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      Seroprevalence of viral hepatitis in riverine communities from the Western Region of the Brazilian Amazon Basin

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          Abstract

          The western region of the Brazilian Amazon Basin has long been shown to be a highly endemic area for hepatitis B and hepatitis D viruses. Data concerning the prevalence of hepatitis C and E viruses in this region are still scarce. In this study we investigated the presence of hepatitis A, B, C, D and E viruses infection in communities that live along the Purus and Acre rivers in the states of Acre and Amazonas within the Amazon Basin. A total of 349 blood samples were collected and tested for hepatitis A-E serological markers (antibodies and/or antigens) using commercial enzyme linked immunosorbent assays. Anti-HCV positive sera were further assayed by an immunoblot. HBsAg positive sera were subtyped by immunodifusion. The overall prevalence for hepatitis A, B, C, and E were 93.7%, 66.1%, 1.7%, and 4%, respectively. A very high prevalence of delta hepatitis (66.6%) was found among HBsAg positive subjects. Hepatitis A, B and D viruses were shown to be largely disseminated in this population, while hepatitis C and E viruses infection presented low prevalence rates in this region. The analysis of risk factors for HBV infection demonstrated that transmission was closely associated with sexual activity.

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          Hepatitis B: evolving epidemiology and implications for control.

          Control and the possible elimination of transmission of HBV infection is possible with the appropriate use of hepatitis B vaccines. The prevention of chronic HBV infection has the potential of reducing the association burden of chronic liver disease and primary hepatocellular carcinoma. Worldwide, strategies for the effective use of hepatitis B vaccine have been developed and are being implemented in those areas where childhood transmission is the predominant source of chronic HBV infections. However, in the United States and other areas with "low" rates of HBV infection, current vaccination strategies have not been effective and have not fully taken into account the multifaceted epidemiology of HBV infection in those areas. Unfortunately, the majority of infections occur among adults who have been the most difficult to access, who acquire infection before they realize they are at risk, and where the changing epidemiology of HBV infections among the various risk groups only emphasizes the problems of vaccine delivery. In addition, the majority of persons receiving vaccine as a result of the current strategy to immunize adult high-risk groups have been persons who acquire HBV infection through occupational exposure, a group that accounted for no more than 5% of cases even before vaccine was introduced. The failure of the current immunization strategy to prevent a disease with significant health care and economic consequences is beginning to cause a reevaluation of this approach. A comprehensive approach to eliminating HBV transmission must address infections acquired during early childhood as well as those acquired by teenagers and adults.(ABSTRACT TRUNCATED AT 250 WORDS)
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            Hepatitis C

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              Outbreak of hepatitis B virus in recent arrivals to the Brazilian Amazon.

              An outbreak of acute hepatitis cases in a small community took place 6 months after the community's arrival to the Brazilian Amazon. An epidemiological investigation was performed and included residents aged more than two years. Study subjects were interviewed and bled to test for hepatitis markers by enzyme immunoassays. Around 80% of the village population was surveyed. The overall prevalence of hepatitis B virus (HBV) markers was 75.1% (281/374). The surface antigen of HBV (HBsAg) and the IgM class antibody against hepatitis B core antigen (IgM anti-HBc) were present in 10.4% and 9.6%, respectively. Evidence of HBV-HDV (Delta virus) coinfection or hepatitis C infection was not found. IgM class antibody against hepatitis A virus was uncommon (3.7%). Follow-up evaluation 6 and 12 months later were carried out to identify new HBV infections. An incidence rate of 7.2 new infections per 100 exposed subjects per month was found. Average individual risk for HBV infection among susceptible inhabitants of the village between June 1995 and June 1996 can be estimated at 57.6%. The predominant HB-sAg subtype found (ayw3) suggests that immigrants may have carried HBV from the original area. Time living in the study region was significantly associated with HBV markers in analysis for linear trend and logistic regression analysis. Environmentally related factors may have facilitated HBV transmission.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                mioc
                Memórias do Instituto Oswaldo Cruz
                Mem. Inst. Oswaldo Cruz
                Instituto Oswaldo Cruz, Ministério da Saúde (Rio de Janeiro )
                1678-8060
                November 2001
                : 96
                : 8
                : 1123-1128
                Affiliations
                [1 ] Instituto Oswaldo Cruz-Fiocruz Brasil
                [2 ] Fiocruz Brasil
                [3 ] Universidade Federal Fluminense Brazil
                Article
                S0074-02762001000800016
                10.1590/S0074-02762001000800016
                7ee48455-5ad9-4b11-9107-2030459244e6

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0074-0276&lng=en
                Categories
                PARASITOLOGY
                TROPICAL MEDICINE

                Parasitology,Infectious disease & Microbiology
                hepatitis A,hepatitis B,hepatitis C,hepatitis D,hepatitis E,Amazon Basin,Brazil

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