Gastric autoimmune disorders in patients with chronic hepatitis C before,during and after interferon-alpha therapy

AIM: To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of α-intefferon (IFN) treatment on autoimmune gastritis.METHODS: We performed a prospective study on 189patients with positive anti-HCV and viral RNA enrolled in a 12-month IFN protocol. We evaluated: a) the baseline prevalence of autoimmune gastritis, b) the impact of IFN treatment on development of biochemical signs of autoimmune gastritis (at 3, 6 and 12 months), c) the evolution after IFN withdrawal (12 months) in terms of anti-gastric-parietal-cell antibodies (APCA), gastrin, anti-thyroid, and anti-non-organ-specific antibodies.RESULTS: APCA positivity and 3-fold gastrin levels were detected in 3 (1.6 %) and 9 (5 %) patients, respectively, at baseline, in 25 (13 %) and 31 (16 %) patients at the end of treatment (both P＜0.001, vs baseline), and in 7 (4 %) and 14 (7 %) patients 12 months after withdrawal (P=0.002and ,P=0.01 respectively, vs baseline; P=not significant vs end of treatment). The development of autoimmune gastritis was strictly associated with the presence of autoimmune thyroiditis (P =0.0001), no relationship was found with other markers of autoimmunity.CONCLUSION: In HCV patients, IFN frequently precipitates latent autoimmune gastritis, particularly in females. Following our 12-month protocol, the phenomenon generally regressed. Since APCA positivity and high gastrin levels are associated with the presence of antithyroid antibodies,development of autoimmune thyroiditis during IFN treatment may provide a surrogate preliminary indicator of possible autoimmune gastritis to limit the need for invasive examinations.

Extreme Events Assessment Methodology Coupling Debris Flow,Flooding and Tidal Levels in the Coastal Floodplain of the Sao Paulo North Coast(Brazil)

The North Coastal Region of the State of S?o Paulo, which comprises the Municipalities of Caraguatatuba, S?o Sebasti?o, Ilhabela and Ubatuba, is one of the most prone to flooding and debris flow deposition Brazilian areas, owing to hydrological extreme rainfall events usually coupled with extreme tidal levels. This risk is also high due to human lives and material assets, with increasing population rates and the establishment of large companies such as the Oil industry, with reduced defense/prevention measures and works.The catastrophic scenario of the city of Caraguatatuba, in March 1967, resulting from one of the most serious natural disasters in Brazil, fosters discussions about probabilities of heavy rainfall-caused events and rise in the sea level in coastal areas. Hence, this research is a consequence of this reality. The research is founded on an innovative methodology based on the analysis of past data of rainfall and tidal stations, complemented with debris flow registers in the region of the north coastal zone of the State of S?o Paulo (Brazil). The anaysis developed involved the meteorological, hydraulic, geotechnical and statistical knowledge areas.Practical results are intended to be used for urban planning, designs of macro-drainage, fluvial, maritime projects and debris flow retention structures. These practical applications will then associate the probability of occurrence of certain types of heavy rainfall-caused events such as flooding or debris flow coupled with a corresponding increase in tidal levels.