Hepatitis C Virus among Female Sex Workers: A Cross-Sectional Study Conducted along Rivers and Highways in the Amazon Region

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Abstract

Background: Previous studies found a high prevalence of pathogens among female sex workers (FSWs) in the Amazon region, and established their parenteral and sexual transmission. This study estimated the prevalence of hepatitis C virus (HCV) infection and associated risk factors, and the frequency of HCV genotypes and resistance-associated substitutions (RASs) in this vulnerable group. Methods: Distinct sampling methods were used to access 412 FSWs in cities and riverside communities in the Amazon region from 2015 to 2018. Three methods for HCV diagnosis were used to determine infection status. HCV genotypes and RASs were identified by sequencing and nucleotide fragment analysis. An association between HCV infection and exposure factors was determined by bivariate and multivariate analysis. Results: In total, 44 (10.7%) FSWs were exposed to HCV, and 32 (7.8%) of them had active infection. Nine socioeconomic characteristics and risky sexual behaviors were associated with HCV exposure, particularly unprotected sex and condom exemption for the clients who paid extra money. Genotype 1 (81.3%) and 3 (18.7%) were detected. The frequency of FSWs with RASs was 23.1% (6/26) for grazoprevir related to the occurrence of substitutions Y56F and S122G. Conclusions: HCV infection among FSWs is highly prevalent and dominated by genotype I. Urgent preventive and treatment measures are required to reduce HCV infection in FSWs and the general population.

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Most cited references 65

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Boceprevir for untreated chronic HCV genotype 1 infection.

Fred Poordad, Jonathan McCone, Bruce Bacon … (2011)

Peginterferon-ribavirin therapy is the current standard of care for chronic infection with hepatitis C virus (HCV). The rate of sustained virologic response has been below 50% in cases of HCV genotype 1 infection. Boceprevir, a potent oral HCV-protease inhibitor, has been evaluated as an additional treatment in phase 1 and phase 2 studies. We conducted a double-blind study in which previously untreated adults with HCV genotype 1 infection were randomly assigned to one of three groups. In all three groups, peginterferon alfa-2b and ribavirin were administered for 4 weeks (the lead-in period). Subsequently, group 1 (the control group) received placebo plus peginterferon-ribavirin for 44 weeks; group 2 received boceprevir plus peginterferon-ribavirin for 24 weeks, and those with a detectable HCV RNA level between weeks 8 and 24 received placebo plus peginterferon-ribavirin for an additional 20 weeks; and group 3 received boceprevir plus peginterferon-ribavirin for 44 weeks. Nonblack patients and black patients were enrolled and analyzed separately. A total of 938 nonblack and 159 black patients were treated. In the nonblack cohort, a sustained virologic response was achieved in 125 of the 311 patients (40%) in group 1, in 211 of the 316 patients (67%) in group 2 (P<0.001), and in 213 of the 311 patients (68%) in group 3 (P<0.001). In the black cohort, a sustained virologic response was achieved in 12 of the 52 patients (23%) in group 1, in 22 of the 52 patients (42%) in group 2 (P=0.04), and in 29 of the 55 patients (53%) in group 3 (P=0.004). In group 2, a total of 44% of patients received peginterferon-ribavirin for 28 weeks. Anemia led to dose reductions in 13% of controls and 21% of boceprevir recipients, with discontinuations in 1% and 2%, respectively. The addition of boceprevir to standard therapy with peginterferon-ribavirin, as compared with standard therapy alone, significantly increased the rates of sustained virologic response in previously untreated adults with chronic HCV genotype 1 infection. The rates were similar with 24 weeks and 44 weeks of boceprevir. (Funded by Schering-Plough [now Merck]; SPRINT-2 ClinicalTrials.gov number, NCT00705432.).

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Telaprevir for previously untreated chronic hepatitis C virus infection.

Ira M Jacobson, John G McHutchison, Geoffrey Dusheiko … (2011)

In phase 2 trials, telaprevir, a hepatitis C virus (HCV) genotype 1 protease inhibitor, in combination with peginterferon-ribavirin, as compared with peginterferon-ribavirin alone, has shown improved efficacy, with potential for shortening the duration of treatment in a majority of patients. In this international, phase 3, randomized, double-blind, placebo-controlled trial, we assigned 1088 patients with HCV genotype 1 infection who had not received previous treatment for the infection to one of three groups: a group receiving telaprevir combined with peginterferon alfa-2a and ribavirin for 12 weeks (T12PR group), followed by peginterferon-ribavirin alone for 12 weeks if HCV RNA was undetectable at weeks 4 and 12 or for 36 weeks if HCV RNA was detectable at either time point; a group receiving telaprevir with peginterferon-ribavirin for 8 weeks and placebo with peginterferon-ribavirin for 4 weeks (T8PR group), followed by 12 or 36 weeks of peginterferon-ribavirin on the basis of the same HCV RNA criteria; or a group receiving placebo with peginterferon-ribavirin for 12 weeks, followed by 36 weeks of peginterferon-ribavirin (PR group). The primary end point was the proportion of patients who had undetectable plasma HCV RNA 24 weeks after the last planned dose of study treatment (sustained virologic response). Significantly more patients in the T12PR or T8PR group than in the PR group had a sustained virologic response (75% and 69%, respectively, vs. 44%; P<0.001 for the comparison of the T12PR or T8PR group with the PR group). A total of 58% of the patients treated with telaprevir were eligible to receive 24 weeks of total treatment. Anemia, gastrointestinal side effects, and skin rashes occurred at a higher incidence among patients receiving telaprevir than among those receiving peginterferon-ribavirin alone. The overall rate of discontinuation of the treatment regimen owing to adverse events was 10% in the T12PR and T8PR groups and 7% in the PR group. Telaprevir with peginterferon-ribavirin, as compared with peginterferon-ribavirin alone, was associated with significantly improved rates of sustained virologic response in patients with HCV genotype 1 infection who had not received previous treatment, with only 24 weeks of therapy administered in the majority of patients. (Funded by Vertex Pharmaceuticals and Tibotec; ADVANCE ClinicalTrials.gov number, NCT00627926.).

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Epidemiology of hepatitis B and C viruses: a global overview.

Helen Te, Donald Jensen (2010)

This article reviews the prevalence, disease burden, genotype distribution, and transmission patterns of hepatitis B virus (HBV) and hepatitis C virus in the 6 World Health Organization regions. The global epidemiology of hepatitis B and C demonstrates a predominantly declining prevalence of the diseases. Improvement in the control of hepatitis B has been largely achieved with implementation of a more universal HBV vaccine program, although a large gap still remains in the effort toward global prevention of hepatitis B. The transmission of hepatitis C has been greatly impacted by mandatory screening of blood donors in most countries in the world, although intravenous drug use continues to be a major source of infection. Public education regarding the risks of exposure to infected paraphernalia as well as household items such as razors is necessary in the continuing effort to curb this disease. (c) 2010 Elsevier Inc. All rights reserved.

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Journal

Journal ID (nlm-ta): Pathogens

Journal ID (iso-abbrev): Pathogens

Journal ID (publisher-id): pathogens

Title: Pathogens

Publisher: MDPI

ISSN (Electronic): 2076-0817

Publication date (Electronic): 14 November 2019

Publication date Collection: December 2019

Volume: 8

Issue: 4

Electronic Location Identifier: 236

Affiliations

[1 ]Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança PA 68600-000, Brazil; diego_wendel_@ 123456hotmail.com (D.W.F.A.); nattycavalcante2014@ 123456hotmail.com (N.S.C.); nayraiol94@ 123456gmail.com (N.C.R.); brenda_ufpa1@ 123456yahoo.com (B.L.A.L.); gcoliveira@ 123456ufpa.br (G.C.S.-O.)

[2 ]Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis SC 88040-900, Brazil; emil.kupek@ 123456ufsc.br

[3 ]Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém PA 66055-240, Brazil; paulacrfrade@ 123456gmail.com (P.C.R.F.); luanam.c@ 123456hotmail.com (L.M.d.C.); caricio@ 123456ufpa.br (L.C.M.)

[4 ]Faculdade de Ciências Biológicas, Campus do Marajó, Universidade Federal do Pará, Soure PA 68870-000, Brazil; lmarcelo@ 123456ufpa.br

[5 ]Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém PA 66077-830, Brazil; lfam@ 123456ufpa.br (L.F.A.M.); jalemos@ 123456ufpa.br (J.A.R.L.)

[6 ]Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo SP 05403-000, Brazil; jrrpinho@ 123456usp.br

[7 ]Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis SC 88040-900, Brazil

[8 ]Centro de Hematologia e Hemoterapia do Pará, Laboratório de Biologia Molecular, Belém PA 66033-000, Brazil

Author notes

[* ]Correspondence: olivfilho@ 123456ufpa.br ; Tel.: +55-91-3425-1209

Author information

Aldemir B. Oliveira-Filho https://orcid.org/0000-0002-4888-3530

Brenda Luena A. Lisboa https://orcid.org/0000-0001-5607-5835

Paula Cristina R. Frade https://orcid.org/0000-0001-7455-3490

Luana M. da Costa https://orcid.org/0000-0003-1755-6200

Luiz Fernando A. Machado https://orcid.org/0000-0002-4571-4715

Luisa C. Martins https://orcid.org/0000-0001-8832-148X

João Renato R. Pinho https://orcid.org/0000-0003-3999-0489

Emil Kupek https://orcid.org/0000-0001-6704-1673

José Alexandre R. Lemos https://orcid.org/0000-0002-7595-2597

Article

Publisher ID: pathogens-08-00236

DOI: 10.3390/pathogens8040236

PMC ID: 6963267

PubMed ID: 31739623

SO-VID: adf0b458-7fa4-4646-8e5e-fe710dcd76ba

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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Hepatitis C Virus among Female Sex Workers: A Cross-Sectional Study Conducted along Rivers and Highways in the Amazon Region

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Ticks and tick-borne pathogens

Most cited references 65

Boceprevir for untreated chronic HCV genotype 1 infection.

Telaprevir for previously untreated chronic hepatitis C virus infection.

Epidemiology of hepatitis B and C viruses: a global overview.

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