Performance of rapid test for antibodies to hepatitis C virus (anti-HCV) in hemodialysis patients and kidney transplant recipients.

Rapid tests (RT) have been widely used for screening of hepatitis C virus (HCV) in general population, but its performance in hemodialysis (HD) patients and mainly in kidney-transplant recipients (RTx) is less known. The aim of this study was to evaluate the accuracy of RT for detection of anti-HCV in HD and RTx patients. Patients were prospectively included subdivided in four groups according to the positivity for anti-HCV detected by conventional serology: (1) HD patients anti-HCV +, (2) HD patients anti-HCV -, (3) RTx patients anti-HCV +, and (4) RTx patients anti-HCV -. All patients were retested for HCV using the commercial kit Alere HCV® Bioeasy Rapid Test (Bioeasy Diagnóstica LTDA-Minas Gerais, Brazil) in capillary whole blood samples. During the period of study were included 46 HD patients anti-HCV+, 62 HD patients anti-HCV -, 53 RTx patients anti-HCV + and 56 RTx patients anti-HCV -. In patients on HD, the RT showed sensitivity (S), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy of 100%. In RTx patients, S of 96%, SP of 100%, PPV of 100% and NPV of 97% were found (accuracy of 98%). In conclusion, in patients on HD there was 100% agreement between RT and the conventional immunoassay. In the RTx group, although the agreement was not 100%, the RT performed very well when compared to conventional serology. This study demonstrates that the RT can be an alternative to conventional serology in HCV screening of patients on HD and RTx.

Doença hepática gordurosa não alcoólica em pacientes com índice de massa corporal normal: etiologia e fatores de risco associados em um hospital terciário / Non-alcoholic fatty liver disease in patients with normal body mass index: etiology and associated risk factors in a tertiary hospital

Introdução: A prevalência de doença hepática gordurosa não alcoólica (DHGNA) está aumentando, inclusive em pacientes não obesos. O presente estudo tem como objetivo determinar a prevalência de pacientes com peso normal e com esteatose não alcóolica, determinar a frequência de esteatose primária e secundária e comparar os fatores de risco conforme o índice de massa corporal (IMC). Métodos: Estudo transversal que avaliou pacientes com evidência de esteatose em exames de imagem. Foram avaliados dados demográfi cos, perfil virológico e lipídico, provas de função hepática; os dados foram comparados entre grupos subdivididos de acordo com IMC (<25 e ≥25). Resultados: A percentagem de pacientes com esteatose e IMC normal foi de 10,9%. Não houve diferença na prevalência de Diabetes melitus tipo 2, hipertensão arterial sistêmica ou tabagismo entre os grupos. Causas secundárias de esteatose foram encontradas em 12 pacientes (09 com hepatite C, 01 com doença celíaca, 01 com hepatite autoimune e 01 com hemocromatose). Houve um percentual maior de causas secundárias específicas no grupo com IMC <25. Conclusão: Em pacientes com esteatose e sem sobrepeso/obesidade, fatores secundários sempre devem ser investigados (AU)

Introduction: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing, even in non-obese patients. This study aims to determine the prevalence of normal-weight patients with non-alcoholic steatosis, determine the frequency of primary and secondary steatosis, and compare risk factors according to the body mass index (BMI). Methods: Cross-sectional study that evaluated patients with evidence of steatosis on imaging. Demographics, virologic and lipid profiles, and liver function tests were evaluated; the data were compared between groups divided according to BMI (<25 and ≥25). Results: The percentage of patients with normal BMI and steatosis was 10.9 %. There was no difference in the prevalence of diabetes mellitus type 2, hypertension or smoking between the groups. Secondary causes of steatosis were found in 12 patients (09 with HCV, 01 with celiac disease, 01 with autoimmune hepatitis, and 01 with hemochromatosis). There was a higher percentage of specifi c secondary causes in the group with BMI <25. Conclusion: In patients with steatosis and without overweight/obesity, secondary factors should always be investigated (AU)

Progression of liver fibrosis in monoinfected patients by hepatitis C virus and coinfected by HCV and human immunodeficiency virus.

CONTEXT: The progression of liver fibrosis in patients coinfected by hepatitis C virus and human immunodeficiency virus (HCV/HIV) has been increasingly studied in the past decade. Studies made before the highly active antiretroviral therapy suggest that HIV can change the natural history of the HCV infection, leading to a faster progression of the liver fibrosis. OBJECTIVE: To evaluate and compare the fibrosis progression in two groups of patients (HCV/HIV coinfected and HCV monoinfected) METHODS: Seventy patients HCV monoinfected and 26 patients HCV/HIV coinfected who had not undertaken HCV treatment and were submitted to serial percutaneous liver biopsies were retrospectively evaluated. There was no difference in the fibrosis progression between the two groups. CONCLUSION: The fibrosis grade evolution was not worse in the coinfected patients. The immunosuppression absence and the shortest time period between the biopsies in the coinfected group are possible explanations.

Progression of iiver fibrosis in monoinfected ptients by hepatitis c virus andd coinfected by hcv and human immunodeficiency virus

Context The progression of liver fibrosis in patients coinfected by hepatitis C virus and human immunodeficiency virus (HCV/HIV) has been increasingly studied in the past decade. Studies made before the highly active antiretroviral therapy suggest that HIV can change the natural history of the HCV infection, leading to a faster progression of the liver fibrosis. Objective To evaluate and compare the fibrosis progression in two groups of patients (HCV/HIV coinfected and HCV monoinfected) Methods Seventy patients HCV monoinfected and 26 patients HCV/HIV coinfected who had not undertaken HCV treatment and were submitted to serial percutaneous liver biopsies were retrospectively evaluated. There was no difference in the fibrosis progression between the two groups. Conclusion The fibrosis grade evolution was not worse in the coinfected patients. The immunosuppression absence and the shortest time period between the biopsies in the coinfected group are possible explanations. .

Contexto A progressão da fibrose hepática em pacientes coinfectados pelos vírus da hepatite C (VHC) e da imunodeficiência humana (VHC/HIV) tem sido mais estudada na última década. Estudos realizados antes da terapia antiretroviral de alta potência (HAART) sugerem que o HIV pode mudar a história natural da infecção pelo VHC, levando a uma progressão mais rápida da fibrose hepática. Objetivo Avaliar e comparar a progressão de fibrose em duas populações de pacientes (coinfectados VHC/HIV e monoinfectados VHC). Métodos Foram avaliados retrospectivamente 70 pacientes monoinfectados VHC e 26 coinfectados VHC/HIV nunca tratados para o VHC e que haviam realizado duas biopsias hepáticas seriadas. Não houve diferença na progressão de fibrose entre os dois grupos. Conclusão A evolução do grau de fibrose não foi pior nos pacientes coinfectados. A ausência de imunodepressão e o menor intervalo de tempo entre as biopsias no grupo de coinfectados são possíveis justificativas. .