Soroepidemiologia para o virus da hepatite B (VHB) em gestantes/parturientes e sua transmissão para recém-nascidos em Goiânia, GO

Abstract

In order to detect hepatitis B vírus (HBV), 1459 serum samples from pregnant/parturient women were collected at two public hospitals in Goiânia, GO. These samples were tested by enzyme linked immunosorbent assay forHBsAg and anti-HBs. 109 (7.5%) serum samples were positive. Eight (0.5%) sera were positive for HBsAg and 101 (7.0%) for anti-HBs. Viral positivity for both HBsAg and anti- HBs were observed in women which age ranged from 15 to 30 years. Four newborns from HBsAg positive mothers were submitted to the treatment with HBV vaccine (Engerix B) and with hyperimmune gammaglobulin (HBIG - Abbott Laboratories - Brazil). Cord blood from one of the newborns was positive for HBsAg. A positive association was found between hepatitis B and sexually transmited infections and blood transfusion. These results emphasize the need for prenatal sereening for HBV in pregnant women and treatment of the newborns from AgHBs positive mothers.

ARTIGOS

Soroepidemiologia para o virus da hepatite B (VHB) em gestantes/parturientes e sua transmissão para recém-nascidos em Goiânia, GO

Divina das Dores P. Cardoso; Edson Luis de Faria; Marli S. Pereira de Azevedo; Divina Aparecida O. Queiroz; Regina Maria B. Martins; Terezinha Teixeira de Souza; Roberto Ruhman Daher; Celina Maria Turchi Martelli

Endereço para correspondência

------------

RESUMO

Foram coletadas, entre março de 1990 e julho de 1992, 1459 amostras sanguíneas de mulheres gestantes/parturientes na cidade de Goiânia-GO, objetivando detecção da infecção pelo vírus da hepatite B (VHB), através dos marcadores sorológicos AgHBs e anti-HBs. O percentual depositividade encontrado, pelo teste imunoenzimãtico, foi de 7,5%, sendo 0,5%para AgHBs e 7,0%para anti-HBs. A análise efetuada, considerando a faixa etária, mostra que 7 de 8 mulheres AgHBs-positivas pertenciam à faixa etária de até 30 anos, situação semelhante em relação ao anti-HBs(83/101). Das 8 mulheres positivas, 4 tiveram seus recém-nascidos submetidos a tratamento profilático com vacina (Engerix B) e imunoglobulina humana anti-hepatite B (HBIG). Além disso, 3 dessas crianças foram analisadas sorologicamente, sendo que uma era AgHBs-positiva ao nascimento. Doença sexualmente transmissível e transfusão sanguínea foram fatores de risco que coirelacionaram significantemente com a infecção. Esses resultados parece-nos reforçar a indicação de triagem à infecção pelo vírus da hepatite B no período pré-natal, assim como a adoção de medidas imunoprofiláticas nas crianças nascidas de mães positivas.

Palavras-chaves: Hepatite B. Gestante. Recém-nascido.

------------

ABSTRACT

In order to detect hepatitis B vírus (HBV), 1459 serum samples from pregnant/parturient women were collected at two public hospitals in Goiânia, GO. These samples were tested by enzyme linked immunosorbent assay forHBsAg and anti-HBs. 109 (7.5%) serum samples were positive. Eight (0.5%) sera were positive for HBsAg and 101 (7.0%) for anti-HBs. Viral positivity for both HBsAg and anti- HBs were observed in women which age ranged from 15 to 30 years. Four newborns from HBsAg positive mothers were submitted to the treatment with HBV vaccine (Engerix B) and with hyperimmune gammaglobulin (HBIG - Abbott Laboratories - Brazil). Cord blood from one of the newborns was positive for HBsAg. A positive association was found between hepatitis B and sexually transmited infections and blood transfusion. These results emphasize the need for prenatal sereening for HBV in pregnant women and treatment of the newborns from AgHBs positive mothers.

Keywords: Hepatitis B. Pregnant women. Newborn.

------------

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

REFERÊNCIAS BIBLIOGRÁFICAS

1. Azevedo MSP, Cardoso DDP, Martins RMB, Daher RR, Camarota SCT, Barbosa AJ. Rastreamento sorológico para hepatite B em profissionais de saúde na cidade de Goiânia, GO. Revista da Sociedade Brasileira de Medicina Tropical 27:157- 162,1994. [ Links ]

2. Beasley RP, Hwang Lu-Yu. Postnatal infectivity of hepatitis B surface antigen-carrier mothers. The Journal of Infectious Diseases 147:185-190,1983. [ Links ]

3. Beasley RP, Shiao I-S,WuT-C, Hwang LY. Hepatoma in an HBsAg carrier - Seven years after perinatal infection. The Journal of Pediatrics 101:83-84,1982. [ Links ]

4. Bogomolski-Yahalom V, Granot E, Linder N, Adler R, Korman S, Manny N, Tur-Kaspa R, Shouval D. Prevalence of HBsAg carriers in native and immigrant pregnant female populations in Israel and passive/active vaccination against HBV of newborns at risk. Journal of Medical Virology 34:217-222,1991. [ Links ]

5. Borhanmanesh F, Haghighi P, Herkmat K, Rezaizadeh K, Ghavami A. Viral hepatitis during pregnancy. Severity and effect on gestation. Gastrenterology 64:304-312,1973. [ Links ]

6. Committee on Infectious Diseases. Universal Hepatitis B Immunization. Pediatrics 89:795-800, 1992. [ Links ]

7. Centers For Disease Control. Prevention of perinatal transmission of hepatitis B virus. Prenatal screening of all pregnant women for hepatitis B surface antigen. Morbidity and Mortality Weekly Report 37:341-351,1988. [ Links ]

8. Gonçalves CS, Pereira FEL, Vargas PRM, Ferreira LSE. Hepatocellular carcinoma HBsAg positive in pregnancy. Arquivo de Gastroenterologia, São Paulo 21:75-77,1984. [ Links ]

9. Goudeau A, Lesage G, Denis F, Chiron JP, Yvonnet B, Barin F, Coursaget P, Mar DI. Lack of anti-HBc IgM in neonates with HBsAg carrier mothers argues against transplacental transmission of Hepatitis B virus infection. The Lancet 12:1103- 1104,1983. [ Links ]

10. Kumar ML, Dawson NV, Mc Cullough AJ, Radivoyevitch M, King K-C, Hertz R, Kiefer H, Hampson M, Cassidy R, Tavill AS. Should all pregnant women be screened for hepatitis B? Annals of Internal Medicine 107:273-277,1987. [ Links ]

11. Lange W, Masihi KN. Epidemiology and economic importance of hepatitis B in Federal Republic of Germany. Postgraduate Medical Journal 63 (suppl 2):21-26,1987. [ Links ]

12. Lo K-J,TsaiY-T, Lee S-D,\VuT-C,Wang J-Y, Chen G- H, Yeh C-L, Chiang BN, Yeh S-H, Goudeau A, Coursaget P, Tong MJ. Immunoprophylaxis of infection with hepatitis B virus in infants born to hepatitis B surface antigen-positive carrier mothers. The Journal of Infectious Diseases. 152:817-822,1985. [ Links ]

13. Martelli CMT,Andrade ALSS, Cardoso DDP, Souza LCS, Silva SA, Sousa MA, Zicker F. Soroprevalência e fatores de risco para infecção pelo vírus da Hepatite B pelos marcadores AgHBs e antiHBs em prisioneiros e primodoadores de sangue. Revista de Saúde Pública de Sao Paulo 24:270-276,1990. [ Links ]

14. Papaevangelou G, Roumeliotou-Karayannis A, Tassopoulos N, Kolaitis N, Stathopoulou P. Source of infection due to hepatitis B virus in Greece. The Journal of Infectious Diseases 147:987-989, 1981. [ Links ]

15. Porto SOB, Cardoso DDP, Queiroz DAO, Rosa H, Andrade ALSS, Zicker F, Martelli CMT. Prevalence and risk factors for HBV infection among street youth in Central Brazil. Journal of Adolescent Health 15:577-581,1994. [ Links ]

16. Stevens CE,Toy PT,Tong MJ, Taylor PE, Vyas GN, Nair PV, Gudavalli M, Krugman S. Perinatal hepatitis B virus transmission in the United States. Prevention by passive-active immunization. Journal American Medical Association 253:22-29, 1985. [ Links ]

17. Tiollais P, Buendio M-A. Hepatitis B virus. Scientific American 4:48-54,1991. [ Links ]

18. Voller A, Bartlett A, Bidwell DE. Enzime immunoassays with special reference to ELISA techniques. Journal of Clinical Pathology 31:507- 520,1978. [ Links ]

Recebido para publicação em 26/07/95.

Laboratório de Virologia/Departamcnto de Microbiologia/Instituto de Patologia Tropical e Saúde Pública/Universidade Federal de Goiás, Goiânia, GO.

Suporte Financeiro: CNPq Processo n° 400641-90.8, CONCITEG (Conselho de Ciência e Tecnologia do Estado de Goiás), PNI (Plano Nacional de Imunização).

Endereço para correspondência:

Profa Divina das Dores de Paula Cardoso.

R. Delenda Rezende de Melo, esquina com 1a avenida, Setor Universitário, 74605-050

Goiânia, GO.