Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 1.827
Filter
1.
Braz. j. biol ; 83: e244977, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1285621

ABSTRACT

Abstract Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.


Resumo O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.


Subject(s)
Humans , Male , Female , Hepatitis C/epidemiology , Hepacivirus/genetics , Pakistan/epidemiology , Prevalence , Genotype
2.
Ann. afr. méd. (En ligne) ; 15(2): e4543-e4549, 2022. figures, tables
Article in English | AIM, AIM | ID: biblio-1366652

ABSTRACT

Context and objective. The steady increase in the number of chronic hemodialysis patients in sub-Saharan Africa (SSA) calls for improved management of those patients. The present study aimed to determine the frequency of hepatitis C virus (HCV) infection, the prevalent genotypes, and the risk factors associated with HCV in hemodialysis patients in Kinshasa (DR Congo). Methods. A cross-sectional study was conducted from February to June 2018 in all hemodialysis centers in Kinshasa. Blood samples were collected from 127 chronic hemodialysis patients and tested for the presence of antibodies against HCV. The HCV genotype was identified by real-time polymerase chain reaction (RT- PCR). Results. Twenty-two (17.3 %) patients were positive for anti-HCV antibodies, ranging from 0 % to 52.9 % in different centers. Genotype 4 was detected in 18/22 (81.8 %), followed by genotype 2 in 2/22 (9.1%), and both genotypes 2 and 4 in one patient (4.5%). One patient had an undetermined genotype (4.5 %). Having received at least 4 transfusions [7,21 (1,09- 10,61); p=0.040)], not being under EPO treatment [5,81(1,47-12,96); p=0.012)], being on hemodialysis for at least 14 months [3,63(1,60-5,05); p=0.035)]and being dialyzed in an overloaded center [2,06(0,83-5,86); p=0.073)] were associated with a greater risk of HCV infection. Conclusion. This high HCV prevalence (17.3 %) represents a substantial health burden in HD patients from Kinshasa, DR Congo. It is largely driven by the number of blood transfusions, the duration time in hemodialysis. Observations from the present study underscore the need of reducing the number of blood transfusions in people on dialysis through the administration of erythropoietin, given the unaffordable cost of HCV therapy for most individuals in DR Congo.


Contexte et Objectifs. Le nombre des patients hémodialisés en Afrique subsaharienne en constante augmentation ; justifiant de ce fait une meilleure prise en charge de ces patients. La présente étude détermine la prévalence de l'infection par le virus de l'hépatite C en en determinant les génotypes ainsi que les facteurs y associés dans ce groupe de patients. Méthodes. 127 patients hémodialisés chroniques ont subis des tests sérologiques à la recherche des anticorps anti-VHC dans plusieurs centres de Kinshasa de février à juin 2018. Le génotype viral a été déterminé par la RT-PCR. Résultats. La fréquence des anticorps anti-VHC a varié de 0 à 52,9 % dans ce groupe. Les génotypes le plus fréquents ont été le 4 (18/22) et le 2 (2/22) ; étant sumultanément rétrouvé chez un patient, et indéterminé chez un autre sujet. Avoir reçu au moins 4 transfusions [7,21 (1,09-10,61; p=0.040)], ne pas être sous EPO [5,81(1,47-12,96); p=0.012)], être en hémodialyse depuis au moins 14 mois [3,63(1,60- 5,05); p=0.035)] et être dialysé dans un centre surchargé [2,06 (0,83-5,86); p=0.073)] étaient associés à un risque plus élevé d'infection par le VHC. Conclusion. Ses principaux déterminants sont : le nombre des transfusions sanguines et la durée d'HD ; d'où la nécessité de réduire les transfusions sanguines chez les sujets dialysés par l'administration d'EPO, étant donné le coût prohibitif du traitement contre le VHC dans notre contexte


Subject(s)
Humans , Male , Female , Epidemiologic Factors , Hepacivirus , Genotype , Prevalence , Renal Dialysis
3.
Braz. j. biol ; 82: e243283, 2022. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1278505

ABSTRACT

ABSTRACT Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.


RESUMO Agentes infecciosos causam doenças graves em humanos em todo o mundo, e são responsáveis pelo alto índice de morbimortalidade. A prevalência e a epidemiologia das doenças infecciosas no hospital que atendeu pacientes encaminhados pelos médicos por meio dos achados iniciais e seus fatores de risco associados foram estudadas em Peshawar. Os dados de 174 pacientes infectados foram coletados durante o período de 2015 a 2017 oriundos de dois laboratórios clínicos de Tehsil Matta Swat. O formulário de consentimento informado foi obtido antes da coleta de sangue. Após a obtenção do consentimento informado, foram coletadas amostras de sangue e foi realizado o teste ICT e, em seguida, os casos ICT positivos foram confirmados por PCR. Um total de 174 amostras ICT positivas [106 homens e 68 mulheres] foi incluído neste estudo. A idade considerada foi de 10 a 72 anos. Das 174 tiras de ICT positivas, 99 casos [63 homens, 36 mulheres] foram confirmados por PCR. A taxa de prevalência foi de 56,89%. A injeção IV / IM foi registrada em 100% dos indivíduos. A visita à barbearia foi relatada em (58%) dos indivíduos, os números de casados foram (81,0%), e a operação cirúrgica foi relatada em (44,8%), o compartilhamento de escova de dente foi observado em (29,9%), o piercing foi relatado em (39,7%), antecedentes familiares foram relatados em (26,4%), tratamento odontológico em (21,8%), icterícia (13,2%) e tatuagem em (1,7%). Transfusão de sangue, operações cirúrgicas, icterícia, histórico familiar e tratamento odontológico foram fatores de risco significativos para adquirir infecção por Vírus da Hepatite C (VHC). Concluiu-se que a implementação adequada de medidas de precaução deve ser necessária para controlar a propagação do VHC em um futuro próximo.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Hepatitis C/epidemiology , Hepacivirus , Pakistan/epidemiology , Prevalence , Risk Factors
4.
Infectio ; 25(4): 241-249, oct.-dic. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1286717

ABSTRACT

Abstract Infection through the Hepatitis C virus does not have a vaccine and treatment with pegylated interferon and ribavirin can fail; which is why it may cause chronic infection and, consequently, could develop liver failure or hepatocellular carcinoma. It has been described that virus-cell recognition occurs between the E2 viral envelope protein and diverse cell receptors, with this interaction being critical in viral infection. which is why the study sought to identify inhibitory peptides of the interaction between viral E2 protein and the CD81 and CD209 receptors. Methodology: Through the RCSB protein database, crystals from the CD81 and CD209 receptors were selected, CD81/E2-HCV, CD209/E2-HCV complexes were carried out by SWISS-MODEL to generate inhibitory peptides of protein interaction through the Rosetta web server, this interaction was validated through ClusPro and finally, determined the theoretical physicochemical and cytotoxic properties of these peptides. Results: two peptides were obtained, without predicted toxicity, with a theoretical capacity of blocking the protein interaction between the E2 protein of the virus and CD81 and CD209.


Resumen La infección por el virus de la hepatitis C, no cuenta con vacuna y el tratamiento con interferón pegilado y ribavirina puede fallar; por lo que puede causar infec ción crónica y como consecuencia podría desarrollarse falla hepática o carcinoma hepatocelular. Se ha descrito que el reconocimiento virus-célula, se da entre la proteína de envoltura viral E2 y diversos receptores celulares, siendo esta interacción crítica en la infección viral. Razón por la cual este estudio buscó identificar péptidos inhibidores de la interacción entre la proteína E2 viral y los receptores CD81 y CD209. Metodología: A través de la base de datos de proteínas RCSB, se seleccionaron cristales de los receptores CD81 y CD209, se realizaron complejos CD81/E2-HCV, CD209/E2-HCV para generar péptidos inhibidores de interacción proteica a través del servidor web Rosetta, esta interacción fue validada a través de ClusPro y finalmente se evaluaron las propiedades fisicoquímicas y citotóxicas teóricas para estos péptidos. Resultados: se obtuvo dos péptidos, sin toxicidad predicha, con capacidad teórica de bloquear la interacción proteica entre la proteína E2 del virus y CD81 y CD209.


Subject(s)
Humans , Hepatitis Viruses , Peptides , Vaccines , Proteins , Hepatitis C , Liver Failure , Hepacivirus , Infections
5.
Article in English | LILACS | ID: biblio-1353156

ABSTRACT

2021.174934ABSTRACTIntroduction: The mechanisms by which hepatitis C virus (HCV) infection induces autoimmune thyroiditis (AIT) have been studied, and it was suggested that inflammatory cytokines during HCV infection would change the thy-roperoxidase (TPO) signaling cascade and thyroglobulin (Tg) determining autoimmune thyroid disease.Objective: To show the signaling pathway, of TPO and Tg, and their potential targets mediated HCV in individuals with hepatitis C.Methods: The mapping of the signaling pathway was based on a review study approach and performed using the automatic annotation server of the Kyoto and Genome Encyclopedia (KEGG). PathVisio is free software for analysis and design of open source routes, and was used for the graphic representation of the signaling pathway.Results: The contigs were extracted from the KEGG database and their mapped transcription represents the signa-ling pathway of the main biomolecules that triggers the AIT. The action of HCV, or its treatment can trigger AIT that is characterized by the presence of autoantibodies against TPO and Tg. In AIT, autoreactive CD4 + T lymphocytes recruit B cells and CD8 + T cells in the thyroid. The progression of the disease leads to the death of thyroid cells and hypothyroidism. Conclusion: HCV or its treatment activates several signaling pathways with thyroid cells damage resulting in AIT and secondary hypothyroidism to cellular apoptosis. (AU)


RESUMOIntrodução: Os mecanismos pelos quais a infecção com o vírus da hepatite C (HCV) induz à tireoidite autoimune (TAI) têm sido alvo de estudos. Tem sido sugerido que citocinas inflamatórias, como a elevação das interleucinas na inflamação causadas pelo HCV, alterariam a cascata de sinalização da tireoperoxidase (TPO) e tireoglobulina (Tg) determinando um quadro de doença autoimune da tireóide.Objetivo: Demonstrar a via de sinalização da TPO e da Tg e seus potenciais alvos para a TAI mediados pelo HCV em indivíduos com hepatite C.Método: O mapeamento da via de sinalização foi realizado usando o servidor de anotação automática da Enciclopé-dia Quioto de Genes e Genomas (KEGG). O PathVisio, um software gratuito de análise e desenho de vias de código aberto, foi utilizado para a representação gráfica da via de sinalização.Resultado: As sequências foram retiradas do banco de dados KEGG e sua transcrição mapeada representa a via de . sinalização das principais biomoléculas que desencadeia a TAI. A ação do HCV, ou seu tratamento pode desen-cadear a TAI que é caracterizada pela presença de autoanticorpos contra a TPO e Tg. Na TAI os linfócitos T CD4+ auto-reativos recrutam células B e células T CD8+ na tireóide. A progressão da doença leva à morte de células da tireóide e hipotireoidismo.Conclusão: O HCV ou o seu tratamento ativa várias vias de sinalização com dano na célula tireoidiana, tendo como resultado TAI e hipotireoidismo secundário a apoptose celular. (AU)


Subject(s)
Humans , Autoimmune Diseases , Thyroid Diseases , Thyroiditis, Autoimmune , CD4 Antigens , CD8 Antigens , Hepacivirus , Disease Progression , Hypothyroidism
6.
Arq. gastroenterol ; 58(3): 399-401, July-Sept. 2021.
Article in English | LILACS | ID: biblio-1345294

ABSTRACT

ABSTRACT According to the World Health Organization, 71 million people live with chronic hepatitis C. The treatment of this disease requires assistance from specialized physicians and a highly complex health care system. The prison population has been recognized as being at a high risk of acquiring confinement-related infections, including viral hepatitis. Hepatitis C virus (HCV) infection is a primary cause of death owing to liver disease among liberty-deprived individuals. Generally, prisons do not have adequate isolation wards for persons with communicable diseases, and overcrowding is a risk factor for this population. Besides prison overcrowding, violence, poor sanitary conditions, low socioeconomic status, social isolation, and emotional instability are factors that can lead detainees to adopt unhealthy habits that make them more susceptible to infections, including HCV, and complicate effective treatment. The Criminal Execution Law 7, 210 of July 11, 1984, in Article 14, grants preventive and curative medical, dental, and pharmacological healthcare to detainees. However, adequate hepatitis C treatment is rarely provided at prisons owing to social stigma and lack of knowledge on the severity of this condition or because most detainees are unaware of their condition. Given the multiple limitations imposed by the prison system model, implementing measures to treat diseases effectively is challenging. However, it is possible to eliminate hepatitis C in prisons in the long term through the coordinated action of public health institutions and the prison system.


RESUMO De acordo com a Organização Mundial da Saúde, 71 milhões de pessoas vivem com hepatite C crônica. O tratamento dessa doença requer assistência de médicos especializados e um sistema de saúde de alta complexidade. A população carcerária tem sido reconhecida como sendo de alto risco de adquirir infecções relacionadas às condições de confinamento, incluindo hepatites virais. O vírus da hepatite C (VHC) é uma causa primária de morte por doença hepática em pessoas privadas de liberdade. Geralmente, as prisões não possuem locais adequados para isolamento de pessoas com doenças transmissíveis e a superlotação é um fator de risco para essa população. Além da superlotação das prisões, violência, más condições sanitárias, baixo nível socioeconômico, isolamento social e instabilidade emocional são motivos adicionais que induzem os detidos a praticar hábitos não saudáveis, que os tornam mais suscetíveis a certas infecções (incluindo VHC) e complicam o tratamento específico. A Lei de Execução Penal n. 7.210, de 11 de julho de 1984, em seu artigo 14, garante assistência preventiva e curativa à saúde, incluindo assistência médica, farmacêutica e odontológica aos detidos. No entanto, o tratamento adequado da hepatite C é raramente fornecido nas prisões devido estigma social ou falta de conhecimento de sua condição ou porque a maioria dos detidos não tem conhecimento de sua condição. Devido a múltiplas limitações impostas pelo modelo prisional, a implementação de medidas para o tratamento eficaz de doenças é desafiadora. No entanto, é possível eliminar a hepatite C em um ambiente prisional de longa permanência através de ações coordenadas de instituições de saúde pública e o sistema prisional.


Subject(s)
Humans , Prisoners , Hepatitis C/prevention & control , Hepatitis C/epidemiology , Hepatitis C, Chronic/prevention & control , Hepatitis C, Chronic/drug therapy , Hepatitis C, Chronic/epidemiology , Prevalence , Risk Factors , Hepacivirus
7.
Medisan ; 25(4)2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1340218

ABSTRACT

Introducción: Hoy día, las enfermedades infecciosas constituyen una de las causas de muerte más frecuentes, de ahí que la actual epidemia de hepatitis es un problema de salud a escala mundial. Las hepatitis B y C se propagan por medio del contacto con la sangre, el semen u otro líquido corporal de una persona infectada. Objetivo: Actualizar algunos elementos sobre las hepatitis virales crónicas como un problema de salud. Desarrollo: Se analizan aspectos de las hepatitis virales crónicas relacionados con las estadísticas globales, regionales y locales; también se abordan los indicadores de impacto, la epidemiología, las características de los virus y las formas de trasmisión. Conclusiones: Esta problemática se ha convertido en un grave problema de salud en todo el orbe y Cuba no está exenta de esta situación. El principal eslabón para prevenir y reducir el número de pacientes y la trasmisión de estas enfermedades es la atención primaria, donde el trabajo educativo y preventivo que se desarrolla en la comunidad es fundamental.


Introduction: Nowadays, infectious diseases constitute one of the most frequent causes of death, with the result that current hepatitis epidemic is a health problem worldwide. The hepatitis B and C are spread by means of the blood contact, semen or another body fluid of an infected person. Objective: To update some elements on the chronic viral hepatitis as a health problem. Development: Some aspects of the chronic viral hepatitis related to the global, regional and local statistics are analysed; the impact indicators, epidemiology, characteristics of the virus and the ways of transmission are also approached. Conclusions: This question has become a serious health problem worldwide and Cuba is not exempt of this situation. The main link to prevent and reduce the number of patients and the transmission of these diseases is the primary health care, where the educational and preventive work that is developed in the community is fundamental.


Subject(s)
Communicable Diseases , Hepatitis, Viral, Human/epidemiology , Hepatitis B virus , Hepacivirus
8.
Medicina (B.Aires) ; 81(2): 252-256, June 2021. graf
Article in English | LILACS | ID: biblio-1287277

ABSTRACT

Abstract The clinical management of hepatitis C virus (HCV) infection presents several challenges today. WHO's goal is to eliminate it by 2030. It is an ambitious goal and difficult to meet given the barriers to care that arise. This is possible today thanks to the discovery of direct-acting antivirals (DAAs). This treatment achieves a high cure rate and is virtually free of adverse effects. To try to comply with this, in addition to the use of DAAs, it is necessary to reduce the rate of undiagnosed patients and facilitate the access of those diagnosed to care and treatment. For that, it is proposed to carry out a simplified treatment of HCV. This involves reducing controls during and after treatment. This simplification varies according to whether patients have cirrhosis or not. In this way, it seeks to increase significantly the number of patients treated and cured to reduce the burden on public health of this disease.


Resumen El manejo clínico de la infección por el virus la hepatitis C (HCV) presenta varios desafíos en la actualidad. El objetivo de la OMS es eliminarlo para el 2030. Es un objetivo ambicioso y muy difícil de cumplir dadas las barreras al cuidado que se presentan. Sin embargo, esto es posible hoy gracias al descubrimiento de los antivirales de acción directa (AAD). Este tratamiento logra una alta tasa de curación y prácticamente está libre de efectos adversos. Para tratar de cumplirlo, además del uso de los AAD, es nece sario reducir la tasa de pacientes no diagnosticados y facilitar el acceso de los diagnosticados al cuidado y el tratamiento. Para eso se propone llevar adelante el tratamiento simplificado del HCV. Esto implica reducir los controles durante y después del tratamiento. Esta simplificación varía según los pacientes tengan o no cirrosis. De esta manera se busca aumentar significativamente el número de pacientes tratados y curados para así poder reducir el impacto en la salud pública de esta enfermedad.


Subject(s)
Humans , Hepatitis C/drug therapy , Hepatitis C, Chronic/drug therapy , Antiviral Agents/therapeutic use , Hepacivirus , Liver Cirrhosis
9.
Medicina (B.Aires) ; 81(1): 1-5, mar. 2021. graf
Article in Spanish | LILACS | ID: biblio-1287233

ABSTRACT

Resumen La principal infección viral transmisible por sangre es actualmente la debida al virus de hepatitis C (VHC). Uno de los mayores obstáculos para el logro de su control en la Argentina se relaciona con las dificultades de acceso al diagnóstico y tratamiento oportuno de las personas infectadas. Este estudio se realizó con el objetivo de caracterizar a los pacientes infectados con VHC que iniciaron tratamiento con antivirales de acción directa (AAD) y describir la experiencia vinculada al tratamiento. Se seleccionaron las historias clínicas de 82 pacientes, 44 (53.7%) de sexo masculino, 37 (45.1%) de sexo femenino, y uno (1.2%) transgénero. La media de edad fue de 49 años. Se halló una frecuencia de cirrosis de 39%, 32 pacientes, coinfección con HIV en 48 (58.5%) y con VHB en 27 (32.9%). En 52 (63.4%) no se observó ningún factor de riesgo claramente asociado a infección. Todos completaron la terapia, de ellos 72 (87.8%) efectuaron el control para confirmar respuesta viral sostenida (RVS), que fue de 98.6%. Concluimos que el testeo universal debe implementarse por sobre el testeo con enfoque de riesgo, y que debe promoverse un criterio de atención simplificado y descentralizado, reservando la atención especializada para pacientes con cirrosis descompensada y cáncer de hígado.


Abstract Hepatitis C virus (HCV) infection is currently the main blood-borne viral infection. One of the main obstacles to achieving its control in Argentina is related to difficulties in accessing the diagnosis and timely treatment of infected people. We carried out this study with the aim of characterizing the HCV-infected patients who started treatment with direct-acting antivirals (DAAs) and to describe the experience related to treatment. The medical records of 82 patients, 44 (53.7%) male, 37 (45.1%) female, and one (1.2%) transgender, were selected. The mean age was 49 years. We report a frequency of cirrhosis, 39%, in 32 patients, coinfection with HIV in 48 (58.5%) and with HBV in 27 (32.9%). In 52 patients (63.4%), no risk factor clearly associated with infection was observed. All completed the therapy, of them 72 (87.8%) carried out the control to confirm sustained viral response (SVR), that attained 98.6%. We conclude that universal testing should be implemented over testing based on a risk approach, and that a simplified and decentralized care criterion should be promoted, reserving specialized care for patients with decompensated cirrhosis and liver cancer.


Subject(s)
Humans , Male , Female , Middle Aged , Antiviral Agents/therapeutic use , HIV Infections/drug therapy , Hepatitis C/diagnosis , Hepatitis C/drug therapy , Hepatitis C/epidemiology , Hepatitis C, Chronic/drug therapy , Coinfection/epidemiology , Argentina/epidemiology , Hepacivirus , Liver Cirrhosis
10.
Rev. Soc. Bras. Med. Trop ; 54: e02532020, 2021. tab
Article in English | LILACS | ID: biblio-1155541

ABSTRACT

Abstract INTRODUCTION: We compared the hepatitis C virus (HCV) core antigen test with the HCV RNA assay to confirm anti-HCV results to determine whether the HCV core antigen test could be used as an alternative confirmatory test to the HCV RNA test. METHODS: Sera from 156 patients were analyzed for anti-HCV and HCV core antigen using a chemiluminescent microparticle immunoassay (Architect i2000SR) and for HCV RNA using the artus HCV RG RT-PCR Kit (QIAGEN) in a Rotor-Gene Q instrument. RESULTS: The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 77.35%, 100%, 100%, and 89.38%, respectively. HCV core antigen levels showed a good correlation with those from HCV RNA quantification (r =0.872). However, 13 samples with a viral load of less than 4000 IU/mL were negative in the HCV core antigen assay. All gray-zone reactive samples were also RNA positive and were positive on repeat testing. CONCLUSIONS: The Architect HCV core antigen assay is highly specific and has an excellent positive predictive value. At the present level of sensitivity (77%), the study is still relevant in a low-income setting in which most of the HCV-positive patients would go undiagnosed, since HCV RNA testing is not available and/or not affordable. HCV core antigen testing can also help determine the true burden of infection in a population, considering the fact that almost 50% of the anti-HCV positive cases are negative for HCV RNA.


Subject(s)
Humans , Hepatitis C/diagnosis , Hepacivirus/genetics , RNA, Viral , Sensitivity and Specificity , Hepatitis C Antigens , Hepatitis C Antibodies
11.
J. venom. anim. toxins incl. trop. dis ; 27: e20200154, 2021. graf
Article in English | LILACS, VETINDEX | ID: biblio-1287093

ABSTRACT

Inflammation is closely related to renal diseases. This is particularly true for renal diseases caused by infections as in viral diseases. In this review, we highlight the inflammatory mechanisms that underlie kidney dysfunction in SARS-CoV-2, human immunodeficiency (HIV), hepatitis C (HCV), and hepatitis B (HBV) infections. The pathophysiology of renal involvement in COVID-19 is complex, but kidney damage is frequent, and the prognosis is worse when it happens. Virus-like particles were demonstrated mostly in renal tubular epithelial cells and podocytes, which suggest that SARS-CoV-2 directly affects the kidneys. SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptor, which is found in endothelial cells, to infect the human host cells. Critical patients with SARS-CoV-2-associated acute kidney injury (AKI) show an increase in inflammatory cytokines (IL-1β, IL-8, IFN-γ, TNF-α), known as cytokine storm that favors renal dysfunction by causing intrarenal inflammation, increased vascular permeability, volume depletion, thromboembolic events in microvasculature and persistent local inflammation. Besides AKI, SARS-CoV-2 can also cause glomerular disease, as other viral infections such as in HIV, HBV and HCV. HIV-infected patients present chronic inflammation that can lead to a number of renal diseases. Proinflammatory cytokines and TNF-induced apoptosis are some of the underlying mechanisms that may explain the virus-induced renal diseases that are here reviewed.(AU)


Subject(s)
Hepatitis B virus , HIV , Hepacivirus , COVID-19 , Glomerulonephritis , Inflammation , Kidney Diseases
12.
Chinese Journal of Hepatology ; (12): 319-325, 2021.
Article in Chinese | WPRIM | ID: wpr-879638

ABSTRACT

Viral hepatitis C is one of the important causes of liver cirrhosis and hepatocellular carcinoma. There are approximately 10 million cases of chronic hepatitis C virus (HCV) infection in China. However, over 70% of HCV infections of China have not yet been detected. According to the goal of "eliminating viral hepatitis as a public health threat by 2030" of the World Health Organization Viral Hepatitis Strategy, and the fact that medical institutions remain the main places for detecting HCV infections or patients in China at present, we established the " In-hospital process for viral hepatitis C screening and management in China (Draft)", with intention to promote the multidisciplinary collaboration and cooperation among the departments of clinic, laboratory, infection control, management, and etc. in medical institutions, and strengthen consultation and referral of patients with detected HCV antibodies and advance the diagnosis and antiviral treatment of patients with chronic hepatitis C.


Subject(s)
Antiviral Agents/therapeutic use , China/epidemiology , Hepacivirus/genetics , Hepatitis C/epidemiology , Hepatitis C, Chronic/epidemiology , Hospitals , Humans , Liver Neoplasms/drug therapy
13.
Journal of Experimental Hematology ; (6): 1987-1990, 2021.
Article in Chinese | WPRIM | ID: wpr-922237

ABSTRACT

Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease. HCV is not only related to hepatic malignancies but may also promote lymphoid neoplasms. Currently, research has confirmed HCV-related lymphoma, including marginal zone lymphoma (MZL), lymphoplasmacytic lymphoma (LPL), follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Burkitt lymphoma (BL). Many types of research have shown that antiviral therapy can improve or even remission several HCV-related lymphomas. The direct-acting antiviral agents (DAAs) (such as NS5A protease inhibitors, NS4/4A protease inhibitors and viral polymerase inhibitors) have shown clinical advantages of high efficacy and low side effects for both virus elimination and tumor regression in several HCV-related lymphomas, which may make the selected HCV-related lymphoma patients treated without chemotherapy. In this review the research progress and development direction of antiviral therapy in treating HCV-related lymphoma has summarized briefly.


Subject(s)
Antiviral Agents/therapeutic use , Hepacivirus , Hepatitis C/drug therapy , Hepatitis C, Chronic/drug therapy , Humans , Lymphoma, B-Cell, Marginal Zone/drug therapy , Lymphoma, Large B-Cell, Diffuse/drug therapy
14.
Article in English | WPRIM | ID: wpr-878357

ABSTRACT

Objective@#The aim of the present study was to evaluate the performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one dried blood spot (DBS) as an alternative sample to plasma.@*Method@#A total of 571 paired DBS/plasma samples were collected from men who have sex with men (MSM) and injection drug users (IDUs), and serological and molecular assays were performed. Using plasma results as the reference standard, the performance of DBS tests for HIV-1 RNA, HIV-1 DNA, and HCV RNA was evaluated. Pearson's correlation coefficients and Bland-Altman analysis were performed to assess the correlation and concordance between DBS and plasma.@*Results@#Among paired plasma/DBS samples with detectable HIV-1 RNA and HCV RNA, five samples (5/32) were not detectable in DBS, while measurable HIV-1 RNA levels were present in plasma (1.44 to 3.99 log @*Conclusion@#The performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one DBS was acceptable. DBS, as an alternative sample to plasma, may be a viable option for the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA in resource-limited settings or for individuals living in areas that are difficult to access.


Subject(s)
DNA, Viral/analysis , Diagnostic Tests, Routine/methods , Dried Blood Spot Testing/methods , HIV Infections/diagnosis , HIV-1/isolation & purification , Hepacivirus/isolation & purification , Hepatitis C/diagnosis , RNA, Viral/analysis , Sensitivity and Specificity , Specimen Handling/methods , Syphilis/diagnosis , Treponema pallidum/isolation & purification
16.
Arq. gastroenterol ; 57(3): 267-271, July-Sept. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131666

ABSTRACT

ABSTRACT BACKGROUND: Chronic hepatitis C still figures as an important cause of morbidity among the Brazilian population, and is closely associated with metabolic disturbances, including insulin resistance (IR), which can be evaluated by the Homeostatic Model Assessment (HOMA-IR). IR may entail lower sustained virologic response (SVR) on certain therapeutic regimens and faster progression to advanced hepatic fibrosis. With the arrival of the direct acting agents (DAA) in hepatitis C treatment, there is an increased need in observing the impact in patients' IR profile while using such therapies. OBJECTIVE: - 1) To compare the results of HOMA-IR in patients affected by chronic hepatitis C before treatment with DAA and 12 months after finishing it with SVR. 2) To evaluate the evolution of weight after curing chronic hepatitis C. METHODS: We included patients older than 18 from two tertiary care in Curitiba - PR, of both sexes, with chronic hepatitis C, treated with DAA, from July 2015 to September 2017. We also evaluated the patients' levels of fasting insulin, fasting glucose and glycated hemoglobin before starting treatment and 12 months after finishing it. We also used epidemiologic data, such as age, sex, hepatic fibrosis degree, body mass index, abdominal circumference, viral genotype and the presence of diabetes mellitus before and after treatment. IR was assessed before and after treatment and calculated by the HOMA-IR score. Insulin resistance was defined by a HOMA-IR greater than 2.5. We excluded patients who lost follow-up, those who did not achieve SRV and those who did not have a laboratory profile. The results of quantitative variables were described by means, medians, and standard deviations. P values <0.05 indicated statistical significance. RESULTS: We included 75 patients in this study, with a mean age of 55.2 years and 60% of males. Forty-three patients had advanced fibrosis. Twenty one (28%) had a previous diabetes mellitus diagnosis. We identified 31 (41.3%) patients with IR before antiviral treatment, and this number increased to 39 (52%) after 12 months of finishing treatment, according to HOMA-IR. There was no statistic difference between insulin, glucose and HOMA-IR measurements before and after curing hepatitis C. We observed a weight gain in patients shortly after curing hepatitis C, but this did not persist at the end of the study. We also had no significant difference in IR prevalence when viral genotype was concerned. CONCLUSION: In this study, there was no statistically significant difference between HOMA-IR results in patients before and 12 months after treatment for hepatitis C. Even though patients gained weight after the cure, this was not statistically significant after a year (P=0.131).


RESUMO CONTEXTO: A hepatite C crônica ainda figura como importante causa de morbimortalidade na população brasileira, e está associada a alterações metabólicas, incluindo a resistência insulínica (RI), que pode ser avaliada pelo índice HOMA-IR. A RI pode inclusive implicar em menores taxas de reposta virológica sustentada (RVS) em certos regimes terapêuticos e à uma mais rápida progressão para fibrose hepática avançada. Com o advento dos novos antivirais de ação direta (DAA) oferecidos para hepatite C, há crescente necessidade de observar o impacto dos mesmos no perfil de RI em pacientes submetidos à tais terapêuticas. OBJETIVO: - 1) Comparar os valores do HOMA-IR dos pacientes com hepatite C crônica antes do tratamento com os DAAS com os valores deste índice após 12 meses do término do tratamento com RVS. 2) Avaliar evolução do peso após obtenção da cura da hepatite C crônica. MÉTODOS: Foram incluídos pacientes maiores de 18 anos de dois serviços terciários de Curitiba - PR, de ambos os sexos, portadores de hepatite C crônica, com tratamento com os antivirais de ação direta, no período de julho de 2015 a setembro de 2017. Tais pacientes também foram submetidos a dosagem dos níveis de insulina de jejum, glicemia de jejum e hemoglobina glicada antes de iniciar o tratamento da hepatite C e até 12 meses após o término. Também foram utilizados dados como idade, sexo, grau de fibrose hepática, índice de massa corporal, circunferência abdominal, genótipo viral e presença de diabetes mellitus antes e depois do tratamento. A RI foi estimada antes e após 12 meses do término do tratamento e calculada pelo HOMA-IR. Os resultados de variáveis quantitativas foram descritos por médias, medianas, valores mínimos, valores máximos e desvios padrões. Valores de P<0,05 indicaram significância estatística. RESULTADOS: Foram incluídos 75 pacientes no estudo com média de idade de 55,2 anos, sendo 60% do sexo masculino. Destes pacientes, 43 tinham fibrose avançada. Vinte e um (28%) pacientes tinham o diagnóstico de diabetes mellitus. A RI foi observada em 31 (41,3%) pacientes antes do tratamento antiviral, sendo que este número aumentou para 39 (52%) de acordo com a dosagem do HOMA-IR 12 meses após o término do tratamento. Não houve diferença estatística entre os valores de insulina, glicemia e HOMA-IR antes e após a cura da hepatite. Houve um ganho de peso inicial após a obtenção da cura da hepatite C, mas que não se manteve ao final do estudo. CONCLUSÃO: Não foi vista diferença estatística significante entre os valores do HOMA-IR apresentados pelos pacientes portadores de hepatite C crônica antes do tratamento e 12 meses após a cura da doença. Embora tenha ocorrido ganho de peso após obtenção da cura da doença, este não se deu de forma estatisticamente significativa (P=0,131) ao final de um ano.


Subject(s)
Humans , Male , Female , Insulin Resistance , Hepatitis C, Chronic/drug therapy , Antiviral Agents/therapeutic use , Antiviral Agents/pharmacology , Ribavirin/therapeutic use , Brazil , Treatment Outcome , Hepacivirus/drug effects , Hepacivirus/genetics , Middle Aged
17.
Medisan ; 24(4)jul.-ago. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1125138

ABSTRACT

Introducción: La hepatitis C es una infección viral que puede presentarse como una afección leve, de pocas semanas de duración, o evolucionar hasta una enfermedad hepática crónica. Objetivo: Caracterizar a pacientes con anticuerpos contra el virus de la hepatitis C según variables clínicas, humorales, laparoscópicas e histológicas. Métodos: Se realizó un estudio observacional, descriptivo, de serie de casos, de 150 pacientes con anticuerpos contra el virus de la hepatitis C, atendidos en la consulta de Hepatología del Hospital General Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba desde diciembre de 2017 hasta igual mes de 2019, a los cuales se les realizó una biopsia hepática por laparoscopia. Como medida de resumen se utilizó el porcentaje. Resultados: Predominaron el grupo etario de 61-70 años y el sexo femenino. La vía sanguínea resultó ser la de mayor riesgo para la transmisión del virus de la hepatitis C. A pesar de estar infectados, 45,3 % de los pacientes evolucionaron en algunos momentos de la enfermedad con valores de alanina aminotransferasa normales. Conclusiones: En los estudios laparoscópicos fueron más frecuentes el hígado normal y la hepatitis crónica, a la vez que primaron estas últimas con lesiones leves y moderadas. Se constató la presencia de lesiones hísticas tanto en los pacientes sintomáticos como asintomáticos.


Introduction: Hepatitis C is a viral infection that can be presented as a light disorder, during few weeks, or become into a chronic hepatic disease. Objective: To characterize patients with antibodies against the hepatitis C virus according to clinical, humoral, laparoscopic and histological variables. Methods: An observational, descriptive, serial cases study, of 150 patients with antibodies against the hepatitis C virus was carried out, they were assisted in the hepatology service of Dr. Juan Bruno Zayas Alfonso General Hospital in Santiago de Cuba from December, 2017 to the same month in 2019, to whom a hepatic biopsy by laparoscopy was carried out. The percentage was used as summary measure. Results: There was a prevalence of the 61-70 age group and the female sex. The higher risk for the transmission of hepatitis C virus was by blood. In spite of being infected, the 45.3 % of patients had a clinical course in some moments of the disease with normal alanine aminotransferase values. Conclusions: In the laparoscopic studies the normal liver and chronic hepatitis were more frequent, at the same time that these last ones prevailed with light and moderate lesions. The presence of tissue lesions was verified either in the symptomatic or asymptomatic patients.


Subject(s)
Hepacivirus , Hepatitis C Antibodies , Biopsy/methods , Liver Diseases
18.
Arq. gastroenterol ; 57(1): 45-49, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1098060

ABSTRACT

ABSTRACT BACKGROUND: Direct-acting antivirals have revolutionized hepatitis C treatment, also for patients with chronic kidney disease (CKD), but some controversy exists regarding the use of sofosbuvir (SOF) in patients with glomerular filtration rate (GFR) <30 mL/min. OBJECTIVE: To evaluate the efficacy and safety of these regimens for hepatitis C treatment of patients with CKD and after renal transplantation, as well as the impact of SOF on renal function in non-dialysis patients. METHODS: All patients with hepatitis C and CKD or renal transplant treated with direct-acting antivirals at a referral center in Brazil between January 2016 and August 2017 were included. Efficacy was evaluated based on viral load (HCV RNA) and a sustained virological response (SVR) consisting of undetectable RNA 12 and/or 24 weeks after the end of treatment (SVR12 and SVR24) was defined as cure. Safety was determined by adverse events and ribavirin, when combined, was administered in escalating doses to all patients with GFR <60 mL/min. The impact of SOF on renal function was determined by the measurement of baseline creatinine during and after the end of treatment and its increase was evaluated using the Acute Kidney Injury Network (AKIN) classification. RESULTS: A total of 241 patients (52.7% females) with a mean age of 60.72±10.47 years were included. The combination of SOF+daclatasvir was the predominant regimen in 75.6% of cases and anemia was present in 28% of patients who used ribavirin (P=0.04). The SVR12 and SVR24 rates were 99.3% and 97.1%, respectively. The treatment was well tolerated and there were no major clinically relevant adverse events, with the most prevalent being asthenia (57.7%), itching (41.1%), headache (40.7%), and irritability (40.2%). Among conservatively treated and renal transplant patients, oscillations of creatinine levels (AKIN I) were observed in 12.5% of cases during treatment and persisted in only 8.5% after the end of treatment. Of these, 2.0% had an initial GFR <30 mL/min and this percentage decreased to 1.1% after SOF use. Only 0.5% and 1.6% of the patients progressed to AKIN II and AKIN III elevation, respectively. CONCLUSION: The direct-acting antivirals were safe and efficacious in CKD patients treated with SOF-containing regimens, with the observation of high SVR rates, good tolerability and few severe adverse events. The combination with ribavirin increased the risk of anemia and the administration of escalating doses seems to be useful in patients with GFR <60 mL/min. In patients with GFR <30 mL/min, SOF had no significant renal impact, with serum creatinine returning to levels close to baseline after treatment.


RESUMO CONTEXTO: Os antivirais de ação direta revolucionaram o tratamento da hepatite C, inclusive para os pacientes com doença renal crônica (DRC), porém ainda há divergências no emprego do sofosbuvir (SOF) quando taxa de filtração glomerular (TFG) <30 mL/min. OBJETIVO: Avaliar a eficácia e segurança desses esquemas no tratamento da hepatite C em pacientes com DRC e pós-transplante renal, além de avaliar o impacto do SOF sobre a função renal dos não-dialíticos. MÉTODOS: Todos os pacientes com hepatite C e DRC ou transplante renal que realizaram tratamento com antivirais de ação direta em centro referenciado do Brasil no período de janeiro/2016 a agosto/2017 foram incluídos. A eficácia foi avaliada por meio da carga viral (HCV-RNA), considerando-se cura uma resposta virológica sustentada (RVS) com resultado indetectável após 12 e/ou 24 semanas do término do tratamento (RVS12 e RVS24). A segurança foi determinada pelos eventos adversos e a ribavirina, quando associada, foi introduzida de forma escalonada em todos os pacientes com TFG <60 mL/min. Para determinação do impacto do SOF sobre a função renal, foram observadas as dosagens de creatinina basal, durante e após término do tratamento com seu incremento avaliado por meio da classificação de AKIN (acute kidney injury network). RESULTADOS: Foram incluídos 241 pacientes, sendo 52,7% do sexo feminino, com média de idade de 60,72±10,47 anos. A associação de SOF+daclatasvir predominou em 75,6% dos casos e anemia esteve presente em 28% dos pacientes que utilizaram ribavirina (P=0,040). As taxas de RVS12 e RVS24 foram de 99,3% e 97,1%. O tratamento foi bem tolerado, com eventos adversos pouco relevantes, sendo os mais prevalentes: astenia (57,7%), prurido (41,1%), cefaleia (40,7%) e irritabilidade (40,2%). Entre os pacientes em tratamento conservador e transplantados renais, os valores de creatinina sofreram oscilações AKIN I em 12,5% dos casos, durante o tratamento, persistindo em apenas 8,5% da amostra após o término, dos quais 2,0% apresentavam TFG <30 mL/min inicialmente, com queda para 1,1% após uso do SOF. Apenas 0,5% e 1,6% evoluíram com elevação AKIN II e AKIN III. CONCLUSÃO: Os antivirais de ação direta foram seguros e eficazes em pacientes com DRC tratados com esquemas contendo SOF, apresentando altas taxas de RVS, boa tolerabilidade e poucos eventos adversos graves. A associação com ribavirina aumentou o risco de anemia, portanto sua introdução de forma escalonada parece ser útil nos pacientes com TFG <60 mL/min. Em pacientes com TFG <30 mL/min o SOF não apresentou impacto renal significativo, com creatinina sérica retornando a valores próximos ao basal após o tratamento.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Antiviral Agents/administration & dosage , Kidney Transplantation/adverse effects , Hepacivirus/genetics , Hepatitis C, Chronic/drug therapy , Ribavirin/administration & dosage , Treatment Outcome , Viral Load , Drug Therapy, Combination , Renal Insufficiency, Chronic/surgery , Simeprevir/administration & dosage , Sofosbuvir/administration & dosage , Sustained Virologic Response , Genotype , Glomerular Filtration Rate/genetics , Imidazoles/administration & dosage , Middle Aged
19.
Arq. gastroenterol ; 57(1): 39-44, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1098056

ABSTRACT

ABSTRACT BACKGROUND: Hepatitis C virus (HCV) infection is the most common hepatotropic viral infection affecting the patients on maintenance hemodialysis. Treatment of chronic HCV infection in stage 4 and 5 CKD includes a combination of elbasvir/grazoprevir and glecaprevir/pibrentasvir, which are not available in many countries. OBJECTIVE: Hence, we have conducted this study to look for the safety and efficacy of sofosbuvir combination therapy in this difficult to treat population. METHODS: We conducted a single-center, prospective, open-label study in which Stage 5 CKD patients on maintenance hemodialysis with HCV infection. Total of 18 patients was included. sofosbuvir with daclatasvir or ledipasvir was used according to genotype for 12 weeks. HCV RNA, genotype, transient elastography (TE) was considered for every patient. HCV RNA was quantified at 4th week, 12th week and 12 weeks post-treatment to look for sustained virologic response (SVR 12). RESULTS: Infection due to genotype 1 was seen in 12 (66.7%) patients followed by genotype 3 in 4 (22.3%) with each patient of genotype 2 and 5. The median value of HCV RNA was 2,35,000 IU/mL. On TE, all had liver stiffness of <9.4 KPa. All patients had HCV RNA of <15 IU/mL at 4th and 12th week of treatment and 12 weeks post-treatment. No significant change in hemoglobin, eGFR and liver stiffness was observed. CONCLUSION: Full dose sofosbuvir i.e. 400 mg, in combination with NS5A inhibitors daclatasvir or ledipasvir is found to be safe and effective in patients with end stage renal disease, who are on maintenance hemodialysis.


RESUMO CONTEXTO: A infecção pelo vírus da hepatite C (HCV) é a infecção viral hepática mais comum que afeta pacientes em hemodiálise de manutenção. O tratamento da infecção crônica por HCV no estágio 4 e 5 da doença renal crônica inclui uma combinação de elbasvir/grazoprevir e glecaprevir/pibrentasvir, que não estão disponíveis em muitos países. OBJETIVO: Portanto, realizamos este estudo para procurar a segurança e eficácia da terapia combinada de sofosbuvir nesta população de difícil tratamento. MÉTODOS: Realizamos um estudo de centro único, prospectivo e aberto, no qual pacientes com doença renal crônica em estágio 5 em hemodiálise de manutenção com infecção por HCV. Um total de 18 pacientes foi incluído. Sofosbuvir com daclatasvir ou ledipasvir foi usado de acordo com o genótipo por 12 semanas. O HCV RNA, genótipo, elastografia transitória foi considerado para cada paciente. O HCV RNA foi quantificado na 4ª semana, 12ª semana e 12 semanas após o tratamento para procurar uma resposta virológica sustentada. RESULTADOS: A infecção por genótipo 1 foi observada em 12 (66,7%) pacientes, seguido pelo genótipo 3 em 4 (22,3%), em um paciente do genótipo 2 e em outro, 5. O valor mediano do HCV RNA foi de 2.35.000 IU/mL. Na elastografia transitória, todos tinham rigidez hepática de <9.4 KPa. Todos os pacientes tinham RNA HCV <15 IU/mL na 4ª e 12ª semana de tratamento e 12 semanas após o tratamento. Não foi observada nenhuma alteração significativa na hemoglobina, eGFR e rigidez hepática. CONCLUSÃO: A dose completa sofosbuvir ou seja, 400 mg, em combinação com inibidores NS5A daclatasvir ou ledipasvir foi considerada segura e eficaz em pacientes com doença renal em estágio final, que estão em manutenção hemodiálise.


Subject(s)
Humans , Male , Female , Adult , Antiviral Agents/administration & dosage , Hepatitis C, Chronic/drug therapy , 2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage , Fluorenes/administration & dosage , Sofosbuvir/administration & dosage , Imidazoles/administration & dosage , Severity of Illness Index , RNA, Viral , Prospective Studies , Renal Dialysis , Treatment Outcome , Hepacivirus/genetics , Drug Therapy, Combination , Sustained Virologic Response , Genotype , Middle Aged
20.
Article in English | LILACS | ID: biblio-1130051

ABSTRACT

Introduction: With the improvement of biosafety and quality of blood products, hepatitis C virus (HCV) transmission decreased in Brazil. Analyzing temporal trends in the incidence of acute cases may indicate how current HCV circulation is. Objective: To analyze the temporal trend of acute hepatitis C cases from 2007 to 2018. Methods: Analysis of reported cases of acute hepatitis C, using data from the National System of Notifiable Diseases (Sistema Nacional de Agravos de Notificação ­ SINAN) and the Health Surveillance Department, Ministry of Health. The non-parametric Cusick test was applied to analyze temporal trend. Results: 6,199 cases of acute HCV were reported between 2007 and 2018. The annual incidence rate ranged from 0.17 cases per 100,000 inhabitants in 2007 at 0.28 (2018) (p=0.005). Regarding the age group, the trend of increased notifications was significant in individuals <5 years (p=0.025) and >40 years (p=0.008) of age. Conclusion: Despite the few acute cases reported annually, there has been an increase in recent years, especially in age extremes. Cases in >40 years may mean that some of them are not new, but chronic infections, or because of the growing importance of sexual transmission as a consequence of relaxation in safe sex. Despite possible inconsistencies and weaknesses in the notification systems, these numbers are of concern, justifying efforts to review cases for better classification and clarification of contagion routes


Introdução: Com a melhoria da biossegurança e qualidade dos hemoderivados, houve queda da transmissão do vírus da hepatite C (HCV) no Brasil. Analisar tendência temporal da incidência de casos agudos pode indicar como está a circulação do HCV atualmente. Objetivo: Analisar a tendência temporal dos casos de hepatite C aguda entre 2007 e 2018 no país. Métodos: Análise de casos notificados de hepatite C aguda, utilizando dados do Sistema Nacional de Agravos de Notificação e da Secretaria de Vigilância em Saúde, do Ministério da Saúde. Teste não paramétrico de Cusick foi aplicado para analisar tendência temporal. Resultados: Foram notificados 6.199 casos de hepatice C aguda entre 2007 e 2018. A taxa de incidência anual variou de 0,17 casos por 100 mil habitantes em 2007 a 0,28 (2018) (p=0,005). Quanto à faixa etária, tendência de aumento de notificações mostrou-se significativa em indivíduos <5 anos (p=0,025) e >40 anos (p=0,008). Conclusão: Apesar dos poucos casos agudos notificados anualmente, houve aumento em anos recentes, especialmente nos extremos etários. Os casos em >40 anos podem significar que alguns deles não sejam infecções novas, mas crônicas ou por crescente importância da transmissão sexual, como consequência de relaxamento quanto à prática de sexo seguro. Em que se pesem as possíveis inconsistências e fragilidades nos sistemas de notificação, esses números trazem preocupação, justificando esforços para revisão dos casos para melhor classificação e esclarecimentos das rotas de contágio.


Subject(s)
Humans , Hepatitis C , Hepacivirus , Infections , Disease Transmission, Infectious , Blood-Derivative Drugs , Public Health Surveillance
SELECTION OF CITATIONS
SEARCH DETAIL