Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados

Detalhes bibliográficos
Autor(a) principal: NUNES, Jomar Diogo Costa
Data de Publicação: 2018
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UFMA
Texto Completo: https://tedebc.ufma.br/jspui/handle/tede/tede/2247
Resumo: Introduction. Hepatitis B Virus (HBV) infection can lead to chronic disease. Hepatitis Delta virus (HDV) coinfection may favor an increased risk for liver cirrhosis and hepatocellular carcinoma (HCC) in HBV carriers. HBV infected individuals may present detectable HBV DNA with absence of hepatitis B surface antigen (HBsAg). HBV and HDV infections prevalence rates are heterogeneous in Brazil. The aim of this study was to estimate the prevalence of HBV and HDV infections located in the state of Maranhão in Brazil (Axixá, Morros, Icatu, Humberto de Campos and Urbano Santos). Methods. A total of 3.856 to 4,000 individuals participated of this study. Sample size was obtained by considering a prevalence of 0.5% of HBsAg (according to previous national survey), absolute error of 0.3% and 95% confidence interval. Individuals should be age 1 or older to participate in this study. Questionnaires were applied to identify sociodemographic characteristics and transmission risk factors. Samples of blood were collected and serologies were performed for HBsAg, antiHBc, anti-HBs and anti-HDV markers by enzyme-linked immunosorbent assay (ELISA). Results. A total of 3.984 individuals were screened for HBsAg serological markers. The prevalence of HBsAg was 2.30%. Anti-HBc marker was found in 38.47% of samples, 13.95% and 20.10% presented isolated anti-HBc and anti-HBs respectively. Considering the 3,984 samples, anti-HDV was found in 0.35% individuals (among the 92 HBV carriers, eight presented the anti-HDV marker, corresponding to 8.6%). Among the 561 participants with anti-HBc alone, 223 (39.75%) Conclusion. The prevalence of HBV in the region was considered to be intermediate (more than 2% of carriers). Among those carriers, 8% tested positive for anti-HDV. Thus, prevention measures should be implemented to prevent Infection by these viruses and progression to liver cirrhosis and HCC.
id UFMA_f5c225dbe4f7d72f0216a5ec62479213
oai_identifier_str oai:tede2:tede/2247
network_acronym_str UFMA
network_name_str Biblioteca Digital de Teses e Dissertações da UFMA
repository_id_str 2131
spelling FERREIRA, Adalgisa de Souza Paiva850.818.767-04http://lattes.cnpq.br/6707376027989566PEREZ, Renata de Mellohttp://lattes.cnpq.br/0870986021644250BRANCO, Maria dos Remédios Freitas Carvalhohttp://lattes.cnpq.br/5449951869928014FONSECA, Lena Maria Barroshttp://lattes.cnpq.br/6007134685901712AZEVEDO, Conceição de Maria Pedrozo e Silva dehttp://lattes.cnpq.br/1702212486285798024.338.143-32http://lattes.cnpq.br/1239440266493234NUNES, Jomar Diogo Costa2018-05-21T18:41:21Z2018-05-17NUNES, Jomar Diogo Costa. Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados. 2018. 101 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal do Maranhão, São Luís, 2018.https://tedebc.ufma.br/jspui/handle/tede/tede/2247Introduction. Hepatitis B Virus (HBV) infection can lead to chronic disease. Hepatitis Delta virus (HDV) coinfection may favor an increased risk for liver cirrhosis and hepatocellular carcinoma (HCC) in HBV carriers. HBV infected individuals may present detectable HBV DNA with absence of hepatitis B surface antigen (HBsAg). HBV and HDV infections prevalence rates are heterogeneous in Brazil. The aim of this study was to estimate the prevalence of HBV and HDV infections located in the state of Maranhão in Brazil (Axixá, Morros, Icatu, Humberto de Campos and Urbano Santos). Methods. A total of 3.856 to 4,000 individuals participated of this study. Sample size was obtained by considering a prevalence of 0.5% of HBsAg (according to previous national survey), absolute error of 0.3% and 95% confidence interval. Individuals should be age 1 or older to participate in this study. Questionnaires were applied to identify sociodemographic characteristics and transmission risk factors. Samples of blood were collected and serologies were performed for HBsAg, antiHBc, anti-HBs and anti-HDV markers by enzyme-linked immunosorbent assay (ELISA). Results. A total of 3.984 individuals were screened for HBsAg serological markers. The prevalence of HBsAg was 2.30%. Anti-HBc marker was found in 38.47% of samples, 13.95% and 20.10% presented isolated anti-HBc and anti-HBs respectively. Considering the 3,984 samples, anti-HDV was found in 0.35% individuals (among the 92 HBV carriers, eight presented the anti-HDV marker, corresponding to 8.6%). Among the 561 participants with anti-HBc alone, 223 (39.75%) Conclusion. The prevalence of HBV in the region was considered to be intermediate (more than 2% of carriers). Among those carriers, 8% tested positive for anti-HDV. Thus, prevention measures should be implemented to prevent Infection by these viruses and progression to liver cirrhosis and HCC.Introdução: A infecção pelo vírus da hepatite B (VHB) pode se tornar crônica. A coinfecção com o vírus Delta (VHD) pode piorar a primeira, favorecendo maior risco para cirrose hepática e carcinoma hepatocelular (CHC). No Brasil, as taxas de prevalência destas infecções são heterogêneas. O objetivo desse estudo foi estimar as prevalências das hepatites B e Delta em cinco municípios localizado no estado do Maranhão no Brasil (Axixá, Morros, Icatu, Humberto de Campos e Urbano Santos). Metodologia: A amostra foi calculada, levando em consideração uma prevalência de 0,5% do HBsAg (considerando o resultado da prevalência do HBsAg, encontrada no inquérito nacional na região Nordeste) com erro absoluto de 0,3%, nível de confiança de 95% com uma amostra total de 3.856 a 4.000 indivíduos maiores de 1 ano de idade. Foram aplicados questionários para identificar características sóciodemográficas e fatores de risco de transmissão. Amostras de sangue foram coletadas e foram realizadas sorologias para HBsAg, anti-HBc, anti-HBs e anti-HDV por ensaio imunoenzimático (ELISA). Resultado: Um total de 3984 participantes foram incluídos. A prevalência de HBsAg foi de 2,30%, 38,47% tinham anti-HBc positivo,13,95% tinham anti-HBc isolado e 20,10% apresentaram anti-HBs isoladamente positivo. A prevalência de VHD na amostra total foi de 0,35% (entre os 92 portadores do VHB, oito tinham o marcador anti-HDV positivo, correspondendo a 8.6%). Conclusão: A prevalência do HBsAg na região foi considerada intermediária (mais de 2% da população é portadora) e entre estes, 8% tinham positividade para o VHD, sugerindo que é uma região em que medidas rigorosas de prevenção devem ser implementadas para prevenir a infecção por estes vírus impedindo a progressão para cirrose hepática e CHC.Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2018-05-21T18:41:21Z No. of bitstreams: 1 JomarNunes.pdf: 5055279 bytes, checksum: 7e0cb837b9b756096b335c44a83af2bc (MD5)Made available in DSpace on 2018-05-21T18:41:21Z (GMT). No. of bitstreams: 1 JomarNunes.pdf: 5055279 bytes, checksum: 7e0cb837b9b756096b335c44a83af2bc (MD5) Previous issue date: 2018-05-17FAPEMAapplication/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE/CCBSUFMABrasilDEPARTAMENTO DE EDUCAÇÃO I/CCSOHepatite BHepatite DeltaPrevalênciaFatores associadosHepatitis BHepatitis deltaPrevalenceAssociated factorsGenética Molecular e de MicroorganismosHepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associadosHepatitis B (HBV) and Delta (VHD) in five municipalities of Maranhão State: prevalence and associated factorsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALJomarNunes.pdfJomarNunes.pdfapplication/pdf5055279http://tedebc.ufma.br:8080/bitstream/tede/2247/2/JomarNunes.pdf7e0cb837b9b756096b335c44a83af2bcMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/2247/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/22472018-05-21 15:41:21.197oai:tede2: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Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312018-05-21T18:41:21Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false
dc.title.por.fl_str_mv Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados
dc.title.alternative.eng.fl_str_mv Hepatitis B (HBV) and Delta (VHD) in five municipalities of Maranhão State: prevalence and associated factors
title Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados
spellingShingle Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados
NUNES, Jomar Diogo Costa
Hepatite B
Hepatite Delta
Prevalência
Fatores associados
Hepatitis B
Hepatitis delta
Prevalence
Associated factors
Genética Molecular e de Microorganismos
title_short Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados
title_full Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados
title_fullStr Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados
title_full_unstemmed Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados
title_sort Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados
author NUNES, Jomar Diogo Costa
author_facet NUNES, Jomar Diogo Costa
author_role author
dc.contributor.advisor1.fl_str_mv FERREIRA, Adalgisa de Souza Paiva
dc.contributor.advisor1ID.fl_str_mv 850.818.767-04
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/6707376027989566
dc.contributor.referee1.fl_str_mv PEREZ, Renata de Mello
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/0870986021644250
dc.contributor.referee2.fl_str_mv BRANCO, Maria dos Remédios Freitas Carvalho
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/5449951869928014
dc.contributor.referee3.fl_str_mv FONSECA, Lena Maria Barros
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/6007134685901712
dc.contributor.referee4.fl_str_mv AZEVEDO, Conceição de Maria Pedrozo e Silva de
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/1702212486285798
dc.contributor.authorID.fl_str_mv 024.338.143-32
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/1239440266493234
dc.contributor.author.fl_str_mv NUNES, Jomar Diogo Costa
contributor_str_mv FERREIRA, Adalgisa de Souza Paiva
PEREZ, Renata de Mello
BRANCO, Maria dos Remédios Freitas Carvalho
FONSECA, Lena Maria Barros
AZEVEDO, Conceição de Maria Pedrozo e Silva de
dc.subject.por.fl_str_mv Hepatite B
Hepatite Delta
Prevalência
Fatores associados
topic Hepatite B
Hepatite Delta
Prevalência
Fatores associados
Hepatitis B
Hepatitis delta
Prevalence
Associated factors
Genética Molecular e de Microorganismos
dc.subject.eng.fl_str_mv Hepatitis B
Hepatitis delta
Prevalence
Associated factors
dc.subject.cnpq.fl_str_mv Genética Molecular e de Microorganismos
description Introduction. Hepatitis B Virus (HBV) infection can lead to chronic disease. Hepatitis Delta virus (HDV) coinfection may favor an increased risk for liver cirrhosis and hepatocellular carcinoma (HCC) in HBV carriers. HBV infected individuals may present detectable HBV DNA with absence of hepatitis B surface antigen (HBsAg). HBV and HDV infections prevalence rates are heterogeneous in Brazil. The aim of this study was to estimate the prevalence of HBV and HDV infections located in the state of Maranhão in Brazil (Axixá, Morros, Icatu, Humberto de Campos and Urbano Santos). Methods. A total of 3.856 to 4,000 individuals participated of this study. Sample size was obtained by considering a prevalence of 0.5% of HBsAg (according to previous national survey), absolute error of 0.3% and 95% confidence interval. Individuals should be age 1 or older to participate in this study. Questionnaires were applied to identify sociodemographic characteristics and transmission risk factors. Samples of blood were collected and serologies were performed for HBsAg, antiHBc, anti-HBs and anti-HDV markers by enzyme-linked immunosorbent assay (ELISA). Results. A total of 3.984 individuals were screened for HBsAg serological markers. The prevalence of HBsAg was 2.30%. Anti-HBc marker was found in 38.47% of samples, 13.95% and 20.10% presented isolated anti-HBc and anti-HBs respectively. Considering the 3,984 samples, anti-HDV was found in 0.35% individuals (among the 92 HBV carriers, eight presented the anti-HDV marker, corresponding to 8.6%). Among the 561 participants with anti-HBc alone, 223 (39.75%) Conclusion. The prevalence of HBV in the region was considered to be intermediate (more than 2% of carriers). Among those carriers, 8% tested positive for anti-HDV. Thus, prevention measures should be implemented to prevent Infection by these viruses and progression to liver cirrhosis and HCC.
publishDate 2018
dc.date.accessioned.fl_str_mv 2018-05-21T18:41:21Z
dc.date.issued.fl_str_mv 2018-05-17
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv NUNES, Jomar Diogo Costa. Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados. 2018. 101 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal do Maranhão, São Luís, 2018.
dc.identifier.uri.fl_str_mv https://tedebc.ufma.br/jspui/handle/tede/tede/2247
identifier_str_mv NUNES, Jomar Diogo Costa. Hepatite B (VHB) e Delta (VHD) em cinco municípios do Estado Maranhão: prevalência e fatores associados. 2018. 101 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal do Maranhão, São Luís, 2018.
url https://tedebc.ufma.br/jspui/handle/tede/tede/2247
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Federal do Maranhão
dc.publisher.program.fl_str_mv PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE/CCBS
dc.publisher.initials.fl_str_mv UFMA
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv DEPARTAMENTO DE EDUCAÇÃO I/CCSO
publisher.none.fl_str_mv Universidade Federal do Maranhão
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações da UFMA
instname:Universidade Federal do Maranhão (UFMA)
instacron:UFMA
instname_str Universidade Federal do Maranhão (UFMA)
instacron_str UFMA
institution UFMA
reponame_str Biblioteca Digital de Teses e Dissertações da UFMA
collection Biblioteca Digital de Teses e Dissertações da UFMA
bitstream.url.fl_str_mv http://tedebc.ufma.br:8080/bitstream/tede/2247/2/JomarNunes.pdf
http://tedebc.ufma.br:8080/bitstream/tede/2247/1/license.txt
bitstream.checksum.fl_str_mv 7e0cb837b9b756096b335c44a83af2bc
97eeade1fce43278e63fe063657f8083
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)
repository.mail.fl_str_mv repositorio@ufma.br||repositorio@ufma.br
_version_ 1809926189863665664