Seroprevalence of antibodies against herpesvirus type 2 in a female prison population in Mato Grosso / Soroprevalência de anticorpos contra herpesvírus tipo 2 em população prisional feminina mato-grossense

Descrever a soroprevalência de anticorpos contra herpes vírus simples 2 em reeducandas de uma cadeia pública feminina de Mato Grosso no ano de 2016. Trata-se de um estudo transversal com abordagem quantitativa, realizado com 50 reeducandas reclusas de uma cadeia pública feminina de Mato Grosso. A coleta de dados foi realizada por meio de entrevista com 50 mulheres. Para determinar a soroprevalência da infecção por HSV-2, foram analisadas amostras de soro pelo método ELISA em busca de anticorpos do tipo IgG no Laboratório de Imunologia Viral do Instituto Oswaldo Cruz ­ RJ. A soroprevalência de HSV-2 encontrada na população avaliada foi de 80%, valor muito superior ao relatado na população geral brasileira e em outras estudos com populações prisionais em todo o mundo. O perfil das reeducandas predominou entre mulheres jovens, pardas, com baixa escolaridade, solteiras e com renda mensal baixa. O presente estudo encontrou alta soroprevalência de anticorpos contra HSV-2 nesta população. Esses dados fornecem importantes informações que podem auxiliar na implementação de ações efetivas que melhor previnam e controlem a herpes genital, bem como as demais ISTs em populações encarceradas.

High prevalence of hepatitis A and E viruses in environmental and clinical samples from West Argentina

ABSTRACT Environmental surveillance of water sources is important to monitoring viral hepatitis transmission in clinical settings. This study investigated the circulation of hepatitis A (HAV) and E (HEV) viruses in sewage and clinical samples from Argentina. Between 2016 and 2017, 80 raw sewage samples and 86 clinical samples (stool and serum) from suspected cases of hepatitis A and hepatitis E were obtained. HAV and HEV were tested by both real-time and nested PCR. Positive samples were sequenced for genotype determination and phylogenetic analysis. Overall, HAV was recovered in 39% of sewage samples and 61.1% of clinical samples. HEV was detected in 22.5% of sewage samples and 15.9% of clinical samples. HAV was found more frequently in sewage during the winter and in clinical samples in spring; HEV was more prevalent in sewage during summer and in clinical samples in autumn. All HAV isolates belonged to genotype IA and HEV isolates belonged to genotype 3, the most prevalent genotypes in South America. High prevalence of HAV and HEV in environmental and clinical samples in Mendoza, Argentina was observed. These findings reinforce the importance of environmental surveillance and implementation of health strategies to control the spread of HAV and HEV in developing countries.

Serological and molecular characterization of hepatitis B virus infection in chronic kidney disease patients from Rio de Janeiro, Brazil

ABSTRACT Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) are more vulnerable to blood-borne viral infections due to frequent invasive procedures. Hepatitis B virus (HBV) infection in this cohort of patients has been a matter of concern worldwide. The objective of this cross-sectional study was to evaluate the frequency of serological markers for hepatitis B, and the occurrence of overt and occult HBV infection (OBI) and its molecular characterization in serum samples from 644 CKD patients in HD units located in Rio de Janeiro, Brazil, from 2013 to 2017. HBV DNA was investigated in HBsAg reactive and "anti-HBc alone" samples to determine infecting genotypes and genetic relatedness between sequences. The prevalence of serological markers HBsAg+, anti-HBc alone, anti-HBc+/anti-HBs+, anti-HBs+, anti-HBc/anti-HBs/HBsAg were 5.9%, 2.8%, 30.7%, 26.6%, 34.0%, respectively. HBV DNA was detected in 39.5% (15/38) of the HBsAg+ and in 5/18 (27.8%) of the "anti-HBc alone" individuals, indicating a high prevalence of OBI within this group. We found a higher prevalence of HBV/A1 (65%), followed by HBV/D3 (20%), and HBV/A2 (15%). Bayesian MCC tree with a highly supported clade, genetic distance comparison, and identical nucleotide sequences suggested a nosocomial spread of HBV in some units. The high prevalence of HBV infection and low number of individuals immune to infection reinforces the need for vaccination in this group. The presence of closely related strains in the same HD unit reinforces the importance of continuous improvement of safety control measures and laboratory surveillance of serological markers to prevent the risk of infection and transmission of HBV.

Hepatitis A and E among immigrants and refugees in Central Brazil

ABSTRACT OBJECTIVE To estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, Central Brazil. METHODS Overall, 355 individuals were interviewed, and blood samples were tested for anti-HAV and anti-HEV IgG. Anti-HEV-positive samples were similarly tested for HEV RNA. RESULTS All participants were from Latin American countries, most of whom, young adult males. The overall anti-HAV IgG prevalence was 87.4% (95%CI: 83.5-90.4), of whom 94.9%, 75.6%, and 60% were from Haiti, Venezuela, and other Latin American countries, respectively (p < 0.001). Age above 19 years and more than 36 months residing in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall anti-HEV IgG prevalence was 6.5% (95%CI: 4.4-9.5). All anti-HEV IgG-positive individuals were Haitians, including a child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG-positive samples. CONCLUSION The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently required to interrupt enteric virus transmission in this emergent and vulnerable population.

Hepatitis B virus genotypes prevalence in patients from hepatology services in Ceará, Brazil

Abstract INTRODUCTION: Hepatitis B virus (HBV) infection is a public health problem; therefore, we aimed to report HBV genotypes in Ceará, Brazil. METHODS: A total of 103 HBsAg-positive samples were subjected to HBV genotyping and subgenotyping. RESULTS: The following genetic compositions of samples were found: F-54% (F2-83.33%), A-40% (A1-65%), D-6%, C2-1%, E-1%, and G-1%. CONCLUSIONS: Some genotypes are only prevalent in certain parts of the world; however, the State of Ceará is a hub for migration and has one of the most important liver transplantation centers in Brazil, which can explain the prevalence of the F genotype.

High prevalence of insulin resistance among Brazilian chronic hepatitis C patients

ABSTRACT Objective: This study aims to estimate the prevalence of insulin resistance (IR) among chronic hepatitis C (CHC) patients and their related laboratory and demographic data. Subjects and methods: In this study, non-diabetic CHC patients referred to Viral Hepatitis Ambulatories from Rio de Janeiro (Brazil) donated blood samples. Insulin was measured using a chemiluminescence immunoassay. IR was determined by HOMA-IR, where HOMA-IR > 2 was defined as IR. Results: A total of 214 CHC patients were recruited (123 females aged 53.6 years ± 10.9 years). IR was present in 133 patients (62.1%) and was associated in bivariate analysis to higher mean values of age (p = 0.040), triglycerides (p = 0.032), glucose (p = 0.000), insulin (p = 0.000), waist circumference (p = 0.001), and body mass index (p = 0.007); however, none of these variables were significant in the multivariate analysis. Conclusions: The high prevalence of IR was observed among CHC patients, and there was no difference in clinical or laboratory parameters when both groups were compared in the multivariate analysis. This high IR prevalence could lead to a high risk for development of cardiovascular disease and metabolic disorders.

A cross sectional study regarding HCV patients' knowledge about viral transmission and attitudes regarding toothbrush care / Estudo transversal sobre o conhecimento da transmissão viral e as atitudes em relação aos cuidados com as escovas dentárias entre pacientes infectados com o HCV

Hepatitis C virus (HCV) is transmitted mainly by parenteral route, although, some studies have pointed the potential of transmission by sharing infected instruments, like toothbrushes. The aim of this study was to investigate the knowledge about viral transmission among HCV infected individuals and attitudes regarding toothbrush care. A cross-sectional study was conducted among 112 HCV-infected individuals from Uberlandia City, Minas Gerais State (Southeast Brazil). Data were collected through a questionnaire containing demographic data and other questions (correct responses were given one point, incorrect and uncertain responses were given zero point) about knowledge of HCV transmission (6 items in total; scores lower than 4 points indicated poor knowledge level and scores equal or higher than 4 indicated good knowledge level); attitudes regarding toothbrush care (7 items; scores 0 to 3 indicated inadequate attitudes, and scores higher than 3 indicated adequate attitudes). The statistical analysis included Chi-square test, Exact Fisher's test and Maximum Likelihood Estimation (p < 0.05 was considered significant). Out of the 112 questionnaires distributed, 85 (response rate: 75.9%) were included. Most individuals were male (60%), Caucasian (69.4%), aged more than 51 years (51.7%), had attended pre-school (35.1%), and had incomes up to $525.2 per month (49.4%). Fifty four percent of individuals showed good Knowledge level of HCV transmission; 43.5% did not identify HCV transmission through toothbrushes and 80% did not believe in HCV transmission by saliva. A significant association were observed between Knowledge level of HCV and age (p= 0.020); and education level (p= 0.000). Forty-five HCV-infected individuals (64.70%) had adequate attitudes regarding toothbrushes care. Significant associations were observed between toothbrush care level and: age (p= 0.005); education level (p= 0.000); and family income (p= 0.038). HCV-infected individuals showed good knowledge level about main aspects of HCV infection and adequate attitudes regarding toothbrush care.

O vírus da hepatite C (HCV) é transmitido principalmente por via parenteral, entretanto, estudos têm apontado o potencial de transmissão do HCV por vias não parentais, tal como por meio do compartilhamento de objetos contaminados, como as escovas dentárias. O objetivo deste estudo foi investigar o conhecimento sobre a transmissão viral e as atitudes em relação aos cuidados com as escovas dentárias entre indivíduos infectados com HCV. Trata-se de um estudo transversal realizado com 112 indivíduos, em Uberlândia, Minas Gerais (região sudeste do Brasil). Os dados foram coletados através de um inquérito contendo questões sobre os dados demográficos e outras questões (respostas corretas receberam um ponto, respostas incorretas e incertas receberam zero ponto) sobre o conhecimento da transmissão do HCV (6 itens no total; pontuações inferiores a 4 indicaram um nível de conhecimento pobre e pontuações igual ou superior a 4 indicaram um bom nível de conhecimento); atitudes em relação ao cuidado com as escovas dentárias (7 itens; pontuações de 0 a 3 indicaram atitudes inadequadas e superiores a 3 indicaram atitudes adequadas). A análise estatística incluiu os testes: Qui-quadrado, exato de Fisher e estimação de máxima verossimilhança (p <0,05 foi considerado significativo). Dos 112 questionários distribuídos, 85 foram incluídos (taxa de resposta: 75,9%). A maioria dos indivíduos era do sexo masculino (60%), com idade acima de 51 anos (51,7%), havia concluído apenas a pré-escola (35,1%) e tinha renda de US$ 525,2 por mês (49,4%). Entre os pacientes, 54% apresentaram um bom nível de conhecimento sobre a transmissão do HCV; 43,5% não acreditavam na transmissão do vírus por meio das escovas dentárias e 80% não acreditaram na transmissão do HCV pela saliva. Verificou-se associação significativa entre o nível de conhecimento sobre o HCV e: idade (p = 0,020); nível de escolaridade (p = 0,000). Quarenta e cinco indivíduos (64,70%) apresentaram atitudes adequadas em relação aos cuidados com escovas dentárias. Foram observadas associações significativas entre o nível de cuidado em relação às escovas e: idade (p = 0,005); nível de escolaridade (p = 0,000); renda familiar (p = 0,038). Os indivíduos infectados pelo HCV mostraram um bom nível de conhecimento sobre os principais aspectos da infecção pelo vírus e atitudes adequadas em relação aos cuidados com as escovas dentárias.

Detection and molecular characterisation of a diagnosis escape variant associated with occult hepatitis B virus in Brazil

BACKGROUND Many studies have identified mutations in the hepatitis B surface antigen (HBsAg) as important factors limiting the ability of commercial serological assays to detect this viral antigen. However, an association between mutations in the HBsAg gene and the occurrence of occult HBV infection (OBI) in patients has not been established. OBJECTIVES To detect hepatitis B virus (HBV) DNA in patients with anti-HBc as a unique serological marker, a previously published, cost-effective TaqMan-based real-time polymerase chain reaction (PCR) test with minor groove binding probes was adapted for use in this study. The current study also aimed to investigate HBsAg mutations and genotypes of HBV in OBI at the Viral Hepatitis Ambulatory Clinic in Rio de Janeiro to determine any possible association. METHODS Intra-assay and inter-assay reproducibility were determined, and the mean coefficient of variation values obtained were 2.07 and 3.5, respectively. Probit analysis indicated that the 95% detection level was 25 IU/mL. The prevalence of OBI was investigated in 35 serum samples with an ‘anti-HBc alone’ profile from individuals who attended our clinic between 2011 and 2013. FINDINGS HBV DNA was detected in only one sample, resulting in an OBI rate of 2.9%. Nucleotide sequencing of the pre-S/S region was performed to genotype and analyse mutations within the HBsAg gene of this HBV DNA. The HBV in the OBI case was classified as sub-genotype A1, and a sequence analysis of the small S gene revealed 12 mutations in the major hydrophilic region compared to the consensus A1 sequence. Most of these mutations occurred in amino acid residues that have been reported as clinically relevant because they have been implicated in vaccine escape and/or inability to detect HBsAg by commercial serological assays. MAIN CONCLUSIONS Our study suggests the importance of specific HBsAg mutations, different from those in D, B, and C genotypes, in sub-genotype A1 HBV associated with OBI.

Poor sensitivity of rapid tests for the detection of antibodies to the hepatitis B virus: implications for field studies

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.

Assessment of health-related quality of life and related factors in patients with chronic liver disease

ABSTRACT BACKGROUND AND OBJECTIVES: Assessing health-related quality of life is an important aspect of clinical practice. Thus, the present study attempts to assess the health-related quality of life of patients with chronic liver disease. METHODS: A cross-sectional survey was conducted on 133 chronic liver disease patients, using three instruments: a demographic questionnaire, the Chronic Liver Disease Questionnaire, and Model for End-Stage Liver Disease index. Variables were expressed as frequencies, percentages, means, and standard deviations. The statistical analysis included Pearson's correlation, Student's t-test, and analysis of variance (p < 0.05 was considered significant). RESULTS: The mean age of included subjects was 50.5 ± 13.3 years. The majority were male (66.2%), Caucasian (70.7%), and had a family income of US$329-US$658.2. Over half of the patients (56.4%) were infected by hepatitis C virus and 93.2% had low Model for End-Stage Liver Disease scores. Model for End-Stage Liver Disease score was related to age (r = 0.185;p = 0.033). Higher mean Chronic Liver Disease Questionnaire scores were obtained for emotional function (39.70/SD ± 12.98) and while lower scores were obtained for abdominal symptoms (16.00/SD ± 6.25). Fifty-two patients (39.1%) presented overall low (<5) Chronic Liver Disease Questionnaire scores. Furthermore, Chronic Liver Disease Questionnaire score was related to family income (r = 0.187, p = 0.031). CONCLUSION: Most individuals presented high mean Chronic Liver Disease Questionnaire scores, indicating low health-related quality of life, especially individuals with low family income.

Inosine triphosphatase allele frequency and association with ribavirin-induced anaemia in Brazilian patients receiving antiviral therapy for chronic hepatitis C

Inosine triphosphatase (ITPA) single nucleotide polymorphisms (SNPs) are strongly associated with protection against ribavirin (RBV)-induced anaemia in European, American and Asian patients; however, there is a paucity of data for Brazilian patients. The aim of this study was to evaluate the ITPA SNP (rs7270101/rs1127354) frequency in healthy and hepatitis C virus (HCV)-infected patients from Brazil and the association with the development of severe anaemia during antiviral therapy. ITPA SNPs were determined in 200 HCV infected patients and 100 healthy individuals by sequencing. Biochemical parameters and haemoglobin (Hb) levels were analysed in 97 patients who underwent antiviral therapy. A combination of AArs7270101+CCrs1127354 (100% ITPase activity) was observed in 236/300 individuals. Anaemia was observed in 87.5% and 86.2% of treated patients with AA (rs7270101) and CC genotypes (rs1127354), respectively. Men with AA (rs7270101) showed a considerable reduction in Hb at week 12 compared to those with AC/CC (p = 0.1475). In women, there was no influence of genotype (p = 0.5295). For rs1127354, men with the CC genotype also showed a sudden reduction in Hb compared to those with AC. Allelic distribution of rs7270101 and rs1127354 shows high rates of the genotypes AA and CC, respectively, suggesting that the study population had a great propensity for developing RBV-induced anaemia. A progressive Hb reduction during treatment was observed; however, this reduction was greater in men at week 12 than in women.

Epidemiological profile of Hepatitis C virus infection in patients from West Region of Minas Gerais State, Brazil / Perfil epidemiológico da infecção pelo vírus da hepatite c em pacientes da região oeste de Minas Gerais, Brasil

Hepatitis C virus (HCV) is a serious public health problem and is the leading cause of liver transplantation due to cirrhosis and hepatocellular carcinoma. In Brazil, it is estimated that there are approximately 2 to 3 million HCV chronic carriers. Few data regarding HCV infection are available in West region of Minas Gerais State. Due to the absence of an effective vaccine against this important human pathogen and the high costs of antiviral treatment, it is important to conduct epidemiological studies with the purpose of carry out the planning and implementation of measures to prevent hepatitis C in different populations. Therefore, the aim of this study is to describe the epidemiological aspects of HCV patients from West region of Minas Gerais State, Brazil. Sociodemographic data and risk factors for HCV infection were determined from 74 HCV patients from Uberlândia city (Minas Gerais State). Reactive anti-HCV sera samples were submitted to HCV RNA and genotype detection. Most of individuals were male (63.5%) with mean age of 51 years and presenting low socioeconomic status. HCV genotype was determined among 40 samples and the frequencies were: genotype 2 (45%), 1 (37.5%) and 3 (17.5%). Hepatitis C virus (HCV) infection was common among male and low socioeconomic status individuals.

O vírus da hepatite C (HCV) é um sério problema de saúde pública e a principal causa de transplante de fígado devido à cirrose e carcinoma hepatocelular. No Brasil, estima-se que há aproximadamente 2 a 3 milhões de portadores crônicos do HCV. Poucos dados sobre a infecção pelo HCV na região oeste do estado de Minas Gerais estão disponíveis. Devido à ausência de vacina eficaz contra esse importante patógeno humano e aos altos custos do tratamento antiviral, é importante realizar estudos epidemiológicos com a finalidade de executar o planejamento e implementação de medidas para prevenir a hepatite C em diferentes populações. Portanto, o objetivo deste estudo é descrever os aspectos epidemiológicos dos pacientes portadores de HCV da região oeste do estado de Minas Gerais, Brasil. Dados sociodemográficos e fatores de risco para a infecção com HCV foram determinados de 74 pacientes portadores de HCV da cidade de Uberlândia, Minas Gerais. Amostras de soro reativas foram submetidas às detecções de HCV RNA e genótipo. A maioria dos indivíduos eram homens (63,5%) com média de idade de 51 anos e baixo nível socioeconômico. O genótipo do HCV foi determinado entre 40 amostras e as frequências foram: genótipo 2 (45%), 1 (37,5%) e 3 (17,5%). A infecção com o vírus da hepatite C foi frequente entre homens e indivíduos de baixo nível socioeconômico.

Hiv and hcv coiffection: prevalence, associatedfactors and genotype characteriization in the midwest region of Brazil / Coinfecção HIV e HCV: prevalência, fatores associados e caracterização dos genótipos na Região Centro-Oeste do Brasil

A cross-sectional study on prevalence, associated factors and genotype distribution of HCV infection was conducted among 848 HIV-infected patients recruited at reference centers in the Midwest Region of Brazil. The prevalence rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6). In multivariable analysis, increasing age, use of illicit drugs (injection and non-injection), a history of blood transfusion before 1994, and the absence of a steady partnership were significant independent associated factors for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region revealed the presence of two major circulating genotypes of HCV: genotypes 1 (58.3%) and 3 (41.7%). The prevalence of HIV-HCV coinfection was lower than those reported in studies conducted with HIV-infected patients in different regions of Brazil, due to the fact that illicit drug use is not a frequent mode of HIV transmission in this region of Brazil. Serologic screening of HIV-patients for HCV before initiating antiretroviral treatment, a comprehensive identification of associated factors, and the implementation of effective harm reduction programs are highly recommended to provide useful information for treatment and to prevent HCV coinfection in these patients.

Estudo transversal sobre a prevalência, fatores associados e distribuição dos genótipos do HCV foi realizado em 848 pacientes infectados pelo HIV, recrutados em centros de referência na Região Centro-Oeste do Brasil. A taxa de prevalência de coinfecção HIV-HCV foi de 6,9% (IC 95%: 5,2-8,6). Na análise multivariada, o aumento da idade, o uso de drogas ilícitas (injetáveis e não injetáveis), história de transfusão de sangue antes de 1994, e ausência de companheiro constante foram fatores associados independentes e significativos para a coinfecção HIV-HCV. A análise filogenética baseada na região NS5B revelou a presença de dois principais genótipos do HCV em circulação: genótipos 1 (58,3%) e 3 (41,7%). A prevalência da coinfecção HIV-HCV foi menor do que as relatadas em estudos realizados com pacientes infectados pelo HIV em diferentes regiões do Brasil, devido ao fato de que o uso de drogas ilícitas não é modo frequente de transmissão do HIV neste Estado do Brasil. Triagem sorológica de pacientes HIV-positivos para HCV antes de iniciar o tratamento antirretroviral, identificação completa dos fatores associados e a implementação de programas eficazes de redução de danos são altamente recomendados para fornecer informações úteis, para o tratamento e para evitar a coinfecção com HCV nestes pacientes.

Conhecimento e utilização de medidas de precaução-padrão por profissionais de saúde / Knowledge and utilization of standard precaution measures by health professionals

O objetivo deste trabalho foi descrever o conhecimento sobre medidas de precaução-padrão (MPP), bem como analisar a sua utilização entre 266 profissionais de saúde do Estado do Rio de Janeiro. Foi utilizado um questionário autoaplicável com três domínios: A - Identificação e capacitação profissional; B - Conhecimento e suporte após acidente biológico; C - Utilização de MPP em atividades profissionais. Na população estudada, 174 (65,4%) relataram ter feito nos últimos dois anos algum curso de atualização em sua área, 106 (39,8%) fizeram algum curso contendo temas de biossegurança, e 31,9% relataram acidente de trabalho anteriormente. Observamos que os acidentados tinham maior mediana de idade e tempo de conclusão de curso. Concluímos que a maioria dos profissionais reconhece e utiliza as principais MPPs, porém uma parcela desta população ainda não utiliza estas medidas. É importante a capacitação em biossegurança a fim de minimizar o risco durante a atividade profissional.

The aim of this study was to describe knowledge about standard precautions (MPP) and analyze its usage among 266 health professionals from the State of Rio de Janeiro. We used a selfadministered questionnaire with three domains: A - Identification and vocational training; B-Knowledge and support after biological accident, C-Use of MPP in professional activities. In this population, 174 (65.4%) reported having done in the last two years a course in your area, 106 (39.8%) made some progress containing matters of biosecurity, and 31.9% reported work-related accident previously. We observed that the victims had a higher median age and time of completion. We conclude that most professionals recognize and use the key MPPs, but a part of the population still does not use these measures. It is important training in biosafety in order to minimize risk during their career.

El objetivo de este estudio fue describir los conocimientos acerca de las medidas de precauciones patrón (MPP) y analizar su uso entre los 266 profesionales de salud del Estado de Rio de Janeiro. Se utilizó un cuestionario autoadministrado con tres dominios: A - Identificación y formación profesional; B - Conocimiento y apoyo después de accidente biológico, C - Uso del MPP en las actividades profesionales. En esta población, 174 (65,4%) informaron que habían hecho en los últimos dos años un curso en su área, 106 (39,8%) que lograron algunos cursos que contienen temas de bioseguridad, y el 31,9% relataron accidente de trabajo anteriormente. Se observó que las víctimas tenían una edad mediana y mayor tiempo de ejecución. Se concluye que la mayoría de los profesionales reconocen y utilizan el MPP clave, pero una parte de la población todavía no utiliza estas medidas. Es importante la formación en bioseguridad con el fin de minimizar los riesgos durante su actividad profesional.

Investigação de acidentes biológicos entre profissionais de saúde / Investigation of biological accidents among health care workers / Investigación de accidentes biológicos entre los trabajadores de la salud

Os objetivos deste trabalho foram identificar a principal categoria profissional exposta a risco biológico e os principais tipos de acidentes ocorridos entre trabalhadores da área de saúde, em Campos dos Goytacazes, RJ. A partir da análise das fichas denotificação de acidentes biológicos dos 183 profissionais acidentados entre janeiro de 2005 e setembro de 2005, observamos que a categoria profissional mais exposta foi a dos auxiliares/técnicos de enfermagem (54,1%), seguida pela dos acadêmicos de medicina e odontologia (10,4%). A ocorrência de acidentes com materiais perfurocortantes foi relacionada à manipulação frequente desses objetos e ao comportamento dos profissionais que utilizam práticas que oferecem riscos de acidentes com agulhas, tais como o descarte inadequado de objetos perfurocortantes.

A percepção ambiental entre os habitantes da região noroeste do estado do Rio de Janeiro / Environmental perception among inhabitants of northwest region of the state of Rio de Janeiro / La Percepción del Medio Ambiente entre los Habitantes de la Región Noroeste de Rio de Janeiro

Foi desenvolvido um estudo para avaliar a percepção ambiental de indivíduos residentes do Município de Itaperuna, localizado na região Noroeste do Rio de Janeiro, Brasil. Foram selecionados 243 indivíduos, entre os meses de julho a outubro de 2005, que responderam sobre questões que abordavam a relação indivíduo/ambiente; ações individuais em favor da área ambiental;preocupação com o impacto ambiental e consumo; hábitos pessoais e ambiente. Com base na análise das respostas dosindivíduos, foi observada maior percepção ambiental em indivíduos mais velhos em relação a crianças e jovens. Este resultado demonstra que os programas de educação ambiental nesta região devem ser voltados para crianças e adolescentes, para que os mesmos se tornem adultos conscientes, uma vez que os indivíduos respondentes apresentaram grande interesse pelos temas ambientais e disposição para participar de campanhas e ações de recuperação ambiental.

A percepção ambiental entre os habitantes da região noroeste do estado do Rio de Janeiro / Environmental perception among inhabitants of northwest region of the state of Rio de Janeiro / La Percepción del Medio Ambiente entre los Habitantes de la Región Noroeste de Rio de Janeiro

Foi desenvolvido um estudo para avaliar a percepção ambiental de indivíduos residentes do Município de Itaperuna, localizado na região Noroeste do Rio de Janeiro, Brasil. Foram selecionados 243 indivíduos, entre os meses de julho a outubro de 2005,que responderam sobre questões que abordavam a relação indivíduo/ambiente; ações individuais em favor da área ambiental;preocupação com o impacto ambiental e consumo; hábitos pessoais e ambiente. Com base na análise das respostas dosindivíduos, foi observada maior percepção ambiental em indivíduos mais velhos em relação a crianças e jovens. Este resultado demonstra que os programas de educação ambiental nesta região devem ser voltados para crianças e adolescentes, para que os mesmos se tornem adultos conscientes, uma vez que os indivíduos respondentes apresentaram grande interessepelos temas ambientais e disposição para participar de campanhas e ações de recuperação ambiental.

Hepatitis A virus subgenotypes dissemination during a community outbreak in a surrounding region of Rio de Janeiro

From December 1999 to December 2001, many cases of hepatitis A were notified in the county of Belford Roxo involving individuals aged 0 to 79 years. Serum samples were collected to evaluate the prevalence of anti-hepatitis A virus (HAV) antibodies, to detect HAV-RNA and to correlate with possible risk factors of HAV infection. Serum samples were screened by commercial IgM and total anti-HAV antibody ELISA and HAV-RNA was isolated and subsequently amplified by reverse transcription-polymerase chain reaction (RT-PCR) at VP1/2A region, sequenced and analyzed. Total anti-HAV prevalence was 87.9 percent (203/231) and IgM anti-HAV prevalence was 38.7 percent (89/231). Multivariate analysis showed that individuals under 20 years old are risks groups to acquire the infection suggesting that hygienic habits of young subjects are the principal factor of transmission and so they could be the target for vaccine programs. HAV-RNA was amplified from 29 (32.5 percent) IgM anti-HAV positive patients and 26 samples were sequenced and classified into subgenotypes IB (8 isolates) and IA (18 isolates). Isolates classified into subgenotype IB were identical representing one distinct strain. We could observe both subgenotypes circulating during the study which suggests different sources of infection. Prophylactic measures as vaccination strategies added to improvements in hygienic and sanitary conditions would be highly effective to reduction of infection.

Virus da hepatite A: epidemiologia molecular e desenvolvimento de técnicas de concentração e detecção em amostras ambientais / Hepatitis A virus: molecular epidemiology and development of concentration techniques and detection in environmental samples

A incidência da hepatite A tem diminuído no Brasil, entretanto o vírus da hepatite A(HAV)devido a sua grande estabilidade ainda persiste no ambiente ocasionando surtos principalmente em creches e escolas devido à ingestão de água e alimentos contaminados.A epidemiologia molecular do HAV associada à detecção do mesmo em águas ambientais permite um melhor conhecimento da circulação do vírus e a definição de fontes de infecção e de medidas de controle desta doença.Nossos objetivos foram avaliar a aplicação de testes moleculares no diagnóstico da hepatite A para:(i)a definição de casos de hepatite aguda em pacientes negativos para o anticorpo anti-HAV IgM;(ii)no estudo da variabilidade genômica em diferentes regiões do Brasil;(iii)na detecção qualitativa e quantitativa do genoma do HAV em águas ambientais.Um estudo com 241 indivíduos expostos a surtos epidêmicos e pacientes com hepatite aguda não A-C foi possível detectar o RNA do HAV nas amostras de soro coletadas de indivíduos negativos para o anticorpo anti-HAV demonstrando a aplicabilidade da técnica de nested RT-PCR no diagnóstico precoce em surtos epidêmicos,assim como para elucidar casos de hepatite aguda de etiologia desconhecida.Os estudos sobre o seqüenciamento nucleotídico de isolados de HAV provenientes de surtos e casos esporádicos da doença nas regiões Sudeste,Norte e Nordeste do país demonstraram a co-circulação dos subgenótipos IB e IA nestas regiões.A eficiência...para titulação do HAV.Dois métodos de concentração[eluição com tampão fosfato uréia arginina e reconcentração com cloreto de magnésio(método 1);e eluição com hidróxido de sódio/reconstrução com concentrador comercial(método2)]e de detecção(nested RT-PCR e PCR em tempo real)do HAV foram avaliados inoculando a cepa HAF-203 com título conhecido em 4 tipos de amostras de água(rio,mar,mineral e torneira).O método de concentração não afeta a detecção pelo PCR quantitativo,mas é extremamente importante quando se utiliza o PCR qualitativo...

Comparison of four extraction methods to detect hepatitis A virus RNA in serum and stool samples

The efficiency of extraction methods for hepatitis A virus (HAV) RNA in clinical samples is of great importance for molecular diagnosis, especially in regions endemic for HAV, such as Brazil. We compared the efficiency of four different extraction techniques in serum and stool samples for the detection of hepatitis A virus by reverse transcription PCR (RT-PCR). We used PCR to analyse serum and stool samples of 12 patients who were referred to the Brazilian Reference Center for Viral Hepatitis (BRCVH) in Rio de Janeiro. The methods tested were Proteinase K, Silica, TRIzol and Guanidine isothiocyanate. Proteinase K extraction was the best method for serum samples; it detected the HAV-RNA in 11 of the 12 samples. The guanidine isothiocyanate method was the most effective for stool samples, detecting HAV-RNAs in 9 of the samples. The TRIzol« method worked best with serum samples, and the silica method was unsatisfactory with both serum and stool samples. The RNA extraction method affected the outcome. The use of appropriate RNA extraction methods is a critical step for successful and valid PCR studies on clinical samples. We recommend that RNA extraction techniques be carefully selected for their efficiency with each type of specimen