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Mem. Inst. Oswaldo Cruz ; 112(4): 255-259, Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-841784


BACKGROUND Porto Alegre is the Brazilian state capital with second highest incidence of tuberculosis (TB) and the highest proportion of people infected with human immunodeficiency virus (HIV) among patients with TB. Hepatitis C virus (HCV) infection increases the risk of anti-TB drug-induced hepatotoxicity, which may result in discontinuation of the therapy. OBJECTIVES The aim of this study was (i) to estimate prevalence of HCV and HIV in a group of patients newly diagnosed with active TB in a public reference hospital in Porto Alegre and (ii) to compare demographic, behavioural, and clinical characteristics of patients in relation to their HCV infection status. METHODS One hundred and thirty-eight patients with TB were tested for anti-HCV antibody, HCV RNA, and anti-HIV1/2 antibody markers. HCV RNA from real-time polymerase chain reaction (PCR)-positive samples was submitted to reverse transcription and PCR amplification. The 5′ non-coding region of the HCV genome was sequenced, and genotypes of HCV isolates were determined. FINDINGS Anti-HCV antibody, HCV RNA, and anti-HIV antibodies were detected in 27 [20%; 95% confidence interval (CI), 13-26%], 17 (12%; 95% CI, 7-18%), and 34 (25%; 95% CI, 17-32%) patients, respectively. HCV isolates belonged to genotypes 1 (n = 12) and 3 (n = 4). Some characteristics were significantly more frequent in patients infected with HCV. Among them, non-white individuals, alcoholics, users of illicit drugs, imprisoned individuals, and those with history of previous TB episode were more commonly infected with HCV (p < 0.05). MAIN CONCLUSIONS HCV screening, including detection of anti-HCV antibody and HCV RNA, will be important to improving the management of co-infected patients, given their increased risk of developing TB treatment-related hepatotoxicity.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Tuberculosis/diagnosis , Tuberculosis/epidemiology , HIV Antibodies/blood , HIV Infections/diagnosis , HIV Infections/epidemiology , Hepatitis C/diagnosis , Coinfection/diagnosis , Coinfection/epidemiology , Brazil/epidemiology , RNA, Viral/blood , Polymerase Chain Reaction
Mem. Inst. Oswaldo Cruz ; 109(3): 345-351, 06/2014. tab
Article in English | LILACS | ID: lil-711738


Certain host single nucleotide polymorphisms (SNPs) affect the likelihood of a sustained virological response (SVR) to treatment in subjects infected with hepatitis C virus (HCV). SNPs in the promoters of interleukin (IL)-10 (-1082 A/G, rs1800896), myxovirus resistance protein 1 (-123 C/A, rs17000900 and -88 G/T, rs2071430) and tumour necrosis factor (TNF) (-308 G/A, rs1800629 and -238 G/A, rs361525) genes and the outcome of PEGylated α-interferon plus ribavirin therapy were investigated. This analysis was performed in 114 Brazilian, HCV genotype 1-infected patients who had a SVR and in 85 non-responders and 64 relapsers. A significantly increased risk of having a null virological response was observed in patients carrying at least one A allele at positions -308 [odds ratios (OR) = 2.58, 95% confidence intervals (CI) = 1.44-4.63, p = 0.001] or -238 (OR = 7.33, 95% CI = 3.59-14.93, p < 0.001) in the TNF promoter. The risk of relapsing was also elevated (-308: OR = 2.87, 95% CI = 1.51-5.44, p = 0.001; -238: OR = 4.20, 95% CI = 1.93-9.10, p < 0.001). Multiple logistic regression of TNF diplotypes showed that patients with at least two copies of the A allele had an even higher risk of having a null virological response (OR = 16.43, 95% CI = 5.70-47.34, p < 0.001) or relapsing (OR = 6.71, 95% CI = 2.18-20.66, p = 0.001). No statistically significant association was found between the other SNPs under study and anti-HCV therapy response.

Female , Humans , Male , Middle Aged , Antiviral Agents/administration & dosage , Hepacivirus/drug effects , Hepatitis C, Chronic/drug therapy , Interferon-alpha/administration & dosage , Promoter Regions, Genetic , Ribavirin/administration & dosage , Tumor Necrosis Factor-alpha/genetics , Drug Therapy, Combination , Genotype , Hepatitis C, Chronic/genetics , /genetics , Myxovirus Resistance Proteins/genetics , Polymorphism, Single Nucleotide , Treatment Failure , Viral Load
Clin. biomed. res ; 34(2): 64-68, 2014. graf, tab
Article in English | LILACS | ID: biblio-997748


Infection with hepatitis C virus (HCV) is a global public health issue. The bloodborne nature of HCV transmission poses a substantial risk to healthcare workers, due to occupational exposure to needlestick injuries and blood and other body fluids containing the virus. Undiagnosed HCV infection, including in healthcare workers, represents a growing problem worldwide as the infected population ages, and HCV-related mortality and morbidity is expected to rise substantially over the coming decades. Consequently, diagnostic tests for HCV play an important role in this scenario. The aim of this study was to standardize a one-step RT-PCR assay for detection of HCV. The test demonstrated reproducibility, sensibility (100%), and the limit of detection was set at 100IU/mL. Our study indicates that this assay can be used as a diagnostic tool to follow up healthcare workers after occupational exposure

Humans , RNA, Viral/blood , Hepatitis C/diagnosis , Hepacivirus/isolation & purification , Untranslated Regions/genetics , RNA, Viral/genetics , Hepatitis C/virology , Hepacivirus/genetics , Viral Load/methods
Mem. Inst. Oswaldo Cruz ; 108(1): 48-53, Feb. 2013. graf, tab
Article in English | LILACS | ID: lil-666043


A single-nucleotide polymorphism (SNP) upstream of interleukin (IL)28B was recently identified as an important predictor of the outcome of chronic hepatitis C patients treated with pegylated interferon plus ribavirin (PEG-IFN/RBV). The aim of this study was to investigate the association between the IL28B gene polymorphism (rs12979860) and virological response in chronic hepatitis C patients. Brazilian patients (n = 263) who were infected with hepatitis C virus (HCV) genotype 1 and were receiving PEG-IFN/RBV were genotyped. Early virological response (EVR) (12 weeks), end-of-treatment response (EOTR) (48 weeks), sustained virological response (SVR) (72 weeks) and relapse were evaluated using conventional and quantitative polymerase chain reaction (PCR) assays. The frequency of the C allele in the population was 39%. Overall, 43% of patients experienced SVR. The IL28B CC genotype was significantly associated with higher treatment response rates and a lower relapse rate compared to the other genotypes [84% vs. 58% EVR, 92% vs. 63% EOTR, 76% vs. 38% SVR and 17% vs. 40% relapse rate in CC vs. other genotypes (CT and TT), respectively]. Thus, the IL28B genotype appears to be a strong predictor of SVR following PEG-IFN/RBV therapy in treatment-naïve Brazilian patients infected with HCV genotype 1. This study, together with similar research examining other SNPs, should help to define adequate protocols for the treatment of patients infected with HCV genotype 1, especially those with a poor prognosis.

Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antiviral Agents/administration & dosage , Hepatitis C, Chronic/drug therapy , Interferon-alpha/administration & dosage , Interleukins/genetics , Polyethylene Glycols/administration & dosage , Polymorphism, Single Nucleotide/genetics , Ribavirin/administration & dosage , Alleles , Cohort Studies , Drug Therapy, Combination , Genotype , Hepatitis C, Chronic/genetics , Hepatitis C, Chronic/virology , Polymerase Chain Reaction , Prospective Studies , Recombinant Proteins/administration & dosage , Treatment Outcome
Mem. Inst. Oswaldo Cruz ; 102(7): 867-870, Nov. 2007. tab
Article in English | LILACS | ID: lil-470359


Hepatitis C virus (HCV) isolates have been divided into six genotypes (1 to 6). The duration of hepatitis C standard treatment is 48 weeks for patients infected with HCV genotype 1 vs 24 weeks for those infected with genotypes 2 and 3. A total of 1544 HCV isolates from chronic patients living in the southern Brazilian states of Rio Grande do Sul (RS, n = 627) and Santa Catarina (SC, n = 917) were genotyped by restriction fragment length polymorphism (RFLP) of polymerase chain reaction (PCR) products. In RS, 338 (53.9 percent; 95 percent CI 50.0 - 57.8 percent), 34 (5.4 percent; 95 percent CI 3.8 - 7.4 percent) and, 255 (40.7 percent; 95 percent CI 36.9 - 44.6 percent) samples were from genotypes 1, 2, and 3, respectively. In SC, 468 (51 percent; 95 percent CI 47.8 - 54.2 percent), 26 (2.9 percent; 95 percent CI 1.9 - 4.1 percent) and, 423 (46.1 percent; 95 percent CI 42.9 - 49.3 percent) samples were from genotypes 1, 2, and 3, respectively. Genotyping results were confirmed by direct nucleotide sequencing of PCR products derived from 68 samples, without any discrepancy between PCR-RFLP and nucleotide sequencing methods. In conclusion, almost half of the hepatitis C patients from South of Brazil are infected by genotypes 2 and 3 and, these results have important consequential therapeutic implications as they can be treated for only 24 weeks, not 48.

Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Hepacivirus/genetics , Hepatitis C, Chronic/virology , Polymorphism, Single Nucleotide , Brazil , Cohort Studies , Genotype , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Retrospective Studies , RNA, Viral/genetics