Risk factors for hepatitis B transmission in South Brazil

Pereira, Vagner Reinaldo Zingalli Bueno; Wolf, Jonas Michel; Luz, Camila Albani da Silva; Stumm, Gláucia Zuleide; Boeira, Thais da Rocha; Galvan, Josiane; Simon, Daniel; Lunge, Vagner Ricardo

doi:10.1590/0074-02760170043

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ARTICLES • Mem. Inst. Oswaldo Cruz 112 (8) • Aug 2017 • https://doi.org/10.1590/0074-02760170043 copy

Risk factors for hepatitis B transmission in South Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

BACKGROUND

Hepatitis B virus (HBV) infection is a major public health problem in Brazil. Several risk factors are involved in HBV infection and their identification by a rational and essential approach is required to prevent the transmission of this infection in Brazil.

OBJECTIVES

To evaluate risk factors associated with HBV infection in South Brazil.

METHODS

A total of 260 patients with HBV and 260 controls from Caxias do Sul (state of Rio Grande do Sul, Brazil) participated in this study. All participants were given a standard questionnaire to yield the sociodemographic information and to identify HBV risk factors. HBV infection was detected by HBsAg test in all participants.

FINDINGS

HBV infection in these cases was strongly associated with history of a family member HBV-infected, mainly mother [odds ratio (OR) = 4.86; 95% confidence intervals (CI): 1.69–13.91], father (OR = 5.28; 95% CI: 1.58–17.71), and/or siblings (OR = 22.16; 95% CI: 9.39–52.25); sharing personal objects (OR = 1.40; 95% CI: 1.37–2.38); and having history of blood transfusion (OR = 2.05; 95% CI: 1.10–2.84).

CONCLUSIONS

HBV infection was strongly associated with having a family member infected with hepatitis B, sharing personal objects, and having history of blood transfusion.

chronic hepatitis B; South Brazil; epidemiologic factors

Variables	Cases (n = 260)		Controls (n = 260)		p

	n	%	n	%
Age (years)					> 0.999
< 20	3	1.1	3	1.1
20–40	70	26.9	70	26.9
41–60	148	56.9	148	56.9
61–80	38	14.6	38	14.6
> 80	1	0.5	1	0.5
Sex					> 0.999
Male	143	55	143	55
Female	117	45	117	45
Ethnic group					> 0.999
Not white	31	11.9	31	11.9
White	229	88.1	229	88.1
Marital status					< 0.001
Married	203	78.1	167	64.2
Not married	57	21.9	93	35.8
Level of schooling					< 0.001
Elementary school or less	159	61.1	212	81.5
High school	101	38.9	48	18.5
Place of residence in childhood					< 0.001
Rural area	183	71	112	43
Urban	76	29	148	57
Occupation					0.017
Farmer	45	17.3	21	8.1
Mason	22	8.4	31	11.9
Metallurgical	24	9.2	20	7.7
Other	122	47	141	54.2
Retired/housewife	47	18.1	47	18.1
Number of siblings^a					0.015
> 5	145	55.8	114	43.8
≤ 5	112	43.1	136	52.3

Variable	Cases (n = 260)		Controls (n = 260)		p	OR (95% CI)

	n	%	n	%
History of mother infected (HBV)
Yes	109	48.2	8	3.2	< 0.001	28.18 (13.29–59.72)
No	117	51.8	242	96.8	-	1.00
History of father infected (HBV)
Yes	75	36	6	2.4	< 0.001	22.50 (9.54–53.05)
No	135	64	243	97.6	-	1.00
History of siblings infected (HBV)
Yes	174	67	10	3.8	< 0.001	50.58 (25.55–100.12)
No	86	33	250	96.2	-	1.00
Alcohol consumption
Yes	204	78.5	191	73.3	0.182	1.31 (0.87–1.97)
No	56	21.5	69	26.5	-	1.00
Illicit drugs use^a
Yes	29	11.2	30	11.5	0.890	0.96 (0.56–1.65)
No	231	88.8	230	88.5	-	1.00
Sharing of personal objects
Yes	145	56	104	40	< 0.001	1.92 (1.35–2.73)
No	113	44	156	60	-	1.00
Blood transfusion history
Yes	39	15	18	6.9	< 0.001	3.28 (1.70–6.31)
No	221	85	242	93.1	-	1.00
Previous use of glass syringe
Yes	167	65	120	46.2	< 0.001	2.18 (1.53–3.12)
No	89	34.5	140	53.8	-	1.00
Body piercing
Yes	5	1.9	4	1.5	0.737	1.25 (0.33–4.72)
No	255	98.1	256	98.5	-	1.00
Tattoo
Yes	23	8.8	46	17.7	0.003	0.45 (0.26–0.77)
No	237	91.2	214	82.3	-	1.00
Type of birth
Normal	239	93	241	95	0.388	0.73 (0.35–1.49)
Caesarean	19	7	14	5	-	1.00
Previous STI
Yes	215	91.5	241	93.5	0.332	0.72 (0.36–1.41)
No	20	8.5	16	6.2	-	1.00

Variables	p	OR	95% CI
History of mother infected (HBV)	0.003	4.86	1.69–13.91
History of father infected (HBV)	0.007	5.28	1.58–17.71
History of siblings infected (HBV)	< 0.001	22.16	9.39–52.25
Sharing of personal objects	< 0.001	1.40	1.37–2.38
Blood transfusion history	0.023	2.05	1.10–2.84
Previous use of glass syringe	0.086	1.43	0.84–1.72
Tattoo	0.079	0.82	0.67–1.17
Marital status	0.072	1.33	0.82–1.74
Level of schooling	0.065	0.92	0.76–1.35
Place of residence in childhood	0.063	0.96	0.82–2.77
Occupation	0.080	0.98	0.90–2.95
Number of siblings	0.095	1.90	0.80–3.10

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[1] + Corresponding author: jonasmwolf@gmail.com