Virus de la hepatitis C: variabiliad en las regiones del CORE y NS5A y su impacto en la infección por el genotipo 1b

La infección por el virus de la hepatitis C (VHC) tiene un gran impacto a nivel mundial, considerándose una de las principales causas de hepatitis crónica, enfermedad hepática terminal y hepatocarcinoma. Hasta la incorporación de los nuevos agentes antivirales, el genotipo 1b era el que tenía tasas más bajas de respuesta viral sostenida (RVS); y a su vez, el de mayor prevalencia en nuestro medio. Lo que ha llevado a la búsqueda de marcadores predictores de respuesta, con el fin de identificar a aquellos pacientes que pudieran beneficiarse del tratamiento. Estudios previos han mostrado que la variabilidad genómica en la región codificante de la proteína C del Core y en la región comprendida entre los aminoácidos 2209 y 2248 (región determinante de la sensibilidad al IFN: ISDR) de la región que codifica la proteína no-­‐estructural 5A (NS5A) están relacionados con la respuesta al tratamiento con biterapia. Es por ello, que el objetivo de nuestro estudio es caracterizar a nivel genómico ambas regiones y analizar su impacto en pacientes con infección crónica por el genotipo 1b. Se analizan, además, otros factores basales implicados en la respuesta: sexo, edad y carga viral basal...

Hepatite C crônica em serviço de referência no nordeste do Brasil: um estudo retrospectivo de dezoito anos de acompanhamento

Chronic Hepatitis C is the leading cause of chronic liver disease in advanced final stage of hepatocellular carcinoma (HCC) and of death related to liver disease. Evolves progressively in time 20-30 years. Evolutionary rates vary depending on factors virus, host and behavior. This study evaluated the impact of hepatitis C on the lives of patients treated at a referral service in Hepatology of the University Hospital Onofre Lopes - Liver Study Group - from May 1995 to December 2013. A retrospective evaluation was performed on 10,304 records, in order to build a cohort of patients with hepatitis C, in which all individuals had their diagnosis confirmed by gold standard molecular biological test. Data were obtained directly from patient charts and recorded in an Excel spreadsheet, previously built, following an elaborate encoding with the study variables, which constitute individual data and prognostic factors defined in the literature in the progression of chronic hepatitis C. The Research Ethics Committee approved the project. The results were statistically analyzed with the Chi-square test and Fisher's exact used to verify the association between variable for the multivariate analysis, we used the Binomial Logistic regression method. For both tests, it was assumed significance p < 0.05 and 95%. The results showed that the prevalence of chronic hepatitis C in NEF was 4.96 %. The prevalence of cirrhosis due to hepatitis C was 13.7%. The prevalence of diabetes in patients with Hepatitis C was 8.78 % and diabetes in cirrhotic patients with hepatitis C 38.0 %. The prevalence of HCC was 5.45%. The clinical follow-up discontinuation rates were 67.5 %. The mortality in confirmed cases without cirrhosis was 4.10% and 32.1% in cirrhotic patients. The factors associated with the development of cirrhosis were genotype 1 (p = 0.0015) and bilirubin > 1.3 mg % (p = 0.0017). Factors associated with mortality were age over 35 years, abandon treatment, diabetes, insulin use, AST> 60 IU, ALT> 60 IU, high total bilirubin, extended TAP, INR high, low albumin, treatment withdrawal, cirrhosis and hepatocarcinoma. The occurrence of diabetes mellitus increased mortality of patients with hepatitis C in 6 times. Variables associated with the diagnosis of cirrhosis by us were blood donor (odds ratio 0.24, p = 0.044) and professional athlete (odds ratio 0.18, p = 0.35). It is reasonable to consider a revaluation in screening models for CHC currently proposed. The condition of cirrhosis and diabetes modifies the clinical course of patients with chronical hepatitis C, making it a disease more mortality. However, being a blood donor or professional athlete is a protective factor that reduces the risk of cirrhosis, independent of alcohol consumption. Public policies to better efficient access, hosting and resolution are needed for this population.

Avaliação do potencial cancerigénico de microcistinas (cianotoxinas)

Tese de doutoramento em Farmácia (Toxicologia), apresentada à Faculdade de Farmácia da Universidade de Lisboa, 2009.

Marine photosynthetic organisms from the Portuguese coast as sources of antitumoural compounds

Dissertação de Mestrado, Ciências Biomédicas, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, 2016

Diseño de un vector no viral basado en nanopartículas lipídicas para el tratamiento de la hepatitis C mediante ARN de interferencia

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