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‣ The ongoing impacts of hepatitis C - a systematic narrative review of the literature

Miller, E.; McNally, S.; Wallace, J.; Schlichthorst, M.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
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BACKGROUND: Many countries have developed, or are developing, national strategies aimed at reducing the harms associated with hepatitis C infection. Making these strategies relevant to the vast majority of those affected by hepatitis C requires a more complete understanding of the short and longer term impacts of infection. We used a systematic approach to scope the literature to determine what is currently known about the health and psychosocial impacts of hepatitis C along the trajectory from exposure to ongoing chronic infection, and to identify what knowledge gaps remain. METHODS: PubMed, Current Contents and PsychINFO databases were searched for primary studies published in the ten years from 2000-2009 inclusive. Two searches were conducted for studies on hepatitis C in adult persons focusing on: outcomes over time (primarily cohort and other prospective designs); and the personal and psychosocial impacts of chronic infection. All retrieved studies were assessed for eligibility according to specific inclusion/exclusion criteria, data completeness and methodological coherence. Outcomes reported in 264 included studies were summarized, tabulated and synthesized. RESULTS: Injecting drug use (IDU) was a major risk for transmission with seroconversion occurring relatively early in injecting careers. Persistent hepatitis C viraemia...

‣ White cell count and platelet count associate with histological alcoholic hepatitis in jaundiced harmful drinkers

Hardy, T.; Wells, C.; Kendrick, S.; Hudson, M.; Day, C.; Burt, A.; Masson, S.; Stewart, S.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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Background: Patients with suspected alcoholic hepatitis and a Discriminant Function ≥32 underwent liver biopsy to confirm the diagnosis. Of these (n = 58), 43 had histological features of alcoholic hepatitis and 15 (25%) did not. We aimed to determine the laboratory features that differentiated those patients with a histological diagnosis of alcoholic hepatitis from those without, and assess potential clinical utility. Methods: Laboratory investigations at presentation for each of the histologically confirmed cases of alcoholic hepatitis (n = 43) were compared to those without (n = 15) to determine whether there were differences between the two groups. Univariate analysis was by Mann Whitney U Test and Multivariate analysis was by a stepwise approach. Results: White cell count (16.2 ± 10.5 v 6.9 ± 3.5 (× 109/L); p = 0.0001) and platelet count (178 ± 81 v 98.4 ± 43 (× 109/L); p = 0.0005) were higher in the patients with histological features of alcoholic hepatitis than in those without. The area under the ROC curve for AH diagnosis was estimated to be 0.83 (0.73, 0.94) and 0.81 (0.69, 0.93) for white cell count and platelet count respectively. Conclusions: Clinicians cannot accurately differentiate patients with or without alcoholic hepatitis without liver biopsy. This is critically important when deciding on specific therapies such as corticosteroids or when interpreting data from future trials in which biopsy is not mandated. In situations where liver biopsy is unsuitable or unavailable the white cell and platelet counts can be used to determine the likelihood of histological alcoholic hepatitis and guide treatment.; Timothy Hardy...

‣ Therapie der chronischen Hepatitis B Virus Infektion:Geno- und phänotypische Analyse der Selektion von Resistenzmutationen unter antiviraler Therapie mit Nukleos/tidanaloga; Treatment of chronic hepatitis B: Genotypic and phenotypic analysis of the selection of HBV drug-resistant mutants under antiviral therapy with nucleoside/nucleotide analogues

Walker, Christine
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
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Hintergrund und Ziel: Die HBV-Infektion zählt mit 400 Millionen chronisch infizierten Menschen zu den häufigsten Infektionskrankheiten weltweit. Der therapeutische Einsatz der Immunmodulatoren Interferon-alpha (IFN-alpha) und pegyliertes Interferon-alpha (PEG-IFN-alpha) sowie der antiviralen Medikamente, den Nukleos/tidanaloga ist durch ein breites Nebenwirkungsspektrum, bzw. die Selektion von Resistenzmutationen limitiert. Da die Selektion von Resistenzmutationen zur Progression der Lebererkrankung führen kann, hat die Untersuchung und Charakterisierung der Selektion von Resistenzmutationen für das antivirale Therapiemanagement der chronischen HBV-Infektion weitreichende klinische Konsequenzen. Dementsprechend sollte im Rahmen dieser Arbeit das Vorkommen und die Selektion von Resistenzmutationen gegenüber Nukleos/tidanaloga, insbesondere dem Nukleotidanalogon Adefovir dipivoxil (Hepsera®) (ADV) untersucht werden. Unter ADV-Monotherapie ist die Selektion von bislang zwei publizierten Mutationen (rtN236T und rtA181V) bekannt. Patienten und Methodik: Für die Untersuchung eines ADV-induzierten Resistenzprofils wurde im Rahmen dieser Arbeit HBV-DNA aus Seren von 276 Patienten eines ausgewählten Patientenkollektivs isoliert und molekulargenetisch analysiert. Die Mutationsanalyse erfolgte durch Sequenzierung der mittels PCR amplifizierten reverse Transkriptasedomänen...

‣ Prevalence of hepatitis C virus in Brazil’s inmate population: a systematic review

Magri,Mariana Cavalheiro; Ibrahim,Karim Yaqub; Pinto,Walkyria Pereira; França,Francisco Oscar de Siqueira; Bernardo,Wanderley Marques; Tengan,Fátima Mitiko
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 Português
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OBJECTIVE To estimate the prevalence of hepatitis C virus infection in Brazil’s inmate population.METHODS Systematic review on hepatitis C virus infection in the inmate population. Brazilian studies published from January 1, 1989 to February 20, 2014 were evaluated. The methodological quality of the studies was assessed using a scale of 0 to 8 points.RESULTS Eleven eligible studies were analyzed and provided data on hepatitis C virus infection among 4,375 inmates from seven states of Brazil, with a mean quality classification of 7.4. The overall hepatitis C virus prevalence among Brazilian inmates was 13.6% (ranging from 1.0% to 41.0%, depending on the study). The chances of inmates being seropositive for hepatitis C virus in the states of Minas Gerais (MG), Sergipe (SE), Mato Grosso do Sul (MS), Rio Grande do Sul (RS), Goiás (GO) and Espirito Santo (ES) were 84.0% (95%CI 0.06;0.45), 92.0% (95%CI 0.04;0.13), 88.0% (95%CI 0.09;0.18), 74.0% (95%CI 0.16;0.42), 84.0% (95%CI 0.08;0.31) and 89.0% (95%CI 0.01;0.05) respectively, lower than that observed in the Sao Paulo state (seroprevalence of 29.3%). The four studies conducted in the city of Sao Paulo revealed a lower prevalence in more recent studies compared to older ones.CONCLUSIONS The highest prevalence of hepatitis C virus infection in Brazil’s inmate population was found in Sao Paulo...

‣ INTERMEDIATE ENDEMICITY OF HEPATITIS A VIRUS INFECTION IN RURAL SETTLEMENT PROJECTS OF SOUTHWEST GOIÁS, BRAZIL

PINHEIRO,Raquel Silva; ARAÚJO,Lyriane Apolinário de; CAETANO,Karlla Antonieta Amorim; MATOS,Marcos André de; CARNEIRO,Megmar Aparecida dos Santos; TELES,Sheila Araújo
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2015 Português
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BackgroundRural populations present an elevated risk of exposure to hepatitis A virus.ObjectiveThe objective of this study was to estimate the prevalence and risk factors associated with hepatitis A virus infection among residents of rural settlement projects of southwest Goiás, Central Brazil.MethodsA total of 466 residents were interviewed and tested for the detection of anti- hepatitis A virus antibodies by ELISA.ResultsThe global prevalence of anti- hepatitis A virus was 82.2%. In individuals aged 5-9 years and 10-19 years, the prevalence was 15% and 58.8%, respectively. Persons in the 10-19 age group, with a history of life in encampments, with more than five people per residence consuming well water, were predictors for exposure to hepatitis A virus.ConclusionOur results suggest that the hepatitis A virus endemicity in rural settlements in southwest Goiás similar to that found in the urban population of the Midwest Region, confirming the implementation of universal hepatitis A vaccination in children.

‣ Equity in primary health care delivery: an examination of the cohesiveness of strategies relating to the primary healthcare system, the health workforce and hepatitis C

Scarborough, J.; Eliott, J.; Miller, E.; Aylward, P.
Fonte: CSIRO Publishing Publicador: CSIRO Publishing
Tipo: Artigo de Revista Científica
Publicado em //2015 Português
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OBJECTIVE: To suggest ways of increasing the cohesiveness of national primary healthcare strategies and hepatitis C strategies, with the aim of ensuring that all these strategies include ways to address barriers and facilitators to access to primary healthcare and equity for people with hepatitis C. METHODS: A critical review was conducted of the first national Primary Healthcare System Strategy and Health Workforce Strategy with the concurrent Hepatitis C Strategy. Content relating to provision of healthcare in private general practice was examined, focussing on issues around access and equity. RESULTS: In all strategies, achieving access to care and equity was framed around providing sufficient medical practitioners for particular locations. Equity statements were present in all policies but only the Hepatitis C Strategy identified discrimination as a barrier to equity. Approaches detailed in the Primary Healthcare System Strategy and Health Workforce Strategy regarding current resource allocation, needs assessment and general practitioner incentives were limited to groups defined within these documents and may not identify or meet the needs of people with hepatitis C. CONCLUSIONS: Actions in the primary healthcare system and health workforce strategies should be extended to additional groups beyond those listed as priority groups within the strategies. Future hepatitis C strategies should outline appropriate...

‣ Hepatitis C and hepatitis B virus infection in different hemodialysis units in Belo Horizonte, Minas Gerais, Brazil

Busek,Solange U; Babá,Élio H; Tavares Filho,Hélcio A; Pimenta,Lermíno; Salomão,Abraão; Corrêa-Oliveira,Rodrigo; Oliveira,Guilherme C
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2002 Português
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The prevalence, virological and epidemilogical aspects of the hepatitis C virus (HCV) and the hepatitis B virus (HBV) infections vary among hemodialysis patients in different countries. Aiming at analyzing these aspects of HCV and HBV infections in hemodialysis patients in Belo Horizonte, MG, Brazil, we studied three hemodialysis units including 434 patients. Serology was used to detect anti-HCV and HBsAg. Reverse trancriptase nested polymerase chain reaction (RT-nested-PCR) of the 5'-noncoding region was used to detect circulating HCV RNA and restriction fragment length polymorphism analysis for genotyping. Seroprevalence varied from 26.5% to 11.1% for hepatitis C and from 5.9% to 0% for hepatitis B. Risk factors observed for HBV and/or HCV infections were the number of patients per dialysis unit, duration of treatment, number of clinics attended, number of blood units transfused, and lower level scholarity. Alanine aminotransferase levels were altered with a higher frequency in HBV or HCV seropositive patients. Half of ten patients, negative for anti-HCV, had detectable viremia by RT-nested-PCR, indicating that this technique should be used to confirm infections in this group of patients. The HCV genotype 1 was the most frequently observed...

‣ Survival analysis of acquired immune deficiency syndrome patients with and without hepatitis C virus infection at a reference center for sexually transmitted diseases/acquired immune deficiency syndrome in São Paulo, Brazil

Alencar,Wong Kuen; Duarte,Paulo Schiavom; Waldman,Eliseu Alves
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 Português
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INTRODUCTION: Survival of patients with acquired immune deficiency syndrome has improved with combination antiretroviral therapy; mortality due to liver diseases, however, has also increased in these patients. OBJECTIVES: To estimate the accumulated probability of survival in human immunodeficiency virus-hepatitis C virus coinfected and non-coinfected patients and to investigate factors related to acquired immune deficiency syndrome patients' survival. METHODS: Non-concurrent cohort study using data from surveillance information systems of acquired immune deficiency syndrome patients over 13 years of age. Hepatitis C and B, human immunodeficiency virus exposure category, CD4+ T cell count, age group, schooling, race, sex, and four acquired immune deficiency syndrome diagnosis periods were studied. Kaplan-Meier survival analysis and Cox model with estimates of the hazard ratio and 95% confidence interval were used. RESULTS: Of the total 2864 individuals included, with median age was 35 years, 219 died (7.5%), and 358 (12.5%) were human immunodeficiency virus-hepatitis C virus coinfected. The accumulated probability of survival in human immunodeficiency virus-hepatitis C virus coinfected patients, after acquired immune deficiency syndrome diagnosis...

‣ Situación actual de la hepatitis B en Chile

Vera, Lilian; Valenzuela B., M. Teresa; Mora, Judith; Pereira S., Ana
Fonte: Sociedad Médica de Santiago Publicador: Sociedad Médica de Santiago
Tipo: Artículo de revista
Português
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Hepatitis B virus infection generates carriers and 8% will evolve to a chronic phase. Aim: To perform a compilation of studies on hepatitis B in Chile and other sources of information to estimate the impact of this disease in our country. Material and methods: Published and unpublished evidence about the infection, in the general population and risk groups in our country, was compiled and reviewed critically. Informal interviews to experts, revision of the mandatory notification book of the Ministry of Health and collection of data from laboratories that study hepatitis B virus, were also carried out. Results: The seroprevalence of chronic carriers in blood donors is nearly 0.3%. Among risk groups such as health care personnel, the figure is 0.7%, among homosexuals 29%, among HIV positive patients 30%, among sexual workers 2% and among children with chronic hemodialysis, 9%. Prevalence rate according to notified cases in 2004 was 1.8 x 100,000 habitants. Detection of viral hepatitis B surface antigen in laboratories occurs in 0.2% of donors and 1.3% of non donors. Conclusions: The seroprevalence of hepatitis B virus, the lack of notification, and the introduction of hepatitis B vaccine to our Regular Program of Immunizations...

‣ Tratamiento de la hepatitis alcohólica grave corticoides frente a nutrición enteral : efectos a corto y largo plazo /

Rodríguez Iglesias, Pilar
Fonte: Bellaterra : Universitat Autònoma de Barcelona, Publicador: Bellaterra : Universitat Autònoma de Barcelona,
Tipo: Tesis i dissertacions electròniques; info:eu-repo/semantics/doctoralThesis Formato: application/pdf
Publicado em //2002 Português
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Descripció del recurs: 13 març 2002; Títol obtingut de la pantalla digitalitzada; Antecedentes: El espectro clínico de la hepatitis alcohólica es muy variable, desde formas leves, que se recuperan fácilmente con la abstinencia enólica, hasta formas graves, en las que la tasa de mortalidad puede llegar hasta el 40%. En las últimas tres décadas se han ensayado numerosas estrategias terapéuticas, y los corticosteroides se han investigado ampliamente. A pesar de que algunos estudios no observan un efecto beneficioso, los corticoides continúan siendo el único tratamiento recomendado en la actualidad para los pacientes con hepatitis alcohólica grave. En estos pacientes malnutridos y anoréticos, el tratamiento nutricional también se ha mostrado eficaz. Sin embargo, no existen estudios que comparen la eficacia de ambos tratamientos en la hepatitis alcohólica grave. Por este motivo, hemos realizado este estudio aleatorizado sobre los efectos a corto y largo plazo del tratamiento con nutrición enteral o con corticoides en este grupo de pacientes. Métodos: Se aleatorizaron 71 pacientes (índice de Maddrey >32 y/o encefalopatía) para recibir 40 mg/día de prednisolona (n = 36) o nutrición enteral continua por sonda de alimentación (2000 Kcal/día) durante 28 días (n = 35)...

‣ Informação de profissionais de saúde sobre transmissão transfusional de hepatites virais; Health providers' knowledge on transfusion-transmitted viral hepatitis

Gaze, Rosangela; Carvalho, Diana Maul de; Tura, Luiz Fernando Rangel
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf; application/pdf
Publicado em 01/10/2006 Português
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OBJETIVO: O treinamento de profissionais de saúde é uma estratégia para garantir a qualidade da atenção à saúde que deve respeitar a adequação técnica dos conteúdos e o universo conceitual dos treinandos. Efetuou-se estudo piloto para explorar a consistência da informação dos profissionais da atenção básica acerca da transmissão transfusional das hepatites virais. MÉTODOS: Aplicou-se questionário anônimo e voluntário a 190 profissionais de curso de especialização em saúde pública, entre 2003 e 2004. Os dados foram analisados segundo dois grupos ocupacionais: médicos, enfermeiros e dentistas (com 115 sujeitos;) e outros profissionais da saúde (com 66 indivíduos), comparando-se as freqüências das respostas certas e erradas de cada subgrupo pelo chi2. Nove sujeitos não informaram a ocupação. RESULTADOS: Dos profissionais avaliados, 80% eram mulheres, de 22 a 60 anos, procedentes das regiões: Nordeste (27,4%), Sudeste (35,3%) e Centro-Oeste (37,3%). A hemotransfusão foi associada às hepatites B e C por 57,5% dos respondentes; hemofilia foi associada às hepatites B e C por 55,7% dos respondentes. Dos respondentes, 74% discordaram da proposição de que as "hepatites virais não se transmitem, atualmente...

‣ A influência do genoma humano no curso das hepatites virais crônicas; The influence of the human genome on chronic viral hepatitis outcome

Andrade Júnior, Dahir Ramos de; Andrade, Dahir Ramos de
Fonte: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo Publicador: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/06/2004 Português
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Os mecanismos que determinam o clearance ou a persistência da infecção viral nas hepatites virais crônicas não estão ainda bem identificados. O progresso no conhecimento sobre as ferramentas genéticas moleculares tem permitido detectar variações na resposta imune, que freqüentemente são associadas com polimorfismos do genoma humano. As diferenças na susceptibilidade do hospedeiro para as doenças infecciosas e a intensidade das doenças não podem ser atribuídas apenas à virulência do agente microbiano. Neste artigo são discutidos vários avanços recentes no conhecimento sobre a influência dos genes humanos nas hepatites crônicas B e C, a saber: a) As associações entre os polimorfismos HLA e a susceptibilidade ou resistência às doenças hepáticas virais; b) Alelos protetores influenciando as hepatites virais B (HVB) e C (HVC); c) Alelos prejudiciais influenciando HVB e HVC; d) Genes candidatos associados com a evolução clínica de HVB e HVC (genes que influenciam as células estreladas do fígado, a produção de TGF-beta1 e TNF-alfa, os depósitos de ferro hepáticos, a produção de angiotensina II, entre outros). O conhecimento das associações genéticas com as hepatites virais crônicas pode fornecer indícios para o pleno entendimento de como se desenvolvem as suas complicações terminais...

‣ Marcadores serológicos y factores de riesgo para los virus de la hepatitis B y C en individuos infectados por el VIH; Serological markers and risk factors for hepatitis B and C viruses in patients infected with human immunodeficiency virus

Hoyos-Orrego, Alvaro; Massaro-Ceballos, Mónica; Ospina-Ospina, Marta; Gómez-Builes, Carolina; Vanegas-Arroyave, Nora; Tobón-Pereira, Juan; Jaramillo-Hurtado, Javier; Rugeles-López, María Teresa
Fonte: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo Publicador: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/12/2006 Português
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La infección por los virus de la hepatitis B y hepatitis C (VHB y VHC) es frecuente en individuos infectados por el VIH como resultado de compartir factores de riesgo para su contagio. Se realizó un estudio serológico para el VHB y VHC en 251 individuos VIH positivos de la ciudad de Medellín, Colombia. En 90 pacientes con un recuento de linfocitos T < 150 células por mm³ se hizo una PCR-RT cualitativa para el VHC. Se encontraron marcadores serológicos para la infección por el VHB en 97 (38.6%) pacientes. Treinta y seis de 97 (37.1%) tuvieron un anti-HBc aislado. El análisis multivariado indicó que los factores de riesgo significativos asociados a la presencia de estos marcadores fueron: edad (OR = 1.05, 95% IC: 1.01-1.08), pediculosis púbica (OR = 1.83, 95% IC: 1.01-3.33), hombres que tienen sexo con hombres y mujeres (OR = 3.23, 95% IC: 1.46-7.13) y hombres que tienen sexo solo con hombres (OR = 3.73, 95% IC: 1.58-8.78). El mismo análisis restringido a mujeres mostró que la sífilis fue el único factor de riesgo significativo. Por lo tanto, la infección por el VHB fue considerablemente asociada a conductas sexuales de alto riesgo. El VHC se presentó en solo 2 (0.8%) de los pacientes VIH. Ambos pacientes fueron positivos por la PCR-RT y los anti-VHC. La baja frecuencia de la coinfección VIH/VHC fue probablemente debido al bajo uso de drogas intravenosas en esta población. El hallazgo frecuente de anti-HBc como marcador aislado asegura estudios moleculares para descartar la presencia de infección críptica por el VHB.; Both hepatitis B and hepatitis C viruses (HBV and HCV) infection are common in HIV-infected individuals as a result of shared risk factors for acquisition. A serological study for HBV and HCV was performed in 251 HIV-positive individuals from Medellín...

‣ Estado actual de inmunidad para hepatitis por virus A en diversos grupos de adultos

Ibarra V,Humberto; Riedemann G,Stella; Prado J,Valeria; Reinhardt V,Germán; Vega R,Inés; Potin S,Marcela; Frick O,Pablo
Fonte: Sociedad Médica de Santiago Publicador: Sociedad Médica de Santiago
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/1999 Português
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Background: As sanitary and economic conditions improve, the prevalence of antibodies to hepatitis A is now significantly lower. Aim: To evaluate the prevalence of hepatitis A virus antibodies in healthy Chilean adults. Material and methods: Antibodies to hepatitis A virus were measured, using a commercial ELISA assay, in 215 voluntary blood donors (163 male, aged 19 to 30 years old) and 295 medical students and health personnel (156 male, aged 19 to 39 years old), residing in Valdivia, Chile. Results: Antibodies against hepatitis A virus were found in 68,2% of the total sample (351/510). Ninety percent of flood donors and 54% of health personnel and students were positive (p <0.01). Age specific prevalence in blood donors 19 to 22, 23 to 29 and 27 to 30 years old was 81,0%, 95,2% and 95,6% respectively. Among the same age groups in medical students, the prevalence was 47,9%, 53,2% and 61,9% respectively (p <0.01). Conclusions: This study indicates a reduction in the prevalence of hepatitis A virus antibodies among adults in Valdivia (Chile). Differences detected between individuals are probably related to different socioeconomic levels. Medical students have an increased risk for hepatitis A infections than the general population.

‣ Hepatitis crónica por virus C: factores asociados a la severidad del daño histológico

Orellana N,Ivonne; Poniachik T,Jaime; Smok S,Gladys; Madrid S,Ana María; Menéndez A,Alejandra; Tobar A,Eduardo; Brahm B,Javier
Fonte: Sociedad Médica de Santiago Publicador: Sociedad Médica de Santiago
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2005 Português
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Twenty percent of patients with chronic hepatitis C evolve to cirrhosis in 10 to 20 years. The degree of steatosis and hepatic iron stores in liver biopsy increase the risk. Age, high body mass index, diabetes mellitus and alcohol consumption are factors associated to the severity of liver damage. Aim: To study the association of steatosis and increased iron stores in the liver biopsy and age, overweight, alcohol consumption and diabetes with the severity of liver damage in patients with hepatitis C virus infection. Patients and methods: Retrospective study of 84 liver biopsies of patients with chronic infection with hepatitis C virus were studied. The pathological appearance was classified as stage I when chronic hepatitis with mild activity without fibrosis was observed; as stage II when moderate chronic hepatitis with mild fibrosis was observed and as stage III when there was a moderate chronic hepatitis with fibrosis or cirrhosis. The amount of steatosis and iron deposition in the biopsy were also assessed. Results: Forty one percent of patients were in stage I, 32% in stage II and 27% in stage III. Patients in stage I were younger than those in stages II and III (40.7 and 52.2 years respectively, p <0,001). No association between the severity of liver damage and the degree of steatosis...

‣ Anti-VHE IgM en casos de infección por el virus hepatitis E

Hurtado H,Carmen; Muñoz G,Gabriela; Brahm B,Javier
Fonte: Sociedad Médica de Santiago Publicador: Sociedad Médica de Santiago
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2005 Português
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Background: Hepatitis E virus is the main enterically transmitted non A non B hepatitis agent. The host IgM response in the acute infection phase is short lived. Therefore, only IgG antibodies against E virus are usually investigated. Aim: To measure IgM antibodies against virus E in serum samples. Material and Methods: IgM antibodies against virus E were measured by ELISA in 35 positive and 18 negative serum samples for IgG antibodies against hepatitis virus E, without evidence of infection with hepatitis A, B or C virus. Measurement of the same antibodies in 25 additional samples positive for IgM antibodies against hepatitis A virus but without study for hepatitis virus B or C. Results: IgM antibodies against virus E were detected in 12 of the 35 samples positive for IgG antibodies (34%) and in five of the 25 samples positive for antibodies against virus A (20%). Conclusions: An acute hepatitis E virus infection was detected in 34% of samples positive for IgG antibodies against this virus. The absence of IgM antibodies in the rest of the IgG positive samples could be due to an old or a recent virus E infection in the stage of antibody titer reduction. The detection of IgM antibodies against virus E in samples positive for virus A antibodies...

‣ Prevalencia de seropositividad para VIH, hepatitis B y C en donadores de sangre

Rivera-López,María Rebeca F.; Zavala-Méndez,Celia; Arenas-Esqueda,Alfonso
Fonte: Academia Nacional de Medicina de México, A.C. Publicador: Academia Nacional de Medicina de México, A.C.
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2004 Português
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A pesar de las distintas medidas que se toman para brindar sangre segura durante el proceso transfusional, persiste el riesgo de transmitir alguna infección, por esta razón es importante determinar la seroprevalencia de las infecciones por el VIH y por los virus de la hepatitis B y C en los donadores de sangre. Estudios previos realizados en México, indican que para el VIH la seroprevalencia se encuentra entre 0.01 % y 0.13%. la hepatitis B se encuentra entre 0.11 %y 1.22%. la hepatitis C se encuentra entre 0.47%y 1.47%. Se revisaron los resultados de las pruebas de tamizaje (ELISA de tercera generación y estudios de quimioluminiscencia) de los donadores estudiados en el Banco Central de Sangre del CMN Siglo XXI de 1995 al año 2002, los que resultaron reactivos fueron estudiados por técnicas confirmatorias, WesternBlot para el VM, prueba de neutralización de AgHBs para hepatitis B y RIBA-HCV3. Opara la hepatitis C. Se revisaron resultados de anticuerpos anti-VIH de 513 062 donadores, de los cuales resultaron positivos y confirmados 0.07% asi como511 733 resultados de antígeno de superficie de hepatitis B, de los cuales resultaron reactivos y confirmados 0.13% y los resultados de antihepatitis C de 511115 donadores, de los cuales fueron positivos y confirmados 0.31%. los índices encontrados son bajos en comparación con los reportados en estudios realizados en nuestro país para anticuerpos de VIH...

‣ Hepatitis viral tipo A recurrente complicada con insuficiencia renal

Tagle,Martín; Barriga,José A; Gutierrez,Sussy; Valdez,Luis Manuel; Castle,James; Antúnez de Mayolo,Antonio; Scavino Levy,Yolanda; León Barúa,Raúl; Mendoza,Carlos; Cajas,Lucy; Santibáñez,Vilma
Fonte: Revista de Gastroenterología del Perú Publicador: Revista de Gastroenterología del Perú
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2004 Português
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Reportamos el caso de un paciente varón de 42 años con episodio de hepatitis viral A recurrente, con patrón colestásico, cuyo curso clínico fue complicado por fiebre, anemia e insuficiencia renal, requiriendo hemodiálisis. Se detectó presencia de crioglobulinas y niveles disminuídos de complemento. Se realizó una biopsia renal que mostró evidencia de microangiopatía trombótica. El paciente tuvo una buena respuesta terapéutica a corticosteroides, aunque desarrolló recurrencia de fiebre y rash purpúrico palpable en sus extremidades inferiores cuando se redujo la dosis. Una biopsia de piel mostró vasculitis leucocitoclástica. Los síntomas y los hallazgos físicos mejoraron cuando se inició terapia con ciclofosfamida y se incrementó la dosis de corticosteroides. La infección por el virus de la hepatitis A tiene un curso clínico usualmente benigno, aunque ocasionalmente puede verse complicaciones. La forma recurrente puede verse un un 3-20% de casos; puede presentarse con un patrón colestásico y la mayoría de las veces tiene un curso clínico leve. A diferencia de la hepatitis viral B, las manifestaciones extrahepáticas son raras en la hepatitis A, y las manifestaciones renales son aún más infrecuentes. La insuficiencia renal aguda (IRA) en la hepatitis A no fulminante se ha reportado sólo ocasionalmente y su etiología es aún desconocida. Se ha propuesto diferentes hipótesis...

‣ Factores de riesgo para la progresión de la infección crónica de la Hepatitis viral C

Valladares Álvarez,Guillermo
Fonte: Revista de Gastroenterología del Perú Publicador: Revista de Gastroenterología del Perú
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2003 Português
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El virus de la hepatitis C ha surgido como la causa de la segunda mayor epidemia de infección viral después del virus de la inmunodeficiencia humana (VIH) en las pasadas dos décadas. Una característica importante de la infección del virus de la Hepatitis C es el curso variable de su historia natural. Las personas que contraen este agente desarrollan infección crónica en aproximadamente el 80% de casos con grado variable de daño hepático incluyendo cirrosis y más aún carcinoma hepatocelular. Sin embargo sólo una minoría progresa a las formas severas. Diversos factores relacionados al huésped parecen influir en la progresión de la hepatitis C a cirrosis. Los más importantes incluyen abuso de alcohol, edad en la que se adquiere la infección, duración de la infección, sobrepeso, sexo masculino y coinfección con el virus de la hepatitis A, B o VIH. Es menos clara la evidencia acerca del rol de los niveles de fierro en el hígado ,el tabaco o la fuente de infección. Los factores relacionados al agente no parecen jugar un rol en la progresión de la enfermedad. Se requieren estudios adicionales con grupos de control apropiados para confirmar la participación de los factores de huésped antes mencionados e identificar otros que podrían influenciar la historia natural de la infección por hepatitis C. La reducción de la ingestión de alcohol...

‣ Hepatitis viral como factor desencadenante de Hepatitis autoinmune: Reporte de un caso y revisión de la literatura

Tagle Arrospide,Martin; León Barúa,Raúl
Fonte: Revista de Gastroenterología del Perú Publicador: Revista de Gastroenterología del Perú
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2003 Português
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Se reporta el caso de una paciente de 61 años que desarrolla un cuadro de hepatitis viral tipo A con curso clínico no complicado. Sin embargo, nueve meses después del diagnóstico las aminotransferasas aún se mantenían discretamente elevadas (AST 78 UI/L y ALT 95 UI/L). En ese momento la paciente comienza a presentar artralgias transitorias y se solicita marcadores de hepatitis autoinmune, siendo positivos, además de presentar hipergammaglobulinemia. Una biopsia hepática realizada mostró cambios compatibles con hepatitis autoinmune leve. Se consideró que el caso no ameritaba tratamiento con corticoides o inmunosupresores y se continúa observando a la paciente, que se encuentra asintomática hasta el momento de esta publicación. Hasta donde tenemos conocimiento éste es el primer reporte en nuestro medio de hepatitis autoinmune desencadenada a partir de una hepatitis viral tipo A. Se reporta el caso y se realiza una revisión de la literatura.