Servicio Hepatitis y Servicio Hepatitis y Gastroenteritis Gastroenteritis Laboratorio Nacional de Laboratorio Nacional de Referencia Referencia INEI-ANLIS “Dr. C. G. INEI-ANLIS “Dr. C. G. MALBRAN” MALBRAN” Sunrise Symposium at 13 Sunrise Symposium at 13 th th ISVHLD ISVHLD Washington USA. March 2009 Washington USA. March 2009 Viral Hepatitis. Viral Hepatitis. Epidemiology & Research Epidemiology & Research in ARGENTINA. in ARGENTINA. South America. South America. Jorge Enrique González Jorge Enrique González
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Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Lab Surveillance System
Sentinel
TBC
Vaccines
HUS
Hepatitis STDDiarrheas
PneumoniesFebrile IllnessNosocomial
Infections
Specific NetworksProvinces Networks
Modular Modular SystemSystem
(since 2001)(since 2001)
ProgramsMedical consultations
Meningoencephalitis
Immunizables
Laboratories
Cards
Early Alert
+
Sentinel Units
Injuries
Specialized
National Health Surveillance SystemNational Health Surveillance System
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
*Common working protocol*Common working protocol -Guidelines consensus-Guidelines consensus -Web resident specific software-Web resident specific software
*External Quality Control for *External Quality Control for SerologySerology -Biannual Panel for HBV & HCV-Biannual Panel for HBV & HCV
Posters at this meetingPosters at this meeting#P-003#P-003#P-004 #P-004
Saturday 03/21Saturday 03/21 12-15 hrs 12-15 hrs
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Access to SanitationAccess to Sanitation (% of population) 2001(% of population) 2001
Access to Tap waterAccess to Tap water (% of population) (% of population)
20012001
Sewage 42.5 %Sewage 42.5 % Area: 2 736 690 sq km Safe water 77 % Area: 2 736 690 sq km Safe water 77 % Population : 39 000 000 (mostly urban) Population : 39 000 000 (mostly urban)
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
GEOGRAPHICAL DISTRIBUTION OF GEOGRAPHICAL DISTRIBUTION OF HEPATITIS A VIRUS INFECTIONHEPATITIS A VIRUS INFECTION
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
HAV infection in ArgentinaHAV infection in Argentina
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Hepatitis A Hepatitis A surveillance surveillance
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
0 20 40 60 80 100 120 140
FORMOSARIO NEGRO
TIERRA DEL FUEGOENTRE RIOS
SANTA CRUZNEUQUENSAN LUIS
SANTA FEJ UJ UY
CORDOBAMENDOZALA PAMPA
PAISCHUBUT
SAN J UANLA RIOJ A
CABATUCUMAN
CATAMARCACORRIENTES
MISIONESBUENOS AIRES
SANTIAGO DEL ESTEROSALTA
CHACO
Ju
risd
ició
n
Cobertura
Cobertura país: 93,5%
Cobertura de Vacunación anti Hepatitis A en niños de 1 año de edad,según provincias. Argentina 2007
Source : National Health Surveillance SystemSource : National Health Surveillance System
Vaccination coverage against HAV in one-year-old children. Argentina 2007
pro
vin
ces
% coverage
Country coverage 93.5%
Poster at this Poster at this meetingmeeting#P-002#P-002
Saturday 03/21Saturday 03/2112-15 hrs12-15 hrs
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Fields Virology 2001 ; Rev Med Virol 2003
Hepatitis EHepatitis E
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Identification of 2 Novel Isolates Identification of 2 Novel Isolates of Hepatitis E Virus in Argentinaof Hepatitis E Virus in ArgentinaIdentification of 2 Novel Isolates Identification of 2 Novel Isolates of Hepatitis E Virus in Argentinaof Hepatitis E Virus in Argentina
Schlauder GG, Frider B, Sookoian S, Castaño G & Mushawar I.Schlauder GG, Frider B, Sookoian S, Castaño G & Mushawar I.
Virus Discovery Group Abbott Laboratories, Chicago. USAVirus Discovery Group Abbott Laboratories, Chicago. USA
Unidad de Hígado. Hospital Argerich. Buenos Aires Argentina.Unidad de Hígado. Hospital Argerich. Buenos Aires Argentina.
Ar 1Ar 1
Male, 80 yearsMale, 80 years
Ar 2Ar 2
Male, 65 yearsMale, 65 years
JID 2000;182:294-7JID 2000;182:294-7
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
HEVPhylogenetic relation
between swine & human Argentinian
strains
Identification of the first strain of Swine Hepatitis E virus in Identification of the first strain of Swine Hepatitis E virus in South South America and prevalence of anti-HEV antibodies in swine in America and prevalence of anti-HEV antibodies in swine in Argentina.Argentina.Munné et al. 2006. Journal of Medical Virology; Munné et al. 2006. Journal of Medical Virology; 78: 1579-83.78: 1579-83.
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Munné et al. 2006Munné et al. 2006Acta Gastroenterológica Acta Gastroenterológica Latinoamericana ; 36: 125-130.Latinoamericana ; 36: 125-130.
HEV & pediatrics FHFHEV & pediatrics FHF
3 HEV RNA +ve in 35 FHF (2003-2004)Serum & feces samples
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Laboratory Diagnosis of Laboratory Diagnosis of Hepatitis EHepatitis ELaboratory Diagnosis of Laboratory Diagnosis of Hepatitis EHepatitis E
Direct MarkersDirect Markers Ag Ag : in : in developmentdevelopment
Indirect Markers Indirect Markers Ab Ab : -low titer : -low titer -low -low specificity specificity
*Diagnostic tests not required *Late sampling*Diagnostic tests not required *Late sampling
*Difficult accesibility of commercial tests *High costs for the *Difficult accesibility of commercial tests *High costs for the tests.tests.
Sub diagnosis !!!Sub diagnosis !!!
*sampling*sampling improvement mprovement
*better handling of *better handling of serum serum
and stoolsand stools
*Local strains as *Local strains as
capture Ag ??capture Ag ??
ProblemsProblems Solutions ???Solutions ???
Poster at this Poster at this meetingmeeting
P-158P-158Saturday 03/21Saturday 03/21
12-15 hrs12-15 hrs
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
GEOGRAPHIC DISTRIBUTION OF CHRONIC HBV INFECTIONGEOGRAPHIC DISTRIBUTION OF CHRONIC HBV INFECTION
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Tasas de notificación de casos de Hepatitis B y tendenciaArgentina 1998-2008
Source : National Health Surveillance SystemSource : National Health Surveillance System
Rates of hepatitis B notification and trend.Rates of hepatitis B notification and trend.Argentina 1998 - 2008Argentina 1998 - 2008
year
Rat
es /
000
0
3.5
2.5
1.5
0.5
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
20062006 20072007
REGIONREGIONSS
Total Total ControlleControlled donorsd donors
ControllControlleded
HBsAg HBsAg % %
+ve+ve
Total Total ControlleControlled donorsd donors
ControlleControlled HBsAgd HBsAg
%% +ve+ve
CENTER CENTER 109 650 109 650 108 610108 610 0.310.31 116 997116 997 116 436116 436 0.230.23
West West CENTERCENTER 31 03331 033 30 73330 733 0.270.27 25 69025 690 25 69025 690 0.310.31
North North EAST EAST 38 40138 401 37 69237 692 0.400.40 37 27237 272 36 63436 634 0.460.46
North North WEST WEST 39 69139 691 39 44939 449 1.171.17 39 76239 762 38 35038 350 1.181.18
SOUTH SOUTH 25 16825 168 24 67024 670 0.320.32 25 47125 471 24 95524 955 0.210.21
TOTAL TOTAL 243 943243 943 241 154241 154 0.40.466 398 590398 590 242 065242 065 0.420.42
HBsAg prevalence in Blood HBsAg prevalence in Blood donors.donors.
Source : Provinces communications to CNRL ANLIS “Dr C G Malbran”Source : Provinces communications to CNRL ANLIS “Dr C G Malbran”
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
20062006 20072007
REGIONSREGIONSTotal Total
ControlleControlledd
donorsdonors
ControlledControlledantiHBcantiHBc
% % +ve+ve
Total Total ControlledControlled
donorsdonors
ControlleControlledd
antiHBcantiHBc% %
+ve+ve
CENTER CENTER 291 989 291 989 286 403286 403 1.671.67 270 395270 395 267 267267 267 1.861.86
West West CENTERCENTER 31 03331 033 30 49230 492 1.751.75 25 69025 690 25 69025 690 1.921.92
North North EAST EAST 38 40138 401 21 95421 954 5.505.50 37 27237 272 24 02624 026 4.994.99
North North WEST WEST 39 69139 691 38 61338 613 7.397.39 39 76239 762 38 12738 127 6.656.65
SOUTH SOUTH 25 16825 168 23 88923 889 1.371.37 25 47125 471 24 51224 512 1.531.53
antiHBc prevalence in Blood donors.antiHBc prevalence in Blood donors.
Source : Provinces communications to CNRL ANLIS “Dr C G Malbran”
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
HEPATITIS B at the SUsHEPATITIS B at the SUs
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
0 20 40 60 80 100 120
LA RIOJ AJ UJ UY
CHUBUTBUENOS AIRES
SANTIAGO DEL ESTEROSALTA
CORDOBALA PAMPASAN J UANSAN LUIS
CHACOPAIS
CORRIENTESSANTA FE
ENTRE RIOSMISIONES
TUCUMANCATAMARCASANTA CRUZ
MENDOZACABA
TIERRA DEL FUEGONEUQUEN
RIO NEGROFORMOSA
Source : National Health Surveillance SystemSource : National Health Surveillance System
Country coverage 83.7%Country coverage 83.7%
Cobertura de Vacunación antihepatitis Bantes de las 12 horas de recién nacidos Argentina 2007
Vaccination coverage against HBV in newborns.Vaccination coverage against HBV in newborns. Argentina 2007Argentina 2007
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
HBV HBV genotypesgenotypes
Poster at this meetingPoster at this meeting#P-038#P-038
Saturday 03/21Saturday 03/2112-15 hrs12-15 hrs
Strong association between genotype F and Strong association between genotype F and … … Franca P, et al. Franca P, et al. J Clin MicrobiolJ Clin Microbiol. 2004 . 2004 Nov;42(11)Nov;42(11)
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
(World J Gastro 2007)
HEPATITIS CHEPATITIS C
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
0.5
Source : National Health Surveillance SystemSource : National Health Surveillance System
Tasas de notificación de casos de Hepatitis C y tendencia
Rates of hepatitis C notification and trend.Rates of hepatitis C notification and trend.Argentina 1998 – 2008Argentina 1998 – 2008
year
Rat
es /
000
0
2.5
1.5
0.50.5
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
REGIONSREGIONS
20062006 20072007Total Total
ControllControlled ed
donorsdonors
antiHCV antiHCV ControllControll
eded%%
+ve+veTotal Total
ControlleControlled donorsd donors
antiHCV antiHCV ControllControll
eded%%
+ve+ve
CENTER CENTER 291 989 291 989 290 787290 787 0.660.66 270 395270 395 270 101270 101 0.750.75
WEST WEST CenterCenter 31 03331 033 30 73330 733 0.660.66 25 69025 690 25 69025 690 0.600.60
North North EAST EAST 38 40138 401 37 34637 346 0.660.66 37 27237 272 36 66336 663 0.800.80
North North WEST WEST 39 69139 691 39 39139 391 1.161.16 39 76239 762 38 31238 312 1.001.00
SOUTH SOUTH 25 16825 168 24 65924 659 0.520.52 25 47125 471 24 68524 685 0.530.53
antiHCV prevalence in Blood donors.antiHCV prevalence in Blood donors.
Source : communications from the Provinces to the CNRL ANLIS “Dr C G Malbran”Source : communications from the Provinces to the CNRL ANLIS “Dr C G Malbran”
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
SOURCESOURCE nnPrevalencPrevalenc
ee
*General population spontaneous-demand *General population spontaneous-demand studies studies : :
Buenos Aires city (FAPHLE) (1996) (Buenos Aires city (FAPHLE) (1996) (11))7 1077 107 2.8%2.8%
Rosario city (Sta Fe Prov)(CTSP) (1997-Rosario city (Sta Fe Prov)(CTSP) (1997-1998) (1998) (22))
5 4605 460 3.4%3.4%
Buenos Aires city (1996) (Buenos Aires city (1996) (33)) 666666 5.6%5.6%
Salta city (Salta Prov) (2000) (Salta city (Salta Prov) (2000) (44)) 722722 3.3%3.3%
*General population studies *General population studies ::
Derqui city, (Bs As Prov) (2003) Derqui city, (Bs As Prov) (2003) (5)(5) 1 4721 472 0.87%0.87%
*General population with high endemicity *General population with high endemicity studies :studies :
O´Brien city (Bs As Prov) (1999)O´Brien city (Bs As Prov) (1999)(6)(6)
1 817 1 817
(79% total (79% total population)population)
5.6%5.6%
Wheelright city (Sta Fe Prov) (2004) Wheelright city (Sta Fe Prov) (2004) (7)(7)
1 8141 814
(31 % total (31 % total pop)pop)
4.9%4.9% 1.-Htal de Clínicas, Htal Ramos Mejía; Htal J. Méndez (Bs.As.) 2.- Sur de Santa Fe y E. Rios (Gualeguay)1.-Htal de Clínicas, Htal Ramos Mejía; Htal J. Méndez (Bs.As.) 2.- Sur de Santa Fe y E. Rios (Gualeguay) 3.- H. Argerich, H.Muñiz, H.Udaondo, y LNR-INEI-ANLIS C.G.Malbrán (Bs As) 4.-Htal del Milagro (Salta), Htal 3.- H. Argerich, H.Muñiz, H.Udaondo, y LNR-INEI-ANLIS C.G.Malbrán (Bs As) 4.-Htal del Milagro (Salta), Htal
Muñiz, y LNR-INEI- ANLIS C.G.Malbrán (Bs As) (Muñiz, y LNR-INEI- ANLIS C.G.Malbrán (Bs As) (Referenciados en el Consenso Argentino Hepatitis C – AAEEH Referenciados en el Consenso Argentino Hepatitis C – AAEEH (2004) (2004) 5.- O¨Flaherty et al. XIII Congreso Arg de Hepatología (2005) 6.-Soria et al, XI Congreso Arg de 5.- O¨Flaherty et al. XIII Congreso Arg de Hepatología (2005) 6.-Soria et al, XI Congreso Arg de Hepatología (2001) Hepatología (2001) ( Referenciado en el Consenso Arg Hepatitis C. AAEEH (2004)( Referenciado en el Consenso Arg Hepatitis C. AAEEH (2004) 7.-Bessone et al, XIII Congreso 7.-Bessone et al, XIII Congreso Arg de Hepatología (2005)Arg de Hepatología (2005)
HCV Prevalence studies HCV Prevalence studies
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
HEPATITIS C at the SUsHEPATITIS C at the SUs
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
HCC in HCC in Argentina.Argentina.
Etiology of chronic liver disease in Etiology of chronic liver disease in 551 cases with diagnosis of HCC551 cases with diagnosis of HCC..
HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HBV, hepatitis B virus;HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HBV, hepatitis B virus; PBC, primary biliary cirrhosis; AIH, autoimmune hepatitis.PBC, primary biliary cirrhosis; AIH, autoimmune hepatitis.
Fassio et al Acta G. Lat 2009 in pressFassio et al Acta G. Lat 2009 in press
*Retrospective survey 2005 – 2008*Retrospective survey 2005 – 2008From 15 Centers located at 5 provinces From 15 Centers located at 5 provinces
Median age : 62 years oldMedian age : 62 years old
93% underlying cirrhosis93% underlying cirrhosis
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
Fulminant H Cirrhosis HBV Cirrhosis HCV ALL causes
>= 18 years old
Since 2006 all people are potentialSince 2006 all people are potentialdonors by federal law donors by federal law
www.incucai.gov.ar (Access: March 2009) (Access: March 2009)
*Evaluation of 3 causes among 20 recorded at*Evaluation of 3 causes among 20 recorded at
1998 20081998 2008Dn rate* 6.81 13.06Dn rate* 6.81 13.06Tx rate* 3.72 6.82Tx rate* 3.72 6.82 * per M inhab* per M inhab
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
Washington USA. March 2009Washington USA. March 2009
SERVICIO HEPATITIS Y GASTROENTERITIS
DEPARTAMENTO VIROLOGIA
LABORATORIO NACIONAL DE REFERENCIALABORATORIO NACIONAL DE REFERENCIA
INSTITUTO NACIONAL DE ENFERMEDADES INFECCIOSAS (INEI)
ADMINISTRACION NACIONAL DE LABORATORIOS E INSTITUTOS DE SALUD (ANLIS)
““Dr. Carlos Gregorio Malbrán”Dr. Carlos Gregorio Malbrán”
Servicio Hepatitis y Servicio Hepatitis y GastroenteritisGastroenteritisLaboratorio Nacional de Laboratorio Nacional de ReferenciaReferenciaINEI-ANLIS “Dr. C. G. MALBRAN”INEI-ANLIS “Dr. C. G. MALBRAN”
Sunrise Symposium at 13Sunrise Symposium at 13thth ISVHLDISVHLD
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… … ARGENTINA, ARGENTINA, offers much more offers much more
than viral hepatitis than viral hepatitis … !! … !!