[Seroprevalence and risk factors for hepatitis B virus infection by AgHBs and anti-HBs markers in prisoners and prime blood donors]

Sexually transmitted infections in women deprived of liberty in Roraima, Brazil

OBJECTIVE

To evaluate the prevalence of HIV, syphilis and hepatitis B infection among women deprived of liberty in the state of Roraima, Brazil, and its correlation with perceptions, knowledge and behavioral factors.

METHOD

This is a cross-sectional study, with simple systematic sampling, conducted at the Public Female Prison in Boa Vista, State of Roraima, in 2017. A total of 168 inmates (93.8% of the population) were evaluated by in-person interviews and rapid tests.

RESULTS

The prevalence of sexually transmitted infections (STI) was 20.2%, being 4.7% HIV, 15.5% syphilis, and 0.0% hepatitis B. Multivariate analysis confirmed as risk factors for acquiring an STI: being over 30 years of age [adjusted odds ratio (OR): 2.57; 95%CI 1.03-6.40); low schooling (adjusted OR: 2.77; 95%CI 1.08-5.05); little knowledge about condom use (adjusted OR: 2.37; 95%CI 1.01-7.31); and believing that there is no risk of contracting syphilis (adjusted OR: 2.36; 95%CI 1.08-6.50).

CONCLUSION

The population deprived of liberty is a group of highly vulnerable to STI. The high prevalence of these infections can be explained by knowledge deficits on the subject, distorted perceptions and conditions peculiar to imprisonment, which result in risky behavior. We emphasize the need to implement educational programs for preventing, diagnosing and treating STI for this population.

Cobertura vacinal contra hepatite B entre usuários de drogas ilícitas

OBJETIVO: Identificar a cobertura vacinal contra a hepatite B e os comportamentos de risco entre usuários de drogas ilícidas (UDI) em Dourados-MS. MÉTODOS: Trata-se de uma pesquisa de campo, descritiva de corte transversal realizada mediante aplicação de questionário em 49 usuários atendidos pelos centros de recuperação e programas de apoio desse Município. RESULTADOS: Identificou-se predomínio de homens jovens que utilizavam drogas não injetáveis. A história de prisão, e de hepatite na família, tatuagens, múltiplos parceiros sexuais e realização de todas as formas de relação sexual, foram os fatores de risco mais frequentes. CONCLUSÃO: Estes fatores combinados com a baixa cobertura vacinal e a falta de término do esquema confirmam a vulnerabilidade do grupo em adquirir a hepatite B.

Seroprevalence of hepatitis B virus infection and associated factors among prison inmates in state of Mato Grosso do Sul, Brazil

INTRODUCTION: This study aimed to estimate the prevalence of HBV infection and associated factors among prison inmates in Campo Grande, MS. METHODS: A total of 408 individuals were interviewed regarding sociodemographic characteristics, associated factors and HBV vaccination using a standardized questionnaire. Blood samples were collected from all participants and serological markers for HBV were detected by enzyme-linked immunosorbent assay. Hepatitis B surface antigen (HBsAg) and/or antibodies against hepatitis B core antigen (anti-HBc) positive samples were tested for HBV-DNA by polymerase chain reaction. RESULTS: The overall prevalence of HBV infection was 17.9% (95%CI: 14.4-22.0). The HBsAg carrier rate was 0.5%; 56 (13.7%) individuals had been infected and developed natural immunity and 15 (3.7%) were positive for anti-HBc only. Ninety eight (24%) prisoners had only anti-HBs, suggesting that they had low vaccine coverage. An occult HBV infection rate of 0% was verified among anti-HBc-positive individuals. Multivariate analysis of associated factors showed that age > 35 years-old, low schooling level and illicit drug use are significantly associated with HBV infection. CONCLUSIONS: Analysis of the data showed HBV infection prevalence similar or slightly lower than that reported in other of Brazilian prisons. Independent predictors of HBV infection in this population include older age, low schooling level and illicit drug use.

Soroprevalência da infecção pelo vírus da Hepatite B em uma prisão brasileira

Esta pesquisa objetivou estimar a prevalência do marcador do HBV e seus fatores de risco na população masculina carcerária da Penitenciária de Ribeirão Preto - SP, Brasil. De 1.030 presidiários, foram sorteados 333 participantes, os quais foram submetidos à aplicação de um questionário e à coleta de sangue, no período de maio a agosto de 2003. Para diagnóstico de exposição ao HBV foi utilizado o ensaio imunoabsorvente de ligação de enzimas (ELISA) para detecção dos marcadores HBsAg, anti-HBsAg e anti-HBc total. A prevalência total de infecção pelo HBV nos presidiários foi de 19,5% (IC95%: 15,2 - 23,8). A média de idade dos participantes foi de 30,1 anos. Na análise univariada, a infecção pelo HBV esteve associada à idade acima de 30 anos (p<0,001), uso prévio de drogas injetáveis (p<0,001) e compartilhamento de agulhas prévio (p<0,001). Em um modelo multivariado, de regressão logística, a infecção pelo HBV foi associada à idade acima de 30 anos (OR = 3,3: IC95%: 1,8 - 6.1) e uso prévio de droga injetável (OR = 2,7; IC95%: 1.9 - 6.4). Infecção pelo HBV nas prisões representa grave problema de saúde pública, principalmente relacionado à idade acima de 30 anos e uso prévio de drogas injetáveis.

Tattooing and transfusion-transmitted diseases in Brazil: a hospital-based cross-sectional matched study

BACKGROUND

Presence of tattoos has been a criterion for temporary deferral of blood donors. Scientific evidence remains equivocal regarding the association between tattooing and transfusion-transmitted diseases (TTDs).

METHODS

A cross-sectional matched study was undertaken among adults attending a Brazilian hospital and blood bank. The exposure of interest was having at least one permanent tattoo, and the outcomes were the presence of serological markers for the following TTDs: hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections, syphilis, and Chagas' disease. Exposed and unexposed subjects were matched on age, sex, and main clinical complaint. Associations were assessed by odds ratios (ORs), adjusted for confounders by unconditional logistic regression.

FINDINGS

The study recruited 345 subjects, 182 with tattoos. Having a tattoo was associated with HCV (OR: 6.41; 95% confidence interval (CI) 1.29, 31.84), and with having at least one positive test for any TTD (OR: 2.05, 95% CI: 1.11, 3.81). No statistically significant associations were found between tattooing and HBV or HIV infection, syphilis or Chagas' disease, but these results are inconclusive given the large CI obtained.

INTERPRETATION

Having a tattoo is not an important indicator for testing positive for a TTD, except for HCV infection. Taking into consideration the increasing prevalence of tattooing in the general population, the absolute need of a safe and sustainable blood supply and optimization of the cost-effectiveness of screening blood donors, further research on tattoos is urgently required.

Tattoos as risk factors for transfusion-transmitted diseases

BACKGROUND

Several infectious diseases have been found to be associated with tattooing, including some transfusion-transmitted diseases (TTDs). Information on tattooing has been included in screening interviews of prospective blood donors and may be a reason for deferral.

METHODS

Review of articles identified through Medline (and other computerized data bases) using medical subject heading (MeSH) terms and textwords for "tattooing," "transfusion", "hepatitis", "human immunodeficiency virus", "acquired immunodeficiency syndrome", "syphilis", "Chagas disease", "infection", "risk factors", and their combinations.

RESULTS

There is strong evidence for the transmission of hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, and syphilis by tattooing. Tattooing may also transmit the human immunodeficiency virus (HIV), although convincing evidence is still lacking. There is little or no evidence that other TTDs can be transmitted by tattooing. Epidemiologic studies to date have shown a large variation in odds ratio estimates of the association between tattooing and HBV, HCV, and HIV infections.

CONCLUSION

Further studies are required to clarify the risk of tattoos in transmitting infectious diseases through blood transfusions. A reassessment of tattoos as a screening criterion among blood donors is justified.

[Prevalence of serologic markers of hepatitis B virus in hospital personnel]

OBJECTIVE

To verify the prevalence of the anti-HBc, anti-HBs and HBsAg markers of hepatitis B virus, and to identify the risk factors determining occupational infection with this virus among hospital personnel.

METHODS

Samples of serum from 210 persons both male and female who work in different occupations at a hospital university, were analysed. The technique employed was the immunoenzymatic assay using commercial kits.

RESULTS

As a control group, samples of serum from 45 volunteer blood donors were utilized. It was verified that 20.5% of the hospital personnel presented a positive reaction to at least one of the markers songht, as against 6.6% of the control group. The prevalence of each marker separately was: anti-HBc 8.1%, anti-HBs 5.2%, and HBsAg 2.9% in the hospital personnel; and 4.4%, 2.2% and 0.0% in the control group. The simultaneous presence of the anti-HBc and anti-HBs markers was detected in 4.3% of the workers. In the control group, the presence of the anti-HBc and anti-HBs markers was detected, isolately, with respective prevalences of 4.4% and 2.2%. Those who presented the highest rates of positivite reaction were: laboratory technicians 24.0%, nurses 23.6%, physicians 20.8%, and cleaning personnel 18.2%.

CONCLUSIONS

The findings suggest that direct contact with patients and handling of blood and other body fluids are risk factors related to occupational infection with HBV. Therefore, it is recommended that hospital personnel be vaccinated against hepatitis B.

Soroepidemiologia para o virus da hepatite B (VHB) em gestantes/parturientes e sua transmissão para recém-nascidos em Goiânia, GO

Foram coletadas, entre março de 1990 e julho de 1992, 1459 amostras sanguíneas de mulheres gestantes/parturientes na cidade de Goiânia-GO, objetivando detecção da infecção pelo vírus da hepatite B (VHB), através dos marcadores sorológicos AgHBs e anti-HBs. O percentual depositividade encontrado, pelo teste imunoenzimãtico, foi de 7,5%, sendo 0,5%para AgHBs e 7,0%para anti-HBs. A análise efetuada, considerando a faixa etária, mostra que 7 de 8 mulheres AgHBs-positivas pertenciam à faixa etária de até 30 anos, situação semelhante em relação ao anti-HBs(83/101). Das 8 mulheres positivas, 4 tiveram seus recém-nascidos submetidos a tratamento profilático com vacina (Engerix B) e imunoglobulina humana anti-hepatite B (HBIG). Além disso, 3 dessas crianças foram analisadas sorologicamente, sendo que uma era AgHBs-positiva ao nascimento. Doença sexualmente transmissível e transfusão sanguínea foram fatores de risco que coirelacionaram significantemente com a infecção. Esses resultados parece-nos reforçar a indicação de triagem à infecção pelo vírus da hepatite B no período pré-natal, assim como a adoção de medidas imunoprofiláticas nas crianças nascidas de mães positivas.

Prevalence and risk factors for HBV infection among street youth in central Brazil

PURPOSE

A seroprevalence survey was carried out among 496 street adolescents from 9 to 20 years old in central Brazil to determine the prevalence of hepatitis B (HBV) markers, as well as to assess the role of potential risk factors.

RESULTS

The findings reveal that 20.4% of the participants were homeless adolescents without family links, living and/or working on the streets. The age at first sexual intercourse was as low as 9 years old, and approximately 60% of this population had had at least one sexual relationship by the age of thirteen, indicating prepubertal initiation of sexual experiences among street adolescents. 13.5% were HBV marker-positive (anti-HBc) and 2.0% had antigenemia. Street-based youth had a higher HBV marker-positive rate when compared to home-based teens (OR = 4.1, 95% CI: 2.1-8.5) and, similarly, higher HBV prevalence was obtained for those reporting sexual activity versus the group without sexual activity (OR = 2.1, 95% CI: 1.1-3.9), even after adjusting for potential confounders.

CONCLUSIONS

We have found that street youth, particularly street-based adolescents, should be considered at-risk group for hepatitis B infection in our region. These findings may be used as a baseline information for policy changes not only in hepatitis B prevention but also to reverse the scenario of adolescents sexual abuse.

[Serologic screening for hepatitis B in health professionals in the city of Goiânia-Goiás]

Markers for hepatitis B virus in health care workers were analysed in 625 employees of three institutions in Goiânia city. The virus prevalence was 23.4% related to different markers (AgHBs, anit-HBs and anti-HBc). Among the positive individuals, 1.3% presented acute infection, 1.0% were virus carriers and 21.1% presented only anti-HBs and 32.6% only anti-HBc as markers. There were 19 reports of virus vaccination. Eight of them seroconverted for anti-HBs and 6 were positive for both anti-HBc and anti-HBs. Higher prevalence rates were found above 30 year of age (p < 0.05). The male and female prevalence rates were 29.5% and 21.1% (p < 0.05) respectively. The virus prevalence rates among blood and patient contacts were 25.9% (p < 0.05) and the highest prevalence was found in persons followed up for at least ten years (p < 0.05). The greatest risk section has shown to be hemodialysis unit personnel with a percentual of 77% (p < 0.05).

[NO TITLE AVAILABLE]

This investigation presents the results of Hepatitis B virus screening among leprosy patients conducted in Central Brazil as a preliminary information for a HBV vaccination programme. The main objectives were to assess the seroprevalence of HBV serum markers among lepromatous patients and to analyse institutionalization as risk factor for HBV infection in this population. Two groups of lepromatous patients were studied, 83 outpatients and 171 institutionalized ones. Screening for HBV serum markers included the detection of HBsAg, anti-HBc by radioimmune assay (RIA). The prevalence of carrier state (HBsAg) was 4.8% and 8.8% among outpatients and institutionalized, respectively, (p>0.05). Seroprevalence of exposure (all markers) was statistically significant different between outpatients (16.9%) and institutionalized ones (50.3%). Institutionalized patients had an almost four fold risk of HBV infection when compared to the outpatients, and the highest risks were among patients with more than 21 years of residence in the colony, after adjusting for age and sex.

[Methodological considerations in the interpretation of serologic screening for hepatitis B virus among blood donors]

Between October 1988 and February 1989, 1,033 voluntary first-time blood donors were screened for hepatitis B infection in five blood banks in Goiâna, Central Brazil. The survey was part of a major study designed to estimate seroprevalence of HBsAg and anti-HBs and to discuss methodological issues related to prevalence estimation based on data from blood banks. Donors were interviewed and blood samples were collected and tested for HBsAg and anti-HBs by ELISA tests. Prevalences of 1.9% and 10.9% were obtained for HBsAg and anti-HBs, respectively, and no statistical difference was found between the sexes. Prevalence of anti-HBs increased with age (X2 for trend = 7.9 p = 0.004). The positive predictive value and sensitivity of history of jaundice or hepatitis reported in the interview in detecting seropositives were 13.6% and 2.2%, respectively. The methodological issues, including internal and external validity of HBV prevalence estimated among blood donors are discussed. The potential usefulness of blood banks as a source of morbidity information for surveillance for Hepatitis B virus infection is stressed.