Navegando por Assunto "Resposta viral sustentada"

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Avaliação do grau de fibrose hepática em pacientes com hepatite C crônica, através de métodos não invasivos, após o tratamento com antivirais de ação direta, em um centro de referência de Belém-PA
(Centro Universitário do Estado do Pará, 2020) Melo, Raphael Anaissi Castelo Branco de; Penna Neto, Ruy; Sampaio, Regiane Miranda Arnund; Miranda, Esther Castello Branco Mello; http://lattes.cnpq.br/2603804265819507; http://lattes.cnpq.br/4904370452637372
INTRODUCTION: Viral hepatitis represents a group of diseases of great relevance in the world and also in Brazil. Staging of chronic liver disease must be performed by any available method: Liver biopsy is a gold standard, but invasive method. Other non-invasive methods such as APRI (AST Platelet Ratio Index), FIB4 (Fibrosis-4) and hepatic elastography have been widely used. For a long time, interferon, pegylated interferon and ribavirin were used to treat hepatitis C, however, they did not achieve significant responses. In contrast, direct-acting antivirals (DAAs), now available, have shown high efficacy and tolerance. OBJECTIVE: To evaluate the degree of hepatic fibrosis in patients with chronic hepatitis C who underwent direct action antiviral therapy, demonstrating whether there was a change in the disease stage. METHOD: This study is characterized as descriptive, cross-sectional and retrospective in patients with hepatitis Chronic C seen at a Reference Unit in Belém-PA, from January 2015 to August 2019. Data collection was performed by analyzing the physical and electronic records by the authors of the research at the Patient Information Management (GIPE) of FSCMPA. Clinical data such as age, sex, stage of the disease, type and duration of treatment with direct action antivirals, platelet counts, AST, ALT and APRI, FIB4 and elastography results were evaluated. RESULTS: Data from 60 patients were collected in this study, of which 51, 67% (31) were female and 48.33% (29) male. The variation from the median before treatment to after treatment was 12 kPa to 7.4 kPa (p <0.0001) by elastography. Evaluating APRI, the median variation was from 1.51 to 0.41 (p <0.0001). For the FIB-4, the median variation was 4.02 to 1.75 (p <0.0001). CONCLUSION: The research showed that there was a statistically significant reduction in the degree of liver fibrosis in patients undergoing therapy with AEDs, according to the medical records analyzed, based on the evaluation by Fibroscan®. The same occurred when the invasive mathematical methods APRI and FIB4 were evaluated. There was also a reduction in the degree of staging by the METAVIR classification, since before treatment most patients were between stages F3 and F4, however, after treatment, most patients are between stages F1 and F2.
Tratamento da Hepatite C com os antivirais de ação direta: análise dos fatores interferentes na adesão ao tratamento e na resposta virológica sustentada em pacientes atendidos em um Centro de Especialidades Médicas em Belém-PA
(Centro Universitário do Estado do Pará, 2022-11-10) Bico, Aimee Wagner; Aood, Raiza Pontes; Santos, Eliane Regine Fonseca; Souza, Rhomero Salvyo Assef; Ribeiro, Helem Ferreira
Viral hepatitis are public health problems in Brazil. They present modes of transmission that vary from fecal-oral, sexual, parenteral and vertical transmission. Hepatitis C is caused by the Hepacivirus of the Flaviviridae family, the subclinical development with unspecific symptoms contributes to the chronicity of inflammation, cirrhosis and untreated hepatocellular cancer, which are performed through Direct Action Antiviral Drugs that aim at Sustained Virological Response with an elimination plan of the disease. Evaluate the adhesion to treatment and its interfering factors in addition to the prevalence of co-infections and the therapeutic response of these patients to the use of Direct-Action Antiviral Drugs (DAA). The present undergraduate thesis analyzed patients with Hepatitis C treated in the city of Belém-PA in a Center of Medical Specialties. The descriptive and analytical cross-sectional study developed used the Pearson’s Chi-Square and the Fisher's Exact Test for statistical analysis of data collected from medical records. It was noted at the end of the data analysis of 167 patients that the highest prevalence of notifications was in the metropolitan region (91%) with a greater number of cases among females (53,3%), but with a higher prevalence of coinfections among men (64,3%), especially in the younger age group (21,4%) aged 22 to 39 years. It was identified that 48.5% of the patients being followed up were older than 60 years and in most cases had less than 2 years of the period between diagnosis and the beginning of treatment, a factor that did not influence the therapeutic response, which was promising in more than 80% of the medical records analyzed. It is important to emphasize that, based on the better governmental structuring of the testing models and with the simplification of the diagnosis of Hepatitis C over the years, it was possible to analyze patients who, by adhering to treatments with DAAs, managed to obtain a cure for Hepatitis C without major side effects and with higher quality of life.