RESUMO
Fulminant hepatic failure (FHF) is characterized by massive hepatocellular injury, whose physiopathology is still unclear. Hepatitis B (HBV) is probably the most common viral cause of FHF, while hepatitis A (HAV) virus seem occurs less frequently. However, the host and viral factors that determine the outcome of these infections are poorly understood. In the present study, viral load and genotyping determining regions of HAV and HBV genomes were sequenced. Eight FHF patients and one patient with severe acute hepatitis (SAH) were included. Liver and blood samples were collected during liver transplantation or necropsy procedures. HAV-RNA and HBV-DNA were extracted from serum, biopsy and paraffin liver. Nucleotide sequencing of HAV-RNA was performed from VP1/2A and HBV-DNA from PreS/S region. The amplified samples were quantified by Real-Time PCR. The cases of HAV infection were due to subgenotype IA. The cases of HBV infection were due to genotype A2 and D4. The case of HAV/HBV coinfection was infected by genotype IA and D3. Hepatitis A and B infection were associated with genotypes most prevalent in Brazil. In hepatitis A infection the mean of period evolution was 13 days. In hepatitis B, FHF patients infected by genotype D have a shorter period of evolution than FHF patients infected by genotype A (mean 15 v. 53 days). There was no association with genotype-determining region with the severity of hepatitis, however nucleotide differences and high viral load could be observed among FHF.
Assuntos
Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vírus da Hepatite A Humana/genética , Hepatite A/virologia , Vírus da Hepatite B/genética , Hepatite B/virologia , Falência Hepática Aguda/virologia , Doença Aguda , Sequência de Bases , Brasil , DNA Viral/análise , Genótipo , Vírus da Hepatite A Humana/imunologia , Hepatite A/complicações , Vírus da Hepatite B/imunologia , Hepatite B/complicações , Dados de Sequência Molecular , Mutação , Filogenia , Reação em Cadeia da Polimerase , RNA Viral/análise , Carga ViralRESUMO
Fulminant hepatic failure (FHF) is characterized by massive hepatocellular injury, whose physiopathology is still unclear. Hepatitis B (HBV) is probably the most common viral cause of FHF, while hepatitis A (HAV) virus seem occurs less frequently. However, the host and viral factors that determine the outcome of these infections are poorly understood. In the present study, viral load and genotyping determining regions of HAV and HBV genomes were sequenced. Eight FHF patients and one patient with severe acute hepatitis (SAH) were included. Liver and blood samples were collected during liver transplantation or necropsy procedures. HAV-RNA and HBV-DNA were extracted from serum, biopsy and paraffin liver. Nucleotide sequencing of HAV-RNA was performed from VP1/2A and HBV-DNA from PreS/S region. The amplified samples were quantified by Real-Time PCR. The cases of HAV infection were due to subgenotype IA. The cases of HBV infection were due to genotype A2 and D4. The case of HAV/HBV coinfection was infected by genotype IA and D3. Hepatitis A and B infection were associated with genotypes most prevalent in Brazil. In hepatitis A infection the mean of period evolution was 13 days. In hepatitis B, FHF patients infected by genotype D have a shorter period of evolution than FHF patients infected by genotype A (mean 15 v. 53 days). There was no association with genotype-determining region with the severity of hepatitis, however nucleotide differences and high viral load could be observed among FHF.
Assuntos
Vírus da Hepatite A Humana/genética , Hepatite A/virologia , Vírus da Hepatite B/genética , Hepatite B/virologia , Falência Hepática Aguda/virologia , Doença Aguda , Adulto , Idoso , Sequência de Bases , Brasil , Criança , Pré-Escolar , DNA Viral/análise , Feminino , Genótipo , Hepatite A/complicações , Vírus da Hepatite A Humana/imunologia , Hepatite B/complicações , Vírus da Hepatite B/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Mutação , Filogenia , Reação em Cadeia da Polimerase , RNA Viral/análise , Carga ViralRESUMO
OBJETIVO: Investigar a área de necrose focal induzida pela injeção intra-hepática de quatro diferentes substâncias no fígado de ratos. MÉTODOS: Foram utilizados 25 ratos Wistar, com peso variando entre 200 a 250 g, distribuidos em 5 grupos, que receberam 0,1cc das seguintes substâncias: Grupo I (Gr. I) - soro fisiológico a 0,9 por cento (controle). Grupo II (Gr. II) - glicose hipertônica a 50 por cento. Grupo III (Gr. III) - NaCl a 20 por cento. Grupo IV (Gr. IV) - formol a 10 por cento. Grupo V (Gr. V) - etanol. Os animais foram submetidos a laparotomia para que a punção fosse realizada no lobo hepático médio sob visão direta. Todos os animais foram sacrificados após 24 horas da injeção.. Os fígados foram avaliados histologicamente, com o intuito de mensurar a área do tecido necrótico. RESULTADOS: Nos cinco grupos estudados observou-se: Gr. I - 2829mm² (controle); Gr. II - 3805mm² (glicose hipertônica); Gr. III - 3930mm² (NaCl); Gr. IV - 4532mm² (formol) e Gr. V - 6432mm² (etanol). A análise estatística destes valores foi feita pelo método das comparações múltiplas. CONCLUSÃO: 1. O soro fisiológico foi à substância que causou a menor área de necrose (P< 0,05). 2. O NaCl a 20 por cento e a glicose hipertônica a 50 por cento produzem efeitos semelhantes (P > 0,05). 3. O formol a 10 por cento produziu necrose mais extensa que a glicose hipertônica a 50 por cento (P < 0,05) e que o NaCl a 20 por cento, porém não apresentou diferença estatisticamente significativa com esta última (P > 0,05). 4. O etanol foi à substância que, comparada com as outras, mais necrose produziu (P < 0,05).
