Feasibility of dried blood spot for hepatitis C diagnosis in vulnerable subjects and people living in remote areas from Brazil.

BACKGROUND: Agile, accessible and cheap diagnosis of hepatitis C virus (HCV) infection is essential to achieve the elimination of this infection, worldwide, as mandated by the World Health Organzation as part of its strategy for 2030. Dried blood spots (DBS) can be an attractive alternative for sample collection among people living in remote areas and vulnerable populations due to the less invasive collection, its biosafety, and storage & transportation of samples at room temperature. DESIGN: This study aims to estimate the usefulness of dried blood spot samples for the diagnosis and the assessment of HCV infection rates in three different settings in Brazil. Cross-sectional analysis of a sample collection from different populations, aiming to assess the performance of the testing algorithms and respective procedures among different populations with diverse background infection rates. METHODS: We reported the evaluation of DBS as alternative samples for detecting anti-HCV in different groups in real life conditions: (I) Vulnerable subjects living in remote areas of Southeast, North and Northeast Brazil (n = 1464); (II) Beauticians (n = 288); (III) People who use non-injectable drugs (n = 201); (IV) patients referred to outpatient care (n = 275). RESULTS: General assay accuracy was 99%, with a weighted kappa value of 0.9, showing an excellent performance. Sensitivities ranged from 87.5% to 100.0% between groups and specificities were above 99.2%. A total of 194 individuals had HCV RNA in serum and concordance of anti-HCV detection in DBS was 98.4%. CONCLUSIONS: DBS samples could be used for anti-HCV detection in different populations recruited in real life conditions and ambulatory settings, with a high overall sensitivity and specificity.

[Seroprevalence and factors associated with human immunodeficiency virus (HIV) and syphilis in inmates in the state of Pernambuco, Brazil]. / Soroprevalência e fatores associados ao Vírus da Imunodeficiência Humana (HIV) e sífilis em presidiários do Estado de Pernambuco, Brasil.

Prison inmates are more vulnerable to HIV and other Sexually Transmitted Infections (STIs) due to risk factors such as needle sharing and unprotected sex with homosexuals. The aim of this work was to determine the seroprevalence and risk factors associated with the human immunodeficiency virus (HIV-1/2) and syphilis among male inmates in Caruaru, State of Pernambuco, Brazil. A cross-sectional study was performed between May and July 2011, when 1,097 inmates at a prison in Caruaru were assessed by means of interviews and blood sample collection for performing the respective tests. The prevalence was 1.19% for HIV infection and 3.92% for syphilis. HIV infection showed a statistically significant association (p <0.05), with injected drug use, homosexuality and blood transfusions. With respect to HIV status and syphilis, factors related to sex life were statistically significant (p <0.05). The prison population is a high risk group for the diseases investigated. The prevalence rates identified indicate the need to implement prevention programs, helping to contain such diseases in this particular population group.

[Hepatitis C serum prevalence in hemodialyzed patients]. / Soroprevalência da hepatite C em pacientes hemodialisados.

The objectives of this study were to estimate the serum prevalence of hepatitis C virus (HCV) infection in a dialysis center in the greater Recife region, and to correlate HCV serum positivity with some risk factors. Analyses were performed on 250 patients of both sexes, with ages ranging from 17 to 92 years old. Epidemiological data on these patients were obtained in order to determine the risk factors for this infection. Anti-HCV antibodies were investigated using fourth-generation ELISA. Statistically significant associations (p<0.05) were observed in relation to the risk factors of hemodialysis duration, number of blood component transfusions and time taken for transfusions. The prevalence was low (8.4%) in relation to other Brazilian studies. However, more studies in other centers are needed in order to estimate the real prevalence of HCV infection among patients undergoing hemodialysis in the State of Pernambuco.