Epidemiological profile of viral hepatitis infection in the population treated at a reference hospital in Alagoas / Perfil epidemiológico da infecção por hepatite viral na população atendida em hospital de referência em Alagoas

Viral hepatitis are widely spread infectious diseases caused by a variety of etiological agents that displays liver tropism as a common characteristic. A descriptive, cross-sectional, observational and retrospective study was conducted through the analysis of viral hepatitis medical records treated and diagnosed from 2010 to 2015. The relationship between the variables were made through the chi-square test. 632 viral hepatitis medical records were analyzed. The highest number of cases happened in 2011. Hepatitis A virus (HAV) infection was predominant. The most affected age group was < 20 years and the highest number of cases observed in this age group was related to HAV (p<0.001). The acute clinical form was predominant, with 70.2% of the cases. 92.3% of which corresponded to HAV infection (p<0.001). Most of the cases occurred in the brown race and male gender. Moreover, regarding the probable source/mechanism of infection, the contact with suspicious water/food for hepatitis A cases was highlighted. The sexual form predominated in HBV infection and previous history of blood transfusion in cases of hepatitis C. Most cases were spotted in the mesoregion of Eastern Alagoas, especially in the capital Maceió. It must be observed the importance of knowing the profile of this disease in order to understand its dissemination and thus have subsidies for the creation of actions and strategies to combat the infection.

A hepatite viral é uma doença infecciosa amplamente difundida causada por uma variedade de agentes etiológicos que exibem o tropismo hepático como uma característica comum. Um estudo descritivo, transversal, observacional e retrospectivo foi realizado por meio da análise de prontuários de hepatites virais tratados e diagnosticados de 2010 a 2015. A relação entre as variáveis foi feita através do teste qui-quadrado. Foram analisados 632 prontuários de hepatite sustero. O maior número de casos aconteceu em 2011. A infecção pelo vírus da hepatite A (HAV) foi predominante. A faixa etária mais atingida foi < 20 anos e o maior número de casos observados nessa faixa etária foi relacionado ao HAV (p<0,001). A forma clínica aguda foi predominante, com 70,2% dos casos. 92,3% dos quais corresponderam à infecção por HAV (p<0,001). A maioria dos casos ocorreu na raça parda e no sexo masculino. Além disso, quanto à provável fonte/mecanismo de infecção, foi destacado o contato com água/alimento suspeitos para os casos de hepatite A. A forma sexual predominou na infecção pelo HbV e histórico anterior de transfusão de sangue em casos de hepatite C. A maioria dos casos foi avistada na mesorregião do Leste de Alagoas, especialmente na capital Maceió. Deve-se observar a importância de conhecer o perfil dessa doença para entender sua disseminação e, assim, contar com subsídios para a criação de ações e estratégias de combate à infecção.

Epidemiological profile of viral hepatitis infection in the population treated at a reference hospital in Alagoas

Abstract Viral hepatitis are widely spread infectious diseases caused by a variety of etiological agents that displays liver tropism as a common characteristic. A descriptive, cross-sectional, observational and retrospective study was conducted through the analysis of viral hepatitis medical records treated and diagnosed from 2010 to 2015. The relationship between the variables were made through the chi-square test. 632 viral hepatitis medical records were analyzed. The highest number of cases happened in 2011. Hepatitis A virus (HAV) infection was predominant. The most affected age group was 20 years and the highest number of cases observed in this age group was related to HAV (p 0.001). The acute clinical form was predominant, with 70.2% of the cases. 92.3% of which corresponded to HAV infection (p 0.001). Most of the cases occurred in the brown race and male gender. Moreover, regarding the probable source/mechanism of infection, the contact with suspicious water/food for hepatitis A cases was highlighted. The sexual form predominated in HBV infection and previous history of blood transfusion in cases of hepatitis C. Most cases were spotted in the mesoregion of Eastern Alagoas, especially in the capital Maceió. It must be observed the importance of knowing the profile of this disease in order to understand its dissemination and thus have subsidies for the creation of actions and strategies to combat the infection.

Resumo A hepatite viral é uma doença infecciosa amplamente difundida causada por uma variedade de agentes etiológicos que exibem o tropismo hepático como uma característica comum. Um estudo descritivo, transversal, observacional e retrospectivo foi realizado por meio da análise de prontuários de hepatites virais tratados e diagnosticados de 2010 a 2015. A relação entre as variáveis foi feita através do teste qui-quadrado. Foram analisados 632 prontuários de hepatite sustero. O maior número de casos aconteceu em 2011. A infecção pelo vírus da hepatite A (HAV) foi predominante. A faixa etária mais atingida foi 20 anos e o maior número de casos observados nessa faixa etária foi relacionado ao HAV (p 0,001). A forma clínica aguda foi predominante, com 70,2% dos casos. 92,3% dos quais corresponderam à infecção por HAV (p 0,001). A maioria dos casos ocorreu na raça parda e no sexo masculino. Além disso, quanto à provável fonte/mecanismo de infecção, foi destacado o contato com água/alimento suspeitos para os casos de hepatite A. A forma sexual predominou na infecção pelo HbV e histórico anterior de transfusão de sangue em casos de hepatite C. A maioria dos casos foi avistada na mesorregião do Leste de Alagoas, especialmente na capital Maceió. Deve-se observar a importância de conhecer o perfil dessa doença para entender sua disseminação e, assim, contar com subsídios para a criação de ações e estratégias de combate à infecção.

Epidemiological profile of viral hepatitis infection in the population treated at a reference hospital in Alagoas / Perfil epidemiológico da infecção por hepatite viral na população atendida em hospital de referência em Alagoas

Viral hepatitis are widely spread infectious diseases caused by a variety of etiological agents that displays liver tropism as a common characteristic. A descriptive, cross-sectional, observational and retrospective study was conducted through the analysis of viral hepatitis medical records treated and diagnosed from 2010 to 2015. The relationship between the variables were made through the chi-square test. 632 viral hepatitis medical records were analyzed. The highest number of cases happened in 2011. Hepatitis A virus (HAV) infection was predominant. The most affected age group was < 20 years and the highest number of cases observed in this age group was related to HAV (p<0.001). The acute clinical form was predominant, with 70.2% of the cases. 92.3% of which corresponded to HAV infection (p<0.001). Most of the cases occurred in the brown race and male gender. Moreover, regarding the probable source/mechanism of infection, the contact with suspicious water/food for hepatitis A cases was highlighted. The sexual form predominated in HBV infection and previous history of blood transfusion in cases of hepatitis C. Most cases were spotted in the mesoregion of Eastern Alagoas, especially in the capital Maceió. It must be observed the importance of knowing the profile of this disease in order to understand its dissemination and thus have subsidies for the creation of actions and strategies to combat the infection.(AU)

A hepatite viral é uma doença infecciosa amplamente difundida causada por uma variedade de agentes etiológicos que exibem o tropismo hepático como uma característica comum. Um estudo descritivo, transversal, observacional e retrospectivo foi realizado por meio da análise de prontuários de hepatites virais tratados e diagnosticados de 2010 a 2015. A relação entre as variáveis foi feita através do teste qui-quadrado. Foram analisados 632 prontuários de hepatite sustero. O maior número de casos aconteceu em 2011. A infecção pelo vírus da hepatite A (HAV) foi predominante. A faixa etária mais atingida foi < 20 anos e o maior número de casos observados nessa faixa etária foi relacionado ao HAV (p<0,001). A forma clínica aguda foi predominante, com 70,2% dos casos. 92,3% dos quais corresponderam à infecção por HAV (p<0,001). A maioria dos casos ocorreu na raça parda e no sexo masculino. Além disso, quanto à provável fonte/mecanismo de infecção, foi destacado o contato com água/alimento suspeitos para os casos de hepatite A. A forma sexual predominou na infecção pelo HbV e histórico anterior de transfusão de sangue em casos de hepatite C. A maioria dos casos foi avistada na mesorregião do Leste de Alagoas, especialmente na capital Maceió. Deve-se observar a importância de conhecer o perfil dessa doença para entender sua disseminação e, assim, contar com subsídios para a criação de ações e estratégias de combate à infecção.(AU)

Epidemiological profile of viral hepatitis infection in the population treated at a reference hospital in Alagoas / Perfil epidemiológico da infecção por hepatite viral na população atendida em hospital de referência em Alagoas

Viral hepatitis are widely spread infectious diseases caused by a variety of etiological agents that displays liver tropism as a common characteristic. A descriptive, cross-sectional, observational and retrospective study was conducted through the analysis of viral hepatitis medical records treated and diagnosed from 2010 to 2015. The relationship between the variables were made through the chi-square test. 632 viral hepatitis medical records were analyzed. The highest number of cases happened in 2011. Hepatitis A virus (HAV) infection was predominant. The most affected age group was < 20 years and the highest number of cases observed in this age group was related to HAV (p<0.001). The acute clinical form was predominant, with 70.2% of the cases. 92.3% of which corresponded to HAV infection (p<0.001). Most of the cases occurred in the brown race and male gender. Moreover, regarding the probable source/mechanism of infection, the contact with suspicious water/food for hepatitis A cases was highlighted. The sexual form predominated in HBV infection and previous history of blood transfusion in cases of hepatitis C. Most cases were spotted in the mesoregion of Eastern Alagoas, especially in the capital Maceió. It must be observed the importance of knowing the profile of this disease in order to understand its dissemination and thus have subsidies for the creation of actions and strategies to combat the infection.

A hepatite viral é uma doença infecciosa amplamente difundida causada por uma variedade de agentes etiológicos que exibem o tropismo hepático como uma característica comum. Um estudo descritivo, transversal, observacional e retrospectivo foi realizado por meio da análise de prontuários de hepatites virais tratados e diagnosticados de 2010 a 2015. A relação entre as variáveis foi feita através do teste qui-quadrado. Foram analisados 632 prontuários de hepatite sustero. O maior número de casos aconteceu em 2011. A infecção pelo vírus da hepatite A (HAV) foi predominante. A faixa etária mais atingida foi < 20 anos e o maior número de casos observados nessa faixa etária foi relacionado ao HAV (p<0,001). A forma clínica aguda foi predominante, com 70,2% dos casos. 92,3% dos quais corresponderam à infecção por HAV (p<0,001). A maioria dos casos ocorreu na raça parda e no sexo masculino. Além disso, quanto à provável fonte/mecanismo de infecção, foi destacado o contato com água/alimento suspeitos para os casos de hepatite A. A forma sexual predominou na infecção pelo HbV e histórico anterior de transfusão de sangue em casos de hepatite C. A maioria dos casos foi avistada na mesorregião do Leste de Alagoas, especialmente na capital Maceió. Deve-se observar a importância de conhecer o perfil dessa doença para entender sua disseminação e, assim, contar com subsídios para a criação de ações e estratégias de combate à infecção.

Inflammation and kidney involvement in human viral diseases caused by SARS-CoV-2, HIV, HCV and HBV

Inflammation is closely related to renal diseases. This is particularly true for renal diseases caused by infections as in viral diseases. In this review, we highlight the inflammatory mechanisms that underlie kidney dysfunction in SARS-CoV-2, human immunodeficiency (HIV), hepatitis C (HCV), and hepatitis B (HBV) infections. The pathophysiology of renal involvement in COVID-19 is complex, but kidney damage is frequent, and the prognosis is worse when it happens. Virus-like particles were demonstrated mostly in renal tubular epithelial cells and podocytes, which suggest that SARS-CoV-2 directly affects the kidneys. SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptor, which is found in endothelial cells, to infect the human host cells. Critical patients with SARS-CoV-2-associated acute kidney injury (AKI) show an increase in inflammatory cytokines (IL-1β, IL-8, IFN-γ, TNF-α), known as cytokine storm that favors renal dysfunction by causing intrarenal inflammation, increased vascular permeability, volume depletion, thromboembolic events in microvasculature and persistent local inflammation. Besides AKI, SARS-CoV-2 can also cause glomerular disease, as other viral infections such as in HIV, HBV and HCV. HIV-infected patients present chronic inflammation that can lead to a number of renal diseases. Proinflammatory cytokines and TNF-induced apoptosis are some of the underlying mechanisms that may explain the virus-induced renal diseases that are here reviewed.(AU)

Inflammation and kidney involvement in human viral diseases caused by SARS-CoV-2, HIV, HCV and HBV

Inflammation is closely related to renal diseases. This is particularly true for renal diseases caused by infections as in viral diseases. In this review, we highlight the inflammatory mechanisms that underlie kidney dysfunction in SARS-CoV-2, human immunodeficiency (HIV), hepatitis C (HCV), and hepatitis B (HBV) infections. The pathophysiology of renal involvement in COVID-19 is complex, but kidney damage is frequent, and the prognosis is worse when it happens. Virus-like particles were demonstrated mostly in renal tubular epithelial cells and podocytes, which suggest that SARS-CoV-2 directly affects the kidneys. SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptor, which is found in endothelial cells, to infect the human host cells. Critical patients with SARS-CoV-2-associated acute kidney injury (AKI) show an increase in inflammatory cytokines (IL-1β, IL-8, IFN-γ, TNF-α), known as cytokine storm that favors renal dysfunction by causing intrarenal inflammation, increased vascular permeability, volume depletion, thromboembolic events in microvasculature and persistent local inflammation. Besides AKI, SARS-CoV-2 can also cause glomerular disease, as other viral infections such as in HIV, HBV and HCV. HIV-infected patients present chronic inflammation that can lead to a number of renal diseases. Proinflammatory cytokines and TNF-induced apoptosis are some of the underlying mechanisms that may explain the virus-induced renal diseases that are here reviewed.(AU)

Cloning and high-level expression of Thermus thermophilus RecA in E. coli: purification and novel use in HBV diagnostics

We studied the role of Thermus thermophilus Recombinase A (RecA) in enhancing the PCR signals of DNA viruses such as Hepatitis B virus (HBV). The RecA gene of a thermophilic eubacterial strain, T. thermophilus, was cloned and hyperexpressed in Escherichia coli. The recombinant RecA protein was purified using a single heat treatment step without the use of any chromatography steps, and the purified protein (>95%) was found to be active. The purified RecA could enhance the polymerase chain reaction (PCR) signals of HBV and improve the detection limit of the HBV diagnosis by real time PCR. The yield of recombinant RecA was ~35 mg/L, the highest yield reported for a recombinant RecA to date. RecA can be successfully employed to enhance detection sensitivity for the diagnosis of DNA viruses such as HBV, and this methodology could be particularly useful for clinical samples with HBV viral loads of less than 10 IU/mL, which is interesting and novel.(AU)

In-house quantitative real-time PCR for the diagnosis of hepatitis B virus and hepatitis C virus infections

The quantification of viral nucleic acids in serum by real-time PCR plays an important role in diagnosing hepatitis B virus and hepatitis C virus infection. In this study, we developed an assay using specific primers and probes to quantify hepatitis B virus DNA or hepatitis C virus RNA in serum from infected patients. For standardization and validation of the assay, an international panel of hepatitis B virus/hepatitis C virus and standard plasmids was used. A correlation coefficient of 0.983 and 0.963 for hepatitis B virus and hepatitis C virus, respectively, was obtained based on cycle threshold values and concentrations of DNA or RNA. The standard curve showed a linear relationship from 19 IU/mL to 1.9 × 109 IU/mL of serum, with a coefficient of determination (r2) of 0.99. In sera from patients infected with hepatitis B virus or hepatitis C virus viral loads (19 IU/mL and 1.9 × 109 IU/mL), we quantified viral loads with a detection limit of 1.9 × 102 IU/mL. The real-time quantitative PCR assay developed in this study provides an ideal system for routine diagnosis and confirmation of indeterminate serological results, especially in immunosuppressed patients.(AU)

Hepatitis B monovalent vaccines produced by different manufacturers: comparative study on the quality of vaccine in period before and after the shelf life / Vacinas de Hepatite B monovalente produzidas por diferentes fabricantes: estudo comparativo da qualidade das vacinas no período pré e após o prazo de validade

For over 20 years, the hepatitis B (HB) vaccine has been produced by the expression of the viral gene encoding the hepatitis B surface antigen (HBsAg) in yeast. According to the data from WHO, the hepatitis B vaccines are generally stable for up to three years when stored at 2 ºC to 8 ºC. The purpose of this study was to evaluate whether the hepatitis B vaccine, at the time of their release, the quality criteria of this product were maintained seven years after the expiration date. Vaccine vials in multi-dose (10 and 05 doses) and three lots from each manufacturer (A, B and C) were analyzed. All batches were assayed for visual appearance, potency, bacterial endotoxin, thiomersal amount, aluminum hidroxyde contents and pH by means of validated tests. The nine lots evaluated seven years after the expiration date showed similar concentrations when compared to those demonstrated at the time of batches release by the National Institute for Quality Control in Health (INCQS). No significant change in the quality of the hepatitis B vaccine after the expiration date was confirmed. These data might be useful to subsidize a future evaluation for reviewing an extension of the vaccines shelf life(AU)

As vacinas contra a hepatite B são produzidas pela expressão do gene viral codificado para o antígeno de superfície do vírus da hepatite B (HBsAg) em levedura, há mais de 20 anos. De acordo com os dados da OMS, a vacina de hepatite B tem até três anos de estabilidade quando armazenada entre 2 ºC e 8 ºC. O objetivo deste estudo foi de avaliar se, no momento da liberação, os critérios de qualidade da vacina de hepatite B foram mantidos após sete anos da data de validade. Foram analisados frascos de vacinas multi-dose (10 e 5 doses), sendo três lotes de cada produtor (A, B e C). Todos os lotes foram avaliados quanto às características de aparência visual, potência, endotoxina bacteriana, presença de timerosal, conteúdo de hidróxido de alumínio e pH por meio de testes validados. Os nove lotes avaliados sete anos após a data de expiração tiveram resultados similares quando comparados às concentrações na época de liberação dos lotes, realizada pelo Instituto Nacional de Controle de Qualidade em Saúde (INCQS). Os estudos confirmaram a manutenção da qualidade da vacina após o período de expiração. Estes dados podem subsidiar uma futura avaliação para extensão do prazo de validade das vacinas(AU)

Decrease in hepatitis B prevalence among blood donors in Central-West Brazil

The aim of the present study was to estimate hepatitis B virus seroprevalence among first-time blood donors in the city of Campo Grande, Mato Grosso do Sul State, in the central-western region of Brazil. Findings A retrospective analysis of first-time voluntary blood donor records, from January 2010 to December 2010, was conducted at the Hematology Center of Mato Grosso do Sul. The prevalence of the HBsAg and anti-HBc serological markers and their respective 95% confidence intervals were calculated. Chi-square analysis was performed between the seroprevalence previously found in 2001 and the one determined by the current study. Results were considered statistically significant if p< 0.05. Among 8,840 subjects, 269 (3.04%, 95% CI: 2.7-3.4) were positive for HBV markers. The prevalence rate of HBsAg was 0.19% (95% CI: 0.1-0.3) and anti-HBc alone was 2.85% (95% CI: 2.5-3.2). Conclusions There was no statistically significant difference regarding gender. However, an important association was observed between HBV infection and older age (p< 0.01). The seroprevalence of HBV infection in first-time blood donors diminished from 2001 to 2010 (p< 0.01). Such decrease suggests an improvement in the recruitment of safe donors, the positive impact of vaccination programs and the decreasing of HBV infection prevalence in the general population.(AU)

Hepatitis B virus surface antigen seroconversion in HIV-infected individual after pegylated interferon-alpha treatment: a case report

Hepatitis B virus (HBV) infects from 6 to 14% of HIV-infected individuals. Concurrent HIV/HBV infection occurs due to the overlapping routes of transmission, particularly sexual and parenteral. HIV-infected patients that have acute hepatitis B have six times greater risk of developing chronic hepatitis B, with higher viral replication, rapid progression to end-stage liver disease and shorter survival. The coinfection is also associated with poor response to hepatitis B treatment with interferon-alpha and increased liver toxicity to the antiretroviral therapy. Herein, we describe the case of a 35-year-old man who engages in sex with men and presented with newly diagnosed HIV-1, serological markers for acute hepatitis B and progression to chronic hepatitis B infection (HBsAg+ > 6 months, high alanine aminotransferase levels and moderate hepatitis as indicated by liver biopsy). Lacking indication of antiretroviral treatment (CD4 768 cells/mm 3 ), he was treated with pegylated-interferon alpha2b (1.5 mg/kg/week) by subcutaneous injection for 48 weeks. Twelve weeks after treatment, the patient presented HBeAg seroconversion to anti-HBe. At the end of 48 weeks, he presented HBsAg seroconversion to anti-HBs. One year after treatment, the patient maintained sustained virological response (undetectable HBV-DNA). The initiation of antiretroviral therapy with nucleosides and nucleotides is recommended earlier for coinfected individuals. However, this report emphasizes that pegylated interferon remains an important therapeutic strategy to be considered for selected patients, in whom the initiation of HAART may be delayed.(AU)

Hepatitis B virus surface antigen seroconversion in HIV-infected individual after pegylated interferon-alpha treatment: a case report

Hepatitis B virus (HBV) infects from 6 to 14% of HIV-infected individuals. Concurrent HIV/HBV infection occurs due to the overlapping routes of transmission, particularly sexual and parenteral. HIV-infected patients that have acute hepatitis B have six times greater risk of developing chronic hepatitis B, with higher viral replication, rapid progression to end-stage liver disease and shorter survival. The coinfection is also associated with poor response to hepatitis B treatment with interferon-alpha and increased liver toxicity to the antiretroviral therapy. Herein, we describe the case of a 35-year-old man who engages in sex with men and presented with newly diagnosed HIV-1, serological markers for acute hepatitis B and progression to chronic hepatitis B infection (HBsAg+ > 6 months, high alanine aminotransferase levels and moderate hepatitis as indicated by liver biopsy). Lacking indication of antiretroviral treatment (CD4 768 cells/mm 3 ), he was treated with pegylated-interferon alpha2b (1.5 mg/kg/week) by subcutaneous injection for 48 weeks. Twelve weeks after treatment, the patient presented HBeAg seroconversion to anti-HBe. At the end of 48 weeks, he presented HBsAg seroconversion to anti-HBs. One year after treatment, the patient maintained sustained virological response (undetectable HBV-DNA). The initiation of antiretroviral therapy with nucleosides and nucleotides is recommended earlier for coinfected individuals. However, this report emphasizes that pegylated interferon remains an important therapeutic strategy to be considered for selected patients, in whom the initiation of HAART may be delayed.

Decrease in hepatitis B prevalence among blood donors in Central-West Brazil

The aim of the present study was to estimate hepatitis B virus seroprevalence among first-time blood donors in the city of Campo Grande, Mato Grosso do Sul State, in the central-western region of Brazil. Findings A retrospective analysis of first-time voluntary blood donor records, from January 2010 to December 2010, was conducted at the Hematology Center of Mato Grosso do Sul. The prevalence of the HBsAg and anti-HBc serological markers and their respective 95% confidence intervals were calculated. Chi-square analysis was performed between the seroprevalence previously found in 2001 and the one determined by the current study. Results were considered statistically significant if p< 0.05. Among 8,840 subjects, 269 (3.04%, 95% CI: 2.7-3.4) were positive for HBV markers. The prevalence rate of HBsAg was 0.19% (95% CI: 0.1-0.3) and anti-HBc alone was 2.85% (95% CI: 2.5-3.2). Conclusions There was no statistically significant difference regarding gender. However, an important association was observed between HBV infection and older age (p< 0.01). The seroprevalence of HBV infection in first-time blood donors diminished from 2001 to 2010 (p< 0.01). Such decrease suggests an improvement in the recruitment of safe donors, the positive impact of vaccination programs and the decreasing of HBV infection prevalence in the general population.

Hepatitis B virus surface antigen seroconversion in HIV-infected individual after pegylated interferon-alpha treatment: a case report

Hepatitis B virus (HBV) infects from 6 to 14% of HIV-infected individuals. Concurrent HIV/HBV infection occurs due to the overlapping routes of transmission, particularly sexual and parenteral. HIV-infected patients that have acute hepatitis B have six times greater risk of developing chronic hepatitis B, with higher viral replication, rapid progression to end-stage liver disease and shorter survival. The coinfection is also associated with poor response to hepatitis B treatment with interferon-alpha and increased liver toxicity to the antiretroviral therapy. Herein, we describe the case of a 35-year-old man who engages in sex with men and presented with newly diagnosed HIV-1, serological markers for acute hepatitis B and progression to chronic hepatitis B infection (HBsAg+ > 6 months, high alanine aminotransferase levels and moderate hepatitis as indicated by liver biopsy). Lacking indication of antiretroviral treatment (CD4 768 cells/mm 3 ), he was treated with pegylated-interferon alpha2b (1.5 mg/kg/week) by subcutaneous injection for 48 weeks. Twelve weeks after treatment, the patient presented HBeAg seroconversion to anti-HBe. At the end of 48 weeks, he presented HBsAg seroconversion to anti-HBs. One year after treatment, the patient maintained sustained virological response (undetectable HBV-DNA). The initiation of antiretroviral therapy with nucleosides and nucleotides is recommended earlier for coinfected individuals. However, this report emphasizes that pegylated interferon remains an important therapeutic strategy to be considered for selected patients, in whom the initiation of HAART may be delayed.

Seroprevalence of Hepatitis B and C markers at the population level in the municipality of Caxias do Sul, southern Brazil

Chronic viral hepatitis are main public health problems worldwide. Data about the seroprevalence to Hepatitis B and C viruses (HBV e HCV) at the population level are scarce on Brazil and especially for the Southern region of the country. The seroprevalence to HBV and HBC antigens was evaluated on a large portion of the population of the municipality of Caxias do Sul (427,858 inhabitants), Brazil. A total of 60,604 individual serum samples collected from 2008 to 2011 were screened for HBV surface antigen (HBsAg) and for antibodies against HBsAg; anti HCV antibodies were measured by ELISA (Enzyme Linked Immunosorbent Assay). Overall, 1.63% of the individuals were positive for HBsAg and 1.43% showed seropositivity to HCV. From the total, 31,749 samples were analyzed for HBsAg and 28,855 for HCV. For HBsAg, 519 samples showed positive (1.63%) while the results for 37 patients (0.12%) remained inconclusive. For the anti-HCV test, 412 individuals (1.43%) showed positive. From the positive samples for HBsAg 216 (50.6%) were from male individuals whereas for anti-HCV the seroprevalence was slightly higher for females 216 (52.4%). The higher prevalence for both hepatitis viruses were found among individuals at the age group of 40 to 59 years and the lower levels of positivity for both HBV and HBC were among children and teenagers.

Seroprevalence of Hepatitis B and C markers at the population level in the municipality of Caxias do Sul, southern Brazil

Chronic viral hepatitis are main public health problems worldwide. Data about the seroprevalence to Hepatitis B and C viruses (HBV e HCV) at the population level are scarce on Brazil and especially for the Southern region of the country. The seroprevalence to HBV and HBC antigens was evaluated on a large portion of the population of the municipality of Caxias do Sul (427,858 inhabitants), Brazil. A total of 60,604 individual serum samples collected from 2008 to 2011 were screened for HBV surface antigen (HBsAg) and for antibodies against HBsAg; anti HCV antibodies were measured by ELISA (Enzyme Linked Immunosorbent Assay). Overall, 1.63% of the individuals were positive for HBsAg and 1.43% showed seropositivity to HCV. From the total, 31,749 samples were analyzed for HBsAg and 28,855 for HCV. For HBsAg, 519 samples showed positive (1.63%) while the results for 37 patients (0.12%) remained inconclusive. For the anti-HCV test, 412 individuals (1.43%) showed positive. From the positive samples for HBsAg 216 (50.6%) were from male individuals whereas for anti-HCV the seroprevalence was slightly higher for females 216 (52.4%). The higher prevalence for both hepatitis viruses were found among individuals at the age group of 40 to 59 years and the lower levels of positivity for both HBV and HBC were among children and teenagers.

Prevalence of the precore G1896A mutation in Chinese patients with e antigen negative hepatitis B virus infection and its relationship to pre-S1 antigen

This study investigated the prevalence of the precore G1896A mutation in Chinese patients with hepatitis B e antigen (HBeAg) negative HBV infection and its relation to serum HBV pre-S1 antigen. The overall prevalence of the precore G1896A mutation was 72.6% in HBeAg-negative Chinese patients with detectable serum HBV DNA. The prevalence of the precore G1896A is significantly higher in Chinese HBeAg-negative patients with chronic hepatitis B than that in inactive HBV carriers with detectable serum HBV DNA. Serum pre-S1 and the precore G1896A mutation were simultaneously detected in most of Chinese HBeAg-negative patients.

Serological markers and risk factors related to hepatitis B virus in dentists in the Central West region of Brazil

The hepatitis B virus (HBV) has been considered the major occupational risk agent for dentists. The Central West region of Brazil is considered an intermediate endemic pattern area, but currently there is no information about the HBV prevalence in dentists of Goiânia, Goiás. This study aimed at the detection of the HBV infection rate and risk factors for dentists of Goiânia and the comparison of the obtained data with the general population and other groups. A randomized sample of 680 professionals participated in this study. All dentists gave written consent for the procedure and filled out a questionnaire about risk factors. The HBV serological markers were analyzed using ELISA test and the presence of anti-HBc was observed in 41 (6.0%) of the dentists. None of them was HBsAg positive. Significant relationships with HBV positivity were observed with gender, the time working as a dentist and the use of incomplete personal protective equipment (PPE). The HBV prevalence found in this group of dentists was lower than the endemic pattern of the general population, other health care workers of the region and the dentists from other regions in Brazil. These results may indicate a positive impact of vaccination considering the high adherence of the dentists to the immunization program (98.4%). Finally, the use of complete PPE by the majority as well as other standard precautions recommended for health care workers could be responsible for the low HBV seroprevalence.

O vírus da hepatite B (VHB) tem sido considerado o agente de maior risco ocupacional para o cirurgião-dentista (CD). A região Centro Oeste do Brasil é considerada de padrão endêmico intermediário para a infecção pelo vírus e não há informações sobre a prevalência do VHB em CD da cidade de Goiânia, Goiás. Este estudo objetivou determinar a soroprevalência da infecção pelo VHB e fatores de risco relacionados em CD de Goiânia comparando com dados da população geral e outros grupos populacionais. Uma amostra randomizada de 680 profissionais participou deste estudo. Após consentimento escrito, todos os CD responderam um questionário com informações sobre fatores de risco. Os marcadores sorológicos da infecção para o VHB foram analisados por meio do teste ELISA tendo sido observado o marcador de infecção viral, anti-HBc, em 41 (6.0%) dentistas, nenhum deles positivo para o HBsAg. Associações significantes com a positividade ao VHB foram observadas em relação a gênero, ao tempo de trabalho e ao uso incompleto de equipamentos de proteção individual (EPI). A soroprevalência ao VHB observada em CD foi inferior ao da população geral, para outros grupos de profissionais de saúde na mesma região e para CD de outras regiões do Brasil. Os resultados deste estudo sugerem impacto positivo da vacinação, considerando a alta adesão pelos CD ao programa de imunização (98,4%). Finalmente, a adoção de todos os EPI pela maioria dos CD assim como às outras medidas de precauções padrão recomendadas para profissionais de saúde pode justificar a menor soroprevalência observada.

Seroprevalence of HIV, syphilis, and hepatites B and C among women confined at Centro de Ressocialização Feminino of Rio Claro, São Paulo / Soroprevalência de HIV, sífilis, hepatite B e C em mulheres do Centro de Ressocialização Feminino, Rio Claro, São Paulo

This study presents the seroprevalence rates of HIV, syphilis and hepatitis B and C viruses among femaleindividuals confined at Centro de Ressocialização Feminino of Rio Claro (CRF-RC), São Paulo State. Atotal of 225 serum samples sent from CRF-RC, during the period from March 2003 to June 2004, wereanalysed at Rio Claro Regional Laboratory of Instituto Adolfo Lutz. For determining hepatitis B and Cmarkers , and for HIV screening testing commercially available ELISA reagents kits were employed. HIVpositive and indeterminate samples were tested by IFI and/or Western Blot. Syphilis laboratory markerswere detected by means of VDRL and TPHA assays. The prevalence value found for HIV and syphiliswere 3.6% and 3.0%, respectively , and for hepatitis B and C markers were: 1.3%(HbsAg) ; 20.1%(anti-HBsAg); 8.5 %(anti-HBc) , and 7.5 %(anti-HCV). About 63 % of HIV positive samples also showedpositivity for hepatitis B and C markers and/or syphilis. This study emphasizes the relevance in performingserological testing for STD among individuals confined in prisons or jails in order to avoid or to minimizethe STD transmission to other persons who live in or outside of a penal system.

O objetivo deste estudo foi conhecer a soroprevalência de HIV, hepatites B e C e sífilis, em mulheres do Centro de Ressocialização Feminino de Rio Claro, SP. Foram analisados os resultados laboratoriais de 225 amostras de soro encaminhadas ao IAL - Rio Claro, entre março de 2003 e junho de 2004. Os marcadores sorológicos para as hepatites (HBsAg, anti HBsAg, anti HBc e anti HCV) e os anticorpos anti-HIV foram detectados por ELISA. Amostras positivas e/ou indeterminadas para HIV, foram submetidas às técnicas de Imunofluorescência Indireta e Western Blot. No imunodiagnóstico de sífilis foram utilizados os testes de VDRL e de TPHA . Foram detectadas as seguintes soropositividades: HIV - 3,6%; VDRL/TPHA - 3,0%; anti HCV- 7,5%; HBsAg - 1,3%; anti -HBsAg - 20,1%; anti-HBc - 8,5%. Cerca de 63 % das amostras positivas para HIV apresentaram soropositividades concomitantes para: sífilis (01); anti HCV (02); HBsAg (01) e HBsAg/anti HCV (01). As amostras analisadas foram de mulheres de 18 a 61 anos de idade, sendo 70,2% pertencentes à faixa etária de 21 a 40 anos. O presente estudo reforça a importância do diagnóstico precoce das DST/aids em mulheres ingressantes nas instituições, minimizando a disseminação das doenças dentro e fora do sistema prisional.