Epidemiologia da infecção pelo vírus da hepatite b em assentados em Goiás: subsídios para ações de prevenção e controle em populações emergentes
Carregando...
Data
2014-07-22
Autores
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Federal de Goiás
Resumo
Estimates indicate a total of 240 million chronic hepatitis B carriers worldwide. In
Brazil, rural settlements present adverse life conditions that favor the acquisition of
health problems, such as the hepatitis B virus (HBV). The objective of the present
study was to investigate the epidemiology of the infections caused by the hepatitis B
and D viruses in people living in settlements in the southwest region of the state of
Goiás. This is an observational, analytical, cross-sectional study, with a subsequent
cohort of susceptible subjects for vaccination against HBV, assessment of adherence
and vaccine response. In the period from May to July of 2011, 467 subjects were
selected from seven settlements in the southwest of Goiás. All subjects were
interviewed and tested for the detection of the serological markers HBsAg, anti-HBc
and anti-HBs, by means of the enzyme-linked immunosorbent assay (ELISA).
Reactive HBsAg samples were tested for total anti-HDV and IgM, by means of the
ELISA, submitted to the detection of the HBV DNA by semi-nested PCR and
genotyped by sequencing. Chemiluminescent microparticle immunoassay was used
for the quantitative determination of anti-HBs. The research proposal was approved
by the Research Ethics Committee of the Federal University of Goiás. Of the total
sample, 52.2% were men, 57.8% were married and 49% had less than five years of
education. Most subjects were from cities in the midwest region (81.6%) and were
older than 19 years of age (73.7%). Overall prevalence for infection by the HBV was
10.9% (51/467), being 0.8% (4/467) for HBsAg, 7.9% (37/467) for anti-HBc and anti-
HBs, and 2.1% (10/467) for anti-HBc. Moreover, 19.3% of the people living in
settlements presented isolated positivity for the anti-HBs marker, which indicates
they were previously vaccinated against hepatitis B. The four reactive HBV DNA
samples were classified as subgenotype A1 (3/4) and D3 (1/4). The male gender
(adjusted OR: 2.65; p= 0.007), age (adjusted OR: 1.07; p= 0.000), history of
transfusion (adjusted OR: 2.52; p= 0.025) and greater period of time living in the
settlements (adjusted OR: 1.10; p= 0.026) were variables associated with the HBV. A
total of 181 subjects susceptible to the infection started vaccine against hepatitis B,
but only 106 (58.6%; 106/181) completed the vaccine scheme. Of these, it was
possible to assess the vaccine response in 77 subjects, and 68.8% (53/77)
presented protective titers of anti-HBs. Of those subjects living in the settlements
who did not respond to the vaccine, a greater proportion was male, had more than 40
years and was smokers (p< 0.001). No subject presented positivity for the anti-HDV
marker. The results of this study evidence the need for effective strategies to prevent
hepatitis B in the studied settlements, emphasizing vaccine against hepatitis. In light
of the low vaccine response against this infection in older subjects, more
immunogenic schemes are suggested, so as to induce a protective vaccine
response.
Descrição
Palavras-chave
Citação
CAETANO, Karlla Antonieta Amorim. Epidemiologia da infecção pelo vírus da hepatite b em assentados em Goiás: subsídios para ações de prevenção e controle em populações emergentes. 2014. 124 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia,2014.