Hepatitis B infection among patients attending a sexually transmitted diseases clinic in Rio de Janeiro, Brazil

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Abstract

Hepatitis B virus (HBV) has a low endemicity in Rio de Janeiro, Brazil. Sexual transmission must play an important role in this virus, but the prevalence and risk factors have never been properly investigated. The aim of this paper is to determine the prevalence and risk factors for HBV infection in patients attending a Sexually Transmitted Diseases Clinic of the Universidade Federal Fluminense, from the State of Rio de Janeiro, Brazil. In a retrospective study, HBV seroprevalence was investigated in 440 patients. Serum of each patient was assayed for antibodies against hepatitis B core antigen (anti-HBc), hepatitis B surface antigen (HBsAg) and antibodies against hepatitis B surface antigen (anti-HBs). Demographic and risk factor data were extracted from clinic notes. The overall seroprevalence of exposure markers for HBV (anti-HBc, HBsAg and anti-HBs) were 13%, 3.4% and 8.5% respectively. Homo/bisexual behaviour, anal intercourse, HIV infection, positive serology for syphilis and blood transfusion were predictors of the HBV exposure. Among demographic data, age and place of birth were associated with the anti-HBc seropositivity.

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Hepatitis B: evolving epidemiology and implications for control.

M Alter, Kieran S Hadler, Jeffrey H Margolis (1991)

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 B in homosexual men: prevalence of infection and factors related to transmission.

Mary Reynolds, Marshall T Schreeder, T Nylund … (1982)

Of 3,816 homosexual men examined in five sexually transmitted disease clinics in the United States, 6.1% had hepatitis B surface antigen, 52.4% had antibody to hepatitis B surface antigen, and 3.0% of the men who had no other indicator of infection with hepatitis B virus (HBV) had antibody to hepatitis B core antigen. The rate of seropositivity for HBV indicated by the presence of one or more of these serologic markers was 61.5%; seropositivity was significantly related to the duration of regular homosexual activity and to the number of nonsteady male sexual contacts in the four months before the patients were interviewed. Anal-genital intercourse, oral-anal intercourse, and rectal douching were significantly related to evidence of HBV infection, but oral-oral contact and oral-genital contact were not. Trauma to the rectal mucosa is a feature common to the practices that were significantly related to seropositivity for HBV.