NODAT, recurrent and de novo NAFLD are common after LT but are not associated with signs of graft dysfunction, possibly due to the low frequency of IR and NASH. No correlation is observed between NAFLD and NODAT, MS, hypertriglyceridemia, obesity and IR. β-cell dysfunction and diabetes, however, are seen in most of the patients, possibly due to calcineurin inhibitor toxicity.

BACKGROUND There has been an increase in cases of inflammatory bowel disease (IBD) in recent years. There is also greater access and availability of immunosuppressive and biological agents, which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing. Tuberculosis (TB) remains a public health problem, and it has a high incidence in several countries. Therefore, knowledge of the risk of developing TB in patients with IBD is important. AIM To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America. METHODS A standard questionnaire included demographic variables, clinical aspects of IBD disease, history of active TB during treatment, active TB characteristics and evolution, initial screening and results and time from the start of anti-tumor necrosis factor alpha (TNFα) to TB development. RESULTS Azathioprine, anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence. The TNFα blockers increased the relative risk of developing active TB compared to other treatments. All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB. After adjustment for sex, age, type of IBD and latent TB, anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional treatment. Late TB, which was diagnosed 3 mo after the start of anti-TNFα, was the most frequent. CONCLUSION Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America. This risk was increased when anti-TNFα was combined with azathioprine. The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.

Osteoporosis has been reported among Human T-cell Lymphotropic Virus type 1 (HTLV-1) infected aged patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) diagnosis. However, the association between osteoporosis and HTLV-1 infection remains unclear. This study aimed to evaluate the presence of bone disorders in young HTLV-1 asymptomatic individuals. A cross sectional study was carried out at the HTLV Reference Center in Salvador, Brazil. Forty-seven HTLV-1 infected asymptomatic and 108 healthy subjects aged between 20 to 45 years were included. Biochemical markers of bone metabolism were measured and bone mineral density (BMD) was determined at the femoral neck and at the lumbar spine (L1 -L4). Significant low BMD (Z-score <-1 ) was found in HTLV-1 infected individuals (1.177 ± 0.103) compared to control subjects (1.225 ± 0.146). In logistics regression analysis HTLV-1 infected subjects were more likely to have low BMD (OR = 3.48; 95%CI 1.29- 9.43) adjusted for low education and body mass index (BMI). Osteoporosis (Z-score <-2) was not found among HTLV-1-infected group. In conclusion, our results found a low BMD in patients infected with HTLV-1 compared to uninfected controls. However, osteoporosis was not observed. Further studies should be conducted to evaluate the relationship between HTLV-1-infection and low BMD.