Seroprevalence of HBV and HCV markers among young adult males in the Air Force in Florianópolis, South Brazil

We investigated the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) serological markers of infection in young adults from the metropolitan region of Florianópolis who were conscripts of the Air Base of Florianópolis in the state of Santa Catarina, Brazil. A population-based cross-sectional seroprevalence study was conducted with 371 young males during a one year period starting in June 2009. Demographic characteristics, socio-economic characteristics and possible risk factors to HBV and HCV were assessed. Blood samples were analyzed for HBsAg, anti-HBc, anti-HCV and anti-HBs through automated microparticle enzymatic immunoassays (Abbott®, AxSYM System, Wiesbaden, Germany). None of the participants showed positivity to HBsAg or anti-HCV. The prevalence of anti-HBc was 1.6% (95% CI 0.6 - 3.5), and the prevalence of anti-HBs was 40.7% (95% CI 35.7 - 45.9). Unsafe sex was associated with positive anti-HBc in a bivariate analysis. There was a very low prevalence of past HBV infection and no cases of past HCV infection in a young adult population in the metropolitan region of Florianópolis. The very low prevalence of markers of infection and risk factors indicates a very optimistic future with respect to HBV and HCV infection in this population.Este estudo teve como objetivo investigar a prevalência dos marcadores sorológicos de infecção pelo HBV e HCV em adultos jovens na Região Metropolitana de Florianópolis, conscritos da Base Aérea de Florianópolis, Santa Catarina, Brasil. Trata-se de um estudo soroepidemiológico transversal de base populacional com 371 adultos jovens, no período de um ano a partir de junho de 2009. Foram pesquisadas características sócio-econômicas e possíveis fatores de risco para HBV e HCV. As amostras de sangue foram analisadas quanto à presença de HBsAg, anti-HBc, anti-HCV e anti-HBs pelo método imunoensaio enzimático automatizado de micropartículas (Abbott®, Sistema AxSYM, Wiesbaden, Alemanha). Nenhum dos participantes demonstrou positividade para HBsAg ou anti-HCV. A prevalência do anti-HBc foi de 1,6% (IC 95% 0,6 - 3,5) e do anti-HBs foi 40,7% (IC 95% 35,7 - 45,9). Relação sexual desprotegida associou-se com a positividade do anti-HBc na análise bivariada. Demonstrou-se prevalência muito baixa de infecção passada pelo HBV e ausência de HCV nesta população de adultos jovens na Região Metropolitana de Florianópolis. A particularidade desta prevalência muito baixa de marcadores de infecção e fatores de risco aponta para um quadro otimista em relação ao HBV e HCV no futuro para esta população

Hepatitis C Worldwide and in Brazil: Silent Epidemic—Data on Disease including Incidence, Transmission, Prevention, and Treatment

Hepatitis C virus (HCV) is endemic worldwide and according to the World Health Organization (WHO), there are about 150 million chronic carriers worldwide. The infection is a leading cause of liver diseases like cirrhosis and hepatocellular carcinoma (HCC); thus, HCV infection constitutes a critical public health problem. There are increasing efforts worldwide in order to reduce the global impact of hepatitis C through the implementation of programmatic actions that may increase the awareness of viral hepatitis and also improve surveillance, prevention, and treatment. In Brazil, about 1,5 million people have been chronically infected with HCV. The country has a vast territory with uneven population density, and hepatitis C incidence rates are variable with the majority of cases concentrated in the most populated areas. Currently, the main priorities of Brazilian Ministry of Health's strategies for viral hepatitis management include the prevention and early diagnosis of viral hepatitis infections; strengthening of the healthcare network and lines of treatment for sexually transmitted diseases, viral hepatitis, and AIDS; improvement and development of surveillance, information, and research; and promotion of universal access to medication. This review aims to summarize the available data on hepatitis C epidemiology and current status of efforts in prevention and infection control around the world and in Brazil

The effects of N-acetylcysteine supplementation in patients seropositive for HIV

Na infecção pelo HIV o equilíbrio entre antioxidantes e pró-oxidantes e a produção de citocinas encontram-se alterados, causando estresse oxidativo crônico. Presume-se que o estresse oxidativo crônico e a ativação do sistema imunológico favorecem a replicação do vírus através da ativação do NF-kB e a apoptose de células mononucleares do sangue periférico. O objetivo deste estudo foi avaliar o efeito da suplementação, durante 180 dias, com 600mg/dia de N-acetilcisteína (NAC), sobre a carga viral, os níveis de sub-populações de linfócitos, a viabilidade de linfócitos e sobre os níveis séricos de citocinas, proteínas, lipídeos, β2 microglobulina e outros marcadores da ativação do sistema imunológico em pacientes assintomáticos, submetidos ao primeiro tratamento anti-retroviral. Participaram deste estudo, duplo cego controlado por placebo, que teve a duração de 180 dias, 30 indivíduos que iniciaram a terapia anti-retroviral. O grupo estudo foi constituído por 14 indivíduos que além do tratamento anti-retroviral foram suplementados com NAC, enquanto o grupo controle foi constituído por 16 indivíduos que além do tratamento anti-retroviral receberam placebo. Os marcadores avaliados foram determinados no dia anterior ao início do tratamento a que foram submetidos e após 60, 120 e 180 dias. Verificou-se aumento significante dos linfócitos CD4+, da relação CD4/CD8, de linfócitos viáveis, albumina, cisteína e glutationa, bem como diminuição significante dos níveis de TNF-α, IL-8, haptoglobina e α1-glicoproteína ácida, β2-microglobulina, IgA e IgM, nos dois grupos estudados. Os níveis séricos de IL-6, colesterol total, LDL-colesterol, VLDL-colesterol e triglicerídeos não apresentaram alteração significante ao final deste estudo. Concluindo, a suplementação com 600 mg/dia de NAC, em pacientes submetidos ao tratamento anti-retroviral, não proporcionou benefícios adicionais àqueles decorrentes deste tratamento.In HIV infection, the balance between antioxidants and pró-oxidants and the production of citokines are disturbed leading to a chronic state of oxidative stress and immune activation. It is presumed that HIV takes advantage of the proinflammatory and prooxidative environment to replicate through the NF-kB pathway leading to the apoptosis of peripheral blood mononuc1ear cells. The aim of this work was to study the effect of oral administration of N-acetylcysteine (NAC) 600 mg per day during 180 days on viral load, viability of lymphocytes, cytokines, proteins, lipids, β2-microglobulin and other immune activation markers in asymptomatic patients under their first antiretroviral therapy. This was a double-blind, placebo-controlled study with 30 individuals who started antiretroviral therapy and were followed for 180 days. These individual were divided into two subgroups: the study group consisted of 14 participants who received NAC supplementation, whereas the control group had 16 individuals who received placebo. The studied markers were determined on the day before the beginning of treatment and after 60, 120 and 180 days of treatment. A significant increase was seen for CD4+ lymphocytes, the CD4/CD8 ratio, albumin, cysteine and glutathione; also, a significant reduction was found for levels of TNF-α, IL-8, β2 microglobulin, IgA, IgG, IgM, haptoglobin, and acid α1-glycoprotein as a consequence of antiretroviral treatment. After 180 days of treatment, the levels of total protein, globulins and HDL-cholesterol presented significant alteration on1y in the control group, while the serum levels of IL-6, total cholesterol, LDL-cholesterol, VLDL-cholesterol and triglyceride did not show significant alteration at the end of the present study. In conclusion, the supplementation of HIV-positive patients with 600 mg/day of NAC did not bring additional benefits to those resulting from antiretroviral treatment

Metabolic changes and the antioxidant defense system in plasma and mononuclear cells resulting from infection with human immunodeficiency virus

No presente trabalho analisou-se um total de 101 indivíduos, sendo 26 não infectados e 75 infectados pelo HIV e classificados de acordo com o Walter Reed Army Institute (28 pacientes WR 1, 31 pacientes WR 2 e 16 pacientes WR 3/4). 05 indivíduos infectados pelo HIV apresentaram, nos estágios iniciais, uma diminuição progressiva do peso corporal, dos níveis séricos de uréia, albumina, colesterol total, HOL colesterol e LOL colesterol. Já os níveis séricos de proteínas totais, globulinas, IgG, IgA, α1 glicoproteína ácida, haptoglobina e as atividades enzimáticas da AST e da LD apresentaram elevação nos indivíduos infectados e em conseqüência da evolução da infecção. Os triglicérides demonstraram apenas tendência para aumento dos níveis séricos nos indivíduos estadiados como WR3/4. Os níveis de ferro sérico encontraram-se diminuídos nos indivíduos estadiados como WR 3/4, enquanto que a concentração de transferrina apresentou-se diminuída apenas no Grupo WR 2. Houve uma tendência para a elevação progressiva dos níveis médios de ferritina com a evolução da doença. Nenhuma alteração foi verificada nos níveis de proteína \"C\" reativa. A EC-SOO apresentou diminuição dos níveis de atividade nos indivíduos infectados pelo HIV, enquanto que em células mononucleares a SOD apresentou atividade diminuída nos indivíduos estadiados como WR 3/4. A GSH-Px não apresentou alteração de sua atividade em decorrência da infecção pelo HIV. Os níveis plasmáticos do α-tocoferol e do ascorbato apresentaram tendência para diminuição, enquanto o β-caroteno não apresentou alteração nos grupos estudados. Estes resultados sugerem que a haptoglobina, as globulinas e a IgA podem ser utilizadas para a avaliação da evolução da infecção pelo HIV. Por outro lado, os níveis dos constituintes do sistema de defesa antioxidante analisados indicam que os indivíduos soropositivos encontram-se menos protegidos contra a ação de espécies reativas de oxigênio, o que favoreceria a presença de um estresse oxidativo e a replicação viral.A total number of 101 individuals, including 26 controls and 75 patients classified according to the Walter Reed Army Institute (28 WR 1, 31 WR 2 and 16 WR 3/4) was studied. HIV infected individuals presented, during the early stages, a progressive reduction of body weigth, as well as urea, albumin, total cholesterol, HDL cholesterol and LDL cholesterol in blood serum. However, increased serum levels of total protein, globulin, IgG, IgA, α1 acid glycoprotein, haptoglobin, AST and LD were observed in HIV infected individuals during the evolution of infection. Decreased serum iron and a trend for increasing triglyceride was shown only for those individuals classified as WR 3/4. Transferrin was diminished only in the WR 2 group. A trend for enhancing serum ferritin following the progession of HIV infection was also observed. No alteration was observed on the levels of reactive \"C\" protein. Decreased EC-SOD activities were observed in HIV infected individuals as compared to controls, whereas in mononuclear cells the SOD activity was diminished only in WR 3/4 patients. HIV infection did not alter GSH-Px activity. A trend for decreasing α-tocopherol and ascorbate plasma levels was shown during the evolution of HIV infected patients, while no difference was observed for β-carotene levels in the studied groups. The above results suggest that haptoglobin, globulins and IgA can be used to assess the evolution of the HIV infection. Moreover, the decreased levels of the antioxidant defense system components observed in HIV infected patients may indicate that they are under an oxidative stress that could favor HIV replication

The effects of N-acetylcysteine supplementation in patients seropositive for HIV

Na infecção pelo HIV o equilíbrio entre antioxidantes e pró-oxidantes e a produção de citocinas encontram-se alterados, causando estresse oxidativo crônico. Presume-se que o estresse oxidativo crônico e a ativação do sistema imunológico favorecem a replicação do vírus através da ativação do NF-kB e a apoptose de células mononucleares do sangue periférico. O objetivo deste estudo foi avaliar o efeito da suplementação, durante 180 dias, com 600mg/dia de N-acetilcisteína (NAC), sobre a carga viral, os níveis de sub-populações de linfócitos, a viabilidade de linfócitos e sobre os níveis séricos de citocinas, proteínas, lipídeos, β2 microglobulina e outros marcadores da ativação do sistema imunológico em pacientes assintomáticos, submetidos ao primeiro tratamento anti-retroviral. Participaram deste estudo, duplo cego controlado por placebo, que teve a duração de 180 dias, 30 indivíduos que iniciaram a terapia anti-retroviral. O grupo estudo foi constituído por 14 indivíduos que além do tratamento anti-retroviral foram suplementados com NAC, enquanto o grupo controle foi constituído por 16 indivíduos que além do tratamento anti-retroviral receberam placebo. Os marcadores avaliados foram determinados no dia anterior ao início do tratamento a que foram submetidos e após 60, 120 e 180 dias. Verificou-se aumento significante dos linfócitos CD4+, da relação CD4/CD8, de linfócitos viáveis, albumina, cisteína e glutationa, bem como diminuição significante dos níveis de TNF-α, IL-8, haptoglobina e α1-glicoproteína ácida, β2-microglobulina, IgA e IgM, nos dois grupos estudados. Os níveis séricos de IL-6, colesterol total, LDL-colesterol, VLDL-colesterol e triglicerídeos não apresentaram alteração significante ao final deste estudo. Concluindo, a suplementação com 600 mg/dia de NAC, em pacientes submetidos ao tratamento anti-retroviral, não proporcionou benefícios adicionais àqueles decorrentes deste tratamento.In HIV infection, the balance between antioxidants and pró-oxidants and the production of citokines are disturbed leading to a chronic state of oxidative stress and immune activation. It is presumed that HIV takes advantage of the proinflammatory and prooxidative environment to replicate through the NF-kB pathway leading to the apoptosis of peripheral blood mononuc1ear cells. The aim of this work was to study the effect of oral administration of N-acetylcysteine (NAC) 600 mg per day during 180 days on viral load, viability of lymphocytes, cytokines, proteins, lipids, β2-microglobulin and other immune activation markers in asymptomatic patients under their first antiretroviral therapy. This was a double-blind, placebo-controlled study with 30 individuals who started antiretroviral therapy and were followed for 180 days. These individual were divided into two subgroups: the study group consisted of 14 participants who received NAC supplementation, whereas the control group had 16 individuals who received placebo. The studied markers were determined on the day before the beginning of treatment and after 60, 120 and 180 days of treatment. A significant increase was seen for CD4+ lymphocytes, the CD4/CD8 ratio, albumin, cysteine and glutathione; also, a significant reduction was found for levels of TNF-α, IL-8, β2 microglobulin, IgA, IgG, IgM, haptoglobin, and acid α1-glycoprotein as a consequence of antiretroviral treatment. After 180 days of treatment, the levels of total protein, globulins and HDL-cholesterol presented significant alteration on1y in the control group, while the serum levels of IL-6, total cholesterol, LDL-cholesterol, VLDL-cholesterol and triglyceride did not show significant alteration at the end of the present study. In conclusion, the supplementation of HIV-positive patients with 600 mg/day of NAC did not bring additional benefits to those resulting from antiretroviral treatment

Metabolic changes and the antioxidant defense system in plasma and mononuclear cells resulting from infection with human immunodeficiency virus

No presente trabalho analisou-se um total de 101 indivíduos, sendo 26 não infectados e 75 infectados pelo HIV e classificados de acordo com o Walter Reed Army Institute (28 pacientes WR 1, 31 pacientes WR 2 e 16 pacientes WR 3/4). 05 indivíduos infectados pelo HIV apresentaram, nos estágios iniciais, uma diminuição progressiva do peso corporal, dos níveis séricos de uréia, albumina, colesterol total, HOL colesterol e LOL colesterol. Já os níveis séricos de proteínas totais, globulinas, IgG, IgA, α1 glicoproteína ácida, haptoglobina e as atividades enzimáticas da AST e da LD apresentaram elevação nos indivíduos infectados e em conseqüência da evolução da infecção. Os triglicérides demonstraram apenas tendência para aumento dos níveis séricos nos indivíduos estadiados como WR3/4. Os níveis de ferro sérico encontraram-se diminuídos nos indivíduos estadiados como WR 3/4, enquanto que a concentração de transferrina apresentou-se diminuída apenas no Grupo WR 2. Houve uma tendência para a elevação progressiva dos níveis médios de ferritina com a evolução da doença. Nenhuma alteração foi verificada nos níveis de proteína \"C\" reativa. A EC-SOO apresentou diminuição dos níveis de atividade nos indivíduos infectados pelo HIV, enquanto que em células mononucleares a SOD apresentou atividade diminuída nos indivíduos estadiados como WR 3/4. A GSH-Px não apresentou alteração de sua atividade em decorrência da infecção pelo HIV. Os níveis plasmáticos do α-tocoferol e do ascorbato apresentaram tendência para diminuição, enquanto o β-caroteno não apresentou alteração nos grupos estudados. Estes resultados sugerem que a haptoglobina, as globulinas e a IgA podem ser utilizadas para a avaliação da evolução da infecção pelo HIV. Por outro lado, os níveis dos constituintes do sistema de defesa antioxidante analisados indicam que os indivíduos soropositivos encontram-se menos protegidos contra a ação de espécies reativas de oxigênio, o que favoreceria a presença de um estresse oxidativo e a replicação viral.A total number of 101 individuals, including 26 controls and 75 patients classified according to the Walter Reed Army Institute (28 WR 1, 31 WR 2 and 16 WR 3/4) was studied. HIV infected individuals presented, during the early stages, a progressive reduction of body weigth, as well as urea, albumin, total cholesterol, HDL cholesterol and LDL cholesterol in blood serum. However, increased serum levels of total protein, globulin, IgG, IgA, α1 acid glycoprotein, haptoglobin, AST and LD were observed in HIV infected individuals during the evolution of infection. Decreased serum iron and a trend for increasing triglyceride was shown only for those individuals classified as WR 3/4. Transferrin was diminished only in the WR 2 group. A trend for enhancing serum ferritin following the progession of HIV infection was also observed. No alteration was observed on the levels of reactive \"C\" protein. Decreased EC-SOD activities were observed in HIV infected individuals as compared to controls, whereas in mononuclear cells the SOD activity was diminished only in WR 3/4 patients. HIV infection did not alter GSH-Px activity. A trend for decreasing α-tocopherol and ascorbate plasma levels was shown during the evolution of HIV infected patients, while no difference was observed for β-carotene levels in the studied groups. The above results suggest that haptoglobin, globulins and IgA can be used to assess the evolution of the HIV infection. Moreover, the decreased levels of the antioxidant defense system components observed in HIV infected patients may indicate that they are under an oxidative stress that could favor HIV replication

The prevalence of hepatitis B virus infection markers and socio-demographic risk factors in HIV-infected patients in Southern Brazil

IntroductionHepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections are two of the world's most important infectious diseases. Our objective was to determine the hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) prevalences among adult HIV-infected patients and identify the associations between socio-demographic variables and these HBV infection markers.MethodsThis study was performed from October 2012 to March 2013. Three hundred HIV-seropositive patients were monitored by the Clinical Analysis Laboratory of Professor Polydoro Ernani de São Thiago University Hospital, Santa Catarina, Brazil. The blood tests included HBsAg, anti-HBc immunoglobulin M (IgM) and total anti-HBc. Patients reported their HIV viral loads and CD4+ T-cell counts using a questionnaire designed to collect sociodemographic data.ResultsThe mean patient age was 44.6 years, the mean CD4 T-cell count was 525/mm3, the mean time since beginning antiretroviral therapy was 7.6 years, and the mean time since HIV diagnosis was 9.6 years. The overall prevalences of HBsAg and total anti-HBc were 2.3% and 29.3%, respectively. Among the individuals analyzed, 0.3% were positive for HBsAg, 27.3% were positive for total anti-HBc, and 2.0% were positive either for HBsAg or total anti-HBc and were classified as chronically HBV-infected. Furthermore, 70.3% of the patients were classified as never having been infected. Male gender, age >40 years and Caucasian ethnicity were associated with an anti-HBc positive test.ConclusionsThe results showed an intermediate prevalence of HBsAg among the studied patients. Moreover, the associations between the anti-HBc marker and socio-demographic factors suggest a need for HBV immunization among these HIV-positive individuals, who are likely to have HIV/HBV coinfection

Seroprevalence of hepatitis B and hepatitis C markers in adolescents in Southern Brazil

This study was carried out to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) markers among adolescents aged between 10 and 16 years old, who are elementary school students in the city of Chapecó, Santa Catarina State, Brazil. The study involved a cross-sectional survey that included 418 volunteers, from March to July, 2008. Serology comprised HBsAg, anti-HBc, anti-HBs and anti-HCV. Tests were performed using automated Microparticle Enzyme Immunosorbant Assay (Abbott, AxSYM System, Wiesbaden, Germany). The prevalence of HBsAg was found to be 0.2% (95%CI: 0.0-1.3), and the prevalence of anti-HBc was found to be 1.4% (95%CI: 0.5-3.1). Regarding anti-HBs, 48.6% had titers greater than 10UI/L. None of the volunteers presented reactive results for anti-HCV. This study showed a low prevalence of HBV and HCV markers of infection and a great number of volunteers immunized against HBV. Finally this study shows the importance of proper health campaigns and policies in reducing those prevalences

Evaluation of annexin V and Calcein-AM as markers of mononuclear cell apoptosis during human immunodeficiency virus infection

Evaluation of apoptosis by flow cytometry is generally accomplished by methods that use annexin V-FITC as vital dye, which access phosphatidylserine exposed on the external membrane at the beginning of this process. In addition, the concomitant use of propidium iodide makes possible to verify the characteristic nuclear alterations in the late stages of apoptosis, as a consequence of the increase in membrane permeability. On the other hand, the use of calcein-AM in association with ethidium homodimer (EthD-1) allows the evaluation of cell apoptosis through detection of esterase activity and cellular membrane physical and chemical alterations. The aim of this study was to compare the sensibility of calcein-AM and EthD-1 with annexin V-FITC and propidium iodide for early apoptosis evaluation in peripheral blood mononuclear cell culture, obtained from HIV-infected patients. Apoptosis and cellular viability were detected and quantified by flow cytometry after 24 and 48 hours incubation times. Our results showed that calcein-AM/EthD-1 was more sensitive for apoptotic cell quantification in both incubation times than annexin V-FITC/propidium iodide (mean of 46.95% ± 3.56, p < 0.0001, for 24 hours and mean of 37.67% ± 2.47, p < 0.0014 for 48 hours), besides allowing to clearly define viable, apoptotic and dead cell populations