ABSTRACT
In Brazil, hepatitis delta virus (HDV) is only reported in Western Amazonia, where severe cases of acute and chronic HDV hepatitis have been described. The study area was chosen in the States of Acre and Rondonia where most cases of hepatitis B virus (HBV)/HDV are reported. From December 2003 to October 2004, 40 HBsAg carriers with anti-HDV IgM were selected. An epidemiologic questionnaire, including demographic and clinical/epidemiologic variables was filled out. HDV amplification and genotyping were performed. Genotype I was detected in 22 patients (55.0%), whereas genotype III was identified in 18 (45.0%). Patients who were infected with genotype I were older (45.1 +/- 17.8 years) than patients infected with genotype III (32.8 +/- 10.9 years; P = 0.01). No symptoms were reported by 21 (52.5%) patients. Otherwise, 19 (47.5%) had symptoms (fatigue, abdominal pain, weight loss, and decompensated liver disease) that motivated them to seek medical care. Genotype III carriers were more symptomatic, but no statistical significance was achieved. Our preliminary results show that HDV genotypes I and III are present in Brazilian Amazonia and that HDV genotype III is not limited to the Amerindian population.
Subject(s)
Hepatitis B/virology , Hepatitis Delta Virus/genetics , Adolescent , Adult , Brazil , Carrier State , Child , Female , Genotype , Humans , Male , Nucleic Acid HybridizationABSTRACT
Severe cases of hepatitis caused by hepatitis B virus (HBV) or hepatitis D virus (HDV) are often seen in the Brazilian Amazon, but there is a paucity of epidemiologic studies on viral hepatitis in this area. Thus, a cross-sectional study to investigate the prevalence of markers for HBV and HDV was performed. Serum samples were collected after participants completed an epidemiologic questionnaire. Markers for HBV and HDV were analyzed with an enzyme-linked immunosorbent assay. The HBV genotype was determined by sequencing of the gene for hepatitis B surface antigen (HBsAg). Of 2,656 samples, 89 (3.3%) were positive for HBsAg and 1,628 (61.5%) were positive for IgG antibody to hepatitis B core antigen. Markers for HDV were found in 47 cases (1.7%). Antibodies to HDV were associated with Amerindian ethnic origin, a lower educational level, a history of acute viral hepatitis, a history of malaria, male sex, a history of tattooing, and older age. The most frequent HBV genotypes were A and F. This study showed a high prevalence of HBV and HDV in the western Brazilian Amazon, as well as the predominance of HBV genotypes A and F.
Subject(s)
Hepatitis Antibodies/blood , Hepatitis B Antibodies/blood , Hepatitis B virus/immunology , Hepatitis B/epidemiology , Hepatitis D/epidemiology , Hepatitis Delta Virus/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Child , Child, Preschool , Enzyme-Linked Immunosorbent Assay , Female , Genotype , Hepatitis B/virology , Hepatitis B Core Antigens/immunology , Hepatitis B Surface Antigens/genetics , Hepatitis B virus/classification , Hepatitis B virus/genetics , Hepatitis D/virology , Hepatitis Delta Virus/classification , Hepatitis Delta Virus/genetics , Humans , Immunoglobulin G/blood , Infant , Infant, Newborn , Male , Middle Aged , Prevalence , Seroepidemiologic StudiesABSTRACT
During a yellow fever vaccination campaign among residents of Rio Branco (Acre State), the frequency of HI antibodies to the most prevalent arboviruses in the Amazon region and to yellow fever virus was determined before and three months after immunization with YF 17D vaccine. From 390 inhabitants included in the first phase of serologic survey (August 1999), only 190 provided a second serum sample, after the use of 17D vaccine (January 2000). Among first phase samples, the frequency of HI antibodies was: 17D (27.2%); Ilheus (5.9%); Mayaro (5.4%); Caraparu (4.9%); Dengue-2 (4.1%); Oropouche (2.3%); and Dengue-1 (0.3%). In the second study phase, the serologic conversion to YF reached 89.7% among previously negative persons. Serologic conversions were also observed to Ilheus (6.2%); Dengue-3 (3.2%); Mayaro (1.1%); and Oropouche (1.1%) viruses. In conclusion, considering the high YF antibody rate after vaccination, the risk of urban yellow fever seems insignificant, although the lower prevalence of HI antibodies to dengue viruses, is of concern and inhabitants are under high risk of dengue outbreaks, especially to DEN-3 recently introduced in Brazil, as was observed in 2000 and 2001 with DEN-1 and DEN-2.
Subject(s)
Antibodies, Viral/blood , Arboviruses/immunology , Yellow Fever Vaccine/immunology , Antibodies, Viral/immunology , Arboviruses/classification , Brazil/epidemiology , Dengue/epidemiology , Dengue/immunology , Dengue Virus/immunology , Female , Hemagglutination Inhibition Tests , Humans , Male , Seroepidemiologic Studies , Yellow Fever/epidemiology , Yellow Fever/immunologyABSTRACT
Em amostra da populaçäo da cidade de Rio Branco (Acre), foi pesquisada a freqüência de portadores de anticorpos contra os arbovírus, mais prevalentes na regiäo amazônica, e o vírus vacinal da febre amarela, antes e após a imunizaçäo com a vacina 17D. Das 390 pessoas incluídas na primeira fase do estudo (agosto de 1999), somente 190 compareceram em janeiro de 2000, três meses após a aplicaçäo da vacina 17D (outubro de 1999). Nas amostras da primeira fase, as freqüências de soropositivos (IH) para os vírus estudados foram: 17D (27,2 por cento); Dengue-1 (0,3 por cento); Dengue-2 (4,1 por cento); Dengue-3 (0 por cento); Dengue-4 (0 por cento), entre outros 8 vírus. Nas amostras séricas de janeiro (2000), a soroconversäo para o 17D foi de 89,7 por cento (130/145) e 3,2 por cento (6/190) passaram a ter anticorpos contra o sorotipo 3 (DEN-3). Em conclusäo, por conta da elevada taxa de cobertura vacinal e de soroconversäo há reduçäo significativa do risco de urbanizaçäo do vírus da febre amarela na cidade de Rio Branco, apesar de näo ser desprezível a possibilidade de uma nova epidemia de dengue, pelo DEN-3, a semelhança da registrada em 2000 e 2001 pelos sorotipos 1 e 2.
Subject(s)
Humans , Male , Female , Antibodies, Viral , Arboviruses , Yellow Fever , Antibodies, Viral , Arboviruses , Brazil , Dengue , Dengue Virus , Hemagglutination Inhibition Tests , Seroepidemiologic Studies , Yellow FeverABSTRACT
Na cidade de Rio Branco (Acre), foram pesquisadas as amostras séricas de 390 pessoas sadias, de 2 a 79 anos de idade (26,5+/-14,9), usando métodos sorológicos (ELISA e Western blot específicos) para determinar a prevalência da infecção pelo HIV e/ou HTLV-I/II. Nenhuma pessoa foi soropositiva. Em conclusão, os dados sugerem a baixa transmissão na população sadia da cidade de Rio Branco, onde é elevada a freqüência de pessoas de origem indígena.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Deltaretrovirus Antibodies/blood , Deltaretrovirus Infections/epidemiology , HIV Infections/epidemiology , Blood Donors , Blotting, Western , Brazil/epidemiology , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , HIV Seroprevalence , HTLV-I Infections/epidemiology , HTLV-II Infections/epidemiologyABSTRACT
Os autores descrevem 40 casos novos de lobomicose do Estado do Acre. Trinta e sete pacientes säo do sexo masculino e 90 porcento deles trabalharam em seringais da regiäo. A maioria dos pacientes (34/40) apresenta lesöes monomórficas, de aspecto queloidiforme e localizadas principalmente nos pavilhöes auriculares (18/40). Os demais (6/40) apresentam lesöes polimórficas de aspectos queloidiforme e verrucoso. Em cinco dos 40 casos as lesöes cutâneas säo disseminadas. Säo destacados um caso com lesöes em ambos os pavilhöes auriculares, outro com lesöes verrucosas na planta do pé e um terceiro com lesöes de disposiçäo linear ascendente na coxa e comprometimento de linfonodo inguinal. Os autores enfocam o número de casos descritos na literatura, os quais estäo, em parte, embasados em comunicaçöes pessoais e em estimativas. Consideram epidemiológicamente importante, em uma doença de difícil tratamento e de morbidade näo desprezível, como é a lobomicose, que todos os casos sejam bem documentados para fornecer visäo mais exata da real extensäo do problema
