Perfil de citocinas e desfecho clínico de pacientes coinfectados HIV e Leishmania spp

Detalhes bibliográficos
Ano de defesa: 2022
Autor(a) principal: COSTA, Larissa Di Leo Nogueira lattes
Orientador(a): AZEVEDO, Conceição de Maria Pedrozo e Silva de lattes
Banca de defesa: PEREIRA, Silma Regina Ferreira lattes, MACIEL, Marcia Cristina Gonçalves lattes, CALDAS, Arlene de Jesus Mendes lattes, SANTOS, Daniel Wagner de Castro Lima lattes, RODRIGUES, Vandilson Pinheiro lattes
Tipo de documento: Tese
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal do Maranhão
Programa de Pós-Graduação: PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE/CCBS
Departamento: DEPARTAMENTO DE MEDICINA I/CCBS
País: Brasil
Palavras-chave em Português:
Palavras-chave em Inglês:
Área do conhecimento CNPq:
Link de acesso: https://tedebc.ufma.br/jspui/handle/tede/4474
Resumo: Visceral leishmaniasis (VL) is an endemic parasitic disease in Latin America, and its clinical picture is aggravated in co-infections with human immunodeficiency virus (HIV). In these patients, a complex immune response is observed, with correlation of pro-, anti-inflammatory and modulating cytokines. The aim of this study is to identify the profile of inflammatory cytokines and the outcomes presented by VL/HIV coinfected patients. A prospective, longitudinal study was conducted from January 2013 to July 2020 among 169 patients coinfected with VL and HIV. The outcomes investigated were the occurrence of VL relapse, hospital death of coinfected patients, and the clinical presentation of coinfected patients. For statistical analysis, the Chi-square test, the Mann-Whitney test and Oddis Ratio measurements were performed. As main results, in the present study the occurrence rates were 41.4% for VL relapse and 5.5% for death. Splenomegaly and adenomegaly were associated with increased risk of VL relapse. Weight loss and edema were associated with increased risk of death. Patients with relapse had higher levels of urea (P = .005) and creatinine (P < .001). Patients who died had lower red blood cell (P = .012), hemoglobin (P = .017), and platelet (P < .001) counts. Among the sample of 169 coinfected patients, 50 patients were separated by primary sample separation to perform blood sample collection and analyzed for cytokine release. It was observed that there was a statistically significant difference in IL-2 and IL-10 production between the groups. Furthermore, in co-infected patients there is a moderate or strong and statistically significant positive correlation in the production of IL-2 and IL-4; IL-2 and IL-6; IL-4 and TNF; IL-4 and IL-6; IL-6 and TNF. The results suggest that clinical and laboratory factors show associations with the outcomes of VL relapse and death in VL/HIV coinfected patients, however, there was no association of the cytokines produced with the clinical presented.