Jéfferson Luis de Almeida Silva

Co-infecção por HIV/HCV em hospital universitário de Recife, Brasil

OBJECTIVE To estimate the prevalence of hepatitis C virus (HCV) infection and risks factors associated with coinfection in HIV-positive individuals. METHODS A cross-sectional descriptive study was conducted with 343 HIV patients attended at a university hospital in Recife, Northeastern Brazil, from March to December 2003. A standardized questionnaire about risk factors was administered. Serum samples were analyzed for anti-HCV antibodies using enzyme-linked immunosorbent assay (ELISA), HCV-RNA using reverse transcription-polymerase chain reaction (RT-PCR), and genotyping using the ABI 377 (PE Biosystems). Univariate and multivariate analyses and multiple logistic regression were performed. RESULTS HCV prevalence was 4.1% (14/343) using ELISA and 3.2% (11/343) using RT-PCR. The most common genotypes were 1b (45%), 3 (33%) and 1a (22%). Co-infection was higher among those aged 30 to 39 years, and predominantly in males (64.3 %). In the multiple logistic regression, the variable blood transfusion was the single remaining risk factor for HCV (OR=4.28; 95% CI 1.44;12.73). CONCLUSIONS The prevalence of HIV/HCV coinfection was low. Blood transfusion was a risk factor and HCV genotype 1b was the most frequently found.OBJETIVO: Estimar a prevalencia do virus da hepatite C (HCV) e fatores de risco associados com a co-infeccao em pessoas soropositivas para HIV. METODOS: Estudo do tipo transversal, descritivo e analitico, com 343 portadores do HIV atendidos em um hospital universitario de Recife (PE), no periodo de marco a dezembro de 2003. Os pacientes foram submetidos a um questionario padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HCV pelo ELISA, o HCV-RNA por meio da RT-PCR e a identificacao dos genotipos foi realizada no equipamento ABI377 (PE Biosystems®). As analises estatisticas utilizadas foram a univariada, a multivariada e a regressao logistica multipla. RESULTADOS: A prevalencia encontrada para o HCV foi de 4,1% (14/343) pelo ELISA e de 3,2 % (11/343) quando utilizada a RT-PCR. Os genotipos mais frequentes foram 1b (45%), 3 (33%) e 1a (22%). A faixa etaria com maior proporcao de co-infectados foi a de 30 a 39 anos, com predominio do sexo masculino (64,3%). Apos regressao logistica multipla, apenas a variavel transfusao sanguinea permaneceu como fator de risco para o HCV (OR=4,28; IC 95%: 1,44;12,73). CONCLUSOES: A prevalencia da co-infeccao HIV/HCV foi baixa, a transfusao sanguinea foi um fator de risco e o genotipo 1b do HCV foi o mais frequente.

Platelet function and the von Willebrand factor antigen in the hepatosplenic form of schistosomiasis mansoni.

Forty-five individuals with hepatosplenic schistosomiasis mansoni were studied with the aim of measuring levels of von Willebrand factor antigen (vWF:Ag), detecting abnormalities in platelet morphology and aggregation, and identifying changes to surface antigens. Haemograms, platelet aggregation tests, flow cytometry investigations of CD41/CD42b antibody and vWF:Ag assays were performed. Mean platelet counts were low (77,522/mm3) and 82.2% of patients presented thrombocytopenia. An inverse relationship between spleen size and platelet count was seen. Macroplatelets were found in 57.1% of patients, indicating good bone-marrow response, but were insufficient to compensate for the decrease in platelets due to splenomegaly. Decreased or absent platelet aggregation was seen in 50% of patients, probably due to low platelet counts. Markers for GPIIb/IIIa were normal in more than 90% of patients, not supporting the increased capture and destruction of platelets in the spleen that is hypothesized to occur with cirrhosis. Similar to cirrhosis, vWF:Ag levels were high or very high in 70.5% of patients. High levels of vWF:Ag were associated with platelet counts <100,000/mm3, larger spleen diameter and oesophageal varices. In conclusion, hepatosplenic schistosomiasis leads to a lower platelet count due to pooling in the spleen and, consequently, impaired aggregation, but not to increased capture and destruction of platelets in the spleen. High vWF:Ag levels probably promote stabilization of platelet microaggregates and prevent minor manifestations of thrombocytopenia such as petechiae, ecchymosis and gingival bleeding.

HIV/HCV coinfection at an university hospital in Recife, Brazil

OBJECTIVE To estimate the prevalence of hepatitis C virus (HCV) infection and risks factors associated with coinfection in HIV-positive individuals. METHODS A cross-sectional descriptive study was conducted with 343 HIV patients attended at a university hospital in Recife, Northeastern Brazil, from March to December 2003. A standardized questionnaire about risk factors was administered. Serum samples were analyzed for anti-HCV antibodies using enzyme-linked immunosorbent assay (ELISA), HCV-RNA using reverse transcription-polymerase chain reaction (RT-PCR), and genotyping using the ABI 377 (PE Biosystems). Univariate and multivariate analyses and multiple logistic regression were performed. RESULTS HCV prevalence was 4.1% (14/343) using ELISA and 3.2% (11/343) using RT-PCR. The most common genotypes were 1b (45%), 3 (33%) and 1a (22%). Co-infection was higher among those aged 30 to 39 years, and predominantly in males (64.3 %). In the multiple logistic regression, the variable blood transfusion was the single remaining risk factor for HCV (OR=4.28; 95% CI 1.44;12.73). CONCLUSIONS The prevalence of HIV/HCV coinfection was low. Blood transfusion was a risk factor and HCV genotype 1b was the most frequently found.OBJETIVO: Estimar a prevalencia do virus da hepatite C (HCV) e fatores de risco associados com a co-infeccao em pessoas soropositivas para HIV. METODOS: Estudo do tipo transversal, descritivo e analitico, com 343 portadores do HIV atendidos em um hospital universitario de Recife (PE), no periodo de marco a dezembro de 2003. Os pacientes foram submetidos a um questionario padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HCV pelo ELISA, o HCV-RNA por meio da RT-PCR e a identificacao dos genotipos foi realizada no equipamento ABI377 (PE Biosystems®). As analises estatisticas utilizadas foram a univariada, a multivariada e a regressao logistica multipla. RESULTADOS: A prevalencia encontrada para o HCV foi de 4,1% (14/343) pelo ELISA e de 3,2 % (11/343) quando utilizada a RT-PCR. Os genotipos mais frequentes foram 1b (45%), 3 (33%) e 1a (22%). A faixa etaria com maior proporcao de co-infectados foi a de 30 a 39 anos, com predominio do sexo masculino (64,3%). Apos regressao logistica multipla, apenas a variavel transfusao sanguinea permaneceu como fator de risco para o HCV (OR=4,28; IC 95%: 1,44;12,73). CONCLUSOES: A prevalencia da co-infeccao HIV/HCV foi baixa, a transfusao sanguinea foi um fator de risco e o genotipo 1b do HCV foi o mais frequente.

HBV and HCV serological markers in patients with the hepatosplenic form of mansonic schistosomiasis

CONTEXT Blood transfusion is one of the major risk factors for the transmission of the hepatitis B (HBV) and C (HCV) viruses. However, there are no reports describing the endoscopic transmission of these viruses in patients with the hepatosplenic form of schistosomiasis. OBJECTIVE To estimate the prevalence of serological markers of HBV and HCV in patients with the hepatosplenic form of schistosomiasis and evaluate the possible risk factors associated with these infections. METHODS A cross-sectional study was conducted on 230 patients with hepatosplenic form of schistosomiasis who attended a university hospital in Recife, Northeastern Brazil, from February to August 2008. The patients answered a standardized questionnaire about risk factors. Serum samples were analyzed for anti-HBc total, anti-HBs, HBsAg, and anti-HCV using enzyme-linked immunosorbent assays. Univariate analysis and multiple logistic regression were performed. RESULTS The prevalence was 30% for anti-HBc total and/or HBsAg and 7.4% for anti-HCV. There was a higher frequency of the serological markers in females and in patients aged .50 years. A significant association was detected between the presence of anti-HCV and the receipt of six or more blood transfusions. There was no association of history and number of digestive endoscopies with the serological markers analyzed. CONCLUSIONS We observed a higher prevalence of serological markers for HBV and a lower prevalence of anti-HCV. Our results indicate that females and patients of an advanced age are the most affected categories and that patients that received multiple transfusions are at a higher probability of HCV infection.

Hepatitis B virus in the State of Alagoas, Brazil: genotypes characterization and mutations of the precore and basal core promoter regions

The aims of this study were to investigate the genotypes of hepatitis B virus and to identify the precore G1896A and basal core promoter A1762T/G1764A mutations in HBsAg and anti-HBc-positive patients. Eighty-three asymptomatic individuals, three with acute hepatitis B and 33 with chronic hepatitis B referred to viral hepatitis centers in the State of Alagoas, Brazil were analyzed according to their viral load, HBeAg/anti-HBe profile and alanine aminotransferase serum level. The genotypes identified were: A (92.5%), C (5%), D (1.25%) and F (1.25%). The precore mutation was detected in 3.8% of sequences and basal core promoter mutation in 52.4%. These were identified in 45.45% of the asymptomatic individuals and 54.55% of the patients with chronic hepatitis, irrespective of viral load and alanine aminotransferase serum level. In genotype C, only the basal core promoter mutation was identified and no mutations were identified in genotypes D and F.

The relationship between hepatitis B virus (HBV) load and levels of transforming growth factor beta 1 (TGF-β1) and soluble Fas (sFas) in human immunodeficiency virus patients with occult HBV infection.

The aim of this study was to evaluate the correlation between hepatitis B virus (HBV) load and serum levels of transforming growth factor beta 1 (TGF-β1) and soluble Fas (sFas) cytokines in human immunodeficiency virus (HIV) patients who have never been treated with antiretroviral therapy. HBV and hepatitis C virus (HCV) serological markers, sFas and TGF-β1 levels, and HBV load were evaluated in 116 patients. While there was no correlation between TGF-β1 levels and HBV load, a positive correlation between sFas levels and HBV load was observed in patients with occult HBV infection.

Coinfección por HIV/HCV en hospital universitario de Recife, Brasil

OBJECTIVE To estimate the prevalence of hepatitis C virus (HCV) infection and risks factors associated with coinfection in HIV-positive individuals. METHODS A cross-sectional descriptive study was conducted with 343 HIV patients attended at a university hospital in Recife, Northeastern Brazil, from March to December 2003. A standardized questionnaire about risk factors was administered. Serum samples were analyzed for anti-HCV antibodies using enzyme-linked immunosorbent assay (ELISA), HCV-RNA using reverse transcription-polymerase chain reaction (RT-PCR), and genotyping using the ABI 377 (PE Biosystems). Univariate and multivariate analyses and multiple logistic regression were performed. RESULTS HCV prevalence was 4.1% (14/343) using ELISA and 3.2% (11/343) using RT-PCR. The most common genotypes were 1b (45%), 3 (33%) and 1a (22%). Co-infection was higher among those aged 30 to 39 years, and predominantly in males (64.3 %). In the multiple logistic regression, the variable blood transfusion was the single remaining risk factor for HCV (OR=4.28; 95% CI 1.44;12.73). CONCLUSIONS The prevalence of HIV/HCV coinfection was low. Blood transfusion was a risk factor and HCV genotype 1b was the most frequently found.OBJETIVO: Estimar a prevalencia do virus da hepatite C (HCV) e fatores de risco associados com a co-infeccao em pessoas soropositivas para HIV. METODOS: Estudo do tipo transversal, descritivo e analitico, com 343 portadores do HIV atendidos em um hospital universitario de Recife (PE), no periodo de marco a dezembro de 2003. Os pacientes foram submetidos a um questionario padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HCV pelo ELISA, o HCV-RNA por meio da RT-PCR e a identificacao dos genotipos foi realizada no equipamento ABI377 (PE Biosystems®). As analises estatisticas utilizadas foram a univariada, a multivariada e a regressao logistica multipla. RESULTADOS: A prevalencia encontrada para o HCV foi de 4,1% (14/343) pelo ELISA e de 3,2 % (11/343) quando utilizada a RT-PCR. Os genotipos mais frequentes foram 1b (45%), 3 (33%) e 1a (22%). A faixa etaria com maior proporcao de co-infectados foi a de 30 a 39 anos, com predominio do sexo masculino (64,3%). Apos regressao logistica multipla, apenas a variavel transfusao sanguinea permaneceu como fator de risco para o HCV (OR=4,28; IC 95%: 1,44;12,73). CONCLUSOES: A prevalencia da co-infeccao HIV/HCV foi baixa, a transfusao sanguinea foi um fator de risco e o genotipo 1b do HCV foi o mais frequente.