IntroductionChronic hepatitis B virus (HBV) infection is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. HIV-positive patients are commonly co-infected with HBV due to shared routes of transmission.ObjectivesOur aim was to determine the risk factors, prevalence, genotypes, and mutations of the Surface S gene of HBV, and occult hepatitis B infection (OBI) among patients infected with HIV in a northeastern Colombian city.MethodsA cross-sectional study was conducted with 275 HIV-positive patients attending an outpatient clinic in Bucaramanga, Colombia during 2009–2010. Blood samples were collected and screened for serological markers of HBV (anti-HBs, anti-HBc and HBsAg) through ELISA assay. Regardless of their serological profile, all samples were tested for the HBV S gene by nested-PCR and HBV genotypes were determined by phylogenetic inference. Clinical records were used to examine demographic, clinical, virological, immunological and antiretroviral therapy (ART) variables of HIV infection.ResultsParticipants were on average 37±11 years old and 65.1% male. The prevalence of HIV-HBV coinfection was 12% (95%CI 8.4–16.4) of which 3.3% had active HBV infection and 8.7% OBI. The prevalence of HIV-HBV coinfection was associated with AIDS stage and ART treatment. Sequence analysis identified genotype F, subgenotype F3 in 93.8% of patients and genotype A in 6.2% of patients. A C149R mutation, which may have resulted from failure in HBsAg detection, was found in one patient with OBI.ConclusionsThe present study found a high prevalence of HIV-HBV coinfection with an incidence of OBI 2.6-fold higher compared to active HBV infection. These findings suggest including HBV DNA testing to detect OBI in addition to screening for HBV serological markers in HIV patients.

Abstract. Characteristics of Trypanosoma cruzi infection were studied in a rural area of the eastern plains of Colombia. Using enzyme-linked immunosorbent assay and indirect fluorescent-antibody tests, the infection was determined in 11.6% of the inhabitants of 142 dwellings. During 6 months of community surveillance, in 42.3% dwellings, 609 triatomines were collected (597 Rhodnius prolixus and seven, three, one, and one of Panstrongylus geniculatus, Psammolestes arturi, Eratyrus mucronatus, and Triatoma maculata, respectively). Rhodnius prolixus was found in 80% peridomiciliary Attalea butyracea palms examined with baited traps, and its infection with T. cruzi was 30% and 38.5% in dwellings and palms, respectively. Trypanosoma cruzi was isolated in five of 35 triatomines and in one of 24 dogs. The blood of domestic and wild animals was identified in triatomines collected in the intradomicile and in palms. These results support the extension of the wild cycle of T. cruzi to human dwellings and the characterization of a new scenario for transmission in Colombia.Trypanosoma cruzi infection continues to affect nearly 6 million people in 21 countries of the Americas 1 despite the success of control programs against domestic triatomines. 2There are zones where dwellings are infested by other species of Triatominae with peridomiciliary and wild ecotopes. In the Amazon, some of the more than 27 wild species described, principally of the genus Rhodnius, have made incursions into dwellings, with the risk of infecting human populations. 3In Colombia, the Andean region in the eastern zone below 2,000 m above sea level has been considered endemic for Chagas disease because of the high degree of domiciliary infestation, wide dispersion, and the high densities of Rhodnius prolixus.4,5 A decade after the adoption of a government program to control domiciliary triatomines, in our observation, this species has been controlled. However, another transmission scenario has begun to be known with checking of the wild cycle in peridomiciliary palms as a transmission risk factor in the departments of the eastern plains 6 and the reporting of high prevalence rates of human infection with T. cruzi.7 This study was conducted for the purpose of clarifying the epidemiological characteristics of this scenario in this region.In December 2008, the prevalence of T. cruzi infection was evaluated in the inhabitants of 142 dwellings in the department of Casanare, dispersed in rural areas of the municipalities of Maní (04°49′02″N/72°17′19″W) and Aguazul (05°10′23″N/ 72°33′17″W), which were fumigated by the program of VectorTransmitted Diseases (Enfermedades Transmitidas por Vectores [ETV], in Spanish) in that department. This territory corresponds to the alluvial and eolic plains of the Orinoquía, composed of flooded savannas with herbaceous and graminaceous vegetation in the humid warm thermal floor, with an average temperature of 25-27°C and an annual rainfall of 2,400-2,600 mm (Figure 1).The dwellings are constructed with brick walls, cement, ti...

ObjectiveTo determine the prevalence and risk factors associated with Chagas disease in pregnant women in an endemic area of Santander, Colombia.MethodsCross‐sectional study included 23 municipalities of Santander, Colombia. Serological IFAT and ELISA tests were undertaken to detect IgG anti‐ Trypanosoma cruzi. A questionnaire was conducted for assessing the risk factors of each participant. Newborns were evaluated at birth and followed up to 1 year of age to determine congenital infection.ResultsAn overall prevalence of 3.2% (95% CI 2.4–4.2) among 1518 pregnant women was detected. Prevalences by provinces were as follows: Guanentina: 6.0% (95% CI 4.1–8.5), García Rovira: 2.9% (95% CI: 1.5–4.8) and Comunera: 0.4% (0.4–2.3). The main risk factors identified were age >32 years old (OR: 2.1; 95% CI: 1.1–3.9); currently having a thatched roof (OR: 11.8; CI95% 2.2–63.2) and a thatched roof during childhood (OR: 3.0; 95% CI: 1.4–6.6); having below primary school education level (OR: 4.6; 95% CI: 2.2–9.5); and a history of a close contact with the vector (triatomine bugs) at least once during their lifetime (OR: 6.9; 95% CI: 3.7–12.9). No congenital cases were detected by parasitological or serological techniques.ConclusionsPrevalence of Chagas disease in pregnant women is a potential source of infection in this Colombian endemic area. The main risk factors associated with seropositivity were related to conditions favouring the contact with the vector. The results show that it is necessary to continue an active surveillance in order to offer diagnosis and treatment to mothers and their newborns in addition to screening to pregnant women from endemic areas.

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