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1.
Oncol Lett ; 27(4): 179, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38464340

RESUMO

Worldwide, gastric cancer (GC) is estimated to be the fifth most common type of cancer type in both sexes, ranking sixth for new cases, with >640,850 cases per year, and fourth in terms of mortality rate. Cancer presents numerical and structural alterations in chromosomes, often through gains and losses of regions. In GC, there are multiple genetic alterations, in which those located in cytoband 8q24 have been frequently described; essential genes are present in this cytoband, regulating the homeostasis of crucial biological processes, such as the MYC gene, which induces expression of selective genes to promote cell growth and proliferation. Conversely, DNA sequence variations can also occur when a single nucleotide in the genome sequence is altered, and this is termed a single nucleotide polymorphism (SNP). These alterations, which can serve as a biological marker, are present in at least 1% of the population and assist in identifying genes associated with GC. In the present review, 12 genes present in cytoband 8q24 related to GC (NSMCE2, PCAT1, CASC19, CASC8, CCAT2, PRNCR1, POU5F1B, PSCA, JRK, MYC, PVT1 and PTK2) are discussed. The PSCA gene was cited more frequently than others; it has four known SNPs associated with GC (rs2978980, rs2294008, rs2976392 and rs9297976). Thus, these SNPs should be further studied in different populations to determine their risk value in patients with GC.

2.
Mol Med Rep ; 25(5)2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35362543

RESUMO

Gastric cancer (GC) is a common malignancy with the highest mortality rate among diseases of the digestive system, worldwide. The present study of GC alterations is crucial to the understanding of tumor biology and the establishment of important aspects of cancer prognosis and treatment response. In the present study, DNA from Mexican patients with diffuse GC (DGC), intestinal GC (IGC) or non­atrophic gastritis (NAG; control) was purified and whole­genome analysis was performed with high­density arrays. Shared and unique copy number alterations (CNA) were identified between the different tissues involving key genes and signaling pathways associated with cancer. This led to the molecular distinction and identification of the most relevant molecular functions to be identified. A more detailed bioinformatics analysis of epithelial­mesenchymal transition (EMT) genes revealed that the altered network associated with chromosomal alterations included 11 genes that were shared between DGC, IGC and NAG, as well as 19 DGC­ and 7 IGC­exclusive genes. Furthermore, the main molecular functions included adhesion, angiogenesis, migration, metastasis, morphogenesis, proliferation and survival. The present study provided the first whole­genome high­density array analysis in Mexican patients with GC and revealed shared and exclusive CNA­associated genes in DGC and IGC. In addition, a bioinformatics­predicted network was generated, focusing on CNA­altered genes associated with EMT and the hallmarks of cancer, as well as precancerous alterations that may lead to GC. Molecular signatures of diffuse and intestinal GC, predicted bioinformatically, involve common and distinct CNA­EMT genes related to the hallmarks of cancer that are potential candidates for screening biomarkers of GC, including early stages.


Assuntos
Neoplasias Gástricas , Biologia Computacional , Variações do Número de Cópias de DNA , Transição Epitelial-Mesenquimal/genética , Regulação Neoplásica da Expressão Gênica , Humanos , México , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologia
3.
PeerJ ; 9: e12270, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34760355

RESUMO

Infection with Helicobacter pylori is one of the most important risk factors for developing gastric cancer (GC). The type IV secretion system (T4SS) encoded in the cag pathogenicity island is the main virulence factor of H. pylori associated with GC. Additionally, other virulence factors have been shown to play a role in the H. pylori virulence, such as vacuolizing cytotoxin (VacA), urease, flagella, and adhesins. Long-chain fatty acids (LCFAs) are signaling molecules that affect the transcription of virulence genes in several pathogenic bacteria such as Salmonella enterica, Vibrio cholerae, Pseudomonas aeruginosa and Mycobacterium tuberculosis. However, the effect of LCFAs on the transcription of H. pylori virulence and regulatory genes remains unknown. Here we analyzed whether the transcription of virulence genes that encode T4SS and cellular envelope components, flagellins, adhesins, toxins, urease, as well as the transcription of different regulatory genes of the H. pylori strain 26695, are altered by the presence of five distinct LCFAs: palmitic, stearic, oleic, linoleic, and linolenic acids. Palmitic and oleic acids up-regulated the transcription of most of the virulence genes tested, including cagL, cagM, flaB, sabA, mraY and vacA, as well as that of the genes encoding the transcriptional regulators NikR, Fur, CheY, ArsR, FlgR, HspR, HsrA, Hup, and CrdR. In contrast, the other LCFAs differentially affected the transcription of the virulence and regulatory genes assessed. Our data show that LCFAs can act as signaling molecules that control the transcription of the H. pylori virulome.

4.
Oncol Lett ; 20(5): 224, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32968446

RESUMO

Breast cancer (BC) is the most common type of cancer in women worldwide, and despite advances in treatments, its incidence and mortality are increasing. Therefore, it is necessary to develop new, non-invasive tests that provide more accurate diagnosis and prognosis in a timely manner. A promising approach is measuring the presence of biomarkers to detect tumors at various stages and determine their specific characteristics, thus allowing for more personalized treatment. MicroRNAs (miRNAs) serve a role in gene expression, primarily by interacting with messenger RNAs, and may be potential biomarkers for detecting cancer. They are detectable in tissues and blood, including plasma and/or serum, are stable and often tumor specific. Also, different miRNAs are associated with specific BC molecular subtypes. Triple-negative BC (TNBC) is a type of BC in which the primary targets for hormonal therapy are absent. It is an aggressive phenotype, which frequently metastasizes and is associated with an unfavorable prognosis. The present review focuses on circulating miRNAs in patients with TNBC, with an emphasis on their interaction with the immune response checkpoint genes PD-1, PD-L1 and CTLA4. Modulation and response of the immune system are of interest in cancer treatment due to the success of immunotherapy in the treatment of various neoplasms. Based on the findings of this literature review and the in silico analysis performed as part of this review, it is concluded that circulating hsa-miR-195 and hsa-miR-155 in TNBC interact with checkpoint genes involved in the immune response. Further analysis of the expression of these circulating miRNAs and their association with prognosis in patients with TNBC treated with immunotherapy should be assessed to evaluate their possible use as non-invasive predictive biomarkers. In addition, functional studies to analyze biologically relevant targets in the development and prognosis of TNBC, which could be therapeutic targets, are also recommended.

5.
Rev Med Inst Mex Seguro Soc ; 58(2): 154-160, 2020 04 13.
Artigo em Espanhol | MEDLINE | ID: mdl-34101560

RESUMO

BACKGROUND: Cytomegalovirus (CMV) is able to cause serious and even deadly diseases in immunocompromised patients. It is important to have a sensitive, specific and molecular viral tests for its detection, using as targets, key genes for viral replication. The following genes have been used in the molecular detection of CMV: UL122 (replication) and UL83 (most abundant protein of the tegument). OBJECTIVE: Detect and quantify CMV, by real-time duplex PCR, from a minimum amount of plasma. MATERIAL AND METHODS: The UL122 and UL83 genes were amplified with different fluorophores, by real-time duplex PCR. To quantify CMV, curves were generated, starting with DNA-CMV (1.0-0.0000001 ng). RESULTS: The dynamic range of "master" duplex straight had a pendent (m) −3.0, the amplification efficiency was 115.44% plasmas from patients with HIV viral load ≥ 100,000 copies/mL, 11.36% were true positive for CMV and 88.64% had no amplifications or they were outside of the linear range of molecular detection. CONCLUSIONS: This test identified two important CMV genes (UL122 and UL83) in a single reaction (FAM:VIC), viral detection was confirmed from a minimum amount of plasma. This mean a smaller amount of biological sample required and would add a tool to the clinical area, as well as a lower consumption of reagents and materials.


INTRODUCCIÓN: El citomegalovirus (CMV) es capaz de provocar enfermedades graves e incluso mortales en pacientes inmunocomprometidos. Es importante contar con pruebas moleculares de detección viral, sensibles y específicas, utilizando como blanco los genes clave para la replicación viral. En la detección molecular de CMV se han utilizado los genes UL122 (replicación) y UL83 (proteína más abundante del tegumento). OBJETIVO: Detectar y cuantificar el CMV mediante reacción en cadena de la polimerasa (PCR) dúplex en tiempo real, a partir de una mínima cantidad de plasma. MATERIAL Y MÉTODOS: Los genes UL122 y UL83 se amplificaron con diferentes fluoróforos mediante PCR dúplex en tiempo real. Para cuantificar el CMV se generó una recta estándar, a partir de DNA del CMV (1.0-0.0000001 ng). RESULTADOS: El rango dinámico de la «recta maestra¼ tuvo una pendiente (m) de -3.0; la eficiencia de amplificación fue del 115.44%; de los plasmas de pacientes con infección por el virus de la inmunodeficiencia humana (VIH) con una carga viral ≥ 100,000 copias/ml, el 11.36% fueron verdaderos positivos para CMV y el 88.64% no tuvieron amplificaciones o estuvieron fuera del rango lineal de detección molecular. CONCLUSIONES: Esta prueba identificó dos genes importantes del CMV (UL122 y UL83) en una sola reacción (FAM:VIC), y se ratificó la detección viral a partir de una mínima cantidad de plasma. Esto se traduce en una menor cantidad de muestra biológica requerida y sumaría una herramienta al área clínica, así como un menor consumo de reactivos y materiales.


Assuntos
Infecções por Citomegalovirus , Infecções por HIV , Citomegalovirus/genética , Infecções por Citomegalovirus/diagnóstico , DNA Viral , Infecções por HIV/complicações , Humanos , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade
7.
Oncol Lett ; 13(5): 3109-3117, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28521416

RESUMO

Gastric cancer (GC) is the fifth most common type of malignancy and the third leading cause of cancer-associated mortality worldwide. It is necessary to identify novel methods aimed at improving the early diagnosis and treatment of GC. MicroRNA expression profiles in the plasma of patients with GC have demonstrated a potential use in the opportune diagnosis of this neoplasm. However, there are currently no standardized targets for use in the normalization of microRNA Cq values for different neoplasms. The present study tested two normalization approaches while analyzing plasma derived from patients with GC and non-atrophic gastritis. The first method utilized a panel of small nucleolar RNAs (snoRNAs) and a small nuclear RNA (snRNA) provided by a commercial array. The second normalization approach involved the use of hsa-miR-18a-5p and hsa-miR-29a-3p, which were identified by a stability analysis of the samples being tested. The results revealed that the snoRNAs and snRNA were not expressed in all samples tested. Only the stable microRNAs allowed a narrow distribution of the data and enabled the identification of specific downregulation of hsa-miR-200c-3p and hsa-miR-26b-5p in patients with GC. hsa-miR-200c-3p and hsa-miR-26b-5p have been previously linked to cancer, and a Kyoto Encyclopedia of Genes and Genomes analysis demonstrated that these microRNAs were associated with cell adhesion, cell cycle and cancer pathways.

8.
Front Microbiol ; 8: 615, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28443084

RESUMO

Helicobacter pylori is a Gram-negative bacterium that colonizes the human gastric mucosa and causes peptic ulcers and gastric carcinoma. H. pylori strain 26695 has a small genome (1.67 Mb), which codes for few known transcriptional regulators that control bacterial metabolism and virulence. We analyzed by qRT-PCR the expression of 16 transcriptional regulators in H. pylori 26695, including the three sigma factors under different environmental conditions. When bacteria were exposed to acidic pH, urea, nickel, or iron, the sigma factors were differentially expressed with a particularly strong induction of fliA. The regulatory genes hrcA, hup, and crdR were highly induced in the presence of urea, nickel, and iron. In terms of biofilm formation fliA, flgR, hp1021, fur, nikR, and crdR were induced in sessile bacteria. Transcriptional expression levels of rpoD, flgR, hspR, hp1043, and cheY were increased in contact with AGS epithelial cells. Kanamycin, chloramphenicol, and tetracycline increased or decreased expression of regulatory genes, showing that these antibiotics affect the transcription of H. pylori. Our data indicate that environmental cues which may be present in the human stomach modulate H. pylori transcription.

9.
Helicobacter ; 20(3): 223-30, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25582431

RESUMO

BACKGROUND AND AIMS: The biliary tract cancer or cholangiocarcinoma (CCA) represents the sixth leading cause of gastrointestinal tumors in the Western world, and mortality varies across the world, with regions such as Chile, Thailand, Japan, and northeastern India presenting the highest rates. CCA may develop in the bile duct, gallbladder, or ampulla of Vater; and risk factors include obesity, parity, genetic background, geographical and environmental factors. Inflammation induced by bacterial infections might play a role in the pathogenesis of CCA. In this work, we investigated whether there is an association between extrahepatic cholangiocarcinoma (ECCA) and infection with S. typhi, H. hepaticus, or H. bilis in a Mexican population. METHODS: A total of 194 patients were included and divided into 91 patients with benign biliary pathology (controls) and 103 with ECCA (cases). Tumor samples were taken during endoscopic retrograde cholangiopancreatography by biliary brushing, followed by DNA extraction and PCR testing for infections. RESULTS: We found that 44/103 cases were positive for H. bilis, compared with 19/91 controls (p = 0.002; OR 2.83, 95% CI 1.49-5.32), and when analyzed by sub-site, H. bilis infection was significantly more associated with cancer in the common bile duct (p = 0.0005; OR 3.56, 95% CI 1.77-7.17). In contrast, H. hepaticus infection was not different between cases (17/103) and controls (13/91) (p = 0.82; OR 1.19, 95% CI 0.54-2.60). None of the samples were positive for S. typhi infection. CONCLUSION: In conclusion, infection with H. bilis but neither H. Hepaticus nor S. typhi was significantly associated with ECCA, particularly with tumors located in the common bile duct.


Assuntos
Neoplasias dos Ductos Biliares/microbiologia , Neoplasias do Sistema Biliar/microbiologia , Colangiocarcinoma/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter hepaticus/fisiologia , Helicobacter/fisiologia , Adulto , Idoso , Ductos Biliares Extra-Hepáticos/microbiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade
10.
Rev Med Inst Mex Seguro Soc ; 52(6): 624-9, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-25354055

RESUMO

BACKGROUND: Cytomegalovirus is a betaherpesvirus responsible for persistent infections that are generally asymptomatic in healthy individuals. In the absence of an effective immune response, as in neonates, cancer patients, organ transplant recipients, individuals with AIDS, etc., cytomegalovirus may cause severe disease. Early detection of this virus would prevent serious health consequences in immunocompromised patients; it is important to employ sensitive methods and accurate detection to support treatment-related decision making. Real-time molecular methods, such as the polymerase chain reaction, possess higher sensitivity to detect positive samples. METHODS: We compared the sensitivity and specificity of the following detection methods: the endpoint PCR trade-validated method (Pol, viral gene target) and real-time PCR, which detects viral genes Pol (early gene), and pp65 (late gene). We performed a cross-sectional study of 43 human immunodeficiency virus-positive samples. RESULTS: The molecular detection methods in real-time detected a greater number of cytomegalovirus-positive samples than those at the endpoint. CONCLUSIONS: There must be at least two independent cytomegalovirus target-genes in order to make the detection by real-time PCR.


INTRODUCCIÓN: el citomegalovirus es responsable de infecciones persistentes, generalmente asintomáticas en personas sanas pero que en ausencia de una respuesta inmune efectiva puede causar enfermedad severa, por ello es muy importante su detección temprana en los individuos con trastornos de la inmunidad. El objetivo de esta investigación fue hacer un análisis del límite de detección, sensibilidad y concordancia de la reacción en cadena de la polimerasa (PCR) en punto final con los obtenidos con la PCR en tiempo real. MÉTODOS: se realizó un estudio transversal con 43 muestras de plasma humano positivas al virus de la inmunodeficiencia humano, provenientes de individuos de 18 o más años de edad, de uno u otro sexo. Todas las muestras tuvieron una carga viral-VIH mayor a 100 000 copias/mL. Para la PCR en punto final se empleó un método comercial para identificar UL54 (gen viral blanco) y para la PCR en tiempo real se amplificaron fragmentos de los genes UL54 (gen temprano) y UL83 (gen tardío) del citomegalovirus humano. RESULTADOS: mediante PCR en punto final (método comercial-validado) solo tres individuos fueron positivos a citomegalovirus humano (7 %), con una la carga viral de 1500 a 1670 copias/mL. Las muestras positivas a citomegalovirus humano mediante PCR en tiempo real tuvieron un rango de 4.36 a 4692.86 copias de citomegalovirus humano CONCLUSIONES: es necesario tener al menos dos genes blancos de citomegalovirus humano para detectarlo de manera ratificada mediante PCR en tiempo real.


Assuntos
Coinfecção/diagnóstico , Infecções por Citomegalovirus/diagnóstico , Citomegalovirus/isolamento & purificação , DNA Viral/análise , Infecções por HIV/complicações , Reação em Cadeia da Polimerase em Tempo Real , Adolescente , Adulto , Idoso , Coinfecção/sangue , Coinfecção/virologia , Estudos Transversais , Citomegalovirus/genética , Infecções por Citomegalovirus/sangue , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/virologia , Feminino , Infecções por HIV/sangue , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Sensibilidade e Especificidade , Adulto Jovem
11.
Infect Agent Cancer ; 8(1): 12, 2013 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-23557440

RESUMO

BACKGROUND: It has been hypothesized that human cytomegalovirus (HCMV) may be associated with breast cancer progression. However, the role of HCMV infection in breast cancer remains controversial. We aimed to assess whether HCMV genes (UL122 and UL83) could be detected in breast carcinomas and reinvestigated their possible association with breast cancer progression. DNA from paraffin-embedded tissues was analyzed by real-time PCR. We investigated 20 fibroadenomas and 27 primary breast carcinomas (stages II, III, and IV). FINDINGS: Two carcinomas were positive for HCMV, one was positive for two TaqMan viral detection probes, and one was positive for a sole TaqMan viral detection probe (UL83), whereas the remainder of the samples was negative. CONCLUSIONS: Samples studied showed no association between HCMV infection and breast cancer progression.

12.
Arch Virol ; 155(7): 1117-25, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20496089

RESUMO

In third-world countries, dried blood samples (DBS) are a convenient alternative to plasma for monitoring viral load during HIV-1 therapy. In this study, we evaluated the feasibility of using DBS to perform HIV-1 drug resistance genotyping in a ViroSeq assay in which the protease and reverse transcriptase regions of the pol gene are analyzed. Fifty-seven antiretroviral genotypes from plasma samples were tested, and drug resistance genotypes were determined. Only 38.6% paired DBS samples were sequenced. Failure to amplify DNA from DBS samples generally correlated with plasma viral loads below log(10) 5.1. The majority of the mutations identified in plasma pol sequences were also found in their DBS counterpart, with a concordance in genotype interpretation of 96.4%. Several factors were identified that could potentially improve both the sensitivity and the quality of genotype data, such as sample storage conditions and sequence analysis. Therefore, DBS sampling is useful to determine viral load and drug resistance genotypes in HIV patients.


Assuntos
Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral Múltipla , HIV-1/efeitos dos fármacos , HIV-1/genética , Adulto , Idoso , Feminino , Genes pol/genética , Genótipo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , HIV-1/classificação , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/sangue , Carga Viral , Viremia/virologia , Adulto Jovem
13.
Virol J ; 6: 153, 2009 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-19788743

RESUMO

BACKGROUND: Hepatitis B virus (HBV) infection is a problem in several regions of the world with limited resources. Blood samples dried on filter paper (DBS) have been successfully used to diagnose and monitor several infectious diseases. In Mexico there is an urgent need for an affordable and easy sampling method for viral load (VL) testing and monitoring of chronic HBV infection. The purpose of this work was to validate the utility of DBS samples for monitoring HBV infection in patients from Mexico City. METHODS: Matched samples of plasma and DBS on filter paper from 47 HBV infected patients from the Instituto Mexicano del Seguro Social (IMSS), were included. To evaluate the DNA stability and purity from DBS stored at different temperature conditions, samples from ten patients were stored at 4 degree, 25 degree, and 37 degree C for 7 days. After DBS elution and DNA extraction, the purity of these samples was determined measuring the O.D. rate 260/280. The DBS utility for molecular studies was assessed with PCR assays to amplify a 322 bp fragment from the "a" determinant region of the HBV "S" gene. The VL from all samples was determined to evaluate the correlation between plasma and DBS matched samples. RESULTS: The quality of the DNA from DBS specimen is not adversely affected by storage at 4 degree, 25 degree and 37 degree C for up 7 days. Statistical ANOVA analyses did not show any significant difference. The same amplification efficiency was observed between DNA templates from samples stored at different temperatures. The Pearson correlation between the VL from DBS and plasma matched samples was 0.93 (p = 0.01). The SD was 1.48 for DBS vs.1.32 for Plasma, and an average of log10 copies/mL of 5.32 vs. 5.53. ANOVA analysis did not show any statistically significant difference between the analyzed groups (p = 0.92). CONCLUSION: The results provide strong evidence that the isolation and quantification of DNA-HBV from DBS is a viable alternative for patient monitoring, and molecular characterization of the virus variants circulating in Mexico.


Assuntos
Sangue/virologia , Dessecação , Vírus da Hepatite B/isolamento & purificação , Hepatite B/diagnóstico , Manejo de Espécimes/métodos , Adulto , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade , Temperatura , Fatores de Tempo , Adulto Jovem
14.
Virol J ; 4: 6, 2007 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-17217533

RESUMO

BACKGROUND: Hepatitis B virus (HBV) is a small DNA-containing virus with 4 genes, C, S, X and P. The S gene codes for the surface antigen (HBsAg), which contains the "a" determinant, the main region for induction of a protective humoral immune response. To compare the genotype and sequence of the "a" determinant between strains isolated from asymptomatic and symptomatic Mexican HBV carriers. RESULTS: 21 asymptomatic (blood donors) and 12 symptomatic (with clinical signs and with >1 year lamivudine treatment) HBV carriers were studied; all patients were positive for the HBsAg in serum. Viral load, genotypes, and subtypes were determined in plasma. A fragment of the S gene including the "a" determinant was PCR amplified and sequenced to determine genotype, subtype and to identify mutations. Mean viral load was 0.7965 x 104 copies/ml in asymptomatic carriers and 2.73 x 106 copies/ml in symptomatic patients. Genotypes H, C, and F were identified in asymptomatic individuals; whereas H was dominant in symptomatic patients. A fragment of 279 bp containing the "a" determinant was amplified from all 33 carriers and sequences aligned with S gene sequences in the GenBank. Mutations identified were Y100N, T126I, Q129H and N146K in the asymptomatic group, and F93I and A128V in the symptomatic group. CONCLUSION: Differences in genotype and in mutations in the "a" determinant were found between strains from asymptomatic and symptomatic HBV Mexican carriers.


Assuntos
Portador Sadio/virologia , Antígenos de Superfície da Hepatite B/genética , Vírus da Hepatite B/classificação , Vírus da Hepatite B/genética , Hepatite B Crônica/virologia , Adulto , Doadores de Sangue , Portador Sadio/fisiopatologia , DNA Viral/análise , DNA Viral/isolamento & purificação , Feminino , Variação Genética , Genótipo , Antígenos de Superfície da Hepatite B/química , Vírus da Hepatite B/patogenicidade , Hepatite B Crônica/fisiopatologia , Humanos , Masculino , México , Pessoa de Meia-Idade , Mutação , Reação em Cadeia da Polimerase , Carga Viral
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