Revista chilena de infectologia: organo oficial de la Sociedad Chilena de Infectologia
Cytomegalovirus (CMV) is a frequent opportunistic infection in human immunodeficiency virus type ... more Cytomegalovirus (CMV) is a frequent opportunistic infection in human immunodeficiency virus type 1 (HIV-1) infected children associated with significant morbidity and mortality. The aim of this study was to determine the frequency and impact of CMV disease in a prospective ly followed cohort of HIV-1 infected Chilean children. CMV disease was diagnosed in 28 out of 222 HIV infected children (12.6%); 92% of them were classified in category C and 61% in category 3 (CDC, 1994). Lung disease was the most common manifestation (25 children). Samples were obtained from the respiratory tract, blood, urine and tissue biopsies. Shell vial for CMV early antigen detection was the most commonly used diagnostic technique (20/ 28). All patients were treated with iv.ganciclovir and two children died during the CMV episode. The mean survival time for the remaining children is currently 42 months. Conclusion: CMV disease was frequent and caused mortality in HIV-1 infected Chilean children. Early diag...
Revista chilena de infectologia: organo oficial de la Sociedad Chilena de Infectologia
The article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associat... more The article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases in the world and in Chile and the scientific information of the licensed HPV vaccines: Gardasil and Cervarix. Considering the available information, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases, summarizes its conclusions and makes recommendations for vaccination against HPV in Chile.
Revista chilena de infectología : órgano oficial de la Sociedad Chilena de Infectología, 2006
The article briefly reviews the epidemiology of rotavirus infection and the scientific informatio... more The article briefly reviews the epidemiology of rotavirus infection and the scientific information of the rotavirus vaccines: Rotashield, withdrawn from the market due to its association with intussusception, Rotateq currently in an advanced phase of development, and Rotarix, recently licensed in Chile. Considering the available information, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases, summarizes its conclusions and makes recommendations for infants vaccination against rotavirus in our country.
The incidence of cytomegalovirus infection or reactivation is 8 times more frequent in transplant... more The incidence of cytomegalovirus infection or reactivation is 8 times more frequent in transplant recipients than in the general population. To evaluate the prevalence and usefulness of different diagnostic techniques for cytomegalovirus infection in renal transplant recipients. Twenty nine renal transplant recipients were followed for at least five months. Cytomegalovirus infection was assessed by the presence of serum antibodies against the virus using ELISA and viral detection in urine and lymphocytes, using classical viral isolation, shell vial assay, and detection of viral genome by polymerase chain reaction. Prior to transplantation, 23 of 27 patients had IgG type anti cytomegalovirus antibodies. In 40%, IgM type antibodies were detected in some moment of the follow up. Three of these corresponded to seroconversion. Cytomegalovirus was detected in urine in 41% of patients and it was not detected in lymphocytes. Shell vial assay detected the virus in 5 of 13 urine samples and i...
Cytomegalovirus is the main agent of congenital viral infections. The aim of this study was to co... more Cytomegalovirus is the main agent of congenital viral infections. The aim of this study was to compare the incidence of congenital cytomegalovirus infections of two groups of newborns of differing socioeconomic status. Cytomegalovirus was isolated from urine or oropharingeal secretions in 218 children born in a private clinic and 471 born in a public hospital. Positive viral isolates were confirmed with indirect immunofluorescence using monoclonal antibodies. Infection was detected in 12 children (1.82%), four coming from the private clinic (1.86%) and 8 coming from the public hospital (1.81%). Ninety two percent of infected children were asymptomatic. Urine and oropharingeal secretion samples had the same yield for viral isolation. It is concluded that the incidence of congenital cytomegalovirus infection is similar to that described in developed countries.
Cytomegalovirus (CMV), herpes simplex type I (HSV-1) and Epstein Barr virus (EBV) are latent pers... more Cytomegalovirus (CMV), herpes simplex type I (HSV-1) and Epstein Barr virus (EBV) are latent persistent infections. Their reactivation may cause illnesses and death in human immunodeficiency virus-infected (HIV) people. World wide seroprevalence of these viruses is over 50%. In Chile, information is not available. To determine the seroprevalence of CMV HSV-1 and EBV in Chilean HIV-infected adults. A total of 400 HIV-infected adults aged 17 to 67 years (340 males) were studied during 2005 and 2006 CMV HSV-1 and EBV serum antibodies were measured by enzyme-linked immunoabsorbent assay. The mean lapse from the diagnosis of HIV and serum testing was 67 months and 69.5% patients received antiretroviral therapy. Sixty seven percent of the sample were men who had sex with men (MSM). The seroprevalence for CM, HSV-1 and EBV were 98.5, 92.2 and 99.7%, respectively. No patient had negative antibodies for all three viruses. Male patients that were negative for HSV-1 had a lower frequency of MS...
Revista chilena de infectología : órgano oficial de la Sociedad Chilena de Infectología, 2005
Influenza is a seasonally, acute respiratory disease, highly transmissible. The diversity of the ... more Influenza is a seasonally, acute respiratory disease, highly transmissible. The diversity of the natural reservoirs of influenza A virus and its faculty of reassortment increase the risk of a new pandemia. Prevention strategies during the outbreaks include vaccination indicated to risk population as infants between 6 to 2 years old, persons above 65 years old, pregnant women and patients with underlying diseases. Antiviral prophylaxis is useful to control small outbreaks and to be used in household contacts of risk population who have not been vaccinated. Antiviral drugs as a treatment should be considered in persons with severe disease. During a pandemia these prevention measures must be reinforced and rational use of antiviral drugs and vaccine with the pandemic strain should be emphasized.
This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associa... more This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific information of the licensed HPV vaccines: Gardasil and Cervari. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual activity, i.e., approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program.
Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infection in infant... more Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infection in infants. The immune response plays a leading role in the severity of the disease. We hypothesized that severe RSV disease is associated with an impaired immune response characterized by low circulating T lymphocytes and plasma cytokine concentrations. We evaluate the in vivo immune responses of previously healthy infants with their first proven RSV-acute lower respiratory infection that required hospitalization. According to the clinical severity, defined by using a strict scoring system, the in vivo immune response was compared through the analysis of plasma cytokine values and the phenotyping of peripheral blood lymphocyte and natural killer (NK) cells. Absolute blood cell counts of CD4+, CD8+, and CD19+ lymphocytes and NK cells were lower in subjects with RSV than in control infants. Lowest cell counts were observed in more severe RSV-infected infants. Significant low values were obtained in CD8+ lymphocytes (P = 0.03) and nonactive NK cells, that express CD94 antigen (P = 0.046). In contrast, activated NK cells that do not express CD94 molecules were significantly higher in RSV infected infants than in healthy controls (% of cells: P = 0.004). The interferon-gamma and tumor necrosis factor-alpha values in RSV infected patients were lower than in controls subjects. Interleukin-17 cytokine was not detected in healthy infants and the largest concentration was found in moderately ill patients as compared with severe cases (P = 0.033). RSV infection showed significantly higher interleukin-8 chemokine than in control infants (P = 0.024). We propose that severe RSV infection in very young infants is associated with poor blood proinflammatory cytokine production, low counts of CD8+ T cells and with a greater activity of a group of NK cells, that are independent of the major histocompatibility complex class Ib recognition system.
Human metapneumovirus (hMPV) was identified in 2001 as a cause of acute respiratory illness, but ... more Human metapneumovirus (hMPV) was identified in 2001 as a cause of acute respiratory illness, but its characteristics are still being defined. We analyzed 3740 nasopharyngeal-wash specimens obtained during 2002-2004, using assays for common respiratory viruses and real-time polymerase chain reaction for hMPV. We detected hMPV in 5% of all specimens, compared with 28% for other respiratory viruses. Nucleotide sequence analysis of hMPV isolates revealed the predominant circulation of hMPV genotype A in the 2003 season but a switch to predominantly genotype B in 2004. Sequence analysis also revealed major differences in the hMPV G and SH genes but relative conservation of the F and N genes within each genotype. Phylogenetic analysis indicated a seasonal switch within hMPV genotype A subtypes as well. Despite genetic variability, we found no difference in the severity of illness caused by various hMPV isolates. These findings suggest that hMPV may vary in genetic structure, to allow for a seasonal shift in predominant genotype and the maintenance of infection rates.
Revista chilena de infectologia: organo oficial de la Sociedad Chilena de Infectologia
Cytomegalovirus (CMV) is a frequent opportunistic infection in human immunodeficiency virus type ... more Cytomegalovirus (CMV) is a frequent opportunistic infection in human immunodeficiency virus type 1 (HIV-1) infected children associated with significant morbidity and mortality. The aim of this study was to determine the frequency and impact of CMV disease in a prospective ly followed cohort of HIV-1 infected Chilean children. CMV disease was diagnosed in 28 out of 222 HIV infected children (12.6%); 92% of them were classified in category C and 61% in category 3 (CDC, 1994). Lung disease was the most common manifestation (25 children). Samples were obtained from the respiratory tract, blood, urine and tissue biopsies. Shell vial for CMV early antigen detection was the most commonly used diagnostic technique (20/ 28). All patients were treated with iv.ganciclovir and two children died during the CMV episode. The mean survival time for the remaining children is currently 42 months. Conclusion: CMV disease was frequent and caused mortality in HIV-1 infected Chilean children. Early diag...
Revista chilena de infectologia: organo oficial de la Sociedad Chilena de Infectologia
The article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associat... more The article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases in the world and in Chile and the scientific information of the licensed HPV vaccines: Gardasil and Cervarix. Considering the available information, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases, summarizes its conclusions and makes recommendations for vaccination against HPV in Chile.
Revista chilena de infectología : órgano oficial de la Sociedad Chilena de Infectología, 2006
The article briefly reviews the epidemiology of rotavirus infection and the scientific informatio... more The article briefly reviews the epidemiology of rotavirus infection and the scientific information of the rotavirus vaccines: Rotashield, withdrawn from the market due to its association with intussusception, Rotateq currently in an advanced phase of development, and Rotarix, recently licensed in Chile. Considering the available information, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases, summarizes its conclusions and makes recommendations for infants vaccination against rotavirus in our country.
The incidence of cytomegalovirus infection or reactivation is 8 times more frequent in transplant... more The incidence of cytomegalovirus infection or reactivation is 8 times more frequent in transplant recipients than in the general population. To evaluate the prevalence and usefulness of different diagnostic techniques for cytomegalovirus infection in renal transplant recipients. Twenty nine renal transplant recipients were followed for at least five months. Cytomegalovirus infection was assessed by the presence of serum antibodies against the virus using ELISA and viral detection in urine and lymphocytes, using classical viral isolation, shell vial assay, and detection of viral genome by polymerase chain reaction. Prior to transplantation, 23 of 27 patients had IgG type anti cytomegalovirus antibodies. In 40%, IgM type antibodies were detected in some moment of the follow up. Three of these corresponded to seroconversion. Cytomegalovirus was detected in urine in 41% of patients and it was not detected in lymphocytes. Shell vial assay detected the virus in 5 of 13 urine samples and i...
Cytomegalovirus is the main agent of congenital viral infections. The aim of this study was to co... more Cytomegalovirus is the main agent of congenital viral infections. The aim of this study was to compare the incidence of congenital cytomegalovirus infections of two groups of newborns of differing socioeconomic status. Cytomegalovirus was isolated from urine or oropharingeal secretions in 218 children born in a private clinic and 471 born in a public hospital. Positive viral isolates were confirmed with indirect immunofluorescence using monoclonal antibodies. Infection was detected in 12 children (1.82%), four coming from the private clinic (1.86%) and 8 coming from the public hospital (1.81%). Ninety two percent of infected children were asymptomatic. Urine and oropharingeal secretion samples had the same yield for viral isolation. It is concluded that the incidence of congenital cytomegalovirus infection is similar to that described in developed countries.
Cytomegalovirus (CMV), herpes simplex type I (HSV-1) and Epstein Barr virus (EBV) are latent pers... more Cytomegalovirus (CMV), herpes simplex type I (HSV-1) and Epstein Barr virus (EBV) are latent persistent infections. Their reactivation may cause illnesses and death in human immunodeficiency virus-infected (HIV) people. World wide seroprevalence of these viruses is over 50%. In Chile, information is not available. To determine the seroprevalence of CMV HSV-1 and EBV in Chilean HIV-infected adults. A total of 400 HIV-infected adults aged 17 to 67 years (340 males) were studied during 2005 and 2006 CMV HSV-1 and EBV serum antibodies were measured by enzyme-linked immunoabsorbent assay. The mean lapse from the diagnosis of HIV and serum testing was 67 months and 69.5% patients received antiretroviral therapy. Sixty seven percent of the sample were men who had sex with men (MSM). The seroprevalence for CM, HSV-1 and EBV were 98.5, 92.2 and 99.7%, respectively. No patient had negative antibodies for all three viruses. Male patients that were negative for HSV-1 had a lower frequency of MS...
Revista chilena de infectología : órgano oficial de la Sociedad Chilena de Infectología, 2005
Influenza is a seasonally, acute respiratory disease, highly transmissible. The diversity of the ... more Influenza is a seasonally, acute respiratory disease, highly transmissible. The diversity of the natural reservoirs of influenza A virus and its faculty of reassortment increase the risk of a new pandemia. Prevention strategies during the outbreaks include vaccination indicated to risk population as infants between 6 to 2 years old, persons above 65 years old, pregnant women and patients with underlying diseases. Antiviral prophylaxis is useful to control small outbreaks and to be used in household contacts of risk population who have not been vaccinated. Antiviral drugs as a treatment should be considered in persons with severe disease. During a pandemia these prevention measures must be reinforced and rational use of antiviral drugs and vaccine with the pandemic strain should be emphasized.
This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associa... more This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific information of the licensed HPV vaccines: Gardasil and Cervari. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual activity, i.e., approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program.
Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infection in infant... more Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infection in infants. The immune response plays a leading role in the severity of the disease. We hypothesized that severe RSV disease is associated with an impaired immune response characterized by low circulating T lymphocytes and plasma cytokine concentrations. We evaluate the in vivo immune responses of previously healthy infants with their first proven RSV-acute lower respiratory infection that required hospitalization. According to the clinical severity, defined by using a strict scoring system, the in vivo immune response was compared through the analysis of plasma cytokine values and the phenotyping of peripheral blood lymphocyte and natural killer (NK) cells. Absolute blood cell counts of CD4+, CD8+, and CD19+ lymphocytes and NK cells were lower in subjects with RSV than in control infants. Lowest cell counts were observed in more severe RSV-infected infants. Significant low values were obtained in CD8+ lymphocytes (P = 0.03) and nonactive NK cells, that express CD94 antigen (P = 0.046). In contrast, activated NK cells that do not express CD94 molecules were significantly higher in RSV infected infants than in healthy controls (% of cells: P = 0.004). The interferon-gamma and tumor necrosis factor-alpha values in RSV infected patients were lower than in controls subjects. Interleukin-17 cytokine was not detected in healthy infants and the largest concentration was found in moderately ill patients as compared with severe cases (P = 0.033). RSV infection showed significantly higher interleukin-8 chemokine than in control infants (P = 0.024). We propose that severe RSV infection in very young infants is associated with poor blood proinflammatory cytokine production, low counts of CD8+ T cells and with a greater activity of a group of NK cells, that are independent of the major histocompatibility complex class Ib recognition system.
Human metapneumovirus (hMPV) was identified in 2001 as a cause of acute respiratory illness, but ... more Human metapneumovirus (hMPV) was identified in 2001 as a cause of acute respiratory illness, but its characteristics are still being defined. We analyzed 3740 nasopharyngeal-wash specimens obtained during 2002-2004, using assays for common respiratory viruses and real-time polymerase chain reaction for hMPV. We detected hMPV in 5% of all specimens, compared with 28% for other respiratory viruses. Nucleotide sequence analysis of hMPV isolates revealed the predominant circulation of hMPV genotype A in the 2003 season but a switch to predominantly genotype B in 2004. Sequence analysis also revealed major differences in the hMPV G and SH genes but relative conservation of the F and N genes within each genotype. Phylogenetic analysis indicated a seasonal switch within hMPV genotype A subtypes as well. Despite genetic variability, we found no difference in the severity of illness caused by various hMPV isolates. These findings suggest that hMPV may vary in genetic structure, to allow for a seasonal shift in predominant genotype and the maintenance of infection rates.
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Papers by Vivian Luchsinger