Alexsandro Ferreira dos Santos

High prevalence of hepatitis B virus subgenotypes A1 and D4 in Maranhão state, Northeast Brazil

In this study, we determined the prevalence of HBV subgenotypes in Maranhão state, located in northeastern Brazil, where the population is heterogeneous, with a high proportion of African descendants. HBV was detected in 119 of 133 (89.5%) chronic hepatitis B patients, including 103 (86.5%) who were HBeAg-negative. Using phylogenetic analysis of the S/Polymerase region of HBV DNA, subgenotype A1 was found to be the most prevalent (67%), followed by genotype D (28%; subgenotype D4 was detected in 24%, D3 in 3%, and D2 in 1%). Genotype F, clustering with subgenotype F2a, was found in six (5%) patients. The topology of the phylogenetic tree showed that HBV/A1 sequences did not cluster together, suggesting that more than one strain was introduced into Maranhão. On the other hand, HBV/D4 sequences formed a monophyletic cluster, suggesting a single entry of this strain in this population. This study showed that HBV/A1 was the only subgenotype of HBV/A present in the population from Maranhão and indicated that in this region HBV/A1 was not restricted to an Afro-descendant community where it was previously reported, but is widely distributed among general population of HBV chronic carriers. Unexpectedly, we found a high frequency of HBV subgenotype D4. Together with previously reported data on the distribution of HBV/D4 in the world, these findings suggest that this subgenotype was more prevalent in the African continent in the past and may have been introduced in Maranhão by means of the slave trade during the late XVIII century, when the largest number of African slaves arrived to this region.

Prevalence of hepatitis B among pregnant women assisted at the public maternity hospitals of São Luís, Maranhão, Brazil

INTRODUCTION Hepatitis B virus (HBV) infection is an important worldwide public health problem. In Brazil, the Ministry of Health estimates that 15% of the population has had contact with HBV, and that the mean rate of chronic carriers in Northeastern Brazil is around 0.5%. OBJECTIVE The aim of this study was to assess the prevalence of HBV markers in pregnant women receiving prenatal care at the public maternity hospitals of São Luís. METHODS Demographical and epidemiological data were collected from 541 pregnant women according to the research protocol. Blood samples were collected, and the anti-HBc test was performed first. If positive, the sample was subsequently tested for HBsAg and anti-HBs. All HBsAg and/or anti-HBc positive samples were additionally tested for HBV-DNA. RESULTS 40 (7.4%) pregnant women turned out positive for anti-HBc. Of those, five (0.9%) were HBsAg positive, four (0.7%) were anti-HBc positive with negative HBsAg and anti-HBs, and 31 (5.7%) were positive for anti-HBc and anti-HBs. Anti-HBc positivity was associated with family history of hepatitis and education level below 11 years of schooling. HBV-DNA was positive in only one HBsAg-positive sample. There was no HBV-DNA positivity among HBsAg negative samples. CONCLUSIONS The prevalence of HBsAg in pregnant women in this study confirmed that São Luís is a low endemicity area. Occult hepatitis B was not detected in these samples.

Scored patient-generated Subjective Global Assessment: Length of hospital stay and mortality in cancer patients

1 Universidade Federal do Maranhão, Centro de Ciências Biológicas e da Saúde, Programa de Pós-Graduação em Saúde do Adulto e da Criança. Av. dos Portugueses, 1966, Prédio das Pós-Graduações, Bacanga, 65085-580, São Luís, MA, Brasil. Correspondência para/Correspondence to: AF SANTOS. E-mail: . 2 Universidade Ceuma, Coordenação do Curso de Nutrição. São Luís, MA, Brasil. 3 Faculdade Santa Terezinha, Coordenação do Curso de Nutrição. São Luís, MA, Brasil. 4 Universidade Federal do Maranhão, Centro de Ciências Biológicas e da Saúde, Departamento do Curso de Nutrição. São Luís, MA, Brasil.

Indicadores antropométricos em crianças e adolescentes com doença do refluxo gastroesofágico atendidos em um ambulatório especializado em São Luís, Maranhão, Brasil

Helicobacter pylori is a Gram negative bacterium that cause chronic gastritis, duodenal ulcers and can predispose the gastric cancer. The study aimed to determinate the prevalence of H. pylori infection by different methods of diagnosis in patients submitted to endoscopy. Of the 145 patients included in the study, were collected fragments of gastric mucosa for histological analysis, and for the rapid urease test. The breath test was also performed. The H. pylori infection was detected in 84 (57.9%) patients by histological study, the rapid test of urease was positive in 81 (55,8%) and the breath test in 62 (56,3%). There was no statistically significant difference when comparing the prevalence of infection by different methods of diagnosis. The prevalence of H. pylori infection in our community was lower than that found in the literature for patients with age similar to this study (mean = 53.19 years).