Elisabete Maria de Figueiredo Brito

Hepatitis D and B virus genotypes in chronically infected patients from the Eastern Amazon Basin

Hepatitis D virus (HDV) is a defective hepatotropic virus whose infectivity is dependent on hepatitis B virus (HBV). HDV super- or co-infection leads to an increased risk of fulminant hepatitis or progression to severe chronic liver disease in HBV infected patients. The Brazilian Amazon Basin has been reported to be endemic for HBV and HDV, especially in the Western Amazon Basin. In this region, HDV infection is frequently associated with acute fulminant hepatitis with characteristic histologic features. HDV is classified into seven major clades (HDV-1 to HDV-7) and HBV is subdivided into eight genotypes (A-H). HDV and HBV genotypes have been shown to have a distinct geographic distribution. The aim of this study was to determine the HBV and HDV genotypes harbored by chronically infected patients from the Eastern Amazon Basin, Brazil. We studied 17 serum samples from HBV and HDV chronically infected patients admitted to a large public hospital (Santa Casa de Misericórdia) at Belém, state of Pará, Brazil, between 1994 and 2002. HDV-3 and HBV genotype A (subtype adw2) have been identified in all cases, in contrast to previous studies from other regions of the Amazon, where HBV genotype F has been found co-infecting patients that harbored HDV-3. The HDV-3/HBV-A co-infection suggests that there is not a specific interaction between HBV and HDV genotypes, and co-infection might merely reflect the most frequent genotypes found in a particular geographic area. The analysis of the carboxy-terminal region of the large hepatitis D antigen (L-HDAg), which interacts with the hepatitis B surface antigen (HBsAg) and is essential for HDV assembly, showed some diversity between the different isolates from the Eastern Amazon. This diversity is not observed among HDV-3 sequences from other South American regions.

Mitochondrial and nuclear sequence polymorphisms reveal geographic structuring in Amazonian populations of Echinococcus vogeli (Cestoda: Taeniidae).

To date, nothing is known about the genetic diversity of the Echinococcus neotropical species, Echinococcus vogeli and Echinococcus oligarthrus. Here we used mitochondrial and nuclear DNA sequence polymorphisms to uncover the genetic structure, transmission and history of E. vogeli in the Brazilian Amazon, based on a sample of 38 isolates obtained from human and wild animal hosts. We confirm that the parasite is partially synanthropic and show that its populations are diverse. Furthermore, significant geographical structuring is found, with western and eastern populations being genetically divergent.

Anatomo-clinical and molecular description of liver neotropical echinococcosis caused by Echinococcus oligarthrus in human host

Since humans rarely play the role as Echinococcus oligarthrus host, there is lack of knowledge about the complex infectious process. Only three cases have been reported to occur in humans in the neotropics until now. We present the anatomo-clinical and molecular findings describing a new case of infection by E. oligarthrus in a man. The muscular or subcutaneous tissues tropism described for this species in the previously reported cases was not present, but a liver tropism was observed. Additionally, the larval stage rostellar hooks morphometry differed from E. oligarthrus in the other human cases.

Prevalence of hepatitis A, B, C and D infections in the Juruti municipal hospital, western Pará, Brazil

The Juruti Municipality, located to the west of the Pará State, possesses major bauxite reserves, the exploration of which started in 2005. The appearance of some diseases and the increased frequency of others have been influenced by this exploration, particularly in relation to viral hepatitis. These epidemiological trends are different from those observed anywhere else worldwide. To define the prevalence of the infections by the hepatitis A, B, C and D viruses in the Juruti municipal hospital between February 2007 and April 2008, serum samples were collected from patients and analyzed for serological markers of hepatitis A (HAV), B (HBV), C (HCV) and D (HDV) by immunoenzymatic techniques. In samples positive for the hepatitis B and C viruses, assays were performed for the detection of HBV-DNA and HCV-RNA by PCR and RT-PCR, respectively. Among the 1,630 samples collected, the prevalence of total anti-HAV was 85.6%; HBsAg was 0.7%; + + anti-HBc/anti-HBs was 9.1% and isolated anti-HBs were 31.4%. Among the HBsAg , 9.1% were HBeAg ; 63.6% were anti+ + HBe and 72.7% were HBV-DNA . Anti-HCV was positive in 0.1% of the samples and positive serologies were not detected for HDV. Laboratory-based characterization revealed a high prevalence of infection by HAV, detected chronic HBV carriers and those susceptible to HBV, identified an HCV carrier and revealed the absence of HDV carriers. Local, community-based epidemiological studies are recommended for comparison to the hospital data presented here.

Prevalência de infecção pelos vírus das hepatites A, B, C e D na demanda de um hospital no Município de Juruti, oeste do Estado do Pará, Brasil

The Juruti Municipality, located to the west of the Pará State, possesses major bauxite reserves, the exploration of which started in 2005. The appearance of some diseases and the increased frequency of others have been influenced by this exploration, particularly in relation to viral hepatitis. These epidemiological trends are different from those observed anywhere else worldwide. To define the prevalence of the infections by the hepatitis A, B, C and D viruses in the Juruti municipal hospital between February 2007 and April 2008, serum samples were collected from patients and analyzed for serological markers of hepatitis A (HAV), B (HBV), C (HCV) and D (HDV) by immunoenzymatic techniques. In samples positive for the hepatitis B and C viruses, assays were performed for the detection of HBV-DNA and HCV-RNA by PCR and RT-PCR, respectively. Among the 1,630 samples collected, the prevalence of total anti-HAV was 85.6%; HBsAg was 0.7%; + + anti-HBc/anti-HBs was 9.1% and isolated anti-HBs were 31.4%. Among the HBsAg , 9.1% were HBeAg ; 63.6% were anti+ + HBe and 72.7% were HBV-DNA . Anti-HCV was positive in 0.1% of the samples and positive serologies were not detected for HDV. Laboratory-based characterization revealed a high prevalence of infection by HAV, detected chronic HBV carriers and those susceptible to HBV, identified an HCV carrier and revealed the absence of HDV carriers. Local, community-based epidemiological studies are recommended for comparison to the hospital data presented here.

Coinfection caused by the human immunodeficiency virus and hepatitis C virus (HIV-1/HCV): a case study in the Brazilian Amazon

INTRODUCTION: Since highly active antiretroviral therapy was developed in 1996, liver injury has become an important cause of morbidity and mortality in individuals infected by the human immunodeficiency virus-1 (HIV-1). OBJECTIVE: To report the demographic and laboratory findings of 62 patients coinfected with HIV-1/HCV. METHODS: This cross-sectional study analyzed HIV patients , confirmed serologically by ELISA and indirect immunofluorescence or Western Blot, with positive anti-HCV by ELISA and confirmed by RT-PCR. These patiens were treated at the Liver Department of the Fundação Santa Casa de Misericórdia do Pará from August 2004 to April 2008. RESULTS: A total of 49 (79%) male and 13 female patients were analyzed. Their age median was 42.6 years and they were single (66.1%, n=41), heterosexual (59.7%, n = 37), bisexual (27.4%, n = 17), man who have sex with man MSM (12.9%, n = 8); the lymphocytes T CD4+ count median 3 was 327 cells/mm , HIV serum viral load median was 2.54 log HIV RNA copies/mL, HCV viral load (RNA-HCV) was 5.9 10 log UI/mL. The HCV genotype 1 was found in 60.87% of the patients. Forty-one (66.12%) patients were submitted to liver 10 biopsies and the histopathology results according to METAVIR were F0 (12%), F1 (24.4%), F3 (17%), F4 (14.6%). CONCLUSION: Patients were predominantly single, with high viral load. They presented with moderate to severe fibrosis in more than 50% of cases without significant changes in their laboratory findings.

Coinfecção provocada pelos vírus da imunodeficiência humana e hepatite C (HIV-1/HCV): uma casuística da Amazônia brasileira

INTRODUCTION: Since highly active antiretroviral therapy was developed in 1996, liver injury has become an important cause of morbidity and mortality in individuals infected by the human immunodeficiency virus-1 (HIV-1). OBJECTIVE: To report the demographic and laboratory findings of 62 patients coinfected with HIV-1/HCV. METHODS: This cross-sectional study analyzed HIV patients , confirmed serologically by ELISA and indirect immunofluorescence or Western Blot, with positive anti-HCV by ELISA and confirmed by RT-PCR. These patiens were treated at the Liver Department of the Fundação Santa Casa de Misericórdia do Pará from August 2004 to April 2008. RESULTS: A total of 49 (79%) male and 13 female patients were analyzed. Their age median was 42.6 years and they were single (66.1%, n=41), heterosexual (59.7%, n = 37), bisexual (27.4%, n = 17), man who have sex with man MSM (12.9%, n = 8); the lymphocytes T CD4+ count median 3 was 327 cells/mm , HIV serum viral load median was 2.54 log HIV RNA copies/mL, HCV viral load (RNA-HCV) was 5.9 10 log UI/mL. The HCV genotype 1 was found in 60.87% of the patients. Forty-one (66.12%) patients were submitted to liver 10 biopsies and the histopathology results according to METAVIR were F0 (12%), F1 (24.4%), F3 (17%), F4 (14.6%). CONCLUSION: Patients were predominantly single, with high viral load. They presented with moderate to severe fibrosis in more than 50% of cases without significant changes in their laboratory findings.

Prevalencia de infección por los virus de las hepatitis A, B, C y D en la demanda de un hospital en el Municipio de Juruti, oeste del Estado de Pará, Brasil

The Juruti Municipality, located to the west of the Pará State, possesses major bauxite reserves, the exploration of which started in 2005. The appearance of some diseases and the increased frequency of others have been influenced by this exploration, particularly in relation to viral hepatitis. These epidemiological trends are different from those observed anywhere else worldwide. To define the prevalence of the infections by the hepatitis A, B, C and D viruses in the Juruti municipal hospital between February 2007 and April 2008, serum samples were collected from patients and analyzed for serological markers of hepatitis A (HAV), B (HBV), C (HCV) and D (HDV) by immunoenzymatic techniques. In samples positive for the hepatitis B and C viruses, assays were performed for the detection of HBV-DNA and HCV-RNA by PCR and RT-PCR, respectively. Among the 1,630 samples collected, the prevalence of total anti-HAV was 85.6%; HBsAg was 0.7%; + + anti-HBc/anti-HBs was 9.1% and isolated anti-HBs were 31.4%. Among the HBsAg , 9.1% were HBeAg ; 63.6% were anti+ + HBe and 72.7% were HBV-DNA . Anti-HCV was positive in 0.1% of the samples and positive serologies were not detected for HDV. Laboratory-based characterization revealed a high prevalence of infection by HAV, detected chronic HBV carriers and those susceptible to HBV, identified an HCV carrier and revealed the absence of HDV carriers. Local, community-based epidemiological studies are recommended for comparison to the hospital data presented here.

Coinfección provocada por los virus de inmunodeficiencia humana y hepatitis C (VIH-1/VHC): una casuística de la Amazonía brasileña

INTRODUCTION: Since highly active antiretroviral therapy was developed in 1996, liver injury has become an important cause of morbidity and mortality in individuals infected by the human immunodeficiency virus-1 (HIV-1). OBJECTIVE: To report the demographic and laboratory findings of 62 patients coinfected with HIV-1/HCV. METHODS: This cross-sectional study analyzed HIV patients , confirmed serologically by ELISA and indirect immunofluorescence or Western Blot, with positive anti-HCV by ELISA and confirmed by RT-PCR. These patiens were treated at the Liver Department of the Fundação Santa Casa de Misericórdia do Pará from August 2004 to April 2008. RESULTS: A total of 49 (79%) male and 13 female patients were analyzed. Their age median was 42.6 years and they were single (66.1%, n=41), heterosexual (59.7%, n = 37), bisexual (27.4%, n = 17), man who have sex with man MSM (12.9%, n = 8); the lymphocytes T CD4+ count median 3 was 327 cells/mm , HIV serum viral load median was 2.54 log HIV RNA copies/mL, HCV viral load (RNA-HCV) was 5.9 10 log UI/mL. The HCV genotype 1 was found in 60.87% of the patients. Forty-one (66.12%) patients were submitted to liver 10 biopsies and the histopathology results according to METAVIR were F0 (12%), F1 (24.4%), F3 (17%), F4 (14.6%). CONCLUSION: Patients were predominantly single, with high viral load. They presented with moderate to severe fibrosis in more than 50% of cases without significant changes in their laboratory findings.