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      Serological, epidemiological and molecular aspects of hepatitis C virus infection in a population from Londrina, PR, Brazil, 2001-2002 Translated title: Aspectos sorológicos, epidemiológicos e moleculares da infecção pelo vírus da hepatite C na população da região de Londrina, Paraná, Brasil, 2001-2002

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          Abstract

          Serological, epidemiological and molecular aspects of hepatitis C virus (HCV) infection were evaluated in 183 subjects from Londrina, Paraná, Brazil, and adjacent areas. Serum samples which tested anti-HCV positive by microparticle enzyme immunoassay (MEIA) obtained from eight patients with chronic hepatitis C, 48 blood donors, and 127 patients infected with the human immunodeficiency virus (HIV) were submitted to another enzyme immunoassay (ELISA) and to the polymerase chain reaction (PCR). About 78.7% of samples were also reactive by ELISA, with the greater proportion (70.8%) of discordant results verified among blood donors. A similar finding was observed for HCV-RNA detection by PCR, with 111/165 (67.3%) positive samples, with higher rates among HIV-positive subjects and patients with chronic hepatitis than among blood donors. Sixty-one PCR-positive samples were submitted to HCV genotyping, with 77.1, 21.3 and 1.6% of the samples identified as types 1, 3 and 2, respectively. Finally, analysis of some risk factors associated with HCV infection showed that intravenous drug use was the most common risk factor among HIV/HCV co-infected patients, while blood transfusion was the most important risk factor in the group without HIV infection. The present study contributed to the knowledge regarding risk factors associated with HCV infection and the distribution of HCV genotypes in the population evaluated.

          Translated abstract

          Aspectos sorológicos, epidemiológicos e moleculares da infecção pelo vírus da hepatite C (HCV) foram avaliados em 183 indivíduos da região de Londrina, Paraná. Amostras soropositivas para anti-HCV pelo enzimaimunoensaio de micropartículas (MEIA), provenientes de oito pacientes com hepatite C crônica, 48 doadores de sangue e 127 indivíduos infectados pelo vírus da imunodeficiência humana (HIV), foram submetidas ao enzimaimunoensaio (ELISA) e a reação em cadeia da polimerase (PCR). Em 78,7% das amostras, verificou-se resultado reagente no ELISA, ocorrendo maior proporção de resultados discordantes entre doadores de sangue (70,8%). O mesmo ocorreu com a pesquisa do RNA viral, na qual 111/165 (67,3%) amostras foram positivas com PCR, verificando-se maior positividade entre indivíduos HIV soropositivos e pacientes com hepatite crônica do que em doadores de sangue. Em 61 amostras com viremia detectável, realizou-se a genotipagem do HCV, encontrando-se os genótipos 1 (77,1%), 3 (21,3%) e 2 (1,6%). Por fim, foram avaliados os fatores epidemiológicos em indivíduos com infecção ativa, nos quais o uso de drogas injetáveis foi o principal fator de risco encontrado em indivíduos co-infectados pelo HIV/HCV e a transfusão sangüínea foi o mais comum em indivíduos sem infecção pelo HIV. O presente estudo contribuiu para o conhecimento do perfil da infecção pelo HCV em indivíduos da nossa população e da distribuição dos genótipos do HCV nesta região.

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          Fluorescent antibody test for the serodiagnosis of American trypanosomiasis. Technical modification employing preserved culture forms of Trypanosoma cruzi in a slide test.

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            Hepatitis B and C virus co-infection and the risk for hepatotoxicity of highly active antiretroviral therapy in HIV-1 infection.

            To investigate the risk of hepatotoxicity after initiation of protease inhibitor-containing highly active antiretroviral therapy (HAART) for HIV-1 infected patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infection. Retrospective study with 394 HIV-1-infected patients initiating HAART at a single university clinic. Liver enzyme elevation (LEE) was defined as alanine aminotransferase or aspartate aminotransferase at least five times the upper limit of normal and an absolute increase of > 100 U/l. Relative risks for time to LEE were estimated using Cox proportional hazards models. Of 394 patients 7% were hepatitis B surface antigen (HBsAg)-positive and 14% were anti-HCV-positive. Patients with chronic hepatitis had a higher risk for LEE compared with patients without co-infection: 37% versus 12% respectively. After adjustment for higher baseline transaminases, the presence of HBsAg or anti-HCV remained associated with an increased risk of LEE - relative risk 2.78 (95% confidence interval, 1.50-5.16) and 2.46 (95% confidence interval, 1.43-4.24) respectively. In patients with LEE, transaminases declined whether HAART was continued or modified. Of patients with chronic HBV infection 38% lost HBeAg or developed anti-HBe after initiation of HAART, and one seroconverted from HBsAg-positive to anti-HBs-positive. However, there was no clear relationship with LEE. HIV-1-infected patients co-infected with HBV or HCV were at considerably higher risk of developing LEE when HAART was initiated compared with patients without co-infection, but it is usually not necessary to modify antiretroviral therapy.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rimtsp
                Revista do Instituto de Medicina Tropical de São Paulo
                Rev. Inst. Med. trop. S. Paulo
                Instituto de Medicina Tropical (São Paulo )
                1678-9946
                December 2004
                : 46
                : 6
                : 303-308
                Affiliations
                [1 ] Universidade Estadual de Londrina Brazil
                [2 ] Hemocentro de São Paulo Brasil
                [3 ] Universidade Estadual de Londrina Brazil
                [4 ] Universidade Estadual de Londrina Brazil
                [5 ] Universidade Estadual de Londrina Brazil
                [6 ] Universidade Estadual de Londrina Brazil
                [7 ] Universidade de São Paulo Brasil
                Article
                S0036-46652004000600002
                10.1590/S0036-46652004000600002
                0a6c16ae-58a9-4a81-8033-853f216841a4

                http://creativecommons.org/licenses/by/4.0/

                History
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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0036-4665&lng=en
                Categories
                TROPICAL MEDICINE

                Infectious disease & Microbiology
                Hepatitis C virus,Anti-HCV,Genotypes,Epidemiology
                Infectious disease & Microbiology
                Hepatitis C virus, Anti-HCV, Genotypes, Epidemiology

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