DISSERTAÇÃO DE MESTRADO - PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE

URI Permanente para esta coleçãohttps://tedebc-teste.ufma.br/handle/tede/545

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AVALIAÇÃO DA EFETIVIDADE DO PROGRAMA DE TRATAMENTO DA HEPATITE C CRÔNICA EM USUÁRIOS DA FARMÁCIA ESTADUAL DE MEDICAMENTOS EXCEPCIONAIS DO MARANHÃO (FEME).
(Universidade Federal do Maranhão, 2011-10-18) TEIXEIRA, Fábio Gomes; FERREIRA, Adalgisa de Souza Paiva; 850.818.767-04; http://lattes.cnpq.br/6707376027989566; FERREIRA, Adalgisa de Souza Paiva; 850.818.767-04; http://lattes.cnpq.br/6707376027989566
Cohort study using retrospective data to evaluate the effectiveness of the treatment program for chronic hepatitis C in users of Farmácia Estadual de Medicamentos Excepcionais do Maranhão (FEME) to determine the rate of sustained virologic response (SVR) and correlate it with demographic, clinical, laboratory, histological and virological features of patients and to identify the rates of discontinuation of treatment. We analyzed data from 256 patients treated for chronic hepatitis C in FEME for the period January 2005 to July 2009, being an SVR by intention to treat 57%. Males predominated (66%). The mean age was 52.5 years, with a predominance of non-white individuals in relation to whites. Genotype 1 was the most common (77%) and 150 (58.6%) patients had viral load above 400,000 UI/ml. With respect to the treatment regimen, pegylated interferon associated with ribavirin was used by 80.5% of patients, the rate of discontinuation of treatment of 13,3%. They were identified as factors independently associated with SVR: white, non-cirrhotic, have not a genotype 1 and viral load below 400,000 IU / ml. These findings demonstrate the effectiveness of treatment provided by FEME, which makes it possible to cure most patients, preventing progression to end-stage liver disease and its disastrous consequences. The factors associated with SVR have seen in other studies, leads us to believe that the results are reliable and that the program is fulfilling the role it has set itself.
Soroconversão tardia do HBeAg em portadores do subgenótipo D4 do vírus da hepatite B
(Universidade Federal do Maranhão, 2016-05-20) SOUZA, Marinilde Teles; FERREIRA, Adalgisa de Souza Paiva; 850.818.767-04
Introduction: The hepatitis B virus (HBV) present diversity of its genome, which is to be classified in different genotypes and subgenotypes (A-J). It has been demonstrated that different genotypes are related to the natural history of infection. The maintenance of viral replication could be one of the factors related to genotypes. Objectives: To identify the viral replication status of HBV carriers among the subgenótipos A1 and D4. Materials and methods: HBV carriers identified have been studied in two studies involving individuals from the state of Maranhão, northeast,Brazil, which had genotyping and subgenotypes, serology for HBeAg and anti-HBe and certain viral loads. Serological tests were performed by ELISA, HBV – DNA quantification real time PCR and genotyping performed by sequencing. Results: We identified 146 patients. Among these, 136 were subgenotype A1 or D4. It is 85 - A1 (62.5%) and 51 - D4 (37.5%). No difference was found between groups when age was evaluated (42 ± 12 vs 38 ± 17 p=0.11) or gender (male 48.5% vs 51.5% p=00.18). Among the D4 subgenotype carriers had more patients with HBeAg positive (23.5% vs 9.4%, p=0.02) and a higher proportion of patients with viral loads above 20.000 IU / ml (43.1% vs 12.9 % p <0.0001), even when only those with negative HBeAg (25.6% vs 6.5%, p=0.007) when compared with the A1 subgenotype. Conclusion: HBV carriers, subgenotype D4, compared to A1 subgenotype have delayed HBeAg seroconversion and higher levels of HBV – DNA, suggesting that this subgenotype is possibly related to

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