Kidney transplantation is the treatment of choice for patients with end‐stage renal disease. In the posttransplant period, the induced immunosuppression leads to an increased risk of developing infectious diseases, a leading cause of death after kidney transplantation. Human pegivirus‐1 (HPgV‐1) is considered a nonpathogenic human virus and is highly frequent in individuals parenterally exposed, however, its impact on kidney transplantation outcome is poorly understood. Given the scarcity of epidemiological data for this infection on organ recipients in Brazil, we conducted a study in a single center for kidney transplantation in Rio de Janeiro, aiming to determine HPgV‐1 prevalence and genotypic distribution. Serum samples from 61 renal recipients, followed up for the first year after transplantation, were evaluated for viral RNA and genotypes were determined by sequencing of the 5′‐untranslated region. HPgV‐1 RNA was detected in 36.1% (22/61) of patients. Genotype 2 was the most commonly found (80.9%), followed by genotypes 3 (9.5%), 1, and 5, in 4.8% each. Statistical comparisons did not reveal any significant impact of HPgV‐1 in patient outcome. Further epidemiologic studies are needed to understand if immunosuppression may interfere in HPgV‐1 persistence rates and if viremia might impact graft dysfunction rates in kidney recipients.

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Introduction: Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system (CNS) characterized by inflammation, demyelination, and neuronal damage. Human herpesvirus-4 (HHV-4), also known as Epstein-Barr virus (EBV) and Human herpesvirus-6 (HHV-6) are latent viruses responsible for infections that can reactivate over the years and is among the most well-established environmental risk factors in MS. MS is the most common autoimmune disease that affects the CNS, affecting> 2.5 million people worldwide. The average age at onset is 30 years old and prevalence according to geographic distribution and ethnicity. The frequency of MS in Brazil is 1.36 / 100,000 to 27.2 / 100,000 inhabitants. MS causes motor, sensory, autonomic, sensitive and cognitive disability, with severe functional impairment in young individuals. Objective:The aim of this study was to investigated the frequency of EBV and HHV-6 infection in patients with relapsing remitting (RRMS) and primary progressive MS (PPMS).Methodology: For this, 167 blood plasma samples from MS patients were tested by real-time PCR assay for detection and quantification of EBV (EBNA-1) and HHV-6 (U56).Results: Among them, the average age found was 44.4 years, of which 34.1% (57/167) are male and 65.9% (110/167) are female. The detection of EBV and HHV-6 in MS patients were 1.7% (3/167) and 8.9% (15/167), respectively. These prevalences are considered low if compared to previous studies. Regarding positive patients, for EBV there were 66.6% (2/3) male patients and for HHV-6, 46.7% (7/15). And for these positive patients, 100%(3/3) EBV and 93.4%(14/15) HHV-6 are RRMS and 6.6%(1/15) HHV-6 are PPMS, according to the literature, information about HHV-6 is in agreement, but about EBV there is still no information, relating RRMS x PPMS. About to clinical phenotype of these patients, upper and lower limbs paresthesias, facial paralysis, myelitis and optic neuritis were the main CNS manifestations. Conclusion:These are the first data on the infection of these viruses in MS patients in Brazil and our findings up to date confirm a higher prevalence of female MS patients, demonstrate a low frequency of EBV, a high frequency of HHV-6 and we observed a high prevalence of herpesviruses in RRMS patients present in the city of Rio de Janeiro. Screening of EBV and HHV-6 in blood donors and evaluation of clinical information are necessary to assess the impact of these viruses on the course of MS and to contribute data on epidemiological and clinical characteristics in patients with MS.

Introduction: Human pegivirus (HPgV), formerly known as GB virus C, is a member of the Flaviviridae family of single-stranded, positive-sense RNA viruses and has genomic similarity to hepatitis C virus (HCV). However, unlike HCV, HPgV is lymphotropic (nonhepatotropic), establishes a subclinical infection and is not related to hepatitis or any other disease. Epidemiological data indicate that HPgV is highly prevalent in populations worldwide. The viremia in general populations varies, being lower (1-5%) in developed countries and higher (up to 20%) in developing ones. Due to the shared transmission route, co-infection in individuals with underlying conditions as HIV, HCV, patients receiving haemodialysis and people who inject drugs is common and HPgV viremia up to 45% has been reported. Several studies reported that HPgV infection is associated with delayed HIV disease progression as indicated by higher CD4 cell counts, lower HIV RNA levels and longer disease-free survival. Conversely, in HCV-infected individuals, studies have indicated that HPgV infection is likely to be associated with slower HCV clearance, leading to a higher likelihood of persistent infection. To better understand the impact of HPgV in co-infections, it is needed to know epidemiological characteristics of this virus. In Brazil, most HPgV studies were performed in São Paulo and in HIV co-infection. Data about HPgV on triple co-infection (HPgV-HCV-HIV) and its influence on the natural history of HCV-HIV is rare. Objective: The aim of this study was to determine the prevalence and genotypic distribution of HPgV in patients attended at a hospital in Rio de Janeiro. Methodology: A RT-PCR assay for specific amplification of 5´UTR region of HPgV genome was performed in 174 serum samples collected from patients under health treatment at a hospital in Rio de Janeiro. The samples were classified into three groups: 56 samples form HCV/HIV coinfected individuals; 58 from HCV mono-infected and 60 from HIV monoinfected individuals. All positive samples were submitted to direct sequencing for genotyping and molecular characterization. Results: The overall prevalence of HPgV-1 was 17.2% (30/174). Among HCV/HIV coinfected patients, HPgV prevalence was 14.3% (8/56), and all of them were successfully sequenced. Phylogenetic analysis revealed the presence of genotypes 2a (12.5%), 2b (62.5%) and 3 (25%). HPgV was also found in coinfection with HCV (8.6%; 5/58) and HIV (28.3%; 17/60). Conclusion: Our findings demonstrate the high frequency of HPgV among HCV/HIV coinfected, HCV and HIV monoinfected individuals attending a public hospital in Rio de Janeiro. Circulating HPgV genotypes described here have already been reported in past Brazilian studies, but this is the first data about HCV/HIV patients in Rio de Janeiro city. This study intends to contribute with insights about epidemiological characteristics and impact (if there is any) of HPgV in the natural course of HCV and/ or HIV infection.

This article addresses the relationship between human herpesviruses (HHVs) and neuroinfections. Alphaherpesviruses, betaherpesviruses and gammaherpesviruses are neurotropic viruses that establish latency and exhibit reactivation capacity. Encephalitis and meningitis are common in cases of HHV. The condition promoted by HHV infection is a purported trigger for certain neurodegenerative diseases. Ongoing studies have identified an association between HSV-1 and the occurrence of Alzheimer's disease, multiple sclerosis and infections by HHV-6 and Epstein-Barr virus. In this review, we highlight the importance of research investigating the role of herpesviruses in the pathogenesis of diseases that affect the nervous system and describe other studies in progress.