MARIO GUIMARAES PESSOA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
13 resultados
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- Uniting to defeat steatotic liver disease: A global mission to promote healthy livers and healthy lives(2023) KRAG, Aleksander; BUTI, Maria; V, Jeffrey Lazarus; ALLEN, Alina M.; BOWMAN, Jacqueline; BURRA, Patrizia; DONNINI, Giacomo; DUSEJA, Ajay; EL-SAYED, Manal H.; GASTALDELLI, Amalia; HAINSWORTH, Ben; KARLSEN, Tom H.; KESSLER, Michael; KORENJAK, Marko; MARK, Henry E.; MANN, Jake P.; MILLER, Veronica; PESSOA, Mario G.; PINEIRO, Daniel; SARIN, Shiv K.; SINGH, Shivaram P.; RINELLA, Mary E.; WILLEMSE, Jose; YOUNOSSI, Zobair M.; FRANCQUE, Sven M.
- Hepatitis D double reflex testing of all hepatitis B carriers in low-HBV- and high-HBV/HDV-prevalence countries(2023) RAZAVI, Homie A.; BUTI, Maria; TERRAULT, Norah A.; ZEUZEM, Stefan; YURDAYDIN, Cihan; TANAKA, Junko; AGHEMO, Alessio; AKARCA, Ulus S.; MASRI, Nasser M. Al; ALALWAN, Abduljaleel M.; ALEMAN, Soo; ALGHAMDI, Abdullah S.; ALGHAMDI, Saad; AL-HAMOUDI, Waleed K.; ALJUMAH, Abdulrahman A.; ALTRAIF, Ibrahim H.; ASSELAH, Tarik; BEN-ARI, Ziv; BERG, Thomas; BIONDI, Mia J.; BLACH, Sarah; BRAGA, Wornei S. M.; BRANDAO-MELLO, Carlos E.; BRUNETTO, Maurizia R.; CABEZAS, Joaquin; CHEINQUER, Hugo; CHEN, Pei-Jer; CHEON, Myeong-Eun; CHUANG, Wan-Long; COFFIN, Carla S.; COPPOLA, Nicola; CRAXI, Antonio; CRESPO, Javier; LEDINGHEN, Victor De; DUBERG, Ann-Sofi; ETZION, Ohad; FERRAZ, Maria Lucia G.; FERREIRA, Paulo R. A.; FORNS, Xavier; FOSTER, Graham R.; GAETA, Giovanni B.; GAMKRELIDZE, Ivane; GARCIA-SAMANIEGO, Javier; GHEORGHE, Liliana S.; GHOLAM, Pierre M.; GISH, Robert G.; GLENN, Jeffrey; HERCUN, Julian; HSU, Yao-Chun; HU, Ching-Chih; HUANG, Jee-Fu; JANJUA, Naveed; JIA, Jidong; KABERG, Martin; KAITA, Kelly D. E.; KAMAL, Habiba; KAO, Jia-Horng; KONDILI, Loreta A.; LAGGING, Martin; LAZARO, Pablo; LAZARUS, Jeffrey V.; LEE, Mei-Hsuan; LIM, Young-Suk; MAROTTA, Paul J.; NAVAS, Maria-Cristina; NAVEIRA, Marcelo C. M.; ORREGO, Mauricio; OSIOWY, Carla; PAN, Calvin Q.; PESSOA, Mario G.; RAIMONDO, Giovanni; RAMJI, Alnoor; RAZAVI-SHEARER, Devin M.; RAZAVI-SHEARER, Kathryn; RIOS-HINCAPIE, Cielo Y.; RODRIGUEZ, Manuel; ROSENBERG, William M. C.; ROULOT, Dominique M.; RYDER, Stephen D.; SAFADI, Rifaat; SANAI, Faisal M.; SANTANTONIO, Teresa A.; SARRAZIN, Christoph; SHOUVAL, Daniel; TACKE, Frank; TERGAST, Tammo L.; VILLALOBOS-SALCEDO, Juan Miguel; VOELLER, Alexis S.; YANG, Hwai-I; YU, Ming-Lung; ZUCKERMAN, EliHepatitis D virus (HDV) infection occurs as a coinfection with hepatitis B and increases the risk of hepatocellular carcinoma, decompensated cirrhosis, and mortality compared to hepatitis B virus (HBV) monoinfection. Reliable estimates of the prevalence of HDV infection and disease burden are essential to formulate strategies to find coinfected individuals more effectively and efficiently. The global prevalence of HBV infections was estimated to be 262,240,000 in 2021. Only 1,994,000 of the HBV in-fections were newly diagnosed in 2021, with more than half of the new diagnoses made in China. Our initial estimates indicated a much lower prevalence of HDV antibody (anti-HDV) and HDV RNA positivity than previously reported in published studies. Ac-curate estimates of HDV prevalence are needed. The most effective method to generate estimates of the prevalence of anti-HDV and HDV RNA positivity and to find undiagnosed individuals at the national level is to implement double reflex testing. This re-quires anti-HDV testing of all hepatitis B surface antigen-positive individuals and HDV RNA testing of all anti-HDV-positive in-dividuals. This strategy is manageable for healthcare systems since the number of newly diagnosed HBV cases is low. At the global level, a comprehensive HDV screening strategy would require only 1,994,000 HDV antibody tests and less than 89,000 HDV PCR tests. Double reflex testing is the preferred strategy in countries with a low prevalence of HBV and those with a high prevalence of both HBV and HDV. For example, in the European Union and North America only 35,000 and 22,000 cases, respectively, will require anti-HDV testing annually. & COPY; 2023 The Author(s).
conferenceObject YSTRATEGIES TO ELIMINATE HEPATITIS C VIRUS INFECTION IN THE AMERICAS(2023) DIAZ, Luis Antonio; GARCIA, Sergio; AYARES, Gustavo; URIBE, Javier; IDALSOAGA, Francisco; FUENTEALBA, Jose Miguel; FUENTES-LOPEZ, Eduardo; MEDEL, Maria Paz; RAMIREZ-CADIZ, Carolina A.; KHAN, Rayan; LAZO, Mariana; FERRECCIO, Catterina; MENDIZABAL, Manuel; DIRCHWOLF, Melisa Melisa; SALAZAR, Patricia Guerra; OLIVEIRA, Claudia P. M. S.; PESSOA, Mario G.; ALVARES-DA-SILVA, Mario R.; SEBASTIANI, Giada; BRAHMANIA, Mayur; RAMJI, Alnoor; NIAZI, Mina; KO, Hin Hin; FELD, Jordan J.; RESTREPO, Juan Carlos; QUESADA, Wagner Enrique Ramirez; ALFARO, Omar; FERNANDEZ, Marlen Ivon Castellanos; ESTUPINAN, Enrique Carrera; AGUIRRE, Jose Roberto; MALDONADO, Katherine; SANCHEZ, Abel; SANCHEZ, Marco; SR., Teresa Andara; CASTRO-NARRO, Graciela Elia; CHAVEZ-TAPIA, Norberto Carlos; MENDEZ-SANCHEZ, Nahum; ADAMES-ALMENGOR, Enrique; LOMBARDO, Julissa; SR., Marcos Girala; MORAN, Elias; PADILLA-MACHACA, Martin; FERRER, Javier Diaz; TAGLE, Martin; MAINARDI, Vitoria; HERNANDEZ, Nelia; MARTINEZ, Edmundo; ALVARADO-TAPIAS, Edilmar; LEON, Roberto; TALAL, Andrew; THOMAS, Emmanuel; SPRINGER, Sandra; SICILIA, Mauricio Garcia Saenz de; ZHANG, Wei; BAJAJ, Jasmohan S.; TAPPER, Elliot B.; IZZY, Manhal; GISH, Robert G.; ATTAR, Bashar M.; COTTER, Thomas G.; LUCEY, Michael R.; KAMATH, Patrick S.; SINGAL, Ashwani K.; BATALLER, Ramon; MEZZANO, Gabriel; SOZA, Alejandro; LAZARUS, Jeffrey V.; ARRESE, Marco; ARAB, Juan Pablo- Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2022 Clinical Practice Guideline(2023) AWAN, Ahmed Arslan Yousuf; BERENGUER, Marina C.; BRUCHFELD, Annette; FABRIZI, Fabrizio; GOLDBERG, David S.; JIA, Jidong; KAMAR, Nassim; MOHAMED, Rosmawati; PESSOA, Mario Guimaraes; POL, Stanislas; SISE, Meghan E.; BALK, Ethan M.; GORDON, Craig E.; ADAM, Gaelen; CHEUNG, Michael; EARLEY, Amy; MARTIN, Paul; JADOUL, MichelDescription: The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease (CKD) is an update of the 2018 guideline from KDIGO.Methods: The KDIGO Work Group (WG) updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and used expert judgment to develop recommendations. New evidence led to updating of recommendations in the chapters on treatment of hepatitis C virus (HCV) infection in patients with CKD (Chapter 2), management of HCV infection before and after kidney transplant (Chapter 4), and diagnosis and management of kidney disease associated with HCV infection (Chapter 5). Recommendations in chapters on detection and evaluation of hepatitis C in CKD (Chapter 1) and prevention of HCV transmission in hemodialysis units (Chapter 3) were not updated because of an absence of significant new evidence.Recommendations: The 2022 updated guideline includes 43 graded recommendations and 20 ungraded recommendations, 7 of which are new or modified on the basis of the most recent evidence and consensus among the WG members. The updated guidelines recommend expanding treatment of hepatitis C with sofosbuvir-based regimens to patients with CKD glomerular filtration rate categories G4 and G5, including those receiving dialysis; expanding the donor pool for kidney transplant recipients by accepting HCV-positive kidneys regardless of the recipient's HCV status; and initiating direct-acting antiviral treatment of HCV-infected patients with clinical evidence of glomerulonephritis without requiring kidney biopsy. The update also addresses the use of immunosuppressive regimens in such patients.
- Impaired anti-HBV vaccine response in non-cirrhotic chronic HCV is not overcome by double dose regimen: randomized control trial(2023) MEDEIROS, Roseane P.; TERRAULT, Norah A.; MAZO, Daniel F.; OLIVEIRA, Claudia P.; DODGE, Jennifer; ZITELLI, Patricia M.; LOPES, Marta H.; CARRILHO, Flair J.; PESSOA, Mario G.Introduction and Objectives: Some studies suggest chronic HCV infection diminishes responses to the antiHBV vaccine. We evaluated the efficacy of double versus standard dose HBV vaccination among HCV patients without cirrhosis.Patients and Methods: 141 adults with untreated chronic HCV were randomized to HBV vaccination with double dose (40 mu g) or standard dose (20 mu g) at 0,1 and 6 months; 70 healthy HCV-negative patients given standard dose served as controls. Vaccine response was defined by anti-HBs >= 10 mIU/mL.Results: 128 patients (60 double, 68 standard doses) completed the study. Patients were of median age 52 years, 61% female, 60% fibrosis <2 of 4, and 76% genotype 1 with median 6-log 10 IU/mL HCV RNA. Overall seroprotection rate was 76.7% (95% CI: 65-87) in the 40 mu g versus 73.5% (95% CI: 63-84) in the 20 mu g dose HCV-positive groups (p =0.68) and 91.2% (95%CI:84-99) in HCV-negative controls (p =0.011 and 0.003, respectively). In multivariate logistic regression, vaccine dose (double vs. standard dose) was not associated with vaccine response (OR=0.63, p =0.33). Of 32 HCV-infected patients who were non-responders to 3- doses, 25 received the fourth dose of vaccine. The fourth dose seroconversion rate for the 40 mu g and 20 mu g groups were 45.5% and 21.4%, respectively.Conclusions: In HCV-infected patients without cirrhosis, impaired responses to HBV vaccination cannot be overcome by the use of double dose HBV vaccination, but adding a fourth dose of vaccine for non-responders may be an effective strategy. Other adjuvant measures are needed to enhance seroconversion rates in these patients. Trial register: U 1111-1264-2343 (www.ensaiosclinicos.gov.br)(c) 2022 Fundacion Clinica Medica Sur, A.C.
- National Brazilian survey on the outcomes of hepatitis c retreatment in patients non-responders to direct antiviral agents(2022) FERRAZ, Maria Lucia Gomes; PICCOLI, Leonora de Zorzi; REZENDE, Rosamar; BORBA, Luiz Augusto; PISSAIA JUNIOR, Alcindo; CHEINQUER, Hugo; SILVA, Giovanni Faria; FERREIRA, Paulo Roberto Abrao; VILLELA-NOGUEIRA, Cristiane Alves; MAZO, Daniel Ferraz; SOUZA, Fernanda Fernandes; CODES, Liana; IVANTES, Claudia Alexandra Pontes; GOMIDE, Geisa Perez Medina; PEREIRA, Gustavo Henrique Santos; PESSOA, Mario Guimaraes; FRANCA, Alex Vianey Callado; PINTO, Arlene dos Santos; TEIXEIRA, Rosangela; BITTENCOURT, Paulo LisboaBackground and aims: Treatment of hepatitis C with direct antiviral agents (DAA) is associ-ated with almost 95% of sustained virological response. However, some patients need retreatment. In Brazil, it should be done according to the Ministry of Health guidelines, fre-quently updated to include newly available drugs. This study aimed to conduct a national survey about the characteristics and outcomes of retreatment of hepatitis C in previously non-responders to DAAs. Patients and methods: Institutions from all over the country were invited to participate in a national registry for retreatment, including information about clinical and epidemiological characteristics of the patients, type and outcomes of retreatment regimens. Only patients previously treated with interferon-free regimens were included. Results: As previous treatments the distribution was: SOF/DCV (56%), SOF/SIM (22%), 3D (11%), SOF/LED (6%) and SOF/RBV (5%). For retreatment the most frequently used drugs were SOF/GP (46%), SOF/DCV (23%) and SOF/VEL (11%). From 159 patients retreated, 132/159 (83%) had complete information in the registry and among them only seven patients were non-responders (SVR of 94.6%). All retreatments were well tolerated, without any serious adverse events or interruptions. Conclusion: The retreatment of patients previously non-responders to DAAs was associated with high rate of SVR in this sample of Brazilian patients. This finding allows us to conclude that the retreatment options available in the public health system in Brazil are effective and safe and are an important component of the strategy of elimination of hepatitis C in our country. (c) 2022 Sociedade Brasileira de Infectologia.
conferenceObject Strategies to eliminate hepatitis C virus infection in the Americas(2023) DIAZ, Luis Antonio; GARCIA, Sergio; KHAN, Rayan; AYARES, Gustavo; MONASTERIO, Javier Uribe; IDALSOAGA, Francisco; FUENTES, Eduardo; MEDEL, Maria Paz; RAMIREZ, Carolina; LAZO, Mariana; FERRECCIO, Catterina; MENDIZABAL, Manuel; DIRCHWOLF, Melisa; GUERRA, Patricia; OLIVEIRA, Claudia; PESSOA, Mario; ALVARES-DA-SILVA, Mario; SEBASTIANI, Giada; BRAHMANIA, Mayur; RAMJI, Alnoor; NIAZI, Mina; KO, Hin Hin; FELD, Jordan J.; RESTREPO, Juan Carlos; RAMIREZ, Wagner; ALFARO, Omar; CASTELLANOS-FERNANDEZ, Marlen; CARRERA, Enrique; AGUIRRE, Jose Roberto; CARDONA, Katherine Emilia Maldonado; SANCHEZ, Abel; SANCHEZ, Marco; ANDARA, Maria Teresa; CASTRO-NARRO, Graciela; CHAVEZ-TAPIA, Norberto Carlos; MENDEZ-SANCHEZ, Nahum; ADAMES, Enrique; LOMBARDO, Julissa; GIRALA, Marcos; MORAN, Elias; PADILLA, P. Martin; DIAZ-FERRER, Javier; TAGLE, Martin; MAINARDI, Victoria; HERNANDEZ, Nelia; MARTINEZ, Edmundo; ALVARADO-TAPIAS, Edilmar; ROBERT, Leon; HERNANDEZ-TEJERO, Maria; SICILIA, Mauricio Garcia Saenz De; ZHANG, Wei; BAJAJ, Jasmohan S.; TAPPER, Elliot; IZZY, Manhal; GISH, Robert G.; ATTAR, Bashar; COTTER, Thomas; KAMATH, Patrick S.; SINGAL, Ashwani; BATALLER, Ramon; MEZZANO, Gabriel; SOZA, Alejandro; LAZARUS, Jeffrey; ARRESE, Marco; ARAB, Juan Pablo- Response to Ursodeoxycholic Acid May Be Assessed Earlier to Allow Second-Line Therapy in Patients with Unresponsive Primary Biliary Cholangitis(2023) CANCADO, Guilherme Grossi Lopes; COUTO, Claudia Alves; TERRABUIO, Debora Raquel Benedita; CANCADO, Eduardo Luiz Rachid; VILLELA-NOGUEIRA, Cristiane Alves; FERRAZ, Maria Lucia Gomes; BRAGA, Michelle Harriz; NARDELLI, Mateus Jorge; FARIA, Luciana Costa; GOMES, Nathalia Mota de Faria; OLIVEIRA, Elze Maria Gomes; ROTMAN, Vivian; OLIVEIRA, Maria Beatriz; CUNHA, Simone Muniz Carvalho Fernandes da; CUNHA-SILVA, Marlone; MENDES, Liliana Sampaio Costa; IVANTES, Claudia Alexandra Pontes; CODES, Liana; BORGES, Valeria Ferreira de Almeida E; PACE, Fabio Heleno de Lima; PESSOA, Mario Guimaraes; GUEDES, Laura Vilar; SIGNORELLI, Izabelle Venturini; CORAL, Gabriela Perdomo; LEVY, Cynthia; BITTENCOURT, Paulo LisboaBackground Response to ursodeoxycholic acid (UDCA) in primary biliary cholangitis (PBC) has been traditionally assessed 1 to 2 years after treatment initiation. With the development of new drugs, some patients may benefit from an earlier introduction of second-line therapies. Aims This study aims to identify whether well-validated response criteria could correctly identify individuals likely to benefit from add-on second-line therapy at 6 months. Methods Analysis of a multicenter retrospective cohort which included only patients with clear-cut PBC. Results 206 patients with PBC (96.6% women; mean age 54 +/- 12 years) were included. Kappa concordance was substantial for Toronto (0.67), Rotterdam (0.65), Paris 1 (0.63) and 2 (0.63) criteria at 6 and 12 months, whereas Barcelona (0.47) and POISE trial (0.59) criteria exhibited moderate agreement. Non-response rates to UDCA was not statistically different when assessed either at 6 or 12 months using Toronto, Rotterdam or Paris 2 criteria. Those differences were even smaller or absent in those subjects with advanced PBC. Mean baseline alkaline phosphatase was 2.73 +/- 1.95 times the upper limit of normal (x ULN) among responders versus 5.05 +/- 3.08 x ULN in non-responders (p < 0.001). Conclusions After 6 months of treatment with UDCA, the absence of response by different criteria could properly identify patients who could benefit from early addition of second-line therapies, especially in patients with advanced disease or high baseline liver enzymes levels.
- Risk factors for cancer in patients with primary biliary cholangitis and autoimmune hepatitis and primary biliary cholangitis overlap syndrome(2023) BRAGA, Michelle Harriz; CANCADO, Guilherme Grossi Lopes; BITTENCOURT, Paulo Lisboa; COUTO, Claudia Alves; GUEDES, Laura Vilar; LIMA, Andre Mourao Costa; FERRAZ, Maria Lucia Gomes; VILLELA-NOGUEIRA, Cristiane Alves; NARDELLI, Mateus Jorge; FARIA, Luciana Costa; GOMES, Nathalia Mota de Faria; OLIVEIRA, Elze Maria Gomes; ROTMAN, Vivian; OLIVEIRA, Maria Beatriz; CUNHA, Simone Muniz Carvalho Fernandes da; CUNHA-SILVA, Marlone; MENDES, Liliana Sampaio Costa; IVANTES, Claudia Alexandra Pontes; CODES, Liana; BORGES, Valeria Ferreira de Almeida e; PACE, Fabio Heleno de Lima; PESSOA, Mario Guimaraes; SIGNORELLI, Izabelle Venturini; CORAL, Gabriela Perdomo; GALIZZI FILHO, Joao; CHAGAS, Aline Lopes; TERRABUIO, Debora Raquel Benedita; CANCADO, Eduardo Luiz RachidIntroduction and objectives: Primary biliary cholangitis (PBC) and autoimmune hepatitis (AIH) and PBC over-lap syndrome (AIH/PBC) have been associated with a higher risk of hepatocellular carcinoma (HCC) and extra-hepatic malignancy (EHM). This study aims to assess potential risk factors associated with cancer development in PBC and AIH/PBC. Materials and methods: The Brazilian Cholestasis Study Group database was reviewed to compare clinical and laboratory features of PBC patients with HCC and EHM with those without cancer. Results: Among the 752 PBC patients enrolled, 64 of them with AIH/PBC, 87 cancers were identified in 72 patients, including 20 cases of HCC and 67 of EHM. Patients with HCC had a higher prevalence of cirrhosis
- Executive Summary of the KDIGO 2022 Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease(2022) MARTIN, Paul; AWAN, Ahmed A.; BERENGUER, Marina C.; BRUCHFELD, Annette; FABRIZI, Fabrizio; GOLDBERG, David S.; JIA, Jidong; KAMAR, Nassim; MOHAMED, Rosmawati; PESSOA, Mario Guimaraes; POL, Stanislas; SISE, Meghan E.; BALK, Ethan M.; GORDON, Craig E.; ADAM, Gaelen; CHEUNG, Michael; EARLEY, Amy; JADOUL, MichelInfection with the hepatitis C virus (HCV) has adverse liver, kidney, and cardiovascular consequences in patients with chronic kidney disease (CKD), including those on dialysis therapy or with a kidney transplant. Since the publication of the Kidney Disease: Improving Global Outcomes (KDIGO) HCV Guideline in 2018, advances in HCV management, particularly in the field of antiviral therapy and treatment of HCV-associated glomerular diseases, coupled with increased usage of HCV-positive kidney grafts, have prompted a reexamination of the 2018 guideline. As a result, the Work Group performed a comprehensive review and revised the 2018 guidance. This Executive Summary highlights key aspects of the updated guideline recommendations for 3 chapters: Chapter 2: Treatment of HCV infection in patients with CKD; Chapter 4: Management of HCV-infected patients before and after kidney transplantation; and Chapter 5: Diagnosis and management of kidney diseases associated with HCV infection.