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1.
Nat Commun ; 12(1): 1439, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33664251

RESUMO

Treatment of advanced melanoma with combined PD-1/CTLA-4 blockade commonly causes serious immune-mediated complications. Here, we identify a subset of patients predisposed to immune checkpoint blockade-related hepatitis who are distinguished by chronic expansion of effector memory CD4+ T cells (TEM cells). Pre-therapy CD4+ TEM cell expansion occurs primarily during autumn or winter in patients with metastatic disease and high cytomegalovirus (CMV)-specific serum antibody titres. These clinical features implicate metastasis-dependent, compartmentalised CMV reactivation as the cause of CD4+ TEM expansion. Pre-therapy CD4+ TEM expansion predicts hepatitis in CMV-seropositive patients, opening possibilities for avoidance or prevention. 3 of 4 patients with pre-treatment CD4+ TEM expansion who received αPD-1 monotherapy instead of αPD-1/αCTLA-4 therapy remained hepatitis-free. 4 of 4 patients with baseline CD4+ TEM expansion given prophylactic valganciclovir and αPD-1/αCTLA-4 therapy remained hepatitis-free. Our findings exemplify how pathogen exposure can shape clinical reactions after cancer therapy and how this insight leads to therapeutic innovations.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Antígeno CTLA-4/antagonistas & inibidores , Infecções por Citomegalovirus/tratamento farmacológico , Hepatite A/prevenção & controle , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Antivirais/uso terapêutico , Linfócitos T CD4-Positivos/transplante , Linfócitos T CD8-Positivos/imunologia , Citomegalovirus/efeitos dos fármacos , Citomegalovirus/imunologia , Hepatite A/imunologia , Hepatite A/virologia , Humanos , Memória Imunológica/imunologia , Melanoma/tratamento farmacológico , Valganciclovir/uso terapêutico , Carga Viral
2.
Viruses ; 13(2)2021 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-33573054

RESUMO

Recently, we experienced an outbreak of acute hepatitis A virus (HAV) infection between 2018 and 2020. Herein, we describe this male-dominant HAV infection outbreak observed among non-human immunodeficiency virus (HIV)-infected persons in the northern part of Tokyo, Japan. Clinical information was collected from patient interviews and from medical record descriptions. In the present study, 21 patients were retrospectively analyzed. A total of 90.4 and 33.3% of patients were males, and men who have sex with men (MSM), respectively. The total bilirubin levels and platelet counts tended to be lower in the MSM group than in the non-MSM group. C-reactive protein (CRP) levels tended to be higher in acute liver failure (ALF) patients than in non-ALF patients. Prolonged cholestasis was observed in one patient (4.8%). We also found that 18 HAV isolates belonged to HAV subgenotype IA/subgroup 13 (S13), which clustered with the HAV isolate (KX151459) that was derived from an outbreak of HAV infection among MSM in Taiwan in 2015. Our results suggest that the application of antivirals against HAV, as well as HAV vaccines, would be useful for the treatment and prevention of severe HAV infection.


Assuntos
Surtos de Doenças , Hepatite A/epidemiologia , Adulto , Feminino , Genótipo , Hepatite A/virologia , Vírus da Hepatite A/classificação , Vírus da Hepatite A/genética , Vírus da Hepatite A/isolamento & purificação , Homossexualidade Masculina , Humanos , Tempo de Internação , Falência Hepática Aguda/epidemiologia , Falência Hepática Aguda/virologia , Masculino , Pessoa de Meia-Idade , Filogenia , Estudos Retrospectivos , Fatores de Risco , Minorias Sexuais e de Gênero , Tóquio/epidemiologia
3.
Viruses ; 13(1)2020 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-33374859

RESUMO

The genetic diversity of Hepatitis A Virus (HAV) circulating in the Campania Region in years 2015-2018 was investigated through the monitoring of sentinel bivalve shellfish and water matrices. Overall, 463 water samples (71 sewage samples, 353 coastal discharge waters, and 39 seawaters samples), and 746 bivalve shellfish samples were analyzed. Positivity for HAV was detected in 20/71 sewage samples, 14/353 coastal discharge waters, 5/39 seawaters, and 102/746 bivalve shellfish. Sixty-one of the positive samples were successfully sequenced and were characterized as genotype IA (n = 50) and IB (n = 11). The prevalent strain circulating in 2015 in both bivalves and waters was the IA strain responsible for the outbreak occurring around the same time in the Naples area. This variant was no longer identified in subsequent years (2017-2018) when, instead, appeared two of the IA variants of the multistate outbreak affecting men who have sex with men (MSM), VRD_521_2016, and RIVM-HAV16-090, with the former prevailing in both shellfish and water environments. HAV IB isolates were detected over the years in shellfish and in water matrices, but not in clinical samples, suggesting that this genotype had been circulating silently. An integrated surveillance system (environment/food/clinical cases) can be a useful tool to monitor changes in viral variants in the population, as well as an early warning system.


Assuntos
Microbiologia Ambiental , Vírus da Hepatite A/classificação , Hepatite A/epidemiologia , Hepatite A/virologia , Animais , Monitoramento Biológico , Bivalves , Monitoramento Ambiental , Genótipo , Geografia , Vírus da Hepatite A/genética , Humanos , Filogenia , Vigilância em Saúde Pública , RNA Viral , Água do Mar/virologia , Esgotos/virologia , Frutos do Mar/virologia
4.
BMC Infect Dis ; 20(1): 529, 2020 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-32698841

RESUMO

BACKGROUND: The risk of viral hepatitis among healthcare students (HCSs) is greater than that among the general population. Therefore, this study was conducted to investigate the seroprevalence of the hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among first-year HCSs at a university in Turkey and as a secondary objective, to determine the factors associated with HAV and HBV seropositivity. METHODS: This cross-sectional study was performed in first-year HCSs in Izmir, western Turkey. Data were collected using a self-administered questionnaire including items on sociodemographic characteristics, medical history, and hygiene. A total of 650 HCSs were tested for the HAV, HBV and HCV markers. Categorical variables were compared using the chi-square test. The association between independent variables and anti-HAV seropositivity and anti-HBs seropositivity was assessed by multinomial logistic regression analysis. RESULTS: The overall frequency of total anti-HAV seropositivity was 34.9%. HBsAg, total anti-HBc and anti-HBs seropositivity were found in 0.3, 1.2 and 93.7% of samples, respectively. All of the HCSs were negative for anti-HCV. Total anti-HAV seropositivity was found to be 1.73 times higher in those ≥21 years old, and it was 1.61 times higher in those who perceived their economic status to be average and 2.75 times higher in those who perceived their economic status to be low. Total anti-HAV seropositivity was found to be 4.37 times higher in those who lived in provinces with intermediate human development index levels. Total anti-HBs seropositivity was found to be 2.48 times higher in those ≤20 years old, and it was 2.13 times higher in those who perceived their economic status to be average. CONCLUSIONS: Approximately two out of three HCSs were susceptible to HAV infection. Since HCSs are at high risk for HAV infection, they should be vaccinated before medical clerkships begin. Our results indicate that there is a high prevalence of anti-HBs seropositivity among HCSs. This result may be largely attributed to the implementation of a successful vaccination program in Turkey since 1998.


Assuntos
Hepacivirus/imunologia , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Estudantes de Medicina , Adolescente , Adulto , Estudos Transversais , Feminino , Hepatite A/sangue , Hepatite A/virologia , Hepatite B/sangue , Hepatite B/virologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Hepatite C/sangue , Hepatite C/virologia , Humanos , Programas de Imunização , Masculino , Prevalência , Autorrelato , Estudos Soroepidemiológicos , Turquia/epidemiologia , Adulto Jovem
5.
Nat Microbiol ; 5(9): 1096-1106, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32541946

RESUMO

Cell-to-cell communication by exosomes controls normal and pathogenic processes1,2. Viruses can spread in exosomes and thereby avoid immune recognition3. While biogenesis, binding and uptake of exosomes are well characterized4,5, delivery of exosome cargo into the cytoplasm is poorly understood3. We report that the phosphatidylserine receptor HAVCR1 (refs. 6,7) and the cholesterol transporter NPC1 (ref. 8) participate in cargo delivery from exosomes of hepatitis A virus (HAV)-infected cells (exo-HAV) by clathrin-mediated endocytosis. Using CRISPR-Cas9 knockout technology, we show that these two lipid receptors, which interact in the late endosome9, are necessary for the membrane fusion and delivery of RNA from exo-HAV into the cytoplasm. The HAVCR1-NPC1 pathway, which Ebola virus exploits to infect cells9, mediates HAV infection by exo-HAV, which indicates that viral infection via this exosome mimicry mechanism does not require an envelope glycoprotein. The capsid-free viral RNA in the exosome lumen, but not the endosomal uncoating of HAV particles contained in the exosomes, is mainly responsible for exo-HAV infectivity as assessed by methylene blue inactivation of non-encapsidated RNA. In contrast to exo-HAV, infectivity of HAV particles is pH-independent and requires HAVCR1 or another as yet unidentified receptor(s) but not NPC1. Our findings show that envelope-glycoprotein-independent fusion mechanisms are shared by exosomes and viruses, and call for a reassessment of the role of envelope glycoproteins in infection.


Assuntos
Endossomos/metabolismo , Exossomos/metabolismo , Receptor Celular 1 do Vírus da Hepatite A/metabolismo , Vírus da Hepatite A/metabolismo , Hepatite A/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Sistemas CRISPR-Cas , Proteínas de Transporte/metabolismo , Linhagem Celular , Ebolavirus , Endocitose , Endossomos/virologia , Exossomos/virologia , Técnicas de Inativação de Genes , Células HEK293 , Hepatite A/imunologia , Hepatite A/virologia , Receptor Celular 1 do Vírus da Hepatite A/genética , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/genética , Glicoproteínas de Membrana , Transcriptoma , Proteínas Virais de Fusão/metabolismo , Vírion/metabolismo , Internalização do Vírus
6.
PLoS One ; 15(5): e0234010, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32470049

RESUMO

In Europe HAV infection occurs mainly among specific risk groups, such as consumers of specific food. Sexual transmission of HAV has been demonstrated, particularly among Men-Who-Have-Sex-With-Men (MSM), causing MSM-specific outbreaksin Europe. Here we report a molecular epidemiologic and phylodynamic analysis on HAV sequences in Lazio (central Italy)to identify genetic background and the phylogenetic relations, and test the HAV infection dynamics during a large outbreak through phylodynamic model.Among all HAV sequences found during 2013-2018 in Lazio, low genetic diversity was observed in HAV population in 2016 and 2017, along with high frequenciesVRD_521_2016and RIVM-HAV16-090, suggesting a large expansion event of viral population. The initial expansion of both VRD_521_2016 and RIVM-HAV16-090 clusters dated back to 2012 (95% HPD:2006-2015). During the2016-2017outbreak in Lazio region, the Re peaked around mid-2016, with a value of 1.73 (95% HPD: 1.03-2.37), consistent with incidence trend of AHA cases in Lazio between 2016 and mid-2017. This study showed the magnitude of HAV outbreak in Lazio during 2016-2017, demonstrating the epidemic continuity to MSM-specific outbreak in Europe. The HAV dataset is available on interactive phylodynamic platform https://nextstrain.org to real-time update of future outbreaks.


Assuntos
Surtos de Doenças , Vírus da Hepatite A/classificação , Hepatite A/epidemiologia , Hepatite A/virologia , Homossexualidade Masculina , Filogenia , Sequência de Bases , Número Básico de Reprodução , Teorema de Bayes , Variação Genética , Genótipo , Vírus da Hepatite A/genética , Humanos , Itália/epidemiologia , Funções Verossimilhança , Masculino , Dinâmica Populacional
7.
J Appl Microbiol ; 129(5): 1120-1132, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32471014

RESUMO

Food contaminated by hepatitis A virus (HAV) is responsible of the 2-7% of all HAV outbreaks worldwide. This review provides a description of the HAV characteristics, its infectivity and epidemiological features. In addition, this review compiles existing original papers reporting HAV prevalence, viral titres in foodstuffs and the risk associated with food contamination. The purpose of this revision is to conduct a structured and systematic review of the published molecular procedures for HAV detection in food, including the assessment of its infectivity.


Assuntos
Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/virologia , Vírus da Hepatite A/isolamento & purificação , Vírus da Hepatite A/fisiologia , Hepatite A/transmissão , Surtos de Doenças/estatística & dados numéricos , Contaminação de Alimentos/análise , Doenças Transmitidas por Alimentos/epidemiologia , Hepatite A/epidemiologia , Hepatite A/virologia , Humanos , Prevalência , Medição de Risco
8.
Am J Trop Med Hyg ; 103(1): 164-168, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32342836

RESUMO

Despite several recent reports of outbreaks of hepatitis A, little is known about the disease burden in Lao People's Democratic Republic (PDR). We conducted a cross-sectional age-stratified seroprevalence study of anti-hepatitis A virus (HAV) IgG and risk factors in a rural province (Xiengkhouang) and Vientiane capital in Lao PDR. Overall, 62% of participants were anti-HAV positive in Xiengkhouang Province compared with 45.5% in Vientiane capital. In Xiengkhouang, 23.7% of 5- to 10-year-olds were already seropositive compared with 5% in Vientiane. A dramatic increase in seroprevalence occurred between 15- to 20-year and 21- to 30-year age-groups (35.7-62.4%, Xiengkhouang, and 11.5-69.7%, Vientiane) until essentially all older adults were positive in both locations. The main risk factors for HAV antibodies were age, non-Lao-Tai ethnicity, and food-related risk factors. In conclusion, Lao children seem to be exposed very early to HAV, particularly in rural settings, and exposure continues throughout their lives, mostly without being reported. In the older birth cohorts, the high seroprevalence may largely reflect poor sanitation and exposure during childhood. In Vientiane capital, the lower seroprevalence at young ages may reflect better water sanitation since the late 1990s. A comparison with neighboring Thailand indicates that the impact of improved sanitation in Lao PDR began only two decades later. Further improvements in water sanitation, in particular in the rural districts, and better food hygiene are warranted. Our study also suggests that HAV infections are underreported. Improved reporting would provide guidance for targeted interventions to further reduce HAV infections.


Assuntos
Anticorpos Antivirais/sangue , Surtos de Doenças , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Imunoglobulina G/sangue , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Notificação de Doenças/estatística & dados numéricos , Feminino , Hepatite A/sangue , Hepatite A/imunologia , Hepatite A/virologia , Humanos , Laos/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , População Rural , Saneamento/métodos , Estudos Soroepidemiológicos , Abastecimento de Água
9.
J Coll Physicians Surg Pak ; 29(12): S103-S105, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31779757

RESUMO

Acute viral hepatitis is a significant health problem in the developing world. Usually, the disease runs a benign course with complete resolution of signs and symptoms within days to weeks. It can be caused by any of the hepatitis viruses as well as other pathogens. Viral hepatitis can also be caused by co-infection from multiple hepatitis viruses, however, this is rare. Here, we report a unique case of acute hepatitis caused by simultaneous infection from Hepatitis A Virus (HAV), Hepatitis B Virus (HBV) and Hepatitis E Virus (HEV). This case is rare as all work-ups for probable causes of acute hepatitis were negative; and the review of the literature showed that such a case had not been previously reported.


Assuntos
Coinfecção/virologia , Vírus da Hepatite A/imunologia , Hepatite A/complicações , Vírus da Hepatite B/imunologia , Hepatite B/complicações , Vírus da Hepatite E/imunologia , Hepatite E/complicações , Doença Aguda , Criança , Hepatite A/virologia , Anticorpos Anti-Hepatite/imunologia , Hepatite B/virologia , Hepatite E/virologia , Humanos , Masculino
10.
Anal Chem ; 91(24): 15748-15756, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31718158

RESUMO

Simultaneous detection of large viruses has been a great obstacle in the field of molecular imprinting. In this work, for the first time, a multifunctional molecularly imprinted sensor for single or simultaneous determination of hepatitis A virus (HAV) and hepatitis B virus (HBV) is provided. Visual detection was realized due to the color of green and red quantum dots that varied with the concentration of the target substance. The combination of hydrophilic monomers and metal chelation reduced the nonspecific binding and enhanced the specificity of adsorption. As a result, satisfactory selectivity and sensitivity were obtained for the detection of the two viruses, with imprinting factors of 3.70 and 3.35 for HAV and HBV, and limits of detection of 3.4 and 5.3 pmol/L, respectively, that were achieved within 20 min. The excellent recoveries during simultaneous detection and single detection modes indicate the prominent ability of the proposed sensor to detect HAV and HBV in human serum and the potential ability to simultaneously detect multiple viruses in real applications.


Assuntos
Técnicas Biossensoriais/métodos , Corantes Fluorescentes/química , Vírus da Hepatite A/isolamento & purificação , Hepatite A/sangue , Vírus da Hepatite B/isolamento & purificação , Hepatite B/sangue , Impressão Molecular/métodos , Compostos de Cádmio/química , Hepatite A/diagnóstico , Hepatite A/virologia , Hepatite B/diagnóstico , Hepatite B/virologia , Humanos , Limite de Detecção , Polímeros/química , Pontos Quânticos , Telúrio/química
11.
Int J Med Sci ; 16(10): 1366-1370, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692913

RESUMO

Hepatitis A virus (HAV) infection is a major cause of acute hepatitis including acute liver failure. Hepatitis B infection (HBV) occurs worldwide, with the highest rates in Asian and African countries, and there are several reports that HAV infection may have a more severe clinical course in patients with chronic HBV infection. We previously demonstrated that Japanese miso extracts have inhibitory effects on HAV replication. In the present study, we examined the replication of HAV and HBV in a hepatocyte superinfection model and the inhibitory effects of Japanese miso extracts on both viruses. According to the results, HAV infection inhibited HBV replication in superinfected hepatocytes, and Japanese rice-koji miso extracts had inhibitory effects on HAV replication. Our findings provide useful information for clinicians in managing HAV infection in patients with chronic HBV infection.


Assuntos
Hepatite A/tratamento farmacológico , Hepatite B Crônica/tratamento farmacológico , Extratos Vegetais/farmacologia , Superinfecção/tratamento farmacológico , Replicação Viral/efeitos dos fármacos , Linhagem Celular , Hepatite A/complicações , Hepatite A/virologia , Vírus da Hepatite A/efeitos dos fármacos , Vírus da Hepatite A/patogenicidade , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/patogenicidade , Hepatite B Crônica/complicações , Hepatite B Crônica/virologia , Hepatócitos/virologia , Humanos , Oryza/química , Extratos Vegetais/uso terapêutico , Soja/química , Superinfecção/complicações , Superinfecção/virologia
12.
Infect Dis Poverty ; 8(1): 80, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31578150

RESUMO

BACKGROUND: Hepatitis A (HepA) vaccination and economic transitions can change the epidemiology of HepA. China's Gross Domestic Product (GDP) per capita was known to be inversely associated with the incidence of HepA, but a deeper understanding of the epidemiology of HepA in different socio-economic regions is lacking. We compare the changing epidemiology of HepA in three socioeconomic-geographic regions of China. METHODS: We obtained data on all HepA cases reported through the National Notifiable Disease Reporting System and assessed trends and changes in age-specific incidence rates by age quartile and season. We categorized the country into three regions, the sequential years into five era, compared the incidence, quartile age, seasonal intensity and coverage of HepA of the three regions. Linear regression was performed to analyse trends in incidence of HepA and to analyse the association between coverage and incidence. RESULTS: The annual mean incidences of HepA in the eastern, central, and western regions decreased from 63.52/100 000, 50.57/100 000 and 46.39/100 000 in 1990-1992 to 1.18/100 000, 1.05/100 000 and 3.14/100 000 in 2012-2017, respectively. Decreases in incidence were seen in all age groups in the three regions; the incidence was highest (9.3/100 000) in the youngest age group (0-4 years) of the western region, while in the central region, the age group with the highest incidence changed from 0 to 9 years to adults ≥60 years old. In 2017, the median age of HepA cases was 43 years (Q1-Q3: 33-55), 47 years (Q1-Q3: 32-60) and 33 years (Q1-Q3: 9-52) in the eastern, central, and western provinces, respectively. Seasonal peaks became smaller or were nearly elimination nationwide, but seasonality persisted in some provinces. After the Expanded Program on Immunization (EPI) included HepA vaccine into the routine schedule in 2007, HepA coverage increased to > 80% in the three regions and was negatively association with the HepA incidence. CONCLUSION: The incidence of HepA decreased markedly between 1990 and 2017. A socioeconomic inequity in coverage of HepA vaccine was almost eliminated after HepA vaccine was introduced into China's EPI system, but inequity in incidence still existed in lower socio-economic developed region.


Assuntos
Vacinas contra Hepatite A/administração & dosagem , Hepatite A/epidemiologia , Programas de Imunização/estatística & dados numéricos , Fatores Socioeconômicos , Vacinação/estatística & dados numéricos , China/epidemiologia , Geografia , Hepatite A/virologia , Incidência , Estudos Longitudinais , Estações do Ano , Fatores de Tempo
14.
Food Environ Virol ; 11(4): 393-399, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31420848

RESUMO

Enteroviruses (EVs) and Hepatitis A Viruses (HAVs) are human pathogens with a wide spectrum of clinical manifestations. The monitoring of sewage samples enables to monitor the EVs and HAVs in circulation among the general population and recognize possible outbreaks. This study focused on the molecular characterization and phylogenetic analysis of the EVs and HAVs identified in 33 sewage samples collected every 15 days at the influent of a wastewater treatment plant located in Northern Italy from March to October 2016. According to the results of the molecular characterization, the most frequently identified viruses were Echovirus 6 (E-6), E-11 and HAV-IA. The phylogenetic analyses indicated the rapid genetic evolution of E-6 and E-1; noteworthy, most E-11 strains clustered with a strain isolated from a clinical sample collected in the same geographical area over the same period by our laboratory. Most of the HAV strains detected clustered with epidemic HAV-IA strains identified during the European hepatitis A outbreak that occurred in 2016-2017 affecting men who have sex with men (MSM). The detection of environmental HAV strains before and at the beginning of its spread amongst humans demonstrated that this outbreak could have been predicted by monitoring sewage samples. Moreover, conducting a genetic comparison between the HAV and EV strains identified in sewage and clinical samples may improve knowledge of viral epidemiology. EV and HAV molecular environmental surveillance may prove useful for identifying viral circulation and for issuing early warning alerts on possible outbreaks among the human population.


Assuntos
Infecções por Enterovirus/virologia , Enterovirus/genética , Vírus da Hepatite A/genética , Hepatite A/virologia , Filogenia , Esgotos/virologia , Enterovirus/classificação , Enterovirus/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Hepatite A/epidemiologia , Vírus da Hepatite A/classificação , Vírus da Hepatite A/isolamento & purificação , Humanos , Itália/epidemiologia
15.
Rev Med Virol ; 29(6): e2078, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31456241

RESUMO

Hepatitis A (HAV) and E (HEV) viruses are able to cause liver disease in humans. Among the five classical hepatotropic viruses, they are mainly transmitted via the fecal-oral route. Historically, many similarities have thus been described between them according to their incidence and their pathogenicity, especially in countries with poor sanitary conditions. However, recent advances have provided new insights, and the gap is widening between them. Indeed, while HAV infection incidence tends to decrease in developed countries along with public health improvement, HEV is currently considered as an underdiagnosed emerging pathogen. HEV autochthonous infections are increasingly observed and are mainly associated with zoonotic transmissions. Extra hepatic signs resulting in neurological or renal impairments have also been reported for HEV, as well as a chronic carrier state in immunocompromised patients, arguing in favor of differential pathogenesis between those two viruses. Recent molecular tools have allowed studies of viral genome variability and investigation of links between viral plasticity and clinical evolution. The identification of key functional mutations in viral genomes may improve the knowledge of their clinical impact and is analyzed in depth in the present review.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/virologia , Vírus da Hepatite A , Hepatite A/epidemiologia , Hepatite A/virologia , Vírus da Hepatite E , Hepatite E/epidemiologia , Hepatite E/virologia , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/transmissão , Variação Genética , Genótipo , Geografia Médica , Saúde Global , Hepatite A/diagnóstico , Hepatite A/transmissão , Vírus da Hepatite A/fisiologia , Vírus da Hepatite A/ultraestrutura , Hepatite E/diagnóstico , Hepatite E/transmissão , Vírus da Hepatite E/fisiologia , Vírus da Hepatite E/ultraestrutura , Humanos , Fenótipo , Filogeografia
16.
Emerg Infect Dis ; 25(8): 1594-1596, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31310213

RESUMO

We implemented subgenomic and whole-genome sequencing to support the investigation of a large hepatitis A virus outbreak among persons experiencing homelessness, users of illicit drugs, or both in California, USA, during 2017-2018. Genotyping data helped confirm case-patients, track chains of transmission, and monitor the effectiveness of public health control measures.


Assuntos
Vírus da Hepatite A/classificação , Vírus da Hepatite A/genética , Hepatite A/epidemiologia , Hepatite A/virologia , Tipagem Molecular , California/epidemiologia , Surtos de Doenças , Genótipo , Hepatite A/história , Hepatite A/transmissão , Vírus da Hepatite A/imunologia , Vírus da Hepatite A/isolamento & purificação , História do Século XXI , Humanos , Vigilância em Saúde Pública , Proteínas Virais/genética , Sequenciamento Completo do Genoma
17.
J Clin Microbiol ; 57(9)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31217273

RESUMO

Laboratory surveillance plays an important role in the detection and control of hepatitis A outbreaks and requires the application of rapid and accurate molecular diagnostic tools for hepatitis A virus (HAV) RNA detection, subgenotype identification, and sequence-based genotyping. We describe the development and validation of a triplex real-time, reverse transcription-PCR (triplex rRT-PCR) assay for the identification and discrimination of HAV subgenotypes IA, IB, and IIIA and a singleplex rRT-PCR assay designed to detect all HAV genotypes infecting humans. Overall, the accuracy, sensitivity, and specificity of the new assays were >97% for serum and plasma specimens collected during unrelated outbreaks of HAV in California and Michigan compared to a nested RT-PCR genotyping assay and the ISO 15216-1 rRT-PCR method for HAV detection. The new assays will permit the rapid detection of HAV RNA and discrimination among subgenotypes IA, IB, and IIIA in serum and plasma specimens, which will strengthen public health surveillance efforts for HAV outbreak detection and response.


Assuntos
Técnicas de Genotipagem/métodos , Vírus da Hepatite A/classificação , Vírus da Hepatite A/isolamento & purificação , Hepatite A/diagnóstico , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , California/epidemiologia , Surtos de Doenças , Monitoramento Epidemiológico , Genótipo , Hepatite A/epidemiologia , Hepatite A/virologia , Vírus da Hepatite A/genética , Humanos , Michigan/epidemiologia , Epidemiologia Molecular/métodos , Sensibilidade e Especificidade
18.
New Microbiol ; 42(3): 181-183, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31157402

RESUMO

From April to October 2017, 27 cases of Hepatitis A (HA), 22 male and 5 female, were reported in Cosenza (South Italy). The median age of cases was 32 years (range 3-49 years). Out of 21 male adults, 14 were identified as men who have sex with men (MSM). Phylogenetic analysis was conducted in 15 cases and revealed two distinct sequences of genotype IA linking to clusters recognised in MSM in other European countries in 2016; genotype IB was recognized in only 2 cases. The report confirms that HA is an emerging issue among MSM. As suggested by the WHO, in countries with low HAV circulation, vaccination programmes should be tailored on local epidemiological patterns to prevent outbreaks among high risk groups and eventual spill-over of the infection into the general population.


Assuntos
Surtos de Doenças , Hepatite A , Minorias Sexuais e de Gênero , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Genótipo , Hepatite A/epidemiologia , Hepatite A/virologia , Vírus da Hepatite A Humana/classificação , Vírus da Hepatite A Humana/genética , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Filogenia , Adulto Jovem
19.
Vaccine ; 37(30): 4111-4117, 2019 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-31196682

RESUMO

BACKGROUND: While the hepatitis A virus (HAV) vaccine is recommended for United States (US) travelers to endemic regions, vaccination rates are lower among non-US-born adults and some racial minority groups. PURPOSE: We aimed to examine the relationship between birthplace, race and their interaction as predictors of self-reported HAV vaccination among adult travelers to high-risk countries (HRCs) through analysis of the National Health Interview Survey (NHIS), 2012-2015. METHODS: The study included 36,872 US adult participants in the 2012-2015 NHIS who traveled to countries where HAV is endemic. The main outcome was self-reported HAV vaccination (≥2 doses). Complex survey methods were applied to all models to provide statistical estimates that were representative of US adults. Multivariable logistic regression models adjusting for demographic, socioeconomic, medical, and access-to-care characteristics were fitted to examine the association between birthplace, race, race-by-birthplace (for interaction) and vaccination status. RESULTS: For adult travelers to HRCs, the adjusted odds ratio (AOR) of HAV vaccination was lower for non-US-born compared to US-born adults, AOR 0.86 (95% CI; 0.76, 0.98). For Hispanics, the AOR of HAV vaccination was 0.80 (95% CI; 0.70, 0.91) as compared to non-Hispanic-Whites. Furthermore, a significant qualitative interaction between birthplace and race was found (P-value 0.0005). Among non-Hispanic Blacks, the adjusted odds of HAV vaccination for non-US-born adults were 1.35 (95% CI; 1.06, 1.72) times the odds for US-born adults. In contrast, the AORs of HAV vaccination of non-US-born versus US-born adults were 36% (95% CI; 17%, 51%) and 30% (95% CI; 12%, 44%), lower for Asians and Hispanics, respectively. CONCLUSIONS: The association between birthplace and HAV vaccination status differs by race among travelers to HRCs, with US-born non-Hispanic Black and non-US-born Asian and Hispanic adults having lower odds of vaccination. Health care resources should be focused on these target populations to improve travel vaccination compliance.


Assuntos
Vírus da Hepatite A/imunologia , Vírus da Hepatite A/patogenicidade , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Hepatite A/epidemiologia , Hepatite A/virologia , Humanos , Hepatopatias/epidemiologia , Hepatopatias/virologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Autorrelato , Medicina de Viagem , Cobertura Vacinal/estatística & dados numéricos , Adulto Jovem
20.
Int J Infect Dis ; 86: 12-14, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31238154

RESUMO

OBJECTIVES: To investigate the prevalence of anti-HAV and HEV markers in order to better understand spread of these two viruses among adults in Rwanda. METHODS: Samples from 1045 and 1133 blood donors, healthy adults and liver disease patients were analysed for anti-HAV IgG and HEV markers respectively. RESULTS: Anti-HAV was present in 96.9% (1013/1045), with proportions of immune persons increasing with age. HEV infection markers were detected in 11.9% (135/1133) without differences between the three categories. Seven persons had low levels of HEV RNA including four blood donors but none of the HEV strains could be sequenced. The highest prevalence of HEV markers was in farmers and persons from the Southern (17.3%) and Western regions (18.6%), which have the national highest density of pigs. This may indicate that pigs constitute an important source of HEV infection for humans in Rwanda. CONCLUSION: HAV remains highly endemic in Rwanda, but there may now be a decline of exposure during childhood. HEV is also endemic in Rwanda, but has a moderate spread and may be transmitted by blood transfusion. Based on the geographical and occupational differences in HEV prevalence, a possible zoonotic transmission from pigs should be further explored.


Assuntos
Vírus da Hepatite A/fisiologia , Hepatite A/epidemiologia , Vírus da Hepatite E/fisiologia , Hepatite E/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Doadores de Sangue/estatística & dados numéricos , Feminino , Hepatite A/sangue , Hepatite A/transmissão , Hepatite A/virologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/isolamento & purificação , Anticorpos Anti-Hepatite/sangue , Hepatite E/sangue , Hepatite E/transmissão , Hepatite E/virologia , Vírus da Hepatite E/genética , Vírus da Hepatite E/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Ruanda/epidemiologia , Estudos Soroepidemiológicos , Suínos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/virologia , Adulto Jovem , Zoonoses/sangue , Zoonoses/epidemiologia , Zoonoses/virologia
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