Base de dados : LILACS Pesquisa : D27.505.954.122.388 [Categoria DeCS] Referências encontradas : 746 [refinar] Mostrando: 1 .. 10   no formato [Detalhado]

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Id: biblio-838088 Autor: Köklü, Seyfettin; Köksal, Iftihar; Salih Akarca, Ulus; Balkan, Ayhan; Güner, Rahmet; Demirezen, Aylin; Sahin, Memduh; Akhan, Sila; Ozaras, Resat; Idilman, Ramazan. Título: Daclatasvir Plus Asunaprevir Dual Therapy for Chronic HCV Genotype 1b Infection: Results of Turkish Early Access Program Fonte: Ann. hepatol;16(1):71-76, Jan.-Feb. 2017. graf. Idioma: en. Resumo: Abstract: Background. Daclatasvir and asunaprevir dual therapy is approved for the treatment of HCV genotype 1b infection in several countries. Aim. To evaluate the efficacy and safety of daclatasvir and asunaprevir dual therapy in Turkish patients. Material and methods. Sixty-one patients with HCV genotype 1b were enrolled in the Turkish early access program. Most of the patients were in difficult-to-treat category. Patients were visited at each 4 week throughout the follow-up period. Laboratory findings and adverse events were recorded at each visit. Results. Fifty-seven of 61 enrolled patients completed 24 weeks of treatment. Two patients died as a result of underlying diseases at 12-14th weeks of treatment. Two patients stopped the treatment early as a consequence of virological breakthrough, and 2 patients had viral relapse at the post-treatment follow-up. Overall SVR12 rates were 90% (55/61) and 93.2% (55/59) according to intention-to-treat (ITT) and per protocol (PP) analysis respectively. In ITT analysis, SVR12 was achieved by 93% (13/14) in relapsers, 80% (12/15) in interferon-ineligible patients and 91% (20/22) in previous nonresponder patients. SVR12 rates were 86.5% and 91.4% in patients with cirrhosis according to ITT and PP analysis respectively. SVR12 was 95.8% in non-cirrhosis group in both analysis. Patients with previous protease inhibitor experience had an SVR12 of 87.5%. Common adverse events developed in 28.8% of patients. There were no treatment related severe adverse event or grade-4 laboratory abnormality. Conclusions. Daclatasvir and asunaprevir dual therapy is found to be effective and safe in difficult-to-treat Turkish patients with HCV genotype 1b infection. Descritores: Antivirais/uso terapêutico Sulfonamidas/uso terapêutico Hepacivirus/efeitos dos fármacos Hepatite C Crônica/tratamento farmacológico Acesso aos Serviços de Saúde Imidazóis/uso terapêutico Isoquinolinas/uso terapêutico -Antivirais/economia Antivirais/efeitos adversos Sulfonamidas/economia Sulfonamidas/efeitos adversos Fatores de Tempo Turquia RNA Viral/genética Avaliação de Programas e Projetos de Saúde Resultado do Tratamento Custos de Medicamentos Análise Custo-Benefício Hepacivirus/genética Carga Viral Hepatite C Crônica/diagnóstico Hepatite C Crônica/economia Hepatite C Crônica/virologia Quimioterapia Combinada Genótipo Acesso aos Serviços de Saúde/economia Imidazóis/economia Imidazóis/efeitos adversos Isoquinolinas/economia Isoquinolinas/efeitos adversos Limites: Humanos Masculino Feminino Pessoa de Meia-Idade Idoso Responsável: BR1.1 - BIREME

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Id: biblio-838090 Autor: Castells, Lluís; Llaneras, Jordi; Campos-Varela, Isabel; Bilbao, Itxarone; Crespo, Manel; Len, Oscar; Rodríguez-Frías, Francisco; Charco, Ramon; Salcedo, Teresa; Esteban, Juan Ignacio; Esteban-Mur, Rafael. Título: Sofosbuvir and Daclatasvir in Mono-and HIV-coinfected Patients with Recurrent Hepatitis C After Liver Transplant Fonte: Ann. hepatol;16(1):86-93, Jan.-Feb. 2017. graf. Idioma: en. Resumo: Abstract: Background and aims. Pegylated interferon (Peg-INF) and ribavirin (RBV) based therapy is suboptimal and poorly tolerated. We evaluated the safety, tolerability and efficacy of a 24-week course of sofosbuvir plus daclatasvir without ribavirin for the treatment of hepatitis C virus (HCV) recurrence after liver transplantation (LT) in both HCV-monoinfected and human immunodeficiency virus (HIV)-HCV coinfected patients. Material and methods. We retrospectively evaluated 22 consecutive adult LT recipients (16 monoinfected and 6 coinfected with HIV) who received a 24-week course of sofosbuvir plus daclatasvir treatment under an international compassionate access program. Results. Most patients were male (86%), with a median age of 58 years (r:58-81y). Median time from LT to treatment onset was 70 months (r: 20-116 m). HCV genotype 1b was the most frequent (45%), 55% had not responded to previous treatment with Peg-INF and RBV and 14% to regiments including first generation protease inhibitors. Fifty-six percent of the patients had histologically proven cirrhosis and 6 had ascites at baseline. All patients completed the 24-week treatment course without significant side effects except for one episode of severe bradicardya, with only minor adjustments in immunosuppressive treatment in some cases. Viral suppression was very rapid with undetectable HCV-RNA in all patients at 12 weeks. All 22 patients achieved a sustained virological response 12 weeks after treatment completion. Conclusion. The combination of sofosbuvir plus daclatasvir without ribavirin is a safe and effective treatment of HCV recurrence after LT in both monoinfected and HIV-coinfected patients, including those with decompensated cirrhosis. Descritores: Antivirais/administração & dosagem Infecções por HIV/virologia Transplante de Fígado/efeitos adversos Hepatite C/tratamento farmacológico Hepacivirus/efeitos dos fármacos Doença Hepática Terminal/cirurgia Coinfecção Sofosbuvir/administração & dosagem Imidazóis/administração & dosagem Cirrose Hepática/tratamento farmacológico -Antivirais/efeitos adversos Recidiva Fatores de Tempo Ativação Viral RNA Viral/genética Esquema de Medicação Infecções por HIV/diagnóstico Estudos Retrospectivos Resultado do Tratamento Hepatite C/diagnóstico Hepatite C/virologia Hepacivirus/genética Hepacivirus/patogenicidade Carga Viral Quimioterapia Combinada Ensaios de Uso Compassivo Doença Hepática Terminal/diagnóstico Doença Hepática Terminal/virologia Sofosbuvir/efeitos adversos Imidazóis/efeitos adversos Imunossupressores/administração & dosagem Cirrose Hepática/diagnóstico Cirrose Hepática/virologia Limites: Humanos Masculino Feminino Pessoa de Meia-Idade Idoso Idoso de 80 Anos ou mais Responsável: BR1.1 - BIREME

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Id: biblio-1136277 Autor: Azevedo, Thomás Cavalcanti Pires de; Azevedo, Pedro Cavalcanti Pires de; Silveira Filho, Robson Natario; Carvalho, Arthur Ricardo Vilar Scavuzzi de; Cezarotti Filho, Murilo Lobo; Barbosa, Fabiano Timbó; Sousa-Rodrigues, Célio Fernando de; Matos-Rocha, Thiago José; Ramos, Fernando Wagner da Silva. Título: Use of remdesivir for patients with Covid-19: a review article Fonte: Rev. Assoc. Med. Bras. (1992);66(6):838-841, June 2020. graf. Idioma: en. Resumo: SUMMARY The etiological agent of COVID-19, which causes severe respiratory diseases such as pneumonia and pulmonary insufficiency, has been confirmed as a new coronavirus, now known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). There is currently no authorized medication for the treatment of COVID-19. No vaccines have been authorized. Thus, this study aimed at conducting a review of the use of Remdesivir in patients with COVID-19. The following electronic databases were used MEDLINE, SCIELO, LILACS, and PUBMED. On May 1, Remdesivir received emergency use authorization from the Food and Drug Administration. Remdesivir is currently the most promising molecule in the treatment of COVID-19, taking into account its broad antiviral spectrum (considering the genetic sequences of the virus, it is expected to maintain activity against SARS-CoV-2). There is in vitro and in vivo information available for coronaviruses, as well as an extensive clinical safety database (from a clinical trial of the Ebola virus and in the context of the Monitored Emergency Use of Unregistered and Investigational Interventions - MEURI). Further studies are relevant as available data on the efficacy and safety of Remdesivir against SARS-nCoV-2 are limited. RESUMO O agente etiológico da COVID-19, que causa doenças respiratórias graves, como pneumonia e insuficiência pulmonar, foi confirmado como um novo coronavírus, agora conhecido como coronavirus de síndrome respiratória aguda grave 2 (SARS-CoV-2). Não existem atualmente medicamentos autorizados para o tratamento de COVID-19, nem estão também autorizadas quaisquer vacinas. Assim, o estudo teve como objetivo realizar uma revisão sobre a utilização de Remdesivir em pacientes com COVID-19. As seguintes bases de dados eletrônicas foram utilizadas MEDLINE, SCIELO, LILACS e PUBMED. Em primeiro de maio, o Redemsivir recebeu autorização de uso de emergência da Food and Drug Administration. Remdesivir é presentemente a molécula promissora no tratamento da COVID-19 tendo em conta o seu largo espetro antiviral (considerando as sequências genéticas do vírus, é expectável que mantenha atividade contra o SARS-CoV-2). A informação in vitro e in vivo está disponível para os coronavírus, assim como a extensiva base de dados de segurança clínica (proveniente de ensaio clínico do vírus Ebola e no contexto do Monitored Emergency Use of Unregistered and Investigational Interventions - MEURI). A realização de novos estudos torna-se relevantes uma vez que os dados disponíveis são limitados sobre eficácia e segurança do Remdesivir contra SARS-nCoV-2. Descritores: Antivirais/uso terapêutico Pneumonia Viral/tratamento farmacológico Monofosfato de Adenosina/análogos & derivados Infecções por Coronavirus/tratamento farmacológico Alanina/análogos & derivados Pandemias -Monofosfato de Adenosina/uso terapêutico Infecções por Coronavirus Alanina/uso terapêutico Betacoronavirus Limites: Humanos Tipo de Publ: Revisão Responsável: BR1.1 - BIREME

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Id: biblio-1144247 Autor: Prieto, Jimena; Masllorens, Ana; Ardao, Gonzalo; Machado, Viviana; López, Martin; Gerona, Solange; Medina, Julio. Título: Optimización del diagnóstico de hepatitis por citomegalovirus en receptores de trasplante hepático: diez años de experiencia / Cytomegalovirus hepatitis diagnosis optimization in liver transplant recipients: 10 years of experience Fonte: Rev. chil. infectol;37(5):531-540, nov. 2020. tab, graf. Idioma: es. Resumo: Resumen Introducción: Para los pacientes receptores de trasplante hepático (TH) la hepatitis por citomegalovirus (CMV) constituye una entidad de difícil diagnóstico. Nuestro objetivo fue determinar la real incidencia de hepatitis por CMV aplicando técnicas diagnósticas más específicas. Material y Métodos: Estudio retrospectivo/ prospectivo, en un centro de trasplante hepático. Período de estudio: años 2009 al 2019. Se incluyeron los TH que presentaron elementos sugestivos y/o específicos de CMV en la histopatología de la punción biopsia hepática (PBH), a los que se les realizó inmunohistoquimica (IHQ) en la PBH. Población control n = 17. Resultados: 41 casos cumplieron los criterios de inclusión. La IHQ fue positiva en n = 6 (14,6%). En la población control, la IHQ fue negativa en el 100% de los casos. Esto traduce un valor predictor negativo de 100% para la histopatología en el diagnóstico de hepatitis por CMV, con un valor predictor positivo de 14,6%. En 85% de los pacientes con IHQ negativa, hubo diagnósticos alternativos. La terapia antiviral en la fase retrospectiva se indicó en 48% y en la prospectiva en 21%. Conclusiones: Combinar la histopatología con la IHQ optimiza el diagnóstico de hepatitis por CMV; lo que permite la racionalización del uso de antivirales de alto costo y la búsqueda de etiologías diferenciales. Abstract Background: Cytomegalovirus (CMV) hepatitis constitutes a challenging diagnostic entity in liver transplant (LT) recipients. Aim: To determine the real incidence of CMV hepatitis using more specific diagnostic tools as those currently used before. Methods: Retrospective/prospective study conducted in a hepatic transplant unit from 2009 to 2019. LT recipients with CMV specific or suggestive elements in histopathology of hepatic biopsies were included. Immunohistochemistry (IHQ) was performed in tissue samples of the studied cohort as well as in a control one. Results: 41 patients met the inclusion criteria. IHQ was diagnostic in 6 (14.6%), and was negative in 100% of the control population. The negative predictive value of the histopathology for CMV hepatitis diagnosis was 100% and the positive predictive value was 14.6%. 85% of patients in whom the IHQ was negative had alternative diagnosis Antiviral therapy in the retrospective analysis was indicated in 48% of patients and in 21% of the prospectively analyzed cohort. Conclusions: Histopathology and IHQ combination improves the diagnostic accuracy of CMV hepatitis which translates into a rational us of expensive antiviral therapy and to search for differential diagnosis Descritores: Transplante de Fígado Infecções por Citomegalovirus/diagnóstico -Antivirais/uso terapêutico Estudos Prospectivos Estudos Retrospectivos Citomegalovirus Hepatite/tratamento farmacológico Limites: Humanos Responsável: CL1.1 - Biblioteca Central

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Id: biblio-887225 Autor: Stine, Jonathan G; Wynter, Javelle A; Niccum, Blake; Kelly, Virginia; Caldwell, Stephen H; Shah, Neeral L. Título: Effect of Treatment with Direct Acting Antiviral on Glycemic Control in Patients with Diabetes Mellitus and Chronic Hepatitis C Fonte: Ann. hepatol;16(2):215-220, Mar.-Apr. 2017. tab. Idioma: en. Projeto: National Institutes of Health. Resumo: ABSTRACT Introduction and aim. The effect of the new direct acting antiviral drugs (DAAs) for chronic hepatitis C (HCV) on glycemic control is unknown. Materials and methods. We conducted a retrospective cohort study of patients who were treated for chronic HCV with direct-acting antiviral medications at a single academic institution between May 2013 and April 2016. Univariate analysis was performed comparing subjects pre- and post-treatment. Results. One hundred seventy-five consecutive adult patients were treated for chronic HCV and met enrollment criteria. The majority (80.8%) were genotype 1 and overall cohort sustained virologic response at week 12 (SVR12) was 97.8%. Thirty-one (18.5%) had diabetes mellitus (DM); twenty-six had pre- and post-treatment HbA1c values. Of these, 76.9% were male and 61.5% had cirrhosis. Ninety-six percent were prescribed sofosbuvir-based therapy and all but one (96.8%) achieved SVR12. Three patients were started on treatment despite meeting the definition for poorly controlled DM (HbA1c > 9 mg/dL). There was no significant difference when comparing pre-treatment (7.36 mg/dL, 95% CI 6.55-8.16) to post-treatment HbA1c (7.11 mg/dL, 95% CI 6.34-7.88, p = 0.268). Thirty-one percent of subjects required dose escalation or the initiation of insulin based therapy during treatment. Discussion. Although chronic HCV is associated with exacerbation of insulin resistance, our results showed HbA1c to be unaffected by eradication of chronic HCV with DAA in diabetic patients with and without cirrhosis. Paradoxically, almost 1/3 of patients required escalation of anti-diabetic therapy during treatment. Long-term studies are warranted to understand the relationship between HCV viral eradication and insulin metabolism.(AU) Descritores: Antivirais/farmacologia Hepatite C Crônica/tratamento farmacológico Índice Glicêmico -Estudos Retrospectivos Estudos de Coortes Diabetes Mellitus/patologia Insulina/metabolismo Limites: Humanos Responsável: BR1.1 - BIREME

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Id: lil-736371 Autor: Santos, Katia Corrêa de Oliveira; Silva, Daniela Bernardes Borges da; Benega, Margarete Aparecida; Paulino, Renato de Sousa; E Silva Jr, Elian Reis; Pereira, Dejanira dos Santos; Mussi, Aparecida Duarte Hg; Silva, Valéria Cristina da; V. Gubareva, Larissa; Paiva, Terezinha Maria de. Título: Influenza virus surveillance by the Instituto Adolfo Lutz, influenza season 2014: antiviral resistance Fonte: Rev. Inst. Med. Trop. Säo Paulo;57(1):92-92, Jan-Feb/2015. Idioma: en. Descritores: Vírus da Influenza A Subtipo H1N1/efeitos dos fármacos /efeitos dos fármacos INFLUENZA A VIRUS, HABATTOIRSNTEMEFOS SUBTYPE/efeitos dos fármacos Vírus da Influenza B/efeitos dos fármacos Influenza Humana/virologia Vigilância da População -Antivirais/uso terapêutico Brasil Farmacorresistência Viral Influenza Humana/tratamento farmacológico Estações do Ano Limites: Humanos Tipo de Publ: Carta Responsável: BR1.1 - BIREME

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Id: lil-734982 Autor: Urquijo Sánchez, Susana; Taborda Vanegas, Natalia Andrea; Rugeles López, María Teresa. Título: Factores solubles con actividad antiviral: en búsqueda de nuevos blancos terapéuticos para la infección por el VIH-1 / Soluble factors with antiviral activity: searching for new therapeutic targets to HIV-1 infection / Fatores solúveis com atividade antiviral: em busca de novos alvos terapêuticos para a infecção pelo HIV-1 Fonte: Iatreia;28(1):44-54, ene.-mar. 2015. ilus, tab. Idioma: es. Resumo: Los mecanismos innatos antivirales han resultado de gran interés debido a su uso potencial para la prevención y tratamiento de la infección por el VIH. En particular, los factores solubles antivirales han sido objeto de múltiples investigaciones por su capacidad de inhibir diferentes pasos del ciclo replicativo viral y de potenciar la respuesta inmune del hospedero. Entre estos factores solubles se destacan TRIM-5α, APOBEC3G, SAMHD1, ELAFIN, SERPINA1 y SLPI, que actúan directamente sobre la partícula viral o la célula, o promueven la producción de moléculas involucradas en la respuesta inmune contra el virus. Algunos de ellos se han correlacionado con un bajo riesgo de adquirir la infección por el VIH o con una lenta progresión a sida. La exploración de los mecanismos antivirales de estas proteínas es requisito para el desarrollo de nuevas alternativas terapéuticas. Antiviral innate mechanisms have a potential use in developing preventive and therapeutic strategies against HIV. Specifically, antiviral soluble factors have been evaluated in multiple investigations, based on their capacity to inhibit different steps of the viral cycle, and to increase the host immune response. Among these factors, TRIM-5α, APOBEC3G, SAMHD1, ELAFIN, SERPINA1 and SLPI are of particular interest, as they can act directly on the viral particle or the cell, or promote the production of molecules related to the viral immune response. Some of these factors have been associated with a low risk of HIV infection or slow progression to AIDS. Evaluation of mechanisms exhibited by antiviral proteins is a requirement for developing new therapeutic alternatives. Os mecanismos inatos antivirais resultaram de grande interesse devido a seu uso potencial para a prevenção e tratamento da infecção pelo HIV. Em particular, os fatores solúveis antivirais foram objeto de múltiplas pesquisas por sua capacidade de inibir diferentes passos do ciclo replicativo viral e de potenciar a resposta imune do hospedeiro. Entre estes fatores solúveis se destacam TRIM-5α, APOBEC3G, SAMHD1, ELAFIN, SERPINA1 e SLPI, que atuam diretamente sobre a partícula viral ou a célula, ou promovem a produção de moléculas envolvidas na resposta imune contra o vírus. Alguns deles se correlacionaram com um baixo risco de adquirir a infecção pelo HIV ou com uma lenta progressão a aids. A exploração dos mecanismos antivirais destas proteínas é requisito para o desenvolvimento de novas alternativas terapêuticas. Descritores: Antivirais Síndrome de Imunodeficiência Adquirida HIV-1 -Terapêutica Limites: Humanos Tipo de Publ: Revisão Responsável: CO332 - Facultad de Medicina

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Id: biblio-887222 Autor: Rezaee-Zavareh, Mohammad Saeid; Hesamizadeh, Khashayar; Behnava, Bita; Alavian, Seyed Moayed; Gholami-Fesharaki, Mohammad; Sharafi, Heidar. Título: Combination of Ledipasvir and Sofosbuvir for Treatment of Hepatitis C Virus Genotype 1 Infection: Systematic Review and Meta-Analysis Fonte: Ann. hepatol;16(2):188-197, Mar.-Apr. 2017. tab, graf. Idioma: en. Resumo: ABSTRACT Background and aim. The combination of Sofosbuvir (SOF) and Ledipasvir (LDV) has been lead to considerable enhancement of treatment of hepatitis C virus (HCV) genotype 1 infection. A meta-analysis of the currently available studies was undertaken with the aim to evaluate the antiviral efficacy of SOF/LDV therapy for 12 or 24 weeks with or without Ribavirin (RBV) in patients with HCV genotype 1 infection. Material and methods. In this meta-analysis, we searched databases including PubMed, Scopus, Science Direct and Web of Science using appropriate keywords. All papers which evaluated the efficacy of combination therapy of SOF/LDV with or without RBV for 12 or 24 weeks among patients with HCV genotype 1 infection were included. Results. The 20 published articles were assessed for eligibility and finally 10 articles pooling 2248 participants were included in this meta-analysis. Pooled SVR12 for four SOF/LDV regimens were 95% (95%CI = 93%-97%) for 12 weeks of treatment with SOF/LDV, 97% (95%CI = 95%-98%) for 24 weeks of treatment with SOF/LDV, 96% (95%CI = 94%-97%) for 12 weeks of treatment with SOF/ LDV/RBV and 98% (95%CI = 97%-99%) for 24 weeks of treatment with SOF/LDV/RBV. Only in treatment regimen of SOF/LDV for 12 weeks, cirrhosis had a significant effect on the SVR12 (OR = 0.21, 95%CI = 0.07-0.66). Furthermore, NS5A resistance-associated substitutions at baseline were associated with decrease in the rate of SVR (OR = 0.31, 95%CI = 0.2-0.5). Conclusions. The Interferon-free regimen of SOF/LDV for 12 or 24 weeks with or without RBV is highly effective for treatment of patients with HCV genotype 1 infection. Descritores: Antivirais/uso terapêutico Benzimidazóis/uso terapêutico Hepatite C/tratamento farmacológico Hepacivirus/efeitos dos fármacos Fluorenos/uso terapêutico Sofosbuvir/uso terapêutico -Antivirais/efeitos adversos Ribavirina/uso terapêutico Fatores de Tempo Benzimidazóis/efeitos adversos Distribuição de Qui-Quadrado Razão de Chances Resultado do Tratamento Hepatite C/diagnóstico Hepatite C/virologia Hepacivirus/genética Quimioterapia Combinada Fluorenos/efeitos adversos Sofosbuvir/efeitos adversos Resposta Viral Sustentada Genótipo Limites: Humanos Responsável: BR1.1 - BIREME

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Id: biblio-887223 Autor: Guarino, Maria; Picardi, Marco; Vitiello, Anna; Pugliese, Novella; Rea, Matilde; Cossiga, Valentina; Pane, Fabrizio; Caporaso, Nicola; Morisco, Filomena. Título: Viral Outcome in Patients with Occult HBV Infection or HCV-Ab Positivity Treated for Lymphoma Fonte: Ann. hepatol;16(2):198-206, Mar.-Apr. 2017. tab. Idioma: en. Resumo: ABSTRACT HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored. Descritores: Ativação Viral Linfoma não Hodgkin/tratamento farmacológico Doença de Hodgkin/tratamento farmacológico Vírus da Hepatite B/patogenicidade Hospedeiro Imunocomprometido Hepatite C/virologia Hepacivirus/patogenicidade Anticorpos Anti-Hepatite C/sangue Rituximab/efeitos adversos Hepatite B/virologia Antineoplásicos/efeitos adversos -Antivirais/administração & dosagem Linfoma não Hodgkin/imunologia Doença de Hodgkin/imunologia Biomarcadores/sangue Vírus da Hepatite B/imunologia Estudos Retrospectivos Hepatite C/diagnóstico Hepatite C/imunologia Hepatite C/prevenção & controle Hepacivirus/imunologia Centros de Atenção Terciária Hepatite B/diagnóstico Hepatite B/imunologia Hepatite B/prevenção & controle Itália Limites: Humanos Adulto Pessoa de Meia-Idade Responsável: BR1.1 - BIREME

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Id: biblio-887224 Autor: Saeedi, Ramesh; Mojebi-Mogharar, Ali; Sandhu, Supna K; Dubland, Joshua A; Ford, Jo-Ann; Yousefi, Masoud; Pudek, Morris; Holmes, Daniel T; Erb, Siegfried R; Kwan, Wing C. Peter; Kendler, David L; Yoshida, Eric M. Título: Lamivudine, Entecavir, or Tenofovir Treatment of Hepatitis B Infection: Effects on Calcium, Phosphate, FGF23 and Indicators of Bone Metabolism Fonte: Ann. hepatol;16(2):207-214, Mar.-Apr. 2017. tab, graf. Idioma: en. Resumo: ABSTRACT Background. Patients with chronic hepatitis B virus (HBV) are often treated with nucleoside/nucleotide antiviral agents and metabolic bone toxicity is a possible concern. Objective. To determine the relationships between fibroblast growth factor 23 (FGF23), a phosphaturic hormone, bone mineral density (BMD), and bone biochemical abnormalities in these patients. Material and methods. This is a cross-sectional observational study comparing HBV-infected subjects treated for at least one year with tenofovir (TDF), lamuvidine (LVD), entacavir (ETV), or not treated (CON). Patients with abnormalities in either calcium (Ca), phosphate (PO4), intact parathyroid hormone (iPTH) or FGF23 were further evaluated with BMD by DXA. Results. No difference in liver enzymes or renal function seen among groups, but hypophosphatemia was seen in all groups with the highest incidence with TDF treatment (14%). FGF 23 levels were found to be elevated in 11.1% of TDF patients, 2.77% amongst controls. No elevations were found in the LVD or ETV groups. Among a subset of subjects (FGF23, PO4, and/or Ca abnormalities) who underwent further evaluation, 67% had insufficient 25-OH vitamin D, and 30% had elevated 24 h urinary Ca or PO4 excretion. No patients with FGF23 abnormalities had urine abnormalities. 40% had low DXA Z-score (<-2) at spine or hip but there was no difference between control and antiviral treatment groups and the mean FRAX score was 2.33% for major osteoporotic fractures and 0.29% for hip fracture. Conclusion. Abnormalities in bone metabolism, particularly involving vitamin D insufficiency, in HBV-treated subjects were observed with a small increased likelihood in TDF treated patients. Descritores: Antivirais/uso terapêutico Fosfatos/sangue Osso e Ossos/efeitos dos fármacos Cálcio/sangue Lamivudina/uso terapêutico Hepatite B Crônica/tratamento farmacológico Fatores de Crescimento de Fibroblastos/sangue Tenofovir/uso terapêutico Guanina/análogos & derivados -Antivirais/efeitos adversos Fatores de Tempo Deficiência de Vitamina D/induzido quimicamente Osso e Ossos/metabolismo Osso e Ossos/diagnóstico por imagem Biomarcadores/sangue Absorciometria de Fóton Densidade Óssea/efeitos dos fármacos Estudos Transversais Fatores de Risco Resultado do Tratamento Remodelação Óssea/efeitos dos fármacos Hepatite B Crônica/diagnóstico Hepatite B Crônica/sangue Fraturas Ósseas/induzido quimicamente Tenofovir/efeitos adversos Guanina/efeitos adversos Guanina/uso terapêutico Limites: Humanos Responsável: BR1.1 - BIREME

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