Viral hepatitis in female sex workers using the Respondent-Driven Sampling

OBJECTIVE To estimate the prevalence of hepatitis B virus and C virus infections and their genotypes and analyze the risk factors for the markers of exposure to hepatitis B virus in female sex workers in a region of intense sex trade. METHODS This is a cross-sectional study performed with four hundred and two female sex workers in Goiânia, Brazil. Data have been collected using the Respondent-Driven Sampling. The women have been interviewed and tested for markers of hepatitis B and C viruses. Positive samples have been genotyped. The data have been analyzed using the Respondent-Driven Sampling Analysis Tool, version 5.3, and Stata 11.0. RESULTS The adjusted prevalence for hepatitis B virus and C virus were 17.1% (95%CI 11.6–23.4) and 0.7% (95%CI 0.1–1.5), respectively. Only 28% (95%CI 21.1–36.4) of the participants had serological evidence of vaccination against hepatitis B virus. Being older (>; 40 years), being single, having a history of blood transfusion and use of cocaine, and ignoring the symptoms of sexually transmitted infections were associated with positivity for hepatitis B virus (p < 0.05). We have detected the subgenotype A1 of hepatitis B virus (n = 3) and the subtypes of hepatitis C virus 1a (n = 3) and 1b (n = 1). CONCLUSIONS We can observe a low prevalence of infection of hepatitis B and C viruses in the studied population. However, the findings of the analysis of the risk factors show the need for more investment in prevention programs for sexual and drug-related behavior, as well as more efforts to vaccinate this population against hepatitis B. The genotypes of the hepatitis B virus and C virus identified are consistent with those circulating in Brazil

Epidemiological and molecular study of hepatites C vírus infection in settlers on the states of Goiás and Mato Grosso do Sul, Brazil

Submitted by Luciana Ferreira ([email protected]) on 2016-03-03T13:03:40Z No. of bitstreams: 2 Dissertação - Lyruane Apolinário de Araújo - 2014.pdf: 2072768 bytes, checksum: 9626c7f70ff133cd2e05e4d0d4a2de6c (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2016-03-03T13:05:30Z (GMT) No. of bitstreams: 2 Dissertação - Lyruane Apolinário de Araújo - 2014.pdf: 2072768 bytes, checksum: 9626c7f70ff133cd2e05e4d0d4a2de6c (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2016-03-03T13:05:30Z (GMT). No. of bitstreams: 2 Dissertação - Lyruane Apolinário de Araújo - 2014.pdf: 2072768 bytes, checksum: 9626c7f70ff133cd2e05e4d0d4a2de6c (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-02-25Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqFundação de Amparo à Pesquisa do Estado de Goiás - FAPEGThe hepatitis C virus (HCV) infection is considered one of the main causes of chronic liver disease, being responsible for great disease burden to the Health Systems Worldwide. According to the World Health Organization, there are approximately 150 million people chronically infected by the HCV in the world. There are only a few studies that have evaluated the HCV occurrence in people that live in settlements, and most of these families are composed by a large number of individuals that have little formal education, that live under poor environmental and sanitation conditions, beyond also usually have no access to adequate health care, due primarily to the difficulties in reaching the health service systems, but also because of the poor quality of the health services. Therefore, the aim of this study was to estimate the prevalence of HCV infection, to analyze the characteristics of the population associated with the infection and to identify the HCV genotypes/subtypes in individuals that live in settlements in the States of Goiás and Mato Grosso do Sul, Central Brazil. The population was consittued by 921 individuals. They were all interviewed and one blood (serum) sample from each person was collected. All sera samples were screened for anti-HCV using an Enzyme Linked Immunosorbent Assay (ELISA). All ELISA positive samples were submitted to RNA extraction and tested by Polymerase Chain Reaction (PCR). All PCR positive samples were further genotyped using the Line Probe Assay (LiPA). The mean age of the population was 39 years old, composed mainly by Caucasian married women, with a low level of formal education, and low family income. Of the 921 samples, four were anti-HCV positive, resulting in an overall prevalence of 0.43% (CI 95%: 0.14-1.19). The viral RNA was detected in all anti-HCV positive samples and the genotyping revealed the presence of the genotype 1, subtype 1a. The HCV infected individuals reported as risk caracteristics for HCV infection: sharing sharp personal hygiene objects, history of surgical intervention, blood transfusions before to 1993, sex without protection, history of sexually transmitted disease and imprisonment. This study showed a low prevalence of HCV infection in this population. This study showed a low prevalence of HCV infection in this population. However, epidemiological investigations are important to verify the circulation of the virus , especially in settled populations, which are often on the margins of public health services.A infecção pelo vírus da hepatite C (HCV) tem assumido uma grande relevância entre as causas de doença hepática crônica, constituindo um sério agravo de saúde. A Organização Mundial de Saúde estima que existam cerca de 150 milhões de pessoas cronicamente infectadas pelo HCV no mundo. Existem poucos estudos sobre a ocorrência do HCV em indivíduos que vivem em assentamentos, sendo que a maioria das famílias são numerosas, possuem baixa escolaridade e renda familiar, além de não receberem assistência adequada a saúde, principalmente, pela dificuldade do acesso aos serviços de saúde e pela qualidade dos mesmos. Este estudo teve como objetivos estimar a prevalência da infecção pelo HCV, analisar as características de risco relatadas pelos indivíduos infectados e identificar os genótipos/subtipos deste vírus em população assentada nos Estados de Goiás e Mato Grosso do Sul, Brasil Central. A população foi constituída por 921 indivíduos, provenientes de assentamentos de Goiás e Mato Grosso do Sul. Todos foram entrevistados e uma amostra de sangue (soro) foi coletada de cada participante. Os soros foram triados para detecção de anti-HCV por ELISA, e as amostras reativas para esse marcador foram submetidas à detecção do RNA viral pela reação em cadeia pela polimerase (PCR). As amostras RNA-HCV positivas foram genotipadas pelo método Line Probe Assay (LiPA). A média de idade da população foi de 39 anos, com predomínio de mulheres, casadas, brancas, com níveis baixos de educação formal e renda familiar. Quatro amostras foram anti-HCV reagentes, resultando em uma prevalência de 0,43% (IC 95%: 0,14-1,19). O RNA viral foi detectado em todas as amostras anti-HCV reagentes e a genotipagem revelou a presença do genótipo 1, subtipo 1a. Os indivíduos infectados pelo HCV relataram como características de risco pela infecção pelo HCV: compartilhamento de objetos cortantes de higiene pessoal, procedimento cirúrgico, transfusão de sangue antes de 1993, não uso de preservativo, histórico de doença sexualmente transmissível (DST) e antecedente de prisão. Este estudo evidenciou uma prevalência baixa da infecção pelo HCV na população estudada. Contudo, investigações epidemiológicas são importantes para verificar a circulação desse vírus, principalmente em populações assentadas, que muitas vezes ficam às margens dos serviços públicos de saúde

INTERMEDIATE ENDEMICITY OF HEPATITIS A VIRUS INFECTION IN RURAL SETTLEMENT PROJECTS OF SOUTHWEST GOIÁS, BRAZIL

BackgroundRural populations present an elevated risk of exposure to hepatitis A virus.ObjectiveThe objective of this study was to estimate the prevalence and risk factors associated with hepatitis A virus infection among residents of rural settlement projects of southwest Goiás, Central Brazil.MethodsA total of 466 residents were interviewed and tested for the detection of anti- hepatitis A virus antibodies by ELISA.ResultsThe global prevalence of anti- hepatitis A virus was 82.2%. In individuals aged 5-9 years and 10-19 years, the prevalence was 15% and 58.8%, respectively. Persons in the 10-19 age group, with a history of life in encampments, with more than five people per residence consuming well water, were predictors for exposure to hepatitis A virus.ConclusionOur results suggest that the hepatitis A virus endemicity in rural settlements in southwest Goiás similar to that found in the urban population of the Midwest Region, confirming the implementation of universal hepatitis A vaccination in children

Mortality Risk Factors for Coronavirus Infection in Hospitalized Adults in Brazil: A Retrospective Cohort Study

Background: The COVID-19 pandemic has presented high morbidity and mortality, with associated high socioeconomic costs. Brazil ranks third in the number of COVID-19 cases, behind only India and the United States. Objective: To analyze risk factors for mortality in adults hospitalized with COVID-19 in Brazil. Methods: Observational retrospective cohort study including data from all Brazilian states and regions. The study included information from 468,226 in-hospital patients from all regions of Brazil from 1 January 2021 to 31 July 2021. Data from the influenza epidemiological surveillance system were used. The participants were adults hospitalized with COVID-19. A Cox regression model was used to analyze factors associated with mortality in adults with COVID-19. Results: The in-hospital mortality lethality was 37.5%. The risk factors associated with COVID-19 mortality were older age, with a linear increase with increments in age, male sex, black or mixed race, low education level, comorbidities, use of ventilatory support, and living in the southeast, north, or northeast regions of the country. Conclusions: Our results illustrate the severity of the COVID-19 pandemic in Brazil and reinforce that policies and practices to deal with this disease should focus on groups and regions with higher risk, whereas public policies should promote nonpharmacological measures and vaccination in the Brazilian population

Human papillomavirus (HPV) genotype distribution in penile carcinoma: Association with clinic pathological factors

<div><p>Background</p><p>Penile carcinoma (PC) is a rare, highly mutilating disease, common in developing countries. The evolution of penile cancer includes at least two independent carcinogenic pathways, related or unrelated to HPV infection.</p><p>Objectives</p><p>To estimate the prevalence, identify HPV genotypes, and correlate with clinicopathological data on penile cancer.</p><p>Methods</p><p>A retrospective cohort study involving 183 patients with PC undergoing treatment in a referral hospital in Goiânia, Goiás, in Midwestern Brazil, from 2003 to 2015. Samples containing paraffin embedded tumor fragments were subjected to detection and genotyping by INNO-LiPA HPV. The clinicopathological variables were subjected to analysis with respect to HPV positivity and used prevalence ratio (PR), adjusted prevalence ratio (PRa) and 95% confidence interval (CI) as statistical measures.</p><p>Results</p><p>The prevalence of HPV DNA in PC was 30.6% (95% CI: 24.4 to 37.6), high-risk HPV 24.9% (95% CI: 18.9 to 31.3), and 62.5% were HPV 16. There was a statistical association between the endpoints HPV infection and HPV high risk, and the variable tumor grade II-III (p = 0.025) (p = 0.040), respectively. There was no statistical difference in disease specific survival at 10 years between the HPV positive and negative patients (p = 0.143), and high and low risk HPV (p = 0.325).</p><p>Conclusions</p><p>The prevalence of HPV infection was 30.6%, and 80.3% of the genotypes were identified as preventable by anti-HPV quadrivalent or nonavalent vaccine. HPV infections and high-risk HPV were not associated with penile carcinoma prognosis in this study.</p></div

Prevalence of HPV-DNA in 183 cases of penile carcinoma in a referral hospital in Goias, Brazil.

<p>Prevalence of HPV-DNA in 183 cases of penile carcinoma in a referral hospital in Goias, Brazil.</p

Bivariate and multivariate analysis of factors associated with infection by high-risk HPV.

<p>Bivariate and multivariate analysis of factors associated with infection by high-risk HPV.</p

HPV genotype distribution in a population with PC.

<p>HR: High risk; LR: Low risk.</p

Curve of survival of patients positive and negative for HPV.

<p>Curve of survival of patients positive and negative for HPV.</p