Hepatitis E virus seroprevalence among schistosomiasis patients in Northeastern Brazil

Abstract Background Hepatitis E virus (HEV) can cause chronic infection with rapid progression to liver cirrhosis in immunocompromised patients. HEV seroprevalence in patients with Schistosoma mansoni in Brazil is unknown. We evaluated the prevalence of past or present HEV infection in schistosomiasis patients in Recife, Pernambuco, Brazil. A total of 80 patients with Schistosoma mansoni were consecutively enrolled in a cross-sectional study. Serum samples were tested for the presence of anti-HEV IgG antibodies by enzyme immunoassay (Wantai anti-HEV IgG, Beijing, China) and for the presence of HEV RNA using real time reverse transcriptase-polymerase chain reaction with primers targeting the HEV ORF2 and ORF3. Clinical and laboratory tests as well as abdominal ultrasound were performed at the same day of blood collection. Results Anti-HEV IgG was positive in 18.8% (15/80) of patients with SM. None of the samples tested positive for anti-HEV IgM or HEV-RNA. Patients with anti-HEV IgG positive presented higher levels of alanine aminotranferase (p = 0.048) and gama-glutamil transferase (p = 0.022) when compared to patients without anti-HEV IgG antibodies. Conclusion This study demonstrates that the seroprevalence of HEV is high in patients with Schistosoma mansoni in Northeastern of Brazil. Past HEV infection is associated with higher frequency of liver enzymes abnormalities. HEV infection and its role on the severity of liver disease should be further investigated among patients with Schistosoma mansoni.

Hepatitis E virus seroprevalence among schistosomiasis patients in Northeastern Brazil.

BACKGROUND: Hepatitis E virus (HEV) can cause chronic infection with rapid progression to liver cirrhosis in immunocompromised patients. HEV seroprevalence in patients with Schistosoma mansoni in Brazil is unknown. We evaluated the prevalence of past or present HEV infection in schistosomiasis patients in Recife, Pernambuco, Brazil. A total of 80 patients with Schistosoma mansoni were consecutively enrolled in a cross-sectional study. Serum samples were tested for the presence of anti-HEV IgG antibodies by enzyme immunoassay (Wantai anti-HEV IgG, Beijing, China) and for the presence of HEV RNA using real time reverse transcriptase-polymerase chain reaction with primers targeting the HEV ORF2 and ORF3. Clinical and laboratory tests as well as abdominal ultrasound were performed at the same day of blood collection. RESULTS: Anti-HEV IgG was positive in 18.8% (15/80) of patients with SM. None of the samples tested positive for anti-HEV IgM or HEV-RNA. Patients with anti-HEV IgG positive presented higher levels of alanine aminotranferase (p=0.048) and gama-glutamil transferase (p=0.022) when compared to patients without anti-HEV IgG antibodies. CONCLUSION: This study demonstrates that the seroprevalence of HEV is high in patients with Schistosoma mansoni in Northeastern of Brazil. Past HEV infection is associated with higher frequency of liver enzymes abnormalities. HEV infection and its role on the severity of liver disease should be further investigated among patients with Schistosoma mansoni.

Brazilian society of hepatology recommendations for the diagnosis and management of autoimmune diseases of the liver

ABSTRACT In order to draw evidence-based recommendations concerning the management of autoimmune diseases of the liver, the Brazilian Society of Hepatology has sponsored a single-topic meeting in October 18th, 2014 at São Paulo. An organizing committee comprised of seven investigators was previously elected by the Governing Board to organize the scientific agenda as well as to select twenty panelists to make a systematic review of the literature and to present topics related to the diagnosis and treatment of autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cirrhosis and their overlap syndromes. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript organized in topics, followed by the recommendations of the Brazilian Society of Hepatology.

RESUMO Para definir as recomendações baseadas em evidências científicas sobre o diagnóstico e tratamento das doenças autoimnus do fígado, a Sociedade Brasileira de Hepatologia organizou em Outubro de 2014, encontro monotemático em São Paulo. Um Comitê organizador de sete investigadores foi selecionado pela Diretoria da Sociedade para organizar a agenda científica, assim como para selecionar vinte debatedores para fazer uma revisão sistemática e apresentar tópicos relacionados à hepatite autoimune, colangite esclerosante primária, cirrose biliar primária e suas síndromes de superposição (overlap). O texto inicial do submetidoo a apreciação e aprovação da Sociedade Brasileira de Hepatologia através de consulta a todos associados através da home page da Sociedade, O trabalho apresentado representa a versão final do trabalho original, devidamente revisado e organizado em tópicos, segundo as recomendações da Sociedade Brasileira de Hepatologia.

Brazilian society of hepatology recommendations for the diagnosis and management of autoimmune diseases of the liver.

In order to draw evidence-based recommendations concerning the management of autoimmune diseases of the liver, the Brazilian Society of Hepatology has sponsored a single-topic meeting in October 18th, 2014 at São Paulo. An organizing committee comprised of seven investigators was previously elected by the Governing Board to organize the scientific agenda as well as to select twenty panelists to make a systematic review of the literature and to present topics related to the diagnosis and treatment of autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cirrhosis and their overlap syndromes. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript organized in topics, followed by the recommendations of the Brazilian Society of Hepatology.

Ocorrência e fatores de risco para co-infecção pelo vírus da hepatite C (HCV) em pacientes com o vírus da imunodeficiência humana (HIV) em Macéio, Brasil. / Occurrence and risk factors for coinfection of hepatitis C virus (HCV) in patients with human immunodeficiency virus (HIV) in Macéio, Brazil

Objetivo: determinar a prevalência e os fatores de risco para a co-infecção pelo vírusda hepatite C (HCV) em pacientes com o vírus da imunodeficiência humana (HIV).Método: estudo analítico; foram testadas 299 amostras de sangue de pacientesinfectados pelo HIV, atendidos no Hospital Universitário de Maceió-AL, entre maio enovembro de 2005. Utilizou-se o teste imunoenzimático (ELISA) kit da Wierner Lab®(Rosário-Argentina) para a detecção do anti-HCV e a Reação em Cadeia daPolimerase (RT-PCR) para a pesquisa do HCV-RNA. Para a análise dos fatores derisco foi utilizado um questionário elaborado especificamente para o estudo.Resultados: das 299 amostras analisadas 10 (3,3%) foram positivas para o anti-HCV edestas 7 (2,3%) apresentaram também o HCV-RNA. Os fatores de risco que estiveramassociados à co-infecção HIV/HCV foram antecedentes de hepatite/icterícia e uso detatuagem/piercing. Conclusão: a baixa prevalência da co-infecção HIV/HCVencontrada na pesquisa poderá estar relacionada com a pouca exposição parenteral,principalmente transfusão de sangue e uso de drogas injetáveis, dos pacientesinfectados com o HIV em Maceió

Objective: the objective of the present study was to determine the prevalence and risk factors of thehepatitis C virus (HCV) in carriers of the human immunodeficiency virus (HIV). Methods: tests werecarried out on 299 blood samples from HIV patients attending the University Hospital of Maceió inthe state of Alagoas, from May to November, 2005. The enzyme linked immunosorbent assay (ELISA)of Wiener Lab® kit (Rosário-Argentina) was used to detect anti-HCV and polymerase chain reaction(RT-PCR) so as to study the HCV-RNA. A questionnaire was created specifically for this study inorder to analyze the risk factors. Results: analysis of the 299 samples revealed that 10 (3.3%) sampleswere positive for anti-HCV and 7 (2.3%) presented HCV-RNA. The risk factors associated toHCV/HIV coinfection indicated a history of hepatitis/jaundice and tattooing/piercing. Conclusion: thelow prevalence of HCV/HIV coinfection encountered during this investigation is probably due to a lowincidence of parenteral exposure, mainly those of blood transfusions and the use of injected drugs inHIV infected patients in Maceió.

Prevalência de asma em funcionários de hospital universitário avaliada por meio de questionário de saúde respiratória da Comunidade Européia / Asthma prevalence among employees of a university hospital as evaluated using a European Union respiratory health questionnaire

OBJETIVO: Determinar a prevalência de asma brônquica em funcionários de um hospital universitário, com idades entre 20 e 44 anos, segundo os critérios do European Community Respiratory Health Survey. MÉTODOS: Através de estudo descritivo, prospectivo, aleatório e estratificado de prevalência, foram analisados os questionários de 351 funcionários do Hospital das Clínicas da Universidade Federal de Pernambuco, entre abril e outubro de 2002. Foram consideradas as variáveis de caracterização amostral, as independentes referentes a sinais e sintomas e a dependente (asma, caracterizada pela informação de crise, diagnosticada por médico, nos doze meses anteriores à pesquisa). RESULTADOS: A prevalência de asma foi de 10,7 por cento. Dispnéia noturna, sensação de aperto torácico e tosse noturna foram os sintomas mais freqüentes, com significância só no sexo feminino (respectivamente p = 0,03, p = 0,04 e p = 0,001). Dispnéia noturna, sibilos nos últimos doze meses, dispnéia com sibilos e uso de medicação para asma predominaram entre 20 e 29 anos, com significância para os dois últimos sintomas (p < 0,001). Houve 35 casos de subtratamento de asma (10,7 por cento). CONCLUSÃO: Este estudo, pioneiramente analisando casuística de funcionários de um hospital universitário de país em desenvolvimento, mostra que a prevalência de asma foi um pouco mais elevada que a encontrada na literatura e sugere que o trabalho em hospital universitário não reduz a freqüência de subtratamento.

Alpha-Interferon therapy for HBV-related glomerulonephritis

We report a case of a patient with hepatitis B virus (HBV)-related membranous glomerulonephritis (MGN) who showed improvement after interferon-alpha (IFN-alpha) therapy. A 35-year-old man with nephrotic syndrome and HBV antigens received a 24-week course of IFN-alpha. At the end of therapy there was an elevation in the level of plasma aminotransferase and an increase in proteinuria, which were followed by antigen/antibody seroconversion. This "flare-up" before seroconversion suggests an increase in disease activity in the liver and kidney, demonstrating in vivo HBV involvement in MGN.

Síndrome de Vogt-Koyanagi-Harada: relato de um caso / Vogt-Koyanagi-Harada syndrome: report of a case

Faz-se relato do caso de uma paciente com 39 anos de idade portadora da síndrome de Vogt-Koyanagi-Harada. O quadro se iniciou com manifestaçöes meningéias, evoluindo com comprometimento oftalmológico e também dermatológico, chegando a apresentar discusia bilateral. As alteraçöes ocorridas säo analisadas em funçäo de registros contidos em literatura que serviu de pesquisa

Sindrome de Vogt-Koyanagi-Harada

Faz-se relato do caso de uma paciente com 39 anos de idade portadora da sindrome de Vogt-Koyanagi-Harada. O quadro se iniciou com manifestacoes meningeias, evoluindo com comprometimento oftalmologico e tambem dermatologico, chegando a apresentar disacusia bilateral. As alteracoes ocorridas sao analisadas em funcao de registros contidos em literatura que serviu d epesquisa.