High prevalence of Hepatitis C Virus infection among people who use crack cocaine in an important international drug trafficking route in Central-West Region Brazil

Prevalence of overt and occult hepatitis B virus infection among an incarcerated population of Central-Western Brazil

Brazilian prison complexes are characterized by overcrowded cells and precarious conditions, leading to chronically low vacancy. Brazilian studies involving overt and occult infection (OBI) in this population are still scarce despite the vulnerability of people deprived of liberty to hepatitis B. Therefore, this study estimated the prevalence of HBV infection (overall and OBI) in individuals deprived of liberty in prisons in Central-Western Brazil. In addition, factors associated with HBV infection were evaluated. This cross-sectional study was conducted with a total of 1083 prisoners who were tested for serological hepatitis B markers and HBV DNA from 2017 to 2020. Factors associated with lifetime HBV infection were investigated using logistic regression. An overall prevalence of HBV infection of 10.1% (95% CI: 8.42-12.11) was detected. Only 32.8% (95% CI: 30.08-35.76) had isolated anti-HBs positivity (serological evidence of HBV vaccination). Indeed, more than half of the population was susceptible to HBV infection (57.1%; 95% CI: 54.15-60.13). HBV DNA was detected in one HBsAg-positive sample (n=1/9; 11%). Also, HBV DNA was detected in five HBsAg-negative samples (n=5/1074), resulting in a prevalence of 0.5% (95% CI: 0.15-1.08) for occult infection. After the multivariate analysis, sexual intercourse with a partner living with HIV was a predictor independently associated with HBV exposure (OR: 4.3; 95% CI: 1.26-14.55; p<0.020). These data demonstrate the need for preventive measures, mainly aimed at health education and better strategies for hepatitis B screening to control this infection in prisons more effectively.

Feasibility of dried blood spot for hepatitis C diagnosis in vulnerable subjects and people living in remote areas from Brazil

Background

Agile, accessible and cheap diagnosis of hepatitis C virus (HCV) infection is essential to achieve the elimination of this infection, worldwide, as mandated by the World Health Organzation as part of its strategy for 2030. Dried blood spots (DBS) can be an attractive alternative for sample collection among people living in remote areas and vulnerable populations due to the less invasive collection, its biosafety, and storage & transportation of samples at room temperature.

Design

This study aims to estimate the usefulness of dried blood spot samples for the diagnosis and the assessment of HCV infection rates in three different settings in Brazil. Cross-sectional analysis of a sample collection from different populations, aiming to assess the performance of the testing algorithms and respective procedures among different populations with diverse background infection rates.

Methods

We reported the evaluation of DBS as alternative samples for detecting anti-HCV in different groups in real life conditions: (I) Vulnerable subjects living in remote areas of Southeast, North and Northeast Brazil (n = 1464); (II) Beauticians (n = 288); (III) People who use non-injectable drugs (n = 201); (IV) patients referred to outpatient care (n = 275).

Results

General assay accuracy was 99%, with a weighted kappa value of 0.9, showing an excellent performance. Sensitivities ranged from 87.5% to 100.0% between groups and specificities were above 99.2%. A total of 194 individuals had HCV RNA in serum and concordance of anti-HCV detection in DBS was 98.4%.

Conclusions

DBS samples could be used for anti-HCV detection in different populations recruited in real life conditions and ambulatory settings, with a high overall sensitivity and specificity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-022-07717-4.

The distribution of hepatitis C virus infection in Shanghai, China: a time-spatial study

BACKGROUND

Shanghai, as a pilot city of China to achieve the goal of eliminating hepatitis C, its strategy of allocating medical resources is a pressing problem to be solved. This study aims to infer the time-spatial clustering patterns of HCV-infected cases, and grasp the dynamic genotype distribution of HCV, thereby inform elimination strategies of HCV with efficacy and efficiency.

METHODS

Reported HCV cases including their demographic information in Shanghai city from 2005 to 2018 were released from the National Infectious Disease Reporting Information System, population data at community scale, geographical layers of hospitals, communities and districts were gathered from former research. Blood samples of HCV-infected individuals were collected during 2014-2018 from 24 sentinel hospitals, HCV-antibody test, qualitative nucleic acid test and NS5B/5'UTR gene amplification were performed accordingly to determine the genotypes of the specimen. Furthermore, global and local spatial self-correlation analysis of both acute and chronic HCV infections were conducted at community scale year by year, then time-spatial clusters of acute and chronic HCV infections and HCV genotype distribution of specimen collected from sentinel hospitals by districts were mapped by using Arcmap10.1.

RESULTS

A total of 2631 acute HCV cases and 15,063 chronic HCV cases were reported in Shanghai from 2005 to 2018, with a peak in 2010 and 2017, respectively. The mean age of chronic HCV patients was 49.70 ± 14.55 years, 3.34 ± 0.32 years older than the acute (t = 10.55, P-value < 0.01). The spatial distribution of acute HCV infection formed one primary cluster (Relative Risk = 2.71), and the chronic formed one primary cluster and three secondary clusters with Relative Risk ranged from 1.94 to 14.42, meanwhile, an overlap of 34 communities between acute and chronic HCV clusters were found with time period spans varied from 6 to 12 years. Genotype 1 (N = 257, 49.71%) was the most prevalent HCV genotype in Shanghai, genotype 3 infections have increased in recent years. Baoshan district presented cluster of acute HCV and the highest proportion of genotype 2, Pudong new area was the cluster of chronic HCV and occupied the highest proportion of genotype 3.

CONCLUSIONS

Despite the low prevalence of HCV infection, it is still needed to push forward the elimination process in Shanghai, as there is a certain amount of HCV infected people waiting to be treated. The time-spatial clustering patterns and the dynamic of HCV genotype distribution together indicated a changing constitution of different transmission routes of HCV infection, thus, a focused strategy may be needed for high-risk population related to genotype 3 infection like drug users, in addition to an enforcement of the existing measures of preventing the iatrogenic and hematogenic transmission of HCV.

Clinical and laboratory characteristics of hepatitis C and COVID-19 coinfection: Prolonged RNA shedding in nonhospitalized case

Nonhospitalized COVID‐19 and hepatitis C‐coinfected patient presented prolonged RNA shedding and mild course of infection. This finding demonstrated the importance of long follow‐up of these patients.