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Pereira JG, Leon LAA, de Almeida NAA, Raposo-Vedovi JV, Fontes-Dantas FL, Farinhas JGD, Pereira VCSR, Alves-Leon SV, de Paula VS. Higher frequency of Human herpesvirus-6 (HHV-6) viral DNA simultaneously with low frequency of Epstein-Barr virus (EBV) viral DNA in a cohort of multiple sclerosis patients from Rio de Janeiro, Brazil. Mult Scler Relat Disord 2023; 76:104747. [PMID: 37267685 DOI: 10.1016/j.msard.2023.104747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 04/18/2023] [Accepted: 04/30/2023] [Indexed: 06/04/2023]
Abstract
Multiple sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease of the central nervous system (CNS). The etiology of MS is not well understood, but it's likely one of the genetic and environmental factors. Approximately 85% of patients have relapsing-remitting MS (RRMS), while 10-15% have primary progressive MS (PPMS). Epstein-Barr virus (EBV) and Human herpesvirus 6 (HHV-6), members of the human Herpesviridae family, are strong candidates for representing the macroenvironmental factors associated with MS) pathogenesis. Antigenic mimicry of EBV involving B-cells has been implicate in MS risk factors and concomitance of EBV and HHV-6 latent infection has been associated to inflammatory MS cascade. To verify the possible role of EBV and HHV-6 as triggering or aggravating factors in RRMS and PPMS, we compare their frequency in blood samples collected from 166 MS patients. The presence of herpes DNA was searched by real-time PCR (qPCR). The frequency of EBV and HHV-6 in MS patients were 1.8% (3/166) and 8.9% (14/166), respectively. Among the positive patients, 100% (3/3) EBV and 85.8% (12/14) HHV-6 are RRMS and 14.4% (2/14) HHV-6 are PPMS. Detection of EBV was 1.2% (2/166) and HHV-6 was 0.6% (1/166) in blood donors. About clinical phenotype of these patients, incomplete multifocal myelitis, and optic neuritis were the main CNS manifestations. These are the first data about concomitant infection of these viruses in MS patients from Brazil. Up to date, our findings confirm a higher prevalence in female with MS and a high frequency of EBV and HHV-6 in RRMS patients.
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Affiliation(s)
| | - Luciane A Amado Leon
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/ Fiocruz, Rio de Janeiro, Brazil
| | | | - Jéssica Vasques Raposo-Vedovi
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, Brazil
| | - Fabrícia Lima Fontes-Dantas
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, (UERJ), Rio de Janeiro, Brazil
| | - João Gabriel Dib Farinhas
- Department of Neurology/Reference and Research Center for Multiple Sclerosis and Other Central Nervous System Idiopathic Demyelinating Inflammatory Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Valéria Coelho Santa Rita Pereira
- Department of Neurology/Reference and Research Center for Multiple Sclerosis and Other Central Nervous System Idiopathic Demyelinating Inflammatory Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Soniza V Alves-Leon
- Department of Neurology/Reference and Research Center for Multiple Sclerosis and Other Central Nervous System Idiopathic Demyelinating Inflammatory Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, Brazil.
| | - Vanessa S de Paula
- Laboratory of Molecular Virology, Oswaldo Cruz Institute/ Fiocruz, Rio de Janeiro, Brazil
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Misnaza-Castrillón SP, Martínez-Angarita JC, Martínez-Gómez VM. [Geographic distribution of mortality due to multiple sclerosis in Colombia, 2010-2015]. Rev Salud Publica (Bogota) 2023; 21:444-451. [PMID: 36753268 DOI: 10.15446/rsap.v21n4.76176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 05/30/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To characterize the geographical distribution of extended mortality due to multiple sclerosis in Colombia between 2010 and 2015. MATERIALS AND METHODS Descriptive study to analyze the geographical distribution of mortality rates from the death certificates between 2010 and 2015. State and municipal mortality rates were calculated and adjusted by age and sex. RESULTS 56.8% of deaths occurred in women and 28.7% in people aged 50 to 59 years. In 2010, the national mortality rate was 0.28 per 100,000 people, and the highest was recorded in Casanare (0.59 per 100,000). In 2011, the rate was 0.24, and Buenaventura recorded the highest (0.51). In 2012, the rate was 0.27, and la Guajira recorded the highest (0.34). In 2013, the rate was 0.27, and the highest was in Arauca (0.83). In 2014, the rate was 0.32, and the highest was occurred in Putumayo (1.14). In 2015 the rate was 0.23 and Santa Marta recorded the highest (0.58). By municipalities, Sativanorte, Arcabuco (Boyacá), San Miguel, la Paz (Santander) and la Merced (Caldas) recorded the highest rates. CONCLUSION The pattern of mortality due to multiple sclerosis is similar in the study period. The highest burden of mortality was recorded in women and in municipalities of Santander and Boyacá.
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Affiliation(s)
- Sandra P Misnaza-Castrillón
- SM: OD. Esp. Gerencia de la Salud Pública. M. Sc. Administración en Salud. Instituto Nacional de Salud. Bogotá, Colombia.
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A systematic review about the epidemiology of primary progressive multiple sclerosis in Latin America and the Caribbean. Mult Scler Relat Disord 2018; 22:1-7. [DOI: 10.1016/j.msard.2018.02.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 01/06/2023]
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Rabadi MH, Aston CE. Predictors of Mortality in Veterans with Multiple Sclerosis in an Outpatient Clinic Setting. Int J MS Care 2017; 19:265-273. [PMID: 29070968 DOI: 10.7224/1537-2073.2016-067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Examining factors that increase risk of death in veterans with multiple sclerosis (MS) may help reduce MS-related mortality. We sought to determine predictors of mortality in veterans with MS attending an outpatient clinic. METHODS Review of electronic medical records of 226 veterans with MS regularly followed up from January 1, 2000, through December 31, 2014. RESULTS Mortality at the end of the 15-year study period was 14%. Patients with MS died prematurely, with a standardized mortality rate of 1.35 relative to the general (Oklahoma) population. The main causes of death documented were MS disease itself (57% of cases), infection (43%), and cancer and respiratory failure (18% each). Cox regression analysis using the whole cohort showed that progressive MS type; older age at entry into the study; presence of sensory, cerebellar, or motor (weakness and/or ataxia) concerns on presentation; more disability on presentation; higher body-mass index; being diabetic; never received disease-modifying therapy; and presence of pressure ulcers or neurogenic bladder were significant predictors of higher mortality. CONCLUSIONS Initial presentation by MS type (progressive MS), higher level of disability, and associated motor, sensory, and cerebellar concerns are significant predictors of MS-related mortality. The main causes of death were MS disease itself, infection, respiratory disease, and cancer. More attention should be given to preventive strategies that delay mortality, such as yearly immunization and aggressively treating MS-related complications and diabetes mellitus.
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Abstract
Novel epidemiological data have appeared in recent years in Latin America (LATAM). The objective of this study was to perform an updated systematic review of the epidemiology of the disease reported in LATAM.
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Affiliation(s)
| | - Juan Ignacio Rojas
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
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Vasconcelos C, Thuler L, Rodrigues B, Calmon A, Alvarenga R. Multiple sclerosis in Brazil: A systematic review. Clin Neurol Neurosurg 2016; 151:24-30. [DOI: 10.1016/j.clineuro.2016.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/11/2016] [Accepted: 07/03/2016] [Indexed: 10/21/2022]
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Pereira VCSR, Malfetano FR, Meira ID, Souza LFD, Liem AM, Maiolino A, Alves-Leon SV. Clinical response to interferon beta and glatiramer acetate in multiple sclerosis patients: a Brazilian cohort. ARQUIVOS DE NEURO-PSIQUIATRIA 2013; 70:774-9. [PMID: 23060103 DOI: 10.1590/s0004-282x2012001000005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 06/19/2012] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Many patients with multiple sclerosis (MS) are currently receiving treatment with interferon beta (IFNb) and glatiramer acetate (GA). Identifying nonresponders patients is important to define therapy strategies. Several criteria for treatment response to IFNb and GA have been proposed. OBJECTIVE It was to investigate the response to treatment with IFNb-1a, IFNb-1b and GA among relapsing-remitting multiple sclerosis (RRMS) patients. METHODS We analyzed treatment response to IFNb and GA in ninety-one RRMS patients followed for at least one year. Clinical response was established by clinical criteria based on relapses, disability progression or both. RESULTS We observed a proportion of nonresponders, ranging from 3.3 to 42.9%, depending on the stringency of the criteria used. CONCLUSIONS Our sample of Brazilian patients with MS has similarities when compared to other studies and there was no statistically significant difference regarding age, gender, ethnicity or disease duration between responders and nonresponders.
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Ojeda E, Díaz-Cortes D, Rosales D, Duarte-Rey C, Anaya JM, Rojas-Villarraga A. Prevalence and clinical features of multiple sclerosis in Latin America. Clin Neurol Neurosurg 2013; 115:381-7. [DOI: 10.1016/j.clineuro.2012.11.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 11/20/2012] [Accepted: 11/27/2012] [Indexed: 01/15/2023]
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Toro J, Cárdenas S, Fernando Martínez C, Urrutia J, Díaz C. Multiple sclerosis in Colombia and other Latin American Countries. Mult Scler Relat Disord 2013; 2:80-9. [DOI: 10.1016/j.msard.2012.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 08/30/2012] [Accepted: 09/05/2012] [Indexed: 11/29/2022]
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Cristiano E, Rojas JI, Romano M, Frider N, Machnicki G, Giunta DH, Calegaro D, Corona T, Flores J, Gracia F, Macias-Islas M, Correale J. The epidemiology of multiple sclerosis in Latin America and the Caribbean: a systematic review. Mult Scler 2012; 19:844-54. [DOI: 10.1177/1352458512462918] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The incidence and prevalence of multiple sclerosis (MS) varies geographically as shown through extensive epidemiological studies performed mainly in developed countries. Nonetheless, scant data is available in Latin America and the Caribbean (LAC). The objective of this review is to assess epidemiological data of MS in LAC. We conducted a systematic review of published articles and gray literature from January 1995 to May 2011. Twenty-two studies met the inclusion criteria after full-text review. Incidence data were found in only three studies and ranged from 0.3 to 1.9 annual cases per 100,000 person-years. Prevalence was reported in 10 studies and ranged from 0.83 to 21.5 cases per 100,000 inhabitants. The most prevalent subtype of MS was the relapsing–remitting form (48% to 91% of the series). No data about mortality were found. This study showed low frequency for MS in LAC compared with North American and European countries. The role of environmental and genetic factors should be well studied, providing new insights about its etiology.
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Affiliation(s)
- E Cristiano
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
| | - JI Rojas
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
| | - M Romano
- Department of Neurocience, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, CEMIC, Argentina
| | - N Frider
- Regional Medical Director in Neuroscience, Novartis Latinoamerica & Canada
| | - G Machnicki
- Global Health Economics and Outcomes Research, Novartis Latinoamerica & Canada
| | - DH Giunta
- Department of Internal Medicine, Section of Epidemiology, Hospital Italiano de Buenos Aires, Argentina
| | - D Calegaro
- Hospital das Clinicas-Universidade de São Paulo, Brazil
| | - T Corona
- Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Mexico
| | - J Flores
- Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Mexico
| | - F Gracia
- Multiple Sclerosis Clinic, Santo Tomás Hospital, Panamá
| | - M Macias-Islas
- Neurosciences Department, CUCS, Guadalajara University, Mexico
| | - J Correale
- Department of Neurology, Raúl Carrea Institute for Neurological Research, FLENI, Argentina
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Alves-Leon SV, Veluttini-Pimentel ML, Gouveia ME, Malfetano FR, Gaspareto EL, Alvarenga MP, Frugulhetti I, Quirico-Santos T. Acute disseminated encephalomyelitis: clinical features, HLA DRB1*1501, HLA DRB1*1503, HLA DQA1*0102, HLA DQB1*0602, and HLA DPA1*0301 allelic association study. ARQUIVOS DE NEURO-PSIQUIATRIA 2010; 67:643-51. [PMID: 19722042 DOI: 10.1590/s0004-282x2009000400013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 05/11/2009] [Indexed: 11/21/2022]
Abstract
We evaluated the frequency, demographic, clinical, disability evolution and genetic association of HLA DRB1*1501, DRB1*1503, DQA1*0102, DQB1*0602 and DPA1*0301 alleles in patients diagnosed as acute disseminated encephalomyelitis (ADEM) among a population of CNS demyelinating diseases. Fifteen patients (8.4%) of our series were diagnosed as ADEM. The mean age onset was 35.23 years (range 12 to 77), 53.3% were male and follow-up range was 8.5 to 16 years. Two cases (13.3%) had a preceding infection before neurological symptoms, one presented a parainfectious demyelinating, and one case had been submitted to hepatitis B vaccination four weeks before the clinical onset. The EDSS range was 3.0 to 9.5. Eight patients (53.3%) presented MRI with multiple large lesions. CSF was normal in 73.3%. The severe disability observed at EDSS onset improved in 86.66% patients. The genetic susceptibility for ADEM was significantly associated with the HLA DQB1*0602, DRB1*1501 and DRB1*1503 alleles (<0.05) in monophasic ADEM.
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