Bolivia: HBV=74% HGV=15% HEV=16% AIDS=0

[Guest guest]

From the same 1999 study.....[included below]....

" In Bolivia, no studies have been carried out specifically on hepatitis

viruses. "

" circulation of HCV has not been detected "

HGV = 14.6%, tested blood donors

Anti-HEV (IgG) = 16.2%

Our data indicate a high prevalence of HGV in native Bolivians.

1999 Oct. PMID: 10488194, UI: 99419156

Absence of HIV infection in low- and high-risk groups in the Santa Cruz

region, Bolivia. AIDS. 1989 Mar;3(3):184-5. No abstract available. PMID:

2496736; UI: 89228603.

Estimates of the risk of acquiring HIV through blood transfusion were much

lower than for acquiring HBV, HCV, or T. cruzi because of significantly

higher screening and lower prevalence.rates for HIV.

Emerg Infect Dis 1998 Jan-Mar;4(1):5-11

Risk for transfusion-transmitted infectious diseases in Central and South

America.

Schmunis GA, Zicker F, Pinheiro F, Brandling- D

Pan American Health Organization, Washington, D.C., USA. schmunig@...

We report the potential risk for an infectious disease through tainted

transfusion in 10 countries of South and Central America in 1993 and in two

countries of South America in 1994, as well as the cost of reagents as

partial estimation of screening costs. Of the 12 countries included in the

study, nine screened all donors for HIV; three screened all donors for

hepatitis B virus (HBV); two screened all donors for Trypanosoma cruzi; none

screened all donors for hepatitis C virus (HCV); and six screened some

donors for syphilis.

Estimates of the risk of acquiring HIV through blood transfusion were much

lower than for acquiring HBV, HCV, or T. cruzi because of significantly

higher screening and lower prevalence.rates for HIV.

An index of infectious disease spread through blood transfusion was

calculated for each country. The highest value was obtained for Bolivia (233

infections per 10,000 transfusions); in five other countries, it was 68 to

103 infections per 10,000. The risks were lower in Honduras (nine per

10,000), Ecuador (16 per 10,000), and Paraguay (19 per 10,000). While the

real number of potentially infected units or infected persons is probably

lower than our estimates because of false positives and already infected

recipients, the data reinforce the need for an information system to assess

the level of screening for infectious diseases in the blood supply. Since

this information was collected, Chile, Colombia, Costa Rica, and Venezuela

have made HCV screening mandatory; serologic testing for HCV has increased

in those countries, as well as in El Salvador and Honduras. T. cruzi

screening is now mandatory in Colombia, and the percentage of screened

donors increased not only in Colombia, but also in Ecuador, El Salvador, and

Paraguay. Laws to regulate blood transfusion practices have been enacted in

Bolivia, Guatemala, and Peru. However, donor screening still needs to

improve for one or more diseases in most countries.

Comments:

Comment in: Emerg Infect Dis 1998 Jul-Sep;4(3):512

PMID: 9452393, UI: 98123012

Rev Panam Salud Publica 1999 Mar;5(3):144-51

[Prevalence of infections by hepatitis B, C, D and E viruses in Bolivia].

[Article in Spanish]

Leon P, Venegas E, Bengoechea L, Rojas E, JA, Elola C, Echevarria JM

Instituto de Salud III, Centro Nacional de Microbiologia, Madrid,

Espana.

In Bolivia, no studies have been carried out specifically on hepatitis

viruses.

Thus, their prevalence and circulation patterns are virtually unknown.

A seroepidemiologic study was performed from 1992 to 1996 to generate a

preliminary idea of the overall prevalence of infection from hepatitis B, C,

D, and E viruses (HBV, HCV, HDV, and HEV, respectively) in different

Bolivian population groups. Prompted by the data obtained in other areas of

Latin America, the study focused on indigenous communities in the Amazon

region. In rural areas of the high Andean plateau,

HBV infection showed an overall prevalence compatible with medium to low

endemicity (11.2%), and no carriers of HCV or HDV antibodies were found. In

two high-risk groups in the city of Cochabamba (homeless children and sexual

workers), the prevalence of HBV infection was similar (11.6%) and could be

considered low by comparison to that of similar population groups in Latin

American urban centers. The prevalence of HCV (one positive case, or 0.5%)

was similar to that found in similar population groups, although the small

number of samples precludes drawing more definite conclusions. As has been

noted previously with similar communities in tropical areas of South

America,

HBV infection is highly endemic in indigenous populations of the Bolivian

Amazon (with an overall prevalence of 74.0%), but circulation of HCV has not

been detected.

It is a well-known fact that HBV is horizontally transmitted and that

transmission can take place very early in life, but the mechanisms involved

are unknown. By 10 years of age, more than half the population has already

had the natural infection that, in approximately 10 more years will have

affected virtually the entire population. The very low rate of positivity to

HBsAg (1.6%), the absence of viral DNA in samples showing isolated

positivity to anti-HBc, and the high prevalence of anti-HBs among

individuals who show markers for natural infection (92.4%) suggest vertical

transmission plays no role in persistent endemicity. So far, no outbreak of

HDV infection has been documented in these communities, but the high

endemicity shown by HBV points to the possibility of future outbreaks.

Results obtained with tests for the detection of antibodies against HEV

suggest that this virus is circulating widely in Bolivia and that it could

have caused recent outbreaks in Cochabamba state. Vaccination against HBV in

endemic populations is recommended as a short-term measure. Also recommended

are actively searching for outbreaks and sporadic cases of hepatitis E in

the entire country and performing additional research that will help in

assessing the public health consequences of the situation described in this

article.

Publication Types:

Review

Review, tutorial

PMID: 10355311, UI: 99283738