Evaluation of practices for the diagnosis and monitoring of cytomegalovirus infection in kidney transplant recipients in Brazil Nayla Azanki Hatem, Elizete Keitel, Guilherme Santoro-Lopes, Ligia Camera Pierrotti, Alessandro Comarú Pasqualotto Jornal Brasileiro De Nefrologia, 2026 Introduction: Cytomegalovirus (CMV) remains a significant challenge in kidney transplantation. Despite prophylactic and preemptive antiviral strategies, clinical practices vary widely. This study assessed CMV diagnostic and monitoring practices in Brazilian kidney transplant centers, focusing on access to diagnostic tools, therapeutic thresholds, and logistical barriers. Methods: A nationwide electronic survey was conducted between August and October 2024, targeting all kidney transplant programs (TP) registered with the Brazilian Society of Organ Transplantation (ABTO). Results: A total of 35 TP (20.6% response rate) participated, representing 62% of kidney transplants performed in Brazil in 2023. While most centers had CMV management protocols (94.3%), significant variability was observed in the initiation of preemptive therapy (PET). Among high-risk patients (D+/R−), 41.9% followed predefined thresholds. Specific cut-off values were applied in 71.0% of R+ patients and in 45.2% of the low-risk group (D−/R−). Quantitative PCR was the primary diagnostic method (97.1%), with whole blood (60%) and plasma (34.3%) as preferred sample types. A significant proportion of CMV TP (60%) relied on outsourced laboratories for CMV diagnostics, with 82.4% experiencing turnaround times exceeding three days for results. Only 8.6% TP had access to molecular testing for CMV-resistant strains. Conclusion: This survey reveals substantial variability in CMV diagnosis and management among Brazilian kidney transplant centers, with limited diagnostic access and delays due to reliance on outsourced laboratories. Expanding diagnostic capacity and standardizing guidelines are essential to improving patient outcomes.
Clinical Features and Mortality of Chronic Pulmonary Aspergillosis in Brazil: a Multicenter Cohort Study Vítor Falcão de Oliveira, João Antonio Gonçalves Garreta Prats, Valdes Roberto Bollela, Alessandro Comarú Pasqualotto, Diego Rodrigues Falci, et al. Open Forum Infectious Diseases, 2026 Background Data on clinical characteristics and prognosis of chronic pulmonary aspergillosis (CPA) in resource-limited, high tuberculosis (TB) burden settings, especially in Brazil, remain scarce. Methods This multicenter retrospective study evaluated all CPA cases diagnosed between 2012 and 2018 across eight centers in Brazil, examining clinical presentation, diagnosis, treatment, mortality, and factors associated with death, including differences related to pulmonary TB. To identify independent predictors of mortality, we conducted multivariate Cox regression. One-year mortality was analyzed using Kaplan–Meier survival curves. Results A total of 191 CPA cases were diagnosed, with a median age of 50 years (IQR 40–59) and 62% were male. TB was the most frequent predisposing condition (n = 138, 72%). Most patients (80%) received antifungal therapy, primarily itraconazole (n = 140, 73%). Surgery was performed in 34% of cases. According to Kaplan–Meier analysis, the cumulative mortality at 12 months was 6%. Compared to survivors, nonsurvivors had significantly lower rates of TB (52% vs 77%, P = .019) and higher rates of malignancies (13% vs 3%, P = .033). In multivariate analysis, only TB was independently associated with lower mortality (HR 0.413, 95% CI: .179–.954, P = .038). The TB group showed more hemoptysis (P = .008) and greater radiological involvement, suggesting delayed diagnosis. Conclusions In Brazil, the mortality of CPA was lower compared with that reported in previous studies, particularly among patients with TB. In TB-endemic, resource-limited settings, overlapping clinical and radiological features may delay diagnosis and antifungal treatment.
Persisting Gaps in Cytomegalovirus Prevention and Management After Solid Organ Transplantation in a Resource-Limited Setting Guilherme Santoro‐Lopes, Luiz Felipe Abreu Guimarães, Wanessa Trindade Clemente, Raquel Silveira Bello Stucchi, Edson Abdala, et al. Transplant Infectious Disease, 2025 Background Cytomegalovirus (CMV) infection remains among the leading complications after solid organ transplantation (SOT). Large international surveys mainly focused on high‐income countries, detected considerable variability in the management of this infection after SOT. Limited data are available from resource‐limited settings. Methods A questionnaire‐based cross‐sectional study was performed. All transplant programs (TP) registered at the Brazilian Organ Transplantation Society (ABTO) were invited to participate. Results Sixty‐one TP participated in the study. Of these, 59 (97%) reported using at least 1 preventive strategy (prophylaxis or preemptive therapy [PET]). Prophylaxis was reported by only 39 (64%). PET was used by 52 (85%), predominantly for R+ recipients ( n = 42/61; 70%). CMV monitoring was performed weekly in only 22 of 52 (42%) TP. This was significantly more common in TP reporting turnaround times ≤72 h for quantitative nuclear acid amplification tests ( p < 0.001). Intravenous (IV) ganciclovir was the predominant drug chosen for prophylaxis (21/39 TP; 54%) and for PET (44/52 TP; 77%). Lack of regular access to valganciclovir was significantly associated with the choice of IV ganciclovir for prophylaxis and PET ( p = 0.002 for both comparisons). Only 8 (13%) TP had access to molecular diagnostic tests for ganciclovir resistance, and 14 (23%) had access to effective therapy for highly resistant infections. Conclusion These results suggest that strategies to improve the management of CMV after SOT in such a resource‐limited setting are needed and should include not only targeted educational programs but also initiatives to tackle economic and structural barriers. image
Interesting case from Argentina: Kidney transplant recipient with skin lesions—A Latin American perspective Marcelo Víctor Radisic, Guilherme Santoro Lopes, Alejandro Marcel Hasslocher‐Moreno, Emily M. Eichenberger, Victoria G. Hall, et al. Transplant Infectious Disease, 2024 This is a case of a kidney transplant recipient who presented with skin lesions, low‐grade fevers, and pancytopenia 2 months after his transplant. image
Neuroinvasive chikungunya in a liver transplant recipient Eduardo Scarlatelli Pimenta, Marta Guimarães Cavalcanti, Mauro Jorge Cabral‐Castro, Marco Antonio Lima, José Mauro Peralta, et al. Transplant Infectious Disease, 2021 The influence of chronic immunosuppression on the course of chikungunya virus (CHIKV) infection in recipients of solid organ transplantation (SOT) is still unsettled. Scarce data suggest that the course of CHIKV infection is generally benign in this population. In addition, the occurrence of severe atypical manifestations associated with CHIKV has not been well documented among SOT recipients. In this report, we describe a 64‐year‐old male liver transplant recipient who was admitted with fever, headache, arthralgia, left palpebral ptosis, mydriasis, and right hemiparesis. Cranial magnetic resonance imaging did not reveal any alteration suggestive of acute infection. Nevertheless, CHIKV was detected in the cerebrospinal fluid (CSF) with a real‐time reverse transcriptase assay. Other PCR assays carried out in CSF were negative for HSV‐1 and 2, cytomegalovirus, dengue virus (DENV), and Zika virus (ZIKV). CHIKV viremia was also detected while PCR assays for ZIKV and DENV in the blood were negative. ZIKV viruria was simultaneously present in this case. All neurologic manifestations waned within 2 weeks after the onset. This report shows that chikungunya must be considered in the differential diagnosis of acute neurologic disease in SOT recipients who live in or have recently traveled to endemic areas.
Simultaneous cytomegalovirus and Mycobacterium tuberculosis infection presenting as hemorrhagic colitis 3 years after a kidney transplant Experimental and Clinical Transplantation, 2011
Predictive model for the length of hospital stay of children with hematologic malignancies, neutropenia, and presumed infection Journal of Pediatric Hematology Oncology, 2004
Effect of unilateral nephrectomy on renal function of diabetic rats Histology and Histopathology, 2004
Gender and survival after AIDS in Rio de Janeiro, Brazil Guilherme Santoro-Lopes, Lee H. Harrison, Lawrence H. Moulton, Luis Antonio Alves Lima, Ana Maria Felix de Pinho, et al. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 1998
HBsAg in the kidneys of patients with HIV-associated nephropathy (HIVAN) Clinical Nephrology, 1996
OCCULT BLOODSTREAM INFECTION IN LIVER DONORS: FREQUENCY, ETIOLOGY AND IMPACT ON RECIPIENTS IN TWO TRANSPLANT CENTERS LF de Abreu Guimarães, TM Curcio, L de Oliveira Pereira, CCT de Sousa, ... The Brazilian Journal of Infectious Diseases 30, 105108 , 2026 2026
BACILLUS CEREUS BACTEREMIA IN A LIVER TRANSPLANT RECIPIENT–CASE REPORT TB de Souza Neves, JG Freiha, AS de Lemos, GS Lopes, M Halpern The Brazilian Journal of Infectious Diseases 30, 105096 , 2026 2026
EPSTEIN–BARR VIRUS (EBV) ENCEPHALITIS IN A KIDNEY TRANSPLANT RECIPIENT–CASE REPORT TB de Souza Neves, AS de Lemos, GS Lopes, TMCC Loyola, M Halpern The Brazilian Journal of Infectious Diseases 30, 105100 , 2026 2026
Clinical Features and Mortality of Chronic Pulmonary Aspergillosis in Brazil: a Multicenter Cohort Study VF De Oliveira, JAGG Prats, VR Bollela, AC Pasqualotto, DR Falci, ... Open Forum Infectious Diseases 13 (1), ofaf746 , 2026 2026
Avaliação das práticas para o diagnóstico e monitoramento da infecção por citomegalovírus em receptores de transplante renal no Brasil NA Hatem, E Keitel, G Santoro-Lopes, LC Pierrotti, AC Pasqualotto Brazilian Journal of Nephrology 48, e20250201 , 2026 2026
Evaluation of practices for the diagnosis and monitoring of cytomegalovirus infection in kidney transplant recipients in Brazil NA Hatem, E Keitel, G Santoro-Lopes, LC Pierrotti, AC Pasqualotto Brazilian Journal of Nephrology 48 (2), e20250201 , 2025 2025 Citations: 2
Emergency and persistence of Escherichia coli ST131 as community-onset antimicrobial resistant urinary tract infection in Rio de Janeiro, Brazil EM de Castro, IS Barcellos, G Santoro-Lopes, APS da Silva, ... The Brazilian Journal of Infectious Diseases 29 (4), 104555 , 2025 2025 Citations: 6
Quantiferon Indeterminate Results: Understanding Their Impact on Tuberculosis Screening for SOT Candidates G Santoro-Lopes, WT Clemente Transplantation 109 (4), 584-585 , 2025 2025
Persisting Gaps in Cytomegalovirus Prevention and Management After Solid Organ Transplantation in a Resource‐Limited Setting G Santoro‐Lopes, LFA Guimarães, WT Clemente, RSB Stucchi, E Abdala, ... Transplant Infectious Disease 27 (2), e14440 , 2025 2025 Citations: 3
Avaliação da estrutura de governança do Fundo Constitucional de Financiamento do Nordeste (FNE) G Lopes, G Quaglio Ipea , 2025 2025 Citations: 2
Um diagnóstico das contratações do Fundo Constitucional de Financiamento do Nordeste (FNE) G Lopes, G Quaglio Ipea , 2025 2025 Citations: 4
Diagnóstico e avaliação de governança dos Fundos Constitucionais de Financiamento (FCFs): análise comparativa entre o FNO, o FCO e o FNE RR Vasconcellos, R Portugal, C Heck, G Quaglio, G Lopes, RG Gumiero Ipea , 2025 2025
EPIDEMIOLOGIA DAS INFECÇÕES FÚNGICAS INVASIVAS EM UMA COORTE CONTEMPORÂNEA DE RECEPTORES DE TRANSPLANTE HEPÁTICO LF de Abreu Guimarães, L de Oliveira Pereira, TM Curcio, CCT de Sousa, ... The Brazilian Journal of Infectious Diseases 28, 104444 , 2024 2024
Recomendações de Triagem de Dengue de Doador e Receptor no Transplante de Órgãos Sólidos DWCL Santos, RSB Stucchi, WT Clemente, E Abdala, G Santoro-Lopes, ... Brazilian Journal of Transplantation 27, e1124 , 2024 2024
Knowledge and engagement in research activities by medical students: challenges and new opportunities-an institutional survey. H Resende, J Aragão, G Lopes, R de Souza, AB Silva, K Santos, ... Medical Research Archives 12 (6) , 2024 2024
Interesting case from Argentina: Kidney transplant recipient with skin lesions—A Latin American perspective. MV Radisic, G Santoro Lopes, AM Hasslocher‐Moreno, EM Eichenberger, ... Transplant Infectious Disease 26 (2) , 2024 2024
Recommendations for dengue screening protocol for donors and recipients in solid organ transplantation DWCL Santos, RSB Stucchi, WT Clemente, E Abdala, G Santoro-Lopes, ... Brazilian Journal of Transplantation 27, e1124 , 2024 2024 Citations: 6
DESEMPENHO AGRONÔMICO E AVALIAÇÃO ECONÔMICA DE COMPOSTO ORGÂNICO QUE CONTÉM BORRA DE CAFÉ NA ADUBAÇÃO DA CULTURA DO MILHO LMB de Souza, G Lopes, JBS Araújo, LF Favarato, RC Guarçoni INCAPER EM REVISTA, 71-82 , 2023 2023
Desempenho agronômico e avaliação econômica de composto orgânico que contém borra de café na adubação da cultura do milho. JBS ARAÚJO, LMB de SOUZA, RG GUARÇONI, LF Favarato, G LOPES Incaper em Revista, Vitória, v. 13 e 14, p. 71-82, dez. 2023. , 2023 2023
INFECÇÕES DA CORRENTE SANGUÍNEA NOS PRIMEIROS 180 DIAS APÓS TRANSPLANTE HEPÁTICO: FREQUÊNCIA, ETIOLOGIA E IMPACTO SOBRE A MORTALIDADE LF de Abreu Guimarães, TM Curcio, L de Oliveira Pereira, ... The Brazilian Journal of Infectious Diseases 27, 103252 , 2023 2023
MOST CITED SCHOLAR PUBLICATIONS
Reduced risk of tuberculosis among Brazilian patients with advanced human immunodeficiency virus infection treated with highly active antiretroviral therapy G Santoro-Lopes, AM Felix de Pinho, LH Harrison, M Schechter Clinical Infectious Diseases 34 (4), 543-546 , 2002 2002 Citations: 240
Surgical site infection among women discharged with a drain in situ after breast cancer surgery WAB Felippe, GL Werneck, G Santoro-Lopes World journal of surgery 31 (12), 2293-2299 , 2007 2007 Citations: 126
Multidrug-resistant bacterial infections after liver transplantation: an ever-growing challenge G Santoro-Lopes, EF de Gouvêa World Journal of Gastroenterology: WJG 20 (20), 6201 , 2014 2014 Citations: 85
Chemoprophylaxis for tuberculosis and survival of HIV-infected patients in Brazil AMF de Pinho, G Santoro-Lopes, LH Harrison, M Schechter Aids 15 (16), 2129-2135 , 2001 2001 Citations: 78
Urinary tract infection in men with AIDS. AM De Pinho, GS Lopes, CF Ramos-Filho, O da R Santos, MP De Oliveira, ... Sexually Transmitted Infections 70 (1), 30-34 , 1994 1994 Citations: 76
Recommendations for management of endemic diseases and travel medicine in solid-organ transplant recipients and donors: Latin America WT Clemente, LC Pierrotti, E Abdala, MI Morris, LS Azevedo, ... Transplantation 102 (2), 193-208 , 2018 2018 Citations: 74
Normal renal dimensions in a specific population MM Fernandes, CC Lemos, GS Lopes, EP Madeira, OR Santos, D Dorigo, ... Int Braz J Urol 28 (6), 510-5 , 2002 2002 Citations: 67
Severe infection in a lung transplant recipient caused by donor‐transmitted carbapenem‐resistant Acinetobacter baumannii N Martins, IS Martins, WV de Freitas, JA de Matos, ACG Magalhães, ... Transplant Infectious Disease 14 (3), 316-320 , 2012 2012 Citations: 63
Prevalence of mutations related to HIV-1 antiretroviral resistance in Brazilian patients failing HAART A Tanuri, E Caridea, MC Dantas, MG Morgado, DLC Mello, S Borges, ... Journal of Clinical Virology 25 (1), 39-46 , 2002 2002 Citations: 58
Glomerular disease and human immunodeficiency virus infection in Brazil GS Lopes, LPJ Marques, LS Rioja, CA Basilio-de-Oliveira, AV Oliveira, ... American journal of nephrology 12 (5), 281-287 , 1992 1992 Citations: 55
The influence of carbapenem resistance on mortality in solid organ transplant recipients with Acinetobacter baumannii infection EF de Gouvêa, IS Martins, M Halpern, ALP Ferreira, ST Basto, ... BMC infectious diseases 12 (1), 351 , 2012 2012 Citations: 53
Invasive fungal disease in renal transplant recipients at a Brazilian center: local epidemiology matters LFA Guimarães, M Halpern, AS de Lemos, EF de Gouvêa, RT Gonçalves, ... Transplantation Proceedings 48 (7), 2306-2309 , 2016 2016 Citations: 51
Willingness to participate in HIV vaccine trials among men who have sex with men in Rio de Janeiro, Brazil ARS Périssé, M Schechter, RI Moreira, RF do Lago, G Santoro-Lopes, ... JAIDS Journal of Acquired Immune Deficiency Syndromes 25 (5), 459-463 , 2000 2000 Citations: 48
HIV disease progression and V3 serotypes in Brazil: is B different from B-Br? G Santoro-Lopes, LH Harrison, MD Tavares, A Xexéo, ACED Santos, ... AIDS research and human retroviruses 16 (10), 953-958 , 2000 2000 Citations: 46
Factors impacting early mortality in tuberculosis/HIV patients: differences between subjects naive to and previously started on HAART CAS Schmaltz, G Santoro-Lopes, MC Lourenço, MG Morgado, ... Public Library of Science 7 (9), e45704 , 2012 2012 Citations: 44
Colonization with methicillin‐resistant Staphylococcus aureus after liver transplantation G Santoro‐Lopes, ÉF de Gouvêa, RCM Monteiro, RC Branco, JR Rocco, ... Liver transplantation 11 (2), 203-209 , 2005 2005 Citations: 44
Gender and survival after AIDS in Rio de Janeiro, Brazil G Santoro-Lopes, LH Harrison, LH Moulton, LAA Lima, AMF De Pinho, ... JAIDS Journal of Acquired Immune Deficiency Syndromes 19 (4), 403-407 , 1998 1998 Citations: 44
Acinetobacter soli as a cause of bloodstream infection in a neonatal intensive care unit FLPC Pellegrino, VV Vieira, PVP Baio, RMR dos Santos, ALA dos Santos, ... Journal of clinical microbiology 49 (6), 2283-2285 , 2011 2011 Citations: 41
Outcome of bacteremia caused by extended-spectrum β-lactamase–producing Enterobacteriaceae after solid organ transplantation EB Aguiar, LC Maciel, M Halpern, AS De Lemos, ALP Ferreira, ST Basto, ... Transplantation Proceedings 46 (6), 1753-1756 , 2014 2014 Citations: 38
Effect of unilateral nephrectomy on renal function of diabetic rats GS Lopes, CCS Lemos, CA Mandarlm-de-Lacerda, R Bregman Histology and histopathology 19 (4), 1085-1088 , 2004 2004 Citations: 37