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Rev. Soc. Bras. Med. Trop ; 53: e20190559, 2020. tab
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136898


Abstract INTRODUCTION: Brazil's western Amazon basin has the highest prevalence of hepatitis B virus (HBV) infection in the country. Coinfection with hepatitis D virus (HDV) is also endemic. To estimate the prevalence of HBV and HDV markers in a population inhabiting the northwest portion of Mato Grosso state in the western Amazon. METHODS: We performed a cross-sectional study of the seroprevalence of antibodies against HBV core antigen (anti-HBc) in the Três Fronteiras District northwest of Mato Grosso. Anti-HBc-positive subjects were tested for HBV surface antigen (HBsAg). Those positive for this marker were tested for HDV antibodies. Anti-HBc-negative participants were tested for anti-HBsAg. All tests were performed by EIA. RESULTS: A total of 623 individuals in the community were assessed; the majority (67.6%) were male, with a mean age of 30.8 ± 15.4 years. Two hundred and fourteen individuals (34.3%) were anti-HBc-positive, and 47 (7.5%) were HBsAg carriers. Only one individual was anti-HDV-positive. Among the 409 individuals without HBV infection, 18.3% were anti-HBsAg-positive. There was no association between HBV infection and known risk factors. CONCLUSIONS: The study area had intermediate-to-high endemicity for HBV infection, but a low prevalence of HDV. Our serological results suggesting low vaccination-induced protection indicate a need for reinforced immunization programs in the populations of northwest Mato Grosso.

Humans , Male , Adolescent , Adult , Young Adult , Hepatitis B/epidemiology , Hepatitis D/epidemiology , Brazil/epidemiology , Seroepidemiologic Studies , Hepatitis B virus/immunology , Prevalence , Cross-Sectional Studies , Hepatitis B Antibodies , Hepatitis B Surface Antigens , Middle Aged
Rev. bras. enferm ; 72(5): 1265-1270, Sep.-Oct. 2019. tab
Article in English | LILACS, BDENF | ID: biblio-1042147


ABSTRACT Objective: to analyze clinical, serological, biochemical and hematological aspects in patients infected with the hepatitis B (HBV) and Delta (HDV) viruses. Method: cross-sectional, descriptive and retrospective study, performed with patients chronically infected with HBV and superinfected with HDV. Results: among the 112 patients selected, 74% were monoinfected with HBV (Group HBV) and 26% were superinfected with HDV (Group HBV+HDV). There was no difference in gender distribution. The average age was 36 years with standard deviation of ±12 years. The symptoms and signs presented a higher proportion in Group HBV+HDV (p=0.001). In both groups, most patients had non-reactive AgHBe. The records of biochemical and hematologic changes showed highest proportion in Group VHB+VHD Group (p<0.05). Conclusion: the study found that patients were in clinical stages of the disease different from those in the initial examination for monitoring their chronic condition. The clinical profile suggests greater severity of liver disease among the patients superinfected with HDV.

RESUMEN Objetivo: Analizar los aspectos clínicos, serológicos, bioquímicos y hematológicos de pacientes infectados por el virus de las hepatitis B (VHB) y Delta (VHD). Método: Se trata de un estudio transversal, descriptivo, retrospectivo, realizado entre pacientes crónicos infectados de VHB y sobre infectados de VHD. Resultados: Entre los 112 pacientes seleccionados, el 74% estaba mono infectado por VHB (Grupo VHB) y el 26%, sobre infectado por VHD (Grupo VHB+VHD). No se encontró diferencia en la distribución por género. La edad promedio era 36 años, con desviación típica de ±12 años. Los síntomas y signos sobresalían en mayor proporción en el grupo VHB+VHD (p=0,001). Para ambos grupos, la mayoría de los pacientes estaba con AgHBe no reactivo. El registro de alteraciones bioquímicas y hematológicas atribuyó proporción más grande al grupo VHB+VHD (p<0,05). Conclusión: El estudio demostró que los pacientes, en la consulta inicial para el seguimiento de la condición crónica, estaban en diferentes estadios clínicos de la enfermedad. El perfil clínico sugiere que la gravedad de la enfermedad hepática es mayor entre pacientes sobre infectados de VHD.

RESUMO Objetivo: Analisar aspectos clínicos, sorológicos, bioquímicos e hematológicos entre pacientes infectados por vírus das hepatites B (VHB) e Delta (VHD). Método: Estudo transversal, descritivo, retrospectivo, realizado com pacientes cronicamente infectados por VHB e superinfectados por VHD. Resultados: Entre os 112 pacientes selecionados, 74% estavam monoinfectados por VHB (Grupo VHB) e 26% superinfectados por VHD (Grupo VHB+VHD). Não houve diferença na distribuição por gênero. A idade média foi de 36 anos, com desvio padrão de ±12 anos. Os sintomas e sinais apresentaram maior proporção no grupo VHB+VHD (p=0,001). Para ambos os grupos, a maioria dos pacientes estava com AgHBe não reagente. O registro de alterações bioquímicas e hematológicas apresentou maior proporção no grupo VHB+VHD (p<0,05). Conclusão: O estudo revelou que os pacientes estavam em diferentes estágios clínicos da doença na consulta inicial para acompanhamento de condição crônica. O perfil clínico sugere maior gravidade da doença hepática entre os pacientes superinfectados por VHD.

Humans , Male , Female , Adult , Hepatitis D/classification , Hepatitis B/classification , Hepatitis D/epidemiology , Brazil/epidemiology , Hepatitis Delta Virus/classification , Hepatitis B virus/classification , Cross-Sectional Studies , Retrospective Studies , Hepatitis B/epidemiology , Middle Aged
Rev. Soc. Bras. Med. Trop ; 52: e20180289, 2019. tab, graf
Article in English | LILACS | ID: biblio-985161


Abstract Hepatitis delta virus (HDV) has been associated with acute or chronic hepatitis in Latin America, but there is no prevalence study covering South American countries. This meta-analysis aimed to estimate anti-HDV prevalence through a systematic review of published articles in English, Portuguese and Spanish until December 2017. Searches were conducted in Health Virtual Library, Capes, Lilacs, PubMed, and SciELO, according to defined criteria regarding participant selection and geographical setting. Study quality was assessed using the GRADE guidelines. Pooled anti-HDV prevalence was calculated using the DerSimonian-Laird random-effects model with Freeman-Tukey double arcsine transformation. Out of the 405 identified articles, only 31 met the eligibility criteria for inclusion in the meta-analysis. In South America, pooled anti-HDV prevalence among hepatitis B virus carriers was 22.37% (95% confidence interval: 13.72-32.26), though it appeared less frequently in some countries and populations, according to the data collection date. The findings indicated significant successive reductions in anti-HDV prevalence over thirty years. However, there was a scarcity of HDV epidemiological studies outside the Amazon Basin, notably in the Southwest continent and absence of target population standardization. There was a high HDV prevalence in South American countries, despite differences in methodological characteristics and outcomes, highlighting a drastic decline in the last decades. Future studies should identify HDV prevalence estimates in other regions of the continent and identify risk factors.

Humans , Hepatitis D/epidemiology , Hepatitis Delta Virus/genetics , Hepatitis Delta Virus/immunology , Phylogeny , South America/epidemiology , Prevalence , Genotype
Rev. bras. enferm ; 70(5): 1048-1053, Sep.-Oct. 2017. tab
Article in English | LILACS, BDENF | ID: biblio-898240


ABSTRACT Objective: compare chronic hepatitis B patients to those superinfected with hepatitis D virus, according to Child-Pugh score regarding disease severity. Method: retrospective descriptive study, performed with 59 patients followed in the ambulatory, of which 22 (37.3%) were chronically infected with hepatitis B virus (Group HBV) and 37 (62.7%) superinfected with Delta virus (Group HBV+HDV); variables of sex, age and items of Child-Pugh score were collected by consulting medical records. Results: out of the patients, 57.6% were male, with a mean age of 30.5 years. Score A, which indicates lesser severity, was found in 100% of group HBV and 78.4% of group HBV+HDV. Score B, which indicates greater severity, was found only in group HBV+HDV in 21.6% of the patients. Conclusion: by means of the Child-Pugh score, it was observed that patients with superinfection by HDV tended to present a worse prognosis.

RESUMEN Objetivo: comparar los pacientes con hepatitis B crónica con superinfectados por el virus D según escore de Child-Pugh cuanto a la gravedad de la enfermedad. Método: estudio descriptivo retrospectivo, realizado con 59 pacientes acompañados en ambulatorio, siendo 22 (37,3%) crónicamente infectados por el virus de hepatitis B (Grupo VHB) y 37 (62,7%) con superinfección por virus Delta (Grupo VHB+VHD); fueron colectadas variables cuanto al sexo, edad y referentes al escore de Child-Pugh por medio de consulta a prontuarios. Resultados: entre los pacientes 57,6% era de varones, con edad media de 30,5 años. El escore A, que indica menor gravedad, fue encontrado en 100% del grupo VHB y 78,4% del grupo VHB+VHD. El escore B, que indica mayor gravedad, fue encontrado apenas en el grupo VHB+VHD en 21,6% de los pacientes. Conclusión: por medio del escore de Child-Pugh, se observó que los pacientes con superinfección por VHD tienden a presentar peor pronóstico.

RESUMO Objetivo: comparar os pacientes com hepatite B crônica com superinfectados pelo vírus D segundo escore de Child-Pugh quanto à gravidade da doença. Método: estudo descritivo retrospectivo, realizado com 59 pacientes acompanhados em ambulatório, sendo 22 (37,3%) cronicamente infectados pelo vírus da hepatite B (Grupo VHB) e 37 (62,7%) com superinfecção por vírus Delta (Grupo VHB+VHD); foram coletadas variáveis quanto ao sexo, idade e referentes ao escore de Child-Pugh por meio de consulta a prontuários. Resultados: entre os pacientes 57,6% era do sexo masculino, com idade média de 30,5 anos. O escore A, que indica menor gravidade, foi encontrado em 100% do grupo VHB e 78,4% do grupo VHB+VHD. O escore B, que indica maior gravidade, foi encontrado apenas no grupo VHB+VHD em 21,6% dos pacientes. Conclusão: por meio do escore de Child-Pugh, observou-se que os pacientes com superinfecção por VHD tendem a apresentar pior prognóstico.

Humans , Male , Female , Adult , Prognosis , Severity of Illness Index , Hepatitis D/classification , Hepatitis B/classification , Brazil , Retrospective Studies , Middle Aged
Rev. Soc. Bras. Med. Trop ; 50(3): 423-426, May-June 2017. graf
Article in English | LILACS | ID: biblio-896983


Abstract Acquired hepatocerebral degeneration is a neurological syndrome with typical clinical (extrapyramidal and neuropsychiatric) symptoms and brain magnetic resonance imaging findings (high T1 signal in the globus pallidus). It occurs mainly in patients with advanced liver disease, such as in patients co-infected with hepatitis B virus (HBV) and hepatitis delta virus (HDV). However, there are no reports relating HBV/HDV coinfection and acquired hepatocerebral degeneration. This report presents the case of a 49-year-old woman with characteristics of acquired hepatocerebral degeneration and liver cirrhosis due to HBV/HDV coinfection, and presents the main theories of the physiopathology of this condition.

Humans , Female , Hepatitis D/complications , Hepatitis B/complications , Hepatolenticular Degeneration/virology , Liver Cirrhosis/virology , Coinfection/virology , Middle Aged
Article in English | WPRIM | ID: wpr-43204


BACKGROUND/AIMS: Mongolia has one of the highest hepatitis A, C, B and D infection incidences worldwide. We sought to investigate changes in the proportion of acute viral hepatitis types in Mongolia over the last decade. METHODS: The cohort comprised 546 consecutive patients clinically diagnosed with acute viral hepatitis from January 2012 to December 2014 in Ulaanbaatar Hospital, Mongolia. A time trend analysis investigating the change in proportion of acute hepatitis A virus, hepatitis C virus (HCV), hepatitis B virus (HBV) and hepatitis delta virus (HDV) infection among the cohort with respect to a previous published study was undertaken. RESULTS: Acute hepatitis A, B and C was diagnosed in 50.9%, 26.2% and 6.0% of the cohort. Notably, 16.8% of the cohort had a dual infection. The etiologies of acute viral hepatitis were varied by age groups. The most common cause of acute viral hepatitis among 2-19 year olds was hepatitis A, HBV and superinfection with HDV among 20-40 year olds, and HCV among 40-49 year olds. Patients with more than one hepatitis virus infection were significantly older, more likely to be male and had a higher prevalence of all risk factors for disease acquisition. These patients also had more severe liver disease at presentation compared to those with mono-infection. CONCLUSIONS: Acute viral hepatitis is still prevalent in Mongolia. Thus, the need for proper infection control is increasing in this country.

Cohort Studies , Hepacivirus , Hepatitis A virus , Hepatitis A , Hepatitis B , Hepatitis B virus , Hepatitis C , Hepatitis D , Hepatitis Delta Virus , Hepatitis Viruses , Hepatitis , Humans , Incidence , Infection Control , Liver Diseases , Male , Mongolia , Prevalence , Risk Factors , Superinfection
Article in English | WPRIM | ID: wpr-258804


<p><b>OBJECTIVE</b>Hepatitis Delt a Virus (HDV) antigen is widely used as a capture antigen in ELISAs for the identification of HDV infection; large amounts of recombinant HDV antigen with active antigenicity are required for this purpose.</p><p><b>METHODS</b>Reconstruct the gene of HDV antigen based on the bias code of Escherichia coli, the recombinant protein expresses by high-density fermentation with fed-batch feeding strategy, and purify by immobilized metal chromatography. The sensitivity and specificity of this antigen detect by ELISA method.</p><p><b>RESULTS</b>The expression of HDV antigen can reach 20% of the total cell mass in the soluble form. The recombinant HDV antigen can be conveniently purified (98%) by immobilized metal ion affinity chromatography (IMAC) using the interaction between a His-tag and nickel ions. Production of recombinant HDV antigen can reach 0.5 g/L under conditions of high-density cell fermentation. Applied to the diagnostic ELISA method, the recombinant HDV antigen shows excellent sensitivity (97% for IgM and 100% for IgG) and specificity (100% for IgG and IgM) for the detection of anti-HDV antibodies.</p><p><b>CONCLUSION</b>Expression and purification the recombinant HDV antigen as a candidate protein for application in a diagnostic ELISA for HDV infection. Large-scale production of the protein can be achieved using the high-density fermentation strategy.</p>

Enzyme-Linked Immunosorbent Assay , Escherichia coli , Genetics , Metabolism , Fermentation , Hepatitis D , Diagnosis , Allergy and Immunology , Virology , Hepatitis Delta Virus , Allergy and Immunology , Hepatitis delta Antigens , Allergy and Immunology , Recombinant Proteins , Genetics , Metabolism
Säo Paulo med. j ; 133(6): 525-530, Nov.-Dec. 2015. tab, graf
Article in English | LILACS | ID: lil-770149


CONTEXT: Orthotopic liver transplantation (OLT) is the treatment of choice for end-stage liver disease. Cirrhosis due to hepatitis C infection is the leading indication for liver transplantation worldwide. However, patients who are given transplants because of viral liver diseases often present clinical coinfections, including hepatitis B together with hepatitis D. Currently, different strategies exist for patient management before and after liver transplantation, and these are based on different protocols developed by the specialized transplantation centers. CASE REPORT: We present a rare case of a 58-year-old man with chronic hepatitis B, C and D coinfection. The patient developed cirrhosis and hepatocellular carcinoma. His treatment comprised antiviral therapy for the three viruses and OLT. The patient's outcome was satisfactory. CONCLUSION: OLT, in association with antiviral therapy using entecavir, which was administered before and after transplantation, was effective for sustained clearance of the hepatitis B and D viruses. A recurrence of hepatitis C infection after transplantation responded successfully to standard treatment comprising peginterferon alfa-2A and ribavirin.

CONTEXTO: O transplante ortotópico de fígado (TOF) é o tratamento de escolha em pacientes com doença hepática terminal. A cirrose por hepatite C é a principal indicação de transplante hepático no mundo. No entanto, pacientes transplantados por hepatopatias virais frequentemente apresentam coinfecções, como hepatite B associada a hepatite D. Atualmente, existem diferentes estratégias de manejo em pacientes pré e pós-transplantados conforme diferentes protocolos de conduta de serviços especializados em transplante. RELATO DE CASO: Apresentamos o raro caso de um homem de 58 anos diagnosticado com as hepatites crônicas B, C e D. O paciente evoluiu com cirrose e carcinoma hepatocelular. O tratamento consistiu de terapia antiviral para os três vírus e de transplante ortotópico de fígado. O desfecho do paciente foi satisfatório. CONCLUSÃO: O transplante ortotópico de fígado, associado à terapia antiviral com entecavir antes e após o procedimento, foi eficaz na depuração sustentada dos vírus B e D. A recidiva do vírus C após o transplante respondeu com sucesso ao tratamento padrão com alfapeginterferon 2A e ribavirina.

Humans , Male , Middle Aged , Carcinoma, Hepatocellular/surgery , Hepatitis, Viral, Human/drug therapy , Hepatitis, Viral, Human/surgery , Liver Cirrhosis/surgery , Liver Neoplasms/surgery , Liver Transplantation/methods , Antiviral Agents/therapeutic use , Coinfection/drug therapy , Coinfection/surgery , Hepatitis B/drug therapy , Hepatitis B/surgery , Hepatitis C/drug therapy , Hepatitis C/surgery , Hepatitis D/drug therapy , Hepatitis D/surgery , Interferon-alpha/therapeutic use , Liver Cirrhosis/virology , Polyethylene Glycols/therapeutic use , Recurrence , Recombinant Proteins/therapeutic use , Ribavirin/therapeutic use , Treatment Outcome
DST j. bras. doenças sex. transm ; 25(3): 141-144, 2013. tab, graf
Article in English | LILACS | ID: lil-776062


O vírus da hepatite Delta (VHD) é considerado um importante causador de doença hepática grave. Objetivo: Este estudo objetivou realizar uma análise epidemiológica dos casos diagnosticados em Rondônia. Métodos: Foi feito um estudo retrospectivo de 1999 a 2012, por meio de dados cedidos pela Agência Estadual de Vigilância em Saúde de Rondônia (AGEVISA RO). As variáveis analisadas foram: ano de diagnóstico, gênero, faixa etária, contato com paciente sabidamente portador do vírus da hepatite B (VHB), cor, vacinação, exposição aos fatores de risco, mecanismo de infecção e forma clínica. Resultados: Foram notificados 149 casos da doença, tendo uma incidência média de 0,7 casos/100.000 habitantes/ano; destes, 62,4% são do gênero masculino e 5,3% são gestantes. A faixa etária mais comum foi entre 20 e 39 anos. Sobre a vacinação da hepatite B, a mioria não tomou nenhuma dose da vacina. A forma mais comum de aquisição do vírus foi a sexual (71,8%), estando a grande maioria dos pacientes na fase crônica de doença (95,9%). Conclusão: A população acometida pelo vírus constituiu-se, principalmente, de homens na faixa etária sexualmente ativa, tendo como principal meio de transmissão a relação sexual. Observou-se baixa aderência da população acometida à vacinação; com isso, medidas de educação e conscientização da populaçãose fazem necessárias.

Hepatitis Delta virus (HDV) is considered an important cause of severe liver disease. Objective: This study aimed at an epidemiological analysis of cases diagnosed in Rondônia. Methods: A retrospective study from 1999 to 2012 was done through data provided by the State Agency of Health Surveillance of Rondônia (AGEVISA-RO). The variables analyzed were: year of diagnosis, gender, age, contact with patients known to have hepatitis B virus (HBV), ethnicity, caccination, exposure to risk factors, mechanism of infection and clinical manifestation. Results: 149 cases have been reported, with an average incidence of 0.7 cases per 100.000 inhabitants/year; 62,4% of these were males and 5,3%, females. The most common agre group was between 20 and 39 years. About hepatitis B vaccination, the majority took no vaccine dose. The most common route of transmission was sexual (71.8%), and most patients were in the chronic phase of the disease (95.9%). Conclusion: The population affected by the virus is mainly composed of men in the sexually active age group, with sexual intercourse as the main mode of transmission. Low adherence to vaccination by the population affected was observed; thereby, measures of education and public awareness are needed.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Middle Aged , Aged, 80 and over , Epidemiology , Hepacivirus , Hepatitis D , Sexually Transmitted Diseases
Rio de Janeiro; s.n; 2013. xvi,92 p. ilus, mapas, graf, tab.
Thesis in Portuguese | LILACS | ID: lil-695563


O vírus da hepatite D (Hepatitis D Virus ou HDV) é um vírus defectivo que necessita da presença do vírus da hepatite B (HBV) para completar seu ciclo infeccioso. A infecção pelo HDV está associada a uma forma mais grave de hepatite e com aumento do risco de progressão para complicações, tais como, cirrose e carcinoma hepatocelular. No Brasil, a Bacia Amazônica é uma área endêmica para a infecção pelo HDV, no entanto, poucos dados foram avaliados em outras regiões do país. Este estudo avaliou a prevalência de HDV em pacientes com infecção aguda ou crônica pelo HBV, acompanhados no Ambulatório Hepatites Virais, Rio de Janeiro, Brasil, entre 2006 e 2011. Um total de 368 amostras de soro de pacientes positivos para o antígeno de superfície do vírus da hepatite B (HBsAg) foi testado para a presença de anticorpos anti-HD utilizando o ensaio comercial ETI-AB-DELTAK-2, de acordo com as instruções do fabricante. Amostras com resultados reagentes ou indeterminados foram retestadas em duplicata, para confirmação ou não do resultado. Amostras anti-HD positivos foram testadas por PCR para amplificar um fragmento da região genômica do antígeno delta (HDAg). As amostras positivas para HDV RNA foram submetidas ao sequenciamento de nucleotídico, a fim de identificar o genótipo do HDV. As sequências obtidas foram alinhadas utilizando o programa Clustal X e a análise filogenética foi realizada usando o programa MEGA v.5. A carga viral do HBV foi quantificada por meio do ensaio comercial COBAS ® TaqMan ® HBV e o genótipo do HBV foi determinado pelo ensaio INNO-LIPA. Nossa população de estudo consistiu de 243 homens e 125 mulheres, com média de idade de 43 anos (1-82 anos), sendo 138 e 230 pacientes com infecção aguda e crônica pelo HBV, respectivamente. Cinco pacientes foram positivos para anticorpos anti-HD (infecção aguda pelo HBV, n = 1; infecção crônica pelo HBV, n = 4) e um dos pacientes com infecção crônica pelo HBV apresentou amostras com HDV RNA detectável. A análise filogenética mostrou que a sequência do HDV se agrupou com o genótipo 3. Dos quatro pacientes que tiveram HBV DNA detectado, três apresentaram baixos níveis de HBV DNA. Em relação ao genótipo de HBV, o genótipo A foi mais prevalente (n = 4). A fim de caracterizar a variabilidade genética de todo o genoma de HDV, o genoma completo foi sequenciado e as sequências de aminoácidos deduzidas foram inferidas utilizando o programa MEGA v.5. O genoma da amostra identificado no presente estudo é constituído por 1673 nucleotídeos e mostrou apenas 88,7% de similaridade com as sequências de genótipo 3 caracterizadas até o momento. A região LHDAg (large HDAg) da amostra brasileira contém múltiplas substituições de aminoácidos, que são conservadas em todas as sequências completas de genótipo 3, cujo significado ainda não foi estabelecido. Este trabalho constitui o primeiro estudo sobre a caracterização da variabilidade genética do genoma completo do HDV no Brasil. Em conclusão, apesar da soroprevalência de HDV ser considerada baixa em nossa coorte, este resultado destacou a importância da investigação infecção pelo HDV em áreas não endêmicas.

Genome , Hepatitis D , Hepatitis Delta Virus
Weekly Epidemiological Monitor. 2013; 06 (29): 1
in English | IMEMR | ID: emr-181971


Like last year, the World Hepatitis Day will be celebrated across the world including in the Eastern Mediterranean Region [EMR] of WHO on 28 July. The global theme of the campaign continues to be: This is hepatitis. Know it. Confront it

Humans , Hepatitis/prevention & control , Hepatitis A , Hepatitis B , Hepatitis C , Hepatitis D , Hepatitis E , Prevalence , Mediterranean Region
PJMR-Pakistan Journal of Medical Research. 2013; 52 (1): 8-11
in English | IMEMR | ID: emr-146868


Hepatitis is an escalating problem in Pakistan due to lack of awareness about its risk factors. To create awareness about risk factors for hepatitis in patients coming for its treatment at a tertiary care hospital using a counseling intervention. The study was conducted at civil hospital, Karachi. Patients having hepatitis B or C were enrolled. Each patient filled a pre and post counseling questionnaire [after 6 months]. A total of 153 hepatitis positive patients were counseled. There were 108 females and 45 males. Majority [83] had hepatitis C virus, 56 had hepatitis B virus, 08 had co-infection of hepatitis B virus and hepatitis D virus and 06 had hepatitis B virus with hepatitis C virus. Counseling was done on multiple parameters. Pre counseling figures for using brand new syringes were 32% which improved to 81% after counseling, for using screened blood these changed from 22% to 81%, for sterilized dental instruments they improved from 21% to 65% and for avoiding road side barbers they improved from 58% to 78%. The figures for hepatitis B virus vaccination in hepatitis C virus patients rose from 3% to 36.6% and for families rose from 2.6% to 43.1%. Great improvements were seen in the awareness and health seeking behavior of hepatitis cases following behavior change communication. More stress should be given on preventive strategies through mass awareness and counseling programs to control disease spread

Humans , Male , Female , Patient Education as Topic , Counseling , Tertiary Care Centers , Hepatitis B , Hepatitis B virus , Hepatitis C , Hepacivirus , Hepatitis D , Hepatitis Delta Virus , Surveys and Questionnaires
Rev. Soc. Bras. Med. Trop ; 45(6): 691-695, Nov.-Dec. 2012. mapas, tab
Article in English | LILACS | ID: lil-661068


INTRODUCTION: A decline in hepatitis D virus (HDV) occurrence was described in Europe and Asia. We estimated HDV prevalence in the Brazilian Amazon following hepatitis B vaccination. METHODS: This is a cross-sectional survey of HDV measured by total antibodies to HDV (anti-HD T). RESULTS: HDV prevalence was 41.9% whiting HBsAg carries and was associated with age (PR = 1.96; 95% CI 1.12-3.42; p = 0.01), hepatitis B virus (HBV) infection (PR = 4.38; 95% CI 3.12-6.13; p < 0.001), and clinical hepatitis (PR =1.44; 95% CI 1.03-2.00; p = 0.03). Risk factors were related to HDV biology, clinical or demographic aspects such as underlying HBV infection, clinical hepatitis and age. CONCLUSIONS: Our study demonstrated that HDV infection continues to be an important health issue in the Brazilian Amazon and that the implementation of the HBV vaccination in rural Lábrea had little or no impact on the spread of HDV. This shows that HDV has not yet disappeared from HBV hyperendemic areas and reminding that it is far from being a vanishing disease in the Amazon basin.

INTRODUÇÃO: É descrito declínio na ocorrência do vírus da hepatite D (VHD) na Europa e Ásia. Estimamos a prevalência de infecção pelo VHD na Amazônia Ocidental, após a introdução da vacinação contra hepatite B. MÉTODOS: Este é um estudo de corte transversal da prevalência do VHD medido pela ocorrência de anticorpos totais (anti-HD T). RESULTADOS: A prevalência do VHD encontrada foi 41,9% entre os portadores do HBsAg, e esteve associado à idade (RP = 1,96; IC 95% 1,12-3,42; p = 0,01), infecção pelo HBV (RP = 4,38; IC 95% 3,12-6,13; p < 0,001) e história clínica de hepatite (RP =1,44; IC 95% 1,03-2,00; p = 0,03). Fatores de risco mostraram-se associados à biologia do HDV, aspectos clínicos e demográficos como infecção prévia pelo VHB e idade. CONCLUSÕES: O estudo demonstra que a infecção pelo VHD continua sendo um importante problema de saúde pública na região, e que a implantação da vacinação contra o VHB na área rural de Lábrea teve um impacto pouco significativo no controle do VHD, percebe-se que este ainda não desapareceu de áreas hiperendêmicas do VHB, e está longe de poder ser classificado como uma doença em declínio na bacia Amazônica.

Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Hepatitis Antibodies/blood , Hepatitis D/epidemiology , Hepatitis Delta Virus/immunology , Immunoglobulin G/blood , Brazil/epidemiology , Hepatitis B Vaccines/administration & dosage , Hepatitis B/epidemiology , Hepatitis B/prevention & control , Hepatitis D/diagnosis , Prevalence , Risk Factors , Rural Population/statistics & numerical data
Rev. Soc. Bras. Clín. Méd ; 10(3)maio-jun. 2012.
Article in Portuguese | LILACS | ID: lil-621489


JUSTIFICATIVA E OBJETIVOS: As hepatites causadas pelos vírus da hepatite B (VHB), vírus da hepatite C (VHC) e vírus da hepatite (VHD) têm como aspecto comum a transmissão por via parenteral e a possibilidade de cronificação. Revisar os aspectos clínico-epidemiológicos, diagnósticos, terapêuticos e profiláticos das infecções virais por tais agentes é o escopo do presente artigo. Realizou-se pesquisa bibliográfica nas bases de dados Scielo e Pubmed empregando-se os descritores hepatite B (hepatitis B); hepatite C (hepatitis C); hepatite D (hepatitis D) e hepatite G (hepatitis G), assim como livros texto, consensos e diretrizes relacionadas ao tema.CONTEÚDO: As formas agudas das hepatites B, C e D são usualmente benignas, podendo, sem embargo, ocorrerem quadros de hepatite fulminante. Em situações nas quais o sistema imunológico não é capaz de depurar o VHB e/ou VHC, há cronificação da infecção, com risco de desenvolvimento de cirrose e consequente insuficiência hepática crônica, bem como carcinoma hepatocelular. As hepatites B e D são imunopreveníveis, graças à vacina parao vírus B, mas, até o momento, não há imunoprofilaxia disponível para o vírus C.CONCLUSÃO: As hepatites pelos VHB e VHC constituem importantes desafios para a medicina atual, especialmente pela prevalência das infecções no planeta e pelo risco de desenvolvimento das complicações crônicas. Neste contexto, destaque-se a importância da avaliação diagnóstica, da instituição da terapêutica adequada e do emprego das medidas preventivas para tais infecções, elementos que devem ser solidamente conhecidas pelo clínico.

BACKGROUND AND OBJECTIVES: Hepatitis caused by hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV) have in common the transmission by parenteral route and the possibility of chronification. Reviewing the clinic, epidemiology, diagnose, therapeutics and prophylaxis of viral infections by these agents is the scope of this work. Bibliographic research was conducted both at databases Scielo and Pubmed through the chosen descriptors: hepatitis B, hepatitis C, hepatitis D and hepatitis G, and text books, consensus and guidelines related to the subject.CONTENTS: The acute viral B, C and D hepatitis are usually benign, though acute liver failure, fulminant hepatitis, may occur. In the cases when the immune system is unable to debug HBV and HCV the infection becomes chronic, cirrhosis with consequent chronic liver insufficiency and hepatocellular carcinomamay develop. HBV and HDV are immunopreventable, thanks to the hepatitis B virus vaccine, but at this point there's no immunoprophylaxis available for hepatitis C virus. CONCLUSION: HBV and HCV hepatitis are great challenges for medicine, particularly due to the prevalence of infections worldwide and the risk of chronic complications. In this context, diagnostic evaluation, adequate therapeutic care, and preventive measures must be soundly known by the physician.

Humans , Hepatitis B/epidemiology , Hepatitis B/etiology , Hepatitis B/drug therapy , Hepatitis C/epidemiology , Hepatitis C/etiology , Hepatitis C/drug therapy , Hepatitis D/epidemiology , Hepatitis D/etiology , Hepatitis D/drug therapy
Article in Chinese | WPRIM | ID: wpr-246173


<p><b>OBJECTIVE</b>To prepare HDAg with biological activities as a candidate of diagnostic reagent.</p><p><b>METHODS</b>To synthesize HDV gene fragment after codon optimization. To construct a thio-fused recombinant plasmid based on M48 expression vector. To express in E. coli induced by IPTG. To purify the protein by affinity chromatography followed by characterization in ELISA:</p><p><b>RESULTS</b>Plasmid construction was verified by enzyme digestion. SDS-PAGE indicated the molecular weight of the protein was the same as we expectation. ELISA proved its affinity with HDV antibodies.</p><p><b>CONCLUSION</b>HDAg was obtained successfully and it will pave the road to the research of HDV diagnostic reagent.</p>

Enzyme-Linked Immunosorbent Assay , Hepatitis D , Diagnosis , Hepatitis delta Antigens , Genetics , Allergy and Immunology , Humans , Plasmids , Recombinant Proteins , Allergy and Immunology
Article in Chinese | WPRIM | ID: wpr-305050


<p><b>OBJECTIVE</b>To investigate the distribution of hepatitis delta virus (HDV) marker among hepatitis B virus (HBV) infected patients and to reveal its clinical significance.</p><p><b>METHOD</b>To collect the clinical data and sera samples of HBV infected patients and to detect HDAg, Anti-HDV as well as HBV infection markers by means of enzyme-linked immunosorbnent assay. These data combined with clinical diagnostic results and biochemical index were then analyzed.</p><p><b>RESULT</b>462 samples of HBV infected patients were collected including 210 HBV carriers without symptom, 175 chronic HBV infections, 35 acute HBV infections and 42 liver fibrosis. The HDV infection rate was 4.8% overall. The highest infection rate of 9.5% was found in the group of liver fibrosis whereas the lower rate of 6.9% was found in HBV chronic carriers. HDV infection rate was 7.8% among the population of 40-60 years old, obviously higher than any other age groups.</p><p><b>CONCLUSION</b>HDV infection was significantly higher in the chronic HBV patients and liver fibrosis patients. Because HDV infection was highly associated with the progress of liver disease, we suggest the screen of HDV markers among hepatitis patients and discriminate whether the patient was co-infected with HDV.</p>

Adolescent , Adult , Aged , Biomarkers , Blood , Child , Coinfection , Blood , Diagnosis , Allergy and Immunology , Virology , Female , Hepatitis Antibodies , Allergy and Immunology , Hepatitis B , Blood , Diagnosis , Allergy and Immunology , Virology , Hepatitis B Antigens , Blood , Hepatitis B virus , Allergy and Immunology , Physiology , Hepatitis D , Blood , Diagnosis , Allergy and Immunology , Virology , Hepatitis Delta Virus , Allergy and Immunology , Humans , Male , Middle Aged , Young Adult
Article in Chinese | WPRIM | ID: wpr-305042


<p><b>OBJECTIVE</b>To study the effect of gene optimization on the expression and purification of HDV small antigen produced by genetic engineering.</p><p><b>METHODS</b>Based on the colon preference of E. coli, the HDV small antigen original gene from GenBank was optimized. Both the original gene and the optimized gene expressed in prokaryotic cells, SDS-PAGE was made to analyze the protein expression yield and to decide which protein expression style was more proportion than the other. Furthermore, two antigens were purified by chromatography in order to compare the purity by SDS-PAGE and Image Lab software.</p><p><b>RESULTS</b>SDS-PAGE indicated that the molecular weight of target proteins from two groups were the same as we expected. Gene optimization resulted in the higher yield and it could make the product more soluble. After chromatography, the purity of target protein from optimized gene was up to 96.3%, obviously purer than that from original gene.</p><p><b>CONCLUSION</b>Gene optimization could increase the protein expression yield and solubility of genetic engineering HDV small antigen. In addition, the product from the optimized gene group was easier to be purified for diagnosis usage.</p>

Electrophoresis, Polyacrylamide Gel , Genetic Engineering , Methods , Hepatitis D , Diagnosis , Hepatitis delta Antigens , Genetics , Recombinant Proteins
Article in Chinese | WPRIM | ID: wpr-305030


<p><b>OBJECTIVE</b>To investigate the seroprevalence of hepatitis D virus in Foshan of Guangdong province, to provide the data for the study about it in China.</p><p><b>METHODS</b>ELISA kits from two different companies were used for detecting anti-HDV IgG of all the serum samples, and then RT-PCR was carried out about the selected serum to ensure the results. All the serum samples were collected in 2011 in The First People's Hospital of Foshan.</p><p><b>RESULTS</b>The results from two ELISA kits and RT-PCR were identical. Eight samples were positive.</p><p><b>CONCLUSIONS</b>The seroprevalence rate of HDV in Foshan is higher than that in China. It has no statistically significant difference between female and male. Morever, the older with HBsAg are susceptible to HDV.</p>

Adolescent , Adult , Aged , Child , Child, Preschool , China , Epidemiology , Coinfection , Epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Hepatitis B , Epidemiology , Hepatitis B Surface Antigens , Blood , Hepatitis D , Epidemiology , Humans , Male , Middle Aged , Reverse Transcriptase Polymerase Chain Reaction
Iatreia ; 24(1): 76-86, mar. 2011. tab
Article in Spanish | LILACS | ID: lil-599275


Las infecciones por los virus de las hepatitis A (VHA), B (VHB), C (VHC), D (VHD) y E (VHE) producen cuadros clínicos y bioquímicos similares, por lo que es necesario recurrir a pruebas de laboratorio diferentes a las de función hepática para identificar con certeza los agentes etiológicos; entre ellas se encuentran: las serológicas, con la que se pueden detectar antígenos virales y los correspondientes anticuerpos, y las moleculares que permiten detectar el genoma viral. Para diagnosticar la existencia de una infección actual por cualquiera de estos virus basta con las pruebas serológicas, excepto en el caso de la infección por VHC para la que es necesario detectar el genoma viral. Las pruebas moleculares son de gran utilidad para el seguimiento y la toma de decisiones terapéuticas en los pacientes con infección crónica por VHB o VHC. El presente artículo es una revisión de las pruebas de laboratorio disponibles para el diagnóstico de cada una de las hepatitis virales.

Infections due to hepatitis viruses A (HAV), B (HBV), C (HCV), D (HDV), and E (HEV) result in similar clinical and biochemical manifestations. Consequently, in order to identify with certainty the etiologic agents of hepatitis, it is necessary to carry out laboratory tests different from those used to assess liver function. Two kinds of tests are available for that purpose, namely: serological and molecular. The former are useful to detect viral antigens and the corresponding antibodies. The latter allow the detection of viral genomes. In order to diagnose current infections with any such viruses, except HCV, serological tests are sufficient. For HCV it is necessary to detect the viral genome. Molecular tests are very useful for follow-up purposes, and to fundament therapeutic decisions in patients with either HBC or HCV chronic infections. This article presents a review of the tests available to diagnose the different agents of viral hepatitis.

Humans , Hepatitis , Hepatitis A , Hepatitis B , Hepatitis C , Hepatitis D , Hepatitis E , Infections/transmission , Serology , Viral Load , Viruses , Hepatitis Delta Virus
Arch. med. interna (Montevideo) ; 32(supl. 1): 36-46, mayo 2010.
Article in Spanish | LILACS | ID: lil-613873