Sofosbuvir and daclatasvir combination therapy for current hepatitis C virus genotype 4 achieves SVR: a case report of HCV genotype 4 from the Amazon

Abstract Hepatitis C is a worldwide endemic disease. However, hepatitis C virus genotype 4 (HCV GT-4) has rarely been reported in Brazil. HCV GT-4 demonstrates high sustained virological response (SVR). Here, we report the case of a 62-year-old HCV GT-4 positive woman complaining of a headache, nausea, and arthralgia. The patient was treated according to the protocol for genotype 4 (12 weeks administration of 400mg sofosbuvir and 60mg daclatasvir daily) and achieved SVR. Although this is not an Amazonas autochthonous case, the presence of genotype 4 is rarely reported in the region.

Polimorfismo do gene de receptor da leptina e a obesidade / Leptin receptor gene polymorphism and the obesity

Introdução: A obesidade consiste em um complexo conjunto de fatores comportamentais, ambientais e genéticos que se relacionam e se potencializam. Acredita-se que polimorfismos de nucleotídeo único (SNPs) possuam relação com a obesidade e que estejam hiperexpressos nesta condição. Objetivo: Revisar a relação da presença de polimorfismos no gene LEPR com a obesidade em crianças e adolescentes, buscando evidenciar condições e/ou fatores ambientais relacionados. Métodos: Trata-se de um artigo de atualização sobre o tema polimorfismo do LEPR e a associação com a obesidade. Resultados: Os dados levantados mostram a influência de polimorfismos do gene receptor de leptina (LEPR) com o desenvolvimento da obesidade, assim como fatores ambientais, tais como dieta hipercalórica na presença do polimorfismo, potencializam o desenvolvimento dessa condição clínica, resultando em aumento das medidas antropométricas e bioquímicas, na presença da mutação genética.

Introduction: Obesity consists of a complex set of behavioral, environmental and genetic factors that relate to and potentiate. It is believed that single nucleotide polymorphisms (SNPs) have relation with obesity and are hiperexpressos this condition. Objective: Review the relationship between the presence of polymorphisms in LEPR gene with obesity in children and adolescents, to disclosing conditions and / or related environmental factors. Methods: This is an update article on the topic LEPR polymorphism and the association with obesity. Results: The data collected show the influence of polymorphisms of the Leptin receptor gene (LEPR) with the development of obesity as well as environmental factors such as caloric diet in the presence of the polymorphism potentiate the development of this medical condition, resulting in increase of action anthropometric and biochemical in the presence of gene mutation.

Frequency of CCR5Δ32 mutation in blood donor candidates from the Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Brazil

The chemokine receptor CCR5 is a major co-receptor for HIV-1 entry into the host cell. Deletion of 32 bp (Δ32) alters the receptor structure and is associated with the protection against infection. The distribution of allelic variant depends on several factors influencing the epidemiology of HIV infections. Thus, the present study sought to estimate the allelic frequency of the CCR5 gene variant / CCR5Δ32 in blood donor candidates with and without positive serology for HIV-1+ at the HEMOAM Foundation. 239 candidates were enrolled and divided into two groups, HIV-1+ (101 individuals) and HIV- controls (138 individuals). After collecting peripheral blood, DNA was extracted and allele-specific PCR for identification of CCR5Δ32 polymorphism, was performed. The results obtained were analyzed using Stata (v.13). The groups were of similar ages, predominantly male and the distribution of genotypes and alleles were in Hardy-Weinberg equilibrium (p=0.725 and p=0.879, respectively). The highest frequency was wild genotype, followed by the heterozygous genotype in both groups (control and the HIV-1+ ). When the frequencies in HIV-1+ subgroups were analyzed, the absence of the allelic variant CCR5Δ32 subgroup ELISA(+) Westen Blot(+) was noted. Therefore, our data indicate that CCR5Δ32 polymorphism has a low frequency in the population studied.

Caracterização do vírus da hepatite C em pacientes com hepatite crônica: genótipos no Estado do Amazonas, Brasil / Characterization of hepatitis C virus in chronic hepatitis patients: genotypes in the State of Amazonas, Brazil

INTRODUÇÃO: No Estado do Amazonas, os dados sobre a prevalência dos genótipos do vírus da hepatite C ainda são escassos. MÉTODOS: Os genótipos do VHC foram determinados em 69 pacientes da Fundação de Medicina Tropical do Amazonas - FMT-AM. O RNA do VHC foi detectado pela técnica de RT-PCR, utilizando-se iniciadores HC11/HC18 para a região 5'não traduzida. RESULTADOS: Dos 69 pacientes, 65,2 por cento era do sexo masculino e 34,8 por cento do feminino. O genótipo 1 foi o mais prevalente, seguidos dos 3 e 2. CONCLUSÕES: Estes dados sugerem que Manaus é uma porta de entrada do vírus VHC no Estado do Amazonas.

INTRODUCTION: In the State of Amazonas, data regarding the prevalence of different genotypes of hepatitis C virus remains scarce. METHODS: The genotype of 69 HCV positive patients was determined. An in-house standardized nested-PCR was used to detect HCV RNA. Genotype assignment was based on type-specific motifs on the sequenced amplicons delimited by primers HC11/HC18 from the 5' untranslated region. RESULTS: Of the 69 patients studied, 65.2 percent were male and 34.8 percent were female. Genotype 1 showed the greatest prevalence, followed by 3 and 2. CONCLUSIONS: These data suggesting that Manaus is the point of arrival of HCV in the State of Amazonas.

Resposta virológica sustentada em pacientes com co-infecção pelos genótipos 1 e 2 do vírus da hepatite C, com apenas nove semanas de terapêutica antiviral: relato de caso / Sustained virological response in patients with coinfection by hepatitis C virus genotypes 1 and 2, after just nine weeks of antiviral therapy: case report

Relata-se um paciente do sexo masculino com 67 anos e sorologia positiva para o vírus da hepatite C (HCV). Exames moleculares revelaram a presença do RNA do HCV, com carga viral de 2.000 cópias/mL e genótipos 1 e 2. O tratamento foi com alfapeginterferon-2a, 180mcg/semana e ribavirina, 1.000mg/dia. Na quarta semana de tratamento, a carga viral para o HCV era indetectável. Na nona semana, o paciente apresentou hematêmese, piora do quadro de astenia, inapetência e comprometimento do estado geral, quando o tratamento foi descontinuado. O PCR foi negativo após 6 meses e permaneceu assim após um ano. O paciente encontra-se assintomático.

A report of a 67 year-old male patient with positive serology for HCV. PCR revealed the presence of HCV RNA, viral load of 2,000 copies/mL and genotypes 1 and 2. The pacient was treated with peginterferon alfa-2a at 180mcg/week and ribavirin at 1,000mg/day. In week four of treatment, HCV viral load was undetectable. In week nine, the patient developed hematemesis, worsening of asthenia, anorexia and impaired general condition, so the treatment was discontinued. The PCR was negative six months and one year after the cessation of treatment. The patient remains asymptomatic.