ABSTRACT
Introducción: Se ha demostrado ampliamente que el genotipo F del virus de la hepatitis B (VHB) es dominante en nuestra población Amerindia. Recientemente, nosotros identificamos que en los pacientes infectados por VHB habitantes no migratorios de áreas urbanas venezolanas prevalece también el genotipo F. Objetivo: Determinar los genotipos del VHB en portadores crónicos urbanos migratorios y compararlos con el grupo no migratorio. Material y Métodos: Se investigaron 136 portadores crónicos del VHB, 110 no inmigrantes y 26 inmigrantes de origen asiático. Se evaluaron antígeno eHB y anti-eHB y los genotipos del VHB, este último mediante PCR. Resultados: En los 110 pacientes urbanos venezolanos persistió la elevada frecuencia del genotipo F (95%) con 3 casos coinfectados, 2 por genotipos A+F y 1 caso con genotipos E+F. Interesantemente, 2 casos demostraron genotipo D del VHB. Hepatitis crónica B (HCB) antígeno-e positivo fue diagnosticada en 83 pacientes (80,6%) mientras 20 casos (19,4%) presentaron HCB antígeno-e negativo. En los pacientes asiáticos infectados con un solo genotipo se identificó el C en 11 casos, el B en 4 pacientes, el F en 3 y, en 1 caso, genotipo D. Se demostró coinfección entre estos diferentes genotipos, incluyendo un caso coinfectado con genotipo E. El genotipo F se encontró coinfectando a 4 pacientes, 2 de ellos con genotipo C. Doce casos presentaron HCB antígeno e positivo y 14 pacientes HCB antígeno e negativo. De los pacientes infectados con genotipo C, 7 de ellos (54%), incluyendo los 2 coinfectados con genotipo F, presentaron HCB antígeno-e negativo. Conclusión: Es notoria la elevada circulación del genotipo F del VHB en nuestras áreas urbanas...
Introduction: It has been widely demonstrated that the genotype F of hepatitis B virus (HBV) is dominant in our Amerindian population. Recently, we identified that genotype F is prevalent in HBV non-migratory infected patients living in urban areas. Objective: To determine the genotypes of HBV in migratory chronic carriers compared to non-migratory population. Material and Methods: We investigated 136 chronic HBV carriers, 110 non-immigrants and 26 immigrants of Asian origin. We assessed hepatitis B e-antigen and antibody and HBV genotypes, the latter using PCR. Results: High prevalence (95%) of genotype F persisted among 110 Venezuelan urban patients, with 3 co-infected patients, 2 with genotypes A+F and 1 case with E+F. Interestingly, 2 cases showed HBV genotype D. Chronic hepatitis B (CHB) e-antigen positive was diagnosed in 83 patients (80.6%) while 20 cases (19.4%) showed CHB e-antigen negative. In Asian patients infected with one sole genotype, C was identified in 11 cases, B in 4 patients, F in 3, and in 1 case, genotype D. Co-infection was demonstrated among these different genotypes, including one case co-infected with genotype E. Genotype F was found in 4 co-infected patients, 2 with genotype C. Twelve cases had CHB e-antigen positive and 14 CHB e-antigen negative. From patients infected with genotype C, 7 of them (54%), including 2 co-infected with genotype F, demonstrated CHB e-antigen negative. Conclusion: It is remarkable the high circulation of HBV genotype F in our urban areas. However, given the distinct outcome described in CHB genotype F and the identification of other genotypes rather than F in urban areas, suggests that inclusion of HBV genotypes in Venezuela, should be considered standard in the management of CHB regardless the patients geographical origin.
Subject(s)
Humans , Male , Female , Epidemiology , Genotyping Techniques , Hepatitis B/diagnosis , Hepatitis B/etiology , Hepatitis B/genetics , Gastroenterology , Genotype , VenezuelaABSTRACT
With the purpose of knowing the spectrum of the disease we studied the outcome of 64 children chronically infected by Hepatitis B Virus (HBV): 38 treated with Interferon (INF) and 26 without treatment. The period of infection was no less than 8 months, the average age was 4.7 years, 39 boys, 25 girls, and the observation period was 5 years, 3 moths (range 6 months-14 years). We divided them in 2 groups: a) 40 patients AgeBH positive from which 26 received treatment. b) 24 patients AgeBH negative from which 12 received treatment. We used 5,000,000 U. of interferon per M2 3 times a week for 16 weeks. The results do not show statistically difference that might favor the use of INF in order to reach seroconversion neither of Age nor Ags. Meanwhile the age is significant in Ags seroconversion. This might lead us to the question if seroconversion is due to the natural course of the disease once the body gets rid of the virus, or to interferon treatment. During the study period only one case turned to cirrhosis (1.7%) and none to Hepato carcinoma.
Subject(s)
Antiviral Agents/therapeutic use , Hepatitis B/therapy , Interferon-alpha/therapeutic use , Age Distribution , Child , Child, Preschool , Chronic Disease , Female , Follow-Up Studies , Hepatitis B/immunology , Hepatitis B e Antigens/blood , Humans , Infant , Interferon alpha-2 , Longitudinal Studies , Male , Recombinant Proteins , Sex DistributionABSTRACT
Intestinal metaplasia has been shown by many investigators to be a premalignant state. Considering this fact, 722 gastric biopsies were studied, a 24% of association was found between gastric carcinoma and intestinal metaplasia and 27% of the cases with metaplasia were found in "apparently normal" or with benign stomach lesions. The group most affected was males over 61 years. Control endoscopy and biopsy was practiced in 17 patients with previously diagnosed intestinal metaplasia and in 11.7% gastric carcinoma with metaplasia was found. Therefore, it cannot be concluded that intestinal metaplasia is a premalignant condition, but its frequent association with gastric adenocarcinoma advises periodical examination by endoscopy in every patient over 40 years in which it is determined by biopsy.
Subject(s)
Adenocarcinoma/pathology , Intestines/pathology , Stomach Neoplasms/pathology , Adenocarcinoma/epidemiology , Adult , Age Factors , Biopsy/statistics & numerical data , Female , Humans , Male , Metaplasia/epidemiology , Metaplasia/pathology , Middle Aged , Prospective Studies , Retrospective Studies , Sex Factors , Stomach/pathology , Stomach Neoplasms/epidemiology , Venezuela/epidemiologyABSTRACT
Twenty children with chronic Hepatitis B virus infection where treated with alfa interferon 2b and compared with a group of 24 non treated patients with similar age and sex distribution. Both treated and untreated patients, all Hepatitis B surface antigen positive for a minimum of 6 months, were divided in 2 groups according to HBeAg status: positive and negative. The treatment was ambulatory at a dose of 5.000.000 U per square meter of body surface, administered 3 times a week during 16 weeks. Tolerance of the drug was good with secondary reactions only at the beginning of the treatment. The only change in laboratory tests was the normalization of aminotransferases in HBeAg positive children. There was no significant difference between the treated and untreated group of HBeAg positive patients regarding the rate of HBeAg seroconversion. There was a striking difference in negativization of HBsAg in HBeAg negative patients: 8% in the treated group and 81% in the untreated group, this is explained by important epidemiological differences between both groups.
Subject(s)
Hepatitis B/therapy , Hepatitis, Chronic/therapy , Interferon-alpha/therapeutic use , Adolescent , Carrier State/immunology , Carrier State/therapy , Child , Child, Preschool , DNA, Viral/analysis , Female , Follow-Up Studies , Hepatitis B/immunology , Hepatitis B Surface Antigens/analysis , Hepatitis B e Antigens/analysis , Hepatitis, Chronic/immunology , Humans , Infant , Infant, Newborn , Interferon alpha-2 , Male , Recombinant Proteins , Time FactorsABSTRACT
We present the results of the determination of hepatitis C virus antibody, recently discovered on a group of 34 patients with chronic liver disease, divided in: a) 23 patients with cirrhosis. b) 8 with protracted hepatitis. c) 2 with steatosis of unknown origin++. d) One patients with hepatocellular carcinoma. Another group examined was integrated by persons of promiscuous sexual activity (15 prostitutes and 14 homosexuals). Finally we included 20 children chronically infected with VB. In the 23 patients with cirrhosis, the VB markers (HBsAg and anti-core were negative in 18 and 5 were only anti-core positive; anti-HCV was positive in 3 of the 18 VB negative (16.6%) and in one of the 5 with anti-core positive (20%), that represents a total of 4 cases anti-HCV positive (17.3%). 5 of the 8 patients with protracted hepatitis were virus B and A negative and 4 of them were anti-HCV positive (80%), 3 of which had parenteral infection. The 15 prostitutes and the 14 homosexuals were negative for the anti-HCV, as well as the 20 children chronically VB infected. Our result of the determination of anti-HCV in cryptogenetic cirrhosis (17.3%) is similar that reported in USA (> 20%) and very much lower than of the Italian group (80%). Meanwhile we found a high incidence in protracted hepatitis (80%) with parenteral infection.
Subject(s)
Hepacivirus/immunology , Hepatitis Antibodies/analysis , Homosexuality , Liver Cirrhosis/immunology , Sex Work , Adolescent , Adult , Aged , Child , Female , Hepatitis C/immunology , Humans , Male , Middle AgedABSTRACT
This article reviews the prevention of hepatitis B virus infection with emphasis on immunoprophylaxis in its 2 forms, passive by the use of immunoglobulins and active by the use of vaccines, plasmatic and recombinant. Both have been shown to be safe, with few secondary effects an highly effective. Response to the vaccine depends on age and immunological status, there are few contraindications. In Venezuela pre-exposure vaccination is recommended taking into account the prevalence of B virus infection, which is high in certain indigenous groups, homosexuals, drug addicts and patients in hemodialysis and intermediate in health workers and pregnant women of low socioeconomic status. Post-exposure vaccination is recommended in sexual contacts of persons infected acutely or chronically with the virus, in newborns of surface antigen positive mothers and in case of accidental percutaneous exposure.
