins of the human parvovirus B19 in the yeast Pichia pastoris. The coding sequence of VP1 and VP2 were amplified by PCR, using DNA virus of B19. PCR-products were initially subcloned in the vector pGEM-TEasy. The DNA fragment EcoRI and NotI was excised, purified, and inserted between the sites EcoRI and NotI of P. pastoris expression-secretion vector pPIC9K.For heterologous expression of the proteins VP1 and VP2 Human parvovirus B19, the transformants were growth on glycerol and induced by the addition of methanol. The expressed recombinant antigens VP1 and VP2 were analyzed by SDS-PAGE and its biological activity were confirmed through Enzyme immunoassay EIA, Dot-Blot e Western Blot.

Foi realizado um estudo seccional sobre a situação epidemiológica da brucelose bovina no Estado de Tocantins com o objetivo de avaliar a eficácia do programa de vacinação implementado. O Estado foi dividido em cinco regiões e em cada uma delas foi aleatoriamente amostrado um número pré-estabelecido de propriedades. Dentro de cada propriedade, fêmeas com idade igual ou superior a 24 meses foram aleatoriamente selecionadas e submetidas à sorologia em série para o diagnóstico da brucelose (AAT e 2-Mercaptoetanol). Ao todo foram examinados 6.846 animais oriundos de 756 propriedades. A prevalência de focos no estado foi de 6,42% [4,76 -8,62] e a de animais 2,21% [1,05 - 4,01]. A prevalência de focos apresentou-se homogeneamente distribuída entre as cinco regiões. Como o estudo realizado em 2003/2003 estimou a prevalência de focos no estado em 21,22% [19,33 - 23,11], conclui-se que o programa de vacinação implementado pelo Tocantins reduziu a prevalência de maneira importante. Assim, recomenda-se que o estado continue seu programa de vacinação, dando grande ênfase para a qualidade dos procedimentos, desde a comercialização do insumo até a inoculação nos animais, pois a imunização ainda é a maneira mais racional de se reduzir a prevalência da brucelose bovina no seu território. Adicionalmente, o estado deve implementar uma forte ação de educação sanitária para que os produtores passem a testar os animais para brucelose antes de introduzi-los nos seus rebanhos, pois verificou-se que a reposição de animais está associada à condição de foco de brucelose bovina. / A cross-sectional study on the situation of bovine brucellosiswas was carried out in the State of Tocantins in order to evaluate the effectiveness of the vaccination program implemented. The state was divided into five regions and in each of them was randomly sampled a pre-established number of farms. Within each property, females aged 24 months or older were randomly selected and submitted to serology for the diagnosis of brucellosis (AAT and 2-ME). A total of 6,846 animals, from 756 farms, were examined. The prevalence of infected herds in the state was 6.42% [4.76 - 8.62] and the prevalence of seropositive animals was 2.21% [1.05 - 4.01]. The prevalence of infected herds was homogeneously distributed among the regions. As the 2003/2003 study estimated the prevalence of infected herds in the state in 21.22% [19.33 - 23.11], it was concluded that the vaccination program implemented by Tocantins significantly reduced prevalence. Thus, it is recommended that the state continue its vaccination program, placing emphasis on the quality of the procedures, from the comercialization of the vaccine to the animal inoculation, since immunization is still the most rational way to reduce the prevalence of brucellosis on its territory. In addition, the state should implement a strong health education program so that farmers start testing animals for brucellosis before introducing them into their herds, as it has been verified that the replacement of animals is the major risk factor for bovine brucellosis in Tocantins.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 5 uppsatser.

Memoria para optar al Título Profesional de Médico Veterinario / Fundamentos: Parvovirus B19 (PV-B19) pertenece a la familia Parvoviridae, género Eritrovirus. Es un virus ADN de hebra simple que presenta secuencias palindrómicas en sus extremos. Es muy prevalente en la población general, llegando a detectarse anticuerpos anti PV-B19 en más del 85% de la población geriátrica. Este virus es el agente causal de una amplia gama de manifestaciones clínicas, cuya severidad depende del estado inmunológico y hematológico del hospedero, e incluye el eritema infeccioso, problemas hematológicos y reumatológicos e hidrops fetal, entre otras. Objetivo: Se determinó la presencia de Parvovirus B19 en pacientes con manifestaciones clínicas asociadas a este virus. Materiales y Métodos: Se analizaron 262 muestras de sangre de pacientes provenientes de distintos centros hospitalarios de la Región Metropolitana y del Servicio de Diagnóstico del Programa de Virología, Facultad de Medicina, Universidad de Chile. De estas muestras, 211 fueron analizadas mediante la técnica de ELISA para la pesquisa de IgM anti PV-B19, 244 con PCR anidado (PCR-Nested), para detectar genoma viral y 185 muestras con ambas técnicas. Resultados: De las muestras analizadas mediante la técnica de PCR anidado, se detectó genoma viral en un 25% de éstas y de las muestras analizadas mediante la técnica de ELISA, se localizó IgM anti PV-B19 en un 19%. Considerando sólo las 185 muestras que fueron analizadas con ambas técnicas, se detectó un 31.9% de positividad. En los casos positivos para el virus, las manifestaciones clínicas prevalentes fueron síndrome febril y eritema infeccioso

La etiología de la arteritis de células gigantes (ACG) es desconocida y sus aspectos etiopatogénicos están poco estudiados.Objetivos. 1. Estudiar la presencia de parvovirus B19 y los virus herpes en las arterias temporales positivas y negativas para la ACG. 2. Estudiar la asociación entre la expresión de metaloproteinasa-2 (MMP-2) y 9 (MMP-9) y el resultado de la biopsia de la arteria temporal (BAT), qué células las expresan y su localización. 3. Analizar si la presencia de estas MMP o los virus se relaciona con las alteraciones histológicas y con las variables clínico-epidemiológicas de los pacientes. 4. Conocer cuáles son los factores predictores del resultado de la BAT. Material y métodos. Se incluyeron todas las BAT valorables realizadas de forma consecutiva en el Hospital Universitari Vall d'Hebron por sospecha clínica de ACG entre Enero de 1997 y Marzo del 2002. Como criterios anatomopatológicos se utilizaron los del ACR. La presencia de ADN vírico se determinó mediante reacción en cadena de la polimerasa. Se realizaron nuevas tinciones de hematoxilina-eosina, de fibras elásticas y tricrómicro de Masson. Los macrófagos CD68, la MMP-2 y la MMP-9 se detectaron mediante inmunohistoquímica. De las historias clínicas se obtuvieron datos clínicos y epidemiológicos. Para el ajuste multivariable se utilizó la regresión logística múltiple.Resultados. En el período en estudio se encontraron 147 BAT válidas, 50 (35%) positivas para ACG y 97 (66%) negativas. Se recuperó la historia clínica de 125 pacientes, 46 (36,8%) con BAT (+) y 79 (63,2%) BAT (-). No se encontró presencia de ADN de los virus estudiados en ninguna de las BAT. La MMP-9 se expresaba con más frecuencia en BAT positivas que negativas para ACG (OR=2,93 p=0,005). Para la MMP-2 la diferencia no fue estadísticamente significativa (p=0,08). Ambas MMP se expresaban en macrófagos de la íntima y de la media cercanos a la lámina elástica interna, en células gigantes y en células con apariencia de músculo liso de la media y de la íntima. Le expresión de MMP-2 se relacionó de forma inversa con la afectación exclusiva de la adventicia (p=0,047) y de forma positiva con la fiebre (p=0,025). La MMP-9 se relacionó de forma positiva con: hiperplasia intimal (0,037), degeneración lámina elástica (0,0001), disminución de la luz (0,008), hipercolesterolemia (0,032), hiperestesia craneal (0,009). Ajustando por variables que podrían influir en el resultado de la biopsia, (edad, género, tiempo de evolución de los síntomas hasta la BAT, tratamiento previo con glucocorticoides y año de realización de la biopsia), se mantuvieron los resultados entre la expresión de MMP-2 y MMP-9. El engrosamiento de la arteria temporal, la disminución de su pulso y la pérdida de peso se asociaron de forma independiente con el resultado de la biopsia, ajustando por edad, género, días de evolución, tratamiento previo, año de realización, cefalea, hiperestesia craneal, claudicación mandibular, alteraciones visuales y VSG.Conclusiones. Ninguno de los virus estudiados parece estar implicado en la etiopatogenia de la ACG. La MMP-9, al contrario de la MMP-2, parece tener un papel en dicha etiopatogenia. La MMP-9 se asocia con hipercolesterolemia y la MMP-2 con la fiebre. El engrosamiento, la disminución de la luz de la arteria temporal y la pérdida de peso se han encontrado asociadas a una elevada probabilidad de resultado positivo de la biopsia en los enfermos estudiados. / The etiology of giant cell arteritis (GCA) is unknown and their etiopathogenic aspects have been little studied.Aims. 1. To study the presence of parvovirus B19 and herpes viruses in positive and negative temporal artery biopsies (TAB) for GCA. 2. To study the association between metalloproteinase-2 (MMP-2) and 9 (MMP-9) expression and TAB result, the type of cells expressing them and their location. 3. To analyse if the presence of these MMP or the viruses is related to histologic findings and to clinical-epidemiological variables of the patients. 4. To identify predictive factors of TAB result. Material and methods. All the valid TAB consecutively performed in Hospital Universitari Vall d'Hebron because of clinical suspicion of GCA between January 1997 and March 2002. ACR anatomopathological criteria were used. The presence of viral DNA was determined by means of polymerase chaín reaction. New hematoxilin-eosin, elastic fibers and Masson's trichromic stainings were performed. CD68 macrophages, MMP-2 and MMP-9 were detected by immunohistochemistry. Clinical and epidemiological data were obtained from clinical files. The multiple logistic regression was used for multivariable analysis. Results. During the study period, 147 valid TAB were found, 50 (35%) positive and 97 (66%) negative for GCA. Clinical files of 125 patients were retrieved, 46 (36.8%) with positive TAB and 79 (63.2%) with negative TAB. DNA of the viruses studied was not found in any of the TAB. MMP-9 was more frequently expressed in positive than in negative TAB for GCA (OR=2.93; p=0.005). The difference was not statistically significant for MMP-2 (p=0.08). Both MMP were expressed in macrophages of the intima and the media near internal elastic lamina, in giant cells and in cells of the media and the intima resembling smooth muscle cells. The expression of MMP-2 was inversely related to the isolated involvement of the adventitia (p=0.047) and positively to fever (p=0.025). MMP-9 was positively related to: intimal hyperplasia (0.037), elastic lamina degeneration (0.0001), luminal narrowing (0.008), hypercholesterolemia (0.032), scalp tenderness (0.009). Controlling for variables which could influence the biopsy result (age, gender, evolution of symptoms before TAB, previous glucocorticoids treatment and year of biopsy performance), the results between MMP-2 and MMP-9 expression remained unaltered. Temporal artery thickening, pulse decrease and weight loss were independently associated with biopsy result, controlling for age, gender, days of evolution of symptoms, previous treatment, year of biopsy performance, headache, scalp tenderness, jaw claudication, visual disturbances and erythrocyte sedimentation rate.Conclusions. None of the viruses studied seems to be involved in GCA etiopathogenesis. MMP-9, in contrast to MMP-2, seems to play an etiopathogenic role in GCA. MMP-9 is associated with hypercholesterolemia and MMP-2 with fever. Temporal artery thickening and luminal narrowing and weight loss are associated with a high probability of positive biopsy result in the patients studied.