Low Prevalence of Hepatitis B and C Virus Markers among Children and Adolescents

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Abstract

This study aimed to determine the prevalence of HBV and HCV among children and adolescents attending schools and daycare centres in Rio de Janeiro State, located in southern Brazil. Serum samples from 1,217 individuals aged 0 to 18 years were collected from 1999 to 2012 and tested for HBsAg, total anti-HBc, anti-HBs, and anti-HCV by ELISA. Reactive HBsAg and anti-HBc samples were tested for HBV DNA. Reactive anti-HCV samples were tested for HCV RNA and genotyped by RFLP. HBsAg was detected in 1.8% of individuals, and total anti-HBc was detected among 3.6% of individuals. Anti-HBs reactivity was found among 25.3% (322/1,217) of the individuals and increased from 6.28% in the years 1999-2000 to 76.2% in the years 2001–2012 ( P < 0.0001). HBV DNA was detected in 18 of 51 individuals who presented with HBsAg or isolated anti-HBc, and nine were considered occult hepatitis B cases. Three individuals were anti-HCV- and HCV RNA-positive: two of them were infected with genotype 1, and the other was infected with genotype 3. Low levels of HBV and HCV markers were observed in children and adolescents. HBV immunity increased during the period of study, indicating that childhood universal HBV vaccination has been effective for controlling HBV infection in Brazil.

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Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Leila MMB Pereira, Celina Martelli, Regina Moreira … (2013)

Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.

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Population-based multicentric survey of hepatitis B infection and risk factor differences among three regions in Brazil.

Celina M T Martelli, Claudio Dornas de Oliveira, M. Costa … (2009)

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.

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Impact of the implementation of a vaccination strategy on hepatitis B virus infections in China over a 20-year period.

Zhuanbo Luo, Lanjuan Li, Bing Ruan (2012)

Hepatitis B virus (HBV) vaccination has been recommended for all neonates in China since 1992. This article reviews the impact of HBV vaccination throughout the past 20 years in China. Before the introduction of the HBV vaccination program, approximately 9.8% of the general Chinese population tested positive for hepatitis B virus surface antigen (HBsAg). Since 1992, vaccination coverage has increased each year. In 1999, a National Expanded Programme on Immunization (EPI) review showed that the immunization coverage with three doses of HBV vaccine was 70.7%, and reached 99.0% in Beijing. The HBsAg carrier rate in the general population decreased to 7.2% in 2006. In particular, the prevalence of HBsAg decreased to 2.3% among children aged 5-14 years and to 1.0% among children younger than 5 years. In addition, the administration of the HBV vaccine may have reduced the risk of hepatocellular carcinoma among adults. Despite the administration of hepatitis B immunoglobulin and the HBV vaccine to children with HBsAg-positive mothers, the failure rate of HBV immunoprophylaxis was 5-10%. In China, vaccine failure was related to HBV S gene mutation and inadequate administration of HBV vaccine. The prevalence of HBV carriers in China was markedly reduced after the introduction of the universal HBV vaccination program. If we immunize all susceptible individuals with the hepatitis B vaccine (especially children), interrupt transmission, and provide antiviral treatment for existing HBV carriers, the number of new cases may be reduced to close to zero in the future and this may eventually result in the eradication of HBV. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): Biomed Res Int

Journal ID (iso-abbrev): Biomed Res Int

Journal ID (publisher-id): BMRI

Title: BioMed Research International

Publisher: Hindawi Publishing Corporation

ISSN (Print): 2314-6133

ISSN (Electronic): 2314-6141

Publication date (Print): 2014

Publication date (Electronic): 1 July 2014

Volume: 2014

Electronic Location Identifier: 324638

Affiliations

¹Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, 21040360 Rio de Janeiro, RJ, Brazil

²Laboratory of Technological Development of Virology, Oswaldo Cruz Institute, FIOCRUZ, 21040360 Rio de Janeiro, RJ, Brazil

Author notes

*Livia Melo Villar: lvillar@ 123456ioc.fiocruz.br

Academic Editor: Fumio Imazeki

Article

DOI: 10.1155/2014/324638

PMC ID: 4100382

SO-VID: 8e5701fa-ab5b-4fd7-aa50-eda498020b8a

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This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 19 February 2014

Date revision received : 22 May 2014

Date accepted : 27 May 2014

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Low Prevalence of Hepatitis B and C Virus Markers among Children and Adolescents

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Point-Of-Care Testing for Hepatitis

Most cited references 29

Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Population-based multicentric survey of hepatitis B infection and risk factor differences among three regions in Brazil.

Impact of the implementation of a vaccination strategy on hepatitis B virus infections in China over a 20-year period.

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