An outbreak of fulminant hepatitis delta in the Waorani, an indigenous people of the Amazon basin of Ecuador.

Abstract

Abstract. An outbreak of delta hepatitis occurred during 1998 among the Waorani of the Amazon basin of Ecuador. Among 58 people identified with jaundice, 79% lived in four of 22 Waorani communities. Serum hepatitis B surface antigen (HBsAg) was found in the sera of 54% of the jaundiced persons, and 14% of asymptomatic persons. Ninetyfive percent of 105 asymptomatic Waorani had hepatitis B core (HBc) IgG antibody, versus 98% of 51 with jaundice. These data confirm that hepatitis B virus (HBV) infection is highly endemic among the Waorani. Sixteen of 23 (70%) HBsAg carriers identified at the onset of the epidemic had serologic markers for hepatitis D virus (HDV) infection. All 16 were jaundiced, where as only two of seven (29%) with negative HDV serology were jaundiced (P ϭ .0006). The delta cases clustered in families, 69% were children and most involved superinfection of people chronically infected with HBV. The data suggest that HDV spread rapidly by a horizontal mode of transmission other than by the sexual route.

Epidemiology and Molecular Characterization of Hepatitis B Virus Infection in Isolated Villages in the Western Brazilian Amazon

“…6,7 We observed a high prevalence rate of total anti-HDV in these three areas. Notably, similar rates were reported in the Amazon region 26,52,53 suggesting that HDV has not yet disappeared from HBV hyperendemic areas. This may have an important health burden because HDV is an established cause of severe liver injuries.…”

The fraction of RNA that folds into the correct branched secondary structure determines hepatitis delta virus type 3 RNA editing levels

“…Here, we compare RNA folding dynamics (in silico and in vitro) and editing (in vitro and in vivo) in two HDV-3 isolates, one from Peru (Casey et al 1993;Casey 2002), the other from Ecuador (Manock et al 2000;Linnstaedt et al 2006). We find that HDV-3 controls RNA editing levels via (1) the fraction of the RNA that folds, following transcription, into the metastable branched structure required for editing and (2) the efficiency with which ADAR1 edits this branched substrate RNA.…”

Prevalência dos marcadores sorológicos dos vírus das hepatites B e D na área indígena Apyterewa, do grupo Parakanã, Pará, Brasil

“…Desde a década de 1950, estudos realizados entre populações autóctones da América do Sul, principalmente em algumas áreas da Amazônia brasileira, venezuelana, colombiana, peruana e equatoriana, têm relatado alta prevalência de infecção e doença ocasionada pelo HBV e HDV 8,9,10,11,12,13,14,15 . Entre as populações indígenas brasileiras, pesquisas têm demonstrado alta endemicidade da infecção pelo HBV e HDV, com variações quanto à prevalência, à idade e ao modo de aquisição dos vírus 16,17,18,19,20,21,22,23,24,25,26,27 .…”