SORAIA MAFRA MACHADO
Projetos de Pesquisa
Unidades Organizacionais
LIM/52 - Laboratório de Virologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
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conferenceObject 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, FernandaconferenceObject 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- Hepatitis C among blood donors: cascade of care and predictors of loss to follow-up(2017) MACHADO, Soraia Mafra; ALMEIDA-NETO, Cesar de; PINHO, Joao Renato Rebello; MALTA, Fernanda de Mello; CAPUANI, Ligia; CAMPOS, Aleia Faustina; ABREU, Fatima Regina Marques; NASTRI, Ana Catharina de Seixas Santos; SANTANA, Rbia Anita Ferraz; SABINO, Ester Cerdeira; MENDES-CORREA, Maria CassiaOBJECTIVE: To investigate the HCV cascade of care and to identify the factors associated with loss or absence to follow-up of patients identified as infected with hepatitis C through blood donation. METHODS: Blood donors from 1994 to 2012, identified with positive anti-HCV by enzyme immunoassay and immunoblot tests were invited to participate in the study, through letters or phone calls. Patients who agreed to participate were interviewed and their blood samples were collected for further testing. The following variables were investigated: demographic data, data on comorbidities and history concerning monitoring of hepatitis C. Multiple regression analysis by Poisson regression model was used to investigate the factors associated with non-referral for consultation or loss of follow-up. RESULTS: Of the 2,952 HCV-infected blood donors, 22.8% agreed to participate: 394 (58.2%) male, median age 48 years old and 364 (53.8%) Caucasian. Of the 676 participants, 39.7% did not receive proper follow-up or treatment after diagnosis: 45 patients referred not to be aware they were infected, 61 did not seek medical attention and 163 started a follow-up program, but were non-adherent. The main reasons for inadequate follow-up were not understanding the need for medical care (71%) and health care access difficulties (14%). The variables showing a significant association with inadequate follow-up after multiple regression analysis were male gender (PR = 1.40; 95% CI 1.15-1.71), age under or equal to 50 years (PR = 1.36; 95% CI 1.12-1.65) and non-Caucasians (PR = 1.53; 95% CI 1.27-1.84). CONCLUSIONS: About 40.0% of patients did not receive appropriate follow-up. These data reinforce the need to establish strong links between primary care and reference centers and the need to improve access to specialists and treatments.
- Effectiveness of direct-acting antivirals for hepatitis C virus infection in hepatitis C/HIV coinfected individuals A multicenter study(2020) MACHADO, Soraia M.; VIGANI, Aline G.; LEITE, Andrea G.; DIAZ, Ana Claudia M.; FERREIRA, Paulo Roberto A.; CARNAUBA-JUNIOR, Dimas; TENORE, Simone B.; BRANDAO-MELLO, Carlos Eduardo; GONZALEZ, Mario P.; SIROMA, Fabiana; PRADO, Kleber D.; V, Delzi Nunes; LISBOA-NETO, Gaspar; PINHO, Joao Renato R.; MALTA, Fernanda M.; AZEVEDO, Raymundo S.; WITKIN, Steven S.; MENDES-CORREA, Maria CassiaIn a hepatitis C virus (HCV)/HIV-positive Brazilian cohort, evaluate the safety and efficacy of HCV DAAs, the frequency of resistance substitutions in the HCV NS5A and NS5B genes and identify predictors of treatment failure. Retrospective multicenter study of HCV/HIV patients treated with sofosbuvir (SOF)-based regimens at 10 reference centers in Brazil. Clinical and virological data were collected. Genetic diversity in the NS5A and NS5B genes was assessed by direct nucleotide sequencing. The primary outcome was sustained virological response (SVR) 12 weeks after DAA completion. Of 643 HCV/HIV patients analyzed, 74.7% were male, median CD4+ T cell count was 617 cells/mm(3), 90% had an undetectable HIV viral load. HCV genotype 1 was detected in 80.2%, and 60% were taking at least 1 medication other than antiretroviral drugs during their DAA therapy. Cirrhosis was present in 42%. An SOF/daclatasvir (DCV) regimen was used in most patients (98%). The frequency of NS5A polymorphisms associated with clinically relevant resistance to DCV was 2%; no relevant NS5B variants were identified. The SVR12 rate was 92.8% in an intention to treat (ITT) analysis and 96% in a modified ITT (m-ITT) analysis. AE occurred in 1.6% of patients. By multivariate analysis, therapeutic failure was associated, in the m-ITT analysis, with concomitant use of anticonvulsant drugs (P = .001), age (P = .04), and female gender (P = .04). SOF/DCV regimens were associated with a high SVR rate in an HCV/HIV population. The use of concurrent anticonvulsant drugs and DAAs decreases the chances of achieving an SVR.
- Impact on mortality of being seropositive for hepatitis C virus antibodies among blood donors in Brazil: A twenty-year study(2019) MENEZES FILHO, Helio Ranes de; BIERRENBACH, Ana Luiza de Souza; CAPUANI, Maria Ligia Damato; MENDRONE JR., Alfredo; BENZAKEN, Adele Schwartz; MACHADO, Soraia Mafra; SAIVISH, Marielena Vogel; SABINO, Ester Cerdeira; WITKIN, Steven Sol; MENDES-CORREA, Maria CassiaIntroduction Hepatitis C virus (HCV) infection is a major health problem associated with considerable risk of mortality in different regions of the world. The purpose of this study was to investigate the contribution of HCV infection on all-cause and liver-related mortality, in a large cohort of blood donors in Brazil. Methods This is a retrospective cohort study of blood donors from 1994 to 2013, at Fundacao Pro-Sangue-Hemocentro de Sao Paulo (FPS). This cohort included 2,892 and 5,784 HCV antibody seropositive and seronegative donors, respectively. Records from the FPS database and the Mortality Information System (SIM: a national database in Brazil) were linked through a probabilistic record linkage (RL). Mortality outcomes were defined based on ICD-10 (10th International Statistical Classification of Diseases and Related Health Problems) codes listed as the cause of death on the death certificate. Hazard ratios (HRs) were estimated for outcomes using Cox multiple regression models. Results When all causes of death were considered, RL identified 209 deaths (7.2%) among seropositive blood donors and 190 (3.3%) among seronegative blood donors. Donors seropositive for HCV infection had a 2.5 times higher risk of death due to all causes (95% CI: 1.76-2.62; p< 0.001). When only liver-related causes of death were considered, RL identified 73 deaths among seropositive blood donors and only 6 among seronegative blood donors. Donors seropositive for HCV infection had a 23.4 times higher risk of death due to liver related causes (95% CI: 10.2-53.9; p<0.001). Donors seropositive for HCV had a 29.5 (95%CI: 3.9-221.7), 2.8 (95% CI: 1.4-5.5) and a 1.9 (95% CI: 1.2-3.0) times higher risk of death due to hepatocellular carcinoma, infection or trauma, respectively, compared to seronegative donors. Conclusions All-cause and liver-related mortality rate was increased among blood donors seropositive for HCV compared with the mortality rate among seronegative blood donors. Our data confirms HCV as a relevant cause of death in Brazil and also suggest that interventions directed at following patients even after access to specific drug treatment are urgent and necessary.
- Survival analysis over a 20-year period of a Brazilian cohort of blood donors coinfected HIV-HCV(2023) MENEZES FILHO, Helio Ranes de; GRANDI, Giuliano; CARDOSO, Ludimila Paula Vaz; SILVA, Juan Felipe Galvao da; MACHADO, Soraia Mafra; ALMEIDA-NETO, Cesar de; SABINO, Ester Cerdeira; MENDES-CORREA, Maria CassiaAmong individuals coinfected with HCV and HIV, studies of mortality from non-hepatic causes have shown inconsistent results. The aim of this study was to investigate the contribution of HCV and HIV co-infection to mortality from hepatic and non-hepatic causes in Brazil. This retrospective cohort study included blood donors from Funda & ccedil;& atilde;o Pr & oacute;-Sangue de S & atilde;o Paulo (FPS) who were followed from 1994 to 2016 to compare mortality and its causes between HIV-HCV coinfected individuals versus those seronegative for all tested infections. Records from the FPS database and the Mortality Information System were linked through a probabilistic record Relationship (RL). The Hazard Ratio (HR) was estimated using Cox multiple regression models. HCV-HIV coinfected individuals compared to seronegative individuals had a higher risk of death from all causes (HR = 14.54), non-liver neoplasms (HR = 2.55), infections (HR = 10.37) and liver disease (HR = 7.0). In addition, HCV mono-infected individuals compared to seronegative individuals had a higher risk of death from all causes (HR = 2.23), liver cancer (HR = 32.21), liver disease (HR = 14.92), infection (HR = 3.22), and trauma (HR = 1.68). Individuals coinfected with HCV and HIV have increased overall mortality and death due to infections, liver diseases and non-liver neoplasms as compared to those uninfected with HCV and HIV.
conferenceObject Risk of liver and non-liver-related mortality among hepatitis C virus and human immunodeficiency virus co-infected persons in a cohort of Brazilian blood donors: a twenty-year study(2020) RANES FILHO, Helio; CAPUANI, Ligia; BIERRENBACH, Ana Luiza; MEDRONI JUNIOR, Alfredo; BENZAKEN, Adele; MACHADO, Soraia; SABINO, Ester Cerdeira; WITKIN, Steven; MENDES-CORREA, Maria Cassia- Knowledge of Hepatitis C virus vertical transmission and subsequent pregnancy outcome in virus-positive female blood donors(2022) MENEZES FILHO, Helio Ranes de; MAIA, Ludmila Grego; MACHADO, Soraia Mafra; SILVA, Iasmin Ramos da; ALMEIDA-NETO, Cesar de; SABINO, Ester Cerdeira; WITKIN, Steven S.; MENDES-CORREA, Maria CassiaIntroduction: Hepatitis C virus (HCV) can be vertically transmitted from mother to fetus. We evaluated knowledge about HCV vertical transmission in female blood donors who became pregnant following detection of HCV in their donated blood. Methods: This was a retrospective descriptive study of females seen at a single blood bank in Sao Paulo, Brazil who were diagnosed with HCV infection in their donated blood. HCV-infected donors who subsequently became pregnant were invited to participate through letters or phone calls. Individuals who agreed to participate were interviewed by questionnaire to evaluate their knowledge on HCV vertical transmission. Results: Among 282 HCV-positive female blood donors, 69 reported becoming pregnant after their HCV diagnosis in donated blood. While 24 of these women were successful treated for their infection prior to becoming pregnant, 45 (65.2%) were at risk for vertical HCV transmission either because they had never been treated for HCV, were pregnant before treatment or became pregnant after unsuccessful treatment. Of the 59 women who responded to the question of whether they were informed about the risk of HCV vertical transmission, 58 (98.3%) reported never receiving this information either after obtaining their blood donation results or during their pregnancy. Conclusion: The lack of knowledge of HCV-infected women on the possibility for mother-to-child transmission of this virus highlights the critical need to improve communication about pregnancy-related risks between health professionals and HCV-infected women of childbearing age. (C) 2022 Sociedade Brasileira de Infectologia.