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      Seroprevalence of hepatitis B virus and hepatitis C virus in Monte Negro in the Brazilian western Amazon region Translated title: Soroprevalência de hepatite B e hepatite C em Monte Negro, Rondônia, Região Amazônica Ocidental Brasileira

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          Abstract

          PURPOSE: This study was carried out in Monte Negro (state of Rondônia), a village in the Brazilian western Amazon region, where a University of São Paulo Medical School program for medical student training in rural assistance took place. It aimed to determine the prevalence of hepatitis B virus and hepatitis C virus, to investigate risk factors for infection, and to evaluate the State immunization program against hepatitis B virus in the region. METHODS: The study is a cross-sectional seroprevalence survey, comprising 267 volunteers who answered a comprehensive questionnaire and had blood samples collected, which were analyzed in São Paulo for the presence of antibodies against hepatitis B virus (Hbs Ag, anti-Hbs, and anti-Hbc) and hepatitis C virus using commercial kits. Data were stored in a specific data bank, and the association between seropositivity and potential risk factors was analyzed by means of uni-, bi-, and multi-variate analysis, considering ±5%. RESULTS: The seroprevalence of hepatitis B virus was 61.79% and of hepatitis C virus was 0.38%. Statistical analysis on the data bank showed that the prevalence of hepatitis B virus rose significantly with age, especially after adolescence. Infection was higher in those coming from outside the state of Rondônia. Exposure to vaccination against hepatitis B virus was higher in younger individuals and in those who were born in Rondônia. CONCLUSION: Monte Negro is a highly endemic region for hepatitis B virus but not for hepatitis C virus. Our results also provide indirect evidence indicating a significant improvement in the immunization program in Rondônia in recent years.

          Translated abstract

          OBJETIVOS: O presente estudo foi realizado em Monte Negro, Rondônia, Amazônia Oriental, onde um projeto de acadêmicos de Medicina da Universidade de São Paulo promoveu assistência médica à população rural. O objetivo foi determinar a soroprevalência de Hepatite B e Hepatite C, investigar os fatores de risco para sua infecção e avaliar o status imunológico vacinal contra Hepatite B nesta região. MÉTODOS: O estudo é uma pesquisa de corte transversal de soroprevalência, compreendendo 267 voluntários que tiveram suas amostras sanguíneas coletadas após preenchimento de um questionário. As amostras foram analisadas em São Paulo usando kits comerciais pesquisando anticorpos contra Hepatite B (AgHBs, Anti-HBs e Anti-HBc) e Hepatite C . Um banco de dados montado através do questionário foi analisado em relação aos resultados sorológicos com testes uni-, bi-, e multivariado, considerando ± = 5%. RESULTADOS: A soroprevalência do VHB encontrada foi de 61.79% e do Hepatite C, 0.38%. A análise dos possíveis fatores de risco mostrou que a prevalência de Hepatite B aumenta com a idade, especialmente após a adolescência, além de ser maior em aqueles nascidos em Rondônia. A exposição à vacinação contra Hepatite B foi maior em indivíduos jovens e aqueles nascidos em Rondônia. CONCLUSÃO: Monte Negro é uma região altamente endêmica para Hepatite B , mas não para Hepatite C . Ademais, os resultados obtidos evidenciam uma significativa melhora no programa de imunizações em Rondônia nos anos recentes.

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          Most cited references17

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          Global surveillance and control of hepatitis C. Report of a WHO Consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium.

          Hepatitis C is a global health problem caused by infection with the hepatitis C virus. Although representative prevalence data are not available from many countries, available data indicate that approximately 3% of the world's population is infected with HCV. It is estimated that as many as 170 million persons world-wide may be infected with HCV. In many countries, the exact magnitude of the problem and the relative contribution of the various routes of transmission have not been defined with population-based studies. Wherever possible such studies should be performed to enable countries to estimate the burden of hepatitis C disease, to prioritize their preventative measures and to make the most appropriate use of available resources. To assess hepatitis C on a global scale, the World Health Organization (WHO) organized a consultation of international experts, in order to review the public health aspects related to hepatitis C infection and to make recommendations for its prevention and control.
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            Hepatitis B: an important public health issue.

            W Maddrey (2000)
            Hepatitis B is one of the most common infectious diseases in the world. It has been estimated that 350 million people world-wide are chronic hepatitis B virus (HBV) carriers. The global prevalence of chronic HBV infection varies widely, from high (>/=8%, e.g., Africa, Asia and the Western Pacific) to intermediate (2-7% e.g., Southern and Eastern Europe) and low (<2%, e.g., Western Europe, North America and Australia). The predominant routes of transmission vary according to the endemicity of the HBV infection. In areas of high endemicity, perinatal transmission is the main route of transmission, whereas in areas of low endemicity, sexual contact amongst high-risk adults is the predominant route. Between one-third and one-quarter of people infected chronically with HBV are expected to develop progressive liver disease (including cirrhosis and primary liver cancer). Although mass vaccination programmes have begun to control the spread of HBV infection, therapeutic intervention is the only option for those with established chronic HBV-associated liver disease. Until recently, the only treatment for chronic hepatitis B was the immune modulator, interferon (IFN) alpha. IFN alpha treatment has several disadvantages; it is expensive, it must be administered by injection, there are side effects, and IFN alpha is poorly tolerated. Lamivudine, a nucleoside analogue, is the first effective, and well tolerated, oral treatment for chronic hepatitis B. In conclusion, although we are still some way from eradicating or curing chronic hepatitis B, the advent of lamivudine allows new populations to benefit from therapy and helps to address the global public health problem of hepatitis B. Copyright 2000 Wiley-Liss, Inc.
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              Hepatitis B epidemiology in Latin America.

              The available data on prevalence of hepatitis B virus (HBV) infection in Latin America are incomplete and largely based on analysis of blood banks, which are not stratified by age or social class. An epidemiological study was recently undertaken in six countries in Latin America to update the data. The highest seroprevalence of antibody to the HBV core antigen (anti-HBc) was found in the Dominican Republic (21.4%), followed by Brazil (7.9%), Venezuela (3.2%) and Argentina (2.1%). The lowest seroprevalence was found in Mexico (1.4%) and Chile (0.6%). The seroprevalence in different regions of Brazil varied from 21% in Manaus to 1.2% in Fortaleza. There were no differences in seroprevalence of anti-HBc between females and males except in Brazil (significantly higher in males) and in the Dominican Republic (significantly higher in females). In Brazil alone, higher seroprevalence was associated with lower socioeconomic class. In both the Dominican Republic and Brazil, seroprevalence was high in childhood, and in Brazil and Argentina, anti-HBc was detected in 3.0-6.6% of children up to 1 year old, suggesting vertical transmission. Other risk factors included dental and surgical procedures, sexual activity and tattooing. There was an increase in seroprevalence in all countries at or after adolescence, suggesting that sexual activity is a major route of transmission.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
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                Role: ND
                Journal
                clin
                Clinics
                Clinics
                Faculdade de Medicina / USP (São Paulo )
                1980-5322
                February 2005
                : 60
                : 1
                : 29-36
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                Article
                S1807-59322005000100007
                10.1590/S1807-59322005000100007
                c6ce1990-3cfd-44b4-8ed7-826287b35c52

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1807-5932&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL

                Internal medicine
                Brazil,Amazon region,hepatitis B,Hepatitis C,Seroprevalence,Immunization programs,Brasil,Região Amazônica,Hepatite B,Hepatite C,Soroprevalência,Programa de imunização

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