Ocorrência de vírus influenza, vírus sincicial respiratório e SARS-CoV-2 no período pandêmico da covid-19, em pessoas que vivem com HIV/aids
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Data
2022-07-29
Autores
Bezerra, Neilton Paulo
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Universidade Estadual Paulista (Unesp)
Resumo
Infecções respiratórias de vias aéreas inferiores têm sido classificadas como uma das principais causas de morte no mundo. Pessoas que vivem com HIV/aids (PVHA) apresentam maior risco de infecção por agentes causadores de síndromes gripais devido à sua condição de imunossupressão. Diante disso, o objetivo desta pesquisa, foi avaliar a ocorrência de infecções respiratórias causadas pelos vírus: influenza, vírus sincicial respiratório (VSR) e SARS-CoV-2 em PVHA, no período de 2020 a 2022. Além disso, avaliar a ocorrência e mortalidade de infecções causadas pelos vírus respiratórios citados acima e identificar os fatores sociodemográficos e clínicos das PVHA. A partir, de secreções de nasoorofaringe de 57 PVHA, e que apresentaram quadro gripal, foi extraído o material genético utilizando o kit BIOPUR Mini Spin Vírus DNA/RNA 2.0, seguido por transcrição reversa e Reação em Cadeia da Polimerase (RT-PCR) no aparelho Hybrispot 12 PCR Auto, utilizando o kit de detecção XGEN Multi PR24 Flow Chip. Após a amplificação, ocorreu hibridização reversa em um chip que é composto por uma membrana de nylon (tecnologia Flow Chip) que permite a detecção de até 24 patógenos, posteriormente os resultados dos ensaios foram validados. Das 57 PVHA, 32 (56,2%) eram do sexo masculino, com mediana de 42 anos [21 - 68] de idade. Em 36 (63,2%) pacientes houve detecção de algum vírus do painel de patógenos. Do total da casuística, 27 (47,5%) correspondiam aos três vírus estudados, sendo 18 (31,5%) do SARS-CoV-2, oito (14,0%) do VSR e um (2,0%) da influenza. Em 21 (36,8%) pacientes não foram identificados quaisquer dos vírus. Três pacientes evoluíram a óbito durante o estudo, apresentando quadro respiratório com piora progressiva e necessidade de suporte ventilatório. Nestes três casos, não houve detecção dos vírus aqui estudados, e ressalta-se, que não foi possível realização de necropsia destes pacientes. Nas 57 PVHA estudadas, houve maior ocorrência do SARS-CoV-2 (31,5%), seguido do VSR (14,0%) e influenza foi encontrado em apenas um paciente, sendo este o subtipo H3N2. O teste de Fisher para a associação entre ocorrência de detectados e não detectados entre SARS-CoV-2 e VSR mostrou que não houve associação entre a ocorrência desses dois vírus (p = 0,085), bem como, não houve associação entre os sintomas presentes em pacientes detectados para SARS-CoV-2 e VSR (p = 0,8851). Pelo menos uma comorbidade esteve presente no grupo com detecção de SARS-CoV-2. Por outro lado, apenas um caso (14,3%) de infecção pelo VSR apresentou obesidade. Está claro que a covid-19 associa-se a uma gama maior de comorbidades que aumentam o risco de doença mais grave ou morte. Foi possível determinar a alta ocorrência de infecções pelo SARS-CoV-2 e VSR em pessoas que vivem com HIV/aids, aqui estudadas, não havendo diferença nos sintomas referentes a cada uma das infecções. Não houve diferença entre as cargas virais e as contagens de células T CD4+ para os três vírus. Foi possível determinar a alta ocorrência de infecções pelo SARS-CoV-2 e VSR em pessoas que vivem com HIV/aids, aqui estudadas, não havendo diferença nos sintomas referentes a cada uma das infecções.
Lower respiratory tract infections have been classified as one of the leading causes of death worldwide. People living with HIV/AIDS are at greater risk of infection with agents that cause flu syndromes due to their immunosuppressive condition. Therefore, the objective of this research was to evaluate the occurrence of infections caused by the Influenza, RSV, and SARS-CoV-2 viruses in people living with HIV/AIDS during the period of 2020 to 2022. And with that, to evaluate the occurrence and mortality of infections caused by the respiratory viruses mentioned above and to identify the sociodemographic and clinical factors of people living with HIV/AIDS. Genetic material was extracted using the BIOPUR Mini Spin Virus DNA/RNA 2.0 2.0 DNA/RNA 2.0 Mini Spin Virus Kit, from nasooropharyngeal swab aspirates of 57 people living with HIV/AIDS, who presented with influenza, followed by reverse transcription and Polymerase Chain Reaction (RT-PCR) in the Hybrispot 12 PCR Auto instrument, using the XGEN Multi PR24 Flow Chip detection kit. After amplification, reverse hybridization took place on a chip that is composed of a nylon membrane (Flow Chip technology) that allows the detection of up to 24 pathogens, later the test results were validated. Of the 57 people living with HIV/AIDS, 32 (56.2%) were male, with a median age of 42 years [21 - 68]. In 36 (63.2%) patients there was the detection of some virus from the viral panel. Of the total sample, 27 (47.5%) corresponded to the three viruses studied, 18 (31.5%) of SARS-CoV-2, eight (14.0%) of RSV and one (2.0%) of influenza. In 21 (36.8%) patients, none of the viruses were identified. Three patients died during the study, both had a progressively worsening respiratory condition and required ventilatory support. In these three cases, none of the viruses studied here were detected, and it should be noted that it was not possible to perform a necropsy on these patients. In the 57 people living with HIV/AIDS studied, there was a higher occurrence of SARS-CoV-2 (31.5%), followed by RSV (14.0%), and influenza was found in only one patient, this being the H3N2 subtype. Fisher's test for the association between the occurrence of detected and undetected SARS-CoV-2 and RSV, with a p-value 0.085, showed that there was no association between the occurrence of these two viruses, it also showed that there was no association between symptoms present in patients detected for SARS-CoV-2and RSV, p-value 0.8851. Therefore, the occurrence proportions are not significant when compared. At least one comorbidity was present in the group with detection of SARS-CoV-2. On the other hand, only one (14.3%) case of RSV infection was obese. It is clear that Covid-19 is associated with a wider range of comorbidities that increase the risk of more serious illness or death. It was possible to determine the high occurrence of infections by SARS-COV-2 and RSV in people living with HIV/AIDS, studied here, with no difference in the symptoms referring to each infection. There were no significant values between viral loads and CD4+ T cell counts for the three viruses. It was possible to determine the high occurrence of SARS-CoV-2 and RSV infections in people living with HIV/aids, studied here, with no difference in the symptoms referring to each of the infections.
Lower respiratory tract infections have been classified as one of the leading causes of death worldwide. People living with HIV/AIDS are at greater risk of infection with agents that cause flu syndromes due to their immunosuppressive condition. Therefore, the objective of this research was to evaluate the occurrence of infections caused by the Influenza, RSV, and SARS-CoV-2 viruses in people living with HIV/AIDS during the period of 2020 to 2022. And with that, to evaluate the occurrence and mortality of infections caused by the respiratory viruses mentioned above and to identify the sociodemographic and clinical factors of people living with HIV/AIDS. Genetic material was extracted using the BIOPUR Mini Spin Virus DNA/RNA 2.0 2.0 DNA/RNA 2.0 Mini Spin Virus Kit, from nasooropharyngeal swab aspirates of 57 people living with HIV/AIDS, who presented with influenza, followed by reverse transcription and Polymerase Chain Reaction (RT-PCR) in the Hybrispot 12 PCR Auto instrument, using the XGEN Multi PR24 Flow Chip detection kit. After amplification, reverse hybridization took place on a chip that is composed of a nylon membrane (Flow Chip technology) that allows the detection of up to 24 pathogens, later the test results were validated. Of the 57 people living with HIV/AIDS, 32 (56.2%) were male, with a median age of 42 years [21 - 68]. In 36 (63.2%) patients there was the detection of some virus from the viral panel. Of the total sample, 27 (47.5%) corresponded to the three viruses studied, 18 (31.5%) of SARS-CoV-2, eight (14.0%) of RSV and one (2.0%) of influenza. In 21 (36.8%) patients, none of the viruses were identified. Three patients died during the study, both had a progressively worsening respiratory condition and required ventilatory support. In these three cases, none of the viruses studied here were detected, and it should be noted that it was not possible to perform a necropsy on these patients. In the 57 people living with HIV/AIDS studied, there was a higher occurrence of SARS-CoV-2 (31.5%), followed by RSV (14.0%), and influenza was found in only one patient, this being the H3N2 subtype. Fisher's test for the association between the occurrence of detected and undetected SARS-CoV-2 and RSV, with a p-value 0.085, showed that there was no association between the occurrence of these two viruses, it also showed that there was no association between symptoms present in patients detected for SARS-CoV-2and RSV, p-value 0.8851. Therefore, the occurrence proportions are not significant when compared. At least one comorbidity was present in the group with detection of SARS-CoV-2. On the other hand, only one (14.3%) case of RSV infection was obese. It is clear that Covid-19 is associated with a wider range of comorbidities that increase the risk of more serious illness or death. It was possible to determine the high occurrence of infections by SARS-COV-2 and RSV in people living with HIV/AIDS, studied here, with no difference in the symptoms referring to each infection. There were no significant values between viral loads and CD4+ T cell counts for the three viruses. It was possible to determine the high occurrence of SARS-CoV-2 and RSV infections in people living with HIV/aids, studied here, with no difference in the symptoms referring to each of the infections.
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Palavras-chave
Detecção, HIV/aids, Covid-19, Vírus influenza, Vírus sincicial respiratório, Detection, Influenza virus, Respiratory syncytial virus