Evidencia serológica de la circulación del virus de la hepatitis E y prevalencia de anticuerpos contra la hepatitis A en una población indígena en el norte argentino

In 2005 a universal vaccination program against hepatitis A was introduced in Argentina. Nevertheless, there are still some unvaccinated marginal population groups. There are no data about the seroprevalence of hepatitis E in the northern region of Argentina mainly because of lack of awareness of this emergent pathogen. We aimed to determine the seroprevalence of hepatitis A, and hepatitis E in an indigenous population in northern Argentina. One hundred and twenty six (126) donor serum samples collected near San Salvador de Jujuy were analyzed for anti-HAV IgG and HEV IgG and IgM, alkaline phosphatase and transaminase values. Volunteers were interviewed about their living conditions, animal farming, consumption of tap water or river water, and level of education. Seroprevalence of specific anti-HAV antibodies was high (80.2%, 95% confidence interval, 72.1–86.7%) in children under 5 years of age, indicating early infection in life. Seroprevalence of anti-HEV antibodies was 5.6% (95% CI: 2.3–11.2%), being slightly higher than the values found in healthy patients from other regions of the country. Although we could not characterize the genotype of the circulating HEV strain, the clear epidemiological difference between seroprevalence of HAV and HEV in a community with poor sanitary conditions suggest that the circulating HEV strains spread through a different transmission route than HAV. Furthermore a significant correlation between anti-HEV IgG and swine farming was found (p < 0.05), which supports a zoonotic transmission path. We reassessed the epidemiological pattern of HAV infection and reported evidence of HEV infection for the first-time in a community belonging to the Guarani ethnic group, highlighting the need to include hepatitis E testing in routine diagnostics in the region.En 2005 se inició un programa de vacunación universal contra la hepatitis A en Argentina, pero todavía existen algunas poblaciones marginales no vacunadas. Además, los datos sobre la circulación de hepatitis E en el noroeste argentino son escasos. El objetivo de este trabajo fue determinar la seroprevalencia de la hepatitis A y la hepatitis E en una población autóctona del norte de Argentina. Se colectaron y analizaron 126 muestras de suero en habitantes de las yungas jujeñas; se determinaron transaminasas, fosfatasa alcalina y anticuerpos contra los virus de hepatitis A (HAV) (IgG) y hepatitis E (HEV) (IgG e IgM). Se obtuvieron los consentimientos informados y los voluntarios fueron entrevistados para identificar posibles factores de riesgo, como las condiciones de vida y la cría de animales, entre otros. La seroprevalencia de anticuerpos específicos anti-HAV fue alta (80,2%; intervalo de confianza [IC] 95%: 72,1-86,7%) en niños menores de 5 años, lo que indica infección temprana. La seroprevalencia de anticuerpos anti-HEV fue del 5,6% (IC 95%: 2,3-11,2%), ligeramente más alta que en otras regiones del país en pacientes sanos. Aunque no se caracterizó el genotipo circulante del HEV, la clara diferencia epidemiológica entre la seroprevalencia de ambos virus en una comunidad con malas condiciones sanitarias sugiere que la cepa circulante de HEV se transmite por una vía diferente que la del HAV. Además, encontramos una significativa correlación entre la cría de cerdo y la presencia de anticuerpos IgG anti-HEV (p < 0,05), lo que sugiere una vía de transmisión zoonótica. Reevaluamos el patrón epidemiológico de infección por el HAV y aportamos por primera vez una evidencia de infección por el HEV en una comunidad que pertenece a la etnia guaraní, por lo que destacamos la necesidad de incluir la detección de hepatitis E en la región.Fil: Remondegui, Carlos. Hospital Zonal General Agudos San Roque; ArgentinaFil: Ceballos, Susana. Hospital Zonal General Agudos San Roque; ArgentinaFil: Arce, Lorena Paola. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentina. Universidad Nacional de Tucumán. Facultad de Medicina; ArgentinaFil: Pintado, Eduardo. Hospital Zonal General Agudos San Roque; ArgentinaFil: Vidaurre, Rene. Hospital Paterson de San Pedro de Jujuy; ArgentinaFil: Nitschko, Hans. Ludwig Maximilians Universitat. Max Von Pettenkofer Institute; Alemania. German Center for Infection Research; AlemaniaFil: Osterman, Andreas. German Center for Infection Research; Alemania. Ludwig Maximilians Universitat. Max Von Pettenkofer Institute; AlemaniaFil: Vizoso Pinto, María Guadalupe. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentina. Universidad Nacional de Tucumán. Facultad de Medicina; Argentin

Acute retroviral syndrome and high baseline viral load are predictors of rapid HIV progression among untreated Argentinean seroconverters

<p>Abstract</p> <p>Background</p> <p>Diagnosis of primary HIV infection (PHI) has important clinical and public health implications. HAART initiation at this stage remains controversial.</p> <p>Methods</p> <p>Our objective was to identify predictors of disease progression among Argentinean seroconverters during the first year of infection, within a multicentre registry of PHI-patients diagnosed between 1997 and 2008. Cox regression was used to analyze predictors of progression (LT-CD4 < 350 cells/mm³, B, C events or death) at 12 months among untreated patients.</p> <p>Results</p> <p>Among 134 subjects, 74% presented with acute retroviral syndrome (ARS). Seven opportunistic infections (one death), nine B events, and 10 non-AIDS defining serious events were observed. Among the 92 untreated patients, 24 (26%) progressed at 12 months versus three (7%) in the treated group (p = 0.01). The 12-month progression rate among untreated patients with ARS was 34% (95% CI 22.5-46.3) versus 13% (95% CI 1.1-24.7) in asymptomatic patients (p = 0.04). In univariate analysis, ARS, baseline LT-CD4 < 350 cells/mm³, and baseline and six-month viral load (VL) > 100,000 copies/mL were associated with progression. In multivariate analysis, only ARS and baseline VL > 100,000 copies/mL remained independently associated; HR: 8.44 (95% CI 0.97-73.42) and 9.44 (95% CI 1.38-64.68), respectively.</p> <p>Conclusions</p> <p>In Argentina, PHI is associated with significant morbidity. HAART should be considered in PHI patients with ARS and high baseline VL to prevent disease progression.</p

Tick paralysis cases in Argentina

Tick paralysis (TP) occurs worldwide and is caused by a neurotoxin secreted by engorged female ticks that affects the peripheral and central nervous system. The clinical manifestations range from mild or nonspecific symptoms to manifestations similar to Guillain-Barré syndrome, bulbar involvement, and death in 10% of the patients. The diagnosis of TP is clinical. To our knowledge, there are no formal reports of TP in humans in South America, although clusters of TP among hunting dogs in Argentina have been identified recently. In this paper, clinical features of two cases of TP occurring during 1994 in Jujuy Province, Argentina, are described

Silent dissemination of HTLV-1 in an endemic area of Argentina. Epidemiological and molecular evidence of intrafamilial transmission

Submitted by Sandra Infurna ([email protected]) on 2017-07-18T13:04:33Z No. of bitstreams: 1 anacarolina_vicente_etal_IOC_2017.pdf: 865469 bytes, checksum: 9807da08afb62e9bdd5e68f2e19c4cfe (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-07-18T13:18:38Z (GMT) No. of bitstreams: 1 anacarolina_vicente_etal_IOC_2017.pdf: 865469 bytes, checksum: 9807da08afb62e9bdd5e68f2e19c4cfe (MD5)Made available in DSpace on 2017-07-18T13:18:38Z (GMT). No. of bitstreams: 1 anacarolina_vicente_etal_IOC_2017.pdf: 865469 bytes, checksum: 9807da08afb62e9bdd5e68f2e19c4cfe (MD5) Previous issue date: 2017Universidad Nacional de Córdoba. Facultad de Ciencias Mèdicas. Instituto de Virologia "Dr. J. M. Vanella". Córdba, Argentina.Universidad Nacional de Córdoba. Facultad de Ciencias Mèdicas. Instituto de Virologia "Dr. J. M. Vanella". Córdba, Argentina.Universidad Nacional de Córdoba. Facultad de Ciencias Mèdicas. Instituto de Virologia "Dr. J. M. Vanella". Córdba, Argentina.Hospital San Roque. Departamento de Enfermedades Infecciones. San Salvador de Jujuy, Argentina.Universidad Nacional de Córdoba. Facultad de Ciencias Mèdicas. Instituto de Virologia "Dr. J. M. Vanella". Córdba, Argentina.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microorganismos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microorganismos. Rio de Janeiro, RJ. Brasil.Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Matemática. Córdoba, Argentina.Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Matemática. Córdoba, Argentina.Universidad Nacional de Córdoba. Facultad de Ciencias Mèdicas. Instituto de Virologia "Dr. J. M. Vanella". Córdba, Argentina.Universidad Nacional de Córdoba. Facultad de Ciencias Mèdicas. Instituto de Virologia "Dr. J. M. Vanella". Córdba, Argentina.Molecular and epidemiological studies of transmission routes and risk factors for infection by HTLV-1 are extremely important in order to implement control measures, especially because of the high prevalence of HTLV-1 in several regions of the world. San Salvador de Jujuy, Northwest Argentina, is a highly endemic area for HTLV-1 and foci of tropical spastic paraparesis/HTLV-1-associated myelopathy

Relevance of HTLV-1 proviral load in asymptomatic and symptomatic patients living in endemic and non-endemic areas of Argentina.

HTLV-1 proviral load (pVL) in peripheral blood mononuclear cell (PBMCs) is proposed as a marker of disease progression but its role still remains controversial. The aim of this study was to evaluate the levels of HTLV-1 pVL in symptomatic patients and asymptomatic HTLV-1 carriers. In this cross-sectional study the pVL was measured by Real Time PCR in 102 asymptomatic carriers and 22 symptomatic patients (5ATLL, 15 TSP and 2 uveitis). We observed that the HTLV-1 pVL was significantly higher in symptomatic patients (median = 4.99 log10 HTLV-1 copies /106 PBMCs) compared to asymptomatic HTLV-1 carriers (median = 4.38 log10 HTLV-1 copies /106 PBMCs; p = 0.0030). A wide variation on the HTLV-1 pVL levels among asymptomatic HTLV-1 carriers was observed with some pVL as high as those observed in symptomatic patients. The asymptomatic HTLV-1 carriers were divided according to the place of birth and the highest levels of pVL were detected among patients from endemics areas from the North of Argentina. Our results reinforce the usefulness of the proviral load would be a prognostic marker of HTLV-1 disease progression. Moreover, host, viral or socio-environmental factors cannot be excluded as determinant of high proviral load

HTLV in the Americas: challenges and perspectives.

The first description of the human T-lymphotropic virus type 1 (HTLV-1) was made in 1980, followed closely by the discovery of HTLV-2, in 1982. Since then, the main characteristics of these viruses, commonly referred to as HTLV-1/2, have been thoroughly studied. Central and South America and the Caribbean are areas of high prevalence of HTLV-1 and HTVL-2 and have clusters of infected people. The major modes of transmission have been through sexual contact, blood, and mother to child via breast-feeding. HTLV-1 is associated with adult T-cell leukemia/lymphoma (ATL), HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and HTLV-associated uveitis as well as infectious dermatitis of children. More clarification is needed in the possible role of HTLV in rheumatologic, psychiatric, and infectious diseases. Since cures for ATL and HAM/TSP are lacking and no vaccine is available to prevent HTLV-1 and HTLV-2 transmission, these illnesses impose enormous social and financial costs on infected individuals, their families, and health care systems. For this reason, public health interventions aimed at counseling and educating high-risk individuals and populations are of vital importance. In the Americas this is especially important in the areas of high prevalence

First description of seronegative HTLV-1 carriers in Argentina

In some areas of Argentina endemic for human T-lymphotropic virus type 1 (HTLV-1), tropical spastic paraparesis is frequent in subjects who lack antibodies against the virus; however, the relevance of this seronegative status in the country has not been investigated. In neighboring countries, HTLV-1 seronegative status has been described in patients with different diseases; however, data regarding features of seronegative HTLV-1 carriers are scarce. We investigated the seronegative status in 124 relatives of 28 HTLV-1 infected subjects from an endemic area in Northwest Argentina. Blood samples and clinical/epidemiological data were collected. Human T-lymphotropic virus type 1 infection was diagnosed by serology and long terminal repeat (LTR) sequence, env and tax gene detection. IgG anti-Tax HTLV-1 antibody, tax gene sequence, and DNA proviral load were also evaluated. Seventy-five percent of the 124 relatives were negative for HTLV-1/2 antibodies; 35.5% were also negative by molecular assays and 64.5% were negative for HTLV-1 LTR and env sequences, but positive for two sequences of HTLV-1 tax gene. Also, 35.7% of these subjects had IgG anti-Tax antibodies. The seronegative HTLV-1 status was significantly associated with male gender, youth, and sensory symptoms/autonomic nervous system dysfunction. High rates of seronegative symptomatic and asymptomatic HTLV-1 carriers in Argentina are described. The evidence highlights that HTLV-1 prevalence may be underestimated worldwide. Larger cohort studies are required to assess disease outcome in these seronegative subjects. Also, the findings emphasize the limitations of ongoing screening assays for diagnosis and blood safety. Therefore, algorithms for HTLV-1 diagnosis should include not only serological but also molecular assays.Fil: Gallego, Sandra Veronica. Universidad Nacional de Córdoba. Facultad de Medicina. Instituto de Virología Dr. J. M. Vanella; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; ArgentinaFil: Frutos, Maria Celia. Universidad Nacional de Córdoba. Facultad de Medicina. Instituto de Virología Dr. J. M. Vanella; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; ArgentinaFil: Blanco, Sebastian. Universidad Nacional de Córdoba. Facultad de Medicina. Instituto de Virología Dr. J. M. Vanella; ArgentinaFil: Castro, Gonzalo. Universidad Nacional de Córdoba. Facultad de Medicina. Instituto de Virología Dr. J. M. Vanella; ArgentinaFil: Balangero, Marcos Cesar. Universidad Nacional de Córdoba. Facultad de Medicina. Instituto de Virología Dr. J. M. Vanella; ArgentinaFil: Panigo, David Elías. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Matemáticas; ArgentinaFil: Mangeaud, Arnaldo. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Matemáticas; ArgentinaFil: Remondegui, Carlos. Hospital San Roque. Servicio de Infectología y Enfermedades Tropicales; ArgentinaFil: Rocha, Anderson Santos. Universidad Federal de Minas Gerais. Instituto de Ciencias Biológicas. Departamento de Microbiología. Laboratorio de Virología Básica y Aplicada; Brasil. Interdisciplinary HTLV Research Group; BrasilFil: Franco, Gabriela Melo. Universidad Federal de Minas Gerais. Instituto de Ciencias Biológicas. Departamento de Microbiología. Laboratorio de Virología Básica y Aplicada; Brasil. Interdisciplinary HTLV Research Group; BrasilFil: Martins, Marina Lobato. Interdisciplinary HTLV Research Group; BrasilFil: Barbosa Stancioli, Edel Figueiredo. Universidad Federal de Minas Gerais. Instituto de Ciencias Biológicas. Departamento de Microbiología. Laboratorio de Virología Básica y Aplicada; Brasil. Interdisciplinary HTLV Research Group; BrasilFil: Nates, Silvia Viviana. Universidad Nacional de Córdoba. Facultad de Medicina. Instituto de Virología Dr. J. M. Vanella; Argentin

Family tree of index cases infected with HTLV-1.

<p>Family tree of index cases infected with HTLV-1.</p

Variables associated with HTLV-1 infection among families in the endemic area of Argentina.

<p>Variables associated with HTLV-1 infection among families in the endemic area of Argentina.</p