Metodologia de um estudo de inquérito nacional da prevalência e de padrõesa epidemiológicos das hepatites A, B e C no Brasil

Um inquérito de base populacional foi conduzido na população urbana de todas as capitais e do Distrito Federal no Brasil para fornecer informações sobre a prevalência de hepatites virais e fatores de risco, entre 2005 e 2009. Este artigo descreve o delineamento e a metodologia do estudo que envolveu a população com idade entre 5 e 19 anos para hepatite A e 10 a 69 anos para hepatite B e C. As entrevistas e amostras de sangue foram obtidas através de visitas domiciliares e a amostra selecionada a partir de uma amostragem estratificada em múltiplos estágios (por conglomerado) com igual probabilidade para cada domínio de estudo (região e faixa etária). Nacionalmente, 19.280 residências e ~31.000 indivíduos foram selecionados. O tamanho da amostra foi suficiente para detectar uma prevalência em torno de 0,1% e para avaliar os fatores de risco por região. A metodologia apresentou-se viável para distinguir entre diferentes padrões epidemiológicos da hepatite A, B e C. Estes dados serão de valia para a avaliação das políticas de vacinação e para o desenho de estratégias de controle.A population-based survey to provide information on the prevalence of hepatitis viral infection and the pattern of risk factors was carried out in the urban population of all Brazilian state capitals and the Federal District, between 2005 and 2009. This paper describes the design and methodology of the study which involved a population aged 5 to 19 for hepatitis A and 10 to 69 for hepatitis B and C. Interviews and blood samples were obtained through household visits. The sample was selected using stratified multi-stage cluster sampling and was drawn with equal probability from each domain of study (region and age-group). Nationwide, 19,280 households and ~31,000 residents were selected. The study is large enough to detect prevalence of viral infection around 0.1% and risk factor assessments within each region. The methodology seems to be a viable way of differentiating between distinct epidemiological patterns of hepatitis A, B and C. These data will be of value for the evaluation of vaccination policies and for the design of control program strategies

Association of a variant in the regulatory region of NADPH oxidase 4 gene and metabolic syndrome in patients with chronic hepatitis C

Abstract\ud \ud Background\ud Given the important contribution of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system to the generation of reactive oxygen species induced by hepatitis C virus (HCV), we investigated two single nucleotide polymorphisms (SNPs) in the putative regulatory region of the genes encoding NADPH oxidase 4 catalytic subunit (NOX4) and its regulatory subunit p22phox (CYBA) and their relation with metabolic and histological variables in patients with HCV.\ud \ud \ud Methods\ud One hundred seventy eight naïve HCV patients (49.3% male; 65% HCV genotype 1) with positive HCV RNA were genotyped using specific primers and fluorescent-labeled probes for SNPs rs3017887 in NOX4 and −675 T → A in CYBA.\ud \ud \ud Results\ud No association was found between the genotype frequencies of NOX4 and CYBA SNPs and inflammation scores or fibrosis stages in the overall population. The presence of the CA + AA genotypes of the NOX4 SNP was nominally associated with a lower alanine aminotransferase (ALT) concentration in the male population (CA + AA = 72.23 ± 6.34 U/L versus CC = 100.22 ± 9.85; mean ± SEM; P = 0.05). The TT genotype of the CYBA SNP was also nominally associated with a lower ALT concentration in the male population (TT = 84.01 ± 6.77 U/L versus TA + AA = 109.67 ± 18.37 U/L; mean ± SEM; P = 0.047). The minor A-allele of the NOX4 SNP was inversely associated with the frequency of metabolic syndrome (MS) in the male population (odds ratio (OR): 0.15; 95% confidence interval (CI): 0.03 to 0.79; P = 0.025).\ud \ud \ud Conclusions\ud The results suggest that the evaluated NOX4 and CYBA SNPs are not direct genetic determinants of fibrosis in HCV patients, but nevertheless NOX4 rs3017887 SNP could indirectly influence fibrosis susceptibility due to its inverse association with MS in male patients

Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions

Background: This study aimed to identify the transmission pattern of hepatitis A (HA) infection based on a primary dataset from the Brazilian National Hepatitis Survey in a pre-vaccination context. The national survey conducted in urban areas disclosed two epidemiological scenarios with low and intermediate HA endemicity. Methods: A catalytic model of HA transmission was built based on a national seroprevalence survey (2005 to 2009). The seroprevalence data from 7,062 individuals aged 5–69 years from all the Brazilian macro-regions were included. We built up three models: fully homogeneous mixing model, with constant contact pattern; the highly assortative model and the highly assortative model with the additional component accounting for contacts with infected food/water. Curves of prevalence, force of infection (FOI) and the number of new infections with 99% confidence intervals (CIs) were compared between the intermediate (North, Northeast, Midwest and Federal District) and low (South and Southeast) endemicity areas. A contour plot was also constructed. Results: The anti- HAV IgG seroprevalence was 68.8% (95% CI, 64.8%–72.5%) and 33.7% (95% CI, 32.4%–35.1%) for the intermediate and low endemicity areas, respectively, according to the field data analysis. The models showed that a higher force of infection was identified in the 10- to 19-year-old age cohort ( , 9,000 infected individuals per year per 100,000 susceptible persons) in the intermediate endemicity area, whereas a higher force of infection occurred in the 15- to 29-year- old age cohort ( , 6,000 infected individuals per year per 100,000 susceptible persons) for the other macro-regions. Conclusion: Our findings support the shift of Brazil toward intermediate and low endemicity levels with the shift of the risk of infection to older age groups. These estimates of HA force of infection stratified by age and endemicity levels are useful information to characterize the pre-vaccination scenario in Brazil

Mannose-binding lectin serum levels in patients with leprosy are influenced by age and MBL2 genotypes

Submitted by Ana Beatriz Oliveira ([email protected]) on 2018-12-28T12:52:31Z No. of bitstreams: 1 1-s2.0-S120197121100097X-main.pdf: 475674 bytes, checksum: 9c9f87b59212693bedca0418d9a58b77 (MD5)Approved for entry into archive by Ana Beatriz Oliveira ([email protected]) on 2018-12-28T13:12:26Z (GMT) No. of bitstreams: 1 1-s2.0-S120197121100097X-main.pdf: 475674 bytes, checksum: 9c9f87b59212693bedca0418d9a58b77 (MD5)Made available in DSpace on 2018-12-28T13:12:26Z (GMT). No. of bitstreams: 1 1-s2.0-S120197121100097X-main.pdf: 475674 bytes, checksum: 9c9f87b59212693bedca0418d9a58b77 (MD5) Previous issue date: 2011FACEPE (Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco) and Programa de Pós-Graduação em Bolsas da Universidade de Pernambuco.Universidade de Pernambuco. Instituto de Ciências Biológicas. Faculdade de Ciências Medicas. Recife PE, Brasil. / Instituto do Fígado de Pernambuco. Recife PE, Brasil.Universidade de Pernambuco. Instituto de Ciências Biológicas. Faculdade de Ciências Medicas. Recife PE, Brasil.Universidade de Pernambuco. Instituto de Ciências Biológicas. Faculdade de Ciências Medicas. Recife PE, Brasil.Universidade de Pernambuco. Instituto de Ciências Biológicas. Faculdade de Ciências Medicas. Recife PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil. / Instituto de Medicina Integral Professor Fernando Figueira. Recife PE, Brasil.Universidade de Pernambuco. Instituto de Ciências Biológicas. Faculdade de Ciências Medicas. Recife PE, Brasil. / Instituto do Fígado de Pernambuco. Recife PE, Brasil.Universidade de Pernambuco. Instituto de Ciências Biológicas. Faculdade de Ciências Medicas. Recife PE, Brasil.Universidade de Pernambuco. Instituto de Ciências Biológicas. Faculdade de Ciências Medicas. Recife PE, Brasil.Mannose-binding lectin (MBL) activates the complement system promoting opsonophagocytosis, which could represent an advantage for Mycobacterium leprae, an intracellular pathogen. Therefore, a single nucleotide polymorphism (SNP) in the MBL2 gene associated with low levels of MBL could confer protection against the development of leprosy disease

Force of HA infection by age (A), as estimated by the catalytic approach, for the intermediate and low endemicity areas (solid lines) and the corresponding 99% CIs for the curves (red dotted lines for the intermediate endemicity area and blue dashed lines for the low endemicity area).

<p>(B) Hepatitis A force of infection curves by age and the ratio between the intermediate and low endemicity areas for the North region (solid line) and its corresponding 99% CI (dashed lines). A value of 1 denotes an equal number of new infected individuals per year in both areas, an integer >1 indicates a higher number of new infected individuals per year in the intermediate endemicity area, and a value <1 indicates a higher number of infected individuals in the low endemicity area. (C) Proportion of new hepatitis A infections for the intermediate and low endemicity regions (red and blue solid lines, respectively) and the corresponding 99% CIs (dotted and dashed lines, respectively). (D) HA incidence ratio (solid line) between the intermediate and low endemicity areas by age and its 99% CI (dashed lines).</p