Prevalência da infecção pelo vírus da hepatite B e situação vacinal em usuários de crack institucionalizados em Goiânia – Goiás

• Ano de defesa: 2014
• Autor(a) principal: Silva, Leandro Nascimento da
• Orientador(a): Teles, Sheila Araujo
• Banca de defesa: Teles, Sheila Araujo, Turchi, Marília Dalva, Carneiro, Megmar Aparecida dos Santos
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Programa de Pós-graduação em Ciências da Saúde (FM)
• Departamento: Faculdade de Medicina - FM (RG)
• País: Brasil
• Palavras-chave em Português: Hepatite B; Crack; Epidemiologia; Vacina contra hepatite B
• Palavras-chave em Inglês: Hepatitis B; Crack cocaine; Epidemiology; Hepatitis B vaccine
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tede/4111

Crack is considered a public health problem in Brazil and in the world because of its impact on social relationships, physical and mental integrity of the user, and the risk associated with infections, such as those caused by the hepatitis B virus (HBV). This study investigated the epidemiology of infection with the hepatitis B virus and immunization status among users of crack institutionalized in Goiania, Brazil. During August 2012 to April 2013, a total of 600 individuals were interviewed, and blood samples collected for the detection of serological markers of HBV (HBsAg, total anti HBc and anti-HBs) by enzyme-linked immune sorbent assay (ELISA). Subsequently a cohort of individuals susceptible to hepatitis B was formed to assess compliance, completion of the vaccination series, and vaccine response against hepatitis B, using an accelerated scheme. Prior exposure to HBV (anti-HBc) was 7.0% (95% CI: 5.22 to 9.32), and 17.7% (95% CI: 14.8 to 20.9) were anti -HBs isolated, suggesting previous vaccination against hepatitis B. The use of crack cocaine through improvised pipes, history of sexually transmitted disease, and exchanging sex for drugs or money were significantly associated with exposure to HBV (p < 0.05). Of the total of individuals who received the first dose of hepatitis B vaccine and eligible to complete the full vaccine scheme (n = 406), 229 (56.4%) and 96 (26.6%) received the second and third doses, respectively. It was possible to evaluate the vaccine response in only 23/96 subjects, and 78% responded with protective titers. The high frequency of risk behaviors, the low frequency of vaccinations, and improper compliance with the vaccination schedule, even using the accelerated scheme, highlights the need for strategies for health education and prevention to reach this population so vulnerable to sexually transmitted infections and parenteral transmission of hepatitis B.