Global Research in Brazil

Brazil is the largest country in South America. Major infectious diseases in Brazil include HIV/AIDS; tuberculosis; arboviruses such as dengue, chikungunya, and Zika; malaria; bacterial diarrhea; hepatitis; and neglected tropical diseases, such as Chagas, leishmaniasis and schistosomiasis. Brazil had a major Zika outbreak from 2015-2017.

NIAID-Funded Activities

NIAID began its research collaboration with institutions in Brazil in 1987. NIAID-supported projects involving institutions in Brazil encompass a broad range of topics, including allergy, immunology, and transplantation; arboviral diseases; fungal diseases; gastrointestinal infectious diseases; hepatitis; HIV/AIDS; influenza; malaria; other bacterial, parasitic, and viral diseases; tuberculosis; and vector biology.

Select NIAID-Supported Research in Brazil

U.S.-Brazil Collaborative Biomedical Research Program

Established in 2014, U.S.-Brazil Collaborative Biomedical Research Program is a joint initiative between NIH, the Brazil Ministry of Health, and the Ministry of Science, Technology, and Innovation. The purpose of the program is to foster, expand, and strengthen U.S.-Brazil research collaboration in areas of mutual interest. The first year of the program focused on basic immunology, infectious diseases including HIV/AIDS and co-morbidities, and cancer. It resulted in 19 one-year, co-funded administrative supplements (13 NIAID), and numerous publications, presentations, and training for graduate students. The second round began in 2018. Research areas supported under this program include allergy; immunology; infectious diseases, including HIV/AIDS and its co-morbidities; child and maternal health; neurological disorders and stroke; environmental health sciences; and cancer. Twelve proposals (nine from NIAID) were selected for joint award and numerous publications have resulted from the grants.

Centers for Research in Emerging Infectious Diseases (CREID)

Centers for Research in Emerging Infectious Diseases (CREID) network is a coordinated group of research centers situated in regions around the globe where emerging and re-emerging infectious disease outbreaks are likely. Institutes in Brazil participate in two CREID Centers: Coordinating Research on Emerging Arboviral Threats Encompassing the Neotropics (CREATE-NEO) and United World Antiviral Research Network (UWARN).

Regional Prospective Observational Research in Tuberculosis (RePORT) Brazil

RePORT Brazil is a jointly funded, multi-organizational, collaborative effort that supports regional TB research aimed at developing diagnostics and quantifying the impact of undiagnosed cases with the ultimate goal of improving outcomes in TB. RePORT Brazil has five clinical sites that were selected to enroll participants across Brazil and one biorepository.

RePORT Brazil is a seminal member of RePORT International, which consists of multiple regional RePORT networks to encourage coordinated, global TB/HIV research in biomarkers, diagnostics, prevention (vaccines) and treatment strategies. The consortium represents regional cohorts in Brazil, China, India, Indonesia, South Africa, and the Philippines that are linked through the implementation of a common protocol and laboratory standards to promote interoperability for data sharing and specimen collection.

NIAID-Supported TV-003 Dengue Vaccine Trials

The Laboratory of Infectious Diseases developed a live attenuated, tetravalent, single-dose dengue vaccine, TV-003. Clinical trials the United States, Thailand, and Brazil have demonstrated that it is uniformly immunogenic in DENV-naïve subjects; safe and immunogenic in infants, children, and older adults; elicits a strong cross-reactive CD8+ T-cell; provides solid protection in dengue challenge studies (DENV2 and DENV3); and can provide protection as early as 30 days post vaccination. Phase 1 clinical trial results showed 100 percent efficacy for those previously exposed to dengue and 93 percent in the unexposed. The vaccine technology is licensed in Brazil by the Butantan Institute, a non-profit producer of immunobiologic products for Brazil.

Zika DNA Vaccine Phase 2/2b Study (VRC 705 Study)

Launched in 2017, the VRC 705: A Zika Virus DNA Vaccine in Healthy Adults and Adolescents was a Phase 2/2b clinical trial is designed to evaluate the safety, immunogenicity, and efficacy of a Zika virus DNA vaccine candidate developed by the NIAID Vaccine Research Center (VRC). The study has concluded, and the vaccine was found to be safe and immunogenic.

Zika in Infants and Pregnancy (ZIP) Study

In May 2015, the first case of Zika virus was reported in Brazil marking the beginning of the 2015-2017 Zika virus outbreak. However, studies indicate that the virus had been circulating as early as 2013. Launched in 2016, the Zika in Infants and Pregnancy (ZIP) was a multi-site, multi-country cohort study designed to improve our understanding of the health effects of Zika virus infection on pregnant women and their developing fetuses. The study enrolled thousands of pregnant women ages 15 years and older in their first and early second trimesters of pregnancy; women were enrolled across 10 sites, four of which were in Brazil.

Scientific Advances

Identification of Anti-Premembrane Antibody as a Serocomplex-Specific Marker To Discriminate Zika, Dengue, and West Nile Virus Infections

A NIAID-supported study under the U.S.-Brazil Collaborative Biomedical Research Program found that anti-premembrane antibody is a flavivirus serocomplex-specific marker that can be used to delineate between current and past flavivirus infections, such as dengue fever, West Nile Fever, and Zika. The ability to use this marker could help investigators design studies to enhance current understanding of the epidemiology, pathogenesis, and complications of Zika in endemic regions. It could also lead to improved vaccine strategies against dengue, Zika, and other flaviviruses.

Rocio Virus: An Updated View on an Elusive Flavivirus

Investigators supported under the CREID network conducted a study to provide an updated overview of the ecology, transmission cycle, epidemiology, pathogenesis, and treatment options of Rocio virus (ROCV), a mosquito-borne flavivirus and human pathogen that is indigenous to Brazil. ROCV has been responsible for several epidemics of meningoencephalitis in coastal Brazilian communities and more than 100 deaths in recent years. This review demonstrates the need for geographically broad surveillance networks, accurate diagnostics, and effective preventative measures to mitigate emerging and re-emerging infectious diseases, in particular zoonotic and arboviral pathogens. The results of this study are contributing to investigators’ ability to understand, predict, and hopefully decrease the risk of ROCV emergence outside of Brazil

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