Browsing by Autor "Lucia Elena Alvarado-Arnez"

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Activation of an Effective Immune Response after Yellow Fever Vaccination Is Associated with the Genetic Background and Early Response of IFN-γ and CLEC5A
(Multidisciplinary Digital Publishing Institute, 2021) Tamiris Azamor; Andréa Marques Vieira da Silva; Juliana Gil Melgaço; Ana Paula Santos; Caroline Xavier-Carvalho; Lucia Elena Alvarado-Arnez; Leonardo Ribeiro Batista-Silva; Denise Matos; Camilla Bayma; Sotiris Missailidis
The yellow fever vaccine (YF17DD) is highly effective with a single injection conferring protection for at least 10 years. The YF17DD induces polyvalent responses, with a TH1/TH2 CD4+ profile, robust T CD8+ responses, and synthesis of interferon-gamma (IFN-γ), culminating in high titers of neutralizing antibodies. Furthermore, C-type lectin domain containing 5A (CLEC5A) has been implicated in innate outcomes in other flaviviral infections. Here, we conducted a follow-up study in volunteers immunized with YF17DD, investigating the humoral response, cellular phenotypes, gene expression, and single nucleotide polymorphisms (SNPs) of IFNG and CLEC5A, to clarify the role of these factors in early response after vaccination. Activation of CLEC5A+ monocytes occurred five days after vaccination (DAV). Following, seven DAV data showed activation of CD4+ and CD8+T cells together with early positive correlations between type II IFN and genes of innate antiviral response (STAT1, STAT2, IRF7, IRF9, OAS1, and RNASEL) as well as antibody levels. Furthermore, individuals with genotypes rs2430561 AT/AA, rs2069718 AG/AA (IFNG), and rs13237944 AC/AA (CLEC5A), exhibited higher expression of IFNG and CLEC5A, respectively. Together, we demonstrated that early IFN-γ and CLEC5A responses, associated with rs2430561, rs2069718, and rs13237944 genotypes, may be key mechanisms in the long-lasting immunity elicited by YF17DD.
Association of NOD2 and IFNG single nucleotide polymorphisms with leprosy in the Amazon ethnic admixed population
(Public Library of Science, 2020) André Luiz Leturiondo; Ariani Batista Noronha; Carla Yael Ribeiro Mendonça; Cynthia de Oliveira Ferreira; Lucia Elena Alvarado-Arnez; Fernanda Saloum de Neves Manta; Ohanna Cavalcanti de Lima Bezerra; Elizeu Fagundes de Carvalho; Milton Ozório Moraes; Fabíola da Costa Rodrigues
Leprosy is a chronic infectious disease, caused by Mycobacterium leprae, which affects skin and peripheral nerves. Polymorphisms in genes associated with autophagy, metabolism, innate and adaptive immunity confer susceptibility to leprosy. However, these associations need to be confirmed through independent replication studies in different ethnicities. The population from Amazon state (northern Brazil) is admixed and it contains the highest proportion of Native American genetic ancestry in Brazil. We conducted a case-control study for leprosy in which we tested fourteen previously associated SNPs in key immune response regulating genes: TLR1 (rs4833095), NOD2 (rs751271, rs8057341), TNF (rs1800629), IL10 (rs1800871), CCDC122/LACC1 (rs4942254), PACRG/PRKN (rs9356058, rs1040079), IFNG (rs2430561), IL6 (rs2069845), LRRK2 (rs7298930, rs3761863), IL23R (rs76418789) and TYK2 (rs55882956). Genotyping was carried out by allelic discrimination in 967 controls and 412 leprosy patients. Association with susceptibility was assessed by logistic regression analyses adjusted for the following covariates: gender, age and ancestry. Genetic ancestry was similar in case and control groups. Statistically significant results were only found for IFNG and NOD2. The rs8057341 polymorphism within NOD2 was identified as significant for the AA genotype (OR = 0.56; 95% CI, 0.37-0.84; P = 0.005) and borderline for the A allele (OR = 0.76; 95% CI, 0.58-1.00; P = 0.053) and carrier (OR = 0.76; 95% CI, 0.58-1.00; P = 0.051). The rs2430561 SNP in IFNG was associated with disease susceptibility for the AT genotype (OR = 1.40; 95% CI, 1.06-1.85; P = 0.018) and carrier (OR = 1.44; 95% CI, 1.10-1.88; P = 0.008). We confirmed that NOD2 and IFNG are major players in immunity against M.leprae in the Amazon ethnic admixed population.
Book Review: Modern Epidemics, From Spanish Flu to COVID-19 by Salvador Macip Maresma
(Frontiers Media, 2021) Paola A. Vargas; Lucia Elena Alvarado-Arnez; Natalia Montellano Duran
Citation: Vargas PA, Alvarado-Arnez LE and Montellano Duran N (2021) Book Review: Modern Epidemics, From Spanish Flu to COVID-19 by Salvador Macip Maresma. Front. Polit. Sci. 3:709290. doi: 10.3389/fpos.2021.709290
Clinical features of fatal cases of Chapare virus hemorrhagic fever originating from rural La Paz, Bolivia, 2019: A cluster analysis
(Elsevier BV, 2020) Juan Pablo Escalera-Antezana; Omar J. Rodriguez-Villena; Ariel Weimar Arancibia-Alba; Lucia Elena Alvarado-Arnez; D. Katterine Bonilla‐Aldana; Alfonso J. Rodríguez‐Morales
Clinical features of the first cases and a cluster of Coronavirus Disease 2019 (COVID-19) in Bolivia imported from Italy and Spain
(Elsevier BV, 2020) Juan Pablo Escalera-Antezana; Nicolas Freddy Lizon-Ferrufino; Americo Maldonado-Alanoca; Gricel Alarcón-De-la-Vega; Lucia Elena Alvarado-Arnez; María Alejandra Balderrama-Saavedra; D. Katterine Bonilla‐Aldana; Alfonso J. Rodríguez‐Morales
Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis
(Elsevier BV, 2020) Alfonso J. Rodríguez‐Morales; Jaime A. Cardona‐Ospina; Estefanía Gutiérrez‐Ocampo; Rhuvi Villamizar‐Peña; Yeimer Holguin-Rivera; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez; D. Katterine Bonilla‐Aldana; Carlos Franco‐Paredes; Andrés F. Henao‐Martínez
Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis
(2020) Alfonso J. Rodríguez‐Morales; Jaime A. Cardona‐Ospina; Estefanía Gutiérrez‐Ocampo; Rhuvi Villamizar‐Peña; Yeimer Holguin-Rivera; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez; D. Katterine Bonilla‐Aldana; Carlos Franco‐Paredes; Andrés F. Henao‐Martínez
Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies, and also case reports, were included and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Results: 660 articles were retrieved (1/1/2020-2/23/2020). After screening by abstract/title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) of hospitalized patients with fatal outcomes (case fatality rate, CFR).Conclusion: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and this group was associated with a CFR of over 13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure, and facilities to treat severe COVID-19.
Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis
(2020) Alfonso J. Rodríguez‐Morales; Jaime A. Cardona‐Ospina; Estefanía Gutiérrez‐Ocampo; Rhuvi Villamizar‐Peña; Yeimer Holguin-Rivera; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez; D. Katterine Bonilla‐Aldana; Carlos Franco‐Paredes; Andrés F. Henao‐Martínez
Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing primary concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic review of the literature with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of confirmed cases of COVID-19. All the observational studies, and also case reports, were included. The case reports were analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95%CI. Measures of heterogeneity, including Cochran&rsquo;s Q statistic, the I2 index, and the &tau;2 test, were estimated and reported.Results: 660 articles were retrieved. After screening by abstract and title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For &gt;656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent clinical manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required ICU, with 32.8% presenting ARDS (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) with a fatal outcome.Discussion: COVID-19 is a new clinical infectious disease, causing considerable compromise, especially in patients with comorbidities, requiring ICU in at least a fifth of them and sometimes with fatal outcomes. Additional research is needed to elucidate factors that may mediate the pathogenesis of the severe and fatal associated disease.
Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis
(2020) Alfonso J. Rodríguez‐Morales; Jaime A. Cardona‐Ospina; Estefanía Gutiérrez‐Ocampo; Rhuvi Villamizar‐Peña; Yeimer Holguin-Rivera; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez; D. Katterine Bonilla‐Aldana; Carlos Franco‐Paredes; Andrés F. Henao‐Martínez
Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of confirmed cases of COVID-19. All the observational studies, and also case reports, were included and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Measures of heterogeneity were estimated and reported. Results: 660 articles were retrieved. After screening by abstract and title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent clinical manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) with a fatal outcome. Discussion: COVID-19 is a new clinical infectious disease, causing considerable compromise, especially in patients with comorbidities, requiring ICU in at least a fifth of them and sometimes with fatal outcomes. Additional research is needed to elucidate factors that may mediate the pathogenesis of the severe and fatal associated disease.
Conocimientos, Actitudes y Prácticas del Personal de Salud Sobre Sexualidad, VIH y SIDA de Cochabamba, Estudio Comparado de 20 Años.
(2019) Edgar Valdez Carrizo; Joaquín Salcedo Cuellar; Lucia Elena Alvarado-Arnez; Iván Rivera Carrasco; Nayra Rojas Escalie
Trascurrieron 35 años desde que se diagnosticó el primer caso de SIDA en Cochabamba, durante este tiempo se observó un aumento continuo de personas infectadas con VIH y reacciones de estigmatización por parte del personal de salud de Cochabamba hacia esta población. El estudio sobre conocimientos, actitudes y prácticas tiene como objetivo comparar los resultados de tres encuestas realizadas en 1997, 2008 y 2018.Es un estudio descriptivo transversal, realizado al personal de salud en servicios de salud públicos y privados de Cochabamba. La primera encuesta se aplicó a 303 personas, la segunda a 305 personas; y la tercera a 308 personas. Asimismo, en el presente trabajo, se observó una disminución de la percepción de la gravedad del VIH y SIDA como problema de salud pública, así como de la percepción de población de riesgo en receptores de transfusiones de sangre. Si bien ha disminuido la discriminación, el rechazo y el miedo hacia las personas con VIH, existe un leve aumento del porcentaje del personal que atendió a las personas con VIH, ya que el personal de salud se siente con menos capacidad para atender a estos pacientes.Los resultados reflejan los deficientes conocimientos por parte del personal de salud en relación a la sexualidad, el VIH y SIDA, por la falta de políticas de formación continua, es decir, talleres y actualizaciones en los servicios de salud, e incluso falta de motivación para un autoaprendizaje.A nivel de actitudes y prácticas, la infraestructura inadecuada de los servicios de salud y la falta de insumos de bioseguridad genera preocupación y miedo a transmitir VIH en el personal de salud, por ello, persiste la estigmatización de estos pacientes.
Fatal Zika virus disease in adults: A critical reappraisal of an under-recognized clinical entity
(Elsevier BV, 2019) Alfonso J. Rodríguez‐Morales; Eduardo Ramírez-Vallejo; Lucia Elena Alvarado-Arnez; Alberto Paniz‐Mondolfi; Lysien I. Zambrano; Albert I. Ko
Zika virus (ZIKV) is a flavivirus that was most likely introduced into Latin America back in 2013 (Rodriguez-Morales, 2015Rodriguez-Morales A.J. Zika: the new arbovirus threat for Latin America.J Infect Dev Ctries. 2015; 9: 684-685Crossref PubMed Scopus (99) Google Scholar), but did not cause identifiable outbreaks until its massive emergence in Brazil in 2015, when it rapidly spread across the Americas and the Caribbean (Weaver et al., 2016Weaver S.C. Costa F. Garcia-Blanco M.A. Ko A.I. Ribeiro G.S. Saade G. et al.Zika virus: history, emergence, biology, and prospects for control.Antiviral Res. 2016; 130: 69-80Crossref PubMed Scopus (474) Google Scholar). The World Health Organization (WHO) declared the ZIKV epidemic a public health emergency of international concern (PHEC) at the height of the pandemic in 2016 (Rodriguez-Morales, 2015Rodriguez-Morales A.J. Zika: the new arbovirus threat for Latin America.J Infect Dev Ctries. 2015; 9: 684-685Crossref PubMed Scopus (99) Google Scholar, Rodriguez-Morales, 2018Rodriguez-Morales A.J. Severe, atypical and fatal cases of Zika virus infection: experience in Colombia.Int J Infect Dis. 2018; 73: 71Abstract Full Text Full Text PDF Google Scholar), after identifying clusters of ZIKV-associated Guillain–Barré syndrome (GBS) (do Rosario et al., 2016do Rosario M.S. de Jesus P.A. Vasilakis N. Farias D.S. Novaes M.A. Rodrigues S.G. et al.Guillain–Barre syndrome after Zika virus infection in Brazil.Am J Trop Med Hyg. 2016; 95: 1157-1160Crossref PubMed Scopus (77) Google Scholar), and more significantly due to its association with outbreaks of microcephaly among newborn infants in which a causal link between ZIKV infection and birth defects was reliably demonstrated (Rasmussen et al., 2016Rasmussen S.A. Jamieson D.J. Honein M.A. Petersen L.R. Zika virus and birth defects—reviewing the evidence for causality.N Engl J Med. 2016; 374: 1981-1987Crossref PubMed Scopus (1336) Google Scholar). The clinical manifestations of congenital ZIKV infection extend beyond microcephaly and comprise a distinct constellation of birth defects and manifestations known as the congenital Zika syndrome (CZS) (Nogueira et al., 2018Nogueira M.L. Nery Junior, N.R.R. Estofolete C.F. Bernardes Terzian A.C. Guimaraes G.F. Zini N. et al.Adverse birth outcomes associated with Zika virus exposure during pregnancy in Sao Jose do Rio Preto, Brazil.Clin Microbiol Infect. 2018; 24: 646-652Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar, Moore et al., 2017Moore C.A. Staples J.E. Dobyns W.B. Pessoa A. Ventura C.V. Fonseca E.B. et al.Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clinicians.JAMA Pediatr. 2017; 171: 288-295Crossref PubMed Scopus (578) Google Scholar). The ZIKV pandemic in the Americas and Caribbean was known to cause over one million cases and there were reports in which the virus was found to cause severe, life-threatening complications in addition to GBS and CZS, especially among patients with associated comorbidities (Rodriguez-Morales, 2018Rodriguez-Morales A.J. Severe, atypical and fatal cases of Zika virus infection: experience in Colombia.Int J Infect Dis. 2018; 73: 71Abstract Full Text Full Text PDF Google Scholar). From a clinical standpoint, until 2013, ZIKV was generally considered to cause a mild, self-limiting illness, which did not pose a serious public health threat (Rodriguez-Morales, 2015Rodriguez-Morales A.J. Zika: the new arbovirus threat for Latin America.J Infect Dev Ctries. 2015; 9: 684-685Crossref PubMed Scopus (99) Google Scholar, Rodriguez-Morales, 2018Rodriguez-Morales A.J. Severe, atypical and fatal cases of Zika virus infection: experience in Colombia.Int J Infect Dis. 2018; 73: 71Abstract Full Text Full Text PDF Google Scholar, Martinez-Pulgarin et al., 2016Martinez-Pulgarin D.F. Acevedo-Mendoza W.F. Cardona-Ospina J.A. Rodriguez-Morales A.J. Paniz-Mondolfi A.E. A bibliometric analysis of global Zika research.Travel Med Infect Dis. 2016; 14: 55-57Crossref PubMed Scopus (56) Google Scholar). However, it was not until the first non-perinatal death was identified in a 15-year-old girl from northern Colombia in October 2015, (Arzuza-Ortega et al., 2016Arzuza-Ortega L. Polo A. Perez-Tatis G. Lopez-Garcia H. Parra E. Pardo-Herrera L.C. et al.Fatal sickle cell disease and Zika virus infection in girl from colombia.Emerg Infect Dis. 2016; 22: 925-927Crossref PubMed Scopus (76) Google Scholar) that an increasing number of ZIKV-associated fatalities were reported in the literature. The case from Malaysia reported by Rajahram et al., 2019Rajahram G.S. Hale G. Bhatnagar J. Hiu J. Thayan R. William T. et al.Postmortem evidence of disseminated Zika virus infection in an adult patient.Int J Infect Dis. 2019; https://doi.org/10.1016/j.ijid.2019.01.047Abstract Full Text Full Text PDF Scopus (5) Google Scholar in the current issue of the International Journal of Infectious Diseases, confirms that ZIKV infection can result in atypical disease and lead to severe and even fatal outcomes (Rodriguez-Morales, 2018Rodriguez-Morales A.J. Severe, atypical and fatal cases of Zika virus infection: experience in Colombia.Int J Infect Dis. 2018; 73: 71Abstract Full Text Full Text PDF Google Scholar). It also demonstrates, as seen in other studies (Sarmiento-Ospina et al., 2016Sarmiento-Ospina A. Vasquez-Serna H. Jimenez-Canizales C.E. Villamil-Gomez W.E. Rodriguez-Morales A.J. Zika virus associated deaths in Colombia.Lancet Infect Dis. 2016; 16: 523-524Abstract Full Text Full Text PDF PubMed Scopus (75) Google Scholar, Soares et al., 2016Soares C.N. Brasil P. Carrera R.M. Sequeira P. de Filippis A.B. Borges V.A. et al.Fatal encephalitis associated with Zika virus infection in an adult.J Clin Virol. 2016; 83: 63-65Crossref PubMed Scopus (93) Google Scholar, Zonneveld et al., 2016Zonneveld R. Roosblad J. Staveren J.W. Wilschut J.C. Vreden S.G. Codrington J. Three atypical lethal cases associated with acute Zika virus infection in Suriname.IDCases. 2016; 5: 49-53Crossref PubMed Scopus (19) Google Scholar, Azevedo et al., 2016Azevedo R.S. Araujo M.T. Martins Filho A.J. Oliveira C.S. Nunes B.T. Cruz A.C. et al.Zika virus epidemic in Brazil. I. Fatal disease in adults: clinical and laboratorial aspects.J Clin Virol. 2016; 85: 56-64Crossref PubMed Scopus (58) Google Scholar), that this neurotropic virus can disseminate to multiple organs and tissues, in addition to the central nervous system, while inflicting pathological effects. Previous to this report, the majority of fatalities associated with ZIKV infection were almost invariably linked to acute neurological complications (Sarmiento-Ospina et al., 2016Sarmiento-Ospina A. Vasquez-Serna H. Jimenez-Canizales C.E. Villamil-Gomez W.E. Rodriguez-Morales A.J. Zika virus associated deaths in Colombia.Lancet Infect Dis. 2016; 16: 523-524Abstract Full Text Full Text PDF PubMed Scopus (75) Google Scholar, Soares et al., 2016Soares C.N. Brasil P. Carrera R.M. Sequeira P. de Filippis A.B. Borges V.A. et al.Fatal encephalitis associated with Zika virus infection in an adult.J Clin Virol. 2016; 83: 63-65Crossref PubMed Scopus (93) Google Scholar, Azevedo et al., 2016Azevedo R.S. Araujo M.T. Martins Filho A.J. Oliveira C.S. Nunes B.T. Cruz A.C. et al.Zika virus epidemic in Brazil. I. Fatal disease in adults: clinical and laboratorial aspects.J Clin Virol. 2016; 85: 56-64Crossref PubMed Scopus (58) Google Scholar). However, amongst those exceptional fatalities without neurological involvement, the question was raised as to whether ZIKV could cause renal and cardiac involvement, as was observed on autopsy examinations of the case described in this issue. Renal and cardiac complications have been reported in atypical, severe (Villamil-Gomez et al., 2016aVillamil-Gomez W.E. Ramirez-Vallejo E. Cardona-Ospina J.A. Silvera L.A. Rodriguez-Morales A.J. Electrocardiographic alterations in patients with chikungunya fever from Sucre, Colombia: a 42-case series.Travel Med Infect Dis. 2016; 14: 510-512Crossref PubMed Scopus (12) Google Scholar, Alvarez et al., 2017Alvarez M.F. Bolivar-Mejia A. Rodriguez-Morales A.J. Ramirez-Vallejo E. Cardiovascular involvement and manifestations of systemic Chikungunya virus infection: a systematic review.F1000Res. 2017; 6: 390Crossref PubMed Scopus (40) Google Scholar), and fatal cases (Hoz et al., 2015Hoz J.M. Bayona B. Viloria S. Accini J.L. Juan-Vergara H.S. Viasus D. Fatal cases of Chikungunya virus infection in Colombia: diagnostic and treatment challenges.J Clin Virol. 2015; 69: 27-29Crossref PubMed Scopus (49) Google Scholar, Mercado et al., 2018Mercado M. Acosta-Reyes J. Parra E. Guzman L. Beltran M. Gasque P. et al.Renal involvement in fatal cases of Chikungunya virus infection.J Clin Virol. 2018; 103: 16-18Crossref PubMed Scopus (25) Google Scholar) of chikungunya virus (CHIKV) infection. Conversely, cases of ZIKV infection with documented renal or cardiac complications have been reported on rarely and have usually lacked detailed histopathological evaluation as well as molecular confirmation of the presence of viral RNA within the renal or cardiac tissues during routine autopsy of fatal cases (Mercado-Reyes et al., 2019Mercado-Reyes M. Acosta-Reyes J. Navarro-Lechuga E. Corchuelo S. Rico A. Parra E. et al.Dengue, Chikungunya and Zika virus coinfection: results of the national surveillance during the Zika epidemic in Colombia.Epidemiol Infect. 2019; 147: e77Crossref PubMed Scopus (43) Google Scholar). ZIKV infection has previously been reported to cause cardiovascular compromise as a consequence of systemic infection, as revealed by electrocardiographic and echocardiographic alterations (Villamil-Gomez et al., 2018Villamil-Gomez W.E. Ramirez-Vallejo E. Rodriguez-Morales A.J. Cardiac compromise in Zika virus infection.Mayo Clin Proc. 2018; 93: 393-394Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar, Schwartzmann et al., 2017Schwartzmann P.V. Ramalho L.N. Neder L. Vilar F.C. Ayub-Ferreira S.M. Romeiro M.F. et al.Zika virus meningoencephalitis in an immunocompromised patient.Mayo Clin Proc. 2017; 92: 460-466Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar), even including venous thromboembolism (in ZIKV and CHIKV infections) (Ramacciotti et al., 2019Ramacciotti E. Agati L.B. Aguiar V.C.R. Wolosker N. Guerra J.C. de Almeida R.P. et al.Zika and Chikungunya virus and risk for venous thromboembolism.Clin Appl Thromb Hemost. 2019; 25Crossref Scopus (37) Google Scholar), as well as demonstrating myocardial inflammation secondary to viral infection (Villamil-Gomez et al., 2018Villamil-Gomez W.E. Ramirez-Vallejo E. Rodriguez-Morales A.J. Cardiac compromise in Zika virus infection.Mayo Clin Proc. 2018; 93: 393-394Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar). Autopsy examinations of a heart transplant recipient who developed ZIKV infection revealed plasma cell infiltrates in the myocardial tissue, along with perivascular and endovascular damage (Schwartzmann et al., 2017Schwartzmann P.V. Ramalho L.N. Neder L. Vilar F.C. Ayub-Ferreira S.M. Romeiro M.F. et al.Zika virus meningoencephalitis in an immunocompromised patient.Mayo Clin Proc. 2017; 92: 460-466Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar). Nevertheless, publications in the literature on cardiovascular manifestations in adult patients with ZIKV infection are scarce, and the case report by Rajahram et al., 2019Rajahram G.S. Hale G. Bhatnagar J. Hiu J. Thayan R. William T. et al.Postmortem evidence of disseminated Zika virus infection in an adult patient.Int J Infect Dis. 2019; https://doi.org/10.1016/j.ijid.2019.01.047Abstract Full Text Full Text PDF Scopus (5) Google Scholar is timely in underscoring how this arboviral infection can produce unexpected clinical complications with renal and cardiovascular involvement. Previous reports have suggested an association between cardiovascular complications and ZIKV during the acute phase of the infection (Villamil-Gomez et al., 2018Villamil-Gomez W.E. Ramirez-Vallejo E. Rodriguez-Morales A.J. Cardiac compromise in Zika virus infection.Mayo Clin Proc. 2018; 93: 393-394Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar, Li et al., 2016Li X.F. Dong H.L. Huang X.Y. Qiu Y.F. Wang H.J. Deng Y.Q. et al.Characterization of a 2016 clinical isolate of Zika virus in non-human primates.EBioMedicine. 2016; : 170-177Google Scholar, Minhas et al., 2017Minhas A.M. Nayab A. Iyer S. Narmeen M. Fatima K. Khan M.S. et al.Association of Zika virus with myocarditis, heart failure, and arrhythmias: a literature review.Cureus. 2017; 9: e1399PubMed Google Scholar). However, only a limited number of studies have addressed this potential association (Martinez-Pulgarin et al., 2016Martinez-Pulgarin D.F. Acevedo-Mendoza W.F. Cardona-Ospina J.A. Rodriguez-Morales A.J. Paniz-Mondolfi A.E. A bibliometric analysis of global Zika research.Travel Med Infect Dis. 2016; 14: 55-57Crossref PubMed Scopus (56) Google Scholar, Minhas et al., 2017Minhas A.M. Nayab A. Iyer S. Narmeen M. Fatima K. Khan M.S. et al.Association of Zika virus with myocarditis, heart failure, and arrhythmias: a literature review.Cureus. 2017; 9: e1399PubMed Google Scholar). Findings in patients (Abdalla et al., 2018Abdalla L.F. Santos J.H.A. Barreto R.T.J. Souza E.M.E. D'Assuncao F.F. Borges M.A. et al.Atrial fibrillation in a patient with Zika virus infection.Virol J. 2018; 15: 23Crossref PubMed Scopus (15) Google Scholar) and non-human primates (Li et al., 2016Li X.F. Dong H.L. Huang X.Y. Qiu Y.F. Wang H.J. Deng Y.Q. et al.Characterization of a 2016 clinical isolate of Zika virus in non-human primates.EBioMedicine. 2016; : 170-177Google Scholar) have provided evidence that ZIKV has a broad tissue tropism, which includes renal and heart tissues (Rajahram et al., 2019Rajahram G.S. Hale G. Bhatnagar J. Hiu J. Thayan R. William T. et al.Postmortem evidence of disseminated Zika virus infection in an adult patient.Int J Infect Dis. 2019; https://doi.org/10.1016/j.ijid.2019.01.047Abstract Full Text Full Text PDF Scopus (5) Google Scholar, Li et al., 2016Li X.F. Dong H.L. Huang X.Y. Qiu Y.F. Wang H.J. Deng Y.Q. et al.Characterization of a 2016 clinical isolate of Zika virus in non-human primates.EBioMedicine. 2016; : 170-177Google Scholar). Nevertheless, further investigations are needed in order to delineate the underlying pathogenic processes in which ZIKV affects myocardial tissue and to characterize the spectrum of cardiovascular manifestations caused by this emerging arboviral infection (Musso et al., 2018Musso D. Rodriguez-Morales A.J. Levi J.E. Cao-Lormeau V.M. Gubler D.J. Unexpected outbreaks of arbovirus infections: lessons learned from the Pacific and tropical America.Lancet Infect Dis. 2018; 18: e355-e361Abstract Full Text Full Text PDF PubMed Scopus (63) Google Scholar). A review of the literature identified a total of 84 fatal cases of ZIKV infection during the recent pandemic in the Americas (Rodriguez-Morales et al., 2018Rodriguez-Morales A.J. Acevedo-Mendoza W.F. Nasner-Posso K.M. Martínez-Pulgarín D.F. Restrepo-López A. Cardona-Ospina J.A. Postnatal acquired fatal Zika virus infection in the Americas: a systematic review.Int J Infect Dis. 2018; 73: 195Abstract Full Text Full Text PDF Google Scholar). However, few of these reported cases underwent an in-depth tissue assessment and molecular characterization during autopsy, as was performed in the case report by Rajahram et al., 2019Rajahram G.S. Hale G. Bhatnagar J. Hiu J. Thayan R. William T. et al.Postmortem evidence of disseminated Zika virus infection in an adult patient.Int J Infect Dis. 2019; https://doi.org/10.1016/j.ijid.2019.01.047Abstract Full Text Full Text PDF Scopus (5) Google Scholar. It should be emphasized that the pathogenesis of severe ZIKV infection remains poorly understood. In vitro and experimental animal models have provided evidence that antibody-dependent enhancement (ADE) may play a role, but clinical correlates for this phenomenon still need to be confirmed in human ZIKV infection (Ngono and Shresta, 2018Ngono A.E. Shresta S. Immune response to dengue and Zika.Annu Rev Immunol. 2018; 36: 279-308Crossref PubMed Scopus (128) Google Scholar, Andrade et al., 2019Andrade P. Gimblet-Ochieng C. Modirian F. Collins M. Cardenas M. Katzelnick L.C. et al.Impact of pre-existing dengue immunity on human antibody and memory B cell responses to Zika.Nat Commun. 2019; 10: 938Crossref PubMed Scopus (31) Google Scholar). Recent studies suggested that preexisting high antibody titers to dengue virus were associated with a reduced risk of acquiring ZIKV infection and disease. In this sense, the landscape of ZIKV immunity that now exists may affect the risks of future transmission (Rodriguez-Barraquer et al., 2019Rodriguez-Barraquer I. Costa F. Nascimento E.J.M. Nery N.J. Castanha P.M.S. Sacramento G.A. et al.Impact of preexisting dengue immunity on Zika virus emergence in a dengue endemic region.Science. 2019; 363: 607-610Crossref PubMed Scopus (155) Google Scholar). Additionally, cases with arboviral co-infections/co-detection (dengue and chikungunya) have been reported in Colombia and Brazil (Villamil-Gomez et al., 2016bVillamil-Gomez W.E. Rodriguez-Morales A.J. Uribe-Garcia A.M. Gonzalez-Arismendy E. Castellanos J.E. Calvo E.P. et al.Zika, dengue, and chikungunya co-infection in a pregnant woman from Colombia.Int J Infect Dis. 2016; 51: 135-138Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar, Sardi et al., 2016Sardi S.I. Somasekar S. Naccache S.N. Bandeira A.C. Tauro L.B. Campos G.S. et al.Coinfections of Zika and Chikungunya viruses in Bahia, Brazil, identified by metagenomic next-generation sequencing.J Clin Microbiol. 2016; 54: 2348-2353Crossref PubMed Scopus (89) Google Scholar), as well as concurrent infections with other microorganisms such as Leptospira (Neaterour et al., 2017Neaterour P. Rivera A. Galloway R.L. Negron M.G. Rivera-Garcia B. Sharp T.M. Fatal Leptospira spp./Zika virus coinfection-Puerto Rico, 2016.Am J Trop Med Hyg. 2017; 97: 1085-1087Google Scholar) and co-infections with other arboviruses (Mercado-Reyes et al., 2019Mercado-Reyes M. Acosta-Reyes J. Navarro-Lechuga E. Corchuelo S. Rico A. Parra E. et al.Dengue, Chikungunya and Zika virus coinfection: results of the national surveillance during the Zika epidemic in Colombia.Epidemiol Infect. 2019; 147: e77Crossref PubMed Scopus (43) Google Scholar). Co-circulation with other arboviruses and ADE pose a challenge for physicians and public health authorities, given the potential to confound and delay diagnosis and possibly influence poorer outcomes in patients with previous exposure to other flaviviruses (Ngono and Shresta, 2018Ngono A.E. Shresta S. Immune response to dengue and Zika.Annu Rev Immunol. 2018; 36: 279-308Crossref PubMed Scopus (128) Google Scholar). As a result, multiple research networks on ZIKV and arboviruses in general have been established, which can leverage protocols, methodologies, and multidisciplinary approaches to inform treatment, prevention, and control strategies. Although recent advances have greatly contributed to our understanding of ZIKV pathogenesis, systemic involvement and the expanding tissue tropism of this virus and its potential relationship to different lineages highlight important aspects for future investigation. Finally, it is worth considering the setting for vaccine development and preparedness for other emerging arboviruses in Latin America and the Asia-Pacific region, such as Ross River, Mayaro, Oropouche, Madariaga, West Nile, and the Venezuelan equine encephalitis and Eastern equine encephalitis viruses. None. All authors report no potential conflicts. All authors have submitted the ICMJE Disclosure Form for Potential Conflicts of Interest. AJRM conceived the idea of the Editorial and performed a review of the literature on the related topic. All authors read the case that is being editorialized. AJRM developed the first draft of the manuscript. All authors consequently contributed to revisions. All authors approved the final version submitted. This article was presented in part at the 18th International Congress of Infectious Diseases (18th ICID) and the XVIII Congress of the Argentine Society for Infectious Diseases (SADI), Buenos Aires, Argentina, March 1–4, 2018 (Conference of A.J. Rodriguez-Morales at Session 48: Zika: Regional Experiences in Neurological Diseases and Severe Cases). The Faculty of Health Sciences of the Universidad Tecnológica de Pereira, the Colombian Association of Infectious Diseases (ACIN) (Coffee-Triangle Region chapter), and the International Society for Infectious Disease (ISID) supported A.J. Rodriguez-Morales in his participation at the ICID/SADI meetings where this article was initially presented.
Incidence of SARS-CoV-2/COVID-19 in military personnel of Bolivia
(BMJ, 2020) Juan Pablo Escalera-Antezana; C A Mariaca-Cerball; Lucia Elena Alvarado-Arnez; María Alejandra Balderrama-Saavedra; D. Katterine Bonilla‐Aldana; Alfonso J. Rodríguez‐Morales
The impact of COVID-19 has not been described so far in a military setting, especially in Latin America.[1][1] Latin America has recently become the main epicentre of the pandemic due to the significant rise in the number of cases in Brazil and other countries in the region, accounting for more than
Infectious diseases prevention and vaccination in migrants in Latin America: The challenges of transit through the treacherous Darien gap, Panama
(Elsevier BV, 2025) Alfonso J. Rodriguez-Morales; María Camila Puerta-Arias; Rola Husni; Juan José Montenegro-Idrogo; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez; D. Katterine Bonilla‐Aldana; Germán Camacho‐Moreno; Henry Mendoza; Ivan Arturo Rodriguez-Sabogal
Interferon-lambda 3 and 4 Polymorphisms Increase Sustained Virological Responses and Regulate Innate Immunity in Antiviral Therapy With Pegylated Interferon-Alpha
(Frontiers Media, 2021) Andréa Marques Vieira da Silva; Lucia Elena Alvarado-Arnez; Tamiris Azamor; Leonardo Ribeiro Batista-Silva; Thyago Leal-Calvo; Ohanna Cavalcanti de Lima Bezerra; Marcelo Ribeiro‐Alves; Fernanda de Souza Gomes Kehdy; Patrícia Neves; Camilla Bayma
Sustained virologic response (SVR) in chronic hepatitis C (CHC) treatment denotes that the host genetics controls the immune response and unequivocally contribute to viral clearance or disease severity. In this context, single nucleotide polymorphisms (SNPs) in the locus of interferon lambda 3 and 4 genes (IFNL3/4) have been important genetic markers of responsiveness to CHC as prognostic markers for the pegylated-Interferon-alpha/ribavirin (Peg-IFN-α/RBV). Here, we analyzed 12 SNPs at the IFNL3/4 region in 740 treatment-naïve patients with CHC infected with hepatitis C virus (HCV) genotypes 1, 2, or 3 treated with Peg-IFN-α/RBV. Individually, rs12979860-CC, rs8109886-CC, or rs8099917-TT were predictive markers of SVR, while rs12979860-CC demonstrated the stronger effect. Besides, the genotypic combination of these three predictors' genotypes, CC/CC/TT, increased the rate of SVR. Serum levels of cytokines and gene expression analysis on the genes IFNL3, IFNL4, IFNA1, and some of the IFN-stimulated genes (ISGs) were measured in a subgroup of 24 treated patients and 24 healthy volunteers. An antagonist effect was highlighted between the expression of IFNL3/4 and IFNA1 mRNA among patients. Besides, a prominent production of the pro-inflammatory chemokines CCL4 and CXCL10 was observed at a 12-week treatment follow-up. Lower serum levels of these chemokines were detected in patients with an rs12979860-CC genotype associated with the better treatment outcome. Also, lower expression levels of the IFI6, IFI16, IRF9 genes were observed among rs12979860-CC individuals. In conclusion, a combination of the genotypes at the IFNL3/4 locus can act as a better marker for the prognosis for virological responses in an admixed Brazilian population presenting the modulating effect over innate immunity and inflammation that are controlling the outcome of the viral infection, but also other infectious diseases. This study is registered on the ClinicalTrials.gov platform (accession number NCT01889849 and NCT01623336).
Is Plague Globally Reemerging?
(Elsevier BV, 2018) Alfonso J. Rodríguez‐Morales; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez
Is Plague Globally Reemerging?
Latin America: Situation and preparedness facing the multi-country human monkeypox outbreak
(Elsevier BV, 2022) Alfonso J. Rodríguez‐Morales; Gustavo Lopardo; Sergio Verbanaz; Tomás Orduña; Susana Lloveras; Jose María Azeñas-Burgoa; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez; Alexandre Naime Barbosa; Fredi Alexander Díaz-Quijano
Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Grupo de Investigación Biomedicina. Pereira, Risaralda, Colombia / Universidad Científica del Sur. Master of Clinical Epidemiology and Biostatistics. Lima, Peru / Latin American network of Monkeypox Virus Research. Pereira, Risaralda, Colombia
Organisms of Concern But Not Foodborne or Confirmed Foodborne: Bolivian Hemorrhagic Fever Virus (Machupo Virus)
(Elsevier BV, 2019) Alfonso J. Rodríguez‐Morales; D.M. Castañeda-Hernández; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez
Orthohantavirus pulmonary syndrome in Santa Cruz and Tarija, Bolivia, 2018
(Elsevier BV, 2019) Juan Pablo Escalera-Antezana; Roberto Torrez-Fernandez; Dagner Montalvan-Plata; Claudia Marcela Montenegro-Narváez; Jorge Luis Aviles-Sarmiento; Lucia Elena Alvarado-Arnez; D. Katterine Bonilla‐Aldana; Alfonso J. Rodríguez‐Morales
Percepción sobre la Economía Naranja en el municipio de Cochabamba-Bolivia
(Centro de Diseño, Cine y Television, 2024) R Camacho; José Manuel Troche Souza; Lucia Elena Alvarado-Arnez; L. Jiménez; Gabriela Roxana Sanjinés-Mancilla
En este artículo se busca i) conocer la percepción de la población del municipio de Cochabamba sobre la Economía Naranja y ii) evaluar el grado de desarrollo, de innovación, de participación y frecuencia de consumo en los rubros que son parte de la Economía Naranja. Se realizaron 350 encuestas a individuos entre las edades de 18 a 60 años, con diversas ocupaciones como profesionales dependientes, independientes y estudiantes entre otros. La información fue tabulada y analizada con cruces de variables para las diferentes preguntas en función al género, rangos de edad y ocupación. El estudio reveló que más de la mitad de los encuestados están familiarizados sobre los nuevos emprendimientos. La percepción sobre el nivel de desarrollo de los diferentes sectores de la Economía Naranja es variada, teniendo que el rubro audiovisual y el de publicidad se perciben como los más desarrollados y los rubros como software de contenidos, artes escénicas y educación artística como menos desarrollados. Dentro de la innovación están las agencias de noticias, pero la publicidad es vista como la menos innovadora. Quienes presentan una participación más activa de los sectores de la Economía Naranja, son los empleados públicos, respecto a los estudiantes, amas de casa y profesionales independientes teniendo una participación menor.
Pharmacogenetics of HIV therapy: State of the art in Latin American countries
(Brazilian Society of Genetics, 2022) Camila de Almeida Velozo; Flávia Rachel Moreira Lamarão; Lucia Elena Alvarado-Arnez; Cynthia Chester Cardoso
The use of combined antiretroviral therapy (cART) has resulted in a remarkable reduction in morbidity and mortality of people living with HIV worldwide. Nevertheless, interindividual variations in drug response often impose a challenge to cART effectiveness. Although personalized therapeutic regimens may help overcome incidence of adverse reactions and therapeutic failure attributed to host factors, pharmacogenetic studies are often restricted to a few populations. Latin American countries accounted for 2.1 million people living with HIV and 1.4 million undergoing cART in 2020-21. The present review describes the state of art of HIV pharmacogenetics in this region and highlights that such analyses remain to be given the required relevance. A broad analysis of pharmacogenetic markers in Latin America could not only provide a better understanding of genetic structure of these populations, but might also be crucial to develop more informative dosing algorithms, applicable to non-European populations.