Infecção pelo vírus da hepatite c em hospital de referência na Amazônia brasileira / Infection with hepatitis c virus at reference hospital in the brazilian amazon

Objetivo: descrever as características clínicas e socio-demográficas dos indivíduos com hepatite C, atendidos no am-bulatório de Fígado da Fundação Santa Casa de Misericórdia do Pará. Método: estudo transversal e retrospectivo, com 82 pacientes com hepatite C no período de agosto a dezembro de 2011. Utilizou-se um protocolo de pesquisa, com entrevista dos pacientes associada à análise de prontuários. Resultados: a maioria era do sexo masculino (52,4%), com 40 a 59 anos (57,3%), ensino médio completo (50%), história de relação sexual desprotegida (90,2%), uso compartilhado de materiais passíveis de transmissão (84%), histórico de cirurgias (70,7%), transfusão sanguínea (35%), genótipo 1b (13,4%), classificação METAVIR com grau de fibrose F2 (33,3%) e atividade inflamatória A1 (40%). Conclusão: a maioria dos pacientes eram do sexo masculino, com 40 a 59 anos, com nível médio completo, com exposição passada através de relação sexual desprotegida, uso compartilhado de materiais passíveis de transmissão, histórico de cirurgias e transfusão sanguínea, com genótipo 1b e grau de Fibrose, F2 e Atividade, A1 pela classificação de METAVIR.

Objective: describe the clinical and socio-demographic characteristics of individuals infection by hepatitis C treat at liver outpatient clinic of Santa Casa de Misericordia do Pará. Methods: cross-sectional and retrospective study with 82 patients with hepatitis C assisted in the period from August to December 2011. Was used a research protocol, with interviews of patients associated an analysis of medical records. Results: the majority were male (52.4%), with 40 to 59 years (57.3%), secondary education (50%), with a history of unprotected sexual intercourse (90.2%), shared use of materials which are suitable for transmission (84%), history of surgery (70.7%), blood transfusion (35%), genotype 1b (13.4% ), classification with METAVIR fibrosis F2 (33.3%) and A1 inflammatory activity (40%). Conclusion: most patients were male, 40 to 59 years, with complete secondary school, with past exposure through unprotected sex, use shared materials which are suitable for transmission, history of surgery and blood transfusion, genotype 1b and classi-fication METAVIR F2 and A1.

Mannose-binding lectin gene polymorphisms are not associated with susceptibility to hepatitis C virus infection in the Brazilian Amazon region.

The present study compares the genotype frequencies between two population groups composed by 73 hepatitis C virus (HCV)-infected patients and 92 seronegative controls and investigates the role of allele variants as a possible factor in the susceptibility to HCV infection and the influence on disease progression. The identification of MBL*B and MBL*C alleles was performed by restriction fragment length polymorphism analysis of the 349-bp product using BanI and MboII restriction enzymes, respectively, and a polymerase chain reaction-sequence-specific polymorphism for discrimination of MBL*D. The analysis of allele and genotype frequencies between an HCV-infected group and seronegative controls did not indicate significant differences. The comparison of chronically infected subjects with and without liver cirrhosis was also not statistically significant. The odds ratio estimations were not significant, and the values obtained cannot suggest that the presence of allele variant MBL*B could have some influence in the risk of HCV infection progression to liver cirrhosis and that the presence of allele MBL*D could confer some protection against disease progression, but a larger sample size is necessary to confirm the present results.

[Prevalence of hepatitis B virus genotypes and the occurrence of precore mutation A-1896 and to correlate them with the clinical presentation of chronic hepatitis, in a population group of the Eastern Amazon region]. / Prevalência de genótipos e de mutantes pré-core A-1896 do vírus da hepatite B e suas implicações na hepatite crônica, em uma população da Amazônia oriental.

Hepatitis B virus (HBV) infection presents itself with a variety of clinical manifestations. The present work aims to describe the prevalence of HBV genotypes and the occurrence of precore mutation A-1896 in a population group of the Eastern Amazon region of Brazil and to correlate them with the clinical presentation of chronic HBV infection. 51 HBsAg carriers (HBV-DNA positive) were selected and divided into three groups: A (14 asymptomatic subjects), B (20 HBeAg positive symptomatic patients) and C (17 HBeAg negative symptomatic patients). Using an automa ed DNA sequencer ABI model 377 by sequencing for determined of genotypes and precore mutation. The results showed that the genotype A was the most commonly found (81.1%, 89.5% and 93.7% in groups A, B and C, respectively) and precore mutation A-1896 was described in 11.5% (3/26) of group A subjects. Genotype A of HBV was the most prevalent (89.1%) and low occurrence of precore mutation A-1896, both not associate with the worst outcome of the chronic infection of HBV.

[Hepatitis B and C virus infection and the hepatocellular carcinoma in the East Amazon, Brazil]. / Infecções pelos vírus das hepatites B e C e o carcinoma hepatocelular na Amazônia oriental.

In order to contribute to a better understanding of the possible role of hepatits B and C in the etiopathogenis of HCC in the East Amazon, there were studied 36 patients in Belém/PA. Serological hepatitis markers were evaluated and polymerase chain reaction assays were used to detect HBV-DNA and HCV-RNA. Alcohol abuse was observed in 33.3% and cirrhosis in 83.3%. In 88.9% of the sample, one or more hepatitis B markers were positive. Also, 8.3% those patients had anti-HCV simultaneously positive. The HBsAg serological test was positive in 58.3%; anti-HBc in 86%; anti-HBe in 85.7%; anti-HBe in 9.5%; IgM anti-HBc in 57.1%. The HBV DNA was found in 37.7% and in 65% of the HBsAg positive. The HCV RNA was detected in 8.5% and in 100% of the patients positive to anti-HCV. The AFP was above the normal value in 88.9% of patients, with levels up to 400ng/ml in 75% of them. In conclusion, hepatitis B virus infection seems to be important in the etiology of HCC and improving measures such immunization and screening in the risk population should be emphasyzed.

Prevalência de genótipos e de mutantes pré-core A-1896 do vírus da hepatite B e suas implicações na hepatite crônica, em uma população da Amazônia oriental / Prevalence of hepatitis B virus genotypes and the occurrence of precore mutation A-1896 and to correlate them with the clinical presentation of chronic hepatitis, in a population group of the eastern Amazon region

A infecção pelo virus da hepatite B apresenta amplo espectro de manifestações clínicas. Objetivando conhecer os genótipos do HBV mais prevalentes e determinar a ocorrência da mutação pré-core A-1896, em uma população da Amazônia oriental, correlacionando com o diagnóstico clínico, foram selecionados 51 pacientes portadores crônicos de HBsAg e HBV-DNA positivos e divididos em três grupos: grupo A (n=14, pacientes assintomáticos); grupo B (n=20, sintomáticos HBeAg positivos) e grupo C (n=17, sintomáticos HBeAg negativos), sendo usado o sequenciador automático ABI modelo 377 para identificação de genótipos e mutantes pré-core. Os resultados evidenciaram o genótipo A como o mais prevalente, 81,8%, 89,5% e 93,7%, nos grupos A, B e C, respectivamente. A mutação pré-core A-1896 foi encontrada em 11,5% (3/26), sendo todos assintomáticos. Concluiu-se que na população estudada o genótipo A foi o mais prevalente e houve baixa ocorrência do mutante pré-core A-1896, ambos não se constituindo fatores agravantes da doença hepática.

Hepatitis B virus (HBV) infection presents itself with a variety of clinical manifestations. The present work aims to describe the prevalence of HBV genotypes and the occurrence of precore mutation A-1896 in a population group of the Eastern Amazon region of Brazil and to correlate them with the clinical presentation of chronic HBV infection. 51 HBsAg carriers (HBV-DNA positive) were selected and divided into three groups: A (14 asymptomatic subjects), B (20 HBeAg positive symptomatic patients) and C (17 HBeAg negative symptomatic patients). Using an automa ed DNA sequencer ABI model 377 by sequencing for determined of genotypes and precore mutation. The results showed that the genotype A was the most commonly found (81,1%, 89,5% and 93,7% in groups A, B and C, respectively) and precore mutation A-1896 was described in 11,5% (3/26) of group A subjects. Genotype A of HBV was the most prevalent (89,1%) and low occurrence of precore mutation A-1896, both not associate with the worst outcome of the chronic infection of HBV.

Infecções pelos vírus das hepatites B e C e o carcinoma hepatocelular na Amazônia oriental / Hepatitis B and C virus infection and the hepatocellular carcinoma in the east Amazon, Brazil

Com o objetivo de contribuir para um melhor conhecimento do envolvimento das infecções pelos vírus das hepatites B e C, na etioepidemiologia do CHC na Amazônia Oriental, estudou-se 36 pacientes em Belém-PA. Foram avaliados marcadores sorológicos e a pesquisa do HBV-DNA e HCV-RNA pela reação em cadeia da polimerase. Observou-se etilismo em 33,3% e cirrose em 83,3%. Marcadores sorológicos das infecções pelo HBV e HCV foram encontrados respectivamente em 88,9% e 8,3%. O HBsAg foi encontrado em 58,3%; anti-HBc em 86%; anti-HBe em 85,7; HBeAg em 9,5%; anti-HBc IgM em 57,1%. O HBV-DNA foi detectado em 37,7% e em 65% dos HBsAg positivos; o HCV-RNA em 8,5% e em 100% dos anti-HCV positivos. AFP esteve alterada em 88,9% e acima de 400ng/ml em 75% dos casos. Conclui-se que a infecção pelo HBV parece ter importância na etiologia do CHC e ressalta-se a importância de implementar programas de vacinação e detecção precoce do tumor.

In order to contribute to a better understanding of the possible role of hepatits B and C in the etiopathogenis of HCC in the East Amazon, there were studied 36 patients in Belém/PA. Serological hepatitis markers were evaluated and polymerase chain reaction assays were used to detect HBV-DNA and HCV-RNA. Alcohol abuse was observed in 33.3% and cirrhosis in 83.3%. In 88.9% of the sample, one or more hepatitis B markers were positive. Also, 8.3% those patients had anti-HCV simultaneously positive. The HBsAg serological test was positive in 58.3%; anti-HBc in 86%; anti-HBe in 85.7%; anti-HBe in 9.5%; IgM anti-HBc in 57.1%. The HBV DNA was found in 37.7% and in 65% of the HBsAg positive. The HCV RNA was detected in 8.5% and in 100% of' the patients positive to anti-HCV. The AFP was above the normal value in 88.9% of patients, with levels up to 400ng/ml in 75% of them. In conclusion, hepatitis B virus infection seems to be important in the etiology of HCC and improving measures such immunization and screening in the risk population should be emphasyzed.