Hepatitis B prevalence in Brazilian waste pickers: a systematic review with meta-analysis

ABSTRACT OBJECTIVE: To describe the hepatitis B prevalence in Brazilian waste pickers. METHODS: We performed a literature search in the SciELO, Biblioteca Virtual em Saúde (BVS), PubMed and Web of Science databases using the descriptors: "hepatitis B" AND ("informal recycling" OR "waste picker" OR "recyclable waste collectors" OR "solid waste segregator") AND ("recyclable waste" OR "solid waste") AND Brazil. Epidemiological studies on HBV in Brazilian waste pickers published prior to February 2020 were included and evaluated for quality and bias using a funnel plot. RESULTS: This meta-analysis consisted of five articles. Prevalence of HBV surface antigen seropositivity was 14% (95%CI: 6%-22%) in Brazilian waste pickers. CONCLUSION: HBV prevalence in Brazilian waste pickers remains high. There should be more campaigns showing the importance of vaccination and personal protective equipment use.

Viral hepatitis in female sex workers using the Respondent-Driven Sampling

ABSTRACT OBJECTIVE To estimate the prevalence of hepatitis B virus and C virus infections and their genotypes and analyze the risk factors for the markers of exposure to hepatitis B virus in female sex workers in a region of intense sex trade. METHODS This is a cross-sectional study performed with four hundred and two female sex workers in Goiânia, Brazil. Data have been collected using the Respondent-Driven Sampling. The women have been interviewed and tested for markers of hepatitis B and C viruses. Positive samples have been genotyped. The data have been analyzed using the Respondent-Driven Sampling Analysis Tool, version 5.3, and Stata 11.0. RESULTS The adjusted prevalence for hepatitis B virus and C virus were 17.1% (95%CI 11.6-23.4) and 0.7% (95%CI 0.1-1.5), respectively. Only 28% (95%CI 21.1-36.4) of the participants had serological evidence of vaccination against hepatitis B virus. Being older (> 40 years), being single, having a history of blood transfusion and use of cocaine, and ignoring the symptoms of sexually transmitted infections were associated with positivity for hepatitis B virus (p < 0.05). We have detected the subgenotype A1 of hepatitis B virus (n = 3) and the subtypes of hepatitis C virus 1a (n = 3) and 1b (n = 1). CONCLUSIONS We can observe a low prevalence of infection of hepatitis B and C viruses in the studied population. However, the findings of the analysis of the risk factors show the need for more investment in prevention programs for sexual and drug-related behavior, as well as more efforts to vaccinate this population against hepatitis B. The genotypes of the hepatitis B virus and C virus identified are consistent with those circulating in Brazil.

Comparação do perfil epidemiológico das hepatites B e C em um serviço público de São Paulo / Comparison between hepatitis B and C epidemiological profiles at a public institution in São Paulo, Brazil

CONTEXTO: As hepatites virais constituem doença de notificação compulsória e apresentam grande importância em nosso meio devido à elevada prevalência. OBJETIVO: Comparar o perfil epidemiológico dos casos confirmados de hepatites B e C notificados no Núcleo de Vigilância Epidemiológica do Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, no período entre janeiro de 2004 e abril de 2007. MATERIAL: Os resultados foram analisados através do teste do qui ao quadrado. RESULTADOS: Observou-se 112 casos confirmados de hepatite B e 651 de hepatite C. Houve predominância do sexo masculino dentre os casos de hepatite B e do sexo feminino entre os de hepatite C, com significância estatística. A faixa etária mais frequente foi de 30 a 39 anos, considerando-se hepatite B (P<0,01) e 40 a 49 anos para hepatite C (P = 0,49). A astenia foi o sintoma mais relatado. Os fatores de risco predominantes foram: doenças sexualmente transmissíveis (hepatite B; P<0,01), tratamento cirúrgico e transfusão de sangue (hepatite C; P<0,01). A confirmação por critério laboratorial foi predominante e quanto à forma clínica, observou-se evolução para hepatite crônica em 54,5 por cento e 81,7 por cento dos casos, respectivamente para hepatite B e C (P<0,01). A transmissão do vírus B ocorreu predominantemente por via sexual (P<0,01), enquanto o vírus C foi predominantemente transmitido por transfusão (P<0,01). CONCLUSÕES: Os dados referentes ao perfil epidemiológico dos pacientes foram semelhantes aos disponíveis na literatura nacional e internacional. Ressalta-se a importância da vigilância epidemiológica na determinação do perfil das hepatites virais, permitindo que se estabeleçam propostas adequadas de prevenção e rastreamento.

CONTEXT: Viral hepatitis is a disease of compulsory notification and is very important due to its high prevalence. OBJECTIVE: To analyze the epidemiological profiles of hepatitis B and C, reported through surveillance at the "Hospital do Servidor Público Estadual", São Paulo, SP, Brazil, from January 2004 to April 2007. METHODS AND RESULTS: The study revealed 112 confirmed cases of hepatitis B and 651 of hepatitis C. Male gender predominated among hepatitis B while female gender predominated among hepatitis C, statistically significant. Hepatitis B occurred mainly among patients from 30 to 39 years old (P<0.01), and hepatitis C was more frequent among patients from 40 to 49 years old (P = 0.49). Asthenia was the most frequent symptom. The main risk factors were: sexually transmitted diseases (hepatitis B; P<0.01), previous surgery and blood transfusion (hepatitis C; P<0,01). Cases were mostly confirmed through laboratory tests. Chronic hepatitis occurred in 54.5 percent and 81.7 percent cases of hepatitis B and C, respectively (P<0,01). Virus B was mostly transmitted by sexual contact (P<0,01); virus C was transmitted mainly by blood transfusion (P<0,01). CONCLUSIONS: The findings were similar to national and international data available. Epidemiologic surveillance plays an important role in determining the viral hepatitis profile in order to provide adequate screening and prevention.