MARIO GUIMARAES PESSOA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
9 resultados
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- Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection(2021) ZITELLI, Patricia Momoyo Yoshimura; GOMES-GOUVEA, Michele; MAZO, Daniel F.; SINGER, Julio da Motta; OLIVEIRA, Claudia P. M. S.; FARIAS, Alberto Queiroz; PINHO, Joao Renato; TANIGAWA, Ryan Yukimatsu; ALVES, Venancio Avancini Ferreira; CARRILHO, Flair Jose; PESSOA, Mario GuimaraesOBJECTIVES: Co-infection with hepatitis A or B viruses may aggravate liver injury in patients infected with hepatitis C virus (HCV). However, few studies have assessed co-infection with hepatitis E virus (HEV) and HCV. Therefore, this study aimed to assess the prevalence and impact of HEV infection among Brazilian patients with chronic HCV infection. METHODS: This observational study included adult patients with chronic HCV infection who were naive to antiviral therapy from January 2013 to March 2016. A total of 181 patients were enrolled, and HEV serology and PCR were performed for all patients. RESULTS: Seropositivity for anti-HEV IgG was detected in 22 (12.0%) patients and anti-HEV immunoglobulin M in 3 (1.6%). HEV RNA showed inconclusive results in nine (4.9%) patients and was undetectable in the remaining patients. HEV serology positive patients had more severe liver disease, characterized by liver fibrosis >= 3 versus <= 2 (p<0.001), Aspartate Aminotransferase-to-Platelet Ratio Index of >= 1.45 (p=0.003), and Fibrosis-4 score of >= 3.25 (p=0.001). Additionally, the odds of HEV-positive patients developing diabetes mellitus were 3.65 (95% CI 1.40-9.52) times the corresponding odds of HEV-negative patients. A case-control-based histological analysis (n=11 HEV-HCV-positive patients and n=22 HCV-positive patients) showed no significant differences between the groups. CONCLUSIONS: This prevalence is higher than that reported in previous studies of the general population in Brazil. Thus, HEV infection may influence the severity of liver disease and may represent an additional risk of developing diabetes mellitus in patients with HCV infection.
- The role of PNPLA3 and TM6SF2 polymorphisms on liver fibrosis and metabolic abnormalities in Brazilian patients with chronic hepatitis C(2021) OLIVEIRA, Arthur Ivan N.; MALTA, Fernanda M.; ZITELLI, Patricia Momoyo Y.; SALLES, Ana Paula M.; GOMES-GOUVEA, Michele S.; NASTRI, Ana Catharina S.; PINHO, Joao Renato R.; CARRILHO, Flair J.; OLIVEIRA, Claudia P.; MENDES-CORREA, Maria Cassia; PESSOA, Mario G.; MAZO, Daniel F.BackgroundDespite the growing body of knowledge about TM6SF2 and PNPLA3 polymorphisms in non-alcoholic fatty liver disease, their influence in the spectrum of HCV liver disease is not yet fully defined. Besides that, admixed populations, such as Brazilians, were not included in most of the studies.MethodsThis cross-sectional study enrolled 365 treatment-naive patients with HCV and 134 healthy individuals. TM6SF2 (rs58542926 c.499C>T) and PNPLA3 (rs738409 c.444C>G) polymorphisms were evaluated regarding their association with clinical and laboratory data, histological liver steatosis and fibrosis, and with components of the metabolic syndrome.ResultsIn HCV subjects, the frequencies of TM6SF2 CC and CT+TT were 89% and 11%, while PNPLA3 frequencies of CC and CG+GG were 51.4% and 48.6%. In the univariate logistic regression analysis, the TM6SF2 CT+TT genotype in HCV was associated with significant liver fibrosis (p=0.047; OR 1.953; 95% CI 1.009-3.788). In comparison to the CT+TT genotype, the TM6SF2 CC genotype in HCV was associated with older age (p=0.002), higher frequency of arterial hypertension (p=0.032), obesity (p=0.030), metabolic syndrome (p=0.014) and lower total cholesterol levels (p=0.036). The PNPLA3 GG subjects had lower body mass index than CG/ CC individuals (p=0.047). None of the polymorphisms, or their combinations, was independently associated with hepatic steatosis or fibrosis. On the other hand, older age, lower serum levels of total cholesterol, and higher serum levels of alanine aminotransferase and alkaline phosphatase were associated with liver fibrosis in the multivariate logistic regression analysis.ConclusionIn this evaluation of an admixed HCV population, neither TM6SF2 nor PNPLA3 polymorphisms were independently associated with hepatic steatosis or fibrosis. Other factors seem more influential than these specific polymorphisms in isolation. More studies are warranted to clarify the role of the TM6SF2 and PNPLA3 polymorphisms in Brazilians with HCV.
conferenceObject The Impact of HEV Infection on the Disease Severity of Patients with Chronic Hepatitis C(2018) ZITELLI, Patricia; GOMES-GOUVEA, Michele; MAZO, Daniel; PINHO, Joo Renato R.; ALVES, Venancio A. F.; TANIGAWA, Ryan Yukimatsu; OLIVEIRA, Claudia S.; CARRILHO, Flair Jose; PESSOA, Mario GuimaraesconferenceObject Evidence of Hepatitis E Virus Infection in Liver Transplant Recipients from Brazil(2013) GOMES-GOUVEA, Michele S.; FERREIRA, Ariana C.; FEITOZA, Bruna; PESSOA, Mario G.; ABDALA, Edson; TERRABUIO, Deborah R.; MORAES, Adriano C.; BONAZZI, Patricia R.; D'ALBUQUERQUE, Luiz C.; CARRILHO, Flair J.; PINHO, Joao R.conferenceObject Impaired Anti-HBV Vaccine Response In Non-Cirrhotic Chronic HCV Patients Is Not Overcome By Double Or Additional (4th) Dosing(2016) MEDEIROS, Roseane P.; MAZO, Daniel F.; OLIVEIRA, Claudia P.; DODGE, Jennifer L.; ZITELLI, Patricia M.; LOPES, Marta H.; CARRILHO, Flair J.; PINHO, Joao R.; TERRAULT, Norah; PESSOA, Mario G.- The impact of hepatitis E infection on hepatic fibrosis in liver transplanted patients for hepatitis C infection(2021) MORAES, Adriano Claudio Pereira de; GOUVEA, Michele Gomes; FERREIRA, Ariana Carolina; PINHO, Joao Renato Rebello; MELLO, Evandro Sobroza de; D'ALBUQUERQUE, Luiz Augusto Carneiro; TERRABUIO, Debora; ABDALA, Edson; CARRILHO, Flair Jose; PESSOA, Mario GuimaraesHepatitis E Virus (HEV) is an infection known worldwide for its asymptomatic and self-limited course in most cases. Some cases progressing to chronicity have been described in immunosuppressed patients, especially in recipients of solid organ transplants. We evaluated laboratory parameters of HEV infection (HEV RNA, anti-HEV IgM and anti-HEV IgG) through enzyme-linked immunosorbent assay (Elisa), confirmed by immunoblotting, in a cohort of 294 patients who received liver transplants at the HCFMUSP (Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo). Laboratory and demographic data were collected from the entirety of the transplanted population. Hepatic biopsies of 122 patients transplanted due liver failure secondary to hepatitis C (HCV), with or without serological or molecular markers of HEV, were analyzed according to METAVIR score. Out of 24 (8.2%) patients tested positive for anti-HEV IgG, six (2%) were positive for anti-HEV IgM and 17 (5.8%) for HEV RNA. Of the patients transplanted because of HCV infection, 95 (77.8%) had received treatment including ribavirin for at least six months before blood sample collection. Among patients transplanted due to HCV cirrhosis who tested positive for anti-HEV IgG, only three (37.5%) showed fibrosis beyond stage 2, while five (41.7%) of the HEV RNA-positive patients had liver fibrosis beyond stage 2. Overall, the prevalence of HEV in the post-hepatic transplant scenario appears to be low, and, at least histologically, seemingly not harmful. We conclude that, although some studies reported a risk of HEV chronification, patients who had their livers transplanted due to HCV and showed serological or molecular markers of HEV did not have higher levels of fibrosis compared to patients who showed no indications of HEV infection at the time of the analysis. (C) 2021 Sociedade Brasileira de Infectologia.
conferenceObject IMPAIRED ANTI-HBV VACCINE RESPONSE IN NON-CIRRHOTIC CHRONIC HCV PATIENTS IS NOT OVERCOME BY DOUBLE DOSE REGIMEN: A RANDOMIZED CONTROL TRIAL(2016) PESSOA, M. G.; PORTO, R.; MAZO, D.; OLIVEIRA, C. P.; TERRAULT, N.; DODGE, J.; ZITELLI, P. M.; PINHO, J. R.; LOPES, M.; CARRILHO, F. J.conferenceObject The Antibody response to hepatitis B virus vaccination is not influenced by the hepatitis C virus viral load in patients with chronic hepatitis C(2015) MEDEIROS, Roseane P.; LOPES, Marta; MAZO, Daniel F.; OLIVEIRA, Claudia P.; ZITTELI, Patricia M.; PINHO, Joao Renato R.; CARRILHO, Flair J.; PESSOA, Mario G.conferenceObject IMPAIRED ANTI-HBV VACCINE RESPONSE IN NON-CIRRHOTIC CHRONIC HCV PATIENTS COMPARED TO HEALTHY CONTROLS(2015) PESSOA, M. G.; MEDEIROS, R. P.; LOPES, M.; MAZO, D.; OLIVEIRA, C. P.; ZITELLI, P. M.; PINHO, J. R.; CARRILHO, F. J.