RESUMO
In 1991, Peru launched the first vaccination program against hepatitis B in children aged under 5 years in the hyperendemic [hepatitis B virus (HBV) and hepatitis D virus (HDV)] province of Abancay. We conducted a cross-sectional study to determine the prevalence of HBV and HDV infections, 23 years after the launch of the vaccination program, as well as the post-vaccine response against hepatitis B in terms of prevalence of hepatitis B surface antibody (anti-HBs ≥10 mUI/ml). Among 3165 participants aged from 0 to 94 years, the prevalence rates of hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (total anti-HBc) were 1.2% [95% confidence interval (CI) 0.85-1.64%], and 41.67% (95% CI 39.95-43.41%), respectively. The prevalence rate of anti-HBs at protective levels (≥10 mUI/ml) in individuals who HBsAg and anti-HBc negative was 66.36% (95% CI 64.15-68.51%). The prevalence rate of HBsAg in children aged <15 years was nil, and among adult HBsAg carriers, the prevalence of hepatitis D antibody (anti-HDV) was 5.26% (2/38; 95% CI 0.64-17.74). These findings showed that HBV prevalence has changed from high to low endemicity, 23 years following implementation of the vaccination program against hepatitis B, and HDV infection was not detected in those aged <30 years.
Assuntos
Vacinas contra Hepatite B/história , Hepatite B/prevenção & controle , Hepatite D/epidemiologia , Programas de Imunização/história , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Doenças Endêmicas , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite B/epidemiologia , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/farmacologia , Vírus da Hepatite B/imunologia , Hepatite D/imunologia , Vírus Delta da Hepatite/imunologia , História do Século XX , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Projetos Piloto , Prevalência , Adulto JovemAssuntos
Coinfecção/epidemiologia , Infecções por HIV/epidemiologia , HIV , Vacinas contra Hepatite B/farmacologia , Vírus da Hepatite B/imunologia , Hepatite B Crônica/prevenção & controle , Vacinação/métodos , Região do Caribe/epidemiologia , Hepatite B Crônica/epidemiologia , Humanos , Incidência , América Latina/epidemiologiaRESUMO
INTRODUCTION AND AIM: Viral hepatitis is a serious public health problem. The risk of progression to chronic hepatitis in hepatitis B virus (HBV) infection occurs in 5-10% of adults and is a leading cause of cirrhosis and hepatocellular carcinoma worldwide. Individuals infected with human immunodeficiency virus (HIV) may have coinfection with HBV. The existence of unvaccinated groups represents a significant risk not only individually but also at the community level. The aim of this study was to evaluate HBV vaccine response in adults with HIV infection. MATERIALS AND METHODS: A retrospective, descriptive study of the cross-sectional type was carried out in an outpatient HIV referral center in southern Brazil. All medical records of adult HIV patients seen during January 2006 to December 2015 were selected. In statistical analysis, a significance level of 5% was used. RESULTS: Of the 201 patients evaluated with a complete vaccination scheme, 55.72% were males, with a mean age of 43.86±12.68 years. Vaccine response occurred in 80.10% (161/201) of the patients, and it did not correlate with age, CD4+ cell count or viral load. CONCLUSION: HBV vaccine response in a HIV population was satisfactory, highlighting the importance of vaccination for prevention, cost reduction and better prognosis in preventing HBV/HIV coinfection.
Assuntos
Coinfecção/prevenção & controle , Infecções por HIV/epidemiologia , HIV , Vacinas contra Hepatite B/farmacologia , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Vacinação/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Coinfecção/epidemiologia , Estudos Transversais , Feminino , Hepatite B/terapia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE:: to assess predictive factors for noncompletion of the hepatitis B vaccination schedule in female sex workers in the city of Teresina, Northeastern Brazil. METHOD:: 402 women were interviewed and, for those who did not wish to visit specialized sites, or did not know their hepatitis B vaccination status, the vaccine was offered at their workplaces. Bi- and multivariate analyses were performed to identify potential predictors for noncompletion of the vaccination schedule. RESULTS:: of the 284 women eligible for vaccination, 258 (90.8%) received the second dose, 157/258 (60.8%) and 68/258 (26.3%) received the second and third doses, respectively. Working at clubs and consuming illicit drugs were predictors for noncompletion of the vaccination schedule. CONCLUSION:: the high acceptability of the vaccine's first dose, associated with low completion rates of the vaccination schedule in sex workers, shows the need for more persuasive strategies that go beyond offering the vaccine at their workplaces. OBJETIVO:: avaliar fatores preditores de não completude do esquema vacinal contra hepatite B em mulheres que se prostituem em Teresina, Nordeste do Brasil. MÉTODO:: Um total de 402 mulheres foi entrevistado e, para as que se negaram a irem a lugares especializados, ou desconheciam sua situação vacinal contra hepatite B, a vacina foi oferecida no local do trabalho. Análises bi e multivariadas foram realizadas para identificar potenciais preditores de não completude do esquema vacinal. RESULTADOS:: Das 284 mulheres elegíveis para vacinação, 258 (90,8%) receberam a primeira dose, 157/258 (60,8%) e 68/258 (26,3%) receberam a segunda e terceira doses. Trabalhar em boates e consumir drogas ilícitas foram preditores de não completude do esquema vacinal (p<0,05). CONCLUSÃO:: A elevada aceitabilidade da primeira dose da vacina, associada à baixa completude do esquema vacinal em profissionais do sexo, evidencia a necessidade de estratégia mais persuasiva que vá além da oferta da vacina no local de trabalho.
Assuntos
Vacinas contra Hepatite B/uso terapêutico , Adesão à Medicação/psicologia , Profissionais do Sexo/psicologia , Vacinação/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Hepatite B/prevenção & controle , Hepatite B/psicologia , Vacinas contra Hepatite B/farmacologia , Humanos , Adesão à Medicação/estatística & dados numéricos , Análise Multivariada , Fatores de Risco , Profissionais do Sexo/estatística & dados numéricosRESUMO
ABSTRACT Objective: to assess predictive factors for noncompletion of the hepatitis B vaccination schedule in female sex workers in the city of Teresina, Northeastern Brazil. Method: 402 women were interviewed and, for those who did not wish to visit specialized sites, or did not know their hepatitis B vaccination status, the vaccine was offered at their workplaces. Bi- and multivariate analyses were performed to identify potential predictors for noncompletion of the vaccination schedule. Results: of the 284 women eligible for vaccination, 258 (90.8%) received the second dose, 157/258 (60.8%) and 68/258 (26.3%) received the second and third doses, respectively. Working at clubs and consuming illicit drugs were predictors for noncompletion of the vaccination schedule. Conclusion: the high acceptability of the vaccine's first dose, associated with low completion rates of the vaccination schedule in sex workers, shows the need for more persuasive strategies that go beyond offering the vaccine at their workplaces.
RESUMEN Objetivo: Evaluar factores predictores del no completamiento del esquema de vacunación contra la hepatitis B en mujeres que se prostituyen en Teresina, noreste de Brasil. Método: Fueron entrevistadas 402 mujeres. Para las que se negaron a ir a lugares especializados o desconocían su situación de vacunación contra la hepatitis B, la vacuna fue ofrecida en lugar de trabajo. Fueron efectuados análisis multivariados para identificar potenciales predictores del no completamiento del esquema de vacunación. Resultados: de las 284 mujeres elegibles para vacunación, 258 (90,8%) recibieron primera dosis, 157/258 (60,8%) y 68/258 (26,3%) recibieron segunda y tercera dosis. Trabajar en burdeles y consumir drogas fueron factores predictores de no completamiento del esquema (p<0,05). Conclusión: La elevada aceptación de la primera dosis, asociada al bajo completamiento del esquema de vacunación en profesionales del sexo, evidencia necesidad de una estrategia más persuasiva, más allá de la oferta de vacunación en el lugar de trabajo.
RESUMO Objetivo: avaliar fatores preditores de não completude do esquema vacinal contra hepatite B em mulheres que se prostituem em Teresina, Nordeste do Brasil. Método: Um total de 402 mulheres foi entrevistado e, para as que se negaram a irem a lugares especializados, ou desconheciam sua situação vacinal contra hepatite B, a vacina foi oferecida no local do trabalho. Análises bi e multivariadas foram realizadas para identificar potenciais preditores de não completude do esquema vacinal. Resultados: Das 284 mulheres elegíveis para vacinação, 258 (90,8%) receberam a primeira dose, 157/258 (60,8%) e 68/258 (26,3%) receberam a segunda e terceira doses. Trabalhar em boates e consumir drogas ilícitas foram preditores de não completude do esquema vacinal (p<0,05). Conclusão: A elevada aceitabilidade da primeira dose da vacina, associada à baixa completude do esquema vacinal em profissionais do sexo, evidencia a necessidade de estratégia mais persuasiva que vá além da oferta da vacina no local de trabalho.
Assuntos
Humanos , Feminino , Adulto , Vacinação/estatística & dados numéricos , Vacinas contra Hepatite B/uso terapêutico , Adesão à Medicação/psicologia , Profissionais do Sexo/psicologia , Brasil , Estudos Transversais , Análise Multivariada , Fatores de Risco , Vacinas contra Hepatite B/farmacologia , Adesão à Medicação/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Hepatite B/prevenção & controle , Hepatite B/psicologiaRESUMO
El virus de la hepatitis B (VHB), es un virus DNA, el cual tiene varios antígenos, como el antígeno de superficie, y antígeno core. Colombia, es un país de baja endemicidad, sin embargo, en la Sierra Nevada de Santa Marta, está endemicidad es alta. El VHB tiene como una de sus complicaciones la hipertensión porta. En general, el VHB no atraviesa la placenta, por lo que la infección es rara in utero. Son pocos los pacientes que se presentan con HB y falla hepática fulminante y por lo tanto, son pocos los antivirales que han sido utilizados, con muy poca experiencia.
The hepatitis B virus (HBV) is a DNA virus, which has several antigens such as surface antigen and core antigen. Colombia is a country of low endemicity, however, in the Sierra Nevada of Santa Marta, is endemic is high. HBVis one of the complications of portal hypertension. In general, HBV does not cross the placenta, so the infection is rare in utero. Few patients who present with HB and fulminant hepatic failure and therefore, few antiviral drugs that have been u s e d , wi t h v e r y l i t t l e e x p e r i e n c e.
Assuntos
Humanos , Masculino , Feminino , Criança , Anticorpos Anti-Hepatite B/classificação , Anticorpos Anti-Hepatite B , Hepatite B/classificação , Hepatite B/complicações , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Hepatite B/etiologia , Hepatite B/genética , Hepatite B/patologia , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/genética , Anticorpos Anti-Hepatite B , Anticorpos Anti-Hepatite B/uso terapêutico , Hepatite B/transmissão , Hepatite B/virologia , Vacinas contra Hepatite B/administração & dosagem , Vacinas contra Hepatite B/isolamento & purificação , Vacinas contra Hepatite B/classificação , Vacinas contra Hepatite B/farmacologia , Vacinas contra Hepatite BRESUMO
BACKGROUND: Transplant recipients develop antibodies against a wide array of HLA specificities, and not only against the antigens to which they have been exposed. The aim of the present study was to establish if HLA-unrelated immune stimulation is capable of triggering the production of HLA antibodies. METHODS: We determined the presence of HLA antibodies in 20 healthy adults before and after the administration of an immune stimulus (hepatitis B vaccine plus tuberculin skin test). HLA antibodies were assessed with a flow-cytometry based system. RESULTS: At baseline, HBsAg antibodies were detected in protective titers in 75% of the subjects; HLA antibodies were negative in all but one. One week after the antigenic stimulus, HBsAg antibody titers increased significantly, without any detectable changes in HLA antibodies. Surprisingly, HLA antibodies developed in 8 participants one month after the application of the stimulus. One additional subject developed HLA antibodies one month later. Therefore 9/20 subjects became PRA positive during the observation period. Antibody specificities were identified by single antigen assay. The alloantibody response elicited by the immune stimulus was not consistent with memory cell stimulation. CONCLUSIONS: The findings of this study demonstrate that a non-HLA antigenic stimulus is capable of eliciting the development of HLA antibodies in healthy adults.
Assuntos
Anticorpos/imunologia , Antígenos HLA/imunologia , Vacinas contra Hepatite B/farmacologia , Adulto , Formação de Anticorpos , Especificidade de Anticorpos , Feminino , Citometria de Fluxo/métodos , Vacinas contra Hepatite B/imunologia , Humanos , Isoanticorpos/biossíntese , Isoanticorpos/imunologia , Masculino , Pessoa de Meia-Idade , Imunologia de Transplantes , Teste TuberculínicoRESUMO
The current total of AIDS cases in Mexico is 37,000 of which 86% have occurred in men. The major route of transmission is sexual. The campaign to prevent AIDS has fallen into four phases, and has now been extended to other sexually transmitted diseases, including hepatitis B. The first phase (1985-1989) was based around question and answer brochures, which increased awareness but did not remove misconceptions. A mass media campaign addressed these misconceptions and stressed preventive measures. The campaign was halted by opposition to the promotion of condom use on the grounds that it encouraged promiscuity. The second phase (1989-1992) used more conservative messages, but these were too obscure and failed to reach the target audience. A poster campaign using popular lottery characters was widely accepted. In the third phase (1992-1994), a combination of messages was targeted at different populations, including parents and women, and general public sympathy for social support for people with AIDS was encouraged. In the fourth phase (1996-2000), a mass media campaign was aimed at teenagers, with parents and teachers as support groups. The campaign was widened to include HBV infection, and posters and brochures for teenagers were produced. These are distributed as part of a collaboration with non-governmental organizations providing sex education. The private medical sector is being encouraged to provide facilities for hepatitis B vaccination. So far the campaign has only been established in Mexico City, but it is hoped that this will be extended nationwide. Hepatitis B vaccination has been recently included in the National Immunization Programme for infants in the first year of life and it is officially recommended for at-risk populations.