introduction:The collection of recyclable waste materials is a widespread activity among the urban poor. Today, this occupation attracts an increasingly large number of individuals. Despite its economic and environmental importance, this activity is associated with unsafe and unhealthy working conditions. The aim of this study was to investigate the seroepidemiological profi le of hepatitis B virus (HBV) infection in a population of recyclable waste collectors in central Brazil. Methods: Recyclable waste collectors from all 15 recycling cooperatives in Goiânia City were invited to participate in the study. The participants (n = 431) were interviewed and screened for hepatitis B surface antigen (HBsAg) and antibodies against HBsAg (anti-HBs) and hepatitis B core antigen (anti-HBc) by enzyme-linked immunosorbent assay (ELISA). HBsAg-and anti-HBc-positive samples were tested for HBV DNA and genotyped. Results: The overall prevalence of HBV infection (HBsAg-and/or anti-HBc-positive) was 12.8%. An age over 40 years and illicit drug use were associated with HBV infection. HBV DNA was detected in 2/3 HBsAg-positive samples and in 1/52 anti-HBc-positive/HBsAg-negative samples (an occult HBV infection rate of 1.9%), in which the genotypes/subgenotypes A/A1, D/D3 and F/F2 were identifi ed. Only 12.3% of the recyclable waste collectors had serological evidence of previous HBV vaccination. Conclusions: These fi ndings highlight the vulnerability of recyclable waste collectors to HBV infection and reinforce the importance of public health policies that address the health and safety of this socially vulnerable population.
Recebido para publicação em 06�08�2009 �ceito em 27�10�2009 � infecção pelo vírus linfotrópico de células T humanas 1 (HTLV�1) está associada com desenvolvimento de doenças graves como a leucemia�linfoma de células T do adulto (�TL) e mielopatia associada ao HTLV�1�paraparesia espástica tropical (H�M�TSP), além de síndromes inflamatórias e complicações infecciosas 24 ABSTRACTThis study aimed to determine the prevalence of HTLV�1 infection among remnant black quilombo communities in Central Brazil. � total of 1,837 individuals were evaluated, among whom nine were HTLV�1�2 seropositive according to ELIS�. �ll of them were positive for HTLV�1 by means of Western blot and�or PCR, thus resulting in a prevalence of 0.5% (95% CI: 0.2�1.0). The HTLV�1 infected individuals ranged in age from 11 to 82 years. The majority of them were females. Regarding risk characteristics, histories of breastfeeding, blood transfusion, multiple sexual partners and sexually transmitted diseases were reported by these individuals. The findings from this study indicate the importance of identifying HTLV�1 infected individuals, as a strategy for infection control and prevention in these remnant quilombos.Key-words: Human T�cell lymphotropic virus 1. Remnant quilombo. Central Brazil. Prevalence.observadas em algumas regiões como o sudoeste do Japão, Melanésia, África equatorial, Caribe e �mérica do Sul 20 . O Brasil é o país com maior número absoluto de indivíduos infectados por HTLV�1, possuindo cerca de dois milhões de portadores 3 . Essa infecção é endêmica em Salvador, Bahia, onde uma prevalência de 1,8% foi encontrada 8 . Segundo �lcântara e cols 1 , a introdução do HTLV�1 nesse estado ocorreu com o tráfico de escravos africanos. Estudo sobre HTLV�1�2, realizado em doadores de sangue nas capitais dos Estados brasileiros e Distrito Federal, obteve soroprevalência de 0,1% a 1%, sendo superior nas Regiões �orte e �ordeste, e inferior no sul do Brasil. �a Região Centro�Oeste, a prevalência verificada nessa população variou de 0,2% a 0,7% 4 . Em gestantes, uma prevalência de 0,1% foi observada para o HTLV�1 em Mato Grosso do Sul e Goiás 7 18 , e de 0,2% para HTLV�1�2 em Mato Grosso 25 . �s comunidades remanescentes de quilombos semi�isoladas no Brasil Central foram fundadas por africanos escravizados, que fugiram para locais de difícil acesso, e instituíram sociedades alternativas conhecidas como quilombos 21 . Considerando a possível origem africana do HTLV�1 e a escassez de estudos
Independent epidemiology for respective human T-cell lymphotropic virus (HTLV) types 1 and 2 is little known in blood donors in Brazil, where screening for HTLV-1/2 is mandatory at blood banks, but no testing to confirm/differentiate these viruses. Therefore, this study aims to assess the prevalence of HTLV-1 and -2 in a first-time blood donor population in Northeastern Brazil and to carry out molecular characterization of respective isolates. A cross-sectional study was conducted at the State Blood Bank in Piauí. Samples were screened for anti-HTLV-1/2 by enzyme immunoassay, and reactive samples were confirmed using a line immunoassay and polymerase chain reaction (PCR). Of 37 306 blood donors, 47 were anti-HTLV-1/2 reactive by enzyme immunoassay. After confirmed by line immunoassay, 22 were positive for HTLV-1 (0.59 per 1000; 95% CI: 0.38-0.87), 14 were positive for HTLV-2 (0.37 per 1000; 95% CI: 0.21-0.61), 1 was indeterminate, and the remaining donors were negative. The HTLV-1 infection was also confirmed by PCR in all anti-HTLV-1-positive samples, and sequencing classified these isolates as belonging to the Transcontinental (A) subgroup of the Cosmopolitan (1a) subtype. Of 14 anti-HTLV-2-positive samples, 11 were also PCR positive, which belonged to subtype a (HTLV-2a/c). In addition, 38 family members of 5 HTLV-1- and 3 HTLV-2-infected donors were analyzed. Familial transmission of HTLV-1 and -2 was evidenced in 3 families. In conclusion, in Northeastern Brazil, where HTLV-1 and -2 are endemic, counseling blood donor candidates and their families might play a key role in limiting the spread of these viruses.
This study describes human immunodeficiency virus 1 (HIV-1) prevalence, associated factors, viral genetic diversity, transmitted drug resistance (TDR), and acquired drug resistance mutations (DRM) among a population of 522 men who have sex with men (MSM) recruited by the respondent-driven sampling (RDS) method, in Goiânia city, the capital of the State of Goiás, Central-Western Brazil. All serum samples were tested using a four-generation enzyme-linked immunosorbent assay (ELISA), and reactive samples were confirmed by immunoblotting. Plasma RNA or proviral DNA was extracted, and partial polymerase (pol) gene including the protease/reverse transcriptase (PR/RT) region was amplified and sequenced. HIV-1 subtypes were identified by phylogenetic inference and by bootscan analysis. The time and location of the ancestral strains that originated the transmission clusters were estimated by a Bayesian phylogeographic approach. TDR and DRM were identified using the Stanford databases. Overall, HIV-1 prevalence was 17.6% (95% CI: 12.6–23.5). Self-declared black skin color, receptive anal intercourse, sex with drug user partner, and history of sexually transmitted infections were factors associated with HIV-1 infection. Of 105 HIV-1-positive samples, 78 (74.3%) were sequenced and subtyped as B (65.4%), F1 (20.5%), C (3.8%), and BF1 (10.3%). Most HIV-1 subtype B sequences (67%; 34 out of 51) branched within 12 monophyletic clusters of variable sizes, which probably arose in the State of Goiás between the 1980s and 2010s. Most subtype F1 sequences (n = 14, 88%) branched in a single monophyletic cluster that probably arose in Goiás around the late 1990s. Among 78 samples sequenced, three were from patients under antiretroviral therapy (ART); two presented DRM. Among 75 ART-naïve patients, TDR was identified in 13 (17.3%; CI 95%: 9.6–27.8). Resistance mutations to non-nucleoside reverse transcriptase inhibitors (NNRTI) predominated (14.7%), followed by nucleoside reverse transcriptase inhibitor (NRTI) mutations (5.3%) and protease inhibitor (PI) mutations (1.3%). This study shows a high prevalence of HIV-1 associated with sexual risk behaviors, high rate of TDR, and high genetic diversity driven by the local expansion of different subtype B and F1 strains. These findings can contribute to the understanding about the dissemination and epidemiological and molecular characteristics of HIV-1 among the population of MSM living away from the epicenter of epidemics in Brazil.
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