Hepatitis C as a risk factor for diabetes type 2: lack of evidence in a hospital in central-west Brazil.

In order to assess the importance of HCV infection as a possible risk factor for type 2 diabetes mellitus, a case-control study was conducted, comparing the prevalence of HCV infection among diabetic and non-diabetic patients. Diabetic outpatients attending to a University Hospital in Central-West Brazil were evaluated between April and October 2005. A control group composed by patients from the same institution was matched by gender and age. Candidates to control group were included only if fasting glucose measures were under 100 mg/dL. Diabetics and controls had blood samples taken in order to test for antibodies against HCV (anti-HCV) by enzyme-immunoassay. Polymerase chain reaction and immunoblot were performed to confirm the anti-HCV status. Each group included 206 participants. Despite of the groups were in general comparable. The diabetics had a greater body mass average and smaller family income. The prevalence of confirmed anti-HCV in the diabetic group was of 1.4%, which was similar to the controls (1%). Finding statistical difference may have been hampered by the low frequency of HCV infection in both groups. It was not possible to demonstrate a role of HCV as an etiologic factor in type 2 diabetes, since HCV infected patients represented a small portion of the overall diabetes cases. This finding does not allow to recommend regular screening for HCV infection in type 2 diabetics in this region.

Hepatitis C as a risk factor for diabetes type 2: lack of evidence in a hospital in central-west Brazil

In order to assess the importance of HCV infection as a possible risk factor for type 2 diabetes mellitus, a case-control study was conducted, comparing the prevalence of HCV infection among diabetic and non-diabetic patients. Diabetic outpatients attending to a University Hospital in Central-West Brazil were evaluated between April and October 2005. A control group composed by patients from the same institution was matched by gender and age. Candidates to control group were included only if fasting glucose measures were under 100 mg/dL. Diabetics and controls had blood samples taken in order to test for antibodies against HCV (anti-HCV) by enzyme-immunoassay. Polymerase chain reaction and immunoblot were performed to confirm the anti-HCV status. Each group included 206 participants. Despite of the groups were in general comparable. The diabetics had a greater body mass average and smaller family income. The prevalence of confirmed anti-HCV in the diabetic group was of 1.4 percent, which was similar to the controls (1 percent). Finding statistical difference may have been hampered by the low frequency of HCV infection in both groups. It was not possible to demonstrate a role of HCV as an etiologic factor in type 2 diabetes, since HCV infected patients represented a small portion of the overall diabetes cases. This finding does not allow to recommend regular screening for HCV infection in type 2 diabetics in this region.

Epidemiological aspects of hepatitis C virus infection among HIV-infected individuals in Mato Grosso State, Central Brazil.

The present study has been carried out to estimate the prevalence of HCV among HIV-positive individuals in the state of Mato Grosso, Central Brazil, as well as to identify the associated epidemiological factors. One thousand and eight individuals over 18 years of age bearing HIV/aids and being attended in the reference public health network of the state of Mato Grosso participated in this research. HIV-positive subjects were interviewed and blood samples were taken to be tested for anti-HCV antibodies by enzyme immunoassay (EIA). The anti-HCV antibodies were investigated in all the individuals by immunoenzymatic assay. The reactive samples in duplicate were submitted to a polymerase chain reaction (PCR) to detect HCV-RNA. The positive tests were submitted for genotyping by the LIA method. One hundred and ten (10.9%; CI 95%: 9.1-13.0) HIV-positive individuals presented anti-HCV by EIA. The PCR was positive in 60 (6.0%; CI 95%: 4.6-7.6) individuals. The 1a genotype was the most frequent, followed by the 3a and 1b. The genotype 2 was found in only one individual. There were more male and intravenous drug users among HIV-HCV coinfected individuals when compared to only HIV-infected individuals. Multivariate analysis revealed an association between the HIV-HCV coinfection, regarding either EIA or PCR results, and the use of intravenous drugs, the presence of tattoos, and having received blood transfusions before 1994. There was no association of the coinfection with the variables related to sexual transmission. The relatively low prevalence of HCV infection in the HIV-positive population in that region may be a consequence of a small number of intravenous drug users in the sample, despite a strong association between HCV infection and use of intravenous drugs.

Molecular screening shows extensive HIV-1 genetic diversity in Central West Brazil.

BACKGROUND: Information is limited about HIV-1 subtypes circulating in less populated Brazilian areas where the AIDS epidemic is expanding, such as in the Central West region. OBJECTIVE: To describe HIV-1 subtypes in patients from the States of Goias, Mato Grosso do Sul and Mato Grosso in Central West Brazil. STUDY DESIGN: Heteroduplex mobility analysis of nested-PCR products from env (primers: ED5/ED12, ES7/ES8) and gag regions (primers: H1P202/H1G777, H1Gag1584/g17) of 406 HIV-1 isolates from Goias (n=271), Mato Grosso do Sul (n=85) and Mato Grosso (n=50) collected from 2001 to 2004. RESULTS: Median age of patients was 26 years (1-79 range), 68.7% (279/406) females, 69.9% (269/385) sexual exposure, 14.3% parenteral risk, 15.8% vertical cases. Overall 69.9% (284/406) of HIV-1 subtypes were concordant B(env)/B(gag), 1.7% F(env)/F(gag) and 1% C(env)/C(gag). Discordant HIV-1 isolates were 14.5% (59/406), mainly B(env)/F(gag) and F(env)/B(gag) (49/59); five were B(env)/D(gag), four B(env)/C(gag) and one C(env)/D(gag). B/B and discordant B/F isolates were detected among all risk categories and among children and adults. CONCLUSION: Extensive genetic diversity of HIV-1 was observed in Central West Brazil. Continued molecular studies should monitor the changing dynamics of HIV-1 over time especially in areas where the epidemic is growing.

Distribution of hepatitis C virus genotypes among blood donors from mid-west region of Brazil.

In order to investigate the hepatitis C virus (HCV) genotypes in mid-west region of Brazil, 250 anti-HCV positive blood donors were studied. Among them, the anti-HCV serological status was confirmed in 205 (82%). HCV RNA was detected in 165 samples, which were genotyped. HCV types 1, 2 and 3 were found in 67.9%, 3% and 29.1% of the donors, respectively. In Goiás state, subtype 1a (50%) was the most prevalent, followed by subtypes 3a (30.9%) and 1b (16.7%). In Mato Grosso state, subtype 1a was also predominant (41%), followed by subtypes 1b (29.5%) and 3a (25%). In Mato Grosso do Sul state, subtypes 1a and 1b were detected equally (36.8%), followed by 3a (21.1%). Subtype 2b was rare (2.4%, 4.5% and 5.3%, respectively). In Distrito Federal, subtype 3a (39%) was more frequent than 1a (31.7%) and the remaining (29.3%) belonged to subtype 1b.

Hepatitis B Virus infection in HIV-positive population in Brazil: results of a survey in the state of Mato Grosso and a comparative analysis with other regions of Brazil.

BACKGROUND: End-stage liver disease is currently a major concern among HIV-positive individuals due to co-infection with hepatotropic virus. Hepatitis C has been pointed out as a remarkable factor for that. More recently, hepatitis B virus (HBV) infection has also been found to play a role on liver disease in this population. HIV-HBV co-infection prevalence remains largely unknown in vast areas of Brazil. The objective of the present study was to estimate the prevalence of HBV and HDV infection in HIV-infected subjects living in the state of Mato Grosso, in the Central region of Brazil, and compare it to other Brazilian studies. We also assess epidemiologic data regarding risk factors and vaccinal status. METHODS: HIV-positive individuals followed at the Central Laboratory of the Department of Public Health of Mato Grosso in the city of Cuiabá composed the sample. Participants answered a specific questionnaire and had a blood sample taken and tested for serologic markers. RESULTS: A thousand individuals were interviewed and tested for HBsAg, anti-HBc, anti-HBs and anti-HDV if positive for HBsAg. Measurements of CD4 and viral load for HIV-1 were also performed. Overall prevalence of HBV exposure (anti-HBc +ve) was 40.0%, and 3.7% for HBsAg. This prevalence data was similar or slightly lower than for other Brazilian regions, which ranged from 40% and 3% to 71% and 24%, respectively. Testing for anti-HDV in the 37 HBsAg positive patients was positive in only one subject. Factors that showed independent association with HBV exposure, after adjustment, were: male gender, older age groups, tattooing, and reporting more than ten sexual partners throughout life (p < 0.01). Eighty-one (27.5%) out of 291 HBV-unexposed individuals who reported vaccination were anti-HBs positive. Anti-HBs prevalence was higher among those who had higher levels of CD4 by multivariate analysis. CONCLUSION: Our data showed HBV infection prevalence similar or slightly lower than that reported in other regions of Brazil. In addition, our data revealed a less important role for drug injection in the spread of HIV and HBV in Mato Grosso compared to other regions of the country. The high rate of non-vaccinated subjects among this HBV-unexposed, HIV-infected population is a matter of considerable health concern in this region. The relationship between CD4 levels and HBV vaccine response found in the present study reinforces the need of keeping health care workers alert to this issue.

Distribution of hepatitis C virus genotypes among blood donors from mid-west region of Brazil

Com objetivo de determinar os genótipos do vírus da hepatite C (HCV) circulantes na Região Centro-Oeste do Brasil, 250 doadores de sangue anti-HCV positivos foram estudados. Dentre eles, a positividade para anti-HCV foi confirmada em 205 (82%). O RNA-HCV foi detectado em 165 amostras, as quais foram genotipadas. Os tipos 1, 2 e 3 do HCV foram encontrados em 67,9%, 3% e 29,1% dos doadores, respectivamente. No Estado de Goiás, o subtipo 1a (50%) foi o mais prevalente, seguido pelos subtipos 3a (30,9%) e 1b (16,7%). No Estado de Mato Grosso, o subtipo 1a (41%) foi também predominante, seguido pelos subtipos 1b (29,5%) e 3a (25%). No Estado de Mato Grosso do Sul, os subtipos 1a e 1b foram igualmente detectados (36,8%), seguidos por 3a (21,1%). O subtipo 2b foi raro (2,4%, 4,5% e 5,3%, respectivamente). No Distrito Federal, o subtipo 3a (39%) foi mais freqüente que 1a (31,7%), sendo o restante (29,3%) identificado como subtipo 1b.