The absence of the human platelet antigen polymorphism effect on fibrosis progression in human immunodeficiency virus-1/hepatitis C virus coinfected patients

AbstractINTRODUCTION:Hepatic fibrosis progression in patients with chronic hepatitis C virus infections has been associated with viral and host factors, including genetic polymorphisms. Human platelet antigen polymorphisms are associated with the rapid development of fibrosis in HCV-monoinfected patients. This study aimed to determine whether such an association exists in human immunodeficiency virus-1/hepatitis C virus-coinfected patients.METHODS:Genomic deoxyribonucleic acid from 36 human immunodeficiency virus-1/hepatitis C virus-coinfected patients was genotyped to determine the presence of human platelet antigens-1, -3, or -5 polymorphisms. Fibrosis progression was evaluated using the Metavir scoring system, and the patients were assigned to two groups, namely, G1 that comprised patients with F1, portal fibrosis without septa, or F2, few septa (n = 23) and G2 that comprised patients with F3, numerous septa, or F4, cirrhosis (n = 13). Fisher's exact test was utilized to determine possible associations between the human platelet antigen polymorphisms and fibrosis progression.RESULTS:There were no deviations from the Hardy-Weinberg equilibrium in the human platelet antigen systems evaluated. Statistically significant differences were not observed between G1 and G2 with respect to the distributions of the allelic and genotypic frequencies of the human platelet antigen systems.CONCLUSION:The greater stimulation of hepatic stellate cells by the human immunodeficiency virus and, consequently, the increased expression of transforming growth factor beta can offset the effect of human platelet antigen polymorphism on the progression of fibrosis in patients coinfected with the human immunodeficiency virus-1 and the hepatitis C virus.

Hepatitis E virus infection in Brazil: results of laboratory-based surveillance from 1998 to 2013

INTRODUCTION:Data on hepatitis E virus (HEV) in Brazil are limited. We analyzed 15 years of HEV surveillance data in a major clinical laboratory in São Paulo, Brazil.METHODS:The seroprevalence of HEV of 2,271 patients subjected to anti-HEV tests from 1998 to 2013 were analyzed.RESULTS:HEV seroprevalence was 2.1%, and the anti-HEV IgM positivity rate was 4.9%. Six hepatitis E patients were identified.CONCLUSIONS:HEV seroprevalence and detection rates appear to have increased in recent years. Hepatitis E should be investigated further and included in the differential diagnosis of hepatitis in Brazil.

Clinical and epidemiological profile of female blood donors with positive serology for viral hepatitis B

ABSTRACTINTRODUCTION:Since women are frequently the minority among blood donors worldwide, studies evaluating this population usually reflect male features. We assessed the features of female blood donors with positive serology for HBV and compared them with those of men.METHODS The study comprised consecutive blood donors referred to a specialized liver disease center to be evaluated due to HBsAg- and/or anti-HBc-positive tests.RESULTS: The study encompassed 1,273 individuals, 219 (17.2%) of whom were referred due to positive HBsAg test and 1,054 (82.8%) due to reactive anti-HBc test. Subjects' mean age was 36.8±10.9 years, and 28.7% were women. Female blood donors referred for positive HBsAg screening tests demonstrated higher prevalence of healthcare workers (9.3% vs 2.5%) and lower prevalence of sexual risk behaviors (15.1% vs 41.1%) and alcohol abuse (1.9% vs 19.8%) compared to men. Women had lower ALT (0.6 vs 0.8×ULN), AST (0.6 vs 0.8×ULN), direct bilirubin (0.2 vs 0.3mg/dL), and alkaline phosphatase (0.5 vs 0.6×ULN) levels and higher platelet count (223,380±50,293 vs 195,020±53,060/mm3). Women also had a higher prevalence of false-positive results (29.6% vs 17.0%). No differences were observed with respect to liver biopsies. Female blood donors referenced for reactive anti-HBc screening tests presented similar clinical, epidemiological, and biochemical characteristics to those reported for positive HBsAg screening tests and similarly had a higher prevalence of false-reactive results.CONCLUSIONS: Compared to men, female blood donors with positive HBsAg and/or anti-HBc screening tests demonstrated higher prevalence of professional risk and false-positive results and reduced alteration of liver chemistry.

Hepatitis B and C in a Brazilian deaf community

ABSTRACTINTRODUCTION:Although deaf people are exposed to hepatitis B and C risk factors, epidemiological studies regarding these diseases in deaf people are lacking.METHODS:After watching an explanatory digital versatile disc (DVD) in Brazilian Sign Language, 88 deaf people were interviewed and tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBc), and hepatitis C virus antibody (anti-HCV).RESULTS:The prevalence of hepatitis B markers was 8%; they were associated with incarceration and being born outside the State of São Paulo. No cases of hepatitis C were identified.CONCLUSIONS:Participants showed a substantial lack of knowledge regarding viral hepatitis, indicating a need for public policies that consider linguistic and cultural profiles.

Incidence of hepatitis C in Brazil

Abstract INTRODUCTION: Hepatitis C is a public health problem of global dimensions, affecting approximately 200 million people worldwide. The main objective of this study was to estimate the incidence rate of hepatitis C in Brazil during the period between 2001 and 2012. METHODS: An epidemiological, temporal, and descriptive study was performed using data from the Information System for Reportable Diseases. RESULTS: Between 2001 and 2012, a total of 151,056 hepatitis C cases were recorded, accounting for 30.3% of all hepatitis notifications in Brazil. The average gross coefficient for the analysis period was 6.7 new cases per 100,000 inhabitants. The regions with the highest rates were the Southeast region (8.7 new cases/100,000 inhabitants) and the South (13.9 new cases/100,000 inhabitants). There was a predominance of men with respect to the incidence rate (8.0 new cases/100,000 inhabitants) compared to women (5.5 new cases/100,000 inhabitants). Injection drug use was the most common source of infection, and members of the white race, residents of urban areas, and those aged 60 to 64 years had the highest incidences. CONCLUSIONS: Over the last 10 years, the incidence of hepatitis C in Brazil has increased, mainly in the South and Southeast. The adoption of fast, accurate diagnostic methods, together with epidemiological awareness, can facilitate early intervention measures for adequate control of the disease.

Epidemiological study of hepatitis B and C in a municipality with rural characteristics: Cássia dos Coqueiros, State of São Paulo, Brazil

Abstract: INTRODUCTION: Hepatitis B and C viral infections remain an important cause of global morbidity and mortality. Studies have been conducted in population groups of large cities, leaving gaps in the knowledge regarding the situation in small municipalities. We aimed to measure the prevalence of hepatitis B and C markers and presence of infection-associated factors. METHODS: All inhabitants of Cássia dos Coqueiros aged ≥18 years who agreed to participate in the research were included. We collected blood as well as information via a questionnaire between March 2011 and December 2013. Univariate and multivariate analyses were conducted. RESULTS: Among the 1,001 participants, 41 (4.1%) participants had a serological profile of hepatitis B viral exposure, and only one (0.1%) participant was considered a virus carrier. The frequency of isolated antibody to hepatitis B virus surface antigen (anti-HBs) markers was 17.8% for the overall population. In the multivariate analysis, hepatitis B virus (HBV) infection was associated with age, birth outside the State of São Paulo, history of hepatitis, ≥2 sexual partners in the last 6 months, and tattoos. Four (0.4%) participants had a serological profile of hepatitis C viral exposure. However, after confirmation using viral ribonucleic acid (RNA) evaluation, only one (0.1%) individual remained positive. CONCLUSIONS: The positivity rates for hepatitis B and C were low, despite greater sexual freedom and the recent emergence of illicit drugs, as observed by the health personnel working in Cássia dos Coqueiros.

Distribution of hepatitis B infection in Brazil: the epidemiological situation at the beginning of the 21 st century

Abstract Brazil was formerly considered a country with intermediate hepatitis B endemicity, with large heterogeneity between Brazilian regions and areas of high prevalence, especially in the Amazon basin. Systematic vaccination of children was initiated in 1998. Between 2004 and 2009, a large population-based study reported decreased prevalence in all regions of Brazil. This review analyzed the current hepatitis B epidemiological situation in Brazil through a systematic search of the scientific literature in MEDLINE, LILACS, and CAPES thesis database, as well as disease notifications to the Information System for Notifiable Diseases. The search strategy identified 87 articles and 13 theses, resulting in 100 total publications. The most recent results indicate reduced hepatitis B prevalence nationwide, classifying Brazil as having low endemicity. Most studies showed HBV carrier prevalence less than 1%. However, there are still isolated regions with increased prevalence, particularly the Amazon, as well as specific groups, such as homeless people in large cities and isolated Afro-descendant communities in the center of the country. This review alsao detected successful vaccination coverage reported in a few studies around the country. The prevalence of anti-HBs alone ranged from 50% to 90%. However, isolated and distant localities still have low coverage rates. This review reinforces the downward trend of hepatitis B prevalence in Brazil and the need to intensify vaccination strategies for young people and adults in specific regions with persisting higher HBV infection prevalence.

Clinical, demographic, and epidemiologic characteristics of hepatitis B virus-infected patients at a tertiary public hospital in Presidente Prudente, State of São Paulo, Brazil

Abstract: INTRODUCTION: Few studies have addressed the primary characteristics of patients infected with hepatitis B virus (HBV) in the general population, especially those living in small- and medium-sized cities in Brazil. We aimed to determine the clinical, demographic, and epidemiologic characteristics of patients diagnosed with HBV who were followed up at an infectious diseases clinic of a public hospital in State of São Paulo, Brazil. METHODS: Medical records of patients aged >18 years and diagnosed with HBV infection between January 2000 and December 2013 were reviewed. RESULTS: Seventy-five patients were enrolled with male-female main infection-associated risk factors; 9 (12%) were co-infected with human immunodeficiency virus (HIV), 5 (6.7%) with hepatitis C virus (HCV), and 3 (4%) were co-infected with both HIV and HCV. Antiviral HBV therapy was applied in 21 (28%) patients and tenofovir monotherapy was the most prescribed medication. After approximately 2 years of antiviral treatment, the HBV-DNA viral load was undetectable in 12 (92.3%) patients and lower levels of alanine aminotransferase were found in these patients. CONCLUSIONS: Over a 13-year interval, very few individuals infected with HBV were identified, highlighting the barriers for caring for patients with HBV in developing countries. New measures need to be implemented to complement curative practices.

Endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris: immunoglobulin G heterogeneity detected by indirect immunofluorescence

Pemphigus are autoimmune intraepidermal blistering diseases in which immunoglobulin G (IgG) autoantibodies are directed against desmosomal glycoproteins. The aim of this study was to determine the IgG subclass profile of endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris utilizing indirect immunofluorescence. PATIENTS AND METHODS: Twenty-five patients with pemphigus vulgaris, 25 with endemic pemphigus foliaceus (fogo selvagem), and 25 healthy controls were analyzed by indirect immunofluorescence for circulating autoantibodies (total IgG and its subclasses). RESULTS: Our data revealed a significant correlation (P <.05) of disease activity and autoantibody levels in both forms of pemphigus, i.e., negative titers related to clinical remission, whereas positive results related to active disease. Immunoglobulin G subclass analysis in fogo selvagem demonstrated that in patients in remission, 56% showed positive immunoglobulin G4; in active disease, immunoglobulin G4 was the predominant subclass (100% positive in all cases). The IgG subclass profile in pemphigus vulgaris showed that in patients in remission, only 10% were positive for immunoglobulin G4; in active disease, positivity for immunoglobulin G4 was present in 78% to 88% of the cases. CONCLUSION: Subclass characterization of immunoglobulin G autoantibodies is a useful tool for pemphigus follow-up, since immunoglobulin G4 (IgG4) is the subclass that is closely related to recognition of pathogenic epitopes, and consequently with disease activity. Careful monitoring should be performed for fogo selvagem in clinical remission with a homogeneous IgG4 response, since this may indicate more frequent relapses.

COMPORTAMENTO DE LEVEDURAS DO GÊNERO CANDIDA"IN VITRO" A ANTIFÚNGICOS

Estudou-se o comportamento de leveduras do gênero Candida a antifungicos, pela determinação da Concentração Inibitória Mínima (CIM) e da Concentração Fungicida Mínima (CFM) "in vitro"de 30 cepas de Candida frente aos antifungicos: miconazol, cetoconazol e anfotericina B. Empregou-se o método de diluição em meio líquido e os antifungicos foram diluídos visando proporcionar concentrações a partir de 0,06 a 128 μg/mL. O inóculo foi padronizado ajustando-se a suspensão para conter 1X 106 ufc/mL. A concentração para a qual houve maior convergência de cepas foi de 1 μg/mL (26,5%) para anfotericina B. Para miconazol foi de 16 μg/mL (26,0%) e para cetoconazol 32 μg/mL (23,0%). Os valores de CFM foram de 2 μg/mL (23,5%) para anfotericina B, de 16 e 64 μg/mL (26,5%) para miconazol e 32 e 64 μg/mL (30,0%) para cetoconazol. Este imidazólico mostrou os valores de CIM e CFM mais elevados atingindo até 128 μg/mL em algumas espécies. As espécies de Candida mostraram-se mais sensíveis à Anfotericina B, quando comparadas em relação aos antifungicos testados. Sobre o desempenho das espécies de Candida, melhor padrão de comportamento foi verificado para C. albicans com níveis mais baixos de sensibilidade.

Descrição de Syndyas amazonica SP. N., Primeiro registro do gênero na região Neotropical (Diptera, Empididae, Hybotinae)

Uma espécie amazônica de Syndyas é descrita e ilustrada: Syndyas amazonica sp.n.. Este é o primeiro registro do gênero na Região Neotropical.

Descrição de três novas espécies do gênero Melittomma (Coleoptera: Lymexylidae) da região neotropical e considerações sobre Melittomma brasiliense (Castelnau, 1832)

Estudo taxonômico das espécies neotropicais de Melittomma é apresentado, enfatizando as espécies distribuídas no território brasileiro. Discute-se brevemente os caracteres diagnósticos de M. brasiliense com dados de sua distribuição geográfica; descrições e ilustrações de três novas espécies, Melittomma nana sp.n. distribuída pela região Neotropical, Μ. brunnea sp.n. da Amazônia Central e M. panamensis sp.n. do Panamá, são apresentadas.

Fauna parasitológica de Alevinos de Matrinchã Brycon cephalus (Günther, 1869) coletados nos Rios Negro e Solimões, na Amazônia central

Aproximadamente 2500 alevinos de matrinchã com comprimento padrão de 0,8 a 5,0cm foram coletados no lago Catalão, margem direita do rio Negro e no rio Solimões, próximo a ilha da Marchantaria, Estado do Amazonas. Uma subamostra de 136 peixes foi retirada para exames parasitológicos e o restante foi colocado em tanques em uma estação de piscicultura, durante 30 dias. Após esse período uma segunda amostra foi retirada e examinada. Dos 136 peixes: 49 (36%) estavam parasitados com metacercárias de trematódeos; 32 (23,5%) com nematóides Spirocamallanus inopinatus; 26 (19%) com monogenóideos Jainus amazonensis; 3 (2%) com protozoários Trichodina sp.; 1 (0,7%) com acantocéfalo Echinorhynchus sp. e 2 (1,5%) com estágios larvais de cestóides. Dos peixes mantidos nos tanques, após 30 dias foi examinada uma subamostra de 60 peixes: 42 (70%) estavam parasitados com J. amazonensis; 14 (23%) com S. inopinatus; 9 (15%) com metacercárias de trematódeos e 2 (3%) com Echinorhynchus sp. A intensidade média e abundância média foram maiores em J. amazonensis (342 e 65), seguido por cestóides (70 e 1), Trichodina sp. (13 e 0,3), trematódeos (5 e 2), S. inopinatus (1 e 0,3) e Echinorhynchus sp. (1 e 0,007). Na estação de piscicultura a intensidade média e abundância média também foram maiores para o J. amazonensis (222 e 115) em relação aos demais grupos. A espécie J. amazonensis apresentou maior intensidade média e menor prevalência na natureza. Houve variação na composição da fauna parasitógica e nos índices de infestação, após 30 dias de permanência na estação de piscicultura.

Composição corporal e alimentar do Matrinxã, Brycon cephalus (Günther, 1869), na Amazônia central

Foram estudados a dieta, a composição corporal e o valor de energia bruta do conteúdo estomacal, filé e fígado, bem como alguns frutos e sementes que fazem parte da dieta do matrinxã, relacionando-se estes parâmetros com as flutuações do nível da água durante um ciclo anual. Observou-se que a espécie se alimenta de sementes, frutos, flores, restos de vegetais e insetos, apresentando hábito alimentar onívoro. Estômagos vazios foram frequentes (68,5%) nos diferentes períodos hidrológicos. As análises proximais e valor da energia bruta do filé e fígado dos peixes analisados não apresentaram diferenças significativas entre os sexos (P>0,05). No entanto, observou-se diferenças entre os períodos de águas baixas e altas. As médias das composições centesimais e os valores de energia bruta do conteúdo estomacal, expressos com base na matéria seca revelaram, na enchente, um baixo teor de proteína (8,9%) e cinza (1,3%), alto valor de lipídios (70,2%) e energia (775 Kcal EB/100g). Na seca, o teor de proteína (24,9%) e cinza (6,3%) foram maiores, porém os teores de lipídios (13,2%) e de energia (416,9 Kcal EB 100g) foram mais baixos que na cheia. Foi verificado abundante depósito de gordura cavitária o ano todo, diminuindo em janeiro, mês em que o matrinxã realiza a desova.

Estocagem tecidual e utilização de lipídeos em Matrinxã, Brycon cephalus (Günther, 1869)

Os lipídeos exercem diversas funções biológicas, como constituintes de membranas, precursores de hormônios, e por seu alto conteúdo calórico, um eficiente composto para estoque de energia. Nos peixes, ao contrário dos mamíferos, os modelos de deposição lipídica são mais diversos. O objetivo deste trabalho foi avaliar a concentração de lipídeo total no plasma e nos tecidos somático e reprodutivo do matrinxã, Brycon cephalus, macho e fêmea, destacando alguns índices somáticos relacionados à dinâmica desse substrato. De outubro/97 a janeiro/99, foram amostrados, mensalmente, 8 a 12 peixes, totalizando 174 animais. Após anestesia, retirou-se sangue heparinizado para dosagem do triacilglicerol plasmático. Cada peixe foi mensurado e fígado, gônadas e gordura visceral retirados e pesados para cálculo do IHS (índice hepatossomático) IGS (índice gonadossomático) e IGVS (índice gorduro-viscerossomático). Os maiores teores do lipídeo total ocorreram no músculo vermelho, com aproximadamente 18%, seguido pelo fígado e gônadas com valores médios de 16,5%. O músculo branco apresentou o menor teor com 2,3%. A análise de variância dos IHS e IGVS mostrou que ambos apresentaram efeito significativo para bimestre, com índices mais baixos em períodos de temperaturas mais altas, e não significativo para sexo e a interação sexo e bimestre. O matrinxã estoca lipídeos em vários tecidos corpóreos incluindo gordura mesentérica, fígado, músculos e gônadas.