Prevalência da hepatite C e ações para a macro e microeliminação em Uberaba/Minas Gerais – Brasil

Abstract

Introduction: Viral hepatitis is responsible for millions of chronic infections and deaths worldwide. Hepatitis C, an easily curable infection today, is a socially determined disease, remaining highly prevalent in socially vulnerable populations. Objectives: Identify the prevalence of hepatitis C to implement actions for macroelimination and microelimination in the adult population of the city of Uberaba, in the prison population and in individuals undergoing hemodialysis; report the experience in managing action research on a hepatitis C survey with the prison community and analyze the measures to contain the transmission of Hepatitis C in a Hemodialysis Hospital Unit. Methods: This is a mixed methods study. Initially, an exploratory, descriptive, cross-sectional, retrospective study with an epidemiological approach was carried out on 17,845 people in the city of Uberaba. Subsequently, in a penitentiary in the same municipality, a cross-sectional study was carried out using an epidemiological survey, with an exploratory, observational, quantitative-analytical component, with semi-structured individual interviews and anti-HCV testing carried out in a simple random sample with 240 prisoners, followed by critical analysis about the work experience within the institution. Finally, a case study was carried out consisting of multiple analysis units, in a hospital hemodialysis unit, in the same municipality, where an increase in the incidence of HCV was reported in 2019. Results: Of 17,845 people tested for anti-HCV, 0.73% were positive, 79.3% of whom were born in the 1950s to 1970s; and 24% had moderate, advanced liver fibrosis or cirrhosis. The most frequently cited forms of transmission were drug use (any route); multiple sexual partners and transfusions, hemodialysis or organ transplantation. In the penitentiary, strategies for managing action research are described, where 240 people were tested and interviewed. The prevalence of anti-HCV was 2%, with the use of injectable drugs (RP 14.75; RPIC95% 2.09-104.28), having been born in the decades from 1951 to 1980 (RP 9.28; RPIC95 % 1.06-81.57) and being co-infected with the hepatitis B virus (RP 10.75; RPIC95% 1.66-69.65) were the aspects that presented a prevalence ratio for the presence of the virus. 76.6% were men, average age 33.8 years, with incomplete secondary education (80.5%). 93.8% were heterosexual, with multiple partners and inappropriate condom use. 70% reported using non-injectable drugs and 72.9% reported alcohol consumption, with an average quantity of 188.5 grams/day. 70.4% were repeat offenders and 75.8% had tattoos on their bodies. In the Hemodialysis Unit, in August 2019, of the 45 patients, six were reactive for anti-HCV. Patients were exposed to medical equipment, objects or professionals' hands that were not adequately sanitized. Preventive measures were adopted and routine techniques corrected. Situational Analysis Committee guided the management of the event. All received treatment. No new cases were detected. Conclusions: the study as a whole results in an instructional design/model on how to guide the Expansion of the Diagnosis of Hepatitis C. Coordinated in a few stages: survey to identify the general prevalence and the most prevalent vulnerable groups in the localities and in sequence, the strategies of intersectoral mobilization to address microelimination.