Hepatitis C virus genotypes in hemodialysis patients in the Federal District, Brazil / Genótipos do vírus da hepatite C em pacientes em hemodiálise no Distrito Federal, Brasil

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 percent) and 3 (9.8 percent). Subtype 1a (82.3 percent) was the most prevalent, followed by subtypes 3a (9.8 percent), 1b (5.9 percent) and 1a/1b (2.0 percent). Forty-two samples could be amplified and genotyped in the NS5B region: 38 (90.5 percent) as genotype 1, subtypes 1a, and 8 (9.5 percent) as genotype 3, subtype 3a. For the 42 samples sequenced in both regions, the genotypes and subtypes determined were concordant in 100 percent and 95.2 percent 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.

Os genótipos e subtipos do vírus da hepatite C (HCV) foram determinados em pacientes em hemodiálise no Distrito Federal, Brasil, pelo sequenciamento das regiões 5' não codificante (NC) e não estrutural 5B (NS5B). De 761 pacientes, 66 amostras anti-HCV positivas foram testadas para RNA-HCV. Todas as 51 amostras RNA-HCV positivas por PCR para a região 5' NC foram genotipadas como dos genótipos 1 (90,2 por cento) e 3 (9,8 por cento). O subtipo 1a (82,3 por cento) foi o mais prevalente, seguido pelos subtipos 3a (9,8 por cento), 1b (5,9 por cento) e 1a/1b (2,0 por cento). Quarenta e duas amostras puderam ser amplificadas e genotipadas na região NS5B: 38 (90,5 por cento) como genótipo 1, subtipo 1a, e 8 (9,5 por cento) como genótipo 3, subtipo 3a. Para as 42 amostras sequenciadas nas duas regiões, os genótipos e subtipos determinados foram concordantes em 100 por cento e 95,2 por cento dos casos, respectivamente. Duas amostras apresentaram resultados discrepantes, sendo que a região 5' NC não diferenciou corretamente os subtipos 1a e 1b. Estes achados indicam que o genótipo 1, subtipo 1a, do HCV é o mais prevalente em pacientes em hemodiálise no Distrito Federal, Brasil.

Prevalência, fatores de risco e genótipos da hepatite C entre usuários de drogas / Prevalencia, factores de riesgo y genotipos de la hepatitis C entre usuarios de drogas / Prevalence, risk factors and genotypes of hepatitis C virus infection among drug users, Central-Western Brazil

OBJETIVO: Avaliar a utilização da Escala de Depressão Pós-natal de Edimburgo como instrumento de triagem no sistema público de saúde. MÉTODOS: A Escala foi administrada entre o 40° e 90° dia do pós-parto, a 245 mulheres que tiveram parto em uma maternidade privada no município de Belo Horizonte (MG), entre 2005 e 2006. As participantes foram submetidas a uma entrevista psiquiátrica estruturada (Mini-Plus 5.0) utilizada como padrão-ouro para diagnóstico de depressão. Foram calculadas sensibilidade e especificidade da escala e utilizou-se a curva ROC para achar o melhor ponto de corte. Foi utilizado o teste t de Student para comparação das variáveis numéricas e o qui-quadrado para as variáveis categóricas. A confiabilidade foi aferida pelo coeficiente de consistência interna alfa de Cronbach. RESULTADOS: Foram diagnosticadas 66 mulheres com o quadro depressivo pós-parto (26,9 por cento da amostra). Não houve diferença entre mulheres com e sem depressão pós-parto em relação à idade, escolaridade, número de partos anteriores e estado civil. Utilizando-se o ponto de corte de 10, a sensibilidade da escala foi 86,4, a especificidade 91,1 e o valor preditivo positivo 0,78. CONCLUSÕES: As propriedades psicométricas da Escala a carcterizam como um bom instrumento de triagem da depressão pós-parto e seu uso disseminado no Sistema Único de Saúde poderia repercutir positivamente com aumento significativo na taxa de reconhecimento, diagnóstico, e tratamento da depressão pós parto.

Compliance with and response to hepatitis B vaccination in remaining quilombo communities in Central Brazil / Adesão e resposta à vacinação contra hepatite B em comunidades remanescentes de quilombos no Brasil Central

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 percent) individuals received the first dose, only 198 (28 percent) complied with the full vaccination scheme. Of 148 subjects who agreed to be tested for anti-HBs, 123 (83.1 percent; 95 percentCI: 75.9-88.6) responded to the vaccine. A geometric mean titer of 512mIU/mL (95 percentCI: 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.

A adesão e resposta à vacina contra hepatite B foram avaliadas em comunidades remanescentes de quilombos no Brasil Central. Um total de 708 indivíduos suscetíveis à infecção pelo vírus da hepatite B foi convidado para participar do programa de vacinação contra hepatite B em oito comunidades. Apesar de 567 (80 por cento) indivíduos terem recebido a primeira dose, somente 198 (28 por cento) aderiram ao esquema completo de vacinação. De 148 sujeitos que concordaram em dosar o anti-HBs, 123 (83,1 por cento; IC95 por cento: 75,9-88,6) responderam à vacina. Um título geométrico médio de 512mUI/mL (IC95 por cento: 342,5-765,3) foi encontrado. Sexo masculino e idade foram independentemente associados com ausência de resposta. Programas adicionais de educação em saúde e esquemas alternativos de vacinação contra hepatite B são necessários para melhorar a cobertura vacinal nessas comunidades no Brasil Central.

Prevalence of hepatitis C virus infection in quilombo remnant communities in Central Brazil / Prevalência da infecção pelo vírus da hepatite C em comunidades remanescentes de quilombos no Brasil Central

In order to determine the prevalence of hepatitis C virus (HCV) infection in quilombo remnant communities in Central Brazil, 1,007 subjects were interviewed in all 12 communities existing in Mato Grosso do Sul State, Central Brazil. Blood samples were collected and sera were tested for anti-HCV by enzyme-linked immunosorbent assay. Positive samples were retested for confirmation using a line immunoassay and were also subjected to HCV RNA detection. The prevalence of HCV infection was 0.2 percent. This finding shows a low prevalence of HCV infection in quilombo remnant communities in Central Brazil.

Com objetivo de estimar a prevalência da infecção pelo vírus da hepatite C (HCV) em comunidades remanescentes de quilombos no Brasil Central, 1.007 indivíduos foram entrevistados nas 12 comunidades quilombolas existentes no Estado de Mato Grosso do Sul, Brasil Central. Amostras sanguíneas foram coletadas e os soros testados para anti-HCV pelo ensaio imunoenzimático. As amostras positivas foram testadas pelo ensaio confirmatório "line immunoassay" e também submetidas à detecção do RNA-HCV. A prevalência da infecção pelo HCV foi de 0,2 por cento. Este achado mostra uma baixa prevalência da infecção pelo HCV em comunidades remanescentes de quilombos no Brasil Central.

Prevalence, genotypes and risk factors associated with hepatitis C virus infection in hemodialysis patients in Campo Grande, MS, Brazil

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 percent (95 percent 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 percent) and 1b (8.3 percent), and two were of genotype 3, subtype 3a (16.7 percent).

Prevalence of hepatitis A virus infection in Afro-Brazilian isolated communities in Central Brazil

To investigate hepatitis A virus (HAV) infection rates among isolated African-descendant communities in Central Brazil, 947 subjects were interviewed about demographic characteristics in all 12 isolated Afro-descendant communities existing in the state of Mato Grosso do Sul, Central Brazil, between March 2002 and November 2003. Blood samples were collected and sera were tested for HAV antibodies (total and IgM anti-HAV) by enzyme-linked immunosorbent assay. The overall prevalence of HAV infection was 75.6 percent (95 percent CI: 72.7-78.3), ranging from 55.4 to 97.3 percent, depending on the communities studied. The prevalence of anti-HAV increased significantly with age, from 13.8 percent in the age 0-5 age group to 96.6 percent in those older than 40 years. The findings point out an intermediate endemicity of HAV infection in some Afro-Brazilian isolated communities in Central Brazil. In addition, the high proportion of susceptible young subjects could be target of future HAV vaccination programs.

Hepatitis B virus infection profile in hemodialysis patients in Central Brazil: prevalence, risk factors, and genotypes

Hemodialysis patients are at high risk for hepatitis B virus (HBV) infection. A survey was conducted in the hemodialysis population of the state of Goiás, Central Brazil, aiming to assess the prevalence of HBV infection, to analyse associated risk factors, and also to investigate HBV genotypes distribution. A total of 1095 patients were interviewed in 15 dialysis units. Serum samples were screened for HBV serological markers by enzyme-linked immunosorbent assay. Hepatitis B surface antigen (HBsAg) positive samples were tested for HBV DNA by polymerase chain reaction and genotyped by restriction fragment length polymorphism. Global HBV infection prevalence was 29.8 percent (95 percent CI: 27.1-32.5). Multivariate analysis of risk factors showed that male gender, length of time on hemodialysis, and blood transfusion before 1993 were associated with HBV positivity. HBV DNA was detected in 65.4 percent (17/26) of the HBsAg-positive samples. Thirteen of 17 HBV DNA positive samples were genotyped. Genotype D (61.5 percent) was predominant, followed by A (30.8 percent), while genotype F was detected in only one (7.7 percent) sample.

Seroepidemiology of hepatitis B virus infection and high rate of response to hepatitis B virus Butang®vaccine in adolescents from low income families in Central Brazil

In order to evaluate the seroepidemiology and response to Butang® vaccine in adolescents from low income families in Central Brazil, blood samples of 664 adolescents were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs) markers, and multiple logistical regression analysis was carried out to determine variables associated with hepatitis B virus (HBV) infection markers. further, three 20 µg butang® vaccine doses were offered to all susceptible individuals (n = 304). Among those who accepted them (n = 182), the seroresponse was evaluated in 170 individuals by quantitative anti-HBs. an overall hbv prevalence of 5.9 percent was found: four adolescents were HBsAg positive, 24 were anti-HBc, anti-HBs-reactive, and 11 were anti-HBc only. The analyse of risk factors showed that age 16-19 years, place of birth outside Goiás, school B and body piercing were statistically associated with HBV infection markers (p < 0.05). All 170 adolescents responded to butang®, and a geometric mean titer (gmt) of 4344 mui/ml was obtained. these results reinforce the importance of hepatitis b vaccine in adolescents despite of the hbv regional endemicity, and suggest that three doses of 20 µg of the butang® should guarantee protective anti-hbs levels to individuals at a critical time for hepatitis b acquiring such as latter adolescence and adulthood.

Distribution of hepatitis C virus genotypes among blood donors from mid-west region of Brazil

Com objetivo de determinar os genótipos do vírus da hepatite C (HCV) circulantes na Região Centro-Oeste do Brasil, 250 doadores de sangue anti-HCV positivos foram estudados. Dentre eles, a positividade para anti-HCV foi confirmada em 205 (82%). O RNA-HCV foi detectado em 165 amostras, as quais foram genotipadas. Os tipos 1, 2 e 3 do HCV foram encontrados em 67,9%, 3% e 29,1% dos doadores, respectivamente. No Estado de Goiás, o subtipo 1a (50%) foi o mais prevalente, seguido pelos subtipos 3a (30,9%) e 1b (16,7%). No Estado de Mato Grosso, o subtipo 1a (41%) foi também predominante, seguido pelos subtipos 1b (29,5%) e 3a (25%). No Estado de Mato Grosso do Sul, os subtipos 1a e 1b foram igualmente detectados (36,8%), seguidos por 3a (21,1%). O subtipo 2b foi raro (2,4%, 4,5% e 5,3%, respectivamente). No Distrito Federal, o subtipo 3a (39%) foi mais freqüente que 1a (31,7%), sendo o restante (29,3%) identificado como subtipo 1b.

Decline of hepatitis C infection in hemodialysis patients in Central Brazil: a ten years of surveillance

Hepatitis C virus (HCV) has been a significant problem for hemodialysis patients. However this infection has declined in regions where the screening for anti-HCV in blood banks and hemodialysis-specific infection control measures were adopted. In Brazil, these measures were implemented in 1993 and 1996, respectively. In addition, all studied units have implemented isolation of anti-HCV positive patients since 2000. In order to evaluate the impact of these policies in the HCV infection prevalence, accumulated incidence, and risk factors in hemodialysis population of Goiânia City, Central Brazil, all patients were interviewed and serum samples tested for HCV antibodies in 1993, 1996, 1999, and 2002. In the first six years (1993-1999), anti-HCV prevalence increased from 28.2 to 37.2 percent, however a b decrease in positivity was detected between 1999 and 2002 (37.8 vs 16.5 percent) when the measures were fully implemented. Also, a decrease of the anti-HCV accumulated incidence in cohorts of susceptible individuals during 1993-2002 (71 percent), 1996-2002 (34.2 percent), and 1999-2002 (11.7 percent) was found. Analysis of risk factors showed that length of time on hemodialysis, blood transfusion before screening for anti-HCV and treatment in multiple units were statistically associated with anti-HCV (p < 0.05). Our study showed a significant decline of hepatitis C infection in hemodialysis patients of Central Brazil, ratifying the importance of public health strategies for control and prevention of hepatitis C in the hemodialysis units.

Hepatitis C virus genotypes in blood donors from the Federal District, Central Brazil

The objective of this study was to characterize hepatitis C virus (HCV) genotypes in blood donors from the Federal District, Central Brazil, and to compare HCV screening by serological assays and reverse transcriptase polymerase chain reaction (RT-PCR). Plasma samples from 57 individuals with reactive or indeterminate results in serological anti-HCV screening assays (ELISA or EIA) were tested for HCV RNA by RT-PCR. The results from a confirmatory LIA serological assay were also evaluated. The 5' non-coding region of the HCV genome was amplified from 41 PCR positive samples (71.9 percent), which were further characterized by nucleotide sequencing analysis. Of these, 60.9 percent were of HCV genotype 1 and 39.1 percent of genotype 3.

GB virus C/hepatitis G virus infection in dialysis patients and kidney transplant recipients in central Brazil

In order to investigate the prevalence of GB virus C (GBV-C)/hepatitis G virus (HGV) infection in dialysis patients and kidney transplant recipients in Central Brazil and also to analyze the virus genotypes distribution, a total of 123 patients including 98 on hemodialysis, 13 on continuous ambulatory peritoneal dialysis treatment, and 12 who received kidney transplantation were interviewed in one unit of dialysis treatment in Goiânia city. Blood samples were collected and serum samples tested for GBV-C/HGV RNA by polymerase chain reaction. Genotypes were determined by restriction fragment length polymorphism (RFLP) analysis. Eighteen samples were GBV-C/HGV RNA-positive, resulting in an overall prevalence of 14.6 percent (95 percent CI: 9.2-21.7). A high positivity for GBV-C/HGV RNA was observed in patients who had received kidney transplant (16.7 percent), followed by those on hemodialysis (15.3 percent), and peritoneal dialysis (7.7 percent). RFLP analysis revealed the presence of genotypes 1, 2, and 3 of GBV-C/HGV; more precisely, 9 (50 percent) samples were found belonging to the 2b subtype, 4 (22 percent) to the 2a subtype, 3 (17 percent) to genotype 1, and 2 (11 percent) to genotype 3. The present data indicate an intermediate prevalence of GBV-C/HGV infection among dialysis patients and kidney transplant recipients in Central Brazil. Genotype 2 (subtype 2b) seems to be the most prevalent GBV-C/HGV genotype in our region.

Infecção pelo vírus da hepatite B em hemofílicos em Goiás: soroprevalência, fatores de risco associados e resposta vacinal / Seroprevalence, vaccination response and risk factors for hepatitis B virus infection in hemophiliacs in Goiás

Objetivando determinar a prevalência da infecção pelo vírus da hepatite B (HBV) em hemofílicos em Goiás, analisar os fatores de risco associados e avaliar a resposta vacinal contra hepatite B, 102 pacientes foram entrevistados e amostras sangüíneas coletadas para detecção dos seguintes marcadores sorológicos: HBsAg, anti-HBs e anti-HBc. Uma prevalência global de 43,7 por cento (IC 95 por cento: 33,5-54,2) para infecção pelo HBV foi encontrada. A análise multivariada dos fatores de risco mostrou que o número de episódios transfusionais e sorologia positiva para o vírus da hepatite C estiveram significantemente associados à positividade ao HBV. Foram identificados 49 (48,1 por cento) hemofílicos susceptíveis a esta infecção, sendo imunizados 30 pacientes com a vacina recombinante Euvax-B. Destes, 28 (93,3 por cento) indivíduos apresentaram títulos de anti-HBs maiores que 10 UI/L, o que mostra uma boa resposta à vacina. Os achados deste estudo ressaltam a importância das medidas de controle e prevenção da hepatite B nesta população.

In order to study the prevalence and risk factors for hepatitis Bin hemophiliacs in Goiás, 102 patients were interviewed andblood samples collected and screened for the following serologicalmarkers: HBsAg, anti-HBs and anti-HBc. An overall prevalenceof 43.7% (95% IC: 33.5-54.2) was found to hepatitis B virus(HBV) infection. Multivariate analysis of risk factors showedthat the number of transfusions and positive serology for hepatitisC virus were significantly associated with HBV positivity. Therewere 48 (48.1%) susceptible patients for this infection, of whom30 were immunized with the Euvax-B vaccine. Among them, 28(93.3%) individuals developed anti-HBs titers higher than 10IU/L. Thus, a good response was observed in the studiedpopulation. The findings of this study emphasize the importanceof strategies of control and prevention of hepatitis B in thispopulation.

Hepatitis B and C in the hemodialysis unit of Tocantins, Brazil: serological and molecular profiles

A survey was conducted in the hemodialysis population of the state of Tocantins, Brazil, aiming to assess the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, to analyze associated risk factors, and also to investigate these viruses genotypes distribution. During January and March 2001, all patients (n = 100) were interviewed at the unique dialysis unit in Tocantins. Blood samples were collected and serum samples were screened for HBV serological markers. Hepatitis B surface antigen positive samples were tested for HBV DNA. All samples were also tested for anti-HCV antibodies and HCV RNA. An overall prevalence of 45 percent was found for HBV infection (4 percent were HBsAg/anti-HBc positive, 2 percent were anti-HBc only and 39 percent had anti-HBc/anti-HBs markers). Concerning HCV infection, anti-HCV and HCV RNA were detected in 13 percent and 14 percent of the subjects, respectively. Three patients were HCV RNA positive and anti-HCV negative, resulting in an overall HCV prevalence of 16 percent. Univariate analysis of risk factors showed that only shift and length of time on hemodialysis were associated with HBV and HCV positivity, respectively. Among the four HBsAg-positive samples, HBV DNA was detected in three of them, which were identified as genotype A by restriction fragment length polymorphism (RFLP) analysis. All 14 HCV RNA-positive samples were genotyped by INNO-LiPA. Genotypes 1a and 3a were found in 85 percent and 15 percent, respectively. The present data show low HBsAg and HCV prevalence rates. The risk factors associated with HBV and HCV positivity suggest that nosocomial transmission may influence in spreading these viruses in the dialysis unit studied

Seroprevalence of Hepatitis B virus infection among an afro-descendant community in Brazil

Furnas dos Dionísios is an Afro-Brazilian black community whose descendants were mainly fugitive slaves that established themselves in the State of Mato Grosso do Sul (MS), Brazil. The population is comprised mainly of low socioeconomic individuals who are engaged in agricultural activities. The objective of this study was to investigate the prevalence of hepatitis B (HB) and its correlation with epidemiological data obtained from the community. The studied population totaled 260 individuals with ages varying from 1 to 79 years (median 20). One hundred thirty-three (51.2 percent) were females and 127 (48.8 percent) were males. A high prevalence for anti-HBc was observed (42.7 percent), with present infection detected in 9.2 percent of the subjects who were also HB surface antigens (HBs Ag) positive; 27.3 percent were anti-HBc and anti-HBs reactive, and 6.2 percent had anti-HBc as only marker. The prevalence for anti-HBc was proportional to age, reaching its highest peak in age categories greater than 50. No serological marker was detected in children under the age of 2 years, however anti-HBc was present in 12 subjects with ages between 2 and 14 years, of these 8 (7.4 percent) were HBsAg positive. Among individuals over the age of 15 years, 99 were anti-HBc reactive, of these 16 (10.5 percent) were also HBsAg positive, thus suggesting an increased prevalence of HBV carriers among children and adolescents. The risk factors observed in this community that were significantly associated with anti-HBc positivity were age (over 20 years) and having an anti-HBc positive mother. Both HBeAg and anti-HBe were detected in 44.4 percent of the samples tested. HBsAg subtypes found in the studied population were adw2 (77.7 percent) and ayw2 (23.3 percent). While intrafamilial transmission was most likely responsible for HBV infection among children, other routes such as sexual contact might be considered for individuals with ages over 15 years

Prevalence and genotypes of GB Virus C/Hepatitis G virus among blood donors in Central Brazil

A survey was conducted in a blood donor population of Central Brazil aiming to investigate the prevalence of GB virus C (GBV-C)/hepatitis G virus (HGV) infection and also to analyze the virus genotypes distribution. A total of 241 voluntary blood donors were interviewed at the State Blood Bank in Goiânia, State of Goiás, Brazil. Blood samples were collected and serum samples tested for GBV-C/HGV RNA by polymerase chain reaction. Genotypes were determined by restriction fragment length polymorphism (RFLP) analysis. Seventeen samples were GBV-C/HGV RNA-positive, resulting in a prevalence of 7.1 percent (95 percent CI: 4.2-11.1). A significant trend of GBV-C/HGV RNA positivity in relation to age was observed, with the highest prevalence in donors between 29-39 years old. Ten infected individuals were characterized by reporting parenteral (30 percent), sexual (18 percent), both (6 percent) and intrafamiliar (6 percent) transmission. However, 7 (40 percent) GBV-C/HGV RNA-positive donors did not mention any potential transmission route. RFLP analysis revealed the presence of genotypes 1 and 2 of GBV-C/HGV; more precisely, 10 (58.9 percent) samples were found belonging to the 2b subtype, 4 (23.5 percent) to the 2a subtype, and 3 (17.6 percent) to genotype 1. The present data indicate an intermediate endemicity of GBV-C/HGV infection among this blood donor population, and a predominant circulation of genotype 2 (subtype 2b) in Central Brazil

Prevalence of hepatitis C Virus infection among hemophiliacs in Central Brazil

In order to investigate the hepatitis C virus (HCV) infection prevalence and risk factors in hemophiliacs in Central Brazil, 90 patients were interviewed and serum samples tested for HCV RNA and anti-HCV antibodies. An overall prevalence of 63.3 percent (CI 95 percent: 53.0-72.7) was found. Multivariate analysis of risk factors showed that number of blood transfusions was significantly associated with this infection. Most hemophiliacs received locally produced cryoprecipitate. All infected patients were transfused before the screening of blood units for anti-HCV. However, hemophiliacs who received exclusively screened cryoprecipitate were HCV negative. It confirms the expected decline in transfusion-acquired hepatitis C

Hepatitis C prevalence and risk factors in hemodialysis patients in Central Brazil: a survey by polymerase chain reaction and serological methods

An hemodialysis population in Central Brazil was screened by polymerase chain reaction (PCR) and serological methods to assess the prevalence of hepatitis C virus (HCV) infection and to investigate associated risk factors. All hemodialysis patients (n=428) were interviewed in eight dialysis units in GoiÔnia city. Blood samples were collected and serum samples screened for anti-HCV antibodies by an enzyme-linked immunosorbent assay (ELISA). Positive samples were retested for confirmation with a line immunoassay (LIA). All samples were also tested for HCV RNA by the PCR. An overall prevalence of 46.7 percent (CI 95 percent: 42-51.5) was found, ranging from 20.7 percent (CI 95 percent: 8.8-38.1) to 90.4 percent (CI 95 percent: 79.9-96.4) depending on the dialysis unit. Of the 428 patients, 185 were found to be seropositive by ELISA, and 167 were confirmed positive by LIA, resulting in an anti-HCV prevalence of 39 percent. A total of 131 patients were HCV RNA-positive. HCV viremia was present in 63.5 percent of the anti-HCV-positive patients and in 10.3 percent of the anti-HCV-negative patients. Univariate analysis of risk factors showed that the number of previous blood transfusions, transfusion of blood before mandatory screening for anti-HCV, length of time on hemodialysis, and treatment in multiple units were associated with HCV positivity. However, multivariate analysis revealed that blood transfusion before screening for anti-HCV and length of time on hemodialysis were significantly associated with HCV infection in this population. These data suggest that nosocomial transmission may play a role in the spread of HCV in the dialysis units studied. In addition to anti-HCV screening, HCV RNA detection is necessary for the diagnosis of HCV infection in hemodialysis patients

Hepatitis B virus infection profile in Central Brazilian hemodialysis population

A hepatite B tem sido uma grande ameaca aos pacientes de hemodialise. Para investigar o perfil da infeccao pelo virus da hepatite B (VHB) na populacao de hemodialise de Goiania - Brasil Central, 282 pacientes foram estudados. A prevalencia de marcadores do VHB (AgHBs, anti-HBc e anti-HBs) foi de 56,7 por cento (IC 95 por cento: 51,1 - 62,7) variando de 33,3 por cento a 77,7 por cento entre as unidades de dialise. O VHB-DNA foi detectado nas amostras AgHBs positivas em 67,6 por cento e 88,2 por cento, nas AgHBs e AgHBe em 91,3 por cento e 100 por cento, e nas AgHBe e anti-HBe e soro reativas em 18,2 por cento e 63,6 por cento por hibridizacao e PCR, respectivamente. O tempo de tratamento hemodialitico mostrou-se estatisticamente associado a soropositividade ao VHB. Somente 10 por cento dos pacientes relataram vacinacao para a hepatite B. Assim, uma prevalencia elevada para infeccao pelo VHB nesta populacao e o risco aumentado do tempo de tratamento hemodialitico sugerem a transmissao ambiental deste virus...