The epidemiology of the viral hepatitis in Brazil: A scoping review

Figures
Abstract
Background
Brazil has advanced toward eliminating viral hepatitis by 2030 through broad prevention, diagnosis, and treatment policies. Yet substantial gaps persist across the care continuum, especially in vulnerable populations and underserved regions. This scoping review synthesizes nationwide epidemiologic patterns and identifies knowledge gaps to inform policy.
Methods
We conducted a PRISMA‑guided scoping review on seven databases (2013–2024) for Portuguese/Spanish/English observational studies or systematic reviews with post‑2010 data, extracting epidemiological patterns by viral hepatitis type and population group.
Results
Across 200 included studies, the combined sample encompassed more than 14.5 million individuals. Hepatitis B was the most studied, followed by hepatitis C. Hepatitis A seroprevalence in general population ranged from 33.3–67.8%. In vulnerable populations, highest seroprevalence was among incarcerated populations (88.1%), followed by immigrants (87.4%) and transgender individuals (75.6%). Hepatitis B presented HBsAg prevalence ranging from 0–7.5% in the general population, with the highest rates in an endemic Amazon region. Hepatitis C seroprevalence varied from 0.04–2.2% in the general population, with higher rates among people who use drugs (36.9%). Hepatitis D was predominantly reported in the Amazon region, with prevalence ranging from 0–23.9%. For hepatitis E, prevalence in the general population ranged from 0.9–59.4%, with the highest value in the South region.
Conclusions
Viral hepatitis in Brazil shows heterogeneous epidemiologic patterns across regions and populations, alongside unequal research output. The predominance of small, cross‑sectional studies and their limited integration with social determinants of health highlight the need for future research employing methodologies that address the gaps identified in this review. The resulting evidence map can guide policies aligned with national elimination goals.
Citation: Inoue CA, Domingues TSdP, Sucupira MCA, Sitnik R, Panico CT, de Oliveira DOPS, et al. (2026) The epidemiology of the viral hepatitis in Brazil: A scoping review. PLoS One 21(7): e0353840. https://doi.org/10.1371/journal.pone.0353840
Editor: Vinícius Silva Belo, UFSJ: Universidade Federal de Sao Joao del-Rei, BRAZIL
Received: August 18, 2025; Accepted: June 29, 2026; Published: July 17, 2026
Copyright: © 2026 Inoue et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: Initials of the authors who received each award: JRRP Grant numbers awarded to each author: NUP: 25000.171379/2023-67 The full name of each funder: Ministério da Saúde - Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS) URL of each funder website: https://www.gov.br/saude/pt-br/composicao/se/proadi-sus Did the sponsors or funders play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript? No.
Competing interests: The authors have declared that no competing interests exist.
Introduction
Viral hepatitis represents a major public health issue, accounting for high rates of morbidity and mortality worldwide. It is estimated that these infections result in approximately 1.34 million deaths per year, with the majority attributed to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections [1,2]. Chronic forms of these infections are associated with severe clinical outcomes, such as liver cirrhosis and hepatocellular carcinoma, with HBV and HCV responsible for more than 50% of all liver cancer cases [1].
Brazil is estimated to be one of the countries with the highest viral hepatitis global burden, although national prevalence data remain limited [1,3]. Despite a decline in incidence and mortality rates over the years [4], largely due to the strengthening of public health policies such as the expansion of hepatitis B vaccination coverage and the incorporation of direct-acting antivirals for hepatitis C into the Brazilian Unified Health System (SUS), significant challenges remain in improving diagnostic coverage and access to treatment [3]. In addition, regional inequalities directly impact the country’s epidemiological landscape, underscoring the importance of health social determinants in shaping effective strategies for viral hepatitis prevention and control.
These disparities are particularly relevant given Brazil’s continental dimensions and its strategic importance as the largest country in Latin America, both in population and territory. As such, the country plays a central role in achieving hepatitis elimination goals in the region. Its national efforts are aligned with the goals of the Sustainable Development Agenda and the World Health Organization (WHO) Global Health Sector Strategy on Viral Hepatitis [5,6]. Aligned with these commitments, the country has adopted measures to accelerate the elimination of viral hepatitis as a public health problem. Notable initiatives include the establishment of the Interministerial Committee for the Elimination of Tuberculosis and Other Socially Determined Diseases (Comitê Interministerial para a Eliminação da Tuberculose e de Outras Doenças Determinadas Socialmente – Cieds) [7] and the creation of the program “Brasil Saudável” [8], both aimed at promoting intersectoral actions to mitigate social vulnerabilities and reduce health inequities, particularly among historically neglected populations.
Considering this context, this study proposes a scoping review of viral hepatitis A, B, C, D, and E epidemiology in Brazil over the last decade. The objective is to map epidemiological patterns, identify regional disparities and vulnerable populations, and uncover critical knowledge gaps. By consolidating and critically analyzing scientific literature, this review aims to support evidence-based public health policies and to highlight areas requiring further investment in research and epidemiological surveillance.
Methodology
Development of research questions using the “PCC Strategy”
To conduct this scoping review, three guiding questions were formulated based on the central theme – “Epidemiology of viral hepatitis”:
- What evidence/information currently exists on the epidemiological profile and regional distribution of viral hepatitis cases in Brazil?
- What evidence/information currently exists on the global burden of viral hepatitis in Brazil?
- What evidence/information currently exists on the epidemiological profile and regional distribution of viral hepatitis cases in vulnerable populations in Brazil?
These questions were structured following the PCC strategy (Population, Concept, and Context), as recommended by the Joanna Briggs Institute (JBI) for formulating scoping review questions [9].
Standardization and search strategy
This scoping review was conducted according to JBI methodology [9,10] and reported following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines [11]. A protocol was developed for this scoping review, including the data extraction framework, prior to the conduct of the review. The protocol guided the study selection and data extraction processes. It was subsequently registered on the Open Science Framework platform (https://doi.org/10.17605/OSF.IO/NFUMV) during the review process and updated to reflect the final methodological approach.
To ensure comprehensive search, Medical Subject Headings (MeSH), and text words were used, applied to titles, abstracts, and keywords (Table 1). The strategies were adapted according to each database structure (S1 Table).
The databases consulted were PubMed, Virtual Health Library (BVS), EMBASE, SciELO, Scopus, Web of Science, and CINAHL. The final search was conducted on 16th April 2024 and was restricted to references published between January 1, 2013, and March 15, 2024, containing data produced after January 1, 2010.
Selection of articles and sources of evidence
The inclusion and exclusion criteria are described in Table 2.
Selection of texts included in the scoping review
Article selection followed a structured three-step process. Initially, references were organized in EndNote v.20 software [12], with duplicate removal. Then, two independent reviewers screened titles and abstracts in the Rayyan platform [13], excluding studies irrelevant to the research questions. Finally, selected texts underwent full-text reading to confirm eligibility. In cases of disagreement, a third reviewer was consulted to resolve conflicts [10].
Data extraction from selected texts
Data extraction followed JBI guidelines, using a standardized form in the REDCap platform [14,15]. The form included variables such as publication type, study characteristics (author, year, location, methodological design), target population characterization (age group, sex at birth, race/ethnicity, and education level), sample size, epidemiological data (prevalence, incidence, mortality, vaccination coverage).
Populations included in this scoping review were categorized based on official documents from the Brazilian Ministry of Health [16] and grouped by similarity, considering epidemiological characteristics and associated vulnerabilities. The classification was structured into six categories with operational definitions as follows. (1) General population and proxy groups were defined as samples intended to approximate the broader community distribution or routinely screened groups used as proxies for population-level estimates (for example, blood donors and pregnant women). (2) Age groups were defined as samples explicitly restricted to a specific age range (for example, children or older adults). (3) Clinical populations were defined as groups characterized by clinical conditions or healthcare-related exposures that may modify viral hepatitis risk, testing pathways, or disease susceptibility; this category included individuals with chronic diseases, or liver diseases, those on hemodialysis, transplant recipients, people with a history of blood transfusion, people living with HIV/aids (PLWHA), and individuals with alcohol abuse. (4) Occupational risk groups were defined as workers whose professional activities entail potential exposure to blood or body fluids, sharp injuries, or contaminated materials, this category included healthcare workers, urban sanitation/waste collection workers, beauty sector workers, and public safety personnel. (5) Remote area populations were defined as communities living in geographically remote settings or with limited access to health services and surveillance, including rural, riverside, quilombola, and Indigenous communities. (6) Socially and structurally vulnerable populations were defined as groups experiencing social exclusion, marginalization, or structural barriers to prevention, diagnosis, and care, which may increase exposure or reduce access to timely services, this category included gay and men who have sex with men (MSM), transgender individuals, immigrants and refugees, incarcerated individuals, homeless people, people who use drugs (PWUD), and sex workers. Additionally, in line with national surveillance reports and clinical guidelines, we defined a seventh analytic stratum called Amazonian populations. This stratum covers the Legal Amazon region and includes urban, rural, riverine, and Indigenous communities which are prioritized for viral hepatitis prevention and screening [16–19].
Epidemiological data were collected and extracted following the established standardization. Discrepancies between reviewers were resolved through the same process as described for study selection. In cases of overlap between population groups, where the study did not present specific values for each population, prevalence was assigned to multiple groups, ensuring the representativeness of the different contexts analyzed.
Data analysis
Extracted data were analyzed descriptively and categorized according to the variables defined in the extraction form. The primary analytical approach incorporated key variables including publication characteristics, study design methodology, geographic coverage of data collection (whether national or regional in scope), the hepatitis virus type being examined, and the target population under investigation. Each study was classified based on the population groups previously established by the reviewers. In cases of overlap, such as studies involving multiple groups simultaneously (e.g., transgender incarcerated individuals, sex workers residing in the Amazon region, gay men and MSM living with HIV/aids), all relevant categories were assigned, allowing for a more comprehensive analysis.
Data extraction was followed by an analysis plan development aggregating information on all viral hepatitis types and subsequently stratifying them by specific hepatitis type. Results were presented according to the number of references addressing each variable in the extraction form. Since a single study could report multiple variables, the total records per category did not necessarily correspond to the total number of studies included in the review.
Epidemiological data, such as prevalence, incidence, and mortality, were extracted from the articles based on findings consistent with viral hepatitis infection, confirmed by serological testing or medical records. The epidemiological data were systematized according to the specific serological markers for each type of viral hepatitis, with these values being used for analysis within each population group defined in the scoping review design. To optimize result presentation, a graph was developed for each hepatitis type containing study identification, publication year, and sample size.
As a scoping review, this study mapped descriptive epidemiological data and did not pursue meta-analyses, risk factor hierarchies, or causal inference, which fall under analytical epidemiology, although the extracted data included information on prevalence. Described results prioritized the most relevant prevalence data; therefore, not all studies in this review were presented in the text.
Results
PRISMA flowchart description
The search in the PubMed, LILACS, EMBASE, Cochrane Library, Scopus, Web of Science, CINAHL databases, and gray literature resulted in the identification of 7,649 references. After removing 5,999 records (5,120 duplicates, 790 data collection outside time frame, 88 without abstracts, and 1 in an unsupported language), 1,650 references were selected for title and abstract screening (Fig 1 and S1 Table).
At this stage, 1,116 articles were excluded according to the pre-established eligibility criteria. The remaining 534 articles underwent full-text reading, leading to the exclusion of 335 studies. Among the exclusion reasons, 12 articles were considered duplicates at this stage, mainly gray literature and conference abstracts whose full texts were identified in the final selection. One study was excluded for being in a language incompatible with the scope criteria. Four articles did not present data on viral hepatitis epidemiology in Brazil, while 16 studies did not address viral hepatitis. Thirty-six articles lacked relevant epidemiological information. Another 37 studies were discarded for not presenting pertinent data to the analysis, and 18 were excluded due to poor methodological quality or scientific rigor. Additionally, 14 texts were unavailable in full, 113 studies were excluded for having a data collection period outside the inclusion criteria, and 84 articles were not original publications or presented study design incompatible with the criteria of this review. In the end, 200 studies were included, one of which was identified through manual search (Fig 1).
General information
Among the 200 articles, the period between 2017 and 2020 (n = 92) had the highest number of included texts. Regarding publication type, 173 references were peer-reviewed original articles, followed by short communications (n = 15), conference abstracts (n = 9), and dissertations and theses (n = 3). Almost all included articles (n = 181) were cross-sectional studies, 6 were cohort studies, 4 were ecological studies, 3 employed mixed methodology (cross-sectional study combined with a cohort study), and 3 were based on secondary data/surveillance data. Few studies had national coverage (n = 13), while most had regional reach, distributed in descending order across the following regions: Southeast, Central-West, North, Northeast, and South (Fig 2).
(A) Map authored by the authors in R from IBGE vector boundary data. No basemap or satellite imagery was used. Data source: Brazilian Institute of Geography and Statistics (IBGE) (accessed on 19 Jan 2026): https://www.ibge.gov.br/en/geosciences/downloads-geosciences.html?lang=en-GB. (B) State abbreviations by Brazilian macro-region: North: AC – Acre; AM – Amazonas; AP – Amapá; PA – Pará; RO – Rondônia; RR – Roraima; TO – Tocantins. Northeast: AL – Alagoas; BA – Bahia; CE – Ceará; MA – Maranhão; PB – Paraíba; PE – Pernambuco; PI – Piauí; RN – Rio Grande do Norte; SE – Sergipe. Central-West: DF – Federal District; GO – Goiás; MS – Mato Grosso do Sul; MT – Mato Grosso. Southeast: ES – Espírito Santo; MG – Minas Gerais; RJ – Rio de Janeiro; SP – São Paulo. South: PR – Paraná; RS – Rio Grande do Sul; SC – Santa Catarina.
Collectively, the evidence base comprises more than 14.5 million participants. Sample sizes varied widely overall (minimum 38; maximum 11,397,607; median 464). Hepatitis A showed the broadest range (51–11,397,607; median 523; 25 studies), while hepatitis B contributed to the largest evidence base (115 studies; 56–1,991,120; median 435). Hepatitis C had the highest median sample size (median 600; 81–1,991,120; 91 studies). In contrast, hepatitis D study sizes were consistently low, with no dataset exceeding 4,000 participants (38–3,983; median 560.5; 16 studies). Hepatitis E study sizes were also limited, all below 3,000 participants (150–3,000; median 434; 30 studies).
Most studies were conducted exclusively with adults (n = 122), while 57 studies included all age groups, and 11 focused on children and young people. Data on age group were available in 192 texts, while 10 studies indicated age as an inclusion criterion without presenting specific analyses on this variable. Nearly all studies provided data on sex at birth (n = 192), and 124 texts included information on education level. However, only 89 studies addressed race/skin color.
Regarding the viral hepatitis investigated, hepatitis B was the most studied (n = 115), followed by hepatitis C (n = 91), hepatitis E (n = 30), hepatitis A (n = 25) and hepatitis D (n = 16). Some studies addressed more than one viral hepatitis, so the total number of texts presented in this result exceeds the total number of selected texts.
It is important to note that epidemiological estimates are based on different serological markers depending on hepatitis type, reflecting distinct aspects of infection (e.g., current infection or past exposure), and should therefore be interpreted within the context of each marker.
Hepatitis A
Twenty-five texts included in this review addressed hepatitis A, with studies conducted between 2014 and 2023. Among them, four had national coverage, while the others (n = 21) were regional, predominantly in the Southeast region, followed by the Central-West, North, and South region.
The general population was analyzed in two studies, with anti-HAV IgG/anti-HAV total seroprevalence ranging from 33.3% to 67.8% [20,21], both conducted in the Southeast region (Rio de Janeiro). The lowest value was identified in a young population aged 15–19 years [20] (Figs 2 and 3).
(A) Each point is one extracted prevalence estimate, grouped by population category and ordered by year of data collection. Labels indicate first author, data-collection period, sample size, and study location (Brazilian state/UF). Study locations (states/UF) correspond to those shown in Fig 2. When a study reports more than one eligible estimate (e.g., for different population subgroups, settings, or assays), each estimate is plotted as a separate point and indicated with suffixes (e.g., “a/b”). When stratum-specific estimates are unavailable for overlapping populations, the same estimate may be displayed in more than one category. See Methods and S2 Table (supplementary dataset) for point-level details. (B) Canaã city, Pará State (Anti-HAV IgG: 76.4%; Anti-HAV IgM: 0.1%); Curionópolis city, Pará State (Anti-HAV IgG: 84.8%; Anti-HAV IgM: 0%). (C) 10–19 years (50%); ≤ 9 years (65.2%). (D) Serum sample (79.01%); Oral fluid (80.8%).
Among children, anti-HAV total seroprevalence ranged from 16.6% to 20.7% [20,22]. In a study involving Latin American immigrants and refugees, anti-HAV IgG prevalence among children was 50% − 65.2% [23] (Fig 3).
Analysis of specific populations revealed higher seroprevalence values. Among individuals living in remote areas, total anti-HAV ranged from 79.01% to 85.9% [24–26], while anti-HAV IgG reached 89.1% [27], with all studies conducted regionally in the Central-West and Southeast regions (Figs 2 and 3).
Among individuals with specific clinical conditions, a study conducted in a tertiary care service identified an anti-HAV IgG seroprevalence of 92.3% in people with chronic hepatitis C [28]. In the occupational risk population, anti-HAV total was 73.9% [29] (Fig 3).
In populations with social/structural vulnerabilities, anti-HAV total seroprevalence was 75.63% in transgender women/travestis [30] and 69.7% in gay men and MSM [31]. Additionally, in these groups, anti-HAV IgM, a marker of recent infection, was identified in 0.23% of trans people [30] and 0.2% of gay men and MSM [31]. In a study with Latin American immigrants and refugees, anti-HAV IgG seroprevalence was 87.4%, with the highest values observed among Haitians (94.9%) [23]. Anti-HAV total seroprevalence was 88.1% in the incarcerated population [32] (Fig 3).
In the Amazonian population, anti-HAV total values varied widely, ranging from 16.6% to 84.8% [22,33]. The highest prevalence was identified in the state of Pará, in areas with intense migratory flows due to mining exploitation, while the lowest value was observed in a study focused on children in the Amazon region (Figs 2 and 3).
Hepatitis B
Hepatitis B was addressed in 115 publications, with studies conducted between 2013 and 2024. Four studies presented national data, while the others had regional coverage, with most of them conducted in the Southeast region, followed by the Central-West, Northeast, North, and South regions (Fig 2).
In the general population and proxy groups (youth, pregnant women, and individuals over 50 years old), HBsAg prevalence was reported in 16 regional studies [34–49] and one national study [50]. The values ranged from 0% to 7.5%, with the highest prevalence observed in a population from the Western Amazon, an area considered endemic [41]. The national study, conducted with young members of the Armed Forces, found a prevalence of 0.22% [50] (Figs 2 and 4). Meanwhile, anti-HBc seroprevalence in the general population varied widely, from 0.51% to 34.3% [34–38,41,43,45,46,51] with the highest value also recorded in the Western Amazon [41]. Among individuals over 60 years old, anti-HBc prevalence ranged from 13.7% to 15.1% [35,38] (Figs 2 and 5).
A) Each point is one extracted prevalence estimate, grouped by population category and ordered by year of data collection. Labels indicate first author, data-collection period, sample size, and study location (Brazilian state/UF). Study locations (states/UF) correspond to those shown in Fig 2. When a study reports more than one eligible estimate (e.g., for different population subgroups, settings, or assays), each estimate is plotted as a separate point and indicated with suffixes (e.g., “a/b”). When stratum-specific estimates are unavailable for overlapping populations, the same estimate may be displayed in more than one category. See Methods and S2 Table (supplementary dataset) for point-level details. (B) Southeastern region of Bahia State (0.2%); Southern region of Bahia State (0.29%). (C) Canaã city, Pará State (0.2%); Curionópolis city, Pará State (0.5%). (D) Clinical population: PLWHA (3.9%); Hemodialysis (7%). (E) Rio de Janeiro city, Rio de Janeiro State (6,2%); Salvador city, Bahia State (0%).
(A) Each point is one extracted prevalence estimate, grouped by population category and ordered by year of data collection. Labels indicate first author, data-collection period, sample size, and study location (Brazilian state/UF). Study locations (states/UF) correspond to those shown in Fig 2. When a study reports more than one eligible estimate (e.g., for different population subgroups, settings, or assays), each estimate is plotted as a separate point and indicated with suffixes (e.g., “a/b”). When stratum-specific estimates are unavailable for overlapping populations, the same estimate may be displayed in more than one category. See Methods and S2 Table (supplementary dataset) for point-level details. (B) Canaã city, Pará State (13.8%); Curionópolis city, Pará State (23.7%). (C) Clinical population: PLWHA (28.6%); Coagulopathy patients (31.4%); Hemodialysis (55.9%). (D) Occupational risk population: Domestic waste workers (5.6%); Healthcare waste workers (9.8%).
In clinical populations, HBsAg prevalence was reported in 19 studies [52–70]. Notably: patients undergoing hemodialysis (0.8%−7%), blood transfusion recipients (0%−0.5%), individuals with mental disorders (0.65%−1.1%), and PLWHA, had coinfection HBV (HBsAg)/HIV rates from 0.3% to 3.9% [52–70]. Anti-HBc seroprevalence was identified in 11 studies, with the widest range observed in hemodialysis patients (0%−55.9%) [56,60,65,69]. In a study with a convenience sample from a dialysis service in the Northeast, prevalence reached 55.9% [65], while in the North, it was 35.6% [56] (Figs 2 and 4). In blood transfusion recipients, anti-HBc prevalence was 31.4%, with most participants having received blood before 1994. HBV (anti-HBc)-HIV coinfection ranged from 10.8% to 28.6% in PLWHA. Among individuals with alcohol abuse, prevalence ranged from 1.6% to 15.7% [57,59], while in individuals with mental disorders, it varied from 4.2% to 7.9% [63,66] (Fig 5).
Nine studies evaluated workers exposed to occupational risk for hepatitis B. Healthcare professionals had 0.4% and 1.4% HBsAg and total anti-HBc prevalence, respectively [71]. Urban cleaning and hospital waste workers had the highest HBsAg prevalence (0.4% to 0.7%) [72,73], while anti-HBc total ranged from 1.8% to 9.8% [73–75]. Beauty and aesthetics workers were mentioned in two studies, with HBsAg ranging from 0% to 0.4% [29,76]. For public security professionals, values ranged from 0% to 0.22% [50,77] (Figs 4 and 5).
In remote area populations, four studies in rural settings reported HBsAg prevalence ranging from 0.1% to 0.7% [24,78–80], while anti-HBc values varied from 0.8% to 5.3% [24,79,80], with the highest values for both markers identified among sugarcane cutters in the Northeast and Central-West [79]. Riverside populations had HBsAg prevalence between 0.9% and 2% and anti-HBc total between 3.9% and 10.1% [81,82], with overlapping vulnerabilities in both groups, including sex workers [82] and PWUD [81]. Indigenous populations were analyzed in three studies, with HBsAg ranging from 0% to 8.8% [83–85] and anti-HBc between 14.5% and 45.5% [84,85], with the highest endemicity among Yanomami Indigenous people [84] (Figs 2, 4 and 5).
Twenty-eight studies addressed socially/structurally vulnerable populations. Among incarcerated individuals, HBsAg prevalence ranged from 0.04% to 2.6%, while anti-HBc ranged from 1.2% to 3.2% [86–92]. Among PWUD, values ranged from 0% to 6.2% for HBsAg and from 1.6% to 35.2% for anti-HBc [59,81,93–97]. Among immigrants and refugees, HBsAg prevalence ranged from 0.3% to 6.6% [98–100], with the highest value recorded in the Central-West [99]; for anti-HBc, it was 2.7% [98]. Among homeless individuals, prevalence ranged from 0.8% to 3.7% for HBsAg [97,101,102] and from 4.5% to 35.2% for anti-HBc [97,103], while in low‑income individuals the prevalence of anti‑HBc was 1.3% [104]. Among gay men/MSM, values ranged from 0.6% to 1.1% [105,106] for HBsAg and 5.5% for anti-HBc [106]; however, in a study with individuals on pre-exposure prophylaxis for HIV, the prevalence was lower (0.1%) [107]. Among transgender women/travestis, prevalence was 0.7% for HBsAg [108] and 3.4% for anti-HBc [30]. Among sex workers, values ranged from 0.4% to 2% for HBsAg [82,109] and 3.9% for anti-HBc [82]. (Figs 2, 4 and 5).
In Amazonian populations, hepatitis B markers display marked heterogeneity: HBsAg prevalence ranges from 0% to 8.8% across studies [33,41,43,56,59,81,82,84,85,94,96,110,111], with higher values among PWUD [81,94,96] and in hard to reach endemic settings such as Indigenous communities [84,85] and remote or rural areas with precarious socioeconomic conditions [41,110,111]. Anti-HBc prevalence is likewise heterogeneous, ranging from 1.6% to 45.5% [33,37,41,43,56,59,81,82,84,85,94,96,111], with particularly elevated values among Indigenous groups living in remote areas [84,85], residents of socioeconomically deprived remote settings [41,84], and clinical populations (e.g., patients on hemodialysis [56]). For both markers, the broad variability reflects overlapping vulnerabilities found in Amazonian studies, (Figs 4 and 5).
Hepatitis C
Ninety-one publications addressed hepatitis C, with studies conducted between 2013 and 2024. Four articles had national coverage, while 87 were conducted at the regional level. The Southeast region had the highest number of studies, followed by the Central-West/North and Northeast/South regions.
Seroprevalence of anti-HCV in general population and proxy groups (blood donors, elderly individuals >60 years old, pregnant women, and young adults) was identified in 14 studies, one with national and 13 with regional coverage [35,36,42,44–48,50,112–116]. Values ranged from 0.04% to 2.2%, with the highest prevalence observed within elderly individuals (>60 years old) in Santa Catarina state (South region) [115]. Among pregnant women, anti-HCV ranged from 0.07% to 0.7% [44,48,116], with the highest prevalence found in a study conducted in a South region hospital (Rio Grande do Sul state). The only national study was conducted among young members of the armed forces, identifying an anti-HCV prevalence of 0.28% [50] (Figs 2 and 6).
(A) Each point is one extracted prevalence estimate, grouped by population category and ordered by year of data collection. Labels indicate first author, data-collection period, sample size, and study location (Brazilian state/UF). Study locations (states/UF) correspond to those shown in Fig 2. When a study reports more than one eligible estimate (e.g., for different population subgroups, settings, or assays), each estimate is plotted as a separate point and indicated with suffixes (e.g., “a/b”). When stratum-specific estimates are unavailable for overlapping populations, the same estimate may be displayed in more than one category. See Methods and S2 Table (supplementary dataset) for point-level details. (B) Southeastern region of Bahia State (0.07%); Southern region of Bahia State (0.09%). (C) Canaã city, Pará State (0.1%); Curionópolis city, Pará State (0.5%). (D) Clinical population: PLWHA (1.3%); Hemodialysis (12.6%); Coagulopathy patients (47%). (E) Occupational risk population: domestic waste workers (0.9%); healthcare waste workers (3.3%). (F) 0% (Rio de Janeiro city – Rio de Janeiro State); 1.3% (Salvador city – Bahia State).
Clinical populations were addressed in 17 studies [52–54,56–59,65–68,117–121]. Anti-HCV seroprevalence among people with blood transfusion history or blood products use was investigated in two studies, with values ranging from 2.5% to 47% [53,65]. The highest prevalence was reported in a study conducted in a specialized service in the Northeast region, with a sample composed of patients diagnosed with coagulopathy, a history of sexually transmitted infections, and transfusions performed before 1994. Among individuals on hemodialysis, seroprevalence ranged from 2.8% to 18.24%, with the lowest value found in the North region (Tocantins state) and the highest in the South region (Rio Grande do Sul state). One study reported a 5.3% HCV RNA prevalence [118]. Seven studies assessed anti-HCV prevalence among PLWHA [52,54,65,67,68,119,120], with values ranging from 0.7% to 11.5%. The highest HIV-HCV coinfection rate was recorded in a study conducted in an outpatient clinic, predominantly involving men with possible sexual transmission [119]. Among people with alcohol abuse, seroprevalence ranged from 3.2% to 5.6% [57,59] (Figs 2 and 6).
Among populations at occupational risk, anti-HCV prevalence ranged from 0.11% to 3.3% [29,50,72,73,75,77,122], with waste collectors handling hospital waste presenting the highest prevalence (Fig 6).
For populations in remote areas including Amazonian populations, anti-HCV seroprevalence ranged from 0% to 28.3%. The lowest prevalences were identified in the rural population (0% to 0.4%) [24,78–80]. In Amazonian populations, anti-HCV prevalence showed wide heterogeneity, ranging from 0.1% to 36.9% across studies [33,56,59,81,84,85,123–127]. Most investigations assessed PWUD, among whom the highest prevalences were observed [26,123–126,128], Indigenous populations presented low anti-HCV prevalence (2.1%) [84], in opposition to the elevated HBV burden reported for these groups elsewhere in our analysis. The lowest anti-HCV prevalence was documented in a study conducted in mining/garimpo areas characterized by precarious socioeconomic conditions [33] (Figs 2 and 6).
Twenty-nine studies addressed populations in social and structural vulnerability situations. Incarcerated individuals were the most frequently analyzed, with anti-HCV prevalences ranging from 0.17% to 8.3% [86–88,90,91,129–134]. Among homeless people, values ranged from 0.9% to 3.4% [97,135,136]. PWUD focused studies reported prevalence rates ranging from 0% to 36.9% [59,81,95,97,123–126,137,138], predominantly from the North region [59,81,123–125]. A national study on female sex workers found a prevalence of 0.9% [109]. Seroprevalence among transgender people/travestis was investigated in three studies, with values ranging from 0.8% to 1.37%. A national study reported a prevalence of 0.7% among gay men/MSM [139], while a regional study with PrEP users, mostly MSM, found a prevalence of 0.3% [107] (Fig 6).
Hepatitis D
Hepatitis D was the least studied, with 16 publications conducted between 2017 and 2024, primarily concentrated in the period from 2018 to 2022. Three studies had national coverage (two with an exclusive focus on genotypes and one with prevalence data), while 13 were conducted at the regional level. Most publications focused on the Legal Amazon regions, except for one study conducted with a clinical population in the Southeast region.
Hepatitis D prevalence was assessed in individuals infected with the hepatitis B virus using the serological markers anti-HDV total or anti-HDV IgG. The highest prevalence variation was observed in the Amazonian/Legal Amazon population, ranging from 0% to 23.9%, making it the region with the largest number of studies [33,41,82,84,85,96,111,128,140]. The highest prevalence was recorded in a study conducted with patients with chronic hepatitis B treated at a specialized service in Acre state [128]. A high prevalence (19.5%) was also identified in a study among PWUD using the respondent-driven sampling (RDS) methodology [96]. In remote area populations, two studies on Indigenous populations reported prevalences between 0.3% and 12.5% [84,85]. Another study conducted in riverine communities in the Amazon region identified a prevalence of 4.8% among female sex workers [82] (Figs 2 and 7).
(A) Each point is one extracted prevalence estimate, grouped by population category and ordered by year of data collection. Labels indicate first author, data-collection period, sample size, and study location (Brazilian state/UF). Study locations (states/UF) correspond to those shown in Fig 2. When a study reports more than one eligible estimate (e.g., for different population subgroups, settings, or assays), each estimate is plotted as a separate point and indicated with suffixes (e.g., “a/b”). When stratum-specific estimates are unavailable for overlapping populations, the same estimate may be displayed in more than one category. See Methods and S2 Table (supplementary dataset) for point-level details.
In the Southeast region, HDV prevalence was found to be 1.7% in a study of patients with chronic kidney disease undergoing hemodialysis or kidney transplantation [141] and 6.22% in a convenience sample for viral hepatitis testing in a reference public health laboratory [142]. A nationwide study estimated anti-HDV total prevalence by region [140], with the highest rate in the North region (8.5%), followed by Central-West (2.5%), Southeast (1.7%), and Northeast (0.8%). No HDV cases were identified in the South region (Figs 2 and 7).
Finally, three other studies conducted with Indigenous populations, Japanese immigrants, and rural populations did not detect serological markers for HDV [24,83,98] (Fig 7).
Hepatitis E
Thirty texts addressed hepatitis E, with studies conducted between 2013 and 2024. All studies had regional coverage, with the highest number of publications in the Southeast region, followed by the Central-West, Northeast/South, and North regions.
In the general population, eight studies identified anti-HEV IgG/total seroprevalence, ranging from 0.9% to 59.4% [143–150]. The highest value (59.4%) was observed in a study involving 3,000 participants from three major cities in Rio Grande do Sul state. According to the authors, this finding suggests possible endemicity in the region, possibly associated with a high density of swines [150]. Other studies were conducted among blood donors in the South, Southeast, Central-West, and Northeast regions, with variations between 0.9% and 18.7% [143–149] (Figs 2 and 8A).
(A) Each point is one extracted prevalence estimate, grouped by population category and ordered by year of data collection. Labels indicate first author, data-collection period, sample size, and study location (Brazilian state/UF). Study locations (states/UF) correspond to those shown in Fig 2. When a study reports more than one eligible estimate (e.g., for different population subgroups, settings, or assays), each estimate is plotted as a separate point and indicated with suffixes (e.g., “a/b”). When stratum-specific estimates are unavailable for overlapping populations, the same estimate may be displayed in more than one category. See Methods and S2 Table (supplementary dataset) for point-level details. (B) Repeated study labels indicate distinct estimates from the same study for different populations. (C) Immunoblot (5.3%); ELISA (5.8%). (D) Clinical population: Chronic hepatitis C without cirrhosis (8%); Chronic hepatitis C with cirrhosis (13.2%). (E) Clinical population: Transplant recipients (18.7%); Cirrhotic (22.5%). Vulnerable population: Residents of a low-income area (17.5%); PWUD (20%). (F) Immunoblot (5.1%); ELISA (5.6%). (G) Remote population: Indigenous (2.8%); Rural population (14.2%). B. Evidence map of hepatitis E (anti-HEV IgM) prevalence estimates in Brazil by population group, 2013–2024A,B. (A) Each point is one extracted prevalence estimate, grouped by population category and ordered by year of data collection. Labels indicate first author, data-collection period, sample size, and study location (Brazilian state/UF). Study locations (states/UF) correspond to those shown in Fig 2. When a study reports more than one eligible estimate (e.g., for different population subgroups, settings, or assays), each estimate is plotted as a separate point and indicated with suffixes (e.g., “a/b”). When stratum-specific estimates are unavailable for overlapping populations, the same estimate may be displayed in more than one category. See Methods and S2 Table (supplementary dataset) for point-level details. (B) Repeated study labels indicate distinct estimates from the same study for different populations. (C) Clinical population: Transplant recipients (0%); Cirrhotic (1.5%). Vulnerable population: low-income area residents (1.25%); PWUD (3.75%;). (D) Immunoblot (0.7%); ELISA (0.9%).
In remote area populations, prevalence ranged from 0.5% to 20.7% [24,27,151–154]. The highest value was found in a rural community in São Paulo state, where the authors suggested that zoonotic exposure may have influenced the high seroprevalence, although without conclusive epidemiological evidence [27]. In other studies, prevalence ranged from 0.5% to 8.6% [24,151,152,154]. One study evaluated a quilombola community, reporting a 0.5% anti-HEV IgG prevalence [153]. Among Indigenous populations, the rate was 2.8% [154] (Figs 2 and 8A).
Anti-HEV IgG/total seroprevalence was also investigated in some clinical populations. Among individuals with transplantation history, prevalence ranged from 2.5% to 18.7% [143,155–157], with the highest prevalence study noting limitations due to a small sample size [143]. Among individuals with viral and non-viral origin chronic hepatitis, values ranged from 3.1% to 22.5% [143,158–162]. Additionally, one study reported a prevalence of 13% in individuals who had received blood transfusions. Among PLWHA, seroprevalence ranged from 4.1% to 6.7% [145,163] (Fig 8A).
Among socially and structurally vulnerable populations, prevalence values ranged from 14.2% to 20% for PWUD [143,164,165], with studies conducted in the South, North, and Central-West regions. It was 6.5% for Latin American immigrants and refugees in the Central-West region [23]; and finally, a prevalence of 1.82% was observed among people experiencing homelessness [166] (Figs 2 and 8A).
The prevalence of the acute infection marker for hepatitis E (anti-HEV IgM) was reported in 12 studies [143,153,155–157,160–162,164–167]. In the general population, a value of 1.25% was found [143]. In a remote area community, prevalence was 1.1% [153]. Among clinical populations, values varied according to the studied group, 0% to 2.6% in transplant recipients [143,155–157], and 0.3% to 4.4% in people with chronic hepatitis [160–162]. Among urban sanitation workers, prevalence ranged from 0.7% to 0.9% [166,167]. Finally, in vulnerable populations, a study assessed low-income individuals, reporting a seroprevalence of 1.25% [143], and in PWUD 0.3% to 3.8% [143,164,165] (Fig 8B).
Discussion
The findings of this review reveal a heterogeneous viral hepatitis panorama in Brazil, highlighting regional inequalities, methodological gaps, and limitations in epidemiology incorporating health social determinants. The predominance of regional studies and the scarce national coverage suggest an uneven distribution of research output, possibly related to disparities in research funding and healthcare service infrastructure.
The geographical distribution of scientific evidence on viral hepatitis in Brazil showed discrepancies compared to the disease burden reported in the historical series of epidemiological bulletins [18]. While hepatitis A was more frequently studied in the Southeast and Midwest regions, data from the Brazilian Ministry of Health indicate a higher proportion of cases in the Northeast and North, suggesting an underrepresentation of these regions in research [18]. A similar situation was observed for hepatitis B, where the South region accounted for 31.2% of diagnosed cases between 2000 and 2023 but had one of the lowest numbers of studies [18]. Hepatitis C followed this trend, with the highest research output in the Southeast, while the South, which had the second-highest number of cases, had few studies [18]. For hepatitis D, most studies were concentrated in the North region, where most diagnosed cases are found. However, research on this infection remains scarce [18]. Hepatitis E showed a more aligned distribution between the number of cases and research efforts but remains under investigation, with heterogeneous prevalence estimates across studies [18]. These discrepancies underscore the need to expand epidemiology research not only in regions with a high disease burden, particularly in the North and Northeast, but also among vulnerable populations to ensure a more equitable understanding of viral hepatitis impact in Brazil.
The significant increase in publications between 2017 and 2020 may be related to intensified testing and treatment policies and epidemiological surveillance expansion during this period. Increased availability of rapid tests and direct-acting antiviral treatments for hepatitis C within the SUS, along with Brazil’s adherence to the WHO’s strategic plan to eliminate viral hepatitis as a public health problem by 2030, may have encouraged greater academic production on these topics. However, a decline in publication volume was observed in subsequent years, coinciding with the COVID-19 pandemic. This phenomenon reflects impacts on research output: disproportionate growth in COVID-19-related publications at the expense of non-COVID research, reallocation of research funding priorities, and pandemic-related disruptions to healthcare services [168–174]. In this context, viral hepatitis research publications may possibly have been affected by these intersecting factors. The economic contraction and the redirection of resources to other health emergencies may have compromised support for research, including viral hepatitis studies [174].
The heterogeneity of outcomes, study populations, research designs, methodologies employed, study locations, and sample sizes limited the comparability of the evidence, including across the population groups addressed and geographic regions. Methodologically, the predominance of small-scale cross-sectional studies represents a significant limitation in understanding the epidemiological patterns of viral hepatitis in Brazil. While cross-sectional studies are essential for estimating infection prevalence, their inability to establish causal relationships limits the exploration of risk factors and transmission dynamics. Moreover, small sample sizes compromise findings generalizability, particularly in the socioeconomic and geographical heterogeneity context.
Additionally, many studies relied on convenience samples, often recruited from specialized healthcare services, potentially overestimating infection prevalence due to selection bias, making extrapolation to the general population difficult. On the other hand, for hard-to-reach populations, such as people who use drugs, sex workers, and transgender individuals, methodologies like snowball sampling and respondent-driven sampling (RDS) have been widely used to overcome logistical and recruitment challenges [175,176]. However, these approaches also present limitations, such as dependence on the social networks of initial participants and difficulty ensuring population representativeness. The scarcity of population-based studies using probabilistic sampling reinforces the need for more methodologically robust investigations to enable a more precise characterization of viral hepatitis epidemiological determinants in Brazil.
The analysis of studied viruses revealed a concentration of research on hepatitis B and C, which may be explained by the disease burden associated with these infections and the greater availability of diagnostic tests [177]. In contrast, hepatitis D remained under-researched, with only 16 studies identified, reflecting both the underreporting of the infection and the limited laboratory infrastructure for its diagnosis [17,19,140,178]. Hepatitis A, in turn, showed wide variability in seroprevalence, highlighting changes in infection patterns in Brazil due to improved sanitation conditions and vaccine introduction [179,180]. This has led to reduced exposure in urban populations and a concentration of infections mainly in vulnerable groups, like incarcerated individuals, rural residents, and on specific outbreak situations, such as among gay and MSM populations [32,181].
Our synthesis reinforces the persistence of hepatitis B as a public health concern in Amazonian settings [182]. Heterogeneous HBsAg prevalence is observed. Studies describe overlapping vulnerabilities and potential transmission contexts, including cultural practices such as scarification, bloodletting, piercing and tattooing, early sexual debut, possible perinatal or early life exposures, and reduced access to vaccination in remote areas [84,85]. Perinatal interventions and timely newborn vaccination have helped to lower HBV infection risk where implemented [183,184]. Some reports also describe vaccine and antiviral escape due to mutations in the HBV genome, which may contribute to sustained transmission and variability in prevalence [96,183]. In clinical populations, the prevalence of anti-HBc and HBsAg was elevated, warranting focused prevention, screening, and vaccination efforts [182]. In line with WHO, the Amazon Basin is a pocket of elevated HDV occurrence among HBsAg positive people, shaped by migration, socioeconomic conditions, timing and coverage of HBV vaccination, and differences between HDV genotypes [3]. These observations support tailored prevention and linkage to care in Amazonian contexts.
For hepatitis C, population‑based studies reported low seroprevalence, consistent with prior literature [185]. Marked heterogeneity emerged across subgroups, with substantially higher values among PWUD, other vulnerable, and clinical populations (including patients with coagulopathies). Across PWUD studies, the most consistently reported correlates of anti‑HCV positivity were older age, longer duration of drug use, and sharing of needles/syringes or other drug paraphernalia [123–125]. In these groups, sustained case finding and prompt antiviral initiation remain priorities. Most estimates were based on anti‑HCV, with HCV RNA reported in only one study. Consequently, we cannot estimate active infection, and seropositivity may reflect past, successfully treated, or spontaneously cleared infection rather than current viremia.
The lack of information on health social determinants in a significant proportion of the analyzed studies represents an important gap in understanding health inequities in viral hepatitis in Brazil. Only 44.5% reported race/ethnicity, limiting sociodemographic infection patterns identification. This finding reinforces the low inclusion of race/ethnicity data in high-impact medical journals [186]. The reasons for these omissions remain unexplained, yet such absence affects the representativeness, equity, and applicability of research findings, with direct consequences for the prioritization of public health policies. As a solution, the engagement of multiple stakeholders (policymakers, healthcare professionals, researchers, and civil society) is needed to raise awareness, establish regulations, and promote the integration of race/ethnicity data across all stages of research, alongside the development of explicit editorial guidelines on this issue in medical journals [186,187].
Considering this context, there is a pressing need to expand national studies using robust methodologies, such as cohort and longitudinal investigations, to enable a deeper understanding of viral hepatitis determinants in Brazil. Additionally, incorporating social and structural variables into epidemiological research is essential to guide intervention strategies targeting vulnerable groups. Strengthening epidemiological surveillance, combined with investments in research and innovation, can contribute to the development of equitable public health policies and to the elimination of viral hepatitis as a public health problem in the country, in alignment with regional and population-specific needs. Examples include hepatitis D screening among individuals with reactive HBsAg from the Amazon region [19], targeted hepatitis A vaccination efforts during a recent outbreak among MSM [188] and expanded access to point-of-care diagnosis and timely treatment for vulnerable populations [189], as integral components of the national hepatitis elimination strategy within SUS.
Regarding data quality, a simplified assessment was conducted, focusing on inclusion criteria clarity, adequate subjects’ characterization, and transparency in reporting results, particularly concerning exposure measurements reliability. While most studies demonstrated satisfactory quality across these parameters, it is important to note that we did not perform an in-depth critical appraisal according to the methodological standards recommended for systematic reviews. As a result, conclusions are subject to limitations regarding bias risk assessment.
Finally, despite standardizing extraction criteria and holding periodic discussions among reviewers to harmonize content, subjective interpretations in article analysis could not be entirely eliminated. However, measures were taken to mitigate these limitations, including regular team meetings to review extracted indicators and clarify methodological questions throughout the process and it was possible to reach an extensive scope review that will guide health managers to formulate priority actions to eliminate hepatitis, considering sociodemographic and regional aspects. It will also help to clarify the main gaps to be filled in terms of investment in research.
Conclusion
This review provides a comprehensive overview of viral hepatitis epidemiology in Brazil, emphasizing the vulnerable populations epidemiological profile and the regional infection distribution. It represents a pioneering effort in consolidating evidence from the past decade, identifying epidemiological patterns, research gaps, and persistent challenges in hepatitis surveillance.
Building on the gaps identified, future research should prioritize strengthening evidence generation in regions with limited scientific output but high epidemiological relevance, particularly the North of Brazil, as well as expanding nationally representative studies with more robust methodological designs, including longitudinal and population-based approaches. These efforts are essential to improve the characterization of the national epidemiological profile, including transmission patterns and disease burden. In parallel, particular attention should be given to vulnerable and hard-to-reach populations, in which higher prevalence reflects underlying social and structural determinants. This requires the incorporation of analytical variables that capture these dimensions, combined with appropriate sampling strategies to better address epidemiological inequities. Finally, efforts to translate epidemiological findings into accessible reports and data systems are essential to support decision-making processes and strengthen public health policies aligned with viral hepatitis elimination goals.
Supporting information
S1 Table. Search strategies (by database with respective filters used and search date).
https://doi.org/10.1371/journal.pone.0353840.s001
(DOCX)
S2 Table. Database hepatitis scoping review (Supporting Information).
https://doi.org/10.1371/journal.pone.0353840.s002
(XLSX)
S3 Table. Codebook of the viral hepatitis scoping review database.
https://doi.org/10.1371/journal.pone.0353840.s003
(PDF)
S4 Table. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist.
https://doi.org/10.1371/journal.pone.0353840.s004
(DOCX)
References
- 1. Cooke GS, Andrieux-Meyer I, Applegate TL, Atun R, Burry JR, Cheinquer H, et al. Accelerating the elimination of viral hepatitis: A Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol. 2019;4(2):135–84. pmid:30647010
- 2. WHO. The Global Health Observatory - Explore a world of health data. https://www.who.int/data/gho/data/themes/chronic-viral-hepatitis. 2025. Accessed 2025 July 11.
- 3.
WHO. Global hepatitis report 2024: action for access in low- and middle-income countries. Geneva: World Health Organization. 2024.
- 4. Brasil Ministerio da Saude. Boletim epidemiológico - hepatites virais 2023. 2023. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/especiais/2023/boletim-epidemiologico-de-hepatites-numero-especial-jul.2023/view
- 5.
W.H.O. Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030. Geneva: World Health Organization. 2022.
- 6. Brasil Nacoes Unidas. Objetivos de Desenvolvimento Sustentável no Brasil 2025. [cited 2025 June, 11]. https://brasil.un.org/pt-br/sdgs
- 7.
Brasil Presidencia da Republica. Decreto nº 11.494, de 17 de abril de 2023. Institui o comitê interministerial para a eliminação da tuberculose e de outras doenças determinadas socialmente - CIEDS. Jurídicos CCSEpA. Brasília, Brasil. 2023.
- 8.
Brasil Presidencia da Republica. Decreto Nº 11.908, de 6 de fevereiro de 2024. Institui o Programa Brasil Saudável - Unir para Cuidar, e altera o Decreto nº 11.494, de 17 de abril de 2023, para dispor sobre o Comitê Interministerial para a Eliminação da Tuberculose e de Outras Doenças Determinadas Socialmente - CIEDDS. Jurídicos CCSEpA. Brasília, Brasil. 2024.
- 9.
Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z. JBI Manual for Evidence Synthesis. 2024.
- 10. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119–26. pmid:33038124
- 11. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467–73. pmid:30178033
- 12.
EndNote T. EndNote. 20 ed. Philadelphia, PA: Clarivate. 2013.
- 13. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. pmid:27919275
- 14. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95:103208. pmid:31078660
- 15. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. pmid:18929686
- 16. Brasil Ministerio da Saude. Linhas de Cuidado Hepatites Virais. 2021. https://linhasdecuidado.saude.gov.br/portal/hepatites-virais/
- 17.
Brasil Ministerio da Saude. Protocolo clínico e diretrizes terapêuticas de hepatite B e coinfecções. Brasília: Brasil. 2023. http://bvsms.saude.gov.br/bvs/publicacoes/protocolo_clinico_diretrizes_terapeuticas_hepbdigital.pdf
- 18.
Brasil Ministerio da Saude. Boletim epidemiológico - hepatites virais 2024. Brasilia, Brasil. 2024. https://www.gov.br/aids/pt-br/central-de-conteudo/boletins-epidemiologicos/2024/boletim-epidemiologico-hepatites-virais-2024
- 19.
Brasil Ministerio da Saude. Nota técnica nº 176/2024-CGHA/.DATHI/SVSA/MS - Implantação piloto do exame de carga viral do vírus da hepatite D ou Delta (CV-HDV) no Sistema Único de Saúde (SUS). Brasilia, Brazil: Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Departamento de HIV/Aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis. Coordenação-Geral de Vigilância do HIV/Aids. 2024.
- 20. Kury CM, Pinto MA, Silva JP, Cruz OG, Vitral CL. Hepatitis A seroprevalence in public school children in Campos dos Goytacazes, Rio de Janeiro State, Brazil, prior to the introduction of the hepatitis A universal childhood vaccination. Cad Saude Publica. 2016;32(11):e00175614. pmid:27982290
- 21. Carvalho F de, Brandão LGP, Varela MC, Tuyama M, Correa DF, Santos ATS, et al. Hepatitis A seroprevalence among special populations in the Rio de Janeiro Metropolitan Area, Brazil. Cad Saude Publica. 2023;39(2):e00075522. pmid:36946796
- 22. Mantovani SAS, Delfino BM, Martins AC, Oliart-Guzmán H, Pereira TM, Branco FLCC, et al. Socioeconomic inequities and hepatitis A virus infection in Western Brazilian Amazonian children: Spatial distribution and associated factors. BMC Infect Dis. 2015;15:428. pmid:26471064
- 23. Silva GRCE, Martins TLS, Silva CA, Caetano KAA, Carneiro MADS, Silva BVDE, et al. Hepatitis A and E among immigrants and refugees in Central Brazil. Rev Saude Publica. 2022;56:29. pmid:35476107
- 24. Caetano KAA, Bergamaschi FPR, Carneiro MAS, Pinheiro RS, Araújo LA, Matos MA, et al. Hepatotropic viruses (hepatitis A, B, C, D and E) in a rural Brazilian population: Prevalence, genotypes, risk factors and vaccination. Trans R Soc Trop Med Hyg. 2020;114(2):91–8. pmid:31608957
- 25. Pinheiro RS, Araújo LA, Caetano KAA, Matos MA, Carneiro MA, Teles SA. intermediate endemicity of hepatitis a virus infection in rural settlement projects of Southwest Goiás, Brazil. Arq Gastroenterol. 2015;52(3):200–3. pmid:26486287
- 26. Tourinho RS, de Almeida AJ, Villar LM, Murat PG, Capelin GJM, Castro ARCM, et al. Cross-Sectional study of hepatitis A virus infection in the pantanal population before vaccine implementation in Brazil: Usage of non-invasive specimen collection. Int J Environ Res Public Health. 2015;12(7):7357–69. pmid:26133128
- 27. de Almeida E Araújo DC, de Oliveira JM, Haddad SK, da Roza DL, Bottino F de O, Faria SBSC, et al. Declining prevalence of hepatitis A and silent circulation of hepatitis E virus infection in southeastern Brazil. Int J Infect Dis. 2020;101:17–23. pmid:32947056
- 28. da Silva EF, Mazo DF, Oliveira CP, Medeiros RP, Carrilho FJ, Pessôa MG. HAV and HBV seroprevalence in 1,000 patients with chronic HCV infection in a Tertiary Care Center in São Paulo, Brazil. Ann Hepatol. 2016;15(5):691–5. pmid:27493107
- 29. Villar LM, de Paula VS, de Almeida AJ, do Ó KMR, Miguel JC, Lampe E. Knowledge and prevalence of viral hepatitis among beauticians. J Med Virol. 2014;86(9):1515–21. pmid:24916521
- 30. Ferri LP, Junqueira PDS, de Almeida MMS, Oliveira MG, de Oliveira BR, Diniz E Silva BV, et al. Viral Hepatitis A, B and C in a Group of Transgender Women in Central Brazil. Trop Med Infect Dis. 2022;7(10):269. pmid:36288010
- 31. Castro LS, Rezende GR, Pires Fernandes FR, Bandeira LM, Cesar GA, do Lago BV, et al. HAV infection in Brazilian men who have sex with men: The importance of surveillance to avoid outbreaks. PLoS One. 2021;16(9):e0256818. pmid:34529672
- 32. Castro LS, de Rezende GR, Puga MAM, Bandeira LM, Ortiz Tanaka TS, Weis-Torres S, et al. Hepatitis A virus infection in Brazilian correctional facilities. PLoS One. 2023;18(4):e0283868. pmid:37098017
- 33. Nunes HM, Sarmento VP, Malheiros AP, Paixão JF, Costa OSG, Soares MCP. As hepatites virais: Aspectos epidemiológicos, clínicos e de prevenção em municípios da Microrregião de Parauapebas, sudeste do estado do Pará, Brasil. Revista Pan-Amazônica de Saúde. 2017;8:29–35.
- 34. De Oliveira CMA, Souza AJS, Brasil MDJS, Soares MDCP, Nunes HM, Nunes MRT. Contágio intradomiciliar e status vacinal entre comunicantes de portatores do vírus da hepatite B. revenf. 2020;11(3).
- 35.
Barcos IP. Análise da prevalência e de fatores de risco para as hepatites virais crônicas B e C em idosos residentes no município de Botucatu-SP. 2013.
- 36. Borelli SD, Mazzola JC, Matta ACG, Takemoto AY, Bértoli M. Blood discard rate and the prevalence of infectious and contagious diseases in blood donors from provincial towns of the state of Paraná, Brazil. Rev Bras Hematol Hemoter. 2013;35(6):395–9. pmid:24478604
- 37. Castro RS, Cordeiro BS, Rolim MAF, Costa APM, Santos MDC, Silva MACN, et al. High prevalence of hepatitis B virus and low vaccine response in children and adolescents in Northeastern Brazil. Rev Inst Med Trop Sao Paulo. 2023;65:e33. pmid:37098921
- 38. de Paula Machado DFG, Martins T, Trevisol DJ, Vieira E Silva RA, Narciso-Schiavon JL, Schuelter Trevisol F, et al. Prevalence and factors associated with hepatitis B virus infection among senior citizens in a southern brazilian city. Hepat Mon. 2013;13(5):e7874. pmid:23922561
- 39. Farias NSO, Holcman MM, Compri AP, Silva CRC, Figueiredo GM, Moreira RC, et al. Occurrence of hepatitis B in pregnant women and follow-up of exposed children in the State of São Paulo, Brazil, in 2012. Epidemiol Serv Saude. 2020;29(2):e2019443. pmid:32401886
- 40. Ferezin RI, Bertolini DA, Demarchi IG. Prevalence of positive sorology for HIV, hepatitis B, toxoplasmosis and rubella in pregnant women from the northwestern region of the state of Paraná. Rev Bras Ginecol Obstet. 2013;35(2):66–70. pmid:23412005
- 41. Antonio Ferreira-Junior P, de-Oliveira EC, Martin TOG, Rodrigues Alves-Junior E, Silva LJ, Mello FC, et al. Prevalence of hepatitis B and D virus infection in a district of Mato Grosso, bordering Amazonas and Rondônia states. Rev Soc Bras Med Trop. 2020;53:e20190559. pmid:33111905
- 42. Lopes F, Tso FK, Speck NMG. The Brazilian army and the low prevalence of sexually transmitted infections in women of the military garrison of Campinas between 2017 to 2020: A prospective, cross-sectional epidemiological study. Sao Paulo Med J. 2023;142(2):e2022557. pmid:37531524
- 43. Moresco MN, Virgolino HA, de Morais MPE, da Motta-Passos I, Gomes-Gouvêa MS, de Assis LMS, et al. Occult hepatitis B virus infection among blood donors from the Brazilian Amazon: Implications for transfusion policy. Vox Sang. 2014;107(1):19–25. pmid:24697276
- 44. Pedro SAPS, Silva CAL, Rebouças MC, Costa MFD. Screening on prenatal infections in the South and Southwest macro-regions in the State of Bahia, Brazil: detected on paper filter. Rev Bras Saude Mater Infant. 2019;19(3):681–90.
- 45. Pinto FP, Ferreira OC, Olmedo DB, Precioso PM, Barquette FR, Castilho MC. Prevalence of hepatitis B and C markers in a population of an urban university in Rio de Janeiro, Brazil: a cross-sectional study. Ann Hepatol. 2015;14(6):815–25. pmid:26436353
- 46. Rebouças KAAF, Narici FM, Santos Junior MN, Neres NS Oliveira MV, Souza CL. Seroprevalence of transfusion-transmissible infectious diseases at a hemotherapy service located in southwest Bahia, Brazil. Hematol Transfus Cell Ther. 2019;41(4):324–8. pmid:31412988
- 47. Santos APA, Rios DRA, Trindade CLC, Oliveira FEG, Oliveira MB, de Melo SN, et al. Prevalence, incidence, risk factors and residual risk associated with viral infections among eligible Brazilian blood donors. Transfus Med. 2024;34(1):46–53. pmid:38165014
- 48. Vargas L, Bastos F, Guimarães A, Amaral S, Fausto T, Arriaga M, et al. Seroprevalence and factors associated with Human Immunodeficiency virus, Human T lymphotropic virus and Hepatitis B/C infections in parturient women of Salvador - Bahia, Brazil. Braz J Infect Dis. 2020;24(4):279–87. pmid:32464116
- 49. da Cunha Rosa LR, Brandão LGVA, Moura WÉA, Campos LR, Pessoni GC, de Oliveira Roque e Lima J, et al. Prevalence, Risk Factors and Vaccine Response against Hepatitis B in People Aged 50 Years or Older. Vaccines (Basel). 2023;11(3):597. pmid:36992181
- 50. da Motta LR, Adami ADG, Sperhacke RD, Kato SK, Paganella MP, Pereira GFM, et al. Hepatitis B and C prevalence and risk factors among young men presenting to the Brazilian Army: A STROBE-compliant national survey-based cross-sectional observational study. Medicine (Baltimore). 2019;98(32):e16401. pmid:31393348
- 51. Lima Filho CA, Silva Júnior JA, Carvalho ABTN, Campos HM, Silva A, Santos ALM. Aspectos epidemiológicos dos casos de hepatite B no estado de Pernambuco. Saúde Coletiva (Barueri). 2023;13(88):13193–206.
- 52. Amorim LT, Schlemper Junior BR. HIV/AIDS in small cities in Midwest Santa Catarina, south of Brazil: clinical and epidemiological aspects, opportunistic infections. Rev Soc Bras Med Trop. 2019;52:e20180430. pmid:31188912
- 53. Blatyta PF, Kelly S, Sabino E, Preiss L, Mendes F, Carneiro-Proietti AB, et al. Prevalence of serologic markers of transfusion and sexually transmitted infections and their correlation with clinical features in a large cohort of Brazilian patients with sickle cell disease. Transfusion. 2020;60(2):343–50. pmid:31804727
- 54. Brandão NAA, Pfrimer IAH, Martelli CMT, Turchi MD. Prevalence of hepatitis B and C infection and associated factors in people living with HIV in Midwestern Brazil. Braz J Infect Dis. 2015;19(4):426–30. pmid:25766773
- 55. Calux SJ, Silva VCM, Compri AP, Lemos MF, Santos AP, Oba IT, et al. Hepatitis B: Prevalence and occult infection in HIV-infected patients. Rev Soc Bras Med Trop. 2020;53:e20180533. pmid:31994654
- 56. Cordeiro VM, Martins BCT, Teles SA, Martins RMB, Cruvinel KPS, Matos MAD, et al. Decline in hepatitis B and C prevalence among hemodialysis patients in Tocantins, Northern Brazil. Rev Inst Med Trop Sao Paulo. 2018;60:e36. pmid:30066804
- 57. Cortes VF, Taveira A, Cruz HM, Reis AA, Cezar JS, Silva BS, et al. Prevalence of Hepatitis B and C virus infection among alcoholic individuals: Importance of screening and vaccination. Rev Inst Med Trop Sao Paulo. 2017;59:e47. pmid:28793018
- 58. Costa JEF, Morais VMS, Gonçales JP, Silva DM, Coêlho MRCD. Prevalence and risk factors for hepatitis B and C viruses in patients with leprosy. Acta Trop. 2017;172:160–3. pmid:28457830
- 59. de Araújo Júnior JRR, Abrahão de Oliveira CM, de Sousa Brasil IF, Lopes da Silva D, Correa das Chagas AA, Marceliano Nunes H. Perfil bioquímico e sorológico das hepatites B e C num centro recuperação para dependentes químicos. Enfermagem em Foco. 2023;14:1–7.
- 60. Fontenele AMM, Gainer JBF, da Silva E Silva DV, Cruz Santos MD, Salgado JV, Salgado Filho N, et al. Occult hepatitis B among patients with chronic renal failure on hemodialysis from a capital city in northeast Brazil. Hemodial Int. 2015;19(3):353–9. pmid:25733070
- 61. Martinez VO, D’Arede SO, de Almeida ES, Lima FWM. Prevalence of serum markers of infection and naturally acquired immunity to hepatitis B virus in transfused children treated at a children’s hospital in Salvador, Bahia: A cross-sectional study. Pediatr Hematol Oncol. 2018;35(7–8):422–6. pmid:30588876
- 62. Martins S, Livramento A, Andrigueti M, Kretzer IF, Machado MJ, Spada C, et al. The prevalence of hepatitis B virus infection markers and socio-demographic risk factors in HIV-infected patients in Southern Brazil. Rev Soc Bras Med Trop. 2014;47(5):552–8. pmid:25467254
- 63. Moraes TC, Fiaccadori FS, Souza M, Almeida TNV, Cunha Mdos P, Castro Íde A, et al. Hepatitis B virus infection among institutionalized mentally ill patients in Brazil. Braz J Infect Dis. 2015;19(6):643–7. pmid:26361836
- 64. Pessoni GC, Marinho TA, Carneiro MMS, Martins RM, Soares CC, Silva LN, et al. Hepatitis B virus infection among oncohematologic disease patients in Central Brazil: prevalence, risk factors and immunization. Hematol Transfus Cell Ther. 2019;41(3):199–204. pmid:31036513
- 65. Ribeiro Barbosa J, Sousa Bezerra C, Carvalho-Costa FA, Pimentel de Azevedo C, Lopes Flores G, Baima Colares JK, et al. Cross-sectional study to determine the prevalence of hepatitis B and C virus infection in high risk groups in the Northeast Region of Brazil. Int J Environ Res Public Health. 2017;14(7):793. pmid:28714924
- 66. Silva ASS, Costa FJLS, Câmara JT, Neves FM, Assis JT. Prevalência de doenças infecciosas em usuários de Centro de Atenção Psicossocial de Caxias-MA. Rev Pesqui. 2018;10(1):137–44.
- 67. Silva BEBD, Santos VS, Santos IER, Batista MVA, Gonçalves LLC, Lemos LMD. Prevalence of coinfections in women living with human immunodeficiency virus in Northeast Brazil. Rev Soc Bras Med Trop. 2019;53:e20190282. pmid:31859952
- 68. Tosato Boldrini NA, Bondi Volpini LP, Freitas LB, Spano LC, Musso C, Silva Santos MCLF, et al. Sexually transmitted infections among women living with HIV in a Brazilian city. Braz J Infect Dis. 2021;25(1):101044. pmid:33417851
- 69. Villar LM, Fraga KA, Mendonça ACF, Miguel JC, Silva EF, Barbosa JR, et al. Serological and molecular characterization of hepatitis B virus infection in chronic kidney disease patients from Rio de Janeiro, Brazil. Braz J Infect Dis. 2022;26(3):102371. pmid:35661641
- 70. Weissmann L, Picone C de M, Gouvêa MSG, Ferreira PRA, Viana MSVB, Pinho JRR, et al. Hepatitis B viremia in HIV-coinfected individuals under antiretroviral therapy. Braz J Infect Dis. 2019;23(6):441–50. pmid:31715124
- 71. Morais LQ, Motta-Castro ARC, Frota OP, Contrera L, Carvalho PRT, Fernandes FRP. Hepatite B em profissionais de enfermagem: prevalência e fatores ocupacionais de risco. Rev enferm UERJ. 2016;24(3):e11143-e.
- 72. Sherine Ganem Dos Santos F, Rava Zolnikov T, Bolibar Ribas I, Casabona J, Monteiro E, Martins E, et al. Syphilis and other sexually transmitted infections among waste pickers in Brasilia, Brazil. Waste Manag. 2020;118:122–30. pmid:32892089
- 73. Weis-Torres SMDS, Fitts SMF, Cardoso WM, Higa Junior MG, Lima LA, Bandeira LM, et al. High level of exposure to hepatitis B virus infection in a vulnerable population of a low endemic area: A challenge for vaccination coverage. Int J Infect Dis. 2020;90:46–52. pmid:31589921
- 74. Marinho TA, Lopes CLR, Teles SA, Matos MA, Matos MAD, Kozlowski AG, et al. Epidemiology of hepatitis B virus infection among recyclable waste collectors in central Brazil. Rev Soc Bras Med Trop. 2014;47(1):18–23. pmid:24603732
- 75. Mol MP, Gonçalves JP, Silva EA, Scarponi CF, Greco DB, Cairncross S, et al. Seroprevalence of hepatitis B and C among domestic and healthcare waste handlers in Belo Horizonte, Brazil. Waste Manag Res. 2016;34(9):875–83. pmid:27207769
- 76. Cavaretto L, Motta-Castro ARC, Teles SA, Souza FQ, Cardoso WM, de Rezende GR, et al. Epidemiological and molecular analysis of hepatitis B virus infection in manicurists in Central Brazil. J Med Virol. 2018;90(2):277–81. pmid:28885693
- 77. Villar LM, Scalioni LP, Cruz HM, Portilho MM, Mendonça ACF, et al. Prevalence of hepatitis B and C virus infections among military personnel. Braz J Infect Dis. 2015;19(3):285–90. pmid:25769737
- 78. Barbosa KF, Batista AP, Nacife M, Vianna VN, Oliveira WW, Machado EL. Factors associated with non-use of condoms and prevalence of HIV, viral hepatitis B and C and syphilis: a cross-sectional study in rural communities in Ouro Preto, Minas Gerais, Brazil, 2014-2016. Epidemiol Serv Saude. 2019;28(2):e2018408. pmid:31460658
- 79. de Castro Rocha DFN, da Cunha Rosa LR, de Almeida Silva C, de Oliveira BR, Martins TLS, Martins RMB, et al. Epidemiology of HIV, syphilis, and hepatitis B and C among manual cane cutters in low-income regions of Brazil. BMC Infect Dis. 2018;18(1):546. pmid:30390628
- 80. Melo LVL, Silva MAB, Perdoná GSC, Nascimento MMP, Secaf M, Monteiro RA, et al. Epidemiological study of hepatitis B and C in a municipality with rural characteristics: Cássia dos Coqueiros, State of São Paulo, Brazil. Rev Soc Bras Med Trop. 2015;48(6):674–81. pmid:26676491
- 81. Andrade AP, Pacheco SDB, Silva FQ, Pinheiro LML, Castro JAA, Amaral CEM, et al. Characterization of hepatitis B virus infection in illicit drug users in the Marajó Archipelago, northern Brazil. Arch Virol. 2017;162(1):227–33. pmid:27718074
- 82. Frade PC, Raiol NC, da Costa LM, Pinheiro LM, Silva-Oliveira GC, Pinho JR, et al. Prevalence and genotyping of hepatitis B virus: a cross-sectional study conducted with female sex workers in the Marajó Archipelago, Brazil. Int J STD AIDS. 2019;30(9):902–10. pmid:31226914
- 83. Lafer MM, Sitnik R, Santos Júnior MSD, Rodrigues DA, Pinho JRR. Seroprevalence of hepatitis B, C and D markers in indigenous patients seen at the Native American Outpatient Clinic of Universidade Federal de São Paulo. Einstein (Sao Paulo). 2022;20:eAO6651. pmid:35476084
- 84. Vasconcelos MPA, Sánchez-Arcila JC, Peres L, de Sousa PSF, Castro-Alves J, Albuquerque HG, et al. Seroprevalence of hepatitis B, C, and D and associated factors in the semi-isolated Yanomami Amazonian indigenous community. BMC Infect Dis. 2024;24(1):15. pmid:38166687
- 85. Villar LM, Milagres FAP, Lampe E, Cruz HM, Scalioni L de P, Magalhães M de AFM, et al. Determination of hepatitis B, C and D prevalence among urban and Amerindian populations from the Eastern Brazilian Amazon: a cross sectional study. BMC Infect Dis. 2018;18(1):411. pmid:30126364
- 86. do Nascimento CT, Pena DZ, Giuffrida R, Bandeira Monteiro FN, da Silva FA, Flores EF, et al. Prevalence and epidemiological characteristics of inmates diagnosed with infectious diseases living in a region with a high number of prisons in São Paulo state, Brazil. BMJ Open. 2020;10(9):e037045. pmid:32895275
- 87. Leite AGS, Damasceno LM, Conceição SC, Motta PFC. Rapid tests for HIV, syphilis, and chronic hepatitis in a prison population in a prison complex in Salvador (BA), Brazil. Cien Saude Colet. 2022;27(12):4467–74. pmid:36383860
- 88. Machado F, Becker D, Oliveira CF, Possuelo LG, Renner JDPR. Seroprevalence of HIV, hepatitis B and C and syphilis infection in prisoners of the central region of Rio Grande do Sul, Brazil. Mundo saúde. 2019;43(1):117–28.
- 89. Marques JMS, Matos MA, Silva ÁMC, Freitas NR, Okita MT, Souza SO, et al. Prevalence of overt and occult hepatitis B virus infection among an incarcerated population of Central-Western Brazil. Acta Trop. 2023;241:106886. pmid:36871619
- 90. Prates Fonseca CE, Tupinambás U. Epidemiological profile of cases of HIV, syphilis and hepatitis in private of freedom, Minas Gerais. Saúde Coletiva. 2023;13(88):13381–8. pmid:175424008
- 91. Rezende GR, Lago BV, Puga MA, Bandeira LM, Pompilio MA, Castro V, et al. Prevalence, incidence and associated factors for HBV infection among male and female prisoners in Central Brazil: A multicenter study. Int J Infect Dis. 2020;96:298–307. pmid:32315810
- 92. Silva AAS, Araújo TME, Teles SA, Magalhães RLB, Andrade ELR. Prevalência de hepatite B e fatores associados em internos de sistema prisional. Acta paul enferm. 2017;30(1):66–72.
- 93. da Silva LN, da Silva França DD, Del-Rio NHA, Dos Santos Carneiro MA, Martins RMB, Guimarães RA, et al. Low prevalence, low immunization and low adherence to full hepatitis B vaccine scheme and high-risk behaviors among crack cocaine users in central Brazil. J Infect Public Health. 2017;10(1):76–83. pmid:27026240
- 94. Piauiense JNF, Costa CCS, Silva RJS, Cardoso YMN, Di Miceli JFF, Resque RL, et al. Hepatitis B virus infection among people who use illicit drugs: Prevalence, genotypes and risk factors in the state of Amapá, Northern Brazil. Subst Use Misuse. 2020;55(10):1633–9. pmid:32338560
- 95. Santos Cruz M, Andrade T, Bastos FI, Leal E, Bertoni N, Villar LM, et al. Key drug use, health and socio-economic characteristics of young crack users in two Brazilian cities. Int J Drug Policy. 2013;24(5):432–8. pmid:23632130
- 96. Silva RJS, do Nascimento RS, Oliveira-Neto JAJ, Silva FQ, Piauiense JNF, Gomes CM, et al. Detection and genetic characterization of hepatitis B and D viruses: a multi-site cross-sectional study of people who use illicit drugs in the Amazon region. Viruses. 2021;13(7). pmid:34372586
- 97. Villar L, Do Nascimento GP, Miguel JC, Da Silva EF, Marques JT, Cruz MS. Viral hepatitis B and C infection on homeless population who use illicit drugs in a complex of shantytowns in Rio de Janeiro, Brazil. Hepatology International. 2023;17:S60.
- 98. Demarchi LHF, Bandeira LM, Taira DL, Zardin MCSU, Ibanhes ML, Esposito AOP, et al. Hepatitis B virus infection among japanese immigrants and descendants: The need to strengthen preventive and control measures. Viruses. 2022;14(5):1085. pmid:35632826
- 99. Martins TLS, Silva GR, Silva CA, Gomes DO, Diniz E Silva BV, Carneiro MADS, et al. Hepatitis B and C in Immigrants and Refugees in Central Brazil: Prevalence, Associated Factors, and Immunization. Viruses. 2022;14(7):1534. pmid:35891514
- 100. Silva CA, Silva GRC, Martins TLS, Moura WÉA, Gomes DO, Bandeira GN, et al. Getting knowledge to provide care: prevalence and factors associated with Sexually Transmitted Infections in immigrants from Goiás. Rev Esc Enferm USP. 2024;57(spe):e20230034. pmid:38197674
- 101. Caetano KAA, Matos MA, Teles SA, Pinheiro RS, Santos PMRS, Souza MM. Prevalence and correlates of sexually transmitted infection among homeless persons in central Brazil. Sexually Transmitted Infections. 2017;93:A137.
- 102. De Matos MA, Caetano KAA, Teles SA, Pinheiro RS, Dos Santos Carvalho PMR, Da Cunha Rosa LR, et al. Evaluating the prevalence and knowledge of sexually transmitted infection among homeless persons in central Brazil. Sexually Transmitted Infections. 2017;93:A147.
- 103. Carvalho PMRDS, Matos MA, Martins RMB, Pinheiro RS, Caetano KAA, Souza MM, et al. Prevalence, risk factors and hepatitis B immunization: helping fill the gap on hepatitis B epidemiology among homeless people, Goiânia, Central Brazil. Cad Saude Publica. 2017;33(7):e00109216. pmid:28792993
- 104. Guimarães LCC, Brunini S, Guimarães RA, Galdino-Júnior H, Minamisava R, da Cunha VE, et al. Epidemiology of hepatitis B virus infection in people living in poverty in the central-west region of Brazil. BMC Public Health. 2019;19(1):443. pmid:31035990
- 105. Motta-Castro ARC, Kerr L, Kendall C, Mota RS, Guimarães MDC, Leal AF, et al. Hepatitis B Prevalence among Men Who Have Sex with Men in Brazil. Trop Med Infect Dis. 2023;8(4):218. pmid:37104344
- 106. Oliveira MP, Matos MAD, Silva ÁMC, Lopes CLR, Teles SA, Matos MA, et al. Prevalence, risk behaviors, and virological characteristics of hepatitis B virus infection in a group of men who have sex with men in Brazil: Results from a respondent-driven sampling survey. PLoS One. 2016;11(8):e0160916. pmid:27508385
- 107. Roth MJ, Valderrama MR, Acras JS, Moro MG, Lehmkuhl JVB, Pazin DC. Analysis of sexually transmitted infections in PrEP users: Population assessment in Curitiba, Brazil. J Bras Doenças Sex Transm. 2021;33.
- 108. Grinsztejn B, Jalil EM, Monteiro L, Velasque L, Moreira RI, Garcia ACF, et al. Unveiling of HIV dynamics among transgender women: A respondent-driven sampling study in Rio de Janeiro, Brazil. Lancet HIV. 2017;4(4):e169–76. pmid:28188030
- 109. Ferreira-Júnior O da C, Guimarães MDC, Damacena GN, de Almeida W da S, de Souza-Júnior PRB, Szwarcwald CL, et al. Prevalence estimates of HIV, syphilis, hepatitis B and C among female sex workers (FSW) in Brazil, 2016. Medicine (Baltimore). 2018;97(1S Suppl 1):S3–8. pmid:29912817
- 110. Cruz-Santos MD, Gomes-Gouvêa MS, Costa-Nunes JD, Malta-Romano C, Teles-Sousa M, Fonseca-Barros LM, et al. High Prevalence of Hepatitis B Subgenotype D4 in Northeast Brazil: An Ancient Relic from African Continent?. Ann Hepatol. 2018;17(1):54–63. pmid:29311410
- 111. Nunes JDC, Silva DLF, Fonseca LMB, Felipe IMA, Ferreira BR, Santana RC, et al. Unexpected findings of hepatitis B and delta infection in northeastern Brazil: A public health alert. Ann Hepatol. 2021;22:100272. pmid:33075579
- 112. Carvalho-Louro DM, Soares EB, Trevizoli JE, Marra TMG, da Cunha ALR, Rodrigues MP, et al. Hepatitis C screening, diagnosis, and cascade of care among people aged > 40 years in Brasilia, Brazil. BMC Infect Dis. 2020;20(1):114. pmid:32041537
- 113. Gomide GPM, Melo CB, Santos VDS, Salge VD, Camargo FC, Pereira GA, et al. Epidemiological survey of hepatitis C in a region considered to have high prevalence: the state of Minas Gerais, Brazil. Rev Soc Bras Med Trop. 2019;52:e20190202. pmid:31596352
- 114. Gardona R, Appel F, Ercolin S, Carvalho-Filho RJ, Barbosa DA, Ferraz ML. Evaluation of a strategy for identification of hepatitis C virus carriers in outpatient and emergency units: contribution to the microelimination of hepatitis C in Brazil. Braz J Infect Dis. 2021;25(2):101546. pmid:33636108
- 115. Martins T, Machado DFGP, Schuelter-Trevisol F, Trevisol DJ, Vieira e Silva RA, Narciso-Schiavon JL, et al. Prevalence and factors associated with HCV infection among elderly individuals in a southern Brazilian city. Rev Soc Bras Med Trop. 2013;46(3):281–7. pmid:23856863
- 116. Pinto RB, Ramos ARL, Padua LT, Swayze EJ, Cambou MC, Fiorini M, et al. Prospective cohort study of children exposed to hepatitis C virus through a pregnancy screening program. Int J Infect Dis. 2021;110:62–8. pmid:34273517
- 117. Arrelias CCA, Rodrigues FB, Torquato MT, Teixeira CRS, Rodrigues FFL, Zanetti ML. Prevalence of serological markers for hepatitis and potential associated factors in patients with diabetes mellitus. Rev Lat Am Enfermagem. 2018;26:e3085. pmid:30517576
- 118. de Jesus Rodrigues de Freitas M, Fecury AA, de Almeida MKC, Freitas AS, de Souza Guimarães V, da Silva AM, et al. Prevalence of hepatitis C virus infection and genotypes in patient with chronic kidney disease undergoing hemodialysis. J Med Virol. 2013;85(10):1741–5. pmid:23852735
- 119. Ferrufino RQ, Bierrenbach AL, Rodrigues C, Figueiredo GM, Gleison D, Yapura S, et al. The Changing Epidemiology of Hepatitis C Virus Acquisition Among HIV-Infected Individuals in Brazil. AIDS Res Hum Retroviruses. 2023;39(1):44–9. pmid:36301937
- 120. Lobo MN, Irias SDF, Neto PLF, Avelino MES, da Silva Torres MK, de Carvalho Souza M, et al. HCV-HIV Chronic Coinfection Prevalence in Amazon Region. J Clin Med. 2022;11(24):7284. pmid:36555906
- 121. Vidales-Braz BM, da Silva NMO, Lobato R, Germano FN, da Mota LD, Barros EJG, et al. Detection of hepatitis C virus in patients with terminal renal disease undergoing dialysis in southern Brazil: Prevalence, risk factors, genotypes, and viral load dynamics in hemodialysis patients. Virol J. 2015;12:8. pmid:25644891
- 122. Marinho TA, Lopes CLR, Teles SA, Reis NRS, Carneiro MA, de Andrade AA, et al. Prevalence of hepatitis C virus infection among recyclable waste collectors in Central-West Brazil. Mem Inst Oswaldo Cruz. 2013;108(4):519–22. pmid:23828009
- 123. Oliveira-Filho AB, Santos FJA, Silva FQ, Raiol NC, Costa CCS, Piauiense JNF, et al. Hepatitis C virus infection status and associated factors among a multi-site sample of people who used illicit drugs in the Amazon region. BMC Infect Dis. 2019;19(1):634. pmid:31315569
- 124. Oliveira-Filho AB, Sawada L, Pinto LC, Locks D, Bahia SL, Brasil-Costa I, et al. HCV infection among cocaine users in the state of Pará, Brazilian Amazon. Arch Virol. 2013;158(7):1555–60. pmid:23408127
- 125. Pacheco SDB, Silva-Oliveira GC, Maradei-Pereira LMC, Crescente JÂB, Lemos JAR, Oliveira-Filho AB. Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil. Rev Soc Bras Med Trop. 2014;47(3):367–70. pmid:24728470
- 126. Silva FQ, Santos FJA, Andrade AP, Pacheco SDB, Fischer B, Pinho JRR, et al. Hepatitis C virus infection among illicit drug users in an archipelago of the Amazon. Arch Virol. 2018;163(3):617–22. pmid:29164400
- 127. Valois RC, Maradei-Pereira LMC, Crescente JÂB, Oliveira-Filho AB, Lemos JAR. HCV infection through perforating and cutting material among candidates for blood donation in Belém, Brazilian Amazon. Rev Inst Med Trop Sao Paulo. 2014;56(6):511–5. pmid:25351546
- 128. Melo Da Silva E, Kay A, Lobato C, Muwonge R, Zoulim F, Brites C, et al. Non-F HBV/HDV-3 coinfection is associated with severe liver disease in Western Brazilian Amazon. J Med Virol. 2019;91(6):1081–6. pmid:30695106
- 129. Alves-da-Silva CR, Bonan C, Gomes Junior SCDS, Vieira RS. Detection of sexually transmitted infections among transvestites and transsexual women in prison in the metropolitan region of Rio de Janeiro, Brazil. Rev Bras Epidemiol. 2023;26:e230058. pmid:38088717
- 130. da Silva JB, Soares E, Munhoz A, Dias RD, Barrufi APMDS, Dassoler JR. P- 43 HCV testing and treatment in four Brazilians’ correctional settings. Annals of Hepatology. 2024;29.
- 131. Defante Ferreto LE, Guedes S, Braz Pauli F, Soligo Rovani S, Aní Caovilla Follador F, Paula Vieira A, et al. Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study. PLoS One. 2021;16(7):e0255173. pmid:34310633
- 132. Felisberto M, Saretto AA, Wopereis S, Machado MJ, Spada C. Prevalence of HCV infection in a prison population of the greater Florianópolis area. Rev Soc Bras Med Trop. 2019;52:e20190143. pmid:31340375
- 133. Puga MAM, Bandeira LM, Pompilio MA, Croda J, Rezende GR, Dorisbor LFP, et al. Prevalence and Incidence of HCV Infection among Prisoners in Central Brazil. PLoS One. 2017;12(1):e0169195. pmid:28060860
- 134. Silva TMPM, Ferreto LED, Follador FAC, Vieira AP, Yamada RS, Lucio LC, et al. Characteristics associated with anti-HCV serological markers in prisoners in the state of Paraná, Brazil: a case-control study. Braz J Infect Dis. 2019;23(3):173–81. pmid:31228459
- 135. Felipetto LG, Teider-Junior PI, da Silva FFV, Couto AC, Kmetiuk LB, Martins CM, et al. Serosurvey of anti-treponema pallidum (syphilis), anti-hepatitis C virus and anti-HIV antibodies in homeless persons of São Paulo city, southeastern Brazil. Braz J Infect Dis. 2021;25(4):101602. pmid:34389284
- 136. Ferreira PM, Guimarães RA, Souza CM, Guimarães LC, Barros CVL, Caetano KAA, et al. Exposure to hepatitis C virus in homeless men in Central Brazil: a cross-sectional study. BMC Public Health. 2017;17(1):90. pmid:28100196
- 137. Castro VOL, Kamili S, Forbi JC, Stabile AC, da Silva EF, do Valle Leone de Oliveira SM, et al. High prevalence of Hepatitis C Virus infection among people who use crack cocaine in an important international drug trafficking route in Central-West Region Brazil. Infect Genet Evol. 2020;85:104488. pmid:32745809
- 138. Del-Rios NHA, de Araujo LA, Martins RMB, Guimarães RA, de Matos MAD, Caetano KAA, et al. Molecular and epidemiological aspects of hepatitis C virus infection among crack cocaine users. J Med Virol. 2020;92(8):1239–45. pmid:31746475
- 139. Silva VCM, Kerr LRFS, Kendall C, Mota RS, Guimarães MDC, Leal AF, et al. Hepatitis C virus prevalence among men who have sex with men: a cross-sectional study in 12 Brazilian cities. BMC Infect Dis. 2023;23(1):705. pmid:37858036
- 140. Lago BV, Mello FCA, Barros TM, Mello VM, Villar LM, Lewis-Ximenez LL, et al. Hepatitis D infection in Brazil: Prevalence and geographical distribution of anti-Delta antibody. J Med Virol. 2018;90(8):1358–63. pmid:29663457
- 141. Pierre AMMA, Feldner A, Carvalho Filho RJ, Lopes EPA, Gouvea MSG, Pinho JRR, et al. Prevalence of hepatitis delta virus among hemodialysis and renal transplant patients. Int J Artif Organs. 2018;41(3):171–4. pmid:29546807
- 142. Scarponi CF, Kroon EG, Vieira DS, Fernandes AP, Gomes KB, Mota BE. Molecular epidemiology of Hepatitis delta virus infection in Minas Gerais state from Brazil, an area outside the hyperendemic region of the Amazon Basin. Mem Inst Oswaldo Cruz. 2019;114:e190074. pmid:31460570
- 143. Costa MB, Gouvêa MSG, Chuffi S, Dellavia GH, Ornel F, Von Diemen L, et al. Seroprevalence of hepatitis E virus in risk populations and blood donors in a referral hospital in the south of Brazil. Sci Rep. 2021;11(1):6011. pmid:33727656
- 144. Cunha GG, Bezerra LA, Silva Júnior JVJ, Gonçales JP, Montreuil ACB, Côelho MRCD. Analysis of seroprevalence and risk factors for hepatitis E virus (HEV) in donation candidates and blood donors in Northeast Brazil. Braz J Microbiol. 2022;53(4):1995–2001. pmid:36100808
- 145. Moss da Silva C, Oliveira JM, Mendoza-Sassi RA, Figueiredo AS, Mota LD, Nader MM, et al. Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil. Int J Infect Dis. 2019;86:114–21. pmid:31279609
- 146. Passos-Castilho AM, de Sena A, Geraldo A, Spada C, Granato CFH. High prevalence of hepatitis E virus antibodies among blood donors in Southern Brazil. J Med Virol. 2016;88(2):361–4. pmid:26211918
- 147. Passos-Castilho AM, Reinaldo MR, Sena A, Granato CFH. High prevalence of hepatitis E virus antibodies in Sao Paulo, Southeastern Brazil: analysis of a group of blood donors representative of the general population. Braz J Infect Dis. 2017;21(5):535–9. pmid:28606414
- 148. Slavov SN, Maçonetto JDM, Martinez EZ, Silva-Pinto AC, Covas DT, Eis-Hübinger AM, et al. Prevalence of hepatitis E virus infection in multiple transfused Brazilian patients with thalassemia and sickle cell disease. J Med Virol. 2019;91(9):1693–7. pmid:31066064
- 149. Weis-Torres SMDS, França AO, Granato C, Passarini A, Motta-Castro ARC. Seroprevalence of hepatitis E virus infection among volunteer blood donors in Central Brazil. Braz J Infect Dis. 2022;26(2):102350. pmid:35487275
- 150. Zorzetto R, Klein RL, Erpen LMS, Klein BD, Giacobbo I, da Silveira RA, et al. Unusual high prevalence of antibodies to hepatitis E virus in South Brazil. FEMS Microbiol Lett. 2021;368(13):fnab076. pmid:34196363
- 151. Bastos FA, Miranda U, Santos RMD, Andrade CLB, Schaer R, Rosa IMDRP, et al. P- 51 health education and seroprevalence of hev in rural and peri-urban population, with agricultural activity in Bahia – Brazil - preliminary data. Annals of Hepatology. 2023;28:100951.
- 152. Freitas NR, Teles SA, Caetano KAA, Matos MA, Carneiro MADS, Gardinali NR, et al. Hepatitis E seroprevalence and associated factors in rural settlers in Central Brazil. Rev Soc Bras Med Trop. 2017;50(5):675–9. pmid:29160516
- 153. Souza AJS, Oliveira CMA, Sarmento VP, Chagas AAC, Nonato NS, Brito DCN, et al. Hepatitis E virus infection among rural Afro-descendant communities from the eastern Brazilian Amazon. Rev Soc Bras Med Trop. 2018;51(6):803–7. pmid:30517534
- 154. Vasconcelos MPA, de Oliveira JM, Sánchez-Arcila JC, Faria SC, Rodrigues MM, Perce-da-Silva D, et al. Seroprevalence of the Hepatitis E Virus in Indigenous and Non-Indigenous Communities from the Brazilian Amazon Basin. Microorganisms. 2024;12(2):365. pmid:38399768
- 155. de Oliveira JMNS, Freitas NR, Teles SA, Bottino FO, Lemos AS, de Oliveira JM, et al. Prevalence of hepatitis E virus RNA and antibodies in a cohort of kidney transplant recipients in Central Brazil. Int J Infect Dis. 2018;69:41–3. pmid:29408465
- 156. Gomes-Gouvêa MS, Ferreira AC, Feitoza B, Pessoa MG, Abdala E, Terrabuio DR. Evidence of hepatitis E virus infection in liver transplant recipients from Brazil. Hepatology. 2013;58(4):1052A.
- 157. Zicker M, Pinho JRR, Welter EAR, Guardia BD, da Silva PGTM, da Silveira LB, et al. The Risk of Reinfection or Primary Hepatitis E Virus Infection at a Liver Transplant Center in Brazil: An Observational Cohort Study. Viruses. 2024;16(2):301. pmid:38400077
- 158. Bricks G, Senise JF, Pott-Jr H, Grandi G, Carnaúba-Jr D, de Moraes HAB, et al. Previous hepatitis E virus infection, cirrhosis and insulin resistance in patients with chronic hepatitis C. Braz J Infect Dis. 2019;23(1):45–52. pmid:30836071
- 159. de Araújo LRMG, Batista AD, Côelho MRCD, Santos JC, Cunha GG, Leal GRA, et al. Seroprevalence of hepatitis E virus in patients with chronic liver disease. Braz J Microbiol. 2024;55(1):357–64. pmid:38123902
- 160. Freitas NR, Santana EBR, Silva ÁM, Silva SM, Teles SA, Gardinali NR, et al. Hepatitis E virus infection in patients with acute non-A, non-B, non-C hepatitis in Central Brazil. Mem Inst Oswaldo Cruz. 2016;111(11):692–6. pmid:27759769
- 161. Magri MC, Manchiero C, Dantas BP, da Silva Nunes AK, Figueiredo GM, Barone AA, et al. Hepatitis E Virus Seroprevalence in Patients With Chronic Hepatitis C at a University Hospital in Brazil. Future Virol. 2020;15(12):791–9.
- 162. Zitelli PMY, Gomes-Gouvêa M, Mazo DF, Singer JM, Oliveira CPMS, Farias AQ, et al. Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection. Clinics (Sao Paulo). 2021;76:e3270. pmid:34852140
- 163. Bezerra LA, de Oliveira-Filho EF, Silva JVJ, Santos Morais VM, Gonçales JP, da Silva DM, et al. Risk analysis and seroprevalence of HEV in people living with HIV/AIDS in Brazil. Acta Trop. 2019;189:65–8. pmid:30292751
- 164. Castro VOL, Tejada-Strop A, Weis SMS, Stábile AC, de Oliveira SMVL, Teles SA, et al. Evidence of hepatitis E virus infections among persons who use crack cocaine from the Midwest region of Brazil. J Med Virol. 2019;91(1):151–4. pmid:30133759
- 165. do Nascimento RS, Baia KLN, de Souza SB, Fontoura GMG, Nunes PF, Machado LFA, et al. Hepatitis E Virus in People Who Use Crack-Cocaine: A Cross-Sectional Study in a Remote Region of Northern Brazil. Viruses. 2021;13(5):926. pmid:34067873
- 166. Teles SA, Caetano KAA, Carneiro MADS, Villar LM, Stacciarini J-M, Martins RMB. Hepatitis E Prevalence in Vulnerable Populations in Goiânia, Central Brazil. Viruses. 2023;15(10):2070. pmid:37896847
- 167. Martins RMB, Freitas NR, Kozlowski A, Reis NRS, Lopes CLR, Teles SA, et al. Seroprevalence of hepatitis E antibodies in a population of recyclable waste pickers in Brazil. J Clin Virol. 2014;59(3):188–91. pmid:24480723
- 168. Brasil Ministerio da Ciencia TeI. Painel de fomento em ciência, tecnologia e inovação do CNPq. http://bi.cnpq.br/painel/v2/p-fomento-cti.html. 2023. Accessed 2025 June 23.
- 169. Else H. How a torrent of COVID science changed research publishing - in seven charts. Nature. 2020;588(7839):553. pmid:33328621
- 170. Sloane PD, Zimmerman S. The Impact of the COVID-19 pandemic on scientific publishing. J Am Med Dir Assoc. 2021;22(3):484–8. pmid:33549563
- 171. Blach S, Kondili LA, Aghemo A, Cai Z, Dugan E, Estes C, et al. Impact of COVID-19 on global HCV elimination efforts. J Hepatol. 2021;74(1):31–6. pmid:32777322
- 172. Gleriano JS, Chaves LDP, Ferreira JBB. Repercussões da pandemia por Covid-19 nos serviços de referência para atenção às hepatites virais. Physis. 2022;32(4).
- 173. Kondili LA, Buti M, Riveiro-Barciela M, Maticic M, Negro F, Berg T, et al. Impact of the COVID-19 pandemic on hepatitis B and C elimination: An EASL survey. JHEP Rep. 2022;4(9):100531. pmid:35967191
- 174. Riccaboni M, Verginer L. The impact of the COVID-19 pandemic on scientific research in the life sciences. PLoS One. 2022;17(2):e0263001. pmid:35139089
- 175. Magnani R, Sabin K, Saidel T, Heckathorn D. Review of sampling hard-to-reach and hidden populations for HIV surveillance. AIDS. 2005;19 Suppl 2:S67-72. pmid:15930843
- 176. Heckathorn DD. Respondent-Driven Sampling: A New Approach to the Study of Hidden Populations. Social Problems. 1997;44(2):174–99.
- 177. Cooke GS, Flower B, Cunningham E, Marshall AD, Lazarus JV, Palayew A, et al. Progress towards elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission update. Lancet Gastroenterol Hepatol. 2024;9(4):346–65. pmid:38367629
- 178. Razavi HA, Buti M, Terrault NA, Zeuzem S, Yurdaydin C, Tanaka J, et al. Hepatitis D double reflex testing of all hepatitis B carriers in low-HBV- and high-HBV/HDV-prevalence countries. J Hepatol. 2023;79(2):576–80. pmid:37030400
- 179. De Oliveira TM, Vieira NSG, Sepp TDS, Souto FJD. Recent trends in hepatitis A incidence in Brazil. J Med Virol. 2020;92(8):1343–9. pmid:32009240
- 180. Souto FJD, de Brito WI, Fontes CJF. Impact of the single-dose universal mass vaccination strategy against hepatitis A in Brazil. Vaccine. 2019;37(6):771–5. pmid:30639462
- 181. Ré VE, Ridruejo E, Fantilli AC, Moutinho BD, Pisano MB, Pessoa MG. Hepatitis A in Latin America: The current scenario. Rev Med Virol. 2024;34(4):e2566. pmid:38970225
- 182. Souto FJD. Distribution of hepatitis B infection in Brazil: the epidemiological situation at the beginning of the 21 st century. Rev Soc Bras Med Trop. 2016;49(1):11–23. pmid:26689276
- 183. Braga WSM, Castilho MC, Borges FG, Martinho ACS, Rodrigues IS, Azevedo EP, et al. Prevalence of hepatitis B virus infection and carriage after nineteen years of vaccination program in the Western Brazilian Amazon. Rev Soc Bras Med Trop. 2012;45(1):13–7. pmid:22370822
- 184. Rueda BZG, Gonçalves LL, Rueda-Dantas MA, Ferreira BVC, Zago-Gomes MP. Change in the Epidemiological Profile of Hepatitis B in Brazil. SN Compr Clin Med. 2019;1(12):1015–8.
- 185. Shepard CW, Finelli L, Alter MJ. Global epidemiology of hepatitis C virus infection. Lancet Infect Dis. 2005;5(9):558–67. pmid:16122679
- 186. Buttery SC, Philip KEJ, Alghamdi SM, Williams PJ, Quint JK, Hopkinson NS. Reporting of data on participant ethnicity and socioeconomic status in high-impact medical journals: a targeted literature review. BMJ Open. 2022;12(8):e064276. pmid:35977760
- 187. Breathett KK, Spatz ES, Nallamothu BK. Reporting of race and ethnicity in medical and scientific journals. JAMA. 2021;326(7):673–4. pmid:34402835
- 188.
Brasil Ministerio da Saude. Nota informativa nº 10/2018 - COVIG/CGVP/.DCCI/SVS/MS - Ampliação da indicação do uso da vacina de hepatite A para pessoas que tenham prática sexual com contato oral-anal (com priorização de gays e homens que fazem sexo com homens (HSH)). Brasilia, Brasil. 2018.
- 189.
Brasil Ministerio da Saude. Plano para eliminação da hepatite C no Brasil. In: Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância PeCdI, do HIV/Aids e das Hepatites Virais, editor. Brasilia, Brasil. 2018.