Eugênia Ubiali | Universidade de São Paulo (original) (raw)
Papers by Eugênia Ubiali
Transfusion medicine (Oxford, England), Jan 31, 2015
Dear Sir, In transfusion medicine, the development of alloantibodies against red blood cell (RBC)... more Dear Sir, In transfusion medicine, the development of alloantibodies against red blood cell (RBC) antigens is a major problem. Therefore, for multiply-transfused patients a safe blood transfusion requires precise determination of the erythrocyte antigen profile in order to avoid life-threatening immunologic reactions. The use of diagnostic serology has some limitations, because it is not applicable in recently transfused patients and in those with positive direct antiglobulin test (DAT) (Denomme & Van Oene, 2005; Westhoff, 2006). To avoid these short-comings, nucleic acid amplification techniques to determine blood group antigens can be applied as they are not influenced by the circulating RBC phenotypes of the donor (Reid & Denomme, 2011). However, there is no consensus between the different laboratories for the best molecular reference test to be used and in many transfusion laboratories such tests are not implemented due to the lack of technology and high costs. In this study, we developed a real-time TaqMan® PCR (LifeTechnologies, São Paulo, Brazil) to genotype Rhesus (RHCE*01/RHCE*02/RHCE*03/RHCE*04), MNS (GYPB*03/GYPB*04), Kidd (JK*01/JK*02) and Duffy (FY*01/FY*02 and FY*02N.01) blood groups. The optimised real-time genotyping assay showed improved detection limit and used reduced amount of reagents. Thus, this reaction diminishes the overall costs and at the same time maintaining reaction accuracy. This methodology can be applied for quick and safe genotyping of blood samples obtained from multiply-transfused patients. For genotyping of blood groups, the primers and hydrolytic probes were designed based on the Rh (307 C>T, 676G>C), MNS (c.143C>T), Kidd (c.838 A>G), Duffy (c.125 A>G) and FY*02N.01 (c.1-67T>C) single-nucleotide polymorphism (SNPs). One of the probes representing one allele was labelled by the reporter FAM (6-carboxyfluorescein), and the probe representing the other was labelled by VIC (4, 7, 2′-trichloro-7′-phenyl-6-carboxyfluorescein) (Table 1). The real-time reactions were performed using the 7500 Real-time
Vox Sanguinis, 2019
Background and objectives The rare S-s-phenotype has two main molecular backgrounds. GYPB deletio... more Background and objectives The rare S-s-phenotype has two main molecular backgrounds. GYPB deletions give rise to the S-s-U-phenotype, which loses the expression of the U antigen, while variant GYPB alleles usually lead to the S-s-U +var phenotype, which express a variant U antigen. The S-s-phenotype is typically found in people of African origin and represents a challenge in transfusion sets, especially when S-s-patients develop anti-U. Molecular analysis is the most reliable method for determining U antigen status. We studied the molecular basis of the S-s-phenotype in donors and patients at Regional Blood Center of Ribeirão Preto. Material and Methods Five patients and 25 donors with the S-s-phenotype were investigated through real-time PCR for the GYPB*S/s polymorphism, followed by an allele-specific/RFLP-PCR for GYPB deletion (GYPB*) and for its main variants: GYPB*P2 and GYPB*NY. DNA sequencing was conducted in one sample. Results Two samples were heterozygous GYPB*P2/GYPB*NY, eight were homozygous/hemizygous for GYPB*P2 and 19 samples were homozygous for GYPB*. A hybrid gene (GYPB-E-B.Ros) was found in one sample after discrepant results in the initial tests. Conclusion GYPB deletion is the main mechanism responsible for the S-s-phenotype in our donors and patients. It is essential to evaluate the main GYPB variant alleles when genotyping in order to obtain the correct prediction of the phenotype. Hybrid genes lead to discrepancies between genotype and phenotype and may not be detected by conventional molecular assays.
Blood transfusion = Trasfusione del sangue, 2020
BACKGROUND Post-donation illness can be described as appearance of clinical symptoms in blood don... more BACKGROUND Post-donation illness can be described as appearance of clinical symptoms in blood donors after donation. The consequent call back of the donor to report these symptoms to the blood collection institution is considered a post-donation illness report (PDIR). The most suitable way to examine whether PDIR is related to infection is to apply next-generation sequencing (NGS) and viral metagenomics. Investigation into a PDIR can reveal its importance for transfusion safety and help elaborate strategies for donor education in order to prevent the transfusion transmission of infections which are not routinely tested by the blood collection services. MATERIALS AND METHODS We applied NGS and viral metagenomics on blood donations which were deferred due to a PDIR. Thirty-three PDIR donations obtained in the Blood Center of Ribeirão Preto, Southeast Brazil, were evaluated. Sequencing was performed using Illumina NextSeq 550 (Illumina Inc, San Diego, CA, USA) equipment and the reads o...
Revista do Instituto de Medicina Tropical de São Paulo, 2012
The seroprevalence and geographic distribution of HTLV-1/2 among blood donors are extremely impor... more The seroprevalence and geographic distribution of HTLV-1/2 among blood donors are extremely important to transfusion services. We evaluated the seroprevalence of HTLV-1/2 infection among first-time blood donor candidates in Ribeirão Preto city and region. From January 2000 to December 2010, 1,038,489 blood donations were obtained and 301,470 were first-time blood donations. All samples were screened with serological tests for HTLV-1/2 using enzyme immunoassay (EIA). In addition, the frequency of coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), Chagas disease (CD) and syphilis was also determined. In-house PCR was used as confirmatory test for HTLV-1/2. A total of 296 (0.1%) first-time donors were serologically reactive for HTLV-1/2. Confirmatory PCR of 63 samples showed that 28 were HTLV-1 positive, 13 HTLV-2 positive, 19 negative and three indeterminate. Regarding HTLV coinfection rates, the most prevalent was with HBV (51.3%) a...
Transfusion Medicine, 2017
Background: In the last few decades, various red blood cell (RBC) freezing techniques have been d... more Background: In the last few decades, various red blood cell (RBC) freezing techniques have been developed and improved to enable the preservation of erythrocytes for future use in pre-transfusion tests in reference immunohaematology laboratories. However, not all these techniques have been sufficiently evaluated for the preservation of blood group antigens. Objectives: In this study, we evaluated the antigenic pattern of RBCs preserved by droplet freezing in liquid nitrogen in a blood bank context. Methods: Blood samples were evaluated for the reactivity of blood group antigens after droplet freezing using the non-permeable cryoprotective agent polyvinylpyrrolidone (PVP) and sucrose-dextrose (S + D) solutions. Results: No qualitative changes were observed in RBC reactivity after freezing and thawing for the antigens Fy b , Le b , C, E, C w , Lu a , Lu b , Kp a , Kp b and Di a. However, cryopreservation using PVP resulted in a significant increase in reactivity of Fy b antigen on comparing fresh and frozen samples (P < 0•001). Conclusion: The establishment of detailed protocols for cryopreservation of RBCs, which take into account the maintenance of antigenic characteristics, is necessary to increase security in pre-transfusion testing using frozen RBCs.
Revista Brasileira de Hematologia e Hemoterapia, 2014
Hematology, Transfusion and Cell Therapy, 2021
Gil Cunha De Santisa,b, Alfredo Mendronea,c,d, Dante Langhi Jr. a,e,∗, Dimas Tadeu Covasa,b, Antô... more Gil Cunha De Santisa,b, Alfredo Mendronea,c,d, Dante Langhi Jr. a,e,∗, Dimas Tadeu Covasa,b, Antônio Fabron Jr. a,f, Afonso José Pereira Corteza,g, Carla Luana Dinardoa,c, Eugênia Maria Amorim Ubiali a,b, José Francisco Comenalli Marques Jr. a,h, José Orlando Bordina,e,i, Marilia Alvares Rugania,j a Associação Brazileira de Hematologia, Hemoterapia e Terapia Celular(ABHH), São Paulo, SP, Brazil b Hemocentro de Ribeirão Preto, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil c Fundação Pró-Sangue, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil d Hospital Sírio Libanês, São Paulo, SP, Brazil e Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil f Faculdade de Medicina de Marilia (FAMEMA), Marília, SP, Brazil g Associação Beneficente de Coleta de Sangue (Colsan), São Paulo, SP, Brazil h Hemocentro da Universidade Estadual de ...
Hematology, Transfusion and Cell Therapy
Journal of Medical Virology
Transfusion
A 26‐year‐old woman with sickle cell disease (SCD) on chronic transfusion therapy complained of s... more A 26‐year‐old woman with sickle cell disease (SCD) on chronic transfusion therapy complained of severe arthralgia, myalgia, abdominal pain, headache, and fever 24 hours after transfusion of a red blood cells (RBCs). Dengue virus (DENV) infection was suspected and the patient was hospitalized for clinical support and RBC transfusion, to lower the hemoglobin S to less than 30%. The patientʼs clinical condition improved approximately 8 days after the onset of symptoms.
Revista do Instituto de Medicina Tropical de São Paulo
This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Emerging Infectious Diseases
Blood
Estimating risks of transfusion-transmitted infections is essential for monitoring blood safety a... more Estimating risks of transfusion-transmitted infections is essential for monitoring blood safety and for helping physicians and patients decide about the risks/benefits of an allogeneic transfusion. In 2000, the residual risk of HIV in our institution was estimated in 1/325,000 units transfused and the prevalence of HIV among all blood donors was 0.06%. The goal of this study was to calculate the current residual risk of transfusion-transmitted HIV infection in the Regional Blood Center of Ribeirão Preto, University of São Paulo, Brazil. We evaluated 292,587 repeated donations of a total of 403,568 donations between january/2002 and december/2005. During this period, we identified 43 seroconversions among the repeated donors. The serological tests performed were 2 different enzyme immunoassays (EIA): HIV 1/2 and a conjugated p24 antigen/antibody as screening tests and Western Blot as a confirmatory test for all positive samples. In order to calculate the residual risk, we used the ...
Transfusion
BACKGROUND: In 2015, there was a large Zika virus (ZIKV) outbreak in Brazil. The proportion of as... more BACKGROUND: In 2015, there was a large Zika virus (ZIKV) outbreak in Brazil. The proportion of asymptomatic infections is very high, and it is possible for transfusion-transmitted ZIKV (TT-ZIKV) infection to occur. The prevalence of asymptomatic ZIKV infection among Brazilian blood donors during this epidemic outbreak is unknown. STUDY DESIGN AND METHODS: Plasma samples obtained between October 2015 and May 2016 from 1393 volunteer blood donors were tested for ZIKV RNA. The viral load was quantified using an in-house standard curve. Additionally, positive ZIKV RNA samples were tested for anti-ZIKV immunoglobulin (Ig)M and anti-ZIKV IgG. ABBREVIATIONS: CHIKV 5 chikungunya virus; DENV 5 Dengue virus; TT-DENV 5 transfusion-transmitted Dengue virus; TT-ZIKV 5 transfusion-transmitted Zika virus; ZIKV 5 Zika virus.
Journal of infection in developing countries, Jan 31, 2017
American tripanosomiasis (Chagas disease), the second most neglected disease in the world, is cau... more American tripanosomiasis (Chagas disease), the second most neglected disease in the world, is caused by the protozoan parasite Trypanosoma cruzi. Though natural transmission by insect vectors has been controlled, there is significant risk of T. cruzi transmission by blood transfusion in non-endemic regions, generally due to immigration processes from endemic areas. The objective of this study was to evaluate anti-T. cruzi seroprevalence in blood donors from the western part of São Paulo State, Brazil, by serologic and immunofluorescence confirmation tests for the period between 2012 and 2014. Currently, this region is regarded as a non-endemic area for Chagas disease. The confirmed overall T. cruzi seroprevalence among blood donors was 0.10%, which can be considered low compared to other Brazilian regions. Nevertheless, the distribution of the anti-T. cruzi antibodies within the examined region was uneven, and some areas of significantly higher prevalence were observed. We could con...
Os antígenos polimórficos do Sistema Sangüíneo Duffy, Fy® e Fyb, encontram-se em proteínas produz... more Os antígenos polimórficos do Sistema Sangüíneo Duffy, Fy® e Fyb, encontram-se em proteínas produzidas pelos genes codominantes FY A e FY B.O alelo FY B silencioso foi descrito em negros, associado à mutação T -33C que ocorre no "box" GATA-1, na região promotora do gene Duffy. Esta mutação não foi descrita em brancos. Enfraquecimento do antígeno Fyb na raça branca foi associado à mutação C265T. A literatura registra vários casos de aparente discrepância entre o fenótipo e o genótipo Duffy. Parte destes casos são atribuídos ao alelo FY B silencioso que é responsável pela maioria dos fenótipos Fy(a-b- ) de negros africanos. Entre os brancos, por outro lado, o antígeno Fyb enfraquecido pode muitas vezes não ser detectado na avaliação sorológica e ser responsável também por casos de discrepância genótipo/fenótipo Duffy. Com a finalidade de realizar um estudo comparativo entre o genótipo Duffy determinado por biologia molecular e o fenótipo sorológico Duffy e para determinar eve...
Revista da Sociedade Brasileira de Medicina Tropical, 2016
Introduction: Human T-lymphotropic virus types 1/2 (HTLV-1/2) are distributed worldwide and are e... more Introduction: Human T-lymphotropic virus types 1/2 (HTLV-1/2) are distributed worldwide and are endemic in specific regions. Methods: Serological evaluation of the HTLV-1/2 prevalence and co-infection rate [human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Chagas disease, and syphilis)] for 2011-2014 was performed with volunteer blood donors from the western part of São Paulo State. Results: Serrana and Araçatuba had higher HTLV seroprevalence rates (0.1%); while Franca, Olimpia, and Bebedouro had lower seroprevalences (0.04%). Co-infection (HBV and syphilis) was present in 12.3% of HTLV-infected blood donors. Conclusions: Our findings provide data for the prevalence of HTLV in Brazil and demonstrate the importance of regional and global hemovigilance.
Evaluation of the antimicrobial effect of skin disinfection techniques is essential to avoid the ... more Evaluation of the antimicrobial effect of skin disinfection techniques is essential to avoid the transmission of infectious agents during blood transfusion. The aim of this study was to examine the effectiveness of two methods of arm skin disinfection used in blood donors at a Hemotherapy Center in Brazil that represents an important centre for distributing haemocomponents to many cities in the country. Two skin disinfection techniques in 50 blood donors were evaluated. For the first arm, 10% povidone-iodine/two-stage technique was used. On the opposite arm, 0.5% chlorhexidine digluconate alcohol solution/one-stage technique was used. The swabs were seeded on three culture media: blood agar, mannitol salt agar and Mac Conkey agar. Automated bacterial classification based on biochemical tests/specific substrates was performed. Donor characteristics were collected using the computerised system of the Hemotherapy Center. We found that microbial reduction was significantly higher for 10% povidone-iodine technique (98.57-98.87%) when compared with 0.5% chlorhexidine technique (94.38-95.06%). The species Leuconostoc mesenteroides and Staphylococcus hominis showed resistance to both disinfection techniques. We did not find statistically significant relationships between donor characteristics and microbial reduction. Arm skin disinfection with 10% povidone-iodine produced better antimicrobial activity. We must acknowledge that 10% povidone-iodine technique has the limitation of being a two-stage method. However, prevention of adverse events due to bacterial contamination and transfusion reactions should be prioritised. Production of hypoallergenic and stronger antiseptics that allowed a safe one-stage disinfection technique should be encouraged in health systems, not only in Brazil but also around the world.
Transfusion medicine (Oxford, England), Jan 31, 2015
Dear Sir, In transfusion medicine, the development of alloantibodies against red blood cell (RBC)... more Dear Sir, In transfusion medicine, the development of alloantibodies against red blood cell (RBC) antigens is a major problem. Therefore, for multiply-transfused patients a safe blood transfusion requires precise determination of the erythrocyte antigen profile in order to avoid life-threatening immunologic reactions. The use of diagnostic serology has some limitations, because it is not applicable in recently transfused patients and in those with positive direct antiglobulin test (DAT) (Denomme & Van Oene, 2005; Westhoff, 2006). To avoid these short-comings, nucleic acid amplification techniques to determine blood group antigens can be applied as they are not influenced by the circulating RBC phenotypes of the donor (Reid & Denomme, 2011). However, there is no consensus between the different laboratories for the best molecular reference test to be used and in many transfusion laboratories such tests are not implemented due to the lack of technology and high costs. In this study, we developed a real-time TaqMan® PCR (LifeTechnologies, São Paulo, Brazil) to genotype Rhesus (RHCE*01/RHCE*02/RHCE*03/RHCE*04), MNS (GYPB*03/GYPB*04), Kidd (JK*01/JK*02) and Duffy (FY*01/FY*02 and FY*02N.01) blood groups. The optimised real-time genotyping assay showed improved detection limit and used reduced amount of reagents. Thus, this reaction diminishes the overall costs and at the same time maintaining reaction accuracy. This methodology can be applied for quick and safe genotyping of blood samples obtained from multiply-transfused patients. For genotyping of blood groups, the primers and hydrolytic probes were designed based on the Rh (307 C>T, 676G>C), MNS (c.143C>T), Kidd (c.838 A>G), Duffy (c.125 A>G) and FY*02N.01 (c.1-67T>C) single-nucleotide polymorphism (SNPs). One of the probes representing one allele was labelled by the reporter FAM (6-carboxyfluorescein), and the probe representing the other was labelled by VIC (4, 7, 2′-trichloro-7′-phenyl-6-carboxyfluorescein) (Table 1). The real-time reactions were performed using the 7500 Real-time
Vox Sanguinis, 2019
Background and objectives The rare S-s-phenotype has two main molecular backgrounds. GYPB deletio... more Background and objectives The rare S-s-phenotype has two main molecular backgrounds. GYPB deletions give rise to the S-s-U-phenotype, which loses the expression of the U antigen, while variant GYPB alleles usually lead to the S-s-U +var phenotype, which express a variant U antigen. The S-s-phenotype is typically found in people of African origin and represents a challenge in transfusion sets, especially when S-s-patients develop anti-U. Molecular analysis is the most reliable method for determining U antigen status. We studied the molecular basis of the S-s-phenotype in donors and patients at Regional Blood Center of Ribeirão Preto. Material and Methods Five patients and 25 donors with the S-s-phenotype were investigated through real-time PCR for the GYPB*S/s polymorphism, followed by an allele-specific/RFLP-PCR for GYPB deletion (GYPB*) and for its main variants: GYPB*P2 and GYPB*NY. DNA sequencing was conducted in one sample. Results Two samples were heterozygous GYPB*P2/GYPB*NY, eight were homozygous/hemizygous for GYPB*P2 and 19 samples were homozygous for GYPB*. A hybrid gene (GYPB-E-B.Ros) was found in one sample after discrepant results in the initial tests. Conclusion GYPB deletion is the main mechanism responsible for the S-s-phenotype in our donors and patients. It is essential to evaluate the main GYPB variant alleles when genotyping in order to obtain the correct prediction of the phenotype. Hybrid genes lead to discrepancies between genotype and phenotype and may not be detected by conventional molecular assays.
Blood transfusion = Trasfusione del sangue, 2020
BACKGROUND Post-donation illness can be described as appearance of clinical symptoms in blood don... more BACKGROUND Post-donation illness can be described as appearance of clinical symptoms in blood donors after donation. The consequent call back of the donor to report these symptoms to the blood collection institution is considered a post-donation illness report (PDIR). The most suitable way to examine whether PDIR is related to infection is to apply next-generation sequencing (NGS) and viral metagenomics. Investigation into a PDIR can reveal its importance for transfusion safety and help elaborate strategies for donor education in order to prevent the transfusion transmission of infections which are not routinely tested by the blood collection services. MATERIALS AND METHODS We applied NGS and viral metagenomics on blood donations which were deferred due to a PDIR. Thirty-three PDIR donations obtained in the Blood Center of Ribeirão Preto, Southeast Brazil, were evaluated. Sequencing was performed using Illumina NextSeq 550 (Illumina Inc, San Diego, CA, USA) equipment and the reads o...
Revista do Instituto de Medicina Tropical de São Paulo, 2012
The seroprevalence and geographic distribution of HTLV-1/2 among blood donors are extremely impor... more The seroprevalence and geographic distribution of HTLV-1/2 among blood donors are extremely important to transfusion services. We evaluated the seroprevalence of HTLV-1/2 infection among first-time blood donor candidates in Ribeirão Preto city and region. From January 2000 to December 2010, 1,038,489 blood donations were obtained and 301,470 were first-time blood donations. All samples were screened with serological tests for HTLV-1/2 using enzyme immunoassay (EIA). In addition, the frequency of coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), Chagas disease (CD) and syphilis was also determined. In-house PCR was used as confirmatory test for HTLV-1/2. A total of 296 (0.1%) first-time donors were serologically reactive for HTLV-1/2. Confirmatory PCR of 63 samples showed that 28 were HTLV-1 positive, 13 HTLV-2 positive, 19 negative and three indeterminate. Regarding HTLV coinfection rates, the most prevalent was with HBV (51.3%) a...
Transfusion Medicine, 2017
Background: In the last few decades, various red blood cell (RBC) freezing techniques have been d... more Background: In the last few decades, various red blood cell (RBC) freezing techniques have been developed and improved to enable the preservation of erythrocytes for future use in pre-transfusion tests in reference immunohaematology laboratories. However, not all these techniques have been sufficiently evaluated for the preservation of blood group antigens. Objectives: In this study, we evaluated the antigenic pattern of RBCs preserved by droplet freezing in liquid nitrogen in a blood bank context. Methods: Blood samples were evaluated for the reactivity of blood group antigens after droplet freezing using the non-permeable cryoprotective agent polyvinylpyrrolidone (PVP) and sucrose-dextrose (S + D) solutions. Results: No qualitative changes were observed in RBC reactivity after freezing and thawing for the antigens Fy b , Le b , C, E, C w , Lu a , Lu b , Kp a , Kp b and Di a. However, cryopreservation using PVP resulted in a significant increase in reactivity of Fy b antigen on comparing fresh and frozen samples (P < 0•001). Conclusion: The establishment of detailed protocols for cryopreservation of RBCs, which take into account the maintenance of antigenic characteristics, is necessary to increase security in pre-transfusion testing using frozen RBCs.
Revista Brasileira de Hematologia e Hemoterapia, 2014
Hematology, Transfusion and Cell Therapy, 2021
Gil Cunha De Santisa,b, Alfredo Mendronea,c,d, Dante Langhi Jr. a,e,∗, Dimas Tadeu Covasa,b, Antô... more Gil Cunha De Santisa,b, Alfredo Mendronea,c,d, Dante Langhi Jr. a,e,∗, Dimas Tadeu Covasa,b, Antônio Fabron Jr. a,f, Afonso José Pereira Corteza,g, Carla Luana Dinardoa,c, Eugênia Maria Amorim Ubiali a,b, José Francisco Comenalli Marques Jr. a,h, José Orlando Bordina,e,i, Marilia Alvares Rugania,j a Associação Brazileira de Hematologia, Hemoterapia e Terapia Celular(ABHH), São Paulo, SP, Brazil b Hemocentro de Ribeirão Preto, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil c Fundação Pró-Sangue, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil d Hospital Sírio Libanês, São Paulo, SP, Brazil e Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil f Faculdade de Medicina de Marilia (FAMEMA), Marília, SP, Brazil g Associação Beneficente de Coleta de Sangue (Colsan), São Paulo, SP, Brazil h Hemocentro da Universidade Estadual de ...
Hematology, Transfusion and Cell Therapy
Journal of Medical Virology
Transfusion
A 26‐year‐old woman with sickle cell disease (SCD) on chronic transfusion therapy complained of s... more A 26‐year‐old woman with sickle cell disease (SCD) on chronic transfusion therapy complained of severe arthralgia, myalgia, abdominal pain, headache, and fever 24 hours after transfusion of a red blood cells (RBCs). Dengue virus (DENV) infection was suspected and the patient was hospitalized for clinical support and RBC transfusion, to lower the hemoglobin S to less than 30%. The patientʼs clinical condition improved approximately 8 days after the onset of symptoms.
Revista do Instituto de Medicina Tropical de São Paulo
This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Emerging Infectious Diseases
Blood
Estimating risks of transfusion-transmitted infections is essential for monitoring blood safety a... more Estimating risks of transfusion-transmitted infections is essential for monitoring blood safety and for helping physicians and patients decide about the risks/benefits of an allogeneic transfusion. In 2000, the residual risk of HIV in our institution was estimated in 1/325,000 units transfused and the prevalence of HIV among all blood donors was 0.06%. The goal of this study was to calculate the current residual risk of transfusion-transmitted HIV infection in the Regional Blood Center of Ribeirão Preto, University of São Paulo, Brazil. We evaluated 292,587 repeated donations of a total of 403,568 donations between january/2002 and december/2005. During this period, we identified 43 seroconversions among the repeated donors. The serological tests performed were 2 different enzyme immunoassays (EIA): HIV 1/2 and a conjugated p24 antigen/antibody as screening tests and Western Blot as a confirmatory test for all positive samples. In order to calculate the residual risk, we used the ...
Transfusion
BACKGROUND: In 2015, there was a large Zika virus (ZIKV) outbreak in Brazil. The proportion of as... more BACKGROUND: In 2015, there was a large Zika virus (ZIKV) outbreak in Brazil. The proportion of asymptomatic infections is very high, and it is possible for transfusion-transmitted ZIKV (TT-ZIKV) infection to occur. The prevalence of asymptomatic ZIKV infection among Brazilian blood donors during this epidemic outbreak is unknown. STUDY DESIGN AND METHODS: Plasma samples obtained between October 2015 and May 2016 from 1393 volunteer blood donors were tested for ZIKV RNA. The viral load was quantified using an in-house standard curve. Additionally, positive ZIKV RNA samples were tested for anti-ZIKV immunoglobulin (Ig)M and anti-ZIKV IgG. ABBREVIATIONS: CHIKV 5 chikungunya virus; DENV 5 Dengue virus; TT-DENV 5 transfusion-transmitted Dengue virus; TT-ZIKV 5 transfusion-transmitted Zika virus; ZIKV 5 Zika virus.
Journal of infection in developing countries, Jan 31, 2017
American tripanosomiasis (Chagas disease), the second most neglected disease in the world, is cau... more American tripanosomiasis (Chagas disease), the second most neglected disease in the world, is caused by the protozoan parasite Trypanosoma cruzi. Though natural transmission by insect vectors has been controlled, there is significant risk of T. cruzi transmission by blood transfusion in non-endemic regions, generally due to immigration processes from endemic areas. The objective of this study was to evaluate anti-T. cruzi seroprevalence in blood donors from the western part of São Paulo State, Brazil, by serologic and immunofluorescence confirmation tests for the period between 2012 and 2014. Currently, this region is regarded as a non-endemic area for Chagas disease. The confirmed overall T. cruzi seroprevalence among blood donors was 0.10%, which can be considered low compared to other Brazilian regions. Nevertheless, the distribution of the anti-T. cruzi antibodies within the examined region was uneven, and some areas of significantly higher prevalence were observed. We could con...
Os antígenos polimórficos do Sistema Sangüíneo Duffy, Fy® e Fyb, encontram-se em proteínas produz... more Os antígenos polimórficos do Sistema Sangüíneo Duffy, Fy® e Fyb, encontram-se em proteínas produzidas pelos genes codominantes FY A e FY B.O alelo FY B silencioso foi descrito em negros, associado à mutação T -33C que ocorre no "box" GATA-1, na região promotora do gene Duffy. Esta mutação não foi descrita em brancos. Enfraquecimento do antígeno Fyb na raça branca foi associado à mutação C265T. A literatura registra vários casos de aparente discrepância entre o fenótipo e o genótipo Duffy. Parte destes casos são atribuídos ao alelo FY B silencioso que é responsável pela maioria dos fenótipos Fy(a-b- ) de negros africanos. Entre os brancos, por outro lado, o antígeno Fyb enfraquecido pode muitas vezes não ser detectado na avaliação sorológica e ser responsável também por casos de discrepância genótipo/fenótipo Duffy. Com a finalidade de realizar um estudo comparativo entre o genótipo Duffy determinado por biologia molecular e o fenótipo sorológico Duffy e para determinar eve...
Revista da Sociedade Brasileira de Medicina Tropical, 2016
Introduction: Human T-lymphotropic virus types 1/2 (HTLV-1/2) are distributed worldwide and are e... more Introduction: Human T-lymphotropic virus types 1/2 (HTLV-1/2) are distributed worldwide and are endemic in specific regions. Methods: Serological evaluation of the HTLV-1/2 prevalence and co-infection rate [human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Chagas disease, and syphilis)] for 2011-2014 was performed with volunteer blood donors from the western part of São Paulo State. Results: Serrana and Araçatuba had higher HTLV seroprevalence rates (0.1%); while Franca, Olimpia, and Bebedouro had lower seroprevalences (0.04%). Co-infection (HBV and syphilis) was present in 12.3% of HTLV-infected blood donors. Conclusions: Our findings provide data for the prevalence of HTLV in Brazil and demonstrate the importance of regional and global hemovigilance.
Evaluation of the antimicrobial effect of skin disinfection techniques is essential to avoid the ... more Evaluation of the antimicrobial effect of skin disinfection techniques is essential to avoid the transmission of infectious agents during blood transfusion. The aim of this study was to examine the effectiveness of two methods of arm skin disinfection used in blood donors at a Hemotherapy Center in Brazil that represents an important centre for distributing haemocomponents to many cities in the country. Two skin disinfection techniques in 50 blood donors were evaluated. For the first arm, 10% povidone-iodine/two-stage technique was used. On the opposite arm, 0.5% chlorhexidine digluconate alcohol solution/one-stage technique was used. The swabs were seeded on three culture media: blood agar, mannitol salt agar and Mac Conkey agar. Automated bacterial classification based on biochemical tests/specific substrates was performed. Donor characteristics were collected using the computerised system of the Hemotherapy Center. We found that microbial reduction was significantly higher for 10% povidone-iodine technique (98.57-98.87%) when compared with 0.5% chlorhexidine technique (94.38-95.06%). The species Leuconostoc mesenteroides and Staphylococcus hominis showed resistance to both disinfection techniques. We did not find statistically significant relationships between donor characteristics and microbial reduction. Arm skin disinfection with 10% povidone-iodine produced better antimicrobial activity. We must acknowledge that 10% povidone-iodine technique has the limitation of being a two-stage method. However, prevention of adverse events due to bacterial contamination and transfusion reactions should be prioritised. Production of hypoallergenic and stronger antiseptics that allowed a safe one-stage disinfection technique should be encouraged in health systems, not only in Brazil but also around the world.