Population-Based Multicentric Survey of Hepatitis B Infection and Risk Factor Differences among Three Regions in Brazil

Abstract

This multicentric population-based study in Brazil is the first national effort to estimate the prevalence of hepatitis B (HBV) and risk factors in the capital cities of the Northeast, Central-West, and Federal Districts (2004-2005). Random multistage cluster sampling was used to select persons 13-69 years of age. Markers for HBV were tested by enzyme-linked immunosorbent assay. The HBV genotypes were determined by sequencing hepatitis B surface antigen (HBsAg). Multivariate analyses and simple catalytic model were performed. Overall, 7,881 persons were included; < 70% were not vaccinated. Positivity for HBsAg was less than 1% among non-vaccinated persons and genotypes A, D, and F co-circulated. The incidence of infection increased with age with similar force of infection in all regions. Males and persons having initiated sexual activity were associated with HBV infection in the two settings; healthcare jobs and prior hospitalization were risk factors in the Federal District. Our survey classified these regions as areas with HBV endemicity and highlighted the risk factors differences among the settings.

Epidemiology of hepatitis B virus infection among recyclable waste collectors in central Brazil

“…The prevalence of HBV infection found among recyclable waste collectors was 2.4-fold higher than that reported in a population-based study in the same region (5.3%; 95% CI: 4.6-6.1) 19 . Compared with the prevalence in other Brazilian populations, the prevalence determined in this study was within the confi dence interval range recorded for patients attending an STD clinic (13%; 95% CI: 10.0-16.5) 20 , non-injection drug users (14%; 95% CI: 11.7-16.5) 21 and individuals reporting to an HIV testing and counseling center (14.6%; 95% CI: 11.2-18.0) 22 .…”

“…Although no comparable data have been published, the proportion of occult HBV infection identifi ed was similar to that reported in a community of African origin (1.7%), which utilized similar methods for the detection of HBV DNA 29 . The HBV genotypes/ subtypes A/A1, D/D3 and F/F2 were identifi ed in the three HBV DNA-positive serum samples, consistent with those circulating in the central-western region and other regions in Brazil 19,30,31 . Furthermore, it is noteworthy that the identifi ed genotype F/subtype F2 may indicate movement of the population from the Amazon region, where the frequency of this genotype/subtype is considerable 30,32 .…”

“…Other authors have reported that sexual transmission seems to be an important HBV transmission route in areas of low endemicity 19,25,26 . In the current study, however, unprotected sex with multiple partners and previous STDs were not signifi cantly associated with HBV infection in the adjusted analysis, even though previous STDs were associated in the bivariate analysis.…”

“…As described elsewhere, age may be a proxy for lifetime exposure, indicating that over time, there is a cumulative risk of acquiring an HBV infection linked to sexual and parenteral exposures 19,23 . This possibility is supported by the observation that illicit drug use was associated with increased HBV prevalence in the studied population.…”

Prevalence and clinical features of celiac disease in patients with hepatitis B virus infection in Southern Brazil

“…In Brazil, 16,775 cases of hepatitis B were reported in the year 2011 9 , but the actual number of cases is not completely known; there have been few studies, and Brazil has a poor notifi cation system and a large geographic area 10 . In the State of Santa Catarina, the described seroprevalence of HBsAg is 0.7% to 1.2% among blood donors in Florianopolis [11][12][13] . The prevalence of HBsAg-positive individuals in Western Santa Catarina is 1.63%, which is higher than that described in the northern and Southern regions of the state (1.12% and 0.91%, respectively) 12 .…”