RESUMO
BACKGROUND: Hepatitis B virus (HBV) and tuberculosis (TB) represent major public health problems. There is currently little data on HBV infection among TB patients with and without human immunodeficiency virus (HIV). OBJECTIVES: To assess HBV prevalence among TB patients with and without HIV. STUDY DESIGN: From April 2008 to March 2010, a cross-sectional study was conduct among TB patients attended at a reference hospital in Goiânia City, Brazil. The participants were tested for serological markers of HBV infection and HIV antibodies. HBV DNA was detected in HBsAg-positive samples, and also in HBsAg-negative/anti-HBc-positive samples to look for HBV occult infection. RESULTS: Of 425 patients, 402 (94.6%) agreed to participate in the study. The overall prevalence of HBV (HBsAg and/or anti-HBc positive) and HIV infections were 25.6% (103/402) and 27.6% (111/402), respectively. A higher HBV infection rate was found among HIV-infected patients (36.9%; 41/111) compared to patients infected with TB only (20.0%; 57/285). A multivariate analysis of risk factors showed that age ≥ 50 years (p=0.03), non-injecting (p<0.01) and injecting (p<0.01) drugs use were associated with HBV infection. Among the HBsAg-positive samples (n=13), HBV DNA was detected in 10 (76.9%) samples. Of the 90 anti-HBc-positive samples, 13 were HBV DNA positive (with very low levels) resulting in an occult HBV infection rate of 14.4%. PCR-RFLP was successfully performed in 20 HBV DNA-positive samples: 15 were genotype A and 5 were genotype D. CONCLUSIONS: HBV infection was common, particularly among this with HIV infection.
Assuntos
Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Hepatite B/complicações , Hepatite B/epidemiologia , Tuberculose/complicações , Tuberculose/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , DNA Viral/sangue , Feminino , HIV-1/imunologia , Hepatite B/virologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/classificação , Vírus da Hepatite B/genética , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Prevalência , Fatores de Risco , Tuberculose/microbiologia , Adulto JovemRESUMO
SETTING: Goiânia City, Goiás State, Brazil. OBJECTIVES: To determine the prevalence of hepatitis C virus (HCV) infection, risk factors, HCV genotype/ subtype, HCV viral load and human immunodeficiency virus (HIV) status in patients with tuberculosis (TB) in Central Brazil. DESIGN: A cross-sectional study was carried out with 402 patients who were under tuberculosis (TB) treatment in the reference hospital for infectious diseases in Goiânia, Goiás, Central Brazil. RESULTS: The prevalence rates of HCV and HIV were respectively 7.5% and 27.6%. Two thirds of the HCV-infected patients (20/30) were HIV-positive. Age, injecting drug use (IDU) and HIV status were factors independently associated with HCV infection. HCV RNA was detected in 23 serum samples; HCV RNA levels were measured in 22/23 samples. HCV RNA level was slightly higher in HCV-HIV co-infected patients than in HCV monoinfected patients. Genotypes 1 (n = 17) and 3 (n = 6) were determined by LiPA. Using phylogenetic tree analysis of the NS5B region, subtypes 1a (n = 12), 1b (n = 2) and 3a (n = 6) were identified. CONCLUSION: These data indicate that patients with TB may benefit from integrated HIV and HCV screening, which may have an important impact upon TB management and treatment.
Assuntos
Coinfecção , Hepatite C/epidemiologia , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Estudos Transversais , Feminino , Genótipo , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Soropositividade para HIV , HIV-1/imunologia , Hepacivirus/genética , Hepacivirus/imunologia , Hepatite C/diagnóstico , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/análise , Medição de Risco , Fatores de Risco , Tuberculose/diagnóstico , Tuberculose/terapia , Adulto JovemRESUMO
OBJECTIVE: To investigate the epidemiology of hepatitis B virus (HBV) infection and viral genotypes in long distance truck drivers in Brazil. METHODS: We interviewed 641 long distance truck drivers to gather data on sociodemographics and risk factors and collected blood samples to test for HBV markers (HBsAg, anti-HBs and anti-HBc) by ELISA. HBsAg-positive samples were submitted to HBV DNA detection and genotyped. RESULTS: We found a global HBV prevalence of 18.9% (95% CI 15.9 to 22.2). Thirty truck drivers (4.7%) had only anti-HBs, suggesting that they had a previous HBV vaccination. More than 20 years in the profession, more than 15 days away from home and a history of sexual transmitted infections were independently and positivity associated with HBV markers. HBV DNA was detected in nine samples in which genotypes A (n = 5), D (n = 2) and F (n = 2) were found. CONCLUSIONS: These findings confirm that truck drivers are at high risk for hepatitis B infection and highlight the importance of having a public health policy that addresses this population and is based on the characteristics of HBV acquisition and dissemination.