Soroprevalência da infecção pelo vírus da hepatite B em portadores de doença mental

Abstract

Objectives: Hepatitis B virus (HBV) infection is an important worldwide public health problem and it has been cause of elevated morbidity and mortality rates. This study aimed to determine the HBV infection seroprevalence in psychiatric institutions and in individuals with Down's syndrome, to detect viral DNA in HBsAg and antiHBc total positive serum samples and to determine the HBsAg subtypes circulating these groups. Methods: The study assessed 433 subjects, with 408 being mentally disordered inpatients (71 had also chemical dependence), and 25 were Down's syndrome outpatientes. Blood samples were collected and tested for HBV markers: HBsAg, anti-HBs and anti-HBc total by enzyme-linked immunoabsorbent assay (ELISA). HBsAg positive samples were also tested for anti-HBc IgM, HBeAg, anti-HBe, and subtyped by radial immunodifusion. HBV-DNA was investigated in HBsAg and/or anti-HBc total positive samples by PCR methodology. Results: A global HBV positivity of 22.4% was detected. HBsAg was found in 1.6% of the samples. Among them, five were subtyped as adw 2 , adw 4 and ayw 3 . Viral DNA was found in 3 HBsAg samples and in 11 HBsAg and in anti-HBc total/anti-HBs positive samples, respectively. Risk factor analysis showed that multiple hospital admission was significantly associated with HBV markers. Conclusion: These results show high HBV seroprevalence in the investigated groups and reinforce the importance of HBV-specific preventive measures to reduce the risk of hepatitis B in individuals with mental disturbances and retardation.Hepatitis B. HBV. Seroprevalence. Subtypes. Mental disorders. Mental retardation. Chemical dependence. Down's syndrome.Objetivos: O vírus da hepatite B representa um importante problema de saúde pública mundial e é responsável por altos índices de morbidade e de mortalidade. Este estudo objetivou a determinação da soroprevalência da infecção pelo vírus da hepatite B (VHB) em pacientes internados em instituições psiquiátricas e em indivíduos com síndrome de Down, a detecção do DNA viral nas amostras positivas para HBsAg e anti-HBc total, e a caracterização dos subtipos do HBsAg. Métodos: O estudo avaliou 433 indivíduos, sendo que 408 eram portadores de doença mental e internos em instituições psiquiátricas (71 deles tinham também dependência química) e 25 eram indivíduos com síndrome de Down, não institucionalizados. Amostras sangüíneas de todos os participantes foram testadas para os marcadores do VHB: HBsAg, anti-HBs e anti-HBc total pelo ensaio imunoenzimático (ELISA). Soro positivos ao HBsAg foram testados também para o anti-HBc IgM, HBeAg, anti-HBe, e subtipadas pela técnica de imunodifusão radial. A detecção do DNA-VHB foi realizada em amostras reagentes ao HBsAg e/ou anti-HBc total, utilizando-se a metodologia da Reação em Cadeia pela Polimerase (PCR). Resultados: Foi observado um índice global de soropositividade para o VHB de 22,4% sendo que 1,6% dos indivíduos foram positivos para HBsAg. Dentre as amostras HBsAg positivas, 5 foram subtipáveis pela metodologia de imunodifusão radi...

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“…When comparing our results with those reported in similar psychiatric populations of other countries, our frequencies were only comparable with that found in northern Ireland [10]. However, our figure was much lower than those reported in Brazil [8], the U.S.A. [11], Spain [9], Singapore [13], and Taiwan [12]. A likely explanation for this finding could be differences in the characteristics of the patients studied.…”

“…A sample size calculation was performed based on the reported prevalence of HBV infection in a comparable Latin-American population [8]. A 99% confidence level sample size of 74 patients was obtained.…”

“…For instance, in a Brazilian study, 22.4% of the psychiatric patients studied were positive for HBV infection [8]. In European countries, a study carried out in Spain showed that HBV seropositivity in mentally handicapped adults was 81.3% [9].…”

Serological markers of hepatitis A, B and C viruses in rural communities of the semiarid Brazilian Northeast

“…In contrast, there is a high prevalence of hepatotrophic viruses in the Amazon region with virological peculiarities, such as genotype F of HBV [8,9] and hepatitis D virus [10]. Many Brazilian studies, as well as international studies, describe the prevalence of hepatotrophic viruses among specific groups, such as blood donors [11], patients in hemodialysis programs [12][13][14], hemophiliacs [15], afro-descendants [16], mental disease patients [17] and hepatitis patients [18,19]. Due to a lack of studies conducted on the Brazilian northeastern semiarid region, we examined the distribution of hepatitis A (HAV), B (HBV) and C (HCV) serological markers in this population.…”

Disease prevalence in infectious Care Center of Users of Psychosocial Caxias-MA / Prevalência de doenças infecciosas em usuários de Centro de Atenção Psicossocial de Caxias-MA

“…20 in a study carried out in the cities of Goiânia-GO and Anápolis-GO, investigated a population consisting of patients that presented a mental problem associated or not with chemical dependence and individuals with Down Syndrome, obtaining the prevalence of hepatitis B of 24.3% For mental problems without chemical dependence and 16.9% associated to chemical dependence.…”