Departamento de Doenças Infecciosas
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- Mpox in People Living with HIV: Clinical Challenges, Preventive Strategies and Public Health ImplicationsPublication . Cordeiro, Rita; Caria, J.; Sobral, D.; Póvoas, D.; .Monkeypox virus (MPXV) re-emerged in 2022 with a global outbreak that affected more than 100,000 individuals worldwide. People living with HIV (PLWH) accounted for a substantial proportion of cases, raising concerns about disease presentation, management, and outcomes in this population. Evidence indicates that PLWH with advanced or uncontrolled HIV infection experienced more severe mpox, with higher hospitalization rates, more complications, and longer disease courses. In contrast, individuals with well-controlled HIV generally had outcomes similar to those without HIV. Access to timely diagnosis, consistent antiretroviral therapy, and availability of tecovirimat were key factors influencing prognosis. Reports also suggest bidirectional interactions between mpox and HIV pathogenesis. Immune activation and APOBEC3-related viral evolution have been proposed; however, these mechanisms remain incompletely characterized and warrant further investigation. Moreover, disparities in healthcare access and stigma compound the vulnerability of PLWH, emphasizing the need for integrated approaches.
- Surveillance of invasive meningococcal disease in Portugal, from 2020 to 2024Publication . Bettencourt, Célia; Nunes, A.; VigLab-DM – Network for the Laboratory Surveillance of Meningococcal Disease; Bajanca-Lavado, M.P.; .Introduction: Since 2002, laboratory surveillance of Invasive Meningococcal Disease (IMD) has been carried out by the National Reference Laboratory for Neisseria meningitidis, at the National Institute of Health Doutor Ricardo Jorge, Portugal. This study aims to analyse the epidemiology of IMD and the genetic diversity of Neisseria meningitidis strains from 2020 to 2024. Material and Methods: Suspected IMD cases and N. meningitidis isolates were sent to the reference laboratory for confirmation and strain characterization. Invasive isolates were characterized by WGS (Illumina) and sequences were submitted to the PubMLST/Neisseria database. Results: Between 2020 to 2024, 125 IMD cases were confirmed. Annual incidence rate ranged from 0.36 cases/100,000 inhabitants in 2020 to 0.32 in 2023 [1, 2]. Serogroup B was the most prevalent (49.6%), followed by serogroups Y (14.4%), W (13.6%) and C (5.6%). Serogroup W mainly affected those over 45 years old (58.8%). In silico analysis of 89 (71.2%) isolates identified major clonal complexes (cc): B-cc213 (22%) and cc41/44 (18%), Y-cc23 (80%), W-cc11 (66.7%), and C-cc11/cc103 (33.3% each). Conclusions: Compared to previous studies (2003-2020), the incidence of IMD in Portugal has decreased [1-3]. However, serogroup B remains the leading cause of IMD, raising concerns, particularly due to cases in children and emerging clusters with low vaccination coverage (e.g. serogroup B cc213) [4]. In contrast, serogroup W cases have increased, especially among adults [2, 3]. This study highlights the importance of laboratory surveillance for understanding IMD epidemiology and monitoring long-term trends.
