Ronald Aquino-Ortega

Background: HPV16 is the most prevalent high-risk genotype associated with cervical cancer, yet the genetic variability and immune potential of the replication protein E1 are less characterized in asymptomatic infections. We assessed HPV16 E1 diversity and predicted conserved T-cell epitopes. Methods: We conducted a descriptive cross-sectional study of cervical samples from women undergoing HPV screening. HPV was detected with universal primers and then HPV16-specific PCR. Thirty HPV16-positive samples underwent full-length E1 amplification and nanopore amplicon sequencing. Variability and phylogeny were analyzed with Clustal Omega and MEGA (maximum likelihood). MHC class I and II epitopes were predicted with the IEDB using HLA alleles representative of South American populations and evaluated for conservation, toxicity, allergenicity, and population coverage. Results: Mutations were detected in 14/30 samples, while 16 sequences matched the reference (GenBank: NC_001526.3). European lineages (A1–A3) predominated, with one sequence in the Asian-American lineage D. Seven highly conserved MHC I epitopes and 37 conserved MHC II epitopes were identified. Epitopes mapped to multiple regions across the E1 sequence. Predicted global coverage was 94.38% for MHC I, 83.75% for MHC II, and 99.09% combined. Conclusions: HPV16 E1 is highly conserved and contains candidate T-cell targets with broad predicted coverage, supporting evaluation for future vaccine or immunotherapy strategies.

Klebsiella pneumoniae is a World Health Organization priority pathogen because of its rapidly accumulating resistance to multiple drug classes. Over-expres

Background: The HPV16 E2 gene plays a crucial role in viral replication and oncogene regulation. This study aimed to assess the genetic variability of the E2 gene and to identify immunogenic epitopes of the E2 protein. Methods: The E2 gene was amplified and sequenced. T-cell epitope prediction and evaluation were performed using IEDB, NetMHCpan v4.0, NetMHCIIpan v4.1, VaxiJen, ToxNet, and pLM4Alg. Results: Phylogenetic analysis of 47 E2 sequences demonstrated co-circulation of the D (n = 4) and A (n = 43) HPV16 lineages in Cajamarca. Twenty-eight Single Nucleotide Polymorphism (SNPs) were identified in E2, 21 of which were nonsynonymous. Seventeen variations were associated with positive Papanicolaou (Pap) test results. Epitope prediction identified 2 MHC class I and 27 MHC class II epitopes classified as potentially antigenic, non-toxic, and non-allergenic, with an overall global population coverage across both MHC classes of 99.78%. Conclusions: The A HPV16 lineage predominated among the women studied. The identified SNPs indicate substantial variability in the E2 gene and a relationship with endocervical lesions. In total, 29 E2-derived T-cell epitopes with immunogenic potential were identified.

In the context of SARS‐CoV‐2 infection, the present study aimed to determine the clinical and laboratory characteristics and serum levels of IL‐6 and zinc in patients with COVID‐19 according to their clinical condition in a hospital in Lima, Peru. Patients were divided into 4 groups according to the clinical condition of the disease, the group of patients hospitalized in the intensive care unit, hospitalized patients who did not require intensive care unit, COVID‐19 patients who did not require hospitalization, and a control group. It was determined that 64.8% of the patients evaluated were men. Patients hospitalized in the ICU were 11.25 times more likely to have a cough and 36.7 times more likely to have a fever compared to the control group. In the group of hospitalized patients who did not require ICU, the presence of cough was 9.44 times higher than in the control group. The lowest IL‐6 values were obtained in the group of COVID‐19 patients who did not require hospitalization (2 pg/mL) and the highest in the ICU group (168.5 pg/mL). On the other hand, the highest values of the micronutrient zinc were also obtained in the ICU group (3402.5 μg/dL). In this group, the highest values of lymphocytes, C‐reactive protein, and lactate dehydrogenase were also found with statistical significance compared to the group of hospitalized patients who did not require ICU. In conclusion, patients with COVID‐19 in the ICU had higher levels of IL‐6 and zinc compared to the other groups. This group also had the highest levels of lymphocytes, C‐reactive protein, and lactate dehydrogenase compared to the group of hospitalized patients who did not require ICU care.

Background: Despite great scientific efforts, understanding the role of COVID-19 clinical biomarkers remains a challenge. Methods: A cross-sectional descriptive study in two Peruvian cities at different altitudes for comparison: Lima and Huaraz. In each place, three groups were formed, made up of 25 patients with COVID-19 in the ICU, 25 hospitalized patients with COVID-19 who did not require the ICU, and 25 healthy subjects as a control group. Five biomarkers were measured: IL-6, hepcidin, ferritin, C-reactive protein, and zinc using ELISA assays. Results: Ferritin, C-reactive protein, and IL-6 levels were significantly higher in the ICU and non-ICU groups at both study sites. In the case of hepcidin, the levels were significantly higher in the ICU group at both study sites compared to the non-ICU group. Among the groups within each study site, the highest altitude area presented statistically significant differences between its groups in all the markers evaluated. In the lower altitude area, differences were only observed between the groups for the zinc biomarker. Conclusion: COVID-19 patients residing at high altitudes tend to have higher levels of zinc and IL-6 in all groups studied compared to their lower altitude counterparts.

Background: At the end of 2019, a novel coronavirus denominated SARS-CoV-2 rapidly spread through the world causing the pandemic coronavirus disease known as COVID-19. The difference in the inflammatory response against SARS-CoV-2 infection among people living at different altitudes is a variable not yet studied.Methods: A descriptive cross-sectional study was performed in two Peruvian cities at different altitudes for comparison: Lima and Huaraz. Five important proinflammatory cytokines were measured including: IL-6, IL-2, IL-10, IFN-γand TNF-α using ELISA assays.Results: A total of 35 COVID-19 patients and 10 healthy subjects were recruited from each study site. The mean levels of IL-6 (p < 0.03) and TNF-α (p < 0.01) were significantly different among the study groups. In the case of IL-6, patients from Lima had a mean level of 16.2 pg/ml (healthy) and 48.3 pg/ml (COVID-19), meanwhile, patients from Huaraz had levels of 67.3 pg/ml (healthy) and 97.9 pg/ml (COVID-19). Regarding TNF-α, patients from Lima had a mean level of 25.9 pg/ml (healthy) and 61.6 pg/ml (COVID-19), meanwhile, patients from Huaraz had levels of 89.0 pg/ml (healthy) and 120.6 pg/ml (COVID-19). The levels of IL-2, IL-10 and IFN-γ were not significantly different in the study groups.Conclusion: Patients with COVID-19 residing at high-altitude tend to have higher levels of inflammatory cytokines compared to patients living at sea level, particularly IL-6 and TNF-α. A better understanding of the inflammatory response in different populations can contribute to the implementation of therapeutic and preventive approaches. Further studies evaluating more patients, a greater variety of cytokines and their clinical impact are required.

Objective: The objective of this study was to characterize the composition of the gut microbiota in type 2 Diabetes Mellitus (T2DM) patients with adequate and inadequate metabolic control, and its relationship with fiber consumption. Results: A total of 26 patients with type 2 diabetes mellitus (T2DM) were enrolled, of which 7 (26.9%) cases had adequate metabolic control (HbA1c < 7%) and 19 (73.1%) inadequate metabolic control (HbA1c ≥ 7%). It was observed that among patients with controlled T2DM, 2 (28.6%) cases presented good intake of fiber and 5 (71.4%) cases a regular intake. In contrast, in patients with uncontrolled T2DM, 13 (68.4%) patients reported a regular intake and 6 (31.6%) a poor intake. In relation to the identification of the gut microbiota, both groups presented a similar characterization. There were differences in the population of bacteria identified in both groups, however, the results were not statistically significant. The most frequently identified bacteria in controlled and uncontrolled T2DM patients were Prevotella (71.4% vs 52.6%), followed by Firmicutes (71.4% vs 42.1%), Proteobacteria (71.4% vs 36.8%) and Bacteroidetes (57.1% vs 37.8%). On the other hand, Fusobacterium, Actinobacteria were not identified in either of the two groups of study.

Objective: This study was carried out to determine the prevalence of leptospirosis among febrile patients with a suspicious clinical diagnosis of dengue fever in northern Peru. Results: A total of 276 serum samples from patients with acute febrile illness (AFI) and suspected diagnosis for dengue virus (DENV) were analyzed. We identified an etiological agent in 121 (47.5%) patients, DENV was detected in 30.4% of the cases, leptospirosis in 11.2% and co-infection by both pathogens was observed in 5.9% of the patients. In this study the most common clinical symptoms reported by the patients were: headache 89.1%, myalgias 86.9% and arthralgias 82.9%. No differences in symptomatology was observed among the different study groups.

The first report of Ralstonia mannitolilytica bacteremia in Peru is presented. The patient was a pediatric cancer patient with a long-term central venous access device. For the diagnosis, the MicroScan Walk Away 96 automated system was used. 16S rDNA was amplified by conventional PCR, and the bacterial genus and species were identified by genetic sequencing. In addition, the bacterial resistance profile to major antimicrobials was determined. The article discusses the need to actively monitor Ralstonia mannitolilytica, especially in hospital areas of immunocompromised patients.

Objective: To describe frequency and clinical characteristics of MAYV infection in Piura, as well as the association of this pathogen with DENV.Results: A total of 86/496 (17.3%) cases of MAYV were detected, of which 54 were MAYV mono-infection and 32 were co-infection with DENV, accounting for 10.9% and 6.4%, respectively. When evaluating monoinfection by MAYV the main groups were 18–39 and 40–59 years old, with 25.9% and 20.4% respectively. Co-infections were more common in the age group 18–39 and those > 60 years old, with 34.4% and 21.9%, respectively. The most frequent clinical presentation were headaches (94.4%, 51/54) followed by arthralgias (77.8%, 42/54). During the 8-month study period the most cases were identified in the months of May (29.1%) and June (50.0%).