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1
Soares, Sampaio Aletheia. "Marcadores sorológicos para os vírus da hepatite B e C em pacientes HIV-positivos atendidos no Hospital Universitário Oswaldo Cruz". Universidade Federal de Pernambuco, 2005. https://repositorio.ufpe.br/handle/123456789/7445.
Testo completoAbstract (sommario):
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Previous issue date: 2005A ocorrência de co-infecção pelo HIV e hepatites B e C tem sido relatada desde a era- HAART (do inglês Highly Active Antinetrovial Therapy), quando a mortalidade nas pessoas infectadas pelo HIV começou diminuir. Como conseqüência do fato de terem as mesmas rotas de transmissão, a co-infecção do HBV ou HCV em pessoas infectadas pelo HIV tem aumentado e tornou-se um problema de saúde pública. No Brasil, a prevalência média da coinfecção HIV e hepatites, encontrada pelo Ministério da Saúde é em torno de 40%, com a maioria em grupos de usuários de drogas. Freqüências variáveis de co-infecção têm sido relatadas, dependendo da população e da região estudada. O objetivo principal deste estudo foi identificar a freqüência de marcadores sorológicos para hepatite B e C em pacientes infectados pelo HIV, acompanhados em um hospital escola e os possíveis fatores associados à presença de tais marcadores. Quatrocentos e vinte e nove pacientes foram estudados, de ambos os sexos e com idade variando entre 18 a 77 anos. Os participantes respondiam um questionário específico, com características sócio-demográficas e tinham uma amostra de sangue testada para os marcadores HBsAg, Anti-HBc total e Anti-HCV, utilizando a técnica MEIA-Axym-Abbott. A freqüência encontrada de marcadores foi 10,3% para o HBsAg, 38,7% para o Anti-HBc total e 10,7% para o Anti-HCV. Dentre os pacientes, 1,4% possuíam tanto HBsAg quanto Anti-HCV positivos. Não houve associação significante estatisticamente entre as variáveis parceiro homossexual, uso de drogas endovenosas, ingesta de álcool, tatuagem ou piercing, cirurgia, procedimentos invasivos e hemotransfusão e a infecção pelo HBV, expressa pela positividade do HBsAg. A única variável que mostrou associação com infecção pelo HBV foi uso de drogas inalatórias. Nenhuma destas variáveis, incluindo, parceiro homossexual, uso de drogas endovenosas, uso de drogas inalatórias, ingesta de álcool, tatuagem ou piercing, cirurgia, procedimentos invasivos e hemotransfusão tiveram associação significativa estatisticamente com a presença do Anti-HCV. Este estudo encontrou freqüências comparáveis com outros relatados no Brasil, mas com freqüências de coinfeccção menores que aqueles das regiões Sul e Sudeste. Entretanto, nenhuma associação específica com comportamentos de risco foi encontrada neste estudo, mostrando importante diferença quando comparado com estudos realizados em outras regiões do Brasil
2
Burke, Stephanie. "Generalized Impairment of CD8+ T-cells in HCV Mono- and HIV-HCV Co-infection". Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32770.
Testo completoAbstract (sommario):
Chronic hepatitis C virus (HCV) infection has global effects on the immune system. CD8+ T-cells, responsible for viral clearance and control, are dysfunctional for as yet unknown reasons. It is hypothesized that IL-7 signaling pathway deficiencies contribute to this impairment. Blood-derived CD8+ T-cells in chronic HCV mono- and HIV-HCV co-infection had lower IL-7-induced activation of STAT5 and production of Bcl-2, and lower proliferation in co-infection, compared to controls. Lower Bcl-2 production was also associated with increased fibrosis. These changes were independent of the IL-7 receptor α expression and suppressor of cytokine signaling 1 or 3 expression. Intrahepatic CD8+ T-cells in HCV-infection did not activate STAT5 above basal levels with cytokine stimulation and had lower Bcl-2 expression than blood-derived cells. In conclusion, bulk CD8+ T-cells were impaired in response to IL-7 and the IL-7 signaling pathway may be one mechanism by which CD8+ T-cells are impaired in chronic HCV infection.
3
Kleefeld, Felix [Verfasser]. "Untersuchung des Einflusses einer Interferon-freien HCV-Eradikation auf neurokognitive Funktionen in HIV/HCV-koinfizierten und HCV-monoinfizierten Patienten / Felix Kleefeld". Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2019. http://d-nb.info/1179778103/34.
Testo completo
4
Gupta, Priyanka. "Host gene expression and its regulation by microRNA in HCV and HIV/HCV co-infection". Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/11998.
Testo completoAbstract (sommario):
HCV infection is prevalent and long-term infection may lead to liver cirrhosis and hepatocellular carcinoma (HCC). HIV/HCV co-infection has been shown to accelerate progression of HCV associated liver disease, and HCV in exacerbating hepatotoxicity of antiretroviral therapy. Both viruses are able to manipulate the host gene expression (mRNA) and regulatory (miRNA) machinery. It remains unclear how the regulation of mRNA expression is governed in HCV-infected Peripheral Blood Mononuclear Cells (PBMC) and liver tissue (tumor and non-tumor). This may help explain the cross-talk between PBMC and liver for predicting early events guiding the development of cirrhosis and HCC. Differentially expressed (DE) genes and miRNAs in each group comparison were also validated by Polymerase Chain reaction (PCR). We identified significant interactions between the DE miRNAs and genes with Bayesian network analysis. Selected miRNA: mRNA interactions were validated with the dual luciferase reporter assay that showed negative regulatory effect on the gene targets. Overall, this study has helped to not only define the utility of PBMCs in predicting early genomic events guiding cirrhosis and HCC in liver tissue in HCV-infected patients, but also showed evidence for mono and co-infection specific genes and miRNAs, which may help develop new generation of biomarkers for prognosis.
5
RUSSO, DARIO. "Diagnosi parallela automatizzata di infezioni virali trasmissibili per via ematica (HIV, HCV, HBV)". Doctoral thesis, Università degli Studi di Milano, 2007. http://hdl.handle.net/2434/33618.
Testo completoAbstract (sommario):
Automated parallel diagnosis of viral infections transmitted in haematic tract. The aim of this study was to develop a complete system for the identification and quantification of HBV, HCV, HIV using molecular biological techniques by means of Real Time PCR. The first step was to develop a positive control, valid for all considered viruses, absolutely free from risk of infection due to the fact that they are synthetic clones. The second step of this study was to develop a complete kit in basic PCR with detection by gel electrophoresis, to identify specific sequences of viral genomes. This test uses a solid thermopolimers mix which allows retrotranscription and amplification to be performed separately in a single vial. The third step was to develop a complete kit in real time PCR to quantify the viral concentrations using, in a first phase, a simple liquid mix and, in a second phase, a solid thermopolimers mix. At the end of my ph.D study it was produced a complete system containing a positive control to check the system and to make a real time standard curve. The real innovation of this study was the development of a solid master mix that delivers a rapid but highly specific test for the 3 viruses simultaneous
6
Souza, Iury Oliveira. "Validação de ensaio imunocromatográfico para a detecção múltipla de anticorpos específicos contra HIV, HBV e HCV". reponame:Repositório Institucional da UFBA, 2013. http://www.repositorio.ufba.br/ri/handle/ri/11787.
Testo completoAbstract (sommario):
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CAPES
Cerca de 33,3 milhões de pessoas apresentam infecção pelo Human Immunodeficiency Virus (HIV) no mundo; 180 milhões estão infectados pelo Hepatitis C Virus HCV e estima-se que 360 milhões apresentem infecção ativa pelo Hepatitis B Virus (HBV). Outra realidade mundial é a co-infecção entre esses vírus. Os dados mostram a importância global dessas viroses e a urgência do desenvolvimento de novos ensaios de diagnóstico sensíveis, específicos, rápidos e de baixo custo, que possam atender à demanda de entidades públicas inseridas em programas para prevenção e diagnostico dessas doenças. O presente trabalho consiste em validação relativa de um novo teste imunocromatográfico desenvolvido pela empresa canadense Medmira para detecção de anticorpos específicos contra HIV, HCV e HBV. Os resultados encontrados foram extremamente favoráveis para a detecção de anticorpos específicos para HIV, apresentando 98,6% de sensibilidade e 100% de especificidade. Para o anti-HBV a sensibilidade e especificidade encontradas foram de 90,0% e 98,6%, e de 86,3% e 100%, para anti-HCV, respectivamente. Nenhuma reatividade cruzada foi encontrada e a reprodutibilidade e repetitividade foram de 100%. O índice kappa e a acurácia global do teste foram de 0,91 (0,88-0,94) e 95,5% (93,5-97,5), respectivamente. Conclui-se que o ensaio imunocromatográfico é clinicamente útil em triagens rápidas para detecção de anticorpos anti-HIV, HCV e HBV.
Salvador
7
Heller, Sophie [Verfasser]. "Untersuchung visueller Aufmerksamkeitsparameter vor und nach einer Hepatitis C (HCV)-Therapie mit Direct Antiviral Agents bei HCV-monoinfizierten und HCV/HIV-koinfizierten Patienten / Sophie Heller". Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2020. http://d-nb.info/1206186070/34.
Testo completo
8
Hultgren, Catharina. "Immune modulation in chronic HBV and HCV infection /". Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4255-2/.
Testo completo
9
Costa, Cintia Bezerra Almeida. "Polimorfismo do HLA-G na coinfecção HIV/HCV". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-21052014-181750/.
Testo completoAbstract (sommario):
O objetivo geral da pesquisa foi associar os polimorfismos do gene HLA-G (região 3\' NT) com a coinfecção HIV/HCV e com os grupos (HIV, HCV e controles saudáveis). Trata-se de um estudo transversal, comparativo, descritivo. Participaram do estudo, 560 indivíduos, sendo 156 controles saudáveis, 102 coinfetados HIV/HCV, 186 infectados pelo HIV e 116 por HCV. Para a identificação dos polimorfismos, o DNA genômico foi extraído do sangue total e a genotipagem feita por PCR e visualizada em gel de poliacrilamida a 7%, no qual o polimorfismo de 14pb foi identificado, e por sequenciamento os outros sete SNPs. Os resultados sociodemográficos apontam que a amostra na sua grande maioria foi composta por indivíduos adultos e do sexo masculino. No que diz respeito à cor da pele, na comparação entre os grupos HCV e HIV/HCV, observou-se um maior número de coinfectados apresentando a cor preta e parda do que nos monoinfectados (P=0,0001). Com relação à categoria de exposição para aquisição do HIV, na comparação entre os grupos HIV e HIV/HCV, observou-se diferença significante na transmissão por via heterossexual, sendo sua frequência maior no grupo HIV (P=0,0000). No caso da comparação entre os grupos HCV e HIV/HCV, observou-se também diferença na transmissão heterossexual, sendo sua frequência significantemente maior no grupo HIV/HCV (P=0,0001). Quanto aos achados relacionados ao genótipo do HCV, na comparação entre os grupos HCV e HIV/HCV, o genótipo 1a apresentou frequência maior nos coinfectados (P=0,0001). No que diz respeito à carga viral do HIV, na comparação entre os grupos HIV e HIV/HCV, o grupo da monoinfecção apresentou maior carga viral do que o grupo da coinfecção (P=0,0350). Com relação ao grau de fibrose hepática, na comparação entre os grupos HCV e HIV/HCV, o grupo da coinfecção tem mais fibrose leve do que o grupo da monoinfecção (P=0,0009). Quanto aos polimorfismos genéticos da região 3\' NT do HLA-G, foi encontrado que o genótipo de heterozigose Del/Ins de 14 pb apresentou diferença significante nos indivíduos coinfectados pelo HIV/HCV (P=0,0216) quando comparados com o grupo controle. Em relação ao SNP +3003, a comparação dos grupos HCV e controle saudável mostrou que alelo +3003T apresentou uma frequência significantemente maior no grupo HCV (P=0,0147); o genótipo +3003C/T apresentou uma frequência maior no grupo controle (P=0,0095); o genótipo +3003T/T estava maior no grupo HCV (P=0,0095). A comparação entre os grupos HIV e HCV mostrou que a frequência do alelo +3003C estava maior no grupo HIV (P=0,0463); e o genótipo +3003T/T apresentou uma frequência maior no grupo HCV (P=0,0494). A frequência do genótipo +3187A/A estava maior no grupo HIV/HCV em comparação ao HIV (P=0,0193); e do +3187A/G estava maior no grupo HIV (P=0,0187). O genótipo +3196C/G apresentou frequência significamente maior no grupo HIV do que no controle saudável (P=0,0213). A UTR-10, na comparação entre os grupos HIV e controle, mostrou frequência maior no grupo HIV (P=0,0044); quando comparados os grupos HIV/HCV e HIV, frequência foi maior no grupo HIV (P=0,0300) e na comparação entre os grupos HIV e HCV, sua frequência também foi maior no grupo HIV (P=0,0140). A UTR-4, na comparação dos grupos HCV e controle saudável, revelou uma frequência maior no grupo controle (P=0,0147). A UTR-9, na comparação dos grupos HIV/HCV e HIV, mostrou frequência maior no grupo HIV/HCV (P=0,0460). Em relação aos dados clínicos, a presença do alelo T na posição +3035 foi significantemente associada à maior carga viral do HCV, acima de 400.000 cópias/mL (P=0,0244). Em relação aos tipos de genótipos do HCV, a presença do alelo +3027C foi associada ao subtipo 1a do HCV (P=0,0109). Adicionalmente, a presença do genótipo C/C na posição +3027 também foi significantemente associada com o subtipo 1a do HCV (P=0,0015). Ainda, o alelo A do SNP +3187 foi significantemente associado com os outros genótipos do HCV, excluindo o 1a (P=0,0369). Embora não esteja totalmente esclarecida a função do gene HLA-G, estudos têm sido desenvolvidos para melhor elucidar sua função nos contextos fisiológicos, como gestação, e patológicos, como tumores, transplantes, doenças inflamatórias e infecciosas. Tais estudos procuram ampliar o conhecimento sobre o sistema imunológico e contribuem para o desenvolvimento de novas estratégias diagnósticas e terapêuticas. Os resultados do presente estudo contribuem para a ampliação do conhecimento sobre os polimorfismos da região 3\' NT do gene HLA-G, na coinfecção HIV/HCV. Como também, na melhoria da assistência de enfermagem que deve buscar reduzir a morbimortalidade pela referida patologia. Porém, ainda há um longo percurso a ser percorrido na compreensão dos fatores imunogenéticos envolvidos na coinfecção pelo HIV/HCVThe general objective of the research was to associate the polymorphism of the gene HLA-G (region 3\' NT) with the co-infection HIV/HCV and with the groups (HIV, HCV and healthy control). It is a cross-sectional, comparative, descriptive study. 560 individuals participated of the study, being 156 healthy control individuals, 102 co- infected HIV/HCV, 186 infected by HIV and 116 by HCV. For identifying the polymorphisms, the genomic DNA was extracted from the total blood and the genotyping was made by PCR and visualized in gel of polyacrylamide at 7%, in which the polymorphism of 14pb was identified, and by sequencing the other seven SNPs. The social demographic results point that the most of the sample was composed by male adult individuals. Regarding the color of the skin, in the comparison between the groups HCV and HIV/HCV, a bigger number of co-infected with black skin and brown-skinned was observed than in the mono infected (P=0,0001). Regarding to the category of exposition for acquisition of the HIV, in the comparison between the groups HIV and HIV/HCV, a significant difference was observed in the transmission through heterosexual exposition, being its frequency bigger in the group HIV (P=0,0000). In the case of the comparison between the groups HCV and HIV/HCV, the difference in the heterosexual transmission was also observed, being its frequency significantly higher in the group HIV/HCV (P=0,0001). About the finding related to the genotype of the HCV, in the comparison between the groups HCV and HIV/HCV, the genotype 1a presented higher frequency in the co- infected (P=0,0001). Regarding to the viral load of the HIV, in the comparison between the groups HIV and HIV/HCV, the group of the mono infection presented bigger viral load that the group of the co-infection (P=0,0350). Regarding to the level of hepatic fibrosis, in the comparison between the groups HCV and HIV/HCV, the group of co-infection has a lighter fibrosis that the group of the mono infection (P=0,0009). Regarding to the genetic polymorphisms of the region 3\' NT of the HLA-G, it was found that the genotype of heterozygosis Del/Ins of 14 pb, presented significant difference in the individuals co-infected by the HIV/HCV (P=0,0216) when compared with the control group. About the SNP +3003, the comparison of the groups HCV and healthy control, it was showed that the allele +3003T presented a significant higher frequency in the group HCV (P=0,0147); the genotype +3003C/T presented a higher frequency in the control group (P=0,0095); the genotype +3003T/T was bigger in the group HCV (P=0,0095). The comparison between the groups HIV and HCV showed that the frequency of the allele +3003C was bigger in the group HIV (P=0,0463); and the genotype +3003T/T presented a bigger frequency in the group (P=0,0494). The frequency of the genotype +3187A/A was bigger in the group HIV/HCV in comparison to the HIV (P=0,0193); and of the +3187A/G was bigger in the group HIV (P=0,0187). The genotype +3196C/G presented frequency significantly bigger in the group HIV than in the healthy control (P=0,0213). The UTR-10, in comparison between the groups HIV and control, showed bigger frequency in the group HIV (P=0,0044); when compared the groups HIV/HCV and HIV, frequency was bigger in the group HIV (P=0,0300) and in the comparison between the groups HIV and HCV, its frequency was also bigger in the group (P=0,0140). The UTR-4, in the comparison of the groups HCV and healthy control, revealed a bigger frequency in the control group (P=0,0147). The UTR-9, in comparison of the groups HIV/HCV and HIV, showed bigger frequency in the group HIV/HCV (P=0,0460). Regarding to the clinical data, the presence of the allele T in the position +3035, was significantly associated to bigger viral load of the HCV, above 400.000 copies /mL (P=0,0244). About the types of genotypes of the HCV, the presence of the allele +3027C was associated with the subtype 1a of the HCV (P=0,0109). Additionally, the presence of the genotype C/C in the position +3027 was also significantly associated with the subtype 1a of the HCV (P=0,0015). Still, the allele A of the SNP +3187 was significantly associated with the other genotypes of the HCV, excluding the 1a (P=0,0369). Although the function of the gene HLA-G, is not totally clarified, studies have been developed for better elucidate its function in the physiological contexts, like gestation, and pathological, such as tumours, transplants, infectious and inflammatory diseases. These studies aim to extend the knowledge about the immunological system and contribute for the development of new diagnostic and therapeutic strategies. The results of this study contribute for enhancement of the knowledge about the polymorphisms of the region 3\' NT of the gene HLA-G, in the co-infection HIV/HCV. As well as, in the improvement of the assistance of nursing that must seek reducing the morbid mortality by the pathology referred. However, there is still a long path to be followed in the comprehension of the immunogenic factors involved in the co-infection by the HIV/HCV
10
Uccellini, L. "HOST GENETIC INFLUENCE ON HIV AND HCV INFECTIONS". Doctoral thesis, Università degli Studi di Milano, 2013. http://hdl.handle.net/2434/215587.
Testo completoAbstract (sommario):
In patients with chronic hepatitis C, the hepatitis C virus (HCV) RNA level is an important predictor of treatment response. To explore the relationship of HCV RNA with viral and demographic factors, as well as IL28B genotype, we examined viral levels in an ethnically diverse group of injection drug users (IDUs). Between 1998 and 2000, the Urban Health Study (UHS) recruited IDUs from street settings in San Francisco Bay area neighborhoods. Participants who were positive by HCV EIA were tested for HCV viremia by a bDNA assay. HCV genotype was determined by sequencing the HCV NS5B region. For a subset of participants, IL28B rs12979860 genotype was determined by Taqman. Among 1701 participants with HCV viremia, median age was 46 years and median duration of injection drug use was 26 years; 56.0% were African American and 34.0% were of European ancestry (non-Hispanic). HIV-1 prevalence was 13.9%. The overall median HCV RNA level was 6.45 log10 copies/ml. In unadjusted analyses, higher levels were found with older age, male gender, African American ancestry, HBV
infection, HIV-1 infection and IL28B rs12979860-CC genotype; compared to participants
infected with HCV genotype 1, HCV RNA was lower in participants with genotype 3 or
genotype 4. In an adjusted analysis, age, gender, racial ancestry, HIV-1 infection, HCV genotype and IL28B rs12979860 genotype were all independently associated with HCV RNA. The level of HCV viremia is influenced by a large number of demographic, viral and human genetic factors.
HIV
The clinical course of HIV-1 infection is highly variable among individuals, at least in part as a result of genetic polymorphisms in the host. Toll-like receptors (TLR) play a crucial role in the host’s innate immunity and may influence HIV-1 disease progression. The transcription factor IRF-5 is an important player in the TLR-MyD88 signaling cascade. We investigated the impact of two SNPs in TLR9 gene, rs352139 and rs352140, and two SNPs in IRF5 gene, rs10954213 and rs11770589, on CD4 count, HIV viral load, and clinical progression in a cohort of HIV-infected patients. Two SNPs in TLR9 and IRF5 are in linkage disequilibrium and rs352140GA TLR9 was associated with the rapid progressors phenotype: for rs352140 GG+GA versus AA, P = 0.025, OR= 0.5479, confidence interval (CI) 0.31-0.97. No other association was found between TLR9 and IRF5 SNPs and viral load, CD4 count or other clinical data.
Rapid progression of HIV-1 infection was associated with TLR9 polymorphisms. Because of its potential implications for intervention strategies and vaccine developments, additional epidemiological and experimental studies are needed to confirm this association.
11
Mohsen, Abdul Hadi. "The epidemiology of hepatitis C and HCV-HIV coinfection". Thesis, King's College London (University of London), 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.424448.
Testo completo
12
Cezimbra, Helen Minussi. "ALTERAÇÕES METABÓLICAS EM PACIENTES INFECTADOS PELO HIV E HCV". Universidade Federal de Santa Maria, 2013. http://repositorio.ufsm.br/handle/1/5862.
Testo completoAbstract (sommario):
On June 5, 1981, the CDC (Centers for Disease Control) first published a report of
what would be known later as Acquired Immune Deficiency Syndrome (AIDS). More
than 30 years after, universally fatal disease was carried to the level of chronic disease,
but despite numerous advances, HIV patients have shown increased risk of non-AIDSdefining
events and incomplete immune restoration, despite effective virological
control, these include morphological, metabolic and atherosclerotic changes. In this
context, co-infection with hepatitis C virus (HCV) has attracted interest due to the
cumulative and synergistic mitochondrial insults caused by coinfection and enhanced by
the use of antiretrovirals. The aim of this study was to determine the prevalence of
dyslipidemia and metabolic syndrome in patients infected with the HIV and HCV vírus,
with mono or coinfection with each virus. It is a cross-sectional study which included
127 patients, aged 21 to 72 years, 59 with HIV, 36 coinfected and 32 with HCV, males
accounted for 48% (62) and 52% female (67). There was a predominance of men among
coinfected patients (64% - 23 men and 13 women) and women in the HIV group (66% -
22 men and 37 women). The mean age was 40.6 years (38.5 years HIV, 39.6 coinfected
and 45.9 HCV). The white race occurred in 60% of the sample predominantly in all
groups. There was no difference between groups in median time to diagnosis of HIV
and HCV. To HIV group there were 27% metabolic syndrome by IDF criteria and 26%
by HOMA2-IR índex (1,4 cut-off), 63% larger waist by IDF criteria and 26%
abdominal obesity. To HIV/HCV coinfection group there were 30% metabolic
syndrome by IDF, but 54% by HOMA2-IR index, 42% larger waist, but 52% abdominal
obesity. To HCV group there were 25% metabolic syndrome by IDF and 38% by
HOMA2-IR index, 67% larger waist and 47% abdominal obesity. The presence of
hepatitis C coinfection is responsible for alarming levels of insulin resistance,
associated with a more favorable lipid profile that could act as a confounder in the
clinical diagnosis of metabolic syndrome.Em 5 de junho de 1981, o CDC (Centers for Disease Control) publicou o primeiro relato do que mais tarde seria conhecido como Síndrome da Imunodeficiência Adquirida (AIDS). Passados mais de 30 anos, a doença universalmente fatal foi conduzida ao patamar de doença crônica, mas apesar dos inúmeros avanços, os portadores de HIV vêm apresentando risco aumentado de eventos não definidores de AIDS e restauração imune incompleta, a despeito do controle virológico eficaz, estas incluem alterações morfológicas, alterações metabólicas e ateroscleróticas. Neste contexto, a coinfecção com o vírus da Hepatite C (HCV) tem despertado bastante interesse devido aos insultos mitocondriais cumulativos e sinérgicos causados pela coinfecção e potencializado pelo uso de antirretrovirais. O objetivo deste estudo foi determinar a prevalência de dislipidemia e síndrome metabólica em pacientes com infecção pelos vírus do HIV e HCV, em mono ou coinfecção por cada um dos vírus. Trata-se de um estudo transversal onde foram incluídos 127 pacientes, com idades entre 21 e 72 anos, 59 com HIV, 36 coinfectados e 32 com HCV, o sexo masculino representou 48% (62) e o feminino 52% (67). Houve predomínio de homens entre os pacientes coinfectados (64% - 23 homens e 13 mulheres) e mulheres no grupo HIV (66% - 22 homens e 37 mulheres). A média de idade foi 40,6 anos (HIV 38,5, coinfectados 39,6 e HCV 45,9 anos). A raça branca ocorreu em 60% da amostra com predomínio em todos os grupos. Não houve diferença entre os grupos no tempo médio de diagnóstico do HIV e HCV. Para o grupo com HIV houve 27% de síndrome metabólica pelos critérios do IDF e 26% pelo HOMA2-IR (ponto de corte 1,4), 63% de alteração de cintura pelos critérios do IDF, com 26% de obesidade abdominal. Para o grupo de coinfecção HIV/HCV houve 30% de síndrome metabólica pelo IDF, mas 54% pelo HOMA2-IR, com 42% de alteração de cintura, mas 52% de obesidade abdominal. Para o grupo HCV houve 25% de síndrome metabólica pelo IDF, mas 38% pelo HOMA2-IR, com 67% de alteração da cintura e 47% de obesidade abdominal. Foi possível demonstrar que a presença de coinfecção por hepatite C é responsável pela presença de níveis alarmantes de resistência insulínica, associada a um perfil lipídico mais favorável que poderá agir como confundidor no diagnóstico clínico da síndrome metabólica.
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Falconer, Karolin. "HIV-1/HCV co-infection immunity and viral dynamics /". Stockholm, 2010. http://diss.kib.ki.se/2010/978-91-7409-762-7/.
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Ekman, Evelina, e Nicole Karlsson. "Upplevelser av vårdpersonalens bemötande gentemot patienter som lever med HIV, HBV eller HCV : En litteraturstudie". Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-83910.
Testo completoAbstract (sommario):
Introduktion/Bakgrund: Blodsmittor som Humant immunbristvirus [HIV], Hepatit B-virus [HBV] och Hepatit C-virus [HCV] förekommer i många delar av världen. Det finns mycket fördomar om patienter som lever med blodsmitta och patienterna kan uppleva stigmatisering och diskriminering från samhället vilket kan leda till psykisk ohälsa. Syfte: belysa hur patienter som lever med HIV, HBV eller HCV upplever vårdpersonalens bemötande. Metod: En litteraturstudie som följer Polit och Becks (2017) nio steg. PubMed, PsycINFO och Cinahl är de databaser som användes för att söka fram artiklar. 15 artiklar ingick i resultatet, tolv kvalitativa, två mixed-methods och en kvantitativ. Granskningar av artiklarna gjordes med Polit och Becks (2017) granskningsmallar för kvalitativa och kvantitativa studier. Resultat: Fyra teman identifierades till resultatet. Patienterna hade både positiva och negativa erfarenheter av bemötandet från vårdpersonal. De teman som identifierades var Attityder, Nekad vård och vårdpersonalens rädsla för smitta, Bristande sekretess samt Positiva upplevelser av bemötande. Slutsats: Det framkom att flera patienter som lever med blodsmitta hade negativa upplevelser av bemötandet inom hälso- och sjukvården, men de belyser även de positiva erfarenheter de hade av bemötande från vårdpersonal.
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COSTA, Joanne Elizabeth Ferraz da. "Ocorrência de marcadores dos vírus da hepatite B e C e de infecção oculta pelo vírus da hepatite B em pacientes com hanseníase na Paraíba". Universidade Federal de Pernambuco, 2017. https://repositorio.ufpe.br/handle/123456789/24984.
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CAPES
Estudos têm reportado maiores prevalências de marcadores sorológicos do vírus da hepatite B (HBV) e da hepatite C (HCV) em pacientes hansênicos e sua associação com os episódios reacionais. Por outro lado, a deficiência imune apresentada por esses pacientes pode predispor à ocorrência de infecção oculta pelo HBV. O objetivo desta pesquisa foi determinar a prevalência e fatores de risco para os marcadores sorológicos do HBV e do HCV e para a infecção oculta pelo HBV em pacientes com hanseníase. Foi realizado estudo transversal no período de fevereiro de 2015 a janeiro de 2016 em pacientes de Centro de Referência em hanseníase na Paraíba, que após assinatura de termo de consentimento livre e esclarecido foram submetidos à entrevista e coleta de amostras sanguíneas. Os testes sorológicos (ELISA) foram realizados no Setor de Virologia do Laboratório de Imunopatologia Keizo Asami (LIKA) da Universidade Federal de Pernambuco (UFPE). Amostras de plasma foram encaminhadas ao Laboratório Central de Saúde Pública do Estado da Paraíba para estudo molecular (HBV DNA; HCV RNA) por PCR em tempo real. Foram incluídos 403 pacientes no estudo sorológico e 114 pacientes na pesquisa da infecção oculta (HBV DNA). Foi observada frequência de anti-HBc de 14,1% (57/403), de HBsAg 0% (0/403), de anti-HBs isolado 14,1% (57/403), de anti-HCV 0,5% (2/403) e de infecção oculta por HBV 5,3% (6/114). Quanto aos fatores de risco, identificou-se associação do anti-HBc com ter trabalhado na área de saúde e com um menor número de anos de estudo (até nove anos). Não foi observada associação do anti-HBc ou anti-HCV com episódios reacionais, porém identificou-se associação da infecção oculta pelo HBV com história de episódio reacional tipo 2. Assim, as prevalências dos marcadores do HBV e do HCV em hansênicos de Centro de Referência na região Nordeste foram semelhantes às da população geral da mesma região, sugerindo que estes pacientes não apresentam propensão para a infecção crônica por esses vírus. Este foi o primeiro estudo no Brasil sobre a infecção oculta pelo HBV em hansênicos, demonstrando que a pesquisa do HBV DNA deve ser considerada durante o acompanhamento do paciente com hanseníase, tendo em vista a possibilidade de ocorrência de infecção oculta nesses indivíduos. Estudos prospectivos que incluam maior número de pacientes poderão contribuir para uma melhor compreensão da influência da infecção oculta na evolução da hanseníase e em seu tratamento.
Studies have reported higher prevalence of serological markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) in leprosy patients and its association with reactional episodes. On the other hand, the immune deficiency presented by these patients may predispose to occult HBV infection. The objective of this study was to determine the prevalence and risk factors for HBV and HCV serological markers and for occult HBV infection in leprosy patients. A cross-sectional study was carried out from February 2015 to January 2016 with patients from a Leprosy Reference Center in Paraíba. After signing a free and informed consent form, these patients were interviewed and submitted to collection of blood samples. Serological tests (ELISA) were carried out in the Virology Sector of the Keizo Asami Immunopathology Laboratory (LIKA), Federal University of Pernambuco (UFPE), using commercial kits (HBsAg, Wiener; anti-HBc and anti-HBs, DiaSorin). Plasma samples were sent to the Central Public Health Laboratory of the State of Paraíba for molecular tests (HBV DNA; HCV RNA), using real-time PCR. A total of 403 patients were enrolled in the serological study and 114 patients in the occult HBV infection study. Anti-HBc frequency was 14.1% (57/403), HBsAg 0% (0/403), anti-HBs alone 14.1% (57/403), anti-HCV 0.5% (2/403) and occult HBV infection 5.3% (6/114). Regarding risk factors, we identified an association between anti-HBc and multibacillary leprosy classification, with health-related job and with fewer years of study (up to nine years). No association of anti-HBc or anti-HCV with reactional episodes was observed, but the association of occult HBV infection with a history of type 2 reaction episode was identified. Thus, the prevalence of HBV and HCV markers in leprosy patients of a Reference Center in Northest region were similar to that of the general population, suggesting that these patients are not prone to chronic infection by these viruses. This was the first study on occult HBV infection in leprosy patients in Brazil, demonstrating that HBV DNA screening should be considered during follow-up of leprosy patients, considering the possibility of occult infection in these individuals. Further prospective studies involving greater number of patients may contribute to a better understanding of the influence of occult HBV infection on leprosy evolution and its treatment.
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Gonzalez, Mario Peribañez. "Prevalência de hipovitaminose D e fatores de risco associados em pacientes portadores de HIV, HCV e coinfecção HIV/HCV na cidade de São Paulo". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-09032017-115725/.
Testo completoAbstract (sommario):
Introdução e Objetivos: Hipovitaminose D, definida como nível sérico de 25(OH)D insuficiente é considerada pandêmica em muitas populações ao redor do mundo e está associada a comorbidades em hepatite C, infecção por HIV e coinfecção HIV/HCV. Os objetivos deste estudo são: 1) comparar a prevalência de deficiência de vitamina D (DVD) caracterizada por nível sérico de 25(OH)D < 20 ng/mL, entre pacientes monoinfectados pelo HCV, monoinfectados pelo HIV, coinfectados HIV/HCV e participantes do grupocontrole; 2) identificar fatores de risco específicos associados com DVD na população estudada. Pacientes e Métodos: Foram coletados dados clínicos e demográficos, 25(OH)D sérica, testes de função hepática e perfil metabólico durante os meses de inverno de 129 pacientes HCV monoinfectados, 118 pacientes HIV monoinfectados e 53 pacientes coinfectados HIV/HCV tratados em centros de referência na cidade de São Paulo, bem como, em 122 indivíduos saudáveis de um grupo-controle formado de pessoas não infectadas por HIV, HCV ou HBV, sem uso de suplementos de vitamina D. Resultados: A prevalência de deficiência de vitamina D ajustada por sexo, idade ( = 50), cor de pele (branco vs não branco), índice de massa corporal ( = 25), colesterol total (= 200), fração HDL colesterol ( = 40 em homens = 50 em mulheres), triglicérides (= 150), glicemia ( = 110), uso de efavirenz (sim vs não), uso de tenofovir (sim vs não) e índice HOMA-IR, foi menor no grupo HCV do que no controle e no grupo HIV (p < 0.001). Em todos os grupos, a razão de chance de DVD aumenta 1.21 [IC95%(1.01; 1.44) p=0.026] para cada ponto de aumento do índice HOMA. Efavirenz também esteve associado com maior razão de chance de DVD [3.49(IC95% 1.14-10.67) p=0.028]. Análise por regressão logística simples foi aplicada para avaliar fatores de risco associados a DVD dentro de cada grupo. Nesta análise, resultaram com associação significativa o sexo masculino, com uma menor razão de chance para DVD [RC 0,42(IC95% 0,18 - 0,96) p = 0,04] no grupo-controle e no grupo HCV [RC 0,42(IC95% 0,2 - 0,88) p = 0,02]; ainda no grupo HCV houve associação significativa entre DVD e HOMA-IR elevado [RC 5,59(IC 95% 1,37 - 22,8) p = 0,02]; e, no grupo HIV, os indivíduos que apresentaram nadir histórico de CD4 maior que 200 células/mm3 tiveram menos chance de DVD [RC 0,41 (IC95% 0,18 - 0,95) p = 0,04]. Conclusão: Uma alta prevalência de DVD foi observada em toda a população estudada, incluindo o grupo-controle, sugerindo que a apresentação de infecção por HIV e/ou HCV por si só não aumenta as chances de DVD. Por outro lado, o incremento do índice HOMA e o uso de efavirenz se destacaram como fatores de risco nesta população. Estes achados ressaltam a importância da associação da deficiência de vitamina D com outras duas condições; a resistência à insulina e o uso de terapia antirretroviral para o HIV, os quais, isoladamente ou em combinação, podem aumentar a incidência de comorbidades como o diabetes do tipo 2Background and Aims: Hypovitaminosis D, defined as insufficient serum level of 25(OH)D, is considered pandemic in many populations worldwide and is associated with co-morbidities in hepatitis C, HIV and HIV/HCV co-infection. The aim of this study is to 1) compare the prevalence of 25-hydroxyvitamin D deficiency (VDD), defined as serum levels of 25(OH)D < 20 ng/mL, among HCV mono-infected, HIV mono-infected, HIV/HCV co-infected patients and control participants and 2) identify specific risk factors associated with VDD in each group. Patients and Methods: We collected demographic and clinical data, serum 25-hydroxyvitamin D, liver function parameters and metabolic profiles on 129 HCV mono-infected, 118 HIV mono-infected and 53 HIV/HCV co-infected patients treated at reference centers in São Paulo (Brazil) as well as on 122 volunteer controls, not infected by HIV, HCV, HBV or taking vitamin D supplements. Results: VDD prevalence adjusted for sex, age ( = 50), skin color (white vs not white), body mass index ( = 25), total cholesterol (= 200), HDL cholesterol ( = 40 in men and = 50 in women), triglycerides ( = 150), glycemia ( = 110), use of Efavirenz - EFV (yes vs no), use of Tenofovir -TDV (yes vs no) and HOMA-IR was lower in HCV group than control and HIV groups (p < 0.001). In all groups, adjusted odds of VDD increases by 1.21 [CI95% (1.01-1.44)] for each unit increase of HOMA-IR. Antirretroviral therapy regimens containing efavirenz were also associated to higher odds of VDD 3.49 [CI95% (1.14-10.67) p=0.028]. Logistic regression was applied to analyze risk factors associated to VDD within each group. In this analysis male sex resulted significantly associated to lower chance of VDD [OR 0,42(CI95% 0,18 - 0,96) p = 0,04] in control group and in HCV group [RC 0,42(CI95% 0,2 - 0,88) p = 0,02]; still in HCV group, elevated HOMA-IR was significantly associated to VDD [OR 5,59(CI 95% 1,37 - 22,8) p = 0,02]; and in HIV group, individuals presenting CD4 nadir higher than 200 cells/mm3 had less chance of VDD [OR 0,41 (IC95% 0,18 - 0,95) p = 0,04]. Conclusion: High prevalence of VDD was observed across all studied population, including control group, suggesting that being infected with HIV and/or HCV per se does not increase the chance of VDD. Otherwise, VDD was positively associated with HOMA-IR increase for controls and infected patients. It is also associated to use of Efavirenz in HIV/HCV patients. This finding highlights the relevance of vitamin D deficiency association with two other conditions; insulin resistance and antiretroviral therapy, which isolated or in combination, may contribute to the incidence of comorbidities, as Type 2 diabetes mellitus
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Kaya, Selçuk Cicioğlu Arıdoğan Buket. "Isparta il merkezi kan donörlerinde GBV-C/HGV prevalansı ve HBV ve HCV ile koinfeksiyonunun araştırılması /". Isparta : SDÜ Tıp Fakültesi, 2002. http://tez.sdu.edu.tr/Tezler/TT00093.pdf.
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Li, Dongsheng. "The role of HCV core protein in the regulation of HCV replication /". St. Lucia, Qld, 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18009.pdf.
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Alles, Roxane. "Développement de nouveaux nanovecteurs pour les thérapies anti-HCV/HCC". Phd thesis, Université de Strasbourg, 2013. http://tel.archives-ouvertes.fr/tel-00998936.
Testo completoAbstract (sommario):
Ce travail concerne le développement d'un système de vectorisation nanoparticulaire pour l'interférence ARN, constituant une nouvelle proposition thérapeutique applicable à des pathologies virales ou tumorales, et possiblement complémentaire aux traitements existants. La vectorisation de siRNA est ici basée sur l'enrobage multicouche de nanoparticules de phosphate de calcium, la multicouche étant constituée de dépôts alternés de PEI modifié et de siRNA. Ce système permet d'obtenir une efficacité de transfection des cellulaires cibles supérieure à celle des procédés conventionnels et une rémanence fonctionnelle in vitro jusqu'à neuf jours. Les résultats d'interférence ARN obtenus ont permis notamment d'inhiber l'infection par le virus de l'hépatite C jusqu'à 99,95%, l'inhibition de l'expression d'une protéine intrinsèque jusqu'à90,5%, et le ralentissement de la croissance cellulaire dans un modèle 3D mimant une tumeur hépatique jusqu'à 46,5%. Ces nanoparticules pourraient présenter un intérêt majeur, en offrant une action à long terme et en résolvant la plupart des difficultés rencontrées en utilisant des siRNA en thérapie.
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Ушеніна, Л. О., Л. Ю. Сиянова e О. В. Рябоконь. "Епідеміологічні особливості HCV-інфекції". Thesis, Вид-во СумДУ, 2006. http://essuir.sumdu.edu.ua/handle/123456789/13674.
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Ward, Scott Matthew. "Towards an HCV vaccine /". St. Lucia, Qld, 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16402.pdf.
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Potter, Martin. "Estimating variations between health care centres in the uptake of Hepatitis C Virus (HCV) treatment in HIV-HCV co-infected patients". Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114160.
Testo completoAbstract (sommario):
The effect of Health Care Centres on uptake of Hepatitis C Virus (HCV) treatment in HIV-HCV co-infected patientsBackgroundThe purpose of the study was to investigate the effect of health care centres on HCV treatment uptake after adjusting for case-mix variables. Methods Using data from the Canadian Co-infection Cohort, we modelled time to HCV treatment uptake using a Bayesian survival analysis model with random intercepts for each of the 16 cohort centres. To take into account variability in patient populations served at each centre (case-mix), models were adjusted for age, gender, ethnicity, HCV genotype; and at cohort enrolment, duration of HCV infection, receipt of combination antiretroviral therapy, history of psychiatric illness ,CD4 cell count, and self-reports of homelessness, use of intravenous drugs, and current use of alcohol. Variation between centres in treatment uptake was estimated and centres ranked according to their rate of starting patients on HCV treatment. Results Among 996 cohort participants, 390 were excluded (past HCV treatment n=170, spontaneous clearance n=50, contribution of only enrolment data n=160 and missing baseline CD4 cell count n=10). Of the remaining 606 participants, 122 started HCV treatment. Patients with more favourable HCV genotypes (2 or 3) were more likely to initiate treatment. Two centres more frequently initiated patients on HCV treatment while one centre did so less often. Conclusions After adjustment for case-mix, there was still appreciable variation in treatment uptake between centres. Determining the factors associated with higher HCV treatment rates at two centres may be informative for improving wider access to HCV treatment for co-infected persons.Objectif: L'objectif de cette étude mieux est de déterminer l'impact que les centres de sante ont sur l'initiation de traitement à l'infection du VHC chez les patients ayant une coïnfection par le VIH, suite à un ajustement des caractéristiques « case-mix ». Méthode: Utilisant les données obtenues de la Cohorte Canadienne de Co-Infection, des analyses de survie, via une méthode bayésienne, furent entamées avec des interceptes aléatoires pour chacun des 16 centres. Afin de prendre en considération les variations entre les centres, les modèles furent ajustés pour les variables « case-mix » : l'âge, genre, ethnicité, génotype VHC; et a l'admission dans la cohorte, durée de l'infection au VHC, prise d'antirétroviraux, antécédents de maladies psychiatriques, taux de CD4, itinérance, usage de drogue intraveineuse, et usage d'alcool. Les différences entre les centres de sante sur les taux d'initiations au traitement du VHC furent déterminées, et les centres furent classés selon leur taux d'initiation de traitement. Résultats: Parmi les 996 participants de la cohorte, 390 furent exclus (traitement du VHC dans le passé n=170, éradication spontanée n=50, contribution d'une seule donnée n= 160, valeur de CD4 manquante n=10). Sur les 606 participants restants, 122 ont débuté un traitement. Les participants ayant un génotype favorable (2 ou 3) étaient plus prédisposés à débuter un traitement. Les participants de deux centres avaient un taux plus élevé de traitement au VHC, tandis qu'un centre avait un taux d'initiation au traitement inférieur. Conclusions: Apres ajustement des variables « case-mix », il demeure une variation appréciable entre les divers centres de santé sur les taux d'initiation au traitement de l'infection au VHC. Déterminer les facteurs associés aux deux centres ayant le plus haut taux d'initiation au traitement pourrait donner une piste permettant d'augmenter l'accessibilité au traitement du VHC pour les gens ayant une coïnfection VIH-VHC.
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d'Avigdor, William Mark Henry. "Differential gene expression in HCV liver injury". Thesis, The University of Sydney, 2015. http://hdl.handle.net/2123/13896.
Testo completoAbstract (sommario):
Chronic hepatitis C virus (HCV) infection causes liver disease that can lead to cirrhosis and hepatocellular carcinoma (HCC). The predominant HCV genotypes in Australia (G1 and G3) differ in the pathogenesis of liver injury and treatment response, but the molecular mechanisms are not well defined. The aim of this research is to determine specific HCV genotype differences in the global mRNA and miRNA expression associated with HCV induced liver injury. The mRNA transcriptome and miRNA expression of HCV induced liver injury (G1 or G3) was characterised in progressive liver injury, advanced cirrhosis from individuals with and without HCC compared with non diseased liver using Illumina Whole genome BeadChip Arrays and Taqman Low Density Arrays. Further, the mRNA expression of HCV genotype-specific core chimeric JFH1 infected Huh 7 cells following lipid loading was similarly characterised. In progressive liver injury, HCV genotype is associated with the greatest variation in gene expression between individuals. There is increased expression of interferon stimulated genes, inflammation and fibrosis genes in G3, and increased expression of fatty acid degradation and cholesterol transport associated genes in G1. In advanced cirrhosis, the cirrhotic gene signature masks the genotype specific gene expression patterns. No gene signature distinguishes cirrhotic liver injury from individuals with and without HCC. The miRNA expression is associated with the severity of disease with no HCV genotype specific differences identified. The mRNA transcriptome of a hepatic cell line infected with chimeric HCV specific for the HCV core protein is consistent with the in vivo analysis with increased expression of genes associated with fibrosis and proliferation in G3, but no differences were observed in fatty acid metabolism. In conclusion, the HCV genotype specific differences in gene expression are more defined in progressive liver injury compared with changes seen in advanced cirrhosis.
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Eisner, Christopher W. "Predicting Incidences of HCV and Advanced-Stage HCV Outcomes from the Opioid Epidemic". The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1595616293410679.
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Judge, Chelsey J. "IL-7-MEDIATED CD56BRIGHT NK CELL FUNCTION IS IMPAIRED IN HCV IN PRESENCE AND ABSENCE OF CONTROLLED HIV INFECTION, WHILE CD14BRIGHTCD16- MONOCYTES NEGATIVELY CORRELATE WITH CD4 MEMORY T CELLS AND HCV DECLINE DURING HCV-HIV CO-INFECTION". Case Western Reserve University School of Graduate Studies / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=case1481187921533387.
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Souza, Rafael Leme Cardoso. "Avaliação tecnológica do teste molecular (NAT) para HIV, HCV e HBV na triagem de sangue no Brasil". Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/99/99131/tde-09102018-090250/.
Testo completoAbstract (sommario):
Após anos de debates, o teste de detecção de ácidos nucleicos (NAT) para HIV e HCV na triagem de sangue foi implementado de forma obrigatória no Brasil em 2013, e HBV, em 2016. Um dos motivos citados sobre o atraso em sua implementação foi o custo elevado que seria adicionado à sorologia e, até o momento, uma ampla avaliação econômica em saúde (AES) a respeito de sua eficiência no país não está disponível. Diversos artigos já demonstraram que a razão incremental de custo-utilidade (ICUR) do NAT em relação à sorologia varia de 0,21 a 8,84 milhões de dólares americanos (US$) para cada QALY ganho. Esta grande variação dá-se, principalmente, por diferenças entre a idade média dos receptores de sangue (RS), incidência/prevalência dos vírus entre os doadores de sangue (DS), custo dos testes e tratamentos médicos, cobertura da vacina contra o HBV e sensibilidade do teste utilizado. Assim, faz-se necessária uma avaliação abrangente desta tecnologia e sua efetividade para o cenário brasileiro. Objetivos: Realizar uma revisão sistemática (RevS) de estudos econômicos completos sobre o uso do NAT para HIV, HCV e/ou HBV no mundo; realizar a AES sobre o NAT sob a perspectiva pública brasileira; caracterizar as doações de sangue em janela imunológica no país. Métodos: Metodologia Cochrane de RevS das bases de dados Medline, Embase, LILACS, CRD, BVS ECO, Google Scholar e IDEAS; questionário aplicado aos bancos de sangue e modelo econômico on-line da International Society of Blood Transfusion (ISBT) para cálculo da ICUR do \"NAT em mini-pool de seis amostras individuais\" (MP6) versus \"testes sorológicos\" (SR) no Brasil. Resultados: Quatorze estudos de dezesseis diferentes países foram avaliados. O NAT apresentou a maior relevância nos países de baixa renda, onde há as maiores prevalências e incidências virais, menores taxas de doadores de repetição (DR) e RS mais jovens. A maioria dos estudos concluiu que o NAT, independente do vírus analisado, não é custo-efetivo. As principais diferenças entre as características dos estudos foram relacionadas aos custos médicos e idade dos RS. O maior desvio dos padrões de uma RevS foram: não incluir o racional para definição dos desfechos e o modelo utilizado e não ter claro o conflito de interesse dos autores; para esta AES, o MP6 versus SR apresentou um ICUR de US$ 231.630,00/QALY, ou seja, 26,2 vezes o PIB per capita nacional) e um ICER de US$ 330.790,00/Ano de vida ganho (AVG). A análise de sensibilidade univariada do modelo demonstrou que somente a taxa de desconto, idade do RS, custo do NAT e epidemiologia dos vírus alteraram de forma significativa o ICUR obtido, variando desde US$ 76.957,00/QALY a US$ 933.311,00/QALY; a maioria dos casos de janela imunológica no Brasil são jovens, média de 29 anos, do sexo masculino, com pelo menos o ensino médio completo e mesmo com a obrigatoriedade do Anti-HBc no Brasil, o NAT-HBV é o que apresentou o maior rendimento. Conclusões: Os jovens, principalmente, ainda buscam os bancos de sangue como locais de testagem após comportamento de risco e é de extrema importância a revisão do custo real e completo do teste NAT no Brasil para ampla abordagem da tecnologia nacional incorporada e, se necessário, revisar a forma e modelo de reembolso da mesma e permitir a defesa do bem-estar da população e do bem público.After years of discussion, nucleic acid (NAT) testing in the blood screening for HIV and HCV was implemented in Brazil in 2013 and HBV in 2016. One of the reasons cited for the delay in its implementation was the high cost that would be added to serology screening and a comprehensive economic assessment of its efficiency in the country is not yet available. Several articles have already shown that the incremental cost-utility ratio (ICUR) of NAT versus serology ranges from 0.21 to 8.84 million American dollars (US$) for each QALY gained. This large variation is mainly due to differences between the mean age of the blood recipient, viruses\' incidence / prevalence among donor population, cost of medical tests and treatments, HBV vaccine coverage, and sensitivity of the test used. Thus, a comprehensive evaluation of this technology and its effectiveness under the perspective of the Brazilian public health system (SUS) is needed. Objectives: Development of a systematic review (RevS) of complete economic studies about the use of NAT for HIV, HCV and / or HBV in the world. Conduct an economic evaluation of NAT under SUS perspective; characterize Brazilian blood donations in the serology \"window period\". Methods: Cochrane RevS Methodology of the Medline, Embase, LILACS, CRD, CRD ECO, Google Scholar and IDEAS databases; Questionnaire applied to blood banks and online economic model from the International Society of Blood Transfusion (ISBT) to calculate the ICUR for \"NAT in mini-pool of six individual samples\" (MP6) versus \"Serology Tests\" (SR) in Brazil. Results: Fourteen studies from sixteen different countries were assessed. NAT was most relevant in low-income countries, where there are the highest prevalences and viral incidences, lower rates of repeat donors and younger recipients of blood (RS). Most of the studies concluded that NAT, regardless of the virus evaluated, is not cost-effective. Differences in the characteristics of the studies were related to the costs and age of RS. The major deviations from RevS standards were: not including the rationale for selecting the outcomes and the model used and not being clear about the authors\' conflict of interest; MP6 vs SR showed an ICUR of US$ 231.630,00/QALY, 26,2 times Brazilian GND per capita) and an ICER of US$ 330.790,00/Life year gained (AVG). The univariate sensitivity analysis of the model demonstrated that only changes on discount rate, NAT cost, RS age and viruses\' epidemiology significantly altered the ICUR in a range between US$ 76.957,00/QALY and US$ 933.311,00/QALY; Most RS window period cases in Brazil are young, average of 29 years old, male, with at least high school education completed and even with the requirement of Anti-HBc in Brazil, NAT-HBV is the one that presented the highest yield. Conclusions: Young people, mainly, still seek blood banks as testing sites, especially after a risk behavior. It is extremely important to reveal the real and complete cost of the Brazilian NAT to fully evaluate its efficiency and, if needed, reassess its current reimbursement model, allowing the wellbeing defense of the population and public interest.
27
Keim, Hannah [Verfasser]. "Nicht-invasive Fibrosegradbestimmung bei Patienten mit HIV-Monoinfektion und Anzeichen für chronische Leberveränderungen im Vergleich zu Patienten mit HIV/HCV-Koinfektion und HCV-Monoinfektion / Hannah Keim". Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2013. http://d-nb.info/1043197133/34.
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Malin, Jakob Johannes [Verfasser]. "Regression der Lebersteifigkeit nach Ausheilung der Hepatitis C : Eine vergleichende Analyse bei HCV mono- und HCV/HIV koinfizierten Patienten / Jakob Johannes Malin". Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1161527753/34.
Testo completo
29
Müntefering, Alexander Felix [Verfasser], Gabriele [Gutachter] Arendt e Torsten [Gutachter] Feldt. "Einfluss einer HCV-Eradikationstherapie auf die motorischen und neurokognitiven Fähigkeiten HIV/HCV-koinfizierter Patienten / Alexander Felix Müntefering ; Gutachter: Gabriele Arendt, Torsten Feldt". Düsseldorf : Universitäts- und Landesbibliothek der Heinrich-Heine-Universität Düsseldorf, 2020. http://d-nb.info/1217480293/34.
Testo completo
30
Matsukura, Motoi. "Highly active anti-retroviral therapy and liver mitochondrial toxicity in human immunodeficiency virus / hepatitis C virus co-infection". Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/2517.
Testo completoAbstract (sommario):
Background: A third of HIV-infected patients are co-infected with HCV in the developed world, and more of co-infected patients than ever before are dying because of liver related diseases today. Drug-related hepatotoxicity is a growing concern among human immunodeficiency virus (HIV) / hepatitis C virus (HCV) co-infected population. Nucleotide analogues containing HIV antiretroviral therapy, namely highly active anti-retroviral therapy (HAART), can induce mitochondrial toxicity. However, little is known about the effect of nucleotide analogues on the liver at the cellular and molecular level, and how it may affect treatment.
Objective: To investigate whether liver tissue from HIV/HCV co-infected individuals will show greater liver mitochondrial toxicity if currently receiving antiviral HIV medication, compared to those who are not taking it.
Methods: Liver biopsies were collected from 23 HIV/HCV co-infected males. Fourteen patients were on stable HAART (ON-HAART) and 9 were OFF-HAART, including 4 who stopped HAART >6 months prior and 5 who were HAART-nave. Liver mitochondrial toxicity was assessed by transmission electron microscopy-based quantitative stereological analyses of hepatocyte and mitochondrial morphometry, as well as by mitochondrial DNA (mtDNA) and mtRNA (COX1/(ß-actin) real-time-PCR quantification.
Results: Hepatocytes tended to be larger in the ON-HAART group than in the OFF-HAART group (p=0.05), but they both showed similar mitochondrial volume fraction of the cell and mitochondrial crista density. Liver mtDNA and mtRNA levels were not significantly differentbetween ON-HAART and OFF-HAART. Hepatocyte lipid accumulation was significantly higher in HCV genotype 3 compared to genotype 1 infection ()=0.002), but was not associated with HAART status.
Conclusions: We found no evidence or trend of increased mitochondrial toxicity in HIV/HCV co-infected individuals currently on HAART compared to those who are not. This finding could be relevant to the decision-making process with respect to initiating HCV therapy in this population.
31
Zecher, Britta Franziska [Verfasser], e Robert [Akademischer Betreuer] Thimme. "Charakterisierung adaptiver NK-Zellen bei der chronischen HBV- und HCV-Infektion". Freiburg : Universität, 2019. http://d-nb.info/1197536469/34.
Testo completo
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Fialho, Renata. "Neuropsychiatric manifestations of hepatitis C treatment in HIV/HCV co-infection". Thesis, University of Sussex, 2017. http://sro.sussex.ac.uk/id/eprint/71260/.
Testo completoAbstract (sommario):
Hepatitis C (HCV) infection is associated with high rates of mortality and morbidity. Interferon alpha based treatment for HCV offers a good rate of viral clearance, however the associated neuropsychiatric side effects increase the risk of treatment interruption and disease progression. The HIV/HCV coinfection is of particular interest due to association with higher rates of HCV treatment side effects and earlier treatment discontinuation when compared with HCV mono-infection. Therefore, the aim of the thesis was to further explore the effect of coinfection on mood and cognition and how HCV interferon based treatment influences neuropsychiatric side effects in mono and co-infected samples. Firstly a meta-analysis was performed to explore cognitive impairment and depression in HIV HCV co-infection. The results suggested that there was consistent literature indicating that the coinfected group were more cognitively impaired and more likely to be depressed than the HCV and HIV monoinfected groups. Secondly empirical studies were conducted to analyse the profile of depression during interferon-based treatment, and explore potential risk factors, such as gender and immune profile. Co-infected patients appeared less vulnerable to the emergence of depressive symptoms during HCV treatment than HCV mono-infected patients. Additionally, neither female gender nor immune response were associated with increased vulnerability to depression. Finally, a longitudinal study investigating cognitive performance during interferon-based treatment was conducted. A significant effect of treatment on information processing speed level of executive function was observed. Overall the research reported in this thesis further clarifies the nature of interferon induced depression and cognitive effects differences between mono and coinfected groups. Having identified a neurovegetative symptom profile and speed of processing impairment of executive function during HCV treatment, the discussion considers the potential of targeted interventions via psychotropic medication and cognitive interventions to minimise the impact of these treatment effects and optimise outcomes in this clinical group.
33
Alemayehu, Amare Eshetu. "Analysis of HCV Coinfections among Newly Diagnosed HIV Cases in Germany". Doctoral thesis, Humboldt-Universität zu Berlin, 2021. http://dx.doi.org/10.18452/22502.
Testo completoAbstract (sommario):
In Anbetracht der enormen Verbesserung der HCV-Therapie durch die Entwicklung hochwirksamer und direkt wirkender Virostatika (DAA) dient diese Studie der Analyse von HCV-Koinfektionen unter den gemeldeten HIV-Neudiagnosen in Deutschland. Zunächst wurde die Eignung zweier kommerzieller HCV Ag/Ab ELISAs, dem Murex (Abbott) und dem Monolisa (Bio-Rad), zum Nachweis von HCV in getrockneten Serumspots (DSS) verglichen. Der Murex-ELISA zeigte sich sensitiver bei Antigen-positiven Plasma-HCV-Serokonversionsproben während der Monolisa eine höhere Sensitivität bei HCV-Antikörper-positiven DSS-Eluaten. Des Weiteren wurde ein Aviditätstest zur Unterscheidung von neuen und bereits länger bestehenden Infektionen bei einem Aviditätsindex Cut-off von 40% und einem Zeitraum von 364 Tagen etabliert. Von den insgesamt 6.097 untersuchten Proben der Jahre 2015-2017 waren 396 HCV-ELISA-reaktiv (6,5%). Von diesen wurden 256 (64,6%) als aktive und 140 (35,4%) als ausgeheilte Infektionen identifiziert. Ein hoher Anteil der HCV-Koinfektionen wurde bei intra-venösen Drogenkonsumenten (77,8%, n=168/216), in der Altersgruppe der 30-39 Jährigen (9%, n=179/1.978) und bei Menschen osteuropäischer Herkunft (38,3%, n=124/324) beobachtet. Im Vergleich zum Jahr 2016 hat sich der Anteil der ausgeheilten Infektionen im Jahr 2017 bei der Gesamtzahl der Patienten (p<0,01) sowie insbesondere bei Personen ausländischer (p<0,01) und osteuropäischer (p<0,05) Herkunft erhöht. Die HCV Subtypen (St)-1a, St-3a und St-1b waren mit 33,9% (n=79/233), 33,5% (n=78/233) und 23,3% (n=52/233) vorherrschend. Der Anteil der St-1a- und St-1b-Proben, deren HCV-Sequenz gegen DAAs resistent ist, war in allen untersuchten Jahren hoch (25%-42,9%). Der beobachtete Anstieg des Anteils der ausgeheilten HCV-Koinfektionen kann auf die DAA-Therapie zurückgeführt werden. Es sind jedoch weitere Anstrengungen erforderlich, damit Gruppen mit weiterhin hoher HCV-Prävalenz von dieser Behandlung profitieren.In light of the major shift in HCV therapy resulting from the availability of highly potent direct acting antivirals (DAA), this study performed a surveillance of HCV coinfections among reported HIV new diagnoses in Germany. First the suitability of two HCV Ag/Ab ELISAs, Murex (Abbott) and Monolisa (Bio-Rad) for dried serum spots (DSS) was compared. The Murex was more sensitive in antigen positive plasma HCV seroconversion samples while the Monolisa showed a higher sensitivity in HCV antibody positive DSS eluates. Furthermore, an avidity test was established to distinguish between new and already longer existing infections at an avidity index cut-off of 40% and a period of 364 days. Of the total of 6,097 samples examined for the years 2015-2017, 396 were HCV ELISA reactive (6.5%). Of these, 256 (64.6%) were identified as active and 140 (35.4%) as resolved infections. A high proportion of HCV coinfections were observed in intravenous drug users (77.8%, n=168/216), in the age group 30-39 years (9%, n=179/1,978) and in people of Eastern European origin (38.3%, n=124/324). Compared to 2016, the proportion of resolved infections in 2017 has increased in the total number of patients (p<0.01) and especially in people of foreign (p<0.01) and Eastern European (p<0.05) origin. HCV subtypes (St)-1a, St-3a, and St-1b were predominant with 33.9% (n=79/233), 33.5% (n=78/233) and 23.3% (n=52/233), respectively. The proportion of St-1a and St-1b samples whose HCV sequence has resistance to DAAs was high in all diagnoses years (25%-42.9%). The observed increase in the proportion of resolved HCV coinfections can be attributed to DAA therapy. However, further efforts are needed to ensure that groups with continued high HCV prevalence benefit from this treatment.
34
Loughlin, Anita Marie. "Access to antiviral medication for HIV and HCV infected drug users". Available to US Hopkins community, 2003. http://wwwlib.umi.com/dissertations/dlnow/3080718.
Testo completo
35
Tuthill, Tobias J. "Construction expression and preliminary biological analysis of HCV and HCV-dengue chimeric virus genomes". Thesis, Imperial College London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368893.
Testo completo
36
Zhou, Yu. "HCV, Heroin Use, and MicroRNAs". Diss., Temple University Libraries, 2014. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/309425.
Testo completoAbstract (sommario):
PathologyPh.D.
Hepatitis C virus (HCV) infection is common among injection drug users (IDUs). There is accumulating evidence that circulating microRNAs (miRNAs) are related to HCV infection and disease progression. The present study was undertaken to determine the in vivo impact of heroin use on HCV infection and HCV-related circulating miRNA expression. Using the blood specimens from four groups of study subjects (HCV-infected individuals, heroin users with/without HCV infection, and healthy volunteers), we found that HCV- infected heroin users had significantly higher viral load than HCV-infected non-heroin users (p=0.0004). Measurement of HCV-related circulating miRNAs in plasma showed that miRs-122, 141, 29a, 29b, and 29c were significantly increased in the heroin users with HCV infection, whereas miR-351, an HCV inhibitory miRNA, was significantly decreased in heroin users as compared to control subjects. Further investigation identified a negative correlation between the plasma levels of miR-29 family members and severity of HCV infection based on aspartate aminotransferase to platelet ratio index (APRI). Heroin use and/or HCV infection also dysregulated a panel of plasma miRNAs. Taken together, these data for the first time revealed in vivo evidence that heroin use and/or HCV infection alter circulating miRNAs, which provides a novel mechanism for the impaired innate anti-HCV immunity among IDUs. Recent studies revealed that extracellular miRNAs were able to incorporate into cell-derived exosomes as a method of cell-to-cell interaction. Exosomes are a class of cell-released small vesicles that mediate intercellular communication by delivering functional factors to recipient cells. During HCV infection, the interaction between liver resident macrophages and hepatocytes is important for host defense and viral elimination, triggered by innate immune activation, especially Toll like receptors (TLR). In our study, we explored the role of macrophage-derived exosomes in the transmission of innate immune responses against HCV infection in hepatocytes, and the involvement of exosomal miRNAs in transferring the anti-HCV activities. We reported that upon TLR3 activation, macrophages shed exosomes that were able to attenuate HCV-JFH1 infection in Huh7 cells. We further demonstrated that exosomes from poly I:C treated macrophages were internalized by Huh7 cells, which induced the intercellular anti-HCV responses (type I interferon, interferon stimulated genes, etc.) and thus drastically inhibited HCV infection in Huh7 cells. Moreover, using an in vitro macrophage and Huh7 cell co-culture model, we also found exosomes mediated HCV suppression in Huh7 cells after TLR3 activation. The presence of exosome inhibitor in co-culture compromised the anti-HCV activity by TLR3-activated macrophages. Interestingly, the miRNA-29 family, which was reported to suppress HCV infection, was significantly increased in the macrophage exosomes after TLR3 activation. The inhibition of miRNA-29 partially compromised the anti-HCV activity of TLR3-activated macrophages, indicating the potential involvement of exosomal miRNAs in the transmission of anti-HCV activity from macrophages to Huh7 cells through exosomes. In conclusion, this study proposed an antiviral mechanism of TLR3 activation that involves the intercellular communication between immune cells and hepatic parenchymal cells via exosomes, and exosomal miRNAs. This discovery sheds light on exploiting the therapeutic potential of new drugs against HCV infection.
Temple University--Theses
37
Marraiki, Najat A. Y. "Recombinant virus like particles comprising hepatitis C virus (HCV) structural proteins and HCV replicon RNA". Thesis, University of Leeds, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.422629.
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38
Simões, Cristiane Araújo. "Frequência do HCV-RNA em Amostras de Soro e Saliva de Pacientes Anti-HCV Positivos". Universidade Federal de Pernambuco, 2012. https://repositorio.ufpe.br/handle/123456789/12566.
Testo completoAbstract (sommario):
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A pesquisa do vírus da Hepatite C (HCV) em outros fluidos corporais além do sangue é importante quando se avalia a existência de outras possíveis vias de transmissão, afinal cerca de 40% dos pacientes contaminados não apresentam história de exposição por via parenteral. A presença do RNA do HCV (RNA-HCV) na saliva de indivíduos infectados foi observada em alguns trabalhos e esta vem sendo sugerida como uma possível via de transmissão. No entanto, o papel dos fluidos orais na transmissão do HCV permanece controverso. O objetivo deste trabalho foi identificar o HCV-RNA na saliva e no soro de pacientes anti-HCV positivos. Foi realizado um estudo transversal com uma amostra de conveniência composta por 50 pacientes atendidos no Setor de Gastroenterologia do Hospital das Clínicas de Pernambuco (HC-UFPE) no período de junho a setembro de 2011. Amostras de sangue e saliva foram coletadas e processadas. O HCV-RNA foi extraído e uma alíquota utilizada na RT-PCR. O HCV-RNA foi detectado em 82% (41/50) das amostras de soro e em 0% das amostras de saliva. Pela metodologia empregada neste trabalho, não houve presença do HCV-RNA em saliva.
39
Grint, D. "The natural history, treatment strategies and clinical outcomes of HIV/HCV coinfection". Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1470765/.
Testo completoAbstract (sommario):
While the rate of AIDS-related death has declined, as a consequence of the effectiveness of antiviral treatment for HIV, HIV/HCV coinfection and in particular liver-related death (LRD) has assumed increasing importance. This thesis aims to analyse important epidemiological areas of HIV/HCV coinfection to improve the knowledge base of the subject and provide guidance to clinicians in a fast moving area of research. Data for this thesis are from the EuroSIDA study, which is a large multi-centre pan-European prospective observational cohort study with over 18,000 HIV-positive individuals including approaching 5,000 HIV/HCV coinfected individuals. The study was initiated in 1994 and continues to expand and diversify to meet current research needs. Results from the studies included in this thesis have shown that treatment for HIV in coinfected individuals can also have a beneficial effect on the natural course of HCV, with HCV viral load remaining stable over time in those treated for HIV compared with increasing HCV viral load in those not yet treated. The incidence of treatment for HCV has steadily increased in Europe to 4.7 per 100 PYFU in 2010, but remains low with just 25% of eligible patients receiving treatment. LRD accounts for more than a fifth of deaths in this population, with significant liver fibrosis and those triple infected with HBV at increased risk. The 5-year probability of LRD is low for those with F0/F1 fibrosis (2.2%), but increases substantially for those with F2/F3 (10.3%) and F4 (14.0%) fibrosis. With potent new treatments for HCV coming to market, it is clear that while they remain prohibitively expensive they should be targeted at those at the greatest risk of LRD. The prognostic LRD score derived here will help clinicians to make difficult decisions on who should be prioritised for HCV treatment.
40
England, Kirsty Anne. "Paediatric HCV and HIV infection : mode of acquisition, progression and co-infection". Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1444156/.
Testo completoAbstract (sommario):
In this thesis a diverse range of topics related to paediatric HIV and HCV infection are investigated information is provided on the more specific areas of coinfection, disease monitoring methodologies and the impact of mode of acquisition of infection. Four unique epidemiological cohorts of vertically and parenterally HIV, HCV and HIV/IICV coinfcctcd children are analysed. ALT reference ranges adjusted for age and sex in children under five years of age show that ALT levels greater than 60U/1 in boys and 55U/1 in girls should be regarded as elevated in the first 18 months of life while thereafter the upper limits of normal ALT levels are lower 40U/1 in boys and 35U/1 in girls. There are no differences found between vertically and parenterally HCV-only infected groups in their genotype profile, proportion with consistent viraemia, consistently elevated ALT levels or evidence of two or more markers of disease progression. Parenterally HIV infected children are described for the first time and only 12% found to progress to moderate/severe clinical symptoms or immunosuppression during follow-up. The lack of treatment in this group (11% treated) suggests a more favourable disease progression in parenterally than vertically HIV infected children. The possible detrimental effects of ART on ALT levels in HIV/HCV coinfected children are demonstrated along with the possible need for differential management of children infected via different routes given the faster progression to immunosuppression in parenterally coinfected children. The survey of current practices and policies for care of HIV/HCV coinfected children reveals that in general the management practices vary widely in terms of testing high risk groups for coinfection, which laboratory tests to carry out in comparison to those performed on HIV- only and HCV-only infected children and the opinions on optimal treatment for this group emphasise the importance of research in this area to inform clinical guidelines.
41
Thomson, Emma Cassandra. "Acute HCV in HIV positive men : viral evolution and cellular immune responses". Thesis, Imperial College London, 2011. http://hdl.handle.net/10044/1/6812.
Testo completoAbstract (sommario):
Background: The natural history of early HCV infection has been only partially characterised previously, as primary infection is usually asymptomatic. An emerging epidemic of acute HCV virus (HCV) infection in HIV-positive men in Europe, Australia and the USA has allowed the recruitment of new cohorts of patients with early HCV. We aimed to describe the natural history of virus evolution and cellular immune responses in a rare cohort of acute HCV infected HIV-positive patients in order to identify key determinants of spontaneous clearance. Methods: 110 patients were recruited and followed at 1-3 monthly intervals for a median period of 3 years. HCV E2 envelope, NS5B polymerase and NS5A genes were amplified at multiple time points using PCR and cloning techniques from plasma, liver and lymphocytes. A library of 2295 HCV E2 sequences were available for analysis .The functional immune response was assessed by ELISpot and flow cytometry. Results: 14% of patients cleared HCV spontaneously while 86% progressed towards chronicity. Three patterns of infection were observed based on viral load dynamics; spontaneous clearance (SC) and 2 patterns of progression; plateau (PV) and fluctuating viraemia (FV). SC was associated with a >1.7log10 viral load drop within 100 days of infection (OR=2.76; p=<0.001), slow viral diversification of the envelope E2 gene and the emergence of an early multi-specific T-cell response. PV was associated with positive selection within E2 and rapid viral diversification. Superinfection with new HCV strains (40% of the cohort), delayed T-cell responses and the presence of HCV within lymphocytes were all associated with FV. CD4+ responses were particularly important in defining the final outcome of infection. Conclusions: Spontaneous clearance of acute HCV in HIV-positive men can be predicted by rapid decline in viral load, low viral diversity and T-cell response. Key words: HIV, HCV, HVR-1
42
Moorman, Jonathan P., Matthew R. Krolikowski, Stephanie M. Mathis e Robert P. Pack. "HIV/HCV Co-infection: Burden of Disease and Care Strategies in Appalachia". Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/2766.
Testo completoAbstract (sommario):
Purpose of Review: The purpose of this review is to address infection with HIV and hepatitis C in the Appalachian region of the USA and the driving forces underlying this epidemic. We seek to discuss epidemiology of disease and the possible interventions to reduce incidence and burden of disease in this resource-limited area.
Recent Findings: The rise of the opioid crisis has fueled a rise in new hepatitis C infection, and a rise in new HIV infection is expected to follow. Injection drug use has directly contributed to the epidemic and continues to remain a risk factor. Men who have sex with men remains a significant risk factor for HIV acquisition as well.
Summary: Progress has been made in the battle against HIV and, to a lesser extent, hepatitis C, but much more can be done. Limited data on co-infection with HIV/HCV are currently available for this at-risk region, but it is clear that Appalachia is highly vulnerable to co-infection outbreaks. A multipronged approach that includes advances in assessment of co-infection and education for both patients and clinicians can help to recognize, manage, and ideally prevent these illnesses.
43
Bertol, Bruna Cristina. "Expressão da molécula HLA-G e polimorfismos da região codificadora do gene HLA-G em pacientes infectados pelo vírus da hepatite C (HCV) apresentando ou não a coinfecção pelo vírus da imunodeficiência humana (HIV)". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17147/tde-10012017-112046/.
Testo completoAbstract (sommario):
A hepatite C, causada pelo vírus da hepatite C (HCV), afeta milhões de pessoas no mundo. A transmissão do HCV é semelhante ao HIV, justificando a alta taxa de prevalência da coinfecção. Pacientes coinfectados HCV/HIV apresentam maior taxa de progressão da fibrose hepática e da mortalidade, em comparação aos pacientes monoinfectados com HCV. Assim, o estudo de genes e/ou moléculas que controlam a resposta imune é pertinente. No presente estudo, avaliamos o papel do antígeno leucocitário humano G (HLA-G), molécula com reconhecida atividade imunomoduladora, capaz de inibir a ativação das células T e a atividade citotóxica das células Natural Killers (NK) e linfócitos T CD8+, além de induzir a formação células T reguladoras. Nós investigamos 216 pacientes monoinfectados pelo HCV, 135 pacientes coinfectados HCV-HIV e 152 indivíduos não infectados. A variabilidade do gene HLA-G foi avaliada por sequenciamento de Sanger e a expressão hepática da molécula por imunoistoquímica. A expressão de HLA-G foi observada somente no tecido hepático dos pacientes, principalmente nos hepatócitos. O aumento de expressão de HLA-G foi associado com avanço da fibrose e da atividade necroinflamatória no fígado de ambos os grupos de pacientes. Idade igual ou superior a 40 anos e a cor de pele não-branca também foram associados com aumento da expressão hepática da molécula nos pacientes HCV. Outros fatores do hospedeiro analisados como gênero e genótipo do HCV não foram associados com o nível de expressão de HLA-G no fígado. A frequência do alelo HLA-G*01:01:01:01 estava aumentada nos pacientes HCV e do alelo G*01:05N diminuída nos pacientes coinfectados HCV-HIV, porém, não houveram associações significantes entre a variabilidade genética de HLA-G e a expressão hepática de HLA-G. O presente estudo contribui para a ampliar os conhecimentos acerca da participação da molécula HLA-G na hepatite C crônica, associado ou não com infecção pelo HIV.Hepatitis C, caused by the hepatitis C virus (HCV), affects millions of people worldwide. The transmission of HCV is similar to HIV, which explains the high prevalence of coinfection. HCV-HIV coinfected patients have higher rate of liver fibrosis progression and mortality when compared to HCV monoinfected patients. Thus, the study of genes and/or molecules that control the immune response is relevant. In the present study, we evaluated the role of human leukocyte antigen G (HLA-G), a molecule known by its immunomodulatory activity, which is capable to inhibit T cell activation and cytotoxic activity of natural killer (NK) cells and CD8+ T cells, in addition to inducing the formation of regulatory T cells. We studied 216 HCV patients, 135 HIV-HCV coinfected patients and 152 uninfected individual. The variability of the HLA-G gene was evaluated by Sanger sequencing and the hepatic expression of the molecule by immunohistochemistry. The HLA-G expression was observed only in liver tissue of patients, mainly in hepatocytes. The increased HLA-G expression was associated with increased liver fibrosis and necroinflammatory activity in both groups of patients. The age greater than or equal to 40 years and the non-white skin color were also associated with increased hepatic expression of the molecule in the HCV patients. Other host factors analyzed as gender and HCV genotype were not associated with the level of HLA-G expression in the liver. The frequency of HLA-G*01:01:01:01 allele was increased in HCV patients and G*01:05N decreased in HCV-HIV coinfected patients, however, there was no significant association between the genetic variability of HLA-G and HLA-G liver expression. The present study contributes to expand the knowledge regarding the participation of HLA-G in chronic C hepatitis, associated or not with the HIV infection.
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Selvamani, Sakthi. "Effect of Hepatitis B and C Viruses on Mitochondrial Function". Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/24376.
Testo completoAbstract (sommario):
HCV and HBV infections are leading causes of chronic hepatitis, cirrhosis, and hepatocellular carcinoma and can induce metabolic dysfunction, which may offer a selective advantage for liver cancer proliferation and survival. The liver is enriched with numerous mitochondria, providing a continuous supply of ATP for a range of cellular activities. The hypothesis of this thesis is that HBV and HCV induce mitochondrial dysfunction and metabolic disorders. A range of cell culture models and in vitro techniques were used to test this hypothesis, including the Seahorse analyser to measure mitochondrial function in real time. Mitochondrial function and membrane potential during HCV and HBV infection were decreased, which were independent of mitochondrial biogenesis. HCV infection promotes steatosis due to a combination of viral and host metabolic factors, whereas steatosis during HBV is more variable. Therefore, potential changes in lipid metabolism were investigated in our HCV and HBV models. Impaired lipid oxidation was observed during HCV infection, but not during HBV expression. Perturbation of pyruvate metabolism was proposed as a possible mechanism for mitochondrial dysfunction during HBV expression. No significant change in pyruvate but an increase in lactate concentrations was observed, due to elevated lactate dehydrogenase A, which converts pyruvate to lactate. Proteomics analysis revealed other key proteins involved in pyruvate metabolism to be differentially regulated, including increased levels of pyruvate dehydrogenase kinase. In summary, HCV infection causes mitochondrial dysfunction and reduced lipid oxidation, resulting in intracellular accumulation of lipids. In contrast, HBV expression does not affect lipids but alters pyruvate metabolism, causing lactate accumulation and promoting the “Warburg effect”. Thus, although HBV does not cause steatosis, the lactate accumulation and altered cell metabolism may promote the development and progression of liver cancer.
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Del-Rios, Nativa Helena Alves. "Estudo epidemiológico e molecular da infecção pelo vírus da Hepatite C em indivíduos infectados pelo vírus da Imunodeficiência Humana em Goiânia-Goiás". Universidade Federal de Goiás, 2011. http://repositorio.bc.ufg.br/tede/handle/tede/7241.
Testo completoAbstract (sommario):
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Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG
The hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are characterized by causing chronic infections in the host. The advent of potent antiretroviral therapy has resulted in a significant reduction in the incidence of opportunist infections, and thus greater life expectancy for HIV positive patients. However, the liver disease appears as a major cause of morbidity and mortality among these patients, especially those related to hepatitis C virus. Co-infection with HCV/HIV induces a worse prognosis for both infections, which may lead to the development of AIDS, a faster rapid evolution to chronic active hepatitis and / or liver cirrhosis and death. This study aimed to investigate the epidemiology and molecular profile HCV infection in HIV-infected individuals with no prior antiretroviral therapy, seen in the referral hospital for the treatment of infectious diseases (Hospital for Tropical Diseases - Anuar Auad / HDT) in Goiania, Goiás. A total of 505 treatment naïve individuals and were referred to the HDT, from April 2009 to April 2010 were interviewed and underwent blood collection. All sera were tested for antibodies to HCV (anti-HCV) and for HCV RNA by polymerase chain reaction (PCR). Genotyping was performed by reverse hybridization by the Line Probe Assay (LiPA) method. The prevalence of anti-HCV was 4.6% (95% CI: 3.0 to 6.8). The viral RNA was detected in 65.2% (15/23) of anti-HCV positive samples. The genotypes identified were 1 (subtypes 1a and 1b) and 3 (subtype 3a). The age > 40 years, living in other states or Goiania city, surgery, injecting and non-injecting drug and anti-HBc positive (antibody to core antigen of hepatitis B virus) were associated with HCV infection after logistic regression. The data presented shows the vulnerability of the HIV sropositive population to acquisition of infectious diseases such as HCV infection. Thus, the information obtained will be essential for planning public health interventions, preventing and control of hepatitis C in this population.
Os vírus da hepatite C (HCV) e da imunodeficiência humana (HIV) causam infecções crônicas no hospedeiro. O advento da terapia antiretroviral potente trouxe uma redução da incidência de infecções oportunistas, e consequentemente, uma maior expectativa de vida aos pacientes HIV soropositivos. No entanto, as hepatopatias surgem como uma das principais causas de morbimortalidade entre esses pacientes, principalmente aquelas relacionadas ao vírus C. A coinfecção HCV/HIV induz a um pior prognóstico de ambas as infecções, podendo levar ao desenvolvimento da Aids, evolução mais rápida para hepatite crônica ativa e/ou cirrose hepática e morte. Este estudo teve como objetivo investigar o perfil epidemiológico e molecular da infecção pelo HCV em indivíduos infectados pelo HIV, sem tratamento antiretroviral prévio, atendidos no Hospital de referência para o tratamento de doenças infecciosas (Hospital de Doenças Tropicais - Anuar Auad / HDT) em Goiânia, Goiás. Um total de 505 indivíduos, virgens de tratamento, encaminhados ao HDT, no período de abril/2009 a abril/2010, foram entrevistados e submetidos à coleta de sangue. As amostras (soros) foram testadas para a detecção de anticorpos para o HCV (ELISA/LIA) e submetidas à identificação do RNA-HCV pela reação em cadeia da polimerase (PCR). A genotipagem foi realizada por hibridização reversa, pelo método Line Probe Assay (LiPA). A prevalência para anti-HCV foi de 4,6% (IC 95%: 3,0-6,8). O RNA viral foi detectado em 15 amostras, sendo todas elas anti-HCV positivas. Foram identificados os genótipos 1 e 3, com predomínio do subtipo 1a, seguido dos subtipos 1b e 3a. As variáveis idade superior a 40 anos, ser procedente de Goiânia ou outros estados, cirurgia, uso de drogas injetáveis e não-injetáveis, história de prisão e positividade ao anti-HBc foram associados à infecção pelo vírus da hepatite C, após regressão logística. Os dados apresentados revelam a vulnerabilidade da população HIV soropositiva à aquisição de doenças infecciosas como a infecção pelo HCV. Assim, as informações obtidas serão essenciais para o planejamento de ações de saúde pública para a prevenção e controle da hepatite C nessa população.
46
Franco, Kelly Flory. "Hepatitis C virus (HCV) replication in vitroand the effect of HCV on human immunodeficiency virus (HIV-1) coreceptor usage and diversity in the coinfected patient". Cincinnati, Ohio : University of Cincinnati, 2007. http://rave.ohiolink.edu/etdc//view?acc_num=ucin1183474023.
Testo completoAbstract (sommario):
Thesis (Ph.D.)--University of Cincinnati, 2007.Advisor: Dr. Julie A.E. Nelson. Title from electronic thesis title page (viewed Dec. 22, 2009). Includes abstract. Includes bibliographical references.
47
Da, Costa Daniel. "Study of cell host factors involved in Hepatitis C virus tropism". Thesis, Strasbourg, 2012. http://www.theses.fr/2012STRAJ071/document.
Testo completoAbstract (sommario):
Le virus de l’hépatite C (HCV) est un problème majeur de santé publique. Le développement de nouveaux traitements pour lutter contre le HCV a été ralenti par l’absence de modèles d’études in vitro et in vivo convenables. Le but de mon travail de thèse a été, dans un premier temps, de caractériser les facteurs déterminant le tropisme hépatique du HCV. En exprimant des facteurs clés dans une lignée cellulaire humaine non-hépatocytaire, nous avons reconstitué in fine l’ensemble du cycle viral dans ces cellules. L’entrée du virus dans la cellule hôte fait intervenir différents récepteurs d’entrée dont CD81, occludin (OCLN), claudin-1 (CLDN1) et scavenger receptor class B type I (SR-BI). L’expression de ces quatre récepteurs sur cette lignée la rend hautement permissive à l’entrée du virus, mais ne permet pas de rétablir la réplication du virus. L’expression du micro-ARN 122, un micro-RNA important pour l’infection du HCV, dans les cellules exprimant les quatre récepteurs, restaure une forte réplication de l’ARN viral mais ne permet pas de détecter une production de particules infectieuses. L’expression de l’apolipoprotein E (apoE), jouant un rôle primordial dans l’assemblage et la sécrétion, rétablis cette dernière étape du cycle viral du HCV dans la lignée cellulaire humaine non-hépatocytaire. Dans un second temps, j’ai utilisé la stratégie, précédemment établie, pour étudier la spécificité d’espèce de l’infection du HCV dans plusieurs lignées hépatocytaires murines. Nous avons pu rendre ces cellules permissives à l’entrée du HCV et pu détecter une très faible réplication. L’ensemble de mes travaux apportent de nouvelles informations sur la compréhension des facteurs clés nécessaire au cycle viral du HCV dans des cellules murines et humainesHepatitis C virus (HCV) is a global health burden. The development of new therapeutics to treat HCV infection has been hampered by the lack of convenient in vitro and in vivo model systems. The goal of my PhD work was, in a first time, to characterize the factors determining the hepatotropism of HCV. By expressing key factors within a non-hepatic cell line, we reconstituted in fine the full HCV life cycle in those cells. Virus entry into the host cell requires different entry factors which are CD81, occludin (OCLN), claudin-1 (CLDN1) and the scavenger receptor class B type I (SR-BI). The expression of these four factors in this cell line renders it highly permissive to viral entry, but does not allow restoring replication of the virus. The expression of miR-122, a micro-RNA important for HCV infection, into the cell lines expressing the four HCV entry factors restore a strong replication of the HCV RNA but does not allow detecting infectious viral particle production. Further expression of the apolipoprotein E (apoE), which plays a critical role in the assembly and release process, restore the last step of the HCV life cycle in a non-hepatic cell line. In a second part of my PhD, I have used the previously developed strategy to study the species specificity of HCV infection using different mouse hepatoma cell lines. We have been able to render these cell lines permissive to HCV entry and have been able to detect a slight replication. Altogether, my results bring new information on the understanding of key factors important for HCV life cycle in mouse and human cells
48
Коваленко, А. І., Д. О. Кучеренко, А. Р. Романчук, Вікторія Валеріївна Ільїна, Виктория Валерьевна Ильина e Viktoriia Valeriivna Ilina. "Вплив HCV- інфекції на якість життя". Thesis, Сумський державний університет, 2015. http://essuir.sumdu.edu.ua/handle/123456789/41553.
Testo completoAbstract (sommario):
Загальновідомо, що якість життя хворих на HCV-інфекцію значно знижена, насамперед,
через частий розвиток ускладнень, використання противірусної терапії тощо. Важливим серед
них є усвідомлення хворими наявності в них хвороби, що може вплинути на тривалість життя.
49
Vilar, Fernando Crivelenti. "Expressão do HLA-G no tecido hepático de pacientes coinfectados com HIV/HCV". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/17/17138/tde-24082014-194222/.
Testo completoAbstract (sommario):
A doença hepática crônica causada pelo vírus da hepatite C (HCV) tornou-se, nos últimos anos, uma das principais comorbidades dos pacientes portadores do vírus da imunodeficiência humana (HIV) nos países desenvolvidos. Os pacientes coinfectados com HIV/HCV apresentam uma progressão mais rápida para a cirrose e as suas complicações que os pacientes monoinfectados com HCV. Embora os mecanismos responsáveis por esta evolução não estejam totalmente esclarecidos, a expressão da molécula de HLA-G, um HLA de classe Ib não clássico, que tem propriedades bem reconhecidas na regulação negativa da resposta imune, pode estar relacionada à progressão da doença hepática. Os objetivos deste trabalho foram analisar o perfil de expressão de HLA-G em tecido hepático de pacientes coinfectados HIV/HCV e identificar possíveis variáveis do hospedeiro, do HCV e do HIV que possam estar relacionadas com a expressão de HLA-G na biópsia hepática. Para isso, 57 amostras de biópsia hepática de pacientes coinfectados com HIV/HCV, nas quais a imuno-histoquímica para HLA-G foi realizada, foram analisadas retrospectivamente quanto à expressão desta molécula no tecido hepático. Avaliaram-se também outras características histopatológicas da biópsia como grau de fibrose, atividade inflamatória, deposição de ferro e gordura. Determinou-se o polimorfismo de inserção ou deleção de 14 pares de bases da região 3` não traduzida do exon 8 do gene do HLA-G, que está relacionada com a produção de RNA-mensageiro, em 43 destes pacientes, além do polimorfismo de IL-28B, relacionado com a resposta ao tratamento do HCV, em 44 deles. Características bioquímicas e virológicas, tanto do HIV quanto do HCV também foram avaliadas. O genótipo 1 do HCV foi o mais prevalente (87,75%), especialmente o subgenótipo 1a (60%). A expressão do HLA-G foi observada em 38 (66,7%) amostras de fígado, e foi mais frequente em estágios moderados e severos de fibrose do que em estágios mais leves (94,1% x 55%, P < 0,01). Não houve relação entre a expressão do HLA-G e os outros parâmetros estudados. Embora a progressão para a cirrose no contexto da coinfecção por HIV/ HCV seja um processo complexo, modulado por muitos factores, a associação da intensidade de fibrose com a expressão do HLA-G pode indicar que a expressão desta proteína desempenha um importante papel nos mecanismos que contribuem para a progressão da doença, por meio da regulação negativa da resposta imune contra o HCV na coinfecção pelo HIV.Chronic liver disease induced by hepatitis C virus (HCV) infection has recently become one of the most common comorbidities in patients who are infected with the human immunodeficiency virus (HIV) in developed countries. HIV/HCV coinfected patients show faster progression to cirrhosis and its complications than the HCV monoinfected patients. Even though the responsible mechanisms for this evolution have not been entirely clarified yet, the expression of the HLA-G molecule, a HLA from the non-classic Ib class, with well-known properties of negatively regulating the immune response, may be related to the liver disease progression. The aims of the present work were to analyze the HLA-G expression profile in the liver micro ambience of HIV/HCV coinfected patients and to identify possible host factors, HIV or HCV, that may be related to the HLA-G expression on the liver biopsy. For this purpose, 57 liver biopsies of HIV/HCV coinfect patients, in which immunohistochemistry for HLA-G had been performed, were retrospectively analyzed according the HLA-G expression on the hepatic tissue. Other histopathological features in the liver biopsies, such as fibrosis degree, inflammatory activity, iron deposition and fat were also evaluated. The polymorphism of insertion or deletion in 14-base pairs of the 3`non-translated region of exon 8 of the HLA-G gene, which is related to the production of HLA-G messenger RNA, was evaluated in 43 of the patients. Also, the polymorphism of IL-28B, related to the response to HCV treatment, was evaluated in 44 of them. Biochemical and virological features of HIV and HCV were also evaluated. The HCV genotype 1 was the most prevalent (87.75%), especially the subgenotype 1a (60%). The expression of HLA-G was observed in 38 (66.7%) samples of the liver biopsies, and it was most frequent in moderate and severe stages of fibrosis than in the mild stages (94.1% x 55%, P < 0.01). There was no established relationship between HLA-G and other parameters studied. Although the progression to cirrhosis in the context of HIV/HCV coinfection is a complex process modulated by many factors, the association of HLA-G expression with the intensity of the liver fibrosis may indicate the protein expression play an important role in the mechanisms that contribute to the progression of the disease, through the negative regulation of the immune response against HCV setting of a coinfection with HIV.
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Auma, Ann Winniefred Nangobi. "THE IMPACT OF DIRECT-ACTING ANTI-VIRAL THERAPY ON NAIVE CD4+ T CELL LYMPHOPENIA AND CELLULAR IMMUNE ACTIVATION IN HCV INFECTION AND HCV/HIV CO-INFECTION". Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1625764728651756.
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