Anthropogenic environmental changes arising from settlement and agriculture include deforestation and replacement of natural vegetation by crops providing opportunities for pathogen spillover from animals to humans. This study aimed to investigate the prevalence of rodent-borne virus infections in seven rural settlements from Midwestern Brazil. Of the 466 individuals tested 12 (2.57%) were reactive for orthohantavirus and 3 (0.64%) for mammarenavirus. These rural settlers lived under unfavorable infrastructure, socioeconomic disadvantages, and unsanitary conditions, representing a risk for rodent-borne infections. Development of public policies towards the improvement of health, sanitation and awareness of rodent-borne diseases in improvised camps and settlements is imperative, in order to reduce morbidity and mortality caused by these diseases.

Recently, it was suggested that maternal hepatitis B surface antigen antibodies (anti-HBs) acquired transplacentally could play a negative role in newborn infants' immune response to the hepatitis B vaccine. We compared the hepatitis B virus (HBV) vaccine response in infants born to mothers previously vaccinated against HBV (n = 91) to infants born to mothers who were not previously vaccinated (n = 221). All newborn infants received three intramuscular doses (10 μg) of HBV vaccine (Butang®) at 0,1 and six months. The first dose was administered at the maternity hospital within 12 h of birth. The geometric mean titres of anti-HBs were not different among newborn infants born to mothers who were anti-HBs-negative (492.7 mIU/mL) and anti-HBs-positive (578.7 mIU/mL) (p = 0.38). Eight infants did not respond to the HBV vaccine. Of them, six were born to anti-HBs-negative mothers and two were born to mothers with anti-HBs titres less than 50 mlU/mL. Despite the mother's anti-HBs-positive status, our data show a good immunogenicity of the Brazilian HBV recombinant vaccine in neonates.

OBJETIVO: Estimar a prevalência e fatores associados à infecção pelo vírus da hepatite C em usuários de drogas e identificar os genótipos e subtipos virais circulantes. MÉTODOS: Estudo realizado com 691 usuários de drogas de 26 centros de tratamento de uso de drogas filantrópicos, particulares e públicos de Goiânia (GO) e Campo Grande (MS), entre 2005 e 2006. Dados sociodemográficos e fatores de risco para infecção pelo HCV foram obtidos por meio de entrevistas. Amostras sangüíneas foram testadas para a detecção de anticorpos para o HCV. As amostras positivas foram submetidas à detecção do RNA-HCV pela reação em cadeia da polimerase com iniciadores complementares às regiões 5' NC e NS5B do genoma viral e genotipadas pelo line probe assay (LiPA) e por seqüenciamento direto, seguido de análise filogenética. Prevalência e odds ratio foram calculados com intervalo de 95% de confiança. Os fatores de risco com p<0,10 pela análise univariada foram analisados por regressão logística hierárquica. Valores de p<0,05 foram considerados estatisticamente significantes. RESULTADOS: A prevalência para anti-HCV foi 6,9% (IC 95%: 5,2;9,2). A análise multivariada de fatores de risco indicou que idade superior a 30 anos e uso injetável de drogas se mostraram associados à infecção pelo HCV. O RNA-HCV foi detectado em 85,4% (41/48) das amostras anti-HCV positivas. Trinta e três amostras foram do genótipo 1 pelo LiPA, subtipos 1a (63,4%) e 1b (17,1%), e 8 (19,5%) do genótipo 3, subtipo 3a. A análise filogenética da região NS5B mostrou que 17 (68%), 5 (20%) e 3 (12%) amostras foram dos subtipos 1a, 3a e 1b, respectivamente. CONCLUSÕES: Os resultados mostram uma prevalência elevada da infecção e do subtipo 1a do HCV em usuários de drogas, sendo o uso injetável de drogas o principal fator de risco para essa infecção.

OBJECTIVE: To estimate prevalence of hepatitis C virus (HCV) infection and identify risk factors associated and circulating HCV genotypes and subtypes. METHODS: Study conducted including 691 drug users attending 26 charitable, private and public drug treatment centers in Goiânia and Campo Grande, central-western Brazil, between 2005 and 2006. Sociodemographic characteristics and risk factors for HCV infection were collected during interviews. Blood samples were tested for HCV antibodies (anti-HCV). Positive samples were submitted to HCV RNA detection by PCR with primers complementary to 5' NC and NS5B regions of viral genome and genotyped by line probe assay (LiPA) and direct nucleotide sequencing followed by phylogenetic analysis. The prevalence and odds ratio were calculated with 95% confidence intervals. Risk factors were first estimated in the univariate analysis (p<0.10) and then analyzed by hierarchical logistic regression. Statistical significance was assessed at a 5% significance level. RESULTS: The prevalence of anti-HCV was 6.9% (95% CI: 5.2-9.2). The multivariate analysis of risk factors revealed that age over 30 years and injecting drug use were associated with HCV infection. HCV RNA was detected in 85.4% (41/48) of anti-HCV-positive samples. Thirty-three samples were genotyped as genotype 1 by LiPA, subtypes 1a (63.4%) and 1b (17.1%), and 8 samples (19.5%) were genotype 3, subtype 3a. The phylogenetic analysis of the NS5B region showed that 17 (68%), 5 (20%), and 3 (12%) samples were subtypes 1a, 3a, and 1b, respectively. CONCLUSIONS: The results show a high prevalence of HCV infection and predominance of subtype 1a among drug users in Brazil. In addition, injecting drug use was a major risk factor associated with HCV infection.

OBJETIVO: Estimar la prevalencia y factores asociados a la infección por el virus de la hepatitis C en usuarios de drogas e identificar los genotipos y subtipos virales circulantes. MÉTODOS: Estudio realizado con 691 usuarios de drogas de 26 centros de tratamiento de uso de drogas filantrópicos, particulares y públicos de Goiania y Campo Grande (Centro-Oeste), entre 2005 y 2006. Datos sociodemográficos y factores de riesgo para infección por el HCV fueron obtenidos por medio de entrevistas. Muestras sanguíneas fueron evaluadas para la detección de anticuerpos para el HCV. Las muestras positivas fueron sometidas a la detección de RNA-HCV por la reacción en cadena de polimerasa con iniciadores complementarios a las regiones 5' NC y NS5B del genoma viral y genotipadas por el line probe assay (LiPA) y por secuenciación directa, seguido del análisis filogenético. Prevalencia y odds ratio fueron calculados con intervalo de 95% de confianza. Los factores de riesgo con p<0,10 por el análisis univariado fueron analizados por regresión logística jerárquica. Valores de p<0,05 fueron considerados estadísticamente significativos. RESULTADOS: La prevalencia para anti-HCV fue 6,9% (IC 95%:5,2;9,2). El análisis multivariado de factores de riesgo indicó que edades superiores a 30 años y uso inyectable de drogas se mostraron asociados a la infección por el HCV. El RNA-HCV fue dectado en 85,4% (41/48) de las muestras anti-HCV positivas. Treinta y tres muestras fueron del genotipo 1 por el LiPA, subtipos 1a (63,4%) y 1b (17,1%), y 8 (19,5%) del genotipo 3, subtipo 3a. El análisis filogenético de la región NS5B mostró que 17 (68%), 5 (20%) y 3 (12%) muestras fueron de los subtipos 1a, 3a y 1b, respectivamente. CONCLUSIONES: Los resultados muestran una prevalencia elevada de la infección y del subtipo 1a del HCV en usuarios de drogas, siendo el uso inyectable de drogas el principal factor de riesgo para esa infección.

OBJETIVO: Estimar a prevalência e fatores associados à infecção pelo vírus da hepatite C em usuários de drogas e identificar os genótipos e subtipos virais circulantes. MÉTODOS: Estudo realizado com 691 usuários de drogas de 26 centros de tratamento de uso de drogas filantrópicos, particulares e públicos de Goiânia (GO) e Campo Grande (MS), entre 2005 e 2006. Dados sociodemográficos e fatores de risco para infecção pelo HCV foram obtidos por meio de entrevistas. Amostras sangüíneas foram testadas para a detecção de anticorpos para o HCV. As amostras positivas foram submetidas à detecção do RNA-HCV pela reação em cadeia da polimerase com iniciadores complementares às regiões 5' NC e NS5B do genoma viral e genotipadas pelo line probe assay (LiPA) e por seqüenciamento direto, seguido de análise filogenética. Prevalência e odds ratio foram calculados com intervalo de 95% de confiança. Os fatores de risco com p<0,10 pela análise univariada foram analisados por regressão logística hierárquica. Valores de p<0,05 foram considerados estatisticamente significantes. RESULTADOS: A prevalência para anti-HCV foi 6,9% (IC 95%: 5,2;9,2). A análise multivariada de fatores de risco indicou que idade superior a 30 anos e uso injetável de drogas se mostraram associados à infecção pelo HCV. O RNA-HCV foi detectado em 85,4% (41/48) das amostras anti-HCV positivas. Trinta e três amostras foram do genótipo 1 pelo LiPA, subtipos 1a (63,4%) e 1b (17,1%), e 8 (19,5%) do genótipo 3, subtipo 3a. A análise filogenética da região NS5B mostrou que 17 (68%), 5 (20%) e 3 (12%) amostras foram dos subtipos 1a, 3a e 1b, respectivamente. CONCLUSÕES: Os resultados mostram uma prevalência elevada da infecção e do subtipo 1a do HCV em usuários de drogas, sendo o uso injetável de drogas o principal fator de risco para essa infecção.

OBJECTIVE: To estimate prevalence of hepatitis C virus (HCV) infection and identify risk factors associated and circulating HCV genotypes and subtypes. METHODS: Study conducted including 691 drug users attending 26 charitable, private and public drug treatment centers in Goiânia and Campo Grande, central-western Brazil, between 2005 and 2006. Sociodemographic characteristics and risk factors for HCV infection were collected during interviews. Blood samples were tested for HCV antibodies (anti-HCV). Positive samples were submitted to HCV RNA detection by PCR with primers complementary to 5' NC and NS5B regions of viral genome and genotyped by line probe assay (LiPA) and direct nucleotide sequencing followed by phylogenetic analysis. The prevalence and odds ratio were calculated with 95% confidence intervals. Risk factors were first estimated in the univariate analysis (p<0.10) and then analyzed by hierarchical logistic regression. Statistical significance was assessed at a 5% significance level. RESULTS: The prevalence of anti-HCV was 6.9% (95% CI: 5.2-9.2). The multivariate analysis of risk factors revealed that age over 30 years and injecting drug use were associated with HCV infection. HCV RNA was detected in 85.4% (41/48) of anti-HCV-positive samples. Thirty-three samples were genotyped as genotype 1 by LiPA, subtypes 1a (63.4%) and 1b (17.1%), and 8 samples (19.5%) were genotype 3, subtype 3a. The phylogenetic analysis of the NS5B region showed that 17 (68%), 5 (20%), and 3 (12%) samples were subtypes 1a, 3a, and 1b, respectively. CONCLUSIONS: The results show a high prevalence of HCV infection and predominance of subtype 1a among drug users in Brazil. In addition, injecting drug use was a major risk factor associated with HCV infection.

OBJETIVO: Estimar la prevalencia y factores asociados a la infección por el virus de la hepatitis C en usuarios de drogas e identificar los genotipos y subtipos virales circulantes. MÉTODOS: Estudio realizado con 691 usuarios de drogas de 26 centros de tratamiento de uso de drogas filantrópicos, particulares y públicos de Goiania y Campo Grande (Centro-Oeste), entre 2005 y 2006. Datos sociodemográficos y factores de riesgo para infección por el HCV fueron obtenidos por medio de entrevistas. Muestras sanguíneas fueron evaluadas para la detección de anticuerpos para el HCV. Las muestras positivas fueron sometidas a la detección de RNA-HCV por la reacción en cadena de polimerasa con iniciadores complementarios a las regiones 5' NC y NS5B del genoma viral y genotipadas por el line probe assay (LiPA) y por secuenciación directa, seguido del análisis filogenético. Prevalencia y odds ratio fueron calculados con intervalo de 95% de confianza. Los factores de riesgo con p<0,10 por el análisis univariado fueron analizados por regresión logística jerárquica. Valores de p<0,05 fueron considerados estadísticamente significativos. RESULTADOS: La prevalencia para anti-HCV fue 6,9% (IC 95%:5,2;9,2). El análisis multivariado de factores de riesgo indicó que edades superiores a 30 años y uso inyectable de drogas se mostraron asociados a la infección por el HCV. El RNA-HCV fue dectado en 85,4% (41/48) de las muestras anti-HCV positivas. Treinta y tres muestras fueron del genotipo 1 por el LiPA, subtipos 1a (63,4%) y 1b (17,1%), y 8 (19,5%) del genotipo 3, subtipo 3a. El análisis filogenético de la región NS5B mostró que 17 (68%), 5 (20%) y 3 (12%) muestras fueron de los subtipos 1a, 3a y 1b, respectivamente. CONCLUSIONES: Los resultados muestran una prevalencia elevada de la infección y del subtipo 1a del HCV en usuarios de drogas, siendo el uso inyectable de drogas el principal factor de riesgo para esa infección.

A adesão e resposta à vacina contra hepatite B foram avaliadas em comunidades remanescentes de quilombos no Brasil Central. Um total de 708 indivíduos suscetíveis à infecção pelo vírus da hepatite B foi convidado para participar do programa de vacinação contra hepatite B em oito comunidades. Apesar de 567 (80%) indivíduos terem recebido a primeira dose, somente 198 (28%) aderiram ao esquema completo de vacinação. De 148 sujeitos que concordaram em dosar o anti-HBs, 123 (83,1%; IC95%: 75,9-88,6) responderam à vacina. Um título geométrico médio de 512mUI/mL (IC95%: 342,5-765,3) foi encontrado. Sexo masculino e idade foram independentemente associados com ausência de resposta. Programas adicionais de educação em saúde e esquemas alternativos de vacinação contra hepatite B são necessários para melhorar a cobertura vacinal nessas comunidades no Brasil Central.

Compliance with and responses to the hepatitis B vaccine were evaluated in remaining quilombo communities in Central Brazil. A total of 708 individuals who were susceptible to hepatitis B virus infection were invited to participate in the hepatitis B vaccination program in eight communities. Although 567 (80%) individuals received the first dose, only 198 (28%) complied with the full vaccination scheme. Of 148 subjects who agreed to be tested for anti-HBs, 123 (83.1%; 95%CI: 75.9-88.6) responded to the vaccine. A geometric mean titer of 512mIU/mL (95%CI: 342.5-765.3) was found. Male sex and older age were independently associated with non-response. Additional health education programs and alternative hepatitis B vaccine schedules are needed to improve the vaccination coverage in these communities in Central Brazil.

A adesão e resposta à vacina contra hepatite B foram avaliadas em comunidades remanescentes de quilombos no Brasil Central. Um total de 708 indivíduos suscetíveis à infecção pelo vírus da hepatite B foi convidado para participar do programa de vacinação contra hepatite B em oito comunidades. Apesar de 567 (80%) indivíduos terem recebido a primeira dose, somente 198 (28%) aderiram ao esquema completo de vacinação. De 148 sujeitos que concordaram em dosar o anti-HBs, 123 (83,1%; IC95%: 75,9-88,6) responderam à vacina. Um título geométrico médio de 512mUI/mL (IC95%: 342,5-765,3) foi encontrado. Sexo masculino e idade foram independentemente associados com ausência de resposta. Programas adicionais de educação em saúde e esquemas alternativos de vacinação contra hepatite B são necessários para melhorar a cobertura vacinal nessas comunidades no Brasil Central.

Compliance with and responses to the hepatitis B vaccine were evaluated in remaining quilombo communities in Central Brazil. A total of 708 individuals who were susceptible to hepatitis B virus infection were invited to participate in the hepatitis B vaccination program in eight communities. Although 567 (80%) individuals received the first dose, only 198 (28%) complied with the full vaccination scheme. Of 148 subjects who agreed to be tested for anti-HBs, 123 (83.1%; 95%CI: 75.9-88.6) responded to the vaccine. A geometric mean titer of 512mIU/mL (95%CI: 342.5-765.3) was found. Male sex and older age were independently associated with non-response. Additional health education programs and alternative hepatitis B vaccine schedules are needed to improve the vaccination coverage in these communities in Central Brazil.

Com objetivo de estimar a prevalência da infecção pelo vírus da hepatite C (HCV) em comunidades remanescentes de quilombos no Brasil Central, 1.007 indivíduos foram entrevistados nas 12 comunidades quilombolas existentes no Estado de Mato Grosso do Sul, Brasil Central. Amostras sanguíneas foram coletadas e os soros testados para anti-HCV pelo ensaio imunoenzimático. As amostras positivas foram testadas pelo ensaio confirmatório "line immunoassay" e também submetidas à detecção do RNA-HCV. A prevalência da infecção pelo HCV foi de 0,2%. Este achado mostra uma baixa prevalência da infecção pelo HCV em comunidades remanescentes de quilombos no Brasil Central.

In order to determine the prevalence of hepatitis C virus (HCV) infection in quilombo remnant communities in Central Brazil, 1,007 subjects were interviewed in all 12 communities existing in Mato Grosso do Sul State, Central Brazil. Blood samples were collected and sera were tested for anti-HCV by enzyme-linked immunosorbent assay. Positive samples were retested for confirmation using a line immunoassay and were also subjected to HCV RNA detection. The prevalence of HCV infection was 0.2%. This finding shows a low prevalence of HCV infection in quilombo remnant communities in Central Brazil.

An investigation was conducted involving 255 renal transplant recipients in the state of Goiás, Central Brazil, to determine the prevalence of hepatitis C virus (HCV), its risk factors, the genotypes involved, and the level of alanine aminotransferase (ALT) present in the patients. All serum samples were tested for anti-HCV antibodies and HCV RNA. Forty-one patients were anti-HCV and/or HCV RNA positive, resulting in an overall HCV infection prevalence of 16.1% (95% CI: 11.9-21.3). A multivariate analysis of risk factors showed that a history of blood transfusions without anti-HCV screening, the length of time spent on hemodialysis, and renal transplantation before 1994 are all associated with HCV positivity. In HCV-positive patients, only 12.2% had ALT levels above normal. Twenty-eight samples were genotyped as genotype 1, subtypes 1a (62.5%) and 1b (31.3%), and two samples (6.2%) were genotype 3, subtype 3a. These data show a high prevalence of HCV infection and low ALT levels in the studied population. The risk factor analysis findings emphasize the importance of public health strategies such as anti-HCV screening of candidate blood and organ donors, in addition to the stricter adoption of hemodialysis-specific infection control measures. The present study also demonstrates that HCV genotype 1 (subtype 1a) is predominant in this population.

A survey was conducted among the hemodialysis units of the city of Campo Grande, located in the state of Mato Grosso do Sul in the Mid-west region of Brazil, with the aim of investigating the prevalence, risk factors, and genotypes of hepatitis C virus (HCV) infection. A total of 163 patients were interviewed in five dialysis units. Serum samples were screened for anti-HCV. Positive samples were tested for HCV RNA and genotyped. The prevalence of anti-HCV was 11% (95% CI: 6.8-17.1). A history of transfusion with blood that was not screened for anti-HCV and length of time on hemodialysis were associated with HCV infection. HCV RNA was detected in 12 samples: ten were of genotype 1, subtypes 1a (75%) and 1b (8.3%), and two were of genotype 3, subtype 3a (16.7%).

To investigate hepatitis A virus (HAV) infection rates among isolated African-descendant communities in Central Brazil, 947 subjects were interviewed about demographic characteristics in all 12 isolated Afro-descendant communities existing in the state of Mato Grosso do Sul, Central Brazil, between March 2002 and November 2003. Blood samples were collected and sera were tested for HAV antibodies (total and IgM anti-HAV) by enzyme-linked immunosorbent assay. The overall prevalence of HAV infection was 75.6% (95% CI: 72.7-78.3), ranging from 55.4 to 97.3%, depending on the communities studied. The prevalence of anti-HAV increased significantly with age, from 13.8% in the age 0-5 age group to 96.6% in those older than 40 years. The findings point out an intermediate endemicity of HAV infection in some Afro-Brazilian isolated communities in Central Brazil. In addition, the high proportion of susceptible young subjects could be target of future HAV vaccination programs.

Hemodialysis patients are at high risk for hepatitis B virus (HBV) infection. A survey was conducted in the hemodialysis population of the state of Goiás, Central Brazil, aiming to assess the prevalence of HBV infection, to analyse associated risk factors, and also to investigate HBV genotypes distribution. A total of 1095 patients were interviewed in 15 dialysis units. Serum samples were screened for HBV serological markers by enzyme-linked immunosorbent assay. Hepatitis B surface antigen (HBsAg) positive samples were tested for HBV DNA by polymerase chain reaction and genotyped by restriction fragment length polymorphism. Global HBV infection prevalence was 29.8% (95% CI: 27.1-32.5). Multivariate analysis of risk factors showed that male gender, length of time on hemodialysis, and blood transfusion before 1993 were associated with HBV positivity. HBV DNA was detected in 65.4% (17/26) of the HBsAg-positive samples. Thirteen of 17 HBV DNA positive samples were genotyped. Genotype D (61.5%) was predominant, followed by A (30.8%), while genotype F was detected in only one (7.7%) sample.

In order to evaluate the seroepidemiology and response to Butang® vaccine in adolescents from low income families in Central Brazil, blood samples of 664 adolescents were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs) markers, and multiple logistical regression analysis was carried out to determine variables associated with hepatitis B virus (HBV) infection markers. further, three 20 µg butang® vaccine doses were offered to all susceptible individuals (n = 304). Among those who accepted them (n = 182), the seroresponse was evaluated in 170 individuals by quantitative anti-HBs. an overall hbv prevalence of 5.9% was found: four adolescents were HBsAg positive, 24 were anti-HBc, anti-HBs-reactive, and 11 were anti-HBc only. The analyse of risk factors showed that age 16-19 years, place of birth outside Goiás, school B and body piercing were statistically associated with HBV infection markers (p < 0.05). All 170 adolescents responded to butang®, and a geometric mean titer (gmt) of 4344 mui/ml was obtained. these results reinforce the importance of hepatitis b vaccine in adolescents despite of the hbv regional endemicity, and suggest that three doses of 20 µg of the butang® should guarantee protective anti-hbs levels to individuals at a critical time for hepatitis b acquiring such as latter adolescence and adulthood.

Com objetivo de determinar os genótipos do vírus da hepatite C (HCV) circulantes na Região Centro-Oeste do Brasil, 250 doadores de sangue anti-HCV positivos foram estudados. Dentre eles, a positividade para anti-HCV foi confirmada em 205 (82%). O RNA-HCV foi detectado em 165 amostras, as quais foram genotipadas. Os tipos 1, 2 e 3 do HCV foram encontrados em 67,9%, 3% e 29,1% dos doadores, respectivamente. No Estado de Goiás, o subtipo 1a (50%) foi o mais prevalente, seguido pelos subtipos 3a (30,9%) e 1b (16,7%). No Estado de Mato Grosso, o subtipo 1a (41%) foi também predominante, seguido pelos subtipos 1b (29,5%) e 3a (25%). No Estado de Mato Grosso do Sul, os subtipos 1a e 1b foram igualmente detectados (36,8%), seguidos por 3a (21,1%). O subtipo 2b foi raro (2,4%, 4,5% e 5,3%, respectivamente). No Distrito Federal, o subtipo 3a (39%) foi mais freqüente que 1a (31,7%), sendo o restante (29,3%) identificado como subtipo 1b.

In order to investigate the hepatitis C virus (HCV) genotypes in mid-west region of Brazil, 250 anti-HCV positive blood donors were studied. Among them, the anti-HCV serological status was confirmed in 205 (82%). HCV RNA was detected in 165 samples, which were genotyped. HCV types 1, 2 and 3 were found in 67.9%, 3% and 29.1% of the donors, respectively. In Goiás state, subtype 1a (50%) was the most prevalent, followed by subtypes 3a (30.9%) and 1b (16.7%). In Mato Grosso state, subtype 1a was also predominant (41%), followed by subtypes 1b (29.5%) and 3a (25%). In Mato Grosso do Sul state, subtypes 1a and 1b were detected equally (36.8%), followed by 3a (21.1%). Subtype 2b was rare (2.4%, 4.5% and 5.3%, respectively). In Distrito Federal, subtype 3a (39%) was more frequent than 1a (31.7%) and the remaining (29.3%) belonged to subtype 1b.

Hepatitis C virus (HCV) has been a significant problem for hemodialysis patients. However this infection has declined in regions where the screening for anti-HCV in blood banks and hemodialysis-specific infection control measures were adopted. In Brazil, these measures were implemented in 1993 and 1996, respectively. In addition, all studied units have implemented isolation of anti-HCV positive patients since 2000. In order to evaluate the impact of these policies in the HCV infection prevalence, accumulated incidence, and risk factors in hemodialysis population of Goiânia City, Central Brazil, all patients were interviewed and serum samples tested for HCV antibodies in 1993, 1996, 1999, and 2002. In the first six years (1993-1999), anti-HCV prevalence increased from 28.2 to 37.2%, however a b decrease in positivity was detected between 1999 and 2002 (37.8 vs 16.5%) when the measures were fully implemented. Also, a decrease of the anti-HCV accumulated incidence in cohorts of susceptible individuals during 1993-2002 (71%), 1996-2002 (34.2%), and 1999-2002 (11.7%) was found. Analysis of risk factors showed that length of time on hemodialysis, blood transfusion before screening for anti-HCV and treatment in multiple units were statistically associated with anti-HCV (p < 0.05). Our study showed a significant decline of hepatitis C infection in hemodialysis patients of Central Brazil, ratifying the importance of public health strategies for control and prevention of hepatitis C in the hemodialysis units.

In order to investigate the prevalence of GB virus C (GBV-C)/hepatitis G virus (HGV) infection in dialysis patients and kidney transplant recipients in Central Brazil and also to analyze the virus genotypes distribution, a total of 123 patients including 98 on hemodialysis, 13 on continuous ambulatory peritoneal dialysis treatment, and 12 who received kidney transplantation were interviewed in one unit of dialysis treatment in Goiânia city. Blood samples were collected and serum samples tested for GBV-C/HGV RNA by polymerase chain reaction. Genotypes were determined by restriction fragment length polymorphism (RFLP) analysis. Eighteen samples were GBV-C/HGV RNA-positive, resulting in an overall prevalence of 14.6% (95% CI: 9.2-21.7). A high positivity for GBV-C/HGV RNA was observed in patients who had received kidney transplant (16.7%), followed by those on hemodialysis (15.3%), and peritoneal dialysis (7.7%). RFLP analysis revealed the presence of genotypes 1, 2, and 3 of GBV-C/HGV; more precisely, 9 (50%) samples were found belonging to the 2b subtype, 4 (22%) to the 2a subtype, 3 (17%) to genotype 1, and 2 (11%) to genotype 3. The present data indicate an intermediate prevalence of GBV-C/HGV infection among dialysis patients and kidney transplant recipients in Central Brazil. Genotype 2 (subtype 2b) seems to be the most prevalent GBV-C/HGV genotype in our region.