Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil.
Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
BMC Infect Dis. 2023 Oct 19;23(1):705. doi: 10.1186/s12879-023-08690-2.
Despite the preventive policies adopted, reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of hepatitis C virus (HCV) infection has increased among the most vulnerable population groups, including MSM. The aim of this study was to estimate the prevalence of HCV infection and to assess risky practices among MSM from 12 Brazilian cities.
This study was carried out from June to December 2016 using respondent driven sampling (RDS). Participants completed a self-administered questionnaire to collect behavioral, socioeconomic, and demographic variables. In addition, the rapid diagnostic test (RDT) for HCV was offered. Positive results were sent to Instituto Adolfo Lutz for confirmation.
A total of 4,176 participants were recruited and 23 samples were sent for confirmation. Of these, 16 were confirmed, resulting in a prevalence of 0.7% (95% CI: 0.3%-1.7%). The Southeast region showed a prevalence of 0.9% (95% CI: 0.3-2.6), followed by the South region, with 0.6% (95% CI: 0.2-2.1). The Northeast region had a prevalence of 0.3% (95% CI: 0.1-1.0) and the Midwest 0.1% (95% CI: 0.0-0.7). No positive cases were found in the North. Single men aged 40 years or older were the majority of participants exposed to HCV. High levels of alcohol consumption, illicit drug use, irregular condom use, in addition to infection with other STIs, were associated with exposure to HCV.
STIs continue to be important health problems in Brazil and globally. Many STIs are inapparent for many years until they bring more serious consequences. Extra investment in HCV is also warranted, given that it can be eliminated. Relying solely on clinical data to provide information about inapparent infection, especially in stigmatized populations, will make that goal more difficult to achieve. Surveillance studies, such as the one reported here need to be repeated over time to demonstrate trends and to provide information for evaluation, program and policies. Investments in the most vulnerable populations are critical to achieve the World Health Organization global health goals including the elimination of viral hepatitis by 2030.
尽管采取了预防政策，但男男性行为者（MSM）中的性传播感染（STIs）减少有限。包括 MSM 在内的高危人群中，丙型肝炎病毒（HCV）感染的风险有所增加。本研究旨在估计 HCV 感染的流行率，并评估来自巴西 12 个城市的 MSM 的危险行为。
本研究于 2016 年 6 月至 12 月使用受访者驱动抽样（RDS）进行。参与者完成了一份自我管理的问卷，收集行为、社会经济和人口统计学变量。此外，还提供了 HCV 的快速诊断测试（RDT）。阳性结果被送往 Instituto Adolfo Lutz 进行确认。
共招募了 4176 名参与者，其中 23 份样本被送去确认。其中，16 份得到确认，流行率为 0.7%（95%CI：0.3%-1.7%）。东南部地区的流行率为 0.9%（95%CI：0.3-2.6），其次是南部地区，为 0.6%（95%CI：0.2-2.1）。东北地区的流行率为 0.3%（95%CI：0.1-1.0），中西部地区为 0.1%（95%CI：0.0-0.7）。北部地区没有发现阳性病例。40 岁或以上的单身男性是接触 HCV 的大多数参与者。高水平的饮酒、滥用非法药物、不规则使用避孕套，以及感染其他 STIs，都与接触 HCV 有关。
性传播感染仍是巴西乃至全球的重要健康问题。许多性传播感染多年来都没有明显症状，直到它们带来更严重的后果。由于 HCV 可以被消除，因此还需要额外投资。仅依靠临床数据提供关于无症状感染的信息，特别是在受污名化的人群中，将使这一目标更难实现。像这里报告的那样，需要进行监测研究，随着时间的推移进行重复，以展示趋势，并为评估、规划和政策提供信息。对最弱势群体的投资对于实现包括到 2030 年消除病毒性肝炎在内的世界卫生组织全球卫生目标至关重要。
