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Biomedical subjects

F J Carrilho

Publications and source records attributed to F J Carrilho.

52 records · Page 3Linked to original sources
PubMedDate not supplied

Detection of hepatitis B virus DNA by the polymerase chain reaction in anti-HBe positive chronic hepatitis B patients.

Detection of HBV-DNA by PCR was compared with other serological markers (HBsAG, HBeAg and anti-HBe) in a series of 49 Chronic Hepatitis B patients, including 12 with a spontaneous clearance of HBsAg. None of these HBsAg negative cases were PCR positive, but 33/37 (89.2%) HBsAg positive cases were PCR positive (p < 0.0001). Among HBsAg positive samples, nine cases were HBeAg positive and anti-HBe negative, all of them PCR positive. Other 3 patients were HBeAg and anti-HBe positive and these cases were also found PCR positive. A third group included 21 patients anti-HBe positive and HBeAg negative: 19 of them were PCR positive and 2 were PCR negative. The last 4 cases were HBeAg and anti-HBe negative, two of them were PCR positive. The detection of anti-HBe viremic cases in the present series suggest that preC variants could occur in our country. In conclusion, the integrated phase of chronic hepatitis B seems to be less frequent than it was assumed, when only HBeAg or dot blot hybridization techniques were used. The new term "low replication phase" might favorably replace the former "integrated phase".

Base Sequence↗
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Gelatin particle indirect agglutination test for serodiagnosis of schistosomiasis: comparative study with enzyme-linked immunosorbent assay.

A new serological test, the gelatin particle agglutination test (GPAT), was used for the serodiagnosis of schistosomiasis mansoni. This technique showed the sensitivity (90.6%) and specificity (97.8%) close to those of enzyme-linked immunosorbent assay. The GPAT can be easily and rapidly performed without specialized equipment, by using lyophilized antigen-coated gelatin particles. The test also seems to be useful for mass screening of Schistosoma infection in field conditions.

Agglutination Tests↗
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Long term follow-up and patterns of response of ALT in patients with chronic hepatitis NANB/C treated with recombinant interferon-alpha.

The response to interferon treatment in chronic hepatitis NANB/C has usually been classified as complete, partial or absent, according to the behavior of serum alanine aminotransferase (ALT). However, a more detailed observation of the enzymatic activity has shown that the patterns may be more complex. The aim of this study was to describe the long term follow-up and patterns of ALT response in patients with chronic hepatitis NANB/C treated with recombinant interferon-alpha. A follow-up of 6 months or more after interferon-alpha was achieved in 44 patients. We have classified the serum ALT responses into six patterns and the observed frequencies were as follows: I. Long term response = 9 (20.5%); II. Normalization followed by persistent relapse after IFN = 7 (15.9%); III. Normalization with transient relapse = 5 (11.9%); IV. Temporary normalization and relapse during IFN = 4 (9.1%); V. Partial response (more than 50% of ALT decrease) = 7 (15.9%); VI. No response = 12 (27.3%). In conclusion, ALT patterns vary widely during and after IFN treatment and can be classified in at least 6 types.

Alanine Transaminase↗
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Hepatitis G virus/GB virus C in Brazil. Preliminary report.

Hepatitis G virus/GB virus C is a novel flavivirus recently detected in hepatitis non A-E cases. In this study, the presence of this virus in chronic non-B, non-C hepatitis patients was evaluated using GBV-C specific PCR and this virus was detected in one out of thirteen patients. This patient has presented a severe liver failure, has lived for a long time in the Western Amazon basin and no other cause for this clinical picture was reported. The impact of the discovery of this new agent is still under evaluation throughout the world. The study of the prevalence of this virus among chronic hepatitis patients and healthy individuals (as blood donors) will furnish subside to evaluate its real pathogenicity.

Adult↗
PubMedDate not supplied

Transfusion-transmitted virus (TTV) in Brazil. Preliminary report.

TTV is a recently discovered DNA virus, isolated from a patient with post-transfusion hepatitis of unknown etiology by Japanese researchers. In the present study, we evaluated the presence of TTV among chronic liver diseases patients in São Paulo and Pará states, representing two geographically distinct Brazilian regions. TTV DNA was found in 21/105 (20%) and 9/20 (45%) cases from São Paulo and Pará States, respectively. DNA sequence data confirmed the presence of TTV genotypes 1a and 2a, as well as other genotypes not yet described. In conclusion, TTV is present in chronic liver diseases cases from Southeast and North Brazil. However, further studies involving healthy populations are necessary before establishing any causal relationship among TTV and human hepatitis.

Brazil↗
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Predictive factors for response to lamivudine in chronic hepatitis B.

BACKGROUND: Lamivudine has been shown to be an efficient drug for chronic hepatitis B (CHB) treatment. AIM: To investigate predictive factors of response, using a quantitative method with high sensitivity. METHODS: We carried out a prospective trial of lamivudine in 35 patients with CHB and evidence for viral replication, regardless to their HBeAg status. Lamivudine was given for 12 months at 300 mg daily and 150 mg thereafter. Response was considered when DNA was undetectable by PCR after 6 months of treatment. Viral replication was monitored by end-point dilution PCR. Mutation associated with resistance to lamivudine was detected by DNA sequencing in non-responder patients. RESULTS: Response was observed in 23/35 patients (65.7%) but only in 5/15 (33.3%) HBeAg positive patients. Only three pre-treatment variables were associated to low response: HBeAg (p = 0.006), high viral load (DNA-VHB > 3 x 10(6) copies/ml) (p = 0.004) and liver HBcAg (p = 0. 0028). YMDD mutations were detected in 7/11 non-responder patients. CONCLUSIONS: HBeAg positive patients with high viral load show a high risk for developing drug resistance. On the other hand, HBeAg negative patients show a good response to lamivudine even with high viremia.

Adolescent↗
PubMedDate not supplied

[Chronic hepatitis non-A, non-B hepatitis: a clinical and morphologic study].

Few data on chronic non-A, non-B hepatitis (NANB-CH) have been published so far in our country. We have studied 85 patients classified into four groups: I. post-transfusional (PT), 35 patients (41.2%); II. risk group (GR), including health professionals and drug addicts, 11 (12.9%); III. sporadic with a well defined beginning (EBD), 19 (22.4%) and IV. sporadic with ill-defined beginning (END), 20 (23.5%). The mean age in group I was significantly higher than in groups II and III. A polyphasic pattern of serum aminotransferases and severe histological forms were observed in all groups. It is concluded that the way of infection has probably no prognostic importance.

Adolescent↗
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[Recombinant alfa interferon in the treatment of chronic B and non-A, non-B hepatitis: preliminary results].

Recombinant alpha-interferon (IFN-R) was given to 17 patients with non-A, non-B chronic hepatitis (NANB-CH) and to 11 patients with B chronic hepatitis (B-CH). Fever (100.4 to 102.2 Fahrenheit) was observed in every patient during the early phase of treatment. Other side-effects included rigors, myalgia, headache and laboratory changes such as leucopenia, neutropenia and, in some cases, thrombocytopenia. However, the tolerance was considered acceptable and treatment had to be interrupted in only one patient presenting generalized mucosal lesions attributed to a hypersensitivity reaction. The response to IFN-R in NANB-CH was considered positive when serum aminotransferase levels became normal or below two times the upper normal limit. Out of eight patients who completed the treatment, four were considered as responders but one of them, treated during five months, showed a relapse after three months. On the other hand, in one patient treated for twelve months, a persistent normalization of serum amino-transferases was observed: a liver biopsy showed a striking decrease of the inflammatory changes. As to the B-CH. 3 out of 8 patients who completed the treatment showed a disappearance of HBeAg and DNA-polymerase and were considered as responders. These preliminary results show that IFN-R is a promising drug but only multicenter controlled trials will establish its value in the treatment of viral chronic hepatitis.

Adolescent↗
PubMedDate not supplied

[Chronic hepatitis B: anatomo-clinical, serologic and developmental aspects].

Few data on chronic hepatitis B (CHB) have been published in our country, despite the fact that it is responsible for more than 50% of all types of chronic hepatitis. From 1968 to 1988, 164 patients were attended with the diagnosis of CHB, from whom 136 (82.9%) were male. Only 11 (8.1%) admitted homosexual behavior. Twenty six out of 39 (66.7%) health professionals were medical doctors; among them 12 (46.2%) were surgeons. The mode of transmission was unknown in 55% of the cases, but vertical and sexual transmissions were also frequent. Commercial gammaglobulin, used with prophylactic purpose, was probably responsible for eight cases between 1972 and 1975. The most frequent forms of CH were chronic active hepatitis (CAH) and liver cirrhosis (LC): 72 or 43.9% and 53 or 32.3%, respectively. The predominance of HBeAg (66.4%) was observed in all forms of CHB. Repeated biopsies showed that chronic lobular hepatitis (CLH) and chronic persistent hepatitis (CPH) may occasionally progress to CAH. This form may persist as such for some years or progress to cirrhosis. In a few cases the evolution to CPH was observed. In the long term follow-up of our patients, the appearance of hepatocellular carcinoma was observed in 8 (4.9%).

Adolescent↗
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[Clinical treatment of portal hypertension].

In spite of a great number of published papers on the clinical treatment of portal hypertension, some controversies still exist. The role of propranolol for the elective treatment is not established as the prospective trials have shown conflicting results. The vasoconstrictive drugs associated or not to vasodilating ones have an efficacy comparable to that of balloon tamponade. As to the prophylactic use of propranolol, few papers have been published, but three prospective randomized trials showed that the drug is superior to the placebo, particularly in patients without ascites.

Animals↗
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[Cholangiography via laparoscopy in the differential diagnosis of neonatal hepatitis and bile duct atresia].

Twenty-three infants with neonatal cholestasis were examined laparoscopically. The differential diagnosis between biliary atresia and neonatal hepatitis was not established by-clinical and laboratory investigations. In 10 out of 23 cases the transcutaneous-transhepatic-cholangiography, performed with laparoscopy demonstrated the permeability of the biliary tree in children that are not suffering from the atresia. The hepatic biopsy by laparoscopic view allowed to complete the investigation in these cases, avoiding unnecessary laparotomy. In infants suffering from biliary atresia the surgery indication was early and exact.

Bile Ducts↗
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[Duodenal ulcer treated by carbenoxolone sodium. Endoscopically controlled trial (author's transl)].

The authors present the results of a clinical and endoscopic controlled trial of outpatients with duodenal ulcer treated with carbenoxolone (CBX) and carbenoxolone plus antacids (CBX + AA). They observed complete healing of the duodenal ulcer in 77%-83,3% in both groups of patients. They concluded that CBX is important in the treatment of duodenal ulcer been equally effective alone or in association with antacids.

Antacids↗
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Clearance of hepatitis C viral RNA in cirrhotic patients with antiviral therapy.

Interferon is indicated in chronic infection by hepatitis C virus (HCV), however, cirrhosis has been reported as a bad response factor to the therapy. Fifteen cirrhotic patients with HCV, undergoing treatment with recombinant interferon-alpha, ribavirin and/or ursodeoxycholic acid were studied. They were followed-up and evaluated with dosages of alanine aminotransferase and HCV RNA investigation by PCR technique. Of the 15 cirrhotic patients, seven were negative for HCV RNA after antiviral treatment, however ALT was normal in only three of them. Of the eight patients who were not negative, two had normal ALT. Biochemical-virological discrepancy in the follow-up of the patients after antiviral treatment observed in this study has also been reported by other authors. These reports show that the criteria for response to the treatment is to be established.

Antiviral Agents↗
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Viral hepatitis prophylaxis.

Acute viral hepatitis is the most usual cause of jaundice and acute liver failure, whereas chronic viral hepatitis is the major cause of liver cirrhosis and hepatocellular carcinoma. Taking into the consideration the morbidity and mortality of such lesions, their prophylaxis is a mandatory procedure. In this review we discuss the general measures and the active and passive immunoprophylaxis against hepatitis A. B and Yellow fever, and the general management of hepatitis C. D. and E virus infection.

Hepatitis, Viral, Human↗