Seroprevalence of HBV and HCV in female sex workers from four cities in the state of Pará, northern Brazil

Abstract

Female sex workers (FSWs) represent a high vulnerability group for the acquisition of sexual and parenteral infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. The present study aimed to determine the prevalence of serological markers and risk factors associated with exposure to HBV and HCV among FSWs in the state of Pará, Brazil. A cross‐sectional study using principles of the time location sampling (TLS) method was conducted in four cities (Belém, Bragança, Barcarena, and Augusto Corrêa) of the state of Pará, from 2005 to 2006. In total, 365 FSWs were interviewed using a standardized questionnaire. Blood samples were collected and tested for serological markers of exposure to HBV and HCV using an enzyme immunoassay. The overall prevalence of exposure to HBV and HCV was 36.7% and 7.7%, respectively. The prevalence of surface antigen of HBV was 3.0%. The prevalence of anti‐HBc and anti‐HBc+ anti‐HBs antibodies were 6.3% and 27.4%. Very few (4.7%) FSWs had vaccine immunity against HBV (anti‐HBs antibodies only). The prevalence of anti‐HCV antibodies was 7.7%. Low monthly income, drug usage, and unprotected sex were some of the social characteristics associated with exposure to the viruses using different analysis. The seroprevalence of HBV and HCV infections among FSWs in four cities of the state of Pará is high when compared to the general population of Brazil, but similar to those found in FSWs in other nondeveloped countries. The prevalence of HBV was higher in Belém, while the prevalence of HCV was higher in the other three cities, highlighting the importance of establishing control and prevention programs to reduce the risk of acquiring these viruses in Pará.

Detection and Genetic Characterization of Hepatitis B and D Viruses: A Multi-Site Cross-Sectional Study of People Who Use Illicit Drugs in the Amazon Region

“…As a main preventive measure, HBV vaccination should be extended to high-risk groups. Although an HBV vaccination program has been developed in the Amazon region in recent decades [ 14 , 20 ], epidemiological studies have indicated very low vaccine coverage in PWUDs and FSWs in this area, thus indicating the urgent need to vaccinate members of these vulnerable groups [ 13 , 37 , 66 , 98 ]. The neglect of this preventive measure contributes to the maintenance of HBV circulation on a larger scale in these high-risk groups and may contribute to the emergence of new infections, co-infections, and mutations in the genome, such as those recorded in this study.…”

The Epidemiological Impact of STIs among General and Vulnerable Populations of the Amazon Region of Brazil: 30 years of Surveillance

“…The rate of vaccine immunity (anti-HBs only) ranged from 0.7% to 4.7% [ 141 , 142 ] and genotype A (69.0%) was the predominant one [ 143 ]. Reduced monthly income, low education, unprotected sex, multiple sexual partners, unsafe sexual practices, illicit drug use and co-infection with other STIs have been associated with exposure to HBV [ 141 , 143 ]. These findings indicate the need for urgent measures to control the spread of HBV and other STIs and to promote the health of FSWs.…”

“…Epidemiological investigations among high-risk groups (FSWs and PWUD) showed prevalence rates of HBV infection ranging from 3.0% to 13.7% among FSWs that offered their services in municipalities and riverside communities in the state of Pará [121,141]. The rate of vaccine immunity (anti-HBs only) ranged from 0.7% to 4.7% [141,142] and genotype A (69.0%) was the predominant one [143].…”

“…Epidemiological investigations among high-risk groups (FSWs and PWUD) showed prevalence rates of HBV infection ranging from 3.0% to 13.7% among FSWs that offered their services in municipalities and riverside communities in the state of Pará [121,141]. The rate of vaccine immunity (anti-HBs only) ranged from 0.7% to 4.7% [141,142] and genotype A (69.0%) was the predominant one [143]. Reduced monthly income, low education, unprotected sex, multiple sexual partners, unsafe sexual practices, illicit drug use and co-infection with other STIs have been associated with exposure to HBV [141,143].…”

Hepatitis B and C in Immigrants and Refugees in Central Brazil: Prevalence, Associated Factors, and Immunization

“…The World Alliance against Viral Hepatitis and WHO currently promote strategies to eliminate viral hepatitis as a public health problem, to reduce new cases by 90% and deaths from viral hepatitis by 65% by 2030 [ 11 ]. On the other hand, to achieve these goals, it is essential to reach socially vulnerable subpopulations at risk of exposure to HBV and HCV [ 12 , 13 ], such as immigrants and refugees, an emerging population worldwide.…”