Adoption of Euvax-B vaccine in Nineveh

Hepatitis B infection is one of the most important health problems around the world. The high mortality rate of the hepatitis B encouraged research that led to the finding of an effective vaccine against it. The aim of the present study was to find out the use of the Euvax-B vaccine in sectors of Nineveh province. According to the results obtained in this study, in the next five years, the vaccination coverage for the second and third doses needs to improve(AU)

La infección por hepatitis B es uno de los más importantes problemas de salud del mundo. La alta tasa de mortalidad de la hepatitis B impulsó las investigaciones que llevaron a encontrar una vacuna eficaz contra la misma. El objetivo del presente estudio fue conocer el uso de la vacuna Euvax-B en sectores de la provincia de Nínive. De acuerdo con los resultados obtenidos, en los próximos cinco años, se debe incrementar la cobertura de inmunización de la segunda y tercera dosis de la vacuna(AU)

Presencia del antígeno de superficie del virus hepatitis B en donantes de sangre / Presence of hepatitis B surface antigen in blood donors

Introducción: la hepatitis B es considerada un importante problema de salud pública mundial, por su amplia distribución geográfica y elevado número de portadores crónicos. Objetivo: demostrar la asociación existente entre el virus de la hepatitis B con factores de riesgo como: edad, raza, intervenciones quirúrgicas, conducta sexual, tatuajes y tratamiento estomatológico. Material y método: se realizó un estudio longitudinal, aplicado y prospectivo en los donantes de sangre del municipio Sandino, en el período de septiembre de 2010 a agosto del de 2011; se les aplicó una encuesta epidemiológica y realizó el antígeno de superficie de la hepatitis B. La muestra fue de 1420 donantes. Resultados: se encontraron 18 positivos al antígeno de superficie de la hepatitis B, para un 1,3 %, predominó el grupo etáreo de 18-34 años (45,2 %) y la raza blanca (60,2 %), el 80,7% no temían intervenciones quirúrgicas, en cuanto a la conducta sexual el 99,3 % heterosexual y los no tatuados predominaron con un 99,3 %. Respecto al tratamiento estomatológico recibido en el último año fue más representativo el grupo que no había recibido tratamiento para un 67,2 %, encontrándose diferencia estadísticamente significativa. Conclusiones: hay una elevada prevalencia del virus de la hepatitis B en donantes de sangre de Sandino, no hay asociación entre la edad, raza, intervenciones quirúrgicas, conducta sexual y tatuajes y la aparición del virus de la hepatitis B. Por el contrario, si hubo relación entre el virus de la hepatitis B y el tratamiento estomatológico.

Introduction: hepatitis B is considered an important public health problem all over the world, due to the ample geographic distribution and high number of chronic carriers. Objective: to demonstrate the association of hepatitis B virus with risk factors such as: age, race, surgical interventions, sexual preference, tattoos and dental treatment. Material and method: a longitudinal, applied and prospective study was conducted with blood donors in Sandino municipality from September 2010 to August 2011; an epidemiological survey was applied along with hepatitis B surface antigen performed to a sample of 1420 donors. Results: 18 positive hepatitis B surface antigen were found (1,3%), ages from 18-34 (45,2%) and Caucasian race prevailed (60,2%), the 80,7% had no surgical interventions, the sexual preference was heterosexual(99,3%) and those not having tattoos predominated with 99,3%. Regarding the last dental treatment, the group who did not undergo this treatment was more representative 67,2% finding a statistical significant difference. Conclusions: blood donors presented a high prevalence of hepatitis B virus in Sandino municipality, where no association was found among age, race, surgical interventions, sexual preference, tattoos and the onset of hepatitis B. On the contrary, a relationship between hepatitis B and dental treatment was found.

Superficial acral fibromyxoma of the thumb: a case report

The authors report a case of superficial acral fibromyxioma (SAF) in a 74-year-old male who presented with a painless mass in a periungual dorsoradial region of the right thumb. It is a rare benign neoplasm, which was recently described, that arouse on the skin and subcutaneous tissue of the hands and feet, especially in the proximity to the ungual region of male adults. Surgical treatment was performed with the excision in blocks of the margins of the lesion and fragmentation of the nail and nail matrix, according to the literature recommendation. Although there may be local recurrence in 22% of the cases, the patient presents no symptoms, deformities or functional limitations. In addition, there was no sign of tumor recurrence 18 months after the surgery. We are not aware of a similar case report in the Brazilian literature.

Características dos doadores de córneas do Banco de Olhos de Cascavel: impacto do exame anti-HBc para hepatite B / Characteristics of corneal donors in the Cascavel Eye Bank: impact of the anti-HBc test for hepatitis B

OBJETIVOS: Traçar o perfil dos doadores de tecidos oculares humanos na região de atuação do Banco de Olhos de Cascavel - Paraná (PR) e verificar o impacto da positividade da sorologia positiva para hepatite B (anti-HBc) no descartes dos tecidos oculares. MÉTODOS: Estudo do tipo transversal de dados do Banco de Olhos de Cascavel do período de março de 2006 a abril de 2007. Informações como idade, sexo, causa de óbito, tempo entre óbito e enucleação e resultados sorológicos de doadores foram coletadas. Dados foram agrupados para caracterização da população de estudo e distribuídos segundo positividade da sorologia para hepatite B (anti-HBc). RESULTADOS: A média de idade dos doadores foi de 54,2 ± 20,6 anos e a maioria era do sexo masculino (64,7 por cento). Tempo médio entre óbito e enucleação foi de 3,8 ± 2,4 horas, a principal causa de óbito foram doenças cardiovasculares (34,5 por cento). Positividade para os marcadores anti-HBc e HBsAg foi de 47,4 por cento e 1,5 por cento, respectivamente, sendo os exames sorológicos para hepatite B a maior causa de descarte dos tecidos oculares doados. Doadores com sorologia positiva para anti-HBc apresentaram maior média de idade comparados com doadores com sorologia negativa (p<0,001). Somente 0,8 por cento das doações apresentaram sorologia positiva para hepatite C. Não houve doações com sorologia para HIV positiva no período do estudo. CONCLUSÕES: Implementação do Banco de Olhos de Cascavel aumentou significativamente a disponibilização de córneas para transplante no Estado do Paraná. A principal contraindicação para disponibilização de tecidos oculares foi a positividade na sorologia para anti-HBc. Estudos de biosegurança devem ser realizados a fim de investigar o potencial de transmissão da hepatite B de doadores positivos para esse marcador. A inclusão desses doadores como doações efetivas acarretaria maior disponibilização de tecidos para transplantes.

PURPOSE: To describe the characteristics of human ocular tissue donors from the Cascavel Eye Bank in the State of Paraná (PR) and investigate the impact of hepatitis B serologic test positivity on discarded ocular tissues. METHODS: Cross-sectional study of data collected between March 2006 and April 2007 at the Cascavel Eye Bank. Information such as age, gender, cause of death, time between death and enucleation, and serologic tests results was collected. Data were used to characterize the study population and stratified according to hepatitis B (anti-HBc) status. RESULTS: Mean age of donors was 54.2 ± 20.6 years and a greater proportion of men (64,7 percent) was observed. Mean time between death and enucleation was 3.8 ± 2.4 hours, cardiovascular diseases were the main cause of death (34.5 percent). Positivity of anti-HBc and HBsAg tests was 47.4 percent and 1.5 percent, respectively. Hepatitis B was the main reason for discarding corneas. Donors whose serologic tests were positive for anti-HBc had higher mean age compared to those with negative tests (p<0.001). Only 0.8 percent of all donations tested positive for hepatitis C and donors with positive HIV test were not seen in our study. CONCLUSIONS: Activities of the Cascavel Eye Bank significantly increased the availability of corneas for transplant in the State of Paraná. The main contraindication for availability of ocular tissues was positivity of serologic tests for anti-HBc. Biosafety studies should be performed in order to investigate the potential transmission of hepatitis B virus for donors with positive tests for anti-HBc. The inclusion of these donors would increase the number of corneas available for transplant.

Endemic hepatitis b and c virus infection in a brazilian eastern amazon region

CONTEXT: Hepatitis B and hepatitis C infection has been an important cause of morbidity and mortality around the world. However there are few investigations regarding the prevalence and possible risk factors for these diseases in Brazil, particularly in Amazon region, where there are some endemic focus. OBJECTIVES: To determine the prevalence of hepatitis B and hepatitis C in the city of Buriticupu, MA, located in the Brazilian Eastern Amazon region, and try to explore the risk factors for these infections in that area. METHODS: Two hundred forty three subjects (46.5 percent male and 53.5 percent female) were investigated. RESULTS: The prevalence of past or current infection of hepatitis B and C virus was, respectively, 40.74 percent and 5.76 percent. Positivity for HBsAg was found in 2.88 percent of the subjects. The prevalence of current infection or chronic virus carriers found was 2.88 percent (HBsAg). There was a statistically significant relationship between the sera-prevalence of anti-HBc and the distance of the residence from the city center which may reflect an indirect association between the infection and precarious conditions of existence. Individuals with age equal or greater than 60 years were also more likely to be anti-HBc positive which could only reflect that older people have a longer history of exposure to hepatitis B infection. The prevalence of hepatitis C is higher than the worldwide estimate. CONCLUSION: Buriticupu may be considered endemic for hepatitis B and C. Hepatitis B infection could be related to precarious living conditions and old age. Hepatitis C was not associated with the variables investigated in the present investigation.

CONTEXTO: Infecção por hepatites B e C tem sido causa importante de morbimortalidade em todo o mundo. Entretanto, há poucas investigações sobre a prevalência e possíveis fatores de risco relacionados a tais doenças no Brasil, especialmente na região amazônica, onde há algumas regiões endêmicas para tais quadros clínicos. OBJETIVOS: Detectar a prevalência de hepatites B e C na cidade de Buriticupu, MA, localizada na região leste da Amazônia brasileira, e tentar investigar seus fatores de risco nessa área. MÉTODOS: Duzentos e quarenta e três indivíduos (46,5 por cento masculinos e 53,5 por cento femininos) foram investigados. RESULTADOS: A prevalência de hepatite C foi de 5,71 por cento (anti-HCV) e a de hepatite B foi de 40,74 por cento (anti-HBc). A prevalência de indivíduos com infecção atual ou com infecção crônica foi de 2,80 por cento (HBsAg). Houve relação estatisticamente significante entre anti-HBc e a distância da residência dos indivíduos do centro da cidade, o que pode refletir uma associação indireta entre tal quadro infeccioso e condições precárias de existência. Indivíduos com idade igual ou maior a 60 anos também apresentaram maior chance de apresentarem sorologia para anti-HBc, o que pode refletir apenas que pessoas mais velhas apresentam história maior de exposição à infecção. A prevalência de hepatite C é maior do que a mundial estimada. CONCLUSÃO: Buriticupu pode ser considerada endêmica para hepatites B e C. Hepatite B pode estar relacionada com precárias condições de vida e idade avançada. Hepatite C não foi associada com as variáveis investigadas na presente investigação.

Seroprevalence and risk factors for hepatitis B virus infection among general population in Northern India / Soroprevalência e fatores de risco para infecção pelo vírus da hepatite B na população geral do nordeste da Índia

BACKGROUND: Infection with hepatitis-B virus has been a significant cause of morbidity claiming more than a million lives every year. Epidemiological data reveals that there are 360 million carriers of hepatitis-B virus throughout the globe and 78 percent of the world populations’ hail from Asia. Though several studies from Indian sub-continent have provided an estimate of the prevalence of this viral infection, there exist only few studies, which reflect the status in the general population. AIM: The present study was designed to investigate the prevalence of hepatitis-B infection in North Indian general population. METHODS: The study population comprised of 20,000 healthy blood donors who were screened for hepatitis-B surface antigen (HBsAg) status using third generation ELISA kit. Seroprevalence rate of seropositive donors was calculated and stratified by age, sex and blood groups. Statistical analysis was performed using tests of proportions, chi-square and confidence interval. RESULTS: The study showed that out of 20,000 donors, 450 (2.25 percent) were HBsAg positive (95 percent confidence interval (CI), 2.0445-2.4554). Higher prevalence of HbsAg was found among males (440/19235) than females (10/765). The age specific prevalence rose from 1.78 percent (108/6058) in donors aged 19-25 years to a maximum of 3.03 percent (96/3161) in donors aged 35-45 years and decreased in older age groups. The peaks were detected in male donors aged 35-45 years and in females aged 25-35 years. Rh-negative blood group donors (21/873) and Rh-positive group donors (429/19127) had almost equivalent prevalence rates of HBsAg. HBsAg was more prevalent in blood group B donors (174/7426) and less prevalent in AB blood group donors (38/2032). CONCLUSION: It was found that variables including gender and age were significantly associated with HBsAg positivity. HBsAg positivity in our population was statistically not associated with ABO blood groups.

RACIONAL: A infecção pelo vírus B da hepatite é considerada uma significante causa de morbidade, responsável por mais de 1 milhão de casos, a cada ano. Dados epidemiológicos revelam que existem 360 milhões de portadores de vírus da hepatite B no mundo e 78 por cento da população natural da Ásia. Embora vários estudos realizados na Ásia sub-continental tenham fornecido uma estimativa de prevalência desta infecção viral, existem poucos estudos que avaliam esta condição na população geral. OBJETIVO: Investigar a prevalência da infecção pelo víirus B da hepatite na população geral do nordeste da Índia. MÉTODOS: A população estudada compunha-se de 20.000 doadores de sangue sadios, selecionados através de positividade do antígeno de superfície da hepatite B (HBsAg), utilizando-se o kit ELISA de 3ª geração. A taxa de soroprevalência dos doadores soropositivos foi calculada e estratificada por idade, sexo e grupos sangüíneos. Análise estatística foi obtida usando-se testes de proporções, do qui ao quadrado e intervalo de confiança (CI). RESULTADOS: O estudo revelou que dos 20.000 doadores, 450 (2,25 por cento) eram HBsAg positivos (95 por cento CI 2.0445-2.4554). Prevalência maior de HBsAg foi encontrada em homens (440/19235) do que em mulheres (10/765). A prevalência por faixa etária aumentou de 1,78 por cento (108/6058) em doadores entre 19 a 25 anos, para máximo de 3,03 por cento (96/3161) naqueles entre 35-45 anos e decresceu nos grupos de maior idade. Os picos foram detectados em doadores masculinos de 35-45 anos e em mulheres de 25-35 anos. O grupo de doadores Rh negativo (21/873) e o grupo Rh positivo (4299/19127) mostraram taxas de prevalência de HBsAg quase equivalentes. HBsAg foi mais prevalente no grupo de doadores de tipo sangüíneo B (174/7426) e menos no grupo de tipo sangüíneo AB (38/2032). CONCLUSÃO: Verificou-se que variáveis incluindo gênero e idade foram significantemente associadas à positividade do HBsAg e que esta não foi...

Caracterización de una población ghanesa con antígeno de superficie positivo / Characterization of a Ghanese population with positive surface antige

Se realizó un estudio descriptivo en pacientes con antígeno de superficie (HBsAg) positivo diagnosticados en el hospital de Mampong, Ghana, durante un año hasta agosto de 1999, los datos fueron procesados utilizando los programas Microstat. El 80 % del universo tenía de 15 a 46 años de edad, la malaria y el SIDA fueron los antecedentes en el 58 % y el 23, 7 % respectivamente, dentro de los riesgos el más importante fue el de los tratamientos parenterales (70 %). La fiebre, el cansancio, la pérdida de apetito, el dolor abdominal, la coluria y la ictericia fueron las principales manifestaciones clínicas. El 35 % tuvo un examen físico normal.

A descriptive study was performed in patients with psoitive surface antigen (HbsAg) diagnosed in Mampong, Ghana hospital, during one years until August 1999; data were processed using MICROSTAT 46 years old, malaria and AIDS were the antecedents with 58 % and 23, 7 % respectively, among risk the most important was that of parenteral treatments (70 %) fever, tiredness lack of apetite, abdominal pain, choluria and jaundice were the main clinical manifestations, 35 % had a normal physical exam.

Antígeno de superficie: comportamiento de su positividad en un área de salud / Surface Antigen: Behavior of its positivity in a Health Area

Se realizó un estudio descriptivo y transversal en 50 pacientes con antígeno de superficie positivo, pertenecientes al Policlínico Comunitario Docente "Carlos Juan Finlay, de la ciudad de Camagüey, en el período comprendido de enero de 1997 a enero de 1999. A los sujetos objetos de estudio se les llenó una encuesta médica según la bibliografía revisada, y que constituyó el registro primario de la investigación. Los resultados se presentan en porcentaje. Se encontró que el sexo masculino y el grupo de 20 a 29 años fue el más representativo de la muestra de estudio. La promiscuidad, con el 64% fue el factor de riesgo más relevante, junto a la vía de transmisión sexual con el 78%. La hepatitis aguda fue la entidad clínica que más pacientes aportó a la muestra, y la astenia el síntoma clínico más frecuente.

A descriptive cross-sectional study of the 50 patients with antigen of positive Surface, belongin to "Carlos Juan Finlay" Teaching Communitary Hospital of Camagüey City during the period from January, 1997 to January 1999 was performed. The study universe was composed of the oll patients with antigen of positive surface which were selected from the Book of Compulsory Declaration of transmissible Diseases in the health Area and the from individual Clinical Records. All subjects od the study completed a medical survey according to the reviewed literature and which constituted the primary Register of the Research. Data obtained are presented in statistical charts and processed throug the statistic package Microstat in a IBM compatible computer.porcentage was used as a comparison measure. It was found that masculine sex and the group of 20-29 years was the most representative of the study sample. Promiscuity with 64% was the most significant factor of risk, together with the sexual transmission via with 78%. Acute hepatitis was the clinical entity with more patients for the sample an the asthenia was the symptom with more frequent claims.

Correlación del ADN y del antígeno de superficie del virus de hepatitis B en tejidos de animales transgénicos

Se estudió la presencia del ácido desoxirribonucleico (ADN) que codifica para el antígeno de superficie del virus de hepatitis B (AgsHB) en los tejidos de ratones híbridos de transgénicos/BALB-c donde se había expresado el fenotipo previamente. Los órganos extraídos se evaluaron por la técnica de inmunohistoquímica, por un ELISA cuantitativo y reacción en cadena de la polimerasa (RCP) para la detección del ADN viral. En los tejidos estudiados se encontró ADN viral, excepto en el intestino donde no se evidenció su presencia en ninguno de los especímenes. Con la técnica de inmunohistoquímica no se logró detectar expresión de la proteína viral en intestino, músculo y vesícula seminal, sólo muy baja expresión en cerebro. Mediante la técnica inmunoenzimática no se detectó AgsHB en músculo, intestino, cerebro y estómago. Al evaluar el suero de la totalidad de los animales por medio de la técnica inmunoenzimática y con la RPC, 100 % de los sueros fueron positivos.

A study was made on the presence of DNA coding for Hepatitis B surface antigen (HbsAg) in hybrid transgenic /Balb-c mice where the phenotype had not been expressed before. The extracted organs were evaluated by immunohistochemistry, by quantitative ELISA and polymerase chain reaction (PCR) for detecting viral DNA which was found in the studied tissues except for the intestines in which none of the species was evident. The immunohistochemical technique did not manage to detect the expression of viral protein in the intestines, muscles and seminal vesicle, only a very low expression of such protein in the brain. The immunoenzymatic technique did not detect HbsAG in muscles, intestines, brain or stomach. However, when evaluationg the sera of all the animals by immunoenzymatic technique and PCR, 10% pf tje sera were positive to viral DNA.

Método de inmunocomplejos específicos para detectar ADN del virus de hepatitis B en pacientes con antigenemias bajas

Se evaluó la influencia de las concentraciones de las partículas asociadas con el virus de hepatitis B desde el punto de vista inmunológico mediante la formación de inmunocomplejos específicos (ICE), se determinó el DNA antes y después de formado el inmunocomplejo. Se utilizaron 10 muestras serológicas de pacientes portadores crónicos con antigenemia baja (menos de 1 mg/mL), a las que se les realizó la técnica de reacción en cadena de la polimerasa (RCP) para detección del ADN viral. A cada muestra se le aplicó la técnica de ICE mediante un estándar de anticuerpos para su formación in vitro, se realizó una purificación con fenol cloroformo para ser procesado por RCP. La amplificación de las muestras con inmunocomplejos demostró que la técnica de ICE poseía capacidad de concentrar el antígeno y éste pudo ser detectado cuando no era posible determinar las concentraciones en una electroforesis de agarosa.

We evaluated the influence of the concentrations of particles associated with Hepatitis B virus from the immunologic viewpoint through the formation of specific antibody-antigen complexes, and also we determined DNA before and after the formation of the complexes. We used 10 serological samples of chronic carrier patients with low antigenemia(less than 1µg/mL) which were subjected to PCR for detecting viral DNA. The antibody-antigen complex technique was used in each sample through standard antibodies for the complex to be formed in vitro, then purification with phenol chrololform to be PCR-processed. The amplification of samples with the antibody-antigen complexes showed that this technique was able to concentrate antigens, so it could be detected when it was impossible to determine antigen concentrations in an agar electrophoresis.

Evaluación bioquímico-inmunológica de infectados crónicos por el virus de la hepatitis B: Comportamiento de la respuesta inmune en sus contactos familiares

La infección crónica por el virus de la hepatitis B (VHB) es una clara e importante causa de morbilidad y mortalidad en el mundo. Un importante problema para el control y la erradicación de la enfermedad es la exisniveles de anti-AgsHB, después del esquema completo de vacunación en consanguíneos y no consanguíneos, resultó ser de tipo negativa en los primeros e infirió la existencia de genes compartidos relacionados con el control de la respuesta anti-AgsHB y con el aclaramiento viral.

Chronic infection by HBV is a clear and important cause of morbidity and mortality worldwide. An important problem, for the control and eradication of this disease is the existance of chronic HBV carriers and their family contacts. A biochemical and immunological study of chronic HBV reservoirs were conducted to determine the relation between the concentrations of HBV surface antigen, detected and quantified by the ELISA method, and the serum viral DNA concentrations; as well as the correlation between the levels of antigenemia and the transaminase values (ALAT). A direct linking was proved between viral DNA and HbsAg levels and also between antigen concentration and ALAT values. A significant percent of carriers with high viral charges and normal enzymatic levels was observed. The performance of immune response to HBV in those persons living with the chronic HBV-infested subjects was analyzed and the frequency of occurence of immune, sensitive and infected persons was estimated resulting in a high number of infected persons and persons living with the chronic patients without protection. Qualitative and quantitative ELISA were used to assess the response of antibodies to HbsAg, induced by vaccines or by normal contacts of blood related and non-related persons in the family, but there was no difference among them. The HbsAg concentration of the carrier was associated with levels of antibodies to HbsAg; after completion of the vaccination program in blood related and non-related subjects, then the association was found to be negative in the former and the existance of shared gens linked to the control of anti-HbsAg response and viral clearing were infered.

Durabilidad de la respuesta inmune contra el vhb en niños de un círculo infantil en Cuba

El Ministerio de Salud Pública de Cuba se ha propuesto la eliminación para el año 2000 de la hepatitis viral tipo B. Para cumplir este objetivo lleva a cabo un Programa Nacional que comenzó en 1991 con la vacunación de los niños nacidos de madres portadoras de hepatitis B y posteriormente se amplió a todos los recién nacidos a partir de 1992. Uno de los parámetros para evaluar la inmunogenicidad de una vacuna es la durabilidad de la respuesta posvacunal, que permite demostrar, además, la necesidad o no de una dosis refuerzo. Tomando en consideración la importancia de este tipo de estudio se realizó la cuantificación de los niveles de anticuerpos contra el VHB (anti-AgsHB) en niños pertenecientes a un círculo infantil, vacunados según el Programa Nacional de Vacunación. Éstos estaban distribuidos por años de vida: primer año (I): 19 niños, segundo año (II): 10, tercer año (III): 31, cuarto año (IV): 24, y en el quinto año (V): 22, para un total de 106 niños. Las muestras serológicas se evaluaron mediante el método inmunoenzimático ELISA, en el Departamento de Inmunología del Instituto de Ciencias Básicas y Preclínicas "Victoria de Girón" (ICBP). En cada grupo estudiado se determinó la proporción de niños con seroprotección (I0 Ul/L o más) e hiperrespuesta (100 Ul/L o más). Se calculó además la media aritmética. Los niveles de seroprotección e hiperrespuesta fueron superiores a 93 y 76 %, respectivamente. La media aritmética (X) estuvo por encima de 181 Ul/L en todos los grupos estudiados.

The Ministry of Public Health of Cuba sets out to wipe out viral hepatitis B for the year 2000. To attain this goal, it implemented a National Program which started in 1991 with the immunization of children from Hepatitis B carrier mothers and was extended to all neonates from 1992 on. One of the parameters to evaluate immunogenicity of a vaccine is durability of post-vaccine response that permits to prove whether a reinforcement dose is needed or not. Taking the importance of this type of study into account, the levels of antibodies to HBV (anti-HbsAg) were quantified in the children of a day-care center who were vaccinated as part of the National Immunization Program. These children were distributed by years of life: First year(I), 19 children; second year (II) 10; third year (III) 31; fourth year (IV) 24; and firth year (V) 22, totalling 106 children. The serological samples were assessed by ELISA in the Department of Immunology of the "Victoria de Girón" Institute of Basic and Pre-clinical Sciences. In each studied group, the number of children with seroprotection (10 UI/L or higher) and hyperesponse (100 UI/L or higher) were determined. Additionally, the arithmetic mean was calculated. The levels of seroprotection and hyperesponse were over 93 and 76% respectively. The arithmetic mean was over 181 UI/L in all the studied groups.

Respuesta pos-vacunal y persistencia de anticuerpos contra el virus de la hepatitis B en niños asmáticos y no asmáticos vacunados con eberbiovac-HB

Se estudió la presencia de los anticuerpos anti-AgsHB en 1 280 niños con edades entre 7 meses y 3 años, que recibieron la vacuna cubana antihepatitis B, Heberbiovac-HB al nacimiento, al mes y 6 meses de edad dentro del Programa Nacional de Inmunización en Cuba. Se determinó la presencia del AgsHB y se cuantificaron los anticuerpos en el suero mediante métodos ELISA sandwich, desarrollados y validados en el Laboratorio de Inmunología. Teniendo en cuenta el tiempo transcurrido desde el final de la vacunación, la muestra se dividió en 3 grupos: entre 7 meses y 1 año, entre 1 y 2 años, y entre 2 y 3 años. Ninguno de los niños presentó marcadores de infección y los porcentajes de seroprotección fueron 96,6 en el grupo de 7 meses a 1 año, y de 100 en los grupos de 1 a 2 y de 2 a 3 años. Los porcentajes de niños con cifras de anti-AgsHB superiores o iguales a 100 UI/L fueron de 93,1, 90,7 y 77,8, respectivamente. Las medias geométricas de anti-AgsHB fueron de 1 056, 699 y 483 UI/L para cada grupo. Se encontraron diferencias significativas en los porcentajes de seroprotección, hiperrespuesta y medias geométricas de anti-AgsHB cuando se compararon estas variables entre niños con historia de asma bronquial (687,8, 620,2, y 402,9 UI/L) y otros sin este antecedente en los 3 grupos (1 341, 1 047,8, y 528,3 UI/L); las concentraciones fueron mucho más elevadas en los no asmáticos. Estos resultados podrían indicar que aún con antígenos no alergénicos se puede inducir una respuesta a predominio Th 2 en asmáticos y que por causa de la citofilia de las inmunoglobulinas de clase E los anticuerpos no son detectados, o bien que la respuesta es de hecho menor como consecuencia del carácter de disreactor de los asmáticos. Se concluye que la inmunogenicidad de la vacuna en una población abierta es comparable a la de los estudios controlados, y que no se necesita dosis de refuerzo al menos después de transcurridos 4 años de finalizado el esquema, si se tiene en ...

The presence of anti-AgsHB antibodies was studied in 1 280 children aged from 7 months to 3 years, who were administered the Cuban anti-hepatitis B vaccine Heberbiovac HB when they were born, at 1 and 6 months of age as part of the National Immunization Program in Cuba. AgsHB was detected and serum antibodies were determined by ELISA sandwich methods, developed and validated in the Immunology Laboratory. Considering the time elapsed from the end of the vaccination, the sample was divided into 3 groups: 7 months to 1 year, 1-2 years, and 2-3 years of age. None of the children exhibited infection markers and seroprotection percentages were 96.6 in 7months to 1 year old group, and 100% in 1-2 years-old and 2-3 years-old groups. The percentages of children with anti-HbsAg values equal to or over 100 UI/L were 93.1%, 90.7% and 77.8% respectively. The geometric means of anti-HbsAg were 1 0567, 699 and 483 UI/L respectively. Significant differences were found in seroprotection and hyperesponse percentages and in anti-HbsAg geometric means when comparing these variables between children with bronchial asthma history (687.8, 620.2 and 402.9 UI/L) and non-asthmatic children of the 3 groups(1 341, 1 047.8 and 528.3 UI/L); the concentrations were much higher in non-asthmatics. These outcomes could signal that even with non-allergenic antigens, a predominant Th2 response may be induced in asthmatic children and that wither antibodies are not detected due to IgE cytophilia or response is in fact lower as a result of the disreactor nature of the asthmatics. It is concluded that immunogenicity of the vaccine in a population is comparable to that of the controlled studies and that a reinforcement dose is not needed at least 4 years after the completion of the immunization schedule if one takes into account the kinetics of anti-HbsAg elimination. A controlled study of asthmatic populations is required to verify the achieved results with due explanations.

Efectividad absoluta y relativa de la vacunación antihepatitis B en niños de Quillabamba, Perú, 1997-1999

Conociendo la importancia que la Organización Panamericana de la Salud le concede a la hepatitis B como problema de salud en algunas regiones de América del Sur y atendiendo a las recomendaciones de la comisión responsable del control de este tipo de hepatitis en el Perú, el Ministerio de Salud de este país inició en 1996, la vacunación de menores de 1 año en áreas de alta e intermedia endemicidad. En este trabajo se realizó un estudio concurrente de 115 niños inmunizados con la vacuna Heberbiovac HB (10 µg/dosis, 0-2-4 meses) integrada al Programa Ampliado de Inmunizaciones en Perú y 77 niños no vacunados. A todos se les realizó estudio serológico para conocer prevalencia de infección y de portadores del VHB ( AgsHB y anti-AgcHB) y cuantificación del anti-AgsHB, con el uso de métodos inmunoenzimáticos de la Organon Teknika. En ninguno de los niños vacunados existió evidencia de infección por el virus B, para una efectividad de 100 %. Los porcentajes de seroconversión, seroprotección e hiperrespuesta entre los vacunados fueron de 99,1, 98,3 y 42,6 respectivamente. Entre los no vacunados se encontraron marcadores de infección anterior en 31,1 % y 3,9 % fue positivo al AgsHB. Teniendo en cuenta la edad promedio de aparición de los marcadores y los niveles del AgsHB se pudo pensar que predominaba un patrón de trasmisión horizontal que ameritaba el estudio de conviventes y la evaluación de vías inaparentes de infección. A partir del impacto obtenido con la vacunación, se recomendó vacunar a todos los niños que lo necesitaban aunque se encontraran fuera del rango de edad establecido por el Programa Ampliado de Inmunización, así como a los conviventes donde se demostró circulación viral.

Knowing the importance that the Pan-American Health Organization gives to Hepatitis B as a health problem in some regions of South America and bearing in mind the recommendations of the commission in charge of the control of this hepatitis in Peru, the Ministry of Health in this country started a mass vaccination of under one year-old infants in highly and medium endemic areas. This paper sets forth a concurrent study of 115 children immunized with Heberbiovac HB (10 µg/dose, at 0, 2 and 4 months) which incorporated the Extended Immunization Program in Peru and 77 non-vaccinated children. All of them were serologically analyzed to find out prevalence of infection and of HBV carriers (HbsAg and anti-HbcAg) and their anti-HbsAG was quantified using immunoenzymatic methods of Organon Teknika. There was no evidence of virus B infection in the children accounting for 100 % effectiveness. The percentages of seroconversion, seroprotection and hyperesponse among the immunized children were 99.1, 98.3 and 42.6 respectively. Markers of previous infection were found in 31.1 % of children and 3.9 were HbsAg positive. Considering the average age at which markers occur and the levels of HbsAg, it was thought that a pattern of horizontal transmission predominates, which supports the study of people living in the same place as the infested subject and the assessment of non-evident route of infection. On the basis of the impact of vaccination, it was recommended to immunize all children in need of, even if they are not included in the age range set for the Extended Immunization Program as well as to people living with these children if viral spread is detected.

Comparação de uma técnica de ELISA em fase sólida alternativa com o ELISA em fase sólida convencional na detecção do antígeno de superfície do vírus da hepatite B / Comparison of ELISA test in conventional solid phase for detection of surface antigen of the hepatitis B virus

Foi feita comparação de um teste de ELISA em fase sólida alternativo, de execução simples e rápida, de leitura visual, denominado "teste do pente" (Immuno Comb PBS Organics), com um teste de ELISA convencional automatizado, denominado ELFA (bioMéheux), na detecção do antígeno de superfície do vírus da hepatite B (AgHBs). Utilizou-se o ELFA como parâmetro, tendo em vista sua sensibilidade e especificidade, para detecção desse antígeno, no soro de pacientes infectados. Foram analisadas 30 amostras de soro humano das quais 15 se apresentaram positivas e 15 negativas, para o marcador AgHBs, quando analisadas pelo ELFA. Das 15 amostras positivas por esse método, apenas 11 se mostraram positivas no "teste do pente", enquanto 19 se apresentaram negativas. A técnica alternativa avaliada nesse estudo não apresentou resultados falso-positivos, mas a concordância de resultado com a técnica considerada como padrão ocorreu em apenas 73,3% das amostras testadas, apresentando percentual de 26,7% de resultados falso-negativos. Os resultados Indicam que, apesar de apresentar especificidade equivalente ao ELFA e maior facilidade de execução, o "teste do pente" apresentou séria limitação na detecção do marcador AgHBs do vírus da hepatite B, pelo fato de ter apresentado menor sensibilidade que o ELISA convencional.

A comparison between an alternative ELISA test in solid phase, of simple and quick execution visual reading, named the "comb test" (Immunocomb PBS Orgenics) with a convencional automatized ELISA test, named ELFA (bioMérieux), to detect hepatitis B HBsAg virus surface antigen was performed. The ELFA was used as a parameter, because of its sensibility and especifycity, to the detection of the antigen, in the serum of infected patients. 30 human serum samples were analized, of which 15 turned out positive and 15 negative, to the HBsAg marker, when analized by ELFA. Only 11 were positive in the "comb test" while 19 turned out as negative. The alternative technic analized in this study didn't present false-positive results, but the result concordance with the technic considered as standard occured in only 73,3% of the tested samples, presenting a 26,7% percentual of false-negative results. The results indicate that, in spite of presenting similar specificity to the ELFA, and better execution facility, the "comb test" presente a serious limitation in the detection of the HBsAg marker of the hepatitis B virus because it presented lower sensibility than the conventional ELISA.

Prevalencia de marcadores serológicos de los virus de la hepatitis A, B, C, y D en embarazadas / Seroprevalence of hepatitis A, B, C and D virus infection in pregnant women

Objetivo. Describir la prevalencia de maracadores serológicos de los virus de la hepatitis en una población de embarazadas. Material y métodos. Se estudiaron 1 500 sueros de embarazadas en los que se determinaron: anticuerpos IgG contra el virus de la hepatitis A (anti-VHA); anticuerpos IgG contra el antígeno central del virus de la hepatitis B (ant-HB-c), y su antígeno de superficie (AgsHB); así como anticuerpos contra el virus de la hepatitis C (anti-VHC). En los casos positivos al AgsHB se buscaron anticuerpos contra el virus de la hepatitis D (anti-VHD) y el antígeno e del virus de la hepatitis B (AgeHB). Todas las determinaciones se realizaron por la técnica de ELISA. Resultados. El 93.3 por ciento de los sueros estudiados tuvo anti-VHA IgG positivos. La prevalencia del AgsHB fue del 0.26 por ciento y de anti-VHC del 0.53 por ciento. No hubo pacientes con positividad para anti-VHD ni para el AgeHB. Conclusiones. Se encontró una prevalencia del AgsHB superior a la de otros estudios en embarazadas mexicanas. Consideramos que el escrutinio del AgsHB debe formar parte de los exámenes de control prenatal

Objective. To determine the seroprevalence of hepatitis A, B, C and D virus infection among pregnant women attending a perinatal care hospital. Material and methods. A prospective study was carried out to determine the seroprevalence of hepatitis A virus IgG antibodies (anti-HAV), hepatitis B virus markers (anti-HBcAg and HBsAg) and hepatitis C virus antibodies (anti-HCV) in pregnant women. In HBsAg positive cases, HBeAg and hepatitis D virus antibodies (anti-HDV) were investigated. All analyses were performed with the ELISA technique. Results. Of the 1500 pregnant women studied, 93.3% were positive for anti-HAV IgG. The HBsAg seroprevalence was 0.26% and anti-HCV seroprevalence was 0.53%. There were no patients with HBeAg or antiHDV. Conclusions. A higher seroprevalence of HBsAg was found in this study than in other studies of pregnant Mexican women. We propose that HBsAg screening become a routine prenatal test.

Estudo da expressão dos antígenos de superfície celular, CD25 e CD69 em linfócitos ativados por PHA e TPA e tratados com tapsigargina, trifluoperazina e ouabaína / Study of the expression of cell surface antigens, CD25 and CD69 on activated lymphocytes by PHA and TPA and treated with Thapsigargin, Trifluoperazine and ouabain

Neste trabalho estudados a ação de TG, TFP e OUA (substâncias conhecidas por alterar o fluxo iônico da célula) sobre a expressão de dois antígenos de membrana, o CD25 e o CD69, em células ativadas por PHA e por TPA. O CD25 é a cadeia alfa do receptor de II-2 que se expressa na membrana algumas horas após a ativação. O CD69, membro da família das selectinas é rapidamente expresso após a ativação. Além do PHA e TPA,outra substância que que por si só levou a expressão de CD25 e de CD69 foi a TG...Estes dados parecem indicar um possível papel para o CD69 também na morte celular. Nós verificamos que um mesmo sinal PHA pode levar a dissociação de resposta para a expressão de CD25 e CD69 em uma mesma célula. Os nossos resultados, aliados aos dados da literatura, demonstrem o envolvimento de diferentes vias de ativação conduzindo à proliferação, à citotoxicidade e provavelmente à morte celular e a possibilidade de que um mesmo estímulo seja capaz de ativar mais de uma dessas vias.

Inactivación in vitro del Ags HB por extractos de plantas del género Phyllanthus

Se estudiaron 3 especies del género Phyllanthus procedentes de la zona oriental de Cuba con el fin de determinar la capacidad inactivante del antígeno de superficie (Ags HB) del virus hepatitis B in vitro . Para ello se prepararon extractos alcohólicos de cada especie y de diferentes partes de dichas plantas, con las cuales se trataron sueros de pacientes positivos al Ags HB. Los resultados demuestran que las especies estudiadas poseen la propiedad de inactivar dicho antígeno entre el 93 y el 97 % de los sueros ensayados. El análisis de la capacidad de inactivación de las 3 partes del Phyllanthus chamaecristoides reveló una mayor actividad en los extractos de tallos (97 %), con un comportamiento similar en las 2 temperaturas de incubación utilizadas. Se observa presencia de flavonoides en el extracto de esta especie.