[Hepatitis B virus genotypes in chronic carriers on the island of Gran Canaria. Clinical and epidemiological characteristics]. / Genotipos del virus de la hepatitis B en portadores crónicos en la isla de Gran Canaria. Características clinicoepidemiológicas.

OBJECTIVE: To investigate the prevalence of hepatitis B virus (HBV) genotypes in Spanish hepatitis B carriers, and to study the differences in epidemiological characteristics, e antigen (HBeAg) seroconversion, serum DNA viral levels (VL) and liver function alterations. METHODS: This study included 108 patients. Genotyping was carried out in 84 with the INNO-LiPA HBV genotyping assay (Innogenetics). RESULTS: There were 41 women and 67 men, with a mean age of 44.1 years. The source of transmission was family contact in 26 patients (24.1%); transfusions in 10 (9.3%); sexual promiscuity in 9 (8.3%), intravenous drug use in 3 (2.8%), health care accident in 2 (1.8%); and unknown causes in 58 (53.7%). Forty patients had chronic hepatitis and 68 (63%) were healthy carriers. The time of evolution of the infection was known in only in 45 patients, and was over 10 years in 42 of them. One hundred patients (92.6%) were HbeAg-negative and 90 (83.3%) had detectable viral DNA. Genotype A was present in 46 (54.8%), D in 20 (23.8%), F in 2 (2,4%), C in 1 (1.2%), A-G coinfection in 7 (8.3%), A-D in 4 (4.8%), D-G in 2 (2,4%), A-C in 1 (1.2%), and A-D-G in 1 (1.2%). There were no significant differences between genotypes. A trend towards an association was found between VL

Genotipos del virus de la hepatitis B en portadores crónicos en la isla de Gran Canaria. Características clinicoepidemiológicas / Hepatitis B virus genotypes in chronic carriers on the island of Gran Canaria. Clinical and epidemiological characteristics

Objetivo. Conocer la distribución de genotipos del virus de la hepatitis B (VHB) de pacientes españoles portadores crónicos y su relación con las características epidemiológicas, la presencia de antígeno e, el nivel sérico del ADN viral (CV) y la alteración de la función hepática. Métodos. Se estudiaron 108 pacientes. El genotipo se realizó en 84 mediante INNO-LiPA HBV Genotyping-Innogenetics. Resultados. De los pacientes, 41 fueron mujeres y 67 hombres, con una edad media de 44,1 años. Las fuentes de transmisión fueron: contacto familiar, 26 pacientes (24,1%); transfusiones, 10 (9,3%); promiscuidad sexual, 9 (8,3%); adicción a drogas parenterales, 3 (2,8%); accidente sanitario, 2 (1,8%) y en 58 (53,7%) se desconocía. Cuarenta pacientes (37%) presentaron una hepatitis crónica (HC) y 68 (63%) eran portadores asintomáticos. Sólo en 45 pacientes se conocía el tiempo de evolución de la infección y en 42 fue mayor de 10 años. Cien pacientes (92,6%) presentaron antígeno e-negativo y 90 (83,3%) tuvieron ADN viral detectable. La distribución de genotipos fue: A, 46 (54,8%); D, 20 (23,8%); F, 2 (2,4%); C, 1 (1,2%), coinfección A-G, 7 (8,3%); A-D, 4 (4,8%); D-G, 2 (2,4%); A-C, 1 (1,2%) y A-D-G, 1 (1,2%). No se observaron diferencias significativas entre genotipos. Se observó una tendencia en el genotipo A a presentar HC cuando la CV ≤ 10 5 copias/ml (28,9% de los casos) frente al genotipo D (7,7%) (p no significativa). Conclusiones. En nuestra área predomina el genotipo A, D y las coinfecciones con G. Observamos una tendencia del genotipo A a producir una mayor actividad inflamatoria cuando la CV ≤ 10 5 copias/ml (AU)

Objective. To investigate the prevalence of hepatitis B virus (HBV) genotypes in Spanish hepatitis B carriers, and to study the differences in epidemiological characteristics, e antigen (HBeAg) seroconversion, serum DNA viral levels (VL) and liver function alterations. Methods. This study included 108 patients. Genotyping was carried out in 84 with the INNO-LiPA HBV genotyping assay (Innogenetics).Results. There were 41 women and 67 men, with a mean age of 44.1 years. The source of transmission was family contact in 26 patients (24.1%); transfusions in 10 (9.3%); sexual promiscuity in 9 (8.3%), intravenous drug use in 3 (2.8%), health care accident in 2 (1.8%); and unknown causes in 58 (53.7%). Forty patients had chronic hepatitis and 68 (63%) were healthy carriers. The time of evolution of the infection was known in only in 45 patients, and was over 10 years in 42 of them. One hundred patients (92.6%) were HbeAg-negative and 90 (83.3%) had detectable viral DNA. Genotype A was present in 46 (54.8%), D in 20 (23.8%), F in 2 (2,4%), C in 1 (1.2%), A-G coinfection in 7 (8.3%), A-D in 4 (4.8%), D-G in 2 (2,4%), A-C in 1 (1.2%), and A-D-G in 1 (1.2%). There were no significant differences between genotypes. A trend towards an association was found between VL ≤ 10 5 copies/mL and the presence of chronic hepatitis in genotype A (28.9%) as opposed to genotype D (7.7%) (p non significant). Conclusions. HBV genotypes A and D, and coinfections with G are predominant in our area. Genotype A showed a tendency to produce greater inflammatory activity when VL was ≤ 10 5 copies/ml (AU)

[Value of the polymerase chain reaction in the diagnosis of herpes infections of the nervous system]. / Utilidad de la reacción en cadena de la polimerasa en el diagnóstico de las infecciones herpéticas del sistema nervioso.

OBJECTIVE: To assess the performance of a polymerase chain reaction (PCR) method in cerebrospinal fluid (CSF) for the diagnosis of nervous system infections caused by herpesvirus, and to estimate the incidence of encephalitis due to herpes simplex virus type 1 in the adult population of the island of Gran Canaria. METHODS: We studied 330 CSF specimens from 312 patients (281 HIV-negative and 31 HIV-positive) remitted to investigate clinically suspected encephalitis or meningitis, or to study neuropathy or demyelinating disease. A multiplex PCR technique was used to detect herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella-zoster virus (VZV), human cytomegalovirus (CMV), Epstein-Barr virus and human herpesvirus type 6. The patients' clinical records were reviewed to establish the definite diagnosis. RESULTS: Nine samples from eight patients (2.6%) showed positive results (9.7% of patients with pathological CSF and none with normal CSF). The eight patients had clinical and analytic findings of herpesvirus nervous system infection: HSV-1 DNA in four patients with encephalitis, HSV-2 DNA in one patient with meningitis, VZV DNA in two patients with meningitis and CMV DNA in one HIV-positive patient with encephalitis. Herpesvirus was the cause of 50% of encephalitis cases and 10% of meningitis cases. The incidence of HSV-1 encephalitis was five cases per million inhabitants per year. CONCLUSIONS: Diagnosis of herpesvirus nervous system infections by PCR in CSF is not appropriate when CSF parameters are normal. We found a higher incidence of herpesvirus encephalitis than has been reported in other studies.