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Ikeda MLR, Barcellos NT, Alencastro PR, Wolff FH, Moreira LB, Gus M, Brandão ABM, Fuchs FD, Fuchs SC. Alcohol Drinking Pattern: A Comparison between HIV-Infected Patients and Individuals from the General Population. PLoS One 2016; 11:e0158535. [PMID: 27362541 PMCID: PMC4928875 DOI: 10.1371/journal.pone.0158535] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 06/17/2016] [Indexed: 12/17/2022] Open
Abstract
Background Alcohol consumption is highly prevalent in the general population and among HIV-infected population. This study aimed to compare the pattern of alcohol consumption and to describe characteristics associated with heavy alcohol consumption in individuals from the general population with patients infected with HIV. Methods Participants for this analysis came from a population-based cross-sectional study and from a consecutive sampling of patients infected with HIV. Participants aged 18 years or older were interviewed using similar questionnaires with questions pertaining to socio-demographic characteristics, alcohol consumption, smoking, physical activity, and HIV-related characteristics, among others. Blood pressure and anthropometric measures were measured using standardized procedures. Results Weekly alcohol consumption was more prevalent among individuals from the general population than HIV-infected patients: 57.0 vs. 31.1%, P<0.001. The prevalence of heavy episodic drinking was higher in the population sample as well: 46.1 vs. 17.0%, P<0.001. In the general population, heavy alcohol consumption was more prevalent in men. Cigarette smoking was independently associated with heavy alcohol consumption among HIV infected (Prevalence Ratio; PR = 5.9; 95%CI 2.6–13.9; P<0,001) and general population (PR = 2.6; 95%CI 1.9–3.0; P<0.001). Years at school were inversely associated with heavy alcohol consumption among HIV-infected patients and directly associated among participants from the general population, even after controlling for sex, age, skin color, and smoking. Conclusions Heavy alcohol consumption is more prevalent in the general population than among HIV-infected patients. Individuals aware about their disease may reduce the amount of alcoholic beverages consumption comparatively to healthy individuals from the general population.
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Affiliation(s)
- Maria Leticia R. Ikeda
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, 2°. andar, Porto Alegre, RS, Brazil
- Hospital Sanatório Partenon, State Department of Health, Rio Grande do Sul. Av. Bento Gonçalves, 3722, Porto Alegre, RS 90650–001, Brazil
| | - Nemora T. Barcellos
- Hospital Sanatório Partenon, State Department of Health, Rio Grande do Sul. Av. Bento Gonçalves, 3722, Porto Alegre, RS 90650–001, Brazil
| | - Paulo R. Alencastro
- Hospital Sanatório Partenon, State Department of Health, Rio Grande do Sul. Av. Bento Gonçalves, 3722, Porto Alegre, RS 90650–001, Brazil
| | - Fernando H. Wolff
- Postgraduate Program in Sciences in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, Porto Alegre, RS 90035–003, Brazil
| | - Leila B. Moreira
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, 2°. andar, Porto Alegre, RS, Brazil
| | - Miguel Gus
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, 2°. andar, Porto Alegre, RS, Brazil
| | - Ajacio B. M. Brandão
- Postgraduate Program in Medicine-Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Flavio D. Fuchs
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, 2°. andar, Porto Alegre, RS, Brazil
- Cardiolody Division, Hospital de Clinicas de Porto Alegre. Centro de Pesquisa Clínica, R. Ramiro Barcelos 2350, Porto Alegre, RS 90035–003, Brazil
| | - Sandra C. Fuchs
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, 2°. andar, Porto Alegre, RS, Brazil
- * E-mail:
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Wolff FH, Fuchs SC, Brandão ABM. Absence of occult hepatitis B among blood donors in southern Brazil. Braz J Infect Dis 2011; 15:159-162. [PMID: 21503404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 07/12/2010] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Occult hepatitis B virus (HBV) infection is characterized by the detection of HBV DNA in serum and/or in liver in the absence of detectable hepatitis B surface antigen (HBsAg). The reported prevalence of occult hepatitis B varies markedly among populations and according to the sensitivity of the HBV DNA assay. The aim of the present study was to describe the prevalence of occult hepatitis B among HCV-infected and non-infected blood donors in Porto Alegre, Southern Brazil, using a highly sensitive real time polymerase chain reaction (PCR) method. METHODOLOGY Between 1995 and 1997 a sample of 178 blood donors with two positive anti-HCV ELISA tests were consecutively selected as cases, and 356 anti-HCV negative donors were selected as controls. Blood donors were randomly selected from eight blood centers in Porto Alegre, Southern Brazil, representative of the whole blood donor population. Blood samples were kept at 70ºC and defrosted for the first time for the analysis of this report. Tests previously performed in the laboratory using the same real time PCR for HBV DNA had sensitivity for detecting as low as 9 copies/mL. Among 158 blood samples from HBsAg-negative blood donors, five were anti-HBc positive, 53 tested positive for anti-HCV and 105 had anti-HCV negative. The samples analysis was performed in duplicate and all blood samples tested negative for HBV DNA. CONCLUSION The result reflects a very low prevalence of occult hepatitis B in our setting.
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Affiliation(s)
- Fernando Herz Wolff
- National Institute of Science and Technology for Health Technology Assessment, Rua Dr. Freire Alemao 351 /703, Porto Alegre, RS, Brazil.
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Wolff FH, Fuchs SC, Barcellos NT, Falavigna M, Cohen M, Brandão ABM, Fuchs FD. Risk factors for hepatitis C virus infection in individuals infected with the HIV. Dig Liver Dis 2008; 40:460-7. [PMID: 18096448 DOI: 10.1016/j.dld.2007.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Revised: 11/05/2007] [Accepted: 11/07/2007] [Indexed: 12/11/2022]
Abstract
BACKGROUND Except for injecting drug use, other routes of transmission for hepatitis C virus among HIV-AIDS patients have not been consistently described, and risk estimates are often not adjusted for confounding factors. AIMS To evaluate characteristics associated with hepatitis C virus infection in individuals infected with the HIV. PATIENTS Cases were patients co-infected by HIV and hepatitis C virus, and controls were infected only by HIV. METHODS Cases and controls were consecutively enrolled at a public health care outpatient HIV-AIDS reference centre in Porto Alegre, Southern Brazil. RESULTS A total of 227 cases (63% men; 40.3+/-8.7 years) and 370 controls (44.6% men; 38.9+/-9.8 years) were enrolled in the study. In a multiple logistic regression model, male gender (odds ratio 1.9; 95% confidence interval 1.3-2.7), age between 30 and 49 years (odds ratio 2.1; 95% confidence interval 1.2-3.7), elementary school education (odds ratio 4.2; 95% confidence interval 1.9-9.6), lower family income (odds ratio 1.7; 95% confidence interval 1.1-2.7), sharing personal hygiene objects (odds ratio 2.0; 95% confidence interval 1.3-3.3), using injected drugs (odds ratio 21.6; 95% confidence interval 10.8-43.0) and crack cocaine (odds ratio 2.8; 95% confidence interval 1.1-6.9) were independently associated with co-infection by hepatitis C virus. CONCLUSION These results confirm the risk profile for hepatitis C virus-HIV infection and suggest that sharing personal hygiene objects might explain the transmission of virus C to those not infected by the usual routes, which may be of relevance for developing preventive strategies.
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Affiliation(s)
- F H Wolff
- Post-Graduate Program in Medical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Hoppe L, Marroni CA, Bressane R, Lago L, Schiavo FL, Cigerza GC, Brandão ABM, Zanotelli ML, Cantisani GPC. Risk Factors Associated With Cytomegalovirus Infection in Orthotopic Liver Transplant Patients. Transplant Proc 2006; 38:1922-3. [PMID: 16908324 DOI: 10.1016/j.transproceed.2006.06.075] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
UNLABELLED Our objective was to investigate the potential risk factors associated with cytomegalovirus (CMV) infection. PATIENTS AND METHODS From January 1999 to December 2001, 163 liver transplantations were performed in 154 patients. The study inclusion criteria were absence of retransplantation and survival of more than 6 months. One hundred fifteen patients met the inclusion criteria. We determined variables such as age, gender, and number of hemecomponents as well as serum IgG CMV status of donors and recipients. We recorded the immunosuppression used by each patient. CMV infection was detected by positive antigenemia. RESULTS Recipient mean age was 50 years. The etiology of cirrhosis was viral (n = 57; 49.6%), alcoholic (n = 20; 17.4%), virus and alcohol (n = 15; 13.0%), cryptogenic (n = 14; 12.2%), or other causes (n = 9; 7.8%). CMV infection was positive in 75 patients (65.8%). There was no relation between infection and age, gender, or CMV IgG donor recipient status, or the number of hemecomponent units. The risk was 3.8-fold higher for patients receiving a three-drug compared with a two-drug regimen. When cyclosporine was used instead of tacrolimus, the risk of CMV infection was 4.3-fold higher. Logistic regression analysis revealed cyclosporine (OD=5.8) and a three-drug regimen (OD=6.7) to have stronger associations with CMV infection. CONCLUSION The use of cyclosporine (OD=5.8) and a three-drug regimen (OD=6.7) are risk factors for CMV infection.
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Affiliation(s)
- L Hoppe
- Santa Casa, Porto Alegre, FFFCMPA, Rua Uruguai 2001, 312/B Passo Fundo, Rio Grande do Sul, CEP 99010-112 Brazil.
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Hoppe L, Marroni CA, Bressane R, Lago L, Schiavo FL, Cigerza GC, Brandão ABM, Zanotelli ML, Cantisani GPC. Impact of Cytomegalovirus Infection on Long-Term Survival After Orthotopic Liver Transplantation. Transplant Proc 2006; 38:1924-5. [PMID: 16908325 DOI: 10.1016/j.transproceed.2006.06.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
UNLABELLED Cytomegalovirus (CMV) is one of the most common and serious opportunistic infections in solid organ transplant patients. In different series the incidence of CMV infection ranges from 25% to 85%. An indirect effect of infection includes reduced long-term patient and allograft survival. Our objective was to determine the relationship between CMV infection and patient survival after orthotopic liver transplantation. PATIENTS AND METHODS From January 1999 to December 2001, 163 orthotopic liver transplantations were performed in 154 patients. The inclusion criteria for this analysis were the absence of retransplantation and survival of more than 6 months. One hundred fifteen patients met the inclusion criteria. CMV infection was detected by positive antigenemia. RESULTS CMV infection occurred in 65.8% of patients after orthotopic liver transplantation. Their 5-year survival was 85%, with no difference observed between patients with or without infection (P = .8). CONCLUSION CMV infection did not interfere with patient survival after orthotopic liver transplantation.
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Affiliation(s)
- L Hoppe
- Santa Casa, Porto Alegre, FFFCMPA, Rua Uruguai 2001, 312/B Passo Fundo, Rio Grande do Sul, CEP 99010-112 Brazil.
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Hoppe L, Bressane R, Lago LS, Schiavo FL, Marroni CA, Keiserman DR, Brandão ABM, Júnior AMF, Cassal AP, Zanotelli ML, Cantisani GPC. Risk factors associated with cytomegalovirus-positive antigenemia in orthotopic liver transplant patients. Transplant Proc 2004; 36:961-3. [PMID: 15194334 DOI: 10.1016/j.transproceed.2004.03.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of the study was to investigate risk factors associated with cytomegalovirus (CMV)-positive antigenemia in orthotopic liver transplant (OLT) patients. Sixty-nine patients undergoing OLT during 2001 were retrospectively evaluated for CMV antigenemia during a follow-up of 6 months after transplantation for demographic variables, pretransplant donor and recipient CMV serologic status, etiology of liver disease, number of blood transfusions, and type of immunosuppression. Among the 69 patients who underwent 71 OLT in this period, 43 met study criteria. Mean age was 49.7 +/- 10.8 years and 60.5% were men. End-stage liver disease was the indication for liver transplant, except in one case. The most prevalent etiology of liver disease was hepatitis C and/or alcohol in 66% of the cases. CMV-positive status was recorded in 74% of donors and 95% of recipients. None of the CMV-negative recipients received a positive donor allograft. CMV-positive antigenemia was 84% with 12% having two episodes of infection. There was no correlation between CMV infection and age, gender, etiology of liver disease, or number of blood transfusions. However, all patients using cyclosporine had CMV-positive antigenemia compared with 61% using tacrolimus (P <.032). In this study, the incidence of CMV infection after OLT in adult patients was slightly higher than reported in literature. No risk factor was associated with CMV antigenemia; however, this study suggests a higher probability of CMV infection among patients treated with cyclosporine.
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Affiliation(s)
- L Hoppe
- Liver Transplant Group, Irmandade Santa Casa de Misericórdia, Porto Alegre Federal Sciences School Foundation, Porto Alegre, Rio Grande do Sul, Brazil.
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Grezzana TJM, Corso CO, Zanotelli ML, Marroni CA, Brandão ABM, Schlindwein E, Leipnitz I, Meine MHM, Fleck A, Cassal A, Hope L, Hoppen R, Kiss G, Gleisner ALM, Cerski T, Bellò-Klein A, Severo V, Innocenti C, Cantisani GPC. Oxidative stress, hepatocellular integrity, and hepatic function after initial reperfusion in human hepatic transplantation. Transplant Proc 2004; 36:843-5. [PMID: 15194289 DOI: 10.1016/j.transproceed.2004.03.100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The mechanisms underlying liver graft dysfunction are not completely defined, although much of the injury derives from oxidative stress in organ reperfusion. The antioxidant glutathione in its reduced form (GSH) is an important agent to detoxify oxygen species after reperfusion. However, this effect might be limited by low concentrations at the end of cold storage. The objective of this study was to evaluate GSH and glutathione oxidized (GSSG) hepatic levels pre- and postreperfusion and correlate with hepatocellular injury and liver function in the 5 subsequent days after transplantation. METHODS Liver biopsies were taken immediately before implant and 2 hours after venous reperfusion in 34 grafts, determining GSH, GSSG levels, and GSSG/GSH ratio. Aminotransferases (ALT, AST) and PT were measured for 5 days. RESULTS There was a strong decrease in GSH concentration (P <.0001), increase of GSSG levels (P <.01), and increase of the GSSG/GSH ratio (P <.0001). No correlations were found between GSH, GSSG, or GSH/GSSH levels and AST, ALT, and PT. CONCLUSION Glutathione levels showed significant changes after 2 hours of reperfusion, due to intense oxidative stress. Therapies to replenish GSH should be considered as a protective measure to avoid liver graft dysfunction after transplantation.
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Affiliation(s)
- T J M Grezzana
- Liver Transplantation Group, Irmandade Santa Casa de Misericórdia de Porto Alegre, Brazil.
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