Chronic Hepatitis C Virus (HCV) infection is associated with progressive liver injury and subsequent development of fibrosis and cirrhosis. The death of hepatocytes results in the release of cytokines that induce inflammatory and fibrotic responses. The mechanism of liver damage is still under investigation but both apoptosis and immune-mediated processes may play roles. By observing the changes in gene expression patterns in HCV-infected cells, both markers and the causes of HCV-associated liver injury may be elucidated. HCV genotype 1b virus from persistently infected VeroE6 cells induced a strong cytopathic effect when used to infect Huh7.5 hepatoma cells. To determine if this cytopathic effect was a result of apoptosis, ultrastructural changes were observed by electron microscopy and markers of programmed cell death were surveyed. Screening of a human PCR array demonstrated a gene expression profile that contained upregulated markers of apoptosis, including tumor necrosis factor, caspases and caspase activators, Fas, Bcl2-interacting killer (BIK) and tumor suppressor protein, p53, as a result of HCV genotype 1b infection. The genes identified in this study should provide new insights into understanding viral pathogenesis in liver cells and may possibly help to identify novel antiviral and antifibrotic targets.

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To evaluate the epidemiological and molecular features of HBV infection among recyclable waste collectors. Methods: The participants were recruited from the dumping ground and recycling cooperatives in Campo Grande, Brazil, and were screened for hepatitis B and C, and HIV serological markers by ELISA, confirmed by PCR. Results: Among 278 participants, 63.7% (95% CI: 58.0-69.3) were considered susceptible to HBV infection. The prevalence rate of HBV exposure was 10.1% (95% CI: 6.5-13.6) and 0.4% (95% CI: 0.1-0.6) were chronic carriers. Age !45 years (AOR = 7.15), history of homosexual contact (AOR = 5.29), tattoo (AOR = 4.92) and history of surgery (AOR = 2.89) were factors associated with ever infection. Age 18-25 years (AOR = 4.63), educational level !9 years (AOR = 1.98) and knowledge about HBV transmission (AOR = 3.08) were associated with serological HBV vaccination like profile (26.2%; 95% CI: 21.1-31.4). Conclusions: Despite the availability and efficacy of HBV vaccine, this study found high HBV exposure and proportion of susceptible adults in a low endemic area. Vaccination and screening campaigns using accessible language to the economically disadvantaged populations can reduce the number of people susceptible to HBV infection.

Hepatitis B virus (HBV) infection is still a concern in vulnerable populations. in a study performed by our team in 1999-2003 in two Afro-Brazilian communities, Furnas dos Dionísios (FD) and São Benedito (SB), high prevalence rates of HBV exposure (42.7% and 16.0%, respectively), high susceptibility to HBV (55.3% and 63.0%) and low HBV vaccination like profile rates (2.0% and 21.0%) were observed. In 2015-2016, we reassessed HBV epidemiological and molecular features in these two communities to verify the impact of health actions adopted in the last years. the prevalence rate of HBV exposure among the enrolled 331 subjects was 35.3% in FD and 21.8% in SB. HBV chronic infection (5.8% in FD, 4.9% in SB) remained high. The rate of HBV vaccination like profile increased from 10.7% to 43.5% (2.0% to 45.9% in FD, 21.0% to 39.5% in SB) while susceptible subjects declined from 58.9% to 26.3% (55.3% to 18.8% in FD, 63.0% to 38.7% in SB). Among 18 HBsAg positive samples, 13 were successfully sequenced (pre-S/S region). Phylogenetic analyses showed that all isolates belong to HBV subgenotype A1, clustering within the Asian-American clade. Despite the maintenance of high prevalence rate of HBV exposure over these 13 years of surveillance, significant improvements were observed, reinforcing the importance of facilitated HBV vaccination to difficult-to-access population to close gaps in prevention. Hepatitis B virus (HBV) infection is still a major public health issue worldwide despite the availability of an effective vaccine and potent antiviral treatments 1-3. An estimated 2 billion people have been infected with HBV and 257 million people are chronic carriers of the virus. Serious complications of chronic HBV infection such as cirrhosis, liver failure, and hepatocellular carcinoma accounted for 887 000 deaths in 2015 4,5. Hepatitis B surface antigen (HBsAg) is the main HBV clinical marker indicating acute or chronic infection and its prevalence is used to categorize HBV endemicity as low, intermediate low, intermediate high, or high 2,6. Even though Brazil is now a low endemic country, it has some areas with high HBV prevalence, especially in the Amazon basin, some counties of Southern Brazil and, isolated communities 7-9. In Brazil, HBV immunization was first implemented in 1989 for infants in the western area of the Amazonas State and since 1998 HBV vaccine has been incorporated into the immunization schedule for infants as a national policy 10. Nowadays, HBV vaccination is available to all individuals regardless of age or risk group, being considered satisfactory and effective, moving Brazil from moderate HBV endemicity to low-endemicity classification 7. Although Brazilian multi-center population-based studies have observed a decrease in HBV infection prevalence in the last decades, especially among children and young adults 10,11 , vaccination is still a challenge in difficult-to-access populations and therefore, observations cannot be extrapolated to rural or vulnerable populations 7 .

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