Correlation among three non-invasive methods (APRI, FIB-4 and Transient elastography) to evaluate liver function and stiffness in patients with viral hepatitis c or schistosomiasis mansoni

Both chronic viral hepatitis and schistosomiasis are potentially serious causes of liver fibrosis. Several studies suggest, however, that hepatic fibrosis may be reversible, which highlights the importance, not only of early diagnosis, but, above all, observing this while monitoring the disease. This study aimed to evaluate the correlation between three non-invasive methods for classification of hepatic fibrosis in patients with viral hepatitis or schistosomiasis. The sample consisted of 45 patients with chronic hepatitis with HCV and 17 with schistosomiasis. Medical records were analyzed for data collection related to sex, body mass index (BMI) and laboratory testing for biochemical markers. The evaluation was carried out by means of the following hepatic diagnostic methods: APRI, FIB-4 and Transient Elastography (Fibroscan), and the subsequent correlation analysis by Spearman test (r). There was a predominance of males among patients with HCV (64.4%). HCV patients also presented the highest average age (54.8 years) and high levels of AST and ALT. Positive correlation was noted between APRI and FIB-4 results in patients of both groups; positive correlation between APRI and Transient Elastography in patients with HCV; and positive correlation between FIB-4 and Elastography in patients with HCV or schistosomiasis. Our data suggest that the non-invasive methods for diagnosis and monitoring of hepatic fibrosis present a high degree of acceptance, especially in patients with HCV.

Efeito da vacina contra hepatite B em indivíduos com anticorpos contra o antígeno central da hepatite B (anti-HBc) como único mercador / Effect of the hepatitis B vaccine in indididuals with antibodies against the central antigen of hepatitis B virus as the sole marker

Indivíduos repetidamente positivos para o anticorpo contra o antígeno central da hepatite B (anti-HBc), mas nao reativos para o antígeno de superficie (HBsAg) assim como para o seu anticorpo (anti-HBs), podem ter seu teste falso-positivo, ser ainda portadores do VHB ou ter infecçao passada já resolvida. Doadores de sangue com esse padrao sorológico receberam vacina contra o vírus da hepatite B (VHB), com o intuito de estimular o surgimento de anti-HBs na circulaçäo. Dos 33 indivíduos incluidos no estudo, 13 (39por cento) positivaram o anti-HBs após uma dose de vacina. Dos 20 restantes, 15 (75por cento) aresentaram soroconversäo do anti-HBs após duas doses e um depois de tres doses. No total, 29 (88por cento) seroconverteram. Dos 33, 24 foram submetidos a pesquisa de DNA do VHB por tecnica de cadeia de polimerase. O exame foi negativo em todos. Os autores sugerem que estimular o surgimento de anti-HBs atraves de desafio de vacina contra o VHB pode ser uma maneira acessivel de tranquilizar os doadores de sangue com anti-HBc isolado que seroconverteram posteriormente, assegurando-lhes seu bom prognostico