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Carlos JC, Quinones VMT, Adversario MPL, Nailes JM, Songco JC, Garcia DR, Cacayorin MG, Cero MPV, Benedicto-Delfin MPA, Blanco MCC, Natividad NS, Bernabe JD, Chacon HCT, Ascue RAC, Paggao JNK, Comendador LOP, Hernandez-Suarez G, Guzman-Holst A. Seroprevalence and Shifting Endemicities of Hepatitis A Virus Infection in Two Different Geographical Areas in the Philippines. Infect Dis Ther 2024; 13:1019-1035. [PMID: 38578515 PMCID: PMC11098982 DOI: 10.1007/s40121-024-00955-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Infection with hepatitis A virus (HAV) is often asymptomatic in young children, but most adolescents and adults will have symptoms ranging from nausea and tiredness to acute liver failure and even death. The risk of severe disease is higher in older adults and people with pre-existing liver disease. Immunization is recommended in regions with low HAV endemicity levels, i.e., where people get infected later in life. In the Philippines, recent epidemiologic data on HAV infection are lacking. The objective of this study was to assess age-specific seroprevalence and evaluate risk factors associated with HAV seropositivity. METHODS People from two geographic areas (urban and rural) were recruited/enrolled and stratified by age group. HAV-specific immunoglobulin G (IgG) antibodies were measured with a chemiluminescent microparticle immunoassay. Sociodemographic parameters, hepatitis medical history, disease knowledge, hygiene measures and sanitation were assessed via a purpose-made questionnaire. Age at midpoint of population immunity (AMPI) was estimated using Kaplan-Meier curves. Logistic regression analyses were carried out to determine factors that were statistically significantly associated (p < 0.05) with HAV seropositivity. RESULTS Overall, 1242 participants were included in the analysis; 250/602 (41.5%) participants from urban regions and 283/640 (44.2%) participants from rural regions tested positive for HAV IgG antibodies. AMPI was 35 and 37 years for the rural and urban region, respectively. Higher education was associated with lower HAV seropositivity prevalence ratios, while not living in the same region for the last 5 years, regularly consuming street food and lack of handwashing after defecation were associated with a higher likelihood of HAV seropositivity. CONCLUSION Results suggest that HAV endemicity is low in the Philippines. Factors associated with HAV seropositivity were traveling, consuming street food and lack of basic hygienic gestures. Immunization might be an option to protect vulnerable populations against severe hepatitis A disease.
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Affiliation(s)
- Josefina C Carlos
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Vinna Marie T Quinones
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Jennifer M Nailes
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Jangail C Songco
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Donaliz R Garcia
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Michelle G Cacayorin
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - May Priscilla V Cero
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Ma Christina C Blanco
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Nadjah S Natividad
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Jacqueline D Bernabe
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Ronald Alvin C Ascue
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Jayme Natasha K Paggao
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
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Gloriani NG, de Paz-Silava SLM, Allison RD, Takashima Y, Avagyan T. The Shifting Epidemiology of Hepatitis A in the World Health Organization Western Pacific Region. Vaccines (Basel) 2024; 12:204. [PMID: 38400187 PMCID: PMC10891653 DOI: 10.3390/vaccines12020204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 02/25/2024] Open
Abstract
Within the past few decades, improvement in sanitation and economic growth has driven a changing epidemiology of hepatitis A in the Western Pacific Region (WPR) of the World Health Organization (WHO). In this review, we gathered available published information on hepatitis A epidemiology of the countries in the WPR and reviewed the trends reported in the literature from the years 2000 to 2021. Many countries have shifted from high endemicity to low endemicity. Moreover, the administration of the hepatitis A vaccine among children in recent years has shifted disease susceptibility to the older population. Seroprevalence among children has decreased in most countries, while nearly 100% seropositivity is seen in mid adulthood. This is contrary to the epidemiology seen in previous decades when most children achieved immunity by age ten. This also presents a paradox in that better living conditions have caused more vulnerability to the older age groups who are at higher risk for severe disease. Given these trends, we recommend vaccination of vulnerable populations such as the older age groups and inclusion of the hepatitis A vaccine in government immunization programs.
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Affiliation(s)
- Nina G. Gloriani
- Institute of Pathology, St. Luke’s Medical Center, Quezon City 1112, Philippines;
| | | | - Robert D. Allison
- Accelerated Disease Control Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA;
| | - Yoshihiro Takashima
- Vaccine-Preventable Diseases and Immunization Unit, Division of Programmes for Disease Control, Western Pacific Regional Office, World Health Organization, Manila 1000, Philippines; (Y.T.); (T.A.)
| | - Tigran Avagyan
- Vaccine-Preventable Diseases and Immunization Unit, Division of Programmes for Disease Control, Western Pacific Regional Office, World Health Organization, Manila 1000, Philippines; (Y.T.); (T.A.)
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Patterson J, Cleary S, Norman JM, Van Zyl H, Awine T, Mayet S, Kagina B, Muloiwa R, Hussey G, Silal SP. Modelling the Cost-Effectiveness of Hepatitis A in South Africa. Vaccines (Basel) 2024; 12:116. [PMID: 38400100 PMCID: PMC10893480 DOI: 10.3390/vaccines12020116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
The World Health Organization (WHO) recommends the consideration of introducing routine hepatitis A vaccination into national immunization schedules for children ≥ 1 years old in countries with intermediate HAV endemicity. Recent data suggest that South Africa is transitioning from high to intermediate HAV endemicity, thus it is important to consider the impact and cost of potential routine hepatitis A vaccination strategies in the country. An age-structured compartmental model of hepatitis A transmission was calibrated with available data from South Africa, incorporating direct costs of hepatitis A treatment and vaccination. We used the calibrated model to evaluate the impact and costs of several childhood hepatitis A vaccination scenarios from 2023 to 2030. We assessed how each scenario impacted the burden of hepatitis A (symptomatic hepatitis A cases and mortality) as well as calculated the incremental cost per DALY averted as compared to the South African cost-effectiveness threshold. All costs and outcomes were discounted at 5%. For the modelled scenarios, the median estimated cost of the different vaccination strategies ranged from USD 1.71 billion to USD 2.85 billion over the period of 2023 to 2030, with the cost increasing for each successive scenario and approximately 39-52% of costs being due to vaccination. Scenario 1, which represented the administration of one dose of the hepatitis A vaccine in children < 2 years old, requires approximately 5.3 million vaccine doses over 2023-2030 and is projected to avert a total of 136,042 symptomatic cases [IQR: 88,842-221,483] and 31,106 [IQR: 22,975-36,742] deaths due to hepatitis A over the period of 2023 to 2030. The model projects that Scenario 1 would avert 8741 DALYs over the period of 2023 to 2030; however, it is not cost-effective against the South African cost-effectiveness threshold with an ICER per DALY averted of USD 21,006. While Scenario 3 and 4 included the administration of more vaccine doses and averted more symptomatic cases of hepatitis A, these scenarios were absolutely dominated owing to the population being infected before vaccination through the mass campaigns at older ages. The model was highly sensitive to variation of access to liver transplant in South Africa. When increasing the access to liver transplant to 100% for the baseline and Scenario 1, the ICER for Scenario 1 becomes cost-effective against the CET (ICER = USD 2425). Given these findings, we recommend further research is conducted to understand the access to liver transplants in South Africa and better estimate the cost of liver transplant care for hepatitis A patients. The modelling presented in this paper has been used to develop a user-friendly application for vaccine policy makers to further interrogate the model outcomes and consider the costs and benefits of introducing routine hepatitis A vaccination in South Africa.
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Affiliation(s)
- Jenna Patterson
- Vaccines for Africa Initiative, School of Public Health, University of Cape Town, Cape Town 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Susan Cleary
- School of Public Health, University of Cape Town, Cape Town 7925, South Africa
| | - Jared Michael Norman
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Heiletjé Van Zyl
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Timothy Awine
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Saadiyah Mayet
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Benjamin Kagina
- Vaccines for Africa Initiative, School of Public Health, University of Cape Town, Cape Town 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Rudzani Muloiwa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town 7700, South Africa
| | - Gregory Hussey
- Vaccines for Africa Initiative, School of Public Health, University of Cape Town, Cape Town 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Sheetal Prakash Silal
- Modelling and Simulation Hub, Africa (MASHA), Department of Statistical Sciences, University of Cape Town, Cape Town 7700, South Africa
- Centre for Global Health, Nuffield Department of Medicine, Oxford University, Oxford OX3 7LG, UK
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Bardón De Tena P, Tapia Paniagua ST, Vico Sevilla JA, Clavijo E, Martínez Manzanares E, Gonzalez-Domenech CM. Unusual Surge of Acute Hepatitis A Cases in 2016 and 2017 in Malaga, Southern Spain: Characterization and Relationship with Other Concurrent European Outbreaks. J Clin Med 2023; 12:6613. [PMID: 37892751 PMCID: PMC10607832 DOI: 10.3390/jcm12206613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
We aimed to describe the Hepatitis A virus (HAV) cases that arose in Malaga (Spain) in 2016 and 2017 when the European Centre for Disease Prevention and Control (ECDC) reported several outbreaks among men who have sex with men (MSM). Therefore, we conducted a retrospective study gathering demographic, clinical, and immunological data from the acute HAV patients attending our hospital between March 2016 and December 2017. Additionally, VP1/P2A region was amplified from serum samples, sequenced, and genotyped. We finally performed a phylogenetic analysis, including the HAV strains from the other European outbreaks. A total of 184 HAV cases were reported, with the highest number in March 2017. The cohort mostly comprised Spaniards (81.0%), males (84.8%), and MSM (72.3%), with a median age of 33.0 years (interquartile range (IQR) = 25.0-43.0). Most patients exhibited symptoms. In addition, a successful amplification and sequencing of the VP1/P2A region was performed in 25 out of 106 serum samples (23.6%). All the sequences belonged to the genotype IA, and 20 were phylogenetically related to VRD_521_2016, first described in the United Kingdom (UK). In conclusion, HAV cases emerged in Malaga in 2016 and 2017, showing an epidemic character phylogenetically related to the predominant strain first detected in the UK. Characteristics of the cohort were similar to those from the European outbreaks.
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Affiliation(s)
| | - Silvana Teresa Tapia Paniagua
- Department of Microbiology, Faculty of Sciences, University of Malaga, Avenue Louis Pasteur w/n, 29010 Malaga, Spain; (S.T.T.P.); (E.C.); (E.M.M.)
| | | | - Encarnación Clavijo
- Department of Microbiology, Faculty of Sciences, University of Malaga, Avenue Louis Pasteur w/n, 29010 Malaga, Spain; (S.T.T.P.); (E.C.); (E.M.M.)
- Infectious Diseases and Clinical Microbiology Unit, Virgen de la Victoria Hospital, 29010 Malaga, Spain
| | - Eduardo Martínez Manzanares
- Department of Microbiology, Faculty of Sciences, University of Malaga, Avenue Louis Pasteur w/n, 29010 Malaga, Spain; (S.T.T.P.); (E.C.); (E.M.M.)
| | - Carmen Maria Gonzalez-Domenech
- Department of Microbiology, Faculty of Sciences, University of Malaga, Avenue Louis Pasteur w/n, 29010 Malaga, Spain; (S.T.T.P.); (E.C.); (E.M.M.)
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Kunanitthaworn N, Mueangmo O, Saheng J, Wongjak W, Lertsiriladakul T, Chaito T, Nantarat P, Sudjaritruk T. Seroprevalence of hepatitis A virus antibodies among children and adolescents living in Northern Thailand: an implication for hepatitis A immunization. Sci Rep 2023; 13:17432. [PMID: 37833325 PMCID: PMC10575857 DOI: 10.1038/s41598-023-44643-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/11/2023] [Indexed: 10/15/2023] Open
Abstract
This cross-sectional study aimed to assess seroprevalence of hepatitis A virus (HAV) antibodies and identify factors associated with HAV seropositivity among children and adolescents aged 1-18 years who resided in Chiang Mai, Thailand. Sociodemographic characteristics, sanitation/hygiene, and history of HAV vaccination were collected. Anti-HAV IgG antibody was determined, and a level ≥ 1.0 S/CO defined HAV seropositivity. We enrolled 300 participants; median age 8.7 years, 54% male, and 13% overweight (BMI z-score: + 1 to + 2 standard deviation [SD]). Sixty-five participants (22%) were vaccinated against HAV. Overall, 84/300 participants (28%) demonstrated HAV seropositivity, of whom 55/65 (85%) and 29/235 (12%) were among vaccinated and unvaccinated participants (P < 0.001), respectively. Previous HAV vaccination (adjusted odds ratio [aOR] 47.2; 95% CI 20.0-111.8) and overweight (aOR 4.4; 95% CI 1.7-11.3, compared with normal weight [BMI z-score: - 2 to + 1 SD]) were significantly associated with seropositivity of HAV. In the stratified analyses, crowded bedroom (aOR 3.2; 95% CI 1.3-7.8, per one person increase) and overweight (aOR 5.0; 95% CI 1.8-13.7) were factors associated with HAV seropositivity among vaccinated and unvaccinated participants, respectively. Seroprevalence of HAV antibodies in healthy Thai children and adolescents was relatively low. Recommendation of HAV vaccination for these populations, particularly those with high-risk conditions, should be considered.
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Affiliation(s)
- Natchaya Kunanitthaworn
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Oramai Mueangmo
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jutamad Saheng
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Worawan Wongjak
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tanin Lertsiriladakul
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tanachot Chaito
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pasawat Nantarat
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tavitiya Sudjaritruk
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Maki Y, Edo N, Mizuguchi M, Ikeda M, Kitano M, Kitagami E, Osa M, Yamamoto S, Ogawa T, Nakamura T, Kawana A, Kimizuka Y. Impact of frequency and duration of freeze-dried inactivated tissue culture hepatitis A vaccine (Aimmugen®) vaccination on antibody titers; a japanese cross-sectional study. Vaccine 2023; 41:5974-5978. [PMID: 37620202 DOI: 10.1016/j.vaccine.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND The effect of the timing of additional doses and the long-term persistence of lyophilized inactivated tissue culture hepatitis A (HA) vaccine (Aimmugen®) on antibodies is unknown. METHODS A single-center, cross-sectional, observational study was conducted in collaboration with the Japan Air Self-Defense Force, whose personnel were immunized with Aimmugen® when deployed to endemic areas. Patients who consented to this study after a medical examination with blood sampling between June 2022 and February 2023 were included; HA-IgG level in the residual serum was measured using the chemiluminescent immunoassay method. The exact vaccination history was investigated based on immunization records maintained by the Ministry of Defense, and a questionnaire was used to collect confounding factors. RESULTS Of the 181 participants observed, 49 were in the unvaccinated group, and 132 were in the vaccinated group. Out of the vaccinated group, 6.8 % received either one or two doses, 40.9 % received three doses, and 52.3 % received more than four doses. IgG antibody titers (S/CO value) in each group (0, 1 or 2, 3, and over 4) increased in a frequency-dependent manner, with those vaccinated over four times showing significantly higher IgG antibody titers than all other groups (0.19 ± 0.10 vs 3.66 ± 3.00 vs 7.63 ± 3.57 vs 10.57 ± 1.86, respectively). When the number of months elapsed from the last vaccination to the date of blood collection in each group was plotted against IgG antibody titer, the slope of the regression line flattened out from a decreasing trend in the order 1 or 2, 3, over 4. CONCLUSIONS Three doses of Aimmugen® are efficacious, but four or more doses induce more robust and sustained antibody production. Additionally, four or more doses may be effective when there is a need to ensure long-term immunity or risk of prolonged exposure.
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Affiliation(s)
- Yohei Maki
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Naoki Edo
- Division of Behavioral Science, National Defense Medical College Research Institute, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Makoto Mizuguchi
- Department of Healthcare, Japan Self-Defense Force Iruma Hospital, 2-1-4 Koyodai, Iruma, Saitama 358-0001, Japan
| | - Mikihito Ikeda
- Department of Dental, Japan Self-Defense Force Iruma Hospital, 2-1-4 Koyodai, Iruma, Saitama 358-0001, Japan
| | - Masato Kitano
- Division of Behavioral Science, National Defense Medical College Research Institute, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Etsuko Kitagami
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Morichika Osa
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Shotaro Yamamoto
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Takunori Ogawa
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Takahiro Nakamura
- Department of Mathematics, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Akihiko Kawana
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Yoshifumi Kimizuka
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
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Karami A, El Fihry R, Haddaji A, Jadid FZ, Zaidane I, Chihab H, Ouladlahsen A, Tahiri M, Pineau P, Akarid K, Benjelloun S, Ezzikouri S. Epidemiological characteristics of acute hepatitis A, 2013-2016: a cross-sectional study in Morocco. Infect Dis (Lond) 2023; 55:625-634. [PMID: 37368360 DOI: 10.1080/23744235.2023.2228405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Hepatitis A virus (HAV) is the common cause of acute hepatitis worldwide. Indeed, hepatitis A is endemic in developing countries such in Morocco and most residents are exposed in childhood. The characterisation of circulating strains of HAV remains crucial to understand the virological evolution and geo-temporal characteristics, which are essential for controlling infections and outbreaks. The purpose of the current study was the detection and characterisation of HAV strains circulating in Morocco by performing serological test, RT-PCR, sequencing and phylogenetic analysis. METHODS In this cross-sectional study, 618 suspected acute hepatitis cases were examined by Architect HAV abIgM. Of the 162 positives, 64 underwent RNA extraction. None of the suspected cases was immune to HAV and none of them had received a blood transfusion. Samples found positive by RT-PCR using primers targeting the VP1/VP2A junction and the VP1/VP3 capsid region of HAV were subjected to sequencing and phylogenetic analyses. RESULTS HAV Acute infection rate was 26.2% [95% CI, 22.8-29.9], while viraemia reached 45% (29/64) after amplification of the VP3/VP1 region. Phylogenetic analysis of the VP1/2A segment revealed the presence of sub-genotypes IA and IB. Eighty-seven percent of the strains belonged to the subgenotype IA, while twelve percent to IB subgenotype. CONCLUSION This first molecular study of acute hepatitis A in Morocco provided information about genetic diversity of HAV, revealing the co-circulating of only two subgenotypes (IA and IB). Notably, subgenotype IA was found to be the predominant subgenotype in Morocco.
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Affiliation(s)
- Adnane Karami
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
- Santé et Environnement, Faculté des Sciences Aïn Chock, Casablanca, Morocco
| | - Raouia El Fihry
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
- Santé et Environnement, Faculté des Sciences Aïn Chock, Casablanca, Morocco
| | - Asmaa Haddaji
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Fatima-Zahra Jadid
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | | | - Hajar Chihab
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Ahd Ouladlahsen
- Service des Maladies Infectieuses, CHU Ibn Rochd, Casablanca, Morocco
- Faculté de médecine et de pharmacie, Université Hassan II, Casablanca, Morocco
| | - Mohamed Tahiri
- Faculté de médecine et de pharmacie, Université Hassan II, Casablanca, Morocco
- Service d'Hépato-Gastro-Entérologie, CHU Ibn Rochd, Casablanca, Morocco
| | - Pascal Pineau
- Unité "Organisation Nucléaire et Oncogenèse", INSERM U993, Institut Pasteur, Paris, France
| | - Khadija Akarid
- Santé et Environnement, Faculté des Sciences Aïn Chock, Casablanca, Morocco
| | - Soumaya Benjelloun
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
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Han S, Hyun SW, Son JW, Song MS, Lim DJ, Choi C, Park SH, Ha SD. Innovative nonthermal technologies for inactivation of emerging foodborne viruses. Compr Rev Food Sci Food Saf 2023; 22:3395-3421. [PMID: 37288815 DOI: 10.1111/1541-4337.13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/14/2023] [Accepted: 05/21/2023] [Indexed: 06/09/2023]
Abstract
Various foodborne viruses have been associated with human health during the last decade, causing gastroenteritis and a huge economic burden worldwide. Furthermore, the emergence of new variants of infectious viruses is growing continuously. Inactivation of foodborne viruses in the food industry is a formidable task because although viruses cannot grow in foods, they can survive in the food matrix during food processing and storage environments. Conventional inactivation methods pose various drawbacks, necessitating more effective and environmentally friendly techniques for controlling foodborne viruses during food production and processing. Various inactivation approaches for controlling foodborne viruses have been attempted in the food industry. However, some traditionally used techniques, such as disinfectant-based or heat treatment, are not always efficient. Nonthermal techniques are considered a new platform for effective and safe treatment to inactivate foodborne viruses. This review focuses on foodborne viruses commonly associated with human gastroenteritis, including newly emerged viruses, such as sapovirus and Aichi virus. It also investigates the use of chemical and nonthermal physical treatments as effective technologies to inactivate foodborne viruses.
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Affiliation(s)
- Sangha Han
- Advanced Food Safety Research Group, BrainKorea21 Plus, Chung-Ang University, Anseong, Gyeonggi, Republic of Korea
| | - Seok-Woo Hyun
- Advanced Food Safety Research Group, BrainKorea21 Plus, Chung-Ang University, Anseong, Gyeonggi, Republic of Korea
| | - Jeong Won Son
- Advanced Food Safety Research Group, BrainKorea21 Plus, Chung-Ang University, Anseong, Gyeonggi, Republic of Korea
| | - Min Su Song
- Advanced Food Safety Research Group, BrainKorea21 Plus, Chung-Ang University, Anseong, Gyeonggi, Republic of Korea
| | - Dong Jae Lim
- Advanced Food Safety Research Group, BrainKorea21 Plus, Chung-Ang University, Anseong, Gyeonggi, Republic of Korea
| | - Changsun Choi
- Department of Food and Nutrition, School of Food Science and Technology, Chung-Ang University, Anseong, Gyeonggi, Republic of Korea
| | - Si Hong Park
- Food Science and Technology, Oregon State University, Corvallis, Oregon, USA
| | - Sang-Do Ha
- Advanced Food Safety Research Group, BrainKorea21 Plus, Chung-Ang University, Anseong, Gyeonggi, Republic of Korea
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de Brito WI, de Oliveira RM, Silva J, Tubarão LN, Bom APDA, Melgaço JG, Pinto MA, Souto FJD. Persistence of immunity against hepatitis A in Brazilian children vaccinated with a single dose of inactivated virus vaccine. J Viral Hepat 2023; 30:615-620. [PMID: 36807662 DOI: 10.1111/jvh.13819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/01/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023]
Abstract
In 2014, the Brazilian National Immunization Program implemented the universal vaccination against the hepatitis A virus (HAV) for children aged 12 months and older, applying a single dose of the inactivated virus vaccine. It is essential to carry out follow-up studies in this population, aiming to verify the longevity of HAV immunological memory. This study evaluated the humoral and cellular immune response of a cohort of children vaccinated between 2014 and 2015, and further investigated between 2015 and 2016, and who had their initial antibody response assessed after the single dose. A second evaluation took place in January 2022. We examined 109 children out of the 252 that took part in the initial cohort. Seventy (64.2%) of them had anti-HAV IgG antibodies. Cellular immune response assays were performed in 37 anti-HAV-negative and 30 anti-HAV-positive children. Production of interferon-gamma (IFN-y) stimulated with the VP1 antigen was demonstrated in 34.3% of these 67 samples. Of the 37 negative anti-HAV samples, 12 (32.4%) produced IFN-y. Among the 30 anti-HAV-positive, 11 (36.7%) produced IFN-y. In total, 82 (76.6%) children presented some type of immune response against HAV. These findings demonstrate the persistence of immunological memory against HAV in the majority of children vaccinated between 6 and 7 years with a single dose of the inactivated virus vaccine.
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Affiliation(s)
- Wagner Izidoro de Brito
- Medicine School, Postgraduate Program in Health Sciences, Federal University of Mato Grosso, Brazilian Company of Hospital Services (EBSERH), Cuiabá, Brazil
| | | | - Jane Silva
- Laboratory of Immune Technology, Institute of Immunobiological Technology, Bio-Manguinhos, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Luciana Neves Tubarão
- Laboratory of Immune Technology, Institute of Immunobiological Technology, Bio-Manguinhos, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Ana Paula Dinis Ano Bom
- Laboratory of Immune Technology, Institute of Immunobiological Technology, Bio-Manguinhos, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Juliana Gil Melgaço
- Laboratory of Immune Technology, Institute of Immunobiological Technology, Bio-Manguinhos, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Marcelo Alves Pinto
- Laboratory of Immune Technology, Institute of Immunobiological Technology, Bio-Manguinhos, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Francisco José Dutra Souto
- Medicine School, Postgraduate Program in Health Sciences, Federal University of Mato Grosso, Brazilian Company of Hospital Services (EBSERH), Cuiabá, Brazil
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10
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Sasaki-Tanaka R, Shibata T, Moriyama M, Kogure H, Hirai-Yuki A, Okamoto H, Kanda T. Masitinib Inhibits Hepatitis A Virus Replication. Int J Mol Sci 2023; 24:9708. [PMID: 37298659 PMCID: PMC10253910 DOI: 10.3390/ijms24119708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
The hepatitis A virus (HAV) infection causes acute hepatitis. HAV also induces acute liver failure or acute-on-chronic liver failure; however, no potent anti-HAV drugs are currently available in clinical situations. For anti-HAV drug screening, more convenient and useful models that mimic HAV replication are needed. In the present study, we established HuhT7-HAV/Luc cells, which are HuhT7 cells stably expressing the HAV HM175-18f genotype IB subgenomic replicon RNA harboring the firefly luciferase gene. This system was made by using a PiggyBac-based gene transfer system that introduces nonviral transposon DNA into mammalian cells. Then, we investigated whether 1134 US Food and Drug Administration (FDA)-approved drugs exhibited in vitro anti-HAV activity. We further demonstrated that treatment with tyrosine kinase inhibitor masitinib significantly reduced both HAV HM175-18f genotype IB replication and HAV HA11-1299 genotype IIIA replication. Masitinib also significantly inhibited HAV HM175 internal ribosomal entry-site (IRES) activity. In conclusion, HuhT7-HAV/Luc cells are adequate for anti-HAV drug screening, and masitinib may be useful for the treatment of severe HAV infection.
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Affiliation(s)
- Reina Sasaki-Tanaka
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| | - Toshikatsu Shibata
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| | - Mitsuhiko Moriyama
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| | - Hirofumi Kogure
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
| | - Asuka Hirai-Yuki
- Division of Experimental Animal Research, National Institute of Infectious Diseases, Tokyo 208-0011, Japan;
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi 329-0498, Japan;
| | - Tatsuo Kanda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan; (T.S.); (M.M.); (H.K.)
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11
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Ming BW, Yang Z, Yan ZL, Shi C, Xu XH, Li L, Ou CQ. Impact of urbanization on morbidity of hepatitis A: a national panel study in China during 2005-2018. Infect Dis Poverty 2023; 12:56. [PMID: 37231511 DOI: 10.1186/s40249-023-01104-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The effect of urbanization on the morbidity of hepatitis A remains unclear. We aimed to estimate the association between various urbanization-related indices and hepatitis A morbidity in China. METHODS Data on the annual morbidity of hepatitis A, urbanization-related measures (i.e., gross domestic product per capita, the number of hospitalization beds per 1000 persons, illiteracy rate, tap water coverage, motor vehicles per 100 persons, population density, and the proportion of arable land), and meteorological factors in 31 provincial-level administrative divisions of Chinese mainland during 2005-2018 were collected from the National Population and Health Science Data Sharing Platform, China Statistical Yearbooks, and the China Meteorological Data Sharing Service System, respectively. Generalized linear mixed models were applied to quantify the impacts of different urbanization-related indices on the morbidity of hepatitis A in China after adjusting for covariates. RESULTS A total of 537,466 hepatitis A cases were reported in China during 2005-2018. The annual morbidity had a decline of 79.4% from 5.64 cases to 1.16 cases per 100,000 people. There were obvious spatial variations with higher morbidity in western China. Nationally, gross domestic product per capita and the number of hospitalization beds per 1000 persons increased from 14,040 to 64,644 CNY and from 2.45 to 6.03 during 2005-2018, respectively. The illiteracy rate decreased from 11.0 to 4.9%. Gross domestic product per capita [relative risk (RR) = 0.96, 95% confidence interval (CI): 0.92-0.99], and the number of hospitalization beds per 1000 persons (RR = 0.79, 95% CI: 0.75-0.83) were associated with the declined morbidity of hepatitis A. By contrast, the increased morbidity of hepatitis A was linked to the illiteracy rate (RR = 1.04, 95% CI: 1.02-1.06). Similar influential factors were detected for children and adults, with greater effects witnessed for children. CONCLUSIONS People in the western region suffered the heaviest burden of hepatitis A in Chinese mainland. Nationally, there was a sharp decline in the morbidity of hepatitis A. The urbanization process was associated with the reduction of hepatitis A morbidity in China during 2005-2018.
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Affiliation(s)
- Bo-Wen Ming
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Zhou Yang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Ze-Lin Yan
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Chen Shi
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Xiao-Han Xu
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
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12
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Medić S, Anastassopoulou C, Pustahija T, Petrović V, Dragnić N, Boufidou F, Tsakris A, Šaponjić V. Epidemiological Transition and Strategies for the Control of Hepatitis A in Serbia. Viruses 2023; 15:v15030753. [PMID: 36992462 PMCID: PMC10056894 DOI: 10.3390/v15030753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/27/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
Background: Improvements in socioeconomic and hygienic conditions during the past decades led to declining hepatitis A (HA) seroprevalence in many countries. Aiming at informing HA vaccination policy, we assessed current epidemiological trends in Serbia by analyzing surveillance data for 2002–2021. Methods: Data on cases and outbreaks were obtained from the Serbian national surveillance database and descriptively analyzed. HA incidence was calculated in relation to time, patients’ residence, and demographics. Results: Overall, 13,679 HA cases and 419 outbreaks were recorded with the highest incidence in the southeast. Downward HA trends were observed, while infant mortality was halved, and gross domestic product based on purchasing power parity (GDP PP) per capita, tripled. The average incidence dropped from 14.8 (95% CI 14.4–15.2)/100,000) in 2002–2006 to 1 (95% CI 0.9–1.1)/100,000)/100,000 in 2017–2021, while the number of outbreaks decreased (from 174 to 14). Sporadic cases and family clusters living in poor sanitary conditions occurred in recent years. The contact route of transmission was dominant (410/419, 97.9%). The highest average age-specific HA incidence shifted from 5–9 years in 2002–2006 to 10–19 years in 2017–2021.Serbia is transitioning towards very low HA endemicity. Enhanced surveillance and vaccination of high-risk groups are recommended as future public health priorities.
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Affiliation(s)
- Snežana Medić
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Futoška 121, 21000 Novi Sad, Serbia
- Correspondence: ; Tel.: +381-21-4897-800
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Tatjana Pustahija
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Futoška 121, 21000 Novi Sad, Serbia
| | - Vladimir Petrović
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Futoška 121, 21000 Novi Sad, Serbia
| | - Nataša Dragnić
- Department of Social Medicine and Health Statistics with Informatics, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
- Center for Informatics and Biostatistics, Institute of Public Health of Vojvodina, Futoška 121, 21000 Novi Sad, Serbia
| | - Fotini Boufidou
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Vladan Šaponjić
- Institute of Public Health of Serbia, “Dr Milan Jovanović Batut”, Belgrade, Dr Subotića 5, 11000 Belgrade, Serbia
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13
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Bedekar P, Kearsley AJ, Patrone PN. Prevalence estimation and optimal classification methods to account for time dependence in antibody levels. J Theor Biol 2023; 559:111375. [PMID: 36513210 DOI: 10.1016/j.jtbi.2022.111375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/14/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Abstract
Serology testing can identify past infection by quantifying the immune response of an infected individual providing important public health guidance. Individual immune responses are time-dependent, which is reflected in antibody measurements. Moreover, the probability of obtaining a particular measurement from a random sample changes due to changing prevalence (i.e., seroprevalence, or fraction of individuals exhibiting an immune response) of the disease in the population. Taking into account these personal and population-level effects, we develop a mathematical model that suggests a natural adaptive scheme for estimating prevalence as a function of time. We then combine the estimated prevalence with optimal decision theory to develop a time-dependent probabilistic classification scheme that minimizes the error associated with classifying a value as positive (history of infection) or negative (no such history) on a given day since the start of the pandemic. We validate this analysis by using a combination of real-world and synthetic SARS-CoV-2 data and discuss the type of longitudinal studies needed to execute this scheme in real-world settings.
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Affiliation(s)
- Prajakta Bedekar
- Applied and Computational Mathematics Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899, USA; Department of Applied Mathematics and Statistics, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD 21218, USA.
| | - Anthony J Kearsley
- Applied and Computational Mathematics Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899, USA
| | - Paul N Patrone
- Applied and Computational Mathematics Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899, USA
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14
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Ostankova YV, Shchemelev AN, Boumbaly S, Balde TAL, Zueva EB, Valutite DE, Serikova EN, Davydenko VS, Skvoroda VV, Vasileva DA, Semenov AV, Esaulenko EV, Totolian AA. Prevalence of HIV and Viral Hepatitis Markers among Healthcare Workers in the Republic of Guinea. Diagnostics (Basel) 2023; 13:diagnostics13030378. [PMID: 36766482 PMCID: PMC9914033 DOI: 10.3390/diagnostics13030378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Healthcare workers are much more likely to be infected with HIV and hepatitis viruses compared to the general population. Although healthcare workers are more aware of HIV and hepatitis viruses, several countries in Africa lack a comprehensive grasp of disease routes and transmission risks. The aim of this study was to assess the prevalence of the serological and molecular biological markers of HIV and viral hepatitis among healthcare workers in the Republic of Guinea. The study material was 74 blood serum samples collected from healthcare workers who received additional training at the Institute of Applied Biological Research of Guinea (IRBAG, Kindia, Republic of Guinea). The markers examined included HBsAg, HBeAg, anti-HBs IgG, anti-HBcore IgG, anti-HCV qualitative determination, anti-HEV IgM and IgG, anti-HAV IgM and IgG, and anti-HIV. For viral DNA and RNA detection, nucleic acids were extracted from blood serum, and viral presence was inferred using real-time PCR with hybridization fluorescence detection. A high prevalence of viral hepatitis B markers was shown, and significantly fewer cases of viral hepatitis C and HIV were detected. Almost all examined medical workers had anti-HAV IgG antibodies, but no antibodies to hepatitis E virus. Apparently, the identified markers depend on the general prevalence of certain pathogens in the region and are associated with the traditions and characteristics of the country's residents.
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Affiliation(s)
- Yulia V Ostankova
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Alexander N Shchemelev
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Sanaba Boumbaly
- Institute of Applied Biological Research of Guinea (IRBAG), Kindia 100 BP 75, Guinea
- Centre International de Recherche sur les Infections Tropicales en Guinée, Nzerekore 400 BP, Guinea
| | - Thierno A L Balde
- Institute of Applied Biological Research of Guinea (IRBAG), Kindia 100 BP 75, Guinea
| | - Elena B Zueva
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Diana E Valutite
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Elena N Serikova
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Vladimir S Davydenko
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Vsevolod V Skvoroda
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Daria A Vasileva
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Alexander V Semenov
- Ekaterinburg Research Institute of Viral Infections, State Research Center of Virology and Biotechnology Vector of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 620030 Ekaterinburg, Russia
| | - Elena V Esaulenko
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Areg A Totolian
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
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15
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Lim DH, Sohn W, Jeong JY, Oh H, Lee JG, Yoon EL, Kim TY, Nam S, Sohn JH. The chronological changes in the seroprevalence of anti-hepatitis A virus IgG from 2005 to 2019: Experience at four centers in the capital area of South Korea. Medicine (Baltimore) 2022; 101:e31639. [PMID: 36482612 PMCID: PMC9726277 DOI: 10.1097/md.0000000000031639] [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] [Indexed: 12/13/2022] Open
Abstract
Although universal vaccination has been administered to toddlers, South Korea has had periodic nationwide outbreaks of acute hepatitis A since the late 2000s. We examined the chronological changes in the seroprevalence of anti-hepatitis A virus (HAV) immunoglobulin G (IgG) over the past 15 years (2005-2019). We retrospectively collected data from 45,632 subjects who underwent anti-HAV IgG testing without evidence of acute HAV infection at four centers in the capital area of South Korea between January 2005 and December 2019. The seroprevalence of anti-HAV IgG was analyzed according to age and compared among seven age groups and five time periods. Additionally, age-period-cohort analyses were used to identify the age, period, and cohort effects of the seroprevalence of anti-HAV IgG. The mean age of the enrolled subjects was 39.2 ± 19.2 years, and the average anti-HAV IgG positivity rate was 66.4%. During the 15 years, the seroprevalence of anti-HAV IgG in people aged 0 to 19 years significantly increased over time (P < .001). In people aged 20 to 29 years, the seroprevalence slightly decreased to that of the early 2010s (31.3% in 2005-2007 to 19.7% in 2011-2013) but rebounded to 39.5% in 2017 to 2019. In contrast, the seroprevalence of anti-HAV IgG in those aged 30 to 49 years decreased over time (P < .001). The seroprevalence of anti-HAV IgG in those aged 20 to 39 years in 2017 to 2019 was still less than 40%. In addition, the seroprevalence of anti-HAV IgG in people aged 50 to 59 years has recently decreased. Since the introduction of the universal vaccination, the seroprevalence of anti-HAV IgG in children and young adults has gradually increased. However, the seroprevalence of anti-HAV IgG in people in their 20s remains low, and the seroprevalence of anti-HAV IgG in people in their 30s and 40s is gradually decreasing. Therefore, a new strategy for HAV vaccination is needed for those in their 20s to 40s.
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Affiliation(s)
- Dae Hyun Lim
- Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Won Sohn
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yoon Jeong
- Department of Internal Medicine, National Medical Center, Seoul, Korea
- * Correspondence: Jae Yoon Jeong, Department of Internal Medicine, National Medical Center, 245, Eulji-ro, Jung-gu, Seoul 04564, Republic of Korea (e-mail: )
| | - Hyunwoo Oh
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
- Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University College of Medicine, Uijeongbu, Korea
| | - Jae Gon Lee
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Eileen L. Yoon
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
- Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | | | - Seungwoo Nam
- Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Joo Hyun Sohn
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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16
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Comparative prevalence of different types of viral hepatitis in the district Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan. EGYPTIAN LIVER JOURNAL 2022. [DOI: 10.1186/s43066-022-00203-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Viral hepatitis causes both liver inflammation and damage and is a serious health problem.
Methods
The indoor data of different types of hepatitis were collected from the official records of the administration of District Head Quarter Hospital Dera Ismail Khan for 2 years (2020–2021).
Results
A total of 1193 cases of viral hepatitis during the study period were found including viral hepatitis C accounted for 547 (45.9%) cases, followed by the co-infection of viral hepatitis A and E 367 (30.8%) cases, and viral hepatitis B 279 (23.4%) cases. March showed the highest prevalence of hepatitis (33.2%), followed by February (10.2%). The co-infection of hepatitis A and E showed a relatively higher prevalence in 6 months from May to November except September including a peak in June (76.5%) during the study period. While viral hepatitis B demonstrated a comparatively higher percentage prevalence in both February and September with a peak in February (68%), and viral hepatitis C is dominant in January, March, and December with a peak in March (83.8%).
Conclusion
All types of viral hepatitis showed variation in prevalence over months and monthly variation concerning peak prevalence exists among different types of hepatitis. Both viral hepatitis A and E demonstrated similar trend in relative prevalence in both 2020 and 2021. Nevertheless, viral hepatitis A and B showed monthly and seasonal variation in relatively prevalence in both years. The study help in adopting strategies for the prevention of viral hepatitis in the study area.
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17
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Li YS, Zhang BB, Zhang X, Fan S, Fei LP, Yang C, Ren NJ, Li X, Luo YM, Zhang JH. Trend in the incidence of hepatitis A in mainland China from 2004 to 2017: a joinpoint regression analysis. BMC Infect Dis 2022; 22:663. [PMID: 35915398 PMCID: PMC9341093 DOI: 10.1186/s12879-022-07651-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/27/2022] [Indexed: 12/15/2022] Open
Abstract
Background China has experienced a continuous decreasing trend in the incidence of hepatitis A in recent years. Temporal trend analyses are helpful in exploring the reasons for the changing trend. Thus, this study aims to analyse the incidence trend of viral hepatitis A by region and age group in mainland China from 2004 to 2017 to evaluate the effectiveness of prevention and control measures. Methods Data on hepatitis A and population information were collected and analysed with a joinpoint regression model. Annual percentage changes (APCs) and average annual percentage changes (AAPCs) were estimated for the whole country and for each region and age group. Results From 2004 to 2017, the seasonality and periodicity of hepatitis A case numbers were obvious before 2008 but gradually diminished from 2008 to 2011 and disappeared from 2012–2017. The national incidence of hepatitis A (AAPC = − 12.1%) and the incidence rates for regions and age groups showed decreasing trends, with differences in the joinpoints and segments. Regarding regions, the hepatitis A incidence in the western region was always the highest among all regions, while a nonsignificant rebound was observed in the northeastern region from 2011 to 2017 (APC = 14.2%). Regarding age groups, the hepatitis A incidence showed the fastest decrease among children (AAPC = − 15.3%) and the slowest decrease among elderly individuals (AAPC = − 6.6%). Among all segments, the hepatitis A incidence among children had the largest APC value in 2007–2017, at − 20.4%. Conclusion The national annual incidence of hepatitis A continually declined from 2004 to 2017 and the gaps in hepatitis A incidence rates across different regions and age groups were greatly narrowed. Comprehensive hepatitis A prevention and control strategies, including the use of routine vaccination during childhood in mainland China, especially the implementation of the national Expanded Program on Immunization (EPI) in 2008, resulted in substantial progress from 2004 to 2017. However, gaps remain. Regular monitoring and analysis of hepatitis A epidemic data and prompt adjustment of hepatitis A prevention and control strategies focusing on children, elderly individuals and those living in certain regions are recommended.
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18
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du Plessis NM, Haeri Mazanderani A, Motaze NV, Ngobese M, Avenant T. Hepatitis A virus seroprevalence among children and adolescents in a high-burden HIV setting in urban South Africa. Sci Rep 2022; 12:20688. [PMID: 36450802 PMCID: PMC9712520 DOI: 10.1038/s41598-022-25064-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
Abstract
Hepatitis A virus (HAV) infection is one of the most important global causes of viral hepatitis. Recent reviews suggested that HAV endemicity in South Africa could shift from high to intermediate. A hospital-based HAV seroprevalence study was conducted between February 2018 and December 2019 in Pretoria, South Africa. Systematic sampling was performed on children and adolescents (1-15 years) who attended outpatient services. Participants with a known HIV status and valid HAV serology results were included. Of the 1220 participants, the median age was 7 years (IQR: 4-11), with 648 (53.11%) males and 572 (46.89%) females. Of 628 (51.48%) HIV-infected participants, most (329, 71.83%) were both immunologically and virologically controlled or had low-level viremia (74, 16.16%). Almost three-quarters (894, 73.28%) were living in formal dwellings, and just over half (688, 56.39%) had access to clean water sources inside the house. Increasing age was associated with testing HAV IgG-positive (OR 1.25; 95% CI 1.20-1.30, p < 0.001), with 19.8% of participants one year of age compared with 86.7% of participants 15 years of age. This study suggests that South Africa has an intermediate HAV seroprevalence, with rates < 90% by 10 years of age (68.6%). Increased age and informal dwellings are statistically associated with HAV seropositivity, while HIV status does not significantly influence HAV seropositivity.
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Affiliation(s)
- Nicolette M. du Plessis
- grid.49697.350000 0001 2107 2298Department of Paediatrics, Faculty of Health Sciences, Kalafong Hospital, University of Pretoria, Private Bag X396, Pretoria, 0001 South Africa ,Kalafong Provincial Tertiary Hospital, Pretoria, South Africa
| | - Ahmad Haeri Mazanderani
- grid.11951.3d0000 0004 1937 1135Department of Paediatrics & Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ,grid.416657.70000 0004 0630 4574Centre for HIV & STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Nkengafac Villyen Motaze
- grid.25881.360000 0000 9769 2525Medicine Usage in South Africa, School of Pharmacy, Faculty of Health Sciences, North West University, Potchefstroom, South Africa
| | - Makhosazane Ngobese
- grid.49697.350000 0001 2107 2298Department of Paediatrics, Faculty of Health Sciences, Kalafong Hospital, University of Pretoria, Private Bag X396, Pretoria, 0001 South Africa ,Thembisa Provincial Tertiary Hospital, Pretoria, South Africa
| | - Theunis Avenant
- grid.49697.350000 0001 2107 2298Department of Paediatrics, Faculty of Health Sciences, Kalafong Hospital, University of Pretoria, Private Bag X396, Pretoria, 0001 South Africa ,Kalafong Provincial Tertiary Hospital, Pretoria, South Africa
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Hepatitis A and E Viruses in Mussels from Cherrat Estuary in Morocco: Detection by Real-Time Reverse Transcription PCR Analysis. Adv Virol 2022; 2022:8066356. [DOI: 10.1155/2022/8066356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
The aim of the present study was to evaluate hepatitis A virus (HAV) and hepatitis E virus (HEV) contamination in mussels (Mytilus galloprovincialis) from Cherrat estuary (Moroccan Atlantic Coast), Morocco. In total, 52 samples (n = 12 mussels/each) were collected at four sites in the estuary, monthly, between March 2019 and March 2020. HAV and HEV were detected by real-time reverse transcription polymerase chain reaction (RT-PCR) according to the ISO/TS 15216 method. HAV was detected in 46.15% of analyzed samples. Conversely, HEV was not detected in any sample. Moreover, the HAV detection rate was significantly associated with seasonal rainfall variations. This qualitative study on HAV and HEV contamination highlights the interest of studying mussel samples from wild areas. As HAV presence in mussels represents a potential health risk, viral contamination surveillance of mussels is necessary to protect consumers. HAV shellfish contamination must be monitored at Cherrat estuary because of the role played by shellfish as HAV reservoirs and/or vehicles in fecal-oral HAV transmission.
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20
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Rycroft JA, Mullender CM, Hopkins M, Cutino-Moguel T. Improving the accuracy of clinical interpretation of serological testing for the diagnosis of acute hepatitis a infection. J Clin Virol 2022; 155:105239. [DOI: 10.1016/j.jcv.2022.105239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/25/2022]
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21
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Dynamic Changes in Hepatitis A Immunity in Regions with Different Vaccination Strategies and Different Vaccination Coverage. Vaccines (Basel) 2022; 10:vaccines10091423. [PMID: 36146501 PMCID: PMC9506316 DOI: 10.3390/vaccines10091423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/25/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
The data on hepatitis A virus (HAV) seroprevalence are critical for the implementation of a universal mass vaccination (UMV) strategy. The latter has not been implemented in Russia; however, regional child vaccination programs have been adopted in some parts of the country. The aim of this study is to assess changes in HAV immunity within the last decade in regions of Russia with different vaccination strategies and different vaccination coverage rates. In regions where UMV has not been implemented and HAV vaccination coverage rates do not exceed the national average, the 50% seroprevalence threshold has shifted in the Moscow region from people aged under 40 years in 2008 to people aged over 59 years in 2020, and from people aged under 30 years to people aged over 40 years in the Khabarovsk region. In two regions (Yakutia and Sverdlovsk), a two-dose-based UMV scheme has been in place since 2011 and 2003, respectively, and in Tuva single-dose child immunization was launched in 2012. These regional programs have resulted in a significant increase in HAV seroprevalence in children and adolescents. In Yakutia, 50% herd immunity had been achieved by 2020 in age groups under 20 years, compared to 20−30% seroprevalence rates in 2008. In the Sverdlovsk region, HAV immunity has increased to >65% over the decade in children aged over 10 years, adolescents and young adults, whereas it declined in older age groups. However, a three-fold drop in HAV immunity has occurred in children under 10 years of age, reflecting a significant decline in vaccination coverage. In Tuva, HAV immunity rates in children under 10 years old increased two-fold to exceed 50% by 2020. These data suggest that UMV should be implemented on a national level. Measures to control vaccination coverage and catch-up vaccination campaigns are recommended in order to maintain the effectiveness of existing HAV vaccination programs.
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22
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Reuter G, Boros Á, Pankovics P. Seroprevalence and genotype distribution of hepatitis A virus in the pre-vaccine era in South Transdanubia, Hungary (2010-2020). Acta Microbiol Immunol Hung 2022; 69:228-232. [PMID: 35976735 DOI: 10.1556/030.2022.01814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022]
Abstract
In this study, the age-related seroprevalence of hepatitis A virus (HAV) infection was investigated in the population in South-Transdanubia, Southwest Hungary (Central Europe) between years 2010 and 2020. Up to the age of 40, the HAV seropositivity was less than 18% in all age groups indicating a low level of HAV endemicity in this part of the country in the covered study period. The HAV seropositivity started to increase at the age group 41-45 years, reaching the ∼50% at age group 56-60, and 75-80% at age group 66-70, respectively. A total of 43 (0.2%) of the 21,106 tested sera were HAV IgM-positive (the annual percentage range of HAV IgM-positivity was 0.046-0.6%). Total of 24 (55.8%) of the 43 HAV IgM-positive samples tested RT-PCR-positive confirmed as HAV sub-genotypes IA (N = 17; 70.8%) and IB (N = 7; 29.2%), respectively. Imported HAV infections (three cases from Romania, and one-one case from Austria and Italy), two small outbreaks and 11 cases of a genetically identical sub-genotype IA strain (GenBank number of the prototype strain: KM657825) from 2012 to 2014 were identified later connected directly to the enormous HAV outbreak initiated among men who have sex with men (MSM) at the end of 2011 in the capital Budapest. In summary, low endemicity but high and increased susceptibility for HAV infection was found in the population in Southwest Hungary, where repeated introduction of sub-genotypes IA and IB HAV strains were identified between 2010 and 2020.
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Affiliation(s)
- Gábor Reuter
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Pécs, Hungary
| | - Ákos Boros
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Pankovics
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Pécs, Hungary
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23
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Jindal A, Sarin SK. Epidemiology of liver failure in Asia-Pacific region. Liver Int 2022; 42:2093-2109. [PMID: 35635298 DOI: 10.1111/liv.15328] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 02/13/2023]
Abstract
The global burden of deaths caused by liver failure is substantial. The Asia-Pacific region is home to more than half of the global population and accounted for 62.6% of global deaths because of liver diseases in 2015. The aetiology of liver failure varies in different countries at different times. Viruses (Hepatitis A, B and E), drugs (herbs and anti-tuberculous drugs), toxins (alcohol use) and autoimmune flares are mainly responsible of majority of liver failure in individuals with normal liver (acute liver failure; ALF); else these may precipitate liver failure in those with chronic liver disease (acute-on-chronic liver failure; ACLF). Concomitant increases in alcohol misuse and metabolic syndrome in recent years are concerning. Ongoing efforts to address liver failure-related morbidity and mortality require accurate contemporary estimates of epidemiology and outcomes. In light of the ever-changing nature of liver disease epidemiology, accurate estimates for the burden of liver failure across the countries are vital for setting clinical, research and policy priorities. In this review, we aimed to describe the current as well as changing epidemiological trends of common liver failure syndromes, ALF and ACLF in the Asia-Pacific region.
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Affiliation(s)
- Ankur Jindal
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Badur S, Öztürk S, AbdelGhany M, Khalaf M, Lagoubi Y, Ozudogru O, Hanif K, Saha D. Hepatitis A in the Eastern Mediterranean Region: a comprehensive review. Hum Vaccin Immunother 2022; 18:2073146. [PMID: 35617508 PMCID: PMC9621081 DOI: 10.1080/21645515.2022.2073146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction With 583 million inhabitants, the Eastern Mediterranean Region (EMR) is a worldwide hub for travel, migration, and food trade. However, there is a scarcity of data on the epidemiology of the hepatitis A virus (HAV). Methods The MEDLINE and grey literature were systematically searched for HAV epidemiological data relevant to the EMR region published between 1980 and 2020 in English, French, or Arabic. Results Overall, 123 publications were extracted. The proportion of HAV cases among acute viral hepatitis cases was high. HAV seroprevalence rate ranged from 5.7% to 100.0% and it was decreasing over time while the average age at infection increased. Conclusion In the EMR, HAV remains a significant cause of acute viral hepatitis. The observed endemicity shift will likely increase disease burden as the population ages. Vaccinating children and adopting sanitary measures are still essential to disease prevention; vaccinating at-risk groups might reduce disease burden even further.
What is the context?
Hepatitis A is a viral liver disease caused by the hepatitis A virus. It is generally transmitted by ingestion of contaminated food or water or through contact with an infected person. Disease severity increases with age. Children under 6 years of age are usually asymptomatic, while adults are the most affected. Limited information exists on the number of cases and transmission of hepatitis A in the Eastern Mediterranean region, which includes 21 countries and Palestine, as defined by the World Health Organization.
What is new?
We performed a literature review to summarize data on hepatitis A disease in the Eastern Mediterranean region over the last 40 years (1980-2020). As information for many countries is scarce or outdated, most of the data is from Egypt, Iran and Saudi Arabia. We found that:
Hepatitis A virus is the most common cause of acute viral hepatitis. Hepatitis A exposure varied according to the country’s income level. Low- and middle-income countries showed a universal immunity to hepatitis A virus, although this is not the case anymore.
What is the impact?
Hepatitis A infections have decreased worldwide. Lower exposure to the virus has led to an increase in the susceptible population (including adolescent and adults). Hepatitis A vaccination for children and high-risk groups such travelers should be considered in the Eastern Mediterranean region.
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Ruchusatsawat K, Nuengjamnong C, Tawatsin A, Thiemsing L, Kawidam C, Somboonna N, Nuanualsuwan S. Quantitative Risk Assessments of Hepatitis A Virus and Hepatitis E Virus from Raw Oyster Consumption. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:953-965. [PMID: 34601752 DOI: 10.1111/risa.13832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/05/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
A quantitative risk assessment of hepatitis A virus (HAV) and hepatitis E virus (HEV) from raw oyster consumption from farm and retail was evaluated over three seasons. This risk assessment comprises four steps: hazard identification, dose-response assessment, exposure assessment, and risk characterization. We used probabilistic models for prevalence, concentration, and oyster consumption. HEV dose-response (DR) model based on HEV dosing in chimpanzees and used to perform a dose-response assessment of HEV was proposed. Both HAV and HEV were simultaneously enumerated by real-time PCR to determine viral doses. The probabilistic prevalences of HAV and HEV were in the ranges of 8-20% and 8-40%, respectively. The best-fit DR model was the beta-Poisson with alpha and N50 equal to 216.9 and 3.03 × 107 , respectively. After running the Monte Carlo simulation, the annual cases of foodborne hepatitis A and hepatitis E from raw oyster consumption from farms were 9,264-17,526 and 1-604, respectively, while those at retail were 7,694-14,591 and 1-204, respectively. This study suggested that consuming farm oysters poses a significantly higher risk of hepatitis A than hepatitis E. The best-fit DR model for HEV developed in this study could determine risks of hepatitis E from raw oyster consumption in Thailand.
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Affiliation(s)
- Kriangsak Ruchusatsawat
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Chackrit Nuengjamnong
- Department of Animal Husbandry, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Food Risk Hub Research Unit of Chulalongkorn University, Thailand
| | - Apiwat Tawatsin
- Medical Sciences Technical Office, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Laddawan Thiemsing
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Chonthicha Kawidam
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Naraporn Somboonna
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Thailand
- Microbiome Research Unit for Probiotics in Food and Cosmetics, Chulalongkorn University, Thailand
| | - Suphachai Nuanualsuwan
- Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Food Risk Hub Research Unit of Chulalongkorn University, Thailand
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Odenwald MA, Paul S. Viral hepatitis: Past, present, and future. World J Gastroenterol 2022; 28:1405-1429. [PMID: 35582678 PMCID: PMC9048475 DOI: 10.3748/wjg.v28.i14.1405] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
Each hepatitis virus-Hepatitis A, B, C, D, E, and G-poses a distinct scenario to the patient and clinician alike. Since the discovery of each virus, extensive knowledge regarding epidemiology, virologic properties, and the natural clinical and immunologic history of acute and chronic infections has been generated. Basic discoveries about host immunologic responses to acute and chronic viral infections, combined with virologic data, has led to vaccines to prevent Hepatitis A, B, and E and highly efficacious antivirals for Hepatitis B and C. These therapeutic breakthroughs are transforming the fields of hepatology, transplant medicine in general, and public and global health. Most notably, there is even an ambitious global effort to eliminate chronic viral hepatitis within the next decade. While attainable, there are many barriers to this goal that are being actively investigated in basic and clinical labs on the local, national, and international scales. Herein, we discuss pertinent clinical information and recent organizational guidelines for each of the individual hepatitis viruses while also synthesizing this information with the latest research to focus on exciting future directions for each virus.
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Affiliation(s)
- Matthew August Odenwald
- Department of Medicine, Section of Gastroenterology, Hepatology, and Nutrition, Center for Liver Diseases, University of Chicago, Chicago, IL 60637, United States
| | - Sonali Paul
- Department of Medicine, Section of Gastroenterology, Hepatology, and Nutrition, Center for Liver Diseases, University of Chicago, Chicago, IL 60637, United States
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27
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Malik GF, Zakaria N, Majeed MI, Ismail FW. Viral Hepatitis - The Road Traveled and the Journey Remaining. Hepat Med 2022; 14:13-26. [PMID: 35300491 PMCID: PMC8922334 DOI: 10.2147/hmer.s352568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/24/2022] [Indexed: 12/16/2022] Open
Abstract
Hepatitis is defined as inflammation of the liver and is commonly due to infection with The hepatotropic viruses - hepatitis A, B, C, D and E. Hepatitis carries one of the highest disease burdens globally and has caused significant morbidity and mortality among different patient populations. Clinical presentation varies from asymptomatic or acute flu-like illness to acute liver failure or chronic liver disease, characterized by jaundice, hepatomegaly and ascites among many other signs. Eventually, this can lead to fibrosis (cirrhosis) of the liver parenchyma and carries a risk of development into hepatocellular carcinoma. Hepatitis B and C are most notorious for causing liver cirrhosis; in 2019, an estimated 296 million people worldwide had chronic hepatitis B infection and 58 million are currently estimated to have chronic hepatitis C, with 1.5 million new infections of both hepatitis B and C, occurring annually. With the help of latest serological biomarkers and viral nucleic acid amplification tests, it has become rather simple to efficiently screen, diagnose and monitor patients with hepatitis, and to commence with appropriate antiviral treatment. More importantly, the development of vaccinations against some of these viruses has greatly helped to curb the infection rates. Whilst there has been exceptional progress over the years in the management of viral hepatitis, many hurdles still remain which must be addressed in order to proceed towards a hepatitis-free world. This review will shed light on the origin and discovery of the hepatitis viruses, the global epidemiology and clinical symptoms, diagnostic modalities, currently available treatment options, the importance of prevention, and the journey needed to move forward towards the eradication of its global disease burden.
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Affiliation(s)
- Ghulam Fareed Malik
- Section of Gastroenterology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Noval Zakaria
- Section of Gastroenterology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | | | - Faisal Wasim Ismail
- Section of Gastroenterology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
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Ismail F, Alsharif F, El-Garawani I, Abdelsameea E. Acute Hepatitis A Virus Infection in Tobruk, Eastern Libya: Increasing Trends After 2017. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:89-93. [PMID: 34633604 DOI: 10.1007/s12560-021-09499-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
Acute hepatitis A is a self-limited liver inflammation caused by hepatitis A virus (HAV) infection. The infection is transmitted by direct contact from person to person via fecal-oral routes, or through consuming contaminated food and water. This study aims to estimate the frequency of HAV infection from medical records of Tobruk Medical Center, eastern Libya and its distribution during 6 years. The medical records department of Tobruk Medical Center follows guidelines of the international classification of diseases-10 for coding the diseases. The research estimates the frequency and distribution of HAV infection based on age and sex during the period from January 2015 to December 2020. HAV screening assay was performed using commercially available enzyme-linked immunosorbent assays HAV IgM microwell. 245 cases were recorded, 53.5% of cases were males. HAV infection was the most prevalent (92.6%) in age groups of < 5-20 years. A significant rise in the occurrence of HAV infection in the last three years was reported (p < 0.05). More than half of the cases (68%) were reported in 2019 and 2020. No case fatality rate was reported in the present study. There is an increase in the frequency of HAV infection in the last 3 years and the younger age groups (under 20 years old) are more vulnerable to HAV infection. More prevention and control efforts towards this age group should be a top public health priority to avoid the possibility of HAV outbreaks in the future.
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Affiliation(s)
- Faisal Ismail
- Department of Laboratory, Faculty of Medical Technology, University of Tobruk, Tobruk, Libya.
- National Centre for Disease Control, Tobruk, Libya.
- Libyan Medical Research Centre, Kambut, Libya.
| | - Fatma Alsharif
- Department of Physiotherapy, Faculty of Medical Technology, University of Tripoli, Tripoli, Libya
| | - Islam El-Garawani
- Zoology Department, Faculty of Science, Menoufia University, Shebin El-Kom, Egypt
| | - Eman Abdelsameea
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
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29
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Hepatitis A and E in the Mediterranean: A systematic review. Travel Med Infect Dis 2022; 47:102283. [DOI: 10.1016/j.tmaid.2022.102283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/05/2022] [Accepted: 02/23/2022] [Indexed: 11/23/2022]
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30
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Akbulut UE, Arslan E. Hepatitis A Seroprevalence in Mogadishu, Somalia. J Trop Pediatr 2022; 68:6521071. [PMID: 35134249 DOI: 10.1093/tropej/fmac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The hepatitis A virus (HAV) is the most frequent global causes of vaccine-preventable viral hepatitis. Since Somalia is regarded as highly endemic for hepatitis A, the hepatitis A vaccine was not included in the World Health Organization's expanded immunization program. The purpose of this study was to determine the prevalence of hepatitis A infection in the Somalia capital, Mogadishu. METHODS The serological results of 1153 individuals presenting to the Mogadishu Training and Research Hospital between January 2019 and January 2021 were examined retrospectively to evaluate the presence of anti-HAV IgG and IgM. The seroprevalence of anti-HAV IgG and IgM was analyzed on the basis of age and sex. The seroprevalence of anti-HAV IgG was also compared among the 11-year age group. FINDINGS The seroprevalence of anti-HAV IgG and IgM did not vary significantly between the sexes. Overall, the seroprevalence of anti-HAV IgG was 67.6%. The percentage of seropositivity for anti-HAV IgG was highest in adults aged ≥41 years (88.9%) and lowest in children aged 1-2 years (29.4%). Estimated age at midpoint of population immunity was 5 years which is compatible high endemicity. In addition, a significant rate of hepatitis A infection was also observed in the adolescent age group. CONCLUSIONS This study confirms the high HAV endemicity in Mogadishu. These data will be useful towards planning preventive and control measures by improving the sanitation programs in Mogadishu. Furthermore, prospective studies are needed to confirm these findings and evaluate urban-rural heterogeneity.
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Affiliation(s)
- Ulas Emre Akbulut
- Department of Pediatrics, Somalia-Turkey Training and Research Hospital, Mogadishu, Somalia
| | - Ebubekir Arslan
- Department of Emergency, Somalia-Turkey Training and Research Hospital, Mogadishu, Somalia
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31
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Dunn R, Wetten A, McPherson S, Donnelly MC. Viral hepatitis in 2021: The challenges remaining and how we should tackle them. World J Gastroenterol 2022; 28:76-95. [PMID: 35125820 PMCID: PMC8793011 DOI: 10.3748/wjg.v28.i1.76] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/26/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023] Open
Abstract
Viral hepatitis results in 1.4 million deaths annually. The World Health Organization (WHO) set an ambitious target to eliminate viral hepatitis by 2030, but significant challenges remain. These include inequalities in access to healthcare, reaching at risk populations and providing access to screening and effective treatment. Stigma around viral hepatitis persists and must be addressed. The WHO goal of global elimination by 2030 is a worthy aim, but remains ambitious and the coronavirus 2019 pandemic undoubtedly has set back progress. This review article will focus on hepatitis A to E, highlighting problems that have been resolved in the field over the past decade, those that remain to be resolved and suggest directions for future problem solving and research.
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Affiliation(s)
- Rebecca Dunn
- Gastroenterology, University Hospital of North Tees, Stockton on Tees TS198PE, United Kingdom
| | - Aaron Wetten
- Liver Unit, Freeman Hospital, Newcastle NE77DN, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle NE17RU, United Kingdom
| | - Stuart McPherson
- Liver Unit, Freeman Hospital, Newcastle NE77DN, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle NE17RU, United Kingdom
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32
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Shammout R, Alhassoun T, Rayya F. Acute Liver Failure due to Hepatitis A Virus. Case Rep Gastroenterol 2021; 15:927-932. [PMID: 34949977 PMCID: PMC8647103 DOI: 10.1159/000514393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/12/2021] [Indexed: 12/02/2022] Open
Abstract
Acute liver failure (ALF) is a syndrome, rather than a specific disease, with several possible causes, and viral hepatitis is a major cause. The relationship between self-limited and ALF hepatitis A is still poorly understood. A 45-year-old woman presented to our hospital with ALF diagnosis (from another hospital). She suffered from hospital-acquired pneumonia. The patient recovered within 4 weeks and returned to her normal life after 6 months of follow-up.
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Affiliation(s)
- Reem Shammout
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Turki Alhassoun
- Department of General Surgery, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Fadi Rayya
- Department of General Surgery, Al Assad University Hospital, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
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González Grande R, Santaella Leiva I, López Ortega S, Jiménez Pérez M. Present and future management of viral hepatitis. World J Gastroenterol 2021; 27:8081-8102. [PMID: 35068856 PMCID: PMC8704279 DOI: 10.3748/wjg.v27.i47.8081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/08/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023] Open
Abstract
Viral hepatitis can result in important morbidity and mortality, with its impact on health conditioned by the specific type of hepatitis, the geographical region of presentation and the development and access to new drugs, among other factors. Most acute presentation forms are self-limiting and may even go unnoticed, with just a small percentage of cases leading to acute liver failure that may necessitate transplantation or even cause the death of the patient. However, when they become chronic, as in the case of hepatitis B virus and C virus, unless they are diagnosed and treated adequately they may have severe consequences, like cirrhosis or hepatocarcinoma. Understanding of the mechanisms of transmission, the pathogenesis, the presence of vaccinations and the development over recent years of new highly-efficient, potent drugs have meant that we are now faced with a new scenario in the management of viral hepatitis, particularly hepatitis B virus and hepatitis C virus. The spectacular advances in hepatitis C virus treatment have led the World Health Organization to propose the objective of its eradication by 2030. The key aspect to achieving this goal is to ensure that these treatments reach all the more vulnerable population groups, in whom the different types of viral hepatitis have a high prevalence and constitute a niche that may perpetuate infection and hinder its eradication. Accordingly, micro-elimination programs assume special relevance at the present time.
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Affiliation(s)
- Rocío González Grande
- UGC de Aparato Digestivo. Unidad de Hepatología-Trasplante Hepático, Hospital Regional Universitario de Málaga, Málaga 29010, Spain
| | - Inmaculada Santaella Leiva
- UGC de Aparato Digestivo. Unidad de Hepatología-Trasplante Hepático, Hospital Regional Universitario de Málaga, Málaga 29010, Spain
| | - Susana López Ortega
- UGC de Aparato Digestivo. Unidad de Hepatología-Trasplante Hepático, Hospital Regional Universitario de Málaga, Málaga 29010, Spain
| | - Miguel Jiménez Pérez
- UGC de Aparato Digestivo. Unidad de Hepatología-Trasplante Hepático, Hospital Regional Universitario de Málaga, Málaga 29010, Spain
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Mouna L, Akhavan S, Jadoui A, Chevaliez S, Griscelli F, Laperche S, Roque-Afonso AM. Accuracy assessment of total or IgG Immunoglobulin to hepatitis A virus tests around immunity threshold. J Clin Virol 2021; 146:105059. [PMID: 34954664 DOI: 10.1016/j.jcv.2021.105059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Anti-hepatitis A virus (HAV) antibody titers at 20 IU/L are assumed to correlate with protection against HAV challenge. METHODS We examined the accuracy and precision of currently in use immunoassays for total or anti-HAV IgG determination, by repeated testing of dilutions of the international anti-HAV standard, within a 10-50 IU/mL concentration range. RESULTS AND CONCLUSION Eight immunoassays were evaluated. All could confidently identify people who need to be vaccinated, or who might benefit from a booster vaccine: no positive interpretation for the 10 and 15 IU/mL concentrations. However, qualitative interpretation may differ from test to test in the 15-30 IU/mL range. This variation has to be taken into account when comparing seroprevalence data.
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Affiliation(s)
- Lina Mouna
- Universite Paris Saclay, INSERM U1193, AP-HP, Hôpital Paul Brousse, Virology & National Reference Center for HAV, Villejuif, 94800 France
| | - Sepideh Akhavan
- AP-HP, Hôpital Paul Brousse, Virology, Villejuif, 94800 France; AP-HP Pitié-Salpêtrière, Virology, Sorbonne Université, Paris, France
| | - Abir Jadoui
- AP-HP, Hôpital Paul Brousse, Virology, Villejuif, 94800 France
| | - Stéphane Chevaliez
- Université Paris Est Créteil, INSERM U955, Hôpital Henri Mondor, Virology, Créteil, 94000 France
| | - Franck Griscelli
- Université Paris Saclay, INSERM UA9, Gustave Roussy, Département de Biologie Médicale et Pathologie Médicales, Villejuif, 94800 France
| | - Syria Laperche
- Institut National de la Transfusion Sanguine, Département d'études des Agents Transmissibles par le Sang, Centre National de Référence Risques Infectieux Transfusionnels, Paris, 75015 France
| | - Anne-Marie Roque-Afonso
- Universite Paris Saclay, INSERM U1193, AP-HP, Hôpital Paul Brousse, Virology & National Reference Center for HAV, Villejuif, 94800 France.
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Hernandez-Suarez G, Saha D, Lodroño K, Boonmahittisut P, Taniwijaya S, Saha A, Badur S, Poovorawan Y. Seroprevalence and incidence of hepatitis A in Southeast Asia: A systematic review. PLoS One 2021; 16:e0258659. [PMID: 34851983 PMCID: PMC8635355 DOI: 10.1371/journal.pone.0258659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A previous review on hepatitis A virus (HAV) seroprevalence in 2005 categorized Southeast Asia as a low HAV endemicity region. In 2010, the World Health Organization modified this from low to low/medium endemicity, pointing out that these estimates were based on limited evidence. Since then, there has been no attempt to review HAV epidemiology from this region. We conducted a systematic review of literature to collect information on HAV incidence and seroprevalence in select countries in the Southeast Asian region, specifically, The Association of Southeast Asian Nations over the last 20 years. METHODOLOGY This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. From the relevant articles, we extracted data and conducted a risk of bias assessment of individual studies. RESULTS The search yielded 22 and 13 publications on HAV seroprevalence and incidence, respectively. Overall, our findings point to a very low HAV endemicity profile in Thailand and Singapore and evidence of a shift towards low HAV endemicity in Indonesia, Lao People's Democratic Republic, Malaysia, the Philippines, and Vietnam. Only Singapore, Thailand, Malaysia, and the Philippines have existing HAV disease surveillance and reported incidence rates below 1 per 100,000. Several outbreaks with varying magnitude documented in the region provide insights into the evolving epidemiology of HAV in the region. Risk of bias assessment of studies revealed that the individual studies were of low to medium risk. CONCLUSIONS/SIGNIFICANCE The available HAV endemicity profiles in Southeast Asian countries, aside from Thailand, are limited and outdated, but suggest an endemicity shift in the region that is not fully documented yet. These findings highlight the need to update information on HAV epidemiology through strengthening of disease surveillance mechanisms to confirm the shift in HAV endemicity in the region.
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Affiliation(s)
| | - Debasish Saha
- GSK, Medical & Clinical Emerging Markets, Wavre, Belgium
| | - Kris Lodroño
- GSK, Medical Affairs Philippines, Manila, The Philippines
| | | | | | | | - Selim Badur
- GSK, Medical & Clinical Emerging Markets, Istanbul, Turkey
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Status of Immunity Against the Hepatitis A Virus in Healthy Population: A Report From Southeastern Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2021. [DOI: 10.5812/archcid.118869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Recently, epidemiological studies on hepatitis A virus (HAV) infection showed the seroprevalence has been changing due to changes in lifestyle. To the best of our knowledge, there have been no published data on the seropositivity of HAV in Zahedan, southeastern Iran. Objectives: This study aimed to investigate the seroprevalence of HAV immunoglobulin G (IgG) antibody in Zahedan, southeastern Iran, to provide the required information for better planning in preventive strategies. Methods: In this cross-sectional study, using the available sampling method, a total of 250 serum samples (18 years and above) in both the urban and rural areas of Zahedan were evaluated for anti-HAV IgG by enzyme-linked immunosorbent assay. Results: Based on the results, it was observed that 228 out of 250 (91.2%) serum samples were positive for HAV IgG antibody. Male gender, family size, parents’ education, mother’s occupation, and history of jaundice before the age of 12 years were associated with positive HAV antibody (P < 0.001). The seroprevalence HAV rates were not statistically different between the residents of urban and rural regions. Conclusions: The seropositivity of HAV is high in both the urban and rural areas of Zahedan, Iran. Therefore, the HAV vaccination of the general population is not necessary. It is recommended to monitor HAV seroprevalence in the general population to determine high-risk groups, including anti-HAV seronegative individuals, for HAV vaccination in the residents of the southeast border.
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Zanella B, Boccalini S, Biamonte MA, Giorgetti D, Menicacci M, Bonito B, Ninci A, Tiscione E, Puggelli F, Mereu G, Bonanni P, Bechini A. A Study of Hepatitis A Seroprevalence in a Paediatric and Adolescent Population of the Province of Florence (Italy) in the Period 2017-2018 Confirms Tuscany a Low Endemic Area. Vaccines (Basel) 2021; 9:1194. [PMID: 34696301 PMCID: PMC8538179 DOI: 10.3390/vaccines9101194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Italy is considered an area with very low HAV (hepatitis A virus) endemicity. Currently in Italy the anti-HAV vaccine is recommended only for specific risk groups and there is no universal vaccination program. The aim of this study was to assess the level of immunity against hepatitis A in a sample of children and adolescents from the province of Florence. Methods: A total of 165 sera were collected from subjects aged 1 to 18 years, proportionally selected according to the general population size and stratified by age and sex. A qualitative evaluation of anti-HAV antibodies was performed using the enzyme-linked immunosorbent assay (ELISA). Anamnestic and vaccination status data were also collected. Results: Our study showed a hepatitis A seroprevalence of 9.1% in the enrolled population. A statistically significant difference in the prevalence of anti-HAV was found between Italian and non-Italian subjects. About half of the population having anti-HAV antibodies was reported to be vaccinated, and no cases of hepatitis A were found. Conclusions: The data from our study confirmed Tuscany as an area with low HAV endemicity and showed that hepatitis A seroprevalence is significantly higher in foreign children and adolescents. The presence of more seropositive subjects than those vaccinated was probably due to a natural immunization achieved through a subclinical infection and/or to underreporting of the surveillance systems.
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Affiliation(s)
- Beatrice Zanella
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | - Massimiliano Alberto Biamonte
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | - Duccio Giorgetti
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | - Marco Menicacci
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | - Benedetta Bonito
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | - Alessandra Ninci
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | - Emilia Tiscione
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | | | | | - Working Group DHS
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (M.A.B.); (D.G.); (M.M.); (A.N.)
| | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
| | - Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (S.B.); (B.B.); (E.T.); (P.B.)
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Lewin BJ, Rodriguez J, Yang SJ, Tartof SY. Predictors of hepatitis A immunity in adults in California in order to better utilize hepatitis A vaccine. Vaccine 2021; 39:5484-5489. [PMID: 34454784 DOI: 10.1016/j.vaccine.2021.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hepatitis A vaccine recommendations now include homelessness, illegal drug use, and HIV, as well as traditional risk factors and travel to areas endemic for hepatitis A. We examined a large diverse population for predictors of Hepatitis A immunity in order to better utilize Hepatitis A vaccine. METHODS We performed a cross-sectional descriptive study of members of a large integrated health plan with a test for Hepatitis A Immunoglobulin G (IgG) between January 1st, 2007, and December 31st, 2017. Exclusion criteria included age <18 years, <6 months of continuous enrollment, and Hepatitis A vaccine prior to Hepatitis A test. Variables of interest were age, gender, primary language spoken, ethnicity/race, neighborhood household income, and history of travel or history of jaundice. Multivariable logistic regression was performed to evaluate the association of risk factors on Hepatitis A immunity. RESULTS Of the 318,170 persons ≥ 18 years tested for Hepatitis A immunity, 155, 842 persons had a reactive Hepatitis A IgG test (49%). The lowest prevalence was for Whites at 28.1% followed by Blacks at 35.8%. Hispanics and Asian/Pacific Islanders had prevalence rates of 63% and 68.2% respectively. In adjusted analyses, Asian/Pacific Islanders, Hispanics and Blacks were 5.17, 3.44 and 1.42 times more likely to have Hepatitis A immunity than Whites. Those that spoke Spanish or language other than English or Spanish as their primary preferred language were 6.11 and 3.27 time more likely to have immunity than English speakers. Known travel history conferred a 2.16 likelihood of Hepatitis A immunity. CONCLUSIONS Persons of Hispanic and Asian/Pacific Islander background as well as persons with a preferred spoken language other than English have a high prevalence of Hepatitis A immunity. Testing for Hepatitis A immunity prior to vaccination should be considered for these groups.
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Affiliation(s)
- Bruno J Lewin
- Kaiser Permanente Southern California, Department of Family Medicine, Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Clinical Science, United States.
| | - Janelle Rodriguez
- Kaiser Permanente Southern California, Department of Family Medicine, United States
| | - Su-Jau Yang
- Kaiser Permanente Southern California, Department of Research & Evaluation, United States
| | - Sara Y Tartof
- Kaiser Permanente Southern California, Department of Research & Evaluation, Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Health Systems Science, United States
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Zeng DY, Li JM, Lin S, Dong X, You J, Xing QQ, Ren YD, Chen WM, Cai YY, Fang K, Hong MZ, Zhu Y, Pan JS. Global burden of acute viral hepatitis and its association with socioeconomic development status, 1990-2019. J Hepatol 2021; 75:547-556. [PMID: 33961940 DOI: 10.1016/j.jhep.2021.04.035] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/18/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Acute viral hepatitis (AVH) represents an important global health problem; however, the progress in understanding AVH is limited because of the priority of combating persistent HBV and HCV infections. Therefore, an improved understanding of the burden of AVH is required to help design strategies for global intervention. METHODS Data on 4 major AVH types, including acute hepatitis A, B, C, and E, excluding D, were collected by the Global Burden of Disease (GBD) 2019 database. Age-standardized incidence rates and disability-adjusted life year (DALY) rates for AVH were extracted from GBD 2019 and stratified by sex, level of socio-demographic index (SDI), country, and territory. The association between the burden of AVH and socioeconomic development status, as represented by the SDI, was described. RESULTS In 2019, there was an age-standardized incidence rate of 3,615.9 (95% CI 3,360.5-3,888.3) and an age-standardized DALY rate of 58.0 (47.3-70.0) per 100,000 person-years for the 4 major types of AVH. Among the major AVH types, acute hepatitis A caused the heaviest burden. There was a significant downward trend in age-standardized DALY rates caused by major incidences of AVH between 1990 and 2019. In 2019, regions or countries located in West and East Africa exhibited the highest age-standardized incidence rates of the 4 major AVH types. These rates were stratified by SDI: high SDI and high-middle SDI locations recorded the lowest incidence and DALY rates of AVH, whereas the low-middle SDI and low SDI locations showed the highest burden of AVH. CONCLUSIONS The socioeconomic development status and burden of AVH are associated. Therefore, the GBD 2019 data should be used by policymakers to guide cost-effective interventions for AVH. LAY SUMMARY We identified a negative association between socioeconomic development status and the burden of acute viral hepatitis. The lowest burden of acute viral hepatitis was noted for rich countries, whereas the highest burden of acute viral hepatitis was noted for poor countries.
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Affiliation(s)
- Dan-Yi Zeng
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China; School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jing-Mao Li
- Department of Statistics, School of Economics, Xiamen University, Xiamen, Fujian, China
| | - Su Lin
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China
| | - Xuan Dong
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China; School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jia You
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China
| | - Qing-Qing Xing
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China
| | - Yan-Dan Ren
- Department of Gastroenterology, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China
| | - Wei-Ming Chen
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yan-Yan Cai
- School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Kuangnan Fang
- Department of Statistics, School of Economics, Xiamen University, Xiamen, Fujian, China
| | - Mei-Zhu Hong
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Yueyong Zhu
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China.
| | - Jin-Shui Pan
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China.
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Prevalence of Anti-Hav IgG Antibodies in the Population of the Łódź Macroregion by Age Group. POLISH HYPERBARIC RESEARCH 2021. [DOI: 10.2478/phr-2021-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Over the last several decades, a gradual decrease in the incidence of hepatitis A and an increase in the population of non-immune people, especially in the group of young people have been observed in Poland. The aim of this study was to assess of the presence of specific anti-hepatitis A virus IgG class antibodies (anti-HAV IgG) in relation to age among non-vaccinated hepatitis A patients. There were statistically significantly more patients up to 45 years of age with anti-HAV IgG negative results than those over 45 years of age, and the Fi-square correlation coefficient (Φ2) was 0.263 between the analyzed variables. The data analysis shows that the number of people with specific IgG antibodies against hepatitis A increases with age. The risk of hepatitis A infection in people under 45 is high due to widespread seronegativity in this age group.
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Elbahrawy A, Ibrahim MK, Eliwa A, Alboraie M, Madian A, Aly HH. Current situation of viral hepatitis in Egypt. Microbiol Immunol 2021; 65:352-372. [PMID: 33990999 DOI: 10.1111/1348-0421.12916] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/02/2021] [Accepted: 05/11/2021] [Indexed: 12/12/2022]
Abstract
An estimated 8-10 million people suffer from viral hepatitis in Egypt. Hepatitis A virus (HAV) and hepatitis E virus (HEV) are the major causes of viral hepatitis in Egypt as 50% or more of the Egyptian population are already exposed to HAV infection by the age of 15. In addition, over 60% of the Egyptian population test seropositive for anti-HEV in the first decade of life. HEV mainly causes self-limiting hepatitis; however, cases of fulminant hepatitis and liver failure were reported in Egypt. Hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV) are the main causes of chronic hepatitis, liver cirrhosis, and liver cancer (hepatocellular carcinoma [HCC]) in Egypt. Globally, Egypt had the highest age-standardized death rate due to cirrhosis from 1990 to 2017. The prevalence rate of HBV (1.3%-1.5%) has declined after national infantile immunization. Coinfection of HBV patients with HDV is common in Egypt because HDV antibodies (IgG) vary in range from 8.3% to 43% among total HBV patients. After the conduction of multiple national programs to control HCV infection, a lower rate of HCV prevalence (4.6%) was recently reported. Data about the incidence of HCV after treatment with direct antiviral agents (DAAs) are lacking. An HCC incidence of 29/1000/year in cirrhotic patients after DAA treatment is reported. A higher rate of infiltrative pattern among HCC patients after DAA treatment is also recognized. Viral hepatitis is one of the major public health concerns in Egypt that needs more attention and funding from health policymakers.
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Affiliation(s)
- Ashraf Elbahrawy
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Marwa K Ibrahim
- Department of Microbial Biotechnology, Division of Genetic Engineering and Biotechnology Research, National Research Centre, Giza, Egypt.,Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ahmed Eliwa
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Ali Madian
- Department of Internal Medicine, Al-Azhar University, Assiut, Egypt
| | - Hussein Hassan Aly
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
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Cao G, Jing W, Liu J, Liu M. The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention. Hepatol Int 2021; 15:1068-1082. [PMID: 34345993 PMCID: PMC8514357 DOI: 10.1007/s12072-021-10232-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/01/2021] [Indexed: 12/24/2022]
Abstract
Background and purpose Despite decades of improved sanitation and hygiene measures and vaccine introduction, hepatitis A has been spread through numerous outbreaks globally. We used data from the Global Burden of Disease (GBD) study to quantify hepatitis A burden at the global, regional and national levels. Methods Annual incident cases, deaths, age-standardized incidence rates (ASIRs), and age-standardized mortality rates (ASMRs) of hepatitis A between 1990 and 2019 were derived from the GBD study 2019. Percentage changes of cases and deaths, and estimated annual percentage changes (EAPCs) of ASIRs and ASMRs were calculated to quantify their temporal trends. Results Global hepatitis A incident cases increased by 13.90% from 139.54 million in 1990 to 158.94 million in 2019. ASIR of hepatitis A remained stable (EAPC = 0.00, 95% CI −0.01 to 0.01), whereas ASMR decreased (EAPC = −4.63, 95% CI −4.94 to −4.32) between 1990 and 2019. ASIR increased in low (EAPC = 0.09, 95% CI 0.04 to 0.14) and low-middle (EAPC = 0.04, 95% CI 0.03 to 0.06) socio-demographic index (SDI) regions. For GBD regions, the most significant increases of ASIR were detected in high-income Asia Pacific (EAPC = 0.53, 95% CI 0.41 to 0.66), Oceania (EAPC = 0.31, 95% CI 0.25 to 0.36), and Australasia (EAPC = 0.28, 95% CI 0.13 to 0.44). EAPC of ASIR was positively associated with SDI value in countries and territories with SDI value ≥ 0.7 (ρ = −0.310, p < 0.001). Conclusion There is an unfavorable trend that hepatitis A is still pending in hyperendemic regions and is emerging in low endemic regions. These highlight the need of targeted and specific strategies to eliminate hepatitis A, such as sanitation measures and a comprehensive plan for surveillance and vaccination against hepatitis A. Supplementary Information The online version contains supplementary material available at 10.1007/s12072-021-10232-4.
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Affiliation(s)
- Guiying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Haidian District, No. 38 Xueyuan Road, Beijing, 100191, China.
| | - Wenzhan Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Haidian District, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Haidian District, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Haidian District, No. 38 Xueyuan Road, Beijing, 100191, China.
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Torre P, Aglitti A, Masarone M, Persico M. Viral hepatitis: Milestones, unresolved issues, and future goals. World J Gastroenterol 2021; 27:4603-4638. [PMID: 34366625 PMCID: PMC8326259 DOI: 10.3748/wjg.v27.i28.4603] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/11/2021] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
In this review the current overall knowledge on hepatitis A, B, C, D, and E will be discussed. These diseases are all characterized by liver inflammation but have significant differences in distribution, transmission routes, and outcomes. Hepatitis B virus and hepatitis C virus are transmitted by exposure to infected blood, and in addition to acute infection, they can cause chronic hepatitis, which in turn can evolve into cirrhosis. It is estimated that more than 300 million people suffer from chronic hepatitis B or C worldwide. Hepatitis D virus, which is also transmitted by blood, only affects hepatitis B virus infected people, and this dual infection results in worse liver-related outcomes. Hepatitis A and E spread via the fecal-oral route, which corresponds mainly to the ingestion of food or water contaminated with infected stools. However, in developed countries hepatitis E is predominantly a zoonosis. Although hepatitis A virus and hepatitis E virus are usually responsible for a self-limiting hepatitis, a serious, rarely fatal illness is also possible, and in immunosuppressed patients, such as organ transplant recipients, hepatitis E virus infection can become chronic. The description of goals achieved, unresolved issues, and the latest research on this topic may make it possible to speculate on future scenarios in the world of viral hepatitis.
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Affiliation(s)
- Pietro Torre
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana,” University of Salerno, Salerno 84081, Italy
| | - Andrea Aglitti
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana,” University of Salerno, Salerno 84081, Italy
| | - Mario Masarone
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana,” University of Salerno, Salerno 84081, Italy
| | - Marcello Persico
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana,” University of Salerno, Salerno 84081, Italy
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Badur S, Öztürk S, Ozakay A, Khalaf M, Saha D, Van Damme P. A review of the experience of childhood hepatitis A vaccination in Saudi Arabia and Turkey: implications for hepatitis A control and prevention in the Middle East and North African region. Hum Vaccin Immunother 2021; 17:3710-3728. [PMID: 34213403 DOI: 10.1080/21645515.2021.1920871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
In most countries of the Middle East and Northern African (MENA) region, a high hepatitis A virus (HAV) endemicity has been documented. Few others, such as Saudi Arabia and Turkey, are transitioning from high to intermediate endemicity. There is a paucity of recently published HAV disease burden that could be useful to inform or strengthen relevant national hepatitis A vaccination policy and other prevention strategies in the region. This review summarizes information on HAV epidemiology before and after the implementation of a childhood hepatitis A vaccination program in Saudi Arabia and Turkey. In both countries, a clear shift in the age of first HAV exposure has been documented, with more homogeneous trends across regions in Saudi Arabia compared to Turkey. Utilizing the experience of Saudi Arabia and Turkey with hepatitis A vaccination, countries in the region are encouraged to foster discussions on potential vaccination strategies suitable for their own setting.
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Affiliation(s)
- Selim Badur
- Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | - Serdar Öztürk
- Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | - Alev Ozakay
- Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | | | - Debasish Saha
- Medical & Clinical Emerging Markets, GSK, Wavre, Belgium
| | - Pierre Van Damme
- Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Jaisli S, Mayorga O, Flores N, de Berti S, Frösner G, Herzog C, Zwahlen M, Herzog SA. Clinical, serological and epidemiological features of hepatitis A in León, Nicaragua. PeerJ 2021; 9:e11516. [PMID: 34221712 PMCID: PMC8223896 DOI: 10.7717/peerj.11516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
Background and Objectives To monitor and document the endemicity and disease burden of acute hepatitis A in the area of an ongoing vaccine effectiveness study in León, Nicaragua. Methods At community health centres in León, all children, adolescents and young adults presenting with jaundice and/or other clinical signs of hepatitis were offered free serologic screening (hepatitis A, B and C) and blood tests for liver enzymes and bilirubin. Clinical and socioeconomic data were collected with a structured questionnaire. Diagnosis of acute hepatitis A was confirmed by anti-HAV IgM testing. Using logistic regression we compared the characteristics and living conditions of acute hepatitis A cases with those of non-cases. Results Of 557 eligible subjects enrolled between May 2006 and March 2010, 315 (56.6%) were diagnosed with hepatitis A, 80.6% of them ≤10 years and five >18 years of age. No severe cases were encountered. Apart from jaundice (95.6%) and other signs of hepatitis A (fever, pale stool, dark urine, nausea, vomiting, anorexia), two thirds of patients had moderately raised liver enzymes. Cases occurred throughout the year, with highest incidences from August to March. Poor sanitary conditions and crowding were the main risk factors. Conclusions In the study area, hepatitis A is still highly endemic in young and school age children living in low socioeconomic conditions. There are, however, first indications that the endemicity level is shifting from high to high-intermediate.
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Affiliation(s)
- Sophie Jaisli
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Orlando Mayorga
- Department of Microbiology & Parasitology, Faculty of Medical Sciences, National Autonomous University, León, Nicaragua
| | - Nadia Flores
- Department of Microbiology & Parasitology, Faculty of Medical Sciences, National Autonomous University, León, Nicaragua
| | | | - Gustav Frösner
- Institute of Virology, Technical University, Munich, Germany
| | - Christian Herzog
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Medical Department, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sereina A Herzog
- Centre for Health Economics Research and Modelling of Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium.,Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
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46
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Wang X, Luo J, Ma F, Kang G, Ding Z, Pan Y, Zhao Y, Chen J, Feng K, Yan L, Zhang J, Li L, Lan Q, Li D, Yang X, Li G, Yang J, Sun Q. The Safety, Immunogenicity, and Immunopersistence of Hepatitis A Vaccine in HBs-Ag-Positive Participants: A Retrospective Study. Front Cell Infect Microbiol 2021; 11:672221. [PMID: 34222044 PMCID: PMC8248179 DOI: 10.3389/fcimb.2021.672221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/02/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives To compare the safety, immunogenicity, and immune persistence of hepatitis A (HA) vaccines between HBs-Ag-positive and -negative participants. Method 9000 participants were enrolled in the phase IV study of live attenuated HA (HA-L) or inactivated HA (HA-I) vaccines. The HBs-Ag-positive subjects were detected and became an independent observation group. Adverse reactions (ARs), geometric mean concentrations (GMCs) and seroconversion rates (SRs) of the vaccines were analyzed at five time points until three years after vaccination. Results: 120 HBs-Ag-positive subjects were screened out, only 1 participant had grade 1 experienced ARs after HA-L injection. Except the time point of two years, the SRs of HBs-Ag-positive group were 100% for both vaccines. The GMCs were not statistically different between HBs-Ag-positive and -negative groups after the HA-L vaccination. The logarithmically transformed GMCs for HBs-Ag-positive and -negative groups were 3.21 mIU/mL (95% CI, 2.03-4.39 mIU/mL) and 2.95 mIU/mL (95% CI, 2.88-3.02 mIU/mL) 28 days after the HA-L vaccination, respectively. Conclusions Both HA-L and HA-I vaccines were safe for HBs-Ag-positive participants and may provide an excellent long-term protection against HAV in this study. The results indicated that people positive or negative for HBs-Ag can receive both HA-L and HA-I vaccines (ClinicalTrials.gov number, NCT02601040).
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Affiliation(s)
- Xiaodan Wang
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Jia Luo
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Fubao Ma
- Vaccines and Immunization Department, Jiangsu Provincial Center of Disease Control and Prevention, Nanjing, China
| | - Guodong Kang
- Vaccines and Immunization Department, Jiangsu Provincial Center of Disease Control and Prevention, Nanjing, China
| | - Zhengrong Ding
- Vaccines and Immunization Department, Yunnan Provincial Center of Disease Control and Prevention, Kunming, China
| | - Yue Pan
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Yujiao Zhao
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Junying Chen
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Kai Feng
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Lingmei Yan
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Juan Zhang
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China.,School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Linhao Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China.,School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Qiangping Lan
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Daiying Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Xiaolei Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Guoliang Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Jingsi Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
| | - Qiangming Sun
- Institute of Medical Biology, Chinese Academy of Medical Sciences, and Peking Union Medical College, Kunming, China.,Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming, China.,Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Kunming, China
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Ramaswamy M, Bruden D, Nolen LD, Mosites E, Snowball M, Nelson NP, Bruce M, McMahon BJ. Hepatitis A vaccine immunogenicity 25 years after vaccination in Alaska. J Med Virol 2021; 93:3991-3994. [PMID: 33448443 PMCID: PMC10851705 DOI: 10.1002/jmv.26327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 01/11/2023]
Abstract
The hepatitis A vaccine is recommended for all children greater than or equal to 1 year of age, however, the duration of vaccine protection is unknown and protection through adulthood is crucial to prevent symptomatic hepatitis later in life. We report on 25 years of follow-up of a cohort of Alaska Native individuals who were vaccinated in early childhood. We assessed the duration of vaccine protection by calculating the geometric mean concentration and proportion of participants with protective levels of IgG antibody to hepatitis A virus (anti-HAV) (≥20 mIU/mL) every 2 to 3 years. We estimated the amount of time until the anti-HAV dropped below protective levels using survival analyses. At 25 years, 43 of the original 144 participants were available, mean anti-HAV levels were 91.5 mIU/mL, and 35 (81.4%) had protective levels of anti-HAV. Using data from all persons and all time points, a survival analysis estimated 78.7% of participants had protective levels of anti-HAV at 25 years. The high level of protective antibodies in this cohort indicate that supplemental doses of hepatitis A vaccine are not needed 25 years after completion of the vaccine series.
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Affiliation(s)
- Maya Ramaswamy
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Leisha D. Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Emily Mosites
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Mary Snowball
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Noele P. Nelson
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Michael Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Brian J. McMahon
- Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska
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48
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Comparison of PCR with Serology for Detecting Acute Hepatitis A Virus Infection. JOURNAL OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASES 2021. [DOI: 10.52547/jommid.9.2.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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49
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Tripathy AS, Sharma M, Thorat NC, Jadhav S, Koshatwar KA. An outbreak of hepatitis E in Yavatmal, India, 2019. J Med Virol 2021; 93:3761-3768. [PMID: 33617043 DOI: 10.1002/jmv.26377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 12/23/2022]
Abstract
Hepatitis E, a public health concern in developing countries, frequently presents in epidemic, as well as in sporadic forms. This study investigated an outbreak of viral hepatitis at Yavatmal, Maharashtra, India in March 2019. Blood samples from 10 patients were received at Indian Council of Medical Research-National Institute of Virology, Pune to test for the presence of enterically transmitted hepatitis viruses. Subsequently, 49 suspected cases were screened for anti-hepatitis E virus (HEV)/hepatitis A virus (HAV) immunoglobulin M and immunoglobulin G (IgG) antibodies, alanine amino-transferase levels and HEV RNA. Water samples were screened for HEV and HAV RNA followed by phylogenetic analysis. Overall 32 of 49 (65.3%) suspected cases had recent acute HEV infection, while dual infection with HAV was noted in one case (2.04%). Forty-eight of 49 suspected cases were positive for anti-HAV IgG antibodies indicative of previously acquired immunity against HAV. Water samples had evidence of HEV contamination as detected by reverse transcription-polymerase chain reaction. Sequencing of HEV RNA from both patients (n = 2) and water samples (n = 5) indicated HEV genotype 1 to be the etiological agent of this outbreak. Serological and molecular evidence confirmed HEV as the etiology. Mixing of contaminated drain water with the domestic water supply may have triggered this outbreak. Subsequent changing of the defaulted water pipelines and its segregation from drain pipelines by the health authorities resulted in progressive decline of this outbreak. Despite the limitations, periodic surveillance of HEV exposure pattern and reporting of small outbreaks would supplement to the global disease burden data of hepatitis E.
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Affiliation(s)
- Anuradha S Tripathy
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Meenal Sharma
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Neeta C Thorat
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Santosh Jadhav
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
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50
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Ayouni K, Kharroubi G, Mallekh R, Hammami W, Marouani R, Mhamdi M, Ben Salah A, Triki H, Bettaieb J. Seroprevalence of hepatitis A virus infection in Central-West of Tunisia. J Med Virol 2021; 93:3666-3671. [PMID: 32986240 DOI: 10.1002/jmv.26563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/28/2020] [Accepted: 09/23/2020] [Indexed: 11/06/2022]
Abstract
Hepatitis A infections still represent a major global health concern. During the past years, a transition pattern of the hepatitis A epidemiology was noted in many parts of the world. In Tunisia, there is not a recent survey on age-specific hepatitis A virus seroprevalence. This study aimed to investigate the seroprevalence of hepatitis A virus infection in Central-West Tunisia, representative of regions with lowest socioeconomic level in the country, before vaccine implementation. Sera obtained from the blood samples of subjects were screened for the detection of hepatitis A virus. The seroprevalence was evaluated by detection of total antibodies to hepatitis A virus using commercially available immunoassay kits. A total of 1379 subjects, aged 5-75 years (mean age: 29.0 ± 17.3 years) were studied. The global anti-hepatitis A virus seroplevalence was 84.7% (95% confidence interval: [82.6-86.5]). A higher hepatitis A virus seroprevalence was showed in subjects aged 10-14 years compared to those aged less than 10 years (50.0% vs. 31.0%). In subjects aged 20-29 years, a rapid increase in the hepatitis A virus prevalence was noted; it reached 97.0%. The seroprevalence of anti-hepatitis A virus differed by zone of residence (81.1% in rural area vs. 72.4% in urban area, p = .005) and increased significantly with lower level of education (p = .019). There was no statistical significant seroprevalence difference between male and female: 84.2% versus 85.2%, respectively. Our study confirm the transition pattern of the hepatitis A virus endemicity in Tunisia from high to intermediate and provide an evaluation of the hepatitis A virus epidemiological situation before vaccine implementation.
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Affiliation(s)
- Kaouther Ayouni
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ghassen Kharroubi
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Epidemiology, Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Rym Mallekh
- Department of Epidemiology, Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Walid Hammami
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | | | - Moncef Mhamdi
- Regional Health Direction of Kasserine, Kasserine, Tunisia
| | - Afif Ben Salah
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Epidemiology, Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Henda Triki
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Jihène Bettaieb
- Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Department of Epidemiology, Clinical Investigation Center, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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