Rosa, Heitor; Costa, Ana Paula V.F.; Ferraz, Maria Lúcia; Pedroza, Suelene C.; Andrade, Ana Lúcia S.S.; Martelli, Celina M.T.; Zicker, Fábio

doi:10.1590/S0036-46651992000500008

Abstracts

This investigation presents the results of Hepatitis B virus screening among leprosy patients conducted in Central Brazil as a preliminary information for a HBV vaccination programme. The main objectives were to assess the seroprevalence of HBV serum markers among lepromatous patients and to analyse institutionalization as risk factor for HBV infection in this population. Two groups of lepromatous patients were studied, 83 outpatients and 171 institutionalized ones. Screening for HBV serum markers included the detection of HBsAg, anti-HBc by radioimmune assay (RIA). The prevalence of carrier state (HBsAg) was 4.8% and 8.8% among outpatients and institutionalized, respectively, (p>0.05). Seroprevalence of exposure (all markers) was statistically significant different between outpatients (16.9%) and institutionalized ones (50.3%). Institutionalized patients had an almost four fold risk of HBV infection when compared to the outpatients, and the highest risks were among patients with more than 21 years of residence in the colony, after adjusting for age and sex.

Leprosy and Hepatitis B virus infection; Risk factors for Hepatitis B infection; Institutionalized leprosy patients

Este estudo apresenta os resultados de investigação sorológica para o virus da hepatite B (VHB) entre pacientes hansenianos como etapa inicial para um programa de vacinação contra Hepatite B na cidade de Goiânia - Brasil Central. Os principais objetivos foram determinar a soroprevalência dos marcadores sorológicos para hepatite B entre pacientes com hanseníase do polo lepromatoso da doença, e avaliar a institucionalização como fator de risco para a infecção pelo VHB. Foram estudados 83 pacientes ambulatoriais e 171 pacientes institucionalizados e os marcadores testados foram AgHBs, anti-HBs e anti-HBc, utilizando-se a técnica de radioimuno ensaio. A prevalência de portadores virais (HBsAg) foi de 4,8% e 8,8% para os pacientes ambulatoriais e institucionalizados, respectivamente (P>0,05). A prevalência de exposição ao VHB (todos os marcadores) foi estatisticamente diferente entre os pacientes de ambulatório (16,9%) e os institucionalizados (50,5%). Os pacientes institucionalizados tiveram um risco 4 vezes maior de infecção pelo HBV quando comparados aos pacientes ambulatoriais, mesmo após análise multivariada, controlada por sexo e idade.

EPIDEMIOLOGY

Associantion between leprosy and hepatitis B infecion. A survey in Goiânia, Central Brazil

Associação entre hanseniase e infecção pelo virus da hepatite B. Estudo de prevalência realizado em Goiânia, Brasil Central

Heitor Rosa^I; Ana Paula V.F. Costa^II; Maria Lúcia Ferraz^III; Suelene C. Pedroza^II; Ana Lúcia S.S. Andrade^IV; Celina M.T. Martelli^IV; Fábio Zicker^v

^IUnity of Hepatology, Hospital das Clínicas/UFG, Goiânia, Brazil

^IIResearch fellow

^IIIEscola Paulista de Medicina/São Paulo, Brazil

^IVInstituto de Patologia Tropical e Saúde Pública/UFG, Goiânia, Brazil

^VOrganización Pan Americana de la Salud, Maracay-Venezuela

^{Address for Correspondence} Address for Correspondence: Dr. Heitor Rosa, PhD Rua 126 nº 21 apto 102 Setor Sul 74310 Goiânia-Brazil

SUMMARY

This investigation presents the results of Hepatitis B virus screening among leprosy patients conducted in Central Brazil as a preliminary information for a HBV vaccination programme. The main objectives were to assess the seroprevalence of HBV serum markers among lepromatous patients and to analyse institutionalization as risk factor for HBV infection in this population. Two groups of lepromatous patients were studied, 83 outpatients and 171 institutionalized ones. Screening for HBV serum markers included the detection of HBsAg, anti-HBc by radioimmune assay (RIA). The prevalence of carrier state (HBsAg) was 4.8% and 8.8% among outpatients and institutionalized, respectively, (p>0.05). Seroprevalence of exposure (all markers) was statistically significant different between outpatients (16.9%) and institutionalized ones (50.3%). Institutionalized patients had an almost four fold risk of HBV infection when compared to the outpatients, and the highest risks were among patients with more than 21 years of residence in the colony, after adjusting for age and sex.

Key words: Leprosy and Hepatitis B virus infection; Risk factors for Hepatitis B infection; Institutionalized leprosy patients.

RESUMO

Este estudo apresenta os resultados de investigação sorológica para o virus da hepatite B (VHB) entre pacientes hansenianos como etapa inicial para um programa de vacinação contra Hepatite B na cidade de Goiânia - Brasil Central. Os principais objetivos foram determinar a soroprevalência dos marcadores sorológicos para hepatite B entre pacientes com hanseníase do polo lepromatoso da doença, e avaliar a institucionalização como fator de risco para a infecção pelo VHB. Foram estudados 83 pacientes ambulatoriais e 171 pacientes institucionalizados e os marcadores testados foram AgHBs, anti-HBs e anti-HBc, utilizando-se a técnica de radioimuno ensaio. A prevalência de portadores virais (HBsAg) foi de 4,8% e 8,8% para os pacientes ambulatoriais e institucionalizados, respectivamente (P>0,05). A prevalência de exposição ao VHB (todos os marcadores) foi estatisticamente diferente entre os pacientes de ambulatório (16,9%) e os institucionalizados (50,5%). Os pacientes institucionalizados tiveram um risco 4 vezes maior de infecção pelo HBV quando comparados aos pacientes ambulatoriais, mesmo após análise multivariada, controlada por sexo e idade.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

ACKNOWLEDGEMENTS

We are grateful to Dr. H. Junqueira, Dr. I. S. Mondanez and Dr. R. M. Oliveira for their cooperation in the field work.

Recebido para publicação em 9/1/1992

Aceito para publicação em 14/7/1992

1. ANANTHAKRISHNAN, R.; ARNDT-HANSER, A. & WATER, H. - Studies on the Australia Antigen. I - Association between Autralia Antigen and Leprosy. Humangenetik, 16: 235-239, 1972.
2. BALAKRISHNAN, S.; BHATIA, V.N. & HARIKRISHNAN, S. - Hepatitis B surface antigen (HBsAg) in Leprosy patients. Leprosy in India, 55: 45-48, 1983.
3. BARIN, F; PERRIN, J.; CHOTARD, J.; DENIS, F.; N'DOYE, R.; MAR, I.D.; CHIRON, J-P.; COURSAGET, P.; GOUDEAU, A. & MAUPAS, P. - Cross-sectional and longitudinal epidemiology of hepatitis B in Senegal. Progr. med. Virol., 27: 148-162, 1981.
4. BLUMBERG, B.S. & MELARTIN, L. - Lepromatous Leprosy and Australia Antigen with comments on the genetics of Leprosy. J. chron. Dis., 23: 507-516, 1970.
5. BLUMBERG, B.S.; MELARTIN, L.; LECHAT, M. & GUINTO, R.S. - Association between Lepromatous Leprosy and Australia Antigen. Lancet, 2: 173-176, 1967.
6. CHIRON, J-P.; DENIS, F.; YVONNET, B.; COURSAGET, P.; MAR, I.D. & LANGUILLON, J. - Lčpre et Hépatite B. Acta Lepr., 3: 169-199, 1985.
7. DECKER, M.D.; VAUGHN, W.K.; BRODIE, J.S.; HUTCHESON, R.H. & SCHAFFNER, W. - The incidence of hepatitis B in Tenessee prisoners. J. infect. Dis., 152: 214-217, 1985.
8. DITZHUIJSEN, T.J.M.; SCHOOT, E.W.; LOON, A.M.; RIJNTJES, P.J.M. & YAP, S.H. - Hepatitis B virus infection in an institution for the mentally retarded. Amer. J. Epidem., 128: 629-638, 1988.
9. FAKUNLE, Y.M. & WHITTLE, H.C. - Hepatitis-B virus infection in patients with leprosy: a serological study in a leprosarium in Northern Nigeria. Trans. roy. Soc. trop. Med. Hyg., 75: 623-625, 1981.
10. HARBOE, M. - Immunology of leprosy. In: HASTING, R.C., ed. Leprosy. New York, Churchill Livingstone, 1985. p.53-87.
11. KELKAR, S.S.; NIPHADKAR, K.B.; KHARE, P.M. & JUNNARKAR, R.V. - Hepatitis B antigen in a leprosy hospital. Bull. Wld. Hlth. Org., 48: 555-558, 1973.
12. LYRA, L.G.; DAMASCENO, A.P.; COTRIM, P.; MOTA, E. & SILVA, L.- Prevalence of antibody to Hepatitis B virus in an urban population of Northeast Brazil. Rev. Inst. Med. trop. S. Paulo, 28: 406-409, 1986.
13. LONDON, W.T. & BLUMBERG, B.S. - Comments on the role of epidemiology in the investigation of Hepatitis B virus. Epidem. Rev.,7: 59-79, 1985.
14. LUCAS, S.B. & RIDLEY, D.S. - The use of histopathology in leprosy diagnosis and research. Leprosy Rev., 60: 257-262, 1989.
15. MARTELLI, C.M.T. ; ANDRADE, A.L.S.S.; CARDOSO, D.D.P.; SILVA, S.A.; SOUSA, M.A. & ZICKER, F. - Soroprevalęncia e fatores de risco para a infecçăo pelo virus da hepatite B em prisioneiros e em doadores de sangue. Rev. Saúde públ. (S. Paulo), 24: 270-276, 1990.
¹⁶
MINISTÉRIO DA SAÚDE. FUNDAÇÃO NACIONAL DE SAÚDE - Hanseníase: uma endemia ascendente no Brasil. Dermatologia Sanitária, Relatório de Atividades. Brasília, 1990 (doc).
17. MOTTA, C.P. & ZUNIGA, M.G. - Time trend of Hansen's disease in Brazil. Int. J. Leprosy, 58: 453-461, 1990.
18. NUTI, M.; TARABINI, G.; PALERMO, P.; TARABINI, G.L. & THAMER, G.- Leprosy and hepatitis B virus markers: incidence of HBsAg and HBeAg in Somalian patients. Int. J. Leprosy, 47: 580-584, 1979.
19. OTTATI, S. & CANDEIAS, J.A.N. - Subtipos do Antígeno Australia (HBsAg) em doentes de Hanseníase de Săo Paulo, Brasil. Rev. Saúde públ. (S.Paulo), 13: 366-369, 1979.
20. PAPAIOANNOU, D.J.; KAKLAMANI, P.; PARISSIS, G.; KOUMANTAK, I.G.; KARALIS, D.T. & TRIACHOPOULOS, D.B. - Hepatitis B viras (HBV) serum markers in Greek leprosy patients. Int. J. Leprosy, 54: 245-251,1986.
21. PONNIGHAUS, J.M.; FINE, P.E.M. & BUSS, L. - Certainty levels in the diagnosis of leprosy. Int. J. Leprosy, 55: 454-462, 1987.
22. RIDLEY, D.S. & JOPLING, W.H. - Classification of leprosy according to immunity. A five-group system. Int. J. Leprosy, 34: 255-273, 1966.
23. SALZANO, F.M. & BLUMBERG, B.S. - The Australia antigen in Brazilian healthy persons and in leprosy and leukaemia patients. J. clin. Path., 23: 39-42, 1970.
24. SARNO, E.N.; AZULAY, D.R.; VIEIRA, L.M.; QUADRA, A.A.; BARBOSA, I.V. & AZULAY, R.D. - Prevalęncia do antígeno Australia (HBs Ag) em pacientes hansenianos. Rev. Ass. méd. bras., 26: 391-392, 1980.
25. SEHGAL, V.N.; JOGINDER, M.D. & SHARMA, V.K. - Immunology of leprosy. A comprehensive survey. Int. J. Derm., 28: 574-584, 1989.
26. SERJEANTSON, S. & WOODFIELS, D.G. - Immune response of Leprosy patients to Hepatitis B virus. Amer. J. Epidem., 107: 321-327, 1978.
27. ZYNGIER, F.R.; COSTA, F.G.; ZILBERMAN, S.D.; GREY, P.S.S.; LEMME, A.C.; GAZE, R. & PEREIRA, A. - Prevalence of HBsAg in a Brazilian leprosarium. Trans. roy. Soc. trop. Med. Hyg., 73: 599, 1979.

Address for Correspondence:

Dr. Heitor Rosa, PhD

Rua 126 nº 21 apto 102

Setor Sul 74310 Goiânia-Brazil

Publication Dates

Publication in this collection
13 Sept 2006
Date of issue
Oct 1992

History

Accepted
14 July 1992
Received
09 Jan 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ANANTHAKRISHNAN, R.; ARNDT-HANSER, A. & WATER, H. - Studies on the Australia Antigen. I - Association between Autralia Antigen and Leprosy. Humangenetik, 16: 235-239, 1972.

[2] 2. BALAKRISHNAN, S.; BHATIA, V.N. & HARIKRISHNAN, S. - Hepatitis B surface antigen (HBsAg) in Leprosy patients. Leprosy in India, 55: 45-48, 1983.

[3] 3. BARIN, F; PERRIN, J.; CHOTARD, J.; DENIS, F.; N'DOYE, R.; MAR, I.D.; CHIRON, J-P.; COURSAGET, P.; GOUDEAU, A. & MAUPAS, P. - Cross-sectional and longitudinal epidemiology of hepatitis B in Senegal. Progr. med. Virol., 27: 148-162, 1981.

[4] 4. BLUMBERG, B.S. & MELARTIN, L. - Lepromatous Leprosy and Australia Antigen with comments on the genetics of Leprosy. J. chron. Dis., 23: 507-516, 1970.

[5] 5. BLUMBERG, B.S.; MELARTIN, L.; LECHAT, M. & GUINTO, R.S. - Association between Lepromatous Leprosy and Australia Antigen. Lancet, 2: 173-176, 1967.

[6] 6. CHIRON, J-P.; DENIS, F.; YVONNET, B.; COURSAGET, P.; MAR, I.D. & LANGUILLON, J. - Lčpre et Hépatite B. Acta Lepr., 3: 169-199, 1985.

[7] 7. DECKER, M.D.; VAUGHN, W.K.; BRODIE, J.S.; HUTCHESON, R.H. & SCHAFFNER, W. - The incidence of hepatitis B in Tenessee prisoners. J. infect. Dis., 152: 214-217, 1985.

[8] 8. DITZHUIJSEN, T.J.M.; SCHOOT, E.W.; LOON, A.M.; RIJNTJES, P.J.M. & YAP, S.H. - Hepatitis B virus infection in an institution for the mentally retarded. Amer. J. Epidem., 128: 629-638, 1988.

[9] 9. FAKUNLE, Y.M. & WHITTLE, H.C. - Hepatitis-B virus infection in patients with leprosy: a serological study in a leprosarium in Northern Nigeria. Trans. roy. Soc. trop. Med. Hyg., 75: 623-625, 1981.

[10] 10. HARBOE, M. - Immunology of leprosy. In: HASTING, R.C., ed. Leprosy. New York, Churchill Livingstone, 1985. p.53-87.

[11] 11. KELKAR, S.S.; NIPHADKAR, K.B.; KHARE, P.M. & JUNNARKAR, R.V. - Hepatitis B antigen in a leprosy hospital. Bull. Wld. Hlth. Org., 48: 555-558, 1973.

[12] 12. LYRA, L.G.; DAMASCENO, A.P.; COTRIM, P.; MOTA, E. & SILVA, L.- Prevalence of antibody to Hepatitis B virus in an urban population of Northeast Brazil. Rev. Inst. Med. trop. S. Paulo, 28: 406-409, 1986.

[13] 13. LONDON, W.T. & BLUMBERG, B.S. - Comments on the role of epidemiology in the investigation of Hepatitis B virus. Epidem. Rev.,7: 59-79, 1985.

[14] 14. LUCAS, S.B. & RIDLEY, D.S. - The use of histopathology in leprosy diagnosis and research. Leprosy Rev., 60: 257-262, 1989.

[15] 15. MARTELLI, C.M.T. ; ANDRADE, A.L.S.S.; CARDOSO, D.D.P.; SILVA, S.A.; SOUSA, M.A. & ZICKER, F. - Soroprevalęncia e fatores de risco para a infecçăo pelo virus da hepatite B em prisioneiros e em doadores de sangue. Rev. Saúde públ. (S. Paulo), 24: 270-276, 1990.

[16] ¹⁶
MINISTÉRIO DA SAÚDE. FUNDAÇÃO NACIONAL DE SAÚDE - Hanseníase: uma endemia ascendente no Brasil. Dermatologia Sanitária, Relatório de Atividades. Brasília, 1990 (doc).

[17] 17. MOTTA, C.P. & ZUNIGA, M.G. - Time trend of Hansen's disease in Brazil. Int. J. Leprosy, 58: 453-461, 1990.

[18] 18. NUTI, M.; TARABINI, G.; PALERMO, P.; TARABINI, G.L. & THAMER, G.- Leprosy and hepatitis B virus markers: incidence of HBsAg and HBeAg in Somalian patients. Int. J. Leprosy, 47: 580-584, 1979.

[19] 19. OTTATI, S. & CANDEIAS, J.A.N. - Subtipos do Antígeno Australia (HBsAg) em doentes de Hanseníase de Săo Paulo, Brasil. Rev. Saúde públ. (S.Paulo), 13: 366-369, 1979.

[20] 20. PAPAIOANNOU, D.J.; KAKLAMANI, P.; PARISSIS, G.; KOUMANTAK, I.G.; KARALIS, D.T. & TRIACHOPOULOS, D.B. - Hepatitis B viras (HBV) serum markers in Greek leprosy patients. Int. J. Leprosy, 54: 245-251,1986.

[21] 21. PONNIGHAUS, J.M.; FINE, P.E.M. & BUSS, L. - Certainty levels in the diagnosis of leprosy. Int. J. Leprosy, 55: 454-462, 1987.

[22] 22. RIDLEY, D.S. & JOPLING, W.H. - Classification of leprosy according to immunity. A five-group system. Int. J. Leprosy, 34: 255-273, 1966.

[23] 23. SALZANO, F.M. & BLUMBERG, B.S. - The Australia antigen in Brazilian healthy persons and in leprosy and leukaemia patients. J. clin. Path., 23: 39-42, 1970.

[24] 24. SARNO, E.N.; AZULAY, D.R.; VIEIRA, L.M.; QUADRA, A.A.; BARBOSA, I.V. & AZULAY, R.D. - Prevalęncia do antígeno Australia (HBs Ag) em pacientes hansenianos. Rev. Ass. méd. bras., 26: 391-392, 1980.

[25] 25. SEHGAL, V.N.; JOGINDER, M.D. & SHARMA, V.K. - Immunology of leprosy. A comprehensive survey. Int. J. Derm., 28: 574-584, 1989.

[26] 26. SERJEANTSON, S. & WOODFIELS, D.G. - Immune response of Leprosy patients to Hepatitis B virus. Amer. J. Epidem., 107: 321-327, 1978.

[27] 27. ZYNGIER, F.R.; COSTA, F.G.; ZILBERMAN, S.D.; GREY, P.S.S.; LEMME, A.C.; GAZE, R. & PEREIRA, A. - Prevalence of HBsAg in a Brazilian leprosarium. Trans. roy. Soc. trop. Med. Hyg., 73: 599, 1979.

Brasil

Brasil

Associantion between leprosy and hepatitis B infecion: a survey in Goiânia, Central Brazil

Associação entre hanseniase e infecção pelo virus da hepatite B: estudo de prevalência realizado em Goiânia, Brasil Central

Abstracts

Address for Correspondence:

Publication Dates

History