Hepatitis delta: In vitro evaluation of cytotoxicity and cytokines involved in PEG-IFN therapy.

The treatment for hepatitis Delta virus (HDV) still consists of Pegylated interferon (PEG-IFN) combined with inhibitors of Hepatitis B virus (HBV) replication. In some patients may be occur a virological response, which means a negative HDV RNA 6 months after stopping treatment. In this study it was conducted an in vitro approach with the aim to mimic possible immunological events that are observed in patients responding to PEG-IFN therapy. Jurkat cells (human T lymphocyte cell line) were employed alone or co-cultured with THP-1 (human monocytic cell line) and stimulated with controls and HBV Surface Antigen (HBsAg), Small-Delta Antigen (SHDAg), and HBsAg + SHDAg combined. Twenty-four hours stimulation with SHDAg and/or HBSAg led to a toxic profile in a co-culture condition and cell supernatants were collected for cytokines quantification. PEG-IFN was added and cells were incubated for additional 24 h. Co-cultured cells incubated with the association (SHDAg + PEG-IFN) significantly produced levels of IFN-γ, IL-2 and IL-12. On the other hand, the HBsAg alone was able to inhibit the production of IFN-γ, suggesting that this antigen may hinder the treatment exclusively with PEG-IFN.

Decrease in the prevalence of hepatitis B and D virus infections in an endemic area in Peru 23 years after the introduction of the first pilot vaccination program against hepatitis B.

In 1991, Peru launched the first vaccination program against hepatitis B in children aged under 5 years in the hyperendemic [hepatitis B virus (HBV) and hepatitis D virus (HDV)] province of Abancay. We conducted a cross-sectional study to determine the prevalence of HBV and HDV infections, 23 years after the launch of the vaccination program, as well as the post-vaccine response against hepatitis B in terms of prevalence of hepatitis B surface antibody (anti-HBs ≥10 mUI/ml). Among 3165 participants aged from 0 to 94 years, the prevalence rates of hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (total anti-HBc) were 1.2% [95% confidence interval (CI) 0.85-1.64%], and 41.67% (95% CI 39.95-43.41%), respectively. The prevalence rate of anti-HBs at protective levels (≥10 mUI/ml) in individuals who HBsAg and anti-HBc negative was 66.36% (95% CI 64.15-68.51%). The prevalence rate of HBsAg in children aged <15 years was nil, and among adult HBsAg carriers, the prevalence of hepatitis D antibody (anti-HDV) was 5.26% (2/38; 95% CI 0.64-17.74). These findings showed that HBV prevalence has changed from high to low endemicity, 23 years following implementation of the vaccination program against hepatitis B, and HDV infection was not detected in those aged <30 years.

[Reduction of HBV and HDV infection in two indigenousmpeoples of Peruvian Amazon after the vaccination against hepatitis B]. / Reducción en la infección por VHB y VHD en dos poblaciones indígenas de la Amazonia peruana después de la vacunación contra la hepatitis B.

OBJECTIVE: To determine the outcome of the vaccination against hepatitis, we determined the prevalence of hepatitis B virus (HBV) and hepatitis D virus (HDV) infections, eight years after introduction of the vaccination. MATERIALS AND METHODS: A cross-sectional study was performed in 2 944 participants of 67 Kandozi and Chapra indigenous peoples in April 2010. Serological screening for hepatitis B surface antigen (HBsAg), antibody anti-HBc IgM and IgG, antibody anti-HBs and anti-HDV were determined by ELISA tests. RESULTS: The prevalence rates of HBsAg, anti-HBc total, anti- HBs ≥10 mlUI/ml and anti-HDV were 2.3, 39.13, 50.95 and 2.11%, respectively. The prevalence rate of HBsAg in children <11 years was 0%. Among carriers of HBsAg, the prevalence rates of HDV and acute HBV infections were 2.11% (all were >14 years) and 11.94%, respectively. HBsAg and anti-HBc total were associated with individuals ≥10 years (p<0.001). CONCLUSIONS: These findings show the elimination of HBVmcarriers in children <11 years, eight years following introduction of the vaccination against HBV.

OBJETIVO: Conocer el resultado de la vacunación contra la hepatitis B en las comunidades hiperendémicas Kandozi y Chapra de la Amazonia Peruana a partir de la prevalencia de infecciones por los virus de la hepatitis B (VHB) y Delta (VHD), ocho años después de iniciada la vacunación. MATERIAL Y MÉTODOS: Se realizó un estudio transversal en 2 944 pobladores de 67 comunidades indígenas Kandozi y Chapra en abril de 2010. El tamizaje serológico para el antígeno de superficie del VHB (HBsAg), anticuerpos anti-HBc IgM e IgG, anticuerpos anti-HBs y anti-VHD se determinaron mediante pruebas de ELISA. RESULTADOS: Las tasas de prevalencia del HBsAg, anti-HBc IgG, anti-HBs ≥10 mlUI/ml y anti-VHD fueron 2.3, 39.13, 50.95 y 2.11%, respectivamente. La prevalencia del HBsAg en niños <11 años fue cero. Entre los portadores del HBsAg, las tasas de prevalencia de sobreinfeccion por el VHD e infección aguda por el VHB fueron 2.11% (todos fueron >14 años) y 11.94%, respectivamente. CONCLUSIONES: Estos hallazgos muestran la eliminación de portadores de VHB en niños <11 años, ocho años después de iniciada la vacunación contra el VHB.

Reducción en la infección por VHB y VHD en dos poblaciones indígenas de la Amazonia peruana después de la vacunación contra la hepatitis B / Reduction of HBV and HDV infection in two indigenous peoples of Peruvian Amazon after the vaccination against hepatitis B

Resumen: Objetivo: Conocer el resultado de la vacunación contra la hepatitis B en las comunidades hiperendémicas Kandozi y Chapra de la Amazonia Peruana a partir de la prevalencia de infecciones por los virus de la hepatitis B (VHB) y Delta (VHD), ocho años después de iniciada la vacunación. Material y métodos: Se realizó un estudio transversal en 2 944 pobladores de 67 comunidades indígenas Kandozi y Chapra en abril de 2010. El tamizaje serológico para el antígeno de superficie del VHB (HBsAg), anticuerpos anti-HBc IgM e IgG, anticuerpos anti-HBs y anti-VHD se determinaron mediante pruebas de ELISA. Resultados: Las tasas de prevalencia del HBsAg, anti-HBc IgG, anti-HBs ≥10 mlUI/ml y anti-VHD fueron 2.3, 39.13, 50.95 y 2.11%, respectivamente. La prevalencia del HBsAg en niños <11 años fue cero. Entre los portadores del HBsAg, las tasas de prevalencia de sobreinfeccion por el VHD e infección aguda por el VHB fueron 2.11% (todos fueron >14 años) y 11.94%, respectivamente. Conclusiones: Estos hallazgos muestran la eliminación de portadores de VHB en niños <11 años, ocho años después de iniciada la vacunación contra el VHB.

Abstract: Objective: To determine the outcome of the vaccination against hepatitis, we determined the prevalence of hepatitis B virus (HBV) and hepatitis D virus (HDV) infections, eight years after introduction of the vaccination. Materials and methods: A cross-sectional study was performed in 2 944 participants of 67 Kandozi and Chapra indigenous peoples in April 2010. Serological screening for hepatitis B surface antigen (HBsAg), antibody anti-HBc IgM and IgG, antibody anti-HBs and anti-HDV were determined by ELISA tests. Results: The prevalence rates of HBsAg, anti-HBc total, anti-HBs ≥10 mlUI/ml and anti-HDV were 2.3, 39.13, 50.95 and 2.11%, respectively. The prevalence rate of HBsAg in children <11 years was 0%. Among carriers of HBsAg, the prevalence rates of HDV and acute HBV infections were 2.11% (all were >14 years) and 11.94%, respectively. HBsAg and anti-HBc total were associated with individuals ≥10 years (p<0.001). Conclusions: These findings show the elimination of HBV carriers in children <11 years, eight years following introduction of the vaccination against HBV.

Hepatitis delta in HIV/HBV co-infected patients in Brazil: is it important?

OBJECTIVES: This study was carried out to evaluate the prevalence of hepatitis delta virus (HDV) among human immunodeficiency virus (HIV)/hepatitis B virus (HBV) co-infected patients from São Paulo, in the Southeast Region of Brazil. METHODS: A total of 3259 HIV patients with serological markers for HBV were initially enrolled in the study. Among these patients, 154 (4.7%) were hepatitis B surface antigen (HBsAg)-reactive. Serum samples were obtained from 86 HBsAg-positive patients and were submitted to anti-HDV serological assay. RESULTS: One (1.2%) HIV/HBV patient was found to be anti-HDV-positive, and the HDV infection was confirmed by PCR. Phylogenetic analysis showed that this HDV sequence grouped with other HDV genotype 1 sequences from Mediterranean European countries, suggesting that this virus has a common ancestor with HDV from that region. This patient was probably infected by sexual transmission, as he reported unprotected sexual intercourse with multiple partners over the course of many years but denied intravenous drug use or any travel to the Brazilian Amazon, an area known to have a high HDV prevalence. CONCLUSIONS: HDV infection is infrequent in the Southeast Region of Brazil, however there have been a few cases in this region. HIV/HBV patients are at potential risk for HDV infection, therefore investigations for the presence of HDV infection must be carried out in these patients.

Virological and histological re-evaluation of Labrea hepatitis.

BACKGROUND: a peculiar form of fulminant hepatitis known as Labrea hepatitis, probably related to hepatitis B and D, has been reported in Brazilian Amazon as early as the 1930s. METHODS: we reviewed the postmortem liver biopsies of 9 patients with Labrea Hepatitis. Immunostaining for HBV and HDV antigens were performed. RESULTS: we found several important characteristics in the liver tissues: 1) moderate hepatocellular necro-inflammation, 2) hepatocellular ballooning, 3) ballooned hepatocytes with fat droplets surrounding the nucleus (morula-like cells or spongiocytes), 4) mild to moderate necrosis and/or mild portoseptal fibrosis. Hepatitis B surface antigen (HBsAg) was identified in 7 of the 9 cases and was concentrated in the Morula-like cells. Hepatitis B core antigen (HBcAg) was present in 5 cases, mostly in the hepatocyte's nucleous. The hepatitis D virus antigen (HDV Ag) was present in 5 cases, mostly in the cytoplasm and concentrated in the Morula-like cells. CONCLUSION: labrea hepatitis is a fatal disease mostly affecting isolated communities in the Amazon. Evidence implicates HBV and HDV in the etiology of this disease, but this hypothesis needs to be confirmed with genotyping and sequencing research on HBV DNA and HDV RNA extracted from the liver and sera of these patients.

[Prevalence of hepatitis B and D serological markers in the Parakanã, Apyterewa Indian Reservation, Pará State, Brazil]. / Prevalência dos marcadores sorológicos dos vírus das hepatites B e D na área indígena Apyterewa, do grupo Parakanã, Pará, Brasil.

In order to study the prevalence of hepatitis B (HBV) and D (HDV) viruses in the Parakanã Indians and to evaluate the impact of hepatitis B vaccination beginning there in 1995, 258 serum samples were analyzed in the year 2004 for hepatitis B and D serological markers using immunoenzymatic techniques; the results showed a moderate endemic pattern, with a total prevalence of HBV infection of 55.7% and 5.4% of virus carriers in the Apyterewa village and 49.5% with 1.1% of HBV carriers in the Xingu village; 31.4% of anti-HBs+ as an isolated marker in both villages and no detection of positive serological tests for HDV among HBV carriers. The laboratory analysis thus showed the presence of chronic HBV carriers, absence of HDV carriers, and an emerging vaccine profile among susceptibles, confirming the effectiveness and need to maintain vaccination, especially in the first year of life, and the need to implement effective epidemiological surveillance for early detection of HDV infection among HBV carriers.

Hepatitis B virus surface antigen (HBsAg) and antibody (anti-HBs) forming immune complexes in fulminant hepatits

Este trabalho relata um padräo sorológico näo usual para o HBV e a presença de imunocomplexos HBsAg/anti-HBs em amostras de soro provenientes de dois pacientes com hepatite fulminante procedentes da Amazônia Ocidental Brasileira. O diagnóstico foi estabelecido por meio de testes sorológicos e pela demonstraçäo de complexos antígeno/anticorpo por técnicas de microscopia eletrônica de transmissäo. A concomitante superinfecçäo pelo vírus da hepatite Delta também é discutida

Prevalencia de hepatitis D en una población del Noreste de México y su relación con otros virus / Prevalence of hepatitis D in a population of the Northwest Mexico and its relationship with other virus

En México existen escasos reportes donde se estudie la prevalancia de infección por virus D en portadores del Antígeno de Superficie del virus B. Objetivo: Estudiar la prevalancia de infección por virus D en pacientes del Hospital Universitario de la UANL. Métodos: Treinta y ocho pacientes con hepatitis aguda, 28 pacientes con hepatopatía crónica y 7 portadores asintomáticos. Los marcadores serológicos para el virus B, D y C se realizaron por el método ELISA (Abbott). Resultados: El anticuerpo total contral el virus D se detectó en 3 casos (4 por ciento), dos pacientes del sexo masculino presentaron hepatitis aguda, en ambos de diagnosticó coinfección con virus B y D aunque en el primero no se encontró el anticore IgM, este caso evolucionó hacia la cirrosis hepática en 13 meses. Además tenía una probable infección concurrente por el virus C con anticuerpo positivo por ElISA de segunda generación, el segundo caso evolucióno hacia la mejoría. El tercer caso fue una enfermedad también con coinfección por virus B y D con buena evolución. El anticuerpo contra el virus C se detectó en tres de 22 pacientes con hepatopatía crónica (13.6 por ciento), uno de ellos tenía hepatocarcinoma. Conclusiones: Nuestros resultados coinciden con la baja prevalancia de infección por virus D previamente reportada y pone de manifiesto por primera vez en México la infección concurrente por virus B-C y B-D-C

Prevalência dos marcadores sorológicos dos vírus da hepatite B e D em crianças das tribos Caiabi e Txucarramäe do Parque Indígena do Xingu, Brasil central / Prevalence of serological markers of hepatitis B and D viruses in Indian children of the Caiabi and Txucarramäe tribes of Xingu Indian Park in Central Brazil

The medical literature has shown that the inhabitants of the Amazon region are highly affected by hepatitis B and delta viruses infection, but this has never been studied in Indian children by age group. A study of the prevalence of serological markers of hepatitis B and delta viruses in Indian children aged 0 to 14 years living in the PIX was carried out. This Park is located in Central Brazil, a region which is in the transition between the savannab to the south and the Amazon jungle to the north. To determine the prevalence of HBV and HDV markers in Indian children and to characterize the route of HBV transmission in this region. Out of the 17 tribes living in the PIX, two--the Caiabi and the Txucarramäe--were chosen because both live in the North part of the Park, but have quite different ways of life. The overall prevalence of HBV serum markers was: HBsAg, 4.5 per cent; anti-HBs, 39.6 per cent; anti-HBc, 44.1 per cent; any marker of HBV, 47.3 per cent; and anti-HDV, 0.0 per cent. However, a striking difference in the prevalence of hepatitis B markers was observed between the two tribes: younger Caiabi children were much less affected than the Txucarramäe ones. The prevalence of HBsAg in fertile women was 12 per cent, being anti-HBe positive. Our data suggest that HBV infection is highly prevalent among Indian children living in this Indigenous Park and vertical infection is not an important route of transmission in either tribes.

[Prevalence of serologic markers of hepatitis A, B, C, and D viruses in pregnant women]. / Prevalencia de marcadores serológicos de los virus de la hepatitis A, B, C y D en embarazadas.

OBJECTIVE: To determine the seroprevalence of hepatitis A, B, C and D virus infection among pregnant women attending a perinatal care hospital. MATERIAL AND METHODS: A prospective study was carried out to determine the seroprevalence of hepatitis A virus IgG antibodies (anti-HAV), hepatitis B virus markers (anti-HBcAg and HBsAg) and hepatitis C virus antibodies (anti-HCV) in pregnant women. In HBsAg positive cases. HBeAg and hepatitis D virus antibodies (anti-HDV) were investigated. All analyses were performed with the ELISA technique. RESULTS: Of the 1500 pregnant women studied. 93.3% were positive for anti-HAV IgG. The HBsAg seroprevalence was 0.26% and anti-HCV seroprevalence was 0.53%. There were no patients with HBeAg or anti-HDV. CONCLUSIONS: A higher seroprevalence of HBsAg was found in this study than in other studies of pregnant Mexican women. We propose that HBsAg screening become a routine prenatal test.

[Prevalence of serologic markers of hepatitis B and D viruses in children of the Caiabi and Txucarramãe tribes from the Indian Reservation of Xingu, central Brazil]. / Prevalência dos marcadores sorológicos dos vírus da hepatite B e D em crianças das tribos Caiabi e Txucarramãe do Parque Indígena do Xingu, Brasil central.

The medical literature has shown that the inhabitants of the Amazon region are highly affected by hepatitis B and delta viruses infection, but this has never been studied in Indian children by age group. A study of the prevalence of serological markers of hepatitis B and delta viruses in Indian children aged 0 to 14 years living in the PIX was carried out. This Park is located in Central Brazil, a region which is in the transition between the savannab to the south and the Amazon jungle to the north. To determine the prevalence of HBV and HDV markers in Indian children and to characterize the route of HBV transmission in this region. Out of the 17 tribes living in the PIX, two--the Caiabi and the Txucarramãe--were chosen because both live in the North part of the Park, but have quite different ways of life. The overall prevalence of HBV serum markers was: HBsAg, 4.5%; anti-HBs, 39.6%; anti-HBc, 44.1%; any marker of HBV, 47.3%; and anti-HDV, 0.0%. However, a striking difference in the prevalence of hepatitis B markers was observed between the two tribes: younger Caiabi children were much less affected than the Txucarramãe ones. The prevalence of HBsAg in fertile women was 12%, being anti-HBe positive. Our data suggest that HBV infection is highly prevalent among Indian children living in this Indigenous Park and vertical infection is not an important route of transmission in either tribes.

Epidemiological aspects of hepatitis B and D virus infection in the northern region of Amazonas, Brazil.

The State of Amazonas in the Brazilian Amazon region is an area of high prevalence of hepatitis B and D virus (HBV and HDV) infection. The aim of this study was to identify epidemiological patterns and risk factors of HBV and HDV infections in Barcelos, in the basin of the Negro river. A random sample (798 in all) of the total population in the urban area and in 2 rural villages was surveyed. A standardized questionnaire was used and blood samples were tested by enzyme-linked immunosorbent assay: 1.63% had hepatitis B surface antigen, 12.9% had anti-hepatitis B surface antibody and 21.4% had anti-hepatitis B core antigen. The overall prevalence of HBV infection was 24.6%. Anti-hepatitis D was present in 5 subjects, all of them non-natives, and hepatitis B e antigen in 2. A positive association between history of dental treatment with an unqualified dental surgeon was found (P < 0.05). These results suggest a low prevalence of HVB and HDV infection, in contrast with other parts of the Amazon area.

[Prevalence of serological markers of viral hepatitis A, B and delta in apparently healthy schoolchildren of Huanta, Peru]. / Prevalencia de marcadores serológicos de hepatitis viral A, B y delta en escolares aparentemente sanos de Huanta (Perú).

UNLABELLED: Huanta is an Andean valley of Peru, located at 2400 meters above sea level with a population of 45,000 inhabitants. Viral hepatitis is widely known in the area due to its severe clinical symptoms and high morbidity and mortality. METHODS: A study on the prevalence of hepatitis A, B and D markers among 143 clinically healthy school students was carried out. The students were selected randomly from 4 schools in the city. The subjects provided epidemiological data regarding viral hepatitis and a venous blood sample to determine HBsAg, anti HBc antibody, anti-HBc IgM, anti HAV and anti HDV by the ELISA technique (Abbott Lab.). RESULTS: A total of 93 males and 50 females participated in the study. The mean age was 13.2 years (7-20 y.). Anti HAV was detected in 140 of them (98%). Prior infection by HBV was detected in 117 (82%) and an active infection in 4 of them (2.7%). The rate of HBsAg carriers was 16.0% (23). HDV infection was found in 21 of 117 (17.9%) individuals infected by the HBV. HBV infection and the previous use of injections represented a significant association (OR:3.7 IC 1.3-11, p < 0.012). No differences in sex were noted. CONCLUSION: A high prevalence of HAV, HBV, and HDV was found among school students in Huanta and this was the first report of hepatitis delta in the area. The association of HBV infection and the use of injections was meaningful. The high prevalence of HBV and HDV suggests the existence of a relationship to the morbidity and mortality by hepatitis in Huanta, thus the need for control programs by means of immunization against HBV.

Hepatitis viral delta

The etiologic agent of this severe form of hepatitis was identified by Rizzetto et al in Italy in 1977. The Delta virus resembles satellite viruses of plants which can not replicate without another specific virus. In this particular case hepatitis B virus is the helper agent. Clinically this form of hepatitis is characterized by two presentations: coinfeccion, which means simultaneous infection of a host with hepatitis B virus and hepatitis D virus. This variety of hepatitis can present with two distinct peaks of transaminases and usually resolves completely in most of the cases, however 0-4 percent can evolve to chronic hepatitis and 25 percent of the cases of fulminant hepatitis are due to this viral association. The diagnosis can be established demonstrating anti-HDV IgM or HDV-RNA or HDV antigen in the serum. In essence coinfection makers acute hepatic failure more common and the mortality is significantly higher than hepatitis B infections by itself. The second type of clinical presentation is superinfection, which means infection with the Delta virus of a patient previously infected with the hepatitis B virus (healthy carrier). Initially the patient develop a typical acute viral hepatitis in 50-70 percent of the cases, and 30-50 percent can have asymptomatic infection. The real problem with this presentation is that 20-90 percent of the cases evolved to chronicity: chronic active hepatitis and cirrhosis. The diagnosis can be made demonstrating anti-HDB IgM and anti-HDV IfG, although this last one is usually transitory. A liver biopsy can show HDV RNA or HDV antigen using special immunostainings...

[Hepatitis B and delta: the prevalence of seroepidemiological markers in volunteer blood donors and their families]. / Hepatitis B y delta: prevalencia de marcadores seroepidemiológicos en donadores de sangre voluntarios y su grupo familiar.

41 volunteer blood donors and his relatives were studied in order to know about the prevalence of hepatitis B and D virus infections in selected groups. Frequency of HBsAg+ carriers was 0.34 per cent in the Centro Nacional de la Transfusión Sanguínea and 0.15 per cent in the Banco Central de Sangre, IMSS. Most of the HBsAg+ blood donors were 21 to 40 years old (87.8%); 21.9 per cent had IgM antibodies against HBc and just 2.4 per cent were HBeAg positive. Forty one (26.9%) of 152 relatives had one or more of the HBV markers, 3.9 per cent were HBsAg carriers and 1.3 per cent were HBeAg positive. In the infected relatives group 36.6 per cent were ancestory or brothers and just 14.6 per cent of wives were infected. None of the HBsAg+ blood donors or his relatives had antibodies against delta agent. These results support the fact that the frequency of asymptomatic carriers of HBsAg in the volunteer blood donors group is similar to he frequency in the general population and identifies the group of relatives as those with the highest risk to acquire HBV infection.

Seroprevalencia de la infección por virus Delta en un grupo de pacientes AgsHB positivo de la ciudad de Maracaibo / Seroprevalence of Delta infection in a group of patients HBsAg positive sera in Maracaibo city

Con el propósito de aportar información preliminar acerca de la penentración de la infección Delta o la Seroprevalencia de la Infección Delta en nuestra población, fueron estudiados para antidelta los sueros de 40 pacientes AgsHB positivos. De éstos, 20 eran pacientes completamente asintomáticos y 20 eran pacientes sintomáticos. De los 20 pacientes asintomáticos, en 3 se determinaron factores de riesgo; 1 era homosexual, 1 era hemodializado por IRC y 1 era enfermera de la Unidad de Diálisis. Ninguno de los pacientes asintomáticos fue positivo para Delta. De los 20 pacientes sintomáticos, uno fue positivo para Delta, lo cual representó una Seroprevalencia del 5%. En este paciente no se determinaron factores de riesgo, pero es importante reslatar que se trataba de un paciente que aun cuando era procedente de la ciudad, era de raza indígena y natural del Distrito Perijá donde se han detectado foco endémicos. Estos resultaos parecen apoyar el hecho de que la infección está restringida a ciertos grupos raciales, los cuales sin embargo parecen haber rebasado los limites geográficos de las áreas donde hasta ahora parecían estar limitados. Además de lo anterior, la utilización del Antidelta como único marcador serológico (lo cual puede subestimar la prevalencia de la infeccion sobre todo en pacientes con hepatitis aguda que son la mayoría de los pacientes sintomáticos), nos aconseja no infravalorar el papel del agente Delta en la génesis de las hepatopatías en nuestro medio, así como su futuro comportamiento epidemiológico

[Seroprevalence of delta infection in a group of patients with HBsAg positive in the city of Maracaibo]. / Seroprevalencia de la infección por virus delta en un grupo de pacientes AgsHB positivo de la ciudad de Maracaibo.

In order to establish a preliminary information about the penetration of delta infection in our population, 40 HBsAg positive sera were tested for antidelta. 20 were asymptomatic patients and 20 were symptomatics. In the group of asymptomatic patients 3 belong to a high risk population: 1 homosexual, 1 dialysis patient, 1 nurse of dialysis unit. None of the patients of this group were positive for antidelta. In the group of symptomatics one was positive for antidelta. It's represents a seroprevalence of 5%. This patient was an indian who lives in the city but was born in Perijá where severe epidemics have been reported. These results support that the infection seems to be restricted to this indigenous group but the spread must be considered because the patient was living in the city. In addition, the use of antidelta as the unique serologic marker should undervalue the real prevalence of infection in the cases of acute hepatitis, which represent the majority of symptomatics patients. In consequence the paper of delta agent must be considered in the genesis of hepatitis in our population as well as its further epidemiologic course.