Seroprevalence of hepatitis E virus in patients with chronic liver disease.

INTRODUCTION: The seroprevalence of hepatitis E virus (HEV) in patients with chronic liver disease (CLD) is little known in Brazil. Studies have suggested that HEV may harmfully influence the course of CLD, with a higher risk of progression to cirrhosis. OBJECTIVE: To estimate the prevalence of the anti-HEV antibody (IgG) in patients with CLD and to describe demographic data and risk factors, as well as clinical-laboratory and ultrasound parameters. PATIENTS AND METHODS: Cross-sectional study that included 227 patients with CLD followed at a referral outpatient clinic from June 2022 to March 2023. The patients were investigated clinically and tested for liver functions, anti-HEV IgG and, in positive cases, for HEV-RNA. Ultrasonography of the upper abdomen was also carried out. RESULTS: Investigation of 227 patients (50 with hepatitis B, 49 with nonalcoholic fatty liver disease, 33 with hepatitis C, 17 with alcoholic liver disease, 16 with schistosomiasis and 62 with mixed disease), 55.5% were female, with an average age of 57 ± 13 years; 37.9% had liver cirrhosis. Seven patients (3.08%) presented anti-HEV positive and HEV-RNA negative. Ultrasound identified association between anti-HEV and contact with pigs, presence of gynecomastia or palmar erythema, lower platelet count, higher APRI and FIB-4 values, and splenomegaly. CONCLUSION: Although the prevalence of anti-HEV in patients with CLD was low in this study, the antibody was observed more frequently in cases with a history of contact with pigs and with clinical-laboratory or imaging evidence of more advanced chronic liver disease.

Synergism between chikungunya virus infection and rheumatoid arthritis on cytokine levels: Clinical implications?

Post-chikungunya virus (CHIKV) chronic arthritis shares several immunopathogenic mechanisms with rheumatoid arthritis (RA), which has led to discussions about the probable relationship between the two diseases. Indeed, some studies have suggested a role for CHIKV infection in RA development. However, to the best of our knowledge, the influence of CHIKV on previous RA has not yet been demonstrated. Herein, we analyzed the potential synergism between CHIKV infection and RA on cytokine and chemokine levels. For this, we compared the IL-1ß, IL-6, IL-10, IL-17A, CCL2, CXCL8, CXCL9 and CXCL10 levels, in addition to rheumatoid factor (RF) and C-reactive protein (CRP), in patients with post-CHIKV chronic arthritis (named CHIKV group), patients with RA (RA group), and patients with previous RA who were later infected by CHIKV (RA-CHIKV). History of CHIKV infection was confirmed by serology (IgG, ELISA). Cytokines/chemokines were quantified by flow cytometry. RF, CRP, age and sex data were obtained from medical records. IL-1ß, IL-6, IL-10 and IL-17A levels were significantly higher in RA-CHIKV compared to the other groups. CXCL8 levels were higher in the CHIKV group than in RA. CXCL9 was higher in CHIKV than in the RA-CHIKV group. CXCL10 was higher in CHIKV than in the other groups. FR levels were higher in RA than in the CHIKV group, and in RA-CHIKV than in CHIKV. No significant difference was observed in CCL2 and CRP, as well as in age and sex. Finally, our findings suggest an interplay between CHIKV infection and RA, which must be analyzed for its possible clinical impact.

Chikungunya virus as a trigger for different renal disorders: an exploratory study.

INTRODUCTION: Chikungunya virus was detected in cases of acute chikungunya fever in renal tissue. However, chikungunya virus-related kidney injury still lacks characterization, and it is unknown whether the kidneys are reservoirs for the virus. We sought to detect histopathological changes and viral antigens in renal tissue, and to evaluate kidney injury markers in different phases of chikungunya fever. METHODS: Two groups were evaluated in this exploratory study: patients with biopsy-proven kidney injury established after chikungunya fever, and patients with post-chikungunya fever chronic joint manifestations without known kidney injury, in whom we actively searched for kidney injury markers. RESULTS: In the first group, 15 patients had kidney injury 0.5-24 months after chikungunya fever. The most frequent histopathological diagnoses were glomerular lesions. No viral antigens were detected in renal tissue. High-risk genotypes were detected in patients with atypical hemolytic uremic syndrome and focal and segmental glomerulosclerosis. In the second group, 114 patients had post-chikungunya fever joint manifestations on average for 35.6 months. Mean creatinine and proteinuria were 0.9 mg/dl and 71.5 mg/day, respectively. One patient had isolated hematuria. There was no indication for renal biopsy in this group. CONCLUSIONS: Several histopathological features were found after chikungunya fever, without virus detection in renal tissue. These findings suggest that chikungunya virus may trigger kidney lesions with varying degrees of severity at different stages of infection. However, the probability that this virus replicates in the renal tissue seems unlikely.

Correlation between human papillomavirus infection and histopathological diagnosis of women in Northeast Brazil.

Cervical carcinoma is the fourth leading cause of death among women worldwide. Epidemiological studies claim that human papillomavirus (HPV) infection is a necessary condition for cervical cancer development. Knowledge of the geographic distribution of HPV is important in guiding the introduction of prophylactic vaccines. This study analyzed the prevalence of HPV infection in cervical samples obtained from women with abnormal cervical histopathological diagnosis in Northeast Brazil. The study included an analysis of 211 women whose diagnosis was confirmed for cervical intraepithelial neoplasia type 1 (CIN-1), cervical intraepithelial neoplasia type 2 (CIN-2), cervical intraepithelial neoplasia type 3 (CIN-3), and cancer. The identification of the HPV genotypes was based on the polymerase chain reaction-restriction fragment length polymorphism technique. A total of 42.7% of the samples showed a single HPV infection, while 57.3% showed multiple infections. The most common genotypes detected were HPV-16, HPV-18, and HPV-31. HPV-16, HPV-31, HPV-35, and HPV-18 were the most common types in CIN-1 with a single infection. HPV-16 and HPV-18 were the most often found in CIN-2 with a single infection. HPV-16, HPV-18, and HPV-31 were the most detected in CIN-3 with a single infection. HPV-16 and HPV-31 were the most frequent in cancer with a single infection. Multiple infection with HPV-16 shows a 2.7 times greater risk of CIN-3 (P = .04). Multiple infections for HPV with HPV-16 and excluding the HPV18/31 types, were associated with CIN-3 (P = .01). The results allowed the detection and genotyping of HPV types circulating in the population studied. These findings must be taken into account when devising vaccination strategies against HPV.

Association of NFκB and related-cytokines with the viral load and development of antibodies against HHV-8 in people living with HIV/AIDS.

Human gammaherpesvirus 8 (HHV-8) replication is influenced by a complex interaction between viral and host elements. Here, we evaluated the expression of NFκB and TNF-α in B (CD19 +) and T (CD3 +) lymphocytes, and the serum concentration of IL-1ß and IL-12 cytokines in people living with HIV/AIDS (PLHA), negative for HHV-8-related diseases, and who presented antibodies to latent or lytic antigens from HHV-8. In addition, we also evaluated the correlation of HHV-8 viral load with NFκB, TNF-α, IL-1ß and IL-12 levels. The expression of NFκB (p < 0.0001) or TNF-α (p < 0.0001) in B lymphocytes (CD19 +) and the IL-1ß (p < 0.0266) and IL-12 (p < 0.0001) concentrations were associated with the presence of antibodies to HHV-8 lytic antigens. The CD19 + NFκB + TNF-α + and CD3 + NFκB + TNF-α + cells were also associated with the presence of antibodies to lytic infection (p < 0.0001). Among all PLHA evaluated, only individuals with the highest titers of lytic antibodies, i.e., 1:320, had detectable HHV-8 viral load. In these, HHV-8 viral load was correlated to NFκB (r = 0.6, p = 0.003) and TNF-α (r = 0.5, p = 0.01) (both in CD19 + lymphocytes) and with IL-1ß (r = 0.5, p = 0.01) and IL-12 (r = 0.6, p = 0.006) levels. We believe that viral replication and/or reactivation, in addition to being associated with the development of lytic antibodies against HHV-8, may be associated with inflammatory response via NFκB. Finally, although immune response imbalance has been previously related to HHV-8-associated diseases, our results indicate that important changes in immunity, mainly in the inflammatory response, may be clearly observed in individuals with HHV-8, but who have not yet presented clinical manifestations.

Association of IL-6, IL-10 and CXCL10 serum concentrations with visceral Kaposi's sarcoma in people living with HIV/AIDS.

Human gammaherpesvirus 8 (HHV-8) is the etiologic agent of Kaposi's sarcoma (KS), one of the most common cancers in people living with HIV/AIDS. It is believe that the course of both HIV and HHV-8 infection is associated with the imbalance of anti- and/or pro-inflammatory cytokines. Here, we evaluated the IL-6, TNF-α, IL-10, CCL2 and CXCL10 serum concentrations in HIV- and HIV/HHV-8 (without KS) individuals, and in patients with cutaneous or visceral AIDS-KS. Serum concentrations of IL-6, IL-10 and CXCL10 were significantly higher in the AIDS-KS group compared to HIV and HIV/HHV-8 individuals. Similarly, the concentrations of theses cytokines were higher in patients with visceral than in those with cutaneous AIDS-KS. The TNF-α concentration was significantly higher in the HIV group compared to HIV/HHV-8 (with and without KS) individuals, and CCL2 levels did not present significant difference among the groups. The HIV viral load was undetectable in all patients from the HIV and HIV/HHV-8 groups. On the other hand, in the AIDS-KS group, most patients had detectable HIV viral load. In this context, we believe that the cytokine levels in AIDS-KS may be result of a complex interaction between HIV, HHV-8 and immunity.

Association of polymorphisms in NFκB1 promoter and NFκBIA gene with the development of antibodies against HHV-8 in HIV-infected individuals.

Human gammaherpesvirus 8 (HHV-8) is the etiologic agent of Kaposi's sarcoma, multicentric Castleman's disease and primary effusion lymphoma. Like other herpesviruses, the HHV-8 may exhibit latent or lytic cycle, both regulated by viral and host factors. Regarding host factors, we analysed the association of polymorphisms in NFkB1 promoter (NFkB1-94 ins/del ATTG) and NFκBIA gene (NFκBIA 3'UTR A→G) with the development of antibodies against latent or lytic antigens from HHV-8. The ins/del [OR 7.9 (95% CI 3.3-19.1), p < 0.001], AG [OR 12.3 (95% CI 4.3-34.9) p < 0.001], GG [OR 9.4 (95% CI 3.2-27.9), p < 0.001], ins/del + AG [OR 94.5 (95% CI 9.6-924.4), <0.0001], ins/del + GG [OR 50.4 (95% CI 5.2-482.2, p < 0.0001] and G allele [OR 3.3 (95% CI 2.0-5.6), p < 0.001] were strongly related with the presence of antibodies to lytic antigens. This is the first association of polymorphisms in NFκB1 promoter and NFκBIA gene with the development of antibodies against HHV-8.

HTLV 1/2 Prevalence and risk factors in individuals with HIV/AIDS in Pernambuco, Brazil.

INTRODUCTION: Apart from masking the diagnosis of AIDS in patients with HIV/AIDS, human T-cell lymphotropic virus (HTLV), when present, also increases the risk of myelopathies and neurological disease in these patients. METHODS: Disease prevalence was estimated by ELISA and confirmed by Western blot. RESULTS: The coinfection rate was 1.5% (11/720); 10 of 11 patients had HTLV-1, and the remaining one had HTLV-2. The majority were male, over 40 years old, and of pardo color (ethnicity). CONCLUSIONS: There was no association between the risk factors examined and HTLV/HIV coinfection. This is the first study to report the occurrence of HTLV-2 in Pernambuco.

Mannose-binding lectin concentrations in people living with HIV/AIDS infected by HHV-8.

BACKGROUND: Mannose-binding lectin (MBL) plays an important role in the innate immune response by activating the complement system via the lectin pathway, and it has been studied in several viral infections; however, the influence of MBL in PLWHA infected with HHV-8 is unknown. The objective of this study was to verify the association of MBL deficient plasma concentrations in HIV/HHV-8 coinfected and HIV monoinfected patients and to correlate these concentrations with HIV viral load and CD4 counts in both groups. RESULTS: This was an analytical study of case-controls consisting of PLWHA monitored at the medical outpatient of Infectious and Parasitic Diseases of the clinical hospital in the Federal University of Pernambuco. Plasma concentrations of MBL were obtained by an enzyme-linked immunosorbent assay (ELISA) using a commercial Human Mannose Binding Lectin kit (MyBioSource, Inc.) that was performed according to the manufacturer's guidelines, with values < 100 ng/ml considered deficient. A total of 245 PLWHA samples were analysed; 118 were HIV/HHV-8 coinfected and 127 were HIV monoinfected; 5.1% (6/118) of the coinfected patients and 3.2% (4/127) of the monoinfected patients (p = 0.445) were considered plasma concentration deficient. The median of the plasma concentrations of MBL in the coinfected patients was 2803 log10 ng/ml and was 2.959 log10 ng/ml in the monoinfected patients (p = 0.001). There was an inverse correlation between the plasma concentrations of MBL and the HIV viral load in both groups, but no correlation with the CD4 count. CONCLUSIONS: Although the plasma concentrations considered deficient in MBL were not associated with HHV-8 infection in PLWHA, the coinfected patients showed lower MBL concentrations and an inverse correlation with HIV viral load, suggesting that there may be consumption and reduction of MBL due to opsonization of HIV and HHV-8, leading to the reduction of plasma MBL and non-accumulation in the circulation.

HTLV 1/2 Prevalence and risk factors in individuals with HIV/AIDS in Pernambuco, Brazil

Abstract INTRODUCTION: Apart from masking the diagnosis of AIDS in patients with HIV/AIDS, human T-cell lymphotropic virus (HTLV), when present, also increases the risk of myelopathies and neurological disease in these patients. METHODS: Disease prevalence was estimated by ELISA and confirmed by Western blot. RESULTS: The coinfection rate was 1.5% (11/720); 10 of 11 patients had HTLV-1, and the remaining one had HTLV-2. The majority were male, over 40 years old, and of pardo color (ethnicity). CONCLUSIONS: There was no association between the risk factors examined and HTLV/HIV coinfection. This is the first study to report the occurrence of HTLV-2 in Pernambuco.

MBL2 gene polymorphisms in HHV-8 infection in people living with HIV/AIDS.

BACKGROUND: Host genetic factors such as MBL2 gene polymorphisms cause defects in the polymerization of MBL protein and result in a functional deficiency and/or in low serum levels that can influence susceptibility to various viral infections. The aim of this study was to estimate the frequency of alleles, genotypes and haplotypes related to -550, -221 and exon 1 polymorphisms of the MBL2 gene and investigate their association with HHV-8 in people living with HIV/AIDS (PLWHA), as well as the impacts on CD4 cell count and HIV viral load in HIV/HHV-8 coinfected and HIV monoinfected patients. RESULTS: A cross sectional study in PLWHA, with and without HHV-8 infection, exploring associations between different factors, was performed in the outpatient infectious and parasitic diseases clinic at a referral hospital. Genomic DNA extractions from leukocytes were performed using a commercial Wizard® Genomic DNA Purification kit (Promega, Madison, WI). The promoter region (-550 and -221) was genotyped with the TaqMan system (Applied TaqMan Biosystems® genotyping Assays), and the structural region (exon1) was genotyped with Express Sybr Greener Supermix kit (Invitrogen, USA). In total, 124 HIV/HHV-8 coinfected and 213 HIV monoinfected patients were analysed. Median TCD4 counts were significantly lower in HIV/HHV-8 coinfected patients, whereas the mean of the first and last viral load of HIV did not present significant difference. There was no difference in frequency between the LL, YY and AA genotypes between the HIV/HHV-8 coinfected or HIV monoinfected patients. However, in a multivariate analysis, coinfected patients with the intermediate expression haplotype of the MBL2 gene had an odds ratio of 3.1-fold (CI = 1.2-7.6) of their last CD4 cell count being below 350 cells/mm3. Among the coinfected individuals, four developed KS and presented the intermediate expression MBL haplotype, with three being HYA/LXA and one being LYA/LYO. CONCLUSIONS: Host genetic factors, such as -550, -221 and exon 1 polymorphisms, can be related to the may modify coinfections and/or to the development clinical manifestations caused by HHV-8, especially in HIV/HHV-8 coinfected patients who present the intermediate expression haplotypes of MBL.

There is no evident correlation between interleukin-10 gene polymorphisms and periportal fibrosis regression after specific treatment

Abstract INTRODUCTION: We evaluated the associations between interleukin-10 (IL-10) gene polymorphisms -G1082A/-C819T/-C592A and periportal fibrosis regression after specific treatment for schistosomiasis. METHODS: This retrospective cohort study involved 125 Brazilian patients infected with Schistosomiasis mansoni, who were followed up for 2 years after specific treatment to estimate the probability of periportal fibrosis regression. RESULTS: There was no evidence of associations between IL-10 polymorphisms and periportal fibrosis regression after treatment. CONCLUSIONS: There was no evidence of associations between gene promoter polymorphisms of IL-10 and the regression of periportal fibrosis in this Brazilian population.

Produção científica colaborativa na área da saúde tropical: uma análise da rede de colaboração do Programa de Pós-Graduação em Medicina Tropical da Universidade Federal de Pernambuco / Collaborative scientific production in the tropical health field: an analysis of the collaboration network in the Post-Graduation Program in Tropical Medicine of the Universidade Federal de Pernambuco / Producción científica colaborativa en el área de salud tropical: un análisis de la red de colaboración del Programa de Posgrado en Medicina Tropical de la Universidade Federal de Pernambuco

Este trabalho descreve as motivações e os modos de colaboração científica das redes sociais na área de Saúde Tropical, em estudo sobre a produção de conhecimento de pesquisadores do Programa de Pós-Graduação em Medicina Tropical da Universidade Federal de Pernambuco (PPGMEDTROP/UFPE), entre 2004 e 2012, considerando sua contribuição significativa para a solução dos problemas da área. Organiza um banco de dados bibliométricos com indicadores científicos para o estudo de coautoria, fundamentado na análise de redes sociais científicas estabelecidas entre os autores. Entrevista nove pesquisadores do Programa para compreender motivações e visualizar as relações de colaboração. Observa a tendência de organização coletiva da Ciência. Destaca como motivações mais importantes dos pesquisadores em prol da colaboração a possibilidade de enfrentar grandes problemas de pesquisa, a obtenção e/ou ampliação de fomento, o processo de validação nos trabalhos realizados em grupo e a possibilidade de avaliar previamenteos produtos de pesquisa em relação às instâncias avaliadoras...

This paper describes the motivations and forms of scientific collaboration through social networks in thefield of tropical health, studying the production of knowledge by researchers from the Post-GraduationProgram in Tropical Medicine of the Universidade Federal de Pernambuco (PPGMEDTROP/UFPE), from2004 to 2012. It considers their significant contribution to the solution of problems in the field. The studyorganizes a bibliometrical database with scientific indicators for the analysis of co-authorship, based onthe analysis of scientific social networks established between authors. The research performed interviewswith nine researchers from the Program in order to understand their motivations and visualize theircollaboration relationships. It observes the tendency to organize science collectively. The researchers’ mostrelevant motivations to develop collaborations are: the possibility to face large research problems, to obtainand/or enlarge incentives, the process of validation of works performed in group and the possibility toevaluate the research products before the assessment entities...

Este trabajo describe las motivaciones y las prácticas de colaboración científica de las redes sociales enel área de Salud Tropical, en un estudio sobre la producción de conocimiento de los investigadores del Programa de Postgrado en Medicina Tropical de la Universidad Federal de Pernambuco (PPGMEDTROP /UFPE), entre 2004 y 2012, teniendo en cuenta su importante contribución a la solución de los problemasdel área. Se organiza una base de datos con indicadores bibliométricos para el estudio de co-autoría, basadoen el análisis científico de las redes sociales que se establecen entre los autores. Se entrevista a nueveinvestigadores del programa para entender las motivaciones y visualizar las relaciones de colaboración. Seobserva la tendencia hacia la organización colectiva de la ciencia. Entre las motivaciones fundamentales delos investigadores a favor de la colaboración se destaca la posibilidad de enfrentar los principales problemasde investigación, la adquisición o ampliación del financiamiento, el proceso de validación del trabajorealizado en grupos y la posibilidad de evaluar previamente los productos de investigación...

The relationship between hepatitis B virus (HBV) load and levels of transforming growth factor beta 1 (TGF-ß1) 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-ß1) 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-ß1 levels, and HBV load were evaluated in 116 patients. While there was no correlation between TGF-ß1 levels and HBV load, a positive correlation between sFas levels and HBV load was observed in patients with occult HBV infection.

Seroprevalence of HSV-1/2 and correlation with aggravation of oral mucositis in patients with squamous cell carcinoma of the head and neck region submitted to antineoplastic treatment.

PURPOSE: Oral mucositis (OM) is a frequent side effect resulting from antineoplastic treatment and is described as an acute alteration characterized by ulcerative lesions, with the presence of a persistent chronic inflammatory infiltrate, erythema, and pain. AIMS: The purpose of the study was to evaluate the presence of the herpes simplex virus (HSV-1/2) in patients with squamous cell carcinoma of the head and neck region (SCC) and its influence on the aggravation of oral mucositis after radiotherapy or radio/chemotherapy treatment. METHODS: In this prospective cohort study, 91 patients were evaluated with regard to their serological status for IgG before treatment (initial time interval--TI) and for IgM before treatment (T1) and on the 30th day after the first day of radiotherapy application/radiation therapy (final time interval--TF), using immunoenzymatic assay (ELISA), and the results were correlated with the intensity of OM. RESULTS: The seroprevalence for IgG was 97.8 %. IgM (TI) was positive in 18.7% and IgM (TF) in 20.9% of patients. All the patients developed some degree of oral mucositis; however, there was statistically significant correlation between positivity for IgM and degree of severity of OM, irrespective of the type of treatment to which the patient was submitted. CONCLUSION: The reactivation of HSV-1/2 was shown to be relatively infrequent and there was no correlation between presence of the virus and aggravation of oral mucositis resulting from antineoplastic treatment.

Soroprevalência e fatores associados ao Vírus da Imunodeficiência Humana (HIV) e sífilis em presidiários do Estado de Pernambuco, Brasil / Seroprevalence and factors associated with human immunodeficiency virus (HIV) and syphilis in inmates in the state of Pernambuco, Brazil

Os detentos apresentam maior vulnerabilidade ao HIV e outras Infecções Sexualmente Transmissíveis (IST) devido a fatores de risco como: compartilhamento de seringas e sexo desprotegido. O objetivo do presente trabalho foi determinar a soroprevalência e fatores de risco para o HIV-1/2 e sífilis entre presidiários do sexo masculino em Caruaru, Pernambuco, Brasil. Foi realizado um corte transversal no período de maio a julho de 2011, no qual 1097 detentos de uma penitenciária de Caruaru foram avaliados, por meio de entrevista e coleta de amostra de sangue para realização dos testes. A prevalência de infecção pelo HIV foi de 1,19% e de sífilis 3,92%. A associação com a infecção pelo HIV mostrou-se estatisticamente significante com uso de drogas injetáveis, homossexualismo e condição de transfusão (p < 0,05). Em relação à soropositividade para sífilis, fatores relacionados à vida sexual mostraram-se estatisticamente significante (p < 0,05). A população carcerária constitui um grupo de alto risco para as doenças pesquisadas. As taxas de prevalência aqui identificadas indicam a necessidade de implantação de programas de prevenção para que as mesmas não venham a se disseminar no âmbito desta população.

Prison inmates are more vulnerable to HIV and other Sexually Transmitted Infections (STIs) due to risk factors such as needle sharing and unprotected sex with homosexuals. The aim of this work was to determine the seroprevalence and risk factors associated with the human immunodeficiency virus (HIV-1/2) and syphilis among male inmates in Caruaru, State of Pernambuco, Brazil. A cross-sectional study was performed between May and July 2011, when 1,097 inmates at a prison in Caruaru were assessed by means of interviews and blood sample collection for performing the respective tests. The prevalence was 1.19% for HIV infection and 3.92% for syphilis. HIV infection showed a statistically significant association (p <0.05), with injected drug use, homosexuality and blood transfusions. With respect to HIV status and syphilis, factors related to sex life were statistically significant (p <0.05). The prison population is a high risk group for the diseases investigated. The prevalence rates identified indicate the need to implement prevention programs, helping to contain such diseases in this particular population group.

Hepatitis B and C infections in systemic lupus erythematosus patientes

OBJECTIVE: determine the seroprevalence of HBV and HCV in SLE patients attended at the University Hospital fromOctober 2009 to July 2010. METHOD: the serological markers for HBV (HBsAg, anti-HBc total and anti-HBs) andHCV (anti-HCV) were investigated by enzyme-linked immunosorbent assay (ELISA). In HBsAg and/or anti-HBc totaland anti-HCV positive samples were analyzed for HBV-DNA and HCV-RNA by PCR. RESULTS: one hundred andsixty-nine SLE patients were studied and the prevalence of anti-HBc total was 10.1% (17/169) and all were negative forHBV-DNA. The anti-HCV was present in 1.8% (3/169) and only one was HCV-RNA positive, presenting a viral load of212.000 copies/mL. CONCLUSIONS: considering the absence of data on HBV in SLE patients in Brazil, the prevalencefound in this study was high when compared to that reported in the general population in the same geographical area.With regard to the seroprevalence of HCV, it was lower than that observed in other Brazilian SLE patients.

OBJETIVO: determinar a soroprevalência do HBV e HCV em pacientes com LES atendidos em Hospital Universitáriode Outubro de 2009 a Julho de 2010. MÉTODO: pesquisaram-se os marcadores sorológicos para o HBV (HBsAg,anti-HBc total e anti-HBs) e HCV (anti-HCV) através de ensaio imunoenzimático (ELISA). Nas amostras HBsAg e/ouanti-HBc total e anti-HCV positivas foram pesquisados o HBV-DNA e HCV-RNA, pela reação em cadeia da polimerase(PCR). RESULTADOS: 169 pacientes lúpicos foram estudados e a prevalência do anti-HBc total foi 10,1% (17/169),com negatividade para o HBV-DNA. O anti-HCV esteve presente em 1,8% (3/169) dos pacientes e em apenas um oHCV-RNA foi positivo, com carga viral de 212.000 cópias/mL. CONCLUSÃO: em virtude da inexistência de outrostrabalhos brasileiros que relatem a prevalência do HBV em pacientes lúpicos, verificou-se que a prevalência encontradana pesquisa foi superior a da população local. Com relação à soroprevalência do HCV, esta foi menor do que a verificadaem pacientes lúpicos brasileiros.

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.

Occult hepatitis B virus infection in hemodialysis patients in Recife, State of Pernambuco, Brazil / Infecção oculta para o vírus da hepatite B em pacientes hemodialisados de Recife, Estado de Pernambuco, Brasil

INTRODUCTION: Persistence of the hepatitis B virus (HBV) genome in individuals negative for the HBV surface antigen (HBsAg) reflects occult infection. The aim of this study was to identify occult HBV infection among hemodialysis patients at 5 clinics in Recife, State of Pernambuco, Brazil, between August 2006 and August 2007. METHODS: Serum samples underwent enzyme-linked immunosorbent assay to investigate total antibodies against HBcAg (anti-HBc), HBsAg, and antibodies against HBsAg (anti-HBs). Samples that were HBsAg-negative were tested for total anti-HBc, and those that were positive for total anti-HBc were tested for anti-HBs. HBV DNA was investigated with an in-house PCR technique to identify samples positive for total anti-HBc. Subsequently, the samples positive for HBV DNA were sequenced to identify the genotype and mutations. RESULTS: The study population (n = 752) had a mean age of 50 15.1 years and included both sexes. All samples analyzed were negative for HBsAg. The seroprevalence of total anti-HBc was 26.7% (201/752), while that of anti-HBs was 67.2% (135/201). Total anti-HBc alone was detected in 5.7% of the patients. Occult infection was found in 1.5%, comprising genotypes A (33.3%, 1/3) and D (66.7%, 2/3). No mutations were found. CONCLUSIONS: The study detected occult hepatitis B virus infection in hemodialysis patients. Molecular studies on HBV are of fundamental importance because they identify patients that had been considered virus-negative but who, in reality, host the virus and have the ability to transmit it to other patients and staff.

INTRODUÇÃO: A persistência do genoma do vírus da hepatite B (HBV) em indivíduos com o antígeno de superfície para o HBV (HBsAg) negativo, caracteriza-se como infecção oculta. O objetivo desse trabalho foi identificar infecção oculta pelo HBV em hemodialisados provenientes de cinco clínicas de Recife, Estado de Pernambuco, Brasil, de agosto de 2006 a agosto de 2007. MÉTODOS: Os soros foram submetidos à pesquisa do HBsAg, anticorpos totais para o AgHBc (anti-HBc total) e para os anticorpos contra o antígeno de superfície do HBV (anti-HBs) pelo ensaio imunoenzimático (ELISA). As amostras negativas para o HBsAg foram testadas para o anti-HBc total e os soros reativos, foram testados para o anti-HBs. O DNA-HBV foi analisado pela reação em cadeia da polimerase (PCR) in house nas amostras anti-HBc total reagentes. As amostras DNA-HBV positivas foram sequenciadas para a identificação do genótipo e pesquisa de mutação. RESULTADOS: A população estudada foi de 752 hemodialisados, com média de idade de 50±15,1 e ambos os sexos. Todos os soros analisados foram HBsAg negativos. A soroprevalência para o anti-HBc total e anti-HBs foi de 26,7% (201/752) e 67,2% (135/201), respectivamente. O anti-HBc total foi encontrado em 5,7% dos pacientes. A infecção oculta foi identificada em 1,5% (3/201) das amostras, sendo 33,3% com o genótipo A e 66,7% com o D. Nenhuma mutação foi observada. CONCLUSÕES: O estudo encontrou infecção oculta na amostra analisada. A infecção oculta encontrada mostra a importância de estudos moleculares, pois pacientes HBsAg negativos podem albergar o vírus disseminando-o para os demais pacientes.

HBV and HCV serological markers in patients with the hepatosplenic form of mansonic schistosomiasis / Marcadores sorológicos do VHB e VHC em pacientes com esquistossomose mansônica na forma hepatoesplênica

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 percent for anti-HBc total and/or HBsAg and 7.4 percent 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.

CONTEXTO: A transfusão sanguínea destaca-se entre os fatores de risco implicados na transmissão dos vírus das hepatites B (VHB) e C (VHC); entretanto não há relatos da transmissão endoscópica destes vírus em pacientes com esquistossomose na forma hepatoesplênica. OBJETIVO: Estimar a prevalência dos marcadores sorológicos do VHB e VHC em pacientes com esquistossomose hepatoesplênica e avaliar os possíveis fatores de risco associados a essas infecções. MÉTODOS: Estudo do tipo transversal, com 230 pacientes com esquistossomose hepatoesplênica atendidos em um Hospital Universitário de Recife, PE, Brasil, no período de fevereiro a agosto de 2008. Os pacientes responderam a um questionário padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HBc total, o anti-HBs, o HBsAg e o anti-VHC por ensaio imunoenzimático. As análises estatísticas utilizadas foram a univariada e a regressão logística múltipla. RESULTADOS: Encontrou-se prevalencia de 30 por cento para anti-HBc total e/ou HBsAg e 7,4 por cento para o anti-VHC. Houve maior frequencia de pacientes positivos do sexo feminino e idade .50 anos para os marcadores analisados. Verificou-se associação significativa entre a presenca do anti-HCV e a categoria de seis ou mais transfusões. Nao foi constatada associação do antecedente e numero de endoscopias digestivas com os marcadores sorologicos analisados. CONCLUSÕES: Constatou-se maior prevalência de marcadores sorológicos do VHB e menor prevalência para o anti-VHC. Evidenciou-se o sexo feminino e paciente de idade avançada como as categorias mais atingidas e maior probabilidade da infecção pelo VHC em pacientes politransfundidos.