Hepatitis B virus and hepatitis delta virus genotypes in outbreaks of fulminant hepatitis (Labrea black fever) in the western Brazilian Amazon region.

The genotypes of hepatitis B (HBV) and delta (HDV) viruses circulating among fulminant hepatitis cases from the western Amazon Basin of Brazil were characterized in this study. HBV and HDV isolates were obtained from liver samples from 14 patients who developed fulminant hepatitis and died during 1978-1989. HBV DNA and HDV RNA were detected in all samples. Phylogenetic analyses of HDV sequences showed that they all clustered with previously characterized sequences of HDV genotype 3 (HDV-3). HBV genotypes F, A and D were found in 50.0, 28.6 and 21.4 % of cases, respectively. These results confirm the predominance of HDV-3 in South America and its association with the severe form of hepatitis, and the finding of the co-infection of HDV-3 with different genotypes of HBV suggests that the association between HDV-3 and HBV-F is not necessarily causally related to a more severe clinical course of infection.

Isolamento no território federal do Amapá de um vírus nôvo relacionado sorològicamente aos agentes responsáveis pelas febres hemorrágicas da Argentina e da Bolívia / Isolation in the Federal Territory of Amapá of a new virus serologically related to the agents responsible for hemorrhagic fever in Argentina and Bolivia

Um nôvo membro do grupo Tacaribe, o vírus Amapari, tem sido inoculado repetidas vêzes das vísceras e sangue de Oryzomys e Neacomys, capturados em SN, Território Federal do Amapá. Um único isolamento foi obtido da urina das crias e de ectoparasitos dêsses animais. Os autores analisam algumas implicações ecológicas, bem como do ponto de vista de patogenicidade humana do referido agente. Referem, ainda, a importância da prova de FC’ como recurso de grande valor no isolamento dêste vírus, uma vez que os camundongos inoculados com os espécimens provenientes de animais infectados freqüentemente desenvolvem infecção inaparente.

A new member of the Tacaribe group, Amapari virus, has been repeatedly isolated from the viscera and blood of rodents belonging to the genera Oryzomys and Neacomys captured in the Serra do Navio region, Federal Territory of Amapá, Brazil. Single isolations were also obtained from the urine, young, and ectoparasites of these animals. The authors discuss certain aspects of the epizootiology of the above mentioned virus, with special reference to its pathogenicity in man. They also refer the importance of FC’ test as a tool of great value for isolation of this virus, since mice inoculated with specimens obtained from infected animals frequently develop inapparent infection.

Recuperacion de virus amarilico, procedente de un mono centinela, en las cercanias de Belém, Brasil¨

El virus de la Fiebre amarilla fue aislado de un mono centinela Cebus el 4 de diciembre de 1964 en el bosque Utinga, cercano a Belém, Brasil. De 30 monos silvestres, dez tenían anticuerpos del mencionado virus. Más de 1.200 muestras procedentes de otros vertebrados fueron comprobadas, sin que se obtuviera indicio alguno de relación con el virus amarílico. No se descubrieron casos humanos. El episodio hubiera quedado ignorado de no haberse ilevado a cabo una vigilancia habitual con respecto a los arbovirus.

Yellow fever virus was isolated from a sentinel Cebus monkey on 4 December 1964 in the Utinga forest near Belém, Brazil. Ten of 30 wild monkeys had Yellow fever antibody. Over 1,200 samples from other vertebrates were tested without evidence of involvement with Yellow fever virus. No human cases were found. The episode would have gone undetected if routine surveillance for arboviruses had not been in progress.

O vírus da Febre amarela foi isolado de um macaco sentinela Cebus em 4 de dezembro de 1964 no bosque Utinga, próximo a Belém, Brasil. De 30 macacos silvestres, dez tinham anticorpos da Febre amarela. Mais de 1.200 amostras procedentes de outros vertebrados foram examinadas sem que se obtivesse indício algum de relação com o vírus da doença. Não foram descobertos casos humanos. O episódio foi descoberto graças à vigilância habitual sobre os arbovírus.

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

This paper reports an unusual pattern of serological HBV markers and the presence of HBsAg/anti-HBs immune complexes in serum samples from two patients with fulminant hepatitis from the Brazilian Western Amazon Basin. The diagnosis was made by both serologic tests and demonstration of antigen/antibody complexes by transmission electron microscopy. Concurrent Delta virus superinfection is also discussed.

Transfusion-transmitted virus (TTV) in Brazil. Preliminary report.

TTV is a recently discovered DNA virus, isolated from a patient with post-transfusion hepatitis of unknown etiology by Japanese researchers. In the present study, we evaluated the presence of TTV among chronic liver diseases patients in São Paulo and Pará states, representing two geographically distinct Brazilian regions. TTV DNA was found in 21/105 (20%) and 9/20 (45%) cases from São Paulo and Pará States, respectively. DNA sequence data confirmed the presence of TTV genotypes 1a and 2a, as well as other genotypes not yet described. In conclusion, TTV is present in chronic liver diseases cases from Southeast and North Brazil. However, further studies involving healthy populations are necessary before establishing any causal relationship among TTV and human hepatitis.

[Hepatitis C virus (HCV) in children and adolescent hemophiliacs] / Hepatite pelo vírus C (HCV) em crianças e adolescentes hemofílicos.

OBJECTIVE: To evaluate the prevalence of infection by HCV among hemophiliacs in the State of Pará (Brazil), and its possible relation to hepatic enzymes serum level, type of hemophilia involved, age, level of severity, kinds and combinations of treatment, as well as date in which treatment with hemoderivates was started.METHODS: Cross-sectional epidemiological investigation, analyzing 62 hemophilic patients of the Centro de Hemoterapia do Pará (HEMOPA), all born after 01/01/80, by means of the review of the medical records, physical examination and laboratory tests: Anti-HCV (ELISA 3.0), polymerase chain reaction - PCR - (HCV-RNA), and dosage of transaminases serum levels. Statistical analysis was carried out using Chi-square and Fisher's Exact Test, the results being considered significant if p

[Epidemiology of hepatitis B, C and D viruses among indigenous Parakanã tribe in the Eastern Brazilian Amazon Region]. / Epidemiologia dos vírus das hepatites B, C e D na tribo indígena parakanã, Amazônia Oriental Brasileira.

This study sought to establish the prevalence of infection with the hepatitis B, C, and D viruses (HBV, HCV, and HDV) and to describe their transmission among the Parakanã, an indigenous tribe in Pará State, Brazil. This tribe's first contacts with broader Brazilian society occurred in the 1970s and 1980s. As of October 1992, the tribe consisted of 350 individuals, of whom 222 lived in the village of Paranatinga and 128 in the village of Maroxewara. Serum samples from 96.9% of this population were tested for markers of infection with the above-named viruses by means of enzyme immunoassays. Another 106 serum samples collected from Parakanã in the 1970s were also tested. The results obtained with the modern samples showed an overall prevalence of HBV infection of 84.7% among the residents of Paranatinga, 14.4% of whom were carriers. In Maroxewara, the overall prevalence of infection was only 17.7% and no carriers were detected in the study population. HBV carriers were negative for markers of HDV infection. The prevalence of HCV infection, confirmed by immunoblot, was 1.4% and 1.6% in Paranatinga and Maroxewara, respectively. Among the notable findings of this study were that horizontal transmission of HBV takes place at an early age in Paranatinga; that HBV infection prevalences differ greatly between two nearby villages belonging to the same tribe; that HCV infection was detected in both villages; and, from the historic sera, that the prevalence of HBV infection was low and HCV infection was absent during the first years in which the Parakanã people had outside contact.

Hepatitis delta virus infection and Labrea hepatitis. Prevalence and role in fulminant hepatitis in the Amazon Basin.

To define more exactly the epidemiology of delta virus infection and confirm its role in causing fulminant Labrea hepatitis in the Amazon Basin, we studied the prevalence of delta virus infection among persons with acute and chronic hepatitis B virus infection in the Boca do Acre district of the southern Amazon Basin. Delta virus infection was found in 24% of asymptomatic hepatitis B virus carriers, 29% of acute nonfulminant hepatitis B cases, 74% of fulminant hepatitis B cases, and 100% of chronic hepatitis B cases. Chronic delta virus infection occurred primarily in older children and adults, while acute and fulminant delta virus infection occurred in young children as well. In fulminant hepatitis cases, delta virus superinfection of hepatitis B virus carriers was the most common serological pattern; histopathologic examination showed features identical to those described in fulminant hepatitis cases of similar etiology in Colombia and Venezuela. Delta virus infection is highly endemic in the southern Amazon Basin and is the principal cause of Labrea hepatitis.

An outbreak of Oropouche virus diease in the vicinity of santarem, para, barzil.

An epidemic of human febrile illness caused by Oropouche virus was studied in the village of Mojui dos Campos, Pará State, in February 1975. The major clinical symptoms, fever, chills, headache, myalgia, arthralgia and dizziness persisted for 2 to 7 days. Leukopenia was commonly observed. Some patients were severely ill but no deaths were attributed to the disease. Recurrence of symptoms was reported in several people. 55 cases of recent infection were diagnosed in Mojuí dos Campos between February and April. In the same period 26 cases were recorded from the Palhal area, near to Mojuí. Two additional cases were observed, one in the small settlement of Terra Preta and the other in the town of Santarém, which are 12 and 20 km from Mojuí, respectively. Of the 83 infections, 65 were proven by virus isolation from the blood of patients and 18 by the demonstration of an increasing antibody level to the agent. Both sexes of the population were infected in equal proportions. Most patients were below 20 years of age. In the village of Mojuí dos Campos with a population of about 2,900, 45 (40,1%) out of 112 students aged 4 to 18, had HI antibodies to the virus when examined late in February. The epidemic, however, only declined after the middle of March. Two isolations of Oropouche virus were obtained from some 15,000 Culicoides inoculated into mice. About 4,000 Culicoides and all the 9,420 mosquitoes captured during the outbreak remain to be inoculated. Over 95% of the Culicoides were C. paraensis. Only 1 rodent of the genus Proechimys had HI antibodies to Oropouche virus out of the 602 wild and domestic mammals captured in the area. All 5 reptiles examined were negative. 34 (4.9%) out of the 681 wild birds and 12 (5.8%) out of the 206 domestic birds examined were positive for the presence of HI antibodies to the agent.