Risk factors and prevalence of antibodies against hepatitis A virus (HAV) in children from day-care centers, in Goiania, Brazil.

A seroepidemiologic survey about hepatitis A virus (HAV) infection was carried out in a group comprising 310 children, ranging in age from 3 months to 9 years, from day-care centers, in Goiania, a middle sized city in the central region of Brazil. The biomarkers employed in the investigation of previous infection include total IgG and IgM anti-HAV antibodies, and for the detection of more recent infection, IgM anti-HAV antibodies were analyzed. The study was performed in 1991 and 1992. According to the results, 69.7% of the children presented total IgG/IgM anti-HAV antibodies, with 60% of the group in the age range of 1 to 3 years. Among 10 day-care centers analyzed, the prevalence of the biomarker IgM anti-HAV was 3.2%, with an uniform distribution of the cases in the group of children ranging in age from 1 to 4 years. Multivariate analysis was performed to investigate the sociodemographic factors that could influence the results. It was verified that the risk for the infection increased with the length of the attendance in the day-care centers, i.e., the risk for children with attendance of one year or more was 4.7 times higher, when compared with children with one month attendance (CI 95% 2.3-9.9). According to the results, hepatitis A is an endemic infection in day-care centers in the study area. The length of attendance in the day-care settings was demonstrated to be a risk factor for the HAV infection. Such findings suggest that if hepatitis A vaccination becomes available as a routine policy in our region, the target group should be children under one year. Moreover, those children should receive the vaccine before they start to attend the day-care centers.

[Seroepidemiology of hepatitis A virus infection in street children of Goiânia-Goiás]. / Soroepidemiologia da infecção pelo vírus da hepatite A em "meninos de/na rua" de Goiânia-Goiás.

A cross-sectional study was performed to determine the age-prevalence of hepatitis A virus (HAV) among street youth from Goiania city--Central Brazil, and to determine if any risk factors could be identified. The surveys were conducted between 1991/1992. The street youth were 397 individuals aged 7 to 21 years old living in institutions and teenagers working at streets. Then, 313 adolescents working at streets and with family links, and 84 institutionalized ones without family were screened for antibodies against HAV. Prevalences ranged from 80.0% to 92.2% to total anti-HAV and there was not a statistically significant trend of positivity with age in this group. Univariate analysis for risk factors associated with HAV infection was performed with no statistically significant difference for adolescents working at streets and living with parents, and street youth with family links. Economic variables were not statistically associated with seropositivity, probable due to homogeneous characteristics of the group. This study disclosed that street youth have a high rate of HAV infection. These findings do not suggest differences between subgroups of populations in acquiring immunity to HVA. The public health implication and the need of screening other subgroups of population of the same city were suggested in order to discuss vaccine strategy in underdeveloped countries.

[Survival of the hepatitis C virus in a dialysis population in Goiânia, Goiás]. / Soroprevalência do vírus da hepatite C na população em diálise de Goiânia, GO.

The patients were 173, aged 10 to 70 years old. An Elisa II test was undertaken and 61 to 173 (35.3%) had positive test; when INNO-LIA test was made, soropositivity was 26% (44/173). Patients with anti-VHC antibodies have been kept on hemodialysis treatment for periods longer than negatives (p < 0.05). Neither drugs users, blood transfusions, sexual and aminotransferase activity were significantly correlated with the infection. There is an elevated prevalence of anti-VHC antibodies among chronic hemodialysis patients which seems to be related to the time that patients are on dialysis treatment.

[Serologic screening for hepatitis B in health professionals in the city of Goiânia-Goiás]. / Rastreamento sorológico para hepatite B em profissionais de saúde na cidade de Goiânia-Goiás.

Markers for hepatitis B virus in health care workers were analysed in 625 employees of three institutions in Goiânia city. The virus prevalence was 23.4% related to different markers (AgHBs, anit-HBs and anti-HBc). Among the positive individuals, 1.3% presented acute infection, 1.0% were virus carriers and 21.1% presented only anti-HBs and 32.6% only anti-HBc as markers. There were 19 reports of virus vaccination. Eight of them seroconverted for anti-HBs and 6 were positive for both anti-HBc and anti-HBs. Higher prevalence rates were found above 30 year of age (p < 0.05). The male and female prevalence rates were 29.5% and 21.1% (p < 0.05) respectively. The virus prevalence rates among blood and patient contacts were 25.9% (p < 0.05) and the highest prevalence was found in persons followed up for at least ten years (p < 0.05). The greatest risk section has shown to be hemodialysis unit personnel with a percentual of 77% (p < 0.05).

[Seroepidemiology for the hepatitis B virus (HBV) in pregnant women/parturients and its transmission to newborns in Goiânia, GO]. / Soroepidemiologia para o vírus da hepatite B (VHB) em gestantes/parturientes e sua transmissão para recém-nascidos em Goiânia-GO.

In order to detect hepatitis B virus (HBV), 1459 serum samples from pregnant/parturient women were collected at two public hospitals in Goiânia, GO. These samples were tested by enzyme linked immunosorbent assay for HBsAg and anti-HBs. 109 (7.5%) serum samples were positive. Eight (0.5%) sera were positive for HBsAg and 101 (7.0%) for anti-HBs. Viral positivity for both HBsAg and anti-HBs were observed in women which age ranged from 15 to 30 years. Four newborns from HBsAg positive mothers were submitted to the treatment with HBV vaccine (Engerix B) and with hyperimmune gammaglobulin (HBIG, Abbott Laboratories, Brazil). Cord blood from one of the newborns was positive for HBsAg. A positive association was found between hepatitis B and sexually transmitted infections and blood transfusion. These results emphasize the need for prenatal screening for HBV in pregnant women and treatment of the newborns from AgHBs-positive mothers.

Risk factor and prevalence of antibodies against hepatitis a virus (HAV) in children from day-care centers, in Goiania, Brazil

Um estudo seroepidemiologico para o virus da hepatite A (VHA), investigando os marcadores de infeccao passada (anti-VHA total anti-IgG e IgM) e infeccao recente (anti-VHA IgM), foi realizado entre 1991 e 1992, em criancas de creche de Goiania-Brasil central. Das 310 criancas com idade entre 03 meses e 09 anos, 69,7 por cento mostraram soropositividade ao anti-VHA total, sendo 60 por cento, na faixa etaria entre 1 e 3 anos. A prevalencia do marcador anti-VHA IgM foi de 3,2 por cento visto em idade de 1-4 anos e com distribuicao uniforme nas 10 creches estudadas. Entre as variaveis sociodemograficas estudadas, apenas o tempo de frequencia das criancas nas creches, igual ou superior a um ano, mostrou, em analise multivariada ajustada para idade, um risco de 4,7 vezes maior quando comparado com o periodo de um mes (LC 95 por cento 2,3-9,9)...

Soroepidemiologia da infecçäo pelo vírus da hepatite A em meninos de/na rua de Goiânia-Goiás / Seroepidemiology of hepatitis A virus infection in street children of Goiânia-Goiás

Um estudo soro epidemiológico, para anticorpos contra o virus da hepatite A (anti-VHA total-IgM e IgG), foi realizado no período de 1991-1992, em 397 "meninos de/na rua" em Goiânia. Destes, 313 apresentavam vínculo familiar e desenvolviam, em sua maioria, atividades de trabalho informal, enquanto que 84 nao possuiam vínculo familiar e se encontravam na rua ou em Instituiçoes do Governo Estadual. A taxa média de prevalência foi de 90,4 por cento, variando de 80,0 por cento a 92,9 por cento, sem contudo apresentar diferença estatística significante relativa à idade (7-21). Também nao se evidenciou qualquer diferença quando este grupo foi estratificado para presença ou ausência de vínculo familiar ou mesmo quando analisado em relaçao a outras variáveis sócio-demográficas. Estes dados sugerem que a hepatite A é endêmica na populaçao de baixa condiçao sócio-econômica da regiao e que nesta faixa etária a maioria dos indivíduos já adquiriu a infecçao. Outras investigaçoes em grupos e camadas sociais diferentes sao necessárias a fim de parametrar estratégias vacinais em países subdesenvolvidos.