Resumen: Este estudio tuvo como objetivo estimar la prevalencia del COVID-19 e identificar los factores sociales y las estrategias preventivas asociadas a esta enfermedad en personas en situación de vulnerabilidad socioeconómica (recolectores de basura, inmigrantes/refugiados y personas sin hogar) en Goiânia, Estado de Goiás, en la región central de Brasil. Se trata de un estudio transversal realizado de julio a octubre de 2020. Las personas que tuvieron una prueba de anticuerpos anti-SARS-CoV-2 positiva y/o una prueba de ARN para SARS-CoV-2 se consideraron positivas para el COVID-19. Se realizaron análisis de regresión univariante y múltiple para identificar las variables asociadas al COVID-19. De los 594 participantes, el 47,3% eran recicladores; el 29,6% inmigrantes/refugiados; y el 23,1% eran personas sin hogar. La positividad fue del 14,1% para el ARN del SARS-CoV-2; del 30,8% para el total de anti-SARS-CoV-2; y del 39,4% para al menos un marcador del COVID-19. De los 541 participantes, ser inmigrante/refugiado, no usar mascarilla quirúrgica y tener tres o más personas que comparten la misma habitación fueron los factores asociados con la infección por SARS-CoV-2, mientras que confiar en la información sobre la pandemia, especialmente transmitidas por los noticiarios, fue un indicador de protección contra esta enfermedad. Este estudio reveló las desigualdades étnicas y socioeconómicas en la prevalencia del COVID-19 entre las personas de bajos ingresos en Brasil. Además, se detectó una alta prevalencia del COVID-19 en los tres grupos. El desarrollo de nuevas estrategias para combatir y prevenir las enfermedades transmisibles que afectan a esta población es fundamental para mitigar las pandemias futuras y actuales.

Abstract: This study aimed to estimate the prevalence and identify social factors and preventive strategies associated with the coronavirus disease 2019 (COVID-19) in socio and economically vulnerable people (recyclable waste pikers, immigrants/refugees, and homeless people) in Goiânia, Goiás State, Central-Western Brazil. A cross-sectional study was conducted from July 2020 to October 2020. COVID-19 positivity was defined as a positive total anti-SARS-COV-2 antibody test and/or RNA test for SARS-COV-2. Univariable and multiple regression analyses were performed to identify the variables associated with COVID-19. Of the 594 participants, 47.3% were recyclable waste pickers, 29.6% were immigrants/refugees, and 23.1% were homeless people. The positivity for SARS-CoV-2 RNA was 14.1%, whereas for anti-SARS-CoV-2 a total of 30.8% were positive, and 39.4% were positive for at least one COVID-19 marker. Among the 541 individuals, being immigrants/refugees, not wearing a surgical mask, and having three or more people sleeping in the same room were associated with SARS-CoV-2 infection, while using TV news as the main source of information about the pandemic was a protective predictor of COVID-19. This study revealed ethnic and socioeconomic inequalities in the prevalence of COVID-19 among impoverished people in Brazil. Additionally, a high prevalence of COVID-19 was detected in all three groups. Developing new strategies to combat and prevent communicable diseases affecting this population is essential for mitigating future and ongoing pandemics.

Resumo: Este estudo teve como objetivo estimar a prevalência da COVID-19 e identificar fatores sociais e estratégias preventivas associadas a essa doença em pessoas em situação de vulnerabilidade socioeconômica (catadores de lixo, imigrantes/refugiados e moradores de rua) em Goiânia, Estado de Goiás, na região central do Brasil. Trata-se de um estudo transversal realizado de julho a outubro de 2020. Foram considerados positivos para a covid-19 indivíduos que apresentaram um teste de anticorpos anti-SARS-COV-2 e/ou teste de RNA para SARS-COV-2 com resultado positivo. Foram realizadas análises de regressão univariável e múltipla para identificar as variáveis associadas à COVID-19. Dos 594 participantes, 47,3% eram catadores de lixo reciclável, 29,6% eram imigrantes/refugiados e 23,1% eram moradores de rua. A positividade foi de 14,1% para o RNA do SARS-CoV-2, 30,8% para o total de anti-SARS-CoV-2 e 39,4% para pelo menos um marcador da COVID-19. Entre os 541 indivíduos, ser imigrante/refugiado, não usar máscara cirúrgica e ter três ou mais pessoas dormindo no mesmo quarto foram fatores associados à infecção por SARS-CoV-2, enquanto confiar em informações sobre a pandemia, principalmente aquelas transmitidas por noticiários de TV, foi um indicador de proteção contra a COVID-19. Este estudo revelou desigualdades étnicas e socioeconômicas na prevalência da COVID-19 entre pessoas de baixa renda no Brasil. Além disso, uma alta prevalência de COVID-19 foi detectada nos três grupos. O desenvolvimento de novas estratégias para combater e prevenir doenças transmissíveis que afetam essa população é essencial para mitigar pandemias futuras e atuais.

Abstract Background Patients with kidney disease on Hemodialysis (HD) are susceptible to Coronavirus Disease (COVID-19) due to multiple risk factors. Aim This study aims to report the prevalence of antibodies against SARS-CoV-2 among patients on hemodialysis before vaccination in Brazil and to compare with clinical, demographic, and laboratory data. Methods Blood samples from 398 Chronic Kidney Disease (CKD) patients treated in three different private institutions in Rio de Janeiro State, Brazil were submitted to the total anti-SARS-CoV-2 testing. Kidney, liver, and hematological markers were also determined. Respiratory samples were tested by real-time PCR for SARS-CoV-2 RNA and positive samples were subjected to high-throughput sequencing on the MinION device. Results Overall, anti-SARS-CoV-2 prevalence was 54.5 % (217/398) and two individuals had SARS-CoV-2 RNA with variant B.1.1. High anti-SARS-CoV-2 seroprevalence was found in male gender and those with hospital admission in the last 3-months before the inclusion in the study. Lower red blood cell count was observed in the anti-SARS-CoV-2 seropositive group. High levels of anti-SARS-CoV-2 were found in those who reported symptoms, had low levels of eosinophils and low hematocrit, and who practiced physical activity. Conclusion High prevalence of anti-SARS-CoV-2 was found in CKD patients before the universal immunization in Brazil suggesting that dialysis patients were highly exposed to SARS-CoV-2. HD (HD COVID19 COVID 19 (COVID-19 factors SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- clinical demographic data 39 (CKD State antiSARSCoV2 antiSARSCoV anti anti-SARS-CoV- testing liver determined realtime real time highthroughput high throughput device Overall 545 54 5 54. 217/398 217398 217 (217/398 B11 B 1 B.1.1 3months months 3 group symptoms hematocrit activity SARSCoV2. 2. COVID1 (COVID-1 SARS-CoV anti-SARS-CoV 217/39 21739 21 (217/39 B1 B.1. (COVID- 217/3 2173 (217/3 B.1 (COVID 217/ (217/ B. (217 (21 (2 (

Resumo: Este estudo teve como objetivo estimar a prevalência da COVID-19 e identificar fatores sociais e estratégias preventivas associadas a essa doença em pessoas em situação de vulnerabilidade socioeconômica (catadores de lixo, imigrantes/refugiados e moradores de rua) em Goiânia, Estado de Goiás, na região central do Brasil. Trata-se de um estudo transversal realizado de julho a outubro de 2020. Foram considerados positivos para a covid-19 indivíduos que apresentaram um teste de anticorpos anti-SARS-COV-2 e/ou teste de RNA para SARS-COV-2 com resultado positivo. Foram realizadas análises de regressão univariável e múltipla para identificar as variáveis associadas à COVID-19. Dos 594 participantes, 47,3% eram catadores de lixo reciclável, 29,6% eram imigrantes/refugiados e 23,1% eram moradores de rua. A positividade foi de 14,1% para o RNA do SARS-CoV-2, 30,8% para o total de anti-SARS-CoV-2 e 39,4% para pelo menos um marcador da COVID-19. Entre os 541 indivíduos, ser imigrante/refugiado, não usar máscara cirúrgica e ter três ou mais pessoas dormindo no mesmo quarto foram fatores associados à infecção por SARS-CoV-2, enquanto confiar em informações sobre a pandemia, principalmente aquelas transmitidas por noticiários de TV, foi um indicador de proteção contra a COVID-19. Este estudo revelou desigualdades étnicas e socioeconômicas na prevalência da COVID-19 entre pessoas de baixa renda no Brasil. Além disso, uma alta prevalência de COVID-19 foi detectada nos três grupos. O desenvolvimento de novas estratégias para combater e prevenir doenças transmissíveis que afetam essa população é essencial para mitigar pandemias futuras e atuais. Resumo COVID19 COVID 19 COVID-1 imigrantesrefugiados imigrantes refugiados rua Goiânia Goiás Brasil Tratase Trata se 2020 covid19 covid covid-1 antiSARSCOV2 antiSARSCOV anti SARS COV 2 anti-SARS-COV- eou SARSCOV2 SARSCOV SARS-COV- positivo COVID19. 19. 59 participantes 473 47 3 47,3 reciclável 296 29 6 29,6 231 23 1 23,1 141 14 14,1 SARSCoV2, SARSCoV2 SARSCoV CoV 2, SARS-CoV-2 308 30 8 30,8 antiSARSCoV2 antiSARSCoV anti-SARS-CoV- 394 39 4 39,4 54 imigranterefugiado imigrante refugiado imigrante/refugiado pandemia TV disso grupos atuais COVID1 COVID- 202 covid1 covid- anti-SARS-COV SARS-COV 5 47, 29, 23, 14, SARS-CoV- 30, anti-SARS-CoV 39, 20 SARS-CoV

Abstract: This study aimed to estimate the prevalence and identify social factors and preventive strategies associated with the coronavirus disease 2019 (COVID-19) in socio and economically vulnerable people (recyclable waste pikers, immigrants/refugees, and homeless people) in Goiânia, Goiás State, Central-Western Brazil. A cross-sectional study was conducted from July 2020 to October 2020. COVID-19 positivity was defined as a positive total anti-SARS-COV-2 antibody test and/or RNA test for SARS-COV-2. Univariable and multiple regression analyses were performed to identify the variables associated with COVID-19. Of the 594 participants, 47.3% were recyclable waste pickers, 29.6% were immigrants/refugees, and 23.1% were homeless people. The positivity for SARS-CoV-2 RNA was 14.1%, whereas for anti-SARS-CoV-2 a total of 30.8% were positive, and 39.4% were positive for at least one COVID-19 marker. Among the 541 individuals, being immigrants/refugees, not wearing a surgical mask, and having three or more people sleeping in the same room were associated with SARS-CoV-2 infection, while using TV news as the main source of information about the pandemic was a protective predictor of COVID-19. This study revealed ethnic and socioeconomic inequalities in the prevalence of COVID-19 among impoverished people in Brazil. Additionally, a high prevalence of COVID-19 was detected in all three groups. Developing new strategies to combat and prevent communicable diseases affecting this population is essential for mitigating future and ongoing pandemics. Abstract 201 COVID19 COVID 19 (COVID-19 pikers immigrantsrefugees immigrants refugees immigrants/refugees Goiânia State CentralWestern Central Western Brazil crosssectional cross sectional 202 COVID-1 antiSARSCOV2 antiSARSCOV anti SARS COV 2 anti-SARS-COV- andor SARSCOV2. SARSCOV2 SARSCOV 2. SARS-COV-2 COVID19. 19. 59 participants 473 47 3 47.3 pickers 296 29 6 29.6 231 23 1 23.1 SARSCoV2 SARSCoV CoV SARS-CoV- 141 14 14.1% antiSARSCoV2 antiSARSCoV anti-SARS-CoV- 308 30 8 30.8 394 39 4 39.4 marker 54 individuals mask infection Additionally groups pandemics 20 COVID1 (COVID-1 COVID- anti-SARS-COV SARS-COV- 5 47. 29. 23. SARS-CoV 14.1 anti-SARS-CoV 30. 39. (COVID- SARS-COV 14. (COVID

Resumen: Este estudio tuvo como objetivo estimar la prevalencia del COVID-19 e identificar los factores sociales y las estrategias preventivas asociadas a esta enfermedad en personas en situación de vulnerabilidad socioeconómica (recolectores de basura, inmigrantes/refugiados y personas sin hogar) en Goiânia, Estado de Goiás, en la región central de Brasil. Se trata de un estudio transversal realizado de julio a octubre de 2020. Las personas que tuvieron una prueba de anticuerpos anti-SARS-CoV-2 positiva y/o una prueba de ARN para SARS-CoV-2 se consideraron positivas para el COVID-19. Se realizaron análisis de regresión univariante y múltiple para identificar las variables asociadas al COVID-19. De los 594 participantes, el 47,3% eran recicladores; el 29,6% inmigrantes/refugiados; y el 23,1% eran personas sin hogar. La positividad fue del 14,1% para el ARN del SARS-CoV-2; del 30,8% para el total de anti-SARS-CoV-2; y del 39,4% para al menos un marcador del COVID-19. De los 541 participantes, ser inmigrante/refugiado, no usar mascarilla quirúrgica y tener tres o más personas que comparten la misma habitación fueron los factores asociados con la infección por SARS-CoV-2, mientras que confiar en la información sobre la pandemia, especialmente transmitidas por los noticiarios, fue un indicador de protección contra esta enfermedad. Este estudio reveló las desigualdades étnicas y socioeconómicas en la prevalencia del COVID-19 entre las personas de bajos ingresos en Brasil. Además, se detectó una alta prevalencia del COVID-19 en los tres grupos. El desarrollo de nuevas estrategias para combatir y prevenir las enfermedades transmisibles que afectan a esta población es fundamental para mitigar las pandemias futuras y actuales. Resumen COVID19 COVID 19 COVID-1 recolectores basura inmigrantesrefugiados inmigrantes refugiados hogar Goiânia Goiás Brasil 2020 antiSARSCoV2 antiSARSCoV anti SARS CoV 2 anti-SARS-CoV- yo SARSCoV2 SARSCoV SARS-CoV- COVID19. 19. 59 participantes 473 47 3 47,3 recicladores 296 29 6 29,6 231 23 1 23,1 141 14 14,1 308 30 8 30,8 394 39 4 39,4 54 inmigranterefugiado inmigrante refugiado inmigrante/refugiado SARSCoV2, 2, pandemia noticiarios Además grupos actuales COVID1 COVID- 202 anti-SARS-CoV SARS-CoV 5 47, 29, 23, 14, 30, 39, 20

Abstract The serological markers for the diagnosis of COVID-19 plays an important role in the epidemiological investigation of the pandemic. This study aims to assess the prevalence of anti-SARS-CoV-2 in hepatitis B and C patients in a pre-vaccination of COVID-19 period. Between March 2020 and January 2021, 199 serum samples from individuals with HBsAg/HBV DNA or anti-HCV/HCV RNA positivity were tested for antibodies (IgM and IgG) against SARS-CoV-2 using Electrochemiluminescent Immunoassay (ECLIA). Among these, 50.3 % (100/199) tested positive for hepatitis C virus infection and 49.7 % (99/199) for hepatitis B virus, confirmed through molecular and serological diagnosis. The anti-SARS-CoV-2 seroprevalence was 24.1 % (48/199) in this population, with 23.23 % (23/99) hepatitis B and 25 % (25/100) hepatitis C patients tested positive for anti-SARS-CoV-2. The higher seroprevalence of anti-SARS-CoV-2 (16.58 %, 33/199) was detected among those over-40 years of age and the month of November 2020 had the highest number of detections 9 % (18/199) with the majority living in impoverished and neglected neighborhoods in the city of Rio de Janeiro. We found a high prevalence of anti-SARS-CoV-2 in patients with viral hepatitis before COVID-19 vaccination. This demonstrates the high exposure of this population during the period of social isolation. COVID19 COVID 19 COVID-1 pandemic antiSARSCoV2 antiSARSCoV anti SARS CoV 2 anti-SARS-CoV- prevaccination pre vaccination 202 2021 HBsAgHBV HBsAg HBV antiHCV/HCV antiHCVHCV HCV/HCV HCV IgM IgG SARSCoV2 SARSCoV SARS-CoV- ECLIA. ECLIA . (ECLIA) these 503 50 3 50. 100/199 100199 100 (100/199 497 49 7 49. 99/199 99199 99 (99/199 241 24 1 24. 48/199 48199 48 (48/199 2323 23 23.2 23/99 2399 (23/99 25/100 25100 (25/100 antiSARSCoV2. 2. 16.58 1658 16 58 (16.5 33/199 33199 33 over40 over 40 over-4 18/199 18199 18 (18/199 Janeiro isolation COVID1 COVID- anti-SARS-CoV 20 antiHCV HCVHCV SARS-CoV (ECLIA 5 100/19 10019 10 (100/19 4 99/19 9919 (99/19 48/19 4819 (48/19 232 23. 23/9 239 (23/9 25/10 2510 (25/10 16.5 165 (16. 33/19 3319 over4 over- 18/19 1819 (18/19 100/1 1001 (100/1 99/1 991 (99/1 48/1 481 (48/1 23/ (23/ 25/1 251 (25/1 16. (16 33/1 331 18/1 181 (18/1 100/ (100/ 99/ (99/ 48/ (48/ (23 25/ (25/ (1 33/ 18/ (18/ (100 (99 (48 (2 (25 ( (18 (10 (9 (4

ABSTRACT Environmental surveillance of water sources is important to monitoring viral hepatitis transmission in clinical settings. This study investigated the circulation of hepatitis A (HAV) and E (HEV) viruses in sewage and clinical samples from Argentina. Between 2016 and 2017, 80 raw sewage samples and 86 clinical samples (stool and serum) from suspected cases of hepatitis A and hepatitis E were obtained. HAV and HEV were tested by both real-time and nested PCR. Positive samples were sequenced for genotype determination and phylogenetic analysis. Overall, HAV was recovered in 39% of sewage samples and 61.1% of clinical samples. HEV was detected in 22.5% of sewage samples and 15.9% of clinical samples. HAV was found more frequently in sewage during the winter and in clinical samples in spring; HEV was more prevalent in sewage during summer and in clinical samples in autumn. All HAV isolates belonged to genotype IA and HEV isolates belonged to genotype 3, the most prevalent genotypes in South America. High prevalence of HAV and HEV in environmental and clinical samples in Mendoza, Argentina was observed. These findings reinforce the importance of environmental surveillance and implementation of health strategies to control the spread of HAV and HEV in developing countries. settings (HAV (HEV 201 2017 8 stool serum obtained realtime real time PCR analysis Overall 39 611 61 1 61.1 225 22 5 22.5 159 15 9 15.9 spring autumn 3 America Mendoza observed countries 20 6 61. 2 22. 15.

ABSTRACT OBJECTIVE To estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, Central Brazil. METHODS Overall, 355 individuals were interviewed, and blood samples were tested for anti-HAV and anti-HEV IgG. Anti-HEV-positive samples were similarly tested for HEV RNA. RESULTS All participants were from Latin American countries, most of whom, young adult males. The overall anti-HAV IgG prevalence was 87.4% (95%CI: 83.5–90.4), of whom 94.9%, 75.6%, and 60% were from Haiti, Venezuela, and other Latin American countries, respectively (p < 0.001). Age above 19 years and more than 36 months residing in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall anti-HEV IgG prevalence was 6.5% (95%CI: 4.4–9.5). All anti-HEV IgG-positive individuals were Haitians, including a child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG-positive samples. CONCLUSION The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently required to interrupt enteric virus transmission in this emergent and vulnerable population.

ABSTRACT OBJECTIVE To estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, Central Brazil. METHODS Overall, 355 individuals were interviewed, and blood samples were tested for anti-HAV and anti-HEV IgG. Anti-HEV-positive samples were similarly tested for HEV RNA. RESULTS All participants were from Latin American countries, most of whom, young adult males. The overall anti-HAV IgG prevalence was 87.4% (95%CI: 83.5–90.4), of whom 94.9%, 75.6%, and 60% were from Haiti, Venezuela, and other Latin American countries, respectively (p < 0.001). Age above 19 years and more than 36 months residing in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall anti-HEV IgG prevalence was 6.5% (95%CI: 4.4–9.5). All anti-HEV IgG-positive individuals were Haitians, including a child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG-positive samples. CONCLUSION The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently required to interrupt enteric virus transmission in this emergent and vulnerable population.

ABSTRACT Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) are more vulnerable to blood-borne viral infections due to frequent invasive procedures. Hepatitis B virus (HBV) infection in this cohort of patients has been a matter of concern worldwide. The objective of this cross-sectional study was to evaluate the frequency of serological markers for hepatitis B, and the occurrence of overt and occult HBV infection (OBI) and its molecular characterization in serum samples from 644 CKD patients in HD units located in Rio de Janeiro, Brazil, from 2013 to 2017. HBV DNA was investigated in HBsAg reactive and “anti-HBc alone” samples to determine infecting genotypes and genetic relatedness between sequences. The prevalence of serological markers HBsAg+, anti-HBc alone, anti-HBc+/anti-HBs+, anti-HBs+, anti-HBc/anti-HBs/HBsAg were 5.9%, 2.8%, 30.7%, 26.6%, 34.0%, respectively. HBV DNA was detected in 39.5% (15/38) of the HBsAg+ and in 5/18 (27.8%) of the “anti-HBc alone” individuals, indicating a high prevalence of OBI within this group. We found a higher prevalence of HBV/A1 (65%), followed by HBV/D3 (20%), and HBV/A2 (15%). Bayesian MCC tree with a highly supported clade, genetic distance comparison, and identical nucleotide sequences suggested a nosocomial spread of HBV in some units. The high prevalence of HBV infection and low number of individuals immune to infection reinforces the need for vaccination in this group. The presence of closely related strains in the same HD unit reinforces the importance of continuous improvement of safety control measures and laboratory surveillance of serological markers to prevent the risk of infection and transmission of HBV.

Abstract INTRODUCTION: Hepatitis B virus (HBV) infection is a public health problem; therefore, we aimed to report HBV genotypes in Ceará, Brazil. METHODS: A total of 103 HBsAg-positive samples were subjected to HBV genotyping and subgenotyping. RESULTS: The following genetic compositions of samples were found: F-54% (F2-83.33%), A-40% (A1-65%), D-6%, C2-1%, E-1%, and G-1%. CONCLUSIONS: Some genotypes are only prevalent in certain parts of the world; however, the State of Ceará is a hub for migration and has one of the most important liver transplantation centers in Brazil, which can explain the prevalence of the F genotype.

In occult hepatitis B infection (OBI), hepatitis B virus DNA (HBV DNA) can be detected in serum samples; however, oral fluid collection for detection of HBV DNA has not yet been explored, despite the availability of collection devices. Serum and oral fluid samples from 45 hepatitis B core antibody (anti-HBc)-positive patients were collected for the amplification of the HBV polymerase gene. HBV DNA was detected in five serum and four oral fluid samples (the detection limit for oral fluid was 1.656 log IU/mL in paired serum). In conclusion, simple methodologies of sample collection and in-house polymerase chain reaction (PCR) allowed detection of HBV DNA, and these could be used to improve the diagnosis of OBI, especially in locations with limited resources.

ABSTRACT Objective: This study aims to estimate the prevalence of insulin resistance (IR) among chronic hepatitis C (CHC) patients and their related laboratory and demographic data. Subjects and methods: In this study, non-diabetic CHC patients referred to Viral Hepatitis Ambulatories from Rio de Janeiro (Brazil) donated blood samples. Insulin was measured using a chemiluminescence immunoassay. IR was determined by HOMA-IR, where HOMA-IR > 2 was defined as IR. Results: A total of 214 CHC patients were recruited (123 females aged 53.6 years ± 10.9 years). IR was present in 133 patients (62.1%) and was associated in bivariate analysis to higher mean values of age (p = 0.040), triglycerides (p = 0.032), glucose (p = 0.000), insulin (p = 0.000), waist circumference (p = 0.001), and body mass index (p = 0.007); however, none of these variables were significant in the multivariate analysis. Conclusions: The high prevalence of IR was observed among CHC patients, and there was no difference in clinical or laboratory parameters when both groups were compared in the multivariate analysis. This high IR prevalence could lead to a high risk for development of cardiovascular disease and metabolic disorders.

BACKGROUND Many studies have identified mutations in the hepatitis B surface antigen (HBsAg) as important factors limiting the ability of commercial serological assays to detect this viral antigen. However, an association between mutations in the HBsAg gene and the occurrence of occult HBV infection (OBI) in patients has not been established. OBJECTIVES To detect hepatitis B virus (HBV) DNA in patients with anti-HBc as a unique serological marker, a previously published, cost-effective TaqMan-based real-time polymerase chain reaction (PCR) test with minor groove binding probes was adapted for use in this study. The current study also aimed to investigate HBsAg mutations and genotypes of HBV in OBI at the Viral Hepatitis Ambulatory Clinic in Rio de Janeiro to determine any possible association. METHODS Intra-assay and inter-assay reproducibility were determined, and the mean coefficient of variation values obtained were 2.07 and 3.5, respectively. Probit analysis indicated that the 95% detection level was 25 IU/mL. The prevalence of OBI was investigated in 35 serum samples with an ‘anti-HBc alone’ profile from individuals who attended our clinic between 2011 and 2013. FINDINGS HBV DNA was detected in only one sample, resulting in an OBI rate of 2.9%. Nucleotide sequencing of the pre-S/S region was performed to genotype and analyse mutations within the HBsAg gene of this HBV DNA. The HBV in the OBI case was classified as sub-genotype A1, and a sequence analysis of the small S gene revealed 12 mutations in the major hydrophilic region compared to the consensus A1 sequence. Most of these mutations occurred in amino acid residues that have been reported as clinically relevant because they have been implicated in vaccine escape and/or inability to detect HBsAg by commercial serological assays. MAIN CONCLUSIONS Our study suggests the importance of specific HBsAg mutations, different from those in D, B, and C genotypes, in sub-genotype A1 HBV associated with OBI.

Rapid tests (RTs) can be used as an alternative method for the conventional diagnosis of hepatitis B virus (HBV). This study aims to evaluate antibodies to HBsAg (anti-HBs) and antibodies to HBeAg (anti-HBe) RTs under different Brazilian settings. The following three groups were included: GI: viral hepatitis outpatient services; GII: low resource areas; and GIII: crack users and beauticians. Imuno-rápido anti-HBsAg™ and Imuno-rápido anti-HBeAg™ RTs were evaluated and showed specificities greater than 95% in all groups. The sensitivity values to anti-HBs were 50.38%, 51.05% and 46.73% and the sensitivity values to anti-HBe were 76.99%, 10.34% and 11.76% in the GI, GII and GIII groups, respectively. The assays had a low sensitivity and high specificity, which indicated their use for screening in regions endemic for HBV.

ABSTRACT Drug users have been reported to have an increased risk for acquisition of viral hepatitis. This study aims to evaluate the prevalence of HBV and HCV infection and usefulness of saliva for HBsAg and anti-HCV detection in alcoholic patients.A total of 90 alcoholic patients were recruited in 2013. HBsAg and anti-HCV were tested in serum and saliva, anti-HBc and anti-HBs were tested in serum using commercial enzyme immunoassays (EIA).Using serum samples, anti-HCV, HBsAg, anti-HBc and anti-HBs prevalences were 5.6%, 0%, 15.7%, and 29.2%. HBsAg detection in saliva showed 100% of specificity and anti-HCV detection demonstrated 100% of sensitivity and 94.7% of specificity. Low prevalence of HBV and high prevalence of anti-HCV were found and reinforced the recommendation of HBV vaccination to avoid the acute and chronic cases and HCV screening in this group to identify cases for antiviral therapy. Saliva samples could be used for anti-HCV detection in this population, what could increase the diagnosis access.

ABSTRACT BACKGROUND AND OBJECTIVES: Assessing health-related quality of life is an important aspect of clinical practice. Thus, the present study attempts to assess the health-related quality of life of patients with chronic liver disease. METHODS: A cross-sectional survey was conducted on 133 chronic liver disease patients, using three instruments: a demographic questionnaire, the Chronic Liver Disease Questionnaire, and Model for End-Stage Liver Disease index. Variables were expressed as frequencies, percentages, means, and standard deviations. The statistical analysis included Pearson's correlation, Student's t-test, and analysis of variance (p < 0.05 was considered significant). RESULTS: The mean age of included subjects was 50.5 ± 13.3 years. The majority were male (66.2%), Caucasian (70.7%), and had a family income of US$329-US$658.2. Over half of the patients (56.4%) were infected by hepatitis C virus and 93.2% had low Model for End-Stage Liver Disease scores. Model for End-Stage Liver Disease score was related to age (r = 0.185;p = 0.033). Higher mean Chronic Liver Disease Questionnaire scores were obtained for emotional function (39.70/SD ± 12.98) and while lower scores were obtained for abdominal symptoms (16.00/SD ± 6.25). Fifty-two patients (39.1%) presented overall low (<5) Chronic Liver Disease Questionnaire scores. Furthermore, Chronic Liver Disease Questionnaire score was related to family income (r = 0.187, p = 0.031). CONCLUSION: Most individuals presented high mean Chronic Liver Disease Questionnaire scores, indicating low health-related quality of life, especially individuals with low family income.