Seroprevalence of HBV, HCV and HIV co-infection in selected individuals from state of São Paulo, Brazil

Few studies are available on hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection in populations living in small and medium-sized Brazilian cities. We evaluated the seroprevalence of these viruses in selected individuals from a clinic of infectology, who were referred to the University Regional Hospital of the West Region of state of São Paulo, Brazil. Among a total of 7,021 individuals seen in the clinic following receipt of preliminary ELISA results or having the suggested clinical signs of viral hepatitis or HIV, 1,228 were systematically screened. Isolated or associated HBsAg, HCV and HIV antibodies were found in 44.9 percent of the subjects. Anti-HIV antibodies were found in 24.7 percent of the patients, 20.3 percent of whom had an HIV monoinfection and 4.4 percent of whom were co-infected with hepatitis viruses (HCV: 4 percent; HBV: 0.4 percent). Anti-HCV antibodies were found in 14 percent of the patients and 5.9 percent had anti-HBsAg antibodies. HCV infection affected males more than females (p < 0.05) and individuals > 50-years old had an increased prevalence of anti-HCV compared to HIV (p = 0.0001) or HBV (p = 0.0063). HCV-RNA was detected in 73.5 percent of the samples with a predominance of genotype 1 (72.5 percent). A significant percentage (44.9 percent) of the selected individuals was positive for antibodies against HBV, HCV and/or HIV; these patients would otherwise have remained undiagnosed.

Rapid HIV diagnostic test in undocumented pregnant women applied at an inner-city teaching hospital / Diagnóstico da infecção pelo HIV através de um teste rápido em gestantes sem resultados comprobatórios atendidas em um hospital escola do interior

A significant number of Brazilian gestational-age women are still not tested for HIV, representing a high risk of transmission to their newborns. The current study sought to identify the number of pregnant women with no previous testing or undocumented for HIV referred to the Gynecology and Obstetrics Department of a Regional Teaching Hospital and included diagnosis of HIV infection determined by a rapid test and perinatal transmission in pregnancy. Medical records of all pregnant women admitted to hospital from January 2001 to December 2005 were reviewed. Pregnant women without HIV results were submitted to a rapid HIV test. Those who tested positive were further tested by ELISA and confirmed by indirect immunofluorescence assay (IIA) or Western blot (WB). The viral load from babies born to HIV-infected mothers was assessed by bDNA. Of the 16,424 pregnant women analyzed (6.6 percent), 1,089 were undocumented for HIV. Eleven women were positive in rapid testing and 10 were confirmed by ELISA, IIA or WB, with 0.9 percent seropositivity. Mother/infant pairs received zidovudine monotherapy prophylaxis and infant viral load was lower than 50 copies/mL. A higher number of pregnant women previously tested for HIV during antenatal care was verified, compared to that obtained nationwide.

No Brasil um número significativo de mulheres em idade gestacional ainda não foi testado para HIV, representando risco acentuado de transmissão vertical. Nosso objetivo foi determinar o número de gestantes que não foram previamente testadas ou não portavam documentos comprobatórios para HIV, ou seja, o diagnóstico da infecção para HIV através de um teste rápido e a transmissão vertical em gestantes admitidas no Departamento de Ginecologia e Obstetrícia de um Hospital Universitário Regional. Foram revisados os prontuários das gestantes admitidas entre janeiro de 2001 e dezembro de 2005. Gestantes sem resultados para HIV foram submetidas a um teste rápido. Testes positivos foram submetidos ao teste de ELISA e confirmados por imunofluorescência indireta (IIA) ou Western blot (WB). A carga viral dos recém-nascidos de mães infectadas foi determinada por bDNA. Dentre as 16.424 gestantes analisadas, 6,6 por cento (1.089) não apresentaram resultados comprobatórios. Onze gestantes tiveram resultados positivos no teste rápido e 10 foram confirmadas por ELISA, IIA ou WB com 0,9 por cento de positividade. Mães e recém-nascidos receberam profilaxia com zidovudina e todos os recém-nascidos tiveram carga viral inferior a 50 copias/mL. Foi encontrado um número maior de gestantes previamente testadas para HIV quando comparado à média obtida no país.