ABSTRACT
El virus de la Hepatitis B se transmite por diversas vías incluyendo la sanguínea, vertical y sexual. Pacientes con severas condiciones mentales están sometidos a mayor riesgo de adquirir cualquier infección viral como virus de hepatitis B, C y VIH. La duración de la estadía en las instituciones mentales tiene influencia en el contagio de la enfermedad y largos periodos de permanencia, incrementan la oportunidad para una transmisión viral. El objetivo fue conocer la frecuencia de antígeno de superficie de la hepatitis B y determinar los anticuerpos post vacunales contra la hepatitis en mujeres en edad reproductiva, internadas en un Hospital Psiquiátrico del Ministerio de Salud Pública y Bienestar Social de Asunción- Paraguay. Estudio observacional descriptivo llevado a cabo de mayo 2008 a mayo 2010. Se estudiaron 72 pacientes de sexo femenino, en edad fértil, de 18 a 49 años (promedio de 38 años ± 6). Los sueros fueron analizados para detectar: HBsAg basal y anti-HBs post vacunal por el método de ELISA. En las 72 pacientes estudiadas no se encontró evidencia serológica de la infección por virus de hepatitis B. De las 30 pacientes a quienes se les aplicó 3 dosis de vacuna, 29 presentaron valores protectivos adecuados (mayor a 20 mUI/mL) a los dos meses posteriores a la vacunación, una tuvo un valor inferior a 10 mUI/mL. Con la respuesta obtenida en las pacientes estudiadas en esta institución psiquiátrica, se estaría reduciendo las complicaciones de la hepatitis B e impidiendo la transmisión horizontal a las demás pacientes y al personal de salud de la institución y sobretodo se prevendrá la transmisión de hepatitis B al feto, en casos de embarazo.
Hepatitis virus B is transmitted by various routes including blood, vertical and sexual routes. Patients with severe mental health conditions are at greatest risk of acquiring any viral infection such as hepatitis B, C and HIV. The length of the stay in mental institutions influences the spread of the diseases and long periods of stay increase the opportunity for viral transmission. The objective of this study was to know the frequency of the surface antigen of hepatitis B and determine the post-vaccination antibodies against hepatitis in women of reproductive age, hospitalized in a psychiatric hospital of the Ministry of Public Health and Social Welfare of Asunción, Paraguay. This was an observational descriptive study carried out from May 2008 to May 2010. We studied 72 female patients in childbearing age, from 18 to 49 years (mean 38 years ± 6). Sera were tested for HBsAg and post-vaccination anti-HBs by ELISA. Serological evidence of Hepatitis B virus infection was not found in the 72 patients. Twenty nine out of thirty patients who were administered 3 doses of vaccine had adequate protective values (greater than 20 mIU/mL) at two months after vaccination and one had a value less than 10 mIU/mL. With the response found in the study patients of this mental health institution, the complications of hepatitis B would be reduced and the horizontal transmission to other patients and health personnel of the institution would be prevented and specially the hepatitis B transmission to fetus in case of pregnancy.
Subject(s)
Female , Hepatitis B Antibodies , Hepatitis B , Mental Health , Hepatitis B virusABSTRACT
En la actualidad se describen varios agentes virales causantes de hepatitis, entre los más comunes están VHB, VHA, VHC, VHD, VHE, cada uno de ellos con diferentes modos de transmisión, tiempo de incubación y patrones clínicos. El objetivo de este estudio fue determinar la prevalencia de marcadores virales de hepatitis en una población con sospecha clínica de hepatitis durante el periodo 2000 a 2007. En este estudio observacional descriptivo de corte transverso, fueron estudiados 756 pacientes de 1 a 88 años de edad, con una edad promedio de 36±17 años, que concurrieron al Departamento de Inmunología del IICS del 2000 al 2007, a quienes se solicitó, en ocasiones, el dosaje de dos o más marcadores virales. Todas las determinaciones serológicas fueron realizadas por el método de ELISA (Human-Alemania, Adaltis-Italia). El 4,5 % (28/617) tenian HBsAg (+), el 23,4% (11/47) anticuerpos antiBHs (+), el 17,3% (9/52) Ac anti HBcore(+), 37,9% (52/137) Ac anti-VHA de tipo IgM(+) y el 6,6%(11/166) anti-VHC. Coinfección de VHB y VHA en 1 individuo y de VHC y VHA en 1 individuo.El marcador viral más solicitado fue el de HBsAg, los datos obtenidos indican una endemicidad intermedia. En esta población estudiada se destaca la elevada prevalencia de anticuerpos IgM contra el virus de la hepatitis A, (característicos de la etapa aguda), lo cual coincide con que nuestro país pertenece a una zona de alta endemicidad para esta infección viral. Se desea hacer notar la necesidad de monitorear las hepatitis virales, sobre todo aquellas inmunoprevenibles, de modo a evitar el desarrollo de enfermedades crónicas que afecten la calidad de vida del individuo.
Currently, several viral agents are described as causative agents of hepatitises being the most common HBV, HAV, HCV, HDV and HEV. Each one of them has different transmission cycles, incubation periods and clinical patterns. Our objective was to determine the prevalence of viral markers of hepatitis in a population with clinical suspicion of hepatitis from 2000 to 2007. In this observational descriptive study, 756 patients, to whom the dosage of two or more viral markers had been requested occasionally, that attended the Immunology Department of the Instituto de Investigaciones en Ciencias de la Salud from 2000 to 2007 were studied. The patients were 1 to 88 years old with an average age of 36±17 years. All the serologic determinations were performed by ELISA methodology (Human - Germany, Adaltis - Italy). The 4.5% (28/617) had HbsAg (+), 23.4% (11/47) had anti-HBs antibodies (+), 17.3% (9/52) had anti-HBcore (+), 37.9% (52/137) had anti-HAV IgM (+) and 6.6% (11/166) had anti-HCV (+). Co-infection of HBV and HAV in one patient and of HCV and HAV in another patient were found. The most requested viral marker was HBsAg and the data obtained indicate an intermediate endemic status. In this population the high prevalence of IgM antibodies against hepatitis A virus (characteristic of acute phase) stands out. This finding agrees with the consideration of our country as a highly endemic zone. This study remarks the necessity of monitoring viral hepatitis, specially the immunopreventable ones in order to avoid the development of chronic diseases affecting the quality of life.
Subject(s)
Antiviral Agents , Hepatitis , BiomarkersABSTRACT
Cell migration is a crucial event in the general process of thymocyte differentiation. The cellular interactions involved in the control of this migration are beginning to be defined. At least chemokines and extracellular matrix proteins appear to be part of the game. Cells of the thymic microenvironment produce these two groups of molecules, whereas developing thymocytes express the corresponding receptors. Moreover, although chemokines and extracellular matrix can drive thymocyte migration per se, a combined role for these molecules appears to contribute to the resulting migration patterns of thymocytes in their various stages of differentiation. The dynamics of chemokine and extracellular matrix production and degradation is not yet well understood. However, matrix metalloproteinases are likely to play a role in the breakdown of intrathymic extracellular matrix contents. Thus, the physiological migration of thymocytes should be envisioned as a resulting vector of multiple, simultaneous and/or sequential stimuli involving chemokines, adhesive and de-adhesive extracellular matrix proteins, as well as matrix metalloproteinases. Accordingly, it is conceivable that any pathological change in any of these loops may result in the alteration of normal thymocyte migration. This seems to be the case in murine infection by the protozoan parasite Trypanosoma cruzi, the causative agent of Chagas' disease. A better knowledge of the physiological mechanisms governing thymocyte migration will provide new clues for designing therapeutic strategies targeting developing T cells