LEONARDO WEISSMANN
Projetos de Pesquisa
Unidades Organizacionais
LIM/49 - Laboratório de Protozoologia, Hospital das Clínicas, Faculdade de Medicina
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Hepatitis B viremia in HIV-coinfected individuals under antiretroviral therapy(2019) WEISSMANN, Leonardo; PICONE, Camila de Melo; GOUVEA, Michele Soares Gomes; FERREIRA, Paulo Roberto Abrao; VIANA, Monica Salum Valverde Borsoi; PINHO, Joao Renato Rebello; CASSENOTE, Alex Jones Flores; SEGURADO, Aluisio CotrimBackground: Antiretroviral therapy (ART) has decreased AIDS incidence and mortality, rendering comorbidities, such as hepatitis B more relevant for people living with human immunodeficiency virus (HIV). Since antiretroviral drugs may also inhibit hepatitis B virus (HBV) replication, analyzing the impact of ART on management of hepatitis B in this population is important. Objective: To assess HBV viremia among HIV/HBV coinfected individuals on ART and its associated factors. Method: For this cross-sectional study, HIV/HBV-coinfected individuals, aged over 18 years, who were on ART for over six months and receiving care at an outpatient clinic in Sao Paulo were recruited. Sociodemographic characteristics, information about viral exposure, clinical and laboratory data, including evaluation of liver fibrosis were obtained. Plasma HBV DNA was measured by polymerase chain reaction. Viral genome sequencing was conducted for genotyping and identification of drug resistance-conferring mutations if viral load exceeded 900 IU/mL. Results: Out of 2,946 patients who attended the clinic in 2015, 83 were eligible and 56 evaluated. Plasma HBV DNA was detected in 16 (28.6%) (95% CI: 18.0-41.3%), all on lamivudine and tenofovir treatment. HBV DNA detection was associated with lower education (p = 0.015), higher international normalized ratios (p = 0.045), history of an AIDS-defining illness [OR: 3.43 (95% CI: 1.10-11.50)], and HBeAg detection [OR: 6.60 (95% CI: 1.84-23.6)]. In contrast, a last CD4+ count above 500 cells/mm(3) in the year prior to inclusion [OR: 0.18 (95% CI: 0.04-0.71)] and detection of anti-HBe [OR: 0.21 (95% CI: 0.04-0.99)] were negatively associated. Patients with HBV DNA above 900 IU/mL were infected with subgenotypes A1 (n = 3) and D2 (n = 1), and exhibited viral mutations associated with total resistance to lamivudine and partial resistance to entecavir. Conclusions: Despite being on ART, a significant proportion of HIV/HBV-coinfected individuals present HBV viremia. Characterization of factors that are associated with this finding may help professionals provide better management to these patients. (C) 2019 Sociedade Brasileira de Infectologia.
- Impact of COVID-19 Disease in Early Breast Cancer Management: A Summary of the Current Evidence(2022) CAVALCANTE, Francisco Pimentel; ABDALA, Edson; WEISSMANN, Leonardo; FERREIRA, Carlos Eduardo dos Santos; AMORIM, Gilberto; OLIVEIRA, Vilmar Marques de; GUILGEN, Gisah; LANDEIRO, Luciana; PINHO, Joao Renato Rebello; JR, Alvaro Pulchinelli; RIBEIRO, Heber; SOUZA, Rafael; ROSA, Daniela DornellesThe authors discuss the best practices on early breast cancer management during the COVID pandemic. PURPOSE An expert panel on breast cancer and COVID-19 disease was convened to address the impact of the COVID-19 pandemic for early breast cancer (eBC) management. METHODS To ensure that the most clinically relevant information was addressed, essential information was drawn from several of the latest national and international guidelines and another technical document. The expert panel met in five virtual closed sessions from November 2020 to May 2021 to consult on the relevant data from evidence-based results. The data gathered were discussed on an online platform. RESULTS This article reports the expert panel's highlights of these meetings' discussions. In addition, it provides practical recommendations covering topics regarding diagnosis, treatment, and management of patients with eBC in clinical settings routinely encountered by health care professionals amid the COVID-19 pandemic. CONCLUSION This article provided guidance on several topics regarding eBC management amid the COVID-19 pandemics to inform safer care practices.