Cross-sectional study to determine viral hepatitis knowledge in different urban populations in Brazil

AIM To evaluate viral hepatitis knowledge among individuals from different resource areas and health conditions to identify possible gaps.METHODS A cross-sectional, descriptive study was carried out among 447 individuals from five distinct populations in Brazil: Southeast Viral Hepatitis Ambulatory(n = 100), South(n = 89) and Northeast(n = 114) Health Center, Southeast(n = 77) and Northeast(n = 67) low resource areas. All individuals answered a questionnaire assessing sociodemographic characteristics and viral hepatitis awareness. The perception was scored based on the average number of correct answers of all participants and categorized as "low"(0-28 correct answers) or "desirable"(29-46 correct answers). Associations between sociodemographic characteristics and perception were also evaluated.RESULTS A low level of knowledge was observed in individuals from Northeast Health Center, Northeast and Southeast low resource areas while desirable knowledge was observed in individuals from Viral Hepatitis Ambulatory and South Health Center. According to sociodemographic characteristics, desirable scores were more common among those with secondary education(47.1%), those who declared themselves as white(46.3%), and those who lived in houses with three individuals(25.5%). Multivariate analysis showed an association between viral hepatitis perception and type of population. CONCLUSION The results demonstrated high level of knowledge among study participants from health clinics from the Southeast region of Brazil and the importance of education programs in increasing the level of knowledge in low resource areas.

Update on hepatitis B and C virus diagnosis

Viral hepatitis B and C virus(HBV and HCV) are responsible for the most of chronic liver disease worldwide and are transmitted by parenteral route, sexual and vertical transmission. One important measure to reduce the burden of these infections is the diagnosis of acute and chronic cases of HBV and HCV. In order to provide an effective diagnosis and monitoring of antiviral treatment, it is important to choose sensitive, rapid, inexpensive, and robust analytical methods. Primary diagnosis of HBV and HCV infection is made by using serological tests for detecting antigens and antibodies against these viruses. In order to confirm primary diagnosis, to quantify viral load, to determine genotypes and resistance mutants for antiviral treatment, qualitative and quantitative molecular tests are used. In this manuscript, we review the current serological and molecular methods for the diagnosis of hepatitis B and C.

Dried blood spot sampling as an alternative for the improvement of hepatitis B and C diagnosis in key populations

BACKGROUND To achieve the elimination of hepatitis B and C,there is an urgent need to develop alternative strategies to increase the access of diagnosis,particularly among key populations such as people living with human immunodeficiency virus(HIV),individuals with coagulopathies and chronic kidney disease(CKD)patients.AIM To evaluate the use of dried blood spot(DBS)in the detection of hepatitis B virus(HBV)and hepatitis C virus(HCV)markers.METHODS A total of 430 individuals comprised of people living with HIV,coagulopathies and CKD provided paired serum and DBS samples.HBsAg,anti-HBc and anti-HCV were tested in those samples using a commercial electrochemiluminescence.Demographic and selected behavioral variables were evaluated to assess possible association with HBV and HCV positivity.RESULTS Using DBS,HBsAg prevalence varied from 3.9%to 22.1%,anti-HBc rates varied from 25.5%to 45.6%and anti-HCV positivity ranged from 15.9%to 41.2%in key populations.Specificities of HBV and HCV tests using DBS varied from 88.9%to 100%.The HBsAg assay demonstrated the best performance in CKD and coagulopathy individuals and the anti-HCV test had a sensitivity and specificity of 100%in people living with HIV.Accuracy of HBV and HCV detection in DBS varied from 90.2%to 100%.In the CKD group,HBsAg positivity was associated with infrequent use of condoms,and anti-HBc positivity was associated with sharing nail cutters/razors/toothbrushes.Anti-HCV reactivity was positively associated with a history of transplantation and length of time using hemodialysis in both specimens.In people living with HIV,only the male gender was associated with anti-HBc positivity in serum and DBS.CONCLUSION DBS with electrochemiluminescence are useful tools for the diagnosis and prevalence studies of hepatitis B and C among key populations and may increase the opportunity to foster prevention and treatment.