Human immunodeficiency virus cascade-continuum of care stages and outcomes in a hospital in southern Brazil.

Background: The human immunodeficiency virus (HIV) continuum of care cascade illustrates the 90-90-90 goals defined by the Joint United Nations Program on HIV/acquired immunodeficiency syndrome (UNAIDS). The care cascade includes the following five steps: Diagnosis, linkage to care, retention in care, adherence to antiretroviral therapy (ART), and viral suppression.

Aim: To elaborate the HIV cascade of patients diagnosed with HIV at the Nossa Senhora da Conceição Hospital (HNSC) and to determine possible local causes for the loss of patients between each step of the cascade.

Stages of care for patients with chronic hepatitis C at a hospital in southern Brazil.

Background: Hepatitis C virus (HCV) is defined as a public health problem by the World Health Organization (WHO) and since then has defined targets through the HCV elimination. The HCV cascade of care highlights the progress towards these goals and essential interventions that need to be delivered along this continuum care.

Aim: To document the treatment cascade for patients with HCV infection at the Hospital Nossa Senhora da Conceição (HNSC), defining the percentage of antibody-positive patients who collected molecular biology tests (polymerase chain reaction), attended outpatient clinic assistance, underwent treatment, and achieved a virologic cure termed sustained virologic response (SVR).

A minimal monitoring approach for the treatment of hepatitis C virus infection (ACTG A5360 [MINMON]): a phase 4, open-label, single-arm trial.

Background: Despite widespread availability of direct-acting antivirals including generic formulations, limited progress has been made in the global adoption of hepatitis C virus (HCV) treatment. Barriers to treatment scale-up include availability and access to diagnostic and monitoring tests, health-care infrastructure, and requirement for frequent visits during treatment.

Methods: ACTG A5360 was a phase 4, open-label, single-arm trial across 38 sites in Brazil, South Africa, Thailand, Uganda, and the USA.

Top 10 evidence-based recommendations from the Brazilian Society of Infectious Diseases for the Choosing Wisely Project.

The Choosing Wisely Initiative aims to collect statements from medical societies all over the world on medical interventions that result in no benefit to patients, with the potential to cause harm. In this article we present the views of the Diagnostic Laboratory Group at the Brazilian Society of Infectious Diseases (SBI). Ten experts from SBI were asked to list 10 diagnostic tests that were perceived as unnecessary in the field of infectious diseases.

Incidence of hepatocellular carcinoma in patients with chronic liver disease due to hepatitis B or C and coinfected with the human immunodeficiency virus: A retrospective cohort study.

Aim: To assess the incidence of hepatocellular carcinoma (HCC) in chronic liver disease due to hepatitis B virus (HBV) or hepatitis C virus (HCV) coinfected with human immunodeficiency virus (HIV).

Methods: A retrospective cohort study was performed, including patients with chronic liver disease due to HBV or HCV, with and without HIV coinfection. Patients were selected in the largest tertiary public hospital complex in southern Brazil between January 2007 and June 2014.

Relative validity of a food frequency questionnaire in patients coinfected with hepatitis C virus and human immunodeficiency virus.

Introduction:: Validation of food frequency questionnaires (FFQs) is recommended for accurate measurement of habitual food consumption. We assessed the relative validity of a FFQ in patients coinfected with hepatitis C virus and human immunodeficiency virus.

Methods:: Each patient responded to a FFQ and three 24-hour food recalls.

Polymorphisms and resistance mutations of hepatitis C virus on sequences in the European hepatitis C virus database.

Aim: To evaluate the occurrence of resistant mutations in treatment-naïve hepatitis C virus (HCV) sequences deposited in the European hepatitis C virus database (euHCVdb).

Methods: The sequences were downloaded from the euHCVdb (https://euhcvdb.ibcp.

Genetic Barrier to Direct Acting Antivirals in HCV Sequences Deposited in the European Databank.

Background & Aims: Development of resistance results from mutations in the viral genome, and the presence of selective drug pressure leads to the emergence of a resistant virus population. The aim of this study was to analyze the impact of genetic variability on the genetic barrier to drug resistance to DAAs.

Methods: The genetic barrier was quantified based on the number and type of nucleotide mutations required to impart resistance, considering full-length HCV NS3, NS5A and NS5B regions segregated by genotype into subtypes 1a, 1b, 2a, 2b and 3a.

Antiretroviral therapy does not affect response to chronic hepatitis C therapy in HIV-coinfected patients.

Introduction: Many patients coinfected with the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are using highly active antiretroviral therapy (HAART) and HCV therapy with peginterferon (PEG-IFN) and ribavirina (RBV) because the use of direct-acting antivirals is not a reality in some countries. To know the impact of such medications in the sustained virological response (SVR) during HCV treatment is of great importance.

Methodology: This was a retrospective cohort study of 215 coinfected HIV/HCV patients.

Biochemical non-invasive assessment of liver fibrosis cannot replace biopsy in HIV-HCV coinfected patients.

Background And Rationale: The liver biopsy has been considered the gold standard for the diagnosis and quantification of fibrosis. However, this method presents limitations. In addition, the non-invasive evaluation of liver fibrosis is a challenge.

HBV carrying drug-resistance mutations in chronically infected treatment-naive patients.

Background: Nucleoside/nucleotide analogue (NA) treatment causes selection pressure for HBV strains carrying mutations conferring NA resistance. Drug-resistance mutations occur in the reverse transcriptase (RT) region of the HBV polymerase gene and spontaneously arise during viral replication. These mutations can also alter the hepatitis B surface (HBs) protein and in some cases reduce binding to HBs antibodies.

HAART and liver: is it safe?

Introduction: Liver disease caused by hepatitis C virus (HCV) is a major cause of morbidity in HIV patients. This study investigates the possibility that chronic HCV increases the risk of hepatotoxicity after highly active antiretroviral therapy (HAART) initiation.

Methodology: The data from 30 coinfected HIV/HCV and 35 HIV monoinfected patients between August 2008 and August 2010, since the start of HAART, were analyzed along with data from every three months, with clinical/laboratory evaluation until the end of twelve months.

Immune restoration in human immunodeficiency virus and hepatitis C virus coinfected patients after highly active antiretroviral therapy.

Objective: To evaluate the influence of hepatitis C virus on immunological and virological responses after highly active antiretroviral therapy initiation in human immunodeficiency virus/hepatitis C virus coinfected patients compared to monoinfected human immunodeficiency virus-infected patients.

Methods: The study enrolled 65 human immunodeficiency virus-1-infected subjects who initiated highly active antiretroviral therapy and attended follow-up visits over 48 weeks from 2008 to 2010. They were grouped based on hepatitis C virus-RNA results.

Saccharomyces cerevisiae oesophagitis in a patient with oesophageal carcinoma.

Saccharomyces species are emerging opportunistic fungal pathogens that can cause bloodstream infections in humans. These infections have often been associated with the ingestion of probiotics. Saccharomyces oesophagitis is a rare condition which has been described so far in only two publications.

Treatment of severe chromoblastomycosis with itraconazole and 5-flucytosine association.

Chromoblastomycosis is a chronic human melanized fungi infection of the subcutaneous tissue caused by traumatic inoculation of a specific group of dematiaceous fungi through the skin, often found in barefooted agricultural workers, in tropical and subtropical climate countries. We report the case of a male patient presenting a slow-growing pruriginous lesion on the limbs for 20 years, mistreated over that time, which was diagnosed and successfully treated as chromoblastomycosis. Besides the prevalence of this disease, treatment is still a clinical challenge.

[Evaluation of APRI score in liver disease following the introduction of antiretroviral therapy in HIV and HCV coinfected versus HIV monoinfected patients].

Introduction: The impact of highly active antiretroviral therapy (HAART) on hepatic fibrosis progression in HIV and hepatitis C virus coinfected patients is not completely understood. Noninvasive hepatic fibrosis markers show great promise in determining liver fibrosis staging and monitoring disease progression.

Methods: Twenty-four patients divided equally into two groups: 12 HIV-monoinfected and 12 with HIV/HCV coinfected patients, were followed from July 2008 to August 2009, after initiating HAART, with clinical, epidemiological and laboratorial assessments every 3 months and calculation of the aspartate aminotransferase to platelet ratio index (APRI).

Candida esophagitis: species distribution and risk factors for infection.

Although Candida albicans is the main cause of fungal esophagitis, other species such as C. tropicalis, C. krusei and C.