Hepatitis aguda por virus A, E y no A-E en adultos chilenos a fines de los años 90 / Acute hepatitis caused by virus A, E and non A-E in chilean adults

Background: Sanitary and socioeconomic changes and the identification of new causative virus, have changed the epidemiology of hepatitis in Chile. Aim: To study the natural history of acute hepatitis caused by virus A, E and non A-E in Chilean adults. Patients and methods: A special study protocol was followed for patients with a clinical picture of acute hepatitis. Anti HAV IgM, anti HBc IgM, anti HEV IgG and IgM and Anti HCV antibodies were determined by ELISA. Results: Fifty nine patients (30 male), aged 15 to 58 years old were studied. Eighty nine percent had jaundice and 50 to 70 percent had malaise and abdominal pain. Virus A was positive in 80 percent, virus E in 7 percent. In 14 percent of patients, all viral markers were negative. The evolution was typical in 78 percent, biphasic in 14 percent and cholestatic in 5 percent. One patient had a prolonged and one a fulminant course. Mean ALT was 1148 U/l and mean total bilirubin was 5.5 mg/dl. Seventy three percent of cases occurred during early winter and spring and 27 percent during summer and early autumm. Conclusions: The main etiology of acute viral hepatitis in Chile is virus A and most cases occur during the rainy season. Clinical features of hepatitis non A-E are similar to enteral transmission forms

Prevalencia de anticuerpos anti-hepatitis A en escolares en la década actual / Prevalence of antibodies against hepatitis A virus in chilean school age children

Background: As sanitary conditions of a population improve, hepatitis A virus infection occurs at higher ages,thus decreasing the prevalence of antibodies against the virus. In the eighties, the prevalence of antibodies among children was 97 percent and depended on the socioeconomic level. Aim: To assess the prevalence of antibodies against hepatitis A virus in school age children living in Valdivia. Subjects and methods: Two thousand three hundred thirty three school age children were studied. Total antibodies against hepatitis A virus were detected using an ELISA kit from Abbott. Children were stratified in age groups and school were classified as private, subsidized, municipal or foster homes. Results: Antibodies were positive in 65 percent of children (59 percent in children aged 6 to 8 years old, 66 percent in children aged 9 to 11 years and 69 percent in children aged 12 to 15 years. In private schools, the prevalence was 26 percent, in subsidized schools the figure was 54 percent, in municipal schools 73 percent and in foster homes 91 percent. Conclusions: The general prevalence of antibodies against hepatitis A virus is higher in low socioeconomic level children. There is a global decrease in the prevalence of these antibodies in the last years