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

Regulatory T Lymphocytes (Treg): Modulation and Clinical Application

Treg cells CD4+CD25+FOXP3+ have a specific function in the tolerance of autoantigens and regulation of the immune response. Modulation of differentiation pathways and the use of Treg cells in cell therapy have been reported in autoimmune diseases, systemic lupus erythromatosis, autoimmune hepatitis, type 1 diabetes mellitus, multiple sclerosis, rheumatoid arthritis, graft-versus-host disease, bone marrow transplantation and solid organs. The expansion of Treg cells in vivo occurs through low-dose IL-2 treatment. However, because of the heterogeneity and variability of Treg cells, the isolation of peripheral blood cells, through the technique of leucopheresis by GMP (good manuring practice), for in vitro expansion is difficult, necessitating a large combination of specific and reliable cellular markers. Currently, two specific markers, Helios and neuropilin-1, are being studied to facilitate the differentiation of thymus Treg cells and peripheral Treg cells. However, Treg cells induced in vitro are unstable. Modulation of the FOXP3 gene in the CNS1 and CNS2 region is an alternative to maintaining the stability of expanded Treg cells in vitro

Hepcidin: SNP-Like Polymorphisms Present in Iron Metabolism and Clinical Complications of Iron Accumulation and Deficiency

The metabolism of iron is regulated by the peptide hormone hepcidin. Genetic alterations in the proteins involved in the signalling pathway and hepcidin transcription cause damage to the organism. Mutations and polymorphisms in the hepcidin antimicrobial peptide(HAMP), HFE, HJV, ferroportin and matriptase-2 genes influence serum hepcidin concentration. Genetic deficiency of hepcidin increases iron overload in tissues, leading to haemochromatosis. However, genetics changes in the TMPRSS6 gene promote an increase in serum hepcidin, with the development of severe anaemia and resistance to iron treatment, as observed in IRIDA. Making the flow and efflux of extracellular and intracellular iron is impossible. To date, no drug that works by inhibiting or enhancing hepcidin transcription is available, largely because of the cytotoxicity described in vitro models. The proposed therapeutic targets are still in the early stages of clinical trials, some are good candidates, such as heparin derivatives and mini-hepcidins

Influence of Hepcidin in the Development of Anemia

Anemia presents a global public health problem. It is related to several factors, ranging from deficiency in nutrients from food to genetic alterations in iron absorption and metabolism. In this context, hepcidin is a peptide molecule that regulates iron homeostasis. Hepcidin is synthesized, in part, by hepatocytes. In physiological conditions, increased serum transferrin, serum iron, inflammation, and erythropoiesis trigger stimuli that promote hepcidin antimicrobial peptide (HAMP) gene transcription and hepcidin synthesis. However, in pathological situations, an overexpression of hepcidin occurs, an increase in the plasma concentration that damages the organism. Hepcidin contributes to the pathogenesis of iron deficiency anemia, anemia of inflammation, in hemoglobinopathies. Then, there is a restriction of the availability of iron to the tissues and the formation of new erythroid precursors, with the consequent development of anemia

AVALIAÇÃO DO NÍVEL DE CONHECIMENTO DE ADOLESCENTES A RESPEITO DA TRANSMISSÃO E PREVENÇÃO DAS HEPATITES B E C

The aim of this study was to evaluate the knowledge of adolescents of Blumenaucity, Santa Catarina state, in Brazil, on the routes of transmission and preventionof hepatitis B and C. A cross-sectional study was conducted with 393 adolescentsbetween 10 and 15 years old, who were attended in public health institutionsof the city, and answered a questionnaire about hepatitis B and C. 210 out of393 participants (53.4%) were female. Most adolescents (83.2%) demonstratedknowledge of the preventive vaccine against hepatitis B. More than half of theparticipants (55.5%) believe that the contamination for HBV and HCV occurs bythe contact with blood or secretions from an infected person, and 23.5% are unawareof the transmission routes. Among the participants, 29.0% reported knowledge ofone or more cases of hepatitis in the family. Almost 40% of the adolescents informedan antecedent of hospital admission, five (1.3% of the total of participants) receivedblood transfusion and 13 (3.3% of the total) had body piercing and/or tattooing.The level of knowledge in the studied population indicates the need for increase ofeducational activities and the importance of health education for adolescents.O objetivo deste estudo foi avaliar o conhecimento de adolescentes do município de Blumenau, Santa Catarina, sobre os meios de transmissão e prevenção das hepatites B e C. Foi realizado um estudo transversal com 393 adolescentes entre 10 e 15 anos atendidos em postos de saúde do município, que responderam a um questionário relativo às hepatites B e C. Dos 393 participantes, 210 (53,4%) eram do sexo feminino. A maioria dos adolescentes (83,2%) demonstrou ter conhecimento da vacina preventiva contra a hepatite B. Pouco mais da metade dos participantes (55,5%) acreditam que a contaminação pelo HBV e HCV ocorra pelo contato com sangue ou secreções de uma pessoa infectada e 23,5% desconhecem as formas de transmissão. Dentre os participantes, 29,0% relataram conhecimento de um ou mais casos de hepatite na família. Quase 40% dos adolescentes informaram antecedente de internação hospitalar, dos quais 5 (1,3% do total de participantes) já haviam recebido sangue por transfusão e 13 (3,3% do total) possuem body piercing e/ou tatuagem. O nível de conhecimento na população estudada mostra a necessidade de intensificação das atividades educativas e a importância de uma política de educação em saúde voltada para os adolescentes

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