Cruells M R, Mescia G, Gaibisso R, Ramírez M, Gutiérrez M, Kohen S, González M, Russi J, Chiparelli H, Ucar L, Pérez M T
Clinica de Nutrición y Digestivo, Hospital de Clinicas, Montevideo, Uruguay.
Gastroenterol Hepatol. 1997 Jun-Jul;20(6):295-8.
The hepatitis A and E virus (HAV and HEV) share the fecal-oral mechanism. Hepatitis A is an endemo-epidemic disease in Uruguay but no data on the epidemiologic pattern of the HEV is available. The aims of this study were to update the epidemiologic behavior of the HAV in Montevideo and demonstrate the circulation of the HEV in Uruguay. Two hundred fourteen patients who consulted in the Policlínica de Nutrición y Digestivo were studied, 185 (86%) of whom were anti HAV (HAVAB, Abbot) positive. 81.8% (117/143) of those residents in Montevideo and 95.7% (68/71) of those who were from the inland were anti-HAV positive. From the Montevideo population 55.8% cases under the age of 40 years were anti-HAV positive and occurred in 97.6% of those older (p < 0.001). Considering the health care conditions of the positive patients in Montevideo, 95.6% (43/45) had septic chambers and 75.5% (74/98) disposed of toilet facilities (p < 0.001). It is concluded that although the global prevalence has been maintained since 1982, there is a change in the epidemiologic pattern with greater risk of infection in patients under the age of 40 years proceeding from areas without toilet facilities. The prevalence of total antibodies for HEV (EIA, Abbot) was 2.8% in this population. An association was observed with HAV in 2.2% (4/185). Moreover, a sample of 252 blood donors from the National Blood Service was analyzed with 5 being found to be anti HEV positive, with only 3 (1.2%) being confirmed in the Center for Disease Control in the United States. Although no definitive conclusions may be drawn from the present study, from an epidemiologic point of view, it has been shown that there is evidence of the circulation of HEV in Uruguay, in both the out patient and in blood donor populations.
甲型和戊型肝炎病毒(HAV和HEV)具有相同的粪-口传播机制。甲型肝炎在乌拉圭是一种地方性流行疾病,但尚无关于戊型肝炎病毒流行病学模式的数据。本研究的目的是更新蒙得维的亚甲型肝炎的流行病学行为,并证明戊型肝炎病毒在乌拉圭的传播情况。对在营养与消化综合诊所就诊的214例患者进行了研究,其中185例(86%)抗HAV(HAVAB,雅培)呈阳性。蒙得维的亚居民中81.8%(117/143)和内陆居民中95.7%(68/71)抗HAV呈阳性。在蒙得维的亚人群中,40岁以下的病例中有55.8%抗HAV呈阳性,而40岁以上人群中这一比例为97.6%(p<0.001)。考虑到蒙得维的亚阳性患者的卫生保健条件,95.6%(43/45)有化粪池,75.5%(74/98)有卫生设施(p<0.001)。结论是,尽管自1982年以来全球患病率一直保持不变,但流行病学模式发生了变化,来自没有卫生设施地区的40岁以下患者感染风险更高。该人群中戊型肝炎病毒总抗体(酶免疫分析,雅培)的患病率为2.8%。在2.2%(4/185)的患者中观察到与甲型肝炎病毒有关联。此外,对国家血液服务中心的252名献血者样本进行了分析,发现5人抗戊型肝炎病毒呈阳性,在美国疾病控制中心仅确认了3人(1.2%)。虽然本研究无法得出明确结论,但从流行病学角度来看,已表明在乌拉圭的门诊患者和献血者人群中均有戊型肝炎病毒传播的证据。