Decline in hepatitis B and C prevalence among hemodialysis patients in Tocantins, Northern Brazil

Infection control measures have been responsible for a decline in the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in hemodialysis patients. In Brazil, these measures have been in place since 1996. The aim of this study was to evaluate the current HBV and HCV epidemiology among hemodialysis patients in the State of Tocantins comparing them with those found 14 years ago. There was a significant decline in hepatitis B surface antigen (HBsAg) and anti-HCV prevalence from 4% and 13% in 2001 to 0.8% and 2.8% in 2014-2015, respectively (p < 0.05). Variables related to hemodialysis environment such as working shift and length of time on hemodialysis treatment were no longer associated to HCV and HBV exposure in 2014-2015. A high prevalence of self-reported hepatitis B vaccination was observed in both periods, but only 30% of the individuals showed serological profile of effective previous immunization, suggesting a low compliance with surveillance of hepatitis B immunization in hemodialysis centers. The significant decline in viral hepatitis B and C prevalence in hemodialysis patients in Tocantins underscores the importance of infection control measures, but the low frequency of protective serological profile after immunization against hepatitis B points to the need for greater vigilance of the patients’ vaccination

Study of hepatitis c virus infection in patients and professionals of the hemodialysis unit in Tocatins state

Submitted by Liliane Ferreira ([email protected]) on 2018-12-18T13:21:26Z No. of bitstreams: 2 Dissertação - Jonio Arruda Luz - 2003.pdf: 4871415 bytes, checksum: 6edf27591ff12d7b27c92756b11d43cc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2018-12-21T10:24:03Z (GMT) No. of bitstreams: 2 Dissertação - Jonio Arruda Luz - 2003.pdf: 4871415 bytes, checksum: 6edf27591ff12d7b27c92756b11d43cc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2018-12-21T10:24:03Z (GMT). No. of bitstreams: 2 Dissertação - Jonio Arruda Luz - 2003.pdf: 4871415 bytes, checksum: 6edf27591ff12d7b27c92756b11d43cc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2003-04-25Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqHepatitis C virus (HCV) infection is the main cause of hepatitis in hemodialysis patients. In order to investigate the HCV infection profile in the hemodialysis unit of the Tocantins state, 100 patients and 20 staff were studied, from January to March 2001. After interview, blood samples were collected, sera obtained and tested for anti-HCV antibodies by enzyme-linked immunosorbent assay (ELISA). All samples were also tested for RNA-HCV detection by polymerase chain reaction (PCR). HCV-RNA positive samples were genotyped by INNO-LiPA. An overall prevalence of 16% (CI 95%: 9.7 – 24.1) was found. Of the 100 patients, 13 (13%) were anti-HCV positive. HCV viremia was present in 14% of patients: 11 anti-HCV positive and 3 anti-HCV negative. Genotyping of HCV RNA positive samples revealed the presence of genotypes 1 (subtype 1a) and 3 (subtype 3a). Analysis of risk factors studied showed that only length of time on hemodialysis was associated with seropositivity. These data suggest the nosocomial transmission of HCV in the dialysis unit studied, emphasizing the need to evaluate strategies of control and prevention followed in this unit. Additionally, HCV RNA detection is necessary for the diagnosis of HCV infection in hemodialysis patients. Genotyping of HCV-RNA positive samples reveled the presence of genotypes 1 (subtype 1a) and 3 (subtype3a).A infecção pelo vírus da hepatite C (VHC) é a principal causa de hepatite em pacientes em hemodiálise. Com o objetivo de investigar o perfil da infecção pelo VHC na unidade de hemodiálise do Estado do Tocantins, 100 pacientes e 20 profissionais foram estudados, no período de janeiro a março de 2001. Após entrevista, as amostras de sangue foram coletadas, os soros obtidos e testados para a detecção de anticorpos anti-VHC pelo ensaio imunoenzimático (ELISA). Todos foram submetidos também à detecção do RNA-VHC pela reação da polimerase em cadeia (PCR). As amostras RNA-VHC positivas foram genotipadas por INNO-LiPA. Uma prevalênica global de 16% (IC 95%: 9,7- 24,1) foi encontrada. Dos 100 pacientes, 13 (13%) foram anti-VHC positivos. A viremia pelo VHC foi observada em 14% dos pacientes: 11 anti-VHC positivos e 3 negativos. A genotipagem das amostras RNA-VHC positivas revelou a presença dos genótipos 1(subtipo 1a) e 3(subtipo 3a). A análise dos fatores de risco estudados mostrou que apenas o tempo de hemodiálise estava associado à soropositividade. Estes dados sugerem a transmissão nosocomial do VHC no centro de hemodiálise estudado, ressaltando a necessidade de reavaliação das medidas de controle e prevenção adotadas. Além do mais, a detecção do RNA-VHC é necessária no diagnóstico da infecção pelo VHC em pacientes em hemodiálise. A genotipagem das amostras RNA-VHC positivas revelou a presença dos genótipos 1 (subtipo1a) e 3 (subtipo 3a)