Paraná Raymundo, Paiva Tiago, Leite Márcio Rios, Oliveira Fabrizio Ney, Kali Nardino, Lobato Cirley, Dantas Thor, Neto José Tavares
Gastro Hepatology Unit, University Hospital of Bahia, Salvador, Brazil.
Am J Trop Med Hyg. 2007 Jan;76(1):165-9.
Clinical and epidemiologic studies on the hepatitis C virus (HCV) in the western Brazilian Amazon region are scarce. However, reports of clinical cases of hepatitis or pathologies associated to the HCV infection are frequent. In the state of Acre, there have been no studies on the population with the greatest exposure to parenteral transmission of virus infection. The objective of this study was to determine the prevalence of HCV infection among health care workers (HCWs) in this region. Of 2,338 HCWs, 646 were randomly selected for this study. The presence of antibody to HCV was determined. If these persons were antibody positive, they were tested for HCV RNA and the viral genotype was determined. The seroprevalence of antibody to HCV was 4.8% (31 of 646), and 3.7% (24 of 646) of those tested had detectable HCV RNA. Among these 24 viremic cases, HCV genotype 1 was most common (n = 16), followed by genotypes 3 (n = 6), 2 (n = 1), and an unidentified genotype. Infection with HCV (identified by a polymerase chain reaction) was more frequent among those with lower educational levels and lower incomes, those who lived for a longer period in the city of Rio Branco, those who reported intravenous use of vitamin complexes, those with a history of dental treatment, those with alcoholism, and women with history of caesarian parturition. The high prevalence of patients with HCV observed among HCWs in the city of Rio Branco and risk factors indicate the need for prevention and control programs, in addition to assistance programs, because this region is also hyperendemic for hepatitis B virus and hepatitis D virus.
巴西亚马孙地区西部关于丙型肝炎病毒（HCV）的临床和流行病学研究较少。然而，肝炎临床病例或与HCV感染相关病症的报告却很常见。在阿克里州，尚未对病毒感染经肠道外传播暴露风险最高的人群开展研究。本研究的目的是确定该地区医护人员（HCWs）中HCV感染的患病率。在2338名医护人员中，随机选取了646名参与本研究。检测HCV抗体的存在情况。若这些人抗体呈阳性，则检测其HCV RNA并确定病毒基因型。HCV抗体的血清阳性率为4.8%（646人中的31人），检测者中有3.7%（646人中的24人）可检测到HCV RNA。在这24例病毒血症病例中，HCV 1型最为常见（n = 16），其次是3型（n = 6）、2型（n = 1）以及一种未确定的基因型。HCV感染（通过聚合酶链反应确定）在教育程度较低、收入较低、在里奥布兰科市居住时间较长、报告静脉注射维生素复合物、有牙科治疗史、酗酒以及有剖宫产史的女性中更为常见。在里奥布兰科市医护人员中观察到的HCV高患病率及危险因素表明，除援助项目外，还需要预防和控制项目，因为该地区也是乙肝病毒和丁肝病毒的高流行区。
