Prevalence of Hepatitis C Virus in Brazil's Inmate Population: A Systematic Review

OBJECTIVE

To estimate the prevalence of hepatitis C virus infection in Brazil's inmate population.

METHODS

Systematic review on hepatitis C virus infection in the inmate population. Brazilian studies published from January 1, 1989 to February 20, 2014 were evaluated. The methodological quality of the studies was assessed using a scale of 0 to 8 points.

RESULTS

Eleven eligible studies were analyzed and provided data on hepatitis C virus infection among 4,375 inmates from seven states of Brazil, with a mean quality classification of 7.4. The overall hepatitis C virus prevalence among Brazilian inmates was 13.6% (ranging from 1.0% to 41.0%, depending on the study). The chances of inmates being seropositive for hepatitis C virus in the states of Minas Gerais (MG), Sergipe (SE), Mato Grosso do Sul (MS), Rio Grande do Sul (RS), Goiás (GO) and Espirito Santo (ES) were 84.0% (95%CI 0.06;0.45), 92.0% (95%CI 0.04;0.13), 88.0% (95%CI 0.09;0.18), 74.0% (95%CI 0.16;0.42), 84.0% (95%CI 0.08;0.31) and 89.0% (95%CI 0.01;0.05) respectively, lower than that observed in the Sao Paulo state (seroprevalence of 29.3%). The four studies conducted in the city of Sao Paulo revealed a lower prevalence in more recent studies compared to older ones.

CONCLUSIONS

The highest prevalence of hepatitis C virus infection in Brazil's inmate population was found in Sao Paulo, which may reflect the urban diversity of the country. Despite Brazilian studies having good methodological quality to evaluate the prevalence of the hepatitis C virus, they are scarce and lack data on risk factors associated with this infection, which could support decisions on prevention and implementation of public health policies for Brazilian prisons.

Prevalence of hepatitis C virus among inmate populations grouped into seven different states of Brazil.

State	Positive samples	Sample size	HCV sero-prevalence (%)	95%CI		OR	95%CI		p
				Lower	Upper		Lower	Upper
Sao Paulo	624	2,131	29.3	27.3	31.2	Ref.	–	–	< 0.001
Minas Gerais	4	63	6.3	0.3	12.4	0.16	0.06	0.45
Sergipe	13	422	3.1	1.4	4.7	0.08	0.04	0.13
Mato Grosso do Sul	33	686	4.8	3.2	6.4	0.12	0.09	0.18
Rio Grande do Sul	19	195	9.7	5.6	13.9	0.26	0.16	0.42
Goias	9	148	6.1	2.2	9.9	0.16	0.08	0.31
Espirito Santo	7	730	1.0	0.3	1.7	0.02	0.01	0.05
Total	709	4,375	16.2	15.1	17.3	–	–	–

Full article at:   http://goo.gl/tgGDws

By:  Magri MC1, Ibrahim KY2, Pinto WP2, França FO2, Bernardo WM3, Tengan FM2.

• 1Laboratório de Investigação Médica em Hepatologia por Vírus, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
• 2Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
• 3Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. 
• Rev Saude Publica. 2015;49:36. doi: 10.1590/S0034-8910.2015049005886. Epub 2015 Jul 31.

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Efficient Identification of HIV Serodiscordant Couples by Existing HIV Testing Programs in South Brazil

To examine the feasibility of identifying HIV negative at risk individuals in HIV serodiscordant couples, during voluntary HIV testing in South Brazil.

We surveyed HIV testers at 4 public testing sites in Rio Grande do Sul. We obtained information on risk behaviors and sexual partnerships. HIV testing and testing for recent infection were performed; HIV prevalence and risk behaviors were assessed among subjects who reported having a steady partner who was HIV positive (serodiscordant group) and compared with the general testing population.

Among 3100 patients, 490 (15.8%) reported being in a steady relationship with an HIV positive partner. New HIV infections were diagnosed in 23% of the serodiscordant group (vs. 13% in the general population, p = 0.01); among newly positive subjects, recent HIV infections were more frequent (23/86, 26.7%) among testers with positive partners than among the general testing group (52/334; 15.6%; p = 0.016). Less than half of the serodiscordant testers reported having used a condom during the last sexual intercourse with their HIV-positive partner. Participants with inconsistent condom use with steady partner were four times more likely to test positive for HIV compared to those who reported always using condoms with the steady partner (OR: 4.2; 95% CI: 2.3 to 7.5).

It is highly feasible to identify large numbers of HIV susceptible individuals who are in HIV serodiscordant relationships in South Brazil testing sites. Condom use within HIV serodiscordant couples is low in this setting, suggesting urgent need for biomedical prevention strategies to reduce HIV transmission.

Full article at:  http://goo.gl/CnOlUS

By:

Christopher D. Pilcher, Snigdha Vallabhaneni, Frederick M. Hecht

Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States of America

Claudia Alquati Bisol, Machline Paim Paganella, Leonardo Rapone da Motta, Sergio Kakuta Kato, Rosa Dea Sperhacke

Laboratório de Pesquisa em HIV/AIDS, Centro de Ciências Biológicas e da Saúde, Universidade do Caxias do Sul, Caxias do Sul, Brazil

Esper G. Kallas

Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil

Ricardo Sobhie Diaz

Retrovirlogy Lab, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil

 

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