Hepatitis E virus in bottlenose dolphins Tursiops truncatus.

Hepatitis E virus (HEV) infects several animal species that act as zoonotic reservoirs for viral transmission. Solid and liquid residues from infected animals could lead to HEV contamination of food and surface waters. Evidence of human HEV infection through ingestion of seafood (shellfish, mussels) has been reported. Dolphins generally feed on fish and squid but are able to adapt to an environment and consume whatever prey is available. Clinical signs of infected dolphins include lethargy, inappetence, behavioral aberrations and increased serum alanine aminotransferase (ALT). The dolphins examined in this study were maintained at the National Aquarium, Havana, Cuba. A total of 31 dolphins were evaluated for HEV markers. Sera were collected and screened for total immunoglobin (Ig) anti-HEV. Sera and liver homogenate were tested for HEV RNA by nested RT-PCR using primers targeting the open reading frame 1. Phylogenetic analysis was performed using partial nucleotide sequences at the amplified RNA-dependent RNA polymerase gene. Total anti-HEV Ig was detected in 32.2% (10 of 31), and 16.1% (5 of 31) of these dolphins were positive by both serology and HEV RNA testing. Nucleotide sequence analyses revealed that HEV strains identified in dolphins were genotype 3. This virus may represent an environmental contamination of food or wastewater as a source of HEV exposure and infection. Our findings provide evidence that HEV is associated with liver disorders in cetaceans and that it is advisable to screen for exposure of this virus in captive dolphins, particularly animals with elevated serum ALT or compromised liver function test results of undetermined cause.

Genetic Diversity of the Hepatitis B Virus Strains in Cuba: Absence of West-African Genotypes despite the Transatlantic Slave Trade.

Cuba is an HBsAg low-prevalence country with a high coverage of anti-hepatitis B vaccine. Its population is essentially the result of the population mix of Spanish descendants and former African slaves. Information about genetic characteristics of hepatitis B virus (HBV) strains circulating in the country is scarce. The HBV genotypes/subgenotypes, serotypes, mixed infections, and S gene mutations of 172 Cuban HBsAg and HBV-DNA positive patients were determined by direct sequencing and phylogenetic analysis. Phylogenetic analysis of HBV S gene sequences showed a predominance of genotype A (92.4%), subgenotype A2 (84.9%) and A1 (7.6%). Genotype D (7.0%) and subgenotype C1 (0.6%) were also detected but typical (sub)genotypes of contemporary West-Africa (E, A3) were conspicuously absent. All genotype A, D, and C strains exhibited sequence characteristics of the adw2, ayw2, and adrq serotypes, respectively. Thirty-three (19.1%) patients showed single, double, or multiple point mutations inside the Major Hydrophilic domain associated with vaccine escape; eighteen (10.5%) patients had mutations in the T-cell epitope (amino acids 28-51), and there were another 111 point mutations downstream of the S gene. One patient had an HBV A1/A2 mixed infection. This first genetic study of Cuban HBV viruses revealed only strains that were interspersed with strains from particularly Europe, America, and Asia. The absence of genotype E supports previous hypotheses about an only recent introduction of this genotype into the general population in Africa. The presence of well-known vaccine escape (3.5%) and viral resistance mutants (2.9%) warrants strain surveillance to guide vaccination and treatment strategies.

Seroprevalencia y factores asociados a la hepatitis C en los municipios Playa y Marianao / Serological prevalence and risk factors associated to hepatitis C in the municipalities of Playa and Marianao

La Hepatitis C es uno de los principales problemas de salud a escala mundial. Objetivo: Medir la prevalencia de hepatitis C y algunos factores de riesgo asociados en la comunidad. Métodos: Se realizó en los municipios Marianao y Playa en Ciudad de La Habana una encuesta sero-epidemiológica a una muestra aleatoria de 642 habitantes para identificación de anticuerpos al virus de hepatitis C (anti-VHC) por inmunoensayo y estudio de algunos factores de riesgo. Además se realizó la prueba RT-PCR para confirmar la viremia a los casos positivos y la prueba del VIH para identificar coinfección. Resultados: Se encontraron 4 casos con anticuerpos VHC, para una prevalencia general de 0.6% y un intervalo de confianza 95% (IC 95%) entre 0.19 – 1.7 correspondiendo al municipio de Marianao una prevalencia de 0.3% (IC 95%: 0.01- 1.95) y a Playa 0.9% (IC 95%: 0.24 – 3.0) no identificando casos de coinfección con el Virus de Inmunodeficiencia Humana (VIH). La prevalencia en el grupo de 5 a 11 años de edad fue 1.6% (IC 95%: 0.08-10.1). Entre 40 a 49 años la prevalencia fue del 1.6% (IC 95%: 0.27- 6.14) al registrar 2 casos, únicos además con infección activa para un 50% del total de infectados en la comunidad. Entre adultos mayores (50-59 años) la prevalencia fue de 1% (IC 95%: 0.05-6.97). En el análisis de regresión logística multivariada los factores de riesgo más asociados en mayores de 11 años de edad fueron el cambio de pareja sexual (OR: 3.97; IC 95%: 0.35-44.71) y la transfusión sanguínea (OR: 10.57; IC 95%: 0.94 -118.55), aproximándose esta última a tener un valor significativo (p=0.055). Conclusión: La prevalencia en la comunidad de VHC fue baja estando mayormente asociada a antecedentes de transfusión sanguínea