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Cláudia Alexandra Pontes Ivantes Danilo Silva Iara Messias-Reason 《The Brazilian journal of infectious diseases》2010,14(5):483-488
This report describes a cross-sectional survey on the prevalence of hepatitis C antibodies (anti-HCV) in Tamboara, a small community in the northwest area from Paraná State, south of Brazil with a high rate of accumulated detection for HCV. Eight hundred and sixteen residents (17.87% from all the population), independently of the age and time living in Tamboara were included in this study by an epidemiologic questionnaire and by testing for anti-HCV. The rapid immuno-chromatographic test was applied for detection of HCV antibodies. The anti-HCV prevalence by rapid test was 4.28%. The median age for positive and negative test was 60.49 ± 14.14 and 41.67 ± 20.25, respectively (p < 0.001). By multivariate analysis, only familial history of hepatitis (p = 0.001; OR = 6.41; CI 95% = 2.08-19.78) and age (p = 0.007; OR 1.06;95% CI = 1.02-1.10) showed statistical significance for positive anti-HCV. The rapid test sensitivity and specificity were 100% and 92.7% respectively, with an accuracy of 95.8% (95% CI = 91-100). These findings demonstrated a high prevalence of anti-HCV in Tamboara. The familial history of hepatitis was a significant risk factor to the infection and HCV rapid test showed to be accurate and feasible for epidemiological survey. 相似文献
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Hepatitis C virus in long-term bone marrow transplant survivors 总被引:4,自引:0,他引:4
The hepatitis C virus (HCV) infection may change the outcome of patients undergoing stem cell transplantation. This study aimed at determining the prevalence of the HCV antibody in patients who were alive 10 or more years after BMT, defining the annual progression rate of hepatic fibrosis in those patients, and identifying cases of cirrhosis among those who were positive for HCV antibody. Between 1979 and 1990, 259 patients had a bone marrow transplant, and 91 were alive in March 2000. Of those, 80 were included in the study after having been scanned for serum HCV antibodies. A total of 39 were positive (48.8%), one was indeterminate and 40 were negative (50%). The patients who were HCV positive or undetermined were called for a medical appointment and 22 (55%) attended. A total of 16 patients (72.7%) were male, the mean age was 37.8+/-9.2 years and all of them had had an allogeneic transplant. Of the 22 patients studied, 12 (54.5%) agreed to have a liver biopsy. Hepatic fibrosis was diagnosed in 10 patients. The hepatic fibrosis annual progression rate was 0.156 UF/year. Among the anti-HCV-positive patients assessed, three (13.6%) already had cirrhosis. 相似文献
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Vinicius Lins Ferreira Helena Hiemisch Lobo Borba Astrid Wiens Maria Lucia Alves Pedroso Vanessa Ferreira de Camargo Radunz Cláudia Alexandra Pontes Ivantes Aline Satie Oba Kuniyoshi Roberto Pontarolo 《The Brazilian journal of infectious diseases》2018,22(3):186-192
Background
This study aimed to evaluate the clinical effectiveness in terms of sustained virological response and tolerability of available second generation direct-acting antivirals in Brazilian patients.Methods
This was a retrospective observational study conducted in six centers in Southern Brazil. The sample comprised adult patients who were chronically infected with hepatitis C virus, regardless of virus genotype, fibrosis stage, or prior treatment. Statistical analysis was performed to compare the effectiveness among the treatments, and also to uncover the factors influencing the achievement of sustained virological response.Results
A total of 296 patients were included in the study, with the majority receiving sofosbuvir with daclatasvir (59%) or sofosbuvir with simeprevir (26%). Overall sustained virological response rates were approximately 91.6%. For genotype 1, sofosbuvir with daclatasvir had an sustained virological response rate of approximately 95%, while the sustained virological response rate of sofosbuvir with simeprevir was 92%; this difference was statistically significant only for subtype 1b. The only treatment used for genotype 3 patients was sofosbuvir with daclatasvir, and lower rates of sustained virological response were observed for this group, compared to genotype 1 (84% versus 95%, p < 0.05). Apart from this difference between genotypes, and a difference between patients who achieved rapid virologic response compared with those who did not, there were no other statistically significant factors associated with sustained virological response.Conclusions
The results point to the effectiveness of second-generation direct-acting antivirals in hepatitis C virus Brazilian patients, especially those with genotype 1. Furthermore, that patients with genotype 3 need more attention and adjustments in available treatment options. 相似文献4.
Luiz H. Portari-Filho Mario R. Álvares-da-Silva Aline Gonzalez Adalgisa P. Ferreira Cristiane V. Nogueira Maria C. Mendes-Correa José M. Lima Edmundo P. Lopes Carlos E. Brandão Cláudia Ivantes André Lyra Andreia Lindenberg Maria L. Ferraz 《The Brazilian journal of infectious diseases》2019,23(1):34-39
Background
Hepatitis C is an important health problem. In Brazil, 1–2 million people are infected. Despite this expressive number, and the availability of very successful treatment, many patients remained undiagnosed mainly because of the asymptomatic nature of the infection.Objectives
To describe epidemiological characteristics of HCV-infected patients seen at referral centers in Brazil, the source of referral, and the time spanned to reach a reference center, in order to improve the identification of undiagnosed patients.Methods
Multicenter observational, cross-sectional study carried out in 15 centers of Brazil, between January/2016 and June/2017. Data of patients with a confirmed diagnosis (anti-HCV and HCV-RNA) were collected by interview using standard questionnaires and by review of charts.Results
Two thousand patients were included; 55.1% were male, mean age 58 ± 11 years. Only 14.9% had higher education and 84.2% received up to five monthly minimum Brazilian wages (approximately US$260.00/month). The time between diagnosis and beginning of follow-up was 22.9 months. The most common reasons for testing were check-up (33.2%) and blood donation (19%). General practitioners diagnosed most of the patients (30.1%). Fibrosis stage was mainly evaluated by liver biopsy (61.5%) and 31.3% of the patients were cirrhotic at diagnosis.Conclusions
This multicenter Brazilian study showed that the mean time to reach a referral center for treatment was almost two years. Primary care physicians diagnoses most hepatitis C cases in the country. Population campaigns and medical education should be encouraged to intensify screening of asymptomatic individuals, considering the efficiency of check-ups in identifying new patients. 相似文献5.
Celso Nilo Didoné Filho Cleiton Jonei Reginatto Cláudia Alexandra Pontes Ivantes Rodrigo Strobel Ana Paula Percicote Marcio Petenusso Cicero Jordan R. Sobreira da Silva Cicero Jonas R. Benjamim Rosana Bento Radominski 《Obesity research & clinical practice》2021,15(2):152-156
BackgroundObesity is a multifactorial disease characterized by fat accumulation, usually associated with non-alcoholic fatty liver disease, which can lead to advanced fibrosis or even cirrhosis. Bariatric surgery (BS) is a treatment approved for weight loss in morbidly obese patients. However, complications from this modality of treatment have been reported and liver cirrhosis connotes more risk procedure.AimsEvaluate non-invasive methods transient elastography (THE) and scores to establish the degree of liver fibrosis in patients submitted to BS, comparing their performance with liver histology.MethodsWe calculated liver fibrosis by non-invasive scores AST to platelet ration index (APRI), fibrosis-4 (FIB-4) and non-alcoholic fatty liver disease (NAFLD) score and THE before and 6 months after the bariatric surgery. The results were compared to liver histology.ResultsWe included 85 patients, 69.4% females, with a mean age of 36 years, with a mean body mass index (BMI) of 41 kg/m2. The non-invasive scores were able to exclude clinically significant fibrosis in 85.9% (APRI) and advanced fibrosis in 96.5% (FIB-4) and 51.8% (NAFLD score). When comparing with the histological findings, the correlation with elastography was 45.9% for the same degree of fibrosis, with high negative predictive value (94.4%) in pre-surgical analysis. In the post-surgical analysis, the correlation with histology was 69.4% for THE and the negative predictive value to exclude clinically significant fibrosis was 98.5%.ConclusionTHE showed low correlation with histology in the pre-surgical analysis. All the methods had better results in post bariatric evaluation comparing with pre-bariatric data and the non-invasive FIB-4 score showed the best of them. 相似文献
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Helena Medina Cruz Jakeline Ribeiro Barbosa Jeov Keny Baima Colares Antonio Henrique Almeida de Moraes Neto Maria de F tima Leal Alencar Francisco In cio Bastos Jurema Corr a da Mota Filipe An bal Carvalho-Costa Claudia Alexandra Pontes Ivantes Lia Laura Lewis-Ximenez Livia Melo Villar 《World journal of hepatology》2018,10(11):867-876
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Guilherme Grossi Lopes Cançado Michelle Harriz Braga Maria Lúcia Gomes Ferraz Cristiane Alves Villela-Nogueira Debora Raquel Benedita Terrabuio Eduardo Luiz Rachid Cançado Mateus Jorge Nardelli Luciana Costa Faria Nathalia Mota de Faria Gomes Elze Maria Gomes de Oliveira Vivian Rotman Maria Beatriz de Oliveira Simone Muniz Carvalho Fernandes da Cunha Daniel Ferraz de Campos Mazo Liliana Sampaio Costa Mendes Claudia Alexandra Pontes Ivantes Liana Codes Valéria Ferreira de Almeida e Borges Cláudia Alves Couto 《Annals of hepatology》2022,27(1):100546
Introduction and objectivesLittle is known about primary biliary cholangitis (PBC) in non-whites. The purpose of this study was to evaluate clinical features and outcomes of PBC in a highly admixed population.Material and methodsThe Brazilian Cholestasis Study Group multicentre database was reviewed to assess demographics, clinical features and treatment outcomes of Brazilian patients with PBC.Results562 patients (95% females, mean age 51 ± 11 years) with PBC were included. Concurrent autoimmune diseases and overlap with autoimmune hepatitis (AIH) occurred, respectively, in 18.9% and 14%. After a mean follow-up was 6.2 ± 5.3 years, 32% had cirrhosis, 7% underwent liver transplantation and 3% died of liver-related causes. 96% were treated with ursodeoxycholic acid (UDCA) and 12% required add-on therapy with fibrates, either bezafibrate, fenofibrate or ciprofibrate. Response to UDCA and to UDCA/fibrates therapy varied from 39%-67% and 42-61%, respectively, according to different validated criteria. Advanced histological stages and non-adherence to treatment were associated with primary non-response to UDCA, while lower baseline alkaline phosphatase (ALP) and aspartate aminotransferase (AST) levels correlated with better responses to both UDCA and UDCA/fibrates.Conclusions: Clinical features of PBC in highly admixed Brazilians were similar to those reported in Caucasians and Asians, but with inferior rates of overlap syndrome with AIH. Response to UDCA was lower than expected and inversely associated with histological stage and baseline AST and ALP levels. Most of patients benefited from add-on fibrates, including ciprofibrate. A huge heterogeneity in response to UDCA therapy according to available international criteria was observed and reinforces the need of global standardization. 相似文献
10.
Julio C. U. Coelho Eduardo J. B. Ramos Marco A. R. da Costa Alcindo Pissaia Claudia A. P. Junior Ivantes 《肝胆外科与营养》2014,3(4):212-215