Methylene tetrahydrofolate reductase (MTHFR) and vascular endothelial growth factor (VEGF) polymorphisms in Brazilian patients with Hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC)

OBJECTIVE: The folate pathway is involved in hepatic carcinogenesis and angiogenesis. Polymorphisms in genes related to such processes, including methylene tetrahydrofolate reductase (MTHFR) and vascular endothelial growth factor (VEGF)] may play an important role in the development of hepatocellular carcinoma (HCC). The objective of this study was to evaluate MTHFR and VEGF polymorphisms in Brazilian patients with hepatitis C virus (HCV)-related HCC. METHODS: A total of 119 patients diagnosed with confirmed HCC and HCV were included in the study. SNP genotyping assays were performed using real-time PCR. VEGFA (rs2010963, rs3025039, and rs833061) and MTHFRC677T (rs1801133, rs1801131) polymorphisms were evaluated. RESULTS: The C alleles of MTHFR (rs1801131) and VEGF (rs2010963) were associated with protection against the development of multinodular HCC, while the T allele of MTHFR (rs1801133) was associated with a higher risk of multinodular presentation [p=0.04 OR 1.835 CI (1.022-3.297)]. Multivariate analysis revealed that the GG/GC genotypes of VEGF rs2010963 were independently associated with multinodular tumors at diagnosis (p=0.013; OR 4.78 CI (1.38-16.67)]. CONCLUSION: Our results suggest that these polymorphisms may increase the risk of rapid tumor progression in patients with HCV infection. This subgroup of patients with HCC and who present polymorphism is more likely to be diagnosed with multinodular disease and not be amenable to receiving curative treatments. These data must be validated in larger cohorts, and the screening intervals can be customized based on genetic history.

The biological meaning of anti-HBC positive result in blood donors: relation to HBV-DNA and to other serological markers

In order to assess the potential risk of anti-HBc-positive blood donors for post-transfusional hepatitis and to investigate whether other HBV serological markers are capable of identifying the presence of the virus, 1000 first-time blood donors were enrolled between June and July 1997. These donors were screened using routine Brazilian blood center tests (HIV 1 and 2, HTLV 1 and 2, Chagas disease, Syphilis, HCV, HBsAg, anti-HBc and ALT ). The 120 (12 percent) found to be anti-HBc-positive underwent further tests: HBe, anti-HBe, anti-HBs and HBV-DNA by PCR. Ten cases were HBsAg positive and all were HBV-DNA positive by PCR. Three HBsAg-negative donors were HBV-DNA-positive. Two HBV-DNA-positive donors were also anti-HBs-positive. All the HBV-positive donors had at least one HBV marker other than anti-HBc. Anti-HBc is an important cause of blood rejection. Testing for HBsAg alone is not fully protective and anti-HBc remains necessary as a screening test. The presence of anti-HBs is not always indicative of absence of the virus. The addition of other HBV serological markers could represent an alternative in predicting the presence of the virus when compared with PCR. It is recommended that other studies should be carried out to confirm this finding

Hepatites B e C na esquistossomose mansoni / B and C Hepatitis in schistosomiasis mansoni

Foram estudados 234 pacientes com essquistossomose mansoni, sendo 44 com a forma hepatintestinal (EHI), 143 com a forma hepatesplenica compensada (EHEC) e 47 com a forma descompensada (EHED), além de 50 individuos controles. Dos 234 pacientes, 133 (57por cento) tinham pelo menos um marcador sorológico dis HBV e hcv. A frequencia do HBsAg foi significativamente maior (21por cento vs. 6por cento vs. 2por cento) nos com EHED do que nos com EHEC ou nos com EHI (p<0,001. Dos 19 (8por cento) AgHBs positivos,14 (74por cento) foram ant-HBe (um com EHI, sete com EHEC e seis com EHED),incluindo sete (37 por cento) HBV-DNA positivos. Em relaçao ao HCV, 47 (20por cento) dos 234 pacientes foram anti-HCV poistivos, apresentaram também HCV-RNA no soro, sendo11 (69,8 por cento) dos 16 com EHEC,17 (56,7 por cento) dos com EHED e um com EHI. O HCV_DNA foi detectado tambem em cinco pacientes anti-HCV negativos com EHED, totalizando 22 pacientes cm infeccao pelo HCV. Nos 108 pacientes com EHE ( 13 HBsAg positivos, 25 anti-HCV positivos para ambos os marcadores submetidos a esplenectomia) em que foi realizada biópsia hepatica dos com EHEC apresentava hepatite cronica ativa. Os achados deste estudo sugerem que a infecçao concomitante pelos virus das hepatites B e C é importante fator contribuinte para a gravidade da doença hepatica na esquistossomose mansoni