Prevalence of hepatitis B virus and risk factors in Brazilian non‐injecting drug users

Abstract

Non-injecting drug users are at high-risk for acquiring hepatitis B virus (HBV), although the factors contributing to this increased risk are not known. In the present study, the overall and occult HBV infection prevalence rates were determined in a large population of non-injecting drug users in the Central-West region of Brazil. HBV genotypes and predictors of infection were also identified. A total of 852 individuals in 34 drug treatment centers were interviewed, and their serum samples were tested for the presence of HBV markers by ELISA. HBsAg and anti-HBc-positive samples were tested for HBV DNA by PCR. Samples with HBV DNA were genotyped by restriction fragment length polymorphism (RFLP). The overall prevalence of HBV infection was 14% (95% CI: 11.7-16.5). A multivariate analysis of risk factors showed that age >30 years, non-white race/ethnicity, duration of drug use >10 years, lifetime number of sexual partners >10, non-use of condoms, and HCV and HIV status were associated significantly with HBV infection. Of the 9 (1%) HBsAg-reactive samples, HBV DNA was present in 2/2 of HBeAg-positive and in 5/7 anti-HBe-positive samples. An occult HBV infection rate of 2.7% (3/110) was found among anti-HBc-positive individuals. All HBV DNA-positive samples were genotyped: seven were genotype A, two were genotype D, and one was genotype F. Finally, few individuals (8%) had serological evidence of a previous HBV vaccination. These findings indicate that preventive interventions are needed for both sexual and drug-related high-risk behavior. Additionally, non-injecting drug users should be targeted for HBV vaccination.

Prevalence, risk factors and hepatitis B immunization: helping fill the gap on hepatitis B epidemiology among homeless people, Goiânia, Central Brazil

“…In our study, only 19.5% of participants presented a serological profile of prior immunization, confirming the low frequency of hepatitis B vaccination among vulnerable populations in our region and elsewhere 16,19,20,21 . However, it should be noted the wide variation observed in the distribution by age group, with prevalence of 53.6% in individuals aged 18 to 30 years dropping to 1.4% among those aged above 50 years.…”

“…Age (years) 15 and users of illicit drugs (n = 852; 14%; 95%CI: 11.7-16.5) 16 . However, the prevalence found among homeless people in Goiânia was lower than that found ten years before by Brito et al 7 (30.6%; 95%CI: 25.9-35.8) in São Paulo.…”

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

“…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 . Nevertheless, relative to other reported data on recyclable waste collectors, the prevalence found in the present study was lower than that observed in Santos, Brazil (34.4%; 95% CI: 28.5-40.2) 14,15 .…”

“…Among the 71 recyclable waste collectors who reported illicit drug use, the majority had used non-injection drugs only (88.7%; 63/71) (data not shown). Although the factors leading to an increased risk of hepatitis B in non-injection drug users are not well established, HBV infection is associated with unsafe sexual behavior and blood-borne transmission 21,24 .…”

Occult hepatitis B virus infection among injecting drug users in the Central-West Region of Brazil

“…No similar reports from Brazil were available for comparative purposes, but the prevalence of occult HBV infection measured in this study was higher than that observed in a population of non-IDUs in the Central-West Region of Brazil (2.7%, CI 95%: 0.7-8.3) (Ferreira et al 2009). Nevertheless, the prevalence observed in this study is comparable to those observed in IDU populations Italy (3.2%, CI 95%: 0.5-12.1) (Vitale et al 2008) and Argentina (7.7%, CI 95%: 3.9-14.0) (Trinks et al 2008).…”