Enteroparasitoses em indivíduos HIV/aids: aspectos epidemiológicos, nutricionais e imunológicos

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BIBLIOTECÁRIA RESPONSÁVEL: ROSEMEIRE APARECIDA VICENTE Amâncio, Fátima Aparecida Mazzini.

Enteroparasitoses em indivíduos HIV / aids : aspectos

epidemiológicos, nutricionais e imunológicos / Fátima Aparecida Mazzini Amâncio. – Botucatu, 2010

Tese (doutorado) – Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, 2010.

Orientador: Paulo Câmara Marques Pereira Assunto CAPES: 40101096

1. Doenças parasitárias – Teses. 2. Nutrição – Avaliação. 3. Pesquisa imunológica. 4. Epidemiologia – Pesquisa.

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$FRQWDJHPJOREDOHUHODWLYDGHHRVLQyILORVIRLUHDOL]DGDFRP R FRQWDGRU KHPDWROyJLFR DXWRPDWL]DGR$%; 3(175$ $%; 'LDJQRVWLFVŠ(VVHHTXLSDPHQWRDQDOLVRXRVHRVLQyILORVDSDUWLU GH XP UHDJHQWH (RVLQRIL[ RQGH R PHVPR OLVRX RV JOyEXORV YHUPHOKRV FRP DomR GR UHDJHQWH QDV PHPEUDQDV FLWRSODVPiWLFDV2VOHXFyFLWRVPDQWLYHUDPVHXWDPDQKRRULJLQDO H VRPHQWH RV HRVLQyILORV IRUDP SLJPHQWDGRV SDUD D VHSDUDomR yWLFD 2 YDORU GH UHIHUrQFLD HVWi QR LQWHUYDOR D FpOXODVPP

$YDOLDomRGHDOEXPLQD

$ GRVDJHP VpULFD GHDOEXPLQD IRL UHDOL]DGD SHORSistema VITROS da Johnson & Johnson, PpWRGR FRORULPpWULFR TXtPLFD VHFD 2 YDORU GH UHIHUrQFLD HVWi QR LQWHUYDOR GH JG/ ² JG/

2V UHVSHFWLYRV H[DPHV IRUDP UHDOL]DGRV QR /DERUDWyULR GH $QiOLVHV &OtQLFDV GD 6HomR 7pFQLFD GH $QiOLVHV &OtQLFDV GR +RVSLWDO GDV &OtQLFDV GD )0% ² 81(63 TXH SRVVXL FRQWUROH LQWHUQRHH[WHUQRGHTXDOLGDGH

$YDOLDomRLPXQROyJLFD

'HWHUPLQDomRGH,J(

3DUD D PHGLomR GD FRQFHQWUDomR GH ,J( IRL XWLOL]DGD DPRVWUDV GH VRUR RX SODVPD KHSDULQL]DGR HP ('7$ RX DPRVWUDV FRQJHODGDV $ DQiOLVH IRL UHDOL]DGD DWUDYpV GD LPXQRQHIHORPHWULD GH SDUWtFXODV UHIRUoDGDV FRP RV VLVWHPDV %1 SHOR PpWRGR 1 OiWH[ ,J( PRQR 'DGH %HKULQJ 0DUEXUJ *PE+ ² (8$ 1RV DGXOWRV DV FRQFHQWUDo}HVDWpDSUR[LPDGDPHQWH8,P/SRGHP VHUFRQVLGHUDGDVFRPRROLPLWHVXSHULRUGHLQWHUYDORGH UHIHUrQFLD

2UHVSHFWLYRH[DPH IRLUHDOL]DGRQR/DERUDWyULRGH $QiOLVHV&OtQLFDVGD6HomR7pFQLFDGH$QiOLVHV&OtQLFDV GR+RVSLWDOGDV&OtQLFDVGD)0%²81(63RTXDOSRVVXL FRQWUROHLQWHUQRHH[WHUQRGHTXDOLGDGH

&RQWDJHPGHOLQIyFLWRV7&'_H7&'

2UHVSHFWLYRH[DPHIRLUHDOL]DGRQR+HPRFHQWURGR +RVSLWDOGDV&OtQLFDVGD)0%²81(63

&RQWDJHPGHFDUJDYLUDO

)RL XWLOL]DGR R WHVWH 9(56$17Š +,9 51$ E'1$ SDUD TXDQWLILFDomR GLUHWD GR YtUXV GD ,PXQRGHILFLrQFLD+XPDQDWLSR+,951$QRSODVPD GH LQGLYtGXRV SRUWDGRUHV GR YtUXV +,9 SRU PHLR GD DPSOLILFDomR GR VLQDO HPLWLGR SHOR iFLGR QXFOpLFR XVDQGRR6\VWHPE'1$$QDO\VHU%D\HUŠ

2UHVSHFWLYRH[DPHIRLUHDOL]DGRQR+HPRFHQWURGR +RVSLWDOGDV&OtQLFDVGD)0%²81(63

4XDQWLILFDomRGHFLWRFLQDV

VROXomRGHWHUJHQWHFRQWHQGRFORURDFHWDPLGDH VROXomR GHWHUJHQWH FRQWHQGR 7ZHHQ HP 33V S+ (VVH SURFHGLPHQWR IRL UHSHWLGR DWp D IDVH DQWHULRU i DGLomR GR VXEVWUDWR 3RVWHULRUPHQWH DV SODFDVPDUFDGDVFRPELRWLQDUHFHEHUDPHVWUHSWRYLGLQD OLJDGD i SHUR[LGDVH $SyV R SHUtRGR GH LQFXEDomR R VXEVWUDWRIRUPDGRSRUSHUy[LGRGHKLGURJrQLRH WHWUDPHWLOEHQ]LQD IRL DGLFLRQDGR DRV RULItFLRV GDV SODFDV $ LQWHUUXSomR GD UHDomR IRL UHDOL]DGD D WHPSHUDWXUD DPELHQWH XWLOL]DQGRVH —O GH iFLGR VXOI~ULFR02VUHVXOWDGRVIRUDPDYDOLDGRVSHODOHLWXUD GH GHQVLGDGH ySWLFD '2 HP OHLWRU DXWRPiWLFR GH (/,6$7LWHUWHN0XOWLVNDQHPFRPSULPHQWRGHRQGDGH QP $V FRQFHQWUDo}HV GDV FLWRFLQDV HP SJPO SUHVHQWHV QR VRUR IRUDP FDOFXODGDV D SDUWLU GRV UHVXOWDGRV HP '2 DSOLFDGRV HP FXUYD SDGUmR GH FLWRFLQD UHFRPELQDQWH XWLOL]DGD FRPR FRQWUROH VHQGR SJPO R YDORU PtQLPR GHWHFWiYHO SHOD WpFQLFD 2 UHVSHFWLYR H[DPH IRL UHDOL]DGR QR /DERUDWyULR GH 3HVTXLVDGH'RHQoDV7URSLFDLVGD)0%81(63

$QiOLVH(VWDWtVWLFD

3DUD YHULILFDU GLIHUHQoDV HQWUH LQGLYtGXRV SRVLWLYRV H QHJDWLYRV FRP H VHP HQWHURSDUDVLWDV FRP UHODomR jV YDULiYHLV HRVLQyILORV ,J( 7&'_{H7&'WDPEpPIRLDMXVWDGRXPPRGHOROLQHDUJHQHUDOL]DGRFRP} HUURELQRPLDOQHJDWLYRSDUDFDGDXPDGHODVREWHQGRDVVLPRYDORUS

3DUDHVWXGDUDVVRFLDomRHQWUHFDUJDYLUDOGHWHFWiYHOHSUHVHQoDGH HQWHURSDUDVLWDVIRLDSOLFDGRRWHVWHH[DWRGH)LVKHU

3DUD DOEXPLQD ,0& H FDGD FLWRFLQD IRL DSOLFDGR R WHVWH NUXVNDO ZDOOLV SRLV D HVWDV YDULiYHLV QmR IRL SRVVtYHO DMXVWDU XPD GLVWULEXLomR QRUPDODRVHUURVRXHODVQmRSRVVXtDPYDULkQFLDFRQVWDQWH

3DUD DV DQiOLVHV HVWDWtVWLFDV IRL XWLOL]DGR R SDFRWH HVWDWtVWLFR 6$6 YHUVmR

Resultados

5HVXOWDGRV

3RSXODomRHVWXGDGD

'XUDQWHRSHUtRGRGHHQWUHYLVWDVHFROHWDGRVGDGRVIRUDPHQWUHYLVWDGRV SDFLHQWHVHGHVWHVTXHSUHHQFKLDPRVFULWpULRVGHLQFOXVmRIRUDP H[FOXtGRVGRHVWXGRSRUQmRUHDOL]DUHPDFROHWDGRH[DPHSDUDVLWROyJLFRGH IH]HVHXPSDFLHQWHIRLH[FOXtGRSRUyELWR6HQGRDVVLPLQGLYtGXRV FRPSOHWDUDPRHVWXGR

&DUDFWHUL]DomRGDSRSXODomRHVWXGDGD

'RV SDUWLFLSDQWHV HUDP GR VH[R PDVFXOLQR H GRIHPLQLQRQmRKDYHQGRGLIHUHQoDHVWDWtVWLFDQDGLVWULEXLomRTXDQWR DHVVDYDULiYHOS $PpGLDGHLGDGHGRVLQGLYtGXRVQmRSDUDVLWDGRV IRLGH“DQRVHGRVSDUDVLWDGRVIRLGH“$PpGLDGD UHQGD PHQVDO SHU FDSLWD IRL GH DSUR[LPDGDPHQWH VDOiULRV PtQLPRV 5 XPPLOFHQWRHYLQWHHXPUHDLVHVHVVHQWDHWUrVFHQWDYRVPtQLPD GH5FHPUHDLVHPi[LPDGH5VHWHPLOUHDLV$WDEHOD PRVWUD TXH KRXYH SUHGRPtQLR GD FRU GD SHOH EUDQFD HP TXDVH GRV HVWXGDGRVDSHQDVGHDQDOIDEHWRVDPDLRULDUHVLGLDHP]RQDXUEDQDFRP VDQHDPHQWREiVLFRQmRXWLOL]DYDPKRUWDFRPRIRQWHGHDOLPHQWDomRHID]LDXVR GH7$59

7DEHOD&DUDFWHUL]DomRGHLQGLYtGXRV+,9SRVLWLYRVDWHQGLGRVQR

6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRV H +RVSLWDO 'LD 3URI

(PpULWR'RPLQJRV$OYHV0HLUD)0%81(63

Variáveis n %

Sexo Masculino Feminino 54 51 51.43 48.57 Cor da pele

Branca Negra 91 14 86.66 13.33 Escolaridade Analfabeto Fundamental Médio Superior 3 69 25 8 2.85 65.71 23.80 7.61 Moradia Alvenaria Urbana Rural 105 100 5 100 95.23 4.76

Saneamento básico completo

Uso de horta Sim Não 28 77 26.66 73.33 Uso de TARV

Sim Não 93 12 88.57 11.42 Transmissão da doença

Relações heterossexuais Relações homossexuais Uso de drogas

Transfusão de sangue Não sabe 74 4 9 6 18 70.47 3.80 8.57 5.71 17.14 Alergia Sim Não 34 71 32.38 67.61

FMB = Faculdade de Medicina de Botucatu n = número

% = porcentagem TARV = terapia anti-retroviral de alta atividade $YDOLDomRFOtQLFD (PUHODomRjDYDOLDomRFOtQLFDWRGRVRVLQGLYtGXRVQHJDUDPDSUHVHQoD GHGLDUUpLDDOWHUDomRQRDSHWLWHRXSHVRQRV~OWLPRVPHVHV $YDOLDomRQXWULFLRQDO $QiOLVHGH,0&

1mR KRXYH GLIHUHQoD VLJQLILFDWLYD HQWUH RV JUXSRV DQDOLVDGRVS

25,4

23,8

0

5

10

15

20

25

30

IM

C (

K

g/m2

)

Positivos

Negativos

*UiILFR 0HGLDQD GH ,0& QRV LQGLYtGXRV +,9DLGV DWHQGLGRV QR 6HUYLoR GH $PEXODWyULRV(VSHFLDOL]DGRVH+RVSLWDO'LD3URI(PpULWR'RPLQJRV$OYHV 0HLUD )0%81(63 2 YDORU S REWLGR DWUDYpV GR WHVWH GH .UXVNDO:DOOLVSDUDFRPSDUDUSRVLWLYRVFRPQHJDWLYRVIRL

3HUILOQXWULFLRQDO

HVWDYDP GHQWUR GRV SDGU}HV GH QRUPDOLGDGH ,0& ² NJPò HUDP SUpREHVRV ,0& ² NJPò HUD REHVR,,0&²NJPòHQmRVHQGRHQFRQWUDGRQHQKXPLQGLYLGXR REHVR,,,0&²NJPòHREHVR,,,!NJPò

7DEHOD 3HUILO QXWULFLRQDO GH LQGLYtGXRVFRP +,9DLGV DWHQGLGRV QR 6HUYLoRGH$PEXODWyULRV(VSHFLDOL]DGRVH+RVSLWDO'LD3URI(PpULWR 'RPLQJRV$OYHV0HLUD)0%81(63

Sem enteroparasitas Com enteroparasitas Diagnóstico nutricional

(IMC/OMS)

_Q

n %

Baixo peso 6 6.97 0 0

Normal 43 50 5 50

Pré-obeso 27 31.39 4 40

Obeso I 7 8.13 1 10

Obeso II 2 2.32 0 0

Obeso III 1 1.16 0 0

FMB = Faculdade de Medicina de Botucatu n = número %: porcentagem IMC = Índice de massa corporal OMS = Organização Mundial de Saúde

$YDOLDomRODERUDWRULDO

$YDOLDomRGHHQWHURSDUDVLWRVHV

(P UHODomR DR Q~PHUR GH HQWHURSDUDVLWDV YHULILFRXVH XPD PDLRU SRVLWLYLGDGH HP UHODomR DRV SURWR]RiULRV GR TXH DRV KHOPLQWRV $SHQDV GXDVDPRVWUDVDSUHVHQWDUDPSROLSDUDVLWLVPRXPDSRU(QGROLPD[ QDQD H *LDUGLD ODPEOLD H RXWUD SRU (QGROLPD[ QDQD H (QWDPRHED FROL 7DEHOD (QWDPRHED FROL IRL HQFRQWUDGD HP GDV DPRVWUDV VHJXLGR GH *LDUGLD ODPEOLD %ODVWRF\VWLV KRPLQLV

(QGROLPD[QDQDH$VFDULVOXPEULFRLGHV*UiILFR

7DEHOD 'LVWULEXLomR GRV LQGLYtGXRV FRP +,9DLGV VHJXQGR WLSR GH SDUDVLWD DWHQGLGRV QR DWHQGLGRV QR 6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRVH+RVSLWDO'LD3URI(PpULWR'RPLQJRV$OYHV0HLUD

)0%81(63

Pacientes Parasitas

1 B.hominis

2 E.nana + G. lamblia

3 E.coli

4 A.lumbricoides

5 E.coli

6 G. lamblia

7 E.coli

8 G.lamblia

9 E.coli

10 B.hominis

11 G. lamblia

12 E.nana +E.coli

13 B.hominis

1(7,7%) 3(23%) 5(38,5%) 2(15,4%) 4(30,7%) 0 1 2 3 4 5 6 N de p ar asi ta s A.lumbricoides B.hominis E.coli E.nana G.lamblia *UiILFR1~PHURGHHQWHURSDUDVLWDVQRVLQGLYtGXRV+,9DLGVDWHQGLGRVQR6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRV H +RVSLWDO 'LD 3URI (PpULWR 'RPLQJRV $OYHV 0HLUD)0%81(63 2 YDORU GH S REWLGR SHOR DMXVWH GH XPPRGHORELQRPLDOQHJDWLYRIRL

$QiOLVHGHQtYHLVVpULFRVGHHRVLQyILORV

2VQtYHLVVpULFRVGHHRVLQyILORVGHWRGRVRVSDFLHQWHVYDULDUDPGHD FpOXODVPP _{1RV LQGLYtGXRV FRP GLDJQyVWLFR QHJDWLYR GH} HQWHURSDUDVLWRVHV D PpGLD GHVYLR SDGUmR H PHGLDQD IRUDP GH HUHVSHFWLYDPHQWH1RVLQGLYtGXRVFRPGLDJQyVWLFRSRVLWLYR GHHQWHURSDUDVLWRVHVDPpGLDGHVYLRSDGUmRHPHGLDQDIRUDPGH HUHVSHFWLYDPHQWH*UDILFR9DORUQRUPDODWpFpOPP

&RP EDVH QD DQDOLVH HVWDWtVWLFD SRGHPRV REVHUYDU TXH QmR KRXYH GLIHUHQoDVLJQLILFDWLYDHQWUHRVJUXSRVDQDOLVDGRVS

0 50 100 150 200 250 300

E

os

inóf

ilos

(

cel

ul

as/

m

m

3)

Positivos Negativos

*UiILFR 0pGLD GD GRVDJHP GH HRVLQyILORV QRV LQGLYtGXRV +,9DLGV DWHQGLGRV QR 6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRV H +RVSLWDO 'LD 3URI (PpULWR 'RPLQJRV $OYHV 0HLUD )0%81(63 2 YDORU GH S REWLGR SHOR DMXVWHGHXPPRGHORELQRPLDOQHJDWLYRIRLS

$QiOLVHGHQtYHLVVpULFRVGHDOEXPLQD

2VQtYHLVVpULFRVGHDOEXPLQDGRVSDFLHQWHVYDULDUDPGHD JGO 1RV LQGLYtGXRV FRP GLDJQyVWLFR QHJDWLYR GH HQWHURSDUDVLWRVHV D PpGLD GHVYLR SDGUmR H PHGLDQD H IRUDP GH H UHVSHFWLYDPHQWH 1RV LQGLYtGXRV FRP GLDJQyVWLFR SRVLWLYR GH HQWHURSDUDVLWRVHV D PpGLD GHVYLR SDGUmR H PHGLDQD H IRUDP GH

H*UiILFR2YDORUQRUPDOpGHDJGO

3RGHPRV REVHUYDU TXH QmR KRXYH GLIHUHQoD VLJQLILFDWLYD HQWUH RV JUXSRVDQDOLVDGRVS

4,41 4,4

0 0,5 1 1,5 2 2,5 3 3,5 4 4,5 5

A

lbumina (

g

/dl)

Positivos Negativos

*UiILFR0HGLDQDGD GRVDJHPGH DOEXPLQD QRVLQGLYtGXRV+,9DLGV DWHQGLGRVQR 6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRV H +RVSLWDO 'LD 3URI (PpULWR 'RPLQJRV$OYHV0HLUD)0%81(632YDORUSREWLGRDWUDYpVGR WHVWHGH.UXVNDO:DOOLVSDUDFRPSDUDUSRVLWLYRVFRPQHJDWLYRVIRL

$QiOLVHGHQtYHLVVpULFRVGH,J(

2VQtYHLVVpULFRVGH,J(GRVSDFLHQWHVYDULDUDPGHD8,PO 1RV LQGLYtGXRV FRP GLDJQyVWLFR QHJDWLYR GH HQWHURSDUDVLWRVHV D PpGLD GHVYLR SDGUmR H PHGLDQD IRUDP GH H UHVSHFWLYDPHQWH 1RV LQGLYtGXRV FRP GLDJQyVWLFR SRVLWLYR GH HQWHURSDUDVLWRVHV D PpGLD GHVYLRSDGUmRHPHGLDQDIRUDPGHHUHVSHFWLYDPHQWH *UiILFR2YDORUQRUPDODWp8,PO

&RP EDVH QD DQiOLVH HVWDWtVWLFD SRGHPRV REVHUYDU TXH QmR KRXYH GLIHUHQoDVLJQLILFDWLYDHQWUHRVJUXSRVDQDOLVDGRVS

*UiILFR0pGLDGDGRVDJHPGH,J(QRVLQGLYtGXRV+,9DLGVDWHQGLGRVQR6HUYLoRGH $PEXODWyULRV(VSHFLDOL]DGRVH+RVSLWDO'LD3URI(PpULWR'RPLQJRV$OYHV 0HLUD )0%81(63 2 YDORU GH S REWLGR SHOR DMXVWH GH XP PRGHORELQRPLDOQHJDWLYRIRLS

$QiOLVHGHQtYHLVVpULFRVGHFpOXODV7&'

2V QtYHLV VpULFRV GH FpOXODV 7&' _{GRV SDFLHQWHV YDULDUDP GH D} FpOXODVPP _{1RV LQGLYtGXRV FRP GLDJQyVWLFR QHJDWLYR GH} HQWHURSDUDVLWRVHV D PpGLD GHVYLR SDGUmR H PHGLDQD IRUDP GH HUHVSHFWLYDPHQWH1RVLQGLYtGXRVFRPGLDJQyVWLFRSRVLWLYRGH HQWHURSDUDVLWRVHV D PpGLD GHVYLR SDGUmR H PHGLDQD IRUDP GH HHUHVSHFWLYDPHQWH*UiILFR

&RP EDVH QD DQDOLVH HVWDWtVWLFDSRGHPRV REVHUYDU TXH QmR KRXYH GLIHUHQoDVLJQLILFDWLYDHQWUHRVJUXSRVDQDOLVDGRVS

0

100

200

300

400

500

600

700

800

TC

D

4+

(

cél

ul

as/

m

m

3)

Positivos Negativos

*UiILFR0pGLDGDGRVDJHPGHFpOXODV7&'_{QRVLQGLYtGXRV+,9DLGVDWHQGLGRVQR} 6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRV H +RVSLWDO 'LD 3URI (PpULWR 'RPLQJRV $OYHV 0HLUD )0%81(63 2 YDORU GH S REWLGR SHOR DMXVWHGHXPPRGHORELQRPLDOQHJDWLYRIRLS

$QiOLVHGHQtYHLVVpULFRVGHFpOXODV7&'

2V QtYHLV VpULFRV GH FpOXODV 7&' _{GRV SDFLHQWHV YDULDUDP GH D} FpOXODVPP _{1RV LQGLYtGXRV FRP GLDJQyVWLFR QHJDWLYR GH} HQWHURSDUDVLWRVHV D PpGLD GHVYLR SDGUmR H PHGLDQD IRUDP GH HHUHVSHFWLYDPHQWH1RVLQGLYtGXRVFRPGLDJQyVWLFRSRVLWLYRGH HQWHURSDUDVLWRVHV D PpGLD GHVYLR SDGUmR H PHGLDQD IRUDP GH HUHVSHFWLYDPHQWH*UiILFR

&RQVLGHUDQGR DV FRQWDJHQV PpGLDV GH OLQIyFLWRV 7 &' _{H7&' EHP} FRPRDUD]mR&'_{&'QmRIRUDPREVHUYDGDVGLIHUHQoDVVLJQLILFDWLYDVHQWUH} RVGRLVJUXSRV

0

200

400

600

800

1000

1200

1400

T

CD8+ (

cél

ul

as/m

m

3)

Positivos Negativos

*UiILFR0pGLDGDGRVDJHPGHFpOXODV7&'_{QRVLQGLYtGXRV+,9DLGVDWHQGLGRVQR}

6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRV H +RVSLWDO 'LD 3URI (PpULWR

'RPLQJRV $OYHV0HLUD )0%81(63 2 YDORU GH S REWLGR SHOR

DMXVWHGHXPPRGHORELQRPLDOQHJDWLYRIRLS

$QiOLVHGHFDUJDYLUDO

7DEHOD'LVWULEXLomRGRVLQGLYtGXRVFRP+,9DLGVVHJXQGRRQtYHOGHFDUJD YLUDO GHWHFWiYHO SRU PP GH VDQJXH DWHQGLGRV QR DWHQGLGRV QR 6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRV H +RVSLWDO 'LD 3URI (PpULWR'RPLQJRV$OYHV0HLUD)0%81(63

Carga Viral Negativos n %

Positivos

n %

Valor de p para teste exato de Fisher

Indetectável 73 86.9 11 91.7

> 50.000(cópias/ml) 11 13.1 1 8.3 0.6408

Total 84 100.0 12 100.0

FMB = Faculdade de Medicina de Botucatu n = número % = porcentagem

4XDQWLILFDomRGHFLWRFLQDVVpULFDV

$ 7DEHOD H R *UiILFR PRVWUDP D PHGLDQD H GRV LQGLYtGXRV FRP GLDJQyVWLFRQHJDWLYRHSRVLWLYRGHHQWHURSDUDVLWRVHV

7DEHOD 'LVWULEXLomR GRV LQGLYtGXRV FRP +,9DLGV VHP H FRP

HQWHURSDUDVLWRVHV VHJXQGR D TXDQWLILFDomR GH FLWRFLQDV VpULFDV SJPO DWHQGLGRV QR DWHQGLGRV QR 6HUYLoR GH $PEXODWyULRV (VSHFLDOL]DGRV H +RVSLWDO 'LD 3URI (PpULWR 'RPLQJRV $OYHV 0HLUD)0%81(63

Parasitas Medidas TNF-α IFN-γ: IL-2 IL-5 IL-10

Mediana 378,5a ₃₂₈ a ₁₂₁ a ₂₁₀ a ₄₀ a

NEGATIVO

(Q1; Q3) (310;410) (219;430) (104;150) (187;229) (32;54)

Mediana 486 b ₂₃₂ a ₁₃₁ a ₃₂₁ b ₄₃ a

POSITIVO

(Q1; Q3) (404;567) (206;321) (108;143) (276;543) (36;50)

Medianas com letras diferentes apresentaram diferença entre positivos e negativos (p < 0,05) pelo teste de Kruskal-Wallis.

&RP EDVH QD HVWDWtVWLFD SRGHPRV REVHUYDU GLIHUHQoD VLJQLILFDWLYD HP

UHODomRj71)αS H,/S7DEHOD*UiILFR9DORUHV

QRUPDLVPHGLDQD71)α IFN-γ=190,5; IL-2=130; IL-5=101; IL-10=10,5.

7DEHOD 'LVWULEXLomR GRV LQGLYtGXRV FRP +,9DLGV VHP H FRP HQWHURSDUDVLWRVHVVHJXQGRDDQiOLVHHVWDWtVWLFDFRPSDUDWLYD GDV FLWRFLQDV VpULFDV SJPO DWHQGLGRV QR DWHQGLGRV QR 6HUYLoRGH$PEXODWyULRV(VSHFLDOL]DGRVH+RVSLWDO'LD3URI (PpULWR'RPLQJRV$OYHV0HLUD)0%81(63

Citocinas Estatística Comentário TNF-α p=0,0277 Positivo > Negativo

IFN-γ p=0,0956 Positivo = Negativo

IL-2 p=0,5517 Positivo= Negativo IL-5 p<0,0001 Positivo > Negativo

IL-10 P =0,2832 Positivo= Negativo

*UiILFR4XDQWLILFDomRGH71)α,)1γ,/,/H,/QRVLQGLYtGXRV+,9DLGV

DWHQGLGRVQR6HUYLoRGH$PEXODWyULRV(VSHFLDOL]DGRVH+RVSLWDO'LD3URI

(PpULWR 'RPLQJRV $OYHV 0HLUD )0%81(63 2 YDORU S IRL

REWLGR DWUDYpV GR WHVWH GH .UXVNDO:DOOLV SDUD FRPSDUDU SRVLWLYRV FRP

QHJDWLYRVSDUDFDGDFLWRFLQDS

0 100 200 300 400 500 600

TNF-alfa IFN-gama IL-2 IL-5 IL-10

ci

to

ci

n

as

s

ér

ica

s(p

g

/m

l)

Positivos Negativos

*

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Considerações Finais