RESUMO
As little is known about liver histology in the co-infection of hepatitis C virus (HCV) and hepatitis G virus (HGV), HGV RNA was investigated in 46 blood donors with hepatitis C, 22 of them with liver biopsy: co-infection HCV / HGV (n = 6) and HCV isolated infection (n = 16). Besides staging and grading of inflammation at portal, peri-portal and lobular areas (Brazilian Consensus), the fibrosis progression index was also calculated. All patients had no symptoms or signs of liver disease and prevalence of HGV / HCV co-infection was 15.2%. Most patients had mild liver disease and fibrosis progression index, calculated only in patients with known duration of infection, was 0.110 for co-infection and 0.130 for isolated HCV infection, characterizing these patients as "slow fibrosers". No statistical differences could be found between the groups, although a lesser degree of inflammation was always present in co-infection. In conclusion co-infection HCV / HGV does not induce a more aggressive liver disease, supporting the hypothesis that HGV is not pathogenic.
Assuntos
Hepatite Viral Humana/patologia , Fígado/patologia , RNA Viral/análise , Adulto , Progressão da Doença , Feminino , Infecções por Flaviviridae/complicações , Infecções por Flaviviridae/patologia , Vírus GB C/genética , Hepatite C/complicações , Hepatite C/patologia , Hepatite Viral Humana/complicações , Humanos , Cirrose Hepática/patologia , Cirrose Hepática/virologia , Masculino , Prevalência , Estatísticas não ParamétricasRESUMO
Hepatitis C virus subtype 3a (HCV-3a) originates from Asia and has spread widely among injecting drug users as well as other patient groups in industrialized countries. HCV subtype 3a infection remains highly prevalent and frequently transmitted in the population of intravenous drug users. The objective of this study was to understand better the mechanisms of the worldwide HCV-3a epidemics in drug users. Ninety-three sera from HCV-3a-infected IDUs from France, the United States, Brazil, Argentina, and Australia were studied. Phylogenetic analyses of the non-structural 5B region showed no specific clustering according to the continent of the patient's origin. Non-exclusive clusters of viral sequences from South America, Australia, and California were observed, but topologies were not supported by strong bootstrap values. The results suggest that HCV-3a has been transmitted from a common origin through a unique worldwide epidemic that rapidly spread among drug users. Regional transmission occurred in the recent past, leading to an embryonic genetic diversification of HCV-3a among local injecting drug user population.
Assuntos
Hepacivirus/genética , Hepatite C/epidemiologia , Epidemiologia Molecular , Abuso de Substâncias por Via Intravenosa/complicações , Argentina/epidemiologia , Austrália/epidemiologia , Brasil/epidemiologia , França/epidemiologia , Hepacivirus/classificação , Hepatite C/complicações , Humanos , RNA Viral/genética , Estados Unidos/epidemiologia , Proteínas não Estruturais Virais/genéticaRESUMO
Viral hepatitis is a major public health problem throughout the Americas. Each of the several types of hepatitis (A, B, delta, non-A non B) causes significant morbidity and mortality in the Region. Hepatitis B (HB) infection, now a vaccine-preventable disease, requires the most urgent attention at this time. HB infection endemicity in the Region varies from low (temperate North and South America) to moderate (Tropical Central and South America), but high HBV endemicity occurs throughout the Amazon Basin, in Hispaniola, and in certain population of several other tropical countries. Factors such as race, socioeconomic status, and urban-rural status as well as lifestyle (homosexuality, prostitution) and occupational (health care) factors increase HB prevalence in segments of populations, and it is likely that the number of persons at high risk of HB infection is currently underestimated. Chronic consequences of HB infection are likely proportional to disease endemicity and, in high endemicity areas, comparable to those in Africa and Southeast Asia. In addition, delta infection causes high mortality due to fulminant and chronic hepatitis throughout the high HBV endemicity areas in northern South America. Hepatitis A is a disease of childhood throughout the Region, and causes significant morbidity in older children
Assuntos
Hepatite , Hepatite B , Hepatite A , Grupos de Risco , América Latina , ImunizaçãoRESUMO
As little is known about liver histology in the co-infection of hepatitis C virus (HCV) and hepatitis G virus (HGV), HGV RNA was investigated in 46 blood donors with hepatitis C, 22 of them with liver biopsy: co-infection HCV / HGV (n = 6) and HCV isolated infection (n = 16). Besides staging and grading of inflammation at portal, peri-portal and lobular areas (Brazilian Consensus), the fibrosis progression index was also calculated. All patients had no symptoms or signs of liver disease and prevalence of HGV / HCV co-infection was 15.2 percent. Most patients had mild liver disease and fibrosis progression index, calculated only in patients with known duration of infection, was 0.110 for co-infection and 0.130 for isolated HCV infection, characterizing these patients as "slow fibrosers". No statistical differences could be found between the groups, although a lesser degree of inflammation was always present in co-infection. In conclusion co-infection HCV / HGV does not induce a more aggressive liver disease, supporting the hypothesis that HGV is not pathogenic
Assuntos
Humanos , Hepatite Viral Humana , Fígado , RNA Viral , Doadores de Sangue , Progressão da Doença , Flaviviridae , Infecções por Flaviviridae , Hepatite C , Cirrose Hepática , Prevalência , Estatísticas não ParamétricasRESUMO
The seroprevalence of hepatitis B was investigated in over 12.000 subjects in six countries of Latin America: Argentina, Brazil, Chile, the Dominican Republic, Mexico and Venezuela. Each study population was stratified according to age, gender and socioeconomic status. Antibodies against hepatitis B core antigen (anti-HBc) were measured in order to determine hepatitis B infection. The highest overall seroprevalence was found in the Dominican Republic (21.4 por ciento), followed by Brazil (7,9 por ciento), Venezuela (3,2 por ciento), Argentina (2,1 por ciento), Mexico (1,4 por ciento) and Chile (0,6 por ciento). In all the countries an increase in seroprevalence was found among persons 16 years old and older, suggesting sexual transmission as the major route of infection. In addition, comparatively high seroprevalence levels were seen at an early age in the Dominican Republic and Brazil, implicating a vertical route of transmission
Assuntos
Hepatite B , Anticorpos Anti-Hepatite B , Doenças Virais Sexualmente Transmissíveis , Transmissão Vertical de Doenças Infecciosas , Argentina , Brasil , Chile , México , República Dominicana , VenezuelaRESUMO
The seroprevalence of hepatitis B was investigated in over 12.000 subjects in six countries of Latin America: Argentina, Brazil, Chile, the Dominican Republic, Mexico and Venezuela. Each study population was stratified according to age, gender and socioeconomic status. Antibodies against hepatitis B core antigen (anti-HBc) were measured in order to determine hepatitis B infection. The highest overall seroprevalence was found in the Dominican Republic (21.4 por ciento), followed by Brazil (7,9 por ciento), Venezuela (3,2 por ciento), Argentina (2,1 por ciento), Mexico (1,4 por ciento) and Chile (0,6 por ciento). In all the countries an increase in seroprevalence was found among persons 16 years old and older, suggesting sexual transmission as the major route of infection. In addition, comparatively high seroprevalence levels were seen at an early age in the Dominican Republic and Brazil, implicating a vertical route of transmission
Se investigó la seroprevalencia de hepatitis B en más de 12 000 sujetos en seis países de América Latina: Argentina, Brasil, Chile, México, República Dominicana y Venezuela. Cada una de las poblaciones estudiadas fue estratificada por edad, sexo y nivel socioeconómico. Se hicieron determinaciones de anticuerpos contra el antígeno nuclear del virus de la hepatitis B (anti-HBc) con el fin de detectar la infección. La seroprevalencia general más alta se encontró en la República Dominicana (21,4%), seguida del Brasil (7,9%), Venezuela (3,2%), Argentina (2,1%), México (1,4%) y Chile (0,6%). En todos los países se encontró un aumento de la seroprevalencia en personas de 16 años de edad o mayores, lo cual indica que la transmisión sexual es la principal fuente de infección. También se hallaron tasas de seroprevalencia elevadas en personas jóvenes en la República Dominicana y el Brasil, fenómeno que apunta hacia la vía de transmisión vertical
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Doenças Virais Sexualmente Transmissíveis , Transmissão Vertical de Doenças Infecciosas , Hepatite B , Anticorpos Anti-Hepatite B , Argentina , Venezuela , Brasil , Chile , México , República DominicanaRESUMO
Los resultados de una encuesta con 7.342 muestras de sangre de 13 países y territorios de las Américas indican una elevada prevalencia de los anticuerpos contra el virus A de la hepatitis en esa Región. Los resultados señalan también una correlación significativa entre la ausencia de dichos anticuerpos y la ausencia de marcadores indicativos de infección por el virus B de la hepatitis (AU)
Assuntos
Vírus da Hepatite A , Doadores de Sangue , Argentina , Barbados , Colômbia , Costa Rica , Chile , Equador , México , Peru , Porto Rico , República Dominicana , Suriname , Venezuela , Epidemiologia Descritiva , BrasilRESUMO
Los resultados de una encuesta con 7.342 muestras de sangre de 13 países y territorios de las Américas indican una elevada prevalencia de los anticuerpos contra el virus A de la hepatitis en esa Región. Los resultados señalan también una correlación significativa entre la ausencia de dichos anticuerpos y la ausencia de marcadores indicativos de infección por el virus B de la hepatitis (AU)
Assuntos
Vírus da Hepatite A/imunologia , Doadores de Sangue , Epidemiologia Descritiva , Argentina , Barbados , Brasil , Colômbia , Costa Rica , Chile , Equador , México , Peru , Porto Rico , República Dominicana , Suriname , VenezuelaRESUMO
La hepatitis vírica es uno de los principales problemas de salud pública en todas partes de las Américas. Todos los tipos de hepatitis (A, B, delta, no-A, no-B) son causas importantes de morbilidad y mortalidad en la Región. La infección por el virus de la hepatitis B (VHB), actualmente prevenible mediante vacunación, requiere atención inmediata. La endemicidad de esta infección varía de baja (en zonas templadas de América del Norte y América del Sur) a moderada (en zonas tropicales de América Central y América del Sur), pero es muy alta en toda la cuenca del Amazonas, en La Española y en ciertas poblaciones de otros países tropicales. La prevalencia de VHB en grupos de población aumenta conforme a ciertos factores como raza, condición socioeconómica, ambiente urbano o rural, estilo de vida (homosexualidad, prostitución) y factores ocupacionales (servicios de salud), y es posible que se haya subestimado el número de habitantes actualmente en alto riesgo de contraer la infección. Es probable que las consecuencias crónicas de la infección por VHB se relacionen proporcionalmente con la endemicidad y que las zonas más endémicas sean comparables a las de Africa y Asia Sudoriental. Además, la infección delta causa alta mortalidad por hepatitis fulminante y crónica en las zonas de alta endemicidad en el norte de América del Sur. La hepatitis A en la Región es una enfermedad de la niñez y produce altas tasas de morbilidad entre los niños mayores. En los adultos, otra causa importante de morbilidad es la hepatitis no-A, no-B; los tipos de esta hepatitis que se transmiten a través de la sangre existen en todas partes de la Región, pero será necesario realizar estudios adicionales para confirmar la presencia del tipo entérico o epidémico. El control de la infección por hepatitis merece alta prioridad en la Región. Deben dedicarse esfuerzos especiales a la producción de reactivos diagnósticos de bajo costo y al fortalecimiento de los programas de laboratorio...