Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA)
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) |
Texto Completo: | http://repositorio.uem.br:8080/jspui/handle/1/2439 |
Resumo: | Abstract: Human cytomegalovirus (HCMV) is an adenovirus that is present in most healthy subjects in a latent form, and it is a risk when they become immunocompromised. It is a major cause of morbidity and mortality in immunosuppressed patients, a situation where the activation of viral replication occurs. Among individuals with immunosuppression there are transplant recipients, who may experience acute graft rejection. Among dialysis patients, in addition to compromising the body's defense mechanism, possible blood transfusions also occur, increasing the likelihood of infection. The literature makes little reference to the seroprevalence of HCMV and its relationship with the individual's immune system that is mediated by the Major Histocompatibility Complex (MHC), which in humans is defined as Human Leukocyte Antigens - HLA system. Considering the need to obtain more knowledge about the influence of genetic factors in the HCMV entrainment, we proposed this study to identify the presence of HCMV in patients with CRF undergoing dialysis therapy and kidney transplant patients, and evaluate their association with HLA markers. The identification of HCMV was made through the technique of microparticle enzyme immunoassay (MEIA) and One Lambda LABType®SSO kit was used in combination with the Luminex technology for HLA typing. The study population involved 203 dialysis patients, 53 kidney transplant recipients attended at two reference centers in the city of Maringá, in the state of Paraná and 73 healthy volunteers. The data were statistically analyzed to identify the level of significance. The results showed no relationship between the gender variable and seroprevalence of HCMV in both groups. There was no correlation between the presence of the virus and blood transfusion in the dialysis group. Regarding the proportion of chronic infection (anti-HCMV IgG) and acute infection (anti-HCMV IgM), there were no significant differences in the two groups regarding gender. Comparing the results for both with those observed for the control group it was found statistically significant differences when the age variable was correlated with the frequency of anti-HCMV antibodies (IgG and IgM). When correlating the frequency of HCMV-IgG with HLA genes (A, B and DRB1 loci) for both groups the most frequent allele observed was the A*02, although not statistically significant. It was observed that the presence of the B*57 allele found in the transplant group showed a trend for association (p = 0233) with the prevalence of HCMV-IgM. From the data obtained, it can be concluded that the frequency of HCMV is higher in immunocompromised patients and the association between the seroprevalence of HCMV and blood transfusion has not been established. The data suggest the involvement of an HLA class I allele in the susceptibility to virus acquisition, however further studies are needed in new populations, in order to confirm these findings. |
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Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA)Prevalence of cytomegalovirus in patients with chronic renal failureon dialysis and renal transplant patients: association analysis with genetic markers (HLA).Citomegalovírus (HCMVInfecçãoInsuficiência renal crônicaDiáliseTransplante renalAntígenos HLABrasil.HLA AntingensDialysisCytomegalovirusInfectionRenal Insufficiency. ChronicBrazil.Ciências da SaúdeEnfermagemAbstract: Human cytomegalovirus (HCMV) is an adenovirus that is present in most healthy subjects in a latent form, and it is a risk when they become immunocompromised. It is a major cause of morbidity and mortality in immunosuppressed patients, a situation where the activation of viral replication occurs. Among individuals with immunosuppression there are transplant recipients, who may experience acute graft rejection. Among dialysis patients, in addition to compromising the body's defense mechanism, possible blood transfusions also occur, increasing the likelihood of infection. The literature makes little reference to the seroprevalence of HCMV and its relationship with the individual's immune system that is mediated by the Major Histocompatibility Complex (MHC), which in humans is defined as Human Leukocyte Antigens - HLA system. Considering the need to obtain more knowledge about the influence of genetic factors in the HCMV entrainment, we proposed this study to identify the presence of HCMV in patients with CRF undergoing dialysis therapy and kidney transplant patients, and evaluate their association with HLA markers. The identification of HCMV was made through the technique of microparticle enzyme immunoassay (MEIA) and One Lambda LABType®SSO kit was used in combination with the Luminex technology for HLA typing. The study population involved 203 dialysis patients, 53 kidney transplant recipients attended at two reference centers in the city of Maringá, in the state of Paraná and 73 healthy volunteers. The data were statistically analyzed to identify the level of significance. The results showed no relationship between the gender variable and seroprevalence of HCMV in both groups. There was no correlation between the presence of the virus and blood transfusion in the dialysis group. Regarding the proportion of chronic infection (anti-HCMV IgG) and acute infection (anti-HCMV IgM), there were no significant differences in the two groups regarding gender. Comparing the results for both with those observed for the control group it was found statistically significant differences when the age variable was correlated with the frequency of anti-HCMV antibodies (IgG and IgM). When correlating the frequency of HCMV-IgG with HLA genes (A, B and DRB1 loci) for both groups the most frequent allele observed was the A*02, although not statistically significant. It was observed that the presence of the B*57 allele found in the transplant group showed a trend for association (p = 0233) with the prevalence of HCMV-IgM. From the data obtained, it can be concluded that the frequency of HCMV is higher in immunocompromised patients and the association between the seroprevalence of HCMV and blood transfusion has not been established. The data suggest the involvement of an HLA class I allele in the susceptibility to virus acquisition, however further studies are needed in new populations, in order to confirm these findings.O citomegalovírus humano (HCMV) é um adenovírus que está presente na maioria dos indivíduos saudáveis na forma latente, sendo um risco quando estes se tornam imunocomprometidos. É um dos principais causadores de morbimortalidade em pacientes imunodeprimidos, situação onde ocorre a ativação da replicação viral. Entre os indivíduos com imunossupressão há os transplantados, onde pode ocorrer a rejeição aguda do enxerto. Entre os pacientes em diálise, além do comprometimento das defesas do organismo, ocorrem possíveis hemotransfusões, aumentando a probabilidade da infecção. A literatura faz pouca referência sobre a soroprevalência do HCMV e sua relação com o sistema imunitário do indivíduo que é mediada pelo Complexo Principal de Histocompatibilidade (CPH) que nos seres humanos é definida como Antígenos Leucocitários Humanos - sistema HLA, do inglês Human Leucocyte Antigens.Considerando a necessidade de se obter maiores conhecimentos sobre a influência de fatores genéticos no carreamento do HCMV propusemos esse estudo com o objetivo de identificar a presença de HCMV, em portadores de IRC em tratamento dialítico e transplantados renais, e avaliar a associação com marcadores HLA. A identificação do HCMV foi feita por meio da técnica de método imunoenzimático de micropartículas (microparticle enzyme immunoassay - MEIA) e para tipificação HLA foi utilizado o kit LABType® SSO One Lambda aliado à tecnologia Luminex. A população de estudo envolveu 203 pacientes em tratamento dialítico e 53 transplantados renais assistidos em dois serviços de referência do município de Maringá, Paraná e os dados obtidos foram tratados estatisticamente para se identificar o nível de significância. Os resultados mostraram que não há relação entre o variável sexo e a soroprevalência do HCMV em ambos os grupos avaliados. No grupo de diálise não se observou correlação entre a presença do vírus e hemotransfusão. Em relação à proporção da infecção crônica (anti- HCMV-IgG) e a infecção aguda (anti-HCMV-IgM), não houve diferenças significativas nos dois grupos com relação ao gênero. Correlacionando-se a freqüência do anti- HCMV-IgG com os genes HLA (lócus A, B e DRB1), para ambos os grupos, observouse que o alelo A*02 foi o mais freqüente porém não houve correlação estatisticamente significativa. Ao correlacionar a soroprevalência do anti-HCMV-IgM com esses genes, foi observado que o alelo B*57, encontrado no grupo de transplantados, mostrou tendência associativa (p=0233). A partir dos dados obtidos pode se concluir que a frequência do HCMV é maior em pacientes imunocomprometidos e não se estabeleceu associação entre a soroprevalência do HCMV e a hemotransfusão. Os dados sugerem a participação de um alelo HLA classe I na suscetibilidade a aquisição do vírus, entretanto são necessários novos estudos em novas populações a fim de confirmar esses achados.74 fUniversidade Estadual de MaringáBrasilDepartamento de EnfermagemPrograma de Pós-Graduação em EnfermagemUEMMaringá, PRCentro de Ciências da SaúdeJoão BedendoElma Mathias Dessunti - UELMaria Clara Padoveze - USPMaria Angélica Pagliarini Waidman - UEMSandra Marisa Pelloso - UEMOkubo, Patricia2018-04-10T19:17:41Z2018-04-10T19:17:41Z2012info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttp://repositorio.uem.br:8080/jspui/handle/1/2439porinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)instname:Universidade Estadual de Maringá (UEM)instacron:UEM2018-10-15T16:49:01Zoai:localhost:1/2439Repositório InstitucionalPUBhttp://repositorio.uem.br:8080/oai/requestopendoar:2024-04-23T14:55:29.378547Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) - Universidade Estadual de Maringá (UEM)false |
dc.title.none.fl_str_mv |
Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA) Prevalence of cytomegalovirus in patients with chronic renal failureon dialysis and renal transplant patients: association analysis with genetic markers (HLA). |
title |
Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA) |
spellingShingle |
Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA) Okubo, Patricia Citomegalovírus (HCMV Infecção Insuficiência renal crônica Diálise Transplante renal Antígenos HLA Brasil. HLA Antingens Dialysis Cytomegalovirus Infection Renal Insufficiency. Chronic Brazil. Ciências da Saúde Enfermagem |
title_short |
Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA) |
title_full |
Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA) |
title_fullStr |
Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA) |
title_full_unstemmed |
Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA) |
title_sort |
Prevalência de Citomegalovírus entre pacientes com insuficiência renal crônica em tratamento dialítico e transplantados renais : estudo de associação com marcadores genéticos (HLA) |
author |
Okubo, Patricia |
author_facet |
Okubo, Patricia |
author_role |
author |
dc.contributor.none.fl_str_mv |
João Bedendo Elma Mathias Dessunti - UEL Maria Clara Padoveze - USP Maria Angélica Pagliarini Waidman - UEM Sandra Marisa Pelloso - UEM |
dc.contributor.author.fl_str_mv |
Okubo, Patricia |
dc.subject.por.fl_str_mv |
Citomegalovírus (HCMV Infecção Insuficiência renal crônica Diálise Transplante renal Antígenos HLA Brasil. HLA Antingens Dialysis Cytomegalovirus Infection Renal Insufficiency. Chronic Brazil. Ciências da Saúde Enfermagem |
topic |
Citomegalovírus (HCMV Infecção Insuficiência renal crônica Diálise Transplante renal Antígenos HLA Brasil. HLA Antingens Dialysis Cytomegalovirus Infection Renal Insufficiency. Chronic Brazil. Ciências da Saúde Enfermagem |
description |
Abstract: Human cytomegalovirus (HCMV) is an adenovirus that is present in most healthy subjects in a latent form, and it is a risk when they become immunocompromised. It is a major cause of morbidity and mortality in immunosuppressed patients, a situation where the activation of viral replication occurs. Among individuals with immunosuppression there are transplant recipients, who may experience acute graft rejection. Among dialysis patients, in addition to compromising the body's defense mechanism, possible blood transfusions also occur, increasing the likelihood of infection. The literature makes little reference to the seroprevalence of HCMV and its relationship with the individual's immune system that is mediated by the Major Histocompatibility Complex (MHC), which in humans is defined as Human Leukocyte Antigens - HLA system. Considering the need to obtain more knowledge about the influence of genetic factors in the HCMV entrainment, we proposed this study to identify the presence of HCMV in patients with CRF undergoing dialysis therapy and kidney transplant patients, and evaluate their association with HLA markers. The identification of HCMV was made through the technique of microparticle enzyme immunoassay (MEIA) and One Lambda LABType®SSO kit was used in combination with the Luminex technology for HLA typing. The study population involved 203 dialysis patients, 53 kidney transplant recipients attended at two reference centers in the city of Maringá, in the state of Paraná and 73 healthy volunteers. The data were statistically analyzed to identify the level of significance. The results showed no relationship between the gender variable and seroprevalence of HCMV in both groups. There was no correlation between the presence of the virus and blood transfusion in the dialysis group. Regarding the proportion of chronic infection (anti-HCMV IgG) and acute infection (anti-HCMV IgM), there were no significant differences in the two groups regarding gender. Comparing the results for both with those observed for the control group it was found statistically significant differences when the age variable was correlated with the frequency of anti-HCMV antibodies (IgG and IgM). When correlating the frequency of HCMV-IgG with HLA genes (A, B and DRB1 loci) for both groups the most frequent allele observed was the A*02, although not statistically significant. It was observed that the presence of the B*57 allele found in the transplant group showed a trend for association (p = 0233) with the prevalence of HCMV-IgM. From the data obtained, it can be concluded that the frequency of HCMV is higher in immunocompromised patients and the association between the seroprevalence of HCMV and blood transfusion has not been established. The data suggest the involvement of an HLA class I allele in the susceptibility to virus acquisition, however further studies are needed in new populations, in order to confirm these findings. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012 2018-04-10T19:17:41Z 2018-04-10T19:17:41Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.uem.br:8080/jspui/handle/1/2439 |
url |
http://repositorio.uem.br:8080/jspui/handle/1/2439 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Estadual de Maringá Brasil Departamento de Enfermagem Programa de Pós-Graduação em Enfermagem UEM Maringá, PR Centro de Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Estadual de Maringá Brasil Departamento de Enfermagem Programa de Pós-Graduação em Enfermagem UEM Maringá, PR Centro de Ciências da Saúde |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) instname:Universidade Estadual de Maringá (UEM) instacron:UEM |
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Universidade Estadual de Maringá (UEM) |
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UEM |
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UEM |
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Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) |
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Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) |
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Repositório Institucional da Universidade Estadual de Maringá (RI-UEM) - Universidade Estadual de Maringá (UEM) |
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