MARIA CASSIA JACINTHO MENDES CORREA

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Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/52 - Laboratório de Virologia, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • conferenceObject
    Implementation of a hepatitis C elimination plan with a view on access expansion and integrality of viral hepatitis care
    (2018) ALMEIDA, E. C.; CORREA, R. G.; RICK, F. M.; CATTAPAN, E. B.; SANTOS, M. E.; VIVALDINI, S. M.; SOUZA, N. F. de; GOMES, J. N. N.; CORREA, M. C. J. M.; PEREIRA, M. F. C.; PINTO, F. K. A.; RIBEIRO, R. A.; SERENO, L. S.; BENZAKEN, A. S.
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    SARS-CoV-2 Aerosol Generation During Respiratory Equipment Reprocessing
    (2021) BRUNA, Camila Quartim de Moraes; CIOFI-SILVA, Caroline; GRAZIANO, Kazuko Uchikawa; MENDES-CORREA, Maria Cassia; BOAS, Lucy Santos Villas; FERREIRA, Noeli Evangelista; TOZETTO-MENDOZA, Tania; PAULA, Anderson Vicente de
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    HEPATITIS C TREATMENT AMONG HCV-HIV CO-INFECTED PATIENTS IN BRAZIL: A MULTICENTER STUDY ON BASELINE RESISTANCE ANALYSES AND SUSTAINED VIROLOGIC RESPONSE RATE
    (2019) CORREA, Maria Cassia Mendes; MACHADO, Soraia Mafra; LEITE, Andrea Gurgel Batista; VIGANI, Aline; DIAZ, Ana Claudia Marques Barbosa; FERREIRA, Paulo; CARNAUBA JUNIOR, Dimas; TENORE, Simone; SR., Carlos Eduardo Brandao-Mello; GONZALEZ, Mario; SIROMA, Fabiana; PRADO, Kleber D.; GONGORA, Delzi Vigna Nunes; NETO, Gaspar Lisboa; PINHO, Joao Renato R.; MALTA, Fernanda
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    HIV CO-INFECTION IS AN INDEPENDENT FACTOR IN DETERMINING VACCINE SCAPE MUTANTS AMONG HEPATITIS B CHRONIC PATIENTS IN BRAZIL
    (2012) MENDES-CORREA, M. C.; PINHO, J. R. R.; GOMES-GOUVEA, M. S.; CHACHA, S.; MARTINELLI, A. L. C.; GUASTINI, C. F.; SANTOS, A. C. S.; SOARES, M. C. P.; LEITE, O. H. M.; UIP, D. E.
    Background: Prolonged lamivudine (LAM) therapy has been associated with different mutations in the hepatitis B virus (HBV) genome. The aims of this study were: (1) to compare lamivudine-resistance mutation patterns after prolonged LAM use between patients with chronic hepatitis B infection (CHB) with or without human immunodeficiency virus (HIV) co-infection; (2) to evaluate the incidence and factors associated with the presence of mutations in the envelope gene among these patients. Methods: We included patients with CHB treated with LAM and with detectable HBV-DNA (>50IU/mL) after at least six months of LAM use. HBV load was determined using an “in-house” real-time polymerase chain reaction. HBV mutation status analysis were carried out by amplification and sequencing the complete HBV RT-domain. Results: Ninety-one patients infected only with HBV and 34 HIV-HBV co-infected patients were included. The time of exposure to LAM varied from 7 to 140 months among HBV infected patients and from 12 to 182 months among co-infected patients. Mutations associated with resistance to LAM were observed in 42.9% of HBV infected patients and in 67.6% of HIV-HBV co-infected patients. In this latter group, the frequency of the rtV173L + rtL180M + rtM204V triple mutation was 32.0% versus 7.6% observed among patients infected only with HBV. All patients with this triple mutational pattern also showed sE164D + sI195M changes in the envelope gene. Multivariate analysis demonstrated that time of exposure to lamivudine superior of 32 months (adjusted PR 1.51, 95%CI 1.10–2.06) was an independent variable associated with the chance of harboring mutations in the polymerase gene. Multivariate analysis also demonstrated that HIV co-infection (adjusted PR 1.40, 95%CI 1.10–1.78) was the only independent variable associated with the chance of harboring sE164D or I195M changes in the envelope gene (vaccine escape phenotype). Conclusions: Prolonged use of LAM may be associated with multiple changes in the pol gene, among mono or co-infected patients; 2-HIV co-infection is an independent factor in determining sE164D and I195M changes in the envelope gene, a vaccine escape phenotype.
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    IMPACT ON MORTALITY OF BEING SEROPOSITIVE FOR HEPATITIS C VIRUS ANTIBODIES AMONG BLOOD DONORS IN BRAZIL: A TWENTY YEAR STUDY
    (2019) SR., Helio Ranes de Menezes Filho; CAPUANI, Maria Ligia Damato; BIERRENBACH, Ana Luiza De Souza; MENDRONE JUNIOR, Alfredo; BENZAKEN, Adele Schwartz; MACHADO, Soraia Mafra; SAIVISH, Marielena Vogel; SABINO, Ester Cerdeira; WITKIN, Steven Sol; CORREA, Maria Cassia Mendes
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    Absence of anti-HBc in HIV/HBV coinfected individuals with advanced immunosuppression
    (2012) AVELINO-SILVA, Vivian I.; GOMES-GOUVEA, Michele S.; MIRAGLIA, Joao Luiz; GUASTINI, Cristina; PINHO, Joao R.; MENDES-CORREA, Maria Cassia
    HBV chronic infection is frequent among HIV carriers but serological markers may present atypical profiles among these patients. HBsAg reactivity in anti-HBc negative patients is a rare event that has been described in HIV co-infected patients. This pattern was related to mutations in the coding region of the viral core protein, to aberrant host immune response or to both factors. The aim of this study was to evaluate the occurrence of anti-HBc negative/HBsAg positive profile in HIV/HBV coinfected patients and to identify possible associations with clinical variables and HBV mutations. This is a case control study based in medical reports and laboratorial records from the studied patients. For each anti-HBc negative/HBsAg positive identified case, 2 anti-HBc positive/HBsAg positive controls matched by sex and age were selected. HBVDNA was detected by real time PCR. Patients with detectable viral load were further analyzed by amplification and sequencing of precore/core and S regions for genotyping and identification of mutations possibly involved with this anomalous serological pattern. Our study population was selected from 2412 anti-HIV positive patients. Among them, 120 were HBsAg reactive. Patients were followed up for a mean time of 5 years, utilizing from 1 to 5 samples for serological evaluations. We identified 12 patients (11 male and one female) who were negative for anti-HBc but positive for HBsAg in at least one sample during follow up, Compared with controls, anti-HBc negative / HBsAg positive cases had lower mean count of CD4 + T lymphocytes (349.2 vs. 455 cells/mm3, P = 0.048). There was no correlation between anti-HBc negative/HBsAg positive serological profile and the analyzed clinical variables (time of diagnosis, history of opportunistic infections, nadir CD4 + T cells, use of medications effective against HBV or advanced liver disease). Serum samples from 7 patients were submitted to the HBV viral load detection and HBV DNA was detected in only 3 of these patients, with a mean viral load of 5.67 log. These three cases were infected by HBV subgenotype A1 and the analysis of the precore/core region of these viruses did not identify any mutation that could explain the anomalous serological profile. In our series of HBV/HIV co-infected patients, 10% of them were concomitantly HBsAg reactive but anti-HBc nonreactive. No mutation in the precore/core regions was identified that could explain this profile. As these patients showed a lower mean CD4+T cells count compared to the control group, our findings may suggest that advanced immunosuppression may be involved, determining the loss of anti-HBc at least in detectable levels.
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    CHARACTERIZATION OF CLINICAL PREDICTORS OF NATURALLY OCCURRING NS3/NS4A PROTEASE POLYMORPHISM IN GENOTYPE 1 HEPATITIS C VIRUS INFECTED PATIENTS
    (2015) LISBOA NETO, G.; NOBLE, C.; PINHO, J. R. R.; MALTA, F. M.; GOMES-GOUVEA, M. S.; ALVARADO-MORA, M. V.; SILVA, M. H.; LEITE, A. G.; PICCOLI, L. Z.; CARRILHO, F. J.; MENDES-CORREA, M. C.
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    SARS-CoV-2 Aerosol Generation During Respiratory Equipment Reprocessing
    (2021) CIOFI-SILVA, Caroline; BRUNA, Camila Quartim de Moraes; CIOFI-SILVA, Caroline L.; PAULA, Anderson Vicente de; BOAS, Lucy Santos Villas; FERREIRA, Noeli Evangelista; TOZETTO-MENDOZA, Tania; MENDES-CORREA, Maria Cassia; GRAZIANO, Kazuko Uchikawa
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    INSULIN RESISTANCE AND HIGH CHOLESTEROL LEVELS ARE ASSOCIATED WITH VITAMIN D DEFICIENCY IN HCV, HIV AND HIV/HCV COINFECTED PATIENTS
    (2013) GONZALEZ, M. P.; KLAUTAU, G. B.; MAZO, D. F.; NOGUEIRA, R. S.; MENDES-CORREA, M. C. J.; CARRILHO, F. J.; PESSOA, M. G.
    Background and Aims: Vitamin D plays a role in metabolic syndrome and has also been suggested as an immunomodulator. Lower levels are correlated with severe fibrosis in HCV and HIV/HCV coinfected patients and predict lower response to treatment in those individuals. The aim is to evaluate levels of 25(OH)vitamin D among a population of HCV, HIV and HIV/HCV coinfected patients and describe associated factors. Patients and Methods: We collected 25(OH)vitamin D samples, demographic data, clinical information and laboratory tests including liver function and metabolic assessment of four groups of patients; 1 – HCV monoinfected, 2 – HIV monoinfected, 3 – HIV/HCV coinfected, followed at reference centres of São Paulo-Brazil and 4 – Healthy Volunteers Control Group. Results: 422 patients were included for analysis, (129) Group 1, (118) Group 2, (53) Group 3 and (122) Group 4. Mean levels of Vitamin D were similarly insufficient in all groups (Table 1). Table 1. Mean Levels of Vitamin D in the 4 groups Groups n Mean (ng/mL) St. D. St. E. Median (ng/mL) IQ.D Min (ng/mL) Max (ng/mL) 1– HCV 129 23.4 10.1 0.89 23 13 5 55 2– HIV 118 19.5 9.2 0.85 18 12 4 50 3– HIV/HCV 53 24.1 12.9 1.77 22 15 3 66 4– Control 122 17.1 5.9 0.54 17 8.75 6 32 In an overall analysis, Vitamin D deficiency (serum levels < 20ng/mL) was associated with higher HOMA index (Graph 1 – p=0.02 Fisher test) and total cholesterol levels > 200 (p=0.004 Fisher test). When analyzed by Groups, Vitamin D deficiency was associated with: 1. Higher HOMA levels in HCV patients (Grap h 2 – p=0.004 Fisher test), 2. Use of Efavirenz both in HIV (Graph 3 – p=0.03 OR=6.69 95%CI: 1.17–38.3) and Coinfected Patients (p=0.04 OR=15.0 95%CI: 1.22–184). Conclusion: This study found high prevalence of vitamin D deficiency, even in healthy volunteers. The association between Insulin Resistance (IR) and Vitamin D deficiency has been demonstrated in other populations, but not previously described in HCV patients. This finding is relevant because both IR and Vitamin D deficiency are related to poor treatment outcomes of Interferon-based regimens.
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    Elimination of hepatitis C in Brazil is cost-saving
    (2018) BENZAKEN, A.; GIRADE, R.; RAZAVI, H.; SCHMELZER, J.; FERRAZ, M. L.; FERREIRA, P. A.; PESSOA, M. G.; MARTINELLI, A.; CATAPAN, E.; SOUTO, F.; CORREA, M. C. M.