Epidemiological profile of viral hepatitis infection in the population treated at a reference hospital in Alagoas / Perfil epidemiológico da infecção por hepatite viral na população atendida em hospital de referência em Alagoas

Viral hepatitis are widely spread infectious diseases caused by a variety of etiological agents that displays liver tropism as a common characteristic. A descriptive, cross-sectional, observational and retrospective study was conducted through the analysis of viral hepatitis medical records treated and diagnosed from 2010 to 2015. The relationship between the variables were made through the chi-square test. 632 viral hepatitis medical records were analyzed. The highest number of cases happened in 2011. Hepatitis A virus (HAV) infection was predominant. The most affected age group was < 20 years and the highest number of cases observed in this age group was related to HAV (p<0.001). The acute clinical form was predominant, with 70.2% of the cases. 92.3% of which corresponded to HAV infection (p<0.001). Most of the cases occurred in the brown race and male gender. Moreover, regarding the probable source/mechanism of infection, the contact with suspicious water/food for hepatitis A cases was highlighted. The sexual form predominated in HBV infection and previous history of blood transfusion in cases of hepatitis C. Most cases were spotted in the mesoregion of Eastern Alagoas, especially in the capital Maceió. It must be observed the importance of knowing the profile of this disease in order to understand its dissemination and thus have subsidies for the creation of actions and strategies to combat the infection.

A hepatite viral é uma doença infecciosa amplamente difundida causada por uma variedade de agentes etiológicos que exibem o tropismo hepático como uma característica comum. Um estudo descritivo, transversal, observacional e retrospectivo foi realizado por meio da análise de prontuários de hepatites virais tratados e diagnosticados de 2010 a 2015. A relação entre as variáveis foi feita através do teste qui-quadrado. Foram analisados 632 prontuários de hepatite sustero. O maior número de casos aconteceu em 2011. A infecção pelo vírus da hepatite A (HAV) foi predominante. A faixa etária mais atingida foi < 20 anos e o maior número de casos observados nessa faixa etária foi relacionado ao HAV (p<0,001). A forma clínica aguda foi predominante, com 70,2% dos casos. 92,3% dos quais corresponderam à infecção por HAV (p<0,001). A maioria dos casos ocorreu na raça parda e no sexo masculino. Além disso, quanto à provável fonte/mecanismo de infecção, foi destacado o contato com água/alimento suspeitos para os casos de hepatite A. A forma sexual predominou na infecção pelo HbV e histórico anterior de transfusão de sangue em casos de hepatite C. A maioria dos casos foi avistada na mesorregião do Leste de Alagoas, especialmente na capital Maceió. Deve-se observar a importância de conhecer o perfil dessa doença para entender sua disseminação e, assim, contar com subsídios para a criação de ações e estratégias de combate à infecção.

Hepatitis A and E among immigrants and refugees in Central Brazil

ABSTRACT OBJECTIVE To estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, Central Brazil. METHODS Overall, 355 individuals were interviewed, and blood samples were tested for anti-HAV and anti-HEV IgG. Anti-HEV-positive samples were similarly tested for HEV RNA. RESULTS All participants were from Latin American countries, most of whom, young adult males. The overall anti-HAV IgG prevalence was 87.4% (95%CI: 83.5-90.4), of whom 94.9%, 75.6%, and 60% were from Haiti, Venezuela, and other Latin American countries, respectively (p < 0.001). Age above 19 years and more than 36 months residing in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall anti-HEV IgG prevalence was 6.5% (95%CI: 4.4-9.5). All anti-HEV IgG-positive individuals were Haitians, including a child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG-positive samples. CONCLUSION The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently required to interrupt enteric virus transmission in this emergent and vulnerable population.

Epidemiological profile of viral hepatitis infection in the population treated at a reference hospital in Alagoas / Perfil epidemiológico da infecção por hepatite viral na população atendida em hospital de referência em Alagoas

Viral hepatitis are widely spread infectious diseases caused by a variety of etiological agents that displays liver tropism as a common characteristic. A descriptive, cross-sectional, observational and retrospective study was conducted through the analysis of viral hepatitis medical records treated and diagnosed from 2010 to 2015. The relationship between the variables were made through the chi-square test. 632 viral hepatitis medical records were analyzed. The highest number of cases happened in 2011. Hepatitis A virus (HAV) infection was predominant. The most affected age group was < 20 years and the highest number of cases observed in this age group was related to HAV (p<0.001). The acute clinical form was predominant, with 70.2% of the cases. 92.3% of which corresponded to HAV infection (p<0.001). Most of the cases occurred in the brown race and male gender. Moreover, regarding the probable source/mechanism of infection, the contact with suspicious water/food for hepatitis A cases was highlighted. The sexual form predominated in HBV infection and previous history of blood transfusion in cases of hepatitis C. Most cases were spotted in the mesoregion of Eastern Alagoas, especially in the capital Maceió. It must be observed the importance of knowing the profile of this disease in order to understand its dissemination and thus have subsidies for the creation of actions and strategies to combat the infection.

A hepatite viral é uma doença infecciosa amplamente difundida causada por uma variedade de agentes etiológicos que exibem o tropismo hepático como uma característica comum. Um estudo descritivo, transversal, observacional e retrospectivo foi realizado por meio da análise de prontuários de hepatites virais tratados e diagnosticados de 2010 a 2015. A relação entre as variáveis foi feita através do teste qui-quadrado. Foram analisados 632 prontuários de hepatite sustero. O maior número de casos aconteceu em 2011. A infecção pelo vírus da hepatite A (HAV) foi predominante. A faixa etária mais atingida foi < 20 anos e o maior número de casos observados nessa faixa etária foi relacionado ao HAV (p<0,001). A forma clínica aguda foi predominante, com 70,2% dos casos. 92,3% dos quais corresponderam à infecção por HAV (p<0,001). A maioria dos casos ocorreu na raça parda e no sexo masculino. Além disso, quanto à provável fonte/mecanismo de infecção, foi destacado o contato com água/alimento suspeitos para os casos de hepatite A. A forma sexual predominou na infecção pelo HbV e histórico anterior de transfusão de sangue em casos de hepatite C. A maioria dos casos foi avistada na mesorregião do Leste de Alagoas, especialmente na capital Maceió. Deve-se observar a importância de conhecer o perfil dessa doença para entender sua disseminação e, assim, contar com subsídios para a criação de ações e estratégias de combate à infecção.

Epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019 / 中华预防医学杂志

Objective: To analyze the epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019. Methods: The data of hepatitis A incidence in Zhejiang Province from 2010 to 2019 were collected from the infectious disease surveillance system of China Information System for Disease Control and Prevention. ArcGIS 10.7 software was used for spatial autocorrelation analysis. SaTScan 9.6 software was used for spatiotemporal scanning analysis. SPSS 25.0 software was used for additional analysis. Results: Zhejiang Province has reported 5 465 cases of hepatitis A in 2010-2019 years, with an average annual incidence rate of 1.00/100 000, and periodicity and seasonality are not obvious. The incidence of male was higher than that of female (P=0.023), and the highest incidence rate was 50-59 years old. Spatial autocorrelation analysis showed that there was a positive spatial correlation between the incidence of hepatitis A in Zhejiang Province from 2010 to 2017, with the weakest correlation in 2010 (Moran's I =0.103, Z=1.769, P=0.049), and the strongest correlation in 2016 (Moran's I=0.328, Z=4.979, P=0.001). Spatiotemporal scanning analysis showed that there was spatial aggregation of hepatitis A in Zhejiang Province from 2010 to 2019, with a total of three aggregation areas identified. Among them, the mostly aggregation area was concentrated in Xiangshan county of Ningbo city, which covered 10 counties (cities and districts), including Ninghai county and Yinzhou district, and appeared from January 1 to June 30, 2012. Conclusion: The incidence level of hepatitis A in Zhejiang Province shows a stable fluctuation trend from 2010 to 2019, and the seasonal regularity is not obvious. The population group aged 50-59 years old is the key population. There is spatial aggregation in the epidemic situation of hepatitis A. Targeted prevention and control measures of hepatitis A should be done based on the law of spatiotemporal aggregation and local incidence.

Guideline for the investigation of viral hepatitis A outbreak (version 2021) / 中华预防医学杂志

In China, the incidence rate of Hepatitis A has decreased from 56/100 000 in 1991 to 1.05/100 000 in 2020. The number of Hepatitis A outbreaks in China has decreased significantly, however, it has also happened in the last 5 years, and the risk still remains. In order to strengthen the technical guidance for the investigation and control of Hepatitis A outbreak, the Chinese Center for Disease Control and Prevention (China CDC) organized experts in related fields to compile this guideline. The main contents included outbreak definition, outbreak detecting and reporting, outbreak investigation and response, making conclusion and communication. This guideline is intended for use by staff at public health administrative departments, medical and health institutions, centers for disease control and prevention, health supervision agencies at different levels, and other relevant institutions, units and individuals. China CDC will update this guideline periodically based on the progress in this field and feedbacks during the implementation of this guideline.

Perfil dos portadores de hepatite A no Estado do Rio de Janeiro, no período de 2010 a 2018 / Profile of hepatitis carriers in the State of Rio de Janeiro, from 2010 to 2018

Objetivo: Este estudo busca caracterizar o perfil dos indivíduos com hepatite A, no Estado do Rio de Janeiro, no período de 2010 a 2018. Metodologia: Trata-se de uma pesquisa transversal desenvolvida na abordagem quantitativa. Foram utilizados dados secundários provenientes da Ficha de Notificação das Hepatites Virais do banco do Sistema de Informação de Agravos de Notificação, cedida pela Secretaria Estadual de Saúde do Rio de Janeiro. Resultados: Foram analisados 48672 notificações, sendo que 3734 foram notificações confirmadas de portadores exclusivo da hepatite A, 28719 referentes a outras hepatites, 614 de co-infecção por mais de uma hepatite viral e 15605 ignoradas. A maior prevalência da hepatite A foi encontrada nos indivíduos com 4 a 8 anos de estudo, da raça negra, faixa ≤ 24 anos e sendo água e alimentos contaminados a principal fonte de contágio. Conclusão: A notificação dos casos e o preenchimento adequado é importante para definições de ações sanitárias capazes de mitigar os danos à saúde pública. Palavras-chave: Hepatite A; Notificação; Prevalência.

Objective: To characterize the profile of individuals with hepatitis A in the State of Rio de Janeiro, from 2010 to 2018. Methodology: This is a cross-sectional research developed in the quantitative approach. Secondary data from the Viral Hepatitis Notification Form of the Bank of the Notifiable Diseases Information System, provided by the State Health Secretariat of Rio de Janeiro, were used. Results: 48672 notifications were analyzed, of which 3734 were confirmed notifications of hepatitis A carriers only, 28719 were related to other hepatitis, 614 were co-infected with more than one viral hepatitis and 15605 were ignored. The highest prevalence of hepatitis A was found in individuals with 4 to 8 years of study, black, aged ≤ 24 years and with contaminated water and food being the main source of contagion. Conclusion: Notification of cases and proper completion is important for the definition of health actions capable of mitigating damage to public health. Keywords: Hepatitis A; Notification; Prevalence.

Objetivo: Este estudio busca caracterizar el perfil de individuos con hepatitis A, en el estado de Río de Janeiro, de 2010 a 2018. Metodología: Se trata de una investigación transversal desarrollada en el enfoque cuantitativo. Se utilizaron datos secundarios del Formulario de Notificación de Hepatitis Virales del Banco del Sistema de Información de Enfermedades Notificables, proporcionado por la Secretaría de Salud del Estado de Río de Janeiro. Resultados: Se analizaron 48672 notificaciones, de las cuales 3734 fueron notificaciones confirmadas de solo portadores de hepatitis A, 28719 estaban relacionadas con otras hepatitis, 614 estaban coinfectadas con más de una hepatitis viral y 15605 fueron ignoradas. La mayor prevalencia de hepatitis A se encontró en individuos de 4 a 8 años de estudio, negros, ≤ 24 años y con agua y alimentos contaminados como la principal fuente de contagio. Conclusión: La notificación de casos y su debida cumplimentación es importante para la definición de acciones de salud capaces de mitigar los daños a la salud pública. Palabra clave: Hepatitis A; Notificación; Prevalencia.

Incidence of hepatitis A and hepatitis E viruses and norovirus and rotavirus in fish and shrimp samples caught from the Persian Gulf / [Incidência de vírus da hepatite A e hepatite E e norovírus e rotavírus em amostras de peixes e camarões capturados no Golfo Pérsico]

Foodborne viruses including hepatitis A virus (HAV), norovirus (NoV), rotavirus (RoV) and hepatitis E virus (HEV) are easily transmitted through contaminated seafoods. The current research was done to assess the incidence of RoV, NoV GI and GII,hAV and hEV in fish and shrimp samples caught from the Persian Gulf, Iran. Three-hundred and twenty fish and shrimp samples were collected. The presence of foodborne viruses were assessed by the real-time PCR. Forty-nine out of 320 (15.31%) fish and shrimp samples were positive for foodborne viruses. Distribution of hAV, NoV GI and NoV GII amongst all studied samples were 0.93%, 5.93% and 8.43%, respectively. hEV and RoV viruses were not found in studied samples. Parastromateus niger and Scomberomorus commerson fish and Penaeus monodon shrimp were the most frequently contaminated samples. Simultaneous incidence of hAV and NoV GI and hAV and NoV GII were 0.31% and 0.93%, respectively. Distribution of foodborne viruses in samples collected through spring, summer, autumn and winter seasons were 14.28%, 9.33%, 11.76% and 24.44%, respectively. Findings revealed that the incidence of foodborne viruses was significantly associated with seafood species and also season of sampling.(AU)

Vírus transmitidos por alimentos, incluindo hepatite A (HAV), norovírus (NoV), rotavírus (RoV) e hepatite E (HEV) são facilmente transmitidos através de frutos do mar contaminados. Esta pesquisa foi realizada para avaliar a incidência de RoV, NoV GI e GII, hAV e hEV em amostras de peixes e camarões capturadas no Golfo Pérsico, Irã. Foram coletadas 300 amostras de peixes e camarões. A presença de vírus transmitidos por alimentos foi avaliada por PCR em tempo real. Quarenta e nove das 320 amostras de peixes e camarões (15,31%) foram positivas para vírus transmitidos por alimentos. A distribuição de hAV, NoV GI e NoV GII entre as amostras estudadas foi 0,93%, 5,93% e 8,43%, respectivamente. Os vírus hEV e RoV não foram encontrados nas amostras estudadas. Os peixes Parastromateus niger e Scomberomorus commerson e o camarão Penaeus monodon foram as amostras mais frequentemente contaminadas. A incidência simultânea de hAV e NoV GI, e hAV e NoV GII foi de 0,31% e 0,93%, respectivamente. A distribuição dos vírus transmitidos por alimentos nas amostras coletadas na primavera, verão, outono e inverno foi de 14,28%, 9,33%, 11,76% e 24,44%, respectivamente. Os resultados demonstram que a incidência de vírus transmitidos por alimentos foi significativamente associada às espécies de frutos do mar e também à época da amostragem.(AU)

Relação entre casos de hepatite A e áreas de inundação, município de Encantado, Rio Grande do Sul, Brasil / Relationship between cases of hepatitis A and flood areas, municipality of Encantado, Rio Grande do Sul, Brazil

Resumo A relação entre os desastres de origem hidrometeorológicos e a saúde das populações atingidas ainda é pouco abordada no Rio Grande do Sul (RS), Brasil. A Hepatite A é uma doença que envolve questões sanitárias e do meio urbano, sendo uma doença do tipo evitável. Esse estudo tem como objetivo analisar a relação entre áreas de inundação e a ocorrência de doenças de veiculação hídrica, neste caso, a Hepatite A. Foi estruturado um banco de dados dos casos confirmados de Hepatite A e de eventos de inundações no município de Encantado-RS entre os anos de 2012 e 2014. Esses dados foram analisados espacialmente a partir do estimador Kernel dos pontos de ocorrência de casos de Hepatite A e correlacionados para o perímetro urbano. Verificou-se que nos três meses posteriores à ocorrência de inundação, foram registrados 44 casos, um aumento de quase 300%, no registro de casos de Hepatite A. Os resultados identificaram que todos os casos confirmados estão na área urbana localizada na planície de inundação. O que reafirma a importância de incentivo a formulação e implementação de políticas de prevenção a surtos de doenças pós-desastres hidrometeorológicos.

Abstract The relationship between hydrometeorological disasters and the health of affected populations is still hardly discussed in Rio Grande do Sul (RS), Brazil. Hepatitis A is a disease that involves health and urban environment issue and is an avoidable disease. This study aims to analyze the relationship between flood areas and waterborne diseases, in this case, Hepatitis A. A database of confirmed cases of Hepatitis A and flood events in the municipality of Encantado-RS, Brazil between 2012 and 2014 was structured. These data were analyzed spatially from the kernel estimator of the occurrence points of Hepatitis A cases and correlated to the urban perimeter. It was verified that 44 cases were registered in the three months following the occurrence of flood, an increase of almost 300% in the records of Hepatitis A. The results identified that all the confirmed cases are in the urban area located in the floodplain. This reaffirms the importance of encouraging the formulation and implementation of policies to prevent outbreaks of waterborne diseases post hydrometeorological disaster.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: hepatites virais / Brazilian Protocol for Sexually Transmitted Infections 2020: viral hepatitis / Protocolo Brasileño para las Infecciones de Transmisión Sexual 2020: hepatitis virales

Este artigo aborda as hepatites virais, tema tratado no Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis e, mais precisamente, nos Protocolos Clínicos e Diretrizes Terapêuticas para Hepatite B e para Hepatite C e Coinfecções, publicados pelo Ministério da Saúde do Brasil. Além do espectro ampliado de acometimento da saúde, os vírus das hepatites A, B e C também apresentam diferentes formas de transmissão, seja parenteral, sexual, vertical ou oral. Entre as estratégias sugeridas para o controle das hepatites virais, além das medidas comportamentais, estão o diagnóstico ampliado, a vacinação precoce contra os vírus da hepatite A e hepatite B e o acesso aos recursos terapêuticos disponíveis. Considerando a transmissão vertical dos vírus da hepatite B e hepatite C, a triagem das gestantes portadoras crônicas desses vírus é uma importante estratégia de saúde perinatal, indicando com precisão quem pode se beneficiar das intervenções profiláticas disponíveis.

This article discusses viral hepatitis, a theme addressed by the Clinical Protocol and Therapeutic Guidelines to Comprehensive Care for People with Sexually Transmitted Infections and, more precisely, by the Clinical Protocols and Therapeutic Guidelines for Hepatitis B and Hepatitis C and Coinfections, published by the Brazilian Ministry of Health. Besides the broad spectrum of health impairment, hepatitis A, B and C viruses also present different forms of transmission, whether parenteral, sexual, vertical or oral. Among the strategies suggested for the control of viral hepatitis, in addition to behavioral measures, are expanded diagnosis, early vaccination against hepatitis A and hepatitis B viruses, and access to available therapeutic resources. Considering vertical transmission of the hepatitis B and hepatitis C viruses, screening for pregnant women with chronic hepatitis B and C is an important perinatal health strategy, indicating with precision those who can benefit from the prophylactic interventions.

Este artículo aborda las hepatitis virales, tema que hace parte del Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a Personas con Infecciones de Transmisión Sexual y más precisamente de los Protocolos Clínicos y Guías Terapéuticas para Hepatitis B, Hepatitis C y Coinfecciones, publicados por el Ministerio de Salud. Además del amplio espectro de deterioro de la salud, los virus de las hepatitis A, B y C presentan diferentes formas de transmisión, como parenteral, sexual, vertical u oral. Entre las estrategias sugeridas para el control de las hepatitis virales, están las medidas conductuales, el diagnóstico ampliado, la vacunación precoz contra los virus de las hepatitis A y B y el acceso facilitado a los recursos terapéuticos disponibles. Considerando la transmisión vertical de los virus de la hepatitis B y C, la identificación de embarazadas portadoras crónicas de estos virus es importante estrategia de salud perinatal, indicando quiénes pueden beneficiarse de las intervenciones profilácticas.

Vacinação universal contra hepatite A no Brasil: análise da cobertura vacinal e da incidência cinco anos após a implantação do programa / Universal hepatitis A vaccination in Brazil: analysis of vaccination coverage and incidence five years after program implementation

RESUMO: Introdução: Em 2014, o Brasil introduziu programa de imunização universal contra o vírus da hepatite A (HAV) para crianças no segundo ano de vida, por meio de dose única da vacina de vírus inativado. Este estudo teve como objetivo avaliar a cobertura vacinal (CV) contra o HAV no Brasil, diante da incidência de casos notificados cinco anos após a implantação do programa. Metodologia: Dados secundários foram obtidos pesquisando-se sítios eletrônicos de acesso livre do Ministério da Saúde, Departamento de Informática do Sistema Único de Saúde (DATASUS), para análise de incidência e CV. Resultados: A CV variou entre 60,13 e 97,07%. A homogeneidade da CV contra hepatite A nos estados ficou aquém da meta estabelecida. Após 2015, houve queda da CV em todas as regiões do país. Apesar da cobertura insuficiente, houve redução concomitante da incidência da hepatite A em todo o Brasil. A taxa de incidência caiu de 3,29 para 0,80/100 mil entre 2014 e 2018. No entanto, ocorreu diminuição da velocidade de queda da incidência entre 2017 e 2018, o que pode ser consequência dos percentuais insuficientes de CV. Esse fenômeno parece acompanhar tendência geral de enfraquecimento do esforço vacinal no país, verificado também para outras vacinas, como poliomielite e tríplice viral. Conclusão: Esses números sugerem a necessidade de esforços para melhorar as taxas de CV da hepatite A no país.

ABSTRACT: Introduction: In 2014, Brazil introduced a universal immunization program against the hepatitis A virus (HAV) for children in the second year of life, using a single dose of inactivated virus vaccine. The objective of this study was to evaluate the vaccination coverage (VC) against HAV in Brazil, against the incidence of cases reported five years after the implementation of the program. Methodology: Secondary data were obtained by searching free access electronic sites of the Ministry of Health, Department of Informatics of the Unified Health System (Departamento de Informática do Sistema Único de Saúde - DATASUS), for incidence analysis and VC from 2014 to 2018. Results: VC ranged from 60.13 to 97.07%. The homogeneity of VC against hepatitis A did not reach the established goal throughout all states but for a few exceptions. After 2015, CV decreased in all regions of the country. Despite insufficient coverage, a concomitant reduction in the incidence of Hepatitis A took place throughout the country. The incidence rate fell from 3.29 to 0.80/100,000 between 2014 and 2018. However, there was an interruption in the pace of incidence fall between 2017 and 2018, which may be a consequence of insufficient VC. This phenomenon seems to be part of a widespread downward trend in vaccination effort across the country, also verified for other vaccines, such as poliomyelitis and measles, mumps and rubella vaccine. Conclusion: These figures suggest the need for implementing efforts to improve hepatitis A VC rates in the country.

Hepatitis A / Hepatitis A

Resumen El virus de la hepatitis A ha estado clásicamente relacionado con el mecanismo de transmisión fecal-oral, característica de países endémicos. El aumento de las condiciones higiénicas en nuestro entorno había supuesto una importante disminución de los casos de infección por estos patógenos. Sin embargo, en la actualidad, su epidemiología esta cambiando debido a nuevas vías de contagio en Europa. En el caso de la hepatitis A, están aumentando los casos debidos a la transmisión por vía sexual, especialmente en hombres que tienen sexo con hombres. Los cambios descritos deberían promover la implantación de nuevas estrategias de diagnóstico, manejo y prevención. La hepatitis aguda por virus de hepatitis A usualmente sigue un curso corto, benigno y autolimitado sin ocasionar una hepatitis crónica, sin embargo en algunos casos puede manifestarse mediante formas atípicas.

Abstract Hepatitis A virus has been classically linked to the fecal-oral transmission mechanism, characteristic of endemic countries. The increase in hygiene conditions in our environment had led to a significant decrease in cases of infection by these pathogens. However, the epidemiology of these infections is currently changing due to new routes of transmission in Europe. In the case of hepatitis A, cases due to sexual transmission are increasing, especially among men who have sex with men. The changes described should promote the implementation of new strategies for the diagnosis, management and prevention of these diseases. Acute hepatitis due to the hepatitis A virus usually has a short, benign and self-limited course, without causing chronic hepatitis. However, some cases have an atypical presentation.

Comportamiento epidemiológico de la hepatitis A en Barranquilla-Colombia, durante los años 2013 a 2017 / Epidemiological behavior of hepatitis A in Barranquilla, Colombia, in the period 2013-2017 / Comportamento epidemiológico da hepatite A em Barranquilla-Colômbia, durante os anos de 2013 a 2017

RESUMEN Objetivo Analizar el comportamiento epidemiológico de la hepatitis A en el Distrito de Barranquilla (Colombia), durante los años 2013 a 2017. Metodología Estudio descriptivo, en el que se revisó de forma retrospectiva la base de datos de todos los casos de hepatitis A notificados en el Distrito de Barranquilla durante el periodo de observación. Resultados Se notificaron 293 casos nuevos de hepatitis A en el Distrito de Barran-quilla, de los cuales el 62,4% eran hombres y el 37,6% restantes mujeres. Los grupos etarios más afectados fueron los adultos con el 39,6% de los casos, seguido de jóvenes y niños en etapa escolar con el 15% respectivamente. En cuanto a la incidencia de hepatitis A en el Distrito de Barranquilla se observó un descenso entre los años 2013 a 2016 al pasar de 10,9 a 1,5 casos por 100 000 habitantes; sin embargo, en el 2017 se observó un leve aumento en la incidencia a 2,5 por 100 000 habitantes. Conclusiones La Hepatitis A es un evento de interés en salud pública para el Distrito de Barranquilla, que ha mantenido un comportamiento a la baja de su incidencia en los últimos años.(AU)

ABSTRACT Objective To analyze the epidemiological behavior of hepatitis A in the district of Barranquilla (Colombia), in the period 2013-2017. Materials and Methods Descriptive study, in which the database of all hepatitis A cases reported in the district of Barranquilla during the observation period were retrospectively reviewed. Results There were 293 new cases of hepatitis A reported in the district of Barranquilla, of which 62.4% occurred in men and 37.6% in women. The age groups most affected by the disease were adults (39.6%), followed by young people and schoolchildren (15%, respectively). The incidence of hepatitis A in the district of Barranquilla decreased between 2013 and 2016 from 10.9 to 1.5 cases per 100 000 inhabitants; however, in 2017 there was a slight increase to 2.5 cases per 100 000 inhabitants. Conclusions Hepatitis A is an event of interest for public health in the district of Barranquilla, and the behavior of its incidence has had a downward trend in recent years.(AU)

RESUMO: Objetivo Analisar o comportamento epidemiológico da hepatite A no distrito de Barranquilla (Colômbia), durante os anos de 2013 a 2017. Metodologia Estudo descritivo, que revisou retrospectivamente o banco de dados de todos os casos de hepatite A notificados no distrito de Barranquilla durante o período de observação. Resultados Foram notificados 293 novos casos de hepatite A no distrito de Barran-quilla, dos quais 62,4% eram homens e os restantes 37,6% mulheres. As faixas etárias mais afetadas foram adultos com 39,6% dos casos, seguidos por jovens e crianças em idade escolar com 15%, respectivamente. Em relação à incidência de hepatite A no distrito de Barranquilla, observou-se uma diminuição entre 2013 e 2016, passando de 10,9 para 1,5 casos por 100.000 habitantes; No entanto, em 2017, foi observado um ligeiro aumento na incidência, para 2,5 por 100.000 habitantes. Conclusões A hepatite A é um evento de interesse em saúde pública no distrito de Barranquilla, que manteve uma tendência de queda em sua incidência nos últimos anos.(AU)

Aspects épidémiologiques, cliniques, étiologiques et évolutifs des hépatites aiguës au Centre Hospitalier National d'Enfants Albert Royer-Dakar

Introduction : l'hépatite aiguë est fréquente et représente un problème de santé publique dans les pays en développement. Les étiologies sont dominées par l'hépatite A en Afrique subsaharienne et en Asie du Sud-Est. Cependant, très peu d'études locales ont porté sur cette pathologie. Objectif : Étudier les aspects épidémiologiques, cliniques et évolutifs des hépatites aiguës chez les enfants hospitalisés au CHNEAR. Matériel et Méthodes : il s'agissait d'une étude rétrospective réalisée au CHNEAR de Dakar du 1er janvier 2007 au 31 décembre 2017. Étaient inclus les enfants hospitalisés pour une hépatite aiguë. Les données socio démographiques, cliniques, paracliniques et évolutives ont été recueillies. L'analyse des données uni et bivariée était faite grâce au logiciel R studio version 3.5.0. Résultats : au total, 35 000 enfants étaient hospitalisés durant la période d'étude parmi lesquels 71 patients avaient une hépatite aiguë déterminant une prévalence hospitalière de 0,2%. L'âge moyen à l'admission était de 65 mois avec un sex-ratio de 1,5. L'ictère cutanéo-muqueux était le principal signe physique (81,7%). La cytolyse était constante avec une moyenne des ALAT de 549UI/L. Une insuffisance hépatocellulaire était notée chez 24% des patients. L'étiologie était dans la grande majorité des cas indéterminée (66,2%). L'hépatite A représentait 15,5% et la phytothérapie (18,3%). L'évolution était favorable dans l'ensemble sans aucun cas de rechute. La létalité était de 16,9%. Conclusion : l'étiologie des hépatites demeurent encore indéterminées dans une large proportion au CHNEAR de Dakar. Le pronostic reste réservé pour les formes graves avec insuffisance hépatocellulaire

Epidemiologia das hepatites virais por classificação etiológica / Epidemiology of viral hepatitis by etiological classification

OBJETIVO: Descrever e analisar a epidemiologia das hepatites virais. MÉTODOS: Estudo epidemiológico descritivo realizado por meio da análise de dados obtidos do banco de dados da plataforma do Departamento de Informática do Sistema Único de Saúde relativos ao Estado de Minas Gerais, com as variáveis número de casos, hepatite viral CID 10 (B15 a B19), faixa etária, forma de transmissão, sexo e etnia no período de 2010 a 2017. RESULTADOS: Somaram-se 14.308 casos de hepatite A, B e C entre 2010 e 2017 em Minas Gerais. A hepatite C foi a mais prevalente com 50%, seguido da hepatite B com 39% e da hepatite A com 11%. O sexo masculino (70,2%) contrastou com o feminino (50,8%) no panorama geral. Quanto à etnia, foram obtidos 38% na parda e 37,5% na branca, em contraste com 0,4% na indígena. A faixa etária mais acometida foi de 40 a 59 anos com 54% dos casos. Surpreendeu a manutenção do número de casos registrados de vírus C transmitidos via transfusão sanguínea, provavelmente antes do reconhecimento do vírus, nos anos 1990 (1.002 casos), além da existência de casos de vírus A transmitidos via sexual (30 casos). CONCLUSÃO: Em Minas Gerais, a epidemiologia das hepatites virais seguiu a tendência global em faixa etária e número de casos. Todavia tornase imprescindível considerar novas abordagens de prevenção e controle com foco em educação sexual em saúde independente, principalmente nas faixas etárias jovens e avançadas. (AU)

OBJECTIVE: To describe and analyze the epidemiology of viral hepatitis. METHODS: This is a descriptive epidemiological study based on the analysis of data from the Department of Informatics of the Unified Health System in the state of Minas Gerais, with the following variables: viral hepatitis ICD 10 (B15-B19), age range, way of transmission, gender, and ethnicity, from 2010 to 2017. RESULTS: There were 14,308 cases of hepatitis A, B, and C from 2010 to 2017 in the state of Minas Gerais. Hepatitis C vírus was the most prevalent with 50%, followed by hepatitis B virus with 39%, and hepatitis A virus with 11%. The male gender (70.2%) contrasted with the female (50.8%) in the general panorama. As for ethnicity, 38% were in the brown people, and 37.5% in the white people, compared to 0,4% in the indigenous people. The most affected age group was 40-59 years, with 54% of the cases. Surprisingly, the number of registered cases of C virus transmitted by blood transfusion was steady, probably before the virus was recognized in the 1990s (1002 cases), and there were cases of virus A transmitted via sexual intercourse (30 cases). CONCLUSION: In Minas Gerais, the epidemiology of viral hepatitis follows the global trend in terms of age range and number of cases; however, it is imperative to consider new approaches in prevention and control, focusing on sexually independent health education, mainly in the young and advanced age groups. (AU)

Initial evaluation of universal immunization with a single dose against hepatitis A virus in Central Brazil

ABSTRACT Vaccination against the hepatitis A virus (HAV) administered in two doses has been used effectively in universal child immunization programs in several countries. A single-dose vaccination was adopted in some low-income countries in an attempt to reduce costs without losing effectiveness. In 2014, single-dose universal vaccination was introduced in Brazil for children aged two years. Since such strategy is still not universally accepted, its efficacy should be compared to the two-dose strategy. To assess the humoral response after the single-dose HAV vaccination schedule, a cross-sectional study was conducted in Primavera do Leste, in Mato Grosso state, Central Brazil, including 265 children vaccinated through the National Immunization Program. Blood was collected by using a digital puncture and further applied to filter paper cards. Anti-HAV was detected in 218 out of 265 dried blood spots (DBS). Blood venous samples were collected from 34 out of 47 children who were not anti-HAV positive in DBS samples. Eighteen of them tested positive for anti-HAV, giving a final score of 93.6% (236/252) of seropositivity. In conclusion, this study demonstrated a high rate of anti-HAV positivity in the short term after single-dose hepatitis A vaccination in the population investigated. Moreover, the DBS was shown to be a reliable tool for detecting anti-HAV antibodies.

Situación de las hepatitis virales / Present status of virals hepatitis

Las hepatitis virales son enfermedades transmisibles, de evolución aguda y/o crónica, que alcanzan importancia mundial constituyendo un importante problema de salud pública por su morbimortalidad y también debido a los recursos de salud y económicos que insume, primordialmente, el tratamiento de las personas con hepatitis crónica. En este informe especial se analiza la distribución mundial de estas infecciones, y el acceso al tratamiento; así como la situación epidemiológica de Argentina y la Ciudad de Buenos Aires .Para el análisis de los casos de hepatitis virales de CABA se tomaron todos los casos confirmados y probables residentes, notificados a través del SNVS, tanto en el módulo C2 como SIVILA, entre los años 2010 a 2017. Se eliminaron los casos duplicados y se consolidó una base depurada. No se consideraron los casos con residencia desconocida. Se compara el nivel nacional y de la Ciudad de Buenos Aires de las tasas de notificación por 100.000 habitantes de Hepatitis virales A, B y C confirmadas, entre los años 2010-2016; y se analiza la distribución de los casos confirmados y probables de hepatitis virales según tipo de virus identificado y comuna de residencia

Metagenomic analysis reveals Hepatitis A virus in suspected yellow fever cases in Brazil

Using a metagenomic approach, we identified hepatitis A virus among cases of acute febrile illnesses that occurred in 2008-2012 in Brazil suspected as yellow fever. These findings reinforce the challenge facing routine clinical diagnosis in complex epidemiological scenarios.

Opinión del Comité Consultivo de Inmunizaciones de la Sociedad Chilena de Infectología en relación a los brotes de hepatitis A en Chile / Statement of the Advisory Committee on Immunizations of Sociedad Chilena de Infectología about outbreaks of hepatitis A in Chile

Resumen El presente documento corresponde a la opinión del Comité Consultivo de Inmunizaciones de la Sociedad Chilena de Infectología, en relación a los brotes de hepatitis A en Chile. Las recomendaciones emitidas se basan en antecedentes epidemiológicos, características de la infección por virus hepatitis A(VHA) y en la experiencia mundial con las vacunas disponibles En relación a la infección por virus hepatitis A, Chile ha transitado de una endemia alta a una endemia intermedia, concentrándose actualmente los casos en personas mayores de 15 años, con brotes frequentes, uno de ellos este año causado por el genotipo 1A del VHA que se concentró en hombres que tienen sexo con hombres (HSH). La endemia actual, la presencia de brotes regulares, la frecuencia de desastres naturales en el país como terremotos e inundaciones sumado a la disponibilidad de vacunas eficaces, seguras y con estudios de costo efectividad locales, nos llevan a plantear medidas para el control de brotes, medidas focalizadas en grupos de riesgo y especialmente medidas a mediano y largo plazo, que incluyen la vacunación universal de niños contra esta enfermedad.

This document represents the position of the Chilean Infectious Diseases Society Advisory Committee on Immunization Practices regarding hepatitis A epidemiological situation in Chile. The recommendations are based on local epidemiological data, the hepatitis A virus infection characteristics and the global experience with the available vaccines. In relation to hepatitis A, Chile is no longer a highly endemic area but actually an intermediate one, currently concentrating cases in individuals over 15 years of age, with frequent outbreaks. In 2017 we have seen an important outbreak of genotype 1A in men who have sex with men (MSM). The current endemic, the presence of regular outbreaks, the frequency of natural disasters in Chile, together with the availability of safe, effective vaccines and local cost-effectiveness studies led us to propose measures for outbreak control for high risk groups protection and mid and long term, including a more definitive solution which is universal vaccination against this disease in small children.

SEROLOGICAL DETECTION OF HEPATITIS A VIRUS IN FREE-RANGING NEOTROPICAL PRIMATES (Sapajus spp., Alouatta caraya) FROM THE PARANÁ RIVER BASIN, BRAZIL

Nonhuman primates are considered as the natural hosts of Hepatitis A virus (HAV), as well as other pathogens, and can serve as natural sentinels to investigate epizootics and endemic diseases that are of public health importance. During this study, blood samples were collected from 112 Neotropical primates (NTPs) (Sapajus nigritus and S. cay, n = 75; Alouatta caraya, n = 37) trap-captured at the Paraná River basin, Brazil, located between the States of Paraná and Mato Grosso do Sul. Anti-HAV IgG antibodies were detected in 4.5% (5/112) of NTPs, specifically in 6.7% (5/75) of Sapajus spp. and 0% (0/37) of A. caraya. In addition, all samples were negative for the presence of IgM anti-HAV antibodies. These results suggest that free-ranging NTPs were exposed to HAV within the geographical regions evaluated.