title: Hepatitis D virus infection in the Western Brazilian Amazon - far from a vanishing disease.
abstract: BACKGROUND
  A decline in hepatitis D virus (HDV) occurrence was described in Europe and Asia. We estimated HDV prevalence in the Brazilian Amazon following hepatitis B vaccination.
  
  
  METHODS
  This is a cross-sectional survey of HDV measured by total antibodies to HDV (anti-HD T).
  
  
  RESULTS
  HDV prevalence was 41.9% whiting HBsAg carries and was associated with age (PR = 1.96; 95% CI 1.12-3.42; p = 0.01), hepatitis B virus (HBV) infection (PR = 4.38; 95% CI 3.12-6.13; p < 0.001), and clinical hepatitis (PR =1.44; 95% CI 1.03-2.00; p = 0.03). Risk factors were related to HDV biology, clinical or demographic aspects such as underlying HBV infection, clinical hepatitis and age.
  
  
  CONCLUSIONS
  Our study demonstrated that HDV infection continues to be an important health issue in the Brazilian Amazon and that the implementation of the HBV vaccination in rural Lábrea had little or no impact on the spread of HDV. This shows that HDV has not yet disappeared from HBV hyperendemic areas and reminding that it is far from being a vanishing disease in the Amazon basin.
authors.affiliation: Fundação de Medicina Tropical, Manaus, AM. wbraga@fmt.am.gov.br
authors.forename: Wornei Silva Miranda
authors.initials: WS
authors.lastname: Braga
authors.forename: Márcia da Costa
authors.initials: Mda C
authors.lastname: Castilho
authors.forename: Fabiane Giovanella
authors.initials: FG
authors.lastname: Borges
authors.forename: Jorge Roberto Di Tommaso
authors.initials: JR
authors.lastname: Leão
authors.forename: Ana Cristina de Souza
authors.initials: AC
authors.lastname: Martinho
authors.forename: Ivo Seixas
authors.initials: IS
authors.lastname: Rodrigues
authors.forename: Eliete Pereira de
authors.initials: EP
authors.lastname: Azevedo
authors.forename: Gildo Maia de
authors.initials: GM
authors.lastname: Barros Júnior
authors.forename: Raymundo
authors.initials: R
authors.lastname: Paraná
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood*; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D003699:Hepatitis D / Q000175:diagnosis / Q000453:epidemiology*; D003698:Hepatitis Delta Virus / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies; D017325:Hepatitis B Vaccines; D007074:Immunoglobulin G