Ana Leopércio - Academia.edu (original) (raw)

Papers by Ana Leopércio

Research paper thumbnail of Importância Da Elastografia Hepática Transitória Na Doença Hepática Gordurosa Em Pessoas Vivendo Com Hiv (Pvhiv) Em Uso De Terapia Antirretroviral, Acompanhados Em Um Serviço Público De São Paulo

Brazilian Journal of Infectious Diseases, 2022

Research paper thumbnail of Avaliação Do Perfil Epidemiológico Dos Pacientes Portadores De Hepatite C Submetidos À Diferentes Tratamentos Farmacológicos, Conforme Preconizado No Ano De Tratamento, Nos Ambulatórios De Infectolgia Da Faculdade De Medicina Do Abc

The Brazilian Journal of Infectious Diseases, 2021

Research paper thumbnail of Hepatitis B Reactivation in HBsAg Negative Renal Transplant Patients with Evidence of Previous HBV Infection: A Not Neglectable Occurrence

OBM transplantation, Oct 26, 2022

Hepatitis B virus (HBV) infection is frequent among patients with chronic kidney disease (CKD). H... more Hepatitis B virus (HBV) infection is frequent among patients with chronic kidney disease (CKD). HBV reactivation after kidney transplant (KT) is more common in patients with HBsAg+; however, it can also occur in previously infected individuals, particularly those with HBsAg negative and total antiHBc positive (HBsAg-/antiHBcT+). However, reactivation in this population has scarce and conflicting data. This study aimed to assess the reactivation risk in KT recipients with previous HBV infection (antiHBcT+). A retrospective cohort study was conducted, including patients with KT between January 1993 and December 2012 with HBsAg+ (G1) and with previous HBV infection (antiHBcT+) (G2). A total of 10,493 transplants were performed in this period. A total of 203 patients were included (122 HBsAg+ and 81 HBsAg-/anti-HBcT+). The reactivation of infection occurred in 24.6% (30/38) patients and 9.8%

Research paper thumbnail of Chronic Paracoccidioidomycosis of the Intestine as Single Organ Involvement Points to an Alternative Pathogenesis of the Mycosis

Mycopathologia, 2013

Current knowledge on the natural history of paracoccidioidomycosis states that the chronic form o... more Current knowledge on the natural history of paracoccidioidomycosis states that the chronic form of the disease results from reactivation of quiescent foci established years or decades before during the primary lung infection. Once reactivated, the fungi can disseminate to virtually any organ or system. We present herein two chronic paracoccidioidomycosis patients with a single organ involvement that points to an alternative pathogenesis of the mycosis. These patients suggest that the chronic form may also arise from reactivation of foci not confined to the lungs, due to the early dissemination of yeast cells during the primary infection.

Research paper thumbnail of Glaciological and meteorological observations at the SIGMA-D site, northwestern Greenland Ice Sheet

Bulletin of Glaciological Research, 2015

Research paper thumbnail of Changing pattern of chronic hepatitis C in renal transplant patients over 20 years

European Journal of Gastroenterology & Hepatology, 2019

Background The prevalence and clinical epidemiological profile of hepatitis C virus (HCV) infecti... more Background The prevalence and clinical epidemiological profile of hepatitis C virus (HCV) infection have changed over time. Aim This study aimed to evaluate these changes in renal transplant recipients (RTx) comparing two different decades. Materials and methods RTx with HCV referred to RTx from 1993 to 2003 (A) and from 2004 to 2014 (B) were studied retrospectively. The demographic and clinical characteristics and different outcomes were compared between groups A and B. Variables that were statistically different were tested for inclusion in a multivariate Cox proportional hazard model predicting patient survival within the group. Results Among 11 715 RTx, the prevalence of HCV was 7% in A and 4.9% in B. In the more recent period (B), the mean age was older (46.2 vs. 39.5 years), with more males (72 vs. 60.7%), larger number of deceased donors (74 vs. 55%), higher percentage of previous RTx (27 vs. 13.7%), less frequent history of blood transfusion (81 vs. 89.4%), lower prevalence of hepatitis B virus coinfection (4.7 vs. 21.4%), and higher percentage of cirrhotic patients (13 vs. 5%). Patients of group B more frequently underwent treatment of HCV (29 vs. 9%), less frequently used azathioprine (38.6 vs. 60.7%) and cyclosporine (11.8 vs. 74.7%), and more frequently used tacrolimus (91 vs. 27.3%). In the outcomes, graft loss showed no difference between periods; however, decompensation was more frequent (P = 0.007) and patients' survival was lower in the more recent period (P = 0.032) compared with the earlier one. Conclusion The profile of RTx with HCV has changed over the last 20 years. Despite a decrease in the prevalence of HCV, new clinical challenges have emerged, such as more advanced age and a higher prevalence of cirrhosis.

Research paper thumbnail of Incidência Do Carcinoma Hepatocelular Pós-Terapia Com Antivirais De Ação Direta Da Hepatite C: Uma Coorte De 243 Pacientes Cirróticos

The Brazilian Journal of Infectious Diseases, 2022

Research paper thumbnail of Observational Study Evaluating the Outcome of Cirrhotic Hepatitis C Patients Submitted to Renal Transplantation

Transplantation Proceedings, 2020

Background. After renal transplantation (RTx) hepatitis C virus (HCV) is associated with higher m... more Background. After renal transplantation (RTx) hepatitis C virus (HCV) is associated with higher morbidity and mortality resulting in lower patient and graft survival. Few studies have investigated the evolution of renal transplant patients with cirrhosis owing to HCV. The objectives were to evaluate the post-transplant evolution of cirrhotic patients and to compare them with noncirrhotic patients considering the outcomes, including hepatic decompensation, graft loss, and death. Methods. The retrospective-cohort study analyzed the data of patients undergoing RTx between 1993 and 2014, positive anti-HCV, HCV-RNA before RTx, and availability of data for assessment of cirrhosis. Demographic, clinical, and laboratory variables were compared between the groups according to the outcomes. The same were made between cirrhotic patients with and without portal hypertension (PH). Survival curves were constructed by the Kaplan-Meier test and compared by the log-rank test. Variables associated with the outcomes were analyzed using Cox regression. Results. This study included noncirrhotic (n ¼ 201) and cirrhotic patients (n ¼ 23). In cirrhotic patients, they were significantly older (49 vs 41.6 years) and mostly male (87% vs 65%), with a greater number of previous RTx (48% vs 18%), less frequent use of azathioprine (26% vs 54%), cyclosporine (13% vs 46.5%), more frequent use of tacrolimus (87% vs 55%), lower count of platelets  1000 cells/mm 3 (110 vs 187), and higher pre-RTx international normalized ratio (1.20 vs 1.1).The Kaplan-Meier survival differed in cirrhotic vs noncirrhotic patients only in hepatic decompensation. Cox regression analysis identified pretransplant cirrhosis (hazard ratio 6.64, 95% confidence interval, 2.59-17.06) and tacrolimus (hazard ratio 3.17,95% confidence interval, 1.05-9.58) as variables independently associated with decompensation. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e Brasil (CAPES)/ Brazilian agency of research support for the scholarship between 2013 to 2017. Finance Code 001. There are no conflicts of interest.

Research paper thumbnail of Comparação Entre Os Métodos De Biópsia Hepática, Elastografia Hepática Pelo Método Arfi e Os Marcadores Bioquímicos Apri e FIB‐4 Para Avaliação Da Fibrose Hepática Em Pacientes Com Hepatite Crônica C Atendidos Em Um Ambulatório De Referência

The Brazilian Journal of Infectious Diseases

Research paper thumbnail of Importância Da Elastografia Hepática Transitória Na Doença Hepática Gordurosa Em Pessoas Vivendo Com Hiv (Pvhiv) Em Uso De Terapia Antirretroviral, Acompanhados Em Um Serviço Público De São Paulo

Brazilian Journal of Infectious Diseases, 2022

Research paper thumbnail of Avaliação Do Perfil Epidemiológico Dos Pacientes Portadores De Hepatite C Submetidos À Diferentes Tratamentos Farmacológicos, Conforme Preconizado No Ano De Tratamento, Nos Ambulatórios De Infectolgia Da Faculdade De Medicina Do Abc

The Brazilian Journal of Infectious Diseases, 2021

Research paper thumbnail of Hepatitis B Reactivation in HBsAg Negative Renal Transplant Patients with Evidence of Previous HBV Infection: A Not Neglectable Occurrence

OBM transplantation, Oct 26, 2022

Hepatitis B virus (HBV) infection is frequent among patients with chronic kidney disease (CKD). H... more Hepatitis B virus (HBV) infection is frequent among patients with chronic kidney disease (CKD). HBV reactivation after kidney transplant (KT) is more common in patients with HBsAg+; however, it can also occur in previously infected individuals, particularly those with HBsAg negative and total antiHBc positive (HBsAg-/antiHBcT+). However, reactivation in this population has scarce and conflicting data. This study aimed to assess the reactivation risk in KT recipients with previous HBV infection (antiHBcT+). A retrospective cohort study was conducted, including patients with KT between January 1993 and December 2012 with HBsAg+ (G1) and with previous HBV infection (antiHBcT+) (G2). A total of 10,493 transplants were performed in this period. A total of 203 patients were included (122 HBsAg+ and 81 HBsAg-/anti-HBcT+). The reactivation of infection occurred in 24.6% (30/38) patients and 9.8%

Research paper thumbnail of Chronic Paracoccidioidomycosis of the Intestine as Single Organ Involvement Points to an Alternative Pathogenesis of the Mycosis

Mycopathologia, 2013

Current knowledge on the natural history of paracoccidioidomycosis states that the chronic form o... more Current knowledge on the natural history of paracoccidioidomycosis states that the chronic form of the disease results from reactivation of quiescent foci established years or decades before during the primary lung infection. Once reactivated, the fungi can disseminate to virtually any organ or system. We present herein two chronic paracoccidioidomycosis patients with a single organ involvement that points to an alternative pathogenesis of the mycosis. These patients suggest that the chronic form may also arise from reactivation of foci not confined to the lungs, due to the early dissemination of yeast cells during the primary infection.

Research paper thumbnail of Glaciological and meteorological observations at the SIGMA-D site, northwestern Greenland Ice Sheet

Bulletin of Glaciological Research, 2015

Research paper thumbnail of Changing pattern of chronic hepatitis C in renal transplant patients over 20 years

European Journal of Gastroenterology & Hepatology, 2019

Background The prevalence and clinical epidemiological profile of hepatitis C virus (HCV) infecti... more Background The prevalence and clinical epidemiological profile of hepatitis C virus (HCV) infection have changed over time. Aim This study aimed to evaluate these changes in renal transplant recipients (RTx) comparing two different decades. Materials and methods RTx with HCV referred to RTx from 1993 to 2003 (A) and from 2004 to 2014 (B) were studied retrospectively. The demographic and clinical characteristics and different outcomes were compared between groups A and B. Variables that were statistically different were tested for inclusion in a multivariate Cox proportional hazard model predicting patient survival within the group. Results Among 11 715 RTx, the prevalence of HCV was 7% in A and 4.9% in B. In the more recent period (B), the mean age was older (46.2 vs. 39.5 years), with more males (72 vs. 60.7%), larger number of deceased donors (74 vs. 55%), higher percentage of previous RTx (27 vs. 13.7%), less frequent history of blood transfusion (81 vs. 89.4%), lower prevalence of hepatitis B virus coinfection (4.7 vs. 21.4%), and higher percentage of cirrhotic patients (13 vs. 5%). Patients of group B more frequently underwent treatment of HCV (29 vs. 9%), less frequently used azathioprine (38.6 vs. 60.7%) and cyclosporine (11.8 vs. 74.7%), and more frequently used tacrolimus (91 vs. 27.3%). In the outcomes, graft loss showed no difference between periods; however, decompensation was more frequent (P = 0.007) and patients' survival was lower in the more recent period (P = 0.032) compared with the earlier one. Conclusion The profile of RTx with HCV has changed over the last 20 years. Despite a decrease in the prevalence of HCV, new clinical challenges have emerged, such as more advanced age and a higher prevalence of cirrhosis.

Research paper thumbnail of Incidência Do Carcinoma Hepatocelular Pós-Terapia Com Antivirais De Ação Direta Da Hepatite C: Uma Coorte De 243 Pacientes Cirróticos

The Brazilian Journal of Infectious Diseases, 2022

Research paper thumbnail of Observational Study Evaluating the Outcome of Cirrhotic Hepatitis C Patients Submitted to Renal Transplantation

Transplantation Proceedings, 2020

Background. After renal transplantation (RTx) hepatitis C virus (HCV) is associated with higher m... more Background. After renal transplantation (RTx) hepatitis C virus (HCV) is associated with higher morbidity and mortality resulting in lower patient and graft survival. Few studies have investigated the evolution of renal transplant patients with cirrhosis owing to HCV. The objectives were to evaluate the post-transplant evolution of cirrhotic patients and to compare them with noncirrhotic patients considering the outcomes, including hepatic decompensation, graft loss, and death. Methods. The retrospective-cohort study analyzed the data of patients undergoing RTx between 1993 and 2014, positive anti-HCV, HCV-RNA before RTx, and availability of data for assessment of cirrhosis. Demographic, clinical, and laboratory variables were compared between the groups according to the outcomes. The same were made between cirrhotic patients with and without portal hypertension (PH). Survival curves were constructed by the Kaplan-Meier test and compared by the log-rank test. Variables associated with the outcomes were analyzed using Cox regression. Results. This study included noncirrhotic (n ¼ 201) and cirrhotic patients (n ¼ 23). In cirrhotic patients, they were significantly older (49 vs 41.6 years) and mostly male (87% vs 65%), with a greater number of previous RTx (48% vs 18%), less frequent use of azathioprine (26% vs 54%), cyclosporine (13% vs 46.5%), more frequent use of tacrolimus (87% vs 55%), lower count of platelets  1000 cells/mm 3 (110 vs 187), and higher pre-RTx international normalized ratio (1.20 vs 1.1).The Kaplan-Meier survival differed in cirrhotic vs noncirrhotic patients only in hepatic decompensation. Cox regression analysis identified pretransplant cirrhosis (hazard ratio 6.64, 95% confidence interval, 2.59-17.06) and tacrolimus (hazard ratio 3.17,95% confidence interval, 1.05-9.58) as variables independently associated with decompensation. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e Brasil (CAPES)/ Brazilian agency of research support for the scholarship between 2013 to 2017. Finance Code 001. There are no conflicts of interest.

Research paper thumbnail of Comparação Entre Os Métodos De Biópsia Hepática, Elastografia Hepática Pelo Método Arfi e Os Marcadores Bioquímicos Apri e FIB‐4 Para Avaliação Da Fibrose Hepática Em Pacientes Com Hepatite Crônica C Atendidos Em Um Ambulatório De Referência

The Brazilian Journal of Infectious Diseases