Clinical, epidemiological aspects, and trends of Hepatitis B in Brazil from 2007 to 2018.

Hepatitis B virus (HBV) infection is a concern for public health due to its high prevalence, high infectivity, morbidity, and mortality worldwide. Brazil presents a low HBV prevalence, but has considerable heterogeneity among its geographic regions. Here, we describe the epidemiological profile of HBV infection in different regions of Brazil during 2007-2018, as well as the historical trends associated with the infection. We conducted an observational, ecological time-series study using secondary data collected from the National Notifiable Diseases Information System (SINAN). Our findings suggest that HBV infection was more likely to occur in young, sexually active adults. Individuals from Northeast and Midwest regions were more likely to present acute HBV infection, while individuals from South region were more likely to present chronic HBV infection, reinforcing that specific strategies are required for each particular region. Additionally, we observed a general decreasing trend of infection starting in 2014, however there was an increasing trend of infection in men and in individuals over 40 years old. Although we observed a decreasing trend in HBV infection, active surveillance is needed to prevent HBV spread and possible epidemics, as well as encouraging the vaccination of adults, especially young adult males. Our findings can inform the conduct of large-scale observational studies to evaluate clinical, economical, and social impacts of HBV infections, leading to improved social policies. Finally, our results highlight the need to improve data quality and completeness of epidemiological data, minimizing eventual errors that can make prevention and control strategies difficult.