Epidemiology of acute hepatitis B in a university hospital in São Paulo, Brazil: retrospective study of two five-year periods

Ferraz, Maria Lúcia Cardoso Gomes; Yoradjian, Alessandra; Barbieri, Andrea; Figueiredo, Virginia Maria; Lopes, Edmundo Pessoa; Cruz, Cibele Nascimento; Silva, Antônio Eduardo Benedito

doi:10.1590/s1516-31801998000300002

Cited by 5 publications

(6 citation statements)

References 17 publications

(14 reference statements)

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“…In the present study, the evolution to chronicity was calculated based on patients who had complete follow-ups, similar to other studies (15,24). However, some authors did not specify whether there were losses in the follow-up (17) or if they calculated the progression to chronicity based on the total number of patients or only those with completed follow-ups (11). The results of the present study could be overestimated because some patients were lost to follow-up.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of a patient cohort with acute hepatitis B

Souza¹,

Mattos²,

Fiorini³

et al. 2013

Clinics

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Section: Discussionmentioning

confidence: 99%

Clinical outcome of a patient cohort with acute hepatitis B

Souza¹,

Mattos²,

Fiorini³

et al. 2013

Clinics

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“…One of the concerns of treating acute fulminant hepatitis B is the prospect of interfering with the immune control of the virus and therefore inducing chronic hepatitis B. Naturally, the risk of chronification of hepatitis B after symptomatic acute hepatitis B is low; 1 larger study from Brazil stated 1.7 % as rate of chronification of hospitalized patients with acute hepatitis B from 1985 -1994 [27]. However, treatment of acute hepatitis B with corticosteroids as it was used in the 1970 s leads to chronification in most cases.…”

mentioning

confidence: 99%

Treatment of fulminant acute Hepatitis B with nucles(t)id analogues is safe and does not lead to secondary chronification of Hepatitis B

et al. 2016

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Acute hepatitis B virus (HBV) infection is still a major cause of acute liver failure (ALF), necessitating a high rate of emergency liver transplantation (LTx). Acute infection is followed by high viral replication rates leading to hepatocyte death and, ultimately, ALF. The objective of treating HBV-induced ALF thus is to eliminate, or significantly suppress, HBV replication and therefore reduce cell death and support regeneration. In this retrospective study, we want to evaluate the timing, the safety, and the long-term virological outcome of this approach. In this study, we included 32 patients (16 female and 16 males; median age 39.5 years) with ALF due to hepatitis B, who were transferred to the university hospital Essen, Germany between January 2009 and December 2013. Before treatment, transaminases were highly elevated, bilirubin was increased, and elevated international normalized ratio (INR) revealed impaired liver function. HBV-DNA and HBsAg were positive. All 32 patients received oral antiviral treatment (3 lamivudine, 21 entecavir, and 8 tenofovir) between 1 day and 4 months after diagnosis of acute hepatitis B. One patient died, 2 were transplanted, one died shortly after LTx the other patient survived after LTx. These 3 patients received treatment in a state of advanced liver failure, and 1 patient 4 months after initial diagnosis of hepatitis B. Twenty-nine patients survived without LTx. Five patients were discharged without further follow-up. All 24 remaining patients became HBV-DNA negative in median of 100 days. Twenty-two patients were followed further, and all patients lost their HBsAg in median of 108 days. Sixteen of the 22 patients experienced a seroconversion to anti-HBs in median of 137 days. Four patients who were followed for 1 more year after HBsAg did not develop anti-HBs. None of the patients developed chronic hepatitis B. Immediate treatment of HBV-induced ALF with nucleos(t)id-analogues (NUCs) appears save and prevents LTx and death, and there is no indication for increased chronicity.

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“…Nessas condições, a infecção neonatal e na infância é muito rara. Mesmo nessas áreas, contudo, existem grupos de alto risco, que são os usuários de drogas injetáveis, homossexuais masculinos, profissionais da área da saúde, pacientes de hemodiálise ou aqueles sujeitos a tratamento clínico por hemoderivados (5, 7).…”

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“…A Amazônia Legal (média de 8% de prevalência de HBsAg), o Estado do Espírito Santo e o oeste do Estado de Santa Catarina são considerados de alta endemicidade. De modo geral, a taxa de letalidade dos pacientes hospitalizados é de 0,8 a 2%, podendo aumentar nos indivíduos com mais de 40 anos de idade e ser maior nos casos associados ao vírus da hepatite D. No Brasil, a taxa de mortalidade por hepatite B é de 0,6 por 100 000 habitantes (1,5,7).…”

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