Hepatitis E virus genotype 3 in humans and swine, Cuba.

This study was conduced to determinate the seroprevalence and risk factors associated to hepatitis E virus (HEV) exposition, in individuals who work in pig farms located at western of Artemise Province. The presence of HEV in human and swine samples and the phylogenetic analysis were evaluated. One hundred six workers (with an age range of 18-70years) were enrolled in this study. Two groups were defined, 69 employees with swine related occupations and 37 workers without contact with pigs. None had abroad travel history. Serum samples were tested for immunoglobulins (Ig) M, G and A against HEV. Individual fecal samples were obtained from 57 workers and 53 swine. All feces were tested for HEV RNA using reverse transcription PCR (RT-PCR). The amplification products were sequenced and phylogenetically analyzed by using MEGA5 software. A total of 38 (35.8%) (95% CI: 26.2-45.4) sera was positive for antibodies against HEV (anti-HEV). These were higher in persons who work in contact with swine compare as individuals with occupations without pig contact (40.5%, 28/69, 95% CI: 28.2-52.8, versus 27.0%, 10/37, 95% CI: 11.3-42.6, respectively). The prevalence of anti-HEV was higher in workers with an age range of 60-70years old and time-work 10-13years. HEV RNA was detected in 8 (14.0%) of 57 human fecal samples and 10 (18.8%) of 53 swine fecal samples. Phylogenetic analysis was performed on 7 amplification products obtained from 3 human and 4 swine fecal samples. Human and swine HEV sequences were closely related (94-99% nucleotide homology) and belonged to HEV genotype 3, subtype 3a.

HCV genotype determination in monoinfected and HIV co-infected patients in Cuba.

With the aim to characterize the HCV genotype distribution in Cuba, sera were collected from two subgroups: HCV-monoinfected and HCV/HIV co-infected patients. A combination of reverse transcription-PCR using genotype-specific primers, restriction fragment length polymorphism and sequencing was used to determine the genotype of 84 samples. Seventy-nine (94%) showed single infections (10 [12%] were genotype 1a and 69 [82%] genotype 1b) and 5 (6%) samples corresponded to mixed infections (2 [2%] with genotypes 1a/3a and 1 sample [1%] each with 1b/3a, 1b/4a and 1a/1b/3a). HCV/HIV co-infected subjects had a higher frequency of mixed infections (p=0.08), infection with genotype 3a (p=0.18) and for the first time genotype 4a was found. There was no association of any demographic characteristics with any specific genotype although HCV/HIV co-infected patients showed a tendency to have mixed genotypes in those older than 45 years of age (p=0.11). Phylogenetic analysis showed that HCV isolates clustered with subtypes 1b (n=15, maximal genetic distance 2.51%) and 1a (n=2, maximal genetic distance 0.35%). This report presents the prevalence of HCV genotypes in monoinfected and HIV co-infected patients, mixed HCV infections in HCV/HIV co-infected men who have sex with men with high-risk sexual practices and for the first time identifies that the uncommon genotype 4a can be present in a patient co-infected with HIV.

Seroprevalence of antibodies to hepatitis E virus in two large communities in Havana, Cuba.

Hepatitis E virus (HEV) infection is an important cause of acute viral hepatitis in tropical and sub-tropical regions that occurs both as epidemic episodes and sporadic cases. The aim of this investigation was to estimate the prevalence of total immunoglobulin (Ig) anti-hepatitis E virus (anti-HEV) and the risk factors associated to two communities in Havana City. Serum samples (n=469) obtained from healthy individuals with no history of viral hepatitis were screened for total anti-HEV by enzyme immunoassay (EIA). An overall prevalence of 10% (47/469) (95% CI; 7.52-13.19%) was obtained. Higher anti-HEV prevalence was found in the municipality of Marianao (12.1%) compared to Playa (7.1%). Analysis of risk factors revealed a significant association of total anti-HEV prevalence in age group 41-60 years old, with a risk ratio of 3.21 (95% CI: 1.09-9.7) (P=0.01). No relation was found between anti-HEV and other variables such as gender, risk occupations, surgery and transfusions. The detection of total anti-HEV in individuals with no overt acute hepatitis suggests the existence of sub-clinical or anicteric HEV infection in these municipalities.

[Surveillance of viral hepatitis: laboratory results. Cuba, 1992-2004]. / Vigilancia de las hepatitis virales: resultados de laboratorio, Cuba, 1992-2004.

The results of the surveillance of the viral hepatitis in the period 1992-2004 are presented. The HAV infection is the most frequent association that originates pictures of acute viral hepatitis among the patients under 24 years old with positive HBsAg, followed by the hepatitis B virus. The hepatitis A virus alone or co-infected with the hepatitis B virus accounts for 48.88% of the cases. Only 48.71% of the cases among whom acute hepatitis B is suspected, are confirmed from the virological point of view. These results allow to go deep into the knowledge of the behaviour of hepatitis viruses under the Cuban conditions, making possible to establish better strategies for the control or elimination of viral hepatitis, or both.