Doenças socialmente determinadas: saiba mais sobre as hepatites virais

As hepatites virais são um grave problema de saúde pública. Na maioria dos casos, são assintomáticas. No Brasil, as mais comuns são causadas pelos vírus A, B e C.

Sexual Transmission of Viral Hepatitis.

Ongoing sexual transmission presents a significant barrier to viral hepatitis control. Endemic transmission of hepatitis A virus continues through communities of men with male sex partners, despite vaccine availability. Increased incidence of hepatitis B virus from 2014-2018 prompted expanded vaccination guidelines, but uptake and physician awareness remain poor. Hepatitis C virus while strongly associated with injection drug use, is also transmitted by high-risk sexual contact. Despite universal screening recommendations and curative treatment, incidence continues to increase. Even with safe and highly effective vaccinations or treatments, sexual transmission of viral hepatitides must be addressed to achieve disease elimination.

Web-Based Service Provision of HIV, Viral Hepatitis, and Sexually Transmitted Infection Prevention, Testing, Linkage, and Treatment for Key Populations: Systematic Review and Meta-analysis.

BACKGROUND: Despite the growth of web-based interventions for HIV, viral hepatitis (VH), and sexually transmitted infections (STIs) for key populations, the evidence for the effectiveness of these interventions has not been reported. OBJECTIVE: This study aimed to inform the World Health Organization guidelines for HIV, VH, and STI prevention, diagnosis, and treatment services for key populations by systematically reviewing the effectiveness, values and preferences, and costs of web-based outreach, web-based case management, and targeted web-based health information for key populations (men who have sex with men, sex workers, people who inject drugs, trans and gender-diverse people, and people in prisons and other closed settings). METHODS: We searched CINAHL, PsycINFO, PubMed, and Embase in May 2021 for peer-reviewed studies; screened abstracts; and extracted data in duplicate. The effectiveness review included randomized controlled trials (RCTs) and observational studies. We assessed the risk of bias using the Cochrane Collaboration tool for RCTs and the Evidence Project and Risk of Bias in Non-randomized Studies of Interventions tools for non-RCTs. Values and preferences and cost data were summarized descriptively. RESULTS: Of 2711 records identified, we included 13 (0.48%) articles in the effectiveness review (3/13, 23% for web-based outreach; 7/13, 54% for web-based case management; and 3/13, 23% for targeted web-based health information), 15 (0.55%) articles in the values and preferences review, and 1 (0.04%) article in the costs review. Nearly all studies were conducted among men who have sex with men in the United States. These articles provided evidence that web-based approaches are as effective as face-to-face services in terms of reaching new people, use of HIV, VH, and STI prevention services, and linkage to and retention in HIV care. A meta-analysis of 2 RCTs among men who have sex with men in China found increased HIV testing after web-based outreach (relative risk 1.39, 95% CI 1.21-1.60). Among men who have sex with men in the United States, such interventions were considered feasible and acceptable. One cost study among Canadian men who have sex with men found that syphilis testing campaign advertisements had the lowest cost-per-click ratio on hookup platforms compared with more traditional social media platforms. CONCLUSIONS: Web-based services for HIV, VH, and STIs may be a feasible and acceptable approach to expanding services to key populations with similar outcomes as standard of care, but more research is needed in low-resource settings, among key populations other than men who have sex with men, and for infections other than HIV (ie, VH and STIs).

Hepatitis aguda grave en niños de etiología no precisada y lo que es conocido, mayo 2022 / Severe acute hepatitis in children of unspecified etiology and what is known, May 2022

Hepatitis aguda es el término empleado para describir una variedad de condiciones patológicas caracterizadas por la inflamación aguda del parénquima hepático que evoluciona a la normalización de las pruebas funcionales hepáticas en un período menor a seis meses. Puede variar en el rango de leve y autolimitada a enfermedad severa que requiere trasplante hepático. Etiológicamente, puede ser ocasionada por agentes tóxicos, drogas, factores ambientales, procesos autoinmunes o agentes infecciosos (bacterias, hongos, parásitos y virus). Los virus son considerados los agentes etiológicos más comunes de la hepatitis aguda. Los virus de la hepatitis A, B, C, D y E son reconocidos como los causantes de hepatitis viral y difieren entre ellos en modos de trasmisión, severidad de la enfermedad, distribución geográfica y métodos de prevención. Otros agentes virales pueden causar una hepatitis aguda: virus Epstein-Barr, citomegalovirus, virus herpes simplex, coxsackievirus, virus dengue, coronavirus de tipo 2 causante del síndrome respiratorio agudo severo (SARS-CoV-2, por sus siglas en inglés).1 El 5 de abril de 2022, el Punto Focal Nacional del Reglamento Sanitario Internacional de Escocia Central notificó al Reino Unido un aumento significativo e inesperado de casos (10) de hepatitis aguda grave en niños menores de 10 años, previamente sanos, en los que no se identificó asociación conocida con los viajes. En nueve de los casos, el inicio de los síntomas fue en marzo de 2022 y en uno, en enero de 2022. Los 10 casos detectados fueron hospitalizados. Como resultado de una investigación a nivel nacional, el 8 de abril de 2022, en el Reino Unido se habían identificado un total de 74 casos, estableciendo como definición de caso confirmado toda persona que hubiera presentado una hepatitis aguda (resultado negativo a los virus de hepatitis A a la E) con transaminasas séricas >500 UI/L (Aspartato Transaminasa-AST o Alanina Transaminasa -ALT), con 10 años de edad o menos, desde...(AU)

Decreased online hepatitis information seeking during the COVID-19 pandemic: an Infodemiology study.

Introduction: Viral hepatitis remains a public health concern worldwide, mainly in developing countries. The public's awareness and interest in viral hepatitis information are essential in preventing and controlling this disease. Infodemiology has been used as a surrogate to assess the general understanding of disease and measure public awareness of health topics. However, this analysis has not been applied to viral hepatitis. Thus, this study investigated the online global search interest for viral hepatitis in the last decade, focusing on the period before and during the COVID-19 pandemic. Methods: Global online search interest for hepatitis was measured using the Google Trends™ database. Spearman's rank-order correlation correlated country-specific characteristics and prevalence data with search volume index. Results: There was a significant reduction in online search interest for hepatitis during the COVID-19 pandemic (2020). People searching for hepatitis are also interested in hepatitis vaccination. Search volume index is positively correlated with viral hepatitis and HIV prevalence and negatively correlated with GDP. This correlation mirrors the high burden of viral hepatitis in developing countries and their citizens' desire to be informed about this disease. Conclusions: Our study found decreased global online interest in viral hepatitis during the pandemic. Moreover, higher online interest in hepatitis was observed in countries with a lower gross domestic product and high viral hepatitis and HIV prevalence. We demonstrated that global online interest toward viral hepatitis could be assessed through the infodemiologic approach using Google Trends™.

Viral hepatitis elimination: Towards a hepatitis-free world.

Advances in diagnostics and therapeutics have brought the elimination of chronic viral hepatitis into focus. The World Health Organization has defined the targets for elimination, but it is unclear how these can be achieved and how they should be measured. The goal of this special conference was to examine current efforts and metrics to assess progress towards elimination.

Ways to Eliminate Viral Hepatitis as a Global Health Threat.

Hepatitis B (HBV) and C (HCV) have been recognized by the World Health Organization [...].