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1.
Gac. méd. Méx ; 157(1): 37-42, ene.-feb. 2021. tab
Article in Spanish | LILACS | ID: biblio-1279071

ABSTRACT

Resumen Introducción: La identificación de portadores del virus de la hepatitis B en donantes de sangre es imperativo para evitar la transmisión de la enfermedad a través de transfusiones sanguíneas. Objetivo: Determinar si los donantes de sangre con resultados positivos de los marcadores serológicos HbsAg y anti-HBc eran portadores de ADN del virus de la hepatitis B. Métodos: Se recolectaron 12 745 muestras de seis bancos de sangre ecuatorianos, las cuales fueron analizadas con pruebas serológicas para identificar los marcadores infecciosos HBsAg, anti-HBc, anti-HBs mediante prueba ELISA automatizada. Todas las muestras positivas para uno, dos o los tres marcadores fueron analizadas con técnica molecular para determinar la presencia de ADN viral. Resultados: Se identificó que 27.5 % de las muestras reactivas solo a anti-HBc y 100 % de las muestras con resultados positivos de HBsAg/anti-HBc-IgM/IgG presentaron ADN del virus de la hepatitis B (p = 0.001). Conclusiones: La elección de los marcadores de infección y los métodos de detección definen los resultados. Es importante la realización de dos pruebas serológicas y una molecular para identificar a los portadores del virus de la hepatitis B y evitar su transmisión.


Abstract Introduction: Identification of hepatitis B virus carriers in blood donors is imperative in order to avoid transmission of the disease via blood transfusion. Objective: To determine if blood donors with positive results for serological markers HBsAg and anti-HBc were hepatitis B virus DNA carriers. Methods: 12,745 samples were collected from six Ecuadorian blood banks and analyzed for HBsAg, anti-HBc and anti-HBs infectious markers by automated ELISA. All samples that tested positive for one, two or all three markers were analyzed with molecular techniques to determine the presence of viral DNA. Results: 27.5 % of the samples that were reactive for anti-HBc alone and 100 % of those with positive results for HbsAg and IgM/IgG anti-HBc were identified to contain hepatitis B virus DNA (p = 0.001). Conclusions: The selection of infection markers, as well as the detection methods define the results. Performing two serological and one molecular test is important in order to identify hepatitis B virus carriers and prevent its transmission.


Subject(s)
Humans , Blood Donors/statistics & numerical data , DNA, Viral/blood , Immunoglobulin G/blood , Immunoglobulin M/blood , Hepatitis B virus/genetics , Hepatitis B Surface Antigens/blood , Blood Banks , Enzyme-Linked Immunosorbent Assay/methods , Biomarkers/blood , Carrier State/diagnosis , Carrier State/virology , Hepatitis B virus/immunology , Ecuador
2.
Rev. Soc. Bras. Med. Trop ; 53: e20180533, 2020. tab
Article in English | LILACS | ID: biblio-1057270

ABSTRACT

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.


Subject(s)
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
3.
Rev. Soc. Bras. Med. Trop ; 52: e20180132, 2019. tab
Article in English | LILACS | ID: biblio-1041500

ABSTRACT

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.


Subject(s)
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
4.
Braz. j. infect. dis ; 22(4): 294-304, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-974222

ABSTRACT

ABSTRACT Background Hepatitis B virus (HBV) infection is a major public health problem in Brazil. HBV endemicity is usually moderate to low according to geographic regions, and high prevalence of this virus has been reported in people of some specific Brazilian counties, including those with a strong influence of Italian colonization in southern Brazil. Analysis of HBV diversity and identification of the main risk factors to HBV infection are necessary to understand hepatitis B epidemiology in these high prevalence regions in southern Brazil. Objective To investigate epidemiological characteristics and HBV genotypes and subgenotypes circulating in a specific city with high HBV prevalence. Methods A cross-sectional study was performed with 102 HBV chronically infected individuals, recruited in reference outpatient clinics for viral hepatitis in a city of high HBV prevalence (Bento Gonçalves) in Rio Grande do Sul state, Brazil between July and December 2010. Socio-demographic, clinical and behavior-related variables were collected in a structured questionnaire. HBV serological markers (HBsAg, anti-HBc), viral load, genotypes/subgenotypes and drug resistance were evaluated and comparatively analyzed among all patients. Results The HBV infected subjects had a mean age of 44.9 (±12.2) years, with 86 patients (84.3%) reporting to have a family history of HBV infection, 51 (50.0%) to share personal objects, and were predominantly of Italian descendants (61; 64.9%). There was a predominance of genotype D (49/54; 90.7%), but genotype A was also detected (5/54; 9.3%). Subgenotypes D1 (1; 4.7%), D2 (3; 14.3%), and D3 (17; 81.0%) were identified. LAM-resistant mutation (rtM204I) and ADV-resistant mutations (rtA181V) were detected in only one patient each. Conclusions These results demonstrate a pivotal role of intrafamilial transmission for HBV spreading in this population. Furthermore, there is a high prevalence of HBV genotype D in this region.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Hepatitis B virus/genetics , Hepatitis B, Chronic/epidemiology , Drug Resistance, Viral , Antiviral Agents/therapeutic use , Brazil/epidemiology , Hepatitis B virus/drug effects , Polymerase Chain Reaction , Prevalence , Cross-Sectional Studies , Risk Factors , Viral Load , Hepatitis B, Chronic/virology , Genotype , Hepatitis B Surface Antigens/blood , Mutation
5.
Arq. gastroenterol ; 54(4): 356-358, Oct.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-1038704

ABSTRACT

ABSTRACT BACKGROUND: Patients on chronic dialysis present a high prevalence of hepatitis B virus infection. Despite infection-control practices, surveillance of serological markers, and hepatitis B vaccination, there are still outbreaks of the disease in dialysis centers. OBJECTIVE: This study aims to assess the serologic and vaccination status for hepatitis B in hemodialysis patients. METHODS: This cross-sectional study assessed serologic markers and hepatitis B vaccination status of chronic kidney disease patients on regular dialysis program in São Carlos, SP, Brazil. Patients without information about hepatitis B status (anti-HBc, HBsAg and anti-HBs) were referred for testing. Individuals with uncertain or incomplete immunization status and without serological conversion (anti-HBs <10mIU/mL) were referred to vaccination, with adverse effects monitored. RESULTS: The study included 130 from a total of 181 dialysis patients. The majority were male (63.8%), mean age 53.9 years. All patients were already screened and negative for HBsAg, and 73.8% were vaccinated against hepatitis B (59.2% complete and 14.6% incomplete schedule), with a seroconversion rate of 75.3%. Only 11 (8.5%) patients had prior dosage of anti-HBc (negative). Among the 47 patients referred for anti-HBc testing, four were anti-HBc positive and one indeterminate. Of the total of patients referred to immunization, 34 have actually received HBV vaccine; among them five had mild adverse effects. CONCLUSION: Despite the benefit of dosing of anti-HBc and anti-HBs before admission to dialysis, economic constraints have reduced the screening to only HBsAg. Since occult HBV infection has already been demonstrated in hemodialysis patients, the measure of anti-HBc should be encouraged.


RESUMO CONTEXTO: Pacientes cronicamente em diálise apresentam alta prevalência de infecção por vírus da hepatite B. Apesar de práticas de controle de infecção, vigilância de marcadores sorológicos e vacinação contra a hepatite B, ainda há surtos da doença em centros de diálise. OBJETIVO: Este estudo tem como objetivo avaliar o estado sorológico e a vacinação contra hepatite B em pacientes em hemodiálise. MÉTODOS: Estudo transversal avaliando marcadores sorológicos e vacinação contra a hepatite B em pacientes com doença renal crônica em programa regular de hemodiálise em São Carlos, SP, Brasil. Pacientes sem marcadores sorológicos para hepatite B disponíveis (anti-HBc, HBsAg e anti-HBs) foram encaminhados para testagem. Em caso de situação vacinal desconhecida, incompleta ou sem resposta vacinal (anti-HBs <10mIU/mL), os pacientes foram encaminhados para vacinação, sendo os efeitos adversos monitorados. RESULTADOS: O estudo incluiu 130 de um total de 181 pacientes em diálise. A maioria era do sexo masculino (63,8%), com idade média de 53,9 anos. Todos os pacientes já haviam sido rastreados e eram negativos para HBsAg, e 73,8% foram vacinados contra a hepatite B (59,2% esquema completo e 14,6% esquema incompleto), com uma taxa de soroconversão de 75,3%. Apenas 11 (8,5%) pacientes dispunham de dosagem prévia de anti-HBc (negativo). Entre os 47 pacientes encaminhados para testagem anti-HBc, quatro eram anti-HBc reagentes e um indeterminado. Do total de pacientes encaminhados à imunização, 34 receberam efetivamente a vacina contra o HBV; entre eles, cinco tiveram efeitos adversos leves. CONCLUSÃO: Apesar do benefício da dosagem de anti-HBc e anti-HBs antes da admissão à diálise, restrições econômicas reduziram o rastreio apenas à dosagem de HBsAg. Como a infecção oculta por HBV já foi demonstrada em pacientes em hemodiálise, a dosagem de anti-HBc deve ser incentivada.


Subject(s)
Humans , Male , Female , Hepatitis B virus/immunology , Renal Dialysis/adverse effects , Hepatitis B Vaccines/immunology , Hepatitis B/immunology , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Biomarkers/blood , Cross-Sectional Studies , Hepatitis B Vaccines/administration & dosage , Hepatitis B/prevention & control , Middle Aged
6.
Mem. Inst. Oswaldo Cruz ; 112(8): 544-550, Aug. 2017. tab
Article in English | LILACS | ID: biblio-894870

ABSTRACT

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.


Subject(s)
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
7.
Ann. hepatol ; 16(3): 412-420, May.-Jun. 2017. tab, graf
Article in English | LILACS | ID: biblio-887253

ABSTRACT

ABSTRACT Background. A retrospective cohort study was conducted to investigate the effect of hepatitis B surface antigen (HBsAg) level on prognosis in low viral load (< 2000 lU/mL) patients with hepatitis B-related hepatocellular carcinoma (HCC) after curative resection. Material and methods. A total of 192 patients with low viral load who had received curative resection of pathologically confirmed HCC were analyzed to determine the factors affecting prognosis. The risk factors for survival, early and late recurrence (2 years as a cut-off) were studied. Results. The median follow-up time was 38.5 months. The overall survival rates at 1-, 3-, and 5-year after curative resection were 94.2%, 64.0%, and 45.2%, respectively. The cumulative recurrence rates at 1-, 3-, and 5-year after curative resection were 22.4%, 46.5%, and 67.0%, respectively. Patients with high serum HBsAg levels (> 250 lU/mL) had significantly lower survival rates than those with low HBsAg levels (HR: 1.517,95% Cl: 1.005-2.292, P = 0.047). Stratified analysis showed that patients with high HBsAg levels had a significantly higher late recurrence incidence than those with low HBsAg levels (HR: 2.155, 95% Cl: 1.094-4.248, P = 0.026), but did not have a significantly higher risk of early recurrence postoperatively (HR: 1.320,95% Cl: 0. 837-2.082, P = 0.233). Multivariate analysis revealed that HBsAg > 250 lU/mL was an independent risk factor associated with late recurrence (HR: 2.109, 95% Cl: 1.068-4.165, P = 0.032). Conclusions. HBsAg > 250 lU/mL at the time of tumor resection was an independent risk factor for late recurrence in low viral load HCC patients.


Subject(s)
Humans , Carcinoma, Hepatocellular/surgery , Carcinoma, Hepatocellular/diagnosis , Carcinoma, Hepatocellular/virology , Hepatectomy/adverse effects , Hepatitis B Surface Antigens/blood , Time Factors , Biomarkers/blood , Proportional Hazards Models , Hepatitis B virus/immunology , Multivariate Analysis , Retrospective Studies , Risk Factors , Treatment Outcome , Disease-Free Survival , Disease Progression , Kaplan-Meier Estimate , Hepatitis B/complications , Hepatitis B/diagnosis , Hepatitis B/virology , Neoplasm Recurrence, Local
8.
Mem. Inst. Oswaldo Cruz ; 112(3): 209-213, Mar. 2017. tab
Article in English | LILACS | ID: biblio-1040567

ABSTRACT

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.


Subject(s)
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
9.
Ann. hepatol ; 16(1): 63-70, Jan.-Feb. 2017. graf
Article in English | LILACS | ID: biblio-838087

ABSTRACT

Abstract: Approximately 10% of individuals do not respond to hepatitis B virus (HBV) vaccination, i.e. non-responders (NRs). We aimed to investigate the association of interleukin (IL)-4 and IL-12B gene polymorphisms with responsiveness to the HBV vaccine in Korean infants. Among 300 healthy infants (9-12 month), SNPs for the IL-4 gene (rs2243250, rs2070874, and rs2227284) and for the IL-12B gene (rs3213094 and rs17860508) were compared between subgroups in terms of the response to HBV vaccination. The percentages of NRs (< 10 mIU/mL), low-titer responders (LRs, 10-100 mIU/mL), and high-titer responders (HRs, ≥ 100 mIU/mL) were 20.3%, 37.7% and 42.0%, respectively. No SNPs differed in frequency between NRs and responders or between LRs and HRs. We divided the subjects into two groups according to the time interval from the 3rd dose of HBV vaccination to Ab quantification: > 6 months from the 3rd dose (n = 87) and ≤ 6 months from the 3rd dose (n = 213). In the ≤ 6 month subjects, rs2243250C and rs2227284G were significantly frequent in the lower-titer individuals (NRs + LR) than HRs (40.1 vs. 25.9%, p = 0.014 and 45.1 vs. 33.0%, p = 0.018, respectively), and the rs2243250C and rs2227284G frequencies were significantly different among the three subgroups (13.2 vs. 26.9 vs. 25.9%, p = 0.040 and 15.5 vs. 29.6 vs. 33.0%, p = 0.038, respectively). In conclusion, those results suggest that IL-4 gene polymorphisms may play a role in the response to the HBV vaccine in Korean infants.


Subject(s)
Humans , Male , Female , Infant , Interleukin-4/genetics , Hepatitis B Vaccines/administration & dosage , Polymorphism, Single Nucleotide , Interleukin-12 Subunit p40/genetics , Hepatitis B/prevention & control , Pharmacogenetics , Phenotype , Time Factors , Biomarkers/blood , Hepatitis Antibodies/blood , Immunization Schedule , Vaccination , Treatment Outcome , Republic of Korea , Gene Frequency , Hepatitis B/genetics , Hepatitis B/immunology , Hepatitis B Surface Antigens/blood
10.
Rev. saúde pública ; 51: 24, 2017. tab
Article in English | LILACS | ID: biblio-845857

ABSTRACT

ABSTRACT OBJECTIVE To describe the evolution of serological markers among HIV and hepatitis B coinfected patients, with emphasis on evaluating the reactivation or seroreversion of these markers. METHODS The study population consisted of patients met in an AIDS Outpatient Clinic in São Paulo State, Brazil. We included in the analysis all HIV-infected and who underwent at least two positive hepatitis B surface antigen serological testing during clinical follow up, with tests taken six months apart. Patients were tested with commercial kits available for hepatitis B serological markers by microparticle enzyme immunoassay. Clinical variables were collected: age, sex, CD4+ T-cell count, HIV viral load, alanine aminotransferase level, exposure to antiretroviral drugs including lamivudine and/or tenofovir. RESULTS Among 2,242 HIV positive patients, we identified 105 (4.7%) patients with chronic hepatitis B. Follow up time for these patients varied from six months to 20.5 years. All patients underwent antiretroviral therapy during follow-up. Among patients with chronic hepatitis B, 58% were hepatitis B “e” antigen positive at the first assessment. Clearance of hepatitis B surface antigen occurred in 15% (16/105) of patients with chronic hepatitis B, and 50% (8/16) of these patients presented subsequent reactivation or seroreversion of hepatitis B surface antigen. Among hepatitis B “e” antigen positive patients, 57% (35/61) presented clearance of this serologic marker. During clinical follow up, 28.5% (10/35) of those who initially cleared hepatitis B “e” antigen presented seroreversion or reactivation of this marker. CONCLUSIONS Among HIV coinfected patients under antiretroviral therapy, changes of HBV serological markers were frequently observed. These results suggest that frequent monitoring of these serum markers should be recommended.


Subject(s)
Humans , Male , Female , Middle Aged , HIV Infections/complications , Hepatitis B virus/immunology , Hepatitis B, Chronic/immunology , Hepatitis B e Antigens/blood , Hepatitis B Surface Antigens/blood , Biomarkers/blood , CD4-Positive T-Lymphocytes , Viral Load , Hepatitis B, Chronic/complications , Coinfection , Seroconversion , Hepatitis B e Antigens/immunology , Hepatitis B Surface Antigens/immunology
11.
Arq. gastroenterol ; 53(3): 175-179, tab
Article in English | LILACS | ID: lil-787352

ABSTRACT

ABSTRACT Background Occult hepatitis B infection is characterized by negative hepatitis B surface antigen (HBsAg) and also detectable hepatitis B virus (HBV) -DNA, with or without hepatitis B core antibody (anti-HBc). HBV reactivation in individuals under immunosuppressive therapy is critical, occurring in occult HBV. Objective In this study, we aimed to determine the prevalence of occult HBV infection among hepatitis B surface antigen negative in cancer patients before receiving chemotherapy. Methods Sera from 204 cancer patients who were negative for HBsAg, were tested for anti-HBc antibodies. The samples that were negative for HBsAg but positive for anti-HBc also examined for HBV-DNA by polymerase chain reaction (PCR). Results Of the 204 HBsAg negative blood samples, 11 (5.4%) samples were positive for anti-HBc antibodies. HBV-DNA was detected in 9/11 (81%) of anti-HBc positive samples. Occult HBV infection in hematological cancers was more than solid cancers, 4.8% and 4.3% respectively. There was no significant difference in HBc antibody positivity based on vaccination, previous blood transfusions, history of familial hepatitis or biochemical parameters (ALT, AST, total and direct bilirubin levels) (P>0.05). Conclusion Screening of occult HBV infection by HBsAg, HBV DNA and anti HB core antibody should be suggested as a routine investigation in cancer patients before receiving chemotherapy.


RESUMO Contexto A infecção oculta da hepatite B caracteriza-se por antígeno de superfície da hepatite B (AgHBs) negativo com vírus detectável da hepatite B (HBV) -DNA, com ou sem anticorpo de núcleo da hepatite B (anti-HBc). A reativação do HBV em indivíduos sob terapia imunossupressora é crítica, originando a infecção oculta pelo VHB. Objetivo Este estudo teve como objetivo determinar a prevalência de infecção oculta pelo VHB entre em pacientes com câncer e com antígeno de superfície da hepatite B negativo antes de receber quimioterapia. Métodos Soro de 204 pacientes com câncer que foram negativos para AgHBs, foram testados para anticorpos anti-HBc. As amostras que foram negativos para AgHBs, mas positivo para anti-HBc foram também examinadas para HBV-DNA, por reação em cadeia da polimerase. Resultados Entre 204 amostras de sangue AgHBs negativas, 11 (5,4%) foram positivos para anticorpos anti-HBc. HBV-DNA foi detectado em 9/11 (81%) das amostras positivas de anti-HBc. Infecção oculta de VHB em câncer hematológico foi maior que em cânceres sólidos, 4,8% e 4,3% respectivamente. Não houve diferença significativa na positividade anti-HBc, com base na vacinação, transfusões de sangue anteriores, história de hepatite familiar ou parâmetros bioquímicos (ALT, AST, total e níveis de bilirrubina total) (P & gt; 0,05). Conclusão A triagem de infecção oculta por AgHBs, HBV-DNA e anti-anticorpo de núcleo HB deve ser sugerida como uma investigação de rotina em pacientes com câncer antes de receber a quimioterapia.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , DNA, Viral/isolation & purification , Hepatitis B virus/isolation & purification , Hepatitis B/epidemiology , Hepatitis B Surface Antigens/blood , Neoplasms/complications , Neoplasms/immunology , Hepatitis B virus/genetics , Hepatitis B virus/immunology , Prevalence , Cross-Sectional Studies , Hematologic Neoplasms/complications , Hematologic Neoplasms/immunology , Hematologic Neoplasms/epidemiology , Hepatitis B/complications , Hepatitis B/diagnosis , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/immunology , Iran/epidemiology , Middle Aged
12.
Braz. j. infect. dis ; 20(1): 1-7, Jan.-Feb. 2016. tab, graf
Article in English | LILACS | ID: lil-776471

ABSTRACT

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.


Subject(s)
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
13.
Article in English | WPRIM | ID: wpr-215525

ABSTRACT

With recent advances in molecular and genomic investigations, the impact of hepatitis B viral and host factors on the progression of chronic HBV infection has been explored. For viral factors, hepatitis B viral load is a strong predictor for liver disease progression. Hepatitis B viral kinetics appear to be important for successful anti-viral therapy. Serum HBsAg level serves as a complementary marker to viral load for the prediction of HBV-related adverse outcomes in patients with low viral load. In those with low viral load, high serum HBsAg level is associated with higher risks of cirrhosis and HCC. Hepatitis B core-related antigen (HBcrAg) induces host immune responses, and the reduction of the HBcrAg level as well as the increment of total anti-HBc level are significantly associated with favorable outcomes. HBV genotypes (genotype C/D) and mutants (basal core promoter and deletion mutation in pre-S genes) are well known viral genetic markers to predict disease progression. For host factors, serum inflammatory biomarkers have been developed to evaluate the HBV-associated hepatic necroinflammation and fibrosis. Host single nucleotide polymorphism on sodium taurocholate cotransporting polypeptide (NTCP, an HBV entry receptor) may be associated with a decreased risk for cirrhosis and HCC. In conclusion, patients with chronic hepatitis B should be evaluated with relevant viral and host markers to identify those who are at a higher risk of liver disease progression and then receive timely antiviral therapy.


Subject(s)
Biomarkers/blood , DNA, Viral/blood , Hepatitis B Surface Antigens/blood , Hepatitis B e Antigens/blood , Hepatitis B virus/genetics , Hepatitis B, Chronic/complications , Humans , Liver Cirrhosis/etiology , Organic Anion Transporters, Sodium-Dependent/genetics , Polymorphism, Single Nucleotide , Risk Factors , Symporters/genetics
14.
Article in English | WPRIM | ID: wpr-188161

ABSTRACT

BACKGROUND/AIMS: Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response. METHODS: This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log₁₀ IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal. RESULTS: After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076–4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log10 IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log₁₀ IU/mL (n=11) and >3 log₁₀ IU/mL (n=28), respectively. CONCLUSION: The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of <2 log₁₀ IU/mL is an excellent predictor of a sustained off-treatment response in CHB patients who have received ETV for a sufficient duration.


Subject(s)
Adult , Alanine Transaminase/blood , Antiviral Agents/therapeutic use , DNA, Viral/blood , Female , Follow-Up Studies , Guanine/analogs & derivatives , Hepatitis B Surface Antigens/blood , Hepatitis B virus/genetics , Hepatitis B, Chronic/drug therapy , Humans , Male , Middle Aged , Multivariate Analysis , Polymerase Chain Reaction , Recurrence , Treatment Outcome
15.
Article in English | WPRIM | ID: wpr-138553

ABSTRACT

Advances in the treatment of malignant and inflammatory diseases have developed over time, with increasing use of chemotherapeutic and immunosuppressive agents of a range of drug classes with varying mechanism and potency in their effects on the immune system. These advances have been met with the challenge of increased risk of hepatitis B virus (HBV) reactivation in susceptible individuals. The magnitude of risk of HBV reactivation is associated with the individual's HBV serological status and the potency and duration of immunosuppression. Individuals with chronic hepatitis B (CHB) and previously infected but serologically cleared HBV infection are both susceptible to HBV reactivation. HBV reactivation in the setting of immunosuppression is a potentially life threatening condition leading to liver failure and death in extreme cases. It is important to recognize that HBV reactivation in the setting of immunosuppression is potentially preventable. Therefore, identification of patients at risk of HBV reactivation and institution of prophylactic antiviral therapy prior to initiation of immunosuppression is essential.


Subject(s)
Antiviral Agents/therapeutic use , Autoimmune Diseases/complications , Hematopoietic Stem Cell Transplantation , Hepatitis B/complications , Hepatitis B Core Antigens/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/physiology , Humans , Immunosuppressive Agents/therapeutic use , Organ Transplantation , Virus Activation/physiology
16.
Article in English | WPRIM | ID: wpr-138552

ABSTRACT

Advances in the treatment of malignant and inflammatory diseases have developed over time, with increasing use of chemotherapeutic and immunosuppressive agents of a range of drug classes with varying mechanism and potency in their effects on the immune system. These advances have been met with the challenge of increased risk of hepatitis B virus (HBV) reactivation in susceptible individuals. The magnitude of risk of HBV reactivation is associated with the individual's HBV serological status and the potency and duration of immunosuppression. Individuals with chronic hepatitis B (CHB) and previously infected but serologically cleared HBV infection are both susceptible to HBV reactivation. HBV reactivation in the setting of immunosuppression is a potentially life threatening condition leading to liver failure and death in extreme cases. It is important to recognize that HBV reactivation in the setting of immunosuppression is potentially preventable. Therefore, identification of patients at risk of HBV reactivation and institution of prophylactic antiviral therapy prior to initiation of immunosuppression is essential.


Subject(s)
Antiviral Agents/therapeutic use , Autoimmune Diseases/complications , Hematopoietic Stem Cell Transplantation , Hepatitis B/complications , Hepatitis B Core Antigens/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/physiology , Humans , Immunosuppressive Agents/therapeutic use , Organ Transplantation , Virus Activation/physiology
17.
Arq. gastroenterol ; 52(4): 321-324, Oct.-Dec. 2015. tab
Article in English | LILACS | ID: lil-771923

ABSTRACT

Background - Hepatitis B virus and hepatitis C virus are among the principal causes of severe liver disease. There is limited data of epidemiology of Hepatitis B in community, more so in rural population. Objective - To find the prevalence of hepatitis B and C infection in community and study the risk factors for their transmission. Methods - This was a community based cross sectional study. A total of 1833 randomly selected subjects from a rural area were interviewed for risk factors for transmission and tested for markers of hepatitis B and hepatitis C infection. All the positive card tests were confirmed by ELISA. Results - Out of 2400 subjects, rate for participation was 76.38%. None of the subjects was positive for anti hepatitis C virus antibody. Point prevalence for HBsAg positivity was 0.92. Being healthcare worker and having tattoo were significantly associated with HBsAg positive results. Nose and ear piercing was reported by almost. History of blood or blood product transfusion, I/V drug abuse, multiple sexual partners, unsafe Injections, hemodialysis and any h/o surgery was not associated with HBsAg positivity. Conclusion - Health care workers are at high risk for transmission of hepatitis B. Educating common people regarding mode of transmission of Hepatitis B and C will help to reduce their transmission.


Contexto - O vírus da hepatite B e o vírus da hepatite C estão entre as principais causas de doença grave do fígado. Há dados limitados de epidemiologia da hepatite B na comunidade observada, mais ainda na população rural. Objetivo - Encontrar a prevalência de infecção de hepatite B e C em uma comunidade da India e pesquisar os fatores de risco para sua transmissão. Métodos - Feito estudo de corte transversal em uma comunidade. Um total de 1833 sujeitos selecionados aleatoriamente em uma área rural foram entrevistados para fatores de risco para transmissão e testados para marcadores da infecção por hepatite B e C. Todos os testes positivos de cartão foram confirmados por ELISA. Resultados - Dos 2400 pacientes objetivados houve uma taxa de participação de 76.38%. Nenhum dos indivíduos foi positivo para anticorpo anti vírus da hepatite C. A prevalência pontual para a positividade do HBsAg foi de 0,92. Ser trabalhador na área de saúde e ter tatuagem foram significativamente associados com resultados positivos de HBsAg. "Piercing" em nariz e orelha foram relatados por quase todos. História de transfusão de sangue ou uso de hemoderivados, abuso de drogas via endovenosa, múltiplos parceiros sexuais, injeções inseguras, hemodiálise e história prévia de cirurgia, não estiveram associadas à positividade do HBsAg. Conclusão - Os trabalhadores de saúde estão em alto risco para a transmissão de hepatite B. Educar pessoas comuns sobre o modo de transmissão de hepatite B e C ajudará a reduzir a sua transmissão.


Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Hepacivirus/immunology , Hepatitis B virus/immunology , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis B/diagnosis , Hepatitis C Antibodies/blood , Hepatitis C/diagnosis , India/epidemiology , Prevalence , Risk Factors , Rural Population , Seroepidemiologic Studies
18.
Rev. Soc. Bras. Med. Trop ; 48(6): 674-681, Nov.-Dec. 2015. tab, graf
Article in English | LILACS | ID: lil-767824

ABSTRACT

Abstract: INTRODUCTION: Hepatitis B and C viral infections remain an important cause of global morbidity and mortality. Studies have been conducted in population groups of large cities, leaving gaps in the knowledge regarding the situation in small municipalities. We aimed to measure the prevalence of hepatitis B and C markers and presence of infection-associated factors. METHODS: All inhabitants of Cássia dos Coqueiros aged ≥18 years who agreed to participate in the research were included. We collected blood as well as information via a questionnaire between March 2011 and December 2013. Univariate and multivariate analyses were conducted. RESULTS: Among the 1,001 participants, 41 (4.1%) participants had a serological profile of hepatitis B viral exposure, and only one (0.1%) participant was considered a virus carrier. The frequency of isolated antibody to hepatitis B virus surface antigen (anti-HBs) markers was 17.8% for the overall population. In the multivariate analysis, hepatitis B virus (HBV) infection was associated with age, birth outside the State of São Paulo, history of hepatitis, ≥2 sexual partners in the last 6 months, and tattoos. Four (0.4%) participants had a serological profile of hepatitis C viral exposure. However, after confirmation using viral ribonucleic acid (RNA) evaluation, only one (0.1%) individual remained positive. CONCLUSIONS: The positivity rates for hepatitis B and C were low, despite greater sexual freedom and the recent emergence of illicit drugs, as observed by the health personnel working in Cássia dos Coqueiros.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Brazil/epidemiology , Epidemiologic Methods , Hepatitis B Antibodies/blood , Hepatitis B Core Antigens/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/immunology , Hepatitis C Antibodies/blood , Rural Population , Socioeconomic Factors , Urban Population
19.
Rev. Soc. Bras. Med. Trop ; 48(5): 524-531, Sept.-Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-763325

ABSTRACT

ABSTRACTINTRODUCTION:Since women are frequently the minority among blood donors worldwide, studies evaluating this population usually reflect male features. We assessed the features of female blood donors with positive serology for HBV and compared them with those of men.METHODS The study comprised consecutive blood donors referred to a specialized liver disease center to be evaluated due to HBsAg- and/or anti-HBc-positive tests.RESULTS: The study encompassed 1,273 individuals, 219 (17.2%) of whom were referred due to positive HBsAg test and 1,054 (82.8%) due to reactive anti-HBc test. Subjects' mean age was 36.8±10.9 years, and 28.7% were women. Female blood donors referred for positive HBsAg screening tests demonstrated higher prevalence of healthcare workers (9.3% vs 2.5%) and lower prevalence of sexual risk behaviors (15.1% vs 41.1%) and alcohol abuse (1.9% vs 19.8%) compared to men. Women had lower ALT (0.6 vs 0.8×ULN), AST (0.6 vs 0.8×ULN), direct bilirubin (0.2 vs 0.3mg/dL), and alkaline phosphatase (0.5 vs 0.6×ULN) levels and higher platelet count (223,380±50,293 vs 195,020±53,060/mm3). Women also had a higher prevalence of false-positive results (29.6% vs 17.0%). No differences were observed with respect to liver biopsies. Female blood donors referenced for reactive anti-HBc screening tests presented similar clinical, epidemiological, and biochemical characteristics to those reported for positive HBsAg screening tests and similarly had a higher prevalence of false-reactive results.CONCLUSIONS: Compared to men, female blood donors with positive HBsAg and/or anti-HBc screening tests demonstrated higher prevalence of professional risk and false-positive results and reduced alteration of liver chemistry.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Blood Donors/statistics & numerical data , Hepatitis B/epidemiology , Brazil/epidemiology , Epidemiologic Methods , False Positive Reactions , Hepatitis B Antibodies/blood , Hepatitis B Core Antigens/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/immunology , Hepatitis B/diagnosis , Immunoglobulin M/blood , Sex Factors
20.
Braz. j. infect. dis ; 19(3): 285-290, May-Jun/2015. tab
Article in English | LILACS | ID: lil-751887

ABSTRACT

Background: Data regarding Hepatitis B and C viruses (HBV and HCV) prevalence among military personnel in Brazil are lacking, but the work-related risk of exposure can be high. The objective of this study was to estimate the seroprevalence of HBV and HCV and the risk factors associated to HBV exposure among Brazilian military personnel. Methods: A cross-sectional study was conducted and included 433 male military adults aged 18-25 years old working in Rio de Janeiro during October 2013. All individuals completed a questionnaire to assess their risk of exposure and provided a blood sample to HBV and HCV testing. Results: None of the participants presented HBsAg or anti-HBc IgM, 18 (4.1%) were positive for total anti-HBc, 247 (57.0%) were positive for anti-HBs, and 3 (0.7%) were anti-HCV reactive. The majority of military personnel with past HBV infection (anti-HBc reactive) and HBV immunity (anti-HBs reactive) had a history of prior dental procedures (88.9% and 77.3%), consumption of alcohol at least once a week (50% and 55.9%), and practiced oral sex (61.1% and 58.3%, respectively). In addition, anti-HBc positivity was common among individuals with a history of surgery (44.4%) and practice of anal sex (50%). At univariate analysis, age group was associated to anti-HBc and anti-HBs positivity. Conclusions: Low rates of HBV and HCV infection were observed among Brazilian military personnel in comparison to the general Brazilian population. HBV immunity rates were relatively low indicating the need for vaccination campaigns in this group. .


Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Military Personnel/statistics & numerical data , Brazil/epidemiology , Epidemiologic Methods , Hepacivirus/immunology , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/immunology , Hepatitis C Antibodies/blood , Seroepidemiologic Studies , Socioeconomic Factors
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