Abstract
BackgroundThis study was conducted to determine the prevalence of HBV, HCV, and HDV in urban populations and Amerindians living in the state of Tocantins (Eastern Amazon).MethodsA total of 948 individuals were recruited in Tocantinopolis city (Tocantins state) of whom 603 were Amerindians (from 6 tribes) and 345 were non-Amerindians (6 urban areas of Tocantinópolis city). Anti-HCV, HBsAg, anti-HBc, anti-HBs, anti-HBc IgM, anti-HBe, HBeAg, and anti-delta antibodies were determined using enzyme immunoassay.ResultsHBV cleared infection (both anti-HBc/anti-HBs+), chronic inactive/immune controlled HBV infection (anti-HBc + only), previous HBV vaccination (anti-HBs + only), active HBV infection (HBsAg+), individuals susceptible to HBV, and anti-HCV reactivity were found in 12.9, 1.8, 27.2, 0.5, 57.7, 1.2% in Amerindians and 12.1, 2.0, 37.1, 0.3, 55.4, 0.3% in non-Amerindians respectively. Out of 139 anti-HBc reactive individuals, 70 were anti-HBe reactive and none presented HBeAg or anti-HBc IgM. Anti-HBc prevalence was associated to older age (p < 0.0001). Overall anti-Delta prevalence was 0.3% and regarding anti-HBc reactive individuals, anti-delta prevalence was 3.4 and 0% in Amerindians and non-Amerindians respectively.ConclusionsOverall low prevalence of HBV and HCV infection was found in the populations studied, but high HBV and HCV prevalence was observed in Amerindians compared to non-Amerindians suggesting that these individuals have a higher likelihood of acquiring to these infections. Anti-delta antibodies were found among Amerindians from Eastern Amazon suggesting a risk for this population. Of note is that nearly half of Amerindians had no anti-HBs, indicating a need for HBV vaccination campaigns in this population.
Highlights
This study was conducted to determine the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV) in urban populations and Amerindians living in the state of Tocantins (Eastern Amazon)
Viral hepatitis prevalence has been widely investigated in the Western Amazonian region of Brazil [15,16,17,18,19,20,21], but few data are available for the Eastern Amazon region [22, 23], principally in the state of Tocantins
New data about HBV, HCV and HDV prevalence were obtained from Eastern Amazon and low prevalence of Surface antigen of the hepatitis B virus (HBsAg), anti-HCV and anti-delta was observed in these individuals, showing a low risk of transmission of these viruses in this region
Summary
This study was conducted to determine the prevalence of HBV, HCV, and HDV in urban populations and Amerindians living in the state of Tocantins (Eastern Amazon). Multicenter studies conducted in several regions of Brazil have demonstrated seroprevalence rates of anti-HBc (HBV past exposure) of 11.6% and anti-HCV of 3.22% in individuals aged 10 to 69 years old from North region of Brazil [4, 5]. In the period spanning 1999 to 2016, approximately 561,000 confirmed cases of viral hepatitis were reported to health authorities in Brazil. HBV, HCV and HDV prevalence varies considerably according to geographical region of the country, where the highest HCV prevalence (3.22%) is observed in the North region [5]. The highest rates of HBV carriers and more than 70% of reported HDV cases are observed in the Amazon Region located in the North of the country [6, 7]. HDV infection is common in acute hepatitis B cases (29%) and fulminant hepatitis cases (74%) in the North of Brazil [8]
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