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PloS One 2022Hepatitis A virus (HAV) infection is a leading cause of viral hepatitis in children, yet the HAV vaccine is not included in the national immunization program (NIP) in... (Observational Study)
Observational Study
BACKGROUND
Hepatitis A virus (HAV) infection is a leading cause of viral hepatitis in children, yet the HAV vaccine is not included in the national immunization program (NIP) in Mexico. This study addresses an identified evidence gap of the burden of hepatitis A disease, complications, and associated costs in Mexico by analyzing surveillance and healthcare data. Data review included disease morbidity (incidence and hospitalization), mortality, and healthcare resource utilization costs.
METHODS
In this observational, retrospective database study, we conducted a systematic screening, extraction, and analysis of outcome data from the national surveillance system in Mexico from January 2000 to December 2019.
RESULTS
During the analysis period (2000-2019), the average incidence rate/year of HAV cases was 14.7 (5.4-21.5) per 100,000 inhabitants. Children 1-9 years of age (YoA) had the highest average incidence rate/year with 47.8 (14.7-74.5). The average hospitalization rate/year due to HAV infection was 5.8% (2.9-9.6%). Although the highest burden of HAV continued to be in children (1-9 YoA), an increase in incidence and hospitalizations (with complications) in older age groups (≥ 10-64 YoA) was observed. The annual average fatality rate was estimated to be 0.44% (0.26-0.83%) of which 28.8% of deaths were concentrated in adults ≥ 65 YoA. The total direct costs of medical attention due to HAV and related complications were estimated at $382 million Mexican pesos.
CONCLUSION
The overall results suggest an uptrend in HAV infections in adolescents/adults compared to children in Mexico. Therefore, as the overall incidence risk of HAV infection decreases, the mean age of infection increases. This consequently increases the risk of severity and complications in older age groups, thus increasing the demand for healthcare resources. Our findings provide evidence for including the inactivated HAV vaccine in the Mexican NIP.
Topics: Adolescent; Adult; Aged; Child; Cost of Illness; Hepatitis A; Hepatitis A Vaccines; Hepatitis A virus; Humans; Mexico; Retrospective Studies
PubMed: 35584365
DOI: 10.1371/journal.pone.0268469 -
Journal of Hepatology Dec 2021Hepatitis A virus (HAV) is a common cause of enterically transmitted viral hepatitis. In non-immune individuals, infection results in typically transient but...
BACKGROUND & AIMS
Hepatitis A virus (HAV) is a common cause of enterically transmitted viral hepatitis. In non-immune individuals, infection results in typically transient but occasionally fulminant and fatal inflammatory liver injury. Virus-specific T cell frequencies peak when liver damage is at its zenith, leading to the prevalent notion that T cells exacerbate liver disease, as suspected for other hepatotropic virus infections. However, the overall contribution of T cells to the control of HAV and the pathogenesis of hepatitis A is unclear and has been impeded by a historic lack of small animal models.
METHODS
Ifnar1 mice are highly permissive for HAV and develop pathogenesis that recapitulates many features of hepatitis A. Using this model, we identified HAV-specific CD8+ and CD4+ T cells by epitope mapping, and then used tetramers and functional assays to quantify T cells in the liver at multiple times after infection. We assessed the relationships between HAV-specific T cell frequency, viral RNA amounts, and liver pathogenesis.
RESULTS
A large population of virus-specific T cells accumulated within the livers of Ifnar1 mice during the first 1-2 weeks of infection and persisted over time. HAV replication was enhanced and liver disease exacerbated when mice were depleted of T cells. Conversely, immunization with a peptide vaccine increased virus-specific CD8+ T cell frequencies in the liver, reduced viral RNA abundance, and lessened liver injury.
CONCLUSION
These data show that T cells protect against HAV-mediated liver injury and can be targeted to improve liver health.
LAY SUMMARY
Hepatitis A virus is a leading cause of acute viral hepatitis worldwide. T cells were thought to contribute to liver injury during acute infection. We now show that virus-specific T cells protect against infection and limit liver injury.
Topics: Analysis of Variance; Animals; Disease Models, Animal; Hepatitis A; Hepatitis A virus; Liver Diseases; Mice; North Carolina; Statistics, Nonparametric; T-Lymphocytes
PubMed: 34331968
DOI: 10.1016/j.jhep.2021.07.019 -
LaeknabladidHepatitis A virus (HAV) epidemics occurred repeatedly in Iceland in the early 20th century, but since then few cases have been reported and no epidemics since 1952. The...
INTRODUCTION
Hepatitis A virus (HAV) epidemics occurred repeatedly in Iceland in the early 20th century, but since then few cases have been reported and no epidemics since 1952. The latest Icelandic studies on HAV from around 1990 showed low incidence of infection and de-- creasing prevalence of antibodies. The objective of this study was to determine the incidence, clinical presentation and origin of HAV, abroad or in Iceland.
MATERIAL AND METHODS
A retrospective search was undertaken on all patients with positive anti-HAV IgM during the 11 years period of 2006-2016 in the virological database of the National University Hospital of Iceland. Clinical data was collected from medical records on symptoms at diagnosis, blood test results and possible route of transmission.
RESULTS
A total of 12 individuals were diagnosed with acute hepatitis A during the period and 6691 HAV total andibody tests and 1984 HAV IgM antibody tests were performed. Nine (75%) had been abroad within 7 weeks from initial symptoms. The most common symptoms were jaundice (83%), fever (67%) and nausea and/or vomiting (58%). 50% were admitted to a hospital. 42% had elevated INR/PT. Everyone sur-vived without complications.
CONCLUSION
Annually, approximately one case of acute hepatitis A was diagnosed in Iceland during the study period but a very high number of antibody tests were performed. The majority of cases occurred among individuals who had recently been abroad. If patients have jaundice, fever and nausea, testing for HAV infection should be undertaken. HAV is not endemic in Iceland.
Topics: Biomarkers; Databases, Factual; Hepatitis A; Hepatitis A Antibodies; Hepatitis A virus; Hospitals, University; Humans; Iceland; Immunoglobulin M; Incidence; Predictive Value of Tests; Retrospective Studies; Risk Factors; Time Factors; Travel
PubMed: 29493530
DOI: 10.17992/lbl.2018.03.176 -
PloS One Dec 2009Viral hepatitis is a serious health burden worldwide. To date, few reports have addressed the prevalence of hepatitis A, B, C, and E in China. Therefore, the general...
BACKGROUND
Viral hepatitis is a serious health burden worldwide. To date, few reports have addressed the prevalence of hepatitis A, B, C, and E in China. Therefore, the general epidemiological parameters of viral hepatitis remain unknown.
PRINCIPAL FINDINGS
In this cross-sectional study, we performed a serological prevalence analysis of viral hepatitis A, B, C, and E in 8,762 randomly selected Chinese subjects, which represented six areas of China. The overall prevalence of anti-Hepatitis C virus antibody (anti-HCV) was 0.58%, which was much lower than was estimated by WHO. The prevalences of Hepatitis B virus surface antigen (HBsAg), anti-Hepatitis B virus surface protein antibody (HBsAb), and anti-Hepatitis B virus core protein antibody (HBcAb) were 5.84%, 41.31%, and 35.92%, respectively, whereas in the group of subjects less than 5 years old, these prevalences were 1.16%, 46.77%, and 8.69% respectively, which suggests that the Hepatitis B virus (HBV)-carrier population is decreasing, and the nationwide HBV vaccine program has contributed to the lowered HBV prevalence in the younger generation in China. Meanwhile, a large deficit remains in coverage provided by the national HBV immune program. In addition, our data suggested the possibility that HBsAb may not last long enough to protect people from HBV infection throughout life. The overall prevalence of anti-Hepatitis A virus antibody (anti-HAV) and anti-Hepatitis E virus antibody (anti-HEV) were as high as 72.87% and 17.66%, respectively. The indices increased with age, which suggests that a large proportion of Chinese adults are protected by latent infection. Furthermore, the pattern of HEV infection was significantly different among ethnic groups in China.
CONCLUSIONS
Our study provided much important information concerning hepatitis A, B, C, and E prevalence in China and will contribute to worldwide oversight of viral hepatitis.
Topics: Adolescent; Adult; Biomarkers; Child; Child, Preschool; China; Cross-Sectional Studies; Female; Geography; Hepacivirus; Hepatitis A; Hepatitis A Antibodies; Hepatitis A Virus, Human; Hepatitis B; Hepatitis B virus; Hepatitis C; Hepatitis C Antibodies; Hepatitis E; Hepatitis E virus; Hepatitis, Viral, Human; Humans; Male; Middle Aged; Prevalence; Young Adult
PubMed: 20041146
DOI: 10.1371/journal.pone.0008467 -
Intervirology 2017This study investigated the etiology of acute viral hepatitis and compared the clinical features of hepatitis E virus (HEV) infections with those of other acute viral... (Comparative Study)
Comparative Study
OBJECTIVES
This study investigated the etiology of acute viral hepatitis and compared the clinical features of hepatitis E virus (HEV) infections with those of other acute viral hepatitis infections in Korea.
METHODS
This study included 2,357 consecutive patients who were diagnosed with acute hepatitis, based on acute illness with jaundice or elevated alanine aminotransferase levels (>100 IU/L), between January 2007 and January 2016. Acute viral infections were observed in 23 (19.8%) patients with HEV, 49 (42.2%) patients with hepatitis A virus, 28 (24.1%) patients with hepatitis B virus, and 16 (13.8%) patients with hepatitis C virus.
RESULTS
The incidence of acute HEV infection was higher among older patients (median age: 49 years) and male patients (69.6%), and was associated with the consumption of undercooked or uncooked meat (43.5%). Half of the acute HEV infections involved underlying liver disease, such as alcoholic liver disease, chronic hepatitis B, common bile duct stones, and autoimmune hepatitis. Two HEV-infected patients were diagnosed with Guillain-Barré syndrome, although no patients developed fulminant hepatitis.
CONCLUSION
Our findings indicate that HEV infection in Korea is frequently transmitted through the consumption of raw meat and may cause acute or chronic liver disease.
Topics: Adult; Antiviral Agents; Female; Hepatitis A; Hepatitis B, Chronic; Hepatitis C, Chronic; Hepatitis E; Hepatitis, Viral, Human; Humans; Male; Meat; Middle Aged; Raw Foods; Republic of Korea; Retrospective Studies; Treatment Outcome
PubMed: 29145204
DOI: 10.1159/000480506 -
Genetics and Molecular Research : GMR Dec 2015Like other developing countries, China was reported to have a relatively high seroprevalence of anti-hepatitis A antibodies (anti-HAV). However, no studies have...
Like other developing countries, China was reported to have a relatively high seroprevalence of anti-hepatitis A antibodies (anti-HAV). However, no studies have evaluated the prevalence of anti-HAV and HAV RNA among voluntary blood donors with or without elevated serum alanine transaminase (ALT) levels. Anti-HAV antibodies were detected using an enzyme-linked immunosorbent assay, and reverse transcription quantitative polymerase chain reaction was carried out for detection of HAV RNA. In the current study, we analyzed a total of 450 serum samples with elevated ALT levels (≥40 U/L) and 278 serum samples with non-elevated ALT levels. Seroprevalence rates of anti-HAV were 51.6% in donors with elevated ALT and 41.4% in donors with non-elevated ALT; however, none of the samples was positive for HAV RNA. The results of our study showed lower seroprevalence rates of anti-HAV in blood donors (irrespective of ALT levels) than those in published data on Chinese populations. Although donors with elevated ALT had statistically higher prevalence rates of anti- HAV than did those with non-elevated ALT, none of the serum samples had detectable levels of the active virus. In conclusion, our results demonstrate that the transmission of hepatitis A by blood transfusion will occur rarely.
Topics: Adolescent; Adult; China; Female; Hepatitis A; Hepatitis A Antibodies; Hepatitis A Virus, Human; Humans; Liver Function Tests; Male; Middle Aged; Seroepidemiologic Studies; Viral Load; Young Adult
PubMed: 26662440
DOI: 10.4238/2015.December.9.13 -
BMJ Open Mar 2021Differences in immunisation policies have significantly reshaped the epidemiology of hepatitis A and B in the population. Assessment of the susceptibility and...
INTRODUCTION
Differences in immunisation policies have significantly reshaped the epidemiology of hepatitis A and B in the population. Assessment of the susceptibility and transmission potential of these two types of vaccine-preventable hepatitis would enhance the capacity of public health authorities for viral hepatitis elimination. Focusing on Hong Kong, the objectives of this study comprise the determination of the population-level seroprevalence of hepatitis A and B and an examination of the risk factors for virus transmission and the population impacts of vaccinations.
METHODS AND ANALYSIS
This is a cross-sectional household survey on hepatitis A and B. By using socially homogeneous building groups as sampling frame, eligible members of 1327 spatially selected households would be invited to complete a questionnaire and provide blood samples for serological testing (anti-hepatitis A virus, hepatitis B surface antigen, hepatitis B surface and core antibody). The main measures comprise a set of metrics on the prevalence of hepatitis A and B. Analysis would be conducted to examine the association of risk factors with the tested markers and describe the attitudes towards viral hepatitis vaccination.
ETHICS AND DISSEMINATION
Ethical approval from the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee, and approval for laboratory safety from the Chinese University of Hong Kong have been obtained. The study results will be presented in scientific forums to update on the epidemiology of hepatitis A and B and inform the development of new vaccination strategies in Hong Kong.
TRIAL REGISTRATION NUMBER
NCT04371276.
Topics: Cross-Sectional Studies; Hepatitis A; Hepatitis B Vaccines; Hong Kong; Humans; Seroepidemiologic Studies
PubMed: 33753433
DOI: 10.1136/bmjopen-2020-042065 -
Annals of Saudi Medicine 2019Since routine immunization could change the epidemiological profile of hepatitis A virus (HAV) infection in the future, it is important to determine the baseline...
BACKGROUND
Since routine immunization could change the epidemiological profile of hepatitis A virus (HAV) infection in the future, it is important to determine the baseline immunity to HAV across Turkey.
OBJECTIVE
The aim of this study was to determine the seroprevalence of hepatitis A among individuals 6 years of age and older in Yozgat, Turkey.
DESIGN
Cross-sectional.
SETTING
Community in central region of Turkey.
PATIENTS AND METHODS
Questionnaires and blood specimens were collected and the presence of hepatitis A IgG antibodies against hepatitis A virus was determined quantitatively by ELISA.
MAIN OUTCOME MEASURES
The rates of hepatitis A immunity by age group.
SAMPLE SIZE
1862.
RESULTS
Immunity to hepatitis A was 79.1% (n=1473). The mean (SD) age was 17.1 (14.7) years in the nonimmune group and 37.8 (19.5) years in the immune group (P less than .001), and immunity increased with age. No significant difference in immunity rate was detected between gen.ders in children and adults. The seropositivity rate for subjects ages 6-19 years was lower than in subjects aged 20-96 years (52.2% versus 93.9%; P less than .001).
CONCLUSION
A catch-up vaccination program is needed for persons aged 6-19 years in Yozgat.
LIMITATIONS
Single region data which can not be generalized. For this reason, a multi-centered study that can reflect the whole country is recommended.
CONFLICT OF INTEREST
None.
Topics: Adolescent; Adult; Child; Cross-Sectional Studies; Enzyme-Linked Immunosorbent Assay; Female; Hepatitis A; Hepatitis A Antibodies; Hepatitis A Vaccines; Hepatitis A virus; Humans; Male; Middle Aged; Seroepidemiologic Studies; Turkey; Vaccination; Young Adult
PubMed: 30712049
DOI: 10.5144/0256-4947.2019.37 -
Global Journal of Health Science Aug 2012Viral hepatitis is an important preventable infectious disease with various rates of occurrence in different areas of the world. The main objective of the present study...
Predicting acute viral hepatitis serum markers (A and E) in patients with suspected acute viral hepatitis attending primary health care centers in Baghdad: a one year cross-sectional study.
BACKGROUND
Viral hepatitis is an important preventable infectious disease with various rates of occurrence in different areas of the world. The main objective of the present study was to evaluate the role of some risk factors in predicting a positive acute viral hepatitis marker among patients with suspected acute viral hepatitis in a primary health care setting in Baghdad. Besides, finding out the occurrence of jaundice, contribution of viruses A and E to the cases that have occurred in Baghdad province was also searched for.
METHODS
Over a period of 1 year a descriptive cross sectional study was carried out at the primary health care centers in Baghdad. A questionnaire form was used to collect data about demographic factors and the results of the investigations. Total serum bilirubin and bilirubin in urine were done at the primary health care center laboratory. The rest of the sera samples were sent to Hepatitis referral Lab at Central Public Health Laboratory (CPHL) to be tested for anti HAV IgM and anti HEV IgM using ELISA technique.
RESULTS
A total of 7,576,372 consultations to primary health care centers were recorded in Baghdad. Among those a total of 2,692 cases (35.5 per 100,000 consultations) were labeled as acute viral hepatitis cases. A positive hepatitis viral marker (A, B, C and E) was found in 1,332 cases (17.6 per 100,000 consultations). More than two fifths (44.8%) of cases were positive for anti-HAV antibodies and another 1.6% had positive anti-HEV antibodies.
CONCLUSION
During 1 year period, the rate of occurrence of suspected acute viral hepatitis cases was 35.5 per 100000 of consultations to the primary health care centers in Baghdad. Of the total suspected cases, only 17.6 per 100000 of the consultations were positive for one of the viral hepatitis markers. Those who tested positive for one of the viral hepatitis markers represent 49.5% of the suspected cases. Proportion of anti HAV IgM positive tests among suspected cases was 44.8%. Factors that were able to predict positive Anti HAV IgM were (younger age group, negative history of cupping or tattooing, negative past history of jaundice). Male gender was the least important predictor of a positive case for anti HAV IgM. Proportion of Anti HEV IgM positive tests among suspected cases was 1.6%. Of the factors studied, only age was able to predict a positive Anti HEV IgM in those more than 15 years. Further studies are recommended.
Topics: Acute Disease; Adolescent; Adult; Age Factors; Ambulatory Care Facilities; Biomarkers; Child; Child, Preschool; Cross-Sectional Studies; Enzyme-Linked Immunosorbent Assay; Female; Hepatitis A; Hepatitis A Antibodies; Hepatitis Antibodies; Hepatitis E; Humans; Infant; Iraq; Male; Middle Aged; Primary Health Care; Risk Factors; Sex Factors; Young Adult
PubMed: 22980390
DOI: 10.5539/gjhs.v4n5p172 -
Public Health Reports (Washington, D.C.... 2007In 1999, the Florida State Legislature established and funded the statewide Hepatitis Prevention Program (HPP) to address growing concern about hepatitis C virus (HCV)...
In 1999, the Florida State Legislature established and funded the statewide Hepatitis Prevention Program (HPP) to address growing concern about hepatitis C virus (HCV) and its potential public health burden. HPP supports county health departments' (CHDs') provision of viral hepatitis prevention services to at-risk adults through free hepatitis A and B vaccine in most CHDs and hepatitis serologic testing and statewide viral hepatitis-related education, consultation, and referral services. Some CHDs are directly funded by HPP. In 2001-2005, HPP support helped CHDs provide 59,228 hepatitis A and 74,039 hepatitis B vaccinations statewide. In 2005, HPP supported almost 17,000 hepatitis B and C tests. From January to June 2005, 1,603 positive HCV tests were reported, a 9.5% seropositivity rate. With $24 million from the Florida State Legislature through 2006, HPP has helped CHDs statewide provide substantial viral hepatitis prevention services to at-risk adults.
Topics: Counseling; Florida; Hepatitis A; Hepatitis A Vaccines; Hepatitis B; Hepatitis B Vaccines; Hepatitis C; Hepatitis, Viral, Human; Humans; Patient Education as Topic; Prevalence; Public Health Practice; Referral and Consultation
PubMed: 17542449
DOI: 10.1177/00333549071220S205