Brazilian evidence-based guideline for screening, diagnosis, treatment, and follow-up of metabolic dysfunction-associated steatotic liver disease (MASLD) in adult individuals with overweight or obesity: A joint position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM), Brazilian Society of Hepatology (SBH), and Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso)

ABSTRACT Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as Nonalcoholic fatty liver disease (NAFLD), is one of the most common hepatic diseases in individuals with overweight or obesity. In this context, a panel of experts from three medical societies was organized to develop an evidence-based guideline on the screening, diagnosis, treatment, and follow-up of MASLD. Material and methods: A MEDLINE search was performed to identify randomized clinical trials, meta-analyses, cohort studies, observational studies, and other relevant studies on NAFLD. In the absence of studies on a certain topic or when the quality of the study was not adequate, the opinion of experts was adopted. Classes of Recommendation and Levels of Evidence were determined using prespecified criteria. Results: Based on the literature review, 48 specific recommendations were elaborated, including 11 on screening and diagnosis, 9 on follow-up, 14 on nonpharmacologic treatment, and 14 on pharmacologic and surgical treatment. Conclusions: A literature search allowed the development of evidence-based guidelines on the screening, diagnosis, treatment, and follow-up of MASLD in individuals with overweight or obesity.

Prevalência do anticorpo contra hepatite C (anti VHC) em doadores de sangue no Rio de Janeiro, Brasil: sua relaçäo com ALT e anti HBc / Prevalence of antibodies to hepatitis C (anti HCV) in blood donors in Rio de Janeiro, Brazil: its relation with ALT and anti HBC

Estudamos no período de maio a julho de 1990, 933 doadores de sangue atendidos no Serviço de Hemoterapia. Após entrevista e exames rotineiros, foram realizados testes de triagem: antiHBc total, antiVHC e transminase glutâmico pirúvica (ALT). Os marcadores virais foram determinados por técnica de enzimaimunoensaio. 94% dos doadores eram do sexo masculino com média de idade de 33 anos (19-65). A positividad para o antiVHC foi de 3,1%. Entre os doadores antiVHC+, 13,29(44,8%) apresentaram ALT>40UI/L, 9/29(31%) foram positivos para o antiHBc e 5(17,2%) tinham ambos os marcadores. De 109 doadores com ALT > UI/L 13(11.9%) foram anti VHC+. Enquanto de 153 doadores anti HBC+, a positividade para o anti VHC foi de 5,8%, pouco maior que a do grupo total. Conclusöes: 1) Nossos doadores apresentam elevada prevalência de anti VHC(método de ELISA) quando comparada à de outros países estudados; 2) a determinaçäo de ALT e a pesquisa de anti HBc no soro de doadores foi incapaz de detectar 41,4% de doadores anti VHC+; 3) houve maior prevalência de ALT elevada nos doadores antiVHC+ com relaçäo amostra/cutoff > 4