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dc.contributor.authorRaulino, Raisa Clareana Silva-
dc.date.available2023-03-20-
dc.date.available2023-03-29T18:33:14Z-
dc.date.issued2015-10-07-
dc.identifier.urihttp://repositorioinstitucional.uea.edu.br//handle/riuea/4618-
dc.description.abstractHepatitis B is considered one of the main infectious diseases worldwide representing an important public health challenge affecting around 2 billion people, many of them with chronic infection with hepatitis B virus ( HBV). The diagnosis of HBV is based on the positivity to the surface antigen of HBV (HBsAg). However, viral persistence identified by HBV-DNA has been described in HBsAg negative individuals, defining the occult hepatitis B infection (OHB). Occult hepatitis B is almost always associated with anti-HBc and or anti- HBs positivity, as well as low-level viral replication. OHB can represent and important public health problem in endemic areas as it can be involved in HBV transmission by blood or organ transplants by assymptomatic, apparently healthy donors. Improved tests such as the implementation of NAT (nucleic acid tests) for HIV and HCV have been adopted by hemocenters worldwide, especially in highly endemic areas as the Brazilian Amazon region. This study evaluated the prevalence of OHB in subgroups of HBsAg negative donors from a reference public health blood bank in the Amazon (Fundacao de Hematologia e Hemoterapia do Amazonas/FHEMOAM) and among a group of HBsAg negative individuals that participated in a HBV prevalence study in a highly endemic municipality in the Amazonas State/Eirunepé city. Methods/Results: Among 1.494 HBsAg negative blood donors from FHEMOAM and among 288 individuals from Eirunepe HBsAg negative and anti-HBc/anti- HBs positive or negative, pools were tested for the presence of DNA-HBV by real time PCR (qRT PCR) using primers for two genomic regions (gene X and gene S). For the pools which were positive for HBV-DNA (9 in the FHEMAOM group and 25 among Eirunepe participants), individual samples were re-tested for the presence of HBV-DNA by RT-PCR. Among the subgroup of donors from FHEMOAM 1,0% (3/294) was considered DNA-HBV positive, including 2 females and 1 male, 21, 42 and 31 years old respectively. Among these 83,3 were a first time donor and 16,7 were repeat donor. The rate of OBV in participants from Eirunepe was 3,1% (9/288): six females, 3 males, ages ranging from 27 to 64. Among these 9 OHB cases from Eirunepe, 2 were anti-HBc positives, 7 were associated with anti-HBs (above 100 mUI/ml). Conclusion: This study showed low prevalence of OBV in groups of HBsAg negative donors from FHEMOAM and moderate prevalence in participants from Eirunepe/Amazonas. Despite low rates of OBV infection identified, this study indicates that transmission by OHB can occur. These results highlight the importance of more sensitive tests to detect HBV infection, such as NAT which was implemented in 2014 representing an important tool to improve transfusional safety at FHEMOAM among donors from highly endemic areas including the capital and from inland Amazonas Statept_BR
dc.languageporpt_BR
dc.publisherUniversidade do Estado do Amazonaspt_BR
dc.rightsAcesso Abertopt_BR
dc.subjectHepatite B ocultapt_BR
dc.subjectDNA-HBVpt_BR
dc.subjectDoadores de sanguept_BR
dc.subjectAmazônia Brasileirapt_BR
dc.subjectoccult hepatitis Bpt_BR
dc.titleHepatite B oculta em subgrupo de doadores de sangue da Fundação de Hematologia e Hemoterapia do Amazonas (FHEMOAM) e em grupo de moradores do município de Eirunepé Ampt_BR
dc.title.alternativeOccult hepatitis B in a subgroup of blood donors from the Hematology and Hemotherapy Foundation of Amazonas (FHEMOAM) and in a group of residents of the municipality of Eirunepé Ampt_BR
dc.typeDissertaçãopt_BR
dc.date.accessioned2023-03-29T18:33:14Z-
dc.contributor.advisor1Kiesslich, Dagmar-
dc.contributor.advisor1Latteshttp://lattes.cnpq.br/8365049847029324pt_BR
dc.contributor.referee1Kiesslich, Dagmar-
dc.contributor.referee1Latteshttp://lattes.cnpq.br/8365049847029324pt_BR
dc.contributor.referee2Stefani, Mariane Martins de Araújo-
dc.contributor.referee2Latteshttp://lattes.cnpq.br/5581414958714905pt_BR
dc.contributor.referee3Castilho, Márcia da Costa-
dc.contributor.referee3Latteshttp://lattes.cnpq.br/2945789466069728pt_BR
dc.creator.Latteshttp://lattes.cnpq.br/1864098858555589pt_BR
dc.description.resumoA hepatite B é uma das principais patologias mundiais, sendo um desafio a saúde tanto na Amazônia quanto globalemente, afetando cerca de 2 bilhões de pessoas incluindo milhares de casos de infecção crônica pelo vírus da hepatite B (HBV). O diagnóstico da infecção pelo HBV é baseado na positividade do antígeno de superfície do vírus da hepatite B (HBsAg). Contudo existem relatos de persistência viral identificada por DNA-HBV em pacientes HBsAg negativos, o que caracteriza a hepatite B oculta (HBO). Estes casos apresentam baixa replicação viral que pode estar associada a positividade para anti-HBc e ou anti-HBs. A HBO hepatite B pode significar importante problema de saúde púbica em áreas endêmicas uma vez que tem sido evolvida na transmissão transfusional do HBV, ou transmissão por transplante de fígado por doadores de sangue/órgãos assintomáticos e aparentemente saudáveis. Políticas de segurança transfusional, como a implementação do NAT (nucleic acid test) para HIV e HCV E HBV, vem sendo adotadas nos hemocentros em todo o mundo, principalmente em regiões de alta endemicidade como na região da Amazônia Brasileira. O presente estudo teve como objetivo determinar a freqüência de HBO em um subgrupo de doadores de sangue HBsAg negativos do hemocentro (Fundacao de Hematologia e Hemoterapia do Amazonas/ FHEMOAM) e em subgrupo de indivíduos HBsAg negativos que participaram de estudo de prevalência para HBV em moradores de Eirunepe, área de alta prevalência para HBV no Amazonas. Métodos/Resultados: Foram investigados 294 doadores de sangue (HBsAg negativo e anti-HBc +) da FHEMOAM e 288 indivíduos (HBsAg negativo e anti-HBc + associado a anti-HBs ou não) do município de Eirunepé/AM. Todas as amostras foram submetidas a métodos moleculares para detecção e quantificação do DNA-HBV testando-se inicialmente pools de amostras por PCR em tempo real para pelo menos duas regiões do genoma (gene X e gene S). Os pools positivos (9 pools no groupo FHEMOAM e 25no grupo de Eirunepé/AM) foram desmembrados e as amostras do pool foram retestadas individualmente por qRT-PCR. No grupo de doadores de sangue da FHEMOAM 1,0% (3/294) foi considerado DNA-HBV positivo, sendo 2 indivíduos do gênero feminino e 1 do gênero masculino com 21, 42 e 31anos de idade respectivamente. Quanto a classificação do tipo de doadores 83,3% eram doadores de primeira vez e 16,7% eram doadores de repetição.A presença de DNA-HBV nos indivíduos de Eirunepé/AM foi de 3,1% (9/288) sendo 6 indivíduos do gênero feminino e 3 do gênero masculinocom idades entre 27 e 64 anos. Dentre os 9 casos de HBO, 2 eram anti-HBc isolado e 7 tinham anti-HBs associado (acima de 100 mUI/ml). Conclusão: Este estudo evidenciou baixa prevalência de HBO em subgrupo de doadores de sangue da FHEMOAM e em um grupo de moradores de Eirunepé/Amazonas com HBsAg negativo. Embora baixa, esta prevalência indica que transmissão por HBO pode ocorrer na FHEMOAM. Estes resultados destacam a importância da implementação de métodos mais sensíveis para detecção da infecção pelo HBV, como a triagem molecular( NAT), implantado em 2014, representando uma ferramenta importante para ampliar a segurança transfusional na FHEMOAM, tanto na triagem de doadores de áreas endêmicas da capital e do interior do estado do amazonaspt_BR
dc.publisher.countryBrasilpt_BR
dc.publisher.programPPGH -PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS APLICADAS À HEMATOLOGIApt_BR
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