Estudo das alterações linfocitárias CD4/CD8 e carga viral em pacientes co-infectados HIV/Mycobacterium tuberculosis associadas a frequência de mutações na região Pol do HIV-1
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2007-08-16
Autores
Silva, Juliana Cristina da [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Com o surgimento da Síndrome da Imunodeficiência Adquirida (AIDS) em 1981, observou-se tanto em países desenvolvidos como nos países em desenvolvimento um aumento do número de casos notificados de Tuberculose, principalmente em indivíduos infectados pelo HIV. Como agravante nos casos de co-infecção, existe a resistência aos anti-retrovirais, e uma das principais razões é a grande variabilidade genética do HIV. A genotipagem do HIV tornou-se uma ferramenta essencial para orientar e maximizar os benefícios do tratamento anti-retroviral dos pacientes HIV positivos. Neste estudo, pretendeu-se avaliar em um período de 6 meses os perfis imunológico e viral associados à freqüência de mutações no gene “pol” do HIV-1 em pacientes co-infectados HIV-Tuberculose. A casuística compreendeu 33 indivíduos de ambos os sexos e faixa etária entre 12 e 63 anos. Quatro grupos foram estudados: Grupo A (n=19) HIV tratando com anti-retroviral; e co-infectados: Grupo B (n=7) tratando com anti-retroviral; Grupo C (n=4) tratando com tuberculostático e Grupo D (n=3) tratando com anti-retroviral e tuberculostático. O perfil imunológico foi avaliado pela determinação quantitativa de fenótipos CD3/CD4 e CD3/CD8 de linfócitos do sangue periférico; perfil viral foi determinado pela quantificação da viremia RNA-HIV-plasmática; e os polimorfismos na região genômica “pol” avaliado pelo sequenciamento de cDNA. No entanto, na avaliação das contagens de Linfócitos T CD4/CD8 realizada para comparar os grupos foi notada uma tendência de redução das medianas no grupo D, pacientes que realizam tratamento duplo. Os demais grupos apresentaram um perfil imunológico satisfatório (CD4>400 células/μl) e a relação CD4/CD8 mantida inferior a 1.0. Dentre esses, o grupo que melhor apresentou perfil imunológico foi o constituído por indivíduos...
With the outbreak of the Acquired Immunodeficiency Syndrome (AIDS) in 1981, it was observed both in developed countries and in developing countries an increase in the number of known cases of Tuberculosis, mainly in HIV infected individuals. As an aggravation in the co-infection cases there is the anti-retroviral resistance, and one of the main reasons is the HIV great genetic variability. The HIV genotyping became an essential tool to guide and maximize the benefits of the anti-retroviral treatment of positive HIV patients. In this study, it was intended to evaluate in a period of 6 months the immunology and viral profiles associated with the frequency of mutations in the HIV-1 “pol” gene in HIV-Tuberculosis co-infected patients. The study involved 33 individuals of both the sexes and ages between 12 and 63 years. Four groups were studied: Group A (n=19) HIV only under treatment with anti-retroviral drugs; and co-infected: Group B (n=7) under treatment with anti-retroviral drugs; Group C (n=4) under treatment with tuberculostatic drugs and Group D (n=3) under treatment with anti-retroviral and tuberculostatic drugs. The immunology profile was evaluated by quantitative determination of phenotype CD3/CD4 and CD3/CD8 of peripheral blood lymphocytes; viral profile was determined by quantification of the RNA-HIV-plasmatic viremia; and the polymorphisms in the “pol” genomic region were evaluated by sequencing of cDNA. The results were evaluated by non parametric “t” test and ANOVA and the demonstrated median showed that there was not significant difference (p>0,05) among the parameters of CD4/CD8 and viral load in the different studied groups. However, in the Lymphocyte counting evaluation the T CD4/CD8 carried out to compare the groups it was noticed a median reduction trend in group D, patients under double treatment. The other groups presented a satisfactory immunology profile (CD4>400 cells/μl) and the relation CD4/CD8 was kept below 1.
With the outbreak of the Acquired Immunodeficiency Syndrome (AIDS) in 1981, it was observed both in developed countries and in developing countries an increase in the number of known cases of Tuberculosis, mainly in HIV infected individuals. As an aggravation in the co-infection cases there is the anti-retroviral resistance, and one of the main reasons is the HIV great genetic variability. The HIV genotyping became an essential tool to guide and maximize the benefits of the anti-retroviral treatment of positive HIV patients. In this study, it was intended to evaluate in a period of 6 months the immunology and viral profiles associated with the frequency of mutations in the HIV-1 “pol” gene in HIV-Tuberculosis co-infected patients. The study involved 33 individuals of both the sexes and ages between 12 and 63 years. Four groups were studied: Group A (n=19) HIV only under treatment with anti-retroviral drugs; and co-infected: Group B (n=7) under treatment with anti-retroviral drugs; Group C (n=4) under treatment with tuberculostatic drugs and Group D (n=3) under treatment with anti-retroviral and tuberculostatic drugs. The immunology profile was evaluated by quantitative determination of phenotype CD3/CD4 and CD3/CD8 of peripheral blood lymphocytes; viral profile was determined by quantification of the RNA-HIV-plasmatic viremia; and the polymorphisms in the “pol” genomic region were evaluated by sequencing of cDNA. The results were evaluated by non parametric “t” test and ANOVA and the demonstrated median showed that there was not significant difference (p>0,05) among the parameters of CD4/CD8 and viral load in the different studied groups. However, in the Lymphocyte counting evaluation the T CD4/CD8 carried out to compare the groups it was noticed a median reduction trend in group D, patients under double treatment. The other groups presented a satisfactory immunology profile (CD4>400 cells/μl) and the relation CD4/CD8 was kept below 1.
Descrição
Palavras-chave
HIV-1, Mycobacterium tuberculosis, Contagem de linfócitos
Como citar
SILVA, Juliana Cristina da. Estudo das alterações linfocitárias CD4/CD8 e carga viral em pacientes co-infectados HIV/Mycobacterium tuberculosis associadas a frequência de mutações na região Pol do HIV-1. 2007. 110 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Ciências Farmacêuticas, 2007.