Seroprevalencia y factores de riesgo asociados a infección por Trypanosoma cruzi y Toxoplasma gondii en la comunidad Saimadoyi, Sierra de Perijá, estado Zulia / Seroprevalence and risk factors associated to infection by Trypanosoma cruzi and Toxoplasma gondii in the Saimadoyi community, Sierra de Perija, Zulia state

La enfermedad de Chagas y la toxoplasmosis constituyen problemas de salud característicos de zonas rurales. El objetivo de esta investigación fue determinar la seroprevalencia de Trypanosoma cruzi y Toxoplasma gondii en la comunidad Saimadoyi. Se estudiaron 166 muestras de sueros de individuos de ambos sexos (100 femeninos y 66 masculinos) con edades comprendidas entre 1 a 83 años. La determinación de anticuerpos se realizó a través de la técnica de ELISA, utilizando kits disponibles comercialmente. La seroprevalencia de Trypanosomacruzi fue de 51% (87/166), mientras que para Toxoplasma gondii fue de 57% (95/166). La mayoría de casos positivos se encontraron en los individuos menores de 20 años, sin embargo, no se encontraron diferencias significativas con respecto al género o grupo de edad para ambas parasitosis. Los datos epidemiológicos mostraron que los factores de riesgo estadísticamente significativos (p<0,05) para la infección por T. cruzi fueron el tipo de vivienda, contacto con perros o chipos y contaminación del suelo con heces; mientras que para la infección por T. gondii, el contacto con gatos y la higiene inadecuada fueron los riesgos significativos. El elevado número de casos seropositivos en mujeres en edad reproductiva sugiere la transmisión vertical de ambos parásitos.

Chagas disease and toxoplasmosis are health problems characteristic of rural areas. The aim of this research was to determine the seroprevalence of Trypanosoma cruzi y Toxoplasma gondii. in community Saimadoyi. 166 serum samples from individuals of both sexes (100 female 66 male and) aged 1-83 years were studied. The determination of antibodies was performed by ELISA using a commercial kit. Trypanosoma cruzi seroprevalence was 51% (87/166), while for Toxoplasma gondii was 57% (95/166). Most positive cases were found in people under 20 years old, however no significant differences with regard to gender or age group for both parasites were found. Epidemiological data showed statistically significant risk factors (p <0.05) for T. cruzi infection were the type of housing, contact with dogs or chipos and soil contamination with feces; while for T. gondii infection, contact with cats and poor hygiene were the significant risks. The high number of seropositives cases in women of reproductive age suggests vertical transmission of both parasites.

Detección de rotavirus y parásitos intestinales en infantes menores de 5 años de edad de comunidades indígenas del Estado Zulia, Venezuela / Detection of rotavirus and intestinal parasites in children under 5 years old, from indigenous communities in Zulia state, Venezuela

Rotavirus es un agente viral asociado a la gastroenteritis infantil, siendo junto con los parásitos intestinales, los principales causantes de estos cuadros diarreicos. Con el objetivo de detectar rotavirus y parásitos intestinales en infantes de 0 a 5 años de seis comunidades indígenas del estado Zulia, se tomaron 173 muestras de heces en las que se determinó la presencia de rotavirus empleando la técnica de aglutinación en látex. Las muestras fueron caracterizadas macro y microscópicamente a través del examen con SSF, lugol y concentrado con formol-éter, para detectar formas evolutivas parasitarias. Se determinó la prevalencia de parásitos intestinales de un 71%, significativamente más elevada que la de Rotavirus con 16,2%. Se encontró relación estadísticamente significativa entre la presencia de rotavirus y la existencia de diarrea (p=0,0001); más no entre presencia de rotavirus y niños vacunados (p=0,904). Predominaron las protozoosis sobre las helmintiasis; así como el poliparasitismo (52%). Los parásitos más prevalentes fueron Ascaris lumbricoides con 32,4% y Blastocystis spp. con 31,2%. Los principales parásitos asociados a rotavirus fueron Blastocystis spp. y Entamoeba coli, aunque sin significancia estadística. Se concluye que la prevalencia de rotavirus detectada se corresponde a la referida en Venezuela para niños menores de 5 años de áreas urbanas.

Rotavirus is a viral agent associated with childhood gastroenteritis, being with intestinal parasites, the principal cause of diarrhea in children. In order to detect rotavirus, and intestinal parasites in children from 0 to 5 years old of six indigenous communities in Zulia state, 173 stool samples was recolected, where the presence of rotavirus was determinate using agglutination test. The samples were characterized macroscopically and microscopically by examining with SSF, lugol and concentrate formalin-ether to detect parasitic evolutionary forms. It was determined that the presence of intestinal parasites was 71%, significantly higher than the 16,2% of rotavirus. The most prevalent parasites were Ascaris lumbricoides (32,4%) and Blastocystis spp. (31,2%). Statistically significant relationship between the presence of rotavirus and diarrhea existence (p = 0.0001); more no presence of rotavirus among vaccinated children (p = 0.904 ). About they predominated protozoosis over helminths; as well as polyparasitism (52%). Major parasites associated with rotavirus were Blastocystis spp. and Entamoeba coli, although without statistical significance. It is concluded that the prevalence of rotavirus detected corresponds to that reported in Venezuela for children under 5 years of urban areas.

Prevalencia de enteroparásitos y anticuerpos IgG anti-Entamoeba histolytica en indígenas de la comunidad de Toromo, estado Zulia, Venezuela / Prevalence of enteroparasites and IgG antibodies anti-Entamoeba histolytica in the indigenous community of Toromo, Zulia State, Venezuela

Para determinar la seroprevalencia de anticuerpos contra Entamoeba histolytica y la prevalencia de los enteroparásitos en indígenas de la comunidad de Toromo, estado Zulia, Venezuela, se estudiaron 69 individuos de ambos sexos, de 1 a 60 años de edad, en el año 2012. Se recolectaron muestras de heces y suero; a todas las muestras fecales se les realizó examen microscópico con solución fisiológica y lugol, concentración con formol-éter y coloración de Kinyoun; para la detección de anticuerpos IgG anti-Entamoeba histolytica en suero, se empleó una técnica de ELISA comercial. El 98,6% de los individuos estudiados estaban parasitados, predominando el poliparasitismo (88,2%), detectándose asociaciones de hasta 10 especies parasitarias. Entre las especies encontradas están, Ascaris lumbricoides el principal helminto (65%), y Blastocystis sp. (59%) el protozoario más frecuente. Entamoeba histolytica/dispar/moshkovskii se detectó por microscopia en 25 individuos (36% de prevalencia), donde se incluyó un caso de infección por Entamoeba histolytica, por haberse encontrado trofozoítos hematófagos. Se observó una seroprevalencia de anticuerpos contra E. histolytica, del 83%. De los resultados obtenidos, se concluye que existe una elevada seroprevalencia de anticuerpos contra E. histolytica, así como una alta prevalencia de enteroparásitos en la población indígena estudiada.

In order to determine the seroprevalence of antibodies against Entamoeba histolytica and intestinal parasites in the indigenous community of Toromo, Zulia state, Venezuela, 69 individuals of both sexes, from 1 to 60 years of age were studied during the year 2012. Stool and serum samples were collected. Microscopic study of fecal specimens was carried out by saline solution dilution, Lugol staining, formol-ether concentration and Kinyoun’s stain. For determination of anti-Entamoeba histolytica IgG antibodies, a commercial ELISA technique in serum was used; 98.6% of the population were parasitized, predominating the polyparasitism (88.24%) and finding up to 10 different parasite species were associated. The main parasitic species found were: Ascaris lumbricoides (65%), followed by Blastocystis sp. (59%). Entamoeba histolytica/dispar/moshkovskii was detected by microscopy in 25 individuals (36% prevalence), which included a case of infection by Entamoeba histolytica as hematophagous trophozoites were observed. A seroprevalence of 83% for IgG anti-Entamoeba histolytica antibodies in the individuals studied was found. According to the results it is concluded, that there is a high seroprevalence of antibodies against E. histolytica, as well as a high prevalence of intestinal parasites in the indigenous population studied.

Seroprevalencia contra agentes ToRCH en mujeres indígenas en edad fértil, estado Zulia, Venezuela / Prevalence of infectious agents in indigenous women of childbearing age in Venezuela

Introducción. El termino ToRCH comprende a los patógenos Toxoplasma gondii, virus de la rubéola, citomegalovirus y virus herpes simple 1 y 2. En mujeres embarazadas expuestas pueden ser causa de abortos y malformaciones congénitas en el neonato. Objetivo. Determinar la seroprevalencia de infección por los agentes causantes del síndrome ToRCH en mujeres en edad fértil de algunas comunidades indígenas yukpa de Venezuela. Materiales y métodos. En el año 2007 fueron seleccionadas 109 muestras de 151 mujeres, en edades comprendidas entre 14 y 40 años. La detección de anticuerpos se hizo por el método de inmunoensayo enzimático indirecto o ELISA de Smartest Diagnostics™. Resultados. El 85,5 % presentó anticuerpos contra T. gondii, el 95,4 % para rubéola, el 75,2 % para citomegalovirus y el 97,2 % para el virus herpes simple 1 y 2. Se observa que el 21,1 % y el 30,2 % presentaron relación entre la variable aborto y las infecciones por citomegalovirus y virus herpes simple 1 y 2, respectivamente. Conclusiones. Existe alta seroprevalencia de infecciones por los agentes causantes del síndrome ToRCH en mujeres en edad fértil de la etnia indígena yukpa. Las condiciones sanitarias precarias y el consumo de agua contaminada con ooquistes, favorecen la adquisición de la infección por T. gondii. El hacinamiento, el inicio a temprana de edad de la actividad sexual y el número de parejas, pueden incidir en la presencia de citomegalovirus y virus herpes simple 1 y 2.

Introduction. The ToRCH syndrome includes the following infectious pathogens: Toxoplasma gondii, rubella, cytomegalovirus and herpes simplex virus 1 and 2. In susceptible pregnant women, these pathogens can cause abortions and congenital malformation in the newborn babies. Objective. The seroprevalence of infection by ToRCH agents was determined in women of childbearing age in several Venezuelan Yukpa indigenous communities. Material and methods. In 2007, 109 samples were selected from 151 women with an age range of 14 to 40 years old. The determination of antibodies against ToRCH agents was carried out through the indirect enzyme immunoassay technique by ELISA´s technique of Smartest Diagnostics. Results. Of the 109 samples, 85.5% presented antibodies against T. gondii, 95.4% for rubella, 75.2% for cytomegalovirus and 97.2% for and herpes simplex virus 1 and 2. A relationship between abortion and infection by cytomegalovirus and herpes simplex virus 1and 2 was noted in 21.1% and 30.2% of women presented, respectively. Conclusions. The findings show a high prevalence of ToRCH agents in women in childbearing age in Yukpa indigenous communities in Venezuela. Poor sanitary conditions and consumption of water contaminated with oocysts may be an important way of transmission of T. gondii. Overcrowding in the communities, sexual activity at an early age and number of partners and may be related to the presence of cytomegalovirus and herpes simplex virus HSV-1 and 2.

[Prevalence of infectious agents in indigenous women of childbearing age in Venezuela]. / Seroprevalencia contra agentes ToRCH en mujeres indígenas en edad fértil, estado Zulia, Venezuela.

INTRODUCTION: The ToRCH syndrome includes the following infectious pathogens: Toxoplasma gondii, rubella, cytomegalovirus and herpes simplex virus 1 and 2. In susceptible pregnant women, these pathogens can cause abortions and congenital malformation in the newborn babies. OBJECTIVE: The seroprevalence of infection by ToRCH agents was determined in women of childbearing age in several Venezuelan Yukpa indigenous communities. MATERIAL AND METHODS: In 2007, 109 samples were selected from 151 women with an age range of 14 to 40 years old. The determination of antibodies against ToRCH agents was carried out through the indirect enzyme immunoassay technique by ELISA´s technique of Smartest Diagnostics. RESULTS: Of the 109 samples, 85.5% presented antibodies against T. gondii, 95.4% for rubella, 75.2% for cytomegalovirus and 97.2% for and herpes simplex virus 1 and 2. A relationship between abortion and infection by cytomegalovirus and herpes simplex virus 1and 2 was noted in 21.1% and 30.2% of women presented, respectively. CONCLUSIONS: The findings show a high prevalence of ToRCH agents in women in childbearing age in Yukpa indigenous communities in Venezuela. Poor sanitary conditions and consumption of water contaminated with oocysts may be an important way of transmission of T. gondii. Overcrowding in the communities, sexual activity at an early age and number of partners and may be related to the presence of cytomegalovirus and herpes simplex virus HSV-1 and 2.

Detección de infecciones inaparentes de la enfermedad de Chagas en individuos asintomáticos de la etnia Yukpa del occidente de Venezuela / Chagas disease inapparent infection in asymptomatic individuals from a Yukpa ethnic community in western Venezuela

Inapparent infections by Trypanosoma cruzi were detected, for the first time, in symptomless seropositive healthy individuals from a Yukpa ethnic community in western Venezuela where Chagas disease had not been previously reported. Seropositivity was detected in 24 out of 173 (13.9%) sera samples taken from asymptomatic people by using three serological methods (DAT, IFAT, ELISA). Complementary analyses by IFAT revealed a low level of anti-T. cruzi specific IgM and IgG in all seropositive people when compared with detected levels in acute and chronic chagasic patients included as positive controls. In addition, 100% of the sampled dogs (8) were seropositive showing a level of anti-T. cruzi IgG similar to that detected in humans. Genotyping of a T. cruzi isolate obtained from an infected wild specimen of Rhodnius pictipes, revealed the circulation of lineage1 (DTU1) in the study area. The importance of the detection of asymptomatic T.cruzi-infections in this indigenous community and its potential epidemiological implications are discussed.

Infecciones inaparentes por Trypanosoma cruzi fueron detectadas, por vez primera, en individuos seropositivos asintomáticos muestreados en una comunidad Yukpa del occidente de Venezuela donde no se ha registrado hasta el presente enfermedad de Chagas. De un total de 173 muestras de suero examinadas 24 (13,9%) fueron registradas como seropositivas utilizando tres pruebas serológicas. Análisis complementarios por IFI revelaron bajos niveles de IgM e IgG cuando las muestras de individuos seropositivos asintomáticos fueron comparadas con casos agudos y crónicos incluidos como controles positivos. La totalidad de perros examinados (8) reveló seropositividad, registrándose niveles de IgG similares a los detectados en el grupo humano. La caracterización molecular de un aislado de T. cruzi obtenido de un espécimen silvestre de Rhodnius pictipes reveló la circulación del linaje 1 (DTU1) en el área de estudio. Se discute la importancia de infecciones asintomáticas por T. cruzi y sus implicaciones epidemiológicas en la comunidad indígena estudiada.

Baja prevalencia de la infección por el virus de la hepatitis C en una población de reclusos, Maracaibo, Venezuela / Low prevalence of hepatitis C virus infection in a prisoner population from Maracaibo, Venezuela

Introducción. Las conductas de alto riesgo presentes en los centros de reclusión incrementan la probabilidad de transmisión de la infección por el virus de la hepatitis C. En Venezuela no se han realizado estudios del virus en estos centros, por lo que se desconoce la relevancia de la infección en ellos. Objetivo. Estimar la prevalencia del virus de la hepatitis C y los posibles factores de riesgos involucrados en la transmisión del virus en reclusos de la cárcel de Sabaneta, Maracaibo, Venezuela. Material y métodos. Se seleccionó una población de 200 reclusos de un total de 1.000. Las edades estaban comprendidas entre 18 y 69 años (media ± DE: 31,629,93 a˜os). La detección de anticuerpos contra el virus de la hepatitis C se realizó por duplicado mediante el método inmunoenzimático ELISA de IV generación y por el método de inmunoblot INNO-LIA HCV®, ambos de Innogenetic Lab (Bélgica). El ARN viral se detectó por la técnica de reacción en cadena de la polimerasa, previa transcripción inversa, RT-PCR. Resultados. La frecuencia obtenida con el método ELISA fue de 5% (10/20) y 3/200 (1,5%) individuos fueron positivos, a la vez, con los métodos de INNO-LIA y RT-PCR. Conclusiones. La prevalencia de la infección por el virus de la hepatitis C en esta población fue baja, lo que evidencia la baja circulación del virus en el reclusorio. El principal factor de riesgo para la adquisición de la infección, al parecer, es el uso de drogas intravenosas.

Introduction. The high risk behaviors observed in prison centers have favored the transmission of hepatitis C virus infection. The main risk factor to acquire hepatitis C virus infection seems to be the use of intravenous drugs. In Venezuela, the prevalence of the infection in these centers is unknown since studies of the hepatitis C virus there are lacking. Objective. The aim of this study was to determine the prevalence of hepatitis C virus and the risk factors involved in the transmission in prisoner populations. Material and methods. A sample of 200 prisoners was studied from Sabaneta Jail, Maracaibo, Venezuela. The ages were between 18-69 years (average ± DS: 31.6±9.9 years). Serum samples were tested by a fourth generation enzyme-linked immunosorbent assay ELISA and a confirmatory assay INNO-LIA. Both kits were from Innogenetic Laboratories N.V. (Belgium). Viral RNA was tested by the reverse transcription polymerase chain reaction technique (RT-PCR). Results. The ELISA assay determined a hepatitis C virus prevalence of 5.0% (10/200); 3/200 (1.5%) individuals were positive by both INNO-LIA and RT-PCR tests. Conclusions. The observed prevalence of hepatitis C virus antibodies in this population was very low, suggesting a low circulation of the virus in this environment and a low level of associated risk behaviors.

[Low prevalence of hepatitis C virus infection in a prisoner population from Maracaibo, Venezuela]. / Baja prevalencia de la infección por el virus de la hepatitis C en una población de reclusos, Maracaibo, Venezuela.

INTRODUCTION: The high risk behaviors observed in prison centers have favored the transmission of hepatitis C virus infection. The main risk factor to acquire hepatitis C virus infection seems to be the use of intravenous drugs. In Venezuela, the prevalence of the infection in these centers is unknown since studies of the hepatitis C virus there are lacking. OBJECTIVE: The aim of this study was to determine the prevalence of hepatitis C virus and the risk factors involved in the transmission in prisoner populations. MATERIAL AND METHODS: A sample of 200 prisoners was studied from Sabaneta Jail, Maracaibo, Venezuela. The ages were between 18-69 years (average +/- DS: 31.6+/-9.9 years). Serum samples were tested by a fourth generation enzyme-linked immunosorbent assay ELISA and a confirmatory assay INNO-LIA. Both kits were from Innogenetic Laboratories N.V. (Belgium). Viral RNA was tested by the reverse transcription polymerase chain reaction technique (RT-PCR). RESULTS: The ELISA assay determined a hepatitis C virus prevalence of 5.0% (10/200); 3/200 (1.5%) individuals were positive by both INNO-LIA and RT-PCR tests. CONCLUSIONS: The observed prevalence of hepatitis C virus antibodies in this population was very low, suggesting a low circulation of the virus in this environment and a low level of associated risk behaviors.

[High prevalence of hepatitis B infection in Amerindians in Japreira, Zulia State, Venezuela]. / Alta prevalencia de la infección por el virus de hepatitis B en la comunidad indígena Japreira, Estado Zulia, Venezuela.

The aim of this study was to determine the prevalence of hepatitis B virus (HBV) infection in the Japreira indigenous community, Venezuela, and its relationship to age and gender. An intentional, non-probabilistic sample of 149 individuals was selected from a total of 300. All samples were studied for the presence of total HBV antibodies (total anti-HBc), and the positive samples were tested for HBV surface and "e" antigens (HBsAg, HBeAg). Overall prevalence rates of total anti-HBc were 72.9% in females and 81.1% in males. The highest prevalence of HBsAg was observed in males 26-35 years of age. Only four of the 44 HBsAg carriers were positive for HBeAg. The results showed a high endemic HBV infection rate and indicated that its spread begins at early ages. Sexual transmission may be the main route for spread of the virus. Crowding, close contact with bodily fluids, specific social practices, and features of the circulating viral strain among members of this community could be involved in the high chronicity observed in the Japreira indigenous community.

Alta prevalencia de la infección por el virus de hepatitis B en la comunidad indígena Japreira, Estado Zulia, Venezuela / High prevalence of hepatitis B infection in Amerindians in Japreira, Zulia State, Venezuela

A fin de conocer la prevalencia de la infección por el virus de hepatitis B (VHB) en la comunidad indígena Japreira, Venezuela, y determinar las pautas de su adquisición en función de la edad y sexo, se seleccionaron 149 individuos de un total de 300. Se detectó por métodos serológicos la presencia de anticuerpos totales del VHB (anti-HBc total), y en las positivas se investigó la presencia del antígeno de superficie (HBsAg) y del antígeno e del VHB (HBeAg). La prevalencia de anti-HBc total fue de 72,9 por ciento en el sexo femenino y 81,1 por ciento en el masculino, la prevalencia de HBsAg fue elevada (61,1 por ciento) en el sexo masculino, sólo cuatro de los portadores de HBsAg fueron positivos para HBeAg. Los resultados obtenidos indican un grado elevado de endemia para esta infección y que su diseminación comienza a temprana edad. El factor involucrado en la adquisición y diseminación del virus seria la vía sexual. Hacinamiento, contacto intercorpóreo con fluidos biológicos, prácticas sociales, y características de la cepa viral circulante podrían estar involucradas en la alta cronicidad observada en la comunidad indígena Japreira.

The aim of this study was to determine the prevalence of hepatitis B virus (HBV) infection in the Japreira indigenous community, Venezuela, and its relationship to age and gender. An intentional, non-probabilistic sample of 149 individuals was selected from a total of 300. All samples were studied for the presence of total HBV antibodies (total anti-HBc), and the positive samples were tested for HBV surface and e antigens (HBsAg, HBeAg). Overall prevalence rates of total anti-HBc were 72.9 percent in females and 81.1 percent in males. The highest prevalence of HBsAg was observed in males 26-35 years of age. Only four of the 44 HBsAg carriers were positive for HBeAg. The results showed a high endemic HBV infection rate and indicated that its spread begins at early ages. Sexual transmission may be the main route for spread of the virus. Crowding, close contact with bodily fluids, specific social practices, and features of the circulating viral strain among members of this community could be involved in the high chronicity observed in the Japreira indigenous community.

Enteroparasitosis en indígenas de la comunidad Japrería estado Zulia Venezuela / Enteroparasites in indigenous individuals from the Japreria community Zulia state Venezuela

Las enfermedades parasitarias representan un problema médico, económico y social, afectando a todas las clases sociales, pero principalmente a los estratos socioeconómicos más bajos. Para determinar la prevalencia de enteroparásitos en la comunidad indígena Japrer¡a, ubicada en la Sierra de Perijá, Estado Zulia, Venezuela, se procesaron 191 muestras fecales correspondientes a individuos de ambos sexos con edades comprendidas entre 1 mes y 86 años. Las muestras fueron analizadas a través de los métodos coproparasitológico directo y por la técnica de concentración formol-éter. Se encontró una elevada prevalencia de enteroparásitos (82,20 por ciento) y un predominio del poliparasitismo (78,98 por ciento), con asociaciones entre especies comensales y patógenas. No se observó diferencia significativa de susceptibilidad entre la prevalencia de parásitos y el sexo (p>0,05). En cuanto al grupo etario, el estrato más afectado resultó ser el de adultos jóvenes (20-39 años; 25,48 por ciento). Las especies de protozoarios mas frecuentes fueron Blastocystis hominis (46,07 por ciento), Entamoeba coli (42,93 por ciento) y el complejo Entamoeba histolytica/Entamoeba dispar (34,0 por ciento). Entre los helmintos, Ancylostomideos (30,89 por ciento), Ascaris lumbricoides (9,95 por ciento) e Hymenolepis nana (4,19 por ciento) ocuparon los primeros lugares. La presencia incrementada de enteroparásitos se relaciona con el escaso saneamiento ambiental en esta comunidad indígena, por lo que los resultados avalan la importancia de diseñar programas de control específicos para disminuir los factores condicionantes presentes, lo cual tendr¡a impacto en el descenso de las infecciones parasitarias.

Low prevalence of hepatitis C virus infection in Amerindians from Western Venezuela.

Previous studies have not found hepatitis C virus (HCV) infection in Amerindians from Western Venezuela. A survey of 254 Bari and Yukpa natives aged 10-60 years (mean +/- SD age = 35 +/- 5.4 years) from four communities, two Bari and two Yukpa, in this area were studied to assess the prevalence of antibodies to HCV (anti-HCV) and HCV RNA among these indigenous populations. Serum samples were examined initially for anti-HCV by a four generation enzyme-linked immunosorbent assay (ELISA). Reactive samples were then tested using a third generation recombinant immunoblot assay (RIBA-3). Viral RNA was investigated in all immunoblot-reactive samples by a nested polymerase chain reaction (PCR) method. Six (2.3%) of 254 natives were positive by ELISA, one (2.2%) of these reactive samples were positive by RIBA, and four (1.5%) were indeterminate. Only two (0.8%) were positive by PCR, corresponding to 1 (2.1%) of 47 inhabitants of a Yukpa community and to 1 (2.2%) of 45 subjects of a Bari community. Iatrogenic is thought to play a role in acquisition of the infection. The findings indicate a HCV focus of low endemicity and are compatible with a low degree of exposures of the natives to the virus. Studies are necessary to assess the risk factors for infection in these Amerindians.

Low prevalence of hepatitis C virus infection in Amerindians from Western Venezuela

Previous studies have not found hepatitis C virus (HCV) infection in Amerindians from Western Venezuela. A survey of 254 Bari and Yukpa natives aged 10-60 years (mean ± SD age = 35 ± 5.4 years) from four communities, two Bari and two Yukpa, in this area were studied to assess the prevalence of antibodies to HCV (anti-HCV) and HCV RNA among these indigenous populations. Serum samples were examined initially for anti-HCV by a four generation enzyme-linked immunosorbent assay (ELISA). Reactive samples were then tested using a third generation recombinant immunoblot assay (RIBA-3). Viral RNA was investigated in all immunoblot-reactive samples by a nested polymerase chain reaction (PCR) method. Six (2.3 percent) of 254 natives were positive by ELISA, one (2.2 percent) of these reactive samples were positive by RIBA, and four (1.5 percent) were indeterminate. Only two (0.8 percent) were positive by PCR, corresponding to 1 (2.1 percent) of 47 inhabitants of a Yukpa community and to 1 (2.2 percent) of 45 subjects of a Bari community. Iatrogenic is thought to play a role in acquisition of the infection. The findings indicate a HCV focus of low endemicity and are compatible with a low degree of exposures of the natives to the virus. Studies are necessary to assess the risk factors for infection in these Amerindians.

Relación entre el herpes simple tipo 2 y las lesiones preinvasivas de cuello uterino / Relationship between type 2 herpes simples and uterine cervix pre-invasive lesions

Objetivos: Determinar la presencia y relación del virus herpes simple tipo 2 (VHS-2) en mujeres con diferentes gradosde lesiones preinvasivas de cuello uterino. Materiales y métodos: Se estudiaron 176 mujeres con lesiones pre invasivas de cuello uterino y 40 mujeres como grupo control con cuello uterino sano, que asistieron a la consulta ginecológica en diferentes centros de salud, durante los años 2002-2005 en Maracaibo-Venezuela. A las pacientes se les tomó un hisopado del exocervix y una biopsia dirigida del sitio de la lesión por colposcopía. La determinación deVHS-2 se realizó a través de inmunofluorescencia directa. Resultados: La presencia de infección por VHS-2 fue 44/176 (25). El mayor número de VHS-2 se obtuvo en las pacientes con grado de lesión tipo NIC II (66,7). El mayor porcentaje de infección por VHS-2 se determinó en las pacientes que iniciaron sus relaciones sexuales entre los 15 y20 años (34,5), las relaciones sexuales diarias (50), así como relaciones de tipo orogenital fueron consideradas las conductas de mayor riesgo para adquirir la infección. Conclusiones: No se evidenció una relación directa entre VHS-2y la presencia de cáncer. Los factores de riesgo asociados con la infección son similares a otras ITS, y están ligados con la conducta sexual y hábitos propios del individuo.

Objectives: To determine the presence and relationship of type 2 herpes simplex virus (HSV-2) in women with different degrees of pre-invasive cervical lesions. Materials and methods: 176 women with pre-invasive cervical lesions and 40 healthy controls were studied. These women were regular clients of gynecology outpatient clinics in different health centers during the 2002-2005 period in Maracaibo, Venezuela. Subjects underwent an exo-cervical smear and a colposcopy-oriented biopsy of the lesion site. HSV-2 determination was performed using direct immunofluorescence. Results: HSV-2 infection was detected in 44/176 women (25%). The highest figures for HSV-2 were obtained in women with ICN II lesions (66,7%). The highest frequencies of HSV-2 infections were found in women starting sexual life between 15 and 20 years of age (34,5%). Daily intercourse (50%), as well as oral sex, was considered as the most risky behavior for acquiring the infection. Conclusions: No direct relationship between HSV-2 and cancer was evidenced. Risk factors associated with this infection are similar to those for other sexually transmitted diseases, and they are linked with sexual behavior and individual habits.

Balantidiasis en una niña indígena de la Sierra de Perijá -Venezuela: reporte de un caso / Balantidiasis in an amerindian child from the sierra de Perijá-Venezuela: a case report

Se reporta el caso de una paciente indígena de la etnia Yucpa de la Sierra de Perijá-Venezuela, con cuadro de diarrea por Balantidium coli. El diagnóstico se realizó mediante el examen directo de las heces. Se le indicó tratamiento con Metronidazol. La evolución fue satisfactoria.

[Hepatitis B in children with cancer]. / Hepatitis B en niños con cáncer.

INTRODUCTION: Cancer patients can be asymptomatic carriers of the hepatitis B virus (HBV), which can be reactivated by chemotherapy. Our aim was to identify the serological markers of HBV in children with cancer who were asymptomatic carriers of the virus. Fifty two (52) children with cancer treated at the Maracaibo University Hospital in Venezuela were studied, 28 of these children (53.8%) were HBV positive, despite no clinical or biochemical signs or symptoms of hepatitis. The type of serological markers present in each of these children.were investigated. We found 7 cases (25%) with hepatitis B surface antigen (HBsAg) and 2 (7.1%) with anticore as the only markers. Multiple markers were found in the other children: 9 (32.1%) HBsAg and anticore; 7 (25%) HBsAg, e-antigen (HBeAg) and anticore; 3 (10.7%) HBsAg, HBeAg antibody and anticore. In total, of the 28 positive children 20 (71.4%) showed positive anticore and of these 4 (20%) were of the IgM type. Our results show a high level of positivity for HBV in the children with cancer studied. In spite of being asymptomatic carriers of the HBV, it is noticeable the presence of serological markers for acute disease. We recommend testing for HBV serological markers before starting chemotherapy. Should the test results be negative, vaccination is indicated and should they be positive, specialized care is indicated.

[Hepatic alterations in patients with dengue]. / Alteraciones hepáticas en pacientes con dengue.

Clinical features of Dengue are very variable due to multiple alterations induced by the virus in the organism. Increased levels of transaminases similar to those produced by the Hepatitis virus have been reported in patients with Dengue from hiperendemic zones in Asia. The objectives of this study were to determine alterations in the liver tests in patients with Dengue and to relate them to the disease, clinically and serologically. Clinical history, hemathological tests serum transaminases (ALT y AST) and bilirubin assays were performed in 62 patients with clinical and serological diagnosis of Dengue. According to clinical features 38.7% of the patients with classical (CD) and hemorrhagic (DHF) forms of Dengue reffered abdominal pain and 2 patients with DHF had ictericia and hepatomegaly. Laboratory test findings showed leucopenia in 72.5% in both forms of Dengue and of patients with DHF severe thrombocytopenia (< 50.000 platelets x mm3), long PT and PPT in 70.9%, 23.0% and 42.3%, respectively. Transaminase values five fold higher than the normal values (p < 0.005) were observed in 36.8% and 74.4% of patients with CD and DHF respectively; AST was predominant in both groups. Our results suggest liver damage during the course of Dengue. A differential diagnosis has to be done between the hepatic involvement of Dengue cases and others viral diseases with hepatic disfunctions.

Alteraciones hepáticas en pacientes con dengue / Hepatic alterations in patients with dengue

La caracterización clínica del Dengue es muy variable debido a las múltiples alteraciones inducidas por el virus en el organismo. Se ha reportado incremento en los niveles de transaminasas similares a los producidos por el virus de Hepatitis en pacientes con Dengue de zonas hiperendémicas de Asia. Los objetivos del trabajo fueron determinar alteraciones en las pruebas de funcionalismo hepático en pacientes con Dengue y relacionar clínica y serológicamente la infección viral. A 62 casos con confirmación serológica para Dengue, se les realizó historia clínica, hematología completa, Tiempo de Protrombina (TP) y Tiempo Parcial de Tromboplastina (TPT), cuantificación de transaminasas (ALT y AST) y bilirrubina en suero. En relación a las características clínicas el 38,7 por ciento de los pacientes con Dengue Clásico (DC) y Fiebre Hemorrágica por Dengue (FHD) refirieron dolor abdominal y 2 con FHD presentaron hepatomegalia e ictericia. En los resultados de laboratorio se observó leucopenia (72,5 por ciento) en ambas formas de Dengue y en pacientes con FHD, trombocitopenia severa (<50.000×mm3) y TP y TPT alargados en 70,9 por ciento, 23,0 por ciento y 42,3 por ciento, respectivamente. El valor de transaminasas resultó hasta cinco veces más elevado que el valor normal (p<0,005) en 36,8 por ciento de los pacientes con DC y en 74,4 por ciento con FHD, con predominio de AST en ambos grupos. Los resultados sugieren daño hepático durante el curso del Dengue. Esto permite afirmar que la infección por virus Dengue puede causar disfunción hepática aguda y debe ser considerada en el diagnóstico diferencial con otras infecciones virales con disfunción hepática

Concentrations of cytokines, soluble interleukin-2 receptor, and soluble CD30 in sera of patients with hepatitis B virus infection during acute and convalescent phases.

The immunoregulatory roles of interleukin-2 (IL-2), IL-4, IL-10, gamma interferon (IFN-gamma), tumor necrosis factor alpha (TNF-alpha), the soluble form of the IL-2 receptor (sIL-2R), and the soluble form of CD30 (sCD30) were evaluated in patients with hepatitis B virus (HBV) infection. Two groups of subjects were studied: 15 healthy individuals without hepatitis antecedents and 15 patients with HBV infection. Blood samples were taken during the acute and convalescent phases. The analysis of the samples was done by the enzyme-linked immunosorbent assay technique. IFN-gamma and TNF-alpha levels decreased in the convalescent phase. IL-10, IL-2, and sIL-2R levels increased in the acute and convalescent phases, while sCD30 levels increased during the acute phase. The IL-4 concentrations decreased in both phases. During the acute phase, IFN-gamma and TNF-alpha induced increases in IL-2, sIL-2R, IL-10, and sCD30 levels in serum, which allowed the development of immunity characterized by the nonreactivity of the HBV surface antigen, the onset of antibodies to the HBV surface antigen (anti-HBs), and normal alanine aminotransferase levels during the convalescent phase. Increased IL-2 levels during the acute phase would stimulate the activities of NK cells and CD8(+) lymphocytes, which are responsible for viral clearing. The raised sIL-2R levels reveal activation of T lymphocytes and control of the IL-2-dependent immune response. The sCD30 increment during the acute phase reflects the greater activation of the Th2 cellular phenotype. Its decrease in the convalescent phase points out the decrease in the level of HBV replication. The increase in IL-10 levels could result in a decrease in IL-4 levels and modulate IFN-gamma and TNF-alpha levels during both phases of disease, allowing the maintenance of anti-HBs concentrations.