RESUMEN
BACKGROUND: The transmission dynamics of human metapneumovirus (HMPV) in tropical countries remain unclear. Further understanding of the genetic diversity of the virus could aid in HMPV vaccine design and improve our understanding of respiratory virus transmission dynamics in low- and middle-income countries. MATERIALS & METHODS: We examined the evolution of HMPV in Peru through phylogenetic analysis of 61 full genome HMPV sequences collected in three ecologically diverse regions of Peru (Lima, Piura, and Iquitos) during 2008-2012, comprising the largest data set of HMPV whole genomes sequenced from any tropical country to date. RESULTS: We revealed extensive genetic diversity generated by frequent viral introductions, with little evidence of local persistence. While considerable viral traffic between non-Peruvian countries and Peru was observed, HMPV epidemics in Peruvian locales were more frequently epidemiologically linked with other sites within Peru. We showed that Iquitos experienced greater HMPV traffic than the similar sized city of Piura by both Bayesian and maximum likelihood methods. CONCLUSIONS: There is extensive HMPV genetic diversity even within smaller and relatively less connected cities of Peru and this virus is spatially fluid. Greater diversity of HMPV in Iquitos compared to Piura may relate to higher volumes of human movement, including air traffic to this location.
Asunto(s)
Variación Genética , Metapneumovirus/genética , Infecciones por Paramyxoviridae/transmisión , Infecciones por Paramyxoviridae/virología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Genoma Viral , Humanos , Lactante , Masculino , Persona de Mediana Edad , Infecciones por Paramyxoviridae/epidemiología , Perú/epidemiología , Adulto JovenRESUMEN
El virus de la hepatitis C (VHC) ha sido recientemente identificado debido a que desde 1990 se cuenta con pruebas diagnósticas para realizar tamizajes y por ello no se encuentran reportes de la prevalencia de esta enfermedad en el Perú. Se estima que hay una epidemia de hepatitis viral C en nuestro país, en razón que es una patología elevada proporción de asintomáticos, y de larga evolución, hecho que favorece su transmisión. La vía de transmisión, es percutánea, a través de transfusiones sanguíneas, uso de agujas contaminadas por vía sexual. La introducción de la prueba de ELISA para detectar anticuerpos anti-VHC ha permitido su utilización en donantes de sangre a fin de prevenir la infección post-transfusional. Se obtuvo la información de la Unidad de Informática del Hospital Nacional Edgardo Rebagliati Martins (HNERM) del Seguro Social de Salud (ESSALUD), donde se registran datos de los donantes: edad, sexo y resultados respectivos del tamizaje general al cual son sometidos todas las unidades de sangre donadas en el periodo de mayo-noviembre de 1998. En el Servicio de Medicina transfusional del HNERM se realiza la detección de anticuerpos para hepatitis C con el método ELISA de tercera generación utilizando el kit: Ortho HCV 3.0. De las 12,535 donantes de sangre examinados se hallaron 50 casos con resultados positivos. De los cuales 39 (78%) pertenecían al sexo masculino, y 11 (22%) al sexo femenino, obteniéndose una prevalencia de 0.399% de serología positiva para el virus de la hepatitis C. los donantes del sexo femenino sumaron en total de 1930 y la prevalencia en ese grupo fue de 0.57%. En el sexo masculino se identificó a 10,605 donantes, haciendo una prevalencia de 0.39%. La seroprevalencia predominó en las edades de 41 a 50 años (0.80%) y en segundo lugar en el grupo de 51-60 años (0.53%).
The hepatitis C virus (HCV) has been recently identified because since 1990 we count with diagnostic assays to do screenings. For this reason there arent reports about prevalence of this disease in Peru. It is estimated that there is an outbreak of viral hepatitis C in our country. Facts that favor its transmission are that the disease has a high proportion of asymptomatic patients and long evolution. The route of transmission is percutaneous, through blood transfusions, use of contained needles and by sexual contact. The introduction of the Elisa assay for detection of antibodies against HCV has allowed its utilization on blood donors with the purpose of preventing post transfusion infection. Information was obtained from the informatics unit of the Hospital Nacional Edgardo Rebagliati Martins (HNERM) of the health social security system (ESSALUD). We registered the following data: age, sex and results of the screening of all donated blood units between May and November of 1998. In the Transfusion Medical Service of the HNERM detection of hepatitis C antibodies is done with the third generation ELISA method (using the Ortho HCV 3.0 kit). Of 12,535 bloods donors exanimated, we found 50 cases with positive results. Among these, 39 (785) were male and 11 (22%) were female. The prevalence of hepatitis C positive serology was 0.399%. Female donors added a total of 1930 and the prevalence in this group was 0.57%. Male donors added 10,605, with a prevalence of 0.39%. The seroprevalence predominated in the age group 41 50 (0.8%) and in second place the age group 51-60 (0.53%):