Clarina TakahashiI; Clara F. T. YoshidaII; Ana Maria C. GasparII; Marcia L. BaptistaII; Marcos HoetteI; Frederico RuzanyI
IClínica de Doenças Renais - Rio de Janeiro IIDepartamento de Virologia - Fundação Oswaldo Cruz - Avenida Brasil, 4365 CEP 21040 - Rio de Janeiro
RESUMO
A monitorização mensal de alanina aminotransferase (ALT) sérica de pacientes em hemodiálise e os testes sorológicos para exclusões de infecções por vírus da hepatite A (HAV), vírus da hepatite B (HBV), citomegalovirus (CMV) e vírus Epstein-Barr (EBV), permitiu-nos identificar 11 casos de hepatites não-A, não-B em 111 indivíduos avaliados durante o período de 12 meses e acompanhados por 2 anos.
Foram observados 3 padrões de atividade de ALT: elevação em pico monofásico em 2, bifásico ou polifásico em 6 e em platô em 3 pacientes. Individíduos com padrão monofásico exibiram os níveis mais elevados de ALT.
Cinco pacientes apresentaram normalização bioquímica persistente 4,8 meses em média após o início da elevação aguda e seis evoluíram com ascensão crônica de ALT durante o período de estudo. A hepatite não-A, não-B foi, predominantemente, assintomática e anictérica, sempre antecedida por transfusões sangüíneas e com maior incidência nos seis primeiros meses de terapia dialítica dos pacientes.
Palavras-chave: Hepatite não-A, não-B. Hemodiálise. Transfusão sagüinea.
ABSTRACT
Through monthly monitorization of alanine amino transferase (ALT) in hemodialysis patients and serological tests for exclusion of HA V (hepatitis A virus), HBV(hepatitis B virus), CMV (cytomegalovirus) and EBV (Epstein-Barr virus) infections, it was possible to identify 11 cases of non-A, non-B hepatitis among 111 individuals evaluated in a period of 12 months and followed-up for 2 years.
Three patterns of ALT activity were observed: an elevation in monophasic peak in 2 patients, biphasic andpolyphasic in 6 patients and elevation in plateau in three others. Patients with the monophasic pattern showed the most elevated levels of ALT.
Five patients showed biochemical normalization within approximately 4.8 months after the beginning of acute elevation and 6 evolved with chronic intermittent elevation during the period of study.
Hepatitis non-A, non-B was predominantly asymptomatic and anicteric, always preceeded by blood tranfusions and with higher incidence in the 6 first months after hemodialysis.
Keywords: Non-A Non-B Hepatitis. Hemodialysis. Blood transfusion.
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Recebido para publicação em 5/5/88.
