Nearly 400 hemodialysis patients treated at 5 different hemodialysis units in Rio de Janeiro were tested for one year for the presence of hepatitis C and B markers. During the same period, samples were also obtained from 35 continuous ambulatory peritoneal dialysis (CAPD) patients and from 242 health care workers. Depending on the hemodialysis unit studied, anti-HCV prevalence rates ranging from 47% to 82% (mean 65%) were detected. CAPD patients showed a lower prevalence of 17%. The prevalence of antibodies against hepatitis C virus (anti-HCV) among health care workers was 2.9%. We observed a hepatitis C attack rate of 11.5% per year in the anti-HCV-negative hemodialysis patient population. An average of 9.4% of the hemodialysis patients were chronic carriers of hepatitis B virus (HBV) (range 1.8% - 20.4%), while 48.9% showed markers of previous HBV infection. The HBV attack rate was 4.5% per year (range 0% - 6%). These results indicate an alarming high prevalence of anti-HCV among hemodialysis patients of this studied region.
Um estudo soroepidemiológico para anticorpo do vírus da hepatite C (anti-VHC) foi realizado na população em diálise de Goiânia ,com objetivo de avaliar a soroprevalência do vírus e sua associação com possíveis fatores de risco. Foram estudados 173 pacientes com idade variando de 1070 anos, 35,3% (61/173) apresentaram soropositividade pelo ELISA de segunda geração e 25% (44/173) pelo INNO-LIA.Uso de drogas, hábitos sexuais, número de transfusões e atividade de transaminases não apresentaram relação significativa com a soropositividade. A permanência no tratamento e o uso da hemodiálise apresentaram correlação positiva com o anti-VHC (p < 0,05).Os dados sugerem que a hepatite C tem alta prevalência nos pacientes em hemodiálise e que o tempo em tratamento é um fator de risco para adquirir a infecção.
Data concerning HCV infection in Central Brazil are rare. Upon testing 2,350 voluntary blood donors from this region, we found anti-HCV prevalence rates of 2.2% by a second generation ELISA and 1.4% after confirmation by a line immunoassay. Antibodies against core, NS4, and NS5 antigens of HCV were detected in 81.8%, 72.7%, and 57.5%, respectively, of the positive samples in the line immunoassay. HCV viremia was present in 76.6% of the anti-HCV-positive blood donors. A relation was observed between PCR positivity and serum reactivity in recognizing different HCV antigens in the line immunoassay. The majority of the positive donors had history of previous parenteral exposure. While the combination of ALT > 50 IU/l and anti-HBc positivity do not appear to be good surrogate markers for HCV infection, the use of both ALT anti-HCV tests is indicated in the screening of Brazilian blood donors.
The prevalence of hepatitis C virus (HCV) antibodies in 2,557 asymptomatic volunteer Brazilian blood donors is reported. Using the line immunoassay (Inno-LIA) as a confirmatory test on ELISA anti-HCV-positive reacting sera, a prevalence rate of 2.7% for anti-HCV positivity was found. By comparison, prevalences of 1.6% for hepatitis B surface antigen, 0.9% for Treponema pallidum, 0.4% for human immunodeficiency virus and 0.04% for Trypanosoma cruzi were observed. Only 57% of the HCV-positive donors had elevated alanine aminotransferase (ALT) levels. Using previous criteria, based on surrogate markers (ALT > or = 50 IU/l and for anti-hepatitis B core antibody), for HCV infection at that time, only 25% of the HCV-positive donations would have been eliminated. In view of the high prevalence of anti-HCV reactivity among the Brazilian blood donor population and the poor reliability of surrogate markers, it is recommended that routine screening for anti-HCV in Brazilian blood donors is introduced.
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