[Immunologic characteristics of undernutrition. I. The undernourished patient in nutritional recovery]. / Aspectos inmunológicos del desnutrido. I. El desnutrido en recuperación nutricional.

Malnutrition in children is a well known critical factor that determines immunocompetence changes with altered immune response and higher risk to many diseases, especially in developing countries. Moreover, it is related to increased morbi-mortality rates mainly due to infections. For those reasons, 12 undernourished children, age 5 to 24 months were studied along 8 weeks at the Nutritional Recovery Center of Chiquinquira Hospital in Maracaibo, Venezuela. There were 5 cases of kwashiorkor, 5 marasmatics, 1 mixed marasmus/kwashiorkor and 1 case with moderate malnutrition. After a control blood sample was taken and cutaneous tests were done, a nutritional recovery program was began. At regular time intervals and at the end of the study, tests were done again by measuring seric immunoglobulins (IgG, IgA, IgM), secretory IgA (IgAs), C3 and C4 complement, lymphocytic sub-populations, and auto antibodies; cutaneous hipersensitivity tests were also done. As a control group, 10 apparently healthy children of matching age and sex were also studied with the same parameters. Results show that basal seric Igs did not differ significantly from the control group and did not change along the recovery program period, but there was a significant decrease in IgAs at all times of the study. C4 did not change and C3 was lower than control (p < 0.05) but returned to normal value at the end of the recovery period. CD3 and CD4 lymphocytes showed the same pattern. Only two patients showed positive skin tests and auto antibodies were not detected. It is concluded that there is indeed an altered immune competence with low levels of C3, IgAs, and CD3-CD4 lymphocytes that is reversible after nutritional recovery.

[Detection of Borrelia burgdorferi antibodies in a population sample of the state of Zulia]. / Detección de anticuerpos contra Borrelia burgdorferi en una muestra poblacional del estado Zulia.

Between July 1992 and September 1993 an investigation was carried out in a population of Zulia State, Venezuela, in order to detect antibodies against Borrelia burgdorferi for the diagnosis of Lyme disease. A total of 74 patients were studied: 37 asymptomatic and 37 patients clinically suspected having the disease. ELISA tests were performed to determine antibodies against Borrelia burgdorferi. The positive cases, confirmed by duplicate, were tested with VDRL, Monotest, Rheumatoid Factor and Antinuclear Antibodies to eliminate false positives. The total positive cases were 14 of 74 (18.9%). Positive cases in the symptomatic group (29.7%) were higher than in the asymptomatic group (8.9%). The most frequent clinical diagnosis was Morfea (54.5%). The major serological diagnosis (54.32%) was obtained from the chronic patients (more than a year of evolution). A 45.5% of symptomatic patients presented antibodies, despite of receiving antibiotic treatment. Most of the symptomatic positive cases, and also the asymptomatic cases, had a previous visit or permanence in forestal or rural areas. The results of this investigation prove the existence of antibodies against Borrelia burgdorferi in the population of Zulia State, both in the symptomatic as well as in the asymptomatic patients. These results open the path to use a more specific test like immunoblot, for the diagnosis of Lyme disease in our area.

[Seroepidemiologic study of hepatitis A virus among children of Maracaibo, Venezuela]. / Estudio seroepidemiológico para virus de hepatitis A en niños de Maracaibo, Venezuela.

With the purpose of determining the incidence of Hepatitis A virus infection, we determined the presence of antibodies against this virus (anti-VHA) with the ELISA technique in 209 children from Maracaibo city of different socioeconomic levels, ages ranging from 6 months to 12 years. At the same time, we investigated the incidence of a recent infection through IgM antibodies for Hepatitis A (anti-VHA IgM) using the same ELISA technique. We found a global positive incidence of 46.4% for all ages. Individual ages studied showed 31% seropositivity in children less than one year old and a higher seropositivity in children between 9 and 11 years old (50-76.4%). There were noticeable differences in seropositivity in relation to social economic condition observing a higher percentage in children of low social economic level. A recent infection was demonstrated after the second year of life (60%) and a variable percentage through all pediatric ages studied. There was no recent infection detected in children under one year of age which suggests that antibodies anti-VHA obtained transplacentally can last at least for the first year of life as it does with other virus.