P-117 LOW PREVALENCE OF HEPATITIS B AND C AMONG PEOPLE LIVING IN POVERTY IN NORTHEAST BRAZIL

Introduction

Hepatitis B and C infection are responsible for more than 300 million of chronic liver disease patients all over the world. One goal of WHO 2030 agenda is the eradication of hepatitis B and C. However poverty is a great obstacle to achieve this goal. In Brazil, more than 13 million of people live in poverty (PLP) and could be vulnerable to HBV and HCV.

Objectives

This study aims to determine HBV and HCV prevalence and analyze the response to HBV vaccination by measuring anti -HBs antibodies in serum samples from PLP.

Methods

This was a cross­ sectional study carried out in rural settlement in the municipality of Sao Joao do Piaui, Northeast Brazil in March and July 2019. Participants were recruited in their homes and after signing the informed consent, they gave blood samples. A commercial ELISA was use d for measurements of antibodies against i) hepatitis B surface antigen (anti-HBs) and ii) hepatitis B core antigen (HBc) and of the hepatitis surf ace antigen (HBsAg). Nearly half of the population was female (51.0%). The mean age was 36.2±20.4 years, and about 43.2% received a monthly income of approximately $35.00 USD. Most are self­declared black or mixed race (81.9%), were married (50.1%), 15.5% was illiterate and 25.8% had a maximum of six years of formal schooling. Overall zero positivity for HBsAg, anti-HBc and anti -HBs determined by ELISA was 0.2%, 5.1 % and 43.9%, respectively. Anti-HBs reactivity was not associated with monthly income and schooling. Low rates of vaccination against hepatitis B were found among PLP in Northeast Brazil, highlighting the need for preventive actions towards this population segment, vulnerable and a potential disseminator of this infection. Strategies to increase HBV vaccination will be essential to eradicate hepatitis Band achieve the goals of WHO 2030 agenda. Report the levels of biochemical markers in CLD patients with or without COVID-19 to give more information that could help clinical monitoring.

Study was approved by Brazilian Ethics Committee. Blood samples were collected after signed informed consent.

Results

Most of individuals were male 56% (37/66) and mean age of population was 49±17 years. Six out 66 CLD patients were SARS CoV-2 RNA positive at baseline. At the end of follow-up, all of these 6 patients achieved SARS-CoV-2 clearance. At least once during follow-up, the CLD group versus CLD/COVID-19 group, 48% (29/60) vs. 17% (1/6) (P = 0.2) had abnormal alanine aminotransferase; 47% (28/60) vs. 17% (1/6) had abnormal aspartate aminotransferase (P = 0.21); 60% (36/60) vs. 67% (4/6) had abnormal γ-glutamyl transferase (P = 1.00), 32% CLD patients (19/60) had abnormal total bilirubin levels vs. none of the CLD/COVID-19 group (P = 0.17).

Conclusions

Previous liver disease did not seem to increase the biochemical levels, except GGT, during COVID-19 infection. However, liver function monitoring is still essential for both COVID-19 patients with and without liver disease.