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Minas Gerais, Brazil

Loureiro F.C.M.,Fundacao Hemominas | di Lorenzo Oliveira C.,Federal University of Sao Joao del Rei | Carneiro Proietti A.B.F.,Fundacao Hemominas | Proietti F.A.,Federal University of Minas Gerais
Revista Brasileira de Hematologia e Hemoterapia | Year: 2011

Background: Confidential unit exclusion remains a controversial strategy to reduce the residual risk of transfusion-transmitted infections. Objective: This study aimed to analyze confidential unit exclusion from its development in a large institution in light of confidential donation confirmation. Methods: Data of individuals who donated from October 1, 2008 to December 31, 2009 were analyzed in a case-control study. The serological results and sociodemographic characteristics of donors who did not confirm their donations were compared to those who did. Variables with p-values < 0.20 in univariate analysis were included in a logistic multivariate analysis. Results: In the univariate analysis there was a statically significant association between positive serological results and response to confidential donation confirmation of "No". Donation type, (firsttime or return donor - OR 1.69, CI 1.37-2.09), gender (OR 1.66, CI 1.35-2.04), education level (OR 2.82, CI 2.30-3.47) and ethnic background (OR 0.67, CI 0.55-0.82) were included in the final logistic regression model. In all logistic regression models analyzed, the serological suitability and confidential donation confirmation were not found to be statistically associated. The adoption of new measures of clinical classification such as audiovisual touch-screen computer-assisted self-administered interviews might be more effective than confidential unit exclusion in the identification of donor risk behavior. The requirement that transfusion services continue to use confidential unit exclusion needs to be debated in countries where more specific and sensitive clinical and serological screening methods are available. Conclusion: Our findings suggest that there are not enough benefits to justify continued use of confidential donation confirmation in the analyzed institution.

Ribeiro M.A.,Fundacao Hemominas | Proietti F.A.,Federal University of Minas Gerais | Martins M.L.,Fundacao Hemominas | Januario J.N.,Nucleo de Acoes e Pesquisa em Apoio Diagnostico NUPAD | And 3 more authors.
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2010

Objectives. To evaluate the geographic distribution of human T-lymphotropic virus types 1 and 2 (HTLV-1/2) in the State of Minas Gerais, Brazil, in puerperal women whose newborns were tested for HTLV-1/2 during neonatal screening, and to overlap seropositivity with social and economic status determinants. Methods. During September-November 2007, the dry-blood samples taken from newborns on filter paper for routine screening were also tested for maternal IgG anti-HTLV-1/2 antibodies. For reactive samples, the mothers of the newborns had blood drawn to test for these viruses. Results. The study analyzed 55 293 specimens taken from newborns. Of these, 52 (9.4 per 10 000) were reactive and 42 mothers (7.6 per 10 000) were confirmed with HTLV-1/2 infection. HTLV-1/2 geographic distribution was heterogeneous, with a tendency to be higher in the North and North-East parts of Minas Gerais. The highest rates of seropositivity were observed in Vale do Mucuri (55.9 per 10 000) and in Jequitinhonha (16.0 per 10 000), overlapping with the State's worst social and economic indicators. Conclusions. To our knowledge this was the first time that neonatal screening for HTLV-1/2 was performed in Brazil. This model could be used in other areas with high HTLV-1/2 prevalence rates. The detection of carrier mothers can enable intervention measures, such as providing infant formula to newborns, to be implemented expeditiously to reduce vertical transmission.

Ribeiro M.A.,Fundacao Hemominas | Martins M.L.,Fundacao Hemominas | Teixeira C.,Fundacao Hemominas | Ladeira R.,Nucleo Del Acoes e Pesquisa em Apoio Diagnostico NUPAD | And 4 more authors.
Pediatric Infectious Disease Journal | Year: 2012

BACKGROUND: Human T cell lymphotropic virus type 1 and 2 (HTLV-1/2) causes serious diseases and is endemic in many parts of the world. It is transmitted from mother to child in 15-25% of the cases, primarily through breastfeeding. Proviral load and duration of breastfeeding are thought to play a role in transmission. This study aimed to detect HTLV-seropositive mothers through testing of neonates, to evaluate maternal HTLV proviral load and to measure the rates of transmission blocking when interruption of breastfeeding was implemented. METHODS: Neonates were screened for HTLV-1/2 IgG by enzyme immunoassay using the neonatal screening program of Minas Gerais State, Brazil. Breastfeeding interruption was recommended to those whose mothers were confirmed HTLV-positive. Children were tested by polymerase chain reaction at birth and at 12 months of age. RESULTS: Of 55,293 neonates tested, 42 (0.076%) were positive for HTLV-1 or HTLV-2 IgG. All 42 were polymerase chain reaction-negative at birth and 1 of 37 (2.7%) became antibody-positive after 12 months. His mother had delivered him vaginally and was informed of the positive HTLV-1 polymerase chain reaction after 7 days of breastfeeding. The mother's proviral load was 271 copies/10,000 cells, whereas the average is 109.2 copies/10,000 cells (95% confidence interval: 70.56-147.83). CONCLUSIONS: Maternal HTLV-1 proviral load and the route of delivery may have played a role in the transmission observed. Avoidance of breastfeeding was an effective measure to reduce HTLV transmission. In endemic countries, routine prenatal or neonatal screening combined with formula feeding for mothers confirmed HTLV-positive may be an important strategy to prevent future development of illnesses related to HTLV. Copyright © 2012 by Lippincott Williams & Wilkins.

Silva M.R.,Federal University of Minas Gerais | Sendin S.M.,Federal University of Minas Gerais | Pimentel F.S.,Federal University of Minas Gerais | Velloso-Rodrigues C.,Fundacao Hemominas | Viana M.B.,Federal University of Minas Gerais
Hemoglobin | Year: 2012

Almost 3 million babies were tested in a newborn screening program in Minas Gerais, Brazil (19982008); 128 who have S-like hemoglobins (Hbs) were tested for the βS allele and 112 were identified through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or sequencing. Hb Stanleyville-II [α78(EF7)Asn→Lys (α2); HbA2: c.237C>A] was present in 96 children (85.7), two in a homozygous state and 94 in a heterozygous state. Its estimated prevalence was 1:11,500. Hbs Hasharon [α47(CE5)Asp→His, GAC>CAC (α2)], Ottawa [α15(A13) Gly→Arg (GGT>CGT) (α2 or α1)], G-Ferrara [β57(E1)Asn→Lys (AAC>AAA or AAG)], St. Luke's [α95(G2) Pro→Arg, CCG>CGG (α1)], Maputo [β47(CD6)Asp→Tyr (GAT>TAT)] and Etobicoke [α84(F5)Ser→Arg (AGC>AGG or CGC or AGA) (α2 or α1)] were also identified. Many children with Hbs Stanleyville-II and Hasharon also co-inherited the -α3.7 thalassemia gene. African ancestry was recognized by parents of all 31 children with Hb Stanleyville-II who were interviewed. Mean corpuscular volume (MCV) and mean corpuscular Hb (MCH) values were significantly lower in children with α-thalassemia (α-thal). We came to the conclusion that Hb Stanleyville-II is not so uncommon in Brazil and seems to have originated from the African slave trade. This study reinforces the importance of an accurate diagnosis of variants that have electrophoretic mobility similar to Hb S [β6(A3)Glu→Val, GAG>GTG] so that false diagnoses are avoided. © 2012 Informa Healthcare USA, Inc.

Costa E.J.,Fundacao Hemominas | Guimaraes T.M.P.D.,Federal University of Minas Gerais | de Almeida N.C.,Federal University of Minas Gerais | de Toledo V.P.C.P.,Federal University of Minas Gerais
Revista Brasileira de Hematologia e Hemoterapia | Year: 2012

Background: Prolonged storage of platelets could improve availability and logistical management and decrease wastage. Immunobiochemical methods can be used to guarantee the quality of platelets after prolonged storage. Objective: The aim of this study was to compare storage-related changes in buffy coat-derived platelet concentrations versus platelet-rich plasma. Methods: Units of whole blood were drawn using a quadruple-bag blood container system. Plateletrich plasma and buffy coat prepared from whole blood following standard methods were stored for 9 days. During this period test samples were aseptically collected for analysis on Days 1, 2, 3, 5, 7 and 9. Results: The highest CD42b expression was greater than 95%. The percentage of CD62p was significantly lower than the CD42b expression. The pH remained fairly stable during storage. Measurement of pO 2 and pCO 2 showed that oxygen levels were significantly higher than carbon dioxide levels. There were no significant differences in bicarbonate levels, glucose consumption and lactate production between the groups. The swirling effect with platelet-rich plasma samples decreased after 5 days of storage and after 7 days of storage for buffy coat samples. There was a significant twenty-fold increase in the mean IL-1β after 5 days of storage for both groups. Slight increases in IL-6 and IL-8 levels were seen at 5 days. Conclusion: The quality of platelet concentrates remained acceptable during 7 days of storage in respect to the swirling effect, pH and platelet activation. There were no significant differences between buffy coat-derived platelets and platelet-rich plasma in this study.

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