scholarly journals TREND OF ACUTE HEPATITIS A IN THE STATE OF BAHIA, BRAZIL OVER A 5-YEAR PERIOD

2017 ◽  
Vol 5 (4) ◽  
pp. 169-175
Author(s):  
Felicidade Mota Pereira ◽  
Maria Conceição Chagas Almeida ◽  
Monique Lírio ◽  
Maria Fernanda Rios Grassi

ABSTRACT INTRODUCTION: Hepatitis A virus (HAV) has a universal distribution. The prevalence of HAV infection varies greatly according to hygiene and sanitary conditions.OBJECTIVE: To determine the proportion of acute infection of HAV in the state of Bahia during a 5-year period. METHODS: This study was conducted at Central Public Health Laboratory of Bahia (LACEN-BA). All individuals referred for anti-HAV IgM serology from 417 municipalities from January, 2009 to December, 2013 were included.  Percentages of HAV positive cases were presented according to age range for each year of the 5-year study and for each of the nine health districts (RHC) of Bahia.RESULTS: 21,175 samples were analyzed. Proportion of HAV infection was 7.2% (1,535 / 21,175) throughout the study period. The highest proportion was in 2009 (17.4%) and the lowest in 2012 (3.8%), demonstrating a decreasing trend (r = 0.7). The highest infection rates was found in children up to 10 years old. HAV infection was more frequent among males among all age groups. 52.4% (184/351) of the municipalities had acute HAV cases diagnosed. The North and West regions had the highest number of cases. CONCLUSION: There was a progressive decrease of approximately 70% in the proportion of acute HAV infection in the state of Bahia during a five-year assessment period. However, children up to 10 years old remain at higher risk, therefore the vaccine should be expanded to reach this age range.  

2018 ◽  
Vol 95 (1) ◽  
pp. 75-77 ◽  
Author(s):  
Anne Boucher ◽  
Agnes Meybeck ◽  
Kazali Alidjinou ◽  
Thomas Huleux ◽  
Nathalie Viget ◽  
...  

ObjectivesSince February 2017, an increase of acute hepatitis A (AHA) cases has been notified in North of France. We aimed to report clinical and virological features of 49 cases treated in three hospitals in Lille European Metropolis (LEM).MethodsAll adult patients treated for AHA in 3 LEM hospitals between 20 February and 5 July 2017 were included. Demographic characteristics, exposure risk factors to hepatitis A virus (HAV), AHA manifestations and concomitant sexually transmitted infections (STI) were retrospectively recorded.ResultsForty-nine cases of AHA were diagnosed among which 34 (69%) were hospitalised. Severe AHA occurred in 7 (14%) patients. The median age of cases was 36 years. All cases except 1 were men and 32 (65%) were identified as men having sex with men (MSM). Eleven (23%) patients were HIV-infected, 5 were under HIV pre-exposure prophylaxis (PrEP), 6 had a history of HIV postexposure prophylaxis and 19 had a history of at least one STI. Only three patients had received HAV vaccine. Proportion of patients tested for syphilis, chlamydial and gonococcal infections was 75% (18/24) in those seen by sexual health specialists and 21% (6/29) in those seen by other specialists. At least one concomitant STI was diagnosed in 13 out of 24 tested patients (54%). RT-PCR sequencing was available for 38 cases and confirmed co-circulation of 3 different strains of subgenotype IA (VRD 521 2016: n=24, RIVM-HAV16-090: n=13, V16-25801: n=1), already identified in several European countries.ConclusionsWe are facing an outbreak of AHA among MSM in the North of France with a high rate of hospitalisation. Analysis of cases highlighted missed opportunities of vaccination and lack of concomitant STI screening. Awareness among healthcare providers and MSM should be increased and HAV vaccination promoted.


2018 ◽  
Vol 69 (5) ◽  
pp. 1125-1128
Author(s):  
Daniela G. Balan ◽  
Dan Piperea Sianu ◽  
Iulia I. Stanescu ◽  
Dorin Ionescu ◽  
Andra Elena Stroescu Balcangiu ◽  
...  

Assessment of changes in total proteins level, serum and saliva IgG and IgA levels, serum IgM level, serum and saliva IgA/IgG ratio. The study was conducted on a group of 40 subjects, divided into 2 lots: the first lot consisting of 20 healthy individuals and the second consisting of 20 patients with hepatitis with hepatitis A virus (HAV). The levels of total proteins, serum and saliva IgG and IgA, serum IgM and serum and saliva IgA/IgG ratio have higher values in patients with hepatitis A, in comparison to healthy subjects, without necessarily exceeding the maximum admitted value. The results are significant from a statistical point of view. Due to the sensitivity and specificity of salivary anti-HAV IgM and IgG in patients with acute hepatitis A, compared with healthy subjects, there is a possibility of using salivary immunological tests instead of serum tests for the diagnosis and epidemiological study of HAV infection.


2001 ◽  
Vol 12 (6) ◽  
pp. 341-344 ◽  
Author(s):  
Jun Wu ◽  
Shimian Zou ◽  
Antonio Giulivi

Hepatitis A, caused by the hepatitis A virus, occurs most frequently in developing countries, but also causes sporadic cases or outbreaks in industrialized countries. The most common route of transmission is fecal-oral. The incidence of hepatitis A varies with geography, and economic and environmental conditions. The epidemiological pattern of the disease has changed with improvements in hygiene and economic conditions. The incidence and prevalence of hepatitis A has decreased, while the average age of exposure and subsequent infection has increased. The present report describes the current status of hepatitis A in Canada. The incidence rate of reported cases in Canada varies from over 10/100,000 (1991) to 3.6/100,000 (1998), and is higher in males, 4.7/100,000 (1998), than in females, 2.5/100,000 (1998). The highest reported hepatitis A rates are in age groups 30 to 39 years and 40 to 59 years, and in British Columbia. Such information is important for assessing current immunization approaches and for decision-making about new preventive strategies against hepatitis A in Canada.


2016 ◽  
Vol 10 ◽  
Author(s):  
Elena Garlatti Costa ◽  
Michela Ghersetti ◽  
Silvia Grazioli ◽  
Pietro Casarin

Acute hepatitis A is generally a self-limited disease in healthy subjects within few weeks, but an uncommon type of prolonged and biphasic acute course of hepatitis A infection has been also described. This type of presentation is observed in about 6-10% of patients, but a small number of reports, concerning this topic, are available in literature. In addition hepatitis A virus (HAV) infection in hepatitis B virus (HBV) carriers has rarely been discussed. A 41-year-old Italian man, already known to our Department for HBV infection as an inactive carrier HBsAg(+)ve, experienced a prolonged and biphasic course of acute hepatitis A, lasting about 7 months. In this patient possible factors, causing the second flare of transaminases, were excluded (in particular autoimmunity). Liver biopsy as well HAV RNA search in blood/stools were not performed. In conclusion, the hepatologist should take into account this type of atypical course in patients with HAV-related hepatitis and should promote HAV vaccination in subjects with HBV-chronic hepatitis, to prevent possible life-threatening acute exacerbation of hepatic damage, mainly in HBV-carriers with more severe forms of liver diseases.


2014 ◽  
Vol 19 (30) ◽  
Author(s):  
V Hall ◽  
A Abrahams ◽  
D Turbitt ◽  
S Cathcart ◽  
H Maguire ◽  
...  

Identification of acute hepatitis A virus (HAV) infection in a foodhandler in a London hotel led to a large incident response. We identified three potentially exposed groups: hotel staff who had regularly consumed food prepared by the case and shared toilet facilities with the case, patients who shared the same hospital ward as the case and hotel guests who consumed food prepared by the case. We arranged post-exposure HAV vaccination for all 83 potentially exposed hotel staff and all 17 patients. We emailed 887 guests advising them to seek medical care if symptomatic, but did not advise vaccination as it was too late to be effective for most guests. Through the International Health Regulations national focal points and the European Union Early warning and response system (EWRS), we communicated the details of the incident to public health agencies and potential risk of HAV transmission to international guests. Potentially exposed hotel staff and guests were asked to complete an online or telephone-administered questionnaire 50 days following possible exposure, to identify any secondary cases. Survey response was low, with 155 responses from guests and 33 from hotel staff. We identified no secondary cases of HAV infection through follow-up.


2021 ◽  
Author(s):  
Ichiro Misumi ◽  
Zhucui Li ◽  
Lu Sun ◽  
Anshuman Das ◽  
Tomoyuki Shiota ◽  
...  

Iminosugar compounds are monosaccharide mimetics with broad but generally weak antiviral activities related to inhibition of enzymes involved in glycobiology. Miglustat (N-butyl-1-deoxynojirimycin), which is approved for treatment of lipid storage diseases in humans, and UV-4 (N-(9-methoxynonyl)-1-deoxynojirimycin), inhibit replication of hepatitis A virus (HAV) in cell culture (IC50 32.13 μM and 8.05 μM, respectively) by blocking the synthesis of gangliosides essential for HAV cell entry. We used a murine model of hepatitis A and targeted mass spectrometry to assess the capacity of these compounds to deplete hepatic gangliosides and modify the course of HAV infection in vivo. Miglustat, given by gavage to Ifnar1-/- mice (4800 mg/kg/day) depleted hepatic gangliosides by 69-75%, but caused substantial gastrointestinal toxicity and failed to prevent viral infection. UV-4, similarly administered in high doses (400 mg/kg/day), was well tolerated, but depleted hepatic gangliosides by only 20% after 14 days. UV-4 depletion of gangliosides varied by class. Several GM2 species were paradoxically increased, likely due to inhibition of β-glucosidases that degrade gangliosides. Both compounds enhanced, rather than reduced, virus replication. Nonetheless, both iminosugars had surprising anti-inflammatory effects, blocking the accumulation of inflammatory cells within the liver. UV-4 treatment also resulted in a decrease in serum alanine aminotransferase (ALT) elevations associated with acute hepatitis A. These anti-inflammatory effects may result from iminosugar inhibition of cellular α-glucosidases, leading to impaired maturation of glycan moieties of chemokine and cytokine receptors, and point to the potential importance of paracrine signaling in the pathogenesis of acute hepatitis A. IMPORTANCE Hepatitis A virus (HAV) is a common cause of viral hepatitis. Iminosugar compounds block its replication in cultured cells by inhibiting synthesis of gangliosides required for HAV cell entry, but have not been tested for their ability to prevent or treat hepatitis A in vivo. We show that high doses of the iminosugars miglustat and UV-4 fail to deplete gangliosides sufficiently to block HAV infection in mice lacking a key interferon receptor. These compounds nonetheless have striking anti-inflammatory effects on the HAV-infected liver, reducing the severity of hepatitis despite enhancing chemokine and cytokine expression resulting from hepatocyte-intrinsic antiviral responses. We propose that iminosugar inhibition of cellular α-glucosidases impairs maturation of glycan moieties of chemokine and cytokine receptors required for effective signaling. These data highlight the potential importance of paracrine signaling pathways in the inflammatory response to HAV, and add to our understanding of HAV pathogenesis in mice.


2019 ◽  
Vol 34 (10) ◽  
pp. 1836-1842 ◽  
Author(s):  
Tomomi Kogiso ◽  
Takaomi Sagawa ◽  
Mayuko Oda ◽  
Somura Yoshiko ◽  
Kazuhisa Kodama ◽  
...  

mBio ◽  
2016 ◽  
Vol 7 (6) ◽  
Author(s):  
Asuka Hirai-Yuki ◽  
Lucinda Hensley ◽  
Jason K. Whitmire ◽  
Stanley M. Lemon

ABSTRACTHepatitis A virus (HAV) is an unusual picornavirus that is released from cells cloaked in host-derived membranes. These quasi-enveloped virions (eHAV) are the only particle type circulating in blood during infection, whereas only nonenveloped virions are shed in feces. The reason for this is uncertain. Hepatocytes, the only cell type known to support HAV replicationin vivo, are highly polarized epithelial cells with basolateral membranes facing onto hepatic (blood) sinusoids and apical membranes abutting biliary canaliculi from which bile is secreted to the gut. To assess whether eHAV and nonenveloped virus egress from cells via vectorially distinct pathways, we studied infected polarized cultures of Caco-2 and HepG2-N6 cells. Most (>99%) progeny virions were released apically from Caco-2 cells, whereas basolateral (64%) versus apical (36%) release was more balanced with HepG2-N6 cells. Both apically and basolaterally released virions were predominantly enveloped, with no suggestion of differential vectorial release of eHAV versus naked virions. Basolateral to apical transcytosis of either particle type was minimal (<0.02%/h) in HepG2-N6 cells, arguing against this as a mechanism for differences in membrane envelopment of serum versus fecal virus. High concentrations of human bile acids converted eHAV to nonenveloped virions, whereas virus present in bile from HAV-infectedIfnar1−/−Ifngr1−/−andMavs−/−mice banded over a range of densities extending from that of eHAV to that of nonenveloped virions. We conclude that nonenveloped virions shed in feces are derived from eHAV released across the canalicular membrane and stripped of membranes by the detergent action of bile acids within the proximal biliary canaliculus.IMPORTANCEHAV is a hepatotropic, fecally/orally transmitted picornavirus that can cause severe hepatitis in humans. Recent work reveals that it has an unusual life cycle. Virus is found in cell culture supernatant fluids in two mature, infectious forms: one wrapped in membranes (quasi-enveloped) and another that is nonenveloped. Membrane-wrapped virions circulate in blood during acute infection and are resistant to neutralizing antibodies, likely facilitating HAV dissemination within the liver. On the other hand, virus shed in feces is nonenveloped and highly stable, facilitating epidemic spread and transmission to naive hosts. Factors controlling the biogenesis of these two distinct forms of the virus in infected humans are not understood. Here we characterize vectorial release of quasi-enveloped virions from polarized epithelial cell cultures and provide evidence that bile acids strip membranes from eHAV following its secretion into the biliary tract. These results enhance our understanding of the life cycle of this unusual picornavirus.


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