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Sampaio GCL, Ribeiro JR, de Almeida CN, Boa-Sorte N, Galvão-Castro B, Grassi MFR, Nunes Sá K, Dias CMCC. Human T Cell Lymphotropic Virus Type 1 Global Prevalence Associated with the Human Development Index: Systematic Review with Meta-Analysis. AIDS Res Hum Retroviruses 2023; 39:145-165. [PMID: 36571250 DOI: 10.1089/aid.2021.0230] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
In 2012, the number of people infected with human T cell lymphotropic virus type 1 (HTLV-1) was estimated to be 10 million worldwide. Prevalence varies according to geographic location, ethnic factors, sex, age, populations exposed to risk factors, income, and education, reaching countries with the worst socioeconomic scenarios. There is a need to determine the current global prevalence of HTLV-1 and examine its association with countries' human development index (HDI) to provide data for global health policy. Systematic review with meta-analysis is according to PRISMA 2020 recommendations. It was registered at PROSPERO, CRD42021223146. Prevalence or cross-sectional studies of HTLV-1 infection with at least 100 participants, screening, and confirmatory serologic testing were included. Studies with incomplete or unavailable results or with duplicate information were excluded. Data were selected by two independent investigators and analyzed using R software, a metapackage that generated the forest plots [95% confidence interval (CI)]. Heterogeneity was assessed using the I2 statistic, and funnel plot asymmetry was assessed using Egger's test. Countries were compared using an HDI cutoff ≥0.8. Methodological quality was assessed using Joanna Briggs Institute (JBI) criteria. The overall prevalence of HTLV-1 infection was 0.91% (95% CI: 0.80-1.02, p < .0001) and was higher in low HDI countries [1.18% (95% CI: 1.03-1.34)] than in high HDI countries [0.41% (95% CI: 0.27-0.57)]. Prevalence varied according to the populations studied: it was higher in the general population [1.65% (95% CI: 1.08-2.34)] compared to pregnant women [0.34% (95% CI: 0.17-0.57)] and blood donors [0.04% (95% CI: 0.01-0.08)]. Consistently, prevalence for each population group was higher in low HDI countries than in high HDI countries. The worldwide prevalence of HTLV-1 infection is highly heterogeneous, with a global prevalence of 0.91%. In high HDI countries, the observed prevalence is approximately three times lower than in low HDI countries. In the general population, the observed prevalence is about 5 times higher than in pregnant women and 41 times higher than in blood donors.
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Affiliation(s)
- Gleice Castor Lins Sampaio
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | - Jéssica Ramos Ribeiro
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | | | - Ney Boa-Sorte
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Health Technology Assessment Unit, Universidade Federal da Bahia (UFBA), Bahia, Brazil
| | - Bernardo Galvão-Castro
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Advanced Public Health Laboratory, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Maria Fernanda Rios Grassi
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Advanced Public Health Laboratory, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Katia Nunes Sá
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
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Roberto de Souza Fonseca R, Valois Laurentino R, Fernando Almeida Machado L, Eduardo Vieira da Silva Gomes C, Oliveira de Alencar Menezes T, Faciola Pessoa O, Branco Oliveira-Filho A, Resque Beckmann Carvalho T, Gabriela Faciola Pessoa de Oliveira P, Brito Tanaka E, Sá Elias Nogueira J, Magno Guimarães D, Newton Carneiro M, Mendes Acatauassú Carneiro P, Ferreira Celestino Junior A, de Almeida Rodrigues P, Augusto Fernandes de Menezes S. HIV Infection and Oral Manifestations: An Update. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.105894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Human immunodeficiency virus (HIV) causes a complete depletion of the immune system; it has been a major health issue around the world since the 1980s, and due to the reduction of CD4+ T lymphocytes levels, it can trigger various opportunistic infections. Oral lesions are usually accurate indicators of immunosuppression because these oral manifestations may occur as a result of the compromised immune system caused by HIV infection; therefore, oral lesions might be initial and common clinical features in people living with HIV. So, it is necessary to evaluate and understand the mechanism, prevalence, and risk factors of oral lesions to avoid the increase morbidity among those with oral diseases.
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3
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de Lima ACR, Lopes FT, de Oliveira Freitas V, Assad MN, de Sousa RS, Gonçalves JSS, Gomes JLC, dos Santos BC, Lima CNC, Abreu IN, dos Santos Brito WR, Pereira KAS, da Silva Torres MK, Lima SS, Aben-Athar CYU, Guerreiro JF, Cayres Vallinoto IMV, Vallinoto ACR, Feitosa RNM. Prevalence and Risk Factors for HTLV-1/2 Infection inRiverside and Rural Populations of the State of Pará. Viruses 2022; 14:v14102262. [PMID: 36298817 PMCID: PMC9610156 DOI: 10.3390/v14102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
Human T-lymphotropic viruses 1 and 2 (HTLV-1 and HTLV-2) infection has been described in several Amazonian populations; however, there is still a lack of data on the prevalence of the virus in riparian populations living in rural areas of the state of Pará. The present study aimed to evaluate the prevalence of HTLV-1/2 infection in four riverine communities and one rural area in the state of Pará and to describe the possible risk factors for infection. A total of 907 individuals responded to an epidemiological survey and gave blood samples collected for anti-HTLV-1/2 antibodies by immunoenzymatic assay (EIA). The serum-reactive samples were subjected to confirmation by an in-line assay (Inno-Lia) and by proviral DNA screening using real-time PCR (qPCR). The total prevalence was 0.8% (7/907) for HTLV-1/2 (CI: 0.2−1.3%), with 0.66% HTLV-1 and 0.11% HTLV-2. The prevalence by sex was 0.7% in women (4/565) and 0.9% in men (3/342). Among seropositive patients, 83.3% (5/7) reported being sexually active, and 57.1% (4/7) reported not having the habit of using condoms during their sexual relations. Intrafamily infection was also observed. The results reinforce the need for public policies to prevent and block the spread of HTLV, especially in riparian communities that are subject to difficulties in accessing the Unified Health System (Sistema Único de Saúde/SUS) because infected individuals need clinical monitoring for surveillance and early diagnosis of symptoms associated with HTLV-1.
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Affiliation(s)
- Aline Cecy Rocha de Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Felipe Teixeira Lopes
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | | | | | - Janete Silvana Souza Gonçalves
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | | | - Carlos Neandro Cordeiro Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Isabella Nogueira Abreu
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Wandrey Roberto dos Santos Brito
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Keise Adrielle Santos Pereira
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Maria Karoliny da Silva Torres
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Sandra Souza Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | - João Farias Guerreiro
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Izaura M. V. Cayres Vallinoto
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Rosimar Neris Martins Feitosa
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
- Correspondence: ; Tel.: +55-919-9117-9811
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Oliveira-Filho AB, Frade PCR, Fonseca RRDS, Sawada L, Martins LC, Machado LFA, Vallinoto ACR, Ishak R, de Lemos JAR, Fischer B, Kupek E. Spread of Human T-Lymphotropic Virus 1 and 2 Among Relatives of People Who Use Illicit Drugs in Northern Brazil. Front Microbiol 2022; 13:889948. [PMID: 35722295 PMCID: PMC9205188 DOI: 10.3389/fmicb.2022.889948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022] Open
Abstract
The human T-lymphotropic virus 1 (HTLV-1) and 2 (HTLV-2) can be transmitted between humans by mechanisms associated with horizontal and vertical routes. Recently, high prevalence rates and levels of genetic diversity for HTLV-1 and HTLV-2 were detected among people who use illicit drugs (PWUDs) in the Brazilian state of Pará. None of the PWUDs with HTLV-1 or HTLV-2 were aware of their carrier condition of the retrovirus, and they ability to spread it to their family group, sexual partners, and other contacts. Thus, this study evaluated the presence of HTLV-1 and HTLV-2 in families of PWUDs in the state of Pará, in Northern Brazil. This descriptive study used convenience sampling and accessed 37 PWUDs and their respective families (n = 97) in 18 municipalities in the state of Pará, northern Brazil. All participants provided personal data and were tested for the presence of HTLV-1 and HTLV-2 using enzyme-linked immunosorbent assay and western blotting. HTLV positive samples were selected for Nested-PCR, and viral genotyping by nucleotide sequencing and phylogenetic analysis. HTLV-1 or HTLV-2 infections were detected in 15 families of PWUDs: 27 family members of PWUDs were infected with HTLV-1 (27.8%) and another 20 of them with HTLV-2 (20.6%). Subtypes 1a [subgroup A (54.5%)], 2b (20.5%), and 2c (25.0%) were detected. High horizontal (76.9%) and vertical (61.4%) transmission rates of HTLV were ascertained. Factors that facilitate the acquisition and transmission of HTLV-1 and HTLV-2 were reported by the participants, such as long-term relationships, unprotected sex, breastfeeding, and lack of knowledge about the condition of being a carrier of the retrovirus. Evidence indicates intrafamilial transmission of HTLV from PWUDs to members of their respective families. Key interventions should urgently be employed for the control and prevention of HTLV-1 and HTLV-2 to reduce the spread of this retrovirus in PWUDs and the general population in Northern Brazil and elsewhere.
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Affiliation(s)
- Aldemir Branco Oliveira-Filho
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
- Programa de Pós-graduação em Doenças Tropicais, Universidade Federal do Pará, Belém, Brazil
- *Correspondence: Aldemir Branco Oliveira-Filho,
| | | | | | - Leila Sawada
- Seção de Virologia, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Brazil
| | - Luísa Caricio Martins
- Programa de Pós-graduação em Doenças Tropicais, Universidade Federal do Pará, Belém, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Luiz Fernando Almeida Machado
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Universidade Federal do Pará, Belém, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Universidade Federal do Pará, Belém, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Ricardo Ishak
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Universidade Federal do Pará, Belém, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | | | - Benedikt Fischer
- Faculty of Medical and Health Sciences, University of Auckland, Grafton, New Zealand
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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Martel M, Gotuzzo E. HTLV-1 Is Also a Sexually Transmitted Infection. Front Public Health 2022; 10:840295. [PMID: 35433594 PMCID: PMC9008201 DOI: 10.3389/fpubh.2022.840295] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
HTLV-1 is a retrovirus which causes diverse diseases in 10% of its infected population, significantly worsening their quality of life and mortality rate. Even though it is globally distributed and is endemic in many countries (including Peru), it is still highly neglected. It spreads through vertical, sexual and parenteral transmission. As no effective treatment against this virus exist, prevention is required to contain it. The World Health Organization published a technical report on the matter in 2021, with the collaboration of international HTLV-1 experts. However, neither the impact of sexual transmission (cause of the majority of adult cases and infection in non-endemic areas) nor its prevention were considered. Evidence is presented, which shows the magnitude of sexual transmission, its risk factors and preventive measures; hoping it will encourage health workers to help eradicate this infection.
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Affiliation(s)
- Mariana Martel
- Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Gotuzzo
- Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Alexander von Humboldt Institute of Tropical Medicine, Cayetano Heredia National Hospital, Lima, Peru
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Stufano A, Jahantigh HR, Cagnazzo F, Centrone F, Loconsole D, Chironna M, Lovreglio P. Work-Related Human T-lymphotropic Virus 1 and 2 (HTLV-1/2) Infection: A Systematic Review. Viruses 2021; 13:1753. [PMID: 34578335 PMCID: PMC8472817 DOI: 10.3390/v13091753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/17/2021] [Accepted: 08/27/2021] [Indexed: 12/22/2022] Open
Abstract
Human T-lymphotropic virus 1 and 2 (HTLV-1/2) belong to the delta group of retroviruses which may cause a life-long infection in humans, HTLV-1 leading to adult T-cell leukemia/lymphoma and other diseases. Different transmission modes have been described, such as breastfeeding, and, as for other blood-borne pathogens, unsafe sexual activity, intravenous drug usage, and blood transfusion and transplantation. The present systematic review was conducted to identify all peer-reviewed studies concerning the work-related infection by HTLV-1/2. A literature search was conducted from January to May 2021, according to the PRISMA methodology, selecting 29 studies: seven related to health care workers (HCWs), five to non-HCWs, and 17 to sex workers (SWs). The findings showed no clear evidence as to the possibility of HTLV-1/2 occupational transmission in HCWs, according to the limited number and quality of the papers. Moreover, non-HCWs showed a higher prevalence in jobs consistent with a lower socioeconomic status or that could represent a familial cluster, and an increased risk of zoonotic transmission from STLV-1-infected non-human primates has been observed in African hunters. Finally, a general increase of HTLV-1 infection was observed in SWs, whereas only one paper described an increased prevalence for HTLV-2, supporting the urgent need for prevention and control measures, including screening, diagnosis, and treatment of HTLV-1/2, to be offered routinely as part of a comprehensive approach to decrease the impact of sexually transmitted diseases in SWs.
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Affiliation(s)
- Angela Stufano
- Interdisciplinary Department of Medicine-Section of Occupational Medicine, University of Bari, 70124 Bari, Italy; (H.R.J.); (F.C.); (P.L.)
| | - Hamid Reza Jahantigh
- Interdisciplinary Department of Medicine-Section of Occupational Medicine, University of Bari, 70124 Bari, Italy; (H.R.J.); (F.C.); (P.L.)
| | - Francesco Cagnazzo
- Interdisciplinary Department of Medicine-Section of Occupational Medicine, University of Bari, 70124 Bari, Italy; (H.R.J.); (F.C.); (P.L.)
| | - Francesca Centrone
- Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, 70124 Bari, Italy; (F.C.); (D.L.); (M.C.)
| | - Daniela Loconsole
- Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, 70124 Bari, Italy; (F.C.); (D.L.); (M.C.)
| | - Maria Chironna
- Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, 70124 Bari, Italy; (F.C.); (D.L.); (M.C.)
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine-Section of Occupational Medicine, University of Bari, 70124 Bari, Italy; (H.R.J.); (F.C.); (P.L.)
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Machado LFA, Fonseca RRDS, Queiroz MAF, Oliveira-Filho AB, Cayres-Vallinoto IMV, Vallinoto ACR, Ishak MDOG, Ishak R. The Epidemiological Impact of STIs among General and Vulnerable Populations of the Amazon Region of Brazil: 30 years of Surveillance. Viruses 2021; 13:v13050855. [PMID: 34067165 PMCID: PMC8151421 DOI: 10.3390/v13050855] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/13/2022] Open
Abstract
Sexually transmitted infections (STIs) represent a worldwide public health problem and, although many of them are curable, they continue to be neglected, especially in areas with a low human development index, such as in the northern region of Brazil. This review describes the results of 30 years of studies at the Virus Laboratory at the Federal University of Pará, including the prevalence and molecular epidemiology of HIV-1, HTLV-1/2, HPV, HBV, Treponema pallidum and Chlamydia trachomatis among urban and non-urban populations, and also in vulnerable groups in the Brazilian Amazon. Control strategies and challenges in preventing STIs are discussed considering this immense geographic region, where essential health services are unable to reach the entire population, especially the most vulnerable, such as female sex workers, people who use illicit drugs, remnants of quilombolos and indigenous communities.
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Affiliation(s)
- Luiz Fernando Almeida Machado
- Laboratório de Virologia, Instituto de Ciências Biológica, Universidade Federal do Pará, Belém 66.075-110, Brazil; (R.R.d.S.F.); (M.A.F.Q.); (I.M.V.C.-V.); (A.C.R.V.); (M.d.O.G.I.); (R.I.)
- Correspondence:
| | - Ricardo Roberto de Souza Fonseca
- Laboratório de Virologia, Instituto de Ciências Biológica, Universidade Federal do Pará, Belém 66.075-110, Brazil; (R.R.d.S.F.); (M.A.F.Q.); (I.M.V.C.-V.); (A.C.R.V.); (M.d.O.G.I.); (R.I.)
| | - Maria Alice Freitas Queiroz
- Laboratório de Virologia, Instituto de Ciências Biológica, Universidade Federal do Pará, Belém 66.075-110, Brazil; (R.R.d.S.F.); (M.A.F.Q.); (I.M.V.C.-V.); (A.C.R.V.); (M.d.O.G.I.); (R.I.)
| | - Aldemir Branco Oliveira-Filho
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68.600-000, Brazil;
| | - Izaura Maria Vieira Cayres-Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológica, Universidade Federal do Pará, Belém 66.075-110, Brazil; (R.R.d.S.F.); (M.A.F.Q.); (I.M.V.C.-V.); (A.C.R.V.); (M.d.O.G.I.); (R.I.)
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológica, Universidade Federal do Pará, Belém 66.075-110, Brazil; (R.R.d.S.F.); (M.A.F.Q.); (I.M.V.C.-V.); (A.C.R.V.); (M.d.O.G.I.); (R.I.)
| | - Marluísa de Oliveira Guimarães Ishak
- Laboratório de Virologia, Instituto de Ciências Biológica, Universidade Federal do Pará, Belém 66.075-110, Brazil; (R.R.d.S.F.); (M.A.F.Q.); (I.M.V.C.-V.); (A.C.R.V.); (M.d.O.G.I.); (R.I.)
| | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológica, Universidade Federal do Pará, Belém 66.075-110, Brazil; (R.R.d.S.F.); (M.A.F.Q.); (I.M.V.C.-V.); (A.C.R.V.); (M.d.O.G.I.); (R.I.)
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