SUMMARY Human T-cell lymphotropic virus (HTLV) may affect the clinical course of human immunodeficiency virus 1 (HIV1). Both infections are common in endemic areas because these viruses share similar routes of transmission. The aim of this study was to estimate the seroprevalence of HTLV1/2 in a population of HIV1-infected patients in the state of Goiás, Midwestern Brazil. Of the 505 studied patients, four (0.79%) were positive for anti-HTLV1/2 by enzyme-linked immunosorbent assay (ELISA), with HTLV1 infection confirmed by line immunoassay (LIA) and polymerase chain reaction (PCR) in all of the ELISA-positive samples. No cases of HTLV2 infection were observed. The prevalence of HTLV1/HIV1 coinfection was 0.79% (4/505; 95% CI: 0.25-2.16). All the coinfected patients reported sexual risk behaviors and only one reported intravenous drug use. Sequencing of the viral long terminal repeat (LTR) region and phylogenetic analysis revealed that the four HTLV1 isolates belonged to the Transcontinental a subgroup of the Cosmopolitan (1a) subtype, the most frequent subgroup detected in Brazil. This study shows a low prevalence of HTLV1/2 in HIV1-infected patients in Midwestern Brazil.

Introduction: The collection of recyclable waste materials is a widespread activity among the urban poor. Today, this occupation attracts an increasingly large number of individuals. Despite its economic and environmental importance, this activity is associated with unsafe and unhealthy working conditions. The aim of this study was to investigate the seroepidemiological profile of hepatitis B virus (HBV) infection in a population of recyclable waste collectors in central Brazil. Methods: Recyclable waste collectors from all 15 recycling cooperatives in Goiânia City were invited to participate in the study. The participants (n = 431) were interviewed and screened for hepatitis B surface antigen (HBsAg) and antibodies against HBsAg (anti-HBs) and hepatitis B core antigen (anti-HBc) by enzyme-linked immunosorbent assay (ELISA). HBsAg- and anti-HBc-positive samples were tested for HBV DNA and genotyped. Results: The overall prevalence of HBV infection (HBsAg- and/or anti-HBc-positive) was 12.8%. An age over 40 years and illicit drug use were associated with HBV infection. HBV DNA was detected in 2/3 HBsAg-positive samples and in 1/52 anti-HBc-positive/HBsAg-negative samples (an occult HBV infection rate of 1.9%), in which the genotypes/subgenotypes A/A1, D/D3 and F/F2 were identified. Only 12.3% of the recyclable waste collectors had serological evidence of previous HBV vaccination. Conclusions: These findings highlight the vulnerability of recyclable waste collectors to HBV infection and reinforce the importance of public health policies that address the health and safety of this socially vulnerable population.

The prevalence of hepatitis C virus (HCV) in a population of recyclable waste collectors (n = 431) was assessed using a cross-sectional survey in all 15 cooperatives in the city of Goiânia, Central-West Brazil. The HCV prevalence was 1.6% (95% confidence interval: 0.6-3.6) and a history of sexually transmitted infections was independently associated with this infection. HCV RNA (corresponding to genotype 1; subtypes 1a and 1b) was detected in five/seven anti-HCV-positive samples. Although the study population reported a high rate (47.3%) of sharps and needle accidents, HCV infection was not more frequent in recyclable waste collectors than in the general Brazilian population.

The prevalence of occult hepatitis B virus (HBV) infection was investigated in 149 hepatitis B surface antigen (HBsAg) negative injecting drug users (IDUs) in the Central-West Region of Brazil. Of these individuals, 19 were positive for HBV DNA, resulting in an occult HBV infection prevalence of 12.7% (19/149); six of these 19 individuals had anti-HBV core and/or anti-HBV surface antibodies and 13 were negative for HBV markers. All IDUs with occult hepatitis B reported sexual and/or parenteral risk behaviours. All HBV DNA-positive samples were successfully genotyped. Genotype D was the most common (17/19), followed by genotype A (2/19). These findings reveal a high prevalence of occult HBV infection and the predominance of genotype D among IDUs in Brazil's Central-West Region.

O presente estudo teve como objetivo estimar a prevalência da infecção pelo HTLV-1 em remanescentes de comunidades de população negra, os quilombos no Brasil Central. 1.837 indivíduos foram avaliados, sendo nove soropositivos para HTLV-1/2 por ELISA. Todos esses foram positivos para HTLV-1 por Western blot e/ou PCR, resultando em uma prevalência de 0,5% (IC 95%: 0,2-1,0). A idade dos indivíduos infectados variou de 11 a 82 anos, sendo a maioria do sexo feminino. Quanto às características de risco, história de aleitamento materno, transfusão de sangue, múltiplos parceiros sexuais e doenças sexualmente transmissíveis foram relatadas por esses indivíduos. Os achados deste estudo evidenciam a importância da identificação dos indivíduos infectados pelo HTLV-1 na estratégia de controle e prevenção dessa infecção em remanescentes de quilombos.

This study aimed to determine the prevalence of HTLV-1 infection among remnant black quilombo communities in Central Brazil. A total of 1,837 individuals were evaluated, among whom nine were HTLV-1/2 seropositive according to ELISA. All of them were positive for HTLV-1 by means of Western blot and/or PCR, thus resulting in a prevalence of 0.5% (95% CI: 0.2-1.0). The HTLV-1 infected individuals ranged in age from 11 to 82 years. The majority of them were females. Regarding risk characteristics, histories of breastfeeding, blood transfusion, multiple sexual partners and sexually transmitted diseases were reported by these individuals. The findings from this study indicate the importance of identifying HTLV-1 infected individuals, as a strategy for infection control and prevention in these remnant quilombos.

Intravenous drug injection has been reported as the main risk factor for hepatitis C virus (HCV) infection. The aim of the present study was to describe the prevalence and the epidemiological profile of HCV infection among abusers of illegal injected and non-injected drugs in Cuiabá, state of Mato Grosso, Central Brazil. A cross-sectional study including 314 male drug users from eight detoxification centres was performed. Out of 314 subjects studied, 48 (15.2%) were intravenous drug users. Participants were interviewed and had blood samples taken and tested for the presence of anti-HCV antibodies. Positive samples were tested for the presence of HCV RNA. Genotyping was performed on HCV RNA-positive samples. The overall prevalence of anti-HCV antibodies was 6.4% (n = 20). Out of 20 anti-HCV antibody-positive subjects, 16 (80%) were also HCV RNA-positive. Genotype 1 predominated (75%), followed by 3a (25%). Subtype 1a was more common than 1b. HCV infection was more prevalent among intravenous drug users (33%) than non-injecting users (1.5%). Logistic regression analyses showed independent associations between HCV infection and intravenous drug use, imprisonment and increasing age. In the present study, injecting drug use was the factor most strongly associated to HCV infection and inhaling or sniffing did not represent an increased susceptibility to infection.

Para investigar o perfil da infecção pelo vírus da hepatite B (VHB) em profissionais de hemodiálise (N=152) de Goiânia, Goiás, amostras sangüíneas foram testadas para detecção dos marcadores: AgHBs, anti-HBs e anti-HBc. Uma prevalência global de 24,3% (IC 95%: 17,8 - 32) foi encontrada. A análise multivariada dos fatores de risco mostrou que o tempo de profissão, relato de exposição ocupacional e o não uso de equipamentos de proteção estiveram significativamente associados à soropositividade ao VHB. Dos 40 profissionais que apresentaram susceptibilidade a esta infecção, 20 concordaram em participar do programa de vacinação e, após a administração das três doses da vacina (Euvax-B), 18 (90%) apresentaram soroconversão ao anti-HBs com títulos > ou = 10UI/L. Estes dados sugerem, o ambiente dialítico, como possível fonte de transmissão ocupacional do VHB e, enfatizam a necessidade de reavaliação das medidas de controle e prevenção nestas unidades.

In order to investigate the hepatitis B virus (HBV) infection profile in hemodialysis staff (n = 152) of Goiânia,Goiás, blood samples were tested for detection of HBsAg, anti-HBs and anti-HBc markers. An overall HBV infection prevalence of 24.3% (CI 95%: 17.8 - 32) was found. Multivariate analysis of risk factors showed that length of employment, history of occupational exposure and nonuse of protective equipment were significantly associated with HBV seropositivity. Of 40 staff members who were susceptible to this infection, 20 agreed to participate in the vaccination program. After three vaccine doses (Euvax-B), 18 (90%) seroconverted to anti-HBs with titers > or = 10 IU/L. These data suggest the dialytic environmental as a possible source of occupational transmission of HBV, and emphasize the need to evaluate strategies of control and prevention to be followed in these units.

Descriptive study with qualitative approach per ormed on the medical surgical and orfhopaedic treatment units with the objective of verifying and discussing the acceptance/rejection/satisfacfion of bath in bed from the patients themselves perception. The population is composed of self-care non-skilled patients. The semi-structured interview and direct observation have been used for data collecting. Through reports, we have been able to verify that patients perception on bath in bed were diversified, considered disagreeable and constraining by some and indispensable by others. The aspects on the water quality, soap, nurses slowness and more humanised relationship have also been described.

Estudo descritivo com abordagem qualitativa realizado nas unidades para tratamento médico-cirúrgico e ortopédico, com o objetivo de verificar e discutir a aceitação/rejeição/satisfação pelo banho no leito, partindo das percepções dos próprios pacientes. A população constitui-se de pacientes sem possibilidades de autocuidar-se. A entrevista semi-estruturada e observação direta foram utilizadas para a coleta das informações. Através dos relatos podemos verificar que as percepções dos pacientes sobre o banho no leito foram diversificadas, considerado desagradável e constrangedor para uns enquanto para outros indispensável. Aspectos quanto à qualidade de água, sabão, morosidade dos enfermeiros e um relacionamento mais humanizado foram também descritos.

Estudo descritivo com abordagem qualitativa realizado nas unidades para tratamento médico-cirúrgico e ortopédico, com o objetivo de verificar e discutir a aceitação/rejeição/satisfação pelo banho no leito, partindo das percepções dos próprios pacientes. A população constitui-se de pacientes sem possibilidades de autocuidar-se. A entrevista semi-estruturada e observação direta foram utilizadas para a coleta das informações. Através dos relatos podemos verificar que as percepções dos pacientes sobre o banho no leito foram diversificadas, considerado desagradável e constrangedor para uns enquanto para outros indispensável. Aspectos quanto à qualidade de água, sabão, morosidade dos enfermeiros e um relacionamento mais humanizado foram também descritos.

Descriptive study with qualitative approach per ormed on the medical surgical and orfhopaedic treatment units with the objective of verifying and discussing the acceptance/rejection/satisfacfion of bath in bed from the patients themselves perception. The population is composed of self-care non-skilled patients. The semi-structured interview and direct observation have been used for data collecting. Through reports, we have been able to verify that patients perception on bath in bed were diversified, considered disagreeable and constraining by some and indispensable by others. The aspects on the water quality, soap, nurses slowness and more humanised relationship have also been described.

As autoras verificam a distribuição espacial do coeficiente de Mortalidade infantil nas diferentes áreas do Municipio de Goiânia: Estabelecem a reloção entre óbitos menores de 1 ano e os indicadores sócio-econômicos, nas diferentes áreas no Município de Goiânia no ano de 1992. Como também avaliam a influência das variáveis: sexo, idade, causa básica no perfil da mortalidade infantil em Goiânia. Este Trabalho tem o intuito de proporcionar subsídios que venham a contribuir nas propostas de ações de saúde que objetivem diminuir a Mortalidade infantil em Goiânia.

The authors have verified the spacial distribution of rate of infant mortality in the different areas of the district of Goiânia. They estabilished the relationship between deaths less than one year and the social-eco no mica I indicators in the different areas in the district of Goiânia in 1992. Also, they evaluated variable influences such as sex, age, basic cause in the profile of infant mortality in Goiânia.This work aims to provide subsides that would possibly contribute for the proposals in health actions that aim to diminish infant mortality in Goiânia.

The authors have verified the spacial distribution of rate of infant mortality in the different areas of the district of Goiânia. They estabilished the relationship between deaths less than one year and the social-eco no mica I indicators in the different areas in the district of Goiânia in 1992. Also, they evaluated variable influences such as sex, age, basic cause in the profile of infant mortality in Goiânia.This work aims to provide subsides that would possibly contribute for the proposals in health actions that aim to diminish infant mortality in Goiânia.

As autoras verificam a distribuição espacial do coeficiente de Mortalidade infantil nas diferentes áreas do Municipio de Goiânia: Estabelecem a reloção entre óbitos menores de 1 ano e os indicadores sócio-econômicos, nas diferentes áreas no Município de Goiânia no ano de 1992. Como também avaliam a influência das variáveis: sexo, idade, causa básica no perfil da mortalidade infantil em Goiânia. Este Trabalho tem o intuito de proporcionar subsídios que venham a contribuir nas propostas de ações de saúde que objetivem diminuir a Mortalidade infantil em Goiânia.