ANTONIO ALCI BARONE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Evaluation of inflammatory activity on liver biopsy of patients with chronic hepatitis C who have recovered from HBV infection: a case series study(2012) LISBOA NETO, G.; CAVALHEIRO, N.; BARONE, A.bookPart Hepatite Aguda e Hepatite Fulminante(2013) BARONE, Antonio Alci- Very early prediction of response to HCV treatment with PEG-IFN-alfa-2a and ribavirin in HIV/HCV-coinfected patients(2011) ARAUJO, E. S. A.; DAHARI, H.; NEUMANN, A. U.; CAVALHEIRO, N. de Paula; MELO, C. E.; MELO, E. S. de; LAYDEN, T. J.; COTLER, S. J.; BARONE, A. A.The objective of this study was to find very early viral kinetic markers to predict nonresponse to hepatitis C virus (HCV) therapy in a group of human immunodeficiency virus (HIV)/HCV-coinfected patients. Twenty-six patients (15 HCV genotype-1 and 11 genotype-3) were treated with a 48-week regimen of peginterferon-alfa-2a (PEG-IFN) (180 mu g/week) and weight-based ribavirin (11 mg/kg/day). Samples were collected at baseline; 4, 8, 12, 18, 24, 30, 36 and 42 h; days 2, 3, 4, 7, 8, 15, 22, 29, 43 and 57 then weekly and monthly. Five patients discontinued treatment. Seven patients (27%) achieved a sustained virological response (SVR). Nadir HCV RNA levels were observed 1.6 +/- 0.3 days after initiation of therapy, followed by a 0.3- to 12.9-fold viral rebound until the administration of the second dose of PEG-IFN, which were not associated with SVR or HCV genotype. A viral decline < 1.19 log for genotype-1 and < 0.97 log for genotype-3, 2 days after starting therapy, had a negative predictive value (NPV) of 100% for SVR. The day 2 virological response had a similar positive predictive value for SVR as a rapid virological response at week 4. In addition, a second-phase viral decline slope (i.e., measured from day 2 to 29) < 0.3 log/week had a NPV = 100% for SVR. We conclude that first-phase viral decline at day 2 and second-phase viral decline slope (< 0.3 log/week) are excellent predictors of nonresponse. Further studies are needed to validate these viral kinetic parameters as early on-treatment prognosticators of nonresponse in patients with HCV and HIV.
bookPart Imunopatogênese da hepatite C(2015) BARONE, Antonio Alci- Quantification of C4d deposition and hepatitis C virus RNA in tissue in cases of graft rejection and hepatitis C recurrence after liver transplantation(2015) SONG, Alice Tung Wan; MELLO, Evandro Sobroza de; ALVES, Venancio Avancini Ferreira; CAVALHEIRO, Norma de Paula; MELO, Carlos Eduardo; BONAZZI, Patricia Rodrigues; TENGAN, Fatima Mitiko; FREIRE, Maristela Pinheiro; BARONE, Antonio Alci; D'ALBUQUERQUE, Luiz Augusto Carneiro; ABDALA, EdsonHistology is the gold standard for diagnosing acute rejection and hepatitis C recurrence after liver transplantation. However, differential diagnosis between the two can be difficult. We evaluated the role of C4d staining and quantification of hepatitis C virus (HCV) RNA levels in liver tissue. This was a retrospective study of 98 liver biopsy samples divided into four groups by histological diagnosis: acute rejection in patients undergoing liver transplant for hepatitis C (RejHCV+), HCV recurrence in patients undergoing liver transplant for hepatitis C (HCVTx+), acute rejection in patients undergoing liver transplant for reasons other than hepatitis C and chronic hepatitis C not transplanted (HCVTx-). All samples were submitted for immunohistochemical staining for C4d and HCV RNA quantification. Immunoexpression of C4d was observed in the portal vessels and was highest in the HCVTx- group. There was no difference in C4d expression between the RejHCV+ and HCVTx+ groups. However, tissue HCV RNA levels were higher in the HCVTx+ group samples than in the RejHCV+ group samples. Additionally, there was a significant correlation between tissue and serum levels of HCV RNA. The quantification of HCV RNA in liver tissue might prove to be an efficient diagnostic test for the recurrence of HCV infection.
- Hepatitis E virus seroprevalence in patients with chronic hepatitis C at a university hospital in Brazil(2020) MAGRI, Mariana Cavalheiro; MANCHIERO, Caroline; DANTAS, Bianca Peixoto; NUNES, Arielle Karen da Silva; FIGUEIREDO, Gerusa Maria; BARONE, Antonio Alci; TENGAN, Fatima MitikoAim: We investigated the prevalence of anti-hepatitis E virus (HEV) antibodies in patients with chronic hepatitis C and the relationship with liver injury stage. Materials & methods: In total, 451 patients were included and the presence of anti-HEV antibodies was evaluated by ELISA. Results: Anti-HEV IgG antibodies were detected in 45 (10.0%) patients and anti-HEV IgM were detected in two IgG-positive patients (4.4%). The distributions of liver fibrosis, steatosis, inflammatory activity, homeostasis model assessment of insulin resistance and liver enzyme levels were similar between HEV-positive and HEV-negative patients. However, HEV-positive patients had a higher mean age (p = 0.030). The seroprevalence by age group increased from 2.2 (18-30 years) to 53.3% (>60 years). HEV infection was not related to advanced fibrosis. Conclusion: This investigation showed that the seroprevalence of HEV among patients with chronic hepatitis C is similar to that of blood donors in the same region.
- Pharmacodynamics of PEG-IFN-alpha-2a and HCV Response as a Function of IL28B Polymorphism in HIV/HCV-Coinfected Patients(2011) ARAUJO, Evaldo Stanislau Affonso de; DAHARI, Harel; COTLER, Scott J.; LAYDEN, Thomas J.; NEUMANN, Avidan U.; MELO, Carlos Eduardo; BARONE, Antonio AlciWe examined the association between IL28B single-nucleotide polymorphism rs12979860, hepatitis C virus (HCV) kinetic, and pegylated interferon alpha-2a pharmacodynamic parameters in HIV/HCV-coinfected patients from South America. Twenty-six subjects received pegylated interferon alpha-2a + ribavirin. Serum HCV-RNA and interferon concentrations were measured frequently during the first 12 weeks of therapy and analyzed using mathematical models. African Americans and whites had a similar distribution of IL28B genotypes (P = 0.5). The IL28B CC genotype was overrepresented (P = 0.015) in patients infected with HCV genotype-3 compared with genotype-1. In both genotype-1 and genotype-3, the first-phase viral decline and the average pegylated interferon-alpha-2a effectiveness during the first week of therapy were larger (trend P <= 0.12) in genotype-CC compared with genotypes-TC/TT. In genotype-1 patients, the second slower phase of viral decline (days 2-29) and infected cells loss rate, delta, were larger (P = 0.02 and 0.11, respectively) in genotype-CC than in genotypes-TC/TT. These associations were not observed in genotype-3 patients.
bookPart Toxoplasmose(2013) BARONE, Antonio Alci; AMATO NETO, VicentebookPart Infecção Hospitalar(2016) LEVIN, Anna Sara; OLIVEIRA, Maura Salaroli de; BARONE, Antonio Alci- The rs738409 polymorphism of the PNPLA3 gene is associated with hepatic steatosis and fibrosis in Brazilian patients with chronic hepatitis C(2017) MANCHIERO, Caroline; NUNES, Arielle Karen da Silva; MAGRI, Mariana Carvalheiro; DANTAS, Bianca Peixoto; MAZZA, Celso Carmo; BARONE, Antonio Alci; TENGAN, Fatima MitikoBackground: Prospective studies have shown that 80% of acute hepatitis C virus (HCV) cases progress to chronic infection; approximately 10-20% of patients with these conditions will develop liver cirrhosis within 2 to 3 decades, and 1-5% will develop liver cancer. Some studies have indicated that the rs738409 polymorphism of the PNPLA3 gene is associated with steatosis and the progression of advanced fibrosis. This study assessed the contribution of the PNPLA3 rs738409 polymorphism with regard to the steatosis and degree of liver fibrosis in Brazilian patients diagnosed with chronic hepatitis C. Methods: A total of 290 patients were evaluated at the Clinics Hospital of the School of Medicine, University of Sao Paulo, between 2010 and 2015. The inclusion criteria were age >= 18 years and positive anti-HCV antibody and HCV RNA tests. The participants were evaluated based on medical consultation, blood tests, and liver biopsies conducted before specific antiviral therapies were applied. The associations between the rs738409 PNPLA3 gene polymorphism and steatosis and advanced fibrosis were tested under a recessive inheritance model using logistic regression analysis, including age, gender, BMI, ethnicity/color, HOMA-IR, alcohol intake, HCV genotype 3, and the rs58542926 TM6SF2 gene polymorphism as covariates. Results: The mean age of the patients was 54.9 years old (range, 28 to 82 years), and 124 (42.8%) patients were male; 226 (77.9%) were white, 43 (14.8%) were pardo, and 21 (7.2%) were black Brazilians. Of the patients included in this study, 133 (45.9%) presented with the CC genotype, 63 (21.7%) with the CG genotype, and 94 (32.4%) with the GG genotype of the PNPLA3 gene I148M variant. We observed that the associations between PNPLA3 rs738409 GG genotype and steatosis was significant (OR: 2.16; 95% CI 1.26-3.72). The same genotype was associated to advanced fibrosis too (OR: 2.64; 95% CI 1.26-5.53). Conclusions: Associations between the rs738409 polymorphism of the PNPLA3 gene genotype GG and hepatic steatosis and advanced fibrosis were observed. Studies are still needed to clarify the influence of these polymorphisms on hepatic steatosis and degree of fibrosis among individuals diagnosed with chronic hepatitis C.