Homens que fazem sexo com homens e a hepatite C: prevalência e fatores de risco em 12 capitais brasileiras / Men who have sex with men and hepatitis C: prevalence and risk factors in 12 Brazilian capitals

Apesar das políticas preventivas adotadas, a redução da transmissão das infecções sexualmente transmissíveis (ISTs) entre homens que fazem sexo com homens (HSH) tem sido limitada. O risco de infecção pelo vírus da hepatite C (HCV) aumentou entre os grupos populacionais mais vulneráveis incluindo HSH O objetivo do estudo foi estimar a prevalência da infecção pelo HCV e avaliar fatores de risco entre HSH em 12 capitais brasileiras Este estudo foi realizado de junho a dezembro de 2016 por meio do método respondent driven sampling (RDS). Os participantes preencheram um questionário autoaplicável para coletar dados socioeconômicos, demográfico s e comportamentais . Além disso, foi ofertado o teste rápido (TR) para Resultados positivos foram enviados ao Instituto Adolfo Lutz para testes confirmatórios. Foram recrutados 4. 176 participantes e 23 amostras foram enviadas para confirmação. Destas, 16 foram confirmadas, demonstrando prevalência de 0, 7% IC 95%: 0,3% 1,7%). A região Sudeste apresentou prevalência de 0,9% ( IC 95%: 0,3 2,6), seguida pela região Sul, com 0,6 % (IC 95%: 0,2 2,1)2,1). A região Nordeste apresentou prevalência de 0,3% (IC 95%: 0,1 1,0) e a C entro O este 0,1 % (IC%: 0,0 0,7)0,7). Nenhum caso positivo foi encontrado na região Norte . Homens solteiros com mais de 40 anos foram a maioria dos participantes expostos ao HCV. O uso irregular de preservativo s e o número elevado de parceiros sexuais, além da infecção por outras ISTs, foram associados ao aumento da exposição ao HCV. De acordo com os dados apresentados, é necessário implantar políticas de prevenção que se concentrem no segmento de HSH e que tenham estratégias de comunicação mais efetivas. Mostra se necessário o desenvolvimento de conhecimentos que fortaleçam a habilidade e estimulem a motivação para um comportamento mais seguro nessa população Os investimentos nas populações mais vulneráveis são fundamentais para atingir a meta da Organização Mundial da Saúde (OMS ) de eliminar as hepatites virais até 2030. (AU)

Despite the preventive policies adopted, the reduction of the transmission of sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of infection with the Hepatitis C (HCV) has increased among the most vulnerable population groups including MSM The aim of the study was to estimate the prevalence of the infection by HCV and assess risk factors among MSM in 12 Brazilian capitals This study was carried out from June to December 2016 using the method respondent driven sampling (RDS). Participants filled out a self-administered questionnaire to collect socioeconomic data, demographic and behavioral . In addition, the rapid test was offered (TR) for Positive results were sent to Instituto Adolfo Lutz for confirmatory tests. 4, 176 participants were recruited and 23 Samples were sent for confirmation. Of these, 16 were confirmed, demonstrating a prevalence of 0.7% CI 95%: 0.3% 1.7%). The Southeast region presented a prevalence of 0.9% (CI 95%: 0.3 2.6), followed by the South region, with 0.6% (95% CI: 0.2 2.1)2.1). The Northeast region showed a prevalence of 0.3% (CI 95%: 0.1 1.0) and Center West 0.1% (CI%: 0.0 0.7)0.7). None positive case was found in the North region. Single men over 40 years were the majority of participants exposed to HCV. The irregular use of condoms and the high number of sexual partners, in addition to the infection by other I STs, were associated with increased exposure to HCV. In according to the data presented, it is necessary to implement policies of prevention programs that focus on the MSM segment and that have more effective communication strategies. Show if necessary development of knowledge that strengthens the ability and encourages the motivation for safer behavior in this population investments in the most vulnerable populations are fundamental to achieve the World Health Organization (WHO) goal of eliminating viral hepatitis by 2030. (AU)

Characterization of primary direct-acting antiviral (DAA) drugs resistance mutations in NS5A/NS5B regions of hepatitis C virus with genotype 1a and 1b from patients with chronic hepatitis.

The Hepatitis C virus (HCV) infection is a public health problem. The high level of HCV replication and its lack of post-transcriptional correction mechanisms results in the emergence of viral variants and the difficulty in determining polymorphisms and variants that contain the substitutions associated with resistance towards new antivirals. The main focus of this study was to map the NS5A and NS5B polymorphisms and resistance mutations to new antiviral drugs in HCV strains genotype 1 from patients with chronic hepatitis C infection. Serum samples were collected from patients who underwent routine viral load tests at the Instituto Adolfo Lutz, Sao Paulo city, Brazil. A total of 698 and 853 samples were used for the characterization of NS5A and NS5B regions, respectively, which comprise the HCV genotypes 1a and 1b. The prevalence of resistance mutations found in the NS5A region was 6.4%, with Y93H, L31M, Q30R, and Y93N as the main resistance-associated substitutions (RAS). No NS5B-associated RAS was observed for any of the analyzed drugs. These findings support that the RAS test should be offered to individuals with poor response to double combination regimens prior to treatment initiation, thereby assisting strain vigilance and selection of effective treatment or retreatment options using DAA regimens.

Characterization of primary direct-acting antiviral (DAA) drugs resistance mutations in NS5A/NS5B regions of hepatitis C virus with genotype 1a and 1b from patients with chronic hepatitis

ABSTRACT The Hepatitis C virus (HCV) infection is a public health problem. The high level of HCV replication and its lack of post-transcriptional correction mechanisms results in the emergence of viral variants and the difficulty in determining polymorphisms and variants that contain the substitutions associated with resistance towards new antivirals. The main focus of this study was to map the NS5A and NS5B polymorphisms and resistance mutations to new antiviral drugs in HCV strains genotype 1 from patients with chronic hepatitis C infection. Serum samples were collected from patients who underwent routine viral load tests at the Instituto Adolfo Lutz, Sao Paulo city, Brazil. A total of 698 and 853 samples were used for the characterization of NS5A and NS5B regions, respectively, which comprise the HCV genotypes 1a and 1b. The prevalence of resistance mutations found in the NS5A region was 6.4%, with Y93H, L31M, Q30R, and Y93N as the main resistance-associated substitutions (RAS). No NS5B-associated RAS was observed for any of the analyzed drugs. These findings support that the RAS test should be offered to individuals with poor response to double combination regimens prior to treatment initiation, thereby assisting strain vigilance and selection of effective treatment or retreatment options using DAA regimens.

Hepatitis B in the Northwestern region of Sao Paulo State: genotypes and resistance mutations.

In Brazil, few studies on the molecular aspects of hepatitis B virus (HBV) infection have been conducted in the interior regions of Sao Paulo State. This study aimed to identify HBV genotypes and evaluate strains with resistance mutations for nucleoside analogues in the Administrative Region (AR) of the municipality of Sao Jose do Rio Preto. We performed nested PCRs of 127 samples from the Health Care Services of the AR to amplify, sequence and analyze fragments of the HBV DNA, in order to identify genotypes and resistance mutations. The HBV S/Pol regions of 126 samples were successfully amplified and sequenced. Five different genotypes were found, and the main ones were A, D and F; a greater number of samples contained the subgenotypes A1 (n = 51; 40.5%), D3 (n = 36; 28.6%), A2 (n = 14; 11.1%) and F2a (n = 9; 7.1%). Resistance mutations (rtM204V/I/S) associated or not with compensatory mutations (rtL180M, rtV173L) were identified in 13.9% (5/36) of patients undergoing viral treatment and 1.1% (1/90) of naïve patients. The diversity of genotypes/subgenotypes found is probably due to the intense migration occurring in the region. These data can complement epidemiological and clinical surveillance, and can be used for a more effective management of chronic HBV patients.

Hepatitis B: Prevalence and occult infection in HIV-infected patients.

INTRODUCTION: HBV and HIV have identical transmission routes. The aim of this study was to determine the prevalence of HBV in HIV patients and to detect the presence of occult HBV infection. METHODS: All samples were tested for serology markers and using qPCR. RESULTS: This study included 232 individuals, out of which 36.6% presented with HBV markers and 11.8% presented with HBsAg or HBV-DNA, including 3 patients that showed OBI. CONCLUSIONS: We observed a high prevalence of HBV among HIV patients. In addition, the results suggest that OBI can occur in patients with serological profiles that are indicative of past infection. Therefore, the application of molecular tests may enable the identification of infections that are not evident solely based on serology.

Hepatitis B: Prevalence and occult infection in HIV-infected patients

Abstract INTRODUCTION: HBV and HIV have identical transmission routes. The aim of this study was to determine the prevalence of HBV in HIV patients and to detect the presence of occult HBV infection. METHODS: All samples were tested for serology markers and using qPCR. RESULTS: This study included 232 individuals, out of which 36.6% presented with HBV markers and 11.8% presented with HBsAg or HBV-DNA, including 3 patients that showed OBI. CONCLUSIONS: We observed a high prevalence of HBV among HIV patients. In addition, the results suggest that OBI can occur in patients with serological profiles that are indicative of past infection. Therefore, the application of molecular tests may enable the identification of infections that are not evident solely based on serology.

Fluctuations in serological hepatitis C virus levels in HIV patients.

INTRODUCTION: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) have identical transmission routes, explaining the high prevalence of coinfections. The main aim of this study was to detect fluctuations in serological HCV levels in HIV patients. METHODS: We analyzed samples of 147 patients who attended an outpatient service that supports HIV/AIDS patients in São Paulo city. We also recruited 22 HCV-monoinfected patients who attended the Instituto Adolfo Lutz Laboratory in São Paulo city, to compare the test results. Serological testing of the blood samples was performed for the detection of HCV antibodies. The samples were then analyzed using real-time PCR for RNA viral quantification and sequencing. RESULTS: We found that 13.6% of the study population was coinfected with HIV and HCV. In 20% of coinfected patients, fluctuations in serology results were detected in samples collected during the follow-up. No changes in anti-HCV serological markers were observed in HCV-monoinfected patients. An HCV viral load was detected in 9,5% of the samples collected from HIV patients. CONCLUSIONS: Our findings provide important clinical data to public health professionals and highlight the importance of periodic monitoring of HCV/HIV coinfected patients.

Fluctuations in serological hepatitis C virus levels in HIV patients

Abstract INTRODUCTION: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) have identical transmission routes, explaining the high prevalence of coinfections. The main aim of this study was to detect fluctuations in serological HCV levels in HIV patients. METHODS: We analyzed samples of 147 patients who attended an outpatient service that supports HIV/AIDS patients in São Paulo city. We also recruited 22 HCV-monoinfected patients who attended the Instituto Adolfo Lutz Laboratory in São Paulo city, to compare the test results. Serological testing of the blood samples was performed for the detection of HCV antibodies. The samples were then analyzed using real-time PCR for RNA viral quantification and sequencing. RESULTS We found that 13.6% of the study population was coinfected with HIV and HCV. In 20% of coinfected patients, fluctuations in serology results were detected in samples collected during the follow-up. No changes in anti-HCV serological markers were observed in HCV-monoinfected patients. An HCV viral load was detected in 9,5% of the samples collected from HIV patients. CONCLUSIONS: Our findings provide important clinical data to public health professionals and highlight the importance of periodic monitoring of HCV/HIV coinfected patients.

Estudo da infecção do vírus da Hepatite C em pacientes infectados pelo HIV / Study of Hepatitis C virus infection in patients infected with HIV

O vírus da hepatite C e o vírus da imunodeficiência humana partilham a mesma forma de transmissão e, esse fato, explica a alta frequência de coinfecções. Os objetivos do presente estudo foram: determinar a frequência da infecção pelo HCV em um serviço de saúde de São Paulo; caracterizar os genótipos das cepas virais detectadas; monitorar episódios de flutuação de marcadores sorológicos e moleculares na população estudada e detectar possíveis casos de infecção oculta do HCV nos pacientes HIV positivos. Para isso, foi realizado um estudo com o envolvimento de 147 pacientes infectados pelo HIV atendidos no Serviço de Extensão ao Atendimento de Pacientes HIV/AIDS do Departamento de Moléstias Infecciosas da Faculdade de Medicina da Universidade de São Paulo (SEAP), com amostras colhidas periodicamente. As amostras foram, inicialmente, triadas por sorologia baseada na detecção de anticorpos anti-HCV utilizando-se kits comerciais...

The hepatitis C virus and human immunodeficiency virus share the same transmission route and this fact explains the high frequency of coinfections. The objectives of this study were to determine the frequency of HCV infectionin a health service in São Paulo; characterize the genotypes of the detected virus strains; monitor serologic and molecular floating episodes in the study population and detect possible cases of HCV infection hidden in HIV-positive patients. For this, we conducted a study involving 147 HIV patients attendedat the Extension Service to Support Patients HIV / AIDS Department ofInfectious Diseases, Faculty of Medicine, University of São Paulo (SEAP),with samples taken periodically. The samples were initially screened by serology based on the detection of anti-HCV antibodies using commercial kits...