RESUMO
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.
Assuntos
Hepatite B , Prisioneiros , Humanos , Vírus da Hepatite B/genética , Brasil/epidemiologia , Antígenos de Superfície da Hepatite B , Estudos Transversais , DNA Viral/genética , Prevalência , Anticorpos Anti-Hepatite B , Hepatite B/epidemiologiaRESUMO
Although hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection is common, only few data are available on HBV among HIV patients including occult hepatitis B infection (OBI), regardless of serological markers. This study aims to determine the prevalence of OBI and overall HBV infection, associated factors, HBV genotypes, and surface (S) gene mutations in a population of treatment-naïve HIV-infected patients in Brazil. A cross-sectional study was conducted in treatment-naïve HIV-infected patients in Central Brazil. All samples were tested for HBV serological markers and HBV DNA. Sequence analysis of the S gene and overlapping polymerase gene was preformed. Overall, 25.1% (127/505) of the patients had markers of current or previous HBV infection, which was associated with age over 40 years, history of injection drug use, and homosexual sex. The hepatitis B surface antigen (HBsAg) seroprevalence was 4.9% (25/505). HBV DNA was detected in 39 out of 505 patients: 20 of them were HBsAg-positive and 19 were HBsAg-negative, resulting in an OBI prevalence of 3.8%. Patients with OBI had significantly higher HCV seropositivity rate compared to HBsAg-positive patients. Sequencing of the S gene revealed Y100C, T131N, and D144A mutations. One patient had the M204I and L180M drug-resistance mutations (polymerase). HBV genotypes A (A1, A2), D (D2, D3), and F (F2) were identified. In conclusion, OBI represented almost half of all HBV infections with detectable HBV DNA, suggesting that hepatitis B diagnosis in HIV patients should include in addition to serological markers the detection of HBV DNA.
Assuntos
Coinfecção/epidemiologia , DNA Viral/sangue , Infecções por HIV/complicações , Hepatite B/epidemiologia , Hepatite B/virologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Usuários de Drogas , Feminino , Genótipo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Hepatite B/diagnóstico , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/genética , Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/genética , Homossexualidade , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Valor Preditivo dos Testes , Prevalência , Estudos Soroepidemiológicos , Adulto JovemRESUMO
HBV-HIV coinfection is prevalent. Frequently, anti-HBc is the only serological marker of HBV, which can be indicative of HBV resolved infection, when found together with anti-HBs reactivity; or present as "isolated anti-HBc," related to HBV occult infection with presence of detectable DNA HBV, more prevalent in HIV-positive individuals. Regional data about this condition are scarce. Anti-HBc rapid test has been used as screening, but its performance has not been described in HIV-positive patients. The aim of this study was determine prevalence of anti-HBc in HIV-positive patients, serological pattern of HBV resolved infection and isolated anti-HBc, evaluating presence of HBV occult infection. Assess anti-HBc rapid test compared to ECLIA. Methods included measurement of anti-HBc and anti-HBs in HIV-positive patients with negative HBsAg. Serum HBV DNA quantification and HBV booster vaccination to "isolated anti-HBc" individuals. Detection of anti-HBc by rapid test and ECLIA. In 192 patients, prevalence of anti-HBc was 42.7% (82/192); associated to male gender, drug use, men-sex-men, positive-VDRL, and longer time HIV diagnosis. 34.4% (66/192) had presence of anti-HBs, mean titers of 637 ui/ml. Isolated anti-HBc in 8.3% (16/192), associated to detectable HIV viral load and no-use of HAART; in them, HBV DNA was undetectable, and 60% responded to HBV vaccination booster. Anti-HBc rapid test showed low sensibility (32.9%) compared to ECLIA. These results show that prevalence of anti-HBc in HIV-positive individuals is high, in most cases accompanied with anti-HBs as HBV resolved infection. Low prevalence of "isolated anti-HBc," with undetectable HBV DNA, and most had anamnestic response to HBV vaccination; suggest low possibility of occult HBV infection. Anti-HBc rapid test cannot be recommended as screening method for anti-HBc.
Assuntos
Infecções por HIV/complicações , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite B/imunologia , Adulto , Portador Sadio/virologia , Chile/epidemiologia , Feminino , Hepatite B/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto JovemRESUMO
OBJECTIVES: The main objective was to evaluate HBV infection and occult HBV infection (OBI) cases in mentally ill patients based on serological and molecular profiles. MATERIAL AND METHODS: Serum samples of 333 long-stay mentally ill patients were tested for the prevalence of HBV markers by serological (ELISA) and molecular (PCR) assays. The PCR products were sequenced to determine viral genotypes. RESULTS: It was observed a global prevalence of 12.9% (43/333) for HBV infection markers, considering HBsAg and/or anti-HBc positivity. Fourteen samples tested positive for anti-HBs alone. All samples positive (n=57) for any HBV serological markers were tested for HBV-DNA and six were positive: HBsAg/anti-HBc (n=1), anti-HBc/anti-HBs (n=1), anti-HBs alone (n=1), and anti-HBc alone (n=3). The rate of OBI was 9.2% (5/54) from samples that were anti-HBc and/or anti-HBs positive. All sequenced samples were characterized as genotype A. CONCLUSION: The high rate of HBV infections found in this study suggests the possibility of HBV transmission due to risk factors displayed by some patients, and highlights the importance of vaccination of susceptible patients and the staff of that institution.
Assuntos
Vírus da Hepatite B , Hepatite B/epidemiologia , Hospitais Psiquiátricos/estatística & dados numéricos , Pessoas Mentalmente Doentes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , DNA Viral/análise , Ensaio de Imunoadsorção Enzimática , Feminino , Genótipo , Hepatite B/diagnóstico , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prevalência , Fatores de Risco , Adulto JovemRESUMO
Resumen Propósito: La infección oculta por el virus de la hepatitis B se caracteriza por la presencia del genoma viral en muestras de suero y/o tejido hepático pero sin detección de antígeno de superficie. Los mecanismos de patogénesis no se conocen completamente. El propósito del presente artículo es discutir y describir los aspectos clínicos, epidemiológicos y moleculares más importantes de este tipo de infección. Metodología: Se realizó una búsqueda de literatura en la base de datos PUBMED, de trabajos originales y revisiones de tema publicados entre 1979 y 2012. La búsqueda se realizó utilizando las palabras claves "Occult HBV infection, Epidemiology, clinical implications, mechamisms y outcome". Artículos relevantes citados en las publicaciones seleccionadas también fueron consultados. Conclusiones: La identificación de casos de infección oculta por el virus de la hepatitis B y la descripción de la prevalencia es de importancia para la prevención de la transmisión de la infección y del desarrollo de hepatopatías terminales. La disponibilidad de métodos sensibles y específicos para la detección del genoma viral ha permitido explorar la epidemiologia. No obstante, aún son materia de estudio los mecanismos de patogénesis. (Acta Médica Colombiana 2013; 38: 143-153).
Abstract Objective: occult hepatitis B virus infection is characterized by the presence of the viral genome in serum and / or liver tissue samples but without surface antigen detection. The mechanisms of pathogenesis are not fully known. The purpose of this article is to discuss and describe the most important clinical, epidemiological and molecular aspects of this type of infection. Methods: we performed a literature search in PUBMED database of original works and reviews of the subject published between 1979 and 2012. The search was performed using the keywords "occult HBV infection, epidemiology, clinical implications, mechanisms and outcome". Relevant articles cited in the selected publications were also consulted. Conclusions: the identification of cases of occult hepatitis B virus infection and the description of its prevalence is important in preventing transmission of the infection and the development of terminal hepatic diseases. The availability of sensitive and specific methods for the detection of viral genome has allowed us to explore the epidemiology. However, the mechanisms of pathogenesis are still under examination. (Acta Médica Colombiana 2013; 38: 143-153).
Assuntos
Infecções , Patogenesia Homeopática , Vírus da Hepatite B , Epidemiologia , Hepatite B , Antígenos de Superfície da Hepatite BRESUMO
The prevalence of occult hepatitis B virus (HBV) infection was investigated in 149 hepatitis B surface antigen (HBsAg) negative injecting drug users (IDUs) in the Central-West Region of Brazil. Of these individuals, 19 were positive for HBV DNA, resulting in an occult HBV infection prevalence of 12.7% (19/149); six of these 19 individuals had anti-HBV core and/or anti-HBV surface antibodies and 13 were negative for HBV markers. All IDUs with occult hepatitis B reported sexual and/or parenteral risk behaviours. All HBV DNA-positive samples were successfully genotyped. Genotype D was the most common (17/19), followed by genotype A (2/19). These findings reveal a high prevalence of occult HBV infection and the predominance of genotype D among IDUs in Brazil's Central-West Region.
Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Usuários de Drogas/estatística & dados numéricos , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Brasil/epidemiologia , DNA Viral/genética , Ensaio de Imunoadsorção Enzimática , Vírus da Hepatite B/genética , Hepatite B/diagnóstico , Reação em Cadeia da Polimerase , PrevalênciaRESUMO
INTRODUCTION: Persistence of the hepatitis B virus (HBV) genome in individuals negative for the HBV surface antigen (HBsAg) reflects occult infection. The aim of this study was to identify occult HBV infection among hemodialysis patients at 5 clinics in Recife, State of Pernambuco, Brazil, between August 2006 and August 2007. METHODS: Serum samples underwent enzyme-linked immunosorbent assay to investigate total antibodies against HBcAg (anti-HBc), HBsAg, and antibodies against HBsAg (anti-HBs). Samples that were HBsAg-negative were tested for total anti-HBc, and those that were positive for total anti-HBc were tested for anti-HBs. HBV DNA was investigated with an in-house PCR technique to identify samples positive for total anti-HBc. Subsequently, the samples positive for HBV DNA were sequenced to identify the genotype and mutations. RESULTS: The study population (n = 752) had a mean age of 50 15.1 years and included both sexes. All samples analyzed were negative for HBsAg. The seroprevalence of total anti-HBc was 26.7% (201/752), while that of anti-HBs was 67.2% (135/201). Total anti-HBc alone was detected in 5.7% of the patients. Occult infection was found in 1.5%, comprising genotypes A (33.3%, 1/3) and D (66.7%, 2/3). No mutations were found. CONCLUSIONS: The study detected occult hepatitis B virus infection in hemodialysis patients. Molecular studies on HBV are of fundamental importance because they identify patients that had been considered virus-negative but who, in reality, host the virus and have the ability to transmit it to other patients and staff.
INTRODUÇÃO: A persistência do genoma do vírus da hepatite B (HBV) em indivíduos com o antígeno de superfície para o HBV (HBsAg) negativo, caracteriza-se como infecção oculta. O objetivo desse trabalho foi identificar infecção oculta pelo HBV em hemodialisados provenientes de cinco clínicas de Recife, Estado de Pernambuco, Brasil, de agosto de 2006 a agosto de 2007. MÉTODOS: Os soros foram submetidos à pesquisa do HBsAg, anticorpos totais para o AgHBc (anti-HBc total) e para os anticorpos contra o antígeno de superfície do HBV (anti-HBs) pelo ensaio imunoenzimático (ELISA). As amostras negativas para o HBsAg foram testadas para o anti-HBc total e os soros reativos, foram testados para o anti-HBs. O DNA-HBV foi analisado pela reação em cadeia da polimerase (PCR) in house nas amostras anti-HBc total reagentes. As amostras DNA-HBV positivas foram sequenciadas para a identificação do genótipo e pesquisa de mutação. RESULTADOS: A população estudada foi de 752 hemodialisados, com média de idade de 50±15,1 e ambos os sexos. Todos os soros analisados foram HBsAg negativos. A soroprevalência para o anti-HBc total e anti-HBs foi de 26,7% (201/752) e 67,2% (135/201), respectivamente. O anti-HBc total foi encontrado em 5,7% dos pacientes. A infecção oculta foi identificada em 1,5% (3/201) das amostras, sendo 33,3% com o genótipo A e 66,7% com o D. Nenhuma mutação foi observada. CONCLUSÕES: O estudo encontrou infecção oculta na amostra analisada. A infecção oculta encontrada mostra a importância de estudos moleculares, pois pacientes HBsAg negativos podem albergar o vírus disseminando-o para os demais pacientes.