A terapia anti-retroviral altamente ativa, usada contra o Vírus da Imunodeficiência Humana, vem possibilitando a melhora do quadro clínico-laboratorial de portadores da Síndrome da Imunodeficiência Adquirida. Contudo, alterações metabólicas e complicações morfológicas, associadas ao uso da terapia, vêm sendo investigadas. A utilização prolongada desta terapia tem um impacto importante sobre o estado nutricional dos pacientes. Antes da sua utilização, a perda de peso e a desnutrição, conseqüências das infecções oportunistas, eram os maiores problemas nutricionais. Atualmente, o foco principal das discussões têm sido as complicações metabólicas e morfológicas, dentre elas a lipodistrofia, com a dislipidemia, a resistência à insulina, a osteopenia, e a distribuição alterada da gordura corporal, aumentando assim os riscos de doenças cardiovasculares. A nutrição desempenha um papel fundamental no suporte da saúde desses pacientes, integrando as equipes multiprofissionais, promovendo a melhora da adesão à terapia anti-retroviral e do prognóstico da doença. No entanto, para que se tenha mais conhecimento sobre a terapia, as proporções de seus efeitos adversos, e o perfil nutricional desses pacientes, a curto e a longo prazos, é de suma importância que se estude mais sobre este assunto, a fim de permitir perspectivas de um regime terapêutico mais seguro dentro de seus alcances metodológicos, proporcionando uma melhor qualidade de vida aos pacientes. Termos de indexação:Lipodistrofia. Nutrição. Terapia anti-retroviral de alta atividade. A B S T R A C T

In Brazil, Plasmodium vivax infection accounts for around 80% of malaria cases. This infection has a substantial impact on the productivity of the local population as the course of the disease is usually prolonged and the development of acquired immunity in endemic areas takes several years. The recent emergence of drug-resistant strains has intensified research on alternative control methods such as vaccines. There is currently no effective available vaccine against malaria; however, numerous candidates have been studied in the past several years. One of the leading candidates is apical membrane antigen 1 (AMA1). This protein is involved in the invasion of Apicomplexa parasites into host cells, participating in the formation of a moving junction. Understanding how the genetic diversity of an antigen influences the immune response is highly important for vaccine development. In this study, we analyzed the diversity of AMA1 from Brazilian P. vivax isolates and 19 haplotypes of P. vivax were found. Among those sequences, 33 nonsynonymous PvAMA1 amino acid sites were identified, whereas 20 of these sites were determined to be located in predicted B-cell epitopes. Nonsynonymous mutations were evaluated for their influence on the immune recognition of these antigens. Two distinct haplotypes, 5 and 16, were expressed and evaluated for reactivity in individuals from northern Brazil. Both PvAMA1 variants were reactive. Moreover, the IgG antibody response to these two PvAMA1 variants was analyzed in an exposed but noninfected population from a P. vivax endemic area. Interestingly, over 40% of this population had antibodies recognizing both variants. These results have implications for the design of a vaccine based on a polymorphic antigen.

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The course of leprosy depends of the host immune response which ranges from the lepromatous pole (LL) to the tuberculoid pole (TT). A comparative study was conducted in 60 patients with the LL and TT. The results showed a mean expression of TGF-β of 339 ± 99.4 cells/field for TT and of 519.2 ± 68.2 cells/field for LL. Frequency of apoptosis was 6.3 ± 1.8 in TT and 14.0 ± 6.1 in LL. A correlation (p = 0.0251) between TGF-β and caspase-3 in the LL was found. This finding indicates a role of TGF-β and apoptosis in the immune response in leprosy.

DESCRITORESBackgound and Objectives: Lipodystrophy in HIV is adversely affect the antiretroviral therapy (HAART), characterized by redistribution of body fat, as well as metabolic changes related to lipid profile, risk factor associated with increased cardiovascular disease.This study aimed study HIV-positive patients with lipodystrophy and its association with dyslipidemia to and nutritional status.Methods: This is an analytical cross-sectional study conducted from January 2010 to March 2012. The sample consisted of patients with positive serology for HIV, undergoing HAART presenting dyslipidemia and lipodystrophy syndrome. Data were collected anthropometric, biochemical, clinical and sociodemographic. Results: 79 patients were studied, with a mean age of 44.2 years (± 9.4), 62% male. Most had more than 9 years of education (68.3%) and lived with 1-3 minimum wages (40.8%). The most frequent type of marriage was not stable (91.1%). Among the clinical forms of lipodystrophy, the joint was the most prevalent (49.9%). It was observed that 65.8% of patients had nutritional status of eutrophic. Regarding dyslipidemia, it was found that 43.0% of patients had hypercholesterolemia, hypertriglyceridemia 63.3%, 24.0% low HDL-c and 6.3% had high LDL-c. Regarding the association between clinical forms of lipodystrophy and dyslipidemia and nutritional status, was observed an association only with nutritional status (p=0, 0003). Conclusion: The mixed lipodystrophy was the most frequent clinical form and overweight was present in 1 out of 5 patients. Most patients had hypertriglyceridemia, more frequently in men. Clinical forms of lipodystrophy not associated with the types of dyslipidemia, however were associated with nutritional status. RESUMO ABSTRACT ARTIGO ORIGINAL

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