Detection of hepatitis A antibodies by ELISA using saliva as clinical samples

The possibility of detecting acute infection and immunity using body fluids that are easier to collect than blood, mainly in children, would facilitate the investigation and follow-up of outbreaks of hepatitis A (HAV). Our study was carried out to evaluate the detection of anti-HAV IgM, IgA and total antibodies in saliva using serum samples as reference. Forty three paired serum and saliva samples were analyzed. From this total, 24 samples were obtained from children and 1 from one adult during the course of acute hepatitis A; an additional 18 samples were obtained from health professionals from Adolfo Lutz Institute. The sensitivity to detect anti-HAV IgM was 100 per cent (95 per cent CI: 79.1 to 100.0 per cent), employing saliva as clinical samples. In detecting anti-HAV IgA, the sensitivity was 80.8 per cent (95 per cent CI: 60.0 to 92.7 per cent) and for the total antibodies was 82.1 per cent (95 per cent CI: 62.4 to 93.2 per cent). The specificity was 100 per cent for each. The rate of agreement was high comparing the results of serum and saliva samples for detecting HAV antibodies. We conclude that saliva is an acceptable alternative specimen for diagnosing acute hepatitis A infection, and for screening individuals to receive hepatitis A vaccine or immunoglobulin.

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

Duality of patterns in hepatitis a epidemiology: a study involving two socioeconomically distinct populations in Campinas, Sao Paulo State, Brazil

A avaliaçäo da prevalencia de anticorpos contra o virus da hepatite A em duas populaçöes com diferentes niveis sócio-economicos foi realizada pela analise de 101 e 82 amostras de soros provenientes de grupos de alto e baixo nivel sócio-economico, respectivamente, utilizando um teste imunoenzimatico comercial. A prevalência no grupo de baixo nivel sócio-economico foi 95,0 por cento enquanto que no grupo de alto nivel sócio-economico foi apenas 19,6 por cento (p < 0,001). Estes dados mostram uma dualidade no Brasil : a prevalência de anti-HAV em individuos de nivel sócio-economico baixo e similar aquela dos paises em desenvolvimento enquanto que nos individuos de alto nivel sócio-economico e compativel com o padrao de paises desenvolvidos. O controle desta infecçäo depende primariamente da melhoria das condiçöes sanitarias, mas especialmente em populaçöes de alto-nivel sócio-economico, o uso da vacinaçäo contra a hepatite A e altamente aconselhavel para evitar o aparecimento da doença em adultos

Prevalencia de anticuerpos contra el virus de la hepatitis A (VHA) en una poblacion de niños mexicanos / Prevalence of hepatitis A virus antibodies in Mexican children

Se analizaron los datos con relación a la prevalencia de anticuerpos IgG e IgM contra el virus de la hepatitis A (VHA), mediante la técnica de ELISA en 450 ninos sin antecedentes de hepatitis, con edades comprendidas entre los 3 meses y 17 años de edad, que acudieron a consulta al Instituto Nacional de Pediatría de la ciudad de México en el período comprendido de septiembre de 1992 a junio de 1993. La prevalencia de anticuerpos IgG en la población estudiada, fue del 83.6 por ciento. De los niños menores de un año el 50 por ciento mostraron anticuerpo, el 80 por ciento a los 3 años 80 por ciento, y el 96 por ciento a los 10 años de edad. Sólo 9 niños de los 450 tuvieron además anticuerpos IgM contra el virus de la hepatitis A. Se concluye que la prevalencia de HVA en la población que estudiamos es semejante a lo referido hace 13 años en México.

Hepatopatia como causa de óbito pós-transplante renal / Liver disease as a cause of renal post-transplantation death

O objetivo do presente estudo é avaliar os casos de óbito por hepatopatia (cirrose, hepatoma e hepatite aguda) no pós-transplante renal de 1511 pacientes submetidos a 1670 tx renais, entre janeiro de 1965 e dezembro de 1990, com um tempo mínimo de seguimento de quatro anos. O número total de óbitos no período de observaçäo foi de 593 (39,17 por cento), sendo 41 casos (6,9 por cento) em consequência de hepatopatia: 28 casos por cirrose, 7 por hepatoma e 6 por hepatite aguda. Quanto aos dados demográficos, 38 pacientes (92,7 por cento) eram do sexo masculino, enquanto que na populaçäo geral de receptores de tx, 60 por cento dos pacientes sao deste sexo. O tempo médio do óbito pós-transplante nos casos de cirrose e hepatoma foi 115,05 + 60,6 meses, com uma mediana de 103 meses (15-255), ocorrendo 37,1 por cento deles após o 10§ ano e somente 17 por cento nos primeiros 5 anos pós-tx. Todos os óbitos por hepatite aguda ocorreram nos primeiros 5 anos pós-tx. Nos casos de cirrose verificou-se que 19 (67,8 por cento) pacientes eram portadores do HBsAg e 8 (28,6 por cento) apresentavam sorologia anti-HVC positiva. Nos 7 óbitos ocorridos por hepatoma 6 pacientes eram portadores do HBsAg.

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

Infección con el virus de la hepatitis E en Chile: comunicación preliminar / Hepatitis E virus infection in Chile: preliminary report

Using and Elisa technique, IgG antibodies against hepatitis E virus were measured in 40 alcoholics, 40 hemophilics, 174 blood donors, 36 subjects with acute non A non B non C hepatitis and 66 subjects with acute hepatitis A. Antibodies were detected in 1 alcoholic (2,5 percent), 3 hemophilics (7,5 percent), 7 blood donors (4 percent), 3 patients with non-A-non-B-non-C hepatitis (8,3 percent) and 3 patients with acute hepatitis A (4,5 percent). A low frequency of hepatitis E infection was detected in the studied subjects

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

Changing seroepidemiology of hepatitis A virus infection in Thailand.

Hepatitis A is an infectious disease commonly found in many developing countries. The infection usually is asymptomatic in children and only a small percentage has clinical hepatitis of varying severity. Hepatitis A infection becomes more symptomatic with increasing age. We studied hepatitis A antibody prevalence in many population groups of Thailand and investigated the changing patterns of hepatitis A antibody in comparison with previous seroepidemiological surveys in the past decade. The antibody prevalence in Bangkok and in the rural areas of Thailand had markedly declined among the children and adolescents studied. Only one-fifth to one-fourth of children and adolescents had antibody to hepatitis A. The prevalence differed from that of a decade ago. These data probably reflect the marked improvement of hygienic conditions and effective health education, which have reduced exposure to HAV infection among young children. When an effective hepatitis A vaccine with long lasting immunity becomes available, subgroups of the populations at risk of infection will be the targets for immunization.

Prevalence of markers of hepatitis viruses A, B, C and of HIV in healthy individuals and patients of a Cambodian province.

So far little was known on the epidemiology of hepatitis A, B, C and of AIDS in Cambodia and especially not in the rural area of Takeo. Therefore serological markers for past or ongoing infections with the disease causing viruses were measured in 559 healthy individuals (305 adults, 200 children and 54 mothers of children with liver disorders) and in 185 individuals (103 adults and 82 children) with liver or kidney diseases. In none of the 744 samples tested was anti-HIV detected. 10-37% of the children and 73% of the adults showed HBV-markers, HBsAg being detectable in 2-14% of the children and in 8% of the adults. The prevalence for anti-HCV was 6.5% in the adults with a predilection in males (9%). No markers for HCV infections were found in children. Growing, age related proportions of children (27-97%) and 100% of the adults were anti-HAV IgG positive. HBsAg was detected in 46% of the adults with acute hepatitis, in 45% of those with chronic hepatitis/liver cirrhosis and in 90% of patients with hepato-cellular carcinoma (HCC). In children the corresponding figures were 18% for acute hepatitis and 18% for chronic hepatitis. Patients with acute hepatitis or HCC had a similar prevalence of anti-HCV as healthy individuals. However, 34% of the adult patients with chronic hepatitis/cirrhosis showed signs of a HCV-infection. When the data were analysed with respect to modes of viral transmission, crowding, transmission by unsafe sexual practice or contaminated injection material, and to a lesser extent vertical transmission, seem to be relevant for HBV. The main mode of acquiring HCV infection is probably through medical injections of all sorts, a habit which is very popular in Takeo. Prophylactic measures should concentrate on the prevention of HBV and HCV infections by hygienic means. HBV mass vaccination should be considered in the future.

Anticuerpos anti-virus hepatitis C (VHC) en diversos cuadros patológicos en Chile / Anti-hepatitis C viral antibodies in different pathological entities in Chile

In order to determine the prevalence of anti-hipatitis C viral antivbodies in chile, we determined antibody titers in preserved serum form 91 subjects using an ELISA method. The number and percentage of patients with positive titers was as follows: hemophiliacs withouth evidence of liver disease 88% (n=25); prostitutes 0% (n=25); sporadic non A non B hepatitis )% (n=12); chronic non alcoholic hepatitis with negative anti-HbsAg and anti HBc 26% (n=10); hepatomas with negative iters as indicated for the previous group 30% (n=10); post transfusion non A non B hepatitis 66% (n=3). These results suggest that transfusion of blood products may be tha main etiologic factor for hepatitis C in our population

Prevalencia de marcadores serologicos de hepatitis en diversos grupos de poblacion del Perú / Prevalence of viral hepatitis serologic markers in different population groups of Perú

Review was undertaken of 5 521 serum samples that had been tested to detect or confirm the presence of different hepatitis A, B, and delta serologic markers. The sources of the samples included a national reference laboratory, several outbreaks of viral hepatitis in civilian and military populations, and a serologic survey. They were examined using the enzyme linked immunosorbent assay (ELISA). The prevalence of antibody to hepatitis A virus was very high (x=92.2 percent) and it was uniform. Prevalence of hepatitis B markers was more variable and inconsistent; it was high in samples from the Jungle region of Perú, where the average prevalence of hepatitis B surface antigen (HBsAg) was 4.9 percent. Antibodies to delta hepatitis were present in 28.6 percent of the carriers of HBsAg identified in the outbreaks. All the outbreaks had similarities, including a high, ciclic case-fatality rate associate with the delta virus. Hepatitis B is highly endemic in Perú, while hepatitis B has average endemicity. It will be necessary to do more research in order to better understand the epidemiology of viral hepatitis in this country