RESUMO
The objective of the present study was to determine the presence of hepatic iron overload in patients with chronic HCV infection and to correlate it with histologic alterations, HCV genotype and response to therapy. Liver tissue samples from 95 patients with chronic hepatitis C were divided into two groups: group I, presence of iron overload in hepatic tissue (Perls' staining) and group II, no iron overload. Hepatic iron overload was detected in 30 (31.6 percent) of 95 patients. Of the 69 patients tested by genotyping, 49 (71.01 percent) were genotype 1 and 20 (28.99 percent) genotype non-1. Iron overload was detected in 14 (28.6 percent) patients with genotype 1 and in 6 (30 percent) with genotype non-1 (P = 0.906). There was a significant difference in fibrosis stage between groups (P = 0.005). In group I (N = 30), one patient had stage F0/F1 of fibrosis, while in group II (N = 65), 22 (33.8 percent) patients had minimal or no fibrosis. Fibrosis stage F2/F3 was observed in 70 percent of group I patients compared to 46.2 percent of group II. Eighty-five patients were treated with a combination of interferon and ribavirin; 29 of them (34.1 percent) had a sustained virologic response and 8 (27.6 percent) of them had hepatic iron overload. Iron overload was detected in 18 (32.1 percent) of the 56 non-responders (P = 0.73). Hepatic iron overload was frequent among patients with chronic hepatitis C and was associated with a more severe stage of liver fibrosis. There was no association between iron overload and HCV genotype and response to interferon and ribavirin therapy.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Antivirais/uso terapêutico , Hepatite C Crônica/complicações , Interferon-alfa , Sobrecarga de Ferro/complicações , Ribavirina/uso terapêutico , Quimioterapia Combinada , Genótipo , Hepacivirus/efeitos dos fármacos , Hepacivirus/genética , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/patologia , Reação em Cadeia da Polimerase , Índice de Gravidade de DoençaRESUMO
The aim of the present study was to evaluate the prevalence of HEV, TTV and GBV-C/GBV-C/HGV in patients with acute viral hepatitis A, B and non-A-C. We evaluated sera of 94 patients from a sentinel program who had acute hepatitis A (N = 40), B (N = 42) and non-A-C (N = 12); 71 blood donors served as controls. IgM and anti-HEV IgG antibodies were detected by enzyme immunoassay using commercial kits. TTV and GBV-C/HGV were detected by nested PCR; genotyping was done by sequencing and phylogenetic analysis. Anti-HEV IgG was present in 38, 10 and 17 percent of patients with hepatitis A, B and non-A-C. Four patients with hepatitis A and 1 with non-A-C hepatitis also had anti-HEV IgM detected in serum. TTV was detected in 21 percent of patients with acute hepatitis and in 31 percent of donors. GBV-C/HGV was detected in 9 percent of patients with hepatitis, and in 10 percent of donors. We found TTV isolates of genotypes 1, 2, 3, and 4 and GBV-C/HGV isolates of genotypes 1 and 2. Mean aminotransferase levels were lower in patients who were TTV or GBV-C/HGV positive. In conclusion, the detection of anti-HEV IgM in some acute hepatitis A cases suggests co-infection with HEV and hepatitis E could be the etiology of a few cases of sporadic non-A-C hepatitis in Salvador, Brazil. TTV genotype 1, 2, 3 and 4 isolates and GBV-C/HGV genotype 1 and 2 strains are frequent in the studied population. TTV and GBV-C/HGV infection does not appear to have a role in the etiology of acute hepatitis.
Assuntos
Humanos , Masculino , Feminino , Vírus GB C/imunologia , Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/imunologia , Hepatite Viral Humana/virologia , Torque teno virus/imunologia , Doença Aguda , Biomarcadores , Brasil/epidemiologia , Estudos de Casos e Controles , Vírus GB C/genética , Genótipo , Vírus da Hepatite E/genética , Hepatite Viral Humana/diagnóstico , Hepatite Viral Humana/epidemiologia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Reação em Cadeia da Polimerase , Prevalência , Vigilância de Evento Sentinela , Índice de Gravidade de Doença , Torque teno virus/genéticaAssuntos
Humanos , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Anticorpos Anti-Hepatite B/análise , Vírus da Hepatite B/imunologia , Anticorpos , Antígenos de Superfície da Hepatite B/imunologia , Hepatite B/imunologia , Imunoensaio/estatística & dados numéricos , Técnicas ImunoenzimáticasRESUMO
Um grupo de 1.288 indivíduos, residentes em Salvador, Bahia, Brasil, foi examinado para a determinaçäo de anti-HBs, utilizando-se a técnica do radioimunoensaio. Os resultados foram analisados de acordo com a idade, o sexo e o nível de renda. Uma prevalência de anti-HBs de 11,8% foi observada, variando de 6,7% nas crianças com idade inferior a três anos, a 26,1% para aqueles com idade superior a 30 anos. A prevalência de anti-HBs foi similar em indivíduos do sexo masculino e feminino. Aqueles com nível de renda mais alto tiveram prevalência de anti-HBs maior que o grupo de renda baixa. Dos resultados conclui-se: a alta prevalência de anti-HBs em crianças sugere o contato precoce com vírus da hepatite B, possivelmente relacionado com a transmissäo vertical e a disseminaçäo intrafamiliar do vírus; a freqüência de anti-HBs aumentou com a idade; a baixa prevalência de anti-HBs entre aqueles com baixo nível sócio-econômico sugere que neste grupo pode ser alta a prevalência de portadores do vírus B da hepatite
Assuntos
Humanos , Masculino , Feminino , Anticorpos Anti-Hepatite B/análise , Hepatite B/epidemiologia , Fatores Etários , Brasil , Hepatite B/diagnóstico , Fatores SexuaisRESUMO
Na hepatite aguda tipo A caracterizou-se o diagnostico etiologico atraves da determinacao do anticorpo para o virus A (anti-VHA), ressaltando a importancia do conhecimento sobre o anti-VHA IgM e IgG. Na hepatite aguda pelo virus B, descreve-se a importancia clinica e sequencia de aparecimento dos marcadores AgHBs, AgHBe, anti-HBc e IgG, anti-HBe e anti-HBs. Chama-se a atencao para a caracterizacao do estado de viremia cronica e da persistencia do AgHBe por um periodo superior a 3 meses.Correlacionou-se a perspectiva do antigeno delta como fator de importancia prognostica