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1.
Arq. gastroenterol ; 58(2): 150-156, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285316

ABSTRACT

ABSTRACT BACKGROUND: Viral hepatitis is a global phenomenon, with the disease burden varying on a daily basis. Amongst chronic infections, hepatitis B virus and hepatitis C virus (HCV) are egregiously linked to severe health-related complications, with a worldwide prevalence of 248 million and 71 million respectively. Amongst the developing world, a hand full of countries are exhibiting a gross decline in chronic viral infection prevalence, like Bangladesh. While countries such as India have a consistent prevalence, Pakistan bears one of the largest proportions of chronic viral hepatitis globally with increasing trends shown year-by-year. Various old literature texts have stated an approximate national prevalence rate around 2.6% and 5.3% of hepatitis B and C respectively. OBJECTIVE: The objective of this study was to determine the current seroprevalence rates of chronic viral hepatitis amongst the general population of rural Sindh using a screening program to determine the current disease burden. METHODS: An observational, cross-sectional survey based on a screening program was conducted in 5 districts with a combined population of over 6.5 million. The screening was carried out via the administration of various camps with the assistance of local social workers and welfare organizations. A total of 24,322 individuals met the inclusion criteria and were screened through (HBsAg/HCV) rapid test cassette (WC) Imu-Med one-step diagnostic test. RESULTS: Hepatitis B was found positive in 964 (3.96%) individuals including 421 (43.67%) males and 543 (56.32%) females, while hepatitis C was positive in 2872 (11.80%) individuals including 1474 (51.32%) males and 1398 (48.67%) females. The prevalence amongst the districts varied between 0.97% and 9.06% for hepatitis B, and 1.61% and 29.50% for hepatitis C, respectively. Umerkot was found to be the most prevalent district amongst rural Sindh, while Badin had the least number of seropositive people. The second most prevalent district of the study population was found to be Tando Allahyar followed by Mirpur Khas. The combined seroprevalence of 15.76% was calculated for hepatitis B and C together amongst the five studied districts of rural and peri-urban Sindh. CONCLUSION: The alarmingly high prevalence rates revealed in our study warrant the urgent need to generate multiple effective strategies in the region to enhance awareness amongst the general population regarding screening, prevention, and prompt treatment of the disease.


RESUMO CONTEXTO: A hepatite viral é um fenômeno global, com a intensidade da doença variando diariamente. Entre as infecções crônicas, o vírus da hepatite B e o vírus da hepatite C (VHC) estão fortemente ligados a complicações graves relacionadas à saúde, com prevalência mundial de 248 milhões e 71 milhões, respectivamente. Entre o mundo em desenvolvimento, uma quantidade de países está exibindo um declínio bruto na prevalência de infecção viral crônica, tal como Bangladesh. Embora países como a Índia tenham uma prevalência consistente, o Paquistão tem uma das maiores proporções globais de hepatite viral crônica, com tendências crescentes mostradas ano a ano. Vários textos da menos recentes têm declarado uma taxa de prevalência nacional aproximada em torno de 2,6% e 5,3% da hepatite B e C, respectivamente. OBJETIVO: O objetivo deste estudo foi determinar as atuais taxas de soroprevalência da hepatite viral crônica entre a população geral do Sindh rural utilizando um programa de triagem para determinar a carga atual da doença. MÉTODOS: Foi realizada uma pesquisa observacional e transversal baseada em um programa de triagem combinada em cinco distritos com população de mais de 6,5 milhões. A triagem foi realizada por meio da administração de diversos acampamentos com o auxílio de assistentes sociais locais e organizações de assistência social. Um total de 24.322 indivíduos atenderam aos critérios de inclusão e foram examinados através do teste rápido (HBsAg/VHC) Imu-Med em uma etapa. RESULTADOS: Hepatite B positiva foi encontrada em 964 (3,96%) indivíduos incluindo 421 (43,67%) homens e 543 (56,32%) mulheres, enquanto hepatite C foi positiva em 2.872 (11,80%) indivíduos incluindo 1.474 (51,32%) homens e 1.398 (48,67%) mulheres. A prevalência entre os distritos variou entre 0,97% e 9,06% para hepatite B, e 1,61% e 29,50% para hepatite C, respectivamente. Umerkot foi encontrado como o distrito mais prevalente entre Sindh rural, enquanto Badin tinha o menor número de pessoas soropositivas. O segundo distrito mais prevalente da população de estudos foi encontrado como Tando Allahyar, seguido por Mirpur Khas. A soroprevalência combinada de 15,76% foi calculada para hepatite B e C em conjunto entre os cinco distritos estudados do Sindh rural e periurbano. CONCLUSÃO: As taxas de prevalência alarmantemente reveladas em nosso estudo justificam a necessidade urgente de gerar múltiplas estratégias efetivas na região para aumentar a conscientização da população em geral sobre rastreamento, prevenção e tratamento rápido da doença.


Subject(s)
Humans , Male , Female , Hepatitis C/diagnosis , Hepatitis C/epidemiology , Hepatitis B/diagnosis , Hepatitis B/epidemiology , Pakistan/epidemiology , Seroepidemiologic Studies , Prevalence , Cross-Sectional Studies
2.
Rev. Soc. Bras. Med. Trop ; 54(supl.1): e2020834, 2021. graf
Article in English | LILACS | ID: biblio-1250844

ABSTRACT

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


Subject(s)
Humans , Female , Pregnancy , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/prevention & control , Hepatitis C/diagnosis , Hepatitis C/prevention & control , Hepatitis B/diagnosis , Hepatitis B/prevention & control , Brazil , Infectious Disease Transmission, Vertical/prevention & control
3.
Rev. medica electron ; 42(3): 1850-1861, mayo.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1127046

ABSTRACT

RESUMEN Introducción: la cirrosis es un proceso dinámico y actualmente se conoce que cuando se elimina el agente primario de agresión que ha producido la cirrosis, se puede llegar a remitir la fibrosis. En Cuba la enfermedad representa la décima causa de muerte, con una tendencia ascendente en los últimos 20 años y una tasa de 13,4 por 100 000 habitantes. Objetivo: caracterizar clínica y endoscópicamente a pacientes con diagnóstico de cirrosis hepática. Material y método: se realizó un estudio descriptivo transversal, en el período comprendido entre los años 2017 - 19, donde el universo y la muestra quedaron constituidos por todos los pacientes mayores de 18 años ingresados con diagnóstico de cirrosis hepática. Resultados: predominó el sexo masculino en la sexta década de la vida, siento la principal causa el alcoholismo, caracterizado por manifestaciones generales, que en muchos casos debutan por complicaciones, apareciendo várices esofágicas en el 75 % de los casos, aunque gados I y II de Paquet, dependiente a un diagnóstico precoz de la enfermedad. Conclusiones: el alcoholismo crónico es la causa más frecuente de cirrosis hepática, debuta de forma frecuente por sus complicaciones, aunque el diagnóstico se hace en etapas precoces, con varices esofágicas incipientes (AU).


Summary Introduction: liver cirrhosis is a dynamic process and currently it is known that, when the primary agent of aggression that has produced the cirrhosis is eliminated, the fibrosis could remit. In Cuba, this diseases is the tenth cause of death, with an increasing tendency in the last twenty years and a rate of 13.4 per 100 000 inhabitants. Objective: to characterize, clinically and endoscopically, patients with hepatic cirrhosis diagnosis. Material and methods: a cross-sectional descriptive study was carried out, in the period 2017 - 2019, where the universe and the sample were formed by all the patients aged more than 18 years who entered the hospital with diagnosis of liver cirrhosis. Results: in this paper, male patients in their sixties predominated, being alcoholism the main cause of disease, characterized by general manifestations; patients debuted due to complications, appearing esophageal varices in 75 % of the cases, although Paquet I and II grades, in dependence to a disease precocious diagnosis. Conclusions: the authors concluded that chronic alcoholism is the most frequent cause in hepatic cirrhosis, almost always debuting by its complications, though the diagnosis is made in precocious stages, with emerging esophageal varices (AU).


Subject(s)
Humans , Adolescent , Esophageal and Gastric Varices/complications , Liver Cirrhosis/diagnosis , Ascites/complications , Epidemiology, Descriptive , Cross-Sectional Studies , Hepatitis C/diagnosis , Alcoholism/complications , Endoscopy , Hepatitis B/diagnosis , Liver Cirrhosis/epidemiology
5.
Arq. gastroenterol ; 57(1): 69-73, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1098064

ABSTRACT

ABSTRACT BACKGROUND: Patients with inflammatory bowel disease (IBD) vaccinated for hepatitis B have a low success rate in achieving protective antibody levels. The main factors suggested for this are IBD itself and the use of immunosuppressive drugs. OBJECTIVE: To evaluate the concentration of anti-HBs antibodies and to verify factors associated with the effectiveness of hepatitis B vaccination in patients with IBD. METHODS: This is a prospective, consecutive, observational, descriptive and analytical, non-randomized, qualitative study that evaluated the levels of anti-HBs antibodies in IBD patients at the Interdisciplinary Inflammatory Bowel Disease Clinic of the Family and Community Health Unit of UNIVALI - Itajaí, Santa Catarina. RESULTS: Thirty-six patients were vaccinated against hepatitis B virus (HBV), of which 29 were female. The average age was 46.2 years. Regarding the type of IBD, twenty-four patients had Crohn's disease and the duration of inflammatory bowel disease was 74 months. Fifteen patients were on concomitant immunosuppressive therapy. The effective response rate to HBV vaccine was 72.2%, verified by anti-HBs titration ≥10 UI/L. Statistical analysis revealed a negative response to vaccination in patients with Crohn's disease and immunosuppressive drugs. CONCLUSION: The success rate of HBV immunization in IBD patients is low compared to the general population. Type of disease and use of immunosuppressive drugs appear to influence the vaccine response.


RESUMO CONTEXTO: Os pacientes com doenças inflamatórias intestinais (DII) vacinados para hepatite B possuem baixa taxa de sucesso em alcançar níveis protetores de anticorpos. Os principais fatores sugeridos para isso são a própria DII e o uso de medicamentos imunossupressores. OBJETIVO: Avaliar a titulação de anticorpos anti-HBs e verificar fatores associados a efetividade da vacinação contra hepatite B em pacientes com DII. MÉTODOS: Trata-se de um estudo prospectivo e consecutivo, de caráter observacional, descritivo e analítico, não-randomizado, qualiquantitativo, que avaliou a titulação de anticorpos anti-HBs em pacientes portadores de DII no Ambulatório Interdisciplinar de Doença Inflamatória Intestinal da Unidade de Saúde da Família e Comunitária da UNIVALI - Itajaí, Santa Catarina. RESULTADOS: Trinta e seis pacientes foram vacinados contra o vírus da hepatite B (VHB), destes, 29 eram do sexo feminino. A média de idade foi de 46,2 anos. Em relação ao tipo de DII, 24 pacientes eram portadores de doença de Crohn e o tempo médio de doença inflamatória intestinal encontrado foi de 74 meses. Quinze pacientes estavam em uso de terapia imunossupressora concomitante à vacinação. A taxa de resposta à vacina contra o VHB foi de 72,2%, verificada através de titulação de anti-HBs ≥10 UI/L. A análise estatística revelou uma resposta negativa à vacinação em pacientes em uso de medicamentos imunossupressores e portadores de doença de Crohn. CONCLUSÃO: A taxa de sucesso na imunização contra o VHB em pacientes com DII é baixo quando comparado à população em geral. Tipo de doença e uso de medicamentos imunossupressores parecem desempenhar influência na resposta vacinal.


Subject(s)
Humans , Male , Female , Adult , Colitis, Ulcerative/immunology , Crohn Disease/immunology , Hepatitis B virus/immunology , Hepatitis B Vaccines/immunology , Hepatitis B/diagnosis , Hepatitis B/prevention & control , Hepatitis B Antibodies/blood , Colitis, Ulcerative/drug therapy , Crohn Disease/drug therapy , Prospective Studies , Hepatitis B Vaccines/administration & dosage , Qualitative Research , Seroconversion , Hepatitis B/immunology , Hepatitis B Surface Antigens/immunology , Immunosuppressive Agents/therapeutic use , Middle Aged
7.
Clin. biomed. res ; 40(2): 84-90, 2020. graf
Article in Portuguese | LILACS | ID: biblio-1148444

ABSTRACT

Introdução: A hemoterapia consiste no tratamento terapêutico através da transfusão sanguínea. Considerando à vasta quantidade de doenças infecciosas que podem ser transmitidas pelo sangue, se faz necessária a realização de exames laboratoriais de alta sensibilidade para minimizar os riscos transfusionais aos doadores e receptores. Assim, no estudo foi avaliada a prevalência de marcadores sorológicos para Hepatite B e C em um banco de sangue de Porto Alegre- RS, bem como a correlação entre a sorologia e o teste de amplificação de ácido nucléico (NAT). Métodos: Estudo quantitativo, descritivo e retrospectivo que foi realizado através da análise das informações de todos os doadores de sangue contidas em um banco de dados de um Banco de Sangue de Porto Alegre, Rio Grande do Sul, nos anos de 2017 e 2018, avaliando resultados da sorologia e o teste NAT para hepatite B e Hepatite C. Resultados: Das 17.181 doações de sangue, o total de bolsas sorologicamente reagentes foi 162 (0,94%) reagentes para o Anti-HBc, 20 (0,12%) amostras foram positivas para o HbsAg e 62 (0,36%) reagentes para o Anti-HCV. Apenas 4 (0,02%) amostras foram reagentes simultaneamente para o Anti-HBC e para o HbsAg, as quais foram também positivas no teste NAT. Já o teste NAT nas amostras reagente para Hepatite C, corresponderam a 18 (0,10%). Conclusões: A evolução da biotecnologia vem auxiliando a biossegurança nas transfusões de sangue. Considerando que a implementação do teste NAT é relativamente recente nos bancos de sangue, sugere-se mais estudos com períodos diferentes de tempo para a pesquisa de resultados satisfatórios, além disso, possibilitando elucidar ainda mais os resultados voltados à segurança transfusional e a associação dos testes sorológicos e o teste NAT nos bancos de sangue. (AU)


Introduction: Hemotherapy consists of therapeutic treatment using blood transfusion. Because of the vast amount of bloodborne infectious diseases, highly sensitive laboratory tests must be conducted to minimize the transfusion risks for donors and recipients. Thus, the present study aimed to evaluate the prevalence of hepatitis B and C serological markers in samples from a blood bank in Porto Alegre, southern Brazil, as well as the correlation between serology and nucleic acid amplification testing (NAT). Methods: A quantitative, descriptive, retrospective study was conducted to analyze blood donor information obtained from a blood bank database in Porto Alegre, southern Brazil, concerning 2017 and 2018. Serology and NAT results for hepatitis B and C were examined. Results: Of 17,181 blood donations, the total number of serologically reactive samples was 162 (0.94%) for anti-HBc, 20 (0.12%) for HbsAg, and 62 (0.36%) for anti-HCV. Only 4 (0.02%) samples were simultaneously reactive for anti-HBc and HbsAg, being also positive in NAT. The number of samples reactive to hepatitis C in NAT was 18 (0.10%). Conclusions: Biotechnological evolution has contributed to biosafety in blood transfusions. Considering that NAT is relatively recent in blood banks, further studies using different time periods are suggested for yielding satisfactory results for transfusion safety and elucidating the combination of serological testing and NAT at blood banks. (AU)


Subject(s)
Humans , Serology , Blood Banks/methods , Hepatitis C/diagnosis , Hepatitis B/diagnosis , Communicable Diseases/diagnosis , Retrospective Studies
8.
Mem. Inst. Oswaldo Cruz ; 115: e200006, 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1135222

ABSTRACT

BACKGROUND Occult hepatitis B virus (HBV) - characterized by the absence of detectable HBsAg in the presence of HBV DNA - represents a potential threat for blood safety. OBJECTIVES This study was conducted with the aim to investigate the serological and molecular characterization of occult HBV infection (OBI) among blood donors in Mozambique. METHODS 1,502 blood donors were tested for HBsAg. All HBsAg-negative individuals were tested for HBV DNA. Antibodies against HBV core, surface and HBe antigen (anti-HBc, anti-HBs, HBeAg) were measured in HBV DNA positive individuals. FINDINGS 1435 serum samples were HBsAg negative and 16 positive for HBV DNA, 14 confirmed to have OBI, corresponding to a frequency of 0.98%. Of the 14 OBI infections identified, 13/14 (92.8%) were positive for anti-HBc, 4/14 (28.5%) for anti-HBs, and no samples were reactive for HBeAg. Of the 14 OBI cases, nine samples (64.2%) were sequenced for the S/P region. Eight samples (88.9%) belonged to genotype A1 and one (11.1%) to genotype E. One escape mutation (T123A) associated with OBI and various amino acid substitutions for genotype A1 and E were observed. MAIN CONCLUSIONS Our results show the importance of using nucleic acid amplification test to detect occult hepatitis B infection in blood donors in Mozambique.


Subject(s)
Humans , Male , Female , Adult , Blood Donors , Hepatitis B virus/isolation & purification , Hepatitis B virus/genetics , Nucleic Acid Amplification Techniques/methods , Hepatitis B/diagnosis , Hepatitis B Surface Antigens/genetics , Phylogeny , DNA, Viral , Polymerase Chain Reaction , Cross-Sectional Studies , Mozambique
9.
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
10.
Rev. bras. epidemiol ; 22: e190004, 2019. tab, graf
Article in English | LILACS | ID: biblio-990748

ABSTRACT

ABSTRACT: Introduction: This paper details the methods used in the second national Biological and Behavioral Surveillance Survey (BBSS) of HIV, syphilis, and hepatitis B and C among men who have sex with men in Brazil. Methods: Respondent-driven sampling (RDS) was used in 12 cities in 2016. The targeted sample size was initiated with five to six seeds in each city. HIV, syphilis, and Hepatitis B and C rapid tests were offered to participants. RDS Analyst with Gile's successive sampling (SS) estimator was used to adjust results as recommended and a weight for each individual was generated for further analysis. Data for the 12 cities were merged and analyzed using Stata 14.0 complex survey data tools with each city treated as its own stratum. Results: Duration of data collection varied from 5.9 to 17.6 weeks. 4,176 men were recruited in the 12 cities. Two sites failed to achieve targeted sample size due to a six-month delay in local IRB approval. No city failed to reach convergence in our major outcome variable (HIV). Conclusion: The comprehensive BBSS was completed as planned and on budget. The description of methods here is more detailed than usual, due to new diagnostic tools and requirements of the new STROBE-RDS guidelines.


RESUMO: Introdução: Este artigo detalha os métodos utilizados na segunda Pesquisa Nacional de Vigilância Biológica e Comportamental (BBSS) do HIV, sífilis e hepatite B e C entre os homens que fazem sexo com homens no Brasil. Métodos: O método Respondent-driven Sampling (RDS) foi utilizado em 12 cidades em 2016. A amostra foi iniciada com cinco a seis sementes em cada cidade. Testes rápidos para o HIV, sífilis e Hepatite B e C foram oferecidos aos participantes. O software RDS Analyst com o estimador de amostragem sucessiva (SS) de Gile foi utilizado para ajustar os resultados como recomendado, gerando um peso para cada indivíduo para análises. Osdados das 12cidades foram unidos em um único banco e analisados usando as ferramentas de dados complexos do Stata 14.0, com cada cidade sendo tratada como seu próprio estrato. Resultados: A duração da coleta de dados variou de 5,9 a 17,6 semanas e 4.176 homens foram recrutados nas 12 cidades. Dois sites não alcançaram o tamanho da amostra alvo devido a uma demora de seis meses na aprovação local do Comitê de Ética. Todas as cidades atingiram a convergência na principal variável estudada (HIV). Conclusão: O BBSS foi representativo e concluído conforme planejado e dentro do orçamento. A descrição dos métodos aqui é mais detalhada do que o habitual, devido às novas ferramentas e requisitos de diagnóstico das novas diretrizes do STROBE-RDS.


Subject(s)
Humans , Male , Adult , Syphilis/diagnosis , HIV Infections/diagnosis , Hepatitis C/diagnosis , Homosexuality, Male/statistics & numerical data , Hepatitis B/diagnosis , Brazil/epidemiology , Syphilis/epidemiology , HIV Infections/epidemiology , Population Surveillance , Prevalence , Surveys and Questionnaires , Health Surveys/methods , Hepatitis C/epidemiology , Self Report , Hepatitis B/epidemiology
11.
Article in French | AIM, AIM | ID: biblio-1263860

ABSTRACT

Introduction : la transmission verticale du virus de l'hépatite B (VHB) peut être prévenue par la vaccination et l'administration précoce d'immunoglobuline spécifiques anti-HBs. En Côte d'Ivoire, seule la vaccination est faite à la sixième semaine de vie dans le cadre du programme élargi de vaccination (PEV). L'objectif de ce travail était d'étudier la réponse vaccinale du nouveau-né après vaccination précoce à la naissance. Patients et méthodes : une étude prospective longitudinale à visée descriptive et analytique conduite du 1er octobre 2016 au 31 octobre 2017 au CHU de Cocody. Toutes les parturientes admises en salle d'accouchement du CHU de Cocody, ont été dépistées au VHB. Les nouveau-nés de mères Ag HBs positif, qui ont reçu quatre doses de vaccin contre le VHB ont été inclus. Résultats : pendant la période d'étude 1668 femmes ont été dépistées au VHB. Celles qui étaient positives au VHB étaient 5,57 %. Les nouveau-nés retenus étaient au nombre de 45. Leurs mères avaient une charge virale moyenne de 8 217 417Ul/ml et elles avaient accouché par voie basse dans 76% des cas. Ces nouveau-nés étaient nés à terme (97,8%) et présentaient à neuf mois de vie un taux moyen d'Ac antiHBs de 437,2 UI/ml. Ils étaient immunisés contre le VHB dans 89% des cas. Il avait été noté 2,2 % d'infection. La charge virale élevée chez la mère était statistiquement liée à la non-réponse vaccinale (p=0,010). Conclusion : la vaccination contre le VHB débutée précocement, prévient l'infection périnatale du VHB et confère une immunité contre le VHB


Subject(s)
Academic Medical Centers , Cote d'Ivoire , Disease Management , Hepatitis B/diagnosis , Infant, Newborn
12.
Epidemiol. serv. saúde ; 28(2): e2018408, 2019. tab
Article in English, Portuguese | LILACS | ID: biblio-1019842

ABSTRACT

Objetivo: analisar os fatores sociodemográficos relacionados ao não uso do preservativo nas relações sexuais e a prevalência de infecções sexualmente transmissíveis (IST) em comunidades rurais de Ouro Preto, Minas Gerais, Brasil, entre 2014 e 2016. Métodos: foram coletados dados de entrevista individual e realizados testes rápidos; as associações foram testadas pelo modelo de regressão de Poisson, com intervalo de confiança de 95% (IC95%). Resultados: foram detectados 3,8 casos/10 mil habitantes de hepatite B e sífilis, e 1,3/10 mil hab. de hepatite C; não foram detectados casos de HIV; na análise multivariada, foram encontradas maiores prevalências de não uso de preservativos entre indivíduos casados/em união estável/viúvos (RP=1,20 - IC95% 1,06;1,36). Conclusão: o grupo com maior prevalência de não uso de preservativo é o de pessoas com relacionamento fixo; novos casos de sífilis e de hepatites virais foram detectados pelo teste rápido, aplicado no inquérito.


Objetivo: investigar el perfil sociodemográfico asociado al no uso del preservativo en las relaciones sexuales y describir la prevalencia de infecciones de transmisión sexual (ITS) en comunidades rurales de Ouro Preto, Minas Gerais, Brasil, entre 2014 y 2016. Métodos: se recolectaron datos en entrevista individual y se realizaron pruebas rápidas; las asociaciones fueron analizadas por la regresión de Poisson, con intervalo de confianza de 95% (IC95%). Resultados: se detectaron 3,8 casos/10 mil habitantes de hepatitis B y sífilis, y 1,3/10 mil habitantes de hepatitis C; no se detectaron casos de VIH; el análisis multivariado mostró mayor prevalencia de no uso del preservativo para personas casadas /en unión estable/viudos (RP=1,20 - IC95% 1,06;1,36). Conclusión: se detectaron nuevos casos de sífilis y hepatitis virales por las pruebas rápidas en esta investigación; el grupo de mayor riesgo de no usar preservativo fue de personas casadas/con relación fija.


Objective: to investigate socio-demographic factors associated with non-use of condoms, and to describe the prevalence of sexually transmitted infections (STI) in rural communities of Ouro Preto, Minas Gerais, Brazil, 2014 to 2016. Methods: data were gathered from individual interviews and rapid tests were performed; associations were tested using Poisson regression, with a 95% confidence interval (95%CI). Results: we detected 3.8 cases/10,000 inhabitants for hepatitis B and syphilis, and 1.3 cases/10,000 inhabitants for hepatitis C; no HIV cases were detected; in the multivariate analysis we found higher prevalence rates of condom non-use among the group of individuals who were married, had common law partners or were widowed (PR=1.20 - 95%CI 1.06;1.36). Conclusion: individuals in a stable relationship formed the group with the highest prevalence rate of condom non-use; new syphilis and viral hepatitis cases were detected using rapid tests during the survey.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Syphilis Serodiagnosis , AIDS Serodiagnosis , Syphilis/epidemiology , Sexually Transmitted Diseases/epidemiology , HIV Infections/epidemiology , Hepatitis C/diagnosis , Hepatitis C/epidemiology , Hepatitis B/diagnosis , Hepatitis B/epidemiology , Sexual Behavior/statistics & numerical data , Socioeconomic Factors , Brazil/epidemiology , Serologic Tests/methods , Rural Health/statistics & numerical data , Prevalence , Cross-Sectional Studies , Condoms/trends
13.
Rev. Soc. Bras. Med. Trop ; 51(5): 578-583, Sept.-Oct. 2018. tab
Article in English | LILACS | ID: biblio-957468

ABSTRACT

Abstract INTRODUCTION: Here, we conducted an epidemiological study of hepatitis B virus (HBV) mono-infected and asymptomatic malaria/HBV coinfected immigrants and further discussed the possibility of malaria disease modifying the clinical presentation of HBV infection. METHODS: A total of 195 African immigrants were examined for HBV infection or coinfection with HBV and asymptomatic malaria. HBV infection was diagnosed using serological tests and confirmed by PCR; furthermore, we performed a pan-Plasmodium-specific-nucleic-acid-sequence-based-amplification (NASBA) assay to detect asymptomatic malaria infection. The stage/grade of the liver disease was determined using echotomography and elastometry. RESULTS: PCR-NASBA results confirmed that 62 of 195 subjects (31.8%) were positive for Plasmodium infection, whereas 41 of 195 subjects (21%) tested positive for HBV chronic hepatitis (HBV-DNA positive). Among the HBV-positive subjects, 26 (63.4%) of them were mono-infected patients (Group A), whereas 15 (36.6%) patients had HBV chronic hepatitis and asymptomatic malaria coinfections (Group B). The HBV-DNA median levels were 1.4×105IU/mL in HBV-mono-infected patients and 2.0×105IU/mL in coinfected patients. Echotomography and hepatic elastometry presented similar findings for both groups of patients. CONCLUSIONS: Coinfected patients seem to present with the same clinical symptoms of the liver disease as HBV mono-infected patients.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Emigrants and Immigrants/statistics & numerical data , Asymptomatic Infections/epidemiology , Coinfection/epidemiology , Hepatitis B/epidemiology , Malaria/epidemiology , Cohort Studies , Africa South of the Sahara/ethnology , Hepatitis B/diagnosis , Italy/epidemiology , Malaria/diagnosis
14.
Rev. Soc. Bras. Med. Trop ; 51(2): 198-202, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-1041449

ABSTRACT

Abstract INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Viral Hepatitis Vaccines/administration & dosage , Hepatitis C/epidemiology , Sex Workers/statistics & numerical data , Hepatitis B/epidemiology , Risk-Taking , Socioeconomic Factors , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Viral Hepatitis Vaccines/immunology , Hepatitis B virus/immunology , Prevalence , Hepatitis C/diagnosis , Hepatitis C/prevention & control , Hepacivirus/immunology , Hepatitis B/diagnosis , Hepatitis B/prevention & control , Middle Aged
15.
An. bras. dermatol ; 93(1): 129-132, Jan.-Feb. 2018. graf
Article in English | LILACS | ID: biblio-887149

ABSTRACT

Abstract: Secondary syphilis can have different clinical presentations, with corymbiform rash as its rarest manifestation. The disease is characterized by a central papule surrounded by smaller ones. We report the case of a man who has sex with man with corymbiform syphilis. The patient was subsequently diagnosed with HIV infection, hepatitis B, non-gonococcal urethritis, as well as infection of the central nervous system by treponema. This case not only illustrates a rare presentation of secondary syphilis, but also demonstrates the importance of further investigation of sexually transmitted infections, particularly among at-risk patients.


Subject(s)
Humans , Male , Adult , Syphilis/diagnosis , Sexually Transmitted Diseases/diagnosis , Patient Dropouts , Urethritis/complications , Urethritis/diagnosis , Syphilis/complications , Syphilis/therapy , Sexually Transmitted Diseases/complications , Sexually Transmitted Diseases/therapy , HIV Infections/complications , HIV Infections/diagnosis , Risk Factors , Hepatitis B/complications , Hepatitis B/diagnosis , Anti-Bacterial Agents/therapeutic use
16.
Mem. Inst. Oswaldo Cruz ; 113(1): 62-65, Jan. 2018. tab, graf
Article in English | LILACS | ID: biblio-1040579

ABSTRACT

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


Subject(s)
Humans , Male , Female , Adult , Aged , Saliva/virology , DNA, Viral/analysis , Hepatitis B/diagnosis , Hepatitis B Antibodies/analysis , Hepatitis B Surface Antigens/analysis , DNA, Viral/blood , Hepatitis B virus/isolation & purification , Hepatitis B virus/genetics , Polymerase Chain Reaction , Viral Load , Middle Aged
17.
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
18.
Ann. hepatol ; 16(2): 198-206, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-887223

ABSTRACT

ABSTRACT HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.


Subject(s)
Humans , Adult , Middle Aged , Virus Activation , Lymphoma, Non-Hodgkin/drug therapy , Hodgkin Disease/drug therapy , Hepatitis B virus/pathogenicity , Immunocompromised Host , Hepatitis C/virology , Hepacivirus/pathogenicity , Hepatitis C Antibodies/blood , Rituximab/adverse effects , Hepatitis B/virology , Antineoplastic Agents/adverse effects , Antiviral Agents/administration & dosage , Lymphoma, Non-Hodgkin/immunology , Hodgkin Disease/immunology , Biomarkers/blood , Hepatitis B virus/immunology , Retrospective Studies , Hepatitis C/diagnosis , Hepatitis C/immunology , Hepatitis C/prevention & control , Hepacivirus/immunology , Tertiary Care Centers , Hepatitis B/diagnosis , Hepatitis B/immunology , Hepatitis B/prevention & control , Italy
19.
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
20.
Ann. hepatol ; 16(1): 21-47, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-838084

ABSTRACT

Abstract: Background. Hepatitis B virus infection and chronic kidney disease are prevalent and remain a major public health problem worldwide. It remains unclear how infection with hepatitis B virus impacts on the development and progression of chronic kidney disease. Aim. To evaluate the effect of infection with HBV on the risk of chronic kidney disease in the general population. Material and methods. We conducted a systematic review of the published medical literature to determine if hepatitis B infection is associated with increased likelihood of chronic kidney disease. We used the random effects model of DerSimonian and Laird to generate a summary estimate of the relative risk for chronic kidney disease (defined by reduced glomerular filtration rate and/or detectable proteinuria) with hepatitis B virus across the published studies. Meta-regression and stratified analysis were also conducted. Results. We identified 16 studies (n = 394,664 patients) and separate meta-analyses were performed according to the outcome. The subset of longitudinal studies addressing ESRD (n = 2; n = 91,656) gave a pooled aHR 3.87 (95% CI, 1.48; 6.25, P < 0.0001) among HBV-infected patients and no heterogeneity was recorded. In meta-regression, we noted the impact of male (P = 0.006) and duration of follow-up (P = 0.007) upon the adjusted hazard ratio of incidence of chronic kidney disease (including end-stage renal disease). No relationship occurred between HBV positive status and prevalent chronic disease (n = 7, n = 109,889 unique patients); adjusted odds ratio, were 1.07 (95% CI, 0.89; 1.25) and 0.93 (95% CI, 0.76; 1.10), respectively. Conclusions. HBV infection is possibly associated with a risk of developing reduced glomerular filtration rate in the general population; no link between HBV sero-positive status and frequency of chronic kidney disease or proteinuria was noted in cross-sectional surveys.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Renal Insufficiency, Chronic/virology , Hepatitis B/virology , Kidney/virology , Proteinuria/epidemiology , Proteinuria/virology , Time Factors , Chi-Square Distribution , Odds Ratio , Risk Factors , Risk Assessment , Observational Studies as Topic , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/epidemiology , Glomerular Filtration Rate , Hepatitis B/diagnosis , Hepatitis B/epidemiology , Kidney/physiopathology , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/virology
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