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Objective@#To prepare an inactivated hepatitis A vaccine using a attenuated strain of hepatitis A virus (HAV) H2 and to analyze its immunizing dose, so as to provide the reference for development and production of inactivated hepatitis A vaccines.@*Methods@#Human embryonic lung diploid cells (KMB17) were infected with attenuated HAV H2 strain to proliferate the virus, then the cells containing viruses were harvested, extracted and purified. The obtained virus concentrate was prepared into vaccine bulk and test vaccines with 1 280 EU/mL antigen content. Vaccine testing was carried out according to the inactivated hepatitis A vaccine standards specified in the Part Ⅲ of the Pharmacopoeia of the People's Republic of China (2020 edition). A total of 110 mice were randomly divided into 11 groups, including 5 dose groups (80, 160, 320, 640 and 1 280 EU/dose) of the test vaccine and the reference vaccine, as well as the adjuvant control group. Mice were immunized twice by intraperitoneal injection, their serum HAV antibodies were detected, and the geometric mean titer (GMT) and positive conversion rate of antibodies were analyzed to evaluate the immunising dose of the vaccine.@*Results@#The antigen content and viral titer of the virus harvest solution were 5 120 EU/mL and 8.33 lgCCID50/mL, respectively. The removal rate of foreign protein reached 98.05% and the recovery rate of antigen was 66.25%. The test vaccine met the requirements of Part Ⅲ of the Pharmacopoeia of the People's Republic of China (2020 edition). The GMTs of HAV antibodies in the test vaccine and the reference vaccine dose groups after the second immunization were more than twice higher than those after the first immunization. Regardless of primary immunization or secondary immunization, the GMTs (log2) of HAV antibodies in the test vaccine groups with doses of 160 EU/dose and above were higher than those in the 80 EU/dose group (all P<0.05), while there was no statistically significant differences between the dose groups of 160 EU/dose and above (all P>0.05). The antibody positive conversion rate of 160 EU/dose and above of the test vaccine was 100.00% after the secondary immunization.@*Conclusions@#The inactivated hepatitis A vaccine of attenuated H2 strain tested in this study demonstrates strong immunogenicity in mice, suggesting its potential as a candidate vaccine. The preliminary analysis indicates an immunizing dose of 320 EU/dose for children and 640 EU/dose for adults.
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@#Objective To analyze the genomic characteristics of hepatitis A virus(HAV)in environmental sewage in Zhuanghe from 2020 to 2021 and compare them with those in case samples.Methods Eighteen sewage samples(environmental sewage)were collected from the entry point of the sewage treatment plant in Zhuanghe from July to December 2021,and the viral RNA was extracted. After reverse transcription,VP1-2A region was amplified by nested PCR,sequenced and spliced.The five HAV nucleotide sequences(321 bp)obtained were analyzed for phylogenetic tree by using bioinformatics software.Results The HAV of environmental sewage samples in 2021 were all 1A subtype,and the nucleotide sequence homology of VP1-2A region was 98. 7%-100%. The nucleotide sequence homology was 97. 8%-100% with that of the hepatitis A case samples from Zhuanghe in 2020,which could be evolutionarily divided into two branches.Conclusion Subtype 1A was the dominant genotype of HAV in environmental sewage in Zhuanghe,which was different from the genome of the case sample,and also had the same genome of some strains. By comparing the similarities between HAV nucleic acid in environmental sewage and that in case samples,we can better understand the circulation of HAV,so as to make an early warning for the epidemiological monitoring of hepatitis A.
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ABSTRACT BACKGROUND: Osteoporosis, characterized by decreased bone density and increased fracture risk, imposes significant physical, psychosocial, and financial burdens. Early detection and prevention are crucial for managing osteoporosis and reducing the risk of fractures. OBJECTIVES: To investigate the relationship between Hepatitis A seropositivity and bone mineral density (BMD) in adolescents and adults and to explore the potential link between Hepatitis A infection and osteoporosis risk. DESIGN AND SETTING: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 to evaluate the association between hepatitis A seropositivity and BMD in 15,693 participants. METHODS: Multivariable regression analysis was used to calculate the mean BMD and standard error for adolescents and adults, followed by an independent z-test to determine whether there was a significant difference between the seropositive and seronegative groups. RESULTS: Hepatitis A seropositive adolescents and adults had lower BMD than their seronegative counterparts, with significant differences in lumber spine (mean difference = -0.03 g/cm2, P < 0.01 for both age groups) and pelvis BMDs (mean difference = -0.02 g/cm2, P < 0.01 for the adult age groups), after adjusting for various covariates. CONCLUSIONS: This study confirmed that both adolescent and adult individuals seropositive for Hepatitis A antibodies had reduced BMD among both adolescents and adults, especially in the adult group. This finding suggests a possible link between Hepatitis A infection and risk of osteoporosis.
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Dengue and viral hepatitis A are extensively endemic diseases in India. Coinfection of these infections is uncommon and poses difficulty for physicians to diagnose as their clinical features are quite similar and overlapping. This article presents with 8 paediatric age group cases reporting Dengue fever which occurred concomitantly with Hepatitis A virus infection. Usually these infections are self-limiting but complications of coinfection are described in this article
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@#ObjectiveTo explore the purification effect of hepatitis A virus(HAV)with a new type of composite medium Capto Core 400 chromatography packing.MethodsHAV crude liquid cultured with human embryonic lung diploid cells(2BS strain)was purified using Capto Core 400 chromatography media. The optimum conditions for purification of HAV were determined from flow rates(60,150,300 and 450 cm/h),pH of loading buffer(6. 6,7. 0 and 7. 4),salt ion concentration of loading buffer(0,0. 15,0. 3 and 0. 45 mol/L)and capacity[0. 5,1,2 and 4 column volume(CV)],respectively. The purification effect was compared with that of traditional Sepharose 4FF chromatography media.Results The optimum purification conditions of Capto Core 400 were preliminarily determined as follows:flow rate of 150 cm/h,loading buffer pH of 7. 0 ~ 7. 4,salt ion concentration of 0. 15 mol/L,loading volume of 2 CV. The average recovery rate of virus was 92. 61%,and the average removal rate of protein was 84. 25%. The average recovery rate of HAV antigen purified by Sepharose 4FF chromatography media was 76. 03% and the average protein removal rate was 73. 21%. The purification effect of Capto Core 400 chromatography media was better than that of Sepharose 4FF chromatography media.ConclusionThe Capto Core 400 composite chromatography media had a high recovery rate for HAV purification and a relatively simple operation,which was suitable for HAV purification.
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Hepatitis A is a significant global public health concern, with severe clinical symptoms in adult cases that can progress to acute hepatic failure. With the implementation of comprehensive prevention and control measures based on vaccination, the reported incidence of hepatitis A in children has notably decreased in China, while the incidence of hepatitis A in adults has gradually increased. Vaccination against hepatitis A in adults remains a crucial preventive measure. This recommendation is formulated based on the World Health Organization's position paper on hepatitis A vaccines (2022), incorporating the latest domestic and international research advancements and opinions from domestic experts. Its aim is to provide recommendations for hepatitis A vaccination among Chinese adults, offering evidence for public health and vaccination professionals to scientifically use hepatitis A vaccines and maximize their preventive efficacy, thereby enhancing hepatitis A prevention and control efforts.
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Adulto , Criança , Humanos , Hepatite A/prevenção & controle , Vacinas contra Hepatite A , Vacinação , Povo Asiático , China/epidemiologiaRESUMO
The objectives were to estimate hepatitis A virus seroprevalence in subjects attending to a travel medicine and immunization clinic in Rio de Janeiro, Brazil, and to develop a prediction model for hepatitis A virus seroprevalence. This retrospective research included individuals sequentially from April 2011 to June 2019 at a travel medicine and special population immunization clinic with an anti-hepatitis A virus IgG chemiluminescence result. Participants' data were verified via electronic medical records. Data were split into development and validation set taking 2018 as the date break. A cross-validated elastic generalized linear model with binomial distribution was performed. In total, 2,944 subjects were analyzed. Hepatitis A virus overall seroprevalence was 67.8%. Health professionals, travelers, and those who had contact with immunocompromised subjects had lower seroprevalence (40%-55%), whereas subjects with chronic conditions (heart, lung, and liver) ranged from 89% to 94%. The retained predictors in the final model were sex, age, year of birth, travelers, HIV/AIDS, spleen dysfunction, transplant candidates, household communicators, cancer-related immunosuppression, health care professionals. Area under the curve was 0.836 and maximum error was 0.051. Users can make predictions with the following calculator: https://pedrobrasil.shinyapps.io/INDWELL/. The groups with lower seroprevalence should be evaluated more carefully regarding need for hepatitis A virus vaccination even when they seek immunization clinics for other purposes.
Este estudo teve como objetivo estimar a soroprevalência do vírus da hepatite A, em indivíduos atendidos em uma clínica de medicina de viagem e imunização no Rio de Janeiro, Brasil, e desenvolver um modelo de predição para a soroprevalência do vírus da hepatite A. Esta pesquisa retrospectiva incluiu indivíduos sequencialmente de abril de 2011 a junho de 2019, em uma clínica de medicina de viagem e uma clínica de vacinação de população especial, que, por qualquer motivo, tem um resultado de quimioluminescência IgG antivírus da hepatite A . Os dados dos participantes foram verificados em prontuário eletrônico. Os dados foram divididos em desenvolvimento e validação, tomando 2018 como data limite da divisão. Um modelo linear generalizado elástico com distribuição binomial submetido a validação cruzada foi aplicado. Foram analisados 2.944 indivíduos atendidos. A soroprevalência geral do vírus da hepatite A foi de 67,8%. Profissionais de saúde, viajantes e contatantes de indivíduos imunocomprometidos apresentaram menor soroprevalência, variando de 40% a 55%, enquanto indivíduos com condições crônicas (coração, pulmão e fígado) tiveram soroprevalência variando de 89% a 94%. Os preditores retidos no modelo final foram sexo, idade, ano de nascimento, viajantes, HIV/aids, asplenia funcional, candidatos a transplante, comunicante domiciliar, imunossupressão relacionada ao câncer e profissionais de saúde. A área sob a curva foi de 0,836 e o erro máximo foi de 0,051. Os usuários podem fazer previsões com uma calculadora (https://pedrobrasil.shinyapps.io/INDWELL/). Os grupos com menor soroprevalência devem ser avaliados com mais cuidado quanto à necessidade de vacinação contra o vírus da hepatite A, mesmo quando procuram clínicas de vacinação para outros fins.
Los objetivos del estudio son estimar la seroprevalencia de hepatitis A en sujetos que asisten a una clínica de medicina para viajeros e inmunización en Río de Janeiro, Brasil, y desarrollar un modelo de predicción de la seroprevalencia de hepatitis A. Esta investigación de seguimiento retrospectivo incluyó a individuos de forma secuencial desde abril de 2011 hasta junio de 2019 en una clínica de medicina para viajeros y de vacunación de poblaciones especiales que por cualquier motivo tienen un resultado de quimioluminiscencia IgG anti-hepatitis A. Los datos de los participantes se verificaron en los registros médicos electrónicos. Los datos se dividieron en conjunto de desarrollo y validación tomando 2018 como fecha de corte. Se realizó un modelo lineal generalizado validado cruzado elástico con distribución binomial. Se analizaron un total de 2.944 sujetos atendidos. La seroprevalencia global del hepatitis A fue del 67,8%. Los profesionales sanitarios, los viajeros y las personas en contacto con sujetos inmunodeprimidos presentaron una seroprevalencia más baja, que osciló entre el 40% y el 55%, mientras que los sujetos con afecciones crónicas (cardíacas, pulmonares y hepáticas) presentaron una seroprevalencia que varió entre el 89% y el 94%. Los predictores retenidos en el modelo final fueron el sexo, la edad, el año de nacimiento, los viajeros, el VIH/SIDA, la disfunción del bazo, los candidatos a trasplante, los comunicadores domésticos, la inmunosupresión relacionada con el cáncer y los profesionales sanitarios. Su área bajo la curva fue de 0,836 y el error máximo de 0,051. Los usuarios pueden hacer predicciones con una calculadora (https://pedrobrasil.shinyapps.io/INDWELL/). Los grupos con menor seroprevalencia deben ser evaluados más cuidadosamente en cuanto a la necesidad de vacunación contra hepatitis A, incluso cuando acudan a las clínicas de vacunación con otros fines.
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ABSTRACT Vaccination coverage has been dropping in Brazil and other countries. In addition, immune responses after vaccination may not be homogeneous, varying according to sociodemographic and clinical factors. Understanding the determinants of incomplete vaccination and negative antibody test results may contribute to the development of strategies to improve vaccination effectiveness. In this study, we aimed to investigate the frequency of vaccine adherence, factors associated with incomplete vaccination for measles, mumps, rubella (MMR) and hepatitis A, and factors associated with the seronegative test results for measles, mumps and hepatitis A at 2 years of age. This was a population-based cohort that addressed health conditions and mother/infant nutrition in Cruzeiro do Sul city, Brazil. Vaccination data were obtained from official certificates of immunization. The children underwent blood collection at the two-year-old follow-up visit; the samples were analyzed using commercially available kits to measure seropositivity for measles, mumps, and hepatitis A. We used modified Poisson regression models adjusted for covariates to identify factors associated with incomplete vaccination and negative serology after vaccination. Out of the 825 children included in the study, adherence to the vaccine was 90.6% for MMR, 76.7% for the MMRV (MMR + varicella), and 74.9% for the hepatitis A vaccine. For MMR, after the adjustment for covariates, factors associated with incomplete vaccination included: white-skinned mother; paid maternity leave; raising more than one child; lower number of antenatal consultations; and attending childcare. For hepatitis A, the factors included: white-skinned mother and not having a cohabiting partner. The factors with statistically significant association with a negative antibody test result included: receiving Bolsa Familia allowance for measles and mumps; incomplete vaccination for measles; and vitamin A deficiency for mumps. Strategies to improve the efficiency of vaccine programs are urgently needed. These include improvements in communication about vaccine safety and efficacy, and amplification of access to primary care facilities, prioritizing children exposed to the sociodemographic factors identified in this study. Additionally, sociodemographic factors and vitamin A deficiency may impact the immune responses to vaccines, leading to an increased risk of potentially severe and preventable diseases.
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Introducción: la infección por hepatitis A y leptospirosis son causas frecuentes de síndrome febril ictérico en Colombia, caracterizado por fiebre, ictericia y hallazgos compatibles con hepatitis aguda. La transmisión de la hepatitis tipo A es vía fecal-oral mientras la otra es producto del contacto con ciertos animales. El tratamiento de la hepatitis A se centra en medidas de soporte en tanto que el de la leptospira se basa en el pronto inicio de terapia antibiótica. Es rara la coinfección de las dos entidades. Presentación del caso: paciente que acudió al servicio de urgencias con hallazgos clínicos y paraclínicos compatibles con infección aguda por hepatitis A, quien tras una evolución tórpida y la búsqueda activa de otras causas permitieron encontrar coinfección con leptospirosis. Discusión y conclusiones: se analizan temas en cuestión y se revisa la literatura. Se discuten los escasos informes encontrados al respecto, destacando este reporte por su aporte estadístico a la cifra mundial y la importancia de considerar en el servicio de urgencias este diagnóstico cuando acude un paciente con enfermedad febril aguda mayor de siete días, con el propósito de reducir costos en el sistema de salud y mejorar el pronóstico de los pacientes.
Introduction: coinfection with hepatitis A and leptospirosis is a frequent cause of febrile jaundice syndrome in Colombia, characterized by fever, jaundice and findings compatible with acute hepatitis. Transmission of hepatitis A is by fecal-oral route while leptospirosis results from exposure to certain animals. Treatment of hepatitis A focuses on supportive measures while that of leptospirosis is based on prompt initiation of antibiotic therapy. Co-infection with the two entities is rare. Case presentation: patient who attended the emergency department with clinical and laboratory findings compatible with acute hepatitis A. After a torpid progression, an active search for other causes allowed finding a co-infection with leptospirosis. Discussion and conclusions: the abovementioned conditions were analyzed and a literature review was conducted. The few reports on this subject were discussed, highlighting this report for its contribution to global statistics and the importance of considering this diagnosis in the ER in a patient with a history of fever persisting for more than seven days, in order to reduce healthcare costs and to improve prognosis of patients.
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Humanos , Adulto , Adulto JovemRESUMO
@#Abstract:Objective To investigate the adaptability and genetic stability of hepatitis A virus(HAV)SYX1 strain in human diploid cell MRC⁃5. Methods HAV SYX1 strain isolated from feces of patients with hepatitis A was continuously propagated in MRC⁃5 cells for 28 passages,of which the 1st ~ 26th passages were determined for antigen contents and virus titers,the 6th passage was observed for the morphology under microscope and detected for physicochemical properties,and the 13th ~ 15th passages were studied for virus proliferation dynamics to determine the peak yield of virus proliferation. Genomic RNA was extracted from the 8th,12th,18th,20th,22nd,25th,26th and 28th passages and sequenced to analyze the genetic stability. The main seed batch and working seed batch of HAV SYX1 strain were established and verified according to the requirements of Chinese Pharmacopoeia(VolumeⅢ,2020 edition). Results The antigen content of HAV SYX1 was stable at 160 ~ 320 EU/mL and the titer was maintained at 7. 3 ~ 8. 3 lgCCID50/mL after the 8th passages in MRC 5 cells;Virus particles showed two types:hollow and solid,with a diameter of 27 ~ 32 nm,spherical,without envelope and protrusions on the surface,which tolerated low pH value and ether. The peak period of virus proliferation was 10 d with an antigen content of more than 160 EU/mL and a virus titer of more than 7. 0 lgCCID50/mL. HAV SYX1 was a subtype of HAV IB,and no mutation in the coding region of all structural proteins during passage was observed. The verification results of main seed batch and working seed batch of HAV all met the relevant requirements. Conclusion HAV SYX1 strain showed good adapt⁃ ability and genetic stability in MRC⁃5,which might be used for the development and production of inactivated hepatitis A vaccine.
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【Objective】 To evaluate the viability of nucleic acid test(NAT) of human parvovirus B19 (HPV B19), hepatitis A virus (HAV) and hepatitis E virus (HEV) along with routine NAT for voluntary blood donors, and to analyze HPV B19, HAV and HEV prevalence in Nantong, so as to provide reference for rational blood screening programs. 【Methods】 HPV B19 DNA, HAV RNA and HEV RNA of blood donors in Nantong from November 2021 to May 2022 were detected using NAT, and serological antibody testing was performed on NAT reactive samples. 【Results】 Three HPV B19 DNA was yielded out of 3 440 blood donors, with a positive rate of 0.09%, among which 2 were negative for HPV B19-IgM and 1 was undetermined due to insufficient sample size. HAV RNA and HEV RNA were not detected in 3 440 blood donors. HPV B19, HAV, and HEV NAT were conducted simultaneously with routine HBV, HCV and HIV screening, prolonging the test reports by 20 minutes. 【Conclusion】 Although the HPV B19 DNA, HAV RNA and HEV RNA prevalence among voluntary blood donors in Nantong is low, the risk of transfusion transmitted infection still exsits and can be reduced by NAT.
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@#Objective To optimize the adsorption condition of hepatitis A virus(HAV)antigen by aluminum hydroxide[Al(OH)_3]adjuvant and evaluate the immunogenicity of the adsorbed products. Methods The final molar concentration of buffer(0. 01,0. 02 and 0. 04 mol/L),pH value(5. 5,6. 0,6. 5,7. 0,7. 5 and 8. 0),final molar concentration of sodium chloride(NaCl)(0. 075,0. 13,0. 15,0. 17,0. 45,0. 75 and 1. 0 mol/L),mixing mode(mixing after dilution and mixing directly without dilution)and dropping order[HAV stock solution into Al(OH)_3 solution,and Al(OH)_3 solution into HAV stock solution]were selected for single factor screening. Taking Al(OH)_3 adsorption rate as the evaluation index,the selected factors were optimized by orthogonal test. NIH mice were immunized intraperitoneally with adsorbed products prepared under optimal and suboptimal combination conditions with 0. 5 mL/mouse,10 mice in each group with half male and half female. After 28 d of immunization,the blood samples were collected from eyeball or heart,and the serum was separated. The HAV antibody level was detected by ELISA,and the immunogenicity of adsorbed products was evaluated by the seroconversion rate of mouse serum antibody. Results The results of single factor screening test showed that the final molar concentration of buffer,pH value and final molar concentration of NaCl had significant influence on the adsorption effect(F = 6. 582,14. 007 and 8. 612,respectively,each P < 0. 05),while the mixing mode and dropping order had no effect(t =-0. 696 and 1. 153,respectively,each P > 0. 05). The final molar concentration of buffer was 0. 01 and 0. 02 mol/L,the pH value was 5. 5 ~ 7. 0,and the final molar concentration of NaCl was 0. 13 ~ 0. 17 mol/L. The orthogonal test showed that the order of the influence on adsorption effect was the final molar concentration of buffer > pH value > NaCl final molar concentration. The optimal combination was pH 6. 3 + final molar concentration of buffer 0. 01 mol/L + NaCl molar final concentration 0. 15 mol/L,and the suboptimal combination was pH 5. 8 + final molar concentration of buffer 0. 02 mol/L +NaCl final molar concentration 0. 17 mol/L. The seroconversion rate of serum antibody in mice immunized with the adsorbed products prepared by the optimal and suboptimal combination was both 100%. Conclusion The adsorbed products prepared under the optimized conditions have good immunogenicity,which lays a foundation of the research of inactivated hepatitis A vaccine
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@#Objective To express the capsid proteins VP1 and VP3 of hepatitis A virus(HAV) in prokaryotic cells and evaluate their immunogenicity.Methods VP1 and VP3 gene fragments were amplified by PCR,cloned into vector pETG28a to construct recombinant expression plasmids pET-G28a-VP1 and pET-G28a-VP3,which were transformed into competent E.coli BL21(DE3),induced by IPTG,and then analyzed by 12% SDS-PAGE.The target protein was purified by ion exchange chromatography,renatured and combined with several adjuvants to immunize mice.The mice were divided into VP1-MF59,VP1-AH,VP1-AP,VP1-AP-10CpG,VP1-AP-50CpG,VP3-AP,VP3-VP1-AP and PBS control groups,five for each group.Serum IgG antibody titers of mice in various groups were detected by ELISA,and serum neutralizing antibody titers of mice in VP1-AP,VP3-VP1-AP and PBS control groups were detected by rapid fluorescence focus immunosuppression experiment.Results Colony PCR and sequencing showed that the recombinant plasmids pET-G28a-VP1 and pET-G28a-VP3were constructed correctly.The recombinant proteins VP1 and VP3,with relative molecular masses of about 37 000 and26 000 respectively,mainly existed in the form of inclusion bodies,the expression levels were 18.6% and 32.4%,and the purity was 86.3% and 84.7%,respectively.The recombinant proteins VP1 and VP3 reacted specifically with rabbit anti-HAV antiserum and mouse anti-HAV-VP3 antiserum respectively.The serum IgG antibody titer of mice in VP1-AP-50CpG group was significantly higher than that in VP1-AP group(q=22.05,P <0.01),and the serum IgG antibody titer of mice in VP3-VP1-AP group was significantly higher than that in VP1-AP group and VP3-AP group(q=22.05 and 22.49 respectively,each P <0.01).Compared with PBS control group,the serum neutralizing antibody titer of mice in VP1-AP and VP3-VP1-AP group increased significantly(q=7.79 and 25.11 respectively,P<0.01) Conclusion Prokaryotic HAV capsid proteins VP1 and VP3 showed high purity and good immunogenicity,and the addition of CpG in the preparation was beneficial to enhance the immunogenicity of antigens.This study laid a foundation of the development of HAV recombinant subunit vaccine.
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Objective@#To investigate the epidemiological characteristics of hepatitis A and hepatitis E in Jiaxing City, Zhejiang Province from 2005 to 2021, so as to provide insights into prevention and control of hepatitis A and hepatitis E.@*Methods@#Data of hepatitis A and hepatitis E reported in Jiaxing City from 2005 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The temporal, spatial and population distribution of hepatitis A and hepatitis E were analyzed using a descriptive epidemiological method, and the trends in incidence of hepatitis A and hepatitis E were evaluated using annual percent change (APC). @*Results@# Totally 1 830 hepatitis A cases were reported in Jiaxing City from 2005 to 2021, with an annual average incidence of 2.44/105, and 2 deaths were reported, with a fatality rate of 0.11%. The incidence of hepatitis A appeared a tendency towards a decline from 2005 to 2012 (APC=-37.807%, P<0.05) and was relatively stable from 2012 to 2021 (APC=-1.277%, P>0.05), and the incidence peaked from July to September, with a monthly average incidence of 0.30/105. Higher annual average incidence of hepatitis A was seen in urban areas than in rural areas (3.91/105 vs. 1.92/105; P<0.05), among people at ages of 30 to 39 years (4.19/105), and among men than among women (3.00/105 vs. 1.93/105; P<0.05). Farmers were the predominant occupation (759 cases, 41.31%). Totally 2 176 hepatitis E cases were reported in Jiaxing City from 2005 to 2021, with an annual average incidence of 2.91/105, and 7 deaths were reported, with a fatality rate of 0.32%. The incidence of hepatitis E was relatively stable from 2005 to 2011 (APC=3.421%, P>0.05) and appeared a tendency towards a decline from 2011 to 2021 (APC=-4.294%, P<0.05), and the incidence peaked from January to March, with a monthly average incidence of 0.38/105. Higher annual average incidence of hepatitis E was seen in urban areas than in rural areas (3.50/105 vs. 2.70/105; P<0.05), among people at ages of 70 to 79 years (6.20/105), and among men than among women (3.74/105 vs. 2.05/105; P<0.05). Farmers were the predominant occupation (1 079 cases, 49.59%).@*Conclusions@#The incidence of hepatitis A and hepatitis E appeared a tendency towards a decline in Jiaxing City from 2005 to 2021. The incidence of hepatitis A was high in summer, and cases were mainly males, young and middle-aged people and farmers. The incidence of hepatitis E was high in winter, and cases were mainly males, elderly people and farmers.
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Background: Acute hepatitis A virus infection in children in developing countries is a matter of concern though the incidence has come down in developed countries.To observe the clinical presentation and biochemical profile of hepatitis A virus infection in children hospitalized in a tertiary care center in Bangladesh.Material & Methods:In this cross-sectional observational study, data were collected from the records of pediatric patients who were admitted due to acute hepatitis. Demographic data were collected, and complete physical examination findings and laboratory data were also taken. Serum samples were tested for LFT, Anti-HAV IgM and other viral markers among them Anti-HAV IgM positive children were included in the study.Results:Among the total of 40 patients suffering from Acute Viral Hepatitis (AVH), male predominated over female with 57.5% vs. 42.5%. The majority of the study population (65%) came from the urban area. In this study, 65% of the patients used tap water and 35% used tube well water for drinking purposes while the majority 70% used boiled water. Most of the patients (80%) consumed both homemade and outside foods and drinks while 20% consumed only homemade food. Positive family history of viral hepatitis was found in 12.5% of cases. Common presentations were fever (100%), jaundice (100%), anorexia, nausea (95%), vomiting (85%), abdominal pain (50%) etc. On examination Jaundice (100%) and hepatomegaly (95%), splenomegaly (5%), and ascites (7.5%). Only 7.5% of patients developed complications like cholestasis,7.5% showed ascites,5% had relapsed and 2.5% develop liver failure.Conclusions:This study showed that poor sanitation and poor hygiene are the main risk factors for hepatitis A. The common presenting features which should alert the clinicians include fever, jaundice, anorexia, nausea, vomiting, diarrhea, abdominal distension, hepatosplenomegaly and ascites. In Bangladesh, safe water supplies and proper sanitation will constitute the best solution to eliminate endemic hepatitis A.
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Background & objectives: Although several reviews of economic evaluation (EE) studies on hepatitis A virus (HAV) vaccine exist, there remains a need to corroborate such data from time to time. This study aimed to systematically review the literature for reports on EE of HAV vaccination by type of population, characteristics of intervention and income level of the country. Methods: PubMed and Scopus were searched to identify relevant studies from inception up to May 2021 using topic-specific key words in various combinaiton. Full EE studies comparing HAV vaccination to no vaccine or immunoglobulin were included. The risk of bias was assessed by using the ECOBIAS checklist. Results: Among the 1984 identified studies, 43 were found eligible. Of these, 27 were from high-income countries (HICs), 15 from middle-income countries (MICs), and one from low income country. Majority of the studies used Markov model and/or decision tree (n=26). Eight studies used a dynamic model. The discount rate, perspective and time horizon varied across the studies. Universal HAV vaccination without screening was cost-effective among children (14/16, 87.5%) and adolescents (1/5, 20%) but not in adults (0/4, 0%). Analysis by the level of income found that universal HAV vaccination among children without screening was cost-effective in 81.8 per cent of the studies conducted in MICs (9/11) as compared to 66.7 per cent in HICs (4/6). About one-third of the studies conducted among children found that screening and HAV vaccination were cost-effective compared to no vaccination. Interpretation & conclusions: The finding of this review suggest that universal vaccination of children without screening was likely to be cost-effective, especially in MICs. Nevertheless, it should be noted that the methodology varied across studies. Several aspects should also be considered in transferring the EE results across jurisdictions.
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ABSTRACT OBJECTIVE To estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, Central Brazil. METHODS Overall, 355 individuals were interviewed, and blood samples were tested for anti-HAV and anti-HEV IgG. Anti-HEV-positive samples were similarly tested for HEV RNA. RESULTS All participants were from Latin American countries, most of whom, young adult males. The overall anti-HAV IgG prevalence was 87.4% (95%CI: 83.5-90.4), of whom 94.9%, 75.6%, and 60% were from Haiti, Venezuela, and other Latin American countries, respectively (p < 0.001). Age above 19 years and more than 36 months residing in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall anti-HEV IgG prevalence was 6.5% (95%CI: 4.4-9.5). All anti-HEV IgG-positive individuals were Haitians, including a child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG-positive samples. CONCLUSION The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently required to interrupt enteric virus transmission in this emergent and vulnerable population.
Assuntos
Humanos , Masculino , Criança , Adulto , Adulto Jovem , Refugiados , Vírus da Hepatite E/genética , Hepatite E/epidemiologia , Vírus da Hepatite A/genética , Emigrantes e Imigrantes , Hepatite A/epidemiologia , Brasil/epidemiologia , Imunoglobulina G , RNA , Anticorpos Anti-Hepatite , Anticorpos Anti-Hepatite A , HaitiRESUMO
Introducción: La hepatitis es una enfermedad inflamatoria que afecta al hígado. El virus de la hepatitis A produce un cuadro infeccioso agudo por lo general autolimitado en el ser humano, para el cual no existe tratamiento específico. Objetivo: Realizar una actualización acerca del comportamiento y manejo actual de la infección por el virus de la hepatitis A. Métodos: Se realizó una revisión bibliográfica durante septiembre y octubre de 2021, se consultaron 156 artículos en idioma inglés y español de bases de datos como SciELO, PubMed, LILACS y Medigraphic, de ellos se utilizaron 30 citas. Se empleó la combinación de términos y operadores booleanos y métodos teóricos como: análisis-síntesis, inducción-deducción e histórico-lógico. Resultados: Se abordó el comportamiento de la infección causada por el virus de la hepatitis A, se hizo hincapié en su epidemiología, características morfológicas y funcionales que permiten su infectividad, evolución y manifestaciones clínicas, complicaciones, tratamiento y perspectivas actuales. Conclusiones: El virus de la hepatitis A produce un cuadro infeccioso agudo. Se presenta tanto de forma esporádica como epidémica. Es la forma más común de hepatitis viral aguda. La transmisión es de persona a persona por vía fecal oral. Los síntomas relacionados con las hepatitis virales agudas son variables e inespecíficos. El diagnóstico de certeza se realiza mediante las pruebas serológicas y técnicas de biología molecular para la identificación del virus. No existe tratamiento específico para esta infección.
Introduction: Hepatitis is an inflammatory disease that affects the liver. The hepatitis A virus produces a generally self-limited acute infectious picture in humans, for which there is no specific treatment. Objective: To update on current behavior and management of hepatitis A virus infection. Methods: A bibliographic review was carried out during September and October 2021, consulting 156 articles in English and Spanish from databases such as SciELO, PubMed, Lilacs and Medigraphic, of which 30 citations were used. The combination of Boolean terms and operators and theoretical methods such as: analysis-synthesis, induction-deduction and historical-logical was used. Results: The behavior of the infection caused by the hepatitis A virus was addressed, emphasizing its epidemiology, morphological and functional characteristics that allow its infectivity, evolution and clinical manifestations, complications, treatment and current perspectives. Conclusions: The hepatitis A virus produces an acute infectious picture. It occurs both sporadically and epidemically. It is the most common form of acute viral hepatitis. Transmission is person-to-person by the fecal oral route. Symptoms related to acute viral hepatitis are variable and nonspecific. The diagnosis of certainty is carried out by means of serological tests and molecular biology techniques for the identification of the virus. There is no specific treatment for this infection.
RESUMO
Organ transplant recipients are at a high risk of infection with high hospitalization rate, critical rate and fatality, due to low immune function caused by taking immunosuppressants for a period of long time after organ transplantation. Currently, vaccination is recognized as an effective approach to prevent infection. Organ transplant recipients may be vaccinated according to individual conditions. However, the sensitivity to vaccines may decline in organ transplant recipients. The types, methods and timing of vaccination have constantly been the hot spots of clinical trials. In this article, the general principles, specific vaccines and SARS-CoV-2 vaccines of vaccination in organ transplant recipients were briefly reviewed, aiming to provide reference for the vaccination of organ transplant recipients. Moreover, current status of SARS-CoV-2 vaccination for organ transplant recipients was illustrated under the global outbreak of novel coronavirus pneumonia pandemic.
RESUMO
Viral hepatitis are widely spread infectious diseases caused by a variety of etiological agents that displays liver tropism as a common characteristic. A descriptive, cross-sectional, observational and retrospective study was conducted through the analysis of viral hepatitis medical records treated and diagnosed from 2010 to 2015. The relationship between the variables were made through the chi-square test. 632 viral hepatitis medical records were analyzed. The highest number of cases happened in 2011. Hepatitis A virus (HAV) infection was predominant. The most affected age group was < 20 years and the highest number of cases observed in this age group was related to HAV (p<0.001). The acute clinical form was predominant, with 70.2% of the cases. 92.3% of which corresponded to HAV infection (p<0.001). Most of the cases occurred in the brown race and male gender. Moreover, regarding the probable source/mechanism of infection, the contact with suspicious water/food for hepatitis A cases was highlighted. The sexual form predominated in HBV infection and previous history of blood transfusion in cases of hepatitis C. Most cases were spotted in the mesoregion of Eastern Alagoas, especially in the capital Maceió. It must be observed the importance of knowing the profile of this disease in order to understand its dissemination and thus have subsidies for the creation of actions and strategies to combat the infection.
A hepatite viral é uma doença infecciosa amplamente difundida causada por uma variedade de agentes etiológicos que exibem o tropismo hepático como uma característica comum. Um estudo descritivo, transversal, observacional e retrospectivo foi realizado por meio da análise de prontuários de hepatites virais tratados e diagnosticados de 2010 a 2015. A relação entre as variáveis foi feita através do teste qui-quadrado. Foram analisados 632 prontuários de hepatite sustero. O maior número de casos aconteceu em 2011. A infecção pelo vírus da hepatite A (HAV) foi predominante. A faixa etária mais atingida foi < 20 anos e o maior número de casos observados nessa faixa etária foi relacionado ao HAV (p<0,001). A forma clínica aguda foi predominante, com 70,2% dos casos. 92,3% dos quais corresponderam à infecção por HAV (p<0,001). A maioria dos casos ocorreu na raça parda e no sexo masculino. Além disso, quanto à provável fonte/mecanismo de infecção, foi destacado o contato com água/alimento suspeitos para os casos de hepatite A. A forma sexual predominou na infecção pelo HbV e histórico anterior de transfusão de sangue em casos de hepatite C. A maioria dos casos foi avistada na mesorregião do Leste de Alagoas, especialmente na capital Maceió. Deve-se observar a importância de conhecer o perfil dessa doença para entender sua disseminação e, assim, contar com subsídios para a criação de ações e estratégias de combate à infecção.