SUZANE KIOKO ONO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
P ICHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
P ICHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
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article 44 Citação(ões) na Scopus Epidemiology of HCC in Brazil: incidence and risk factors in a ten-year cohort(2014) PARANAGUA-VEZOZZO, Denise C.; ONO, Suzane K.; ALVARADO-MORA, Monica V.; FARIAS, Alberto Q.; CUNHA-SILVA, Marlone; FRANCA, Joao I. D.; ALVES, Venancio A. F.; SHERMAN, Morris; CARRILHO, Flair JoseBackground and aim. The lack of information about hepatocellular carcinoma (HCC) in Brazil weakens health policy in preventing deaths from the illness. The aim of this study was to establish the cumulative incidence and the risk factors for hepatocellular carcinoma development in patients under a surveillance program. Material and methods. 884 patients with compensated cirrhosis were prospectively followed up for at least five years, from August 1998 until August 2008, with at least one annual ultrasonography liver examination and serum alpha fetoprotein (AFP) measurement. Results. Among 884 patients, 72 (8.1%) developed a tumor with a median follow up of 21.4 months. In the hepatocellular carcinoma group, hepatitis C virus infection was the major etiological factor (65.3%), 56.9% (41/72) were male and the mean average age was 57 +/- 10 years. The annual incidence of hepatocellular carcinoma was 2.9%. 79.2% (57/72) of HCCs were detected within Milan Criteria, and the mean survival time was 52.3 months, significantly higher than for those outside Milan, with a mean time of 40.6 months (p = 0.0003). Conclusion. The annual incidence of HCC among this large series of Brazilian cirrhotic patients was around 2.9% with a detection rate of 8.1%, or a cumulative incidence rate over five years of 14.3%. The three variables related to HCC risk were low serum albumin [HR: 0.518 (0.46-0.78)], high AFP > 20 ng/mL [HR: 3.16 (1.86-5.38)], and ethnicity (Brazilian-East Asian descendants vs. other mixed Brazilian ethnicities) [HR: 2.86 (1.48-5.53)].conferenceObject Worldwide Lack of Early Referral of Patients with Alcoholic Liver Disease: Final Results of the Global Alcoholic Liver Disease Survey (GLADIS)(2017) SHAH, Neil D.; VENTURA-COTS, Meritxell; ZHANG, Chaoqun; ZAHIRAGIC, Nerma; YU, Yuanjie; YACOUB, Mohamed A.; WU, Pengbo; WANDERA, Andrew; VOROBIOFF, Julio D.; THURAIRAJAH, Prem H.; TAN, Shiyun; SPRECKIC, Sanjin; SIOW, Way; SCHEURICH, Christoph; SAEZ-ROYUELA, Federico; RODIL, Agustina; REIS, Daniela; ONO, Suzane K.; NABESHIMA, Mariana A.; TEO, Eng Kiong; KARONEY, Mercy J.; FERNANDEZ, Marlen I. Castellanos; FARIAS, Alberto Q.; DOMECH, Caridad Ruenes; COSTA, Pedro Marques Da; ALFADHLI, Ahmad; YANG, Ling; SOME, Fatma; KOCHHAR, Rakesh; KLUWE, Johannes; KIM, Won; ISAKOV, Vasily; HUSIC-SELIMOVIC, Azra; HSIANG, John C.; GEORGE, Jacob; KASSAS, Mohamed El; GURIDI, Zaily Dorta; CARRILHO, Flair J.; BESSONE, Fernando; BADIA, Ester; ALBORAIE, Mohamed; CORTEZ-PINTO, Helena; BATALLER, Ramon- The Molecular Characterization of Hepatitis A Virus Strains Circulating during Hepatitis A Outbreaks in Sao Paulo, Brazil, from September 2017 to May 2019(2022) CHUFFI, Samira; GOMES-GOUVEA, Michele S.; CASADIO, Luciana V. B.; NASTRI, Ana Catharina S. S.; GONZALEZ, Mario P.; COTIA, Andre L. F.; ARANDA, Amanda G. D.; TENORE, Simone B.; ONO, Suzane K.; MALTA, Fernanda M.; MADALOSSO, Geraldine; FERREIRA, Paulo R. A.; CARRILHO, Flair J.; PINHO, Joao R. R.Outbreaks of hepatitis A may occur in countries of medium and high socioeconomic levels in which the population generally exhibits an increased susceptibility in young adults to this infection if they are not vaccinated against the hepatitis A virus (HAV). In Europe, an outbreak involved approximately 22 European countries with 4475 cases reported from 2016 to 2018; most of them were men who have sex with men (MSM). This outbreak expanded to North and South America, including Brazil, particularly in Sao Paulo city with 1547 reported cases from 2016 to 2019. In the present study, we characterized the HAV strains involved in the acute hepatitis A cases identified in the reference centers of Sao Paulo city during this outbreak. A total of 51 cases with positive anti-HAV IgM were included, 80.4% male, 68.6% of them between 20 and 40 years old and 41.7% MSM. HAV RNA was detected in 92% (47/51) of the cases. Subgenotype IA of HAV was identified and most of the strains were closely related to that isolated in outbreaks that occurred in different European countries in 2016. These results showed the epidemiological relation between these outbreaks and reinforce the need to implement vaccination against hepatitis A for the adult population, particularly for a population with a high-risk behavior.
- Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C(2017) PARANAGUA-VEZOZZO, Denise C.; ANDRADE, Adriana; MAZO, Daniel F. C.; NUNES, Vinicius; GUEDES, Ana L.; RAGAZZO, Taisa G.; MOUTINHO, Renata; NACIF, Lucas S.; ONO, Suzane K.; ALVES, Venancio A. F.; CARRILHO, Flair J.AIM To determine the sensitivity and specificity of liver stiffness measurement (LSM) and serum markers (SM) for liver fibrosis evaluation in chronic hepatitis C. METHODS Between 2012 and 2014, 81 consecutive hepatitis C virus (HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography (TE) [FibroScan (R)/ARFI technology (Virtual Touch (R))] and SM [FIB-4/aspartate aminotransferase-to-platelet ratio index (APRI)]. The diagnostic performance of these tests was assessed using receiver operating characteristic curves. The optimal cut-off levels of each test were chosen to define fibrosis stages F >= 2, F >= 3 and F = 4. The Kappa index set the concordance analysis. RESULTS Fifty point six percent were female and the median age was 51 years (30-78). Fifty-six patients (70%) were treatment-naive. The optimal cut-off values for predicting F >= 2 stage fibrosis assessed by TE were 6.6 kPa, for acoustic radiation force impulse (ARFI) 1.22 m/s, for APRI 0.75 and for FIB-4 1.47. For F >= 3 TE was 8.9 kPa, ARFI was 1.48 m/s, APRI was 0.75, and FIB-4 was 2. For F = 4, TE was 12.2 kPa, ARFI was 1.77 m/s, APRI was 1.46, and FIB-4 was 3.91. The APRI could not distinguish between F2 and F3, P = 0.92. The negative predictive value for F = 4 for TE and ARFI was 100%. Kappa index values for F >= 3 METAVIR score for TE, ARFI and FIB-4 were 0.687, 0.606 and 0.654, respectively. This demonstrates strong concordance between all three screening methods, and moderate to strong concordance between them and APRI (Kappa index = 0.507). CONCLUSION Given the costs and accessibility of LSM methods, and the similarity with the outcomes of SM, we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis. This is of particular importance to developing countries.
- World Gastroenterology Organisation Global Guideline Hepatitis B September 2015(2016) FELD, Jordan; JANSSEN, Harry L. A.; ABBAS, Zaigham; ELEWAUT, Andre; FERENCI, Peter; ISAKOV, Vasily; KHAN, Aamir G.; LIM, Seng Gee; LOCARNINI, Stephen A.; ONO, Suzane K.; SOLLANO, Jose; SPEARMAN, Catherine W.; YEH, Chau-Ting; YUEN, Man Fung; LEMAIR, Anton
article 2 Citação(ões) na Scopus m-RECIST at 1 month and Child A are survival predictors after percutaneous ethanol injection of hepatocellular carcinoma(2014) SILVA, Mauricio F.; CARRILHO, Flair J.; PARANAGUA-VEZOZZO, Denise C.; CAMPOS, Luciana T.; NACIF, Lucas S.; DINIZ, Marcio A.; FARIAS, Alberto Q.; ALVES, Venancio A. F.; D'ALBURQUERQUE, Luis A. C.; ONO, Suzane K.Background and aims. Percutaneous ethanol injection (PEI) is a well-established therapeutic option in patients with cirrhosis and hepatocellular carcinoma (HCC). The modified-Response Evaluation Criteria in Solid Tumors (m-RECIST) are an important tool for the assessment of HCC response to therapy. The aim was to evaluate whether HCC response according to the m-RECIST criteria could be an effective predictor of Long-term survival in Barcelona Clinic Liver Cancer (BCLC) stage 0 and A HCC patients undergoing PEI. Material and methods. 79 patients were followed-up for median time of 26.8 months. HCC diagnosis was based on the,current guidelines of the American Association for Study of the Liver Diseases (AASLD) and European Association for Study of the Liver (EASL). Patient survival was calculated from the first PEI session to the end of the follow-up. Results. The 1-, 3-, and 5-year overall survival rates were 79, 48 and 37%, respectively. In the multivariate analysis, Child-Pugh-Turcotte (CPT) (p = 0.022) and the response to m-RECIST criteria (p = 0.016) were associated with patient survival. CPT A patients who achieved Complete Response (CR) 1 month after PEI presented a 5-year survival rate of 55%. By contrast, the worst scenario, the group with CPT B but without CR had a 5-year survival rate of 9%, while the group with either CPT A or CR as a survival predictor had a 5-year survival rate of 31%. In conclusion, in BCLC stage 0 and A HCC-patients, m-RECIST at 1 month and Child A may predict survival rates after PEI.- Assessment of a Computational Approach to Predict Drug Resistance Mutations for HIV, HBV and SARS-CoV-2(2022) PATEL, Dharmeshkumar; ONO, Suzane K.; BASSIT, Leda; VERMA, Kiran; AMBLARD, Franck; SCHINAZI, Raymond F.Viral resistance is a worldwide problem mitigating the effectiveness of antiviral drugs. Mutations in the drug-targeting proteins are the primary mechanism for the emergence of drug resistance. It is essential to identify the drug resistance mutations to elucidate the mechanism of resistance and to suggest promising treatment strategies to counter the drug resistance. However, experimental identification of drug resistance mutations is challenging, laborious and time-consuming. Hence, effective and time-saving computational structure-based approaches for predicting drug resistance mutations are essential and are of high interest in drug discovery research. However, these approaches are dependent on accurate estimation of binding free energies which indirectly correlate to the computational cost. Towards this goal, we developed a computational workflow to predict drug resistance mutations for any viral proteins where the structure is known. This approach can qualitatively predict the change in binding free energies due to mutations through residue scanning and Prime MM-GBSA calculations. To test the approach, we predicted resistance mutations in HIV-RT selected by (-)-FTC and demonstrated accurate identification of the clinical mutations. Furthermore, we predicted resistance mutations in HBV core protein for GLP-26 and in SARS-CoV-2 3CLpro for nirmatrelvir. Mutagenesis experiments were performed on two predicted resistance and three predicted sensitivity mutations in HBV core protein for GLP-26, corroborating the accuracy of the predictions.
- Alcohol-Related Liver Disease Is Rarely Detected at Early Stages Compared With Liver Diseases of Other Etiologies Worldwide(2019) SHAH, Neil D.; VENTURA-COTS, Meritxell; ABRALDES, Juan G.; ALBORAIE, Mohamed; ALFADHLI, Ahmad; ARGEMI, Josepmaria; BADIA-ARANDA, Ester; ARUS-SOLER, Enrique; BARRITT, A. Sidney; BESSONE, Fernando; BIRYUKOVA, Marina; CARRILHO, Flair J.; FERNANDEZ, Marlen Castellanos; GUIRIDI, Zaily Dorta; KASSAS, Mohamed El; ENG-KIONG, Teo; FARIAS, Alberto Queiroz; GEORGE, Jacob; GUI, Wenfang; THURAIRAJAH, Prem H.; HSIANG, John Chen; HUSIC-SELIMOVIC, Azra; ISAKOV, Vasily; KARONEY, Mercy; KIM, Won; KLUWE, Johannes; KOCHHAR, Rakesh; DHAKA, Narendra; COSTA, Pedro Marques; PHARM, Mariana A. Nabeshima; ONO, Suzane K.; REIS, Daniela; RODIL, Agustina; DOMECH, Caridad Ruenes; SAEZ-ROYUELA, Federico; SCHEURICH, Christoph; SIOW, Way; SIVAC-BURINA, Nadja; TRAQUINO, Edna Solange dos Santos; SOME, Fatma; SPRECKIC, Sanjin; TAN, Shiyun; VOROBIOFF, Julio; WANDERA, Andrew; WU, Pengbo; YACOUB, Mohamed; YANG, Ling; YU, Yuanjie; ZAHIRAGIC, Nerma; ZHANG, Chaoqun; CORTEZ-PINTO, Helena; BATALLER, RamonBACKGROUND & AIMS: Despite recent advances in treatment of viral hepatitis, liver-related mortality is high, possibly owing to the large burden of advanced alcohol-related liver disease (ALD). We investigated whether patients with ALD are initially seen at later stages of disease development than patients with hepatitis C virus (HCV) infection or other etiologies. METHODS: We performed a cross-sectional study of 3453 consecutive patients with either early or advanced liver disease (1699 patients with early and 1754 with advanced liver disease) seen at 17 tertiary care liver or gastrointestinal units worldwide, from August 2015 through March 2017. We collected anthropometric, etiology, and clinical information, as well as and model for end-stage liver disease scores. We used unconditional logistic regression to estimate the odds ratios for evaluation at late stages of the disease progression. RESULTS: Of the patients analyzed, 81% had 1 etiology of liver disease and 17% had 2 etiologies of liver disease. Of patients seen at early stages for a single etiology, 31% had HCV infection, 21% had hepatitis B virus infection, and 17% had nonalcoholic fatty liver disease, whereas only 3.8% had ALD. In contrast, 29% of patients seen for advanced disease had ALD. Patients with ALD were more likely to be seen at specialized centers, with advanced-stage disease, compared with patients with HCV-associated liver disease (odds ratio, 14.1; 95% CI, 10.5-18.9; P < .001). Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. These patients had significantly more visits to health care providers, with more advanced disease, compared with patients without excess alcohol use. The mean model for end-stage liver disease score for patients with advanced ALD (score, 16) was higher than for patients with advanced liver disease not associated with excess alcohol use (score, 13) (P < .01). CONCLUSIONS: In a cross-sectional analysis of patients with liver disease worldwide, we found that patients with ALD are seen with more advanced-stage disease than patients with HCV-associated liver disease. Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. Early detection and referral programs are needed for patients with ALD worldwide.
conferenceObject Four years real-life experience with antiviral adherence in chronic hepatitis B infection in a tertiary university hospital(2015) ABREU, Rodrigo M.; BASSIT, Leda C.; TAO, Sijia; JIANG, Yong; PARANAGUA-VEZOZZO, Denise; SCHINAZI, Raymond F.; CARRILHO, Flair J.; ONO, Suzane K.- 52-Week Efficacy and Safety of Telbivudine with Conditional Tenofovir Intensification at Week 24 in HBeAg-Positive Chronic Hepatitis B(2013) PIRATVISUTH, Teerha; KOMOLMIT, Piyawat; TANWANDEE, Tawesak; SUKEEPAISARNJAROEN, Wattana; CHAN, Henry L. Y.; PESSOA, Mario G.; FASSIO, Eduardo; ONO, Suzane K.; BESSONE, Fernando; DARUICH, Jorge; ZEUZEM, Stefan; CHEINQUER, Hugo; PATHAN, Rashidkhan; DONG, Yuhong; TRYLESINSKI, AldoBackground and Aims: The Roadmap concept is a therapeutic framework in chronic hepatitis B for the intensification of nucleoside analogue monotherapy based on early virologic response. The efficacy and safety of this approach applied to telbivudine treatment has not been investigated. Methods: A multinational, phase IV, single-arm open-label study (ClinicalTrials.gov ID NCT00651209) was undertaken in HBeAg-positive, nucleoside-naive adult patients with chronic hepatitis B. Patients received telbivudine (600 mg once-daily) for 24 weeks, after which those with undetectable serum HBV DNA (<300 copies/mL) continued to receive telbivudine alone while those with detectable DNA received telbivudine plus tenofovir (300 mg once-daily). Outcomes were assessed at Week 52. Results: 105 patients commenced telbivudine monotherapy, of whom 100 were included in the efficacy analysis. Fifty-five (55%) had undetectable HBV DNA at Week 24 and continued telbivudine monotherapy; 45 (45%) received tenofovir intensification. At Week 52, the overall proportion of undetectable HBV DNA was 93% (93/100) by last-observation-carried-forward analysis (100% monotherapy group, 84% intensification group) and no virologic breakthroughs had occurred. ALT normalization occurred in 77% (87% monotherapy, 64% intensification), HBeAg clearance in 43% (65% monotherapy, 16% intensification), and HBeAg seroconversion in 39% (62% monotherapy, 11% intensification). Six patients had HBsAg clearance. Myalgia was more common in the monotherapy group (19% versus 7%). No decrease in the mean glomerular filtration rate occurred in either treatment group at Week 52. Conclusions: Telbivudine therapy with tenofovir intensification at Week 24, where indicated by the Roadmap strategy, appears effective and well tolerated for the treatment of chronic hepatitis B.