Hepatitis C, HCV genotypes and hepatic siderosis in patients with chronic renal failure on haemodialysis in Brazil.

BACKGROUND: The aim of this study was to investigate the HCV genotypes, hepatic siderosis, inflammatory activity and fibrosis of the liver in patients with chronic renal failure (CRF) on haemodialysis in Brazil. METHODS: A cohort of 72 CRF patients was compared with a group of 65 candidates for blood donation (CBD). For the subjects selected, who tested positive for anti-HCV antibodies and were HCV-PCR positive, a protocol with epidemiological, clinical and laboratory information was completed. An ultrasound-guided liver biopsy was performed and histological analysis of liver fragments was carried out. The presence of HCV-RNA in plasma was established by nested-RT-PCR. The genotype was determined by Restriction Fragment Length Polymorphism (RFLP) analysis of the PCR product. RESULTS: HCV genotype 1 was predominant in both groups, but genotype 2 was the second most common amongst CRF patients, and there was a significant difference when compared with the CBD group (P=0.016). Regarding inflammation and fibrosis, no significant difference was observed in the histology of the liver between the study groups. Siderosis of the liver was more prevalent in the CRF group (P=0.000). Severe complications of liver biopsies were reported in 10 CRF patients (13.2%). CONCLUSIONS: Genotype 2 was observed more frequently in the haemodialysis group. No statistically significant difference was detected between the CRF and CBD groups with regard to both inflammatory response and liver fibrosis. Hepatic siderosis has been attributed to excessive iron administration. As percutaneous liver biopsy resulted in severe complications, we suggest that other procedures of evaluating liver damage in CRF patients should be looked at thoughtfully.

Febre Amarela

Esta webaula contempla informações atualizadas em janeiro de 2018 sobre a febre amarela. O médico infectologista intensivista da UFMG, Vandack Alencar, discorre sobre a febre amarela, seu vetor e transmissão, o histórico da doença no Brasil e seus ciclos, urbano e silvestre. Apresenta alguns sintomas comuns da doença e as particularidades envolvidas no diagnóstico e que, apesar de ser uma doença grave, a porcentagem dos infectados que evoluem para a forma grave da doença é pouca. Aborda as idades, situações e casos de recomendação da vacina e discorre sobre a dose única, atualmente defendida pelos médicos cientistas de todo o mundo, inclusive pela Organização Mundial da Saúde.