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1.
AIDS Care ; 26(9): 1095-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24617659

RESUMO

Female sex workers (FSWs) are considered a high-risk group for human immunodeficiency virus (HIV) infection due to their social vulnerability and factors associated with their work. We estimated the prevalence of HIV, and identified viral subtypes and risk factors among FSWs. A cross-sectional study using respondent-driven sampling (RDS) method was conducted among 402 FSWs in Campo Grande city, Brazil, from 2009 to 2011. Participants were interviewed using a standardized questionnaire about sociodemograpic characteristics and risk behavior. Blood samples were collected for serological testing of HIV. Of the 402 FSWs, median age and age of initiating sex work were 25 years (Interquartile range [IQR]: 9) and 20 years (IQR: 6), respectively. The majority reported use of alcohol (88.5%), had 5-9 years (median: 9; IQR: 3) of schooling (54.5%), 68.6% had tattoos/body piercings, and 45.1% had more than seven clients per week (median: 7; IQR: 10). Only 32.9% of FSW reported using a condom with nonpaying partners in the last sexual contact. Prevalence of HIV infection was 1.0% (95% CI: 0.1-2.6%). Genotyping for HIV-1 performed on three samples detected subtypes B, C, and F1. Sex work in the Midwestern region of Brazil is characterized by reduced education, large numbers of clients per week, and inconsistent condom use, mainly with nonpaying partners. Although prevalence of HIV infection is currently low, elevated levels of high-risk sexual behavior confirm a need to implement prevention measures. Specific interventions targeting FSWs must emphasize the risk associated with both clients and nonpaying partners while providing knowledge about HIV prevention.


Assuntos
Soroprevalência de HIV , Profissionais do Sexo , Sexo sem Proteção , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Modificação Corporal não Terapêutica/estatística & dados numéricos , Brasil/epidemiologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Escolaridade , Feminino , Humanos , Fatores de Risco , Assunção de Riscos , Fatores Socioeconômicos , Inquéritos e Questionários
2.
Mem Inst Oswaldo Cruz ; 106(1): 113-6, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21340365

RESUMO

Recently, it was suggested that maternal hepatitis B surface antigen antibodies (anti-HBs) acquired transplacentally could play a negative role in newborn infants' immune response to the hepatitis B vaccine. We compared the hepatitis B virus (HBV) vaccine response in infants born to mothers previously vaccinated against HBV (n = 91) to infants born to mothers who were not previously vaccinated (n = 221). All newborn infants received three intramuscular doses (10 µg) of HBV vaccine (Butang®) at 0,1 and six months. The first dose was administered at the maternity hospital within 12 h of birth. The geometric mean titres of anti-HBs were not different among newborn infants born to mothers who were anti-HBs-negative (492.7 mIU/mL) and anti-HBs-positive (578.7 mIU/mL) (p = 0.38). Eight infants did not respond to the HBV vaccine. Of them, six were born to anti-HBs-negative mothers and two were born to mothers with anti-HBs titres less than 50 mlU/mL. Despite the mother's anti-HBs-positive status, our data show a good immunogenicity of the Brazilian HBV recombinant vaccine in neonates.


Assuntos
Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/prevenção & controle , Adulto , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Humanos , Recém-Nascido , Masculino
3.
Trans R Soc Trop Med Hyg ; 114(2): 91-98, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-31608957

RESUMO

BACKGROUND: People living in settlement projects represent an emergent rural population in Brazil. Data on their health is scarce and there are no data on viral hepatitis in this population. This study investigated the epidemiology of viral hepatitis A-E in residents of settlement projects in central Brazil. METHODS: During 2011 and 2012, 923 people living in rural settlements in central Brazil were interviewed and tested to estimate the prevalence of exposure to viral hepatitis A-E, to identify the circulating hepatitis B virus (HBV)/hepatitis C virus (HCV) genotypes and risk factors for HBV exposure and to evaluate adherence to the hepatitis B vaccination series. RESULTS: Overall, 85.9, 3.9, 0.4 and 17.3% of individuals showed evidence of exposure to hepatitis A virus (HAV), hepatitis E virus, HCV and HBV, respectively. Among HBV-DNA positive samples (n=8), subgenotypes A1 (n=3) and A2 (n=1) and genotype D/subgenotype D3 (n=4) were identified. Hepatitis D virus superinfection was detected in 0/16 HBsAg-positive participants. A total of 229 individuals showed serological evidence of HBV vaccination. In total, 442 settlers were eligible for vaccination, but only 150 individuals completed the vaccine series. All anti-HCV-positive samples (n=4) were also HCV-RNA positive and identified as subtype 1a. CONCLUSIONS: The intermediate endemicity of HAV, the higher prevalence of HBV exposure compared with urban areas and the low compliance with HBV vaccination requires preventive measures focused on rural populations, emphasizing the need for HAV and HBV vaccination.


Assuntos
Hepatite A , Hepatite B , Hepatite C , Hepatite D , Hepatite E , Vacinação/estatística & dados numéricos , Brasil/epidemiologia , Genótipo , Hepacivirus/genética , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Vírus da Hepatite B/genética , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Hepatite D/epidemiologia , Hepatite D/prevenção & controle , Vírus Delta da Hepatite/genética , Hepatite E/epidemiologia , Hepatite E/prevenção & controle , Vírus da Hepatite E/genética , Humanos , Prevalência , Fatores de Risco , População Rural
4.
J Med Virol ; 81(4): 602-9, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19235862

RESUMO

Non-injecting drug users are at high-risk for acquiring hepatitis B virus (HBV), although the factors contributing to this increased risk are not known. In the present study, the overall and occult HBV infection prevalence rates were determined in a large population of non-injecting drug users in the Central-West region of Brazil. HBV genotypes and predictors of infection were also identified. A total of 852 individuals in 34 drug treatment centers were interviewed, and their serum samples were tested for the presence of HBV markers by ELISA. HBsAg and anti-HBc-positive samples were tested for HBV DNA by PCR. Samples with HBV DNA were genotyped by restriction fragment length polymorphism (RFLP). The overall prevalence of HBV infection was 14% (95% CI: 11.7-16.5). A multivariate analysis of risk factors showed that age >30 years, non-white race/ethnicity, duration of drug use >10 years, lifetime number of sexual partners >10, non-use of condoms, and HCV and HIV status were associated significantly with HBV infection. Of the 9 (1%) HBsAg-reactive samples, HBV DNA was present in 2/2 of HBeAg-positive and in 5/7 anti-HBe-positive samples. An occult HBV infection rate of 2.7% (3/110) was found among anti-HBc-positive individuals. All HBV DNA-positive samples were genotyped: seven were genotype A, two were genotype D, and one was genotype F. Finally, few individuals (8%) had serological evidence of a previous HBV vaccination. These findings indicate that preventive interventions are needed for both sexual and drug-related high-risk behavior. Additionally, non-injecting drug users should be targeted for HBV vaccination.


Assuntos
Usuários de Drogas , Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Hepatite B/virologia , Adulto , Brasil/epidemiologia , Estudos Transversais , DNA Viral/sangue , Usuários de Drogas/classificação , Feminino , Genótipo , Vírus da Hepatite B/classificação , Vírus da Hepatite B/genética , Humanos , Masculino , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Prevalência , Fatores de Risco , Adulto Jovem
5.
PLoS One ; 14(7): e0220342, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31344111

RESUMO

Hepatitis B virus (HBV) genotype D (HBV/D) is globally widespread, and ten subgenotypes (D1 to D10) showing distinct geographic distributions have been described to date. The evolutionary history of HBV/D and its subgenotypes, for which few complete genome sequences are available, in the Americas is not well understood. The main objective of the current study was to determine the full-length genomic sequences of HBV/D isolates from Brazil and frequency, origin and spread of HBV/D subgenotypes in the Americas. Complete HBV/D genomes isolated from 39 Brazilian patients infected with subgenotypes D1 (n = 1), D2 (n = 10), D3 (n = 27), and D4 (n = 1) were sequenced and analyzed together with reference sequences using the Bayesian coalescent and phylogeographic framework. A search for HBV/D sequences available in GenBank revealed 209 complete and 926 partial genomes from American countries (Argentina, Brazil, Canada, Chile, Colombia, Cuba, Haiti, Martinique, Mexico, USA and Venezuela), with the major circulating subgenotypes identified as D1 (26%), D2 (17%), D3 (36%), D4 (21%), and D7 (1%) within the continent. The detailed evolutionary history of HBV/D in the Americas was investigated by using different evolutionary time scales. Spatiotemporal reconstruction analyses using short-term substitution rates suggested times of the most recent common ancestor for the American HBV/D subgenotypes coincident with mass migratory movements to Americas during the 19th and 20th centuries. In particular, significant linkages between Argentina and Syria (D1), Brazil and Central/Eastern Europe (D2), USA and India (D2), and Brazil and Southern Europe (D3) were estimated, consistent with historical and epidemiological data.


Assuntos
Vírus da Hepatite B/genética , Hepatite B/epidemiologia , Hepatite B/virologia , América/epidemiologia , Teorema de Bayes , DNA Viral/análise , DNA Viral/genética , Demografia , Genética Populacional , Genótipo , Vírus da Hepatite B/classificação , Humanos , Filogenia , Filogeografia , Estudos Retrospectivos , Análise de Sequência de DNA
6.
Mem Inst Oswaldo Cruz ; 103(4): 405-8, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18660998

RESUMO

A survey was conducted among the hemodialysis units of the city of Campo Grande, located in the state of Mato Grosso do Sul in the Mid-west region of Brazil, with the aim of investigating the prevalence, risk factors, and genotypes of hepatitis C virus (HCV) infection. A total of 163 patients were interviewed in five dialysis units. Serum samples were screened for anti-HCV. Positive samples were tested for HCV RNA and genotyped. The prevalence of anti-HCV was 11% (95% CI: 6.8-17.1). A history of transfusion with blood that was not screened for anti-HCV and length of time on hemodialysis were associated with HCV infection. HCV RNA was detected in 12 samples: ten were of genotype 1, subtypes 1a (75%) and 1b (8.3%), and two were of genotype 3, subtype 3a (16.7%).


Assuntos
Hepacivirus/imunologia , Anticorpos Anti-Hepatite C/sangue , Hepatite C/epidemiologia , RNA Viral/genética , Diálise Renal/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Genótipo , Hepatite C/diagnóstico , Hepatite C/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
7.
Mem Inst Oswaldo Cruz ; 103(5): 472-6, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18797761

RESUMO

An investigation was conducted involving 255 renal transplant recipients in the state of Goiás, Central Brazil, to determine the prevalence of hepatitis C virus (HCV), its risk factors, the genotypes involved, and the level of alanine aminotransferase (ALT) present in the patients. All serum samples were tested for anti-HCV antibodies and HCV RNA. Forty-one patients were anti-HCV and/or HCV RNA positive, resulting in an overall HCV infection prevalence of 16.1% (95% CI: 11.9-21.3). A multivariate analysis of risk factors showed that a history of blood transfusions without anti-HCV screening, the length of time spent on hemodialysis, and renal transplantation before 1994 are all associated with HCV positivity. In HCV-positive patients, only 12.2% had ALT levels above normal. Twenty-eight samples were genotyped as genotype 1, subtypes 1a (62.5%) and 1b (31.3%), and two samples (6.2%) were genotype 3, subtype 3a. These data show a high prevalence of HCV infection and low ALT levels in the studied population. The risk factor analysis findings emphasize the importance of public health strategies such as anti-HCV screening of candidate blood and organ donors, in addition to the stricter adoption of hemodialysis-specific infection control measures. The present study also demonstrates that HCV genotype 1 (subtype 1a) is predominant in this population.


Assuntos
Hepacivirus , Anticorpos Anti-Hepatite C/sangue , Hepatite C/epidemiologia , Transplante de Rim , Adolescente , Adulto , Idoso , Alanina Transaminase/sangue , Brasil/epidemiologia , Feminino , Genótipo , Hepacivirus/genética , Hepacivirus/imunologia , Hepatite C/diagnóstico , Hepatite C/etiologia , Humanos , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/genética , Fatores de Risco
8.
J Infect Public Health ; 11(4): 526-529, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29097105

RESUMO

BACKGROUND: Hepatitis C virus (HCV) presents a significant public health issue, especially among high-risk populations, such as truck drivers, prisoners, people living with HIV, people living with tuberculosis, and people who are homeless. METHODS: This cross-sectional study analyzed the data of 1600 individuals recruited from high-risk populations who denied the use of injection drugs and/or history of blood transfusion to better understand on epidemiology of HCV. RESULTS: The presence of HCV antibodies was independently associated with the following risk factors: age >40years, tattoo or body piercing, sharing of personal care items, and non-injection drug use. CONCLUSIONS: While the use of injection drugs is a prevalent mode of HCV transmission, the findings of this study indicate additional routes that lead to viral transmission among vulnerable populations. Since an HCV vaccine is not currently available, public health and education programs should be developed that specifically target high-risk populations to prevent infection acquisition and secondary transmission.


Assuntos
Usuários de Drogas , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Populações Vulneráveis/estatística & dados numéricos , Adulto , Piercing Corporal/estatística & dados numéricos , Brasil/epidemiologia , Estudos Transversais , Feminino , Hepatite C/transmissão , Hepatite C/virologia , Pessoas Mal Alojadas , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prisioneiros/estatística & dados numéricos , Fatores de Risco , Comportamento Sexual/estatística & dados numéricos , Adulto Jovem
9.
BMC Microbiol ; 7: 103, 2007 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-18036224

RESUMO

BACKGROUND: Hepatitis B virus (HBV) isolates have been classified in eight genotypes, A to H, which exhibit distinct geographical distributions. Genotypes A, D and F are predominant in Brazil, a country formed by a miscegenated population, where the proportion of individuals from Caucasian, Amerindian and African origins varies by region. Genotype F, which is the most divergent, is considered indigenous to the Americas. A systematic molecular characterization of HBV isolates from different parts of the world would be invaluable in establishing HBV evolutionary origins and dispersion patterns. A large-scale study is needed to map the region-by-region distribution of the HBV genotypes in Brazil. RESULTS: Genotyping by PCR-RFLP of 303 HBV isolates from HBsAg-positive blood donors showed that at least two of the three genotypes, A, D, and F, co-circulate in each of the five geographic regions of Brazil. No other genotypes were identified. Overall, genotype A was most prevalent (48.5%), and most of these isolates were classified as subgenotype A1 (138/153; 90.2%). Genotype D was the most common genotype in the South (84.2%) and Central (47.6%) regions. The prevalence of genotype F was low (13%) countrywide. Nucleotide sequencing of the S gene and a phylogenetic analysis of 32 HBV genotype F isolates showed that a great majority (28/32; 87.5%) belonged to subgenotype F2, cluster II. The deduced serotype of 31 of 32 F isolates was adw4. The remaining isolate showed a leucine-to-isoleucine substitution at position 127. CONCLUSION: The presence of genotypes A, D and F, and the absence of other genotypes in a large cohort of HBV infected individuals may reflect the ethnic origins of the Brazilian population. The high prevalence of isolates from subgenotype A1 (of African origin) indicates that the African influx during the colonial slavery period had a major impact on the circulation of HBV genotype A currently found in Brazil. Although most genotype F isolates belonged to cluster II, the presence of some isolates belonging to clusters I (subgroup Ib) and IV suggests the existence of two or more founder viral populations of genotype F in Brazil.


Assuntos
DNA Viral/genética , Vírus da Hepatite B/classificação , Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Hepatite B/virologia , Substituição de Aminoácidos , Doadores de Sangue , Brasil/epidemiologia , DNA Viral/sangue , DNA Viral/química , DNA Viral/isolamento & purificação , Genótipo , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Humanos , Filogenia , Polimorfismo de Fragmento de Restrição , Análise de Sequência de DNA
10.
J Infect Public Health ; 10(1): 76-83, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27026240

RESUMO

Crack cocaine users represent a target group for hepatitis B vaccination. We evaluate the HBV epidemiology, immunization status and compliance with a super-accelerated vaccination schedule among in-treatment crack cocaine users in central Brazil. Six hundred in-treatment crack cocaine users were interviewed, and serum samples were tested for HBV markers. A super-accelerated vaccination schedule of HBV vaccine was offered to all susceptible crack cocaine users. In total, 7.0% of those tested had at least one positive marker of HBV exposure. Age, use of crack cocaine through improvised pipe, exchange of sex for money/drugs and previous sexually transmitted infections (STIs) were predictors of HBV exposure. One hundred six (17.7%) individuals showed a serological profile of hepatitis B vaccination. Of these, 54.7% were less than 25 years old, and only 13% of individuals were more than 35 years old. Although 91.8% of crack users accepted the first vaccine dose, only 21.7% received all three doses. Of the 23 crack cocaine users who agreed to have their vaccine response evaluated, 78.3% developed protective anti-HBs titers. Premature termination of treatment was the most common reason for not receiving the full vaccine series. Despite the low prevalence of HBV exposure among in-treatment crack cocaine users in central Brazil, the low rate of immunization and the high frequency of high-risk behaviors highlight the potential for crack users to acquire and disseminate this infection and therefore maintain the viral reservoir. Health practitioners need to keep this in mind, taking advantage of all opportunities to access this population and vaccinate against HBV.


Assuntos
Cocaína Crack , Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Adesão à Medicação , Assunção de Riscos , Transtornos Relacionados ao Uso de Substâncias/complicações , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Brasil , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Adulto Jovem
11.
Rev Inst Med Trop Sao Paulo ; 48(1): 53-5, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16547582

RESUMO

In order to investigate the hepatitis C virus (HCV) genotypes in mid-west region of Brazil, 250 anti-HCV positive blood donors were studied. Among them, the anti-HCV serological status was confirmed in 205 (82%). HCV RNA was detected in 165 samples, which were genotyped. HCV types 1, 2 and 3 were found in 67.9%, 3% and 29.1% of the donors, respectively. In Goiás state, subtype 1a (50%) was the most prevalent, followed by subtypes 3a (30.9%) and 1b (16.7%). In Mato Grosso state, subtype 1a was also predominant (41%), followed by subtypes 1b (29.5%) and 3a (25%). In Mato Grosso do Sul state, subtypes 1a and 1b were detected equally (36.8%), followed by 3a (21.1%). Subtype 2b was rare (2.4%, 4.5% and 5.3%, respectively). In Distrito Federal, subtype 3a (39%) was more frequent than 1a (31.7%) and the remaining (29.3%) belonged to subtype 1b.


Assuntos
Doadores de Sangue , Hepacivirus/genética , Anticorpos Anti-Hepatite C/sangue , Hepatite C/virologia , Regiões 5' não Traduzidas/genética , Adolescente , Adulto , Brasil/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Genótipo , Hepacivirus/imunologia , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/análise
12.
PLoS One ; 11(8): e0160916, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27508385

RESUMO

BACKGROUND: Men who have sex with men (MSM) are at increased risk of exposure to hepatitis B virus (HBV) compared with the general population. This study aims to assess the epidemiological and virological characteristics of HBV infection in a sample of MSM in Brazil, where data are scarce. METHODS: A cross-sectional study was conducted among MSM in the City of Goiânia, Central Brazil, from March to November 2014, using Respondent-Driven Sampling (RDS). After signing the consent form, participants were interviewed and a blood sample collected. All samples were tested for HBV serological markers and HBV DNA. HBV nucleotide sequence analysis was also performed. RESULTS: A total of 522 MSM were recruited in the study. The prevalence of HBV infection (current or past [presence of anti-HBc marker]) was 15.4% (95% CI: 8.7-25.8) and the rate of HBsAg carriers was 0.6% (95% CI: 0.2-1.6). About 40% (95% CI: 32.3-48.8) of the participants had serological evidence of previous HBV vaccination (reactive for isolated anti-HBs). In addition, 44.3% (95% CI: 36.1-52.9) were seronegative for all HBV markers. Age over 25 years old, receptive anal intercourse, previous sex with women, and history of sexually transmitted infections (STIs) were factors associated with HBV infection. HBV DNA was detected only in HBsAg-positive individuals. HBV isolates were classified into genotype A (subgenotypes A1 and A2), and some mutations were identified throughout the genome. Therefore, occult HBV infection was not observed in the study population. CONCLUSIONS: Public health strategies should be improved for the MSM population in order to prevent HBV and other STIs, as well as to provide appropriate management of patients with active infections.


Assuntos
Vírus da Hepatite B/genética , Hepatite B/epidemiologia , Homossexualidade Masculina , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Hepatite B/virologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/isolamento & purificação , Homossexualidade Masculina/psicologia , Humanos , Masculino , Filogenia , Assunção de Riscos , Comportamento Sexual
13.
Am J Infect Control ; 31(7): 431-4, 2003 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-14639441

RESUMO

BACKGROUND: Hepatitis B virus (HBV) vaccine has been recommended to health care workers because of their frequent exposure to patient blood and other body fluid. METHODS: A cross-sectional study was done to determine the compliance with HBV vaccination, and the risk of occupational exposure to blood or other body fluids in intensive care unit (ICU) personnel (n=458) in Goiânia, Brazil. RESULTS: The vast majority (95.5%) of ICU personnel reported HBV vaccination. Among those who did not, housekeepers were statistically associated with nonvaccination (P<.05). They had a 19.1-fold (95% confidence interval: 2.07-444.5) greater risk of nonvaccination compared with physicians. A total of 220 participants reported an incident with biologic fluids. Physician and nursing staff had a higher risk for occupational exposure to blood, other body fluids, or both when compared with housekeepers. CONCLUSIONS: This study showed a high frequency of HBV vaccination in ICU personnel in Brazil. Nevertheless, more efforts are necessary to increase compliance with vaccination in housekeepers. Physician and nursing staffs showed high risk of occupational exposure to blood, other body fluids, or both, ratifying the importance of continuous education programs concerning prevention of bloodborne pathogen transmission for all ICU personnel.


Assuntos
Fidelidade a Diretrizes/estatística & dados numéricos , Guias como Assunto , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Controle de Infecções/normas , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Patógenos Transmitidos pelo Sangue , Brasil/epidemiologia , Estudos Transversais , Feminino , Hepatite B/etiologia , Vacinas contra Hepatite B/administração & dosagem , Zeladoria Hospitalar/normas , Humanos , Unidades de Terapia Intensiva/normas , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/etiologia , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Fatores de Risco
14.
Antivir Ther ; 18(3 Pt B): 435-44, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23792792

RESUMO

BACKGROUND: Many studies have documented the molecular epidemiological scenario of HCV within individual Brazilian states, but we still have an incomplete understanding of the dispersion dynamics of the virus in different regions throughout the country. METHODS: A total of 676 HCV NS5B gene sequences of subtypes 1a (n=321), 1b (n=170) and 3a (n=185), isolated from seven different Brazilian states covering four out of five regions were analysed in the present study. We also analysed 22 HCV NS5B gene sequences of minor genetic variants including genotype 2 (n=13), genotype 4 (n=6) and subtype 5a (n=3). Brazilian HCV sequences were aligned with sequences of non-Brazilian origin and subjected to maximum likelihood phylogenetic analyses. RESULTS: These analyses revealed that the Brazilian HCV epidemic resulted from multiple introductions and autochthonous transmission of subtypes 1a, 1b, 3a and genotypes 2, 4 and 5. Brazilian HCV subtype 1a epidemic is dominated by the dissemination of one major clade; while Brazilian HCV subtypes 1b and 3a epidemics are characterized by concurrent dissemination of several independent HCV lineages. Some HCV Brazilian lineages of subtypes 1a, 1b, 2b and 3a were successful in becoming established and disseminated through several regions in the country. Despite significant phylogenetic intermixing of Brazilian sequences, the distribution of HCV strains from different states across lineages was not completely homogeneous. CONCLUSIONS: These results demonstrate the existence of multiple introductions and local propagation of both prevalent and uncommon HCV genetic variants in Brazil and identify some major Brazilian HCV clades with nationwide dissemination. This study also suggests that the observed HCV diversity in Brazil has been shaped by both frequent viral migration among regions and in situ viral dissemination.


Assuntos
Variação Genética , Hepacivirus/genética , Hepatite C/epidemiologia , Proteínas não Estruturais Virais/genética , Sequência de Bases , Brasil/epidemiologia , Epidemias , Genótipo , Hepacivirus/classificação , Hepacivirus/isolamento & purificação , Hepatite C/transmissão , Humanos , Epidemiologia Molecular , Filogenia , RNA Viral/genética , Análise de Sequência de RNA
16.
Infect Genet Evol ; 10(7): 886-95, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20663735

RESUMO

Hepatitis C virus (HCV) subtypes 1a, 1b and 3a are the most prevalent strains in Brazil, but very little is known about the epidemic history of these subtypes in the country. A total of 231 HCV NS5B gene sequences (subtype 1a=89, subtype 1b=56, and subtype 3a=86) isolated in Brazil between 1995 and 2007 were analyzed in the present study. Sequences (328-pb) were subjected to phylogenetic analyses and statistical tests of phylogenetic mixing by sampling location and risk group. Our results revealed important variations in the pattern of HCV transmission among subtypes. Transmission of subtype 1a was characterized by dissemination of one major Brazilian lineage with a random virus exchange between different geographical regions but not between IDU and non-IDU populations. Transmission of subtype 1b was characterized by concurrent dissemination of multiple HCV lineages with a restricted virus exchange between country regions and risk groups. Transmission of subtype 3a was characterized by simultaneous spreading of multiple HCV lineages and random phylogenetic mixing by risk group and sampling location. Epidemic histories of major subtypes 1a, 1b and 3a Brazilian clades were estimated using a Bayesian coalescent approach. Our results indicate that all major HCV Brazilian clades probably start to circulate in the country during the second half of the 20th century and displayed roughly similar epidemic histories characterized by an initial phase of exponential expansion and by reduction of growth rates since 1980-1995. This suggests that the expansion of HCV may have been effectively controlled in Brazil.


Assuntos
Surtos de Doenças/história , Hepacivirus/genética , Hepatite C/epidemiologia , Evolução Biológica , Brasil/epidemiologia , Hepacivirus/classificação , Hepatite C/virologia , História do Século XX , História do Século XXI , Humanos , Filogenia , Proteínas não Estruturais Virais/genética
17.
Rev Inst Med Trop Sao Paulo ; 52(1): 57-60, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20305957

RESUMO

Hepatitis C virus (HCV) genotypes and subtypes were determined in hemodialysis patients in the Federal District, Brazil, by sequencing of the 5' noncoding (NC) and nonstructural 5B (NS5B) regions. From 761 patients, 66 anti-HCV-positive samples were tested for HCV RNA. All 51 HCV RNA-positive samples by PCR of the 5' NC region were genotyped as genotypes 1 (90.2%) and 3 (9.8%). Subtype 1a (82.3%) was the most prevalent, followed by subtypes 3a (9.8%), 1b (5.9%) and 1a/1b (2.0%). Forty-two samples could be amplified and genotyped in the NS5B region: 38 (90.5%) as genotype 1, subtypes 1a, and 8 (9.5%) as genotype 3, subtype 3a. For the 42 samples sequenced in both regions, the genotypes and subtypes determined were concordant in 100% and 95.2% of cases, respectively. Two samples presented discrepant results, with the 5' NC region not distinguishing correctly the subtypes 1a and 1b. These findings indicate that the HCV genotype 1, subtype 1a, is the most prevalent among hemodialysis patients in the Federal District, Brazil.


Assuntos
Regiões 5' não Traduzidas/genética , Hepacivirus/genética , Hepatite C/virologia , RNA Viral/análise , Proteínas não Estruturais Virais/genética , Sequência de Bases , Genótipo , Hepacivirus/classificação , Humanos , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Diálise Renal
19.
Cad Saude Publica ; 25(4): 738-42, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19347199

RESUMO

Compliance with and responses to the hepatitis B vaccine were evaluated in remaining quilombo communities in Central Brazil. A total of 708 individuals who were susceptible to hepatitis B virus infection were invited to participate in the hepatitis B vaccination program in eight communities. Although 567 (80%) individuals received the first dose, only 198 (28%) complied with the full vaccination scheme. Of 148 subjects who agreed to be tested for anti-HBs, 123 (83.1%; 95%CI: 75.9-88.6) responded to the vaccine. A geometric mean titer of 512mIU/mL (95%CI: 342.5-765.3) was found. Male sex and older age were independently associated with non-response. Additional health education programs and alternative hepatitis B vaccine schedules are needed to improve the vaccination coverage in these communities in Central Brazil.


Assuntos
População Negra/estatística & dados numéricos , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Hepatite B/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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