CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / A regiÃo AmazÃnica à uma das principais Ãreas endÃmicas da hepatite D no Mundo e a Ãnica relacionada com a presenÃa do genÃtipo 3 do vÃrus delta. O objetivo deste estudo foi analisar os resultados do transplante de fÃgado pela cirrose causada pela hepatite D e correlacionar com os transplantados pela monoinfecÃÃo do vÃrus da hepatite B. Foram avaliados 29 pacientes com hepatite D e 40 pacientes com hepatite B, transplantados de fÃgado no Hospital UniversitÃrio Walter CantÃdio da Universidade Federal do Cearà (HUWC/UFC). O grupo de pacientes com hepatite D foi mais jovem (mÃdia 33.9 vs 52.9 anos, p < 0,001), predominante do sexo masculino e todos oriundos da RegiÃo AmazÃnica Brasileira. NÃo houve diferenÃas nos valores dos critÃrios de gravidade, MELD e Child, entre os grupos. A ocorrÃncia de carcinoma hepatocelular (CHC) foi predominante no grupo de pacientes com hepatite B ( frequÃncia 36.8% vs 17.2%, p = 0,05), assim como maior mortalidade ( frequÃncia 25% vs 3.4%, p = 0,019 ). Pacientes com hepatite D, apresentaram mais acentuada plaquetopenia no prÃ-transplante (mÃdia 66.428,57 vs 102.037,50 ÂL, p = 0,02) e no pÃs-operatÃrio imediato (mÃdia 54.242,86 vs 94.063,89 ÂL, p = 0,04). A recuperaÃÃo da lesÃo hepÃtica, avaliada atravÃs dos valores de AST, ALT e BT, mensurados 3 meses apÃs o transplante, nÃo mostrou diferenÃa entre os grupos. A sobrevida analisada pela curva de Kaplan-Meier, no perÃodo de 4 anos, foi de 95% nos pacientes com hepatite D e 75% nos pacientes com a monoinfecÃÃo pelo vÃrus B. Conclui-se que os pacientes com hepatite D possuem excelentes resultados apÃs o transplante hepÃtico e menor incidÃncia para o desenvolvimento do CHC. / The Amazon region is one of the main endemic areas of hepatitis D in the World and the only related to the presence of genotype 3 of delta virus. The objective of this study was to analyze the results of liver transplantation for cirrhosis caused by hepatitis D and correlate with the transplant by monoinfection of hepatitis B. 29 patients were evaluated with hepatitis D and 40 patients with hepatitis B, they were submitted a liver transplantation in the Walter Cantidio University Hospital of the Federal University of Ceara. The group of patients with hepatitis D were younger (mean 33.9 vs 52.9 years, p < 0,001), predominantly male and all from the Brazilian Amazon region. There were no differences in the values of severity criteria, MELD and Child, between groups. The occurrence of hepatocellular carcinoma (HCC) was predominant in patients with hepatitis B (frequency 36.8% vs. 17.2%, p = 0,05), likewise higher mortality (frequency 25% vs 3.4%, p = 0,019). Patients with hepatitis D showed more pronounced thrombocytopenia in pre-transplant (mean 66.428,57 vs 102.037,50 ÂL, p = 0,02) and in the immediate postoperative period (mean 54.242,86 vs 94.063,89 ÂL, p = 0,04). The recovery of liver injury as measured by the values of AST, ALT, and BT, measured 3 months after transplantation showed no difference between groups. The survival analyzed by Kaplan-Meier survival curves, showed a period of four years, the result of 95% in patients with hepatitis D and 75% in patients with monoinfection of hepatitis B. Patients with hepatitis D have excellent results after liver transplantation and lower incidence of HCC development.

Please read the abstract in the 00front part (pp12-17) of this document / Dissertation (MSc (Medical Virology))--University of Pretoria, 2004. / Medical Virology / unrestricted

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published_or_final_version / Medicine / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / Microbiology / Doctoral / Doctor of Philosophy

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Hepatitis E virus (HEV) is the main cause of acute viral hepatitis worldwide, predominantly in developing areas where it is endemic. Recently, HEV has gained more attention in the developed world, prompting several industrialized countries to assess seroprevalence rates using blood donor samples. The seroprevalence among Canadian blood donor samples collected from July 2013 - December 2015 was 5.84% (240/4,107). None of the 14,053 samples tested were positive for HEV RNA. There was no significant increase in the high-risk groups we tested. HIV was determined to be a significant risk-factor for HEV infection in a retrospective study of Kenya-based sex-worker cohorts, but not so in a Canadian cohort of HIV-positive intravenous drug users. Overall, HEV seroprevalence in Canada is lower than that published in other countries. This together with failing to detect HEV RNA in Canadian blood donations indicates that HEV currently poses low risk to the Canadian blood supply. / February 2017

OBJETIVO: Determinar los predictores no invasivos de la severidad de la fibrosis hepática en pacientes con infección crónica por hepatitis C del Servicio de Gastroenterología del Hospital IV Alberto Sabogal (EsSALUD), durante el período diciembre 2000 – diciembre 2002. MATERIAL Y MÉTODOS: Se incluyeron a 30 pacientes con serología positiva para HCV que fueron sometidos a Laparoscopia más biopsia hepática. Estudio observacional, descriptivo, retrospectivo y de corte transversal. Se usó la base de datos del programa SPSS versión 10.0, y se evaluó la asociación mediante el test de Chi cuadrado (_i2), con una significancia estadística del 5%. RESULTADOS: La edad promedio fue de 56.27 ± 12.55 años, Se demostró asociación entre fibrosis severa y radio TGO/TGP mayor de 1 y esplenomegalia(p=0.018 y 0.001, respectivamente) en forma estadísticamente significativa,mientras que la plaquetopenia menor de 150,000 no mostró asociación con fibrosis hepática severa en el grupo de pacientes estudiados (p=0.136). CONCLUSIONES: El radio TGO/TGP mayor de 1 y la esplenomegalia pueden ser considerados como predictores de fibrosis avanzada en pacientes con infección crónica por hepatitis c. En estos pacientes quizás no sea necesaria una biopsia hepática. / --- OBJETIVE: To Determine the non-invasive predictors from Hepatic Fibrosis severity in patients with Hepatitis C chronic infection at Gastroenterology Service from Alberto Sabogal Hospital (EsSALUD), since december 2000 – december 2002. MATERIAL AND METHODS: 30 patients were included with positive HCV serology who had Laparoscopy and hepatic biopsy. This is an observational, descriptive, retrospective and transversal study. It was used SPSS 10.0 database program, and was evaluated its association with chi-square test (_i2), with 5% statistical significance. RESULTS: The age average was 56.27 ± 12.55 years old. A TGO/TGP ratio of major of 1 and splenomegaly correlated significantly with advance stage of fibrosis (p=0.018 and 0.001 respectively) but there wasn’t correlation between platelet count major of 150,000 and severe fibrosis (p=0.136). CONCLUSIONS: A TGO/TGP ratio of major of 1 and splenomegalia can predict advance stage of fibrosis in patients with chronic hepatitis C infection .In these patients, a liver biopsy may not be necessary. Key words: Hepatitis C chronic infection, Hepatic Fibrosis.

Determina la relación entre el nivel de conocimiento y la actitud hacia la Hepatitis B que presentan los estudiantes de pre grado de la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos, en el año 2015. La hipótesis planteaba una relación directa entre el nivel de conocimiento y la actitud. El tipo de estudio es descriptivo transversal. La muestra está constituida por 135 estudiantes. Aplica una encuesta tipo cuestionario con 15 preguntas de alternativas múltiple para la variable conocimiento y un cuestionario tipo Lickert con 18 items para la variable actitud. Determina que el nivel de conocimiento es mayoritariamente regular (93.3%), los items relacionados a conocimientos sobre medidas preventivas para evitar una infección con Hepatitis B son los que menos respuestas correctas tuvieron (38,1%). La pregunta con menos respuestas correctas se refiere al esquema de vacunación contra la Hepatitis B (14 alumnos), el origen viral del Hepatitis B es el ítem que obtuvo mayor número de respuestas correctas (133 alumnos). La mayoría muestra un nivel de actitud indiferente hacia la Hepatitis B (93.3%). El 25% de los alumnos piensa que no deberían atender pacientes con Hepatitis B, un 66% de los alumnos piensan que a pesar de tomar todas las medidas de bioseguridad sienten temor de atender pacientes con Hepatitis B. Según los datos obtenidos se concluye que no existe relación entre el nivel de conocimiento y la actitud hacia la Hepatitis B en los estudiantes de la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos.