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Rev. latinoam. enferm. (Online) ; 28: e3278, 2020. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1101736


Objective: to compare the direct cost, from the perspective of the Unified Health System, of assessing the post-vaccination serological status with post-exposure management for hepatitis B among health care workers exposed to biological material. Method: cross-sectional study and cost-related, based on accident data recorded in the System of Information on Disease Notification between 2006 and 2016, where three post-exposure and one pre-exposure management scenarios were evaluated: A) accidents among vaccinated workers with positive and negative serological status tests for hepatitis B, exposed to known and unknown source-person; B) handling unvaccinated workers exposed to a known and unknown source-person; C) managing vaccinated workers and unknown serological status for hepatitis B and D) cost of the pre-exposure post-vaccination test. Accidents were assessed and the direct cost was calculated using the decision tree model. Results: scenarios where workers did not have protective titles after vaccination or were unaware of the serological status and were exposed to a positive or unknown source-person for hepatitis B. Conclusion: the direct cost of hepatitis B prophylaxis, including confirmation of serological status after vaccination would be more economical for the health system.

Objetivo: comparar o custo direto, sob a perspectiva do Sistema Único de Saúde, da avaliação do status sorológico pós-vacinação com o manejo pós-exposição para hepatite B entre trabalhadores da área da saúde expostos ao material biológico. Método: estudo transversal e de custo, realizado a partir dos dados de acidentes registrados no Sistema de Informação de Agravos de Notificação entre 2006 e 2016, em que foram avaliados três cenários de manejo pós-exposição e um de pré-exposição: A) acidentes entre trabalhadores vacinados com status sorológico positivo e negativo para hepatite B, expostos à pessoa-fonte conhecida e desconhecida; B) manejo dos trabalhadores não vacinados expostos à pessoa-fonte conhecida e desconhecida; C) manejo dos trabalhadores vacinados e status sorológico desconhecido para hepatite B e D) custo do teste pós vacinação pré-exposição. Os acidentes foram avaliados e o custo direto foi calculado utilizando o modelo árvore de decisão. Resultados: apresentaram maior custo os cenários em que os trabalhadores não possuíam títulos protetores após a vacinação ou desconheciam o status sorológico e foram expostos à pessoa-fonte positivo ou desconhecida para hepatite B. Conclusão: o custo direto da profilaxia para hepatite B, incluindo a confirmação do status sorológico após vacinação seria mais econômico para o sistema de saúde.

Objetivo: comparar el costo directo, desde la perspectiva del Sistema Único de Salud, de la evaluación del status serológico post-vacunación con el manejo post-exposición para la hepatitis B entre los trabajadores de la salud expuestos a material biológico. Método: estudio transversal y de costos, basado en datos de accidentes registrados en el Sistema de Información de Enfermedades Notificables entre 2006 y 2016, en el que se evaluaron tres escenarios de gestión posteriores a la exposición y uno previo a la exposición: A) accidentes entre trabajadores vacunados con status serológico positivo y negativo para hepatitis B, expuestos a una fuente de origen conocida y desconocida; B) manejo de trabajadores no vacunados expuestos a una fuente conocida y desconocida; C) manejo de trabajadores vacunados y estado serológico desconocido para hepatitis B y D) costo de la prueba de pre-exposición post-vacunación. Se evaluaron los accidentes y se calculó el costo directo utilizando el modelo de árbol de decisión. Resultados: los escenarios en los que los trabajadores no tenían títulos de protección después de la vacunación o desconocían el status serológico y estaban expuestos a una persona fuente positiva o desconocida para la hepatitis B reflejaron un costo más alto. Conclusión: el costo directo de la profilaxis para la hepatitis B, incluida la confirmación del status serológico después de la vacunación sería más económico para el sistema de salud.

Humans , Male , Female , Adult , Hepatitis B virus/immunology , Occupational Exposure , Vaccination/economics , Health Care Costs , Health Personnel , Hepatitis B Vaccines , Costs and Cost Analysis , Hepatitis B Antibodies , Antibodies, Viral/blood
Rev. Soc. Bras. Med. Trop ; 53: e20190559, 2020. tab
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136898


Abstract INTRODUCTION: Brazil's western Amazon basin has the highest prevalence of hepatitis B virus (HBV) infection in the country. Coinfection with hepatitis D virus (HDV) is also endemic. To estimate the prevalence of HBV and HDV markers in a population inhabiting the northwest portion of Mato Grosso state in the western Amazon. METHODS: We performed a cross-sectional study of the seroprevalence of antibodies against HBV core antigen (anti-HBc) in the Três Fronteiras District northwest of Mato Grosso. Anti-HBc-positive subjects were tested for HBV surface antigen (HBsAg). Those positive for this marker were tested for HDV antibodies. Anti-HBc-negative participants were tested for anti-HBsAg. All tests were performed by EIA. RESULTS: A total of 623 individuals in the community were assessed; the majority (67.6%) were male, with a mean age of 30.8 ± 15.4 years. Two hundred and fourteen individuals (34.3%) were anti-HBc-positive, and 47 (7.5%) were HBsAg carriers. Only one individual was anti-HDV-positive. Among the 409 individuals without HBV infection, 18.3% were anti-HBsAg-positive. There was no association between HBV infection and known risk factors. CONCLUSIONS: The study area had intermediate-to-high endemicity for HBV infection, but a low prevalence of HDV. Our serological results suggesting low vaccination-induced protection indicate a need for reinforced immunization programs in the populations of northwest Mato Grosso.

Humans , Male , Adolescent , Adult , Young Adult , Hepatitis B/epidemiology , Hepatitis D/epidemiology , Brazil/epidemiology , Seroepidemiologic Studies , Hepatitis B virus/immunology , Prevalence , Cross-Sectional Studies , Hepatitis B Antibodies , Hepatitis B Surface Antigens , Middle Aged
Rev. Soc. Bras. Med. Trop ; 53: e20180533, 2020. tab
Article in English | LILACS | ID: biblio-1057270


Abstract INTRODUCTION: HBV and HIV have identical transmission routes. The aim of this study was to determine the prevalence of HBV in HIV patients and to detect the presence of occult HBV infection. METHODS: All samples were tested for serology markers and using qPCR. RESULTS: This study included 232 individuals, out of which 36.6% presented with HBV markers and 11.8% presented with HBsAg or HBV-DNA, including 3 patients that showed OBI. CONCLUSIONS: We observed a high prevalence of HBV among HIV patients. In addition, the results suggest that OBI can occur in patients with serological profiles that are indicative of past infection. Therefore, the application of molecular tests may enable the identification of infections that are not evident solely based on serology.

Humans , HIV Infections/epidemiology , Hepatitis B virus/immunology , Hepatitis B/epidemiology , Hepatitis B Antibodies/blood , Hepatitis B Core Antigens/blood , Hepatitis B Surface Antigens/blood , Brazil/epidemiology , DNA, Viral/blood , HIV Infections/complications , Prevalence , Real-Time Polymerase Chain Reaction , Hepatitis B/complications , Hepatitis B/diagnosis
Braz. j. infect. dis ; 23(1): 40-44, Jan.-Feb. 2019. tab
Article in English | LILACS | ID: biblio-1001500


ABSTRACT Hepatitis E virus (HEV) infection is one of the major public health problems in developing countries. HEV can cause chronic infections in immunocompromised individuals e.g. thalassemic patients with increased risk of morbidity and mortality. In addition there is possibility of HEV transmission through blood transfusion. Therefore, the present study aimed to investigate the seroprevalence and risk factors of HEV infection in β-thalassemic children. Methods: This cross-sectional study was conducted on 140 Egyptian children suffering from β-thalassemia, attending the hematology outpatient clinic from April to October 2016. Serum samples from patients were collected and anti-HEV antibodies; Immunoglobulin G (IgG) and Immunoglobulin M (IgM)were measured by enzyme-linked immunosorbent assay (ELISA). Results: The seroprevalence of HEV in β-thalassemic chidren was relatively high (27.15%). Anti-HEV IgG prevalence was 24.29% while that of IgM was 2.86%. There was significant association between HEV infection and age, residence, liver enzymes and amount of blood transfusion per year. Conclusions: Thalasemic patients are vulnerable to chronicity and increased risk of morbidity and mortality from HEV infection. Frequent assessment of liver enzymes in thalassemic patients to monitor subclinical HEV is recommended. Close monitoring and HEV screening of blood donations should be taken in consideration. Public awareness about HEV endemicity, modes of transmission, and risk hazards especially in high risk group should be done to reduce the disease burden.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Blood Transfusion , Hepatitis E/transmission , Hepatitis E/epidemiology , beta-Thalassemia/epidemiology , beta-Thalassemia/virology , Enzyme-Linked Immunosorbent Assay , Seroepidemiologic Studies , Prevalence , Cross-Sectional Studies , Multivariate Analysis , Risk Factors , Sex Distribution , Age Distribution , Egypt/epidemiology , Hepatitis B Antibodies/blood , Immunocompetence
Journal of Experimental Hematology ; (6): 1856-1861, 2019.
Article in Chinese | WPRIM | ID: wpr-781528


OBJECTIVE@#To investigate the conversion rate from negative to positive (positive rate) of HBsAb in lymphoma patients inoculated with different dose of hepatitis B vaccine, to evaluate the immune efficacy of different dose of hepatitis B vaccine, and to analyze the influencing factors.@*METHODS@#Two hundred thirty six patients with lymphoma were selected, whose 5 indexes of hepatitis B (HBsAg, HBsAb, HBeAg, HBeAb and HBcAb) were all negative confirmed by ELISA. The hepatitis B vaccine was inoculated according to 0, 1 and 6 months immune procedures at 1-2 weeks before chemotherapy. The HBsAb level was detected at 1 month after the immunization, the differences in each indexes between HBeAb and HBeAb patients were compared.@*RESULTS@#The positive rate of HBsAb was 75% in all patients with lymphoma.The positive rate of high dose (20 μg) group was 81.4%, which was significantly higher than that of the low dose (10μg) group with 68.6% (χ=5.09, P<0.05). The positive conversion rate of HBsAb significantly higher in the patients of young, female, B-cell (except DLBCL subtype), early Ann Arbor stage, and the treatment regimens without glucocorticoid and rituximab. There were no statistical significances in systemic symptoms or no and treatment regimens with or without lenalidomide. Two doses of hepatitis B vaccine not displayed obvious adverse reactions.@*CONCLUSION@#The high dose of hepatitis B vaccine can achieve better immune efficacy than that of the low dose in the patients with lymphoma.

Female , Hepatitis B , Hepatitis B Antibodies , Hepatitis B Surface Antigens , Hepatitis B Vaccines , Hepatitis B virus , Humans , Lymphoma , Therapeutics
Rev. Soc. Bras. Med. Trop ; 52: e20180132, 2019. tab
Article in English | LILACS | ID: biblio-1041500


Abstract INTRODUCTION Medical students have an occupational risk for hepatitis B (HB). This study sought to determine anti-HBs and anti-HBc IgG levels in vaccinated students, check their seroconversion, and correlate this with vaccination. METHODS One hundred and forty-three students' blood samples and their vaccination schedules were analyzed. RESULTS: 65.7% were positive for anti-HBs; however, anti-HBs was absent in 34.3%. Only two samples were positive for anti-HBc IgG. CONCLUSIONS More than 30% of students did not have minimum protective levels. Comparing HBV vaccination and anti-HBs reactivity, the majority of reactive individuals received their last dose within the past 16 years.

Humans , Male , Female , Adolescent , Adult , Young Adult , Students, Medical , Hepatitis B virus/immunology , Hepatitis B Vaccines/immunology , Hepatitis B/prevention & control , Immunoglobulin G/immunology , Immunoglobulin G/blood , Cross-Sectional Studies , Hepatitis B Antibodies/immunology , Hepatitis B Antibodies/blood , Hepatitis B Core Antigens/immunology , Hepatitis B Core Antigens/blood , Hepatitis B Surface Antigens/immunology , Hepatitis B Surface Antigens/blood
Mem. Inst. Oswaldo Cruz ; 113(1): 62-65, Jan. 2018. tab, graf
Article in English | LILACS | ID: biblio-1040579


In occult hepatitis B infection (OBI), hepatitis B virus DNA (HBV DNA) can be detected in serum samples; however, oral fluid collection for detection of HBV DNA has not yet been explored, despite the availability of collection devices. Serum and oral fluid samples from 45 hepatitis B core antibody (anti-HBc)-positive patients were collected for the amplification of the HBV polymerase gene. HBV DNA was detected in five serum and four oral fluid samples (the detection limit for oral fluid was 1.656 log IU/mL in paired serum). In conclusion, simple methodologies of sample collection and in-house polymerase chain reaction (PCR) allowed detection of HBV DNA, and these could be used to improve the diagnosis of OBI, especially in locations with limited resources.

Humans , Male , Female , Adult , Aged , Saliva/virology , DNA, Viral/analysis , Hepatitis B/diagnosis , Hepatitis B Antibodies/analysis , Hepatitis B Surface Antigens/analysis , DNA, Viral/blood , Hepatitis B virus/isolation & purification , Hepatitis B virus/genetics , Polymerase Chain Reaction , Viral Load , Middle Aged
Rev. latinoam. enferm. (Online) ; 26: e3085, 2018. tab
Article in English | LILACS, BDENF | ID: biblio-978614


ABSTRACT Objective: to estimate the prevalence of serological markers for hepatitis B and C in patients with diabetes mellitus and analyze potential associated factors. Method: a cross-sectional study with 255 patients with diabetes mellitus. Demographic, clinical, and risk behavior factors for hepatitis B and C were selected. The markers HBsAg, Anti-HBc IgG, Anti-HBc IgM, Anti-HBs, and Anti-HCV were investigated. A questionnaire and venous blood collection and inferential statistical analysis were used. Results: 16.8% of the patients had a total reactive Anti-HBc marker, 8.2% an isolated Anti-HBs, and 75% were non-reactive for all hepatitis B markers. No case of reactive HBsAg was found and 3.3% of the patients had a reactive anti-HCV marker. The prevalence of prior hepatitis B virus infection was directly associated with the time of diabetes mellitus and the prevalence of hepatitis C virus infection was not associated with the investigated variables. The prevalence of hepatitis B and C infection in patients with diabetes mellitus was higher when compared to the national, with values of 16.8% and 3.3%, respectively. Conclusion: the results suggest that patients with diabetes are a population of higher vulnerability to hepatitis B and C, leading to the adoption of preventive measures of their occurrence.

RESUMO Objetivo: estimar a prevalência de marcadores sorológicos para hepatite B e C em pacientes com diabetes mellitus e analisar potenciais fatores associados. Método: estudo transversal com 255 pacientes com diabetes mellitus. Elegeram-se variáveis demográficas, clínicas e comportamentos de risco para hepatite B e C. Investigou-se os marcadores HBsAg, Anti-HBc IgG, Anti-HBc IgM, Anti-HBs e Anti-HCV. Utilizou-se um questionário e coleta de sangue venoso e análise por estatística inferencial. Resultados: 16,8% pacientes apresentaram marcador Anti-HBc total reagente, 8,2% Anti-HBs isolado e 75% foram não reagentes para todos os marcadores de hepatite B. Nenhum caso de HBsAg reagente foi encontrado, 3,3% dos pacientes apresentaram marcador anti-HCV reagente. A prevalência de infecção pregressa pelo vírus da hepatite B mostrou-se diretamente associado ao tempo de diabetes mellitus, e a prevalência de infecção pelo vírus da hepatite C não teve associação com as variáveis investigadas. A prevalência de infecção por hepatite B e C em pacientes com diabetes mellitus foi superior a nacional, 16,8% e 3,3% respectivamente. Conclusão: os resultados sugerem que pacientes com diabetes sejam uma população de maior vulnerabilidade às hepatites B e C, ensejando à adoção de medidas preventivas de sua ocorrência.

RESUMEN Objetivo: estimar la prevalencia de marcadores serológicos para la hepatitis B y C en pacientes con diabetes mellitus y analizar potenciales factores asociados. Método: estudio transversal con 255 pacientes con diabetes mellitus. Se eligieron variables demográficas, clínicas y comportamientos de riesgo para hepatitis B y C. Se investigaron los marcadores HBsAg, Anti-HBc IgG, Anti-HBc IgM, Anti-HBs y Anti-HCV. Se utilizó un cuestionario, colecta de sangre venosa y análisis por estadística inferencial. Resultados: 16,8% de los pacientes presentaron marcador Anti-HBc total reactivo, 8,2% Anti-HBs aislado y 75% fueron no reactivos para todos los marcadores de hepatitis B. Ningún caso de HBsAg reactivo fue encontrado, 3,3% de los pacientes presentaron marcador anti-HCV reactivo. La prevalencia de infección previa por el virus de la hepatitis B se mostró directamente asociado al tiempo de diabetes mellitus, y la prevalencia de infección por el virus de la hepatitis C no tuvo asociación con las variables investigadas. La prevalencia de infección por hepatitis B y C en pacientes con diabetes mellitus fue superior al nacional, 16,8% y 3,3% respectivamente. Conclusión: los resultados sugieren que pacientes con diabetes son una población de mayor vulnerabilidad a las hepatitis B y C, lo que da lugar a la adopción de medidas preventivas de su ocurrencia.

Humans , Male , Female , Biomarkers/blood , Hepatitis C/blood , Diabetes Mellitus/epidemiology , Hepatitis B/blood , Hepatitis B/epidemiology , Hepatitis B Antibodies/blood , Brazil/epidemiology , Cross-Sectional Studies
Biociencias ; 13(1): [17-30], 2018. graf, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-969991


La cirrosis hepática es una de las enfermedades con mayor prevalencia y mortalidad en la población mundial; cuyas etiologías más importantes son de tipo alcohólica, virus de la hepatitis B y C, y esteatosis hepática no alcohólica; la caracterización epidemiológica y clínica, es fundamental para conocer la casuística actual del problema.Se presenta un estudio descriptivo trasversal retrospectivo, con el objetivo de caracterizar epidemiológicamente y clínicamente a los pacientes con diagnóstico de cirrosis hepática en un centro regional del Caribe Colombiano, que reciben atención en la Unidad de Gastroenterología y hepatología de la Clínica General del Norte, durante el periodo enero de 2012 a marzo de 2017.Se concluye que la etiología por virus de hepatitis C es la de mayor prevalencia en el medio local, le siguen en frecuencia el hígado graso no alcohólico, la hepatitis autoinmune, la cirrosis biliar primaria, el alcohol, viral hepatitis B y otras etiologías

Liver cirrhosis is one of the diseases with the highest prevalence and mortality in the world population; whose most important etiologies are of alcoholic type, hepatitis B and C viruses, and non-alcoholic fatty liver disease; The epidemiological and clinical characterization is fundamental to know the current casuistry of the problem. We present a retrospective cross-sectional descriptive study, with the objective of characterizing epidemiologically and clinically patients diagnosed with liver cirrhosis in a regional center of the Colombian Caribbean, who receive attention in the Gastroenterology and Hepatology Unit of the General Clinic of the North, during the period from January 2012 to March 2017. It is concluded that the etiology due to hepatitis C virus is the most prevalent in the local environment, followed in frequency by non-alcoholic fatty liver, autoimmune hepatitis, primary biliary cirrhosis, alcohol, viral hepatitis B and other etiologies

Humans , Hepatitis C , Hepatitis B Antibodies , Liver Cirrhosis
J. bras. nefrol ; 39(3): 296-304, July-Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-893771


Abstract Introduction: Bacterial or viral diseases are one of the major causes of death in patients with chronic kidney disease (CKD). These patients show a quantitative reduction of levels of antibodies over time. Among the infectious diseases that affect CKD patients, stands out hepatitis B (HB). Immunization and control of antibodies levels against the hepatitis B surface antigen (anti-HBs) are ways to prevent the HB infection in this population. Patients with anti-HBs levels ≥10 IU/ml are considered adequate responders, whereas those with anti-HBs levels ≥ 100 IU/ml are considered excellent responders. Objective: To analyze the variation of the anti-HBs levels obtained after vaccination against HB in children and adolescents in the pre-dialysis stage of CKD. Methods: A retrospective cohort study on anti-HBs levels of children and adolescents in the pre-dialysis stage of CKD. Correlation between levels of anti-HBs titers and time since the vaccination were estimated. Results: From the total of 116 studied patients most of the studied patients were considered excellent responders, obtaining in the three anti-HBs titers percentages of 70.7%, 62.1% and 54.9% respectively. The anti-HBs titer levels showed a negative correlation with the time since vaccination (Kendall Tau-b = -0.16; p = 0.02). Conclusion: The majority of the studied population was vaccinated by PNI and showed excellent anti-HBs titer levels, even experiencing a progressive reduced response over the time.

Resumo Introdução: As doenças infecciosas, bacterianas ou virais, são uma das principais causas de morte dos pacientes com doença renal crônica (DRC), que apresentam um decréscimo na duração da imunidade em comparação às pessoas saudáveis. Entre as doenças infecciosas que acometem os portadores de DRC, destaca-se a hepatite B (HB). A imunização e o controle dos níveis de anticorpos contra o antígeno da superfície da hepatite B (anti-HBs) são formas de evitar a contaminação da HB nessa população. Pacientes com o nível de anti-HBs ≥ 10 UI/ml são considerados adequados respondedores, enquanto aqueles com níveis de anti-HBs ≥ 100 UI/ml são considerados excelentes respondedores. Objetivo: Analisar a variação dos níveis de anti-HBs adquiridos após a vacinação contra a HB em crianças e adolescentes na fase pré-dialítica da DRC. Métodos: Estudo de coorte retrospectivo dos níveis de anti-HBs de crianças e adolescentes na fase pré-dialítica da DRC. Resultados: Dos 116 pacientes do estudo, a maior parte foi considerada respondedores excelentes, obtendo nas três titulagens percentuais de 70,7%, 62,1% e 54,9%, respectivamente. Os níveis de anti-HBs apresentaram uma correlação negativa com o tempo de vacinação (Kendall Tau-b = - 0,16; p = 0,02). Conclusão: Conclui-se que a maior parte da população do estudo apresenta níveis de anti-HBs excelentes, ocorrendo uma queda progressiva da titulagem ao longo do tempo.

Humans , Male , Child , Adolescent , Young Adult , Hepatitis B Vaccines , Hepatitis B Antibodies/blood , Kidney Failure, Chronic/blood , Retrospective Studies , Cohort Studies , Renal Dialysis , Kidney Failure, Chronic/therapy , Monitoring, Physiologic
Mem. Inst. Oswaldo Cruz ; 112(8): 544-550, Aug. 2017. tab
Article in English | LILACS | ID: biblio-894870


BACKGROUND Hepatitis B virus (HBV) infection is a major public health problem in Brazil. Several risk factors are involved in HBV infection and their identification by a rational and essential approach is required to prevent the transmission of this infection in Brazil. OBJECTIVES To evaluate risk factors associated with HBV infection in South Brazil. METHODS A total of 260 patients with HBV and 260 controls from Caxias do Sul (state of Rio Grande do Sul, Brazil) participated in this study. All participants were given a standard questionnaire to yield the sociodemographic information and to identify HBV risk factors. HBV infection was detected by HBsAg test in all participants. FINDINGS HBV infection in these cases was strongly associated with history of a family member HBV-infected, mainly mother [odds ratio (OR) = 4.86; 95% confidence intervals (CI): 1.69-13.91], father (OR = 5.28; 95% CI: 1.58-17.71), and/or siblings (OR = 22.16; 95% CI: 9.39-52.25); sharing personal objects (OR = 1.40; 95% CI: 1.37-2.38); and having history of blood transfusion (OR = 2.05; 95% CI: 1.10-2.84). CONCLUSIONS HBV infection was strongly associated with having a family member infected with hepatitis B, sharing personal objects, and having history of blood transfusion.

Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Hepatitis B virus/immunology , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/transmission , Hepatitis B, Chronic/epidemiology , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Socioeconomic Factors , Brazil/epidemiology , Case-Control Studies , Family Health , Transfusion Reaction
J. bras. nefrol ; 39(2): 141-145, Apr.-June 2017. tab
Article in English | LILACS | ID: biblio-893753


Abstract Introduction: Vaccination is the most effective tool in preventing transmission of Hepatitis B Virus (HBV). The patient with chronic kidney disease (CKD) on dialysis appear to be at greater risk of becoming infected with this virus and does not show the same vaccine response when compared to patients without uremia. Objectives: To evaluate the results related to the HBV vaccine and identify factors associated with the response in patients with CKD on hemodialysis. Methods: Individuals with HBsAG and negative anti-HBC, under hemodialysis were assessed in two units of São Luis, Maranhão and were undergone full vaccination schedule for HBV. They were divided in groups: anti-HBs10 mUI/mL and compared as to age, gender, presence of diabetes mellitus (DM), time on dialysis and anti-HCV status. Logistic regression analysis was performed to identify factors independently associated with the vaccine response. p10mUI/Ml (or = 5.239 IC: 1.279-21.459, p = 0.021). Conclusion: The rate of vaccine response to HBV in patients with CKD on dialysis was 70% and the lack of anti-HCV infection was associated with seroconversion of anti-HBs suggesting that infection by the hepatitis C virus may be a factor that decreases the response of the HBV vaccine in dialysis CKD patients.

Resumo Introdução: A vacinação é a medida mais efetiva na prevenção da transmissão do vírus da hepatite B (HBV). O portador de doença renal crônica (DRC) em diálise apresenta maior risco de se contaminar com este vírus e não tem a mesma resposta vacinal quando comparada com indivíduos sem uremia. Objetivos: Avaliar os resultados da vacina para o HBV e identificar fatores associados à resposta, em portadores de DRC em hemodiálise. Metodologia: Foram avaliados indivíduos com HBsAg e anti-HBc negativos, que estavam sob hemodiálise em duas unidades de São Luís, Maranhão e que haviam sido submetidos ao esquema completo de vacinação para o HBV. Foram distribuídos em dois grupos: anti-HBs < 10mUI/mL e anti-HBs ≥ 10mUI/mL e comparados quanto à idade, gênero, presença de diabetes mellitus (DM), tempo em diálise e status do anti-HCV. Análise de regressão logística foi realizada para identificar fatores independentemente associados à resposta vacinal. Anti-HBs ≥ 10mUI/mL(OR = 5.239 IC:1.279-21.459, p = 0.021) Conclusões: A taxa de resposta vacinal ao HBV em portadores de DRC em diálise foi de 70% e a ausência do anti-HCV foi associada à soroconversão do anti-HBs, sugerindo que a infecção pelo vírus da hepatite C pode ser um fator que diminui a resposta da vacina para o HBV em indivíduos portadores de DRC em diálise.

Humans , Male , Female , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Renal Dialysis , Hepatitis B Vaccines , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/therapy , Hepatitis B Antibodies/blood , Cross-Sectional Studies , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/immunology , Hepatitis B/complications , Hepatitis B/prevention & control
Mem. Inst. Oswaldo Cruz ; 112(3): 209-213, Mar. 2017. tab
Article in English | LILACS | ID: biblio-1040567


Rapid tests (RTs) can be used as an alternative method for the conventional diagnosis of hepatitis B virus (HBV). This study aims to evaluate antibodies to HBsAg (anti-HBs) and antibodies to HBeAg (anti-HBe) RTs under different Brazilian settings. The following three groups were included: GI: viral hepatitis outpatient services; GII: low resource areas; and GIII: crack users and beauticians. Imuno-rápido anti-HBsAg™ and Imuno-rápido anti-HBeAg™ RTs were evaluated and showed specificities greater than 95% in all groups. The sensitivity values to anti-HBs were 50.38%, 51.05% and 46.73% and the sensitivity values to anti-HBe were 76.99%, 10.34% and 11.76% in the GI, GII and GIII groups, respectively. The assays had a low sensitivity and high specificity, which indicated their use for screening in regions endemic for HBV.

Humans , Adult , Hepatitis B virus/immunology , Hepatitis B/diagnosis , Hepatitis B Antibodies/blood , Hepatitis B e Antigens/blood , Hepatitis B Surface Antigens/blood , Reagent Kits, Diagnostic , Sensitivity and Specificity , Middle Aged
Cad. Saúde Pública (Online) ; 33(7): e00109216, 2017. tab
Article in English | LILACS | ID: biblio-889724


Data are limited in Brazil on hepatitis B infection among homeless individuals, a marginalized population with high risk of sexually transmissible infections (STI), including hepatitis B. The aim of this study was to investigate hepatitis B epidemiology in homeless persons lodged in a public shelter in Goiânia, Central Brazil. From August 2014 to June 2015, 353 individuals were interviewed and tested for markers of HBV infection. Overall HBV prevalence was 21.8% (95%CI: 17,82-26,41), and 19,5% (95%CI: 15,75-24,0) showed a serological profile of previous HBV vaccination. Older individuals (> 50 years), blacks, and homosexuals or bisexuals showed increased exposure to HBV. The low frequency of individuals immunized against HBV, high social vulnerability, and risk behaviors emphasize the need for health services administrators to provide more opportunities for HBV vaccination in this target population.

No Brasil, existem poucos dados sobre a infecção por hepatite B entre pessoas em situação de rua, uma população marginalizada com alto risco para infecções sexualmente transmissíveis (IST), incluindo a hepatite B. O objetivo deste estudo foi investigar a epidemiologia da hepatite B em pessoas alojadas em um abrigo público da cidade de Goiânia, Brasil Central. De agosto de 2014 a junho de 2015, 353 indivíduos foram entrevistados e testados para os marcadores da infecção pelo HBV. Uma prevalência global de 21,8% (IC95%: 17,82-26,41) para HBV foi estimado, e 19,5% (IC95%: 15,75-24,0) apresentaram perfil sorológico de vacinação prévia contra o HBV. Ser mais velho (acima de 50 anos de idade), preto e homossexual ou bissexual foram preditores de exposição ao HBV. A baixa frequência de indivíduos imunizados contra o HBV, bem como de alta vulnerabilidade social e ocorrência de comportamentos de risco reforçam a necessidade dos gestores de saúde proporcionar mais oportunidades de vacinação para esta população-alvo.

En Brasil, existen pocos datos sobre la infección por hepatitis B entre personas sin techo, una población marginalizada con un alto riesgo de infecciones sexualmente transmisibles (IST), incluyendo la hepatitis B. El objetivo de este estudio fue investigar la epidemiología de la hepatitis B en personas alojadas en un albergue público de la ciudad de Goiânia, Brasil Central. De agosto de 2014 a junio de 2015, se entrevistó a 353 individuos y se probaron los marcadores de la infección por HBV. Se estimó una prevalencia global de un 21,8% (IC95%: 17,82-26,41) para HBV, y 19,5% (IC95%: 15,75-24,0) presentaron un perfil serológico de vacunación previa contra el HBV. Ser más viejo (por encima de 50 años de edad), negro y homosexual o bisexual fueron predictores de exposición al HBV. La baja frecuencia de individuos inmunizados contra el HBV, así como la alta vulnerabilidad social y ocurrencia de comportamientos de riesgo refuerzan la necesidad de los gestores de salud de proporcionar más oportunidades de vacunación para esta población-objetivo.

Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Homeless Persons/statistics & numerical data , Vaccination/statistics & numerical data , Hepatitis B/prevention & control , Hepatitis B/epidemiology , Risk-Taking , Socioeconomic Factors , Brazil/epidemiology , Sex Factors , Hepatitis B virus/isolation & purification , Prevalence , Cross-Sectional Studies , Risk Factors , Age Factors , Hepatitis B Vaccines/administration & dosage , Hepatitis B/etiology , Hepatitis B Antibodies/blood , Middle Aged
Braz. j. infect. dis ; 20(1): 1-7, Jan.-Feb. 2016. tab, graf
Article in English | LILACS | ID: lil-776471


Abstract Background The mechanism underlying the coexistence of hepatitis B surface antigen and antibodies to HBsAg in chronic hepatitis B patients remains unknown. Aims This research aimed to determine the clinical and virological features of the rare pattern. Methods A total of 32 chronic hepatitis B patients infected by HBV genotype C were included: 15 carrying both HBsAg and anti-HBs (group I) and 17 solely positive for HBsAg (group II). S gene and reverse transcriptase region sequences were amplified, sequenced and compared with the reference sequences. Results The amino acid variability within major hydrophilic region, especially the “a” determinant region, and within reverse transcriptase for regions overlapping the major hydrophilic region in group I is significantly higher than those in group II. Mutation sI126S/T within the “a” determinant was the most frequent change, and only patients from group I had the sQ129R, sG130N, sF134I, sG145R amino acid changes, which are known to alter immunogenicity. Conclusions In chronic patients, the concurrent HBsAg/anti-HBs serological profile is associated with an increased aa variability in several key areas of HBV genome. Additional research on these genetic mutants are needed to clarify their biological significance for viral persistence.

Adult , Female , Humans , Male , Young Adult , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/genetics , Hepatitis B, Chronic/genetics , Hepatitis B, Chronic/immunology , RNA-Directed DNA Polymerase/genetics , Viral Envelope Proteins/genetics , China , DNA, Viral , Genotype , Hepatitis B virus/immunology , Mutation , Polymerase Chain Reaction , Sequence Analysis, DNA
Chinese Journal of Epidemiology ; (12): 455-459, 2016.
Article in Chinese | WPRIM | ID: wpr-237519


<p><b>OBJECTIVE</b>To analyze the characteristics of health-seeking behaviors and related influencing factors of the community-based hepatitis B surface antigen (HBsAg) positive adults, in China.</p><p><b>METHODS</b>Based on the cohort formed by the HBsAg positive patients, in the national sero-survey project in 2006, we conducted a follow-up programs in 2010 and 2014. In the latest follow-up project, we carried out a cross-sectional study to collect information on health-seeking behaviors of the patients. Questionnaires would include information on clinic visits, diagnosis, regular physical examination and treatments,etc. We used the SPSS 18.0 software for data analysis.</p><p><b>RESULTS</b>Totally, 2 478 HBsAg positive adults (≥18 years old) were followed through, with 34.4% (853/2 478) of them had visited the doctors and diagnosed after they were informed the status of HBsAg positivity, in the 2006-sero-survey program. Among patients who ever visiting the clinic, 51.2% (372/727) of them underwent at least medical examination once a year, with 31.5% (229/727) of them received treatment. Furthermore, 34.5% (79/229) of the treated patients adopted the traditional Chinese medicine or medicine for ' liver protection'. 56.8% (130/229) of the treated patients received antiviral drugs. Data from the binary logistic regression showed that the major influencing factors on clinic visits would include: age, level of education received and residencial areas (rural/urban).</p><p><b>CONCLUSIONS</b>Consciousness on health was low in those community-based HBsAg positive people. Standerdized management and clinical treatment programs should be set up accordingly.</p>

Adult , Asian Continental Ancestry Group , Psychology , China , Epidemiology , Cross-Sectional Studies , Delivery of Health Care , Hepatitis B , Blood , Diagnosis , Ethnology , Psychology , Hepatitis B Antibodies , Blood , Hepatitis B Surface Antigens , Blood , Humans , Logistic Models , Residence Characteristics , Rural Population , Seroepidemiologic Studies , Surveys and Questionnaires
Chinese Journal of Epidemiology ; (12): 460-463, 2016.
Article in Chinese | WPRIM | ID: wpr-237518


<p><b>OBJECTIVE</b>To examine the influence of three-booster-doses hepatitis B vaccines on children with normal and high antibody response to primary vaccination.</p><p><b>METHODS</b>Antibody against hepatitis B surface antigen (anti-HBs) were detected after primary vaccination and children with normal or high response to hepatitis B primary vaccination at infancy, were identified. Children who were given three booster doses were selected to form the booster group and who were given no booster dose were 1∶1 matched with the same gender and residence to form the control group. Blood samples were obtained from all the participants and tested for anti-HBs and anti-HBc, 5 years after the primary vaccination.</p><p><b>RESULTS</b>The positive rates of anti-HBs response to primary vaccination were 97.39% (224/230, 95% CI: 94.41%-99.04%) in the booster group and 53.91% (124/230, 95% CI: 47.24%-60.48%) in the control group (P<0.05), 5 years after the primary vaccination. Geometric mean concentration (GMC) of anti-HBs were 1 140.02 (887.46-1 464.46) mIU/ml in the booster group and 11.53 (8.73-15.23) mIU/ml in the control group (P<0.05). The prevalence rates of breakthrough HBV infection were 0.87% (2/230) in the booster group and 2.17%(5/230) in the control group (P>0.05). RESULTS from the multivariable analysis showed that the booster doses (OR=38.75, 95%CI: 16.23-92.54) and the level of anti-HBs after the primary vaccination (OR =3.06, 95%CI:1.51-6.17) were independently associated with the positive rates of anti-HBs, 5 years after the primary vaccination (P<0.05).</p><p><b>CONCLUSION</b>Programs with three booster doses to children that showing normal and high antibody response to primary vaccination could improve the persistence of anti-HBs but possibly would not be able to prevent the HBV infection.</p>

Antibody Formation , Case-Control Studies , Child , Hepatitis B , Hepatitis B Antibodies , Blood , Allergy and Immunology , Hepatitis B Surface Antigens , Allergy and Immunology , Hepatitis B Vaccines , Allergy and Immunology , Hepatitis B virus , Humans , Immunization, Secondary , Infant , Prevalence , Treatment Outcome , Vaccination
Article in Chinese | WPRIM | ID: wpr-286883


<p><b>OBJECTIVE</b>To analyze the characteristics of lymphocyte phenotypes in hepatitis B virus (HBV) transgenic mice and the effect of exogenous interferon-α on virological profiles and lymphocytes phenotypes of the mice.</p><p><b>METHODS</b>HBV transgenic mice and wild-type (WT) mice were examined for serum levels of HBsAg, HBcAb, IL-21, and IL-6 using ELISA. The frequencies of CD4(+)T and CD19(+)B cells separated from the liver, spleen, and peripheral blood were detected by flow cytometry. Nine HBV transgenic mice were injected subcutaneously with recombinant mouse interferon alpha (rmIFN-α) and another 9 transgenic mice were injected with PBS, and their HBsAg, HBV DNA, IL-6, and IL-21 levels and frequencies of peripheral blood CD4(+)T and CD19(+)B cells were detected.</p><p><b>RESULTS</b>HBV transgenic mice showed a high level of HBsAg with a detectable level of HBcAb and significantly increased serum levels of IL-21 and IL-6 as compared with WT mice (P<0.05). The transgenic mice had a significantly lower frequency of CD4(+) T cells in the peripheral blood, liver and spleen (P<0.05) but a significantly higher frequency of CD19(+) B cells in the liver (P<0.05). An inverse correlation between intrahepatic CD4(+) T cell frequency and serum HBsAg level while a positive correlation between intrahepatic CD19(+) B cell frequency and HBcAb level were found in HBV transgenic mice. Administration of rmIFN-α significantly increased the frequencies of CD4(+) T and CD19(+) B cells in the peripheral blood and the serum level of IL-6 in HBV transgenic mice (P<0.05).</p><p><b>CONCLUSION</b>HBV transgenic mice have lymphocyte subset dysregulation and exogenous interferon-α can modulate the immune function of the mice by regulating the frequencies of lymphocyte subsets.</p>

Animals , Antiviral Agents , Pharmacology , B-Lymphocytes , DNA, Viral , Blood , Hepatitis B , Drug Therapy , Allergy and Immunology , Hepatitis B Antibodies , Blood , Hepatitis B Surface Antigens , Blood , Hepatitis B virus , Interferon-alpha , Pharmacology , Interleukin-6 , Blood , Interleukins , Blood , Liver , Allergy and Immunology , Lymphocyte Subsets , Cell Biology , Mice , Mice, Transgenic , Phenotype , T-Lymphocytes
Article in Chinese | WPRIM | ID: wpr-248732


<p><b>OBJECTIVE</b>To understand the distribution of both HBsAg and HBsAb negative adults in Mianyang, Sichuan province, and provide evidences for the development of adult immunization policy.</p><p><b>METHODS</b>From June 2013 to April 2014, a total of 200 929 people aged ≥15 years were selected in Mianyang through stratified cluster random sampling to conduct an interview with standard questionnaire. The blood samples were collected from them for the detection of HBsAg and HBsAb with enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>Among the people surveyed, 13 903 were HBsAg positive (7.0%), 93 763 were HBsAb positive (46.6%), and 93 122 were both HBsAg and HBsAb negative (46.3%). The negative rate of both HBsAg and HBsAb in females (47.1%) was higher than that in males (45.4%). The negative rate of both HBsAg and HBsAb increased with age. The negative rate of both HBsAg and HBsAb was highest in people aged ≥65 years (50.3%) and lowest in people aged 15-24 years (42.9%). The negative rate of both HBsAg and HBsAb was highest in farmers (51.1%) and lowest in medical workers (24.1%). The negative rate of both HBsAg and HBsAb was highest in the widowed (51.1%) and lowest in the unmarried (41.6%). The negative rate of both HBsAg and HBsAb was lower in people with family history of hepatitis B (36.5%) than in people without family history of hepatitis B (46.6%). The negative rate of both HBsAg and HBsAb in Han ethnic group was lower (46.3%) than that in Qiang ethnic group (53.1%), but higher than that in other ethnic groups (43.9%). The negative rate of both HBsAg and HBsAb was higher in rural area (48.9%) than in urban area (43.0%). The negative rate of both HBsAg and HBsAb was lower in people who had received hepatitis B immunization (43.7%) than in people who had received no hepatitis B immunization (47.3%). The differences were all statistical significant (P<0.01).</p><p><b>CONCLUSION</b>The negative rate of both HBsAg and HBsAb was 46.3% in people aged ≥15 years in Mianyang. General population are susceptible to hepatitis B virus infection. It is necessary to develop and implement appropriate hepatitis B immunization strategy for local adult population.</p>

Adolescent , Adult , Aged , China , Epidemiology , Enzyme-Linked Immunosorbent Assay , Ethnic Groups , Female , Health Personnel , Hepatitis B , Epidemiology , Hepatitis B Antibodies , Blood , Hepatitis B Surface Antigens , Blood , Hepatitis B Vaccines , Hepatitis B virus , Humans , Male , Middle Aged , Seroepidemiologic Studies , Surveys and Questionnaires , Vaccination , Young Adult