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Klimatförändringarna kan komma att påverka den hydrologiska cykeln på en global skala. Förändringarna kommer tydligast att märkas på ytan, med ökande neder-bördsmängder, en ökad avdunstning och ett minskat snötäcke. Det som sker vid ytan har dock en stor inverkan på vad som sker med grundvattnet och varierar i hög grad mellan magasin, rådande klimat och markanvändning. Den Europeiska miljöby-rån har därför eftersökt att framtida grundvattenförhållanden undersöks på lokala ni-våer. Hedesundaåsen valdes till denna studie på grund av att dess vattenmagasin an-vänds som dricksvattentäkt, utan mänsklig modifiering på dess tillrinning. Inga lik-nande studier har tidigare utförts på Hedesundaåsen. Den är en rullstensås i Gävle-borgs län som förser befolkningen i Hedesunda med dricksvatten. Syftet med detta arbete har varit att presentera en bild över hur grundvattnet i Hedesundaåsen kan komma att påverkas i ett framtida klimat. Den hydrologiska modellen HBV-light kalibrerades för tidsperioden 2000-2009 med hjälp av meteorologiska mätvärden från SMHI, och validerades mot tidsperioden 2011-2017. Simuleringar utfördes för tidsperioderna 2022-2050 samt 2072-2100. I simuleringarna användes två vitt skilda framtidsscenarier för att täcka in en stor bredd över framtida möjliga scenarier. Simuleringarna i studien visade genomgående på trender med ökande grundvattennivåer och -bildning oavsett scenario. Beroende på valt scenario kan grundvattennivån enligt simuleringarna komma att öka med mellan 6,3–11,5 % och grundvattenbildningen med mellan 4,8–13,6 % för tidspe-rioden 2072-2100 jämfört med tidsperioden 1988-2017. En liknande studie som ti-digare genomfördes i ett närliggande område visade på en ökning av grundvatten-bildning med upp till 15 % i slutet av seklet. En jämförelse av resultaten mellan stu-dierna gör det troligt att resultaten från Hedesundaåsen mycket väl kan vara kor-rekta. Det står klart efter denna studie att klimatförändringarna kommer att påverka grundvattnet i Hedesunda i framtiden. Osäkerheterna om detaljerna är dock många, då de framtida scenarierna endast är en uppskattning över hur nederbörd, tempera-tur etc. kommer att påverkas i ett framtida klimat. Osäkerheten byggs på av att dessa faktorer används som en prognos i en hydrologisk modell som också innehåller osäkerheter från den matematiska modellen och framtidsscenarierna. Trots de många osäkerheterna kan simuleringarna ge en indikation över hur klimatföränd-ringarna kan komma att påverka grundvattnet i framtiden, och de kan användas för att förbereda samhället för möjliga framtida konsekvenser av grundvattnets föränd-rade kvantitet och i förlängningen även vattenkvaliteten. / Climate change may affect the hydrological cycle on a global scale. The changes will most clearly be noticed on the surface, with increasing precipitation amounts, in-creased evaporation and a reduced snow cover. What happens at the surface has a great impact on what happens to the groundwater, and varies greatly between the different water storages, the prevailing climate and land use. The European Environ-ment Agency has therefore sought to investigate future groundwater conditions at local levels. The Hedesunda esker was chosen for this study because it is used as a water source without human modification of its inflow. No similar studies have pre-viously been performed on the Hedesunda esker. It is an esker in Gävleborg County, which supplies drinking water to the population in Hedesunda. The purpose of this study has been to present how the groundwater in the Hedesunda esker may be af-fected in a future climate. The hydrological model HBV-light was calibrated for the time period 2000-2009 us-ing meteorological measurements from SMHI, and validated against the time period 2011-2017. Simulations were performed for the time periods 2022-2050 and 2072-2100. In the simulations, two widely different future scenarios were used to cover a large range of possible future scenarios. The simulations in the study consistently showed trends with increasing groundwater levels and recharge, regardless of the scenario. Depending on the chosen scenario, the groundwater level according to the simulations may increase by between 6.3–11.5 % and the groundwater recharge by between 4.8–13.6 % for the period 2072-2100. A similar study, previously con-ducted in a nearby area, showed an increase in groundwater recharge by up to 15 % at the end of the century. A comparison of the results between the studies makes it likely that the results from the Hedesunda esker may well be correct. It is clear after this study that climate change will affect the groundwater in Hede-sunda in the future. The uncertainties about the details are many, as the future sce-narios are only an estimate of how precipitation, temperature etc. will be affected in a future climate. The uncertainty is based on the fact that these factors are used as a forecast in a hydrological model, which also contains uncertainties from the mathe-matical model and the future scenarios. Despite the many uncertainties, the simula-tions can give an indication of how climate change may affect the groundwater in the future, and can be used to prepare society for possible future consequences of the groundwater's changed quantity and, in the long run, also the water quality.

Made available in DSpace on 2016-08-10T10:54:17Z (GMT). No. of bitstreams: 1 PAMELLA FERNANDA MOREIRA.pdf: 1704209 bytes, checksum: 4c9cab3f1c1bf509ca7c228099ec3fa6 (MD5) Previous issue date: 2014-03-12 / This study investigated the prevalence of HBV infection and coinfection with HIV, and risk behaviors associated with male inmates and female of Goiás, Brazil. The sample was composed of men and women of the Prison Complex Aparecida de Goiânia, which provided their risk behaviors and blood to check for the presence of HBsAg marker, and when for these reactants were tested for the presence of anti HIV. In 1173 deprived of liberty the prevalence of HBV was 6.9 % (5.6-8.5), and 6.3% in females and 7% in the male group. The HBV/HIV coinfection was found in two inmates ( 2.5 % ) . The prevalence of HBV infection was higher than that found in several studies in national and international prisons. There were no statistical differences between the sexes for the use of drugs smoked, sniffed and or injected, tattooing and sexual orientation. However, drug users smoked or snuffed have 1.8 times higher risk of having hepatitis B compared with non-use and injecting drug use was not significant for HBV infection. And deprived of liberty with history of previous incarcerations have 1.9 times higher risk of having hepatitis B compared with those with no history of previous incarcerations. / Esta pesquisa investigou a prevalência da infecção pelo HBV e da coinfecção pelo HIV, assim como os comportamentos de riscos associados em detentos do sexo masculino e feminino de Goiás, Brasil. A amostra foi composta por homens e mulheres privados de liberdade do Complexo Prisional de Aparecida de Goiânia, que forneceram dados sobre seus comportamentos de risco e sangue para a verificação da presença do marcador HBsAg, e quando reagentes para este, foram submetidos à pesquisa de anti-HIV. Em 1173 indivíduos privados de liberdade a prevalência do HBV foi de 6,9% (5,6-8,5), sendo de 6,3% no grupo feminino e de 7% no grupo masculino. A coinfecção HBV/HIV foi encontrada em dois detentos (2,5%). A prevalência da infecção pelo HBV foi superior à encontrada em diversos estudos realizados em presídios nacionais e internacionais. Não houve diferenças estatísticas entre os sexos para o uso de drogas fumadas, cheiradas e/ou injetáveis, tatuagens e opção sexual. Contudo, usuários de drogas fumadas ou cheiradas possuem risco 1,8 vezes maior de ter hepatite B se comparados com os que não usam e o uso de drogas injetáveis não foi significativo para a infecção pelo HBV. E indivíduos privados de liberdade com histórico de encarceramentos anteriores possuem risco 1,9 vezes maior de ter hepatite B se comparados com os sem histórico de encarceramentos anteriores.

Introdução. A infecção causada pelo vírus da hepatite B (HBV) é um dos agravos de maior prevalência no mundial. Segundo a Organização Mundial da Saúde (OMS) existem mais de 350 milhões de portadores crônicos da doença. A infecção pelo HBV é rotineiramente identificada quando há a presença do HBsAg circulante. Entretanto, em alguns casos o HBV-DNA tem sido detectado em indivíduos HBsAg negativos, positivos ou negativos para anti-HBc e anti-HBs. Essa apresentação sorológica e molecular é denominada infecção oculta pelo HBV (OBI). Geralmente a concentração do HBV-DNA no soro será abaixo de 200 UI/mL. Objetivo: Determinar a prevalência da OBI, em doadores de sangue do Estado do Amapá no ano de 2014. Material e Métodos. Foram analisadas um total de 62 amostras de doadores de sangue do estado do Amapá, no ano de 2014, que apresentavam o perfil sorológico: HBsAg negativo, anti-HBc positivo e com anti-HBs negativo ou positivo. Os marcadores sorológicos HBsAg e anti-HBc foram determinados através do imunoensaio quimioluminescente. As amostras selecionadas para a detecção do HBV-DNA foram testadas utilizando as metodologias de Real-Time PCR Kit NAT HIV/HCV/HBV (Bio-Manguinhos®) e PCR \"in house\". Resultados. Do total de 13.261 doadores triados para infecções transmissíveis pelo sangue, 283 apresentaram resultados reagentes para os marcadores da hepatite B, nos quais: 35 (0,3%) foram HBsAg e 248 (1,9%) para anti-HBc reagentes. Um total de 62 amostras foram testadas pelos métodos moleculares. Todas as amostras apresentaram resultado HBV-DNA não-detectável. Conclusão: O índice de inaptidão sorológica no ano de 2014 no HEMOAP foi de 1,9% para anti-HBc e 0,3% para HBsAg. A população estudada foi constituída predominantemente por adultos com idade entre 29-65 anos, do sexo masculino, casados e naturais de municípios do estado do Amapá / Introduction. The infection caused by the hepatitis B virus (HBV) is one of the most prevalent diseases in the world. According to the World Health Organization (WHO) there are more than 350 million chronic carriers of the disease. HBV infection is routinely identified when there is presence of circulating HBsAg. However, in some cases HBV-DNA has been detected in HBsAg negative individuals, positive or negative for anti-HBc and anti-HBs. This serological and molecular presentation is termed HBV-occult infection (OBI). Usually the concentration of HBV-DNA in serum will be below 200 IU / mL.Objective: To determine the prevalence of OBI in blood donors, in the State of Amapá, in the 2014. Material and methods. A total of 62 samples of blood donors from the State of Amapá in the year 2014 were analyzed, presenting the serological profile: HBsAg negative, anti-HBc positive and with negative or positive anti-HBs. Serum markers HBsAg and anti-HBc were determined by the chemiluminescent immunoassay. Samples selected for HBV-DNA detection were tested using the Real-Time PCR Kit Kit HIV / HCV / HBV (Bio-Manguinhos®) and in-house PCR. Results. Of the total of 13,261 donors screened for blood-borne infections, 283 presented reactive results for hepatitis B markers, in which: 35 (0.3%) were HBsAg and 248 (1.9%) for anti-HBc reagents. All samples showed nondetectable HBV-DNA result. Conclusion: The serological disability index in the year 2014 in HEMOAP was 1.9% for anti-HBc and 0.3% for HBsAg. The studied population consisted predominantly of adults aged 29-65 years, males, married and natural of cities of the state of Amapá

En France et en Italie, le sida et l’hépatite b touchent de façon massive les migrants qui proviennent d’Afrique Subsaharienne, majoritairement ceux vivant des situations de précarité politique, sociale et économique. Depuis 2010 on assiste dans ces deux pays à un intérêt croissant des politiques publiques autour de l’hépatite b, celle-ci étant de plus en plus associée au VIH dans les stratégies de lutte mises en place au sein des populations migrantes. En dépit de ce constat les difficultés concernant l’accès aux soins et aux droits se sont accrues pour les migrants vivant avec ces deux infections dans les deux pays. En croisant les trajectoires politiques des deux infections et leur utilisation dans le domaine des politiques migratoires, cette thèse présente et analyse les modalités de prise en charge du sida et de l’hépatite b au sein des migrants « primo-arrivants » originaires d’Afrique Subsaharienne. Ce travail entend démontrer que ces pratiques de prise en charge, telle qu’elle se pratique aujourd’hui en France et en Italie, sont partie prenante de la construction de nouvelles formes d’inégalité. L'analyse est comparative et associe une étude microsociale et ethnographique des pratiques quotidiennes de prise en charge des patients migrants atteints du sida et de l’hépatite b – des pratiques observées dans deux structures qui s'occupent des migrants « primo-arrivants » à Paris et à Rome (Comede à Paris, Samifo à Rome) – et une étude macrosociale portant sur la traduction des évolutions politiques de la santé des migrants et de la lutte contre le VIH et l’hépatite b, et ce du niveau international à celui des deux pays concernés, la France et l’Italie. / In France and in Italy, AIDS and hepatitis B profoundly affect migrants from sub-Saharan Africa, particularly those living under precarious political, social, and economic conditions. Since 2010, when the AIDS epidemic had normalized in Western countries, in France and Italy there has been increasing interest in public policies regarding hepatitis B, which is associated more and more with HIV, and disease control strategies for migrant populations. Despite this, following a recent tightening of migration policies, difficulties with accessing healthcare and with asserting one’s rights have increased for migrants living with these two infections in France or in Italy. Building on the intersection of the policy trajectories for these two infections and their use in the area of migration policies, this thesis presents an analysis of the way the treatment of AIDS and hepatitis B currently in effect in France and in Italy for newly arrived migrants from sub-Saharan Africa contributes to the development of new forms of inequality. The analysis is comparative and associated with a microsocial and ethnographic study of the everyday treatments for migrant patients afflicted with AIDS and hepatitis B that are provided by two entities that take care of newly arrived migrants in Paris and in Rome (Comede in Paris, Samifo in Rome), and a macrosocial study of the translation of policy developments in regard to the health of migrants and the fight against AIDS and hepatitis B at the international level and at the national level in France and Italy.

Es gibt wenige Erkenntnisse über den Zusammenhang zwischen Lamivudin induzierten Resistenzmutationen und Hepatitis B Genotypen. Die vorliegende Studie untersucht das Verhältnis zwischen diesen Mutationen und den Hepatitis B Genotypen A-D. Die Datenbank der US-amerikanischen Kongressbibliothek (Pubmed) wurde nach den Begriffen „HBV OR hepatitis B”, „YMDD”, „genotype”, und „lamivudine” durchsucht. Alle in dieser Suche gefundenen Arbeiten, die bis Juni 2009 veröffentlicht worden waren, wurden in die Studie eingeschlossen. Die Ergebnisse der Literaturanalyse wurden mit den Hepatitis B-Genomdaten zweier Referenzlabore in Tübingen und Melbourne verglichen. Insgesamt konnten 29 Arbeiten aus der Datenbankrecherche in die Literaturanalyse eingeschlossen werden. Diese Studien enthielten Daten zu insgesamt 827 Patienten, deren Hepatitis B Genotyp bekannt war und die eine Lamivudinresistenzmutation aufwiesen. In statistischen Untersuchungen konnte nachgewiesen werden, dass die rtM204V-Mutation die dominierende Mutation bei Infektionen mit Genotyp A ist. Dieses Ergebnis konnte durch die Analyse der Genomdaten der Referenzlabore bestätigt werden. Ferner konnte gezeigt werden, dass bei den Genotypen A, B, und D die rtL180M-Mutation hochsignifikant mit der rtM204V-Mutation verknüpft ist. Die Dissertationsschrift enthält neben dem Artikel „Mutation pattern of lamivudine resistance in relation to hepatitis B genotypes: hepatitis B genotypes differ in their lamivudine resistance associated mutation pattern“ (Damerow, H, Yuen L et al.; J Med Virol. 2010 Nov; 82(11):1850-8) eine Einführung in die Rationale der Studie, eine Zusammenfassung der Ergebnisse sowie ein Fazit.

Le virus de l'hépatite B (HBV) infecte chroniquement près de 240 millions d'individus dans le monde. L'infection chronique par HBV est un souci de santé publique majeur puisque l'infection peut évoluer au cours du temps vers la cirrhose et/ou l'hépatocarcinome (CHC). Malgré l'existence de traitements efficaces à base d'analogues de nucléos(t)ides permettant de diminuer la charge virale chez les patients, ceux-ci nécessitent une prise médicamenteuse à vie. En effet, malgré la diminution importante du risque de développer un cancer du foie, ces traitements ne permettent pas l'élimination définitive du virus. Les cellules infectées par HBV sont les hépatocytes du foie, qui remplissent la majorité des rôles vitaux de cet organe. La formation d'un minichromosome viral au sein de ces cellules infectées appelés ADNccc (pour ADN circulaire-covalemment-clos), est majoritairement responsable de la persistance du HBV. Les traitements actuels utilisés sont principalement des analogues de nucléos(t)ides et ceux-ci n'ont pas ou peu d'effets sur l'ADNccc. La nécessité de développer de nouvelles stratégies antivirales visant à éliminer définitivement HBV a donc conduit de nombreux laboratoires, dont le nôtre, à étudier l'utilisation de stratégies immuno-thérapeutiques incluant des stimulateurs de l'immunité innée (agonistes de TLR7, TLR8, RIG-1.) dans le cadre d'infections chroniques. De nombreuses études ont démontré que l'utilisation de ligands stimulant les récepteurs de l'immunité innée promouvait un fort effet antiviral, médié par la production endogène et locale de cytokines pro-inflammatoires et l'induction de gènes régulés par l'interféron (1SG). Dans ce but, nous nous sommes intéressés plus particulièrement aux potentiels effets antiviraux de l'agonisation des senseurs de l'immunité innée les plus connus, les Toll-like récepteurs (TLR), dans le cadre de l'infection par HBV dans les cellules hépatiques. La stratégie immuno-thérapeutique envisagée, vise à stimuler aussi bien les cellules immunitaires que les hépatocytes infectés. La caractérisation de l'expression de différents senseurs de l'immunité innée, d'une part dans les cellules primaires isolées du foie et d'autre part dans certaines lignées cellulaires correspondantes, nous a permis d'avoir une vue d'ensemble 1) des récepteurs exprimés par les différentes cellules du foie notamment dans les hépatocytes (TLR2/TLR3/TLR4/TLR5) ; 2) d'évaluer la fonctionnalité de ceux-ci pour la production de cytokines (IL-6 ; IP-10) lors de leur agonisation 3) d'évaluer les modèles disponibles parmi les lignées cellulaires les plus proches immunologiquement des cellules hépatiques. Les cellules HepaRG et une nouvelle lignée dérivée des macrophages du foie les iKC par exemple sont plus proches respectivement des hépatocytes et des macrophages primaires hépatiques et sont donc des modèles relevant pour les études immuno-thérapeutiques. L'utilisation de ligands de TLR2 et TLR3 sur des hépatocytes infectés chroniquement par HBV, a montré le plus fort effet antiviral (incluant une médiation par la sécrétion de cytokines et l'induction d'1SG) aussi bien sur la réplication d'HBV que sur l'ADNccc. De plus, cet effet semble stable au cours du temps sans résurgence massive de productions virales. Cette stratégie cible non seulement les hépatocytes infectés, mais également les cellules immunitaires dont les productions cytokiniques ont également un fort effet antiviral. Bien que l'effet in vivo, dans un modèle murin, ait été plus modeste, un ajustement des doses d'agonistes utilisées ainsi qu'un meilleur moyen de délivrance au foie de ligands de TLR2 ou TLR3 pourraient être une stratégie immuno-thérapeutique intéressante. Enfin nous nous sommes intéressés au cas particulier de l'agonisation du TLR9 en présence d'HBV… [etc] / HBV chronically infects 240 million peoples around the world. HBV chronic infection is a major public health problem and can lead to cirrhosis or/and hepatocarcinoma (HCC). Even if some efficient treatments are already available, based in particular on the use of nucleos(t)ides analogues that induce a decrease of viral load in patients, these drugs do not lead to a definitive HBV cure They enable an important decrease of liver cancer risk but need to be taken life-long. HBV infects hepatocytes the major liver cells which are involve in many vital mechanisms into the organism. The HBV minichromosome, which is formed into infected cells also called cccDNA (i.e., covalently-closed-circular DNA), is not affected by nucleos(t)ides treatments and thus is responsible for HBV persistence. The use of immune receptors (e.g. Toll-like receptors/TLR) agonists can lead to 1) an important cytokines/interferon (IFN) secretion; 2) promote immune cells activation/recruitment and 3) induction of many Interferon-Stimulated Genes (ISG). These mechanisms could lead to a greater viral clearance by cccDNA degradation or silencing. The need for new strategies to permanently eliminate HBV infection led many laboratories, including ours, to explore the use of immunotherapeutic treatments in a context of chronic infection, including innate immune stimulators (e.g. TLR7, TLR8 or RIG-I agonist are under clinical trials). To this end, we got interested on the potential anti-HBV effects of many TLR agonists in liver cells. Our strategy is to stimulate both infected hepatocytes and immune cells. We first characterized the expression of innate immune sensors in primary liver cells as well as in some liver cell lines. This allowed us to: 1) identify which sensors are expressed by liver cells, especially in hepatocytes (TLR2, TLR3, TLR4, TLR5); 2) evaluate their ability to produce cytokines (IL-6, IP-10) upon agonisation; 3) evaluation of cell lines model which are immunologically closed to the primary liver cells. HepaRG and a new liver macrophage cell line call iKC are immunologically close to their primary cells and appear to be relevant models for immune-therapeutics studies. The use of TLR2 and TLR3 agonists on HBV chronically infected hepatocytes showed a strong antiviral effect (i.e., decrease of HBV replication and cccDNA level) mediated directly by NF- kB-inducible and ISG genes activation and indirectly by cytokines secretion. Furthermore, this effect was shown stable over time without any viral replication rebound. This strategy targets not only infected hepatocytes but also immune cells, whose cytokines production also has a strong antiviral effect. Despite a weak in vivo effect in mice, a tuning in agonist doses used and better liver delivery could be an interesting immune-therapeutic strategy. Finally, we were investigated the particular case of TLR9 agonisation in presence of HBV. We showed an interaction between synthetic or not DNA ligands such as CpG ODN and HBV particles. This interaction leads in one hand, to HBV entry inhibition in hepatocytes, on the other hand, to a blockage of ligand delivery to TLR9 in pDC, which is not due to an inhibition of the TLR9 pathway, but to a lack of access of the ligand to its receptor. These two mechanisms are responsible for a decrease of viral infection during its establishment and a decrease in IFN synthesis by pDC, respectively. A decrease in IFN production, which this time was linked to a bona fide inhibition of the TLR9 pathway, in the presence of the sub-viral particles HBsAg was still observed, without retention of TLR9 ligand of the latter. It would seem, therefore, that use of TLR agonists represent an interesting strategy in setting up new anti-HBV immune-therapeutic approaches. However, their improvement will depend on the evaluation of viro-induced inhibitory mechanisms as well as better ways of in vivo delivering these ligands

Introdução. A infecção causada pelo vírus da hepatite B (HBV) é um dos agravos de maior prevalência no mundial. Segundo a Organização Mundial da Saúde (OMS) existem mais de 350 milhões de portadores crônicos da doença. A infecção pelo HBV é rotineiramente identificada quando há a presença do HBsAg circulante. Entretanto, em alguns casos o HBV-DNA tem sido detectado em indivíduos HBsAg negativos, positivos ou negativos para anti-HBc e anti-HBs. Essa apresentação sorológica e molecular é denominada infecção oculta pelo HBV (OBI). Geralmente a concentração do HBV-DNA no soro será abaixo de 200 UI/mL. Objetivo: Determinar a prevalência da OBI, em doadores de sangue do Estado do Amapá no ano de 2014. Material e Métodos. Foram analisadas um total de 62 amostras de doadores de sangue do estado do Amapá, no ano de 2014, que apresentavam o perfil sorológico: HBsAg negativo, anti-HBc positivo e com anti-HBs negativo ou positivo. Os marcadores sorológicos HBsAg e anti-HBc foram determinados através do imunoensaio quimioluminescente. As amostras selecionadas para a detecção do HBV-DNA foram testadas utilizando as metodologias de Real-Time PCR Kit NAT HIV/HCV/HBV (Bio-Manguinhos®) e PCR \"in house\". Resultados. Do total de 13.261 doadores triados para infecções transmissíveis pelo sangue, 283 apresentaram resultados reagentes para os marcadores da hepatite B, nos quais: 35 (0,3%) foram HBsAg e 248 (1,9%) para anti-HBc reagentes. Um total de 62 amostras foram testadas pelos métodos moleculares. Todas as amostras apresentaram resultado HBV-DNA não-detectável. Conclusão: O índice de inaptidão sorológica no ano de 2014 no HEMOAP foi de 1,9% para anti-HBc e 0,3% para HBsAg. A população estudada foi constituída predominantemente por adultos com idade entre 29-65 anos, do sexo masculino, casados e naturais de municípios do estado do Amapá / Introduction. The infection caused by the hepatitis B virus (HBV) is one of the most prevalent diseases in the world. According to the World Health Organization (WHO) there are more than 350 million chronic carriers of the disease. HBV infection is routinely identified when there is presence of circulating HBsAg. However, in some cases HBV-DNA has been detected in HBsAg negative individuals, positive or negative for anti-HBc and anti-HBs. This serological and molecular presentation is termed HBV-occult infection (OBI). Usually the concentration of HBV-DNA in serum will be below 200 IU / mL.Objective: To determine the prevalence of OBI in blood donors, in the State of Amapá, in the 2014. Material and methods. A total of 62 samples of blood donors from the State of Amapá in the year 2014 were analyzed, presenting the serological profile: HBsAg negative, anti-HBc positive and with negative or positive anti-HBs. Serum markers HBsAg and anti-HBc were determined by the chemiluminescent immunoassay. Samples selected for HBV-DNA detection were tested using the Real-Time PCR Kit Kit HIV / HCV / HBV (Bio-Manguinhos®) and in-house PCR. Results. Of the total of 13,261 donors screened for blood-borne infections, 283 presented reactive results for hepatitis B markers, in which: 35 (0.3%) were HBsAg and 248 (1.9%) for anti-HBc reagents. All samples showed nondetectable HBV-DNA result. Conclusion: The serological disability index in the year 2014 in HEMOAP was 1.9% for anti-HBc and 0.3% for HBsAg. The studied population consisted predominantly of adults aged 29-65 years, males, married and natural of cities of the state of Amapá

Made available in DSpace on 2014-06-12T18:32:19Z (GMT). No. of bitstreams: 2 arquivo8105_1.pdf: 1882884 bytes, checksum: e39c1a843287ccbea7f187b84dbe1593 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2005 / A ocorrência de co-infecção pelo HIV e hepatites B e C tem sido relatada desde a era- HAART (do inglês Highly Active Antinetrovial Therapy), quando a mortalidade nas pessoas infectadas pelo HIV começou diminuir. Como conseqüência do fato de terem as mesmas rotas de transmissão, a co-infecção do HBV ou HCV em pessoas infectadas pelo HIV tem aumentado e tornou-se um problema de saúde pública. No Brasil, a prevalência média da coinfecção HIV e hepatites, encontrada pelo Ministério da Saúde é em torno de 40%, com a maioria em grupos de usuários de drogas. Freqüências variáveis de co-infecção têm sido relatadas, dependendo da população e da região estudada. O objetivo principal deste estudo foi identificar a freqüência de marcadores sorológicos para hepatite B e C em pacientes infectados pelo HIV, acompanhados em um hospital escola e os possíveis fatores associados à presença de tais marcadores. Quatrocentos e vinte e nove pacientes foram estudados, de ambos os sexos e com idade variando entre 18 a 77 anos. Os participantes respondiam um questionário específico, com características sócio-demográficas e tinham uma amostra de sangue testada para os marcadores HBsAg, Anti-HBc total e Anti-HCV, utilizando a técnica MEIA-Axym-Abbott. A freqüência encontrada de marcadores foi 10,3% para o HBsAg, 38,7% para o Anti-HBc total e 10,7% para o Anti-HCV. Dentre os pacientes, 1,4% possuíam tanto HBsAg quanto Anti-HCV positivos. Não houve associação significante estatisticamente entre as variáveis parceiro homossexual, uso de drogas endovenosas, ingesta de álcool, tatuagem ou piercing, cirurgia, procedimentos invasivos e hemotransfusão e a infecção pelo HBV, expressa pela positividade do HBsAg. A única variável que mostrou associação com infecção pelo HBV foi uso de drogas inalatórias. Nenhuma destas variáveis, incluindo, parceiro homossexual, uso de drogas endovenosas, uso de drogas inalatórias, ingesta de álcool, tatuagem ou piercing, cirurgia, procedimentos invasivos e hemotransfusão tiveram associação significativa estatisticamente com a presença do Anti-HCV. Este estudo encontrou freqüências comparáveis com outros relatados no Brasil, mas com freqüências de coinfeccção menores que aqueles das regiões Sul e Sudeste. Entretanto, nenhuma associação específica com comportamentos de risco foi encontrada neste estudo, mostrando importante diferença quando comparado com estudos realizados em outras regiões do Brasil