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Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil

Hepatitis virus infection is a major public health problem worldwide. Currently, Brazil has almost 700,000 cases. The Brazilian Unified Health System (SUS) provides therapeutic regimens for people infected with hepatitis C virus (HCV). We determined the clinical, laboratory, epidemiologic, and geosp...

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Autores principales: Pena, Danilo Zangirolami, Anadão, Murilo Fernandes, Flores, Edilson Ferreira, Okada, Mayara Namimatsu, Filho, Alexandre Martins Portelinha, Ferro, Rodrigo Sala, Prestes-Carneiro, Luiz Euribel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601958/
https://www.ncbi.nlm.nih.gov/pubmed/33066136
http://dx.doi.org/10.3390/microorganisms8101575
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author Pena, Danilo Zangirolami
Anadão, Murilo Fernandes
Flores, Edilson Ferreira
Okada, Mayara Namimatsu
Filho, Alexandre Martins Portelinha
Ferro, Rodrigo Sala
Prestes-Carneiro, Luiz Euribel
author_facet Pena, Danilo Zangirolami
Anadão, Murilo Fernandes
Flores, Edilson Ferreira
Okada, Mayara Namimatsu
Filho, Alexandre Martins Portelinha
Ferro, Rodrigo Sala
Prestes-Carneiro, Luiz Euribel
author_sort Pena, Danilo Zangirolami
collection PubMed
description Hepatitis virus infection is a major public health problem worldwide. Currently, Brazil has almost 700,000 cases. The Brazilian Unified Health System (SUS) provides therapeutic regimens for people infected with hepatitis C virus (HCV). We determined the clinical, laboratory, epidemiologic, and geospatial characteristics of patients infected with HCV treated with second-generation direct-action antivirals (DAAs) in a hospital reference center in São Paulo state, Brazil, using data from file records. A map was constructed using a geographic information system. From 2015 to 2018, 197 individuals received second-generation DAAs (mean age, 57.68 ± 1.36 years; interquartile range, 56.22–59.14 years; 58.9% male; 41.1% female). Genotypes 1a and 1b accounted for 75.7% of cases and the prevalent therapeutic regimen was sofosbuvir/simeprevir. Sustained viral response accounted for 98.9% and the METAVIR score F3/F4 for 50.8%. Increased alanine transferase was significantly correlated with an increase in α-fetoproteins (p = 0.01), and severe necro-inflammatory activity (p = 0.001). Associated comorbidities were found in 71.6%, mainly coronary artery and gastrointestinal disorders. The cumulative incidence in the region was 2.6 per 10,000 inhabitants. Our data highlight the role of reference hospitals in Brazil’s public health system in the treatment of HCV. Low incidence rates demonstrated the fragility of municipalities in the active search for patients.
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spelling pubmed-76019582020-11-01 Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil Pena, Danilo Zangirolami Anadão, Murilo Fernandes Flores, Edilson Ferreira Okada, Mayara Namimatsu Filho, Alexandre Martins Portelinha Ferro, Rodrigo Sala Prestes-Carneiro, Luiz Euribel Microorganisms Article Hepatitis virus infection is a major public health problem worldwide. Currently, Brazil has almost 700,000 cases. The Brazilian Unified Health System (SUS) provides therapeutic regimens for people infected with hepatitis C virus (HCV). We determined the clinical, laboratory, epidemiologic, and geospatial characteristics of patients infected with HCV treated with second-generation direct-action antivirals (DAAs) in a hospital reference center in São Paulo state, Brazil, using data from file records. A map was constructed using a geographic information system. From 2015 to 2018, 197 individuals received second-generation DAAs (mean age, 57.68 ± 1.36 years; interquartile range, 56.22–59.14 years; 58.9% male; 41.1% female). Genotypes 1a and 1b accounted for 75.7% of cases and the prevalent therapeutic regimen was sofosbuvir/simeprevir. Sustained viral response accounted for 98.9% and the METAVIR score F3/F4 for 50.8%. Increased alanine transferase was significantly correlated with an increase in α-fetoproteins (p = 0.01), and severe necro-inflammatory activity (p = 0.001). Associated comorbidities were found in 71.6%, mainly coronary artery and gastrointestinal disorders. The cumulative incidence in the region was 2.6 per 10,000 inhabitants. Our data highlight the role of reference hospitals in Brazil’s public health system in the treatment of HCV. Low incidence rates demonstrated the fragility of municipalities in the active search for patients. MDPI 2020-10-13 /pmc/articles/PMC7601958/ /pubmed/33066136 http://dx.doi.org/10.3390/microorganisms8101575 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pena, Danilo Zangirolami
Anadão, Murilo Fernandes
Flores, Edilson Ferreira
Okada, Mayara Namimatsu
Filho, Alexandre Martins Portelinha
Ferro, Rodrigo Sala
Prestes-Carneiro, Luiz Euribel
Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil
title Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil
title_full Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil
title_fullStr Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil
title_full_unstemmed Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil
title_short Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil
title_sort clinical, epidemiological, and geospatial characteristics of patients infected with hepatitis c virus treated with second-generation direct-action antivirals in a reference center in a mesoregion of são paulo state, brazil
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601958/
https://www.ncbi.nlm.nih.gov/pubmed/33066136
http://dx.doi.org/10.3390/microorganisms8101575
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