101
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Irving GJ, Holden J, Yang R, Pope D. Hepatitis A immunisation in persons not previously exposed to hepatitis A. Cochrane Database Syst Rev 2019; 12:CD009051. [PMID: 31846062 PMCID: PMC6916710 DOI: 10.1002/14651858.cd009051.pub3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This review is withdrawn because it is outdated. A new review is to be published by the end of 2019.
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Affiliation(s)
- Greg J Irving
- University of CambridgeDepartment of Public Health and Primary CareForvie Site, Robinson WayCambridge Biomedical CampusCambridgeCambridgeshireUKCB2 0SR
| | - John Holden
- Garswood SurgeryStation RoadGarswoodSt. HelensMerseysideUKWND 0SD
| | - Rongrong Yang
- Peking UniversityInstitute of Population ResearchYiheyuanroad 5Haidian DistrictBeijingChina100871
| | - Daniel Pope
- University of LiverpoolHealth Inequalities and the Social Determinants of HealthLiverpoolUKL69 3GB
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102
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Agrawal A, Singh S, Kolhapure S, Hoet B, Arankalle V, Mitra M. Increasing Burden of Hepatitis A in Adolescents and Adults and the Need for Long-Term Protection: A Review from the Indian Subcontinent. Infect Dis Ther 2019; 8:483-497. [PMID: 31679118 PMCID: PMC6856242 DOI: 10.1007/s40121-019-00270-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Indexed: 02/06/2023] Open
Abstract
Hepatitis A, an acute inflammatory liver disease caused by hepatitis A virus (HAV) infection from close contact with infected people, is highly endemic in the Indian subcontinent. Due to poor sanitary conditions, most of the population is exposed to the virus in childhood. At this age, the disease is asymptomatic and provides life-long protection against the disease. Due to rapid socioeconomic development in some areas, however, pockets of the population are reaching adolescence/adulthood without prior exposure to the virus and are thus susceptible to infection. At these ages, infection carries a higher risk of symptomatic disease and complications including mortality. This review of epidemiology and burden of disease studies in the Indian subcontinent, published since 2005, shows increasing evidence of a shift from high to intermediate endemicity in high-income-typically urban-populations. The prevalence of anti-HAV antibodies (previously reported at > 90%) is lower now in adolescents and young adults (e.g., around 80% in Bangladesh and 55% in 5-15 years in India). As a result, HAV is responsible for more acute viral hepatitis predominantly in this age group (e.g., > 15 years: 3.4% in 1999 to 12.3% in 2003 or high socioeconomic status 13-20 years: 27% in 1999 to 62% in 2003), with a greater clinical and economic burden. Numerous outbreaks due to HAV have been reported [e.g., Sri Lanka (2009-2010): > 13,000 affected; Kashmir (2015-2017): 12 outbreaks; Kerala (2012-2016): 84 outbreaks] from water or food contamination. Due to current shifts in endemicity, a growing proportion of the population is no longer exposed in childhood. As the disease remains highly endemic, it also provides a source for more severe disease in susceptible people at an older age and for outbreaks. Well-tolerated and effective vaccines are available and help prevent disease burden and provide long-term protection. These should now be used more widely to protect more patients from the growing disease burden of hepatitis A. FUNDING: GlaxoSmithKline Biologicals SA. Plain language summary available for this article-please see Fig. 1 and the following link: https://doi.org/10.6084/m9.figshare.9963044.Fig. 1Plain Language Summary. Highlights the context of the article, the endemicity shift and the burden of hepatitis A in adolescents and adults and steps to be taken to address the impact of this disease.
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103
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Kim H, Ryu J, Lee YK, Choi MJ, Cho A, Koo JR, Baik SY, Lee EH, Yoon JW, Noh JW. Seropositive rate of the anti-hepatitis A immunoglobulin G antibody in maintenance hemodialysis subjects from two hospitals in Korea. Korean J Intern Med 2019; 34:1297-1303. [PMID: 29466851 PMCID: PMC6823562 DOI: 10.3904/kjim.2017.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/25/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Hepatitis A virus (HAV) is a self-limiting infectious disease, but 1% of subjects develop fulminant hepatitis. The prevalence of the anti-HAV immunoglobulin G (IgG) antibody in hemodialysis subjects in Korea remains unknown. The purpose of this study was to describe and compare the seropositive rate of anti-HAV antibody among hemodialysis subjects in two hospitals according to age group. METHODS A total of 170 hemodialysis subjects were evaluated for the seropositive rate of the anti-HAV IgG antibody and its titer. RESULTS Of the 170 maintenance hemodialysis subjects in two hospitals (Kangnam 92 vs. Chuncheon 78), 79 (46.5%) were male. The mean age was 53.2 years old, and 94.1% of the subjects were over 40 years old. The median vintage of hemodialysis was 29.0 months. Anti-HAV antibody was found in 163 subjects (95.9%), with no significant difference between the two areas (Kangnam 97.8% [n = 90] vs. Chuncheon 93.6% [n = 73]). Subjects younger than 40 years old showed a seropositive rate of 50%, while the seropositive rate increased with age for subjects aged 40 or older (p for trend < 0.001). Seropositive subjects from Kangnam showed a higher anti-HAV antibody titer than those from Chuncheon (median: Kangnam 14.2 vs. Chuncheon 11.7). Only age influenced seropositivity. The only factor that influenced the antibody level was the location of hospital (p < 0.001). CONCLUSION The seropositive rate of the anti-HAV antibody in hemodialysis subjects was 95%, which is similar to findings in the general population. Active immunization against hepatitis A is strongly recommended for hemodialysis subjects under 40 years of age after anti-HAV testing.
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Affiliation(s)
- Hyunsuk Kim
- Division of Nephrology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Jiwon Ryu
- Division of Nephrology, Department of Internal Medicine, Cheju Halla Hospital; Jeju, Korea
| | - Young-Ki Lee
- Division of Nephrology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Myung Jin Choi
- Division of Nephrology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Ajin Cho
- Division of Nephrology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Ja-Ryong Koo
- Division of Nephrology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Sae Yun Baik
- Laboratory Medicine, Green Cross Laboratories, Youngin, Korea
| | - Eun Hee Lee
- Laboratory Medicine, Green Cross Laboratories, Youngin, Korea
| | - Jong-Woo Yoon
- Division of Nephrology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Jung-Woo Noh
- Division of Nephrology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
- Correspondence to Jung-Woo Noh, M.D Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University Kangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea Tel: +82-2-829-5108 Fax: +82-2-846-4669 E-mail:
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104
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Styles CE, Hoad VC, Kiely P, Seed CR, Gosbell IB. Blood safety assessment of hepatitis A outbreak linked to frozen pomegranate arils: are foodborne outbreaks an emerging blood safety risk? Transfusion 2019; 59:3683-3688. [PMID: 31642534 DOI: 10.1111/trf.15548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/05/2019] [Accepted: 09/10/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Foodborne hepatitis A virus (HAV) outbreaks are becoming more common in high-income countries with low HAV incidence, and the associated blood safety risk may not be adequately mitigated by routine HAV risk mitigation strategies. This study describes the rapid risk modeling undertaken in response to a 2018 HAV outbreak in Australia associated with imported frozen pomegranate arils. STUDY DESIGN AND METHODS The input parameters used in the modeling were the outbreak-associated HAV incidence, duration of viremia, population seroprevalence, and rate of symptomatic infection in adults. The number and risk of viremic components issued, cases of transfusion transmission, and symptomatic infections among recipients were estimated. RESULTS The incidence of pomegranate-associated HAV infection among donors was very low, with fewer than 0.1 viremic fresh components estimated to have been released during the risk period. The risk of this event was less than one in 500,000, and the risks of transfusion transmission and symptomatic illness in recipients were less than one in one million. When considering only donors who had consumed the pomegranate product, the risk was much higher, with approximately one in 1000 components estimated to be viremic. CONCLUSION Rapid risk assessment indicated that the overall risk to blood safety associated with a small foodborne outbreak of HAV was negligible. Because fresh components collected from donors known to have consumed the affected product were at high risk, these donors were identified via signage in donor centers and deferred. The contribution of factors other than outbreak size to risk management decisions is discussed.
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Affiliation(s)
- Claire E Styles
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Veronica C Hoad
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Philip Kiely
- Clinical Services and Research, Australian Red Cross Blood Service, Melbourne, Victoria, Australia
| | - Clive R Seed
- Clinical Services and Research, Australian Red Cross Blood Service, Perth, Western Australia, Australia
| | - Iain B Gosbell
- Clinical Services and Research, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.,School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
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105
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Kadri SM, Rehman SU, Rehana K, Benetou DR, Ahmad DF, Abdullah A, Chattu VK. Hepatitis A and E Outbreak Surveillance during 2015-2017 in Kashmir, India: Is the Water to Blame? J Epidemiol Glob Health 2019; 8:203-207. [PMID: 30864764 PMCID: PMC7377564 DOI: 10.2991/j.jegh.2018.04.101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/28/2018] [Indexed: 01/17/2023] Open
Abstract
Waterborne diseases, such as hepatitis A and E, are a major public health concern in most developing countries, indicating the need for proper outbreak prevention, surveillance, and timely management. This study presents data regarding the prevalence and epidemiological characteristics of hepatitis A and E outbreaks as well as water quality in Kashmir, India, during 2015–2017. Hepatitis outbreaks were initially investigated by rapid response teams, under the Integrated Disease Surveillance Programme. Suspected cases were further evaluated by blood sampling to confirm the disease along with water sampling evaluation. Between 2015 and 2017, 23 disease outbreaks were recorded; among these, four outbreaks occurred in 2015, 12 in 2016, and seven in 2017. Specifically, 12 of the total outbreaks were concerned with hepatitis A infection, 10 concerned hepatitis E infection, and one involved eight cases of jaundice with neither hepatitis A virus nor hepatitis A virus detected in blood sampling. Overall, during the aforementioned period, 393 cases of hepatitis A or E were detected. Regarding water quality, which was evaluated using the most probable number method for counting coliform, 38 of 50 water samples were found to be unfit for human consumption and one source was found to be suspicious. This study of prevalence and epidemiology of hepatitis A and E along with its relationship with water quality and socioeconomic factors, such as poor hygiene and lack of access to safe water, aids toward the implementation of effective preventive sanitary measures and public health actions.
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Affiliation(s)
| | | | - Kausar Rehana
- Division of Epidemiology, Directorate of Health Services, Kashmir, India
| | | | | | - Afshan Abdullah
- Division of Epidemiology and Public Health, Integrated Disease Surveillance Programme, Barzulla, Kashmir, India
| | - Vijay Kumar Chattu
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
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106
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Velebit B, Djordjevic V, Milojevic L, Babic M, Grkovic N, Jankovic V, Yushina Y. The common foodborne viruses: A review. ACTA ACUST UNITED AC 2019. [DOI: 10.1088/1755-1315/333/1/012110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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107
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Kwon JH, Kim HH, Cho HB, Cha YJ, Lee J. Viral antigen nanoparticles for discriminated and quantitative detection of different subtypes of anti-virus immunoglobulins. NANOSCALE 2019; 11:18282-18289. [PMID: 31573015 DOI: 10.1039/c9nr06160f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The aim of this study is to develop a novel method for the accurate diagnosis of the infection status of viral diseases, which requires discriminated and quantitative detection of different anti-virus immunoglubulin subtypes. Considering hepatitis A as a representative model disease, viral antigen nanoparticles (vAgNPs) were designed and synthesized by genetically presenting hepatitis A virus (HAV) antigens on the surface of human heavy chain ferritin (hFTH) nanoparticles to detect anti-HAV antibodies with discriminating immunoglobulin subtypes M and G (IgM and IgG, respectively). The vAgNPs also display multi-copies of hexa-histidine peptide (H6) on their surface to chemisorb gold ions (Au3+), which is vital for the autonomous generation of quantitatively meaningful detection signals. The quantitative level of anti-HAV IgM or IgG in 30 patient sera was successfully analyzed using the vAgNPs of HAV, which was performed through label-free one-step-immunoassay based on the self-enhancement of optical signals from gold nanoparticles clustered on the viral antigen nanoparticles. The diagnostic performance was compared with that of enzyme-linked immunosorbent assay (ELISA), which did not enable accurate quantitative assay due to the poor linearity between the antibody concentration and detection signal. Furthermore, these vAgNP-based immunoassays did not produce any false negative/positive signals, indicating 100% sensitivity and 100% specificity.
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Affiliation(s)
- J-H Kwon
- Department of Chemical and Biological Engineering, College of Engineering, Korea University, Anam-Ro 145, Seoul 136-713, Republic of Korea.
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108
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Kroneman A, de Sousa R, Verhoef L, Koopmans MPG, Vennema H, On Behalf Of The HAVNet Network. Usability of the international HAVNet hepatitis A virus database for geographical annotation, backtracing and outbreak detection. ACTA ACUST UNITED AC 2019; 23. [PMID: 30229723 PMCID: PMC6144472 DOI: 10.2807/1560-7917.es.2018.23.37.1700802] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
HAVNet is an international laboratory network sharing sequences and corresponding metadata on hepatitis A virus in an online database. Aim: We give an overview of the epidemiological and genetic data and assess the usability of the present dataset for geographical annotation, backtracing and outbreak detection. Methods: A descriptive analysis was performed on the timeliness, completeness, epidemiological data and geographic coverage of the dataset. Length and genomic region of the sequences were reviewed as well as the numerical and geographical distribution of the genotypes. The geographical signal in the sequences was assessed based on a short common nt stretch using a 100% identity analysis. Results: The 9,211 reports were heterogeneous for completeness and timeliness, and for length and genomic region of the sequences. Some parts of the world were not represented by the sequences. Geographical differences in prevalence of HAV genotypes described previously could be confirmed with this dataset and for a third (1,075/3,124) of the included sequences, 100% identity of the short common sequence coincided with an identical country of origin. Conclusion: Analysis of a subset of short, shared sequences indicates that a geographical annotation on the level of individual countries is possible with the HAVNet data. If the current incompleteness and heterogeneity of the data can be improved on, HAVNet could become very useful as a worldwide reference set for geographical annotation and for backtracing and outbreak detection.
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Affiliation(s)
- Annelies Kroneman
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Rita de Sousa
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Linda Verhoef
- Office for Risk Assessment and Research, Netherlands Food and Consumer Product Safety Authority (NVWA), Utrecht, the Netherlands (current affiliation).,National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Harry Vennema
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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109
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Enkirch T, Eriksson R, Persson S, Schmid D, Aberle SW, Löf E, Wittesjö B, Holmgren B, Johnzon C, Gustafsson EX, Svensson LM, Sandelin LL, Richter L, Lindblad M, Brytting M, Maritschnik S, Tallo T, Malm T, Sundqvist L, Ederth JL. Hepatitis A outbreak linked to imported frozen strawberries by sequencing, Sweden and Austria, June to September 2018. ACTA ACUST UNITED AC 2019; 23. [PMID: 30326994 PMCID: PMC6194910 DOI: 10.2807/1560-7917.es.2018.23.41.1800528] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Between June–September 2018, 20 hepatitis A cases were notified in six counties in Sweden. Combined epidemiological and microbiological investigations identified imported frozen strawberries produced in Poland as the source of the outbreak. Sequence analysis confirmed the outbreak strain IB in the strawberries with 100 % identity and the respective batch was withdrawn. Sharing the sequence information internationally led to the identification of 14 additional cases in Austria, linked to strawberries from the same producer.
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Affiliation(s)
- Theresa Enkirch
- European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Public Health Agency of Sweden, Solna, Sweden
| | | | | | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Stephan W Aberle
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Emma Löf
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden.,Public Health Agency of Sweden, Solna, Sweden
| | - Bengt Wittesjö
- Department of Communicable Disease Control and Prevention, Blekinge County, Sweden
| | - Birgitta Holmgren
- Department of Communicable Disease Control and Prevention, Skåne County, Sweden
| | - Charlotte Johnzon
- The Environment and Health Administration of Stockholm Municipality, Stockholm, Sweden
| | - Eva X Gustafsson
- Department of Communicable Disease Control and Prevention, Skåne County, Sweden
| | - Lena M Svensson
- Department of Communicable Disease Control and Prevention, Östergötland County, Sweden
| | - Lisa Labbé Sandelin
- Department of Communicable Disease Control and Prevention, Kalmar County, Sweden
| | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | | | | | - Therese Malm
- Department of Communicable Disease Control and Prevention, Gävleborg County, Sweden
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110
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Beauté J, Westrell T, Schmid D, Müller L, Epstein J, Kontio M, Couturier E, Faber M, Mellou K, Borg ML, Friesema I, Vold L, Severi E. Travel-associated hepatitis A in Europe, 2009 to 2015. ACTA ACUST UNITED AC 2019; 23. [PMID: 29871720 PMCID: PMC6152172 DOI: 10.2807/1560-7917.es.2018.23.22.1700583] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Travel to countries with high or intermediate hepatitis A virus (HAV) endemicity is a risk factor for infection in residents of countries with low HAV endemicity. Aim: The objective of this study was to estimate the risk for hepatitis A among European travellers using surveillance and travel denominator data. Methods: We retrieved hepatitis A surveillance data from 13 European Union (EU)/ European Economic Area (EEA) countries with comprehensive surveillance systems and travel denominator data from the Statistical Office of the European Union. A travel-associated case of hepatitis A was defined as any case reported as imported. Results: From 2009 to 2015, the 13 countries reported 18,839 confirmed cases of hepatitis A, of which 5,233 (27.8%) were travel-associated. Of these, 39.8% were among children younger than 15 years. The overall risk associated with travel abroad decreased over the period at an annual rate of 3.7% (95% confidence interval (CI): 0.7–2.7) from 0.70 cases per million nights in 2009 to 0.51 in 2015. The highest risk was observed in travellers to Africa (2.11 cases per million nights). Cases more likely to be reported as travel-associated were male and of younger age (< 25 years). Conclusion: Travel is still a major risk factor for HAV infection in the EU/EEA, although the risk of infection may have slightly decreased in recent years. Children younger than 15 years accounted for a large proportion of cases and should be prioritised for vaccination.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Therese Westrell
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | - Mia Kontio
- National Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Kassiani Mellou
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | | | - Ingrid Friesema
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Line Vold
- Norwegian Institute of Public Health, Oslo, Norway
| | - Ettore Severi
- Karolinska Institutet, Stockholm, Sweden.,European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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111
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Abstract
Until 1995, the incidence of symptomatic acute hepatitis A was minimal and there were no cases of national outbreak in Korea. However, there was a nationwide outbreak of hepatitis A that peaked in 2009. In 2019, a total of 10,083 cases of acute hepatitis A were reported for seven months of the year according to the Korea Center for Disease Control and Prevention. This may be attributed to the proportion of susceptible subjects in the Korean population, as about 10 years have passed since herd immunity was induced by the epidemic occurring during the late 2000s. Recent studies have shown that the rate of seropositivity for anti-hepatitis A virus antibodies (anti-HAV) is the lowest in adults in their 20s and has not changed much over the past 10 years, and seropositivity of anti-HAV in adults in their 30s has continued to decline from 69.6% in 2005 to 32.4% in 2014. Most young adults who have not yet experienced hepatitis A and are not vaccinated are vulnerable to hepatitis A infection. This year's epidemic of hepatitis A is a predictable outcome for vulnerable populations. Therefore, effective acute hepatitis A control and prevention strategies are needed, particularly for those in their 20s and 30s.
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Affiliation(s)
- Seong Hee Kang
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Moon Young Kim
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Soon Koo Baik
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea.
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112
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Li C, Su HB, Liu XY, Zhang LN, Hu JH. High-dependency units play a key role in the treatment of a Chinese military patient who developed liver failure while abroad. Mil Med Res 2019; 6:29. [PMID: 31522692 PMCID: PMC6745794 DOI: 10.1186/s40779-019-0220-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/06/2019] [Indexed: 12/01/2022] Open
Abstract
High-dependency units (HDUs) provide high-level care to patients who suffer from single organ failure, with the exception of respiratory failure requiring mechanical ventilation; HDUs serve as an intermediary between general wards and Intensive Care Units. Due to military and civilian needs, our hospital has established a unique HDU for patients with liver disease in China. A Chinese military officer in the United Nations Peacekeeping Forces in South Sudan was transferred to our HDU for liver failure treatment in 2018. The patient's disease status, nutrition, sleep habits, and psychological behaviour were monitored on different scales. The patient was provided with vascular monitoring, telemetry, pulse oximetry, drug treatment, nutritional support, sleep intervention, psychological intervention, and humanistic care by a multidisciplinary treatment team. After treatment, the patient recovered and avoided liver transplantation. Based on the experience with this HDU, this new model may create an efficient treatment process for military and civilian patients with severe liver disease at home or abroad.
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Affiliation(s)
- Chen Li
- Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Hai-Bin Su
- Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Xiao-Yan Liu
- Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Li-Na Zhang
- Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Jin-Hua Hu
- Liver Failure Treatment and Research Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
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113
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Abstract
Ursodeoxycholic acid modifies the bile acid pool and its effect on lowering liver enzymes is well documented in certain cases like chronic hepatitis but on the other hand it is known to worsen when given in advanced stages of liver disease. Also, it's effects are still unknown for variety of liver insults. We hereby report a case of Idiopathic Gamma Glutaryl Transferase (GGT) elevation which responded well to Ursodeoxycholic acid.
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Affiliation(s)
| | | | - David Mahan
- Health Unit, American Embassy, New Delhi, India
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114
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Hartard C, Gantzer C, Bronowicki JP, Schvoerer E. Emerging hepatitis E virus compared with hepatitis A virus: A new sanitary challenge. Rev Med Virol 2019; 29:e2078. [PMID: 31456241 DOI: 10.1002/rmv.2078] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 12/21/2022]
Abstract
Hepatitis A (HAV) and E (HEV) viruses are able to cause liver disease in humans. Among the five classical hepatotropic viruses, they are mainly transmitted via the fecal-oral route. Historically, many similarities have thus been described between them according to their incidence and their pathogenicity, especially in countries with poor sanitary conditions. However, recent advances have provided new insights, and the gap is widening between them. Indeed, while HAV infection incidence tends to decrease in developed countries along with public health improvement, HEV is currently considered as an underdiagnosed emerging pathogen. HEV autochthonous infections are increasingly observed and are mainly associated with zoonotic transmissions. Extra hepatic signs resulting in neurological or renal impairments have also been reported for HEV, as well as a chronic carrier state in immunocompromised patients, arguing in favor of differential pathogenesis between those two viruses. Recent molecular tools have allowed studies of viral genome variability and investigation of links between viral plasticity and clinical evolution. The identification of key functional mutations in viral genomes may improve the knowledge of their clinical impact and is analyzed in depth in the present review.
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Affiliation(s)
- Cédric Hartard
- Laboratoire de Virologie, CHRU de Nancy Brabois, Vandœuvre-lès-Nancy, France.,Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement (LCPME), UMR 7564, Vandoeuvre-lès-Nancy, France.,CNRS, LCPME UMR 7564, Nancy, France.,Faculté des Sciences et Technologies, Institut Jean Barriol, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Christophe Gantzer
- Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement (LCPME), UMR 7564, Vandoeuvre-lès-Nancy, France.,CNRS, LCPME UMR 7564, Nancy, France.,Faculté des Sciences et Technologies, Institut Jean Barriol, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | | | - Evelyne Schvoerer
- Laboratoire de Virologie, CHRU de Nancy Brabois, Vandœuvre-lès-Nancy, France.,Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement (LCPME), UMR 7564, Vandoeuvre-lès-Nancy, France.,CNRS, LCPME UMR 7564, Nancy, France.,Faculté des Sciences et Technologies, Institut Jean Barriol, Université de Lorraine, Vandœuvre-lès-Nancy, France
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Cifuente JO, Moratorio G. Evolutionary and Structural Overview of Human Picornavirus Capsid Antibody Evasion. Front Cell Infect Microbiol 2019; 9:283. [PMID: 31482072 PMCID: PMC6710328 DOI: 10.3389/fcimb.2019.00283] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/24/2019] [Indexed: 11/13/2022] Open
Abstract
Picornaviruses constitute one of the most relevant viral groups according to their impact on human and animal health. Etiologic agents of a broad spectrum of illnesses with a clinical presentation that ranges from asymptomatic to fatal disease, they have been the cause of uncountable epidemics throughout history. Picornaviruses are small naked RNA-positive single-stranded viruses that include some of the most important pillars in the development of virology, comprising poliovirus, rhinovirus, and hepatitis A virus. Picornavirus infectious particles use the fecal-oral or respiratory routes as primary modes of transmission. In this regard, successful viral spread relies on the capability of viral capsids to (i) shelter the viral genome, (ii) display molecular determinants for cell receptor recognition, (iii) facilitate efficient genome delivery, and (iv) escape from the immune system. Importantly, picornaviruses display a substantial amount of genetic variability driven by both mutation and recombination. Therefore, the outcome of their replication results in the emergence of a genetically diverse cloud of individuals presenting phenotypic variance. The host humoral response against the capsid protein represents the most active immune pressure and primary weapon to control the infection. Since the preservation of the capsid function is deeply rooted in the virus evolutionary dynamics, here we review the current structural evidence focused on capsid antibody evasion mechanisms from that perspective.
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Affiliation(s)
| | - Gonzalo Moratorio
- Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay.,Laboratorio de Inmunovirología, Institut Pasteur de Montevideo, Montevideo, Uruguay
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116
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Kim JD, Cho EJ, Ahn C, Park SK, Choi JY, Lee HC, Kim DY, Choi MS, Wang HJ, Kim IH, Yeon JE, Seo YS, Tak WY, Kim MY, Lee HJ, Kim YS, Jun DW, Sohn JH, Kwon SY, Park SH, Heo J, Jeong SH, Lee JH, Nakayama N, Mochida S, Ido A, Tsubouchi H, Takikawa H, Shalimar, Acharya SK, Bernal W, O'Grady J, Kim YJ. A Model to Predict 1-Month Risk of Transplant or Death in Hepatitis A-Related Acute Liver Failure. Hepatology 2019; 70:621-629. [PMID: 30194739 DOI: 10.1002/hep.30262] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/20/2018] [Indexed: 12/11/2022]
Abstract
Acute liver failure (ALF) caused by hepatitis A is a rare but fatal disease. Here, we developed a model to predict outcome in patients with ALF caused by hepatitis A. The derivation set consisted of 294 patients diagnosed with hepatitis A-related ALF (ALFA) from Korea, and a validation set of 56 patients from Japan, India, and United Kingdom. Using a multivariate proportional hazard model, a risk-prediction model (ALFA score) consisting of age, international normalized ratio, bilirubin, ammonia, creatinine, and hemoglobin levels acquired on the day of ALF diagnosis was developed. The ALFA score showed the highest discrimination in the prediction of liver transplant or death at 1 month (c-statistic, 0.87; 95% confidence interval [CI], 0.84-0.92) versus King's College criteria (KCC; c-statistic, 0.56; 95% CI, 0.53-0.59), U.S. Acute Liver Failure Study Group index specific for hepatitis A virus (HAV-ALFSG; c-statistic, 0.70; 95% CI, 0.65-0.76), the new ALFSG index (c-statistic, 0.79; 95% CI, 0.74-0.84), Model for End-Stage Liver Disease (MELD; c-statistic, 0.79; 95% CI, 0.74-0.84), and MELD including sodium (MELD-Na; c-statistic, 0.78; 95% CI, 0.73-0.84) in the derivation set (all P < 0.01). In the validation set, the performance of the ALFA score (c-statistic, 0.84; 95% CI, 0.74-0.94) was significantly better than that of KCC (c-statistic, 0.65; 95% CI, 0.52-0.79), MELD (c-statistic, 0.74; 95% CI, 0.61-0.87), and MELD-Na (c-statistic, 0.72; 95% CI, 0.58-0.85) (all P < 0.05), and better, but not statistically significant, than that of the HAV-ALFSG (c-statistic, 0.76; 95% CI, 0.61-0.90; P = 0.28) and new ALFSG indices (c-statistic, 0.79; 95% CI, 0.65-0.93; P = 0.41). The model was well-calibrated in both sets. Conclusion: Our disease-specific score provides refined prediction of outcome in patients with ALF caused by hepatitis A.
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Affiliation(s)
- Jin Dong Kim
- Catholic University Liver Research Center & WHO Collaborating Center of Viral Hepatitis, Catholic University of Korea College of Medicine, Seoul, Korea.,Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea
| | - Eun Ju Cho
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Choonghyun Ahn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Jong Young Choi
- Catholic University Liver Research Center & WHO Collaborating Center of Viral Hepatitis, Catholic University of Korea College of Medicine, Seoul, Korea.,Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul, Korea
| | - Han Chu Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Moon Seok Choi
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jung Wang
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - In Hee Kim
- Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Jong Eun Yeon
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yeon Seok Seo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Won Young Tak
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Moon Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Heon Ju Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Yun Soo Kim
- Department of Internal Medicine, Gachon University School of Medicine, Incheon, Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Joo Hyun Sohn
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - So Young Kwon
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Sang Hoon Park
- Department of Internal Medicine, Hallym Univesity College of Medicine, Seoul, Korea
| | - Jeong Heo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong-Hoon Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Nobuaki Nakayama
- Department of Gastroenterology and Hepatology, Saitama Medical University, Moroyama, Japan
| | - Satoshi Mochida
- Department of Gastroenterology and Hepatology, Saitama Medical University, Moroyama, Japan
| | - Akio Ido
- Department of Digestive and Life-Style Related Disease, Health Research Course, Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Hazime Takikawa
- Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Shalimar
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Subrat Kumar Acharya
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - William Bernal
- Institute of Liver Studies, King's College Hospital, London, United Kingdom
| | - John O'Grady
- Institute of Liver Studies, King's College Hospital, London, United Kingdom
| | - Yoon Jun Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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117
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Burrell S, Vodstrcil LA, Fairley CK, Kilner A, Bradshaw CS, Chen MY, Chow EPF. Hepatitis A vaccine uptake among men who have sex with men from a time-limited vaccination programme in Melbourne in 2018. Sex Transm Infect 2019; 96:110-114. [PMID: 31346067 DOI: 10.1136/sextrans-2019-054132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/30/2019] [Accepted: 07/08/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES In 2017, an outbreak of hepatitis A among gay, bisexual and other men who have sex with men (MSM) was reported in Victoria, Australia. In 2018, the Victorian government implemented a free hepatitis A vaccination programme targeting all Victorian MSM. This study aimed to determine hepatitis A vaccine uptake among MSM in a sexual health clinic in Melbourne. METHODS All MSM attending the Melbourne Sexual Health Centre (MSHC) in 2018 were included. Chart review was performed to determine the proportion of men vaccinated for at least one dose of hepatitis A and to examine why men did not receive the vaccine. Multivariable logistic regression was performed to examine the factors associated with vaccine uptake. Vaccine uptake was defined as receipt of at least one dose of hepatitis A vaccine. RESULTS Of the 9582 MSM who attended MSHC in 2018, 61.3% (95% CI 60.3% to 62.2%) self-reported already being immune to hepatitis A. Of the 3713 remaining eligible men, 62.7% (95% CI 61.1% to 64.2%) received at least one dose of the hepatitis A vaccine on the day of attendance. Compared with MSM not living with HIV and not taking pre-exposure prophylaxis (PrEP), MSM taking PrEP (adjusted OR 1.28; 95% CI 1.01 to 1.62) were more likely to receive the vaccine. 1386 men (37.3%) did not receive the vaccine and 55.4% were not offered the vaccine by their treating clinician. 300 men (21.6%) were identified as non-immune after serological testing but did not return for vaccination. By the end of 2018, 85.5% of MSHC attendees (8196/9582) were immune to hepatitis A. CONCLUSION The critical vaccination threshold for hepatitis A has been estimated at >70%. Continuation of the targeted hepatitis A vaccination programme will improve immunity among the MSM population to prevent ongoing transmission and the likelihood of future outbreaks.
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Affiliation(s)
- Sam Burrell
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lenka A Vodstrcil
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Alex Kilner
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia .,Central Clinical School, Monash University, Melbourne, Victoria, Australia
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118
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Patterson J, Abdullahi L, Hussey GD, Muloiwa R, Kagina BM. A systematic review of the epidemiology of hepatitis A in Africa. BMC Infect Dis 2019; 19:651. [PMID: 31331281 PMCID: PMC6647100 DOI: 10.1186/s12879-019-4235-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/30/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Hepatitis A, caused by the hepatitis A virus (HAV), is a vaccine preventable disease. In Low and Middle-Income Countries (LMICs), poor hygiene and sanitation conditions are the main risk factors contributing to HAV infection. There have been, however, notable improvements in hygiene and sanitation conditions in many LMICs. As a result, there are studies showing a possible transition of some LMICs from high to intermediate HAV endemicity. The World Health Organization (WHO) recommends that countries should routinely collect, analyse and review local factors (including disease burden) to guide the development of hepatitis A vaccination programs. Up-to-date information on hepatitis A burden is, therefore, critical in aiding the development of country-specific recommendations on hepatitis A vaccination. METHODS We conducted a systematic review to present an up-to-date, comprehensive synthesis of hepatitis A epidemiological data in Africa. RESULTS The main results of this review include: 1) the reported HAV seroprevalence data suggests that Africa, as a whole, should not be considered as a high HAV endemic region; 2) the IgM anti-HAV seroprevalence data showed similar risk of acute hepatitis A infection among all age-groups; 3) South Africa could be experiencing a possible transition from high to intermediate HAV endemicity. The results of this review should be interpreted with caution as the reported data represents research work with significant sociocultural, economic and environmental diversity from 13 out of 54 African countries. CONCLUSIONS Our findings show that priority should be given to collecting HAV seroprevalence data and re-assessing the current hepatitis A control strategies in Africa to prevent future disease outbreaks.
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Affiliation(s)
- Jenna Patterson
- Vaccines for Africa Initiative, University of Cape Town, Room N2.09A, Werner Beit North, Health Sciences Campus, Anzio Road, Observatory, Cape Town, 7925 South Africa
- School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Leila Abdullahi
- Save the Children International, Somaliland Country Office, Nairobi, Kenya
| | - Gregory D. Hussey
- Vaccines for Africa Initiative, University of Cape Town, Room N2.09A, Werner Beit North, Health Sciences Campus, Anzio Road, Observatory, Cape Town, 7925 South Africa
- Division of Medical Microbiology & Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Rudzani Muloiwa
- Vaccines for Africa Initiative, University of Cape Town, Room N2.09A, Werner Beit North, Health Sciences Campus, Anzio Road, Observatory, Cape Town, 7925 South Africa
- Department of Paediatrics & Child Health, Groote Schuur Hospital, The University of Cape Town, Cape Town, South Africa
| | - Benjamin M. Kagina
- Vaccines for Africa Initiative, University of Cape Town, Room N2.09A, Werner Beit North, Health Sciences Campus, Anzio Road, Observatory, Cape Town, 7925 South Africa
- School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
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119
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Lun JH, Crosbie ND, White PA. Genetic diversity and quantification of human mastadenoviruses in wastewater from Sydney and Melbourne, Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 675:305-312. [PMID: 31030137 DOI: 10.1016/j.scitotenv.2019.04.162] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 05/27/2023]
Abstract
Human mastadenoviruses (HAdVs) are DNA viruses that can cause a wide range of clinical diseases, including gastroenteritis, respiratory illnesses, conjunctivitis, and in more severe cases hepatitis, pancreatitis and disseminated diseases. HAdV infections are generally asymptomatic or self-limiting, but can cause adverse outcomes within vulnerable populations. Since most HAdV serotypes replicate within the human gastrointestinal tract, high levels of HAdV DNA are excreted into wastewater systems. In this study, we identified the genetic diversity of HAdV at a population level using wastewater samples collected from Sydney and Melbourne from 2016 to 2017, with the use of next generation sequencing (NGS) technologies. In addition, HAdV DNA levels were quantified using quantitative polymerase chain reaction (qPCR) based methods to better understand the health risks involved if wastewater contamination occurs. An average of 1.8 × 107 genome copies of HAdV DNA was detected in one litre of wastewater collected in Sydney and Melbourne, over the two-year study period. A total of six major groups of HAdV were identified in wastewater samples using MiSeq, which included 19 different serotypes. Of those, the most prevalent was F41 (83.5%), followed by F40 (11.0%) and A31 (3.7%). In contrast, five groups of HAdV were identified in clinical samples with F41 as the most dominant serotype, (52.5% of gastroenteritis cases), followed by C1 and C2 (each responsible for 15.0%), and B3 was the fourth most common serotype (7.5%). This study demonstrated the practicability of using amplicon based NGS to identify HAdV diversity and quantify HAdV genome levels in environmental water samples, as well as broadening our current understanding of circulating HAdV in the Australian population.
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Affiliation(s)
- Jennifer H Lun
- School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW, Australia.
| | - Nicholas D Crosbie
- Melbourne Water Corporation, Docklands, VIC, Australia; School of Civil and Environmental Engineering, Faculty of Engineering, University of New South Wales, Sydney, NSW, Australia.
| | - Peter A White
- School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW, Australia.
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120
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Enkirch T, Severi E, Vennema H, Thornton L, Dean J, Borg ML, Ciccaglione AR, Bruni R, Christova I, Ngui SL, Balogun K, Němeček V, Kontio M, Takács M, Hettmann A, Korotinska R, Löve A, Avellón A, Muñoz-Chimeno M, de Sousa R, Janta D, Epštein J, Klamer S, Suin V, Aberle SW, Holzmann H, Mellou K, Ederth JL, Sundqvist L, Roque-Afonso AM, Filipović SK, Poljak M, Vold L, Stene-Johansen K, Midgley S, Fischer TK, Faber M, Wenzel JJ, Takkinen J, Leitmeyer K. Improving preparedness to respond to cross-border hepatitis A outbreaks in the European Union/European Economic Area: towards comparable sequencing of hepatitis A virus. Euro Surveill 2019; 24:1800397. [PMID: 31311618 PMCID: PMC6636214 DOI: 10.2807/1560-7917.es.2019.24.28.1800397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 02/18/2019] [Indexed: 12/13/2022] Open
Abstract
IntroductionSequence-based typing of hepatitis A virus (HAV) is important for outbreak detection, investigation and surveillance. In 2013, sequencing was central to resolving a large European Union (EU)-wide outbreak related to frozen berries. However, as the sequenced HAV genome regions were only partly comparable between countries, results were not always conclusive.AimThe objective was to gather information on HAV surveillance and sequencing in EU/European Economic Area (EEA) countries to find ways to harmonise their procedures, for improvement of cross-border outbreak responses.MethodsIn 2014, the European Centre for Disease Prevention and Control (ECDC) conducted a survey on HAV surveillance practices in EU/EEA countries. The survey enquired whether a referral system for confirming primary diagnostics of hepatitis A existed as well as a central collection/storage of hepatitis A cases' samples for typing. Questions on HAV sequencing procedures were also asked. Based on the results, an expert consultation proposed harmonised procedures for cross-border outbreak response, in particular regarding sequencing. In 2016, a follow-up survey assessed uptake of suggested methods.ResultsOf 31 EU/EEA countries, 23 (2014) and 27 (2016) participated. Numbers of countries with central collection and storage of HAV positive samples and of those performing sequencing increased from 12 to 15 and 12 to 14 respectively in 2016, with all countries typing an overlapping fragment of 218 nt. However, variation existed in the sequenced genomic regions and their lengths.ConclusionsWhile HAV sequences in EU/EEA countries are comparable for surveillance, collaboration in sharing and comparing these can be further strengthened.
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Affiliation(s)
- Theresa Enkirch
- Public Health Agency of Sweden, Solna, Sweden
- European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Ettore Severi
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
- Karolinska Institutet, Stockholm, Sweden
| | - Harry Vennema
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Lelia Thornton
- HSE - Health Protection Surveillance Centre, Dublin, Ireland
| | - Jonathan Dean
- National Virus Reference Laboratory, Dublin, Ireland
| | | | | | | | - Iva Christova
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Koye Balogun
- Public Health England (PHE), London, United Kingdom
| | | | - Mia Kontio
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mária Takács
- National Public Health Institute, Budapest, Hungary
| | | | | | - Arthur Löve
- Landspitali- National University Hospital, Reykjavik, Iceland
| | - Ana Avellón
- Carlos III Institute of Health, Madrid, Spain
| | | | - Rita de Sousa
- National Institute of Health Dr. Ricardo Jorge (INSA), Lisbon, Portugal
| | - Denisa Janta
- National Institute of Public Health, Bucharest, Romania
| | | | - Sofieke Klamer
- Scientific Institute of Public Health, Brussels, Belgium
| | - Vanessa Suin
- Sciensano, Directorate Infectious diseases in humans, Brussels, Belgium
| | - Stephan W Aberle
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | | | - Kassiani Mellou
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | | | | | | | | | - Mario Poljak
- Institute of Microbiology and Immunology, Ljubljana, Slovenia
| | - Line Vold
- Norwegian institute of Public Health, Oslo, Norway
| | | | | | - Thea Kølsen Fischer
- Statens Serum Institut (SSI), Copenhagen, Denmark
- Department of Infectious Diseases and Global Health, University of Southern Denmark, Odense, Denmark
| | - Mirko Faber
- Robert Koch Institute (RKI), Berlin, Germany
| | - Jürgen J Wenzel
- National Reference Laboratory for HAV, Regensburg University Medical Center, Regensburg, Germany
| | - Johanna Takkinen
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Katrin Leitmeyer
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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Haeri Mazanderani A, Motaze NV, McCarthy K, Suchard M, du Plessis NM. Hepatitis A virus seroprevalence in South Africa - Estimates using routine laboratory data, 2005-2015. PLoS One 2019; 14:e0216033. [PMID: 31242191 PMCID: PMC6594585 DOI: 10.1371/journal.pone.0216033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 04/14/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION South Africa is considered highly endemic for hepatitis A virus (HAV) although few seroprevalence studies have been conducted over the past two decades. The World Health Organization recommends integrating HAV vaccination into national childhood immunization schedules where there is transition from high to intermediate endemicity. As a means of gauging age-specific rates of infection, we report HAV seroprevalence rates among specimens tested for HAV serology within South Africa's public health sector from 2005-2015. MATERIALS AND METHODS Hepatitis A serology results (Anti-HAV IgM, IgG and total antibody) from 2005-2015 were extracted from South Africa's National Health Laboratory Service's Corporate Data Warehouse (NHLS CDW), the central data repository of all laboratory test-sets within the public health sector. Results were extracted according to test-set, result, date of testing, health facility, name, surname, age, and sex. Anti-HAV IgG results were merged with total antibody results to reflect anti-HAV seroprevalence. Testing volume, positivity rates and age-specific anti-HAV seroprevalence rates by year and geographic distribution are described. RESULTS AND DISCUSSION A total of 501 083 HAV IgM results were retrieved, of which 16 423 (3.3%) were positive, 484 259 (96.6%) negative and 401 (0.1%) equivocal; and 34 710 HAV total antibody/IgG tests of which 30 675 (88.4%) were positive, 4 020 (11.6%) negative and 15 equivocal. Whereas IgM positivity was highest among the 1-4 year age group (33.5%) and lowest among patients >45 years (<0.5%), total antibody positivity ranged from its lowest level of 52.7% in the 1-4 year age group increasing to levels of >90% only after 25 years of age. CONCLUSION Anti-HAV total antibody testing within the South African public health sector demonstrates seroprevalence rates reach levels >90% only in adulthood, suggesting South Africa could be in transition from high to intermediate endemicity. Prospective studies with geographically representative sampling are required to confirm these findings and evaluate provincial and urban/rural heterogeneity.
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Affiliation(s)
- Ahmad Haeri Mazanderani
- Centre for HIV & STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Nkengafac Villyen Motaze
- Centre for Vaccines and Immunology, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Kerrigan McCarthy
- Outbreak Response Unit, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Melinda Suchard
- Centre for Vaccines and Immunology, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- Chemical Pathology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicolette Marie du Plessis
- Department of Paediatrics, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Psarris A, Sindos M, Daskalakis G, Chondrogianni ME, Panayiotou S, Antsaklis P, Loutradis D. Immunizations during pregnancy: How, when and why. Eur J Obstet Gynecol Reprod Biol 2019; 240:29-35. [PMID: 31226574 DOI: 10.1016/j.ejogrb.2019.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/13/2019] [Indexed: 12/25/2022]
Abstract
Maternal immunization during pregnancy provide protection for the mother and the fetus against certain pathogens. Immunizations during pregnancy are divided to routine immunizations recommended for all pregnant women, immunizations for certain medical indications and vaccines that are potentially harmful during pregnancy and should be avoided. We conducted a comprehensive review of the literature regarding immunizations during pregnancy. The search terms used were immunization, vaccine, pregnancy, influenza, pertussis, safety and efficacy. We gathered all available guidelines on vaccination during pregnancy. Generally, vaccines are allowed during pregnancy when the benefits outweigh the risks. Tdap and inactivated flu vaccines are routinely recommended during pregnancy. Vaccines containing live attenuated viruses are contraindicated during pregnancy. These are LAIV influenza, MMR, Varicella, Zoster, BCG and smallpox pre-exposure. All other vaccines are given when medically indicated and the possible benefits outweigh the risks. Obstetricians and gynecologists should be familiar with the indications of vaccination during pregnancy. Vaccination coverage of pregnant women with routinely recommended vaccines has increased but further efforts are needed. Our aim is to review vaccination practices during pregnancy, demonstrate the benefits and dangers of different vaccines, evaluate their effectiveness and define the proper timing of vaccination.
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Affiliation(s)
- Alexandros Psarris
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vas. Sophias Av., 115 28, Athens, Greece.
| | - Michael Sindos
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vas. Sophias Av., 115 28, Athens, Greece
| | - Georgios Daskalakis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vas. Sophias Av., 115 28, Athens, Greece
| | - Maria Eleni Chondrogianni
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vas. Sophias Av., 115 28, Athens, Greece
| | - Stefani Panayiotou
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vas. Sophias Av., 115 28, Athens, Greece
| | - Panagiotis Antsaklis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vas. Sophias Av., 115 28, Athens, Greece
| | - Dimitrios Loutradis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vas. Sophias Av., 115 28, Athens, Greece
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Medić S, Anastassopoulou C, Milošević V, Dragnić N, Rajčević S, Ristić M, Petrović V. Declining seroprevalence of hepatitis A in Vojvodina, Serbia. PLoS One 2019; 14:e0217176. [PMID: 31163046 PMCID: PMC6548380 DOI: 10.1371/journal.pone.0217176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/07/2019] [Indexed: 11/18/2022] Open
Abstract
To assess the current hepatitis A virus (HAV) endemicity in the Autonomous Province of Vojvodina, Serbia, we examined the seroprevalence and susceptibility profiles of the general population. A serum bank of 3466 residual samples, collected in 2015-16 as per the specifications of the European Sero-Epidemiology Network 2 project (ESEN2), was tested for anti-HAV antibodies with an enzyme immunoassay. Relationships between anti-HAV positivity and demographic features of respondents were examined by univariable and multivariable analyses. Present-day HAV seroprevalence was compared with that obtained in 1978-79. Surveillance data for hepatitis A recorded between 2008 and 2017 were also analyzed. Age was the only demographic variable found to be independently associated with a HAV seropositive status. Seropositivity (17% overall vs. 79% in 1978-79) increased with age to a maximum of 90% in the elderly ≥60 years. Only 5% of subjects <30 years were seropositive, unlike the 44% of seropositives ≥30 years. The estimated age at midpoint of population immunity (AMPI) increased markedly from 14 years in the late 70s to 55 years in 2015-16. Meanwhile, disease incidence decreased noticeably in recent years (from 11 in 2008 to 2 per 100,000 population in 2017). In the ongoing pre-vaccine era, natural infection provides immunity for merely a third (31%) and two thirds (57%) of people in their 40s and 50s, respectively. Hence, the majority of people ≤40 years (94%) and middle-aged adults 40-49 years (69%) are susceptible to HAV. Older susceptible individuals, particularly those ≥50 years (24%), are prone to severe symptoms. Taken together, these changes reflect the epidemiological transition of Vojvodina and Serbia from high to very low HAV endemicity, thereby supporting the current national policy of immunization of only high-risk groups.
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Affiliation(s)
- Snežana Medić
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Cleo Anastassopoulou
- Division of Genetics, Cell and Developmental Biology, Department of Biology, University of Patras, Patras, Greece
| | - Vesna Milošević
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Center for Virology, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Nataša Dragnić
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Center for Informatics and Biostatistics, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Smiljana Rajčević
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Mioljub Ristić
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Vladimir Petrović
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Segura M, Lopez-Gigosos R, Mariscal-Lopez E, Gutierrez-Bedmar M, Mariscal A. Trends in the travelers' demand for pre-travel medical advice at a Spanish International Vaccination Center between 2000 and 2017. PLoS One 2019; 14:e0217588. [PMID: 31145759 PMCID: PMC6542509 DOI: 10.1371/journal.pone.0217588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/14/2019] [Indexed: 11/29/2022] Open
Abstract
Crises and disasters affect the numbers of people traveling either for tourism or other reasons. Many studies have been published on the effects of such events on travel, especially on tourism, and based on the arrivals or departures of travelers to or from countries. Our aim was to assess the influence of these events on the demand for pre-travel medical consultation in an International Vaccination Centre (IVC). Data on 94683 international travelers who visited 113529 international destinations attended at the IVC of Malaga (Spain) during 2000-2017 were studied. A descriptive and time series analyses was conducted. The demand to IVC was 3.47 times higher in 2017 than in 2000. The increase has not been the same for all destinations: Travel to South-East Asia and Western Pacific World Health Organization (WHO) regions has multiplied by 10, while in the same period, Africa WHO region has declined from 36% to 20% of total demand. Thailand, India and Brazil were the countries with the highest demand (21% of all pre-travel consultations). We found out three periods, concurrent with some socioeconomic or health events, in which the number of travellers attend decline with respect to the previous years, or the growth was very slow. Growth in the demand for pre-travel medical advice in parallel with a foreseeable increase in the number of travelers is expected. Pre-travel medical services must be adapted to this increase. This study of the trend of demand for pre-travel medical information should new related problems to travel to be identified and quantified, and should assist improvement of policies and programs aimed at care of travelers.
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Affiliation(s)
- Marina Segura
- International Vaccination Center, Medical Service, Port Health Authority of Malaga, Malaga, Spain
| | - Rosa Lopez-Gigosos
- International Vaccination Center, Medical Service, Port Health Authority of Malaga, Malaga, Spain
- Department of Public Health and Psychiatry, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Eloisa Mariscal-Lopez
- Department of Public Health and Psychiatry, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Mario Gutierrez-Bedmar
- Department of Public Health and Psychiatry, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Alberto Mariscal
- Department of Public Health and Psychiatry, Faculty of Medicine, University of Malaga, Malaga, Spain
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Andrievskaya M, Lenhart A, Uduman J. Emerging Threat: Changing Epidemiology of Hepatitis A and Acute Kidney Injury. Adv Chronic Kidney Dis 2019; 26:171-178. [PMID: 31202389 DOI: 10.1053/j.ackd.2019.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 12/27/2022]
Abstract
In the past decade, hepatitis A has been considered a rare disease in the United States, largely due to targeted vaccination of at-risk children. Evolving epidemiology has resulted in decreasing immunity and increasing hepatitis A infections among adults who are more likely to experience severe disease. A surge in outbreaks has been noted in the past 2 years, resulting in a high volume of hepatitis A related hospitalizations and complications in otherwise healthy individuals. The traditional understanding that acute kidney injury is a rare extrahepatic manifestation is being challenged by the resurgence of hepatitis A in a more vulnerable population. This review examines the epidemiologic factors that contributed to current public health concern and the association between hepatitis A and acute kidney injury.
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Alberts CJ, Boyd A, Bruisten SM, Heijman T, Hogewoning A, Rooijen MV, Siedenburg E, Sonder GJB. Hepatitis A incidence, seroprevalence, and vaccination decision among MSM in Amsterdam, the Netherlands. Vaccine 2019; 37:2849-2856. [PMID: 30992222 DOI: 10.1016/j.vaccine.2019.03.048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several outbreaks of Hepatitis A virus (HAV) were recently documented among men who have sex with men (MSM) in Europe. We investigated the HAV incidence among MSM in Amsterdam, the Netherlands; and HAV seroprevalence and HAV vaccination decision among MSM visiting the Sexually Transmitted Infection (STI) clinic in Amsterdam. METHODS Using surveillance data from 1992 to 2017 of MSM with acute HAV in Amsterdam, we estimated the incidence by calendar year and age. We explored HAV seroprevalence by calendar year and age, determinants for HAV seropositivity, and opting-in/out for HAV vaccination using data collected among MSM that visited the STI clinic between 2006 and 2017 and were included in a nationwide Hepatitis B virus (HBV) vaccination programme. Offering HAV vaccination at the STI clinic differed over three consecutive periods: not offered, offered for free, or offered for 75 euros. Logistic regression analyses were used to explore determinants. RESULTS HAV incidence increased in 2016/17 after 4 years of absence and peaked in MSM around 35 years of age. Among MSM visiting the STI clinic, HAV seroprevalence was 37% (95%CI = 35-40%), which was constant over the period 2006-2017, and increased with age (p < 0.001). Determinants for HAV seropositivity in multivariable analysis were: older age (p < 0.001), originating from an HAV endemic country (p < 0.001), and being HBV seropositive (p = 0.001). MSM opted-in more frequently when HAV vaccination was offered for free versus paid (89% versus 11%, respectively; p < 0.001). Younger MSM were less inclined to vaccinate when payment was required (p = 0.010). Post-hoc analyses showed that 98% versus 46% of MSM visiting the Amsterdam STI clinic would be protected against HAV infection if HAV vaccination was offered for free or for 75 euros, respectively. CONCLUSIONS The MSM population of Amsterdam is vulnerable to a new HAV outbreak. We strongly recommend that MSM have access to free hepatitis A vaccination.
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Affiliation(s)
- Catharina J Alberts
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
| | - Sylvia M Bruisten
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.
| | - Titia Heijman
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands.
| | - Arjan Hogewoning
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.
| | - Martijn van Rooijen
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands.
| | - Evelien Siedenburg
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands.
| | - Gerard J B Sonder
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.
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Bradley-Stewart A, Smith-Palmer A, Hawkins G, Gunson R. Hepatitis A-2017 an unusual year in Scotland. J Clin Virol 2019; 115:1-4. [PMID: 30928816 DOI: 10.1016/j.jcv.2019.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/14/2019] [Accepted: 03/18/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND The number of cases of acute hepatitis A reported in Scotland each year is small, and the majority of cases have been associated with travel to endemic regions. However, in early 2017, in the midst of ongoing outbreaks of hepatitis A among MSM in Europe, there was a sharp rise in the number of cases reported to Health Protection Scotland. OBJECTIVES The initial aim of this study was to investigate the reason for the observed increase in cases of hepatitis A at the start of 2017. As cases continued for the remainder of the year, these cases were typed to determine whether these cases were linked to each other, or other outbreaks. STUDY DESIGN The study population consisted of 42 hepatitis A infected patients with no obvious source of infection. The patient samples were collected between January and December 2017. The VP1/2 A region was amplified and sequenced. RESULTS The majority of samples typed as genotype 1 A (n = 17) or genotype 1B (n = 15). Within genotype 1 A, fifteen samples had strains (VRD_521_2016 or RIVM_HAV16_090) associated with ongoing outbreaks of hepatitis A in MSM in Europe. Within genotype 1B, there were four clusters of infections, with identical cases in geographically distinct regions with no identified epidemiological link. CONCLUSIONS Molecular typing proved useful, as it allowed public health to identify clusters, establish links with other outbreaks and compare Scottish strains with those reported elsewhere.
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Affiliation(s)
- Amanda Bradley-Stewart
- West of Scotland Specialist Virology Centre, Level 5, New Lister Building, 10-16 Alexandra Parade, Glasgow, G31 2ER, United Kingdom.
| | - Alison Smith-Palmer
- Health Protection Scotland, National Services Scotland, 4th Floor Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, United Kingdom
| | - Gill Hawkins
- Health Protection Scotland, National Services Scotland, 4th Floor Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, United Kingdom
| | - Rory Gunson
- West of Scotland Specialist Virology Centre, Level 5, New Lister Building, 10-16 Alexandra Parade, Glasgow, G31 2ER, United Kingdom
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Yan BY, Lv JJ, Liu JY, Feng Y, Wu WL, Xu AQ, Zhang L. Changes in seroprevalence of hepatitis A after the implementation of universal childhood vaccination in Shandong Province, China: A comparison between 2006 and 2014. Int J Infect Dis 2019; 82:129-134. [PMID: 30862519 DOI: 10.1016/j.ijid.2019.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The hepatitis A vaccine (HepA) has been included in the national expanded program on immunization (EPI) in China since 2008. This study was performed to evaluate the change in dynamics of the seroepidemiology of hepatitis A virus (HAV) before and after the introduction of the program. METHODS The trends in seroepidemiology of anti-HAV antibodies were examined in Shandong Province, China, drawing on two population-based samples of persons aged 1-59 years, one obtained in the year 2006 (n = 6682) and the other in 2014 (n = 5095). RESULTS A dramatic increase in seroprevalence of anti-HAV antibodies from 30.76% (95% confidence interval (CI) 26.24-35.28%) to 77.46% (95% CI 74.04-80.87%) among children aged 1.5-7 years (born after HepA was recommended for routine childhood immunization), as well as an increase from 35.32% (95% CI 29.31-41.33%) to 66.69% (95% CI 55.59-77.80%) in subjects aged 8-14 years, was observed in 2014 when compared with 2006. By contrast, a decline in seroprevalence among subjects aged 15-29 years, as seen particularly in those 20-29 years of age, from 85.72% (95% CI 80.29-91.14%) to 69.24% (95% CI 62.02-76.45%), was found in this study. There was no statistically significant difference in seroprevalence between 2006 and 2014 among the subjects older than 30 years of age. CONCLUSIONS The national HepA routine immunization program has had a positive effect, leading to an increase in anti-HAV seroprevalence among children in Shandong Province, China. More attention should be paid to young adults in the province.
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Affiliation(s)
- Bing-Yu Yan
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jing-Jing Lv
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jia-Ye Liu
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yi Feng
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Wen-Long Wu
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Ai-Qiang Xu
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Li Zhang
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China.
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Bravo C, Mege L, Vigne C, Thollot Y. Clinical experience with the inactivated hepatitis A vaccine, Avaxim 80U Pediatric. Expert Rev Vaccines 2019; 18:209-223. [PMID: 30806110 DOI: 10.1080/14760584.2019.1580578] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Hepatitis A, caused by hepatitis A virus (HAV), is primarily transmitted via the fecal/oral route either through ingestion of contaminated food and water or through direct contact with an infectious person. Prevalence of hepatitis A is strongly correlated with socioeconomic factors, decreasing with increased socio-economic development, access to clean water and sanitation. Vaccination against HAV should be part of a comprehensive plan for the prevention and control of viral hepatitis, either as part of regular childhood immunization programs or with other recommended vaccines for travelers. Areas covered: We present here evidence for the immunogenicity and safety of an inactivated HAV pediatric vaccine (Avaxim® 80U Pediatric, Sanofi Pasteur), indicated for use in children aged 12 months to 15 years. Data evaluated are from trials undertaken during the clinical development of this vaccine, a systematic literature review and post-market pharmacovigilance. Expert opinion: The pediatric HAV vaccine is highly immunogenic and generates long-lasting protection against hepatitis A disease in children. The safety and immunogenicity data presented in this review suggest that the pediatric HAV vaccine is a valuable option in the prevention of HAV infection in children in many areas of the world where the disease remains a healthcare issue.
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Affiliation(s)
| | - Larissa Mege
- b Global Pharmacovigilance , Sanofi Pasteur , Marcy-l'Étoile , France
| | - Claire Vigne
- c Research & Development , Sanofi Pasteur , Marcy-l'Étoile , France
| | - Yael Thollot
- a Global Medical Affairs , Sanofi Pasteur , Lyon , France
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Very low prevalence of anti-HAV in Japan: high potential for future outbreak. Sci Rep 2019; 9:1493. [PMID: 30728377 PMCID: PMC6365493 DOI: 10.1038/s41598-018-37349-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 12/03/2018] [Indexed: 12/30/2022] Open
Abstract
Since the early 21st century, almost all developed countries have had a very low hepatitis A virus antibody (anti-HAV) sero-prevalence profile, as sanitation conditions and health care facilities have been optimized to a universal standard. There has not been a report on anti-HAV prevalence among a large scale population in Japan since 2003. Therefore, this study aimed to investigate the current HAV status among the general population in Hiroshima. From each age and sex specific group, a total of 1,200 samples were randomly selected from 7,682 stocked serum samples from residents' and employees' annual health check-ups during 2013-2015. Total anti-HAV was detected using Chemiluminescent Enzyme Immunoassay. The overall anti-HAV sero-prevalence was 16.8%. In both males and females, anti-HAV prevalence among individuals between 20-59 years of age was as low as 0.0-2.0%, whilst that among 70 s was as high as 70.0-71.0%. A large number of residents aged under 60 are now susceptible to HAV infection. The cohort reduction trend of anti-HAV in Japan exposes the high possibility of mass outbreak in the future. HAV vaccine especially to younger generation and high risk population may prevent outbreak in Japan.
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Henriquez-Camacho C, Serre N, Norman F, Sánchez-Montalvá A, Torrús D, Goikoetxea AJ, Herrero-Martínez JM, Ruiz-Giardín JM, Treviño B, Monge-Maillo B, Molina I, Rodríguez A, García M, López-Vélez R, Pérez-Molina JA. Clinicoepidemiological characteristics of viral hepatitis in migrants and travellers of the +Redivi network. Travel Med Infect Dis 2019; 29:51-57. [PMID: 30738196 DOI: 10.1016/j.tmaid.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/28/2019] [Accepted: 02/05/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Continuous growth of mobile populations has influenced the global epidemiology of infectious diseases, including chronic and acute viral hepatitis. METHOD A prospective observational multicentre study was performed in a Spanish network of imported infections. Viral hepatitis cases from January 2009 to September 2017 were included. RESULTS Of 14,546 records, 723 (4.97%) had imported viral hepatitis, including 48 (6.64%) acute cases and 675 (93.36%) chronic cases. Of the 48 acute cases, 31 were travellers and immigrants returning from visiting friends or relatives (VFR), while 19 (61%) were acute Hepatitis A or Hepatitis B. Only 18.2% of VFR immigrants and 35% of travellers received pre-travel advice. Acute hepatitis was more frequent in VFR immigrants (AOR 2.59, CI95% 1.20-5.60) and travellers (AOR 2.83, CI95% 1.46-5.50) than immigrants. Of the 675 Chronic cases, 570 were immigrants, and 439 (77%) had chronic Hepatitis B. Chronic hepatitis was more frequent in immigrants (AOR 20.22, CI95% 11.64-35.13) and VFR immigrants (AOR 11.12, CI95% 6.20-19.94) than travellers. CONCLUSIONS Chronic viral hepatitis was typical of immigrants, acute viral hepatitis was common among travellers, and VFR immigrants had mixed risk. Improving pre-travel consultation and screening of immigrants may contribute to preventing new cases of viral hepatitis and avoiding community transmission.
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Affiliation(s)
- Cesar Henriquez-Camacho
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Núria Serre
- Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain
| | - Francesca Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain
| | - Diego Torrús
- Alicante University Hospital, Calle Pintor Baeza 11, 03010, Alicante, Spain
| | | | | | | | - Begoña Treviño
- Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, PROSICS Barcelona, Passeig Vall d´Hebron 119-129, 08035, Barcelona, Spain
| | - Azucena Rodríguez
- Hospital Universitario Central de Asturias, Av. Roma, s/n, 33011, Oviedo Principado de Asturias, Spain
| | - Magdalena García
- Consorcio Hospital General Universitario de Valencia, Avenida Tres Cruces, 2, 46014, Valencia, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain
| | - José A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain.
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Hong SS, Choi UY, Ma SH, Lee SY, Han SB, Kim KH, Kang JH, Kim JH. Comparison of the immunogenicity and safety of 3 inactivated hepatitis A vaccines in Korean children aged 12 to 18 months: An open-label, randomized, prospective, multicenter study. Medicine (Baltimore) 2019; 98:e14364. [PMID: 30732169 PMCID: PMC6380807 DOI: 10.1097/md.0000000000014364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/29/2018] [Accepted: 01/07/2019] [Indexed: 11/25/2022] Open
Abstract
Several approved inactivated hepatitis A (HA) vaccines are available in Korea. These have been shown to be immunogenic and safe in European children; however, their immunogenicity and safety have not been investigated among Korean children. We aimed to compare the immunogenicity and safety of the most commonly used HA vaccines in ethnic Korean children aged 12 to 18 months.In this open-label, randomized, prospective, multicenter study, 108 children were enrolled and randomized to receive a pediatric form of Avaxim, Epaxal, or Havrix. The 2nd dose was administered after an interval of 6 months. Anti-HA virus (HAV) immunoglobulin (Ig) G was measured to assess geometric mean concentrations (GMCs) and seropositvity rates (≥20 mIU/mL anti-HAV IgG). To assess safety, local solicited adverse events (AEs), systemic solicited AEs, unsolicited AEs, and serious AEs (SAEs) were graded.Among the 108 participants enrolled, 37, 34, and 37 received Avaxim, Epaxal, and Havrix, respectively. After administration of 2 doses, the seropositivity rates in the Avaxim, Epaxal, and Havrix groups were all 100% (95% confidence intervals [CIs]: 99.0-100, 98.9-100, and 99.0-100, respectively; P < .001). The anti-HAV GMCs in the Avaxim, Epaxal, and Havrix groups were 5868.4 (95% CI: 4237.2-8126.6), 1962.1 (95% CI: 1298.0-2965.9), and 2232.9 mIU/mL (95% CI: 1428.4-3490.4), respectively, after administration of 2 doses (P < .001). There were no significant differences in the proportions of participants reporting local solicited AEs, systemic solicited AEs, unsolicited AEs, and SAEs among the 3 vaccine groups after the 1st and 2nd doses. All local solicited and unsolicited AEs were grade 1 or 2. Grade 3 systemic solicited AE occurred in 5.4% and 2.9% of the participants in the Havrix group after the 1st and 2nd doses, respectively. SAEs after the 1st and 2nd doses were reported in 2 participants and 1 participant, respectively, but none was assessed as being related to vaccination.The results indicate that these vaccines were safe and immunogenic in ethnic Korean children. The results have contributed to the establishing of an HA vaccination policy in Korea and will be informative to countries that plan to initiate vaccination programs against HAV.
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Affiliation(s)
- Seung Soo Hong
- Department of Pediatrics, Graduate School of Medical Science
| | - Ui Yoon Choi
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
| | - Sang Hyuk Ma
- Department of Pediatrics, Changwon Fatima Hospital, Changwon
| | - Soo Young Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
| | - Seung Beom Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
| | - Kyung-Hyo Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
| | - Jong-Hyun Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
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133
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Kweon OJ, Lim YK, Kim HR, Kim TH, Lee MK. Analytical performance of newly developed rapid point-of-care test for the simultaneous detection of hepatitis A, B, and C viruses in serum samples. J Med Virol 2019; 91:1056-1062. [PMID: 30668895 DOI: 10.1002/jmv.25405] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/03/2019] [Accepted: 01/18/2019] [Indexed: 01/24/2023]
Abstract
ABSTRACTBACKGROUND Although immunoassays play a major role in the detection of hepatitis viruses, there is a need for a point-of-care (POC) test. We evaluated the EuDx-HE (A,B,C) kit (EUDIPIA, Cheongju, Korea), which detects anti-hepatitis A virus (HAV) immunoglobulin M (IgM), hepatitis B virus surface antigen (HBsAg), and anti-hepatitis C virus (HCV) immunoglobulin G (IgG) simultaneously using an immunochromatographic method within 15 minutes. METHODS A total of 1581 serum samples including 57, 477, and 451 samples positive for anti-HAV IgM, HBsAg, and anti-HBV IgG, respectively, were analyzed. We investigated the diagnostic accuracy of the EuDx-HE (A,B,C) kit by comparison with SD BIOLINE POC kits (Abbott, Chicago, IL) using Architect immunoassays as a reference method. RESULTS For anti-HAV IgM and HBsAg detection, the EuDx-HE (A,B,C) kit showed a higher sensitivity and a slightly lower specificity than the SD BIOLINE kit. For anti-HCV IgG detection, the EuDx-HE (A,B,C) kit had a higher sensitivity and a higher specificity than the SD BIOLINE kit. The agreement for positivity between the POC tests was >89.47%, with κ values of 0.844, 0.941, and 0.943 for HAV, HBV, and HCV, respectively. CONCLUSION The EuDx-HE (A,B,C) kit showed an acceptable clinical performance for detecting anti-HAV IgM, HBsAg, and anti-HCV.
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Affiliation(s)
- Oh Joo Kweon
- Department of Laboratory Medicine, Aerospace Medical Center, Cheongju, Republic of Korea.,Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yong Kwan Lim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Kim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Tae-Hyoung Kim
- Department of Urology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Mi-Kyung Lee
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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134
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Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol 2019; 70:151-171. [PMID: 30266282 DOI: 10.1016/j.jhep.2018.09.014] [Citation(s) in RCA: 1894] [Impact Index Per Article: 378.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 02/06/2023]
Abstract
Liver disease accounts for approximately 2 million deaths per year worldwide, 1 million due to complications of cirrhosis and 1million due to viral hepatitis and hepatocellular carcinoma. Cirrhosis is currently the 11th most common cause of death globally and liver cancer is the 16th leading cause of death; combined, they account for 3.5% of all deaths worldwide. Cirrhosis is within the top 20 causes of disability-adjusted life years and years of life lost, accounting for 1.6% and 2.1% of the worldwide burden. About 2 billion people consume alcohol worldwide and upwards of 75 million are diagnosed with alcohol-use disorders and are at risk of alcohol-associated liver disease. Approximately 2 billion adults are obese or overweight and over 400 million have diabetes; both of which are risk factors for non-alcoholic fatty liver disease and hepatocellular carcinoma. The global prevalence of viral hepatitis remains high, while drug-induced liver injury continues to increase as a major cause of acute hepatitis. Liver transplantation is the second most common solid organ transplantation, yet less than 10% of global transplantation needs are met at current rates. Though these numbers are sobering, they highlight an important opportunity to improve public health given that most causes of liver diseases are preventable.
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Affiliation(s)
| | | | - John Eaton
- Mayo Clinic College of Medicine, Rochester, MN, USA
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135
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Jayasundara D, Hui BB, Regan DG, Heywood AE, MacIntyre CR, Wood JG. Modelling the decline and future of hepatitis A transmission in Australia. J Viral Hepat 2019; 26:199-207. [PMID: 30315680 DOI: 10.1111/jvh.13018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/23/2018] [Accepted: 09/17/2018] [Indexed: 12/13/2022]
Abstract
Hepatitis A incidence has declined in most countries through a combination of prevention measures, augmented through the use of a highly effective vaccine. In Australia, the proportion of the population susceptible to hepatitis A infection has declined over time due to high rates of opportunistic vaccination as well as the sustained inflow of seropositive immigrants from high-endemicity countries. These factors have contributed to a rapid decline in incidence. An age-structured hepatitis A transmission model incorporating demographic changes was fitted to seroprevalence and disease notification data and used to project incidence trends and transmission potential for hepatitis A in the general population. Robustness of findings was assessed through worst-case scenarios regarding vaccine uptake, migration and the duration of immunity. The decline in age-specific seroprevalence until the introduction of hepatitis A vaccine in 1994 was well explained through a declining basic reproduction number (R0 ) that remained >1. Accounting for existing immunity, we estimated that the effective reproduction number (Reff ) <1 in the general population of Australia since the early 1990s, declining more rapidly after the introduction of the hepatitis A vaccine. Future projections under a variety of scenarios support Reff remaining <1 with continued low incidence in the general population. In conclusion, our results suggest that sustained endemic transmission in the general Australian population is no longer possible although risks of sporadic outbreaks remain. This suggests potential for local elimination of hepatitis A infection in Australia, provided that elimination criteria can be defined and satisfied in risk groups. The methodology used here to investigate elimination potential can easily be replicated in settings such as in the USA where sequential seroprevalence studies are supported by routine notification data.
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Affiliation(s)
- Duleepa Jayasundara
- Faculty of Medicine, School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Ben B Hui
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - David G Regan
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Anita E Heywood
- Faculty of Medicine, School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - C Raina MacIntyre
- Faculty of Medicine, School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - James G Wood
- Faculty of Medicine, School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales, Australia
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136
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Vanichanan J, Udomkarnjananun S, Avihingsanon Y, Jutivorakool K. Common viral infections in kidney transplant recipients. Kidney Res Clin Pract 2018; 37:323-337. [PMID: 30619688 PMCID: PMC6312768 DOI: 10.23876/j.krcp.18.0063] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/22/2018] [Accepted: 10/07/2018] [Indexed: 12/15/2022] Open
Abstract
Infectious complications have been considered as a major cause of morbidity and mortality after kidney transplantation, especially in the Asian population. Therefore, prevention, early detection, and prompt treatment of such infections are crucial in kidney transplant recipients. Among all infectious complications, viruses are considered to be the most common agents because of their abundance, infectivity, and latency ability. Herpes simplex virus, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, hepatitis B virus, BK polyomavirus, and adenovirus are well-known etiologic agents of viral infections in kidney transplant patients worldwide because of their wide range of distribution. As DNA viruses, they are able to reactivate after affected patients receive immunosuppressive agents. These DNA viruses can cause systemic diseases or allograft dysfunction, especially in the first six months after transplantation. Pretransplant evaluation and immunization as well as appropriate prophylaxis and preemptive approaches after transplant have been established in the guidelines and are used effectively to reduce the incidence of these viral infections. This review will describe the etiology, diagnosis, prevention, and treatment of viral infections that commonly affect kidney transplant recipients.
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Affiliation(s)
- Jakapat Vanichanan
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Suwasin Udomkarnjananun
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.,Renal Immunology and Therapeutic Apheresis Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Yingyos Avihingsanon
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.,Renal Immunology and Therapeutic Apheresis Research Unit, Chulalongkorn University, Bangkok, Thailand.,Excellence Center of Immunology and Immune-mediated Diseases, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Kamonwan Jutivorakool
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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137
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Guerrero-Latorre L, Romero B, Bonifaz E, Timoneda N, Rusiñol M, Girones R, Rios-Touma B. Quito's virome: Metagenomic analysis of viral diversity in urban streams of Ecuador's capital city. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 645:1334-1343. [PMID: 30248857 DOI: 10.1016/j.scitotenv.2018.07.213] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
In Quito, the microbiological contamination of surface water represents a public health problem, mainly due to the lack of sewage treatment from urban wastewater. Contaminated water contributes to the transmission of many enteric pathogens through direct consumption, agricultural and recreational use. Among the different pathogens present in urban discharges, viruses play an important role on disease, being causes of gastroenteritis, hepatitis, meningitis, respiratory infections, among others. This study analyzes the presence of viruses in highly impacted surface waters of urban rivers using next-generation sequencing techniques. Three representative locations of urban rivers, receiving the main discharges from Quito sewerage system, were selected. Water samples of 500 mL were concentrated by skimmed-milk flocculation method and the viral nucleic acid was extracted and processed for high throughput sequencing using Illumina MiSeq. The results yielded very relevant data of circulating viruses in the capital of Ecuador. A total of 29 viral families were obtained, of which 26 species were associated with infections in humans. Among the 26 species identified, several were related to gastroenteritis: Human Mastadenovirus F, Bufavirus, Sapporovirus, Norwalk virus and Mamastrovirus 1. Also detected were: Gammapapillomavirus associated with skin infections, Polyomavirus 1 related to cases of kidney damage, Parechovirus A described as cause of neonatal sepsis with neurological affectations and Hepatovirus A, the etiologic agent of Hepatitis A. Other emergent viruses identified, of which its pathogenicity remains to be fully clarified, were: Bocavirus, Circovirus, Aichi Virus and Cosavirus. The wide diversity of species detected through metagenomics gives us key information about the public health risks present in the urban rivers of Quito. In addition, this study describes for the first time the presence of important infectious agents not previously reported in Ecuador and with very little reports in Latin America.
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Affiliation(s)
- Laura Guerrero-Latorre
- Grupo de investigación Biodiversidad, Medio Ambiente y Salud (BIOMAS), Facultad de Ingenierías y Ciencias Aplicadas (FICA), Ingeniería en Biotecnología, Universidad de las Américas, Quito, Ecuador.
| | - Brigette Romero
- Grupo de investigación Biodiversidad, Medio Ambiente y Salud (BIOMAS), Facultad de Ingenierías y Ciencias Aplicadas (FICA), Ingeniería en Biotecnología, Universidad de las Américas, Quito, Ecuador.
| | - Edison Bonifaz
- Grupo de investigación Biodiversidad, Medio Ambiente y Salud (BIOMAS), Facultad de Ingenierías y Ciencias Aplicadas (FICA), Ingeniería en Biotecnología, Universidad de las Américas, Quito, Ecuador.
| | - Natalia Timoneda
- Laboratory of Virus Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Catalonia, Spain
| | - Marta Rusiñol
- Laboratory of Virus Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Rosina Girones
- Laboratory of Virus Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Blanca Rios-Touma
- Grupo de investigación Biodiversidad, Medio Ambiente y Salud (BIOMAS), Facultad de Ingenierías y Ciencias Aplicadas (FICA), Ingeniería Ambiental, Universidad de las Américas, Quito, Ecuador.
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138
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Shi N, Rasuli A, Thollot Y. Safety of two doses of an inactivated hepatitis a vaccine given 6 months apart in healthy toddlers, children, and adolescents aged 12 months to 15 years in China: a phase IV study. Hum Vaccin Immunother 2018; 15:748-754. [PMID: 30403910 PMCID: PMC6605741 DOI: 10.1080/21645515.2018.1539600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/24/2018] [Accepted: 10/16/2018] [Indexed: 11/17/2022] Open
Abstract
Hepatitis A is a vaccine-preventable infection caused by the HA virus (HAV) with transitional to intermediate endemicity in China. An inactivated vaccine first licensed in China in 2010 (Avaxim® 80U Pediatric) is indicated for primary and booster vaccination in children from 12 months to 15 years of age. This Phase IV, open-label, single-arm trial supported licensure in pediatric age groups in China. A total of 355 healthy infants and toddlers (< 2 years of age), children (2 to 11 years of age), and adolescents (≥ 12 years of age) were enrolled to receive two doses of intramuscular HA vaccine, separated by 6 months. Participants were split into Group 1 (infants and toddlers: N = 270) and Group 2 (children and adolescents: N = 85). Safety was assessed by solicited injection site and systemic adverse events (AEs) for 7 days and unsolicited AEs for 30 days after each vaccination. Serious AEs (SAEs) were collected throughout. Immunogenicity was not assessed. Analyses were descriptive. Both vaccinations were very well tolerated in each group. The incidence of solicited injection site reactions was lower in Group 1 (17.9%) than Group 2 (33.3%) and for solicited systemic reactions was similar for each group. The incidence of unsolicited AEs in Group 1 was 6.3% and none in Group 2. For solicited and unsolicited AEs the incidence was slightly higher after the first vaccination. There were no SAEs. Overall, the good safety profile of this pediatric HA vaccine was confirmed in infants, toddlers, children, and adolescents aged 12 months to 15 years in China.
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Affiliation(s)
- Nianmin Shi
- Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China
| | - Anvar Rasuli
- Global Medical Affairs, Sanofi Pasteur, Lyon, France
| | - Yaël Thollot
- Global Medical Affairs, Sanofi Pasteur, Lyon, France
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139
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Michaelis K, Poethko-Müller C, Kuhnert R, Stark K, Faber M. Hepatitis A virus infections, immunisations and demographic determinants in children and adolescents, Germany. Sci Rep 2018; 8:16696. [PMID: 30420608 PMCID: PMC6232152 DOI: 10.1038/s41598-018-34927-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 10/28/2018] [Indexed: 12/17/2022] Open
Abstract
Hepatitis A is a vaccine-preventable disease with a global distribution. It predominantly occurs in regions with inadequate living conditions, but also affects populations in industrialised countries. Children are frequently involved in the transmission of hepatitis A virus (HAV) and thus play a central role in the epidemiology of hepatitis A. Here, we investigated HAV infections, immunisations, and associated demographic determinants in a nationwide, population-based, cross-sectional survey conducted in Germany from 2003-2006. Out of 17,640 children and adolescents, complete data sets (HAV serology, demographic information and vaccination card) were available for 12,249 (69%), all aged 3-17 years. We found protective antibody levels (>=20 IU/L) in 1,755 (14%) individuals, 1,395 (11%) were vaccinated against hepatitis A, 360 (3%) individuals were HAV seropositive without prior hepatitis A vaccination, thus indicating a previous HAV infection. Antibody prevalence (attributable to vaccination or infection) increased significantly with age. Multivariate logistic regression revealed that predominantly children and adolescents with migration background-even if they were born in Germany-are affected by HAV infections. Our results provide a rationale to emphasise existing vaccination recommendations and, moreover, to consider additional groups with a higher risk of infection for targeted vaccination, especially children with a migration background.
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Affiliation(s)
- Kai Michaelis
- Department for Infectious Disease Epidemiology, Unit of Gastrointestinal Infections, Zoonoses, and Tropical Infections, Robert Koch Institute (RKI), D-13353, Berlin, Germany.
| | - Christina Poethko-Müller
- Department of Epidemiology and Health Monitoring, Robert Koch Institute (RKI), D-12101, Berlin, Germany
| | - Ronny Kuhnert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute (RKI), D-12101, Berlin, Germany
| | - Klaus Stark
- Department for Infectious Disease Epidemiology, Unit of Gastrointestinal Infections, Zoonoses, and Tropical Infections, Robert Koch Institute (RKI), D-13353, Berlin, Germany
| | - Mirko Faber
- Department for Infectious Disease Epidemiology, Unit of Gastrointestinal Infections, Zoonoses, and Tropical Infections, Robert Koch Institute (RKI), D-13353, Berlin, Germany
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140
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Jefferies M, Rauff B, Rashid H, Lam T, Rafiq S. Update on global epidemiology of viral hepatitis and preventive strategies. World J Clin Cases 2018; 6:589-599. [PMID: 30430114 PMCID: PMC6232563 DOI: 10.12998/wjcc.v6.i13.589] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/07/2018] [Accepted: 10/16/2018] [Indexed: 02/05/2023] Open
Abstract
Viral hepatitis is one of the major public health concerns around the world but until recently it has drawn little attention or funding from global health policymakers. Every year 1.4 million people die from viral hepatitis-related cirrhosis and liver cancer. However, the majority of the infected population are unaware of their condition. This population have significant obstacles to overcome such as lack of awareness, vulnerability, increased migration, disease stigma, discrimination, as well as poor health resources, conflict in policy development and program implementation. Despite implementing infection control measures over the last few decades eradication or significant disease reduction remains elusive. This study aims to present the current global prevalence status and examines potential elimination strategies. The information for this research were obtained through a systematic review, published scientific literatures, the official websites of various government organisations, international public health organisations and internationally recognised regulatory bodies over a period of 40 years between 1978 and 2018.
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Affiliation(s)
- Meryem Jefferies
- Drug Health, Western Sydney Local Health District, North Parramatta NSW 2151, Australia
| | - Bisma Rauff
- Westmead Institute for Medical Research, Westmead Hospital, Sydney Medical School University of Sydney, Westmead NSW 2145, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, the Children’s Hospital at Westmead, and the Discipline of Child and Adolescent Health, Sydney Medical School, Westmead, NSW 2145, Australia
| | - Thao Lam
- Drug Health, Western Sydney Local Health District, North Parramatta NSW 2151, Australia
| | - Shafquat Rafiq
- Croydon University Hospital NHS Trust, Croydon SE23 2SP, United Kingdom
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141
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Kwon JC, Chang HY, Kwon OY, Park JH, Oh IS, Kim HJ, Lee JH, Roh HJ, Lee HW. Seroepidemiology of Hepatitis Viruses and Hepatitis B Genotypes of Female Marriage Immigrants in Korea. Yonsei Med J 2018; 59:1072-1078. [PMID: 30328322 PMCID: PMC6192883 DOI: 10.3349/ymj.2018.59.9.1072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/11/2018] [Accepted: 08/23/2018] [Indexed: 01/21/2023] Open
Abstract
PURPOSE The Korean society has moved rapidly toward becoming a multicultural society. This study aimed to estimate the seroprevalence of hepatitis viruses and investigate hepatitis B virus (HBV) genotypic diversity in female marriage immigrants. MATERIALS AND METHODS Screening program was conducted at support centers for multicultural families in 21 administrative districts in Korea between July 2011 and January 2017. A total of 963 female marriage immigrants were included in this study. Blood samples were tested for hepatitis viral markers and HBV genotype. RESULTS Subjects' median age was 33 years (20-40 years), and they originated from nine countries including Vietnam (n=422, 43.8%), China (n=311, 32.3%), the Philippines (n=85, 8.8%), Cambodia (n=58, 6.0%), and Japan (n=39, 4.0%). About 30% (n=288) of subjects required hepatitis A vaccination. HBsAg positive rate was 5.4% (n=52). Positive HBsAg results were the highest in subjects from Southeast Asia (6.6%, n=38). Anti-HBs positive rate was 60.4% (n=582). About 34% (n=329) of subjects who were negative for anti-HBs and HBsAg required HBV vaccinations. Genotypes B and C were found in 54.6% (n=12) and 45.4% (n=10) of the 22 subjects with HBV, in whom genotypes were tested. Eight (0.8%) subjects were positive for anti-HCV. Positive anti-HCV results were the highest in subjects from Central Asia (7.9%, n=3). CONCLUSION Testing for hepatitis viral marker (hepatitis A virus IgG and HBsAg/anti-HBs) is needed for female marriage immigrants. Especially, HBV genotype B is different from genotype C of Koreans. Therefore, interest and attention to vaccination programs for female marriage immigrants are necessary for both clinicians and public health institutes.
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Affiliation(s)
- Jae Cheol Kwon
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hye Young Chang
- Department of Internal Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Oh Young Kwon
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji Hoon Park
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - In Soo Oh
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyung Joon Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jun Hyung Lee
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Ha Jung Roh
- Molecular Epidemiology and Bioinformatics Laboratory, Division of Viral Hepatitis, Center for Disease Control and Prevention, Atlanta, GA, USA
| | - Hyun Woong Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
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142
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Viral Hepatitis Recommendations for Solid-Organ Transplant Recipients and Donors. Transplantation 2018; 102:S66-S71. [PMID: 29381580 DOI: 10.1097/tp.0000000000002013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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143
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López-Gatell H, García-García L, Echániz-Avilés G, Cruz-Hervert P, Olamendi-Portugal M, Castañeda-Desales D, Sanchez-Alemán MÁ, Romero-Martínez M, DeAntonio R, Cervantes-Apolinar MY, Cortes-Alcalá R, Alpuche-Aranda C. Hepatitis A seroprevalence in adolescents and young adults in Mexico: A 2012 National Health and Nutrition Survey analysis. Vaccine 2018; 36:8094-8099. [PMID: 30337174 DOI: 10.1016/j.vaccine.2018.10.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/27/2018] [Accepted: 10/09/2018] [Indexed: 10/28/2022]
Abstract
To describe hepatitis A virus (HAV) seroprevalence and associated factors in adolescents (10-19 years) and young adults (20-25 years) in different Mexican regions, using 2012 National Health and Nutrition Survey data. A random selection of 1581 serum samples was analyzed. Weighted HAV seroprevalence with 95% confidence intervals (95%CI) and its association with sociodemographic factors were estimated. Mean weighted HAV seroprevalence was 69.3% (95%CI: 64.8-73.4) overall, with 58.8% (95%CI: 53.4-64.1) in adolescents and 83.0% (95%CI: 75.3-88.7) in young adults. By age of 10, 46.7% (95%CI: 33.9-60.0) were seropositive and by age of 15, 52.8% (95%CI: 36.5-68.5), corresponding to intermediate endemicity nationally. Factors associated with HAV seropositivity (adjusted odds ratio, aOR) included: lower socioeconomic status (SES) (aOR = 4.09 for low and aOR = 2.31 for medium versus high SES), older age (aOR = 0.29 for adolescents versus young adults), living in the South (aOR = 2.12 versus Central Mexico) or in rural areas (aOR = 2.25 versus urban areas). Regional differences and increased seroprevalence of HAV in marginalized populations present an important public health issue, as a relatively large proportion of young adults are susceptible to infection. The burden of symptomatic disease must be addressed further to support specific programs of continued sanitation and education improvement, and the possibility of vaccination in more susceptible regions.
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Affiliation(s)
- Hugo López-Gatell
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico
| | - Lourdes García-García
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico
| | - Gabriela Echániz-Avilés
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico
| | - Pablo Cruz-Hervert
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico
| | - María Olamendi-Portugal
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico
| | - Deyanira Castañeda-Desales
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico
| | - Miguel Ángel Sanchez-Alemán
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico
| | - Martín Romero-Martínez
- Centro de Investigación sobre Evaluación y Encuestas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico
| | - Rodrigo DeAntonio
- GSK, Urbanización Industrial Juan Díaz Entre Calles A y B, Apartado Postal 6-1697, Panama City, Panama; Cevaxin - Centro de Vacunación Internacional, Pan-American Hwy, Panama City, Panama
| | - Maria Yolanda Cervantes-Apolinar
- GSK, Urbanización Industrial Juan Díaz Entre Calles A y B, Apartado Postal 6-1697, Panama City, Panama; GSK, Calz México-Xochimilco 4900, Col. San Lorenzo Huipulco, Mexico City 14370, Mexico
| | - Ricardo Cortes-Alcalá
- GSK, Calz México-Xochimilco 4900, Col. San Lorenzo Huipulco, Mexico City 14370, Mexico
| | - Celia Alpuche-Aranda
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Sta. María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, Mexico.
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Abstract
Increased economic interdependence, social integration, and other aspects of globalization are contributing to significant changes in hepatitis A epidemiology. Globally, the incidence of hepatitis A virus (HAV) infection is decreasing, the age at midpoint of population immunity (AMPI) is increasing, and the proportion of symptomatic cases is increasing as the average age at infection increases. In low-income countries, HAV remains endemic but improved water and sanitation systems are reducing transmission rates among young children. In high-income countries, most adults remain susceptible to HAV and foodborne outbreaks are becoming more frequent. Middle-income countries have diverse epidemiological profiles, and they play important roles in the global spread of HAV through international trade and travel. Future changes in the epidemiology of hepatitis A will be heavily influenced by globalization processes.
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Affiliation(s)
- Kathryn H Jacobsen
- College of Health and Human Services, George Mason University, Fairfax, Virginia 22030
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145
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Hassan-Kadle MA, Osman MS, Ogurtsov PP. Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study. World J Gastroenterol 2018; 24:3927-3957. [PMID: 30228786 PMCID: PMC6141335 DOI: 10.3748/wjg.v24.i34.3927] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/25/2018] [Accepted: 06/21/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To provide a clear understanding of viral hepatitis epidemiology and their clinical burdens in Somalia.
METHODS A systematic review and meta-analysis was conducted as Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search of published studies on viral hepatitis was performed from 1977-2016 in PubMed, Google Scholar, Science Direct, World Health Organization African Index Medicus and the Africa Journals Online databases, as well as on the Ministry of Health website. We also captured unpublished articles that were not available on online systems.
RESULTS Twenty-nine studies from Somalia and Somali immigrants (United Kingdom, United States, Italy, Libya) with a combined sample size for each type of viral hepatitis [hepatitis A virus (HAV): 1564, hepatitis B virus (HBV): 8756, hepatitis C virus (HCV): 6257, hepatitis D virus (HDV): 375 and hepatitis E virus (HEV): 278] were analyzed. The overall pooled prevalence rate of HAV was 90.2% (95%CI: 77.8% to 96%). The HAV prevalence among different age groups was as follows: < 1 year old, 61.54% (95%CI: 40.14% to 79.24%); 1-10 years old, 91.91% (95%CI: 87.76% to 94.73%); 11-19 years old, 96.31% (95%CI: 92.84% to 98.14%); 20-39 years old, 91.3% (95%CI: 83.07% to 95.73%); and > 40 years old, 86.96% (95%CI: 75.68% to 93.47%). The overall pooled prevalence of HBV was 18.9% (95%CI: 14% to 29%). The overall pooled prevalence among subgroups of HBV was 20.5% (95%CI: 5.1% to 55.4%) in pregnant women; 5.7% (95%CI: 2.7% to 11.5%) in children; 39.2% (95%CI: 33.4% to 45.4%) in patients with chronic liver disease, including hepatocellular carcinoma (HCC); 7.7% (95%CI: 4.2% to 13.6%), 12.4% (95%CI: 6.3% to 23.0%) and 11.8% (95%CI: 5.3% to 24.5%) in age groups < 20 years old, 20-39 years old and > 40 years old, respectively. The HBV prevalence among risk groups was 20% (95%CI: 7.19% to 44.64%) in female prostitutes, 21.28% (95%CI: 7.15% to 48.69%) in hospitalized adults, 5.56% (95%CI: 0.99% to 25.62%) in hospitalized children, 60% (95%CI: 31.66% to 82.92%) in patients with acute hepatitis, 33.55% (95%CI: 14.44% to 60.16%) in patients with ancylostomiasis, 12.34% (95%CI: 7.24% to 20.26%) in patients with leprosy and 20.19% (95%CI: 11.28% to 33.49%) in schistosomiasis patients. The overall pooled prevalence of HCV was estimated as 4.84% (95%CI: 3.02% to 7.67%). The prevalence rates among blood donors, risk groups, children and patients chronic liver disease (including HCC) was 0.87% (95%CI: 0.33% to 2.30%), 2.43% (95%CI: 1.21% to 4.8%), 1.37% (95%CI: 0.76% to 2.46%) and 29.82% (95%CI: 15.84% to 48.98%), respectively. The prevalence among genotypes of HCV was 21.9% (95%CI: 15.36% to 30.23%) in genotype 1, 0.87% (95%CI: 0.12% to 5.9%) in genotype 2, 25.21% (95%CI: 18.23% to 33.77%) in genotype 3, 46.24% (95%CI: 37.48% to 55.25%) in genotype 4, 2.52% (95%CI: 0.82% to 7.53%) in genotype 5, and 1.19% (95%CI: 0.07% to 16.38%) in genotype 6. The overall pooled prevalence of HDV was 28.99% (95%CI: 16.38% to 45.96%). The HDV prevalence rate among patients with chronic liver disease, including HCC, was 43.77% (95%CI: 35.09% to 52.84%). The overall pooled prevalence of HEV was 46.86% (95%CI: 5.31% to 93.28%).
CONCLUSION Our study demonstrates a high prevalence of all forms of viral hepatitis in Somalia and it also indicates that chronic HBV was the commonest cause of chronic liver disease. This highlights needs for urgent public health interventions and strategic policy directions to controlling the burden of the disease.
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Affiliation(s)
- Mohamed Abdulkadir Hassan-Kadle
- Center For the study of the Liver, Department of Hospital Medicine, Peoples’ Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Abrar Research and Training Center, Abrar University, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Dufle Specialist Hospital, Mogadishu 25, Somalia
| | - Mugtaba Sulaiman Osman
- Department of Psychiatry, School of Medicine, Royal College of Surgeons in Ireland RCSI, Beaumont Hospital, Dublin 9, Ireland
| | - Pavel Petrovich Ogurtsov
- Center For the study of the Liver, Department of Hospital Medicine, Peoples’ Friendship University of Russia (RUDN University), Moscow 117198, Russia
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146
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Bai H, Shiota T, Yoshizaki S, Saito-Obata M, Malbas FF, Lupisan SP, Oshitani H, Takeda N, Muramatsu M, Wakita T, Ishii K, Li TC. Detection of Subgenotype IA and IIIA Hepatitis A Viruses in Rivers Flowing through Metro Manila, the Philippines. Jpn J Infect Dis 2018; 72:53-55. [PMID: 30175732 DOI: 10.7883/yoken.jjid.2018.148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hepatitis A virus (HAV) is a common infectious etiology of acute hepatitis worldwide. The Philippines remains highly endemic for hepatitis A, but there is still a lack of information about HAV in the country. To evaluate the HAV contamination in environmental water in the Philippines, we conducted the detection and genetic analyses of HAV RNA in samples from river water. Twelve water samples were collected at 6 sampling sites of 3 rivers in Metro Manila, in both the dry and wet seasons in 2012 and 2013. The HAV RNA was detected in all the 6 samples collected in the dry season, and in one sample from the wet season. Phylogenetic analysis confirmed that the HAV strains detected in the river water included multiple sequences belonging to subgenotypes IA and IIIA. This indicates that at least 2 genotypes of the HAV strains are circulating in the environment in the Philippines, posing a risk of HAV infection to not only residents, but also tourists, especially in the dry season.
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Affiliation(s)
- Huimin Bai
- Department of Basic Medicine and Forensic Medicine, Baotou Medical College, Baotou Inner Mongolia
| | - Tomoyuki Shiota
- Department of Virology II, National Institute of Infectious Diseases
| | - Sayaka Yoshizaki
- Department of Virology II, National Institute of Infectious Diseases
| | - Mariko Saito-Obata
- Department of Virology, Tohoku University Graduate School of Medicine.,RITM-Tohoku Collaborating Research Center on Emerging and Re-Emerging Infectious Diseases
| | | | | | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine.,RITM-Tohoku Collaborating Research Center on Emerging and Re-Emerging Infectious Diseases
| | - Naokazu Takeda
- Research Institute for Microbial Diseases, Osaka University
| | | | - Takaji Wakita
- Department of Virology II, National Institute of Infectious Diseases
| | - Koji Ishii
- Department of Virology II, National Institute of Infectious Diseases
| | - Tian-Cheng Li
- Department of Virology II, National Institute of Infectious Diseases
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147
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Schmutz C, Mäusezahl D, Jost M. Hepatitis A in Switzerland: An analysis of 29 years of surveillance data and contemporary challenges. Travel Med Infect Dis 2018; 27:53-63. [PMID: 30077655 DOI: 10.1016/j.tmaid.2018.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/19/2018] [Accepted: 07/25/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hepatitis A (HA) incidence declined in most European countries in the past decades. We analysed HA notification data for Switzerland of 29 years looking for disease- and notification system-related factors possibly contributing to observed trends. METHOD Notification data were descriptively analysed using five time intervals (1988-1993, 1994-1999, 2000-2005, 2006-2011, 2012-2016); and notification rates were calculated. RESULTS From 1988 to 2016, the HA notification rate decreased from 9.5 to 0.5 per 100'000 population in Switzerland. Median age and the proportion of hospitalised cases increased over time. In the 1988-1993-time period, intravenous drug use was the most frequently mentioned risk exposure while consumption of contaminated food/beverages was most frequently mentioned in the 2012-2016-time period. CONCLUSIONS Notification data does not allow reliably identifying current risk groups (e.g. travellers) due to low case numbers, limited availability and reliability of information. It is important to document changes in the surveillance system for later analyses and interpretation of long-term trends. Population susceptibility likely increases underlining the importance of continued and continuous surveillance and prevention efforts despite decreasing case numbers. Operational research is recommended to further investigate observed trends of HA and to enhance the abilities for decision making from Swiss HA surveillance data.
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Affiliation(s)
- Claudia Schmutz
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Daniel Mäusezahl
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
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148
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Fouad HM, Reyad EM, El-Din AG. Acute hepatitis A is the chief etiology of acute hepatitis in Egyptian children: a single-center study. Eur J Clin Microbiol Infect Dis 2018; 37:1941-1947. [PMID: 30030693 DOI: 10.1007/s10096-018-3329-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/11/2018] [Indexed: 11/26/2022]
Abstract
Acute hepatic illness is an important health issue in children. Our work aimed to determine the prevalence of viral hepatitis in symptomatic children. It is a prospective cohort study of 268 children presented with acute hepatitis. Complete blood count, liver panel, and anti-hepatitis A virus (HAV) IgM were done initially. Cases negative for HAV were tested for anti-hepatitis E (HEV) IgM, anti-Epstein-Barr virus viral capsid antigen (EBV VCA) IgM, anti-cytomegalovirus virus IgM, hepatitis B surface antigen, anti-hepatitis B core IgM antibody, and anti-HCV antibody. Anti-HCV was repeated after 12 weeks to exclude seroconversion. In cases with negative viral serology, ceruloplasmin, total immunoglobulin G, antinuclear antibody, and abdominal ultrasound were done. Follow-up visits were bimonthly till recovery, then after 6 months. The mean age ± SD was 7.1 ± 3.7 years (1.5-18), and 56% were males. Acute HAV infection was diagnosed in 260 (97%) of cases and acute EBV infection in one case (0.4%). HAV/HEV coinfection was excluded in 70 HAV-positive cases. Six (2.2%) children remain undiagnosed and one child lost follow-up. About 80% of HAV-cases had normal laboratory results within 45 days. Unusual presentation of HAV infection was noticed in six children: four (1.5%) were relapsing, one had a cholestatic course, and one case had severe hemolytic anemia. Acute HAV infection was the chief etiology of acute hepatitis in our Egyptian children. The majority of the presentations were mild and children recover within a few weeks. An unusual pattern of HAV in children can be observed in endemic areas.
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Affiliation(s)
- Hanan M Fouad
- Pediatric Department, Faculty of Medicine, Helwan University, Cairo, Egypt.
| | - Ehab M Reyad
- Departments of Clinical and Chemical Pathology, National Hepatology and Tropical Medicine Research Institute "NHTMRI", Cairo, Egypt
| | - Amany Gmal El-Din
- Departments of Clinical Chemistry, National Hepatology and Tropical Medicine Research Institute "NHTMRI", Cairo, Egypt
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149
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Li C, Su H, Hu J, Duan H, Ji J. Case of severe acute hepatitis A virus infection in United Nations peacekeepers in South Sudan. J ROY ARMY MED CORPS 2018; 165:198-200. [PMID: 30012663 DOI: 10.1136/jramc-2018-000990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 01/30/2023]
Abstract
Hepatitis A virus (HAV) is a major cause of acute viral hepatitis, which can lead to severe cases and acute liver failure. A 41-year-old Chinese military officer of the United Nations peacekeeping forces in South Sudan manifested fever, jaundice and coagulation dysfunction. The patient initially had a negative anti-HAV IgM antibody test result but a positive anti-HAV-IgM antibody test result five days after his alanine aminotransferase (ALT) levels peaked. He was given telemedicine consultation and was transferred to a Chinese military hospital specialising in infectious diseases for treatment of severe acute HAV infection. The peak ALT, aspartate aminotransferase, total bilirubin and international standard ratio were 5410 U/L, 3475 U/L, 225.1 µmol/L and 2.12 during hospitalisation, respectively. Military personnel undergoing missions in areas with high prevalence of HAV should be tested for previous HAV infection before departure if they have not been previously vaccinated. If negative results are obtained, they should be vaccinated. Anti-HAV-IgM examination should be repeated after the first negative test result is obtained to eliminate the effects of a window period if a clinical suspicion exists. If a life-threatening case of HAV infection is present, the patient should be transported to a base military hospital specialising in infectious diseases for treatment.
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Affiliation(s)
- Chen Li
- Liver Failure Treatment and Research Center, 302 hospital of PLA, Beijing, China
| | - H Su
- Liver Failure Treatment and Research Center, 302 hospital of PLA, Beijing, China
| | - J Hu
- Liver Failure Treatment and Research Center, 302 hospital of PLA, Beijing, China
| | - H Duan
- Liver Failure Treatment and Research Center, 302 hospital of PLA, Beijing, China
| | - J Ji
- Liver Failure Treatment and Research Center, 302 hospital of PLA, Beijing, China
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150
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Gassowski M, Michaelis K, Wenzel JJ, Faber M, Figoni J, Mouna L, Friesema IH, Vennema H, Avellon A, Varela C, Sundqvist L, Lundberg Ederth J, Plunkett J, Balogun K, Ngui SL, Midgley SE, Gillesberg Lassen S, Müller L. Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018. Euro Surveill 2018; 23:1800329. [PMID: 29991381 PMCID: PMC6152161 DOI: 10.2807/1560-7917.es.2018.23.27.1800329] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 07/05/2018] [Indexed: 12/02/2022] Open
Abstract
From January to June 2018, two ongoing hepatitis A outbreaks affected travellers returning from Morocco and cases in Europe without travel history, resulting in 163 patients in eight European countries. Most interviewed travel-related cases were unaware of the hepatitis A risk in Morocco. Molecular analysis revealed two distinct hepatitis A virus (HAV) strains (subgenotype IA DK2018_231; subgenotype IB V18-16428). Vaccination recommendations should be emphasised to increase awareness among non-immune travellers to Morocco and HAV-endemic countries.
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Affiliation(s)
- Martyna Gassowski
- These authors contributed equally to this work
- Department for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
- Postgraduate Training for Applied Epidemiology (PAE, German Field Epidemiology Training Programme), Robert Koch Institute, Berlin, Germany
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Kai Michaelis
- These authors contributed equally to this work
- Department for Infectious Disease Epidemiology, Unit of Gastrointestinal Infections, Zoonoses, and Tropical Infections, Robert Koch Institute (RKI), Berlin, Germany
| | - Jürgen J Wenzel
- These authors contributed equally to this work
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Centre Regensburg, Regensburg, Germany
| | - Mirko Faber
- Department for Infectious Disease Epidemiology, Unit of Gastrointestinal Infections, Zoonoses, and Tropical Infections, Robert Koch Institute (RKI), Berlin, Germany
| | - Julie Figoni
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Lina Mouna
- AP-HP, National Reference Centre for Enterically Transmitted Hepatitis Viruses, Paul Brousse hospital, Villejuif, France
| | - Ingrid Hm Friesema
- Centre for Infectious Diseases, Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Harry Vennema
- Centre for Infectious Diseases Research, Diagnostics and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ana Avellon
- Hepatitis Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen Varela
- National Centre of Epidemiology, Instituto de Salud Carlos III, CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Lena Sundqvist
- Department of Communicable Disease Control and Health Protection, the Public Health Agency of Sweden, Stockholm, Sweden
| | | | - James Plunkett
- National Infection Service, Public Health England, London, United Kingdom
| | - Koye Balogun
- National Infection Service, Public Health England, London, United Kingdom
| | - Siew Lin Ngui
- National Infection Service, Public Health England, London, United Kingdom
| | - Sofie Elisabeth Midgley
- Department of Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Sofie Gillesberg Lassen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Luise Müller
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
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