Hepatitis B Virus infection in HIV-positive population in Brazil: results of a survey in the state of Mato Grosso and a comparative analysis with other regions of Brazil

BACKGROUND: End-stage liver disease is currently a major concern among HIV-positive individuals due to co-infection with hepatotropic virus. Hepatitis C has been pointed out as a remarkable factor for that. More recently, hepatitis B virus (HBV) infection has also been found to play a role on liver disease in this population. HIV-HBV co-infection prevalence remains largely unknown in vast areas of Brazil. The objective of the present study was to estimate the prevalence of HBV and HDV infection in HIV-infected subjects living in the state of Mato Grosso, in the Central region of Brazil, and compare it to other Brazilian studies. We also assess epidemiologic data regarding risk factors and vaccinal status. METHODS: HIV-positive individuals followed at the Central Laboratory of the Department of Public Health of Mato Grosso in the city of Cuiabá composed the sample. Participants answered a specific questionnaire and had a blood sample taken and tested for serologic markers. RESULTS: A thousand individuals were interviewed and tested for HBsAg, anti-HBc, anti-HBs and anti-HDV if positive for HBsAg. Measurements of CD4 and viral load for HIV-1 were also performed. Overall prevalence of HBV exposure (anti-HBc +ve) was 40.0%, and 3.7% for HBsAg. This prevalence data was similar or slightly lower than for other Brazilian regions, which ranged from 40% and 3% to 71% and 24%, respectively. Testing for anti-HDV in the 37 HBsAg positive patients was positive in only one subject. Factors that showed independent association with HBV exposure, after adjustment, were: male gender, older age groups, tattooing, and reporting more than ten sexual partners throughout life (p < 0.01). Eighty-one (27.5%) out of 291 HBV-unexposed individuals who reported vaccination were anti-HBs positive. Anti-HBs prevalence was higher among those who had higher levels of CD4 by multivariate analysis. CONCLUSION: Our data showed HBV infection prevalence similar or slightly lower than that reported in other regions of Brazil. In addition, our data revealed a less important role for drug injection in the spread of HIV and HBV in Mato Grosso compared to other regions of the country. The high rate of non-vaccinated subjects among this HBV-unexposed, HIV-infected population is a matter of considerable health concern in this region. The relationship between CD4 levels and HBV vaccine response found in the present study reinforces the need of keeping health care workers alert to this issue

Prevalência do tabagismo em doadores de sangue da região serrana de Santa Catarina - Brasil Smoking prevalence in donors from the mountain region of Santa Catarina - Brazil

O tabagismo é um problema de saúde pouco explorado nos bancos de sangue, um dos motivos que objetivou este estudo, para tornar os dados disponíveis a outros pesquisadores, de forma a garantir a realização de novos estudos interdisciplinares sobre a situação transfusional e a qualidade do sangue doado pelo fumante, melhorando a qualidade de vida do doador. O estudo foi realizado mediante uma pesquisa de 3 mil candidatos aptos à doação de sangue no Hemocentro Regional de Lages. Para abordar o tabagismo foi elaborado um questionário que foi inserido na triagem clínica realizada rotineiramente com os candidatos à doação de sangue. Dos 3 mil doadores avaliados na pesquisa, 373 (12,4%) eram fumantes, sendo 66,5% do sexo masculino, 77,2% da cor branca, 57,5% com idade entre 18 a 35 anos. O grau de escolaridade foi o ensino fundamental com 42,1%. Em relação ao número de doações anteriores, 43,1% doaram pela 1ª vez, 56,9% dos doadores eram de repetição. O número de cigarros fumados entre um e cinco por dia foi 30,8% e de seis a dez/dia, 33,2%. Os valores de hematócrito e hemoglobina, comparando grupos não fumantes e fumantes, diferiram significativamente uns dos outros. A prevalência de doadores fumantes verificada neste estudo foi considerada pequena, possivelmente não interferindo na qualidade do sangue, pois o percentual que traz problemas em relação a carboxi-hemoglobina está relacionado aos grandes fumantes, sendo a minoria dos doadores estudados. Faz-se necessário conhecer o perfil do doador fumante nos bancos de sangue do País para poder levar o conhecimento e informações através de campanhas educativas e preventivas.Exposure to smoking is a public health problem not very often explored in blood banks. This study was carried out for the purpose of making these data available to other researchers in order to develop new interdisciplinary studies concerning the blood quality donated by smokers. Exposure to smoking was measured by a questionnaire applied to 3.000 individuals who donated blood in the Hemocentro Regional of Lages through a clinical selection regularly done with the candidates. Among the 3.000 individuals 373 (12.4%) were cigarette smokers, males (66.5%), white people (77.2%), and between 18 and 35 years of age (57.5%). The educational degree was elementary school (42.1%). Considering the previous donations, 43.1% were donors for the first time, 56.9% were used to donate blood frequently. The number of cigarettes smoked daily from 1 to 5 was 30.8% and from 6 to 10, 33.2%. Haematocrit and hemoglobin values comparing smokers and non-smokers differ meaningfully. Smoking prevalence in these selected donators was considered small and did not affect the blood quality since the percentage due to problems about carboxihemoglobin is related to tobacco users who were the minority group. The profile of smoking addicted donators should be regarded in order to obtain some information through educational and preventive campaigns