SARS-CoV-2 and dialysis: humoral response, clinical and laboratory impacts before vaccination.

BACKGROUND: Patients with kidney disease on Hemodialysis (HD) are susceptible to Coronavirus Disease (COVID-19) due to multiple risk factors. AIM: This study aims to report the prevalence of antibodies against SARS-CoV-2 among patients on hemodialysis before vaccination in Brazil and to compare with clinical, demographic, and laboratory data. METHODS: Blood samples from 398 Chronic Kidney Disease (CKD) patients treated in three different private institutions in Rio de Janeiro State, Brazil were submitted to the total anti-SARS-CoV-2 testing. Kidney, liver, and hematological markers were also determined. Respiratory samples were tested by real-time PCR for SARS-CoV-2 RNA and positive samples were subjected to high-throughput sequencing on the MinION device. RESULTS: Overall, anti-SARS-CoV-2 prevalence was 54.5 % (217/398) and two individuals had SARS-CoV-2 RNA with variant B.1.1. High anti-SARS-CoV-2 seroprevalence was found in male gender and those with hospital admission in the last 3-months before the inclusion in the study. Lower red blood cell count was observed in the anti-SARS-CoV-2 seropositive group. High levels of anti-SARS-CoV-2 were found in those who reported symptoms, had low levels of eosinophils and low hematocrit, and who practiced physical activity. CONCLUSION: High prevalence of anti-SARS-CoV-2 was found in CKD patients before the universal immunization in Brazil suggesting that dialysis patients were highly exposed to SARS-CoV-2.

Genomic Variability of Hepatitis B Virus Circulating in Brazilian Western Amazon.

The emergence of clinically relevant mutations in the hepatitis B virus (HBV) genome has been a matter of great debate because of the possibility of escape from the host's immune system, the potential to cause more severe progression of liver diseases and the emergence of treatment-resistant variants. Here we characterized the circulating variants of HBV in Rondônia State, in the north of Brazil. Serum samples of 62 chronic HBV carriers were subjected to PCR assays and clinical data were collected. Mutations and genotypes were characterized through direct sequencing. The findings show the presence of subgenotypes A1 (54.83%, 34/62), D3 (16.13%, 10/62), F2 (16.13%, 10/62), A2 (4.84%, 3/62), D2 (3.23%, 2/62), D1 (1.61%, 1/62), D4 (1.61%, 1/62) and F4 (1.61%, 1/62). Deletions in the pre-S2 region were found in 13.79% (8/58) of the samples, mutations in the S gene in 59.68% (37/62) and RT mutations in 48.39% (30/62). We found a variable genotypic distribution in different locations and important mutations related to immune escape and drug resistance in Western Amazonia, which contributed to genetic surveillance and provided important information to help control the disease.

Hepatitis B: changes in epidemiological features of Afro-descendant communities in Central Brazil.

Hepatitis B virus (HBV) infection is still a concern in vulnerable populations. In a study performed by our team in 1999-2003 in two Afro-Brazilian communities, Furnas dos Dionísios (FD) and São Benedito (SB), high prevalence rates of HBV exposure (42.7% and 16.0%, respectively), high susceptibility to HBV (55.3% and 63.0%) and low HBV vaccination like profile rates (2.0% and 21.0%) were observed. In 2015-2016, we reassessed HBV epidemiological and molecular features in these two communities to verify the impact of health actions adopted in the last years. The prevalence rate of HBV exposure among the enrolled 331 subjects was 35.3% in FD and 21.8% in SB. HBV chronic infection (5.8% in FD, 4.9% in SB) remained high. The rate of HBV vaccination like profile increased from 10.7% to 43.5% (2.0% to 45.9% in FD, 21.0% to 39.5% in SB) while susceptible subjects declined from 58.9% to 26.3% (55.3% to 18.8% in FD, 63.0% to 38.7% in SB). Among 18 HBsAg positive samples, 13 were successfully sequenced (pre-S/S region). Phylogenetic analyses showed that all isolates belong to HBV subgenotype A1, clustering within the Asian-American clade. Despite the maintenance of high prevalence rate of HBV exposure over these 13 years of surveillance, significant improvements were observed, reinforcing the importance of facilitated HBV vaccination to difficult-to-access population to close gaps in prevention.

Prevalence and Incidence of HCV Infection among Prisoners in Central Brazil.

The aim of this multicenter, cross sectional study was to assess the prevalence, incidence and associated risk factors among incarcerated populations from twelve Brazilian prisons. The total of 3,368 individuals from twelve prisons was randomly recruited between March 2013 and March 2014. Participants were interviewed, and provided blood samples which were tested for antibodies to Hepatitis C (HCV ab). One year after the first investigation, a cohort study was conducted with 1,656 inmates who participated the cross sectional study. Positive samples were tested for the presence of HCV RNA. Out of 3,368 inmates, 520 (15.4%) were females, and 2,848 (84.6%) were males. The overall prevalence of HCV was 2.4% (95% CI: 1.9 to 2.9), with 0.6% (95% CI: 0.4 to 0.8) in females, and 2.7% (95% CI: 2.1 to 3.3) in males (p<0.01). HCV RNA was detected in 51/80 (63.7%) samples. Among men prisoners, multivariate analysis of associated factors showed independent associations between HCV exposure and increasing age, inject drug use, length of incarceration, smoking hashish, sharing needle and syringe and HIV positivity. During the cohort study, 7/1,656 new cases of HCV infection were detected, and the incidence rate was 0.4/100 person-year. Once high frequency rates of specific HCV risk behaviors and new HCV infections have been identified inside prisons, effective interventions strategies such as screening, clinical evaluation and treatment to reduce the spread of HCV infection are essential.

Os genótipos do vírus da hepatite B na África e no Brasil: evolução, disseminação e associação com a rota de escravos / The genotypes of hepatitis B virus in Africa and in Brazil: evolution, spread and association with the route of slaves

A infecção pelo vírus da hepatite B (HBV) representa um grave problema de saúde públicamundial, apesar da existência de uma vacina eficiente. Estima-se que cerca de 350 milhõesde indivíduos no mundo estejam cronicamente infectados, dos quais a maior parte seencontra em países em desenvolvimento. A heterogeneidade das sequências dos isoladosdo HBV permite a sua classificação em oito genótipos, A a H, baseada na divergência do genoma completo de mais de 7,5 por cento. A presente tese é composta principalmente de três manuscritos, sendo um trabalho publicado e dois outros em submissão, além de cinco trabalhos como colaboradora. Esses estudos se propuseram a investigar a evolução dos genótipos do HBV entre África e Brasil e associar a dispersão dos genótipos no Brasil com a rota de escravos. No primeiro trabalho, entitulado Analysis of Complete NucleotideSequences of Angolan Hepatitis B Virus Isolates Reveals the Existence of a SeparateLineage within Genotype E, realizamos a caracterização filogenética viral dos isolados circulantes em Angola e sua associação com os perfis sorológicos e moleculares existentes naquela população. Através dessas análises, identificamos a separação das amostrasangolanas como pertencentes a uma nova linhagem, composta por Angola, Namibia eRepublica Democratica do Congo, provisoriamente denominada pela nossa equipe, SWL(Southwest African Lineage). No segundo trabalho, entitulado HBV subgenotype A1:Relationships between Brazilian, African and Asian isolates, fomos em busca das históriaevolutiva do HBV/A1, e suas suas rotas de dispersão entre África e Brasil durante o período do tráfico negreiro. Surpreendentemente, observamos que todas as amostras brasileiras estão geneticamente relacionadas às amostras da Ásia, ao invés da África. Esse fato sugere quer que o HBV/A1 possa ter sido introduzino no Brasil a partir dos portos de Moçambique,no sudeste africano, ou diretamente atravpés da Índia por navegantes portugueses...

Hepatitis B virus (HBV) infection is one of the major global human health problems, despitethe existence of an effective vaccine. It is estimated that around 350 million people worldwideare chronically infected; most of them is in developing countries. The sequenceheterogeneity of HBV isolates has led to the classification of HBV into eight genotypes, A toH, based on full-length genomic divergence of more than 7.5 percent. This thesis is composedmainly of three manuscripts: One of them is already published and two others are insubmission. Five other manuscripts are listed as complementary production. These studieshave set out to understand the evolution of HBV genotypes between Africa and Brazil andassociate its dispersion with slave routes. In the first study, entitled Analysis of CompleteNucleotide Sequences of Hepatitis B Virus Isolates Angolan Reveals the Existence of aSeparate Lineage Within Genotype E , performed the phylogenetic characterization of viralisolates circulating in Angola and its association with serological and molecular profiles.Through these analyzes, we characterized a separated lineage composed by Angolan,Namibia and Democratic Republic of Congo, provisionally named by our team as SWL(Southwest African Lineage). In the second paper, entitled Hepatitis B virus subgenotypeA1: Relationships between Brazilian, African and Asian isolates we aimed investigate theevolutionary history and migration patterns of HBV/A1 from Africa to Brazil during the slavetrade. Surprisingly, was observed that all Brazilian samples are genetically related to Asianisolates, rather than the African ones. These finds suggest that Asia was the source ofHBV/A1 infection in Brazil, probably through Mozambique in southeastern Africa, or directlythrough India by Portuguese sailors...

Epidemiology and molecular characterization of hepatitis B virus in Luanda, Angola

An estimated 360 million people are infected with hepatitis B virus (HBV) worldwide. Among these, 65 million live in Africa. Despite the high levels of hepatitis B in Africa, HBV epidemiology is still poorly documented in most African countries. In this work, the epidemiological and molecular characteristics of HBV infection were evaluated among the staff, visitors and adult patients (n = 508) of a public hospital in Luanda, Angola. The overall prevalence of hepatitis B core antibody (anti-HBc) and hepatitis B surface antigen was 79.7 percent and 15.1 percent, respectively. HBV infection was higher in males and was more prevalent in individuals younger than 50 years old. HBV-DNA was detected in 100 percent of HBV "e" antigen-positive serum samples and in 49 percent of anti-hepatitis Be antibody-positive samples. Thirty-five out of the 40 HBV genotypes belonged to genotype E. Circulation of genotypes A (4 samples) and D (1 sample) was also observed. The present study demonstrates that HBV infection is endemic in Luanda, which has a predominance of genotype E. This genotype is only sporadically found outside of Africa and is thought to have emerged in Africa at a time when the trans-Atlantic slave trade had stopped.

Epidemiology and molecular characterization of hepatitis B virus in Luanda, Angola.

An estimated 360 million people are infected with hepatitis B virus (HBV) worldwide. Among these, 65 million live in Africa. Despite the high levels of hepatitis B in Africa, HBV epidemiology is still poorly documented in most African countries. In this work, the epidemiological and molecular characteristics of HBV infection were evaluated among the staff, visitors and adult patients (n = 508) of a public hospital in Luanda, Angola. The overall prevalence of hepatitis B core antibody (anti-HBc) and hepatitis B surface antigen was 79.7% and 15.1%, respectively. HBV infection was higher in males and was more prevalent in individuals younger than 50 years old. HBV-DNA was detected in 100% of HBV "e" antigen-positive serum samples and in 49% of anti-hepatitis Be antibody-positive samples. Thirty-five out of the 40 HBV genotypes belonged to genotype E. Circulation of genotypes A (4 samples) and D (1 sample) was also observed. The present study demonstrates that HBV infection is endemic in Luanda, which has a predominance of genotype E. This genotype is only sporadically found outside of Africa and is thought to have emerged in Africa at a time when the trans-Atlantic slave trade had stopped.