Ana Mota

Alcohol consumption among patients with hepatitis B infection in northern Portugal considering gender and hepatitis B virus genotype differences.

Alcohol abuse is an important public health problem. In Portugal with a population of 10 millions of inhabitants, there are around 10% of alcoholics or excessive alcohol drinkers and 1% of chronically infected patients with hepatitis B virus (HBV). To examine the characteristics of patients with higher levels of alcohol consumption and to investigate the association between alcohol consumption and liver damage a total of 298 chronically infected individuals, with HBV genotyped and submitted to liver biopsy, were classified with Childs grading and separated by habits of alcohol intake, less and greater than 20g/day. No significant differences were observed about genotype but genotypes A and D were predominant in both of them. A higher percentage of males (P<.001) were observed in the group with alcohol intake above 20g/day, as well a lower proportion of patients with HBeAg negativity (P< or =.035). In this group, biochemistry parameters, such as alanine aminotransferase (P=.006), aspartate aminotransferase (P=.001), gamma-glutamyl transferase (P<.001) were elevated in a significantly higher proportion than in the other group. The analysis of hematological parameters showed significantly lower values of platelets (P=.042) and mean corpuscular volume (P<.001) and significantly higher values of prothrombin time (P<.001) in the group with higher levels of alcohol consumption. The characteristics of biopsy (P<.001) and Child-Phugs classification (P=.002) revealed more severe results in this group. Logistic regression showed a positive association between liver damage and alcohol intake, increasing with age. In female patients, a strong positive association between alcohol intake and liver damage was also found (odds ratio: 9.379; 95% confidence interval: 0.859-468.422; P = .037); however, the most severe cases were only observed in women older than 45 years. In patients with HBV infection, alcohol is associated with a more severe liver disease. No evidence was found concerning association with HBV genotype.

Characterization of rat heart alkaline phosphatase isoenzymes and modulation of activity

Alkaline phosphatase (ALP) is important in calcification and its expression seems to be associated with the inflammatory process. We investigated the in vitro acute effects of compounds used for the prevention or treatment of cardiovascular diseases on total ALP activity from male Wistar rat heart homogenate. ALP activity was determined by quantifying, at 410 nm, the p-nitrophenol released from p-nitrophenylphosphate (substrate in Tris buffer, pH 10.4). Using specific inhibitors of ALP activity and the reverse transcription-polymerase chain reaction, we showed that the rat heart had high ALP activity (31.73 +/- 3.43 nmol p-nitrophenol.mg protein-1.min-1): mainly tissue-nonspecific ALP but also tissue-specific intestinal ALP type II. Both ALP isoenzymes presented myocardial localization (striated pattern) by immunofluorescence. ALP was inhibited a) strongly by 0.5 mM levamisole, 2 mM theophylline and 2 mM aspirin (91, 77 and 84%, respectively) and b) less strongly by 2 mM L-phenylalanine, 100 mL polyphenol-rich beverages and 0.5 mM progesterone (24, 21 to 29 and 11%, respectively). beta-estradiol and caffeine (0.5 and 2 mM) had no effect; 0.5 mM simvastatin and 2 mM atenolol activated ALP (32 and 36%, respectively). Propranolol (2 mM) tended to activate ALP activity and corticosterone activated (18%) and inhibited (13%) (0.5 and 2 mM, respectively). We report, for the first time, that the rat heart expresses intestinal ALP type II and has high total ALP activity. ALP activity was inhibited by compounds used in the prevention of cardiovascular pathology. ALP manipulation in vivo may constitute an additional target for intervention in cardiovascular diseases.

Epidemiological Study of Genotypes of Hepatitis B Virus in Northern Portugal

While the overall prevalence of hepatitis B virus (HBV) infection in Portugal is around 1%, there are no published studies examining HBV genotypes in this country. This study aimed to survey HBV genotypes in the northern Portugal and to examine the possible associations between genotypes and gender, viral transmission routes, viral markers, viral load, and biochemical tests of liver function. The study sample consists of 340 patients with HBV infection of whom 42.9% were women. Tests were carried out for HBV genotypes and biochemical liver function while demographic information, including alcohol intake, was obtained from the patient files. The results indicate the predominance of genotype D (60.3%) and genotype A (31.5%). Intrafamilial transmission was predominant in female patients, while males were infected in equal proportions by perinatal, sexual, and intrafamilial transmission. Absence of HBeAg was found in a significantly smaller proportion of female patients with genotype D as compared to A (56.6% vs. 82.1%, P = 0.028). High viral load was associated significantly and independently with genotype D and HBeAg. Both alanine and aspartate aminotransferases (ALT and AST) were associated with gender and HBeAg. Thus, genotypes A and D were found to be the most prevalent in the north of Portugal. Patients infected with genotype D had higher levels of HBV DNA. HBeAg was associated with genotype D, viral load, and ALT and AST. J. Med. Virol. 81:1170–1176, 2009.

Chronic liver disease and cirrhosis among patients with hepatitis B virus infection in northern Portugal with reference to the viral genotypes

The prevalence of infection with hepatitis B virus in Portugal is around 1% of the population; 20–30% of those infected typically develop cirrhosis. The study focuses on the epidemiological profile of patients with hepatitis B infection and liver damage, in particular, cirrhosis. Of the 358 individuals that comprised the study, a liver biopsy was performed in 249 to identify the presence of cirrhosis. Cirrhosis was observed in 59 patients (23.7%) The Child–Pugh classification was used to assess the prognosis of cirrhosis: 3 out of the 59 patients were classified as Child–Pugh grade C, the most severe, 17 (28.8%) as grade B, and 39 (66.2%) as grade A. Patients classified as grade B were older, drank more, and showed higher levels of AST and alkaline phosphatase when compared with individuals classified as grade A. Genotypes A and D were predominant, and no significant differences with respect to genotype distribution were observed. Analysis of the hematological parameters showed that patients classified as Childs grade B had lower levels of platelets and higher levels of prothrombin time than those classified as Childs grade A. The profile of the patients with cirrhosis, including an extended number of individual characteristics, provides useful information, however, only a prospective study could evaluate definitively if liver disease is influenced by these factors. Future studies would benefit from the analysis of the impact of genotypes on liver disease, particularly genotypes A and D, the most predominant genotypes in northern Portugal. J. Med. Virol. 83:71–77, 2011.

Perfil epidemiológico e genotípico da infecção pelo vírus da hepatite B no Norte de Portugal

OBJECTIVE To describe the epidemiological and genotypic profile of chronic hepatitis B infection in Northern Portugal. METHODS This survey comprised 358 subjects with positive serology for hepatitis B antigen for at least six months, recruited from specialist appointments in two hospitals in Northern Portugal between 2008 and 2009. Data were obtained from patient files, laboratory tests performed at the time of viral genotyping, echograms and/or ultrasonogram results, and liver biopsies. Demographic characteristics, viral markers, viral load and genotype, and severity of liver disease were evaluated and compared between sexes. RESULTS Genotypes A and D were predominant in both sexes. Intrafamilial transmission occurred mostly among female patients. One-third of females and 58,9% of males showed alcohol intake above 20 g/day. Absence of AgHBe was similar in both sexes (p = 0.662). Elevated biochemical parameters and presence of necroinflammatory activity and steatosis in liver biopsies were more frequent among male patients (p=0.003). CONCLUSIONS Differences in terms of route of HBV infection between men and women may be a consequence of gender-associated risk behaviors. Excessive alcohol intake is more frequent among males than females, as is more severe liver disease.OBJECTIVO: Descrever o perfil epidemiologico e genotipico da infeccao cronica pelo virus da hepatite B na Regiao Norte de Portugal. METODOS: Foram incluidos 358 individuos oriundos das consultas de especialidade que apresentavam resultados positivos para o antigeno da hepatite B durante pelo menos seis meses em dois hospitais do Norte de Portugal em 2008 e 2009. Os dados foram obtidos a partir dos processos clinicos, determinacoes laboratoriais feitas quando da genotipagem do virus, ecografia e/ou ultra-sonografia e biopsia hepatica. As caracteristicas demograficas, marcadores viricos, carga viral e genotipos, e severidade da doenca hepatica foram avaliadas e comparadas entre sexos. RESULTADOS: Os genotipos A e D predominaram. A transmissao intrafamiliar ocorreu predominantemente nas mulheres. Um terco das mulheres apresentava ingestao alcoolica superior a 20 g/dia, aumentando para 58,9% nos homens. A ausencia do AgHBe foi semelhante nos dois sexos (p = 0,662). Os parâmetros bioquimicos em geral apresentaram-se com valores mais altos nos homens, assim como nos estagios necro-inflamatorio e de esteatose hepatica (p = 0,003). CONCLUSOES: As diferencas relativas as vias de transmissao da infeccao pelo virus da hepatite B entre homens e mulheres podem ser consequencia de comportamentos de risco associadas ao genero. A ingestao excessiva de alcool e predominante nos individuos do sexo masculino, assim como maior severidade da doenca hepatica em relacao as mulheres.

Epidemiological and genotypic profile of hepatitis B virus infection in Northern Portugal

OBJECTIVE To describe the epidemiological and genotypic profile of chronic hepatitis B infection in Northern Portugal. METHODS This survey comprised 358 subjects with positive serology for hepatitis B antigen for at least six months, recruited from specialist appointments in two hospitals in Northern Portugal between 2008 and 2009. Data were obtained from patient files, laboratory tests performed at the time of viral genotyping, echograms and/or ultrasonogram results, and liver biopsies. Demographic characteristics, viral markers, viral load and genotype, and severity of liver disease were evaluated and compared between sexes. RESULTS Genotypes A and D were predominant in both sexes. Intrafamilial transmission occurred mostly among female patients. One-third of females and 58,9% of males showed alcohol intake above 20 g/day. Absence of AgHBe was similar in both sexes (p = 0.662). Elevated biochemical parameters and presence of necroinflammatory activity and steatosis in liver biopsies were more frequent among male patients (p=0.003). CONCLUSIONS Differences in terms of route of HBV infection between men and women may be a consequence of gender-associated risk behaviors. Excessive alcohol intake is more frequent among males than females, as is more severe liver disease.OBJECTIVO: Descrever o perfil epidemiologico e genotipico da infeccao cronica pelo virus da hepatite B na Regiao Norte de Portugal. METODOS: Foram incluidos 358 individuos oriundos das consultas de especialidade que apresentavam resultados positivos para o antigeno da hepatite B durante pelo menos seis meses em dois hospitais do Norte de Portugal em 2008 e 2009. Os dados foram obtidos a partir dos processos clinicos, determinacoes laboratoriais feitas quando da genotipagem do virus, ecografia e/ou ultra-sonografia e biopsia hepatica. As caracteristicas demograficas, marcadores viricos, carga viral e genotipos, e severidade da doenca hepatica foram avaliadas e comparadas entre sexos. RESULTADOS: Os genotipos A e D predominaram. A transmissao intrafamiliar ocorreu predominantemente nas mulheres. Um terco das mulheres apresentava ingestao alcoolica superior a 20 g/dia, aumentando para 58,9% nos homens. A ausencia do AgHBe foi semelhante nos dois sexos (p = 0,662). Os parâmetros bioquimicos em geral apresentaram-se com valores mais altos nos homens, assim como nos estagios necro-inflamatorio e de esteatose hepatica (p = 0,003). CONCLUSOES: As diferencas relativas as vias de transmissao da infeccao pelo virus da hepatite B entre homens e mulheres podem ser consequencia de comportamentos de risco associadas ao genero. A ingestao excessiva de alcool e predominante nos individuos do sexo masculino, assim como maior severidade da doenca hepatica em relacao as mulheres.

Perfil epidemiológico y genotípico de la infección por el virus de la hepatitis B en el Norte de Portugal

OBJECTIVE To describe the epidemiological and genotypic profile of chronic hepatitis B infection in Northern Portugal. METHODS This survey comprised 358 subjects with positive serology for hepatitis B antigen for at least six months, recruited from specialist appointments in two hospitals in Northern Portugal between 2008 and 2009. Data were obtained from patient files, laboratory tests performed at the time of viral genotyping, echograms and/or ultrasonogram results, and liver biopsies. Demographic characteristics, viral markers, viral load and genotype, and severity of liver disease were evaluated and compared between sexes. RESULTS Genotypes A and D were predominant in both sexes. Intrafamilial transmission occurred mostly among female patients. One-third of females and 58,9% of males showed alcohol intake above 20 g/day. Absence of AgHBe was similar in both sexes (p = 0.662). Elevated biochemical parameters and presence of necroinflammatory activity and steatosis in liver biopsies were more frequent among male patients (p=0.003). CONCLUSIONS Differences in terms of route of HBV infection between men and women may be a consequence of gender-associated risk behaviors. Excessive alcohol intake is more frequent among males than females, as is more severe liver disease.OBJECTIVO: Descrever o perfil epidemiologico e genotipico da infeccao cronica pelo virus da hepatite B na Regiao Norte de Portugal. METODOS: Foram incluidos 358 individuos oriundos das consultas de especialidade que apresentavam resultados positivos para o antigeno da hepatite B durante pelo menos seis meses em dois hospitais do Norte de Portugal em 2008 e 2009. Os dados foram obtidos a partir dos processos clinicos, determinacoes laboratoriais feitas quando da genotipagem do virus, ecografia e/ou ultra-sonografia e biopsia hepatica. As caracteristicas demograficas, marcadores viricos, carga viral e genotipos, e severidade da doenca hepatica foram avaliadas e comparadas entre sexos. RESULTADOS: Os genotipos A e D predominaram. A transmissao intrafamiliar ocorreu predominantemente nas mulheres. Um terco das mulheres apresentava ingestao alcoolica superior a 20 g/dia, aumentando para 58,9% nos homens. A ausencia do AgHBe foi semelhante nos dois sexos (p = 0,662). Os parâmetros bioquimicos em geral apresentaram-se com valores mais altos nos homens, assim como nos estagios necro-inflamatorio e de esteatose hepatica (p = 0,003). CONCLUSOES: As diferencas relativas as vias de transmissao da infeccao pelo virus da hepatite B entre homens e mulheres podem ser consequencia de comportamentos de risco associadas ao genero. A ingestao excessiva de alcool e predominante nos individuos do sexo masculino, assim como maior severidade da doenca hepatica em relacao as mulheres.