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Rev. habanera cienc. méd ; 19(1): 48-62, ene.-feb. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1099145


Introducción: La efectividad del programa nacional de inmunización ha impactado en la reducción de la incidencia del virus de la hepatitis B en Cuba; sin embargo, no es despreciable la cantidad de pacientes infectados crónicos, que por esta causa, se detectan en la práctica asistencial, aunque insuficientes los estudios epidemiológicos que los caracterizan. Objetivo: Describir las principales características clínicas, biomoleculares e inmunológicas de los pacientes con VHB crónica atendidos en el Instituto de Gastroenterología de Cuba. Materiales y métodos: 97 pacientes que tenían al menos un historial de 6 meses de infección crónica con VHB fueron reclutados en la propia institución desde enero 2016 hasta enero 2018. Se realizaron análisis estadísticos descriptivos para las características clínicas, estudios bioquímicos, virológicos, grado de dureza hepática (medido por elastografía transitoria) y terapia antiviral. Resultados: Todos los pacientes completaron el seguimiento; 61,9 por ciento eran varones y la mediana (rango) de edad fue de 46 (18-84) años. La media de tiempo desde el diagnóstico de la infección fue de 11,7 ± 8,9 años. El 61,9 por ciento tenían enfermedad inactiva sin fibrosis hepática o fibrosis ligera. Solamente el 2 por ciento eran negativos para el antígeno de superficie de la hepatitis B con el DNA cuantificable del VHB, el 81,4 por ciento tenían carga viral detectable y el 85,5 por ciento recibieron uno o más tratamientos antivirales, principalmente los análogos del nucleótido/sido. Conclusiones: Los pacientes con la infección crónica del VHB estudiados, en su mayoría se encuentran en fase inactiva de su enfermedad, sin evidencia significativa de daño hepático, con niveles detectables de viremia y han recibido algún tratamiento antiviral(AU)

Introduction: The effectiveness of the national immunization program has impacted on the reduction of the incidence of hepatitis B virus (HBV) infection in Cuba; however, the number of chronically infected patients is not negligible. These patients are diagnosed in the clinical practice, although the epidemiological studies that indicate the presence of the disease are insufficient. Objective: To describe the main clinical, biomolecular and immunological characteristics of patients with chronic hepatitis B virus infection treated at the National Institute of Gastroenterology, Havana, Cuba. Materials and methods: A total of 97 patients who had at least a 6-month history of chronic HBV infection were recruited at the above mentioned institution from January 2016 to January 2018. Descriptive statistical analyzes were performed to identify the clinical characteristics. Biochemical and virological studies, analysis of both liver stiffness values measured by transient elastography and use of antiviral therapy were also carried out. Results: All patients completed the follow-up. It was observed that 61,9 percent of them were male and the median (range) age was 46 (18-84) years. The mean time since the diagnosis of the infection was 11.7 ± 8,9 years. Inactive disease without liver fibrosis or light fibrosis was present in 61,9 percent. Only 2 percent were negative for hepatitis B surface antigen with quantitative analysis of HBV DNA; also, 81,4 percent of patients had detectable viral load and 85,5 percent received one or more antiviral treatments, mainly nucleotide analogues. Conclusions: The patients with chronic HBV infection studied are mostly in the inactive phase of their disease, without significant evidence of liver damage and detectable levels of viremia. All of them have received some antiviral treatment(AU)

Humans , Male , Female , Hepatitis B, Chronic/immunology , Hepatitis B, Chronic/epidemiology
Braz. j. infect. dis ; 23(6): 419-426, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1089319


ABSTRACT Introduction: Hepatitis B virus (HBV) is responsible for one of the most common human viral infections. An estimated 257 million people are living with chronic HBV infection worldwide, and mortality has reached 900,000 deaths in recent years. In 2001, the World Health Organization reported a prevalence of chronic hepatitis B infection in Iran between 2-7%. Objective: To assess the effect of the national HBV mass vaccination program after 25 years. Methods: A retrospective cohort study was conducted in vaccinated and unvaccinated people according to the year of birth. Blood samples were obtained from each enrolled person and data about demographic variables, and medical and vaccination history were collected using a standardized questionnaire. Persons were considered uninfected if they were negative for both HBsAg and anti-HBc. Also, Vaccine effectiveness was measured by calculating the risk of disease among vaccinated and unvaccinated persons and defining the percentage risk reduction of infection in the vaccinated group. Results: A total of 2720 persons were interviewed. The rate of HBV breakthrough infection among the vaccinated group was significantly lower than in unvaccinated group. One hundred ninety-four cases with positive HBV markers of infection were identified. The risk ratio of HBV infection was 0.71, 95% CI: 0.54-0.94 (vaccinated/unvaccinated). The estimated vaccination effectiveness against Hepatitis B infection was 29% (95% CI: 6%-46%). Conclusions: Iran has successfully combined hepatitis B vaccination into regular immunization programs. The WHO goal of reducing HBsAg prevalence to an equivalent of 1% by 2020 has been reached. With respect to vaccination effectiveness and low prevalence of the disease in the country, catch-up hepatitis B vaccination programs for adolescents can guarantee the immunity of the population.

Humans , Male , Adolescent , Adult , Middle Aged , Young Adult , Vaccination/statistics & numerical data , Hepatitis B Vaccines/administration & dosage , Immunization Programs/statistics & numerical data , Hepatitis B, Chronic/prevention & control , Hepatitis B/prevention & control , Prevalence , Surveys and Questionnaires , Retrospective Studies , Hepatitis B, Chronic/immunology , Hepatitis B, Chronic/epidemiology , Hepatitis B/epidemiology , Iran/epidemiology
Mem. Inst. Oswaldo Cruz ; 114: e190074, 2019. tab, graf
Article in English | LILACS | ID: biblio-1020080


BACKGROUND Hepatitis delta virus (HDV) infections in hepatitis B virus (HBV) carriers are the most severe form of viral hepatitis. HDV prevalence is high in the Brazilian Amazon, but studies in other regions of the country are still scarce and often underestimated its prevalence by including a small numbers of individuals. OBJECTIVE This study aimed to determine the serological prevalence of hepatitis D, the genotypes circulating and to evaluate the associated risk factors for acquisition of HDV in Minas Gerais state, Brazil. METHODS We screened plasma samples (n = 498) from HBV chronic carriers for anti-HD antibodies using a commercial enzyme-linked immunosorbent assay (ELISA) kit. For those samples that were positive for anti-HD antibodies, we performed a reverse transcriptase (RT) nested-polymerase chain reaction (nested-PCR) in order to detect the viral genome and identify the viral genotypes circulating in the state. FINDINGS The prevalence was 6.22% (31/498). Blood transfusion was the only risk factor associated with HDV infection [risk ratio: 3.73; 95% confidence interval (CI): 1.44 to 9.65]. For 26 anti-HD positive patients, HDAg gene sequences were determined and in all patients HDV genotype 1 was found. CONCLUSIONS This study confirmed the circulation of HDV in Minas Gerais, an area previously considered non-endemic for hepatitis D in Brazil. The prevalence found in this study is much higher when compared to other studies performed in Brazil, probably because the population in our study was selected with minimal bias. Furthermore, in 26 anti-HD positive plasma samples, we were also able to detect the viral genome, indicating that these patients were experienced an active infection at the time of sample collection. These findings emphasise the importance of anti-HD testing in HBV infected individuals, which may contribute to this disease control in Brazil.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , RNA, Viral/genetics , Hepatitis Antibodies/blood , Polymerase Chain Reaction , Hepatitis B, Chronic/epidemiology , Hepatitis B/complications , Brazil , Genotype
Braz. j. infect. dis ; 22(4): 294-304, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-974222


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.

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
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
Braz. j. infect. dis ; 20(4): 330-334, July-Aug. 2016. tab, graf
Article in English | LILACS | ID: biblio-828129


Abstract Introduction Worldwide about 30% of HIV-infected patients are coinfected with HCV or HBV. The HIV/HCV coinfection is more common in individuals who have a history of drug addiction. The aims of this study were to assess the HCV and HBV prevalence in HIV-infected patients and analyze their characteristics. Methods We considered the new HIV diagnoses notified by the regional surveillance system of Tuscany from 2009 to 2013. Descriptive analyses were conducted on the socio-demographic characteristics, routes of transmission, and reason to perform the test. In coinfected patients we assessed the risk for being late presenter (LP) or the risk of having AIDS. Results In 5 years of surveillance a total of 1354 new HIV diagnoses were notified: 1188 (87.7%) were HIV alone, 106 (7.8%) HIV/HCV, 56 (4.1%) HIV/HBV, and 4 (0.33%) HIV/HCV/HBV. The main risk factor was injection drug use in 52.8% of HCV/HIV cases, while in HIV/HBV patients the main risk factor was sexual exposure. HIV/HBV coinfected patients showed worse clinical and immunological features than HIV and HIV/HCV patients: 78.6% had CD4 count less than 350 mm−3 (vs. 54.6% and 62.1%, respectively) and 39.4% had AIDS (vs 20.7% and 7.6%). The risk for being LP triples for HIV/HBV (OR 2.98; 95% IC: 1.56–5.70) than patients with HIV alone. Conclusions We have observed less advanced disease in HIV and HCV-HIV patients compared with HBV–HIV coinfected patients. Moreover, our results show a higher prevalence of HIV/HCV among drug addicts and in the age-group 35–59, corresponding to those born in years considered most at risk for addiction. This study also confirms the finding of a less advanced HIV disease in HIV/HCV coinfected patients.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , HIV Infections/epidemiology , Hepatitis B, Chronic/epidemiology , Hepatitis C, Chronic/epidemiology , Coinfection/epidemiology , Prevalence , Risk Factors , Italy/epidemiology
An. bras. dermatol ; 90(6): 828-835, Nov.-Dec. 2015. tab
Article in English | LILACS | ID: lil-769523


Abstract: BACKGROUND: Extrahepatic manifestations are seen in association with chronic infection by hepatitis B or C virus including cutaneous disorders. The frequency of these findings seems to vary among different places and reports. There is a lack of information about this issue in Brazil. OBJECTIVES: To estimate the prevalence of cutaneous findings affecting HBV or HCV carriers from a reference outpatient unit in Mato Grosso. METHODS: A cross-sectional observational study. RESULTS: 108 patients were studied. 88.9% presented some cutaneous findings but must of them were nonrelated to chronic viral infection. Four patients had cutaneous or autoimmune syndromes that may be HBV or HCV related. CONCLUSION: In our study we found no statistical association between viral hepatitis and skin diseases.

Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/epidemiology , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/epidemiology , Skin Diseases, Viral/epidemiology , Skin Diseases, Viral/etiology , Antiviral Agents/adverse effects , Brazil/epidemiology , Cross-Sectional Studies , Hepatitis B, Chronic/drug therapy , Hepatitis C, Chronic/drug therapy , Prevalence , Risk Factors
Braz. j. med. biol. res ; 47(11): 990-994, 11/2014. tab, graf
Article in English | LILACS | ID: lil-723905


Estimates of occult hepatitis B virus (HBV) infection prevalence varies among different studies depending on the prevalence of HBV infection in the study population and on the sensitivity of the assay used to detect HBV DNA. We investigated the prevalence of occult HBV infection in cirrhotic patients undergoing liver transplantation in a Brazilian referral center. Frozen liver samples from 68 adults were analyzed using a nested polymerase chain reaction assay for HBV DNA. The specificity of the amplified HBV sequences was confirmed by direct sequencing of the amplicons. The patient population comprised 49 (72.1%) males and 19 (27.9%) females with a median age of 53 years (range=18-67 years). Occult HBV infection was diagnosed in three (4.4%) patients. The etiologies of the underlying chronic liver disease in these cases were alcohol abuse, HBV infection, and cryptogenic cirrhosis. Two of the patients with cryptic HBV infection also presented hepatocellular carcinoma. Markers of previous HBV infection were available in two patients with occult HBV infection and were negative in both. In conclusion, using a sensitive nested polymerase chain reaction assay to detect HBV DNA in frozen liver tissue, we found a low prevalence of occult HBV infection in cirrhotic patients undergoing liver transplant, probably due to the low prevalence of HBV infection in our population.

Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , DNA, Viral/isolation & purification , Hepatitis B virus/isolation & purification , Hepatitis B, Chronic/epidemiology , Liver Transplantation , Liver Cirrhosis/virology , Asymptomatic Infections/epidemiology , Biomarkers , Brazil/epidemiology , Carcinoma, Hepatocellular/complications , Hepatitis B virus/genetics , Hepatitis B, Chronic/complications , Hepatitis, Chronic/complications , Hepatitis, Chronic/epidemiology , Liver Neoplasms/complications , Polymerase Chain Reaction , Prevalence , Tertiary Care Centers
Rev. Soc. Bras. Med. Trop ; 47(5): 552-558, Sep-Oct/2014. tab
Article in English | LILACS | ID: lil-728894


Introduction Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections are two of the world's most important infectious diseases. Our objective was to determine the hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) prevalences among adult HIV-infected patients and identify the associations between socio-demographic variables and these HBV infection markers. Methods This study was performed from October 2012 to March 2013. Three hundred HIV-seropositive patients were monitored by the Clinical Analysis Laboratory of Professor Polydoro Ernani de São Thiago University Hospital, Santa Catarina, Brazil. The blood tests included HBsAg, anti-HBc immunoglobulin M (IgM) and total anti-HBc. Patients reported their HIV viral loads and CD4+ T-cell counts using a questionnaire designed to collect sociodemographic data. Results The mean patient age was 44.6 years, the mean CD4 T-cell count was 525/mm3, the mean time since beginning antiretroviral therapy was 7.6 years, and the mean time since HIV diagnosis was 9.6 years. The overall prevalences of HBsAg and total anti-HBc were 2.3% and 29.3%, respectively. Among the individuals analyzed, 0.3% were positive for HBsAg, 27.3% were positive for total anti-HBc, and 2.0% were positive either for HBsAg or total anti-HBc and were classified as chronically HBV-infected. Furthermore, 70.3% of the patients were classified as never having been infected. Male gender, age >40 years and Caucasian ethnicity were associated with an anti-HBc positive test. Conclusions The results showed an intermediate prevalence of HBsAg among the studied patients. Moreover, the associations between the anti-HBc marker and socio-demographic factors suggest a need for HBV immunization among these HIV-positive individuals, who are likely to have HIV/HBV coinfection. .

Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , HIV Infections/epidemiology , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/immunology , Hepatitis B, Chronic/epidemiology , Biomarkers/blood , Brazil/epidemiology , Coinfection , Cross-Sectional Studies , HIV Infections/complications , HIV Infections/diagnosis , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/diagnosis , Prevalence , Risk Factors , Socioeconomic Factors , Viral Load
Mem. Inst. Oswaldo Cruz ; 109(6): 728-737, 09/09/2014. tab
Article in English | LILACS | ID: lil-723991


Studies on the prevalence of infection with hepatitis B virus (HBV) among children are scarce in Latin American countries, especially in Mexico. This study was aimed to investigate the prevalence of HBV infection, occult hepatitis B infection (OBI) and HBV genotypes among children with clinical hepatitis. In total, 215 children with clinical hepatitis were evaluated for HBV infection. HBV serological markers and HBV DNA were analysed. OBI diagnosis and HBV genotyping was performed. HBV infection was found in 11.2% of children with clinical hepatitis. Among these HBV DNA positive-infected children, OBI was identified in 87.5% (n = 21/24) of the cases and 12.5% (n = 3/24) were positive for both HBV DNA and hepatitis B surface antigen. OBI was more frequent among children who had not been vaccinated against hepatitis B (p < 0.05) than in those who had been vaccinated. HBV genotype H was prevalent in 71% of the children followed by genotype G (8%) and genotype A (4%). In conclusion, OBI is common among Mexican children with clinical hepatitis and is associated with HBV genotype H. The results show the importance of the molecular diagnosis of HBV infection in Mexican paediatric patients with clinical hepatitis and emphasise the necessity of reinforcing hepatitis B vaccination in children.

Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Asymptomatic Infections/epidemiology , Hepatitis B virus/immunology , Hepatitis B, Chronic/epidemiology , Vaccination/methods , DNA Primers , DNA, Viral/isolation & purification , Genotype , Genotyping Techniques , Hepatitis A/diagnosis , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis B virus/classification , Hepatitis B virus/genetics , Hepatitis B, Chronic/prevention & control , Immunoglobulin M/blood , Mexico/epidemiology , Polymerase Chain Reaction , Prevalence
Rev. bras. epidemiol ; 17(3): 588-599, Jul-Sep/2014. tab, graf
Article in English | LILACS | ID: lil-733201


Objective: To estimate the prevalence of the serological markers anti-HBc, HBsAg and anti-HBs of hepatitis B and anti-HCV of hepatitis C among children and teenagers enrolled at daycare facilities, kindergartens and municipal elementary education network in the city of Santos, São Paulo, Brazil. Methods: A cross-sectional study was carried out from June 28 to December 14, 2007, in which 4,680 finger-prick blood samples were collected from children and teenagers. A survey questionnaire was applied to their family members. The sample was dimensioned using the software Epi Info version 6 with expected frequency of 1%, acceptable error of 0.5% and confidence interval of 95%. The serological tests were performed using the ELISA technique. The molecular analysis was performed using the technique of polymerase chain reaction in House. Results: Age of the studied population ranged from 7 months to 18 years and 1 month. The general prevalence of anti-HBc reagent was 0.1%, HBsAg was 0.02% and anti-HCV was 0.02%. Conclusions: In children, the general prevalence of serological markers for hepatitis B and C in the city of Santos was low when compared with literature data. .

Objetivo: Estimar a prevalência de marcadores sorológicos anti-HBc, AgHBs e anti-HBs da hepatites B e anti-HCV da hepatite C em crianças e adolescentes matriculados em creches e escolas de ensino infantil e fundamental da rede municipal na cidade de Santos, São Paulo. Métodos: Estudo transversal realizado no período de 28 de junho a 14 de dezembro de 2007, no qual foram coletadas 4.680 amostras de sangue colhidas através de punção capilar. Foi aplicado um questionário nos familiares das crianças e adolescentes. Para o cálculo da amostra, foi utilizado o programa Epi Info versão 6 com frequência esperada de 1%, erro aceitável de 0,5% e nível de confiança de 95%. Os exames sorológicos foram realizados utilizando a técnica de ELISA. O estudo molecular foi realizado pela técnica de reação em cadeia de polimerase in House. Resultados: A idade da população estudada variou de 7 meses a 18 anos e 1 mês. A prevalência geral do anti-HBc reagente foi de 0,1%, do AgHBs foi de 0,02% e do anti-HCV foi de 0,02%. Conclusão: A prevalência geral em crianças dos marcadores sorológicos para hepatites B e C na cidade de Santos foi baixa, quando comparada com os dados de literatura. .

Adolescent , Child , Female , Humans , Male , Hepatitis B, Chronic , Hepatitis C, Chronic , Brazil/epidemiology , Child Day Care Centers , Cross-Sectional Studies , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis B, Chronic/blood , Hepatitis B, Chronic/epidemiology , Hepatitis C Antibodies/blood , Hepatitis C, Chronic/blood , Hepatitis C, Chronic/epidemiology , Urban Health
São Paulo; s.n; 2014. 197 p. ilus, mapas, tab, graf.
Thesis in Portuguese | LILACS | ID: lil-730783


O objetivo principal deste estudo foi avaliar a frequência de cepas do HBV com mutações de resistência aos análogos nucleos(t)ídeos (AN) utilizados no tratamento da hepatite B entre indivíduos cronicamente infectados, não submetidos a tratamento, procedentes de diferentes regiões do Brasil. Além disso, foram avaliadas a presença de mutações que alteram a antigenicidade do HBsAg promovendo escape dos anticorpos anti-HBs; mutações nos genes pré-core/core e a associação dos diferentes subgenótipos com as mutações encontradas e características demográficas e laboratoriais dos pacientes. Foram incluídas 779 amostras de soro de pacientes com infecção crônica pelo HBV e virgens de tratamento com AN ou interferon, as quais foram coletadas no período de 2006 a 2011. Os pacientes eram procedentes dos seguintes estados brasileiros: Pará, Maranhão, Bahia, Minas Gerais, São Paulo, Paraná e Rio Grande do Sul. O DNA do HBV foi extraído das amostras de soro utilizando o Kit QIAamp DNA Blood Mini Kit (Qiagen) e posteriormente foi realizada a amplificação das regiões S/polimerase (S/P) e pré-core/core (PCC) do genoma viral por nested PCR. O fragmento amplificado foi submetido a sequenciamento direto em sequenciador automático de DNA (ABI 3500) e as sequências obtidas foram analisadas para identificação dos genótipos e subgenótipos do HBV, pesquisa de mutações na polimerase, no HBsAg e nos genes pré-core/core. A região S/Pol foi amplificada e sequenciada com sucesso em 702 amostras, as quais foram incluídas para atender aos objetivos deste estudo. Entre as 702 amostras analisadas sete genótipos e 12 subgenótipos do HBV foram identificados. O subgenótipo A1 foi o mais frequente (63,7%, 447/702), seguido pelo HBV/D3 (14,5%, 102/702). Os demais genótipos e subgenótipos encontrados e suas frequências foram as seguintes: A2 (3,3%, 23/702), A3 (0,1%, 1/702), B1 (0,1%, 1/702), B2 (0,1%, 1/702), C2 (0,9%, 6/702), D1 (0,9%, 6/702), D2 (4,6%, 32/702), D4 (5,1%, 36/702), D com...

The main aim of this study was to evaluate the frequency of HBV strains harboring mutations that confer resistance to nucleos(t)ide analogues (NA) used to hepatitis B treatment among treatment-naïve patients with chronic hepatitis B from different Brazilian region. Furthermore, we evaluated the presence of mutations that alter the antigenicity of HBsAg causing anti-HBs escape; mutations in genes pre-core/core and the association of different subgenotypes with the mutations detected and demographic and laboratory characteristics of the patients. Serum samples from 779 treatment-naïve patients with chronic HBV infection were included in this study. The samples were collected between 2006 to 2011 and the patients were from the following states: Pará, Maranhão, Bahia, Minas Gerais, São Paulo, Paraná and Rio Grande do Sul. HBV DNA was extracted from serum samples using the QIAamp DNA Blood Mini Kit (Qiagen) and amplification of S/polymerase (S/Pol) and pre-core/core (PCC) regions were performed by nested PCR. The amplified PCR products were submitted to sequencing in an automatic DNA sequencer (ABI 3500). The sequences obtained were analyzed to classify HBV genotypes/subgenotypes and to analyze the presence of mutations. S/Pol region was amplified and sequenced successfully from 702 samples, which were included in this study. Among these 702 samples, seven genotypes and 12 subgenotypes have been identified. HBV subgenotype A1 was the most frequent (63.7%, 447/702), followed by HBV/D3 (14.5%; 102/ 702). The remaining genotypes and subgenotypes identified and their frequencies were as follows: A2 (3.3%, 23/702), A3 (0.1%, 1/702), B1 (0.1%, 1/702), B2 (0.1%, 1/702), C2 (0.9%, 6/702), D1 (0.9%, 6/702), D2 (4.6%, 32/702), D4 (5.1%, 36/702), D unclassified subgenotype (0.7%, 5/702), E (0.6%, 4/702), F2a (4.6%, 32/702), F4 (0.4%, 3/702), and G (0.4%, 3/702). HBV strains harboring mutations conferring NA resistance alone (rtS202G, rtM204V/I, rtA194T,...

Humans , Male , Female , Antiviral Agents , Drug Resistance , Genotype , Hepatitis B virus , Hepatitis B, Chronic/epidemiology , Mutation , Pathology, Molecular
Braz. j. microbiol ; 44(4): 1237-1240, Oct.-Dec. 2013. tab
Article in English | LILACS | ID: lil-705293


Chronic viral hepatitis are main public health problems worldwide. Data about the seroprevalence to Hepatitis B and C viruses (HBV e HCV) at the population level are scarce on Brazil and especially for the Southern region of the country. The seroprevalence to HBV and HBC antigens was evaluated on a large portion of the population of the municipality of Caxias do Sul (427,858 inhabitants), Brazil. A total of 60,604 individual serum samples collected from 2008 to 2011 were screened for HBV surface antigen (HBsAg) and for antibodies against HBsAg; anti HCV antibodies were measured by ELISA (Enzyme Linked Immunosorbent Assay). Overall, 1.63% of the individuals were positive for HBsAg and 1.43% showed seropositivity to HCV. From the total, 31,749 samples were analyzed for HBsAg and 28,855 for HCV. For HBsAg, 519 samples showed positive (1.63%) while the results for 37 patients (0.12%) remained inconclusive. For the anti-HCV test, 412 individuals (1.43%) showed positive. From the positive samples for HBsAg 216 (50.6%) were from male individuals whereas for anti-HCV the seroprevalence was slightly higher for females 216 (52.4%). The higher prevalence for both hepatitis viruses were found among individuals at the age group of 40 to 59 years and the lower levels of positivity for both HBV and HBC were among children and teenagers.

Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Hepatitis B, Chronic/epidemiology , Hepatitis C, Chronic/epidemiology , Brazil/epidemiology , Cities , Cross-Sectional Studies , Demography , Enzyme-Linked Immunosorbent Assay , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis C Antibodies/blood , Seroepidemiologic Studies
Acta gastroenterol. latinoam ; 43(1): 16-21, 2013 Mar.
Article in Spanish | LILACS, BINACIS | ID: biblio-1157353


Several studies have demonstrated that viral load is a key factor to determine the development of HBV infection and to assess treatment options for the disease. There is a lack of studies analyzing viral load levels in chronic hepatitis B patients in Argentina and the epidemiologic information is limited. The aim of this study was to determine viral load levels and its distribution in patients diagnosed with chronic hepatitis B from geographical areas with high prevalence for HBV in Argentina. Fifty-one per cent of the study population had HBV DNA levels > or = 10(4) copies/ml and a median viral load of 11,910 copies/ml. The viral load was significantly higher in HBeAg seropositive patients compared with those seronegative for HBeAg (P < 0.05). Salta and Entre Ríos provinces showed low viral loads, while Chaco, Misiones and Formosa provinces had a median viral load ranging between 10(4) and 10(5) copies/ ml. This is the first study providing detailed information on viral load in chronic hepatitis B patients from Argentina. Availability of viral load levels in chronic hepatitis B enables evaluation of implementation of actions to analyze follow-up and/or treatment options for preventing disease complications, improving health care and diminishing the potential burden on the health care system.

Viral Load , Hepatitis B, Chronic/virology , Hepatitis B virus , Adult , Young Adult , Alanine Transaminase/blood , Hepatitis B e Antigens/blood , Argentina/epidemiology , Aspartate Aminotransferases/blood , DNA, Viral/analysis , Female , Hepatitis B, Chronic/epidemiology , Hepatitis B, Chronic/blood , Humans , Male , Prevalence , Hepatitis B virus/immunology
Botucatu; s.n; 2013. 92 p. ilus.
Thesis in Portuguese | LILACS | ID: lil-756922


A Organização Mundial de Saúde (OMS) define como idoso todo indivíduo com mais de 60 anos de idade. Atualmente no Brasil os idosos são aproximadamente 15 milhões de pessoas e apesar de viverem mais, apresentam maiores condições crônicas devido ao declínio da maioria das funções orgânicas, inclusive do sistema imunológico, aumentando a susceptibilidade e a maior incidência de doenças infecciosas. As hepatites virais tem distribuição mundial e são doenças infecciosas que apresentam características epidemiológicas, clínicas e laboratoriais distintas. Há uma estimativa de que 350 milhões de pessoas sejam portadores crônicos do vírus da hepatite B (VHB) ao redor do mundo e, embora menos prevalente que a hepatite B, o vírus da hepatite C (VHC) é a causa mais comum de hepatite crônica com cerca de 180 milhões de indivíduos infectados. Embora os conhecimentos a respeito da patogênese, curso e tratamento das hepatites virais crônicas tenham avançado nos últimos anos, há ainda pouco conhecimento sobre seu curso e tratamento na população idosa, especialmente no Brasil, justificando a relevância deste estudo, cujo objetivo geral é avaliar a prevalência de hepatites virais crônicas B e C na população idosa residente no município de Botucatu-SP. Foi realizado com 1029 idosos cadastrados na UNIMED, nas Unidades Básicas de Saúde, Unidades de Saúde da Família, participantes de Centros de Convivência de Terceira Idade e residentes em instituições de longa permanência. Os voluntários, após assinarem o Termo de Consentimento Livre e Esclarecido (TCLE), foram submetidas a testes sorológicos para detecção do Anti-HBs, AgHbs e Anti HBc IgG, onde foram coletados 5ml de sangue através de punção venosa com seringa e agulha descartáveis. Para detecção do anti-VHC foram realizados testes sorológicos digitais (HCV Rapid Test Bioeasy®)...

The World Health Organization (WHO) defines as elderly any person aged over 60 years old. Currently in Brazil the elderly are approximately 15 million people and although they live longer have more chronic conditions due to decline in most physiological functions, including immune system, increasing susceptibility and a higher incidence of infectious diseases. Viral hepatitis has a worldwide distribution and are infectious diseases that present epidemiological, clinical and laboratory differences. It is estimated that 350 million people are chronic carriers of hepatitis B virus (HBV) worldwide and, although less prevalent than hepatitis B, hepatitis C virus (HCV) is the most common cause of chronic hepatitis with about 180 million infected individuals. While the knowledge about the pathogenesis, course and treatment of chronic viral hepatitis have advanced in recent years, there is still little knowledge about their course and treatment in the elderly population, especially in Brazil, justifying the relevance of this study, whose general objective is to evaluate the prevalence of chronic viral hepatitis B and C in the elderly population living in Botucatu-SP. Was held with 1029 elderly enrolled in Basic Health Units, the Family Health Units, participants of Social Centers for Seniors and residents of long-term institutions. The volunteers, after having signed an informed consent (IC), were submitted for serological tests for the detection of anti-HBs, HBsAg and Anti HBc IgG, where 5 ml of blood were collected by venipuncture with syringe and disposable needle. For detection of anti-HCV digital serological tests were done (HCV Rapid Test Bioeasy®). Mean age was 72.01 years (± 8.19 years). The prevalence of HBsAg positive with elderly was 0,58% and of these, all showed results for HBeAg negative characterizing inactive chronic disease...

Humans , Male , Female , Aged , Aged, 80 and over , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/epidemiology , Hepatitis C, Chronic/diagnosis , Hepatitis C, Chronic/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors
Acta Medica Iranica. 2012; 50 (4): 265-272
in English | IMEMR | ID: emr-132338


This study was designed to determine the correlation of hepatitis B virus surface Ag [HBsAg] variations with the clinical/serological pictures among chronic HBsAg positive patients. The surface gene [S-gene] was amplified and directly sequenced in twenty-five patients. Eight samples [group I] contained at least one mutation at the amino acid level. Five showed alanine aminotransferase [ALT] levels above the normal range of which only one sample was anti-HBe positive. Group II [17 samples] did not contain any mutation, 4 were anti-HBe positive and 9 had increased ALT levels. In both groups, from a total of 18 mutations, 5 [27.5%] and 13 [72.5%] occurred in anti-HBe and HBeAg positive groups respectively. The small number of amino acid mutations might belong to either the initial phase of chronicity in our patients; or that even in anti-HBe positive phase in Iranian genotype D-infected patients, a somehow tolerant pattern due to the host genetic factors may be responsible

Humans , Male , Female , Prevalence , Hepatitis B, Chronic/epidemiology , Hepatitis B/epidemiology
Article in English | WPRIM | ID: wpr-28122


Because Mongolia has much higher liver disease burden than any other regions of the world, it is necessary to provide information on real-time situation of chronic liver disease in Mongolia. In this article, we reviewed studies performed in Mongolia from 2000 to 2011 on seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among healthy individuals and patients with chronic liver diseases, and on the practice patterns for the management of liver cirrhosis and hepatocellular carcinoma (HCC). According to previous reports, the seroprevalence of HBV and HCV in general population in Mongolia is very high (11.8% and 15% for HBV and HCV, respectively). Liver cirrhosis is also highly prevalent, and mortality from liver cirrhosis remained high for the past decade (about 30 deaths per 100,000 populations per year). Among patients with cirrhosis, 40% and 39% are positive for HBsAg and anti-HCV, respectively, and 20% are positive for both. The seroprevalence is similar for HCC and more than 90% of HCC patients are positive for either HBV or HCV. The incidence of HCC in Mongolia is currently among the highest in the world. The mortality from HCC is also very high (52.2 deaths per 100,000 persons per year in 2010). Partly due to the lack of established surveillance systems, most cases of HCC are diagnosed at an advanced stage. The mortality from liver cirrhosis and HCC in Mongolia may be reduced by implementation of antiviral therapy program and control of alcohol consumption.

Carcinoma, Hepatocellular/blood , Hepatitis B, Chronic/epidemiology , Hepatitis C, Chronic/epidemiology , Humans , Liver Cirrhosis/epidemiology , Liver Diseases/blood , Liver Neoplasms/blood , Mongolia/epidemiology , Prevalence , Prognosis , Risk Assessment , Risk Factors , Seroepidemiologic Studies , Time Factors
GEN ; 65(4): 303-309, dic. 2011. ilus
Article in Spanish | LILACS | ID: lil-664164


La hepatitis B crónica constituye un problema de salud pública a nivel mundial y la población pediátrica no se encuentra excluida de este problema. El objetivo fue evaluar la epidemiología de esta patología en pacientes pediátricos en Venezuela y la respuesta de estos pacientes a las diferentes opciones terapéuticas que disponemos. Se realizó estudio multicéntrico y retrospectivo. Se incluyeron todos los pacientes pediátricos con infección crónica por virus B que consultan a diferentes consultas de Gastroenterología Pediátrica en el país. De 15537 pacientes pediátricos que acudieron a consultas de Gastroenterología pediátricas de diferentes centros hospitalarios encontramos 148 pacientes con hepatitis B crónica dado por persistencia Ags VHB positivo por más de 6 meses que representan el 1% de los pacientes evaluados. De los 148 pacientes 111 (75%) pertenecen al sexo masculino y 37 (25%) al sexo femenino, en edades comprendidas desde 1 año hasta 18 años con promedio de 11,25 años y un tiempo de seguimiento comprendido de entre 3 meses y 14 años con un promedio de 4,45 años. Se evaluaron las formas de transmisión para la adquisición de la infección crónica por VHB entre las que tenemos 65 pacientes (44%) habían tenido patologías oncológicas, 3 (2%) patologías hematológicas, antecedentes intervenciones quirúrgicas 3 (2%), transmisión vertical 11 (7%), transmisión horizontal 4 (3%), insuficiencia renal crónica 2 (1,3%), cardiópatas 1 (0,7%) y se desconoce la causa en 59 (40%). De los 148 pacientes 72 (49%) son portadores activos dado por Ags VHB positivo, Age VHB positivo y ADN VHB positivo. De los 72 pacientes portadores activos 44 (61%) tenían aminotranferasas normales y 28 (39%) tenían aminotranferasas elevadas, 34 (47%) tenían carga viral para VHB mayor de 20000 UI/ ml y 38 (53%) carga viral entre 2000 a 20000 UI/ml. De los 72 pacientes portadores activos se les realizó biopsia hepática a 55 pacientes de los cuales 52 tenían hallazgos de infección...

Chronic hepatitis B represents a major public health problem world wide and pediatric population is not excluded from this reality. We aimed to assess the epidemiology of this disease in pediatric patients in Venezuela and the response of these patients to different treatment options available. A retrospective and multicenter study was conducted. We included all pediatric patients with chronic infection by virus B who were evaluated in different Pediatric Gastroenterology Units all over the the country. Out of 15537 pediatric patients attending Pediatric Gastroenterology Units in different hospitals, 148 resulted with the diagnosis of chronic hepatitis B given by a positive and persistent Ags HBV for more than 6 months. This represented 1% of all patients evaluated. Of all 148 patients, 111 (75%) were male and 37 (25%) female, aged from 1 year up to 18 years (average 11,25 years). The follow-up period ranged from 3 months to 14 years (average 4.45 years). Most frecuent transmission of HBV infection was related to onchological pathologies in 65 patients (44%), hematologic diseases in 3 (2%), surgery 3 (2%), vertical transmission 11 (7%), horizontal transmission 4 (3%), chronic renal insufficiency 2 (1.3%), cardiopathy 1 (0.7%) and unknown cause in 59 (40%). 72 patients (49%) were considered active carriers with positives Ags HBV, Age HBV and HBV DNA. Out of these 72 patients, 44 (61%) had normal aminotranferases and 28 (39%) had high levels of aminotransferases, 34 (47%) had viral load over 20000 UI/ml and 38 (53%) viral load between 2000 and 20000 UI/ml. 55 patients underwent liver biopsy: 52 had findings of chronic HBV infection, 17 (31%) had fibrosis, 1 featured cirrhosis and 3 (2% of the total number of patients) had no liver injury by HBV. This was considered the group of inmunotolerants. 52 patients were treated. 1 patient received Lamivudine with a positive response, 12 patients received monotherapy with Pegylated Interferon (7 patients responded)...

Humans , Male , Female , Child , Hepatitis B, Chronic/epidemiology , Hepatitis B, Chronic/pathology , Hepatitis B, Chronic/therapy , Gastroenterology , Pediatrics
Rev. Soc. Bras. Med. Trop ; 44(1): 13-17, Jan.-Feb. 2011. graf, tab
Article in English | LILACS | ID: lil-579823


INTRODUCTION: Hepatitis B is common in Brazil, although there are regional differences regarding the degree of endemicity, the most frequent forms of transmission and the presence of different evolutive stages of chronic disease. The present study aimed to determine the clinical, demographic and epidemiological characteristics of patients chronically infected with hepatitis B virus (HBV) residing in the Ribeirão Preto region, southeastern Brazil. METHODS: A total of 529 medical records of individuals with HBV monoinfection were reviewed. RESULTS: More than 60 percent of the subjects were males, with a mean age of 38 years-old. The HBeAg-negative serological pattern was verified in 84.4 percent of the patients, among whom the risk of vertical/intrafamily transmission was 43.2 percent (p = 0.02). The consumption of alcohol in amounts exceeding 20g a day was observed in 21.3 percent of the subjects and was more frequent among men (33 percent) (p < 0.001). Among patients with cirrhosis, 54.1 percent were alcohol abusers (p = 0.04), all of them males. The presence of cirrhosis was more frequent in the HBeAg-positive group (24.4 percent) than in the HBeAg-negative group (10.2 percent) (p < 0.001). CONCLUSIONS: High proportions of HBV-infected subjects with an HBeAg-negative pattern were observed, with a higher risk of vertical/intrafamily transmission. Alcohol abuse was associated with male subjects and with cirrhosis of the liver in this group. A tendency toward an increase in the number of HBeAg-negative cases was observed over time.

INTRODUÇÃO: No Brasil, a hepatite B é comum. No entanto, há diferenças regionais no que diz respeito ao grau de endemicidade, as formas de transmissão mais encontradas e a presença dos diferentes estágios evolutivos da doença crônica. O objetivo deste trabalho foi o de conhecer características clínicas, demográficas e epidemiológicas de pacientes cronicamente infectados pelo vírus da hepatite B (HBV), residentes na região de Ribeirão Preto, no sudeste do Brasil. MÉTODOS: Foi realizada a análise retrospectiva de 529 prontuários de indivíduos com monoinfecção pelo HBV. RESULTADOS: Mais de 60 por cento eram masculinos, a média de idade foi de 38 anos. O padrão sorológico HBeAg negativo foi encontrado em 84,4 por cento dos pacientes, entre os quais o risco para transmissão vertical/intrafamiliar foi de 43,2 por cento (p = 0,02). Verificou-se uso de álcool em quantidades maiores que 20g ao dia em 21,3 por cento dos indivíduos, sendo mais frequente entre os homens (33 por cento) (p < 0,001). Entre os pacientes com cirrose, 54,1 por cento faziam uso abusivo de bebidas alcoólicas (p = 0,04), sendo todos estes do gênero masculino. A presença de cirrose foi maior no grupo HBeAg positivo (24,4 por cento) que no grupo HBeAg negativo (10,2 por cento) (p < 0,001). CONCLUSÕES: Observaram-se elevadas proporções de indivíduos com infecção pelo HBV com padrão sorológico HBeAg negativo, entre os quais houve maior risco para a transmissão vertical/intrafamiliar. O uso abusivo de álcool esteve associado a indivíduos do sexo masculino e, neste grupo, à cirrose hepática. Observou-se tendência ao aumento no número de casos HBeAg negativo ao longo do tempo.

Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Hepatitis B Antibodies/blood , Hepatitis B e Antigens/blood , Hepatitis B virus/immunology , Hepatitis B, Chronic/epidemiology , Alcoholism/complications , Alcoholism/epidemiology , Brazil/epidemiology , DNA, Viral/analysis , Hospitals, University , Hepatitis B virus/genetics , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/transmission , Liver Cirrhosis/epidemiology , Liver Cirrhosis/virology , Retrospective Studies , Risk Factors