Hepatitis A and E among immigrants and refugees in Central Brazil

Abstract

The aim of this study was to estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, central Brazil. A total of 355 persons were interviewed and blood samples were tested for anti-HAV and anti-HEV IgG. All participants were from Latin American countries, most of whom were young adult males. The overall prevalence of anti-HAV IgG was 87.4% (95% CI: 83.5-90.4), of which 94.9%, 75.6% and 60% were from Haiti, Venezuela and other Latin American countries, respectively (p < 0.001). Age older than 19 years and more than 36 months of residence in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall prevalence of anti-HEV IgG was 6.5% (95% CI: 4.4-9.5). All anti-HEV IgG-positive individuals were Haitian, including one child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG positive samples. The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently needed to interrupt enteric virus transmission in this emerging and vulnerable population.