Study indicates that the rate of hepatitis B in ES is three times higher than the national average

Study indicates that the rate of hepatitis B in ES is three times higher than the national average

The state of Espírito Santo is among the Brazilian states with the highest rates of hepatitis B virus (HBV) infection in the country. The prevalence of chronic hepatitis B is about three times higher than the national average, which is around 0.5% of the population, with a predominance of the family component in the transmission of HBV. This was the conclusion of a survey developed by Ufes researchers and guest researchers.

With the title Hepatitis B virus genotypes and subgenotypes and the natural history and epidemiology of hepatitis B (Hepatitis B virus genotypes and subgenuses and the natural history and epidemiology of hepatitis B), the study carried out a descriptive analysis of the demographic, epidemiological, laboratory and clinical aspects of 587 chronic HBV patients followed at the Cassiano Antônio Moraes University Hospital (Hucam ). The research was published in Annals of Hepatology Science Direct Elsevier.

The objectives of the study were to characterize the genotypes (viral genetic variety) of the hepatitis B virus, its distribution in the health macro-regions of the state and to evaluate the association between these virological factors and clinical and epidemiological aspects of the individual and stages of the disease.

The professor of the Department of Internal Medicine at the Center for Health Sciences (CCS) and head of the Infectious Diseases Service of Hucam, Tania Reuter, coordinated the study and had the collaboration of sub-research doctors at the Ulisses Duque University Hospital, José Américo Carvalho and Waltesia Perini; from the Higher School of Sciences of the Santa Casa de Misericórdia de Vitória (Emescam), Marcello Queiroz; and from the University of São Paulo (USP), João Renato Rebello Pinho.

To date, the study is the longest and with the largest sample of patients with hepatitis B factors carried out in Brazil. There were 12 years of follow-up at the viral hepatitis outpatient clinic of the Infectious Diseases Service of Hucam, between July 2005 and July 2017. Demographic (age, sex and city of birth), epidemiological, laboratory and clinical data were extracted from medical consultations described in the records throughout the follow-up period.


Of the 587 study participants, 270 had a blood sample available and had detectable HBV DNA. In 202 of these samples, it was possible to amplify and sequence the HBV genome to characterize the genotypes and subgenotypes. Considering only patients from Espírito Santo, the study indicated that 61.9% came from the metropolitan region; 8.4% from the north; 17.4%, from the central region; and 12.2%, south of the state.

According to the researchers, genotype A was the most prevalent in the patients analyzed, with 65.3% of cases, followed by genotypes D (32.7%) and F (2%). This predominance, according to the study, can be correlated with the immigration of black Africans brought during the colonial period of slavery (16th-19th century) and European immigrants, mainly Italians (in the 19th and early 20th centuries).

“It is important to emphasize that these genotypes were introduced several centuries ago and that, in a highly mixed population like ours, they have contributed to the formation of clusters specific, both in samples of individuals from different regions of the state and in different regions of Brazil”, explains professor Tânia Reuter.

The study also noted that mother-to-child transmission (called vertical) occurring during pregnancy or childbirth was the most frequent mechanism in the transmission of HBV. “This is one of the main reasons why Espírito Santo has more cases of hepatitis B than other states. Therefore, safe prenatal care is important as a measure to prevent the transmission of the hepatitis B virus. Before the 1990s, it was still not mandatory to test pregnant women for HIV, hepatitis B and C, and syphilis. Currently, the test is performed in the first and last trimester of pregnancy to avoid this vertical transmission”, concludes the researcher.

Then come transmission between people residing in the same household, sharing needles from injecting or inhaled drug use, blood transfusion and sexual intercourse.

Research participants warn that HBV infection is a major public health problem in Brazil. In some areas or countries, vertical and intrafamilial transmission are the main mode of spread of the disease. “Even after more than two decades of implementation of the vaccine against HBV, epidemiological studies like ours, carried out in some regions of Brazil, still show a strong family component in the transmission of HBV. The research pointed out that vertical and intrafamily transmission is the main responsible for the cases registered in Espírito Santo”, the researchers emphasize.

about the disease

Hepatitis B is an infectious disease that attacks the liver and is present in blood and sexual secretions. The transmission of the disease occurs through blood and genital fluids, so it is also considered a Sexually Transmitted Infection (STI). The HBV virus affects more than 270 million people worldwide, with about 78,000 deaths each year from complications of the disease such as cirrhosis and liver cancer. According to data from the State Department of Health (Sesa), between 1999 and 2021, 16,333 cases of viral hepatitis were confirmed in Espírito Santo.

Although there is still no cure, hepatitis B can be prevented, mainly through vaccination, the use of condoms during sexual intercourse and the non-sharing of syringes, needles, manicure and pedicure materials, in addition to other sharp instruments or objects of personal hygiene that may be a means of spreading the disease. There are also people who have the virus, but the disease has not yet evolved and are considered carriers of HBV with the disease inactive. In this situation, the individual needs regular medical follow-up and laboratory control.

Text: Communication Superintendence of Ufes
Image: Virtual Library of the Federal Nursing Council

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