Occult hepatitis B (OHB) is characterized by the presence of HBV-DNA in the absence of HBsAg in the serum of patients. Hemodialysis patients are at high risk for hepatitis B virus and there are few data on the prevalence of OHB in this population, mainly in Brazil. Thus, the aim of this study was to determine the prevalence of OHB in patients undergoing hemodialysis. A cross-sectional study was performed, including 301 patients on chronic hemodialysis at two dialysis centers in São Luís (Maranhão), northeast Brazil. Serological tests were performed for HBsAg, anti-HBc, anti-HBs, and anti-HCV using enzyme immunoassays (ELISA); HBV-DNA and HCV-RNA were studied by real-time PCR. The mean age was 49 ± 15 years, and 128 (42%) were female. Serological tests confirmed that all samples were HBsAg negative. Anti-HBc was positive in 114 (38%) patients, anti-HBc and anti-HBs were simultaneously positive in 104 (35%), and anti-HBc alone was positive in 10 (3%). Tests were negative for anti-HBc and anti-HBs in 55 patients (18%). Anti-HBs was the only positive marker in 132 (44%) patients. Anti-HCV was positive in 15 (5%) patients with HCV-RNA present in 14 of them (93%). HBV-DNA was positive in seven cases (2.3%). There was no association of HBV-DNA with age, gender, time on dialysis, previous kidney transplant, or HBV serological pattern, but there was a positive correlation with the presence of anti-HCV (P < 0.001). OHB in chronic renal failure patients on hemodialysis appears to be a relevant finding, suggesting that studying HBV-DNA in this population using sensitive molecular tests should be a recommended course of action, especially in candidates for renal transplant.
BACKGROUNDKnee osteoarthritis (OA) is the most common chronic arthropathy. OA has great impact on patients' life quality and can lead to impairment. Age is one of the most important risk factors for OA development. There is no treatment to change the course of the disease; however, intra-articular infiltration (IIA) with corticosteroids is commonly used for its efficacy in controlling pain. Even so, there is few data evaluating the influence of age on IIA response.
METHODSA cohort study was performed to evaluate the influence of age on the response to IIA with triamcinolone hexacetonide (TH). All patients were submitted to IIA with 40 mg of TH in the affected knee. Then they were accessed by a blinded observer on weeks T0, T4 and T12. The variables analyzed were visual analogue scale (VAS) for pain at rest and in movement; functional questionnaire, WOMAC; life quality questionnaire, SF36; and the functional test Timed Up and Go. They were divided in two groups: older and younger group. Groups were paired for demographic variables, Kellgren-Lawrence radiographic classification criteria, body mass index and VAS for pain at rest and in movement at baseline.
RESULTSSixty patients were analyzed: 29 on the younger group, with a mean age of 56 years and 31 patients on the older group, with a mean age of 75 years. The vast majority were women, 93% in younger group and 91% in older group. The mean time from diagnostic were 5 years on younger group and 6 years on the older. In all variables it has been observed an improvement in intragroup analyzes (p < 0.05) when comparing T0 to T12. However, there has not been found difference in the intergroup analyzes in any of the variables.
CONCLUSIONOn this study age has no influence on IIA with TH response.
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