RESUMEN
Argentina exhibits low serological prevalence for Hepatitis B virus (HBV); however, occult hepatitis B infection (OBI) has been reported in blood donors, Amerindians and individuals coinfected with hepatitis C virus (HCV), and/or human immunodeficiency virus (HIV). The aim of this study was to analyze the genetic diversity of HBV and to evaluate serological marker associations and coinfections with HCV and HIV in patients attending and treated in a public hospital in the province of Buenos Aires, Argentina. A total of 189 HBV reactive samples (HBsAg and/or anti-HBc) were analyzed for HBV DNA characterization. All reactive samples were tested for anti-HCV and HIV-antigen/antibody using CMIA assays. Thirty-six samples exhibited detectable HBV DNA, 7 of which were OBI. HBV sequences were classified as subgenotypes A1, A2, B2, D3, F1b, F3 and F4. Mutations related to the ability to escape the host's immune response, resistance to antiviral therapy and progression to disease were found in patients, partly due to the variable sensitivity of HBsAg, the reverse transcriptase, the basal core promoter and the preCore. HCV and HIV prevalence was 10% and most of the genotypes found in the sequences were genotype 1 and B/F recombinant subtype, respectively. Of the total samples analyzed, 7 exhibited coinfections. This study shows the frequency of OBI, subgenotype distribution, HBV mutations and coinfections, which may have important clinical implications in public hospital patients. Planned prevention, detection and treatment adherence are needed to reduce transmission and morbidity in vulnerable populations.
Asunto(s)
Coinfección/genética , Hepatitis B Crónica/genética , Hepatitis B/genética , Hepatitis C/genética , Adolescente , Adulto , Anciano , Argentina/epidemiología , Donantes de Sangre , Coinfección/sangre , Coinfección/tratamiento farmacológico , Coinfección/virología , Farmacorresistencia Viral/genética , Femenino , Genotipo , Infecciones por VIH/sangre , Infecciones por VIH/genética , Infecciones por VIH/virología , Hepacivirus/genética , Hepacivirus/patogenicidad , Hepatitis B/sangre , Hepatitis B/tratamiento farmacológico , Hepatitis B/virología , Anticuerpos contra la Hepatitis B/sangre , Anticuerpos contra la Hepatitis B/inmunología , Antígenos de Superficie de la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/genética , Antígenos de Superficie de la Hepatitis B/inmunología , Virus de la Hepatitis B/genética , Virus de la Hepatitis B/patogenicidad , Hepatitis B Crónica/sangre , Hepatitis B Crónica/tratamiento farmacológico , Hepatitis B Crónica/virología , Hepatitis C/sangre , Hepatitis C/tratamiento farmacológico , Hepatitis C/virología , Hospitales Públicos , Humanos , Masculino , Persona de Mediana Edad , Mutación/genética , Sangre Oculta , Adulto JovenRESUMEN
We analyzed the presence of IgG and IgM anti-Toxoplasma gondii, as a measure of infection, in pregnant women attending seven hospitals in the Metropolitan Area of Buenos Aires during 2006 and 2017. T. gondii seroprevalence in 2006 vs. 2017, was: Hospital Alemán: 22 and 17% (p = 0.004), Hospital Fiorito: 44 and 33% (p < 0.001), Hospital Gandulfo: 30 and 34% (p 0.025), Hospital Grierson 60 and 44% (p < 0.001), Hospital Rivadavia: 59 and 51% (p = 0.003), Hospital Sardá: 47 and 39% (p < 0.001), and Hospital Thompson: 61 and 51% (p < 0.001). The comparison showed a significant decrease in seroprevalence in six hospitals. We also observed a significant decrease in the reactivity for IgM in 2017 compared to 2006 and in the seroprevalence for T. gondii in the overall population of pregnant women in the study. This means that a greater number of women are susceptible to develop acute infection during pregnancy.
Se analizó de forma retrospectiva la presencia de anticuerpos séricos IgG e IgM anti-Toxoplasma gondii en las embarazadas que concurrieron a siete hospitales del área Metropolitana de Buenos Aires durante 2006 y 2017. La prevalencia de infección, medida como presencia de anticuerpos, en 2006 vs. 2017, fue: Hospital Alemán: 22 y 17% (p = 0.004), Hospital Fiorito: 44 y 33% (p < 0.001), Hospital Gandulfo: 30 y 34% (p 0.025), Hospital Grierson: 60 y 44% (p < 0.001), Hospital Rivadavia: 59 y 51% (p=0.003), Maternidad Sardá 47 y 39% (p < 0.001) y Hospital Thompson: 61 y 51% (p < 0.001). La comparación demostró una disminución estadísticamente significativa de la seroprevalencia en seis hos pitales. También disminuyeron significativamente la reactividad para IgM en 2017 respecto de 2006 y la seroprevalencia para T. gondii en el total de la población de embarazadas estudiadas, lo que significa un mayor número de mujeres susceptible de desarrollar infección aguda durante el embarazo.
Asunto(s)
Anticuerpos Antiprotozoarios/sangre , Complicaciones Infecciosas del Embarazo/inmunología , Toxoplasma/inmunología , Toxoplasmosis/inmunología , Adulto , Distribución por Edad , Anticuerpos Antiprotozoarios/inmunología , Argentina/epidemiología , Femenino , Hospitales/estadística & datos numéricos , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Persona de Mediana Edad , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Estudios Seroepidemiológicos , Factores de Tiempo , Toxoplasmosis/sangre , Toxoplasmosis/epidemiología , Adulto JovenRESUMEN
We report a prospective study of 56 pregnant women inadvertently vaccinated with rubella vaccine during the 2006 campaign performed in Argentina. Of these patients, 48 (87%) were immune, whereas the remaining 9 (16%) were susceptible. In the latter group, 7 presented with a primary reaction to the vaccine confirmed through immunoglobulin (Ig) G antibody avidity testing or seroconversion of IgG titers. During the clinical and laboratory follow-up, newborns did not present evidence of infection or malformations compatible with congenital rubella syndrome.
