An outbreak of hepatitis A virus infection with a high case-fatality rate among injecting drug users.
J Hepatol
; 43(6): 958-64, 2005 Dec.
Article
en En
| MEDLINE
| ID: mdl-16143420
ABSTRACT
BACKGROUND/AIMS:
In 2002, the first reported outbreak of hepatitis A virus (HAV) infection involving mostly intravenous drug users (IDU) occurred in Italy. We attempted a thorough evaluation of the outbreak, including epidemiological, clinical and virological analyses.METHODS:
We conducted an epidemiological investigation, including a case-control study, to identify the source and the modes of HAV transmission. Hepatitis B and C (HCV) viruses and human immunodeficiency virus (HIV) coinfections were clinically analysed. Sequence analysis of the VP1/2A junction of the HAV isolates was also performed.RESULTS:
Of the 47 symptomatic cases, 35 were IDUs. The only associated risk factor was contact (not related to injecting practices) with a jaundiced person (odds ratio 5.8; 95% confidence interval 1.3-29.9). Of the cases, 58% were anti-HCV positive and 4.7% anti-HIV positive. Three individuals died of acute liver failure 2 were HCV-coinfected alcohol abusers, with underlying liver cirrhosis; 1 was HCV/HIV-coinfected. HAV-RNA was found in 15 of the 24 tested patients genotype IB (8 cases) and IIIA (7 cases) were detected.CONCLUSIONS:
HAV was probably transmitted through the fecal-oral route, although parenteral transmission cannot be excluded. The high fatality rate was probably due to severe underlying liver damage. The occurrence of this outbreak highlights the need for routine HAV vaccination for IDUs.
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Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
4_TD
/
6_ODS3_enfermedades_notrasmisibles
/
8_ODS3_consumo_sustancias_psicoactivas
Problema de salud:
2_enfermedades_transmissibles
/
2_sustancias_psicoativas
/
4_aids
/
4_hepatitis
/
6_digestive_diseases
/
8_alcohol
Asunto principal:
Abuso de Sustancias por Vía Intravenosa
/
Brotes de Enfermedades
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Virus de la Hepatitis A
/
Hepatitis A
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Hepatol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2005
Tipo del documento:
Article
País de afiliación:
Italia