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1.
Viruses ; 12(12)2020 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-33352751

RESUMO

Hepatitis A virus (HAV) is a waterborne pathogen of public health importance. In South Africa (SA), unique HAV subgenotype IB strains have been detected in surface and wastewater samples, as well as on fresh produce at the point of retail. However, due to the use of molecular-based assays, the infectivity of the detected strains was unknown. Considering the potential shift of HAV endemicity from high to intermediate, which could increase the risk of severe symptomatic disease, this study investigated the identity of HAV strains detected before and after viability treatment of selected wastewater discharge samples. For one year, 118 samples consisting of sewage, treated wastewater discharge and downstream dam water were collected from five wastewater treatment plants (WWTP 1, 2, 3, 4 and 5). Unique HAV IB strains were detected in samples from all five WWTPs, with 11 of these strains carrying amino acid mutations at the immunodominant and neutralisation epitopes. A quasispecies dynamic of HAV has also been detected in sewage samples. The subsequent application of viability PCR revealed that potentially infectious HAV strains were discharged from WWTP 1, 2, 4 and 5 into the dam. Therefore, there is a potential risk of HAV exposure to communities using water sources downstream the WWTPs.


Assuntos
Vírus da Hepatite A/isolamento & purificação , Esgotos/virologia , Águas Residuárias/virologia , Purificação da Água , Vírus da Hepatite A/genética , Vírus da Hepatite A/imunologia , Filogenia
2.
BMC Infect Dis ; 20(1): 627, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32842988

RESUMO

BACKGROUND: The epidemiological pattern of hepatitis A infection has shown dynamic changes in many parts of the world due to improved socio-economic conditions and the accumulation of seronegative subjects, which leads to possible outbreaks and increased morbidity rate. In Tunisia, the epidemiological status of hepatits A virus is currently unknown. However, over the past years higher numbers of symptomatic hepatitis A virus infection in school attendants and several outbreaks were reported to the Ministry of Health, especially from regions with the lowest socio-economic levels in the country. The aim of this study was to investigate the current seroprevalence of hepatitis A virus antibodies in central-west Tunisia and assess the impact of hepatitis A virus vaccination on hepatitis A epidemiology. METHODS: Serum samples from 1379 individuals, aged 5-75 years, were screened for hepatitis A virus antibodies. Adjusted seroprevalence, incidence and force of infection parameters were estimated by a linear age structured SEIR (Susceptible-Exposed-Infectious-Recovered) compartmental model. A vaccine model was then constructed to assess the impact on hepatitis A virus epidemiology of 3 scenarios of vaccination strategies: one dose at 12-months of age, one dose at 6-years and one dose at 12-months and another at 6-years of age during 6 years. RESULTS: A rapid increase in anti-hepatitis A virus seroprevalence was noted during infancy and adolescence: 47% of subjects under 10-years-old are infected; the prevalence increases to 77% at 15-years and reaches 97% in subjects aged 30-years. The force of infection is highest between 10 and 30-years of age and the incidence declines with increasing age. The vaccine model showed that the 3-scenarios lead to a significant reduction of the fraction of susceptibles. The two doses scenario gives the best results. Single-dose vaccination at 6-years of age provides more rapid decrease of disease burden in school-aged children, as compared to single-dose vaccination at 12-months, but keeps with a non-negligible fraction of susceptibles among children < 6-years. CONCLUSIONS: Our study confirms the epidemiological switch from high to intermediate endemicity of hepatitis A virus in Tunisia and provides models that may help undertake best decisions in terms of vaccinations strategies.


Assuntos
Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Hepatite A/transmissão , Modelos Teóricos , Vacinação/métodos , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Hepatite A/sangue , Hepatite A/prevenção & controle , Anticorpos Anti-Hepatite A/sangue , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Soroepidemiológicos , Tunísia/epidemiologia , Adulto Jovem
3.
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
4.
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
5.
Microbiol Immunol ; 64(5): 392-395, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32052883

RESUMO

Hepatitis A virus (HAV) has begun to spread globally among men who have sex with men (MSM). Hepatitis E virus (HEV) also may be transmitted through sexual contact among MSM. To assess the current status of these viruses among MSM in Japan, the seroprevalence of both viruses using 503 plasma samples collected between 2009 and 2018 from human immunodeficiency virus (HIV)-positive male donors who were presumed to be mainly MSM was investigated. Our results suggested that HAV may be spreading within this population, as reported elsewhere. By contrast, the spread of HEV was confirmed only among younger HIV-positive donors.


Assuntos
Doadores de Sangue , Infecções por HIV/epidemiologia , Hepatite A/epidemiologia , Hepatite E/epidemiologia , Adolescente , Adulto , Idoso , HIV-1/imunologia , HIV-2/imunologia , Vírus da Hepatite A/imunologia , Vírus da Hepatite E/imunologia , Homossexualidade Masculina , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Soroepidemiológicos , Minorias Sexuais e de Gênero , Adulto Jovem
6.
Int J Infect Dis ; 93: 163-167, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32045695

RESUMO

OBJECTIVES: To analyze the effects of one dose of live attenuated hepatitis A vaccine in a developing country. METHODS: The reported cases of hepatitis A virus (HAV) infection from 2005 to 2018 in Henan province, China, were analyzed. Data of vaccinated children were assessed on the childhood immunization information management system. Questionnaire survey and blood sample collection were randomly conducted in six counties and districts of Henan province to analyze the prevalence of HAV lgG among the population aged 0-70 years. RESULTS: In 2008, Henan province began to expand its program on immunization, and children aged 18 months were given one dose of live attenuated hepatitis A vaccine (HepA-L). From 2005 to 2007, the HAV incidence remained steady at above 5000 cases per year and increased to 7489 in 2007. Since 2008, the HAV incidence decreased cumulatively from 4576 to 237 in 2018, indicating a 94.8% decrease, which was particularly pronounced among adolescents (98.2%). The proportion of hepatitis A cases in patients younger than 10 years continually decreased from 41.6% in 2012 to 3.8% in 2018. The reduction of reported cases older than 40 years was slower than that of children. In 2012, the proportion of hepatitis A cases older than 40 years was 27.6%, and continually increased to 69.2% (164/237) in 2018. The results of serological investigation showed that the 0-1.5-year age group had the lowest anti-HAV IgG prevalence (38.6%), which increased to 75.0% in the 4-6-year age group, covered by this immunization program. CONCLUSIONS: The data indicated a large decrease in HAV infections in Henan province from 2008 onward in response to the introduction of a planned immunization program of HepA-L.


Assuntos
Vacinas contra Hepatite A , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Países em Desenvolvimento , Feminino , Anticorpos Anti-Hepatite A/sangue , Vírus da Hepatite A/imunologia , Humanos , Programas de Imunização , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Vacinação , Vacinas Atenuadas , Adulto Jovem
7.
Jpn J Infect Dis ; 73(2): 89-95, 2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-31666497

RESUMO

Since 2017, hepatitis A virus (HAV) infection has been an epidemic among men who have sex with men (MSM) in Japan. We have come across 11 MSM patients with hepatitis A who were also infected with HIV. In 1999-2000, we came across 5 HIV-infected patients with hepatitis A. Since the conditions of current HIV-infected patients have changed owing to the recent progress in anti-HIV therapies, we compared clinical features of hepatitis A between patients in 2017-2018 and those in 1999-2000. By comparing the background characteristics of the patients, we found that the CD4/CD8 ratio was significantly higher in the 2017-2018 group. After the onset of hepatitis, peak levels of hepatic transaminases were found to be higher in the 2017-2018 group, suggesting severe hepatocellular damage. In contrast, neither the peak level of total bilirubin nor the nadir of prothrombin time was significantly different among the 2 groups. We also analyzed the HAV genome derived from some of the recently infected patients, and found that the HAV strains were almost the same among these patients; slight differences were observed from the previously identified strain. Thus, we concluded that the recovery of immunity by recent anti-HIV therapies may result in more severe hepatocellular damages and differences in clinical features.


Assuntos
Infecções por HIV/epidemiologia , Hepatite A/epidemiologia , Adulto , Antirretrovirais/efeitos adversos , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Linfócitos T CD8-Positivos , Cidades/epidemiologia , Coinfecção/virologia , Genoma Viral , Infecções por HIV/virologia , Hepatite A/imunologia , Anticorpos Anti-Hepatite A/sangue , Vírus da Hepatite A/genética , Vírus da Hepatite A/imunologia , Homossexualidade Masculina , Humanos , Japão/epidemiologia , Fígado/efeitos dos fármacos , Fígado/patologia , Fígado/virologia , Masculino , Pessoa de Meia-Idade , Minorias Sexuais e de Gênero
8.
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
9.
Epidemiol Infect ; 147: e210, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-31364560

RESUMO

India is experiencing a substantial decrease in early childhood exposure to hepatitis A virus (HAV). Kerala has experienced several hepatitis A outbreaks in young adults/adults in the recent past. The current hepatitis outbreak occurred in Nellikuzhi, Kerala state, India in December 2016. Investigation was carried by preparing a line list of suspected hepatitis cases. The blood and stool samples collected from patients were tested for anti-HAV/anti-Hepatitis E virus (HEV) immunoglobulin (IgM) antibodies and RNA respectively. A total of 562 suspected hepatitis cases were reported during the outbreak. Along with the first case (35 years, male), 86.1% (484/562) of the cases gave history of consuming food/water/cold drinks from one restaurant. Anti-HAV IgM positivity was 74.5% (73/98) in tested samples and amongst the positives, 81% were adults/young adults and adolescents. None of the samples tested positive for anti-HEV IgM. There were three HAV associated deaths without any co-morbidity. Sequence analysis of HAV RNA positive stool samples showed the presence of genotype IIIA HAV. The suspected source of the infection was a private well situated in the premise of a restaurant. Considering increasing HAV naive population in Kerala, there is a need to introduce hepatitis A vaccine in high-risk age groups.


Assuntos
Transmissão de Doença Infecciosa , Doenças Transmitidas por Alimentos/epidemiologia , Vírus da Hepatite A/isolamento & purificação , Hepatite A/epidemiologia , Hepatite A/transmissão , Restaurantes , População Rural , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Fezes/virologia , Feminino , Genótipo , Anticorpos Anti-Hepatite A/sangue , Vírus da Hepatite A/classificação , Vírus da Hepatite A/genética , Vírus da Hepatite A/imunologia , Humanos , Imunoglobulina M/sangue , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , RNA Viral/análise , RNA Viral/genética , Análise de Sobrevida , Adulto Jovem
10.
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
11.
Am J Trop Med Hyg ; 101(1): 45-50, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31162016

RESUMO

Waterborne pathogens, associated with poverty and poor sanitary conditions, are a major cause of morbidity and mortality worldwide. There are limited data on the epidemiology of waterborne pathogens in indigenous populations living in the Amazon region. We did a cross-sectional survey in two indigenous Shuar communities in the Amazon region of Ecuador in which we documented the presence of pathogens representing different sources of environmental contamination of water. We detected protozoa and soil-transmitted helminths by microscopy of fecal samples and the presence of IgG antibodies to hepatitis A and Leptospira spp. in blood samples from individuals older than 2 years and collected data by questionnaire on sociodemographic factors and knowledge of infectious diseases. Seroprevalence for hepatitis A and Leptospira spp. were 98.1% (95% CI: 97.0-99.8) and 50.0% (95% CI: 43.3-56.6), respectively, whereas 62.6% (95% CI: 55.8-69.4) had enteric parasites in stool samples. In participants older than 6 years, eight of 10 had evidence of infection with or exposure to at least one of the pathogens studied. Although prevalence of pathogens varied by age, it did not vary significantly by gender, temporal migration, illiteracy, perceived morbidity, receipt of conditional cash transfers, water boiling practices, poor housing conditions, and anthropometric status. These findings indicate a high level of contamination of drinking water by human pathogens in these indigenous communities and the need for interventions to improve access to and use of clean drinking water in these marginalized communities.


Assuntos
Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Hepatite A/epidemiologia , Leptospirose/epidemiologia , Microbiologia da Água , Água/parasitologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Equador/epidemiologia , Hepatite A/sangue , Vírus da Hepatite A/imunologia , Humanos , Imunoglobulina G/sangue , Povos Indígenas , Leptospira/imunologia , Leptospirose/sangue , Pessoa de Meia-Idade , Pobreza , Saneamento , Estudos Soroepidemiológicos , Abastecimento de Água , Adulto Jovem
12.
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
14.
PLoS One ; 14(6): e0216033, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31242191

RESUMO

INTRODUCTION: South Africa is considered highly endemic for hepatitis A virus (HAV) although few seroprevalence studies have been conducted over the past two decades. The World Health Organization recommends integrating HAV vaccination into national childhood immunization schedules where there is transition from high to intermediate endemicity. As a means of gauging age-specific rates of infection, we report HAV seroprevalence rates among specimens tested for HAV serology within South Africa's public health sector from 2005-2015. MATERIALS AND METHODS: Hepatitis A serology results (Anti-HAV IgM, IgG and total antibody) from 2005-2015 were extracted from South Africa's National Health Laboratory Service's Corporate Data Warehouse (NHLS CDW), the central data repository of all laboratory test-sets within the public health sector. Results were extracted according to test-set, result, date of testing, health facility, name, surname, age, and sex. Anti-HAV IgG results were merged with total antibody results to reflect anti-HAV seroprevalence. Testing volume, positivity rates and age-specific anti-HAV seroprevalence rates by year and geographic distribution are described. RESULTS AND DISCUSSION: A total of 501 083 HAV IgM results were retrieved, of which 16 423 (3.3%) were positive, 484 259 (96.6%) negative and 401 (0.1%) equivocal; and 34 710 HAV total antibody/IgG tests of which 30 675 (88.4%) were positive, 4 020 (11.6%) negative and 15 equivocal. Whereas IgM positivity was highest among the 1-4 year age group (33.5%) and lowest among patients >45 years (<0.5%), total antibody positivity ranged from its lowest level of 52.7% in the 1-4 year age group increasing to levels of >90% only after 25 years of age. CONCLUSION: Anti-HAV total antibody testing within the South African public health sector demonstrates seroprevalence rates reach levels >90% only in adulthood, suggesting South Africa could be in transition from high to intermediate endemicity. Prospective studies with geographically representative sampling are required to confirm these findings and evaluate provincial and urban/rural heterogeneity.


Assuntos
Anticorpos Anti-Hepatite A/sangue , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/imunologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , África do Sul/epidemiologia , Adulto Jovem
15.
Epidemiol Infect ; 147: e154, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-31063104

RESUMO

Cytomegalovirus (CMV) infection is endemic worldwide but its seroprevalence varies widely. The goal of this study was to estimate the age-specific seroprevalence of CMV infection in Belgium based on two cross-sectional serological datasets from 2002 and 2006. The seroprevalence was estimated relying on diagnostic test results based on cut-off values pre-specified by the manufacturers of the tests as well as relying on mixture models applied to continuous pathogen-specific immunoglobulin G antibody titre concentrations. The age-specific seroprevalence of hepatitis A virus (HAV), based on three Belgian cross-sectional serological datasets from 1993, 2002 and 2006, was used as a comparator since individuals acquire lifelong immunity upon recovery, implying an increasing seroprevalence with age. The age group weighted overall CMV seroprevalence derived from the mixture model was 32% (95% confidence interval (CI) 31-34%) in 2002 and 31% (95% CI 30-32%) in 2006. We demonstrated that CMV epidemiology differs from the immunizing infection HAV. This was the first large-scale study of CMV and HAV serial datasets in Belgium, estimating seroprevalence specified by age and birth cohort.


Assuntos
Anticorpos Antivirais/sangue , Infecções por Citomegalovirus/epidemiologia , Citomegalovirus/imunologia , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Bélgica/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Imunoensaio , Imunoglobulina G/sangue , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Adulto Jovem
16.
BMC Infect Dis ; 19(1): 443, 2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113369

RESUMO

BACKGROUND: Hepatitis A Virus (HAV) is one of the most common food and water borne infectious disease prevailing globally. The objective of the study was to determine sero-prevalence of HAV infection in a district of Sri Lanka. METHODS: This was a descriptive cross sectional study conducted on 1403 participants aged 1 year and above selected by multistage stratified (for age group and area of residence) cluster sampling from September 2015 to December, 2016. An interviewer-administered questionnaire was used to collect data and Anti-IgG testing was done to determine sero-positivity. The overall, the age and sex specific sero-prevalence of HAV were calculated with 95% confidence intervals (CI). RESULTS: Of the 1403 participants 1132 were anti HAV IgG positive. Therefore the overall sero-prevalence of HAV infection was 80.7% (95%CI: 78.64-82.76). There were 283 (20.2%) individuals below the age group of 14 years and below and out of them, 204 had anti HAV IgG, therefore sero-prevalence was 72.1% for that age group. The age group 15 years and aboe comprised of 1120 (79.8%) participants and of them 928 had anti HAV IgG, making sero-prevalence 82.9%. The lowest sero-prevalence (66.9%, n = 232) was observed in the age group of 11-20 years followed by 21-30 age group. From age 31 years onwards, the sero-prevalence exceeded 90%, reaching 100% after 71 years. The urban population showed a sero-prevalence of 83% (n = 195) and 80.2% (n = 937) for the rural sector while females had a sero-prevalence of 82.2% (n = 766) and it was 77.7% (n = 366) for males. Thirty-four (3.0%) participants who had sero-positive results (n = 1132) claimed that they have had HAV in the past. CONCLUSIONS: Overall, four fifth of the population was immune to HAV infection in the district of Gampaha.


Assuntos
Vírus da Hepatite A/isolamento & purificação , Hepatite A/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/sangue , Hepatite A/imunologia , Hepatite A/virologia , Anticorpos Anti-Hepatite A/sangue , Anticorpos Anti-Hepatite A/imunologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/imunologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural/estatística & dados numéricos , Estudos Soroepidemiológicos , Sri Lanka/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
17.
S Afr Med J ; 109(5): 314-318, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31131797

RESUMO

BACKGROUND: Hepatitis A virus (HAV) is the most common cause of viral hepatitis worldwide. Hepatitis A vaccine is not included in the Expanded Programme on Immunisation in South Africa (EPI-SA), as the country is considered to be highly endemic for hepatitis A. OBJECTIVES: To determine the seroprevalence of hepatitis A infection in Western Cape Province (WCP), South Africa. METHODS: We conducted a cross-sectional seroprevalence study in the 1 - 7-year age group in WCP. Our samples (N=482) were blood specimens left over after laboratory testing obtained from referral hospitals between August and October 2015. A Siemens enzyme immunoassay was used to test for total hepatitis A antibodies. We also analysed hepatitis A immunoglobulin G antibody results from the National Health Laboratory Service (NHLS) Disa*Lab database at Groote Schuur Hospital from 2009 to 2014, and included 2009 - 2014 acute hepatitis A (immunoglobulin M-positive) surveillance data from the National Institute for Communicable Diseases to look at trends in notified acute infections over the same period. RESULTS: Our cross-sectional study showed 44.1% seroprevalence in the 1 - 7-year age group. Hepatitis A data from the NHLS database indicated a seroprevalence of <90% up to age 10 years, indicating intermediate endemicity. The surveillance data showed that a substantial number of symptomatic hepatitis A infections occurred in the 7 - 40-year age group, suggesting that an increasing proportion of the population is susceptible to HAV infection. CONCLUSIONS: These results suggest an urgent need for detailed evidence-based considerations to introduce hepatitis A vaccine into the EPI-SA.


Assuntos
Anticorpos Anti-Hepatite A/análise , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/virologia , Humanos , Incidência , Lactente , Masculino , Estudos Retrospectivos , Fatores de Risco , Estudos Soroepidemiológicos , África do Sul/epidemiologia
18.
PLoS Biol ; 17(4): e3000229, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31039149

RESUMO

Hepatitis A virus (HAV), an enigmatic and ancient pathogen, is a major causative agent of acute viral hepatitis worldwide. Although there are effective vaccines, antivirals against HAV infection are still required, especially during fulminant hepatitis outbreaks. A more in-depth understanding of the antigenic characteristics of HAV and the mechanisms of neutralization could aid in the development of rationally designed antiviral drugs targeting HAV. In this paper, 4 new antibodies-F4, F6, F7, and F9-are reported that potently neutralize HAV at 50% neutralizing concentration values (neut50) ranging from 0.1 nM to 0.85 nM. High-resolution cryo-electron microscopy (cryo-EM) structures of HAV bound to F4, F6, F7, and F9, together with results of our previous studies on R10 fragment of antigen binding (Fab)-HAV complex, shed light on the locations and nature of the epitopes recognized by the 5 neutralizing monoclonal antibodies (NAbs). All the epitopes locate within the same patch and are highly conserved. The key structure-activity correlates based on the antigenic sites have been established. Based on the structural data of the single conserved antigenic site and key structure-activity correlates, one promising drug candidate named golvatinib was identified by in silico docking studies. Cell-based antiviral assays confirmed that golvatinib is capable of blocking HAV infection effectively with a 50% inhibitory concentration (IC50) of approximately 1 µM. These results suggest that the single conserved antigenic site from complete HAV capsid is a good antiviral target and that golvatinib could function as a lead compound for anti-HAV drug development.


Assuntos
Anticorpos Neutralizantes/ultraestrutura , Desenho de Fármacos , Vírus da Hepatite A/imunologia , Aminopiridinas/metabolismo , Aminopiridinas/farmacologia , Anticorpos Monoclonais , Anticorpos Neutralizantes/metabolismo , Anticorpos Antivirais , Antígenos Virais , Capsídeo/metabolismo , Simulação por Computador , Epitopos , Antígenos da Hepatite A/metabolismo , Antígenos da Hepatite A/ultraestrutura , Vírus da Hepatite A/patogenicidade , Vírus da Hepatite A/ultraestrutura , Humanos , Piperazinas/metabolismo , Piperazinas/farmacologia , Ligação Proteica
19.
Ann Hepatol ; 18(1): 14-22, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31113583

RESUMO

Hepatitis A virus (HAV) is the most common cause of acute viral hepatitis worldwide. The virus is mainly transmitted via the fecaloral route and, the incidence of infection is closely related to low socioeconomic conditions and poor sanitation. Mexico, previously categorized an area of high endemicity for HAV infection, is undergoing epidemiological transition. However, a limited number of HAV-related scientific reports regarding to virus burden is available. According to the local government health agency (Secretarla de Salud, SSA in Spanish), from 1994 to 2017 a reduction in the incidence of hepatitis related to HAV has been reported. However, HAV is still the most common cause of viral hepatitis in the country, and the pediatric population is the most prone to be infected with this virus. The analysis of the SSA data reveals that most of the reported cases from 1994 to 2017 were found in highly industrialized states. This information contradicts the documented relationship between the highest prevalence of infection and the lowest socio-economic status, and supports the necessity of viral detection and notification of HAV cases. Moreover, in spite that four HAV vaccines are available in Mexico and universal vaccination has been shown to be beneficial in developing countries in terms of declining endemicity, HAV vaccination is not mandatory in Mexico. In this review, preventive strategies including appropriate diagnosis, vaccination and public health policies on the basis of the epidemiologic status of HAV in Mexico are discussed.


Assuntos
Anticorpos Anti-Hepatite A/imunologia , Vacinas contra Hepatite A/uso terapêutico , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Vacinação/métodos , Hepatite A/terapia , Humanos , Incidência , México/epidemiologia , Prevalência , Estudos Soroepidemiológicos
20.
Am J Trop Med Hyg ; 101(1): 230-232, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31115307

RESUMO

Hepatitis E virus (HEV) infection is associated with a high fatality rate among pregnant women, and gestational complications have been reported among pregnant women infected with hepatitis A virus (HAV). The aim of this study was to determine the seroprevalence of HAV and HEV infections among pregnant women in Haiti. We stratified the population (n = 1,307) between West and non-West regions. Specimens were tested for total HAV antibody (anti-HAV), and IgM and IgG HEV antibody (anti-HEV). Overall, 96.8% pregnant women were positive for total anti-HAV, 10.3% for IgG anti-HEV, and 0.3% for IgM anti-HEV. The prevalence of IgG anti-HEV in the non-West region (12.3%) was significantly greater than that in the West region (5.3%) (P < 0.0001). Most pregnant women in Haiti had evidence of past exposure and immunity to HAV. The non-West region had a higher prevalence of HEV. Improvement in water and sanitation will help in the prevention and control of these infections in Haiti.


Assuntos
Hepatite A/epidemiologia , Hepatite E/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Feminino , Haiti/epidemiologia , Hepatite A/sangue , Hepatite A/virologia , Vírus da Hepatite A/imunologia , Hepatite E/sangue , Hepatite E/virologia , Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Humanos , Imunoglobulina G/sangue , Gravidez , Estudos Soroepidemiológicos
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