Hepatite B e C em centro de testagem e aconselhamento – aspectos atuais / Hepatitis B and C in a testing and counseling center - current aspects

Introdução. O relatório da Organização Mundial da Saúde de 2017 mostrou que 325 milhões de pessoas são portadores do vírus da Hepatite B (VHB) ou do vírus da Hepatite C (VHC). Por isso, nos Centros de Testagem e Aconselhamento (CTA) já são feitos exames de triagem e diagnostico das hepatites, locais onde o atendimento é prioritariamente para quem tem maior risco de infecção e populações em situações de vulnerabilidade. Metodologia. Estudo observacional, descritivo e analítico que utiliza dados provenientes dos prontuários eletrônicos e físicos dos pacientes atendidos no CEDAP em 2017 diagnosticados com Hepatite B e/ou C. Resultados. Foram encontrados 124 portadores do VHB e 90 do VHC, dentre 6.319 indivíduos. Houve predomino do sexo masculino com VHB. A via de transmissão para ambas foi significante, sendo 76,1% por via sexual no VHB e 53,3% por via desconhecida no VHC. A coinfecção com o HIV foi 47,6% com VHB e 35,5% com VHC. O uso de drogas foi maior no grupo com VHC (p<0.001). Discussão. A prevalência foi mais elevada que na população sem risco acrescido, porém, se assemelhou a encontrada em usuários de drogas e outros CTAs. Os dados epidemiológicos, como sexo, idade e etnia corroboram o encontrado em populações gerais. Conclusão. Foi elevada a prevalência de vírus B e C e a coinfecção com HIV no CTA em 2017, houve predomínio do sexo masculino, etnia parda e procedência de Salvador-BA. A coinfecção entre VHB, VHC e HIV foi significante, assim como o uso de drogas nesses grupos

Epidemiology of hepatocellular carcinoma

<p class="MsoNormal"><span style="font-size: 10pt; font-family: QuorumITCbyBT-Book">The incidence of hepatocellular carcinoma (HCC) has increased both due to the worldwide increase on the virus C infection and to the increase on the survival rate of patients with chronic liver disease. It usually is an aggressive tumor with survival rate directly associated with the hepatic residual liver function as well as the size of the tumor at the diagnosis.</span></p&gt

Current aspects of antibiotic prophylaxis for upper gastrointestinal bleeding in cirrhosis patients

Bacterial infection is a common complication in cirrhotic patients. The portal hypertension as well as the immune depression observed in these patients can explain this high incidence of bacterial infection. Because of the high probability of cirrhotic patients to develop infections, antibiotic prophylaxis is warranted in some conditions, such as upper gastrointestinal bleeding or after spontaneous bacterial peritonitis. Nevertheless, antibiotic prophylaxis is not widely recommended for cirrhotic patients

Current aspects of antibiotic prophylaxis for upper gastrointestinal bleeding in cirrhosis patients

Bacterial infection is a common complication in cirrhotic patients. The portal hypertension as well as the immune depression observed in these patients can explain this high incidence of bacterial infection. Because of the high probability of cirrhotic patients to develop infections, antibiotic prophylaxis is warranted in some conditions, such as upper gastrointestinal bleeding or after spontaneous bacterial peritonitis. Nevertheless, antibiotic prophylaxis is not widely recommended for cirrhotic patients

Occult B infection in the Brazilian northeastern region: a preliminary report

A sentinel study on viral hepatitis is currently being carried out in the village of Cavunge in a semiarid rural region of the state of Bahia, northeastern Brazil. This study has identified individuals in whom anti-HBc IgG was the only serological marker for hepatitis B virus (HBV). This serological pattern may constitute evidence of occult HBV infection. This study Investigated the possibility of occult hepatitis B virus infection in individuals in a rural community who tested positive for anti-HBc IgG alone. A cross-sectional population-based study. ELISA III was performed on serum samples to test for serological viral markers, and ultrasensitive PCR (US-PCR) was used to assess viremia. Among the 1,536 serum samples, 3.6% (n=55) were positive for anti-HBc alone. Four years after this first serological survey, 31 of those 55 individuals (56.3%) were retested, and 11 (35.5%) remained anti-HBc positive alone. Two of these 31 (6.5%) were HBV-DNA positive based on US-PCR, with normal aminotransferase levels in both cases. Cases of occult hepatitis B infection were identified in this semiarid rural community of northeastern Brazil, where endemicity of HBV is moderate

Urinary tract infection in non-hospitalized patients with cirrhosis and no symptoms of urinary tract infection: a case series study

Bacterial infections are important factors in decompensation, and they increase the mortality rate of patients with liver cirrhosis. The most common infections among these patients are spontaneous bacterial peritonitis, pneumonia, skin infections and urinary tract infections (UTI). This transversal study evaluated the frequency of UTI in non-hospitalized patients with cirrhosis followed in a hepatology outpatient unit. Patients with clinical, laboratorial, echographic and/or histological diagnosis of cirrhosis were evaluated from April 2002 to August 2004. Patients who accepted participating in this study were submitted to clinical evaluation and the following laboratorial examinations: urine analysis, urine culture, blood culture and hepatic function tests. Patients with symptoms of UTI, diabetis, prostatic disease were excluded. Eighty-two patients with cirrhosis were studied. Their mean age was 51 years (SD = 11); 73% were male. Hepatitis C virus was the main etiology in 45% of the cases. The Child-Pugh B functional class was observed in 52% of the cases. Urine cultures were positive in 4.9% of these patients. In this study of non-hospitalized cirrhotic patients, with no symptoms of UTI, the frequency of urinary tract infection was approximately 5%. The bacteria found were E. coli and Klebsiella pneumonia. We conclude that it is necessary to screen for UTI in such patients