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‣ Declining prevalence of hepatitis A virus antibodies among children from low socioeconomic groups reinforces the need for the implementation of hepatitis A vaccination in Brazil

Vitral,Claudia Lamarca; Ospina,Fidel Leonardo Navarro; Artimos,Solange; Melgaço,Juliana Gil; Cruz,Oswaldo Gonçalves; Paula,Vanessa Salete de; Luz,Sérgio Bessa; Freire,Marcos; Gaspar,Luciane Pinto; Amado,Luciane Almeida; Engstrom,Elyne Montenegro; Forte
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2012 Português
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Age-related seroprevalence studies that have been conducted in Brazil have indicated a transition from a high to a medium endemicity of hepatitis A virus (HAV) infection in the population. However, most of these studies have focused on urban populations that experience lower incidence rates of HAV infection. In the current study, the prevalence of anti-HAV antibodies was investigated in children with a low socioeconomic status (SES) that live on the periphery of three capital cities in Brazil. A total of 1,162 dried blood spot samples were collected from individuals whose ages ranged from one-18 years and tested for anti-HAV antibodies. A large number of children under five years old (74.1-90%) were identified to be susceptible to HAV infection. The anti-HAV antibody prevalence reached ≥ 50% among those that were 10-14 years of age or older. The anti-HAV prevalence rates observed were characteristics of regions with intermediate level of hepatitis A endemicity. These data indicated that a large proportion of children with a low SES that live at the periphery of urban cities might be at risk of contracting an HAV infection. The hepatitis A vaccine that is currently offered in Brazil is only available for high-risk groups or at private clinics and is unaffordable for individuals with a lower SES. The results from this study suggest that the hepatitis A vaccine should be included in the Brazilian National Program for Immunisation.

‣ Low occurrence of occult hepatitis B virus infection and high frequency of hepatitis C virus genotype 3 in hepatocellular carcinoma in Brazil

Alencar,R.S.M.; Gomes,M.M.S.; Sitnik,R.; Pinho,J.R.R.; Malta,F.M.; Mello,I.M.V.G.C.; Mello,E.S.; Bacchella,T.; Machado,M.C.C.; Alves,V.A.F.; Carrilho,F.J.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2008 Português
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Occult hepatitis B virus (HBV) infection has been reported among patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC). Our aim was to evaluate the presence of occult HBV infection in patients with HCV-related liver cirrhosis (LC) with or without HCC in São Paulo, Brazil. Serum and liver tissue samples from 50 hepatitis B surface antigen-negative patients with HCV-related LC who underwent liver transplantation at the University of São Paulo School of Medicine Hospital from 1993 to 2004 were divided into groups with LC only (N = 33) and with LC plus HCC (N = 17). HBV DNA was assayed for serum and paraffin-embedded liver tissue (tumoral and non-tumoral) using real time PCR and only 1 case with HCC had HBV DNA-positive serum. All liver samples were negative. HCV genotype 3 was detected in 17/39 (43.7%) cases. In conclusion, using a sensitive real time PCR directed to detect HBV variants circulating in Brazil, occult hepatitis B infection was not found among HCV-positive cirrhotic patients and was rarely found among HCV-positive HCC patients. These results are probably related to the low prevalence of HBV infection in our population. Furthermore, we have also shown that HCV genotype 3 is frequently found in Brazilian cirrhotic patients...

‣ Transfusion risk for hepatitis B, hepatitis C and HIV in the state of Santa Catarina, Brazil, 1991-2001

Kupek,Emil
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2004 Português
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We examined the time trend of residual risk of transfusing blood contaminated with HIV, hepatitis B and hepatitis C, in the largest blood bank of the state of Santa Catarina, Brazil, 1991-2001. The HIV risk was reduced approximately 10 times during the decade of 1990, to 1:48777, but then increased significantly by the end of 2001. A similar time trend was observed for hepatitis B and hepatitis C, although the increase was not significant in this case. Even during the period of lowest risk, the estimates were considerably higher than in developed countries.

‣ Serological markers of hepatitis A, B and C viruses in rural communities of the semiarid Brazilian Northeast

Almeida,Delvone; Tavares-Neto,José; Vitvitski,Ludmila; Almeida,Alessandro; Mello,Caroline; Santana,Diana; Tatsch,Fernando; Paraná,Raymundo
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2006 Português
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In the village of Cavunge, located in a dry tropical, semiarid rural region of the state of Bahia, Brazil, a sentinel study on viral hepatitis is underway. We report on the first part of the study. The objective of this study was to determine the prevalence of serological markers for hepatitis A, B and C in the village. Cross sectional study. Blood samples were tested for serological markers of hepatitis A (HAV), B (HBV) and C (HCV) through ELISA-III assay. In HBsAg and anti-HCV carriers, HCV-RNA and HBV-DNA were checked by PCR. The prevalence of anti-HAV IgG was 83.3% (1,210/1,452), being higher among residents from the village (87.4%) than in residents from the rural area (79.5%); it also higher among individuals older than 10 years of age. The prevalence of HBsAg was 2.6% (38/1,476), 9.3% anti-HBc (137/1,476) and 10.5% (155/1,476) anti-HBs of. In more than half (58.1%; 90/155) of anti-HBs carriers, this was the only serological marker found. In 3.7% of the population, (55/1,476), anti-HBc was the only serological marker found. All HBV carriers were infected by genotype A. Only 0.4% (6/1,536) presented anti-HCV antibodies and only one of them was viremic, being infected with genotype 1. The prevalence of patients with antibodies against hepatitis A virus in the village of Cavunge was high...

‣ Characterization of HBeAg-negative chronic hepatitis B in western Brazilian Amazonia

Victoria,Flamir da Silva; Oliveira,Cintia Mara Costa de; Victoria,Marilu Barbieri; Victoria,Cristian Barbieri; Ferreira,Luis Carlos Lima
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2008 Português
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The present study was conducted with 55 patients native from western Brazilian Amazonia, who were HBV-DNA positive after seroconversion of HBeAg. It is a descriptive case study, with the patients separated into two groups: with hepatitis and without hepatitis on histological examination. The aim of the present study was to describe the clinical and molecular characteristics of patients who are chronic carriers of HBsAg. The prevalence of hepatitis was 63.64%, with a predominance of males (41.82%) and a mean age of 42.5 years, occurring mostly in natives of the southeast sub-region (32.73%). Time was a variable proportional to the course of the disease and the most frequent symptoms were: dyspepsia, asthenia and loss of libido with the majority of the patients having history of prior contact with HBV or positive family history. Splenomegalia was the most frequent sign (40%). Among the tests, platelet count, serum albumin and prothrombin activity were significant in the diagnosis of hepatitis. Alpha-fetoprotein was greater in patients with hepatitis, and hepatocellular carcinoma was detected in 3.63% of the patients with hepatic cirrhosis. Three types of HBV genotypes were diagnosed: A, D and F in the samples amplified for gene S. Genotype A (AA) was observed in 54.54% of the cases with hepatitis...

‣ Hepatitis A: the costs and benefits of the disease prevention by vaccine, Paraná, Brazil

Zahdi,Mariana Ribas; Maluf Junior,Ivan; Maluf,Eliane Mara Cesário Pereira
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2009 Português
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This study evaluated the epidemiological behavior of the hepatitis A in Paraná state and compared the costs of the disease and the vaccination. This is an epidemiological descriptive study including a pharmacoeconomy analysis. We collected information in the national database reported cases (SINAN), in the mortality information system (SIM) and in the hospital information system (AIH) among 2000/2003 (Paraná State Public Health Department). We estimated the probability of one cohort of children to acquire hepatitis A during their lifetime and the costs with their treatment. We compared those costs with the cost of vaccinating the children. 14,682 hepatitis A cases were registered during the period studied, and 12,102 (82.4%) occurred in the 0-15 years-old age group. The annual incidence in the general population was 37.5/100,000. We observed 20 deaths caused by this disease; 7 of those occurred by liver failure. The estimated costs with the disease included the hospital costs, liver transplantation, liver failure treatment, and laboratory tests were high. The price of the vaccine is 10 USD/dose. Two doses are necessary to get the protection. The results showed a positive cost - benefit relation when we vaccinate children. We save 2.26 USD in treatment for each dollar invested in the vaccine. Paraná record high number of hepatitis A cases each year. We confirmed the positive cost - benefit relation when we vaccinate children against hepatitis A...

‣ Absence of occult hepatitis B among blood donors in southern Brazil

Wolff,Fernando Herz; Fuchs,Sandra Costa; Brandão,Ajacio BM
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2011 Português
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BACKGROUND: Occult hepatitis B virus (HBV) infection is characterized by the detection of HBV DNA in serum and/or in liver in the absence of detectable hepatitis B surface antigen (HBsAg). The reported prevalence of occult hepatitis B varies markedly among populations and according to the sensitivity of the HBV DNA assay. The aim of the present study was to describe the prevalence of occult hepatitis B among HCV-infected and non-infected blood donors in Porto Alegre, Southern Brazil, using a highly sensitive real time polymerase chain reaction (PCR) method. METHODOLOGY: Between 1995 and 1997 a sample of 178 blood donors with two positive anti-HCV ELISA tests were consecutively selected as cases, and 356 anti-HCV negative donors were selected as controls. Blood donors were randomly selected from eight blood centers in Porto Alegre, Southern Brazil, representative of the whole blood donor population. Blood samples were kept at 70ºC and defrosted for the first time for the analysis of this report. Tests previously performed in the laboratory using the same real time PCR for HBV DNA had sensitivity for detecting as low as 9 copies/mL. Among 158 blood samples from HBsAg-negative blood donors, five were anti-HBc positive, 53 tested positive for anti-HCV and 105 had anti-HCV negative. The samples analysis was performed in duplicate and all blood samples tested negative for HBV DNA. CONCLUSION: The result reflects a very low prevalence of occult hepatitis B in our setting.

‣ Seroprevalence of hepatitis A immunity among brazilian adult patients with liver cirrhosis: is HAV vaccination necessary?

Oliveira,Luiz Carlos Marques de; Comácio,Samantha Martins; Santos,Júlia de Fátima Gonçalves
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2011 Português
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BACKGROUND: Patients with chronic liver disease have a higher risk of fulminant hepatitis when infected with hepatitis A virus, and vaccination of these patients against such infection is recommended. In Brazil, mainly in the South and Southeast regions, the epidemiology of hepatitis A (HA) has shifted from high to intermediate endemicity, which would have implication on policy of HA vaccination for these populations. OBJECTIVE: To verify the prevalence of HA immunity in adult patients with liver cirrhosis (LC), in Uberlândia MG, a city of Southeastern Brazil. METHODS: Between December 2005 and December 2006, 106 patients with LC were consecutively evaluated. In addition, 75 individuals without LC or alcoholism were evaluated (control group - CG). RESULTS: Total anti-HAV (ELISA methods) was positive in 104 (98.1%) patients with LC (82 men, 24 women; mean age, 53.3 ± 11.9 years) and in 74 (98.7%) individuals of the CG (55 men, 20 women; mean age, 47 ± 11.6 years), p > 0.05. CONCLUSIONS: For patients with chronic liver disease, in the geographic regions and age groups evaluated, routine vaccination against hepatitis A is not recommended. Moreover, the serum determination of total anti-HAV, used to assess immunity, is five times cheaper than vaccination against hepatitis A and...

‣ Immune restoration in human immunodeficiency virus and hepatitis C virus coinfected patients after highly active antiretroviral therapy

Antonello,Vicente Sperb; Appel-da-Silva,Marcelo Campos; Kliemann,Dimas Alexandre; Santos,Breno Riegel; Tovo,Cristiane Valle
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2013 Português
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OBJECTIVE: To evaluate the influence of hepatitis C virus on immunological and virological responses after highly active antiretroviral therapy initiation in human immunodeficiency virus/hepatitis C virus coinfected patients compared to monoinfected human immunodeficiency virus-infected patients. METHODS: The study enrolled 65 human immunodeficiency virus-1-infected subjects who initiated highly active antiretroviral therapy and attended follow-up visits over 48 weeks from 2008 to 2010. They were grouped based on hepatitis C virus-RNA results. Virological and immunological responses were monitored at baseline and at the end of weeks 12, 24, 36, and 48. RESULTS: There were 35 human immunodeficiency virus monoinfected and 30 human immunodeficiency virus/hepatitis C virus coinfected patients. In the present study human immunodeficiency virus/hepatitis C virus coinfection did not seem to influence CD4 Tlymphocytes recovery. There was no difference between the curves of CD4 T-lymphocytes raise of coinfected and monoinfected groups. CONCLUSION: This prospective study confirms that hepatitis C virus infection does not seem to be associated with impaired CD4 T-lymphocytes recovery after HAART.

‣ Epidemiology of hepatitis B virus infection in first-time blood donors in the southwestern region of Goiás, central Brazil

Anjos,Giulena Rosa Leite Cardoso dos; Martins,Regina Maria Bringel; Carneiro,Megmar Aparecida dos Santos; Brunini,Sandra Maria; Teles,Sheila Araujo
Fonte: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Publicador: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2011 Português
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INTRODUCTION: Little is known about the epidemiology of hepatitis B virus (HBV) infection in populations from inner cities, especially in Central Brazil. Thus the objective of this study was to estimate the prevalence of HBV infection, and to analyze the factors associated with HBV infection, in a population of first-time blood donors in the southwestern region of Goiás, Central Brazil. METHODS: A total of 984 individuals were interviewed and gave blood samples to detect serological markers of HBV (HBsAg, anti-HBs, and anti-HBc) by enzyme linked immunosorbent assays. RESULTS: An overall prevalence of 6.9% was found for HBV, with constituent prevalence rates of 3.6% and 11.6%, in subjects classified as fit and unfit to donate blood according the epidemiological screening, respectively. Only three individuals were positive for anti-HBs alone, suggesting previous vaccination against HBV. The variables of prior blood transfusion (OR = 2.3), tattoo/piercing (OR = 2.1), illicit drug use (OR = 2.3), sex with a partner with hepatitis (OR = 14.7), and history of sexually transmitted diseases (OR = 2.9) were independently associated with HBV-positivity. These data suggested a low endemicity of hepatitis B in the studied population. CONCLUSION: The findings of low hepatitis B immunization coverage and the association of hepatitis B with risky behavior highlight that there is a need to intensify hepatitis B prevention programs in the southwest region of Goiás.

‣ Chronic Hepatitis C treatment for genotype 2 or 3 in Brazil: cost effectiveness analysis of peginterferon plus ribavirin as first choice treatment

Blatt,Carine Raquel; Storb,Bernd; Mühlberger,Nikolai; Farias,Mareni Rocha; Siebert,Uwe
Fonte: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Publicador: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 Português
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Brazilian Guidelines to HCV treatment (2007) recommended that the first choice treatment for patients with chronic hepatitis C (CHC) and genotype 2 or 3 is interferon alpha (IFN) plus ribavirin (RBV) for 24 weeks. The aim of this study is compare the cost and effectiveness to Hepatitis C treatment in patients with genotype 2 or 3 of peginterferon alpha (PEG) as the first choice of treatment within PEG for those that do not respond to IFN. The target population is CHC patients with genotype 2 or 3 in Brazil. The interventions are: PEG-SEC (first IFN plus RBV for 24 weeks, after, for non-responders and relapsers subsequently PEG plus RBV for 48 weeks); PEG-FIRST24 (PEG+RBV for 24 weeks). The type of the study is cost-effectiveness analysis. The data sources are: Effectiveness data from meta-analysis conducted on the Brazilian population. Treatment cost from Brazilian micro costing study is converted into USD (2010). The perspective is the Public Health System. The outcome measurements are Sustained Viral Response (SVR) and costs. PEG-FIRST24 (SVR: 87.8%, costs: USD 8,338.27) was more effective and more costly than PEG-SEC (SVR: 79.2%, costs: USD 5,852.99). The sensitivity analyses are: When SVR rates with IFN was less than 30% PEG-FIRST is dominant. On the other hand...

‣ Expansion of Adult Hepatitis A and B Vaccination in STD Clinics and Other Settings in New York State

Herlihy, Elizabeth J.; Klein, Susan J.; Newcomb, Martha L.; Blog, Debra S.; Birkhead, Guthrie S.
Fonte: Association of Schools of Public Health Publicador: Association of Schools of Public Health
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
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Since 1995, the New York State (NYS) Adult Hepatitis Vaccination Program has promoted adult hepatitis B vaccination for those receiving sexually transmitted disease (STD) clinic services. An average of 6,333 doses was administered annually from 1995 to 1999. By 2000, only 15 of 57 county STD programs in NYS outside of New York City participated. From 2000 to 2005, efforts to enroll county health departments and others included outreach, provision of hepatitis A and B vaccine, materials and training, and new collaborations. All 57 counties now participate. From 2000 to 2005, the number of settings offering hepatitis vaccination increased from 57 to 119. Sites include STD clinics; jails; migrant, Indian health, and college health centers; and methadone clinics. More than 125,000 doses of hepatitis A and B vaccine were administered from 1995 through 2005, with annual increases up to a high of 21,025 doses in 2005. Intensive promotion expanded hepatitis vaccination to all county STD clinics and other settings where high-risk adults can be vaccinated.

‣ Ipilimumab administration for advanced melanoma in patients with pre-existing Hepatitis B or C infection: a multicenter, retrospective case series

Ravi, Sowmya; Spencer, Kristen; Ruisi, Mary; Ibrahim, Nageatte; Luke, Jason J; Thompson, John A; Shirai, Keisuke; Lawson, David; Bartell, Heddy; Kudchadkar, Ragini; Gunter, Ngoc Thi; Mehnert, Janice M; Lipson, Evan J
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
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Ipilimumab is a fully human, monoclonal antibody directed against Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) that has demonstrated a survival benefit and durable disease control in patients with advanced melanoma. Ipilimumab is associated with potentially serious immune-related adverse events, including autoimmune hepatitis. Because clinical trials of ipilimumab excluded patients with pre-existing hepatitis B or C infection, there is a paucity of data on the safety of ipilimumab administration to that patient population. Here, we report the largest case series to date of patients with hepatitis B or C who received ipilimumab for advanced melanoma. Two of the nine patients described in this case series experienced fluctuations in their liver function tests (LFTs) and were subsequently treated with corticosteroids. Although this is a small series, the rate of hepatotoxicity appears similar to what has been seen in the general population treated with ipilimumab, and the ability to administer ipilimumab did not appear to be affected by concomitant hepatitis B or C infection. The use of ipilimumab in patients with metastatic melanoma who have pre-existing hepatitis can be considered among other therapeutic options.

‣ Reconceiving the Spoiled Female Identity: Childbearing and Motherhood among Women with Hepatitis C

Thetford, H. Clare
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Thesis (PhD); Doctor of Philosophy (PhD)
Português
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This thesis explores the impact of hepatitis C on women’s childbearing decisions and experiences of motherhood. A partial grounded theory approach was used, in which 34 women living with hepatitis C participated in semi-structured interviews to determine the direct and indirect effects of hepatitis C on their own personal decisions regarding childbearing and to describe their lived experiences of motherhood. The qualitative interview data were analysed thematically, in which common themes were identified and explored. ¶ Three key areas are explored: women’s social experience of hepatitis C; hepatitis C and childbearing decisions; and the meaning of motherhood for women with hepatitis C. ¶ ...; yes

‣ Development of novel vaccine strategies for duck Hepatitis B virus infection.

Miller, Darren Scott
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2008 Português
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Hepatitis B virus (HBV) is a life-threatening pathogen with major economic significance. Acute infection in adults is common, albeit usually self-limiting. Importantly, infection in infants typically results in chronic infection and increased incidence of hepatocellular carcinoma (HCC). Furthermore, the infectious carrier state is perpetuated in chronically infected individuals. Successful immuno-therapeutic vaccination would reduce the incidence of chronic infection and of HCC as well as reduce transmission of the disease. Recovery from acute and chronic HBV infection typically occurs in the presence of robust antigen-specific humoral and cellular immune responses (CMI), whereas these responses are low or absent in chronically HBV-infected individuals. Therefore, it was hypothesised that effective stimulation of both humoral and CMI responses, in conjunction with currently available antiviral therapies, may contribute significantly to development of vaccines for treatment of chronic HBV infection. The duck hepatitis B virus (DHBV) model of HBV infection was used to test novel vaccine strategies that could complement existing antiviral therapeutic approaches to treat chronically HBV-infected humans. To this end, three separate vaccine studies were conducted to investigate potential therapeutic regimes. Methods to assess the efficacies of the vaccine strategies included immunoperoxidase detection of viral antigen and immune cell markers within the liver and development of sensitive assays to monitor levels of DHBV DNA...

‣ Efficacy and tolerability of pegylated interferon-α-2a in chronic hepatitis B: a multicenter clinical experience; Efficacy and tolerability of pegylated interferon-alpha-2a in chronic hepatitis B: a multicenter clinical experience

Ratnam, D.; Dev, A.; Nguyen, T.; Sundararajan, V.; Harley, H.; Cheng, W.; Lee, A.; Rusli, F.; Chen, R.; Bell, S.; Pianko, S.; Sievert, W.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
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BACKGROUND AND AIM: Pegylated interferon-α (PEG-IFN) provides potential advantages over nucleos(t)ide analogues in the treatment of chronic hepatitis B (CHB) given its finite course, durability and lack of drug resistance. Much of the evidence is derived from controlled studies and it is unclear whether these results can be replicated in an everyday, non-controlled setting. The aim of this study was to examine the efficacy and tolerability of PEG-IFN-α2A in CHB patients in a clinical setting. METHODS: Chronic hepatitis B patients treated with PEG-IFN-α2A (180µg/week, 48 weeks) at five tertiary hospitals were retrospectively identified. Baseline demographic and clinical data, on-treatment virological and serological responses and adverse events (AE) were recorded. Treatment outcomes were defined as alanine aminotransferase (ALT) normalization, hepatitis B virus DNA <351 IU/mL and hepatitis B e antigen (HBeAg) seroconversion. RESULTS: Sixty three HBeAg positive patients were identified (65% male, 80% born in Asia, 84% with viral loads > 6log IU/mL, 9.5% advanced fibrosis). Six months after therapy 46% achieved normalization of ALT, 16% had viral loads < 351 IU/mL and 32% achieved HBeAg seroconversion. 29 HBeAg negative patients were treated (75% male...

‣ Mutaciones asociadas a la resistencia del virus de la hepatitis C frente a los nuevos tratamientos; Resistance mutations associated with new direct-acting antiviral drugs against hepatitis C virus

Orviz García, Eva
Fonte: Universidade de Cantabria Publicador: Universidade de Cantabria
Tipo: Trabalho de Conclusão de Curso
Português
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En los últimos años, el tratamiento de la hepatitis C ha experimentado un cambio histórico que se traduce en una modificación del abordaje terapéutico de los pacientes infectados por este virus. Sin embargo, la aparición de nuevos fármacos de acción directa contra el virus de la hepatitis C puede generar nuevas mutaciones de resistencia no conocidas hasta ahora, haciendo que su eficacia se reduzca y aumente el fracaso terapéutico. El objetivo de este trabajo ha sido profundizar en aquellos estudios que han abordado la investigación de las mutaciones frente a los nuevos fármacos contra el virus de la hepatitis C, tanto en forma de variantes genéticas que confieren resistencia previa al tratamiento, como en la generación de nuevas mutaciones durante la terapia. Este hecho puede ser fundamental a la hora de elegir la terapia antiviral y, gracias a nuevas técnicas de secuenciación masiva del genoma del virus, podremos conocerlas en profundidad próximamente.; In recent years, treatment for hepatitis C virus has changed completely due to developing new direct-acting antiviral drugs. The prospective approach of patients with this infection is now different. Nevertheless, the emergence of new drugs may lead to the appearance of unknown resistance mutations that may produce a decrease of efficacy and an increase of the cases with treatment failure. The aim of this paper is to summarize and bring together the results of different studies related to the investigation of appearance of resistance amino acid variants before and/or during treatment with new antivirals. This can be essential when choosing the antiviral therapy and...

‣ Análise de custo-efetividade do tratamento da hepatite C crônica genótipo 1: comparação da adição do boceprevir a terapia padrão (interferon-α peguilado e ribavirina); Cost-effectiveness analysis of treatment of genotype 1 chronic hepatitis C: comparison of boceprevir addition to standard of care (pegylated interferon alfa plus ribavirin).

Maia, Sarah Cristina Oliveira Machado
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 30/03/2015 Português
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A hepatite C afeta cerca de 150 milhões de pessoas no mundo e é a razão mais comum de transplantes de fígado. A erradicação viral, por meio de tratamento medicamentoso, é a única intervenção que pode deter a progressão da doença, reduzir a mortalidade e melhorar a qualidade de vida dos pacientes. Em 2011, foi aprovado o boceprevir, um inibidor de protease, que passou a ser adicionado à terapia padrão dupla (interferon peguilado e ribavirina) pelo Protocolo Clínico brasileiro para tratamento de Hepatite C genótipo 1 em pacientes com grau de fibrose maior que F2. Devido ao alto custo de aquisição deste medicamento e à produção cada vez maior de novas tecnologias para essa área terapêutica, foi proposta essa pesquisa que tem como objetivo analisar o custo-efetividade da terapia tripla em relação à terapia dupla, no tratamento da hepatite C crônica genótipo 1 em pacientes virgens de tratamento para todos os graus de fibrose. Para tanto, foi construído um modelo de Markov com 15 estados de saúde representando a história natural da Hepatite C crônica. O modelo seguiu uma coorte hipotética pela vida toda, em que os custos foram expressos em Reais e os desfechos em anos de vida ganhos. A perspectiva adotada foi a do SUS. A RCEI calculada...

‣ Mutantes precore antígeno e negativo del virus de la hepatitis B (HBeAg-) por pruebas serológicas en donantes de sangre de Bogotá Colombia, 2009-2010

Martínez de Rodríguez, Luz Mila
Fonte: Pontifícia Universidade Javeriana Publicador: Pontifícia Universidade Javeriana
Tipo: masterThesis; Trabajo de Grado Maestría Formato: application/pdf
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la Hepatitis B crónica es un crítico problema de salud pública a nivel mundial siendo una de las causas principales de hepatopatía crónica, cirrosis y carcinoma hepatocelular. Según la OMS, 2.000 millones de personas en el mundo han contraído una infección aguda por el virus de la Hepatitis B (VHB), entre 500.000 y 1’000.000 de personas mueren anualmente a causa de complicaciones relacionadas con; Chronic hepatitis B is a critical public health problem worldwide remains a major cause of chronic liver disease, liver cirrhosis and hepatocellular carcinoma. According to WHO, 2,000 million people worldwide have contracted an acute infection with Hepatitis B virus (HBV), between 500,000 and 1'000 .000 people die annually from complications related to infection HBV. HBV is a DNA virus that invol

‣ Prevalência e características clínico epidemiológicas de gestantes com hepatite C atendidas no CAISM - UNICAMP = : Prevalence and clinical epidemiological features of hepatitis C infection among pregnant women at CAISM - UNICAMP; Prevalence and clinical epidemiological features of hepatitis C infection among pregnant women at CAISM - UNICAMP

Mariana Salhab Dall' Aqua Schweller
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 26/08/2015 Português
Relevância na Pesquisa
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Introdução: A Hepatite C é um dos maiores problemas atuais de saúde pública, com mais de 150 milhões de pessoas contaminadas. A evolução da doença geralmente é assintomática e suas complicações são cirrose, fibrose hepática e hepatocarcinoma. Na gestação o tratamento não é recomendado, com possível piora da doença no período. Objetivo: identificar a prevalência de Hepatite C em gestantes que realizaram acompanhamento pré-natal no Hospital da Mulher Professor José Aristodemo Pinotti - Centro de Atenção Integral à Saúde da Mulher (CAISM) da UNICAMP, analisando dados clínicos, epidemiológicos e resultados perinatais. Metodologia: estudo de corte transversal cuja amostra foi composta por gestantes atendidas nos ambulatórios de pré-natal do CAISM entre 2005 e 2014 com sorologia positiva para Hepatite C. As pacientes foram identificadas através de listas informatizadas do serviço, e seus prontuários levantados para análise de dados sociodemográficos, epidemiológicos e desfechos perinatais. A análise dos dados foi feita através da distribuição percentual ou de médias. Resultados: na população de 29.327 gestantes atendidas pelo pré-natal entre 2005 e 2014, a prevalência de Hepatite C foi de 0...