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

Abstract

Hepatitis B virus (HBV) has a low endemicity in Rio deKey words: hepatitis B -seroprevalence -sexual transmission Hepatitis B virus (HBV) is a common worldwide infection, committing over 2 billion of the individuals alive today at some stage of their lives (Davey 1996). The virus is found in high concentrations in blood, serum, and wound exudate; in moderate concentrations in semen, vaginal secretions, and saliva; and in low concentrations in urine, sweat, tears, and breast milk. The predominant routes of transmission vary according to the endemicity of HBV infection. In areas of low endemicity the sexual contact is the major route of transmission. Extensive studies regarding HBV sexual transmission have been conducted in low HBV endemic countries (Struve et al. 1993, Gilson et al. 1998. Heterosexuals who have unsafe sex with multiple partners and homo/bisexual men are the high-risk groups for sexual transmission (Margolis et al. 1991).Brazilian Southeast has been recently categorized as low HBV endemic area (Martelli et al. 1999). Rio de Janeiro, a state within Southeast region, has an overall hepatitis B surface antigen (HBsAg) prevalence about 2% in general population (Nogueira et al. 1990, Vanderborght et al. 1993 the virus by sexual route but risk factors for this way has not been properly evaluated. Screening for hepatitis B in sexual transmission diseases (STD) clinics is not considered as routine procedure. Reports with adolescents (Raffaelli et al. 1993, Porto et al. 1994, pregnant women (Duarte et al. 1997) and women attending a STD clinic (Miranda et al. 1999) have provided information about sexual transmission of hepatitis B in Brazil, but extensive studies with patients attending STD clinics are still incomplete.The aim of this study is to provide epidemiological data regarding association of sexual transmission of HBV and risk factors among patients attending a STD clinic from the State of Rio de Janeiro, Brazil. MATERIALS AND METHODSParticipants -A retrospective study was developed with 440 patients attending the STD Clinic at Universidade Federal Fluminense, State of Rio de Janeiro, Brazil, over April to December in 1997. Demographic data (sex, age, pl0 -1of birth, ethnic origin, civil status, education, and socio-economic conditions) and risk factors for HBV infection (sexual behaviour, oral or anal intercourse, sexual partners, drug abuse (intravenous or not), current and past STD history, syphilis seropositivity, HIV infection and past history1of blood transfusion) were extracted from the clinical notes. Blood sample was taken of each patient at the time of the attending STD clinic.

Epidemiology of hepatitis B virus infection in truck drivers in Brazil, South America

“…When we compare our data to that acquired by other groups, we found that the prevalence we noted was similar to those found in men attending STD clinics (14.2, 95% CI 9.6 to 19.8)16 and in HIV testing and counselling centres (16.5%, 95% CI 11.7 to 22.5),20 but it was lower than that found in injecting drug users (83.3%, 95% CI 74.6 to 89.9) 21…”

“…The study sample was calculated on the basis of a 95% confidence interval (CI) (α = 0.05), power of 80% (β = 20%), an expected HBV prevalence of 3.9%16 and a precision of 1.5%. With these parameters, the minimum necessary sample size was determined to be 640.…”

Prevalence of hepatitis B virus infection among tuberculosis patients with or without HIV in Goiânia City, Brazil

“…23,24 The prevalence determined in this study was within the confidence interval range reported for injecting drug users (27.1%; 95% CI: 23.6-30.8) and hemodialysis patients (29.8%; 95% CI: 27.1-32.5). 25,26 Relative to other data reported in TB patients, the HBV prevalence determined in this study was similar to prevalence rates observed in Rio de Janeiro, Brazil (26.8%; 95% CI: 19.7-31.9) and Argentina (19.8%; 95% CI: 14.3-26.2), 12,13 but was higher than rates determined in Georgia (13%; 95% CI: 9.5-17.5) and Taiwan (11.7%; 95% CI: 6.8-15.5).…”

Sexually acquired hepatitis

“…[53][54][55] There is relatively little published work on homosexual transmission of HBV in the tropics with the exception of parts of Latin America. [56][57][58] In these countries there is evidence of very high rates of hepatitis B spread between homosexual men with indicators of present/past infection of over 40%. [56][57][58] Clinical presentation As with HAV, acute infection of children with HBV is largely asymptomatic 59 60 and this situation accounts for the majority of HBV infections in resource-poor countries.…”