Prevalência dos marcadores das hepatites B e C em adolescentes de Itajaí-SC

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências de Saúde. Programa de Pós-Graduação em FarmáciaAs infecções pelo HBV e pelo HCV são dois preocupantes problemas de saúde pública, que infectam o fígado causando necrose e inflamação do tecido hepático. Quando a infecção persiste, favorecem a progressão para cirrose e carcinoma hepatocelular. No Brasil, a prevalência do HBV em geral é moderada (2% a 7%), com baixa taxa de infecção no Sul, média taxa de infecção no Nordeste e Sudeste, e uma alta prevalência na região da Amazônia, no Espírito Santo e no oeste de Santa Catarina. Atualmente, poucos dados são disponíveis da prevalência e dos fatores de risco ao HBV e do HCV no Brasil, principalmente em indivíduos vacinados contra a hepatite B. Além disso, o conhecimento da prevalência desses vírus é crucial a fim de antecipar impactos futuros nos sistemas de saúde e permitir um adequado gerenciamento dos recursos financeiros. O objetivo do presente estudo foi determinar a prevalência dos marcadores da hepatite B (HBsAg, anti-HBc e anti-HBs) e da hepatite C (anti-HCV) em estudantes voluntários com idade entre 10 a 15 anos. Participaram do estudo um total de 410 estudantes e foi verificado o documento de vacinação de 353. As amostras de sangue foram coletadas e as concentrações do HBsAg, anti-HBc, anti-HBs e anti-HCV foram determinadas. Os 4 marcadores foram analisados através da metodologia de imunoensaio enzimático de micropartículas (MEIA-Abbott AxSym System Laboratories). Os resultados mostram que a prevalência do HBsAg foi 0.5% (2/410), e a prevalência do anti-HBc foi 1% (4/410). A prevalência total do anti-HBs foi 81,22% (333/410), sendo que em 36,10% (148/410) dos adolescentes as concentrações de anti-HBs foram < 10 UI/L e em 45,12%(185/410) foram = 10 UI/L. A prevalência do anti-HBs em estudantes que receberam 3 ou 4 doses da vacina foi 94,48% (325/344), atingindo a cobertura vacinal proposta pelo Ministério da Saúde. Nenhuma prevalência do anti-HCV foi observada. Os resultados do estudo mostram que na população de 10 a 15 anos de idade residentes no município de Itajaí, Santa Catarina, a prevalências dos marcadores HBsAg, anti-HBc e anti-HCV é baixa. Além disso, a elevada cobertura vacinal e a prevalência do marcador anti-HBs demonstram o êxito do programa de vacinação instituído em 1993, que deve ser mantido e ampliado, mas, também, que outras formas de prevenção devem ser desenvolvidas a fim de prevenir a transmissão do HBV e do HCV. Infection by HBV and HCV is a worldwide public health problem, which infect and result in necrosis and inflammation in the liver. When the infection persists, contribute to progression liver cirrhosis and hepatocellular carcinoma. In Brazil, prevalence of HBV is moderate (2% to 7%), with low infection rate in Southern, middle rate in Northeast and Southeast, and high prevalence in the Amazon region, in the Espírito Santo, and in west of Santa Catarina. Little data are available on the seroprevalence and of risk factors for HBV and HCV infections in Brazil, mainly who had received hepatitis B vaccine. Knowing the prevalence of HBV and HCV in the general population is crucial for anticipating their future impact on the health system and for ensuring an adequate allocation of financial resources. The present study aimed to determine the prevalence of HBV (HBsAg, anti-HBc and anti-HBs) and HCV (anti-HCV) markers in voluntary students to aged 10 to 15 years. A total of 410 students participated in the study and 353 students vaccination document was check. Blood samples were collected and were tested four serological markers through Microparticle Enzyme Immunoassay (MEIA-Abbott AxSym System Laboratories). The results show that the overall HBsAg prevalence was 0.5% (2/410) and anti-HBc prevalence was 1% (4/410). The overall prevalence of anti-HBs was 81,22% (333/410), 36,10% (148/410) adolescent had anti-HBs concentrations < 10 IU/L and 45,12%(185/410) had anti-HBs concentrations = 10 IU/L. The prevalence of anti-HBs in vaccinated student that received 3 or 4 doses series was 94,48% (325/344) achieving the vaccination coverage goal of Health Department. None anti-HCV prevalence was observed. The results from study indicate that the prevalence of HBV and HCV markers was low in voluntary adolescents from Itajaí, Santa Catarina, aged from 10 to 15 years old. Moreover, the high vaccination coverage and prevalence of anti-HBs markers show the success of the vaccination program against hepatitis B initialized in 1993, that need to be maintained and expanded, but also that other prevention forms should be developed to prevent the HBV and HCV transmission

Anti-HBs levels among children and adolescents with complete immunization schedule against hepatitis B virus. A cross-sectional study in Blumenau, State of Santa Catarina, Brazil, 2007-2008

INTRODUCTION: Vaccination is the main tool for preventing hepatitis B virus (HBV) infection; however, following the completion of the vaccination series, the concentrations of anti-HBs can decline over the years and reach levels less than 10mIU/mL. The persistence of protection in these individuals is still unknown. The present study aimed to determine the anti-HBs antibody levels among children and adolescents who had received a complete vaccination course for hepatitis B. METHODS: Antibodies against HBV surface antigen (anti-HBs) were tested in 371 individuals aged 10 to 15 years-old. RESULTS: Volunteers who showed undetectable quantities of anti-HBs accounted for 10.2% of the population studied and 39.9% presented antibody titers of less than 10mIU/mL. Anti-HBs > 10mIU/mL were verified in 49.9%. CONCLUSIONS: These results corroborate other studies indicating levels of anti-HBs below 10mIU/mL in vaccinated individuals. Additional studies are required to assess whether this indicates susceptibility to HBV infection and the need and age for booster doses

Anti-HBs levels among children and adolescents with complete immunization schedule against hepatitis B virus. A cross-sectional study in Blumenau, State of Santa Catarina, Brazil, 2007-2008 Níveis de anti-HBs entre crianças e adolescentes com o esquema completo de imunização contra o vírus da hepatite B. Um estudo transversal em Blumenau, Estado de Santa Catarina, 2007-2008

INTRODUCTION: Vaccination is the main tool for preventing hepatitis B virus (HBV) infection; however, following the completion of the vaccination series, the concentrations of anti-HBs can decline over the years and reach levels less than 10mIU/mL. The persistence of protection in these individuals is still unknown. The present study aimed to determine the anti-HBs antibody levels among children and adolescents who had received a complete vaccination course for hepatitis B. METHODS: Antibodies against HBV surface antigen (anti-HBs) were tested in 371 individuals aged 10 to 15 years-old. RESULTS: Volunteers who showed undetectable quantities of anti-HBs accounted for 10.2% of the population studied and 39.9% presented antibody titers of less than 10mIU/mL. Anti-HBs > 10mIU/mL were verified in 49.9%. CONCLUSIONS: These results corroborate other studies indicating levels of anti-HBs below 10mIU/mL in vaccinated individuals. Additional studies are required to assess whether this indicates susceptibility to HBV infection and the need and age for booster doses.<br>INTRODUÇÃO: A vacinação é o principal instrumento para prevenir a infecção pelo vírus da hepatite B. Todavia, após a conclusão da série de vacinação, as concentrações de anti-HBs podem diminuir ao longo dos anos e atingir níveis inferiores a 10mUI/mL. A persistência da proteção nestes indivíduos ainda é desconhecida. O presente estudo objetivou determinar os níveis do anticorpo anti-HBs em crianças e adolescentes que receberam o esquema completo de vacinação para a hepatite B. MÉTODOS: O anticorpo para o antígeno de superfície do vírus da hepatite B (anti-HBs) foi testado em 371 indivíduos com idade entre 10-15 anos. RESULTADOS: Os voluntários que apresentaram quantidades indetectáveis de anti-HBs corresponderam a 10,2% da população estudada, e 39,9% apresentaram títulos do anticorpo inferiores a 10mUI/mL. Anti-HBs > 10mUI/mL foi verificado em 49,9%. CONCLUSÕES: Nossos resultados corroboram com outros estudos que indicam níveis de anti-HBs inferiores a 10mUI/mL em indivíduos vacinados. Estudos adicionais são necessários para avaliar se isso indica suscetibilidade à infecção pelo HBV e necessidade e idade para a dose reforço

Anti-HBs levels among children and adolescents with complete immunization schedule against hepatitis B virus. A cross-sectional study in Blumenau, State of Santa Catarina, Brazil, 2007-2008

INTRODUCTION: Vaccination is the main tool for preventing hepatitis B virus (HBV) infection; however, following the completion of the vaccination series, the concentrations of anti-HBs can decline over the years and reach levels less than 10mIU/mL. The persistence of protection in these individuals is still unknown. The present study aimed to determine the anti-HBs antibody levels among children and adolescents who had received a complete vaccination course for hepatitis B. METHODS: Antibodies against HBV surface antigen (anti-HBs) were tested in 371 individuals aged 10 to 15 years-old. RESULTS: Volunteers who showed undetectable quantities of anti-HBs accounted for 10.2&#37; of the population studied and 39.9&#37; presented antibody titers of less than 10mIU/mL. Anti-HBs &#8805; 10mIU/mL were verified in 49.9&#37;. CONCLUSIONS: These results corroborate other studies indicating levels of anti-HBs below 10mIU/mL in vaccinated individuals. Additional studies are required to assess whether this indicates susceptibility to HBV infection and the need and age for booster doses

Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008

INTRODUCTION: Hepatitis B infection constitutes an important cause of morbidity and mortality worldwide. In Brazil, however, the current epidemiological situation is not clear. Considering the importance of establishing this prevalence, the aim of this study was to determine the prevalence of HBV markers in voluntary adolescents, junior high (secondary school) students, in the City of Itajaí, State of Santa Catarina, Brazil. METHODS: A seroepidemiological, transverse study was conducted with 353 randomly chosen adolescents from elementary school in 2008. Blood samples were analyzed for HBsAg, anti-HBc and anti-HBs. All analyses were conducted by automated microparticle enzyme immunosorbent assay (Abbott®, AxSYM system, Deerfield, IL, USA), according to the manufacturer's instructions. RESULTS: The prevalence of HBsAg was 0.6% (CI 95% 0.1 - 2.0), that of anti-HBc was 1.1% (CI 95% 0.3 - 2.9) and that of detectable anti-HBs was 83.6% (CI 95% 79.3 - 87.3). Hepatitis B vaccination coverage was 97.5% (CI 95% 95.2 - 98.8). CONCLUSIONS: These results demonstrate the success of the vaccination program against hepatitis B in the region studied and indicate that prevention strategies must be maintained and, if possible, expanded to contribute to the establishment of positive prevalence rates in all age groups