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Open AccessArticle

Hepatitis C Virus among Female Sex Workers: A Cross-Sectional Study Conducted along Rivers and Highways in the Amazon Region

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Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança PA 68600-000, Brazil
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Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis SC 88040-900, Brazil
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Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém PA 66055-240, Brazil
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Faculdade de Ciências Biológicas, Campus do Marajó, Universidade Federal do Pará, Soure PA 68870-000, Brazil
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Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém PA 66077-830, Brazil
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Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo SP 05403-000, Brazil
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Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis SC 88040-900, Brazil
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Centro de Hematologia e Hemoterapia do Pará, Laboratório de Biologia Molecular, Belém PA 66033-000, Brazil
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Author to whom correspondence should be addressed.
Pathogens 2019, 8(4), 236; https://doi.org/10.3390/pathogens8040236
Received: 8 October 2019 / Revised: 7 November 2019 / Accepted: 11 November 2019 / Published: 14 November 2019
(This article belongs to the Special Issue Hepatitis C Virus Infections)
Background: Previous studies found a high prevalence of pathogens among female sex workers (FSWs) in the Amazon region, and established their parenteral and sexual transmission. This study estimated the prevalence of hepatitis C virus (HCV) infection and associated risk factors, and the frequency of HCV genotypes and resistance-associated substitutions (RASs) in this vulnerable group. Methods: Distinct sampling methods were used to access 412 FSWs in cities and riverside communities in the Amazon region from 2015 to 2018. Three methods for HCV diagnosis were used to determine infection status. HCV genotypes and RASs were identified by sequencing and nucleotide fragment analysis. An association between HCV infection and exposure factors was determined by bivariate and multivariate analysis. Results: In total, 44 (10.7%) FSWs were exposed to HCV, and 32 (7.8%) of them had active infection. Nine socioeconomic characteristics and risky sexual behaviors were associated with HCV exposure, particularly unprotected sex and condom exemption for the clients who paid extra money. Genotype 1 (81.3%) and 3 (18.7%) were detected. The frequency of FSWs with RASs was 23.1% (6/26) for grazoprevir related to the occurrence of substitutions Y56F and S122G. Conclusions: HCV infection among FSWs is highly prevalent and dominated by genotype I. Urgent preventive and treatment measures are required to reduce HCV infection in FSWs and the general population. View Full-Text
Keywords: epidemiology; HCV; genotype; risk factors; protease inhibitors; female sex workers; women’s health; social vulnerability; amazon region epidemiology; HCV; genotype; risk factors; protease inhibitors; female sex workers; women’s health; social vulnerability; amazon region
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Oliveira-Filho, A.B.; Aires, D.W.F.; Cavalcante, N.S.; Raiol, N.C.; Lisboa, B.L.A.; Frade, P.C.R.; da Costa, L.M.; Pinheiro, L.M.L.; Machado, L.F.A.; Martins, L.C.; Silva-Oliveira, G.C.; Pinho, J.R.R.; Kupek, E.; Lemos, J.A.R. Hepatitis C Virus among Female Sex Workers: A Cross-Sectional Study Conducted along Rivers and Highways in the Amazon Region. Pathogens 2019, 8, 236.

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