Viral hepatitis among men who have sex with men, epidemiology and public health consequences.

Viral hepatitis causes major disease burden worldwide, due to the chronic hepatitis sequelae: cirrhosis and primary liver cancer. Transmission of viral hepatitis is a problem not only in low-income countries, but also in high-income ones where viral hepatitis is a frequently occurring infection among men who have sex with men (MSM). Although the transmission routes of the three main hepatitis viruses, A, B and C, differ, MSM mainly acquire viral hepatitis during sexual contact. Vaccination programmes (only available for hepatitis A and B), raising awareness, and screening can be used to prevent transmission. However, despite the introduction of such methods in many high-income countries, the spread of viral hepatitis among MSM is still ongoing. This paper provides an overview of sexually acquired hepatitis A, B, and C among MSM in high-income countries, using recent insights obtained through molecular epidemiology, with the aim to raise awareness, improve vaccination coverage, and stimulate prevention programs.

A novel hepatovirus identified in wild woodchuck Marmota himalayana.

Hepatitis A virus (HAV) is a hepatotropic picornavirus that causes acute liver disease worldwide. Here, we report on the identification of a novel hepatovirus tentatively named Marmota Himalayana hepatovirus (MHHAV) in wild woodchucks (Marmota Himalayana) in China. The genomic and molecular characterization of MHHAV indicated that it is most closely related genetically to HAV. MHHAV has wide tissue distribution but shows tropism for the liver. The virus is morphologically and structurally similar to HAV. The pattern of its codon usage bias is also consistent with that of HAV. Phylogenetic analysis indicated that MHHAV groups with known HAVs but forms an independent branch, and represents a new species in the genus Hepatovirus within the family Picornaviridae. Antigenic site analysis suggested MHHAV has a new antigenic property to other HAVs. Further evolutionary analysis of MHHAV and primate HAVs led to a most recent common ancestor estimate of 1,000 years ago, while the common ancestor of all HAV-related viruses including phopivirus can be traced back to 1800 years ago. The discovery of MHHAV may provide new insights into the origin and evolution of HAV and a model system with which to explore the pathogenesis of HAV infection.

Review of infectivity studies in nonhuman primates with virus-like particles associated with MS-1 hepatitis.

Using the technique of immune electron microscopy we have conducted hepatitis A infectivity studies in marmoset monkeys and chimpanzees. Marmosets inoculated with human serum containing the MS-1 strain of hepatitis A virus have developed hepatitis and seroconverted to 27 nm virus-like particles isolated from stools of humans in the early acute stages of hepatitis. Similar results have been observed through several marmoset subpassages, and the virus-like particles have been recovered from the liver of animals in the acute phase of hepatitis. Chimpanzees inoculated with stool filtrates containing the virus-like particles develop hepatitis with concomitant excretion of the particles in early acute phase stools and subsequent development of serum antibody to the particles. These studies provide evidence that the above particles constitute the virus of hepatitis A of the MS-1 prototype.

Hepatitis in marmosets.

Some species of marmosets are susceptible, not only by parenteral inoculation but also by oral exposure, to human hepatitis A virus present in sera or feces. The stools of animals inoculated parenterally or orally contained fecal antigen during certain times of the incubation period and the early, acute phase of the disease; viruslike particles were present in feces of orally infected animals and such feces were infectious when inoculated into marmosets. The fecal antigen crossreacted both with the fecal virus particles and the immune-adherence antigen (see also papers by Purcell et al and Hilleman et al). The MS-1 and CR-326 strains of hepatitis A appeared antigenically similar or identical whereas the GB strain was antigenically different and may be associated with the recently defined type of hepatitis termed hepatitis C or hepatitis non-A/non-B. On repeated challenge hyperegic responses with diffuse liver cell necrosis occurred in some immune animals and this phenomenon must be taken into account in any future vaccination studies.

Biophysical and biochemical properties of CR326 human hepatitis A virus.

CR326 human hepatitis A virus purified by isopycnic banding from infected marmoset sera was shown to consist of 27 mmu spherical particles on electron microscopic examination. The particles were identified as hepatitis A virus by tests by infectivity and by specific neutralization of infectivity with convalescent human hepatitis A serum. Also, identical 27 mmu viruses in liver extracts gave specific reactions with hepatitis A antisera when tested by immune electron microscopy. The buoyant density of the virus in CsCl was 1.34 and it was heat (60 C), ether, and acid stable but was destroyed by heat (100 C), formalin (1:4000), and ultraviolet irradiation. Electron microscopic studies of sections of infected marmoset liver showed intracytoplasmic virus particles, usually in vesicles. Presumptive findings for RNA, together with the intracytoplasmic location of the virus, indicated the virus to be of RNA-type. The attributes of the virus indicate it is closely related to the enterovirus family and not to hepatitis B virus.

[Magnitude of rainfall on viral contamination of the marine environment during gastroenteritis epidemics in human coastal population]. / Importance de la pluviométrie sur la contamination virale du milieu littoral lors de phénomènes épidémiques dans la population.

BACKGROUND: Sewage treatments are not efficient to eliminate enteric microorganisms. Viruses are able to persist and are discharged into the marine environment with treated effluents. Few data are now available on the magnitude and the contributive processes of marine viral contamination. This work evaluates the relationship between the magnitude of rainfall and the viral contamination of the marine environment during winter epidemics of gastroenteritis in human coastal populations. METHODS: A RT-PCR method was used to detect enterovirus, hepatitis A virus, Norwalk-like virus, astrovirus and rotavirus in shellfish, harvested monthly between August 1995 and July 1998. The frequency of virus detection in shellfish was expressed as an Index of Viral Contamination. Acute gastroenteritis in the population was estimated using the French Sentinel System for Monitoring of Communicable Diseases. Rainfall effects on the efficiency of sewage treatment were assessed using an estimated staying time of sewage effluents in the plant. RESULTS: The results indicate that the highest viral contamination occurs in winter. Maximal indexes of viral contamination were respectively 70% in January 1996, 100% in January 1997, but only 31% in January 1998. Viral contamination variations seemed to follow the pattern of the winter epidemic of acute gastroenteritis in the local population in 1996 and 1997. These observations should be linked to the winter rainfalls. Heavy rains on short periods of time could create an hydraulic overload in the sewage treatment plant, reducing the staying time of the sewage effluents and thus the efficiency of the disinfection process. CONCLUSION: The magnitude of the viral contamination of shellfish seems to result from the simultaneity between the winter epidemics of acute gastroenteritis in the coastal population and heavy rainfall. To prevent public health hazards associated with shellfish consumption, the monitoring of microbiological quality in shellfish harvesting areas should include accompagning survey of viral epidemic in the coastal population, and of sewage outputs in the coastal environment.

Viral hepatitis--a primer: 1. Epidem.iology.

Hepatitis A is most often transmitted by the fecal-oral route under conditions of crowding, poor hygiene, and prolonged exposure to infected persons. Direct spread of hepatitis B via person-to person contact has only recently been proved. Hepatitis B is usually transmitted indirectly proved. Hepatitis B is usually transmitted indirectly by percutaneous routes, and the increase in drug abuse has brought about a change in its epidemiologic pattern.

[Hereditable characteristics of attenuated live hepatitis A virus H2 strain].

The toxicity of attenuated hepatitis A virus H2 strain was not increased in testing KMB 17 cells of 5 consecutive generations of monkeys at 36 degrees C. After injection of attenuated live hepatitis A virus H2 strain in humans, no abnormality was noted. Serum hepatitis A antigen was positive after 38 children aged 3-9 years were given oral 10(6.5) TCKD50, whereas it was 100% positive in the group of same age after percutaneous vaccination. Noninfection of oral administration is an important hereditable characteristic differentiation from wild strains.

[Characteristics of the manifest and latent components of the hepatitis A epidemic process in cities of Russia]. / Kharakteristika manifestnogo i skrytogo komponentov épidemicheskogo protsessa gepatita A v gorodakh Rossii.

Seroepidemiological study of hepatitis A (HA) morbidity was carried out in three Russian cities, with different levels of HA morbidity. The study included the analysis of HA morbidity for 22 years, the determination of antibodies to HA virus (anti-HAV) in 2,958 healthy persons aged 0-12 months to 40 years and older. In one of the cities 7 isolates of HA virus were obtained from unrelated sources and the genotypes of the virus were determined. The study revealed that the frequency of seropositive cases among persons of different ages correlated with the level and prolonged dynamics of HA morbidity. According to the occurrence of anti-HAV, such cities as St. Petersburg, Rostov-on-Don and Yakutsk may be at present classified as territories, moderately endemic in HA. At the same time in the 90 s the epidemic situation in HA was more favorable in Rostov-on-Don than in two other cities. The suggestion was made that a high proportion of seropositive persons among the population of St. Perersburg was linked with an almost twofold rise in HA morbidity in 1993-1995 caused by genotype 1 of the virus. Seroepidemiological studies in HA during the period of a drop in morbidity acquire special importance in the surveillance and control system of this infection.

[Viral hepatitis with clinical and epidemiological manifestations similar to hepatitis A but of a different etiology]. / Virusnyi gepatit, skodnyi po klinike i épidemiologii s gepatitom A, no otlichaiushchiisia ot nego étiologicheski.

A case of viral hepatitis in man, appearing as the result of infection caused by pooled concentrated suspensions of fecal samples collected from patients having had repeated hepatitis infection during the period of 1-2 years, is described. Though this infection was similar to hepatitis A in many clinical and epidemiological signs, the possibility of its etiologic relationship with hepatitis virus A was positively excluded; there was also no evidence of the participation of hepatitis virus B in the process. Immunoelectron microscopy of excretions collected at the acute stage of the disease revealed the presence of spherical viral particles 27-30 nm in diameter. Antibodies capable of reacting with these particles were detected in the sera of patients having had 2 kinds of hepatitis and in the sera of patients having the 1 kind of hepatitis in the focus of infection where repeated cases of hepatitis had been observed. No such antibodies were found in the sera of patients with hepatitis A alone and in the set of standard sera specific to viruses causing hepatitis A and hepatitis non A, non B. The authors believe that 2 kinds of hepatitis with the fecal-oral mechanism of transmission exist and propose to name their causative agents hepatitis viruses A, type 1 and type 2.

[Hepatitis viruses infection situation in Mianyang of the Sichuan province].

OBJECTIVE: To investigate the seroprevalence of hepatitis viruses in Mianyang of the Sichuan province. METHODS: EIISA was used for detecting anti-HAV IgG, HBsAg/HBsAb, anti-HCV IgG and anti-HEV IgG of the serum samples. All sample were collected in Mianyang areas in 2007. RESULTS: 1352 samples were detected. The positive rates of anti-HAV, HBsAg/HBsAb, anti-HCV,and anti-HEV are 81.07% (1096/1352), 5.40% (73/1352) and 61.32% (829/1352), 0.37% (5/1352) and 49.26% (666/1352), respectively. The positive rate at different age group, for anti-HAV was 38.21% of 10-19 years old, 83% of 20-29 years old, 88% of 30-39 years old, 95.03% of 40-49 years old, 97% of 50-59 years old, 97.77% of 60-69 years old, 97.52% of > or =70 years old. For HBsAg/HBsAb were 5.65% or 50.83%, 10.0% or 68.0%, 5.20% or 78.80%, 5.97% or 78.11%, 6.50% or 62.50%, 1.12% or 51.40%, 4.96% or 30.58% at the same age group, respectively,for anti-HCV, was 0.33% of 10-19 years old, 0.80% of 30-39 years, 0.56% of 60-69 years old, 0.83% of > or =70 years old.For HEV-IgG was 26.58% of 10-19 years old, 42.0% of 20-29 years old, 55.22%-61.0% of 30-> or =70 years old, for anti-HEV IgM, was 10.06% (53/527) in the positive samples of HEV-IgG. CONCLUSION: The inoculation againt HAV and HBV is enhanced in the young population. HBsAg carrier and HCV infection is decreasing. The HEV infection is actually increasing.

Hepatitis A en niños / Hepatitis A in children

La Hepatitis A (HVA), también llamada hepatitis infecciosa, transmitida por alimentos, epidémica,ictericia catarral o epidémica, entre otros, es una enfermedad producida por un agente viral que se trasmite por vía fecal oral y generalmente su curso es autolimitado, aunque, puede progresar ahepatitis fulminante ocasionando la muerte a una proporción pequeña de los infectados. Pertenece al géner o Hepatovir us de la Familia Picornaviridae. La HVA, tiene una distribución universal, aunque con grandes diferencias geográficas en cuanto a su prevalencia, ocurre en forma esporádica y epidémica en todo el mundo, con una tendencia a presentarse en ciclos. La HVA, tiene un periodo de incubación prolongado, entre 15 a 50 días, con un promedio de 29 días, lo que hace difícil relacionar los síntomas con algún alimento o bebida ingerida. El diagnostico de la HVA, se basa en la detección de anticuerpos contra el VHA tipo IgM e IgG. El tratamiento básicamente es de soporte, sintomático y en casos de falla hepática, el trasplante es la única opción. La inmunoglobulina confiere inmunidad pasiva a corto plazo mientras la vacuna provee una protección activa a largo plazo.

Hepatitis A (HVA), also called infectious hepatitis, foodborne, epidemic, or epidemic or catarrhaljaundice, among others, is a disease caused by a viral agent that spreads through fecal-oral routeand usually self-limited course, although fulminant hepatitis can progress to causing death to a small proportion of those infected. Is a Hepatovirus genus of the Picornaviridae Family. The HVA, has a worldwide distribution, but with large geographical differences in its prevalence, occurs in sporadic and epidemic worldwide, with a tendency to occur in cycles. The HVA, has a long incubation period between 15 to 50 days, with an average of 29 days, making it difficult to correlate symptoms with food or drink intake. The diagnosis of HVA was based on the detection of antibodies against HAV IgM and IgG.

Evidence that the genome of hepatitis A virus consists of single-stranded RNA.

Nucleic acid was extracted from purified hepatitis A virus, radiolabeled with 125I, and shown to consist of single-stranded RNA which sediments at 35S and contains sequences of polyadenylic acid. These findings are consistent with hepatitis A virus being a member of the genus Enterovirus within the family Picornaviridae.

Hepatitis A. Perspectives and recent advances.

The basis for the epidemiologic and etiologic differentiation of two major forms of viral hepatitis, hepatitis A and B, was established in a series of studies undertaken between 1930 and 1970. Final recovery and visualization of the presumed etiologic agent of hepatitis A was not, however, accomplished until the technique of immune electron microscopy was applied to the examination of specimen materials collected from individuals in the early acute stages of infection. Morphologically homogeneous virus-like particles of 27 nm diameter have now been recovered from stools of patients with hepatitis A ill from a variety of sources. Antibody to these particles has been shown to develop during the course of infection with hepatitis A but not with hepatitis B and disease has been induced in nonhuman primates inoculated with purified particle containing fractions. The classification of hepatitis A virus has not been conclusively established, but it would appear to be either a parvovirus or an enterovirus.