Publications by authors named "María B Pisano"

7 Publications

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Phylogeography and evolutionary history of hepatitis E virus genotype 3 in Argentina.

Trans R Soc Trop Med Hyg 2021 Mar 19. Epub 2021 Mar 19.

Instituto de Virología 'Dr J. M. Vanella', Facultad de Ciencias Médicas, Universidad Nacional de Córdoba. Enfermera Gordillo Gómez s/n. CP: 5016. Córdoba, Argentina.

Background: Few studies about the evolutionary history of the hepatitis E virus (HEV) have been conducted. The aim of our work was to investigate and make inferences about the origin and routes of dispersion of HEV-3 in Argentina.

Methods: Phylogenetic, coalescent and phylogeographic analyses were performed using a 322-bp ORF2 genomic fragment of all HEV-3 sequences with known date and place of isolation published at GenBank until May 2018 (n=926), including 16 Argentinian sequences (isolated from pigs, water and humans).

Results: Phylogenetic analysis revealed two clades within HEV-3: abchij and efg. All Argentinian samples were grouped intermingled within clade 3abchij. The coalescent analysis showed that the most recent common ancestor for the clade 3abchij would have existed around the year 1967 (95% highest posterior density (HPD): 1963-1970). The estimated substitution rate was 1.01×10-2 (95%HPD: 9.3×10-3-1.09×10-2) substitutions/site/y, comparable with the rate previously described. The phylogeographic approach revealed a correspondence between phylogeny and place of origin for Argentinian samples, suggesting many HEV introductions in the country, probably from Europe and Japan.

Conclusions: This is the first evolutionary inference of HEV-3 that includes Argentinian strains, showing the circulation of many HEV-3 subtypes, obtained from different sources and places, with recent diversification processes.

Accession Numbers: [KX812460], [KX812461], [KX812462], [KX812465], [KX812466], [KX812467], [KX812468], [KX812469].
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http://dx.doi.org/10.1093/trstmh/trab044DOI Listing
March 2021

Unexpected high seroprevalence of hepatitis E virus in patients with alcohol-related cirrhosis.

PLoS One 2019 24;14(10):e0224404. Epub 2019 Oct 24.

Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.

Introduction: Little is known about hepatitis E virus (HEV) infection in patients with cirrhosis. The aim of the present study was to describe the frequency of HEV infection and associated risk factors in patients with cirrhosis from Argentina.

Materials And Methods: We evaluated HEV seroprevalence (IgG anti-HEV) and acute infections (IgM and RNA) in patients with cirrhosis (n = 140) vs. healthy controls (n = 300). Additionally, we compared the same outcomes in individuals with alcohol-related cirrhosis (n = 43) vs. patients with alcohol use disorder (without cirrhosis, n = 72).

Results: The overall HEV seroprevalence in the cohort of subjects with cirrhosis was 25% (35/140), compared to 4% in the healthy control group [12/300; OR = 8; (95% CI = 4-15.99); p<0.05]. HEV seropositivity was significantly higher in alcohol-related cirrhosis compared to other causes of cirrhosis [39.5% vs. 12.4%; OR = 4.71; (95% CI = 1.9-11.6); p<0.05] and to healthy controls [OR = 15.7; (95% CI = 6.8-36.4); p = 0.0001]. The HEV seroprevalence in alcoholic-related cirrhosis vs. with alcohol use disorder was 39.5% vs. 12.5% [OR = 4.58; (95% CI = 1.81-11.58); p<0.001].

Conclusion: We found a high seroprevalence of HEV in patients with cirrhosis and in individuals with alcohol use disorder. The simultaneous presence of both factors (cirrhosis + alcohol) showed more association to HEV infection. Larger studies with prospective follow up are needed to further clarify this interaction.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224404PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812777PMC
March 2020

Environmental hepatitis E virus detection supported by serological evidence in the northwest of Argentina.

Trans R Soc Trop Med Hyg 2018 04;112(4):181-187

Instituto de Virología 'Dr. J. M. Vanella', Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, CONICET, Enfermera Gordillo Gómez s/n, Ciudad Universitaria, X5016, Córdoba, Argentina.

Background: Hepatitis E virus (HEV) is an emergent cause of acute hepatitis worldwide. Water contamination is a possible source of viral infection. In South America, particularly in Argentina, little is known about environmental HEV circulation, including recreational water. The aim of this work was to provide evidence of current environmental and human circulation of HEV in northern Argentina.

Methods: Molecular detection of HEV in water samples from the Arias-Arenales River in the city of Salta by nested polymerase chain reaction (ORF2 region) and anti-HEV immunoglobulin G (IgG) and IgM detection in the general population by enzyme-linked immunosorbent assay was carried out.

Results: HEV RNA was detected in 1.6% (3/189) of the environmental samples. All sequences belonged to HEV genotype 3 and were very similar to those previously detected in the country. The prevalence of IgG anti-HEV was 9% (13/143) and three samples were positive for specific IgM.

Conclusions: Circulation of HEV in the northwest of Argentina was demonstrated for the first time, showing viral presence in environmental samples and infections in people who attended health care centres for routine control. These findings show that recreational waters are a possible source of virus and highlight the need to carry out HEV detection when a case of hepatitis occurs.
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http://dx.doi.org/10.1093/trstmh/try048DOI Listing
April 2018

Hepatitis E virus in South America: The current scenario.

Liver Int 2018 09 9;38(9):1536-1546. Epub 2018 Jun 9.

Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.

Hepatitis E virus (HEV) is one of the most frequent causes of acute viral hepatitis of enteric transmission worldwide. In South America the overall epidemiology has been little studied, and the burden of the disease remains largely unknown. A research of all scientific articles about HEV circulation in South America until November 2017 was carried out. Human seroprevalences of HEV varied according to the studied population: blood donors presented prevalence rates ranging from 1.8% to 9.8%, while reports from HIV-infected individuals, transplant recipients and patients on hemodialysis showed higher prevalence rates. Only 2 cases of chronic hepatitis in solid-organ transplant patients from Argentina and Brazil have been described. Detection of HEV in the swine population is widely prevalent in the region. Anti-HEV antibodies have also been recently documented in wild boars from Uruguay. Although scarce, studies focused on environmental and food HEV detection have shown viral presence in these kind of samples, highlighting possible transmission sources of HEV in the continent. HEV genotype 3 was the most frequently detected in the region, with HEV genotype 1 detected only in Venezuela and Uruguay. HEV is widely distributed throughout South America, producing sporadic cases of acute hepatitis, but as a possible agent of chronic hepatitis. Finding the virus in humans, animals, environmental samples and food, show that it can be transmitted through many sources, alerting local governments and health systems to improve diagnosis and for the implementation of preventive measures.
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http://dx.doi.org/10.1111/liv.13881DOI Listing
September 2018

Environmental Surveillance of Enteroviruses in Central Argentina: First Detection and Evolutionary Analyses of E14.

Food Environ Virol 2018 03 24;10(1):121-126. Epub 2017 Aug 24.

Facultad de Ciencias Médicas, Instituto de Virología "Dr. J. M. Vanella", Universidad Nacional de Córdoba, Enfermera Gordillo Gómez s/n Ciudad Universitaria, 5016, Córdoba, Argentina.

Environmental surveillance is an effective approach to investigate the circulation of human enteroviruses in the population. Enteroviruses E14, CVA9, E-6, E16, E20, E25, E13, and CVA24 were detected in sewage and a watercourse in central Argentina. E14 was the most frequent serotype and was found for the first time in environmental samples in our region. Phylogenetic and coalescence analyses showed at least two recent introduction events.
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http://dx.doi.org/10.1007/s12560-017-9318-0DOI Listing
March 2018

First detection of hepatitis E virus in Central Argentina: environmental and serological survey.

J Clin Virol 2014 Nov 27;61(3):334-9. Epub 2014 Aug 27.

Department of Virology, School of Chemical Sciences, Catholic University of Córdoba, Argentina; Virology Institute "Dr. J.M. Vanella", School of Medical Sciences, National University of Córdoba, Argentina. Electronic address:

Background: The hepatitis E virus (HEV) is an emergent causative agent of acute hepatitis worldwide, transmitted by fecal-oral route. In Argentina it is considered rare, so differential laboratory testing is not routinely performed. Besides, in Argentina's central area epidemiological and molecular characteristics of HEV are still unknown.

Objectives: Provide evidence of local circulation of HEV by molecular detection on environmental samples and by serological survey in healthy adult population of Córdoba city, Argentina.

Study Design: Environmental surveillance was conducted in river and sewage samples collected between 2007 and 2009-2011. Viral detection was performed by RT-Nested PCR of ORF-1 and ORF-2 partial regions. Anti-HEV IgG was determined by EIA in 433 serum samples collected between 2009 and 2010.

Results: HEV was detected in 6.3% of raw sewage samples and in 3.2% of riverine samples. Nucleotide sequencing analyses revealed that all isolates belonged to genotype 3, subtypes a, b and c. The prevalence of IgG anti-HEV was 4.4%. Seroprevalence increased with the age of the individuals (OR: 3.50; 95% CI 1.39-8.87; p=0.0065) and, although the prevalence was higher in low income population, no statistical relation was found between anti-HEV and socioeconomic level.

Conclusions: The environmental findings added to serological results, demonstrate that HEV circulates in central Argentina. Contamination of water with HEV could represent a route of transmission for local populations, which have a high number of susceptible individuals. This fact alerts local health care systems in order to include detection of HEV in the diagnostic algorithm of viral hepatitis.
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http://dx.doi.org/10.1016/j.jcv.2014.08.016DOI Listing
November 2014

Phylodynamics of hepatitis C virus subtype 2c in the province of Córdoba, Argentina.

PLoS One 2011 18;6(5):e19471. Epub 2011 May 18.

Facultad de Ciencias Médicas, Instituto de Virología, Universidad de Córdoba, Córdoba, Argentina.

The Hepatitis C Virus Genotype 2 subtype 2c (HCV-2c) is detected as a low prevalence subtype in many countries, except in Southern Europe and Western Africa. The current epidemiology of HCV in Argentina, a low-prevalence country, shows the expected low prevalence for this subtype. However, this subtype is the most prevalent in the central province of Córdoba. Cruz del Eje (CdE), a small rural city of this province, shows a prevalence for HCV infections of 5%, being 90% of the samples classified as HCV-2c. In other locations of Córdoba Province (OLC) with lower prevalence for HCV, HCV-2c was recorded in about 50% of the samples. The phylogenetic analysis of samples from Córdoba Province consistently conformed a monophyletic group with HCV-2c sequences from all the countries where HCV-2c has been sequenced. The phylogeographic analysis showed an overall association between geographical traits and phylogeny, being these associations significant (α = 0.05) for Italy, France, Argentina (places other than Córdoba), Martinique, CdE and OLC. The coalescence analysis for samples from CdE, OLC and France yielded a Time for the Most Common Recent Ancestor of about 140 years, whereas its demographic reconstruction showed a "lag" phase in the viral population until 1880 and then an exponential growth until 1940. These results were also obtained when each geographical area was analyzed separately, suggesting that HCV-2c came into Córdoba province during the migration process, mainly from Europe, which is compatible with the history of Argentina of the early 20th century. This also suggests that the spread of HCV-2c occurred in Europe and South America almost simultaneously, possibly as a result of the advances in medicine technology of the first half of the 20th century.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0019471PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097208PMC
September 2011
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