Evidence map›Paper›PMID 41305327›Full record

ArticlePathogens (Basel, Switzerland)2025

From Hyperendemic to Low Endemicity: The Effect of Hepatitis B Vaccination on HBV and HDV Prevalence in the Brazilian Amazon.

Andreza Pinheiro Malheiros, Michele Soares Gomes-Gouvêa, Leidiane Barbosa Ribeiro, Alex Junior Souza de Souza, Raymundo Soares Azevedo, Dickson Ciro Nascimento de Brito, Candida Maria Abrahão de Oliveira, Heloisa Marceliano Nunes, João Renato Rebello Pinho

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pathogens (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Andreza Pinheiro MalheirosSeção de Hepatologia, Instituto Evandro Chagas, Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Ananindeua 67030-000, PA, Brazil.ORCID 0000-0002-2643-9754
Michele Soares Gomes-GouvêaLIM07, Instituto de Medicina Tropical, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil.ORCID 0000-0001-5932-2360
Leidiane Barbosa RibeiroLIM07, Instituto de Medicina Tropical, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil.ORCID 0000-0002-6780-0702
Alex Junior Souza de SouzaPrograma de Pós-Graduação em Saúde Única, Universidade Santo Amaro (UNISA), São Paulo 04829-300, SP, Brazil.ORCID 0000-0001-6201-2777
Raymundo Soares AzevedoLIM01, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil.ORCID 0000-0003-0660-2371
Dickson Ciro Nascimento de BritoSeção de Hepatologia, Instituto Evandro Chagas, Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Ananindeua 67030-000, PA, Brazil.ORCID 0000-0002-5247-406X
Candida Maria Abrahão de OliveiraSeção de Hepatologia, Instituto Evandro Chagas, Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Ananindeua 67030-000, PA, Brazil.ORCID 0000-0001-6253-7477
Heloisa Marceliano NunesSeção de Hepatologia, Instituto Evandro Chagas, Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Ananindeua 67030-000, PA, Brazil.ORCID 0000-0002-9335-6932
João Renato Rebello PinhoLIM07, Instituto de Medicina Tropical, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, Brazil.ORCID 0000-0003-3999-0489

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The Amazon Basin was historically hyperendemic for HBV and HDV, associated with severe outcomes like fulminant hepatitis. Brazil initiated its hepatitis B vaccination in 1989. This study assessed the current prevalence in this endemic region to evaluate the impact of vaccination. A cross-sectional population-based survey enrolled 1100 urban and rural residents. HBsAg prevalence was 1.5%, with no cases in individuals under 20 years, demonstrating interrupted vertical and horizontal transmission. Anti-HBc positivity (30.9%) indicated past exposure, predominantly in those over 30 years. Isolated anti-HBc (10.3%) included two occult HBV infections. HDV coinfection occurred in 25% of HBsAg-positive cases, with HDV RNA detected in two. Anti-HDV positivity was exclusive to adults over 30. Vaccination coverage was poorly documented, but 23.7% had protective anti-HBs titers. HBV vaccination has reduced HBsAg prevalence from high to low endemicity in the region, eliminating chronic infections in younger generations. Persistent HDV in older age groups underscores the need for targeted screening. Despite vaccination record gaps, the findings highlight the program's success in interrupting transmission and support continued efforts toward HBV/HDV elimination.

Indexed as

Endemic DiseasesHepatitis BHepatitis B VaccinesHepatitis DAdolescentAdultAgedBrazilChildChild, PreschoolCoinfectionCross-Sectional StudiesFemaleHepatitis B Surface AntigensHepatitis B virusHepatitis Delta VirusHepatitis B Surface AntigensHepatitis B Vaccinesepidemiologyhepatitis Bhepatitis B vaccinehepatitis Dhuman viral hepatitis

Identifiers

PMID41305327
PMCPMC12655251

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.