Oliveira M L, Bastos F I, Telles P R, Yoshida C F, Schatzmayr H G, Paetzold U, Pauli G, Schreier E
Laboratório de Hepatites Virais, Departamento de Virologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
Braz J Med Biol Res. 1999 Sep;32(9):1107-14. doi: 10.1590/S0100-879X1999000900009.
Viral hepatitis constitutes a major health issue, with high prevalence among injecting drug users (IDUs). The present study assessed the prevalence and risk determinants for hepatitis B, C and D viruses (HBV, HCV and HDV) infections among 102 IDUs from Rio de Janeiro, Brazil. Serological markers and HCV-RNA were detected by enzyme immunoassay and nested PCR, respectively. HCV genotyping was determined by restriction fragment length polymorphism analysis (RFLP). HBsAg, anti-HBc and anti-HBs were found in 7.8, 55.8 and 24. 7% of IDUs, respectively. In the final logistic regression, HBV infection was independently associated with male homosexual intercourse within the last 5 years (odds ratio (OR) 3.1; 95% confidence interval (CI) 1.1-8.8). No subject presented anti-delta (anti-HD). Anti-HCV was detected in 69.6% of subjects, and was found to be independently associated with needle sharing in the last 6 months (OR 3.4; 95% CI 1.3-9.2) and with longer duration of iv drug use (OR 3.1; 95% CI 1.1-8.7). These data demonstrate that this population is at high risk for both HBV and HCV infection. Among IDUs from Rio de Janeiro, unprotected sexual intercourse seems to be more closely associated with HBV infection, whereas HCV is positively correlated with high risk injecting behavior. Comprehensive public health interventions targeting this population and their sexual partners must be encouraged.
病毒性肝炎是一个重大的健康问题，在注射吸毒者（IDU）中患病率很高。本研究评估了来自巴西里约热内卢的102名注射吸毒者中乙型、丙型和丁型肝炎病毒（HBV、HCV和HDV）感染的患病率及风险决定因素。分别采用酶免疫测定法和巢式PCR检测血清学标志物和HCV-RNA。通过限制性片段长度多态性分析（RFLP）确定HCV基因分型。在注射吸毒者中，HBsAg、抗-HBc和抗-HBs的检出率分别为7.8%、55.8%和24.7%。在最终的逻辑回归分析中，HBV感染与过去5年内男性同性性行为独立相关（比值比（OR）3.1；95%置信区间（CI）1.1-8.8）。没有受试者出现抗-HD（抗-δ）。69.6%的受试者检测到抗-HCV，且发现其与过去6个月内共用针头（OR 3.4；95%CI 1.3-9.2）以及静脉吸毒时间较长（OR 3.1；95%CI 1.1-8.7）独立相关。这些数据表明，该人群感染HBV和HCV的风险很高。在里约热内卢的注射吸毒者中，无保护性行为似乎与HBV感染关系更为密切，而HCV与高风险注射行为呈正相关。必须鼓励针对该人群及其性伴侣的全面公共卫生干预措施。
