Hepatitis C virus infection among Brazilian hemophiliacs: a virological, clinical and epidemiological study

We determined and analyzed risk factors of hepatitis C virus (HCV)-infected Brazilian hemophiliacs according to their virological, clinical and epidemiological characteristics. A cross-sectional and retrospective study of 469 hemophiliacs was carried out at a Brazilian blood center starting in October 1997. The prevalence of HCV infection, HCV genotypes and factors associated with HCV RNA detection was determined. The seroprevalence of anti-HCV antibodies (ELISA-3.0) was 44.6% (209/469). Virological, clinical and epidemiological assessments were completed for 162 positive patients. There were seven (4.3%) anti-HCV seroconversions between October 1992 and October 1997. During the same period, 40.8% of the positive anti-HCV hemophiliacs had abnormal alanine transaminase (ALT) levels. Plasma HCV RNA was detected by nested-RT-PCR in 116 patients (71.6%). RFLP analysis showed the following genotype distribution: HCV-1 in 98 hemophiliacs (84.5%), HCV-3 in ten (8.6%), HCV-4 in three (2.6%), HCV-2 in one (0.9%), and not typeable in four cases (3.4%). Univariate analysis indicated that older age (P = 0.017) and abnormal ALT levels (P = 0.010) were associated with HCV viremia, while the presence of inhibitor antibodies (P = 0.024) and HBsAg (P = 0.007) represented a protective factor against the presence of HCV RNA. These findings may contribute to a better understanding of the relationship between HCV infection and hemophilia

A multivariate analysis of socio-demographic factors, water contact patterns and Schistosoma mansoni infection in an endemic area in Brazil Análise multivariada de fatores sócio-demográficos, padrões de contatos com água e infecção pelo Schistosoma mansoni em uma área endêmica em Minas Gerais

Associations between socio-demographic factors, water contact patterns and Schistosoma mansoni infection were investigated in 506 individuals (87% of inhabitants over 1 year of age) in an endemic area in Brazil (Divino), aiming at determining priorities for public health measures to prevent the infection. Those who eliminated S. mansoni eggs (n = 198) were compared to those without eggs in the stools (n = 308). The following explanatory variables were considered: age, sex, color, previous treatment with schistosomicide, place of birth, quality of the houses, water supply for the household, distance from houses to stream, and frequency and reasons for water contact. Factors found to be independently associated with the infection were age (10-19 and > 20 yrs old), and water contact for agricultural activities, fishing, and swimming or bathing (Adjusted relative odds = 5.0, 2.4, 3.2, 2.1 and 2.0, respectively). This suggests the need for public health measures to prevent the infection, emphasizing water contact for leisure and agricultural activities in this endemic area.<br>Foi examinada a existência de associação entre fatores sócio-demográficos, padrões de contatos com água e a infecção pelo Schitosoma mansoni em uma área endêmica em Minas Gerais (Divino), com o objetivo de determinar medidas prioritárias para prevenir a infecção; 506 indivíduos (87% dos habitantes com mais de 1 ano de idade) participaram do estudo. Aqueles que apresentavam ovos (n = 198) foram comparados aos que não apresentavam ovos de S. mansoni nas fezes (n = 308). As seguintes variáveis exploratórias foram consideradas: idade, sexo, cor, tratamento anterior com esquistossomicida, local de nascimento, qualidade da habitação, origem da água para o domicílio distância do domicílio em relação ao córrego, freqüência e motivos de contatos com água. As variáveis que apresentaram associações independentes com a infecção foram: idade (10-19 e > 20 anos), contato com águas para trabalho agrícola, pesca e natação ou banho (Odds relativas ajustadas = 5.0, 2.4, 3.2, 2.1 e 2.0, respectivamente). Estes resultados sugerem que medidas para prevenir a infecção devem priorizar os contatos com águas para o trabalho e o lazer nesta área endêmica