Viral hepatitis in patients infected with human immunodeficiency virus

From 1992 to 1995 we studied 232 (69 percent male, 87 percent Caucasian) anti-human immunodeficiency virus (anti-HIV) positive Brazilian patients, through a questionnaire; HIV had been acquired sexually by 50 percent, from blood by 32 percent, sexually and/or from blood by 16.4 percent and by an unknown route by 1.7 percent. Intravenous drug use was reported by 29 percent; it was the most important risk factor for HIV transmission. The alanine aminotransferase quotient (qALT) was >1 for 40 percent of the patients, 93.6 percent had anti-hepatitis A virus antibody, 5.3 percent presented hepatitis B surface antigen, 44 percent were anti-hepatitis B core antigen positive and 53.8 percent were anti-hepatitis C virus (anti-HCV) positive. The anti-HCV test showed a significant association with qALT>1. Patients for whom the probable HIV transmission route was blood had a 10.8 times greater risk of being anti-HCV positive than patients infected by other routes. Among 30 patients submitted to liver biopsy, 18 presented chronic hepatitis

A clinical, epidemological, laboratorial, histological and ultrasonographical evaluation of anti-HCV EIA-2 positive blood donors

Between 1992 and 1997, 790 blood donors with anti-HCV EIA-2 strongly reagent (relationship between the sample optical density/cut-off > 3) detected at the blood bank serological screening, were evaluated in ambulatory environment. They were all negative for Chagas disease, syphilis, hepatitis B (HBsAg) and AIDS. Blood samples were collected at the first ambulatorial evaluation, for hemogram, biochemical tests and new serological tests for HCV (anti-HCV EIA-2). In blood samples of 226 repeatedly reagent anti-HCV EIA-2 blood donors, supplementary "immunoblot" test for HCV (RIBA-2) was used. In 209 donors, the presence of HCV-RNA was investigated by the PCR test. The abdominal ultrasonography was realized in 366 donors. In 269 patients liver biopsy was performed for the histopathological study. The follow-up of blood donors showed that 95.6 percent were repeatedly EIA-2 reagent, 94 percent were symptomless and denied any hepatitis history, with only 2 percent mentioning previous jaundice. In 47 percent of this population at least one risk factor has been detected for the HCV transmission, the use of intravenous drugs being the main one (27.8 percent). Blood transfusion was the second factor for HCV transmission (27.2 percent). Hepatomegaly was detected in 54 percent of the cases. Splenomegaly and signs of portal hypertension have seldom been found in the physical examination, indicating a low degree of hepatic compromising in HCV. Abdominal ultrasound showed alterations in 65 percent of the subjects, being the steatosis the most frequent (50 percent). In 83.5 percent of the donors submitted to the liver biopsy, the histopathological exam showed the presence of chronic hepatitis, usually classified as active (89 percent) with mild or moderate grade in most of the cases (99.5 percent). The histopathological exam of the liver was normal in 1.5 percent of blood donors. The RIBA-2 test and the HCV-RNA investigation by PCR were positive in respectively 91.6 and 75 percent of the anti-HCV EIA-2 reagent donors. The HCV-RNA research was positive in 82 percent of the RIBA-2 positive subjects, in 37.5 percent of the indeterminate RIBA-2 donors and in 9 percent of the negative RIBA-2 donors. Chronic hepatitis has also been observed in 50 percent of the histopathological exams of the anti-HCV EIA-2 reagent donors which were indeterminate RIBA-2...

Hepatitis C virus in monozygotic twins

A case of a pregnant patient with chronic hepatitis C who gave birth to monozygotic twins that were infected with HCV is reported. One of the newborns was positive for HCV-RNA in blood sample collected 12 hours after delivery. The other newborn was negative for HCV-RNA at birth, but was detected HCV viremia at three months of age. The results have led to the conclusion that one of the twins was probably contaminated in the intrauterine period, while the other acquired the infection in the perinatal period. Both were negative for HCV-RNA and for anti-HCV in the serum samples collected at nine months of age. The report describes the changes in the laboratory tests conducted in mother and twins until 29 months after delivery.

Transfusion-transmited virus (TTV) in Brazil: preliminary report

TTV e um virus DNA recentemente descoberto no Japao a partir de um paciente portador de hepatite pos-transfusional de origem desconhecida. Neste estudo, avaliamos a presenca deste virus em pacientes com hepatopatias cronicas dos estados de Sao Paulo e do Para, representando duas regioes geograficamente diferentes. O DNA do TTV foi encontrado em 21/105 (20 por cento) e 9/20 (45 por cento) dos casos de Sao Paulo e do Para, respectivamente. O sequenciamento do DNA amplificado confirmou a presenca dos genotipos 1a e 2a, bem como de outros genotipos ainda nao descritos ate o momento. Em conclusao, TTV esta presente em casos de hepatopatias cronicas do Sudeste e do Norte do Brasil. por outro lado, maiores estudos ainda sao necessarios antes de se estabelecer relacao causal entre o TTV e a hepatite em seres humanos

The epidemiology and control of schistosomiasis mansoni where Biomphalaria tenagophila is the snail host

Desde 1980, está-se estudando a epidemiologia e o controle da esquistossomose mansônica no Município de Pedro de Toledo (Estado de Säo Paulo, Brasil). Em 1980 a prevalência avaliada por exame de fezes (métodos de Kato-Katz) foi de 22,8%. Estatisticamente, ao nível de 5%, näo houve diferença nas prevalências observadas nas zonas rural e urbana. A intensidade de infecçäo foi baixa (média geométrica de 58,5 ovos por grama de fezes). As maiores prevalências e intensidades de infecçäo foram registradas na faixa etária de 5 a 29 anos. Geralmente a transmissäo da endemia verificou-se durante o lazer. Apenas 0,4% de B. tenagophila mostraram-se positivos para cercárias de S. mansoni. A maioria dos portadores era assintomático. O programa de controle foi intensificado após avaliaçäo dos dados de 1980, resultando em diminuiçäo acentuada da prevalência de 22,8% em 1980 para 6%. Esta prevalência residual vem se mantendo ate 1987. Agora iniciamos estudos para investigar as possíveis causas dessa prevalência residual.