Navegando por Palavras-chave "HCV"

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    Acute Hepatitis C in Brazil: Results of a National Survey
    (Wiley-Blackwell, 2011-10-01) Paiva Ferreira, Adalgisa de Souza; Perez, Renata de Mello; Gomes Ferraz, Maria Lucia [UNIFESP]; Lewis-Ximenez, Lia Laura; Pereira, Joao Luis; Lerias de Almeida, Paulo Roberto; Mattos, Angelo Alves de; Acute Hepatitis C Study Grp Brazil; Univ Fed Maranhao; Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de São Paulo (UNIFESP); Osvaldo Cruz Fdn; Gen Hosp Bonsucesso; Nossa Senhora Conceicao Hosp; Fed Fdn Sch Med Sci
    The incidence of acute hepatitis C has decreased in the world. However, new cases are still reported. the objective of this study was to obtain data of acute hepatitis C in Brazil and to identify risk factors of transmission, diagnostic criteria, clinical presentation, evolution, and treatment. A questionnaire was sent to all members of the Brazilian Society of Hepatology. Sixteen centers participated with a total of 170 cases between 2000 and 2008. Among them, 37 had chronic renal failure on hemodialysis and were evaluated separately. the main diagnostic criterion in non-uremic patients was ALT (alanine aminotransferase) elevation associated with risk factors. in patients with chronic renal failure, anti-hepatitis C virus (HCV) sero-conversion was the most frequent criterion. Among the 133 non-uremic patients the main risk factors were hospital procedures, whereas in hemodialysis patients, dialysis was the single risk factor in 95% of the cases. Jaundice was more frequent in non-uremic patients (82% vs. 13%; P < 0.001) and ALT levels were higher in these individuals (P < 0.001). Spontaneous clearance was more frequent in non-uremic patients (51% vs. 3%; P < 0.001). Sixty-five patients were treated: 39 non-urennic patients and 26 on dialysis. Sustained virological response rates were 60% for non-uremic and 58% for uremic patients (P = 0.98). There was no association of these rates with the study variables. These findings show that cases of acute hepatitis C are still occurring and have been related predominantly to hospital procedures. Measures to prevent nosocomial transmission should be adopted rigorously and followed to minimize this important source of infection observed in this survey. J. Med. Virol. 83:1738-1743, 2011. (C) 2011 Wiley-Liss, Inc. J. Med.
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    Algoritmo para Predição de Seleção de Resistência Aos Inibidores de Ns5a do Vírus da Hepatite C
    (Universidade Federal de São Paulo (UNIFESP), 2020-12-14) Almeida, Douglas De Andrade De [UNIFESP]; Janini, Luiz Mario Ramos [UNIFESP]; Universidade Federal de São Paulo
    Summary Objective: To develop an algorithm that, based on the genetic sequence of the HCV infecting virus, can estimate which are the best therapeutic treatments with the least probability of resistance selection for NS5A inhibitors. Method: A phased algorithm was created to select attributes relevant to the study and further development of a machine learning model. The attributes used in this algorithm are the population frequency of the resistance codons, the HCV codon usage and the genetic barrier between the patient's codons and the resistance codons. Results: It was possible to cross-check information from the patient's infectious virus, with information from the medical literature to structure a database with predictive variables and a response variable related to the presence or absence of drug resistance. The model was able to predict with an AUC> 0.99 which characteristics of the virus cause resistance in certain drugs. Conclusion: Codon Usage parameters, population prevalence of codons and genetic barrier, proved to be good predictors of resistance. However, the limitation of the data source implies the possibility of overfitting, which can only be discarded and / or corrected with further studies in the area using similar methodology.
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    Change in hepatitis C virus genotype in hemodialysis patients after end-of-treatment response to interferon monotherapy-relapse or re-infection?
    (Wiley-Blackwell, 2008-01-01) Arrais, Teresa Cristina de Oliveira Maia [UNIFESP]; Van Dooren, Sonia; Vandamme, Anne-Mieke; Brechot, Christian; Rimlinger, Francois; Silva, Antonio Eduardo Benedito [UNIFESP]; Perez, Renata de Mello [UNIFESP]; Ferraz, Maria Lucia Cardoso Gomes [UNIFESP]; Thiers, Valerie; Erasmus MC; Universidade Federal de São Paulo (UNIFESP); Katholieke Univ Leuven; Inst Pasteur; INSERM; Univ Paris Sud
    Hepatitis C virus (HCV) infection remains common among hemodialysis patients and its occurrence is related mainly to nosocomial spread. Although dialysis patients with HCV infection respond well to interferon-based therapy, relapse is frequent. This study aimed at a selected group of hemodialysis patients infected with HCV infection undergoing interferon therapy who achieved end-of-treatment virological response but became HCV-RNA positive again 6 months after end-of-treatment. It was evaluated whether de novo HCV-RNA positivity in these non-sustained responders occurred due to lack of clearance of HCV after the initial response to interferon-alpha (relapse) or due to re-infection with a new strain (re-infection). Genotyping by Inno-LiPA and by phylogenetic tree analysis using partial HCV-NS5B sequences at two evaluation points: pre-treatment (TO) and 6 months after end-of-treatment (T0). Non-sustained responders (n = 15) carried subtypes la (8 patients), 1b (4 patients), 3a (2 patients), and 4a (11 patient) before treatment. Identical subtypes were detected in 10 patients at T18. Five patients changed genotypes at T18, suggesting nosocomial re-infection. This study emphasizes the importance of epidemiologic measures to control the re-exposure of hemodialysis patients treated previously for HCV infection.
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    The clinical effectiveness of pegylated interferon and ribavirin for the treatment of chronic hepatitis C in HIV-infected patients in Brazil: a multicentric study
    (Elsevier B.V., 2015-01-01) Ferreira, Paulo Roberto Abrão [UNIFESP]; Silva, Mariliza Henrique da [UNIFESP]; Brandao-Melo, Carlos Eduardo; Rezende, Rosamar Eulira; Gonzalez, Mario; Reuter, Tania; Urbaez, Jose David; Gianini, Reinaldo Jose; Martinelli, Ana; Mendes-Correa, Maria Cassia; Universidade Federal de São Paulo (UNIFESP); Ctr Referencia & Tratamento DST AIDS São Paulo; Clin Especialidades Sao Bernardo Campo; Univ Fed Estado Rio de Janeiro UNIRIO; Ctr Especialidades Ambulatorio Hepatites; Inst Infectol Emilio Ribas; Univ Fed Espirito Santo; SES DF; Universidade de São Paulo (USP)
    Introduction: in Brazil, chronic hepatitis C in patients coinfected with the human immunodeficiency virus (HIV) is treated with pegylated interferon (Peg-IFN) and ribavirin (RBV). However, few studies have evaluated the effectiveness of this treatment in this particular population. the identification of the factors that predict sustained virological response (SVR) under current clinical practice would enable clinicians to more accurately estimate the probability of achieving an SVR and therefore utilize the appropriate therapeutics, especially in the era of direct-acting antiviral (DAA) agents.Aims: the primary aim of our study was to determine the SVR rate under current clinical practice. the secondary aims were as follows: (1) to determine the factors before and during treatment that predict SVR; and (2) to identify the causes of treatment interruption.Methods: within a cohort of HIV/hepatitis C virus (HCV)-coinfected patients in Brazil, we performed a retrospective analysis of those individuals treated with Peg-IFN and REV.Results: among the 382 analyzed patients, SVR was observed in 118 [30.9% (95% confidence interval (CI): 26.3-35.8)], which included 25.9% (75/289) of the patients with genotypes 1 and 4 and 48.2% (41/85) of those with genotypes 2 and 3. After multivariate analyses the independent positive predictors for SVR after treatment for chronic hepatitis C with Peg-IFN and RBV were: absence of an AIDS-defining illness (p = 0.001), HCV viral load lower than 600,000 IU/mL at the onset of treatment (p = 0.003), higher liver enzyme levels (p = 0.039) at baseline, infection with genotypes 2 or 3 (p = 0.003), and no transient treatment interruption (p = 0.001). the treatment was interrupted in 25.6% (98/382) of the patients because of adverse events (11.3%, 43/382), virologic failure (7.8%, 30/382), and dropout (6.5%, 43/382). the main adverse events were cytopenia and psychiatric disorders.Conclusions: in our Brazilian case series, the SVR rate under current clinical practice conditions was similar to that reported in other studies. There was a correlation between an SVR and being infected by genotypes 2 and 3, low viral load, high ALT levels at the onset of treatment, and absence of an AIDS-defining illness. Cytopenia and psychiatric disorders were the major causes of treatment interruption. Efforts should be focused on optimizing management of side effects and counseling to improve adherence and to keep patients on treatment. (C) 2014 Elsevier Editors Ltda. Este e um artigo Open Access sob a licenca de CC BY-NC-ND
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    Demographic and anthropometrical analysis and genotype distribution of chronic hepatitis C patients treated in public and private reference centers in Brazil
    (Brazilian Society of Infectious Diseases, 2004-10-01) Focaccia, R.; Baraldo, D.c.m.; Ferraz, Maria Lucia Cardoso Gomes [UNIFESP]; Martinelli, A.l.c.; Carrilho, F.j.; Gonçales Junior, Fernando Lopes; Pedroso, M.l.a.; Coelho, H.s.m.; Lacerda, M.a.; Brandão, C.e.; Mattos, A.a.; Lira, L.g.c.; Zamin Jr., I.; Pinheiro, J.o.p.; Tovo, C.v.; Both, C.t.; Soares, J.a.s.; Dittrich, S.; Emílio Ribas Institute; Universidade Federal de São Paulo (UNIFESP); São Paulo University Medical School of Ribeirão Preto; São Paulo University School of Medicine; Universidade Estadual de Campinas (UNICAMP); Federal University of Paraná; Secretary of State of Paraná CRE Metropolitan; Federal University of Rio de Janeiro; Private Institution; UNIRIO Graffée Guinle Universitary Hospital; Santa Casa de Misericórdia Gastroenterology Service; Federal University of Bahia
    Hepatitis C virus (HCV) infection is a serious public health problem, since 80% to 85% of HCV carriers develop a persistent infection that can progress into liver cirrhosis and hepatocarcinoma. Considering that the response of hepatitis C patients to combination therapy with interferon and ribavirin depends on HCV characteristics as well as on host features, we made a retrospective analysis of demographic and anthropometrical data and HCV genotype distribution of chronic hepatitis C patients treated in public and private reference centers in Brazil. The medical records of 4,996 patients were reviewed, 81% from public and 19% from private institutions. Patients' median age was 46 years, and there was a higher prevalence of male (62%) and white patients (80%). The analysis of HCV-infecting strains showed a predominance of genotype 1 (64%) over genotypes 2 and 3. The patients' mean weight was 70.6 kg, and 65% of the patients weighed less than 77kg. Overweight and obesity were observed in 37.8% and 13.6% of the patients, respectively. Since a body weight of 75 kg or less has been considered an independent factor that significantly increases the odds of achieving a sustained virological response, the Brazilian population seems to have a more favorable body weight profile to achieve a sustained response than the American and European populations. The finding that 65% of chronic hepatitis C patients have a body weight of 77 kg or less may have a positive pharmacoeconomic impact on the treatment of genotype 1 HCV patients with weight-based doses of peginterferon.
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    High prevalence of hepatitis C infection in a Brazilian prison: identification of risk factors for infection
    (Brazilian Society of Infectious Diseases, 2001-06-01) Guimarães, Thaís [UNIFESP]; Granato, Celso Francisco Hernandes [UNIFESP]; Varella, Drauzio [UNIFESP]; Ferraz, Maria Lucia Cardoso Gomes [UNIFESP]; Castelo Filho, Adauto [UNIFESP]; Kallas, Esper Georges [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Hepatitis C virus (HCV) causes infectious hepatitis worldwide. It is transmitted mainly by blood products and sharing of intravenous paraphernalia during illicit drug use. High prevalence rates have been described among specific groups considered to be at higher risk for HCV infection, including prison inmates. The objectives of this study were: to determine the HCV seroprevalence among inmates of Casa de Detenção de São Paulo; to identify risk factors for HCV infection; and to compare the seroprevalence of HCV to other blood borne or sexually transmitted diseases. From December, 1993, to January, 1994, a total of 779 inmates were interviewed to collect information on sociodemographic status, sexual behavior, and past experience with illicit drugs. Blood samples were obtained from 756 inmates for serological tests. 310 (41%) blood samples were positive for anti-HCV, 425 (56.2%) were negative, and 21 (2.8%) showed indeterminate results. In this population, we found a seroprevalence of 13.7% for HIV, 3.3% for syphilis (VDRL), and 68.1% for hepatitis B virus previous infection. Four variables were each identified as associated with a positive anti-HCV serologic test: a positive VDRL (OR = 2.63 IC 95% 1.08 to 6.36); a time of current imprisonment longer than 130 months (OR = 2.44 IC 95% 1.04 to 5.71); previous incarceration at Casa de Detenção de São Paulo (OR = 1.73 IC 95% 1.19 to 2.52) and; illicit drug use before admission to the Casa de Detenção de São Paulo (OR = 1.64 IC 95% 1.15 to 2.33). The seroprevalence of HCV antibodies among the study population was high (41%), indeed, one of the highest clusters of HCV infection recorded until now. Four variables were each shown to be associated with HCV infection. The simultaneous presence of these 4 variables is associated with an 82% probability of being anti-HCV positive. Although risk factor analysis indicates most HCV infections occur prior to inprisonment, initiation of control measures to prevent continued transmission after incarceration should be done.
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    Historical epidemiology of hepatitis C virus (HCV) in selected countries
    (Wiley-Blackwell, 2014-05-01) Bruggmann, P.; Berg, T.; Ovrehus, A. L. H.; Moreno, C.; Brandao Mello, C. E.; Roudot-Thoraval, F.; Marinho, R. T.; Sherman, M.; Ryder, S. D.; Sperl, J.; Akarca, U.; Balik, I.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Buti, M.; Calinas, F.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cornberg, M.; Cramp, M. E.; Dore, G. J.; Doss, W.; Duberg, A. S.; El-Sayed, M. H.; Ergor, G.; Esmat, G.; Estes, C.; Falconer, K.; Felix, J.; Ferraz, Maria Lucia Gomes [UNIFESP]; Ferreira, Paulo Roberto [UNIFESP]; Frankova, S.; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L.; Gower, E.; Gschwantler, M.; Guimaraes Pessoa, M.; Hezode, C.; Hofer, H.; Husa, P.; Idilman, R.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Lazaro, P.; Marotta, P.; Mauss, S.; Mendes Correa, M. C.; Muellhaupt, B.; Myers, R. P.; Negro, F.; Nemecek, V.; Ormeci, N.; Parkes, J.; Peltekian, K. M.; Ramji, A.; Razavi, H.; Reis, N.; Roberts, S. K.; Rosenberg, W. M.; Sarmento-Castro, R.; Sarrazin, C.; Semela, D.; Shiha, G. E.; Sievert, W.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; van Thiel, I.; Van Vlierberghe, H.; Vandijck, D.; Vogel, W.; Waked, I.; Wedemeyer, H.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Van Damme, P.; Aleman, S.; Hindman, S. J.; Arud Ctr Addict Med; Univ Leipzig; Odense Univ Hosp; Univ Libre Brussels; Universidade Federal do Rio de Janeiro (UFRJ); Hop Henri Mondor; Hosp Santa Maria; Univ Toronto; Nottingham Univ Hosp NHS Trust; Biomed Res Unit; Inst Clin & Expt Med; Ege Univ; Ankara Univ; Osped Cantonale; Univ Montreal; Adv Tech Hlth Serv Res TAISS; Hosp Valle de Hebron; Hosp Santo Antonio Capuchos; Hosp Puerta Hierro; Univ Fed Rio Grande do Sul; Region Hosp Hovedstaden; Hannover Med Sch; German Liver Fdn; Univ Plymouth; Univ New S Wales; Cairo Univ; Orebro Univ Hosp; Univ Orebro; Ain Shams Univ; Dokuz Eylul Univ; Ctr Dis Anal CDA; Karolinska Inst; Exigo Consultores; Universidade Federal de São Paulo (UNIFESP); Hosp Carlos III; Univ Copenhagen; Direccao Geral Saude; Universidade Estadual de Campinas (UNICAMP); Wilhelminenspital Stadt Wien; Universidade de São Paulo (USP); Med Univ Vienna; Masaryk Univ; Univ Manitoba; Hlth Sci Ctr; European Liver Patients Assoc; Istanbul Univ; Univ British Columbia; Aalborg Univ Hosp; Katholieke Univ Leuven; Univ Western Ontario; Univ Dusseldorf; Univ Zurich Hosp; Univ Calgary; Univ Hosp; Natl Inst Publ Hlth; Univ Southhampton; Dalhousie Univ; Capital Dist Hlth Author; Assembleia Republ; Alfred Hosp; Monash Univ; UCL; Ctr Hosp Porto; JW Goethe Univ Hosp; Cantonal Hosp St Gallen; Egyptian Liver Res Inst & Hosp ELRIAH; Monash Hlth; Catholic Univ Louvain; Med Univ Graz; St Vincents Hosp; Univ Melbourne; Charles Univ Prague; Cent Mil Hosp; Deutsch Leberhilfe eV; Ghent Univ Hosp; Univ Ghent; Hasselt Univ; Med Univ Innsbruck; Natl Liver Inst; Copenhagen Univ Hosp; Univ Antwerp; Karolinska Univ Hosp
    Chronic infection with hepatitis C virus (HCV) is a leading indicator for liver disease. New treatment options are becoming available, and there is a need to characterize the epidemiology and disease burden of HCV. Data for prevalence, viremia, genotype, diagnosis and treatment were obtained through literature searches and expert consensus for 16 countries. for some countries, data from centralized registries were used to estimate diagnosis and treatment rates. Data for the number of liver transplants and the proportion attributable to HCV were obtained from centralized databases. Viremic prevalence estimates varied widely between countries, ranging from 0.3% in Austria, England and Germany to 8.5% in Egypt. the largest viremic populations were in Egypt, with 6358000 cases in 2008 and Brazil with 2106000 cases in 2007. the age distribution of cases differed between countries. in most countries, prevalence rates were higher among males, reflecting higher rates of injection drug use. Diagnosis, treatment and transplant levels also differed considerably between countries. Reliable estimates characterizing HCV-infected populations are critical for addressing HCV-related morbidity and mortality. There is a need to quantify the burden of chronic HCV infection at the national level.
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    Impact of psychiatric disorders on the quality of life of brazilian HCV-infected patients
    (Brazilian Society of Infectious Diseases, 2009-02-01) Batista-Neves, Susana; Quarantini, Lucas de Castro [UNIFESP]; Almeida, Amanda Cristina Galvão Oliveira de [UNIFESP]; Cardeal, Maurício; Lacerda, Acioly Luiz Tavares de [UNIFESP]; Paraná, Raymundo; Reis De-Oliveira, Irismar; Bressan, Rodrigo Affonseca [UNIFESP]; Miranda-Scippa, Ângela Marisa de Aquino [UNIFESP]; Federal University of Bahia Hospital Universitário; Universidade Federal de São Paulo (UNIFESP)
    The aim of our study was to determine the impact of psychiatric comorbidities on the health-related quality of life of HCV-infected patients. Assessment of clinical, socio-demographic and quality of life data of the patients followed up at a Hepatology unit was performed by using a standard questionnaire and the SF-36 instrument. Psychiatric diagnoses were confirmed by using the Mini International Neuropsychiatric Interview, Brazilian version 5.0.0 (MINI Plus). Evaluation using the MINI plus demonstrated that 46 (51%) patients did not have any psychiatric diagnosis, while 44 (49%) had at least one psychiatric diagnosis. Among patients with a psychiatric comorbidity, 26 (59.1%) had a current mental disorder, out of which 22 (84.6%) had not been previously diagnosed. Patients with psychiatric disorders had lower scores in all dimensions of the SF-36 when compared to those who had no psychiatric diagnosis. Scores of physical functioning and bodily pain domains were lower for those suffering from a current psychiatric disorder when compared to those who had had a psychiatric disorder in the past. Females had lower scores of bodily pain and mental health dimensions when compared to males. Scores for mental health dimension were also lower for patients with advanced fibrosis. The presence of a psychiatric comorbidity was the variable that was most associated with the different scores in the SF-36, compared to other variables such as age, gender, aminotransferase levels, and degree of fibrosis.
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    Magnetic bead technology for viral RNA extraction from serum in blood bank screening
    (Brazilian Society of Infectious Diseases, 2011-12-01) Albertoni, Guilherme Ambrozio [UNIFESP]; Arnoni, Carine Prisco; Araujo, Patricia Regina Barboza; Andrade, Sheila Siqueira [UNIFESP]; Carvalho, Fabrício Oliveira; Girão, Manoel João Batista Castello [UNIFESP]; Schor, Nestor [UNIFESP]; Barreto, José Augusto; Associação Beneficente de Coleta de Sangue; Universidade Federal de São Paulo (UNIFESP)
    Nucleic acid amplification testing (NAT) was recently recommended by Brazilian legislation and has been implemented at some blood banks in the city of São Paulo, Brazil, in an attempt to reduce blood-born transmission of human immunodeficiency virus (HIV) and hepatitis C virus. OBJECTIVE: Manual magnetic particle-based extraction methods for HIV and HCV viral nucleic acids were evaluated in combination with detection by reverse transcriptase - polymerase chain reaction (RT-PCR) one-step. METHODS: Blood donor samples were collected from January 2010 to September 2010, and minipools of them were submitted to testing. ELISA was used for the analysis of anti-HCV/HIV antibodies. Detection and amplification of viral RNA was performed using real-time PCR. RESULTS: Out of 20.808 samples screened, 53 samples (29 for HCV and 24 for HIV) were confirmed as positive by serological and NAT methods. CONCLUSION: The manual magnetic bead-based extraction in combination with real-time PCR detection can be used to routinely screen blood donation for viremic donors to further increase the safety of blood products.
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    Mini review: Current molecular methods for the detection and quantification of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus type 1
    (Elsevier B.V., 2014-08-01) Albertoni, Guilherme Ambrozio [UNIFESP]; Girão, Manoel João Batista Castello; Schor, Nestor [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Colsan Assoc Beneficente Coleta Sangue
    The detection of acute human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection is vital for controlling the spread of HIV, HBV, and HCV to uninfected individuals. Considering that these viruses have high replication rates and are undetectable by serological markers, early detection upon transmission is crucial. Various nucleic acid assays have been developed for diagnostics and therapeutic monitoring of infections. in the past decade, rapid and sensitive molecular techniques such as PCR have revolutionized the detection of a variety of infectious viruses, including HIV, HCV, and HBV. Here, we describe two of the most commonly used licensed methods for the detection and quantification of HIV, HCV, and HBV: the cobas TaqScreen MPX (PCR) test and the Tigris System. We used transcription-mediated amplification to review and compare the development and efficiency of these technologies. (C) 2014 the Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
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    PCA statistical method for classification of sensors
    (Universidade Federal de São Paulo, 2022-11-25) Paula, Jessica Fernandes de [UNIFESP]; Antonelli, Eduardo [UNIFESP]; http://lattes.cnpq.br/8535325155568005; http://lattes.cnpq.br/9339565565705439
    A large number of the global population suffers from infectious diseases, so studies in the health area aimed at identifying these diseases are of great importance. Some diseases have a long immunological window, where antibodies take a long time to be identified. Rapid detection tests are essential for disease control and eradication. A possible identification and classification method uses the statistical analysis performed by the Principal Component Analysis (PCA), through which we can reduce the number of variables and identify the presence of these antibodies. This work aims to classify immunosensors according to the antibody detected, analyzing their responses in relation to impedance and frequency using the PCA statistical method. The study was based on data collected from two immunosensors, HCV sensor and HIV sensor (Hepatitis C virus and Human Immunodeficiency Virus), analyzing their response as a function of frequency. For the PCA statistical method, an interactive laboratory was adopted with Jupyter Notebook, Python, using libraries known as Pandas, Plotly, NumPyand Scikit-learn. This study analyzed several data and variables from the dataset of both sensors to build models with the PCA statistical method, it was possible to separate and classify the HIV and HCV sensors at specific frequencies. The PCA analysis results for the selected datasets showed a relevant classification using PC1 and PC2, with a variance of the original data above 90%.
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    Perfil de genótipos do vírus da hepatite C no Brasil entre indivíduos monoinfectados e coinfectados pelo HIV: um levantamento representativo do país
    (Universidade Federal de São Paulo (UNIFESP), 2018-11-30) Nutini, Mariana Fernanda Rodrigues [UNIFESP]; Diaz, Ricardo Sobhie [UNIFESP]; http://lattes.cnpq.br/0846508761438062; http://lattes.cnpq.br/4133591427804494; Universidade Federal de São Paulo (UNIFESP)
    Background: To receive treatment with Direct Antiviral Agents (DAAs), all HCV infected patients in Brazil need a genotype determination, which is provided by the Brazilian government soon after initial diagnosis as is the treatment. We assessed the HCV genotype profile according to Brazilian geographic region, gender, age and HIV coinfection. Methods: We assessed 29.071 samples from HCV infected patients subjected to HCV genotype (Abbott Real Time HCV Genotype) collected from March 2016 to March 2018. Samples which genotype assignment was unclear using qPCR, were subjected to sanger sequencing of either NS5B or 3´UTR regions. 12.336 randomly selected samples were tested for HIV coinfection using the EIA rapid test kit TR DPP HIV 1/2 BioManguinhos. Descriptive statistical analyses were performed using the R statistical system and language. Group comparisons of data was performed using chisquared tests. Results: Overall median age was 55 years old (from 18 to 90); 58,7% being males. Overall HCV genotype (G) distribution was 40.9% G1a, 30.2% G1b, 23.8% G3, 3.8% G2, 0.7% G4, 0.1% G5 and 0.6% with multiples genotypes. Prevalence of G1a was 44.4% among males and 35.8 among females, and G1b, and G2 were more prevalent in older ages than G1a and G3. G3 was more prevalent in the South region than in other Brazilian regions. Among 12.336 samples tested for HIV coinfection, 15% (95% CI = 14.3 – 15.4%) were HIV+, with a median age of 50 among coinfected patients as compared to 57 among monoinfected individuals. 71.1% of coinfected patients were male as compared to 58.7% of overall. The sample of HIV coinfection was: the South of Brazil (19.1%) South east (15.6%), Central (10.9%), Northeast (7.8%), and North (4.3%). Conclusion: This is a report of the genotype HCV that is truly representative of the entire country. High prevalence of G3 in the south of Brazil poses an extra challenge related to HCV disease progression and treatment response, as well as the higher prevalence of G1a especially among males, a genotype with lower genetic barrier to resistance to protease inhibitors.
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    The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm
    (Wiley-Blackwell, 2014-05-01) Razavi, H.; Waked, I.; Sarrazin, C.; Myers, R. P.; Idilman, R.; Calinas, F.; Vogel, W.; Mendes Correa, M. C.; Hezode, C.; Lazaro, P.; Akarca, U.; Aleman, S.; Balik, I.; Berg, T.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Brandao Mello, C. E.; Bruggmann, P.; Buti, M.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cramp, M. E.; Dore, G. J.; Doss, W.; Duberg, A. S.; El-Sayed, M. H.; Ergor, G.; Esmat, G.; Falconer, K.; Felix, J.; Ferraz, Maria Lucia Gomes [UNIFESP]; Ferreira, Paulo Roberto [UNIFESP]; Frankova, S.; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L.; Gower, E.; Gschwantler, M.; Guimaraes Pessoa, M.; Hindman, S. J.; Hofer, H.; Husa, P.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Marinho, R. T.; Marotta, P.; Mauss, S.; Moreno, C.; Murphy, K.; Negro, F.; Nemecek, V.; Ormeci, N.; Ovrehus, A. L. H.; Parkes, J.; Pasini, K.; Peltekian, K. M.; Ramji, A.; Reis, N.; Roberts, S. K.; Rosenberg, W. M.; Roudot-Thoraval, F.; Ryder, S. D.; Sarmento-Castro, R.; Semela, D.; Sherman, M.; Shiha, G. E.; Sievert, W.; Sperl, J.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; Van Damme, P.; van Thiel, I.; Van Vlierberghe, H.; Vandijck, D.; Wedemeyer, H.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Cornberg, M.; Muellhaupt, B.; Estes, C.; Ctr Dis Anal; Natl Liver Inst; JW Goethe Univ Hosp; Univ Calgary; Ankara Univ; Hosp Santo Antonio Capuchos; Med Univ Innsbruck; Universidade de São Paulo (USP); Hop Henri Mondor; Adv Tech Hlth Serv Res TAISS; Ege Univ; Karolinska Inst; Karolinska Univ Hosp; Univ Leipzig; Osped Cantonale; Univ Montreal; Fed Univ State Rio de Janeiro; Arud Ctr Addict Med; Hosp Valle de Hebron; Hosp Puerta Hierro; Univ Fed Rio Grande do Sul; Odense Univ Hosp; Reg Hosp Hovedstaden; Universidade Federal do Rio de Janeiro (UFRJ); Univ Plymouth; Univ New S Wales; Cairo Univ; Orebro Univ Hosp; Univ Orebro; Ain Shams Univ; Dokuz Eylul Univ; Exigo Consultores; Universidade Federal de São Paulo (UNIFESP); Inst Clin & Expt Med; Hosp Carlos III; Univ Copenhagen; Direccao Geral Saude; Universidade Estadual de Campinas (UNICAMP); Wilhelminenspital Stadt Wien; Med Univ Vienna; Masaryk Univ; Univ Manitoba; Hlth Sci Ctr; European Liver Patients Assoc; Istanbul Univ; Univ British Columbia; Aalborg Univ Hosp; Katholieke Univ Leuven; Hosp Santa Maria; Univ Western Ontario; Univ Dusseldorf; Univ Libre Brussels; Univ Hosp; Natl Inst Publ Hlth; Univ Southhampton; Dalhousie Univ & Hepatol Serv; Assembleia Republ; Alfred Hosp; Monash Univ; UCL; Nottingham Univ Hosp NHS Trust; Biomed Res Unit; Ctr Hosp Porto; Cantonal Hosp St Gallen; Univ Toronto; Egyptian Liver Res Inst & Hosp; Monash Hlth; Catholic Univ Louvain; Med Univ Graz; St Vincents Hosp; Univ Melbourne; Charles Univ Prague; Cent Mil Hosp; Univ Antwerp; Deutsch Leberhilfe eV; Ghent Univ Hosp; Univ Ghent; Hannover Med Sch; Copenhagen Univ Hosp; Univ Zurich Hosp
    The disease burden of hepatitis C virus (HCV) is expected to increase as the infected population ages. A modelling approach was used to estimate the total number of viremic infections, diagnosed, treated and new infections in 2013. in addition, the model was used to estimate the change in the total number of HCV infections, the disease progression and mortality in 2013-2030. Finally, expert panel consensus was used to capture current treatment practices in each country. Using today's treatment paradigm, the total number of HCV infections is projected to decline or remain flat in all countries studied. However, in the same time period, the number of individuals with late-stage liver disease is projected to increase. This study concluded that the current treatment rate and efficacy are not sufficient to manage the disease burden of HCV. Thus, alternative strategies are required to keep the number of HCV individuals with advanced liver disease and liver-related deaths from increasing.
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    Protease Inhibitor Resistance Mutations in Untreated Brazilian Patients Infected with HCV: Novel Insights about Targeted Genotyping Approaches
    (Wiley-Blackwell, 2014-10-01) Carvalho, Isabel M. V. G. de [UNIFESP]; Alves, Rafael [UNIFESP]; Vasconcelos-Medeiros de Souza, Polyana A.; Silva, Edvaldo F. da; Mazo, Daniel; Carrilho, Flair J.; Queiroz, Artur T. L.; Pessoa, Mario G.; Butantan Inst; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Goncalo Moniz Res Ctr FIOCRUZ
    Several new direct-acting antiviral (DAA) drugs are being developed or are already approved for the treatment of chronic hepatitis C virus (HCV) infection. HCV variants presenting drug-resistant phenotypes were observed both in vitro and during clinical trials. the aim of this study was to characterize amino acid changes at positions previously associated with resistance in the NS3 protease in untreated Brazilian patients infected with HCV genotypes 1a and 1b. Plasma samples from 171 untreated Brazilian patients infected with HCV were obtained from the Department of Gastroenterology of Clinics Hospital (HCFMUSP) in São Paulo, Brazil. Nested PCR and Sanger sequencing were used to obtain genetic information on the NS3 protein. Bioinformatics was used to confirm subtype information and analyze frequencies of resistance mutations. the results from the genotype analysis using non-NS3 targeted methods were at variance with those obtained from the NS3 protease phylogenetic analyses. It was found that 7.4% of patients infected with HCV genotype 1a showed the resistance-associated mutations V36L, T54S, Q80K, and R155K, while 5.1% of patients infected with HCV genotype 1b had the resistance-associated mutations V36L, Q41R, T54S, and D168S. Notably, codons at positions 80 and 155 differed between samples from Brazilian patient used in this study and global isolates. the present study demonstrates that genotyping methods targeting the NS3 protein showed a difference of results when compared to mainstream methodologies (INNO-LiPA and polymerase sequencing). the resistance mutations present in untreated patients infected with HCV and codon composition bias by geographical location warrant closer examination. (C) 2014 Wiley Periodicals, Inc.
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    Strategies to manage hepatitis C virus (HCV) disease burden
    (Wiley-Blackwell, 2014-05-01) Wedemeyer, H.; Duberg, A. S.; Buti, M.; Rosenberg, W. M.; Frankova, S.; Esmat, G.; Ormeci, N.; Van Vlierberghe, H.; Gschwantler, M.; Akarca, U.; Aleman, S.; Balik, I.; Berg, T.; Bihl, F.; Bilodeau, M.; Blasco, A. J.; Brandao Mello, C. E.; Bruggmann, P.; Calinas, F.; Calleja, J. L.; Cheinquer, H.; Christensen, P. B.; Clausen, M.; Coelho, H. S. M.; Cornberg, M.; Cramp, M. E.; Dore, G. J.; Doss, W.; El-Sayed, M. H.; Ergor, G.; Estes, C.; Falconer, K.; Felix, J.; Ferraz, Maria Lucia Gomes [UNIFESP]; Ferreira, Paulo Roberto [UNIFESP]; Garcia-Samaniego, J.; Gerstoft, J.; Giria, J. A.; Goncales, F. L.; Guimaraes Pessoa, M.; Hezode, C.; Hindman, S. J.; Hofer, H.; Husa, P.; Idilman, R.; Kaberg, M.; Kaita, K. D. E.; Kautz, A.; Kaymakoglu, S.; Krajden, M.; Krarup, H.; Laleman, W.; Lavanchy, D.; Lazaro, P.; Marinho, R. T.; Marotta, P.; Mauss, S.; Mendes Correa, M. C.; Moreno, C.; Muellhaupt, B.; Myers, R. P.; Nemecek, V.; Ovrehus, A. L. H.; Parkes, J.; Peltekian, K. M.; Ramji, A.; Razavi, H.; Reis, N.; Roberts, S. K.; Roudot-Thoraval, F.; Ryder, S. D.; Sarmento-Castro, R.; Sarrazin, C.; Semela, D.; Sherman, M.; Shiha, G. E.; Sperl, J.; Starkel, P.; Stauber, R. E.; Thompson, A. J.; Urbanek, P.; Van Damme, P.; van Thiel, I.; Vandijck, D.; Vogel, W.; Waked, I.; Weis, N.; Wiegand, J.; Yosry, A.; Zekry, A.; Negro, F.; Sievert, W.; Gower, E.; Hannover Med Sch; German Liver Fdn; Orebro Univ Hosp; Univ Orebro; Hosp Valle de Hebron; UCL; Inst Clin & Expt Med; Cairo Univ; Ankara Univ; Ghent Univ Hosp; Wilhelminenspital Stadt Wien; Ege Univ; Karolinska Inst; Karolinska Univ Hosp; Univ Leipzig; Osped Cantonale; Univ Montreal; Adv Tech Hlth Serv Res TAISS; Fed Univ State Rio de Janeiro; Arud Ctr Addict Med; Hosp Santo Antonio Capuchos; Hosp Puerta Hierro; Univ Fed Rio Grande do Sul; Odense Univ Hosp; Region Hosp Hovedstaden; Universidade Federal do Rio de Janeiro (UFRJ); Univ Plymouth; Univ New S Wales; Ain Shams Univ; Dokuz Eylul Univ; Ctr Dis Anal CDA; Exigo Consultores; Universidade Federal de São Paulo (UNIFESP); Hosp Carlos III; Univ Copenhagen; Direccao Geral Saude; Universidade Estadual de Campinas (UNICAMP); Universidade de São Paulo (USP); Hop Henri Mondor; Med Univ Vienna; Masaryk Univ; Univ Manitoba; Hlth Sci Ctr; European Liver Patients Assoc; Istanbul Univ; Univ British Columbia; Aalborg Univ Hosp; Katholieke Univ Leuven; Univ Western Ontario; Univ Dusseldorf; Univ Libre Brussels; Univ Zurich Hosp; Univ Calgary; Natl Inst Publ Hlth; Univ Southhampton; Dalhousie Univ & Hepatol Serv; Assembleia Republ; Alfred Hosp; Monash Univ; Nottingham Univ Hosp NHS Trust; Biomed Res Unit; Ctr Hosp Porto; JW Goethe Univ Hosp; Cantonal Hosp St Gallen; Univ Toronto; Egyptian Liver Res Inst & Hosp ELRIAH; Catholic Univ Louvain; Med Univ Graz; St Vincents Hosp; Univ Melbourne; Charles Univ Prague; Cent Mil Hosp; Univ Antwerp; Deutsch Leberhilfe eV; Univ Ghent; Hasselt Univ; Med Univ Innsbruck; Natl Liver Inst; Copenhagen Univ Hosp; Univ Hosp; Monash Hlth
    The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. the largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical.
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    The use of real-time PCR to detect hepatitis C virus RNA in dried blood spots from Brazilian patients infected chronically
    (Elsevier B.V., 2012-01-01) Santos, Carlos; Reis, Alexanda; Santos, Cintia Vilhena dos; Damas, Cristine; Silva, Mariliza Henrique; Viana, Monica Valverde; Ferraz, Maria Lucia; Carnauba, Dimas; El-Far, Fabiane; Serra, Fernando; Diaz, Ricardo Sobhie [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Lab Ctr Genomas; Ctr Referencia DST AIDS; Hosp Servidor Publ Estadual; Global Med Affairs Dept Schering Plough
    Collecting and transporting samples for RNA analysis can be challenging, especially in situations where financial resources are limited. in this study, a quantitative real-time PCR (qPCR) for the analysis of HCV RNA was developed and adapted for use with dried blood spot (DBS) samples. A qPCR for HCV 5'NCR, an internal control and a calibration curve were developed, and the sensitivity, specificity and dynamic range of amplification were evaluated using a panel of viruses. Plasma and DBS samples from 100 patients who had completed four weeks of Peginterferon alfa-2b + Ribavirin treatment were collected (DBS on SS903 collection cards and transported at room temperature). After 24 weeks of treatment, samples were collected from 68 of these patients. of the 168 samples, 2 yielded false-negative results, and 4 yielded false-positive results (sensitivity was 98%, specificity was 94.3%, positive predictive value was 96.1%, and negative predictive value was 96.9%). Additionally, 2039 DBS samples from 1114 patients currently undergoing treatment for a chronic HCV infection in a clinical trial were tested. Only 10 samples out of the 2039 yielded invalid results warranting re-collection of DBS. the detection of HCV RNA in DBS can be a cost-effective strategy for HCV treatment monitoring, especially in settings where resources are limited. (C) 2011 Elsevier B.V. All rights reserved.