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Low prevalence of hepatitis B and C markers in non-amazonian indigenous population.

In Brazil, there is a high prevalence of markers ofinfection with the hepatitis B virus among groups livingin the Western Amazon. Neighboring countries andindigenous peoples should also be included in thatcontext [1-6].There are virtually no data available on theprevalence of viral hepatitis markers among indigenousgroups living outside the Amazon region or aboutparenterally transmitted hepatitis.Figueiredo et al. [7] reported the prevalence of HBVand HCV markers among the native Xacriaba peopleliving in the northern part of the State of Minas Gerais;they found 0.5%, 2.9%, 62.5, and 0.5% for HBsAg,anti-HBc, anti-HBs and anti-HCV, respectively. Thisgroup is just as acculturated as the Terena and has along history of contact with modern Brazilian society.To assess this situation, a sero-epidemiological studywas conducted in August 1999, involving 312Amerindians from the Buriti, Corrego do Meio andAgua Azul reservations, located in the municipalities ofSidrolândia and Dois Irmaos do Buriti, 100km fromCampo Grande, the state capital of Mato Grosso doSul (Brazil). The samples were randomly selected, andfamily groups were included.This study included all age groups, from childrenunder 1 year to individuals older than 65. Each agegroup was stratified according to gender (Table 1).The material was collected, centrifuged, andseparated into varying aliquots. Tests for anti-HBc, antiHBs and anti-HCV markers were conducted at theOswaldo Cruz Foundation (Fiocruz-RJ) National ViralHepatitis Center. There were small differences in thenumber of tests for each marker due to limitations inthe quantity of material.None of the samples were positive for HBsAg oranti-HCV. Anti-HBc gave positive results in 2.2% ofthe samples and anti-HBs in 13.6%. The highpercentage found for anti-HBs positivity could be aresult of immunity that was artificially acquired throughvaccination.We found very low positivity rates for the abovemarkers in this population. There are discrepanciesbetween our data and findings previously reported forthe same region. Aguiar et al. [8] found prevalencerates of 0.7%, 9.4% and 2.5% for HBsAg, anti-HBcand anti-HCV, respectively among first-time donors inCampo Grande. In a study of people of African descentliving 65 km from Campo Grande and 40 km from themunicipality of Jaraguari (Mato Grosso do Sul), Castro[9] found rates of 9% and 43% for HBsAg and anti-HBc, respectively.These variations in prevalence need to be betterexplained; it may be necessary to use an approachinvolving other components. Authors such as Brabinet al. [10], Passos et al. [11], and Coimbra et al. [12]have suggested that other variables can influence HBVprevalence rates, which would mean that a simpleepidemiological model of this disease is not realistic.It is sometimes necessary to take into accountpecularities of certain population groups in whichdifferent values, norms and cultural standards may beinvolved in health/illness processes [13].