Monitoring of rotavirus infections in amerindian children from western Brazil after vaccine introduction, 2008-2011: detection of uncommon G8P[6] strains and possible interspecies transmission

Abstract

Background: There is a strong relationship between HBeAg sero-status, HBV DNA level and CHB-associated complications, especially cirrhosis and HCC. However, the distribution of HBV DNA and HBeAg seroprevalence and risk factors of cirrhosis among Thai CHB patients have not been adequately described. We aim to determine the patterns of HBV DNA level, HBeAg status, and risk factors of cirrhosis and HCC in Thai CHB patients.Methods: A cross-sectional study was conducted at Chulabhorn Hospital in 2010. CHB patients, aged 20-65 years, were tested for liver function test , HBeAg, HBV DNA, alpha fetoprotein and ultrasound upper abdomen.Results: 2,293 CHB patients (1,086 (47.36%) males) with the mean age (SD) of 41.25 (10.95) years were included. Mean HBV DNA was 3.62(2.22) log 10 IU/ml, and 47.71% had HBV DNA > 2,000 IU/ml. HBeAg positivity was present in 17.2% and most cases (96.19%) had high HBV-VL > 2,000 IU/ml. The majority of CHB (82.8%) were HBeAg negative, and only 37.6% of them had HBV DNA > 2,000 IU/ml. ALT level was 35.5(40.1) IU/L, of which 22.5% had ALT > 40 IU/ml. Higher HBV DNA and increased ALT levels were significantly associated with male gender, HBeAg-seropositivity and cirrhosis (p< 0.001). Liver cirrhosis by liver biopsy, transient elastography and US was found in 180 (7.8%) cases. HBeAg-seropositivity was more frequently found in cirrhosis patients than HBeAgseronegativity (23.33% vs 16.67%, p=0.023). High prevalence of cirrhosis was found in HBV DNA level 2-3 and 5-6 log 10 IU/ml in 18.33% and 18.89%, respectively (p<0.001). Multivariate analysis showed factors associated with cirrhosis, including male gender, age > 50 years and HBV DNA> 2000 IU/ml. Logistic regression analysis revealed HBV DNA level of 200,000-1,999,999 IU/ml, which significantly associated with cirrhosis (OR 5.84).Conclusion: Higher HBV DNA level, HBeAg-seropositivity and risk factors for cirrhosis were commonly found in Thai CHB patients. HBeAg negative with 39.34% viremic regardless of ALT were observed in most CHB cases. The predominant trend towards HBeAg -seronegativity CHB has also been observed as in western countries. Hence, the active national surveillance policy should be implemented in those with high HBV DNA and HBeAg-seropositivity to provide effective treatment and prevent complications.http://dx.Background: Acute diarrhea diseases are the leading health problem in indians communities, specially rotavirus (RV). In 2006 the RV vaccine was included in the Brazilian Immunization Program. The aim of this work was to report the results of a 4-years surveillance study of RV strains in native Brazilian children ≤3 years with acute gastroenteritis in the state of Mato Grosso do Sul, Brazil.Methods: This retrospective study was conducted with 19 indians communities from 2008 to 2011 with convenient surveillance specimens investigated by ELISA, PAGE, RT-PCR and sequencing to genotype characterization.Results: RV infection was detected in 9% of samples (13/144) with the greatest detection proportion during the dry season (from ...