Hepatitis B and C prevalence and risk factors among young men presenting to the Brazilian Army

Motta, Leonardo Rapone da; Adami, Aline De Gregori; Sperhacke, Rosa Dea; Kato, Sérgio Kakuta; Paganella, Machline Paim; Pereira, Gérson Fernando Mendes; Benzaken, Adèle Schwartz

doi:10.1097/md.0000000000016401

Cited by 10 publications

(12 citation statements)

References 19 publications

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“…Viral hepatitis serologies, history of alcohol intake or co-medications use prior to hospital admission were not available. However, the prevalence rates of chronic hepatitis B and C are low in Brazil [ 22 , 23 ] and only four patients (1%) included in the present study reported any liver disease at admission. In addition, we considered aminotransferases levels collected at the first day of hospitalization to minimize the impact of long term COVID-19 or any hepatic drug induced toxicity during hospital stay.…”

Section: Discussionmentioning

confidence: 92%

Liver injury predicts overall mortality in severe COVID-19: a prospective multicenter study in Brazil

et al. 2021

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Background/purpose The relationship between liver injury and mortality remains unclear in patients with COVID-19. We aimed to evaluate the prognostic value of aminotransferases levels at hospital admission to predict mortality in patients with COVID-19. Methods and results This prospective study included 406 patients [57% male, aged 56 years] with COVID-19 hospitalized in 26 centers in Brazil. Overall, 36.7% (95% CI 32.1–41.5) presented at admission with severe disease requiring respiratory support. The prevalence of elevated ALT and AST levels at admission [> 2 × ULN] was 14.0% (95% CI 11.0–17.8) and 12.9% (95% CI 10.0–16.6), respectively. Sixty-two patients [15.3% (95% CI 12.1–19.1)] died during hospitalization and the overall mortality rate was 13.4 (10.5–17.2) deaths per 1000 persons-years. The 15-day-overall survival (95% CI) was significantly lower in patients with ALT levels ≥ 2 × ULN compared to those with ALT < 2 × ULN [67.1% (48.4–80.2) vs 83.4% (76.1–88.6), p = 0.001] and in those with AST levels ≥ 2 × ULN compared to those with AST < 2 × ULN [61.5% (44.7–74.6) vs 84.2% (76.5–89.5), p < 0.001]. The presence of elevated aminotransferases levels at hospital admission significantly increased the risk of in-hospital all-cause mortality adjusted for age-and-sex. Those findings were present in the subgroup of critically ill patients already admitted in need of respiratory support ( n = 149), but not in patients without that requirement at admission ( n = 257). Conclusions Elevated aminotransferases at hospital admission predicted in-hospital all-cause mortality in patients with COVID-19, especially in those with severe disease. Measurement of transaminases levels at hospital admission should be integrated to the care of patients with COVID-19 as an auxiliary strategy to identify patients at higher death risk. Supplementary Information The online version contains supplementary material available at 10.1007/s12072-021-10141-6.

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Section: Discussionmentioning

confidence: 92%

Liver injury predicts overall mortality in severe COVID-19: a prospective multicenter study in Brazil

et al. 2021

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“…Among CKD patients, HBsAg positivity in DBS or serum was associated with infrequent condom use, which was also found among young men enlisted in the Brazilian Army, demonstrating the importance of health campaigns with a focus on condom use[ 19 ]. Anti-HBc positivity in serum and DBS was associated with shared nail cutters/razor/toothbrush and highlights the discussion of the role of manicurists in the transmission of HBV.…”

Section: Discussionmentioning

confidence: 99%

Dried blood spot sampling as an alternative for the improvement of hepatitis B and C diagnosis in key populations

Flores¹,

Barbosa²,

Cruz³

et al. 2021

WJH

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BACKGROUND To achieve the elimination of hepatitis B and C, there is an urgent need to develop alternative strategies to increase the access of diagnosis, particularly among key populations such as people living with human immunodeficiency virus (HIV), individuals with coagulopathies and chronic kidney disease (CKD) patients. AIM To evaluate the use of dried blood spot (DBS) in the detection of hepatitis B virus (HBV) and hepatitis C virus (HCV) markers. METHODS A total of 430 individuals comprised of people living with HIV, coagulopathies and CKD provided paired serum and DBS samples. HBsAg, anti-HBc and anti-HCV were tested in those samples using a commercial electrochemiluminescence. Demographic and selected behavioral variables were evaluated to assess possible association with HBV and HCV positivity. RESULTS Using DBS, HBsAg prevalence varied from 3.9% to 22.1%, anti-HBc rates varied from 25.5% to 45.6% and anti-HCV positivity ranged from 15.9% to 41.2% in key populations. Specificities of HBV and HCV tests using DBS varied from 88.9% to 100%. The HBsAg assay demonstrated the best performance in CKD and coagulopathy individuals and the anti-HCV test had a sensitivity and specificity of 100% in people living with HIV. Accuracy of HBV and HCV detection in DBS varied from 90.2% to 100%. In the CKD group, HBsAg positivity was associated with infrequent use of condoms, and anti-HBc positivity was associated with sharing nail cutters/razors/toothbrushes. Anti-HCV reactivity was positively associated with a history of transplantation and length of time using hemodialysis in both specimens. In people living with HIV, only the male gender was associated with anti-HBc positivity in serum and DBS. CONCLUSION DBS with electrochemiluminescence are useful tools for the diagnosis and prevalence studies of hepatitis B and C among key populations and may increase the opportunity to foster prevention and treatment.

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“…In fact, a study with a large number of young men from Brazilian army showed a prevalence of 0.18% of anti-HCV positivity. 25 The strategy of screening all individuals with more than 18 years in Brazil should be evaluated with caution and based on cost-effectiveness studies.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a strategy for identification of hepatitis C virus carriers in outpatient and emergency units: contribution to the microelimination of hepatitis C in Brazil

Gardona

Appel

Ercolin

et al. 2021

The Brazilian Journal of Infectious Diseases

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Hepatitis B and C prevalence and risk factors among young men presenting to the Brazilian Army

Abstract: Programa NacioNal de imuNizações (PNi): 40 aNos Programa NacioNal de imuNizações (PNi): 40 aNos Ministério da saúde secretaria de Vigilância em saúde departamento de Vigilância das doenças transmissíveis Brasília -DF • 2013

Cited by 10 publications

References 19 publications

Liver injury predicts overall mortality in severe COVID-19: a prospective multicenter study in Brazil

Liver injury predicts overall mortality in severe COVID-19: a prospective multicenter study in Brazil

Dried blood spot sampling as an alternative for the improvement of hepatitis B and C diagnosis in key populations

Evaluation of a strategy for identification of hepatitis C virus carriers in outpatient and emergency units: contribution to the microelimination of hepatitis C in Brazil

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