Navegando por Palavras-chave "Hepatitis E"
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- ItemAcesso aberto (Open Access)Determinação da soroprevalência da infecção pelo vírus da hepatite e em pacientes submetidos à hemodiálise em comparação a transplantados renais e doadores de sangue(Universidade Federal de São Paulo (UNIFESP), 2018-05-05) Sena, Anne de [UNIFESP]; Bellei, Nancy Cristina Junqueira [UNIFESP]; http://lattes.cnpq.br/1571196803842272; http://lattes.cnpq.br/2665388053873440Introduction: Hepatitis E virus (HEV) infection currently accounts for over 50% of acute hepatitis cases in endemic countries. There are cases of hepatic failure in patients with other underlying liver diseases or in women in the third trimester of pregnancy, as well as the chronic form of the disease, especially among solid organ transplant patients. Objective: To establish the seroprevalence of HEV infection in patients submitted to hemodialysis compared to renal transplants patients and healthy controls (blood donors) by detecting antiHEV IgG and IgM antibodies, and in the positive samples the presence of RNAHEV via realtime RTPCR. Methods: 500 blood donors of the Benefit Blood Collection Association, 257 patients undergoing hemodialysis, and 292 kidney transplant recipients from the Hospital of Rim and Hypertension were included in the study. Detection of antiHEV IgG and antiHEV IgM antibodies was performed using the Wantai immunoenzyme assay (Beijing Wantai Biological Pharmacy Enterprise, Beijing, China). Samples with positive antiHEV IgG were submitted to viral RNA extraction for subsequent HEVRNA screening by realtime RTPCR. Results: The seroprevalence of HEV infection in hemodialysis patients was 10.9% when compared to renal transplant recipients (15.8%) and blood donors (9.8%), thus considering age as a risk factor for patients renal transplant patients and patients submitted to hemodialysis presented an increase for the development of hepatitis E in relation to the control group. In none of the seropositive samples was HEV RNA identified. Conclusion: This is the first study of the literature evaluating the seroprevalence of HEV infection in patients submitted to hemodialysis in Brazil and the correlation of the three groups studied shows that age is an important risk factor for the development of the disease.
- ItemAcesso aberto (Open Access)Infecção pelo vírus da hepatite E em pacientes com infecção crônica pelo vírus da hepatite C(Universidade Federal de São Paulo (UNIFESP), 2017-09-25) Bricks, Guilherme [UNIFESP]; Castelo Filho, Adauto [UNIFESP]; Granato, Celso Francisco Hernandes [UNIFESP]; Senise, Jorge Figueiredo [UNIFESP]; Celso Francisco Hernandes Granato: http://lattes.cnpq.br/7880516839350591 ; Jorge Figueiredo Senise: http://lattes.cnpq.br/0363646811603656 ; http://lattes.cnpq.br/0107536337908259; http://lattes.cnpq.br/3128106813335431; Universidade Federal de São Paulo (UNIFESP)Resumo Introdução: O impacto da infecção pelo vírus da hepatite E (HEV) em pacientes com infecção crônica pelo vírus da hepatite C (HCV) é pouco conhecido. Objetivos: Avaliar a associação entre presença de anticorpos anti-HEV e cirrose hepática em pacientes com infecção crônica pelo HCV; estimar a soroprevalência do HEV nesses pacientes, assim como descrever os fatores de risco associados; e avaliar a associação entre infecção prévia pelo HEV e resistência à insulina. Métodos: Entre outubro de 2015 e dezembro de 2016, foram avaliados 618 pacientes de três centros de referência do estado de São Paulo com infecção crônica pelo HCV. Avaliou-se presença de anticorpos da classe IgG contra o vírus da hepatite E por método imunoenzimático (WANTAI HEV-IgG ELISA). Amostras com resultados reagentes e indeterminados foram testadas para presença de anticorpos anti-HEV IgM. Resultados: A soroprevalência encontrada foi de 10,2% (IC 95% 8,0 – 12,8%). Maior soroprevalência apresentou associação independente com idade superior a 60 anos (OR = 2,13; p = 0,001), história de contato prévio com porcos (OR = 2,06; p = 0,02) e hemofilia (OR = 35,69; p = 0,004). Soropositividade para hepatite E, ajustada para sexo, idade e genótipo do HCV, apresentou forte tendência de associação com presença de cirrose hepática (OR = 1,72; IC 95% 0,96 – 3,07; p = 0,06). Presença de anticorpos contra o HEV apresentou associação independente com resistência insulínica (OR: 4,24; p = 0,05). Discussão e Conclusões: Pacientes com infecção crônica pelo HCV estão sob risco de superinfecção pelo vírus da hepatite E em São Paulo. Contato com porcos é fator de risco para a infecção, indicando possível zoonose de transmissão alimentar ou por contato com os dejetos dos animais. Alta prevalência em hemofílicos sugere possibilidade de transmissão alternativa por via parenteral. A tendência de associação entre infecção prévia pelo vírus da hepatite E e cirrose sugere aceleração da progressão de fibrose hepática em pacientes com hepatite C crônica. Infecção prévia pelo vírus da hepatite E se associa à presença de resistência insulínica, podendo esta ser manifestação extra-hepática sustentada após resolução da infecção pelo vírus.
- ItemAcesso aberto (Open Access)Infecção pelo vírus da Hepatite e entre pacientes com níveis alterados de Alanina Aminotransferase(Universidade Federal de São Paulo (UNIFESP), 2020-12-01) Conte, Danielle Dias [UNIFESP]; Bellei, Nancy Cristina Junqueira [UNIFESP]; Universidade Federal de São PauloIntroduction: Hepatitis E virus (VHE) infection affects about 20 million people worldwide annually, with 3 million cases of acute infection and 56,000 deaths. The route of transmission is fecal-oral, and there is evidence of zoonotic transmission. The infection is asymptomatic in 50% of cases but can cause self-limited acute hepatitis. Symptomatic manifestation is commonly reported in men over 50 years of age. In women who acquire VHE during late pregnancy, 20% develop severe forms with fulminant liver failure. There are reports of chronic infection in immunocompromised patients, especially in solid organ transplant recipients or with pre-existing liver disease. Recent studies have shown that in VHE infections, without other viral hepatitis, there is a three-fold increase in the level of alanine aminotransferase (ALT) compared to the upper limit (56 IU/L). This elevation may be a predictive factor of VHE infection. Objective: To evaluate the increase in levels of alanine aminotransferase (ALT) with VHE infection in patients of the emergency care service of two hospitals in the city of São Paulo (Hospital Beneficência Portuguesa and Hospital São Paulo). Casuistic: Cross-sectional study with 400 serological samples of mischaracterized patients who presented increased ALT levels. Method: Serum samples with ALT elevation (> 200 IU/L) were submitted to enzymatic immunoassay for qualitative detection of IgM and IgG antibodies (Commercial Kit- Beijing Wantai Biological Pharmacy Enterprise, Beijing, China). The samples that presented "reactive" results for anti-VHE IgM were submitted to viral RNA extraction for real-time RT-PCR VHE-RNA. Results: In total, 400 patients (200 from each HBP) were tested for VHE by real-time RT-PCR (RT-qPCR), from serum samples. Among these patients, 90 (45 of each BP) were randomly selected for the detection of IgM anti-VHE antibodies by ELISA. In addition, the 200 HSP patients were investigated for the presence of anti-hepatitis A IgM (HAV), B (HBV), and C (IgG-HCV) by ELISA. The age of the patients ranged from 0.8 to 91 years (mean = 46.29±24.47, median = 48). In the RT-qPCR VHE tests, 16 patients were positive (4.1%), 9 HSP and 7 HBP. In the Anti-VHE IgM ELISA test, 2 BPH patients were reactive (2.22%). In the latter, alt values were 1505 and 3831 IU/L, a 77-year-old male patient, and a 39-year-old female, respectively. In the latter, alt values were 1505 and 3831 IU/L, a 77-year-old male patient, and a 39-year-old female, respectively. In positive RT-qPCR, the ALT mean was 441.87 IU/L (range 299 to 698). In the 200 HSP patients, they were reagents for HAV, B, and C, 9%, 4.5%, and 3.5%, respectively. Two RT-qPCR-positive patients for VHE were reagents for HAV and B separately. Conclusion: Hepatitis E remains underreported and neglected in Brazil, with a higher frequency than normally researched. Since this research was conducted in the population of two hospitals of the Unified Health System, which usually serves low-income people and may eventually have poor hygiene conditions. Thus, it is important to establish a routine diagnosis of HEV that allows early intervention and improve the prognosis of patients.