RESUMO
Introducción: La hepatitis es una enfermedad inflamatoria que afecta al hígado. El virus de la hepatitis A produce un cuadro infeccioso agudo por lo general autolimitado en el ser humano, para el cual no existe tratamiento específico. Objetivo: Realizar una actualización acerca del comportamiento y manejo actual de la infección por el virus de la hepatitis A. Métodos: Se realizó una revisión bibliográfica durante septiembre y octubre de 2021, se consultaron 156 artículos en idioma inglés y español de bases de datos como SciELO, PubMed, LILACS y Medigraphic, de ellos se utilizaron 30 citas. Se empleó la combinación de términos y operadores booleanos y métodos teóricos como: análisis-síntesis, inducción-deducción e histórico-lógico. Resultados: Se abordó el comportamiento de la infección causada por el virus de la hepatitis A, se hizo hincapié en su epidemiología, características morfológicas y funcionales que permiten su infectividad, evolución y manifestaciones clínicas, complicaciones, tratamiento y perspectivas actuales. Conclusiones: El virus de la hepatitis A produce un cuadro infeccioso agudo. Se presenta tanto de forma esporádica como epidémica. Es la forma más común de hepatitis viral aguda. La transmisión es de persona a persona por vía fecal oral. Los síntomas relacionados con las hepatitis virales agudas son variables e inespecíficos. El diagnóstico de certeza se realiza mediante las pruebas serológicas y técnicas de biología molecular para la identificación del virus. No existe tratamiento específico para esta infección.
Introduction: Hepatitis is an inflammatory disease that affects the liver. The hepatitis A virus produces a generally self-limited acute infectious picture in humans, for which there is no specific treatment. Objective: To update on current behavior and management of hepatitis A virus infection. Methods: A bibliographic review was carried out during September and October 2021, consulting 156 articles in English and Spanish from databases such as SciELO, PubMed, Lilacs and Medigraphic, of which 30 citations were used. The combination of Boolean terms and operators and theoretical methods such as: analysis-synthesis, induction-deduction and historical-logical was used. Results: The behavior of the infection caused by the hepatitis A virus was addressed, emphasizing its epidemiology, morphological and functional characteristics that allow its infectivity, evolution and clinical manifestations, complications, treatment and current perspectives. Conclusions: The hepatitis A virus produces an acute infectious picture. It occurs both sporadically and epidemically. It is the most common form of acute viral hepatitis. Transmission is person-to-person by the fecal oral route. Symptoms related to acute viral hepatitis are variable and nonspecific. The diagnosis of certainty is carried out by means of serological tests and molecular biology techniques for the identification of the virus. There is no specific treatment for this infection.
RESUMO
Universal vaccination of children against hepatitis A was introduced in 2014 in Brazil as a single-dose schedule. We analyzed the numbers of reported cases of hepatitis A virus infection (HAV) from 2010 to 2017 to evaluate the initial impact of that intervention. Data were assessed and has been freely available on the Brazilian Ministry of Health website. The HAV incidence was steady around 6000 cases per year until 2014. Between 2014 and 2016, there was a 85.5% cumulative drop, independent of gender and geographical macroregions. The fall was especially significant among toddlers (96.8%). In 2017, cases increased due to an outbreak among male adults in São Paulo. Decrease in incidence continued to occur for females and for those under 15â¯years of age. Data show that there was a significant decrease in HAV cases number in Brazil from 2015 after the introduction of single-dose HAV vaccine program.
Assuntos
Anticorpos Anti-Hepatite A/sangue , Vacinas contra Hepatite A/administração & dosagem , Hepatite A/prevenção & controle , Programas de Imunização , Vacinação em Massa/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Surtos de Doenças/prevenção & controle , Feminino , Hepatite A/epidemiologia , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Saúde Pública , Adulto JovemRESUMO
Abstract: This cross-sectional study was carried out between August 2011 and July 2012 in the city of Campos dos Goytacazes in Rio de Janeiro State, Brazil. Dried blood spot samples were collected on filter paper from 919 individuals between the ages of 1 and 19 and were tested for antibodies against the hepatitis A virus (anti-HAV). The total prevalence was 20.7%, while 94.7% of children under the age of 5 were found to be susceptible to HAV infection. The prevalence of anti-HAV increased with age, reaching 33.3% among individuals aged between 15 and 19, thereby indicating that this municipality has a low level of endemicity for hepatitis A. Age, non-white skin color, accustomed to swimming in the river and more than five people living at home were the factors that were associated with an increase in the chance of a positive anti-HAV result. Mother's education level (secondary or tertiary) was considered a protective factor for HAV infection. The data obtained showed that a large proportion of the children from Campos dos Goytacazes were at risk of HAV infection, which should be minimized with the introduction of the vaccination program against hepatitis A that was launched in the municipality in 2011.
Resumo: Estudo do corte transversal, realizado entre agosto de 2011 e julho de 2012 em Campos dos Goytacazes, Rio de Janeiro, Brasil. Amostras de sangue capilar em papel de filtro foram coletadas de 919 indivíduos com idade entre 1 e 19 anos e testadas para anticorpos para o vírus da hepatite A (anti-HAV). A prevalência total foi de 20,7% e 94,7% das crianças abaixo de 5 anos foi suscetível a infecção pelo HAV. A prevalência de anti-HAV aumentou com a idade, alcançando 33,3% entre indivíduos com 15 a 19 anos, caracterizando este município com um nível baixo de endemicidade para hepatite A. Idade, cor da pele não-branca, hábito de nadar no rio e número de moradores na residência acima de 5 foram associados com o aumento de chance de ser positivo para anti-HAV. O nível educacional materno (médio ou superior) foi considerado como fator de proteção para a infecção pelo HAV. Os dados obtidos mostraram que uma grande parte das crianças de Campos dos Goytacazes estava sob risco de infecção pelo HAV, o que deve ser minimizado com o programa de vacinação contra hepatite A implantado em 2011 no município.
Resumen: Estudio de corte transversal, realizado entre agosto de 2011 y julio de 2012 en Campos dos Goytacazes, Río de Janeiro, Brasil. Se recogieron muestras de sangre capilar en papel de filtro de 919 individuos con una edad entre 1 y 19 años y testadas para anticuerpos del virus de la hepatitis A (anti-HAV). La prevalencia total fue de un 20,7% y un 94,7% de los niños por debajo de los 5 años fue susceptible a la infección por el HAV. La prevalencia de anti-HAV aumentó con la edad, alcanzando un 33,3% entre individuos con 15 a 19 años, caracterizando este municipio con un nivel bajo de endemicidad para la hepatitis A. Edad, color de piel no-blanca, hábito de nadar en el río y un número de ocupantes en la residencia de más de 5 se asociaron con el aumento de oportunidad de ser positivo para anti-HAV. El nivel educacional materno (medio o superior) se consideró como un factor de protección para la infección por el HAV. Los datos obtenidos mostraron que una gran parte de los niños de Campos dos Goytacazes estaba bajo riesgo de infección por el HAV, lo que debe ser minimizado con el programa de vacunación contra la hepatitis A implantado en 2011 en el municipio.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Vírus da Hepatite A Humana/imunologia , Vacinas contra Hepatite A/administração & dosagem , Anticorpos Anti-Hepatite A/sangue , Hepatite A/epidemiologia , Fatores Socioeconômicos , Brasil/epidemiologia , Estudos Soroepidemiológicos , Prevalência , Estudos Transversais , Hepatite A/prevenção & controleRESUMO
Age-related seroprevalence studies that have been conducted in Brazil have indicated a transition from a high to a medium endemicity of hepatitis A virus (HAV) infection in the population. However, most of these studies have focused on urban populations that experience lower incidence rates of HAV infection. In the current study, the prevalence of anti-HAV antibodies was investigated in children with a low socioeconomic status (SES) that live on the periphery of three capital cities in Brazil. A total of 1,162 dried blood spot samples were collected from individuals whose ages ranged from one-18 years and tested for anti-HAV antibodies. A large number of children under five years old (74.1-90%) were identified to be susceptible to HAV infection. The anti-HAV antibody prevalence reached ≥ 50% among those that were 10-14 years of age or older. The anti-HAV prevalence rates observed were characteristics of regions with intermediate level of hepatitis A endemicity. These data indicated that a large proportion of children with a low SES that live at the periphery of urban cities might be at risk of contracting an HAV infection. The hepatitis A vaccine that is currently offered in Brazil is only available for high-risk groups or at private clinics and is unaffordable for individuals with a lower SES. The results from this study suggest that the hepatitis A vaccine should be included in the Brazilian National Program for Immunisation.
Assuntos
Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Vacinas contra Hepatite A , Anticorpos Anti-Hepatite A/sangue , Vírus da Hepatite A Humana/imunologia , Hepatite A/epidemiologia , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Hepatite A/prevenção & controle , Prevalência , Estudos Soroepidemiológicos , Fatores Socioeconômicos , População UrbanaRESUMO
BACKGROUND: Patients with chronic liver disease have a higher risk of fulminant hepatitis when infected with hepatitis A virus, and vaccination of these patients against such infection is recommended. In Brazil, mainly in the South and Southeast regions, the epidemiology of hepatitis A (HA) has shifted from high to intermediate endemicity, which would have implication on policy of HA vaccination for these populations. OBJECTIVE: To verify the prevalence of HA immunity in adult patients with liver cirrhosis (LC), in Uberlândia MG, a city of Southeastern Brazil. METHODS: Between December 2005 and December 2006, 106 patients with LC were consecutively evaluated. In addition, 75 individuals without LC or alcoholism were evaluated (control group - CG). RESULTS: Total anti-HAV (ELISA methods) was positive in 104 (98.1 percent) patients with LC (82 men, 24 women; mean age, 53.3 ± 11.9 years) and in 74 (98.7 percent) individuals of the CG (55 men, 20 women; mean age, 47 ± 11.6 years), p > 0.05. CONCLUSIONS: For patients with chronic liver disease, in the geographic regions and age groups evaluated, routine vaccination against hepatitis A is not recommended. Moreover, the serum determination of total anti-HAV, used to assess immunity, is five times cheaper than vaccination against hepatitis A and, for this reason, should precede vaccination.