Abstract
The person-to-person transmission of the hepatitis A virus primarily occurs in enclosed spaces, particularly in the presence of inadequate hygiene conditions and a high proportion of susceptible individuals. Thus, intimate family contact stands out as a risk factor for HAV infection dissemination. The present study aimed to evaluate the occurrence of household HAV transmission. Blood samples were collected from patients with hepatitis A (index cases) and their family members (contacts) that were referred to an ambulatory care clinic specializing in viral hepatitis. A total of 97 samples were collected from 30 families with a confirmed hepatitis A case (index case). Serological and molecular techniques for the diagnosis of hepatitis A were conducted on all samples. HAV infection (anti-HAV IgM + and/or HAV RNA +) was detected in 34.3% (23/67) of the contacts; 34.3% (23/67) of the contacts were immune to HAV, and 31.4% (21/67) were susceptible. In the household contacts, HAV immunity was significantly associated with older age; susceptibility to infection and HAV infection were associated with younger age. Household outbreaks were detected in 16/30 families studied. Co-circulation of subgenotypes IA and IB was found in the household outbreaks, and person-to-person transmission was evidenced in six of the household outbreaks, with 100% homology between the index case and contact strains. The results demonstrated the relevance of HAV household transmission, reaffirming the need for hepatitis A vaccine administration in susceptible contacts and effective infection control procedures to prevent the extension of household outbreaks.
Highlights
Hepatitis A is an inflammatory liver disease that annually affects approximately 1.4 million individuals worldwide [1]
The disease is transmitted primarily via the fecal-oral route, and its incidence rate is strongly correlated with socioeconomic conditions and access to safe drinking water [2,3]
This study aimed to investigate the occurrence of the hepatitis A virus (HAV) transmission in the household environment
Summary
Hepatitis A is an inflammatory liver disease that annually affects approximately 1.4 million individuals worldwide [1]. The hepatitis A virus (HAV) is a Hepatovirus member of the Picornaviridae family and has a positive single-stranded RNA genome approximately 7.5 kb in length [7]. HAV has a single antigenic serotype that provides lifelong immunity after natural infection and follow the use of an inactivated vaccine. Despite the lack of antigenic variability, there are six viral genotypes of HAV (I–VI); three of the genotypes (I–III) are associated with human infections, and three (IV–VI) are associated with simian infections [8]. All the human genotypes (I–III) are divided into two subgenotypes (A and B), which exhibit a nucleotide variation of approximately 7.5% [9]. A new subgenotype IC has been proposed [10]
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