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dc.creatorSILVA, Aline Cristina Souza da-
dc.creator.ID09764018602por
dc.creator.Latteshttp://lattes.cnpq.br/8155613951258793por
dc.contributor.advisor1CAVELLANI, Camila Lourencini-
dc.contributor.advisor1ID22766440879por
dc.contributor.advisor1Latteshttp://lattes.cnpq.br/4489525187547014por
dc.contributor.advisor-co1TEIXEIRA, Vicente de Paula Antunes-
dc.contributor.advisor-co1ID19278063649por
dc.contributor.advisor-co1Latteshttp://lattes.cnpq.br/6788700810093027por
dc.date.accessioned2019-09-19T18:22:01Z-
dc.date.issued2019-06-17-
dc.identifier.citationSILVA, Aline Cristina Souza da. Análise das alterações hepáticas em pacientes autopsiados com a síndrome da imunodeficiência adquirida. 2019. 84f . Tese (Doutorado em Ciências da Saúde) - Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, 2019 .por
dc.identifier.urihttp://bdtd.uftm.edu.br/handle/tede/868-
dc.description.resumoObjetivo: Analisar as alterações histomorfométricas e laboratoriais hepáticas de pacientes autopsiados com a Aids, relacionando esses dados ao uso da terapia antirretroviral (TARV). Métodos: 62 fragmentos hepáticos de pacientes com Aids (n=31) e sem Aids (n=31) autopsiados entre 1996 e 2017, foram pareados pela idade (18-49), sexo e cor. Os pacientes com Aids foram analisados de acordo com o uso (n=15) ou não (n=16) da TARV. Na análise histomorfométrica, foram confeccionadas lâminas para análise da esteatose, fibras colágenas e colágeno tipo III. A densidade das células de Kupffer foi analisada através de imunomarcação com o anticorpo anti- CD68. Para a análise do padrão macro ou microvesicular e da distribuição topográfica da esteatose, foi considerado o predomínio nas diferentes áreas histológicas (área 1, 2 e 3) de acordo com o método de Brunt adaptado. Informações referentes à dosagem sanguínea de bilirrubina total, direta e indireta, alanina aminotransferase, aspartato aminotransferase e plaquetas foram obtidas dos prontuários clínicos. Resultados: Os pacientes com Aids apresentaram significativamente maior porcentagem de esteatose (26,05 vs 21,95%), de fibras colágenas (1,63 vs 1,01%) e colágeno tipo III (8,68 vs 7,83%). Os grupos com e sem Aids tiveram predomínio do padrão macrovesicular e distribuição topográfica da esteatose na área 1. Os pacientes com Aids que fizeram uso da TARV apresentaram significativamente menor porcentagem de esteatose (25,45 vs 26,36%) e de fibras colágenas (1,52 vs 1,75%), enquanto o predomínio do padrão macrovesicular e da área 1 não mostrou diferença significativa. Em relação ao colágeno tipo III, os pacientes que fizeram uso da TARV apresentaram menor valor (8,52 vs 8,77%). Houve uma menor densidade de células de Kupffer nos pacientes com Aids (18,43 vs 23,26 céls/mm2), e semelhança na densidade dos grupos que fizeram ou não o uso de TARV (18,17 vs 18,17 céls/mm2). Na análise dos dados laboratoriais, o grupo com Aids apresentou significativamente menor valor de bilirrubina indireta (0,27 vs 0,91 mg/dL), e aqueles que fizeram uso do tratamento apresentaram valores significativamente maiores (0,45 vs 0,22 mg/dL), porém os valores encontravam-se dentro da normalidade. Conclusão: A Aids ocasiona aumento da esteatose e da fibrose hepática. No entanto, a TARV possui papel benéfico redutor em relação ao acúmulo de gordura nos hepatócitos e no desenvolvimento da fibrose, uma vez que a medicação é capaz de amenizar ambos os processos.por
dc.description.abstractObjective: To analyze the histomorphometric and hepatic laboratory abnormalities of autopsied patients with AIDS, relating these data to use of ART. Methods: 62 liver fragments from patients with (n=31) and without (n=31) AIDS autopsied from 1996 and 2017, matched by age (18-49), gender and race. Patients with AIDS were analyzed according to treatment on ART (n=15) or non-ART (n=16). In the histomorphometric analysis sections were made and stained with hematoxylin-eosin, picrosirius and reticulin for steatosis, collagen fibers and type III collagen analysis, respectively. Immunostaining for CD68 was performed to evaluate the Kupffer cells density. For the analysis of pattern macro or microvesicular and topographical distribution of steatosis was considered the predominance of different histological areas: area 1, area 2 and area 3 using adapted method of Brunt. Information on direct and indirect bilirubin blood count, alanine aminotransferase, aspartate aminotransferase and platelets were obtained from the clinical records. Results: Patients with AIDS showed significantly larger steatosis percentage (26.05 vs 21.95%), collagen fibers (1.63 vs 1.01%) and type III collagen (8.68 vs 7.83%). Groups of patients with and without AIDS showed prevalence of macrovesicular pattern and topographic distribution steatosis in area 1, however no significantly difference was shown. Patients with AIDS on ART showed significantly lower steatosis percentage (25.45 vs 26.36%) and collagen fibers (1.52 vs 1.75%), as the prevalence of macrovesicular pattern and area 1 showed no significantly difference. Regarding type III collagen, patients on ART showed lower value (8.52 vs 8.77%), although no significantly difference. A lower density of Kupffer cells was shown in patients with AIDS (18.43 vs 23.26 cells/mm2) but no statistically significant difference was detected. Group on ART showed no difference in density cells compared to the group on no therapy (18.17 vs 18.17 cells/mm2). Laboratory data presented indirect bilirubin lower value for AIDS group (0.27 vs 0.91 mg/dL) and the group on ART presented greater significant values (0.45 vs 0.22 mg/dL) but still both groups presented range of normal values. Conclusion: AIDS increases steatosis and liver fibrosis. However, ART has a decreased beneficial role in hepatocyte fat accumulation and fibrosis development since the medication detains both processes.eng
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superiorpor
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de Minas Geraispor
dc.description.sponsorshipUniversidade Federal do Triângulo Mineiropor
dc.description.sponsorshipFundação de Ensino e Pesquisa de Uberabapor
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológicopor
dc.formatapplication/pdf*
dc.thumbnail.urlhttp://bdtd.uftm.edu.br/retrieve/5782/Tese%20Aline%20C%20S%20da%20Silva.pdf.jpg*
dc.languageporpor
dc.publisherUniversidade Federal do Triângulo Mineiropor
dc.publisher.departmentInstituto de Ciências da Saúde - ICS::Programa de Pós-Graduação em Ciências da Saúdepor
dc.publisher.countryBrasilpor
dc.publisher.initialsUFTMpor
dc.publisher.programPrograma de Pós-Graduação em Ciências da Saúdepor
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dc.rightsAcesso Abertopor
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/-
dc.subjectAids.por
dc.subjectAutópsia.por
dc.subjectColágeno.por
dc.subjectFígado.por
dc.subjectAIDS.eng
dc.subjectAutopsy.eng
dc.subjectCollagen.eng
dc.subjectLiver.eng
dc.subject.cnpqCiências da Saúdepor
dc.titleAnálise das alterações hepáticas em pacientes autopsiados com a síndrome da imunodeficiência adquiridapor
dc.typeTesepor
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