A prospective study of hepatitis B virus markers in patients with chronic HBV infection from Brazilian families of Western and Asian origin

The purpose of the present study was to determine the frequency of hepatitis B virus (HBV) markers in families of HBsAg-positive patients with chronic liver disease. Serum anti-HBc, HBsAg and anti-HBs were determined by enzyme immunoassay and four subpopulations were considered: genetically related (consanguineous) and non-genetically related (non-consanguineous) Asian subjects and genetically related and non-genetically related Western subjects. A total of 165 and 186 relatives of Asian and Western origin were enrolled, respectively. The occurrence of HBsAg and anti-HBs antibodies was significantly higher (P < 0.0001) in family members of Asian origin (81.8 percent) than in family members of Western origin (36.5 percent). HBsAg was also more frequent among brothers (79.6 vs 8.5 percent; P < 0.0001), children (37.9 vs 3.3 percent; P < 0.0001) and other family members (33.9 vs 16.7 percent; P < 0.0007) of Asian than Western origin, respectivelly. No difference between groups was found for anti-HBs, which was more frequently observed in fathers, spouses and other non-genetic relatives. HBV infection was significantly higher in children of Asian than Western mothers (P < 0.0004). In both ethnic groups, the mothers contributed more to their children's infection than the fathers (P < 0.0001). Furthermore, HBsAg was more frequent among consanguineous members and anti-HBs among non-consanguineous members. These results suggest the occurrence of vertical transmission of HBV among consanguineous members and probably horizontal sexual transmission among non-consanguineous members of a family cluster. Thus, the high occurrence of dissemination of HBV infection characterizes family members as a high-risk group that calls for immunoprophylaxis. Finally, the study showed a high familial aggregation rate for both ethnic groups, 18/19 (94.7 percent) and 23/26 (88.5 percent) of the Asian and Western origin, respectively.

Geographic distribution of hepatitis C virus genotypes in Brazil

Brazil is a country of continental dimension with a population of different ethnic backgrounds. Thus, a wide variation in the frequencies of hepatitis C virus (HCV) genotypes is expected to occur. To address this point, 1,688 sequential samples from chronic HCV patients were analyzed. HCV-RNA was amplified by the RT-PCR from blood samples collected from 1995 to 2000 at different laboratories located in different cities from all Brazilian States. Samples were collected in tubes containing a gel separator, centrifuged in the site of collection and sent by express mail in a refrigerated container to Laboratório Bioquímico Jardim Paulista, São Paulo, SP, Brazil. HCV- RNA was extracted from serum and submitted to RT and nested PCR using standard procedures. Nested PCR products were submitted to cycle sequencing reactions without prior purification. Sequences were analyzed for genotype determination and the following frequencies were found: 64.9 percent (1,095) for genotype 1, 4.6 percent (78) for genotype 2, 30.2 percent (510) for genotype 3, 0.2 percent (3) for genotype 4, and 0.1 percent (2) for genotype 5. The frequencies of HCV genotypes were statistically different among Brazilian regions (P = 0.00017). In all regions, genotype 1 was the most frequent (51.7 to 74.1 percent), reaching the highest value in the North; genotype 2 was more prevalent in the Center-West region (11.4 percent), especially in Mato Grosso State (25.8 percent), while genotype 3 was more common in the South (43.2 percent). Genotypes 4 and 5 were rarely found and only in the Southeast, in São Paulo State. The present data indicate the need for careful epidemiological surveys throughout Brazil since knowing the frequency and distribution of the genotypes would provide key information for understanding the spread of HCV.

Gatifloxacina oral no tratamento da exacerbaçäo aguda da bronquite crônica. Um estudo aberto, multicêntrico, näo comparativo, Fase III b / Oral gatifloxacin in the treatment of acute exacerbation of chronic bronchitis (AECB). An open-label multicenter noncomparative phase IIIb study

Avaliar a eficácia e a segurança da gatifloxacina, uma nova 8-metoxi-fluoroquinolona com amplo espectro de atividade, em pacientes com exacerbaçäo aguda de DPOC. Foram incluídos 50 pacientes näo internados com exacerbaçäo aguda de DPOC, em um estudo aberto, näo comparativo, multicêntrico. Quarenta e três tinham exacerbaçäo aguda do tipo I, de acordo com critérios propostos por Anthonisen. Gatifloxacina foi dada por via oral, 400 mg/dia, por 7-10 dias. O sucesso clínico entre os pacientes avaliáveis foi de 94 por cento. H. influenzae, S. pneumoniae e M. catarrhalis foram isolados 28 vezes em 21 pacientes, e foram erradicados em todos, exceto em um caso. Efeitos adversos ocorreram em 19 pacientes, mas resultaram em interrupçäo do tratamento em apenas dois casos. A gatifloxacina é eficaz e segura em exacerbaçöes agudas da bronquite crônica.