Soroprevalência de infecções por vírus da hepatite B e vírus da hepatite C em indivíduos do Estado do Pará

Abstract

ARTIGO/ARTICLEAs infecções causadas pelo vírus da hepatite B (VHB) e pelo vírus da hepatite C (VHC) constituem grave problema de saúde pública mundial 9 . ABSTRACTHepatitis B and C continue to be important public health problems in Brazil. In this study, the prevalence of serological markers for hepatitis B and C in individuals from the State of Pará, attended at the Central Public Health Laboratory of Pará between January 2002 and December 2005, was determined. 11,282 tests to investigate HBsAg, 2,342 for anti-HBc and 5,542 for anti-HCV were performed. The prevalence of HBsAg was 3.6% and it was predominantly found in the age range of 20 to 29 years old, while anti-HBC was observed in 37.7% of the subjects. The prevalence of anti-hepatitis C virus was 3.6% and it was predominantly found in individuals over 50 years old. Thus, the frequencies of the markers found in Pará were higher than many other states in Brazil, hence suggesting that there is a need for public health measures of greater effectiveness for combating these illnesses in this region.Key-words: Hepatitis B. Hepatitis C. Serological markers. Prevalence. Infections.3 padrões: baixa (<1%), intermediária (1 a 5%) e alta (>5%) 5 . A soropositividade para o HBsAg e anti-HBc variam de região para região e em grupos populacionais específicos.A transmissão do VHB pode se dar horizontalmente através de contato com fluidos orgânicos contendo vírus, de modo especial com sangue, sêmen e saliva 9 . A maior prevalência está relacionada aos fatores de risco: hemodiálise, multitransfusões de sangue ou hemoderivados, manipulação de sangue humano, acidentes com materiais perfuro-cortantes, convivência íntima com infectados, uso de drogas ilícitas e contato com múltiplos parceiros sexuais 2 . A transmissão vertical ocorre através da passagem do vírus da mãe diretamente para o recém nascido no parto 14 . O vírus da hepatite C é transmitido essencialmente por contato com sangue,

Seroprevalence of hepatitis B and hepatitis C markers in adolescents in Southern Brazil

“…This prevalence is lower than that of studies with populations of a similar age in Germany (0.7% and 0.8%) 34,35 , and in the United States (0.3%) 36 . It is also lower that that found in Northern Brazil in volunteers aged below 19 years old (2.1%) 14 and in Pakistan in volunteers aged between 6 and 15 (9.6%) 37 , and corroborates that found in Spain (0%) in a population aged below 19 38 . As foreseeable, due to the young age of participants, our results show a low risk of hepatitis C infection.…”

“…Our anti-HBc prevalence is lower than that reported in Northern Brazil, 6% in children aged below 19 years old 14 and in Southern Brazil among blood donors: 5.3% 7 and 9.2% 17 in Florianópolis and 29% in Chapecó 7 . It is also lower than that found in Thailand, in individuals of a similar age range born before the implementation of the HBV vaccination, 15.8%, and in individuals born afterwards, 2.9% 27 .…”

“…Although several studies have been conducted on hepatitis B and C, especially on blood banks 6,7,8,9,10,11,12 , there are few studies carried out among the general population 13,14,15 , and due to territorial extension, and cultural and economic differences, the distribution of these diseases in the country differs among regions 16 .…”

The impact of HBV vaccination on Brazilian adolescents requires more attention

“…First, the study appears to have underestimated HCV and HBV infection rates because it failed to include children not enrolled in school and/or homeless children, who tend to be exposed to higher risk of infection. Prevalence rates for HCV and HBV infection are higher in street children 6 ; if the authors had enrolled the general population of adolescents in the study, they might have produced a more accurate estimate, as reported previously in Brazil (8.5%) 7 . The students' participation rate in the study was not mentioned, and it would have been better to evaluate vaccination coverage before studying the vaccine's efficacy.…”

Perfil de portadores de hepatite B em um serviço de referência: estudo retrospectivo

“…Observa-se que, mesmo com anamneses extremamente cuidadosas, não se identificam fatores de risco conhecidos em percentuais consideráveis de indivíduos com quadros crônicos, chegando esse desconhecimento a valores aproximadamente iguais a 30% para essa doença. Possivelmente a falta de conhecimento científico por parte dos profissionais de saúde sobre o assunto e a fragilidade do sistema de vigilância epidemiológica nos diversos níveis contribuem para a baixa implementação das medidas de controle da doença (8,9) . Condições como heterogeneidade socioeconômica, má distribuição dos serviços de saúde, incorporação desigual de tecnologia avançada para diagnóstico e tratamento de enfermidades são essenciais na avaliação do processo endemoepidêmico das hepatites virais.…”