Volume 81, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


This multicentric population-based study in Brazil is the first national effort to estimate the prevalence of hepatitis B (HBV) and risk factors in the capital cities of the Northeast, Central-West, and Federal Districts (2004–2005). Random multistage cluster sampling was used to select persons 13–69 years of age. Markers for HBV were tested by enzyme-linked immunosorbent assay. The HBV genotypes were determined by sequencing hepatitis B surface antigen (HBsAg). Multivariate analyses and simple catalytic model were performed. Overall, 7,881 persons were included; < 70% were not vaccinated. Positivity for HBsAg was less than 1% among non-vaccinated persons and genotypes A, D, and F co-circulated. The incidence of infection increased with age with similar force of infection in all regions. Males and persons having initiated sexual activity were associated with HBV infection in the two settings; healthcare jobs and prior hospitalization were risk factors in the Federal District. Our survey classified these regions as areas with HBV endemicity and highlighted the risk factors differences among the settings.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. McQuillan GM, Kruszon-Moran D, Kottiri BJ, Curtin LR, Lucas JW, Kington RS, 2004. Racial and ethnic differences in the seroprevalence of 6 infectious diseases in the United States: data from NHANES III, 1988–1994. Am J Public Health 94 : 1952–1958. [Google Scholar]
  2. Shepard CW, Simard EP, Finelli L, Fiore AE, Bell BP, 2006. Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev 28 : 112–125. [Google Scholar]
  3. Mast EE, Weinbaum CM, Fiore AE, Alter MJ, Bell BP, Finelli L, Rodewald LE, Douglas JM Jr, Janssen RS, Ward JW, 2006. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults. MMWR Recomm Rep 55 : 1–33. [Google Scholar]
  4. World Health Organization, 2000. Hepatitis B. Available at: http://www.who.int/mediacentre/factsheets/fs204/en/print.html. Accessed July 1, 2008.
  5. Lewis E, Shinefield HR, Woodruff BA, Black SB, Destefano F, Chen RT, Ensor R, 2001. Safety of neonatal hepatitis B vaccine administration. Pediatr Infect Dis J 20 : 1049–1054. [Google Scholar]
  6. Souto FJ, Fontes CJ, Gaspar AM, 2001. Prevalence of hepatitis B and C virus markers among malaria-exposed gold miners in Brazilian Amazon. Mem Inst Oswaldo Cruz 96 : 751–755. [Google Scholar]
  7. Viana S, Parana R, Moreira RC, Compri AP, Macedo V, 2005. High prevalence of hepatitis B virus and hepatitis D virus in the western Brazilian Amazon. Am J Trop Med Hyg 73 : 808–814. [Google Scholar]
  8. Souto FJ, Fontes CJ, Oliveira JM, Gaspar AM, Lyra LG, 1997. Epidemiological survey of infection with hepatitis B virus in the savannah and wetlands (Pantanal) of central Brazil. Ann Trop Med Parasitol 91 : 411–416. [Google Scholar]
  9. Clemens SA, da Fonseca JC, Azevedo T, Cavalcanti A, Silveira TR, Castilho MC, Clemens R, 2000. Hepatitis A and hepatitis B seroprevalence in 4 centers in Brazil. Rev Soc Bras Med Trop 33 : 1–10. [Google Scholar]
  10. Echevarria JM, Leon P, 2003. Epidemiology of viruses causing chronic hepatitis among populations from the Amazon Basin and related ecosystems. Cad Saude Publica 19 : 1583–1591. [Google Scholar]
  11. Secretaria de Saúde de São Paulo, 2006. Hepatitis B vaccine. Rev Saude Publica 40 : 1137–1140. [Google Scholar]
  12. Pereira LM, Melo MC, Lacerda C, Spinelli V, Domingues AL, Massarolo P, Mies S, Saleh MG, McFarlane IG, Williams R, 1994. Hepatitis B virus infection in schistosomiasis mansoni. J Med Virol 42 : 203–206. [Google Scholar]
  13. Nascimento MC, Mayaud P, Sabino EC, Torres KL, Franceschi S, 2008. Prevalence of hepatitis B and C serological markers among first-time blood donors in Brazil: a multi-center serosurvey. J Med Virol 80 : 53–57. [Google Scholar]
  14. Martelli CM, Turchi M, Souto FJ, Saez-Alquezar A, Andrade AL, Zicker F, 1999. Anti-HBc testing for blood donations in areas with intermediate hepatitis B endemicity. Rev Panam Salud Publica 6 : 69–73. [Google Scholar]
  15. Marchesini AM, Pra-Baldi ZP, Mesquita F, Bueno R, Buchalla CM, 2007. Hepatitis B and C among injecting drug users living with HIV in Sao Paulo, Brazil. Rev Saude Publica 41 (Suppl 2): 57–63. [Google Scholar]
  16. Bertolini DA, Pinho JR, Saraceni CP, Moreira RC, Granato CF, Carrilho FJ, 2006. Prevalence of serological markers of hepatitis B virus in pregnant women from Parana State, Brazil. Braz J Med Biol Res 39 : 1083–1090. [Google Scholar]
  17. Souto FJ, Santo GA, Philippi JC, Pietro BR, Azevedo RB, Gaspar AM, 2001. Prevalence of and factors associated with hepatitis B virus markers in a rural population of central Brazil. Rev Panam Salud Publica 10 : 388–394. [Google Scholar]
  18. Foccacia R, da Conceição O, Sette H, Sabino E, Bassit L, Nitrini D, Lomar A, Lorenço R, Vieira de Souza F, Kiffer C, Santos E, Gonzales M, Sáez-Alquézar A, Riscal J, Fischer D, 1998. Estimated prevalence of viral hepatitis in the general population of the municipality of São Paulo, measured by a serologic survey of a stratified, randomized and residence-based population. Braz J Infect Dis 2 : 269–284. [Google Scholar]
  19. Kiesslich D, Rocha JE Jr, Crispim MA, 2002. Prevalence of hepatitis E virus antibodies among different groups in the Amazonian basin. Trans R Soc Trop Med Hyg 96 : 215. [Google Scholar]
  20. Ximenes RA, Martelli CM, Merchán-Hamann E, Montarroyos UR, Braga MC, de Lima ML, Cardoso MR, Turchi MD, Costa MA, de Alencar LC, Moreira RC, Figueiredo GM, Pereira LM for the hepatitis study group, 2008. Multilevel analysis of hepatitis A infection in children and adolescents: a household survey in the Northeast and Central-west regions of Brazil. Int J Epidemiol 37 : 852–861. [Google Scholar]
  21. McQuillan GM, Coleman PJ, Kruszon-Moran D, Moyer LA, Lambert SB, Margolis HS, 1999. Prevalence of hepatitis B virus infection in the United States: the National Health and Nutrition Examination Surveys, 1976 through 1994. Am J Public Health 89 : 14–18. [Google Scholar]
  22. Kaneko S, Miller RH, Feinstone SM, Unoura M, Kobayashi K, Hattori N, Purcell RH, 1989. Detection of serum hepatitis B virus DNA in patients with chronic hepatitis using the polymerase chain reaction assay. Proc Natl Acad Sci USA 86 : 312–316. [Google Scholar]
  23. Sitnik R, Pinho JR, Bertolini DA, Bernardini AP, da Silva LC, Carrilho FJ, 2004. Hepatitis B virus genotypes and precore and core mutants in Brazilian patients. J Clin Microbiol 42 : 2455–2460. [Google Scholar]
  24. Sanger F, Nicklen S, Coulson AR, 1977. DNA sequencing with chain-terminating inhibitors. Proc Natl Acad Sci USA 74 : 5463–5467. [Google Scholar]
  25. Anderson RM, May RM, 1992. Dynamic aspects of eradication and control. Anderson RM, May RM, eds. Infectious Disease of Human: Dynamics and Control. First edition. Oxford, United Kingdom: Oxford University Press, 172–207.
  26. Fonseca JC, 1999. Epidemiologia da infecção pelo vírus da hepatite C no Brasil. Gastroenterologia Endoscopia Digestiva 18 : S3–S8. [Google Scholar]
  27. Lyra LG, Damasceno AP, Cotrim P, Mota E, Silva L, 1986. Prevalence of antibody to hepatitis B virus in an urban population of northeast Brazil. Rev Inst Med Trop Sao Paulo 28 : 406–409. [Google Scholar]
  28. Mello FC, Souto FJ, Nabuco LC, Villela-Nogueira CA, Coelho HS, Franz HC, Saraiva JC, Virgolino HA, Motta-Castro AR, Melo MM, Martins RM, Gomes SA, 2007. Hepatitis B virus genotypes circulating in Brazil: molecular characterization of genotype F isolates. BMC Microbiol 7 : 103. [Google Scholar]
  29. Ribeiro NR, Campos GS, Angelo AL, Braga EL, Santana N, Gomes MM, Pinho JR, De Carvalho WA, Lyra LG, Lyra AC, 2006. Distribution of hepatitis B virus genotypes among patients with chronic infection. Liver Int 26 : 636–642. [Google Scholar]
  30. Devesa M, Pujol FH, 2007. Hepatitis B virus genetic diversity in Latin America. Virus Res 127 : 177–184. [Google Scholar]
  31. Silveira TR, da Fonseca JC, Rivera L, Fay OH, Tapia R, Santos JI, Urdeneta E, Clemens SA, 1999. Hepatitis B seroprevalence in Latin America. Rev Panam Salud Publica 6 : 378–383. [Google Scholar]
  32. El Khouri M, Duarte LS, Ribeiro RB, da Silva LF, Camargo LM, dos Santos VA, Burattini MN, Corbett CE, 2005. Seroprevalence of hepatitis B virus and hepatitis C virus in Monte Negro in the Brazilian western Amazon region. Clinics 60 : 29–36. [Google Scholar]
  33. Goldstein ST, Alter MJ, Williams IT, Moyer LA, Judson FN, Mottram K, Fleenor M, Ryder PL, Margolis HS, 2002. Incidence and risk factors for acute hepatitis B in the United States, 1982–1998: implications for vaccination programs. J Infect Dis 185 : 713–719. [Google Scholar]
  34. Coleman PJ, McQuillan GM, Moyer LA, Lambert SB, Margolis HS, 1998. Incidence of hepatitis B virus infection in the United States, 1976–1994: estimates from the National Health and Nutrition Examination Surveys. J Infect Dis 178 : 954–959. [Google Scholar]

Data & Media loading...

  • Received : 26 Oct 2008
  • Accepted : 25 Mar 2009

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error