Evaluation of the therapeutic response of hepatitis C in coinfected patients (HIV/HCV): a study of cases from a hospital for chronic liver diseases in the Eastern Brazilian Amazon

INTRODUCTION: The aim of this study was to evaluate the therapeutic response of hepatitis C in patients coinfected with human immunodeficiency virus (HIV-1). METHODS: A retrospective study of 20 patients coinfected with HIV-1/HCV who were treated in the outpatient liver clinic at the Sacred House of Mercy Foundation Hospital of Pará (Fundação Santa Casa de Misericórdia do Pará - FSCMPA) from April 2004 to June 2009. Patients were treated with 180µg PEG interferon-α2a in combination with ribavirin (1,000 to 1,250mg/day) for 48 weeks. The end point was the sustained virological response (SVR) rate (HCV RNA negative 24 weeks after completing treatment). RESULTS: The mean age of the patients was 40±9.5 years, of which 89% (n=17) were male, and the HCV genotypes were genotype 1 (55%, n=11/20), genotype 2 (10%, n=2/20) and genotype 3 (35%, n=7/20). The mean CD4+ lymphocyte count was 507.8, and the liver fibrosis stages were (METAVIR) F1 (25%), F2 (55%), F3 (10%) and F4 (10%). The early virological response (EVR) was 60%, the end-of-treatment virological response (EOTVR) was 45% and the SVR was 45%. CONCLUSIONS: The median HCV viral load was high, and in 85% of cases in which highly active antiretroviral therapy (HAART) was used, none of the patients with F3-F4 fibrosis responded to treatment. Of the twenty patients treated, 45% achieved SVR and 45% achieved EOTVR. Studies that include cases from a wider region are needed to better evaluate these findings.

Composition of functional ecological guilds of the fish fauna of the internal sector of the Amazon Estuary, Pará, Brazil

O presente estudo descreve a estrutura espacial e temporal da comunidade de peixes estuarinos da porção interna do estuário Amazônico. Amostras foram obtidas no canal principal e canais de maré das Baías do Guajará e Marajó e rio Guamá. Foram coletados um total de 41.516 espécimes, correspondendo 136 espécies, 38 famílias e 12 ordens. Na estação seca, a salinidade média no canal principal aumentou ao longo do gradiente limnico–marinho, entre o rio Guamá e a Baía do Marajó. A riqueza de espécies foi mais baixa na foz do rio Guamá e na margem direita da baía do Guajará. A composição das espécies e as guildas ambientais diferiram significativamente entre as áreas: Migrantes e Ocasionais de água doce foram dominantes no rio Guamá e na Baía do Guajará, enquanto Estuarinas, Marinhas Migrantes e Ocasionais dominaram na Baía do Marajó. Contudo, as guildas tróficas foram relativamente bem balanceadas, em termos funcionais. Piscívoros e Zoobentívoros foram os grupos alimentares dominantes em todas as áreas. Neste estudo, a avaliação da comunidade e o uso da abordagem com guildas foram eficientes para descrever a estrutura e o funcionamento das assembleias de peixes estuarinos e também como ferramenta na avaliação das pressões antrópicas na área.