Presencia de anti-VHE en un estudio de cohorte de porcinos ¿reservorio animal de hepatitis E en Chile? / Presence of anti hepatitis E virus antibodies in swine

Background: Swine hepatitis E virus (HEV) has a cross-reaction with human anti-HEV antibodies. Therefore, pigs could be an animal reservoir, rendering hepatitis E as a zoonosis. The spread of this infection among infected pigs across countries would be possible through trading. Previously, using an anti-human conjugate, we detected anti-HEV antobodies in adult pigs in Chile. Aim: To detect anti-HEV (ELISA) in a cohort of swine at different ages. Material and Methods: Two hundred pigs aged 42 to 360 days, divided in 20 groups of 10 animals were tested. Anti-HEV was detected by ELISA using anti-pig IgG horseradish peroxidase instead of anti-human conjugates. Results: Anti-HEV were detected in one animal aged 90 days, two animals aged 120 days, one animal aged 260 days and 2 animals aged 360 days, five pregnant sows and two old hogs. This represents a total of 14 animals or 7 percent of the sample. Conclusions: There is a significant prevalence of anti-HEV in pigs from 90 days of birth, suggesting that these swine are aprobable reservoir.

Cambios en la epidemiología de las hepatitis virales en Chile y consideraciones en estrategias de prevención / The changing epidemiology of viral hepatitis in Chile

The social and sanitary changes that Chile is experiencing will change the epidemiologic profile of viral hepatitis. Virus A hepatitis will displace to older ages, and immunization plans with specific vaccines should be considered. The real prevalence of hepatitis B may be higher, due to an underreporting of the disease. The education and vaccination of high risk groups should be reinforced. E virus hepatitis requires more research in risk groups and in certain animal species consumed by humans. C virus hepatitis is the greatest challenge as it causes chronic liver disease and is the main cause for liver transplantation.

Seguimientos de anticuerpos contra hepatitis A y E en una cohorte de niños de bajo nivel socioeconómico / Hepatitis A and E virus antibodies in Chilean children of low socioeconomic status. A one year follow-up study

Background: The seroprevalence of antibodies against hepatitis A virus (HAV) is decreasing in many Latin American countries, along with improvements in sanitary standards. However, there is no information available about low socioeconomic status (LSE) populations. Aim: To assess the evolution of hepatitis A and E virus antibodies in a cohort of LSE Chilean children. Material and methods: One hundred sixty eight children aged four years, 97 males, coming from public primary care clinics, were studied. Two blood samples were obtained with an interval of one year. Anti-HAV and anti-hepatitis E virus (HEV) antibodies, were detected by ELISA using Abbott kits. Results: Anti-HAV was positive in 19 children (11.3%). After one year of follow-up, only 10 children had sustained reactivity (52.6%). Fourteen children, initially negative, became positive during the follow up (9.4%). Antibody titers to HAV were significantly higher in samples that remained positive, compared with those that lost reactivity. Anti-HEV was found positive in two children (1.2%). One remained positive and the other became negative. Conclusions: In this cohort of LSE Chilean children, the prevalence to antibodies against HAV and HEV is low. Follow-up detected loss of reactivity to HAV in nearly one half of the children, probably related to lower antibody levels.

Hepatitis aguda por virus A, E y no A-E en adultos chilenos a fines de los años 90 / Acute hepatitis caused by virus A, E and non A-E in chilean adults

Background: Sanitary and socioeconomic changes and the identification of new causative virus, have changed the epidemiology of hepatitis in Chile. Aim: To study the natural history of acute hepatitis caused by virus A, E and non A-E in Chilean adults. Patients and methods: A special study protocol was followed for patients with a clinical picture of acute hepatitis. Anti HAV IgM, anti HBc IgM, anti HEV IgG and IgM and Anti HCV antibodies were determined by ELISA. Results: Fifty nine patients (30 male), aged 15 to 58 years old were studied. Eighty nine percent had jaundice and 50 to 70 percent had malaise and abdominal pain. Virus A was positive in 80 percent, virus E in 7 percent. In 14 percent of patients, all viral markers were negative. The evolution was typical in 78 percent, biphasic in 14 percent and cholestatic in 5 percent. One patient had a prolonged and one a fulminant course. Mean ALT was 1148 U/l and mean total bilirubin was 5.5 mg/dl. Seventy three percent of cases occurred during early winter and spring and 27 percent during summer and early autumm. Conclusions: The main etiology of acute viral hepatitis in Chile is virus A and most cases occur during the rainy season. Clinical features of hepatitis non A-E are similar to enteral transmission forms

Virus de la hepatitis C en un grupo de pacientes hematológicos y oncohematológicos / Hepatitis C virus in a group of hematological and oncohematological patients

Background: Little information is available in Chile about hepatitis C virus (HCV) in hematological and oncohematological patients. Aim: To evaluate the prevalence of hepatitis C virus markers in a group of hematological and oncohematological pediatric patients seen at Valdivia Regional Hospital. Patients and methods: Antibodies against virus C, determined by ELISA and viral RNA, determined using RT-polymerase chain reaction, were measured in 54 blood samples from children with hematological diseases (34 with Acute Lymphoblastic Leukaemia, 4 with Hodgkin Diseases, 4 with Haemolytic Anemia, 5 with Sarcomas, 2 with Non-Hodgkin Lymphoma, 2 with Thrombocytopenic Purpura, 1 with an Ependimoma, one with a Wilms Tumor and 1 with a Von Willebrand Disease). Results: All samples were negative for antibodies against hepatitis C virus. Viral RNA was found in four children, all with a diagnosis of acute lymphoblastic leukemia and who received chemotherapy and multiple transfusions. Conclusions: The prevalence of Viral RNA for hepatitis C virus in oncohematological patients in our study is high and associated with the use of chemotherapy and multiple transfusions

Estado actual de inmunidad para hepatitis por virus A en diversos grupos de adultos / Current state of hepatitis A virus immunity in adults

Background: As sanitary and economic conditions improve, the prevalence of antibodies to hepatitis A is now significantly lower. Aim: To evaluate the prevalence of hepatitis A virus antibodies in healthy Chilean adults. Material and methods: Antibodies to hepatitis A virus were measured, using a commercial ELISA assay, in 215 voluntary blood donors (163 male, aged 19 to 30 years old) and 295 medical students and health personnel (156 male, aged 19 to 39 years old), residing in Valdivia, Chile. Results: Antibodies against hepatitis A virus were found in 68,2 percent of the total sample (351/510). Ninety percent of flood donors and 54 percent of health personnel and students were positive (p <0.01). Age specific prevalence in blood donors 19 to 22, 23 to 29 and 27 to 30 years old was 81,0 percent, 95,2 percent and 95,6 percent respectively. Among the same age groups in medical students, the prevalence was 47,9 percent, 53,2 percent and 61,9 percent respectively (p <0.01). Conclusions: This study indicates a reduction in the prevalence of hepatitis A virus antibodies among adults in Valdivia (Chile). Differences detected between individuals are probably related to different socioeconomic levels. Medical students have an increased risk for hepatitis A infections than the general population

Prevalencia de anticuerpos anti-hepatitis A en escolares en la década actual / Prevalence of antibodies against hepatitis A virus in chilean school age children

Background: As sanitary conditions of a population improve, hepatitis A virus infection occurs at higher ages,thus decreasing the prevalence of antibodies against the virus. In the eighties, the prevalence of antibodies among children was 97 percent and depended on the socioeconomic level. Aim: To assess the prevalence of antibodies against hepatitis A virus in school age children living in Valdivia. Subjects and methods: Two thousand three hundred thirty three school age children were studied. Total antibodies against hepatitis A virus were detected using an ELISA kit from Abbott. Children were stratified in age groups and school were classified as private, subsidized, municipal or foster homes. Results: Antibodies were positive in 65 percent of children (59 percent in children aged 6 to 8 years old, 66 percent in children aged 9 to 11 years and 69 percent in children aged 12 to 15 years. In private schools, the prevalence was 26 percent, in subsidized schools the figure was 54 percent, in municipal schools 73 percent and in foster homes 91 percent. Conclusions: The general prevalence of antibodies against hepatitis A virus is higher in low socioeconomic level children. There is a global decrease in the prevalence of these antibodies in the last years

Prevalencia de anticuerpos del virus hepatitis E en donantes de bancos de sangre y otros grupos de población en la X región, Chile / Prevalence of hepatitis E virus antibodies in blood donors and other population groups at X region, Chile

Little is known about hepatitis E virus (HEV) prevalence in South American countries. AntiHEV was studied in 1,773 subjects from 1,360 blood donors of 3 cities in Chile, 72 in health care workers, 241 inmates in state jails and in 100 Araucarian indians. Anti-HEV was detected in 109 out of 1,360 (8.0 percent) total donors (6.3 percent, 6.1 percent and 18.8 percent from the cities of Valdivia, Osorno and Puerto Montt respectively); 9 out of 72 (12.5 percent) health care workers; 18 out of 241 (7.5 percent) inmates and 17 out of 100 (17 percent) Araucarian indians. Prevalence of anti-HEV was not related to age and sex. Hepatitis E is an endemic infection in some population groups of Southern Chile, associated to environmental pollution, crowding and low socioeconomic level

Virus hepatitis C: resultados de detección en algunos grupos de riesgo en la X región de Chile / Hepatitis C virus: results on detection in some risk groups in X region of Chile

The aim of this study was to determine the prevalence of hepatitis C virus antibodies in high rosk patients coming from Valdivia, Osorno and Puerto Montt. Fiftysix patients in hemodialysis, 51 renal grafts recipients, 42 cirrhotic and 14 patients with acute non A non B hepatitis were studied. Antibodies were detected with a second generation ELISA technique and positive cases were confirmed with RIBA. All hemodialysis patients and renal grafts recipients were negative for hepatitis C virus antibodies. In one non alcoholic patient with cirrhosis, a positive ALISA was confirmed with RIBA. Six patients with acute hepatitis had a positive ALISA tests but none was confirmed with RIBA. It is concluded that the prevalence of hepatitis C virus antibodies in this region of Chile is very low

Infecciones bacterianas en la cirrosis hepática / Bacterial infections in hepatic cirrhosis

The aim of this work was to study the prevalence of bacterial infections in hospitalized patients with liver cirrhosis and to compare clinical, bacteriological and evolution features of patients with (group 1) and without bacterial infection (group 2). 132 hospitalized patients with liver cirrhosis were prospectively studied and 61 episodes of bacterial infections were diagnosed in 52 (27 spontaneous bacterial peritonitis (44.3 per cent) 16 urinary tract infections (26.2 per cent), 10 pneumonias (16.4 per cent), 3 spontaneous bacteremias (4.9 per cent) and 5 miscellaneous infections (8.2 per cent)). 26 per cent of infections were nosocomial. Child-Pugh score was 12 ñ 2 in group 1 vs 10 ñ 2 in group 2 (p=0.047). 65 per cent of identified microorganisms were gram negative and 61.5 per cent of these were E. coli. Hospital mortality of group 1 was 29 per cent and that of group 2 was 9 per cent (p=0.002). It is concluded that there is a high prevalence of bacterial infections in hospitalized cirrhotic patients, that is associated to a high mortality