ABSTRACT
BACKGROUND: During June-2016-May-2017, several outbreaks of HA were recorded in Europe, especially described in MSM. In our area since July-2017, an increase of hepatitis A (HA) notification was reported. OBJECTIVE: In order to understand the unusual increase of cases occurred in the central region of Argentina, the aim of this study was to describe, characterize and contextualize epidemiologically the HA outbreak occurred this area, until April2018. STUDY DESIGN: HA cases (positive anti-HAV IgM) obtained from the calendar week 29/2017 in which the first case of MSM was recognized were included in our study. HAV RNA detection and molecular characterization was performed from serum samples and/or stool by RT - PCR of VP1/2A genomic region (360bp). RESULTS: Of the 32 cases notified, 87.5% of them were unvaccinated men and 69.6% were MSM (mean age 31.9 years). All MSM associated HAV sequences were genotyped as IA, and clustered with the VRD 521-2016 strain, responsible of causing outbreaks mostly in MSM in Europe since mid-2016. CONCLUSION: As a consequence of the implementation of immunization in children, and the improvement in socio-economic, hygienic and sanitation factors, young adults are becoming increasingly susceptible to HAV infections. Here we add evidence in South America to the HA outbreaks described worldwide among young MSM, demonstrating the need to reinforce official policy of vaccination, in this group and adjust epidemiological surveillance, catch-up vaccination for adolescents, young adults and immunosuppressed patients.
Subject(s)
Disease Outbreaks , Hepatitis A virus/classification , Hepatitis A/epidemiology , Homosexuality, Male/statistics & numerical data , Adult , Age Factors , Argentina/epidemiology , Europe/epidemiology , Female , Genotype , Hepatitis A/diagnosis , Hepatitis A virus/genetics , Hepatitis A virus/isolation & purification , Humans , Male , Middle Aged , Phylogeny , Sex Characteristics , Viral Structural Proteins/genetics , Young AdultABSTRACT
Use of detection tests for p24 HIV antigen (p24Ag) in blood banks in Argentina is recommended by the Argentinean Society of Hemotherapy and Immunohematology. In the blood bank of the National University of Cordoba (Argentina), the recent implementation of the p24Ag screening test has considerably increased the cost of the battery of screening tests and its use in all blood donations has not produced the benefits expected. A 4th generation EIA was evaluated for the screening of HIV in comparison with the currently used assays in the blood bank of National University of Cordoba (3rd generation EIA + p24Ag assay). For this comparison, 11 serum samples from subjects with early HIV infection (early seroconversion period) were tested, as well as 27 serum samples from asymptomatic HIV-infected subjects and other 39 from non-HIV infected subjects. The 3rd generation EIA and the 4th generation EIA showed the same sensitivity value (100%) but the specificity of the 3rd generation EIA was higher (97.5%) comparing with 4th generation (95.1%). Besides, the p24Ag test failed to detect 2 samples from subjects with early HIV infection. These results indicate a good performance of both 3rd and 4th generation assays for screening of HIV. However, due to the lowest cost of 4th generation EIA kit, it could replace the currently used assays for HIV screening in regional blood banks. This screening assay will lead to gain in effectiveness and reduced costs until the detection of HIV RNA can be implemented in blood banks.
Subject(s)
Blood Banks , HIV Core Protein p24/blood , HIV Infections/diagnosis , Reagent Kits, Diagnostic , AIDS Serodiagnosis , Enzyme-Linked Immunosorbent Assay/methods , HIV Antibodies/isolation & purification , HIV Infections/blood , HIV Infections/immunology , Humans , Mass Screening , Sensitivity and SpecificityABSTRACT
La determinación de Ag p24 del virus HIV es recomendada por la Asociación Argentina de Hemoterapiae Inmunohematología para el tamizaje de HIV en los bancos de sangre de Argentina. La implementación de dicha determinación en el banco de sangre de la Universidad Nacional de Córdoba (UNC) implicó un costo elevadopara el nulo beneficio obtenido. Se evaluó la eficiencia del ensayo combinado Ag/Ac ELISA de 4ta generaciónpara el screening de HIV, en comparación a la estrategia actualmente utilizada en el banco de sangre de la UNC(ELISA 3ra generación + ELISA Ag p24). Se utilizaron 11 muestras de suero de pacientes infectados con HIV enetapa temprana de seroconversión, 27 muestras de suero de individuos infectados en etapa asintomática de la infección y 39 muestras de suero de individuos no infectados. Se demostró igual sensibilidad (100%) y una especificidad menor para el equipo de 4ta generación (95.1%) frente al equipo de 3ra generación (97.5%). El ensayo de Ag p24 falló en la detección de 2 muestras HIV tempranas. La alta sensibilidad y especificidad demostradas por los equipos de 3ra y 4ta generación, indica que ambos son adecuados para el tamizaje de HIV en bancos de sangre. Sin embargo, el ELISA de 4ta generación podría ser implementado en los bancos de sangre regionales como una alternativa de menor costo a la estrategia actualmente utilizada. Esta alternativa resulta viable hasta tanto sea posible incorporar en los bancos de sangre la detección de ARN de HIV por técnicas moleculares.
Subject(s)
Humans , Blood Banks , HIV Core Protein p24 , HIV Infections , Mass Screening , Enzyme-Linked Immunosorbent Assay , HIV Antibodies , HIV Core Protein p24 , HIV Infections , Reagent Kits, Diagnostic , Sensitivity and Specificity , Serologic TestsABSTRACT
La determinación de Ag p24 del virus HIV es recomendada por la Asociación Argentina de Hemoterapiae Inmunohematología para el tamizaje de HIV en los bancos de sangre de Argentina. La implementación de dicha determinación en el banco de sangre de la Universidad Nacional de Córdoba (UNC) implicó un costo elevadopara el nulo beneficio obtenido. Se evaluó la eficiencia del ensayo combinado Ag/Ac ELISA de 4ta generaciónpara el screening de HIV, en comparación a la estrategia actualmente utilizada en el banco de sangre de la UNC(ELISA 3ra generación + ELISA Ag p24). Se utilizaron 11 muestras de suero de pacientes infectados con HIV enetapa temprana de seroconversión, 27 muestras de suero de individuos infectados en etapa asintomática de la infección y 39 muestras de suero de individuos no infectados. Se demostró igual sensibilidad (100%) y una especificidad menor para el equipo de 4ta generación (95.1%) frente al equipo de 3ra generación (97.5%). El ensayo de Ag p24 falló en la detección de 2 muestras HIV tempranas. La alta sensibilidad y especificidad demostradas por los equipos de 3ra y 4ta generación, indica que ambos son adecuados para el tamizaje de HIV en bancos de sangre. Sin embargo, el ELISA de 4ta generación podría ser implementado en los bancos de sangre regionales como una alternativa de menor costo a la estrategia actualmente utilizada. Esta alternativa resulta viable hasta tanto sea posible incorporar en los bancos de sangre la detección de ARN de HIV por técnicas moleculares.(AU)
Subject(s)
Comparative Study , Humans , Mass Screening , HIV Infections/diagnosis , HIV Core Protein p24/blood , Blood Banks , HIV Infections/blood , HIV Infections/immunology , HIV Core Protein p24/isolation & purification , Enzyme-Linked Immunosorbent Assay/methods , Reagent Kits, Diagnostic , Sensitivity and Specificity , HIV Antibodies/isolation & purification , Serologic TestsABSTRACT
Use of detection tests for p24 HIV antigen (p24Ag) in blood banks in Argentina is recommended by the Argentinean Society of Hemotherapy and Immunohematology. In the blood bank of the National University of Cordoba (Argentina), the recent implementation of the p24Ag screening test has considerably increased the cost of the battery of screening tests and its use in all blood donations has not produced the benefits expected. A 4th generation EIA was evaluated for the screening of HIV in comparison with the currently used assays in the blood bank of National University of Cordoba (3rd generation EIA + p24Ag assay). For this comparison, 11 serum samples from subjects with early HIV infection (early seroconversion period) were tested, as well as 27 serum samples from asymptomatic HIV-infected subjects and other 39 from non-HIV infected subjects. The 3rd generation EIA and the 4th generation EIA showed the same sensitivity value (100
) but the specificity of the 3rd generation EIA was higher (97.5
) comparing with 4th generation (95.1
). Besides, the p24Ag test failed to detect 2 samples from subjects with early HIV infection. These results indicate a good performance of both 3rd and 4th generation assays for screening of HIV. However, due to the lowest cost of 4th generation EIA kit, it could replace the currently used assays for HIV screening in regional blood banks. This screening assay will lead to gain in effectiveness and reduced costs until the detection of HIV RNA can be implemented in blood banks.
ABSTRACT
We studied the occurrence of reovirus infection in children hospitalized with acute gastroenteritis in Argentina during a 20-year interval (1981 through 2001). Three of 2854 (0.10%) stools were positive for reovirus but negative for adenovirus, astrovirus and rotavirus. Children infected with reovirus were <1 year old; one had meningoencephalitis in addition to gastroenteritis. This study indicates that reovirus is an uncommon cause of childhood gastroenteritis requires medical assistance.
