ABSTRACT Dengue Fever, Zika and Chikungunya are febrile infectious diseases transmitted by the Aedes species of mosquito with a high rate of mortality. The most common vector is Aedes aegypti. According to World Health Organization outbreaks of mosquito-borne illnesses are common in the tropical and subtropical climates, as there are currently no vaccines to protect against Dengue Fever, Chikungunya or Zika diseases. Hence, mosquito control is the only known method to protect human populations. Consequently, the affected countries need urgently search for better tools and sustained control interventions in order to stop the growing spread of the vector. This study presents an optimization model, involving chemical, biological and physical control decisions that can be applied to fight against the Aedes mosquito. To determine solutions for the optimization problem a genetic heuristic is proposed. Through the computational experiments, the algorithm shows considerable efficiency in achieving solutions that can support decision makers in controlling the mosquito population.

OBJECTIVES: Suppressor of cytokine signaling 3, myxovirus resistance protein and osteopontin gene polymorphisms may influence the therapeutic response in patients with chronic hepatitis C, and an association with IL28 might increase the power to predict sustained virologic response. Our aims were to evaluate the association between myxovirus resistance protein, osteopontin and suppressor of cytokine signaling 3 gene polymorphisms in combination with IL28B and to assess the therapy response in hepatitis C patients treated with pegylated-interferon plus ribavirin. METHOD: Myxovirus resistance protein, osteopontin, suppressor of cytokine signaling 3 and IL28B polymorphisms were analyzed by PCR-restriction fragment length polymorphism, direct sequencing and real-time PCR. Ancestry was determined using genetic markers. RESULTS: We analyzed 181 individuals, including 52 who were sustained virologic responders. The protective genotype frequencies among the sustained virologic response group were as follows: the G/G suppressor of cytokine signaling 3 (rs4969170) (62.2%); T/T osteopontin (rs2853744) (60%); T/T osteopontin (rs11730582) (64.3%); and the G/T myxovirus resistance protein (rs2071430) genotype (54%). The patients who had ≥3 of the protective genotypes from the myxovirus resistance protein, the suppressor of cytokine signaling 3 and osteopontin had a greater than 90% probability of achieving a sustained response (p<0.0001). The C/C IL28B genotype was present in 58.8% of the subjects in this group. The sustained virological response rates increased to 85.7% and 91.7% by analyzing C/C IL28B with the T/T osteopontin genotype at rs11730582 and the G/G suppressor of cytokine signaling 3 genotype, respectively. Genetic ancestry analysis revealed an admixed population. CONCLUSION: Hepatitis C genotype 1 patients who were responders to interferon-based therapy had a high frequency of multiple protective polymorphisms in the myxovirus resistance protein, osteopontin and suppressor of cytokine signaling 3 genes. The combined analysis of the suppressor of cytokine signaling 3 and IL28B genotypes more effectively predicted sustained virologic response than IL28B analysis alone.

OBJECTIVE: The individual components of metabolic syndrome may be independent predictors of mortality in patients with liver disease. We aimed to evaluate the prevalence of metabolic syndrome and its related components in hepatitis C virus-infected patients who are not obese and do not have type 2 diabetes. METHODS: This cross-sectional study included 125 patients infected with hepatitis C virus genotype 1. Metabolic syndrome was defined according to the International Diabetes Federation. Anthropometric data were measured according to standardized procedures. Bioimpedance analysis was performed on all patients. RESULTS: Metabolic syndrome was diagnosed in 21.6% of patients. Of the subjects with metabolic syndrome, 59.3% had hypertension, 77.8% had insulin resistance, 85.2% were overweight, 48.1% had a high waist circumference, 85.2% had an increased body fat percentage, and 92.3% had an elevated waist:hip ratio. In the bivariate analysis, female sex (OR 2.58; 95% CI: 1.09-6.25), elevated gamma-glutamyl transferase (γGT) (OR 2.63; 95% CI: 1.04-7.29), elevated fasting glucose (OR 8.05; 95% CI: 3.17-21.32), low HDL cholesterol (OR 2.80; 95% CI: 1.07-7.16), hypertriglyceridemia (OR 7.91; 95% CI: 2.88-22.71), elevated waist circumference (OR 10.33; 95% CI: 3.72-30.67), overweight (OR 11.33; 95% CI: 3.97-41.07), and increased body fat percentage (OR 8.34; 95% CI: 2.94-30.08) were independent determinants of metabolic syndrome. Using the final multivariate regression model, similar results were observed for abdominal fat (OR 9.98; 95% CI: 2.63-44.41) and total body fat percentage (OR 8.73; 95% CI: 2.33-42.34). However, metabolic syndrome risk was also high for those with blood glucose >5.55 mmol/L or HDL cholesterol <0.9 mmol/L (OR 16.69; 95% CI: 4.64-76.35; OR 7.23; 95% CI: 1.86-32.63, respectively). CONCLUSION: Metabolic syndrome is highly prevalent among hepatitis C virus-infected patients without type 2 diabetes or obesity. Metabolic syndrome was significantly associated with hypertension, insulin resistance, increased abdominal fat, and overweight.

RACIONAL: Estudos em cinética viral na hepatite C demonstraram que há uma queda dos níveis séricos de interferon 48 h após a sua administração, quando a carga viral do vírus C volta a se elevar. Antes da disponibilidade do interferon peguilado, diversos ensaios clínicos investigaram a terapia de indução com interferon standard OBJETIVOS: Avaliar a segurança e eficácia do esquema de indução diário com interferon alfa associado à ribavirina. PACIENTES E MÉTODOS: Noventa e três pacientes com hepatite crônica C foram incluídos. Através de randomização, foram alocados em um de dois braços terapêuticos: 44 indivíduos no grupo A: IFN 3MU três vezes por semana + ribavirina 1,0-1,2 g diariamente por 48 semanas e 49 indivíduos no grupo B: IFN 3MU diariamente por 12 semanas, seguindo-se por IFN 3MU três vezes por semana até completar 48 semanas + ribavirina 1,0-1,2 g diariamente por 48 semanas. A genotipagem do vírus C foi realizada em 85 indivíduos. Considerou-se resposta virológica sustentada a persistência do HCV-RNA negativo 6 meses após o término da terapia RESULTADOS: Oitenta e três pacientes completaram o tratamento. Houve cinco abandonos (um do grupo A e quatro do grupo B) e em cinco pacientes a terapia foi retirada devido a efeitos adversos (dois do grupo A e três do grupo B). Não houve diferença estatisticamente significante entre os grupos quanto à interrupção do tratamento. A freqüência de cirrose foi 29%, semelhante entre os grupos. Na análise "intention to treat" a resposta virológica sustentada foi 39,8%. Não houve diferença estatística na taxa de resposta virológica sustentada entre ambas as estratégias terapêuticas (36,4% grupo A vs 42,9% grupo B). Nos 83 pacientes que finalizaram o estudo, a resposta virológica sustentada foi 44,6%. Entre os pacientes com genótipo 1, a resposta virológica sustentada foi 42% (40,9% grupo A vs 42,9% grupo B) e entre os pacientes com genótipo 2/3, a resposta virológica sustentada foi 55,6% (50% grupo A vs 63,6% grupo B) CONCLUSÕES: A taxa de resposta virológica sustentada foi 39,8% para a terapia combinada (análise "intention to treat"). Não houve diferença entre as taxas de RVS do grupo de indução comparado ao regime padrão. Efeitos adversos, mesmo mais freqüentes no grupo de indução, não interferiram nas estratégias terapêuticas.

BACKGROUD: Studies on hepatitis C virus kinetics showed that serum levels of interferon fall 48 h after drug administration, when viral load is increasing again. Previously to the availability of pegylated interferon, daily induction therapy with standard interferon was under evaluation. AIMS: To evaluate the safety and efficacy of interferon alpha daily induction regimen in combination with ribavirin. PATIENTS AND METHODS: A randomized trial including 93 patients with chronic hepatitis C was carried out. On satisfying all eligibility criteria, patients were randomly allocated to two different treatment groups: 44 individuals in treatment arm A: IFN 3 MU thrice weekly + ribavirin 1.0-1.2 g daily for 48 weeks (IFN TIW) and 49 individuals in treatment arm B: IFN 3 MU daily + ribavirin 1.0-1.2 g daily for 12 weeks followed by IFN 3 MU thrice weekly + ribavirin 1.0-1.2 g daily, until completion of 48 weeks of therapy (IFN QD). HCV genotyping was obtained in 85 subjects. A negative HCV-RNA 6 months after cessation of therapy was considered a sustained virological response RESULTS: Eighty three patients completed treatment, five dropped out (one from IFN TIW and four from IFN QD) and in five patients therapy was discontinued due to medical request (two from IFN TIW and three from IFN QD). There was no statistically significant difference between groups with respect to therapy interruption. The frequency of cirrhosis was 29%, similar in both groups. In the "intention to treat" analysis the overall sustained virological response was 39.8%. There was no significant difference in sustained virological response rate between both treatment strategies (36.4% IFN TIW vs 42.9% IFN QD). In the 83 patients who finished the trial, sustained virological response was 44.6%. Among subjects with HCV genotype-1, the sustained virological response was 42% (40.9% IFN TIW vs 42.9% IFN QD) and among patients with HCV genotype 2 or 3, the sustained virological response was 55.6% (50% IFN TIW vs 63.6% IFN QD) CONCLUSIONS: Combination therapy had an overall sustained virological response rate of 39.8% ("intention to treat analysis"). There was no difference with respect to sustained virological response rates between patients who used daily induction schedule compared to standard regimen. Adverse events, even more frequent in the daily induction group, did not interfere with the treatment strategies.

INTRODUÇÃO: Esteatose ocorre com freqüência na hepatite crônica pelo vírus C (HCV) e parece estar relacionada a fatores clínicos e/ou virológicos. Contudo, a presença de esteato-hepatite, uma condição indutora de fibrose, tem sido pouco estudada. OBJETIVO: Estudar a associação de HCV com esteato-hepatite em material de biópsia hepática, correlacionando-a com dados clínicos. MÉTODOS: As biópsias hepáticas de pacientes com HCV foram avaliadas quanto a atividade, estádio e presença de alterações morfológicas de esteato-hepatite. Os dados morfológicos foram correlacionados a parâmetros clínicos que incluíam: consumo alcoólico, IMC, colesterol, triglicérides, glicemia, exposição a petroquímicos e genótipo viral. RESULTADOS: Esteato-hepatite foi encontrada em 42 de 252 (16,6%) pacientes com HCV. Entre os 42 casos, critérios para obesidade, diabetes e dislipidemia foram encontrados em 16,7%; 16,7% e 21,4%, respectivamente. O genótipo 3 esteve presente em 38,1% dos casos. Fatores de risco para esteato-hepatite não-alcoólica (NASH) foram encontrados em 73% dos casos em genótipos diferentes do 3, enquanto tais fatores foram presentes em 37,5% dos casos com genótipo 3 (p = 0,05). O padrão morfológico mais freqüente foi a esteatose macrovacuolar de moderada intensidade (61,9%) com distribuição difusa (64,3%). Tanto o padrão de fibrose de NASH quanto o de HCV foram notados: fibrose perissinusoidal (87,8%), portal (87,8%), septal (69,0%) e cirrose (30,9%). CONCLUSÕES: Esteato-hepatite é freqüente em pacientes com HCV, apresentando padrão peculiar de distribuição da esteatose e alta freqüência de cirrose. Em genótipos diferentes do 3, a esteato-hepatite parece estar relacionada à sobreposição de fatores de risco para NASH.

INTRODUCTION: Steatohepatitis and hepatitis C virus (HCV) have been related to several clinical and virological factors and fibrosis progression. OBJECTIVE: To describe clinical and morphological aspects of steatohepatitis associated to HCV. METHODS: The study included patients with HCV without treatment. Biopsies were evaluated by METAVIR score and steatohepatitis was evaluated according to criteria of Sociedade Brasileira de Patologia (SBP). Clinical parameters included alcoholic intake history and determination of risk factors for non-alcoholic steatohepatitis (NASH). RESULTS: Steatohepatitis was observed in 42 out of 252 patients (16.6%) with HCV, and 76.2% were male. Risk factors for NASH were present in 37.5% of the patients with genotype 3 and in 73% of the patients with other genotypes (p = 0.05). Obesity was present in 16.7%, diabetes in 16.7%, hyperlipidemia in 21.4%, and genotype 3 in 38.1%. Macrovacuolar steatosis presented mild intensity in 61.9% and was diffuse in 64.3%. Cirrhosis was present in 33.3% of the patients. CONCLUSIONS: Diffuse steatosis and ballooning of mild to moderate intensity characterized steatohepatitis related to HCV. Patients with genotype different from genotype 3 presented with known risk factors for NASH, whereas most of the patients with genotype 3 had only viral genotype as risk factor for steatosis. The frequency of cirrhosis was relevant and suggests that the association of steatohepatitis with HCV contribute to fibrosis progression.

Patients with chronic hepatitis C can have variable clinical progression. Hepatic histological alterations appear to be milder in asymptomatic subjects who have persistently normal ALT levels. AIMS: To evaluate the severity of histological liver alterations in blood donors with normal and elevated ALT levels. METHODS: We evaluated volunteer blood donors from the main blood bank of the city of Salvador-Brazil. Those who were anti-HCV positive were invited to participate in the study. Serum ALT and AST levels were measured at two time points, two months apart. Donors were divided into two groups: group I, individuals with ALT > 1.5 times the upper limit of normal in at least one time point and group II, individuals with normal or near normal ALT, at both time points RESULTS: We evaluated 30,232 blood donors and 528 (1.7%) of them were anti-HCV positive. Eighty-two attended our service and HCV infection was confirmed in 66 individuals. Male gender predominated in both groups; the mean age was 36 for group I, and 33 for group II. Tattoos and intravenous illicit drug use were frequently-encountered risk factors. Liver biopsy was done in 43 subjects. Among donors with elevated ALT, two (10%) had minimum alterations, while in group II normal liver or minimum alterations were observed in six (26%) subjects. Chronic hepatitis or cirrhosis was encountered in 35 (81%) individuals: three (15%) and five (21%) subjects had chronic hepatitis without inflammatory activity, 10 (50%) and 11 (48%) had minimum to moderate activity and five (25%) and one (4.3%) had cirrhosis, in groups I and II, respectively (P was not significant). CONCLUSIONS: The prevalence of anti-HCV among this population of volunteer blood donors was 1.7%, and these subjects had few liver histological alterations or chronic hepatitis and cirrhosis. Liver injury severity was significant in patients with elevated ALT, however subjects with normal levels may also present chronic hepatitis and cirrhosis.

Helicobacter pylori plays an important role in the etiology of peptic ulcer disease. Its prevalence appears to be higher in developing countries. We evaluated the seroprevalence of H. pylori and risk factors associated with infection in voluntary blood donors who attended the main blood center of the city of Salvador, Brazil. The subjects responded to an epidemiological questionnaire, with information about sex, age, race, lifestyle, social-economic level indicators, and residence and hygiene conditions. Anti-H. pylori antibody was determined by ELISA (Cobas Core, Roche). Three hundred and seven subjects were included in the study. Anti-H. pylori antibody results were indeterminate in 33 individuals (10.8%), who were excluded from analysis. Among the remaining 274 subjects, 187 (68.2%) were anti-H. pylori positive. Based on multivariate logistic regression analysis three variables were found to be significantly associated with a higher prevalence of H. pylori infection: absence of plumbing in the residence during childhood, a history of rainwater invading the dwelling during childhood, and low ingestion of milk.

Racional - A prevalência da infecção pelo vírus da hepatite C em pacientes sob programa de hemodiálise tem sido amplamente variável. Objetivos -- Determinar a prevalência do anticorpo contra o vírus C da hepatite (anti-VHC) em pacientes sob hemodiálise em Salvador, BA e sua associação com transfusão de sangue, duração de hemodiálise e elevação de alaninoaminotransferase. Métodos - Durante um período de 17 meses, foram avaliados todos os pacientes em programa de hemodiálise, totalizando 395 indivíduos, que responderam a questionário e forneceram soro para análise laboratorial (alaninoaminotransferase sérica e anti-VCH pelo ELISA II com confirmação pelo Immunoblotting (RIBA III). Resultados - O anti-VHC foi positivo em 23,8% (94/395). A presença de transfusão mostrou associação com o anti-VHC e quanto maior o número de transfusões, mais freqüente o anti-VHC. Dos pacientes que nunca foram transfundidos, 12,5% (6/48) foram anti-VHC positivos. A duração do tratamento dialítico foi de 53,44 ± 36,45 meses no grupo anti-VHC positivo e de 22,10 ± 22,75 meses no grupo negativo. A elevação de alaninoaminotransferase foi mais freqüente no grupo positivo para o anti-VHC. A positividade para as frações do RIBA III foi de 79,8%, 100%, 80,9% e 52,1% para o c100-3, c33, c22 e NS5, respectivamente. O anti-NS5 foi ainda menos freqüente no grupo com alaninoaminotransferase elevada. Conclusões - A prevalência do anti-VHC em pacientes sob hemodiálise crônica de Salvador, BA é elevada e está associada com transfusão de sangue, maior duração de tratamento dialítico e elevação de alaninoaminotransferase.

Background -- Hepatitis C infection in hemodialysis units has been evaluated in different grographic regions. Aims - The prevalence of anti-HCV in patients undergoing hemodialysis program in the city of Salvador, State of Bahia, Brazil, was studied and its association with transfusions, duration of hemodialysis and ALT elevation. Method - During a period of 17 months, all patients undergoing dialytic treatment, were evaluated. The total number of patients was 395, all of whom completed a questionnaire and provided serum samples for laboratory analysis. Serological levels were measured for ALT and the samples were tested for anti-HCV using ELISA II with a further confirmation using RIBA III. Results - Anti-HCV was positive in 23,8% (94/395). The presence of transfusions was associated with anti-HCV and as the number of transfusions used increased, so did the frequency of anti-HCV. Of the patients who never received transfusions, 12,5% (6/48) were anti-HCV positive. The duration of dialytic treatment lasted from 53,44 ± 36,45 months in the anti-HCV positive group and 22,10 ± 22,75 months for the group testing negative. ALT elevation was more frequent in the anti-HCV positive group. Positivity for the RIBA III fractions was 79,8%, 100%, 80,9% and 52,1%, for c100-3, c33, c22 and NS5, respectively. The anti-NS5 was even less frequent in the group with elevated ALT. Conclusions - The prevalence of anti-HCV in patients undergoing chronic hemodialysis in Salvador, Bahia, is elevated and it is associated with transfusions, a longer duration of dialytic treatment and ALT elevation.

A organização e diversidade genômica do vírus da hepatite C define, pelo menos, 6 genotipos e 52 subtipos com peculiaridades clínicas e epidemiológicas. Há escassez de estudos referentes ao genotipo do vírus da hepatite C no Brasil, assim como sua epidemiologia biomolecular. Foram estudados a freqüência do genotipo e os aspectos epidemiológicos em 232 portadores do vírus da hepatite C, 133 (57,9%) homens e 99 (42,1%) mulheres, seguidos num centro de referência para doenças de fígado em Salvador, nordeste do Brasil. Todos os pacientes eram anti-HCV positivo por ELISA de terceira geração e HCV RNA positivo por RT PCR. O genotipo foi determinado por INNOLIPA. Os fatores de risco para o vírus da hepatite C verificados através de questionário padrão, demonstrou que 93 (40%) tinham história de transfusão, 14 (6%) eram usuários de droga venosa, 19 (18%) referiam inalação de cocaína, 28 (12%) tinham tatuagem, 15 (7%) eram trabalhadores da área da saúde, 5 (2%) referiram reutilização de seringas descartáveis, 5 (2%) tinham múltiplos fatores de risco e 53 (23%) não referiram nenhum fator de risco. O genotipo 1a foi observado em 75 (32%), 1b em 72 (31%), 3a em 61 (26%), 2a em 14 (6%), 5 (2,5%) tinham infecção por mais de um genotipo e 5 (2,5%) tiveram o genotipo indeterminado. Pacientes com genotipo 1 apresentavam média de idade mais alta (P <0,05) e nenhum fator de risco peculiar esteve associado a um genotipo específico. O genotipo 1 predominou amplamente no nordeste do Brasil, seguido pelo genotipo 3. Nesta população o genotipo 3 não parece estar relacionado ao uso de drogas venosas, em contraste ao que foi reportado nos estudos europeus. Embora 80% da população de Salvador seja composta por população negra ou miscigenada, nenhum genotipo africano foi identificado, o que pode significar que o vírus da hepatite C foi introduzido nesta região via imigração européia. Este estudo demonstra algumas peculiaridades da epidemiologia do vírus da hepatite C no Brasil e fortemente sugere que sua introdução nessa região esteve relacionada à imigração européia e não à africana.

The genomic diversity of HCV embraces 6 genotypes and at least 52 subtypes with clinical and epidemiological correlations. There is a paucity of studies assessing HCV genotypes and biomolecular epidemiology in Brazil. We studied genotype distribution and epidemiological aspects in 232 HCV carriers, 133 (57,9%) males and 99 (42,1%) females, followed in the liver disease referral unit in Salvador, BA, northeastern Brazil. All of them were anti-HCV positive by 3rd generation ELISA assay, and HCV-RNA positive by RT-PCR. Genotyping was performed by INNOLIPA. Assessment of risk factors for HCV infection showed that 93 (40%) had past blood transfusion, 14 (6%) intravenous drug use, 19 (8%) inhalation of cocaine, 28 (12%) tattooing, 15 (7%) were health care workers, 5 (2%) had reused disposable syringes, 5 (2%) had multiple risk factors and in 53 (23%) no risk factor was determined. Genotype 1a was observed in 75 (32%), 1b in 72 (31%), 3a in 61 (26%), 2ab in 14 (6%); 5 (2.5%) had mixed genotypes and 5 (2.5%) were undetermined. Patients with genotype 1 had a higher mean age (P <0.05) and no particular risk factors were associated with a specific genotype. Genotype 1 largely predominates in northeast Brazil followed by genotype 3 which, in this population, does not seem to be related to intravenous drug abuse, in contrast to some European studies. Although 80% of the Salvador population comprises African-Brazilians, no African genotype was identified, which may mean that HCV was introduced into this region via European immigration. This study demonstrated some peculiarities of HCV epidemiology in Brazil and strongly suggests that HCV introduction to this region was probably related to European immigration.

Estudou-se a associação entre carcinoma hepatocelular (CHC) e a infecção pelo vírus B da hepatite (VHB) em Salvador, Bahia (Brasil), utilizando-se o desenho caso-controle, pareado por idade e sexo, comparando-se a freqüência de positividade aos marcadores virais de um grupo de 40 casos de CHC com dois grupos controles: 40 indivíduos com outras neoplasias e 80 indivíduos sadios. Utilizou-se a técnica de radioimunoensaio para os testes sorológicos. Foram observadas altas proporções de indivíduos positivos para AgHBs (42,5%) e daqueles com AgHBs ou antiHBs (65,0%) entre os casos de CHC. A proporção de positivos para AgHBs entre os casos foi maior do que no grupo controle com outras neoplasias (7,5%) e no grupo de indivíduos sadios (2,5%), equivalente a estimativas de risco de 15,0 (Intervalo de Confiança (IC) a 95% de 3,29, 68,30) e de 33,0 (IC a 95% de 9,13, 119,28), ambos estatisticamente significantes. Não foi observada positividade ao AgHBe AntiHBe estava presente em 41,2% dos casos, sugerindo a ausência de replicação viral, com integração do DNA do vírus ao genoma hepático. Entre os casos de CHC houve associação entre cirrose e AgHBs. Foi referida história de alcoolismo crônico mais freqüentemente por aqueles com cirrose. O estudo demonstra a relevante associação entre CHC e VHB, principalmente em indivíduos jovens.

Hepatitis B virus (HBV) serological markers were investigated in 40 incident cases of hepatocellular carcinoma (HCC) and in two age and sex matched control groups, comprising 40 patients with other cancers and 80 healthy individuals, resident in Bahia, Brazil. Serologic tests were done by radioimmunoassay. The study observed high proportion of seropositivity to HBsAg (42.5%) and of those presenting HBsAg or antiHBc (65.0%) among HCC cases, higher in men than women and in those aged 17 to 30 years old. HBsAg seropositivity among HCC patients was greater than in the control group with other cancers (7.5%) and in healthy controls (2.5%), corresponding to odds ratio estimates of 15.0 (95% CI 3.29, 68.30) and 33.0 (95% CI 9.13, 119.28), both statistically significant. HBeAg was not observed and antiHBe was present in 41.2% of cases, suggesting the absence of viral replication, possibly with viral DNA intergration into the hepatocyte genome. The presence of cirrhosis was associated with HBsAg seropositivity among HCC cases. A history of chronic alcoholism is shown to be more frequently related to those cases with cirrhosis. This study highlights the relevant association between HCC and HBV in Northeast Brazil, particularly for young individuals, and the high risk of development of HCC for HBsAg carriers.

Estudou-se a associação entre carcinoma hepatocelular (CHC) e a infecção pelo vírus B da hepatite (VHB) em Salvador, Bahia (Brasil), utilizando-se o desenho caso-controle, pareado por idade e sexo, comparando-se a freqüência de positividade aos marcadores virais de um grupo de 40 casos de CHC com dois grupos controles: 40 indivíduos com outras neoplasias e 80 indivíduos sadios. Utilizou-se a técnica de radioimunoensaio para os testes sorológicos. Foram observadas altas proporções de indivíduos positivos para AgHBs (42,5%) e daqueles com AgHBs ou antiHBs (65,0%) entre os casos de CHC. A proporção de positivos para AgHBs entre os casos foi maior do que no grupo controle com outras neoplasias (7,5%) e no grupo de indivíduos sadios (2,5%), equivalente a estimativas de risco de 15,0 (Intervalo de Confiança (IC) a 95% de 3,29, 68,30) e de 33,0 (IC a 95% de 9,13, 119,28), ambos estatisticamente significantes. Não foi observada positividade ao AgHBe AntiHBe estava presente em 41,2% dos casos, sugerindo a ausência de replicação viral, com integração do DNA do vírus ao genoma hepático. Entre os casos de CHC houve associação entre cirrose e AgHBs. Foi referida história de alcoolismo crônico mais freqüentemente por aqueles com cirrose. O estudo demonstra a relevante associação entre CHC e VHB, principalmente em indivíduos jovens.

Hepatitis B virus (HBV) serological markers were investigated in 40 incident cases of hepatocellular carcinoma (HCC) and in two age and sex matched control groups, comprising 40 patients with other cancers and 80 healthy individuals, resident in Bahia, Brazil. Serologic tests were done by radioimmunoassay. The study observed high proportion of seropositivity to HBsAg (42.5%) and of those presenting HBsAg or antiHBc (65.0%) among HCC cases, higher in men than women and in those aged 17 to 30 years old. HBsAg seropositivity among HCC patients was greater than in the control group with other cancers (7.5%) and in healthy controls (2.5%), corresponding to odds ratio estimates of 15.0 (95% CI 3.29, 68.30) and 33.0 (95% CI 9.13, 119.28), both statistically significant. HBeAg was not observed and antiHBe was present in 41.2% of cases, suggesting the absence of viral replication, possibly with viral DNA intergration into the hepatocyte genome. The presence of cirrhosis was associated with HBsAg seropositivity among HCC cases. A history of chronic alcoholism is shown to be more frequently related to those cases with cirrhosis. This study highlights the relevant association between HCC and HBV in Northeast Brazil, particularly for young individuals, and the high risk of development of HCC for HBsAg carriers.

Foi estudada, do ponto de vista ecológico, a poluição da água do rio Capibaribe-Mirim. Foram feitas cerca de 40 coletas de material de janeiro a dezembro de 1974, compreendendo os períodos seco e chuvoso, em 6 estações distribuídas desde o alto curso do rio (perto de Macaparana) até o médio curso (imediações de Goiana). Observaram-se 96 taxa entre espécies e variedades, sendo as mais frequëntes e dominantes as seguintes: Biddulphia laevis (Ehr.) Hustedt, Synedra ulna (Nitzsch) Ehr., Eunotia pectinalis (Kutz) Rabenhost, Nitzschia sigma (Kutz) W. Smith, Navicula cuspidata var. ambigua (Ehr.) Cleve, Eunotia didyma Grunow, Amphora ovalis Kutz., Amphora coffeaeformis Agard, Hantzschia amphioxys (Ehr.) Grunow, Nitzschia triblionella var. victoriae (H.) Grunow, Pinnularia acrospheria Breb., Pinnularia mesolepta (Ehr.) W. Smith, Rhopalodia gibberula (Ehr.) O. Müller, Surirella ovata kutz. É dada especial atenção ás algas Bacillariophyceae e Chlorophyceae. São apresentados, em forma tabular, o inventário ecológico, os índices halóbicos e sapróbicos das espécies, e a freqüência e distribuição das diatomáceas nas diversas estações de coleta.

Ecological studies on water pollution in the Capibaribe-Mirim river were carried out during a period of 12 months (January to December 1974 covering the dry and wet seasons). Six collecting stations were established, from the upper course of the river, near Macaparana town, to the middle course, near Goiana town. In about 40 collected samples, 96 taxons, including species and varieties, were found. Reports and comments were made on the microflora and microfauna observed, more attention having been given to the Bacillariophyceae and Chlorophyceae present in the samples. The most frequent and dominant species of diatoms were the following: Biddulphia laevis (Ehr.) Hustedt, Synedra ulna (Nitzsch) Ehr., Eunotia pectinalis (Kutz.) Rabenhost, Nitzschia sigma (Kutz.) W. Smith, Navicula cuspidata var. ambigua (Ehr.) Cleve, Eunotia didyma Grunow, Amphora ovalis kutz., Amphora coffeaeformis Agard, Hantzschia amphioxys (Ehr.) Grunow, Nitzschia triblionella var. victoriae (H.) Grunow, Pinnularia acrospheria Breb., Pinnularia mesolepta (Ehr.) W. Smith, Rhopalodia gibberula (Ehr.) O. Müller, Surirella ovata Kutz. Table 1 shows the ecological inventory of each taxon, the halobic indices of the species, as well as the indicator species of the saprobic conditions of the water. Table 2 shows the frequency and distribution of diatoms in the several stations.

The author describes an anomalous specimen in diatom Coscinodiscus oculus-iridis Ehr., 1839, caught from Guanabara Bat, (22º 51' 8" Lat. S. - 43º 14' 3" Long. W. G.); its dorsal face (fig. 1), is different from the ventral one, (fig. 2).