Prevalence Of Hepatitis A Virus Research Articles

Meta-analysis of the prevalence of norovirus and hepatitis a virus in berries

Norovirus (NoV) and hepatitis A virus (HAV) stand as the predominant agents associated with viral foodborne infections. Outbreaks have been documented to be caused by various types of food items, including fresh and/or frozen berries. Comprehensive data concerning crucial viral pathogens in berries remain limited and are not currently available in aggregate form. Consequently, the present study aimed to compile the existing information regarding the prevalence of NoV and HAV in this matrix. Records of foodborne viruses were systematically extracted from database repositories up to December 2022, adhering to PRISMA standards and were subjected to a multilevel random effect meta-analysis model to determine the mean occurrence rate of NoV and HAV. A high heterogeneity across studies was observed (I2 = 82 %), reflecting variations in the prevalence of sampling locations, years, berry types, and sample conditions, among other potential contributing factors. The prevalence of NoV and HAV in berries was calculated at 2.12 % (95 % CI 1.74–2.59 %), and no statistically differences were observed among the viral types or genogroup categories. However, it is important to clarify that this estimate should be taken with caution given the high heterogeneity. There was no discernible correlation between viral prevalence and any particular berry type. However, there was a temporal correlation observed with the year of sampling, revealing a significantly decreasing trend throughout the study period. A significant influence of the sample condition (fresh or frozen) was observed in relation to the prevalence of NoV GII and HAV. Overall higher viral prevalences were identified in berries originating from African countries as compared to those sourced from other continents. It was also noted that the prevalence of NoV GI was significantly higher in samples collected directly from farms compared to those obtained from retailers. The outcomes of this comprehensive meta-analysis propose that while viral contamination of berries is diminishing in more recent times, the prevalence remains substantial in certain African countries, having a significant risk for foodborne infections. It is imperative to implement intervention strategies in these regions to enhance product safety.

Impact of prior HBV, HAV, and HEV infection on non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease. The association between prior hepatitis B virus (HBV), hepatitis A virus (HAV), hepatitis E virus (HEV) infection and NAFLD remains unclear. We utilized the 2017-2020 National Health and Nutrition Examination Survey (NHANES) and performed multivariable logistic regression analyses to examine the association of prior HBV, HAV and HEV infection with NAFLD, as well as high risk non-alcoholic steatohepatitis (NASH) and liver fibrosis. Our analysis included 2565 participants with available anti-HBc serology results, 1480 unvaccinated participants with anti-HAV results, and 2561 participants with anti-HEV results. Among participants with NAFLD, the age-adjusted prevalence of prior HBV, HAV and HEV infection was 3.48%, 32.08% and 7.45%, respectively. Prior infection with HBV, HAV and HEV was not associated with NAFLD (cut-off 285 dB/m) [aOR: 0.99 (95% CI, 0.77-1.29), 1.29 (95% CI, 0.95-1.75), and 0.94 (95% CI, 0.70-1.27), respectively] or high-risk NASH [aOR 0.72 (95% CI, 0.45-1.17), 0.92 (95% CI, 0.55-1.52), and 0.89 (95% CI, 0.41-1.94), respectively]. Participants with anti-HBc and anti-HAV seropositivity were more likely to have significant fibrosis [aOR: 1.53 (95% CI, 1.05-2.23) and 1.69 (95% CI, 1.16-2.47), respectively]. The odds of significant fibrosis are 53%, and 69% greater for participants with prior history of HBV and HAV infection. Healthcare providers should prioritize vaccination efforts and employ a tailored approach to NAFLD in patients with prior viral hepatitis and especially HBV or HAV infection to limit disease-related outcomes.

Quantitative Risk Assessment of Hepatitis a Virus Infection Arising from the Consumption of Fermented Clams in South Korea.

This study estimated the risk of hepatitis A virus (HAV) foodborne illness outbreaks through the consumption of fermented clams in South Korea. HAV prevalence in fermented clams was obtained from the Ministry of Food and Drug Safety Report, 2019. Fermented clam samples (2 g) were inoculated with HAV and stored at -20-25 °C. Based on the HAV titer (determined using plaque assay) in fermented clams according to storage, the Baranyi predictive models provided by Combase were applied to describe the kinetic behavior of HAV in fermented clams. The initial estimated HAV contamination level was -3.7 Log PFU/g. The developed predictive models revealed that, when the temperature increased, the number of HAV plaques decreased. The Beta-Poisson model was chosen for determining the dose-response of HAV, and the simulation revealed that there was a 6.56 × 10-11/person/day chance of contracting HAV foodborne illness by eating fermented clams. However, when only regular consumers of fermented clams were assumed as the population, the probability of HAV foodborne illness increased to 8.11 × 10-8/person/day. These results suggest that, while there is a low likelihood of HAV foodborne illness from consuming fermented clams across the country, regular consumers should be aware of the possibility of foodborne illness.

Occurrence of Hepatitis A Virus in Water Matrices: A Systematic Review and Meta-Analysis.

Hepatitis A is a common form of viral hepatitis. It is usually transmitted through the ingestion of contaminated food and water. This systematic review was carried out to summarise the overall prevalence of Hepatitis A virus (HAV) in different water matrices: untreated and treated wastewater, surface water, groundwater, drinking water, and others (e.g., irrigation water and floodwater). The literature search was performed in four databases: PubMed, Web of Science, Global Index Medicus, and Excerpta Medica Database. Heterogeneity (I2) was assessed using the χ2 test on the Cochran Q statistic and H parameters. A total of 200 prevalence data from 144 articles were included in this meta-analysis. The overall prevalence of HAV in water matrices was 16.7% (95% CI: 13.4-20.3). The prevalence for individual matrix was as follows: 31.4% (95% CI: 23.0-40.4) untreated wastewater, 18.0% (95% CI: 9.5-28.2) treated wastewater, 15.0% (95% CI: 10.1-20.5) surface water, 2.3% (95% CI: 0.1-6.0) in groundwater, 0.3% (95% CI: 0.0-1.7) in drinking water, and 8.5% (95% CI: 3.1-15.6) in other matrices. The prevalence was higher in low-income economies (29.0%). Africa and Eastern Mediterranean were the regions with higher HAV prevalence values. This study showed a high heterogeneity (I2 > 75%) with a significant publication bias (p value Egger test < 0.001). The results of this review suggest that water matrices could be an important route of HAV transmission even in industrialized countries, despite the lower prevalence compared to less industrialized countries, and the availability of advanced water management systems. More effective water/wastewater treatment strategies are needed in developing countries to limit the environmental circulation of HAV.

Prevalence of Hepatitis A Virus and Hepatitis E Virus Infection in the Patients Presenting with Acute Viral Hepatitis in Eastern India: A Cross-sectional Study

Introduction: Enterically transmitted Hepatitis A Virus (HAV) and Hepatitis E Virus (HEV) are the most common cause of Acute Viral Hepatitis (AVH) and a major health concern in developing nations like India. Both viruses cause AVH and are spread predominantly through the faecal-oral pathway, most commonly through contaminated water. Aim: To estimate the prevalence of HAV and HEV infection in patients presenting with AVH. Materials and Methods: An analytical cross-sectional study was undertaken in Indira Gandhi Institute of Medical Sciences, Bihar. The study was conducted over a period of 24 months from November 2019 to October 2021. All patients presenting with AVH were included as study participants. The blood samples were subjected to test anti-HAV and anti-HEV positivity. Prevalence of HAV and HEV was calculated taking total cases of AVH as denominator. Patients with confirmed infection with HCV, HBV and any other cause of hepatitis were excluded from the study. Templates were generated in an Microsoft Excel spreadsheet and analysis of data was done using Statistical Package of the Social Sciences software (SPSS) version 20.0. Quantitative data were presented as frequency and percentages. Results: A total of 682 patients presented with acute hepatitis. The AVH patients comprised 467 males (68.5%) and 215 (31.5%) females with the mean age 39.6±18.87 years. The current study reports the seroprevalence of 9.18% HAV and 8.35% of HEV. A total of 4 patients tested positive for coinfection with HAV and HEV. Most of the HAV patients belonged to an age group less than or equal to 12 years (25,58.1%) and none were more than 60 years. However, none of the HEV patients were children and most of them were aged between 13 to 60 years (46,92%). A male preponderance among HAV (28,65.1%), and HEV (38,76%) was noted. Conclusion: Low seroprevalence was noted, with infection more common in younger age group and male patients. Further studies and vaccination along with surveillance system strengthening are warranted.

Prevalence of enteric viruses in wastewater in Egypt after the COVID-19 pandemic

People's hygienic habits greatly affect the spreading rate of enteric viruses. After the COVID-19 pandemic, many people followed announced precautions and improved their hygienic status to protect themselves from SARS-CoV-2 infection. Here, we studied if this indirectly affected the prevalence of enteric viruses in Egypt. A total of 21 samples (one sample per week) were collected from the Zenin wastewater treatment plant (WWTP) through the period between August 2021 and March 2022. Detection of adenovirus, hepatitis A virus (HAV), and rotavirus showed their presence in 66, 14.3, and 9.5% of the collected samples, respectively. Comparing those percentages to previously published data concerned with the detection of the same viruses from the same WWTP or others revealed a remarkable decrease in the prevalence of the three viruses after the COVID-19 pandemic. This allows the conclusion that safety precautions against SARS-CoV-2 lead indirectly to a reduction of adenovirus, HAV, and rotavirus prevalence rates.

KONYA İLİNDE ÇOCUK YAŞ GRUPLARINDA HEPATİT A SEROPOZİTİVİTESİ

OBJECTIVE: Hepatitis A virus (HAV) infection is common especially in developing countries worldwide. Prevalence of HAV varies according to public hygiene and sanitation conditions. In this study, it was aimed to determine seropositivity of HAV in pediatric patients in Konya province, investigate its distribution according to age groups, gender and seasons and compare findings with those reported in previous studies.MATERIAL AND METHODS: In this study, records of 760 pediatric patients admitted to our hospital with various complaints and tested for anti-HAV immunoglobulin G(IgG)/ immunoglobulin M(IgM) between January 2019-April 2020 were evaluated retrospectively. Anti-HAV IgG/IgM in serum samples were analyzed by chemiluminescent microparticle enzyme immunassay method. Statistical analysis was performed by using chi-square Monte Carlo exact test.RESULTS: Anti-HAV IgG seropositivity was found to be 52.2% while anti-HAV IgM positivity was 0.5% for all patients. Seropositivity rate of anti-HAV IgG/IgM was detected as 5.3%. It was observed that anti-HAV IgG/IgM seropositivity rate significantly decreased in age groups of 9-14 (32.5%) and 15-18 (15%) compared to 3-8 (52.5%) age group (p<0.05). Males had significantly higher seropositivity rates of anti-HAV IgG (64.8%) compared with females (p<0.05). Seropositivity rate of anti-HAV IgG/IgM (42.5%) demonstrated a statistically significant increase in winter (p<0.05).CONCLUSIONS: HAV vaccine has been included into routine vaccination program in our country, in 2012. It was thought that anti-HAV IgG seropositivity might be related to maternal antibodies in patients under two years of age and its higher rate in 3-8 age group compared to other age groups has been the result of routine vaccination. Seropositivity rate of anti-HAV IgG/IgM together significantly increased in winter. This can be explained by insufficiency of sewerage and infrastructure systems with increasing rainfall in this season. Frequency of HAV infection can be reduced by strict follow-up of vaccine administration and attention to hygiene and sanitation conditions.

Hepatitis A and E among immigrants and refugees in Central Brazil.

ABSTRACTOBJECTIVE To estimate the prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) among immigrants and refugees in Goiás, Central Brazil.METHODS Overall, 355 individuals were interviewed, and blood samples were tested for anti-HAV and anti-HEV IgG. Anti-HEV-positive samples were similarly tested for HEV RNA.RESULTS All participants were from Latin American countries, most of whom, young adult males. The overall anti-HAV IgG prevalence was 87.4% (95%CI: 83.5–90.4), of whom 94.9%, 75.6%, and 60% were from Haiti, Venezuela, and other Latin American countries, respectively (p < 0.001). Age above 19 years and more than 36 months residing in Brazil were associated with a higher prevalence of previous HAV and HEV infection, respectively. Of the children eligible for HAV vaccination according to the National Immunization Program, only eight (44%) had been vaccinated. The overall anti-HEV IgG prevalence was 6.5% (95%CI: 4.4–9.5). All anti-HEV IgG-positive individuals were Haitians, including a child born in Brazil. HEV RNA was detected in two of the anti-HEV IgG-positive samples.CONCLUSION The survey detected a high prevalence of anti-HAV and anti-HEV IgG among immigrants and refugees, and active HEV infection among some Haitian participants. Prevention measures are urgently required to interrupt enteric virus transmission in this emergent and vulnerable population.

First report of simultaneous assessment of hepatitis A virus and hepatitis E virus seroprevalence among soldiers in Iran

Hepatitis E virus (HEV) and Hepatitis A virus (HAV) have been considered as common causes of viral hepatitis to military service members since their discovery. Although Iran has been recognized as an endemic country for HAV and HEV there is no study about HAV and HEV simultaneous prevalence among Iranian soldiers. The purpose of this study was to assess anti-HAV and anti-HEV antibodies in Iranian soldiers concurrently. In this cross-sectional study, a total of 400 serum samples were collected by simple random sampling for detection of anti-HAV and anti-HEV IgG by commercial HEV enzyme-linked immunosorbent assay (ELISA) kit. Out of 400 individuals, all participants were male with ages ranging from 18 to 26 years. Totally, 12% and 0.5% of the tested specimens were positive for anti-HAV and anti-HEV respectively. There were no significant differences between the subjects grouped according to age groups. Our finding presented a dramatic decrease in seropositivity against HAV. Therefore, vaccination for HAV should be reevaluated for military services in Iran.

Epidemiologic patterns of hepatitis A infection during the pre–vaccination era: A population-based survey in Tunisia in 2015

In the 1980s, Tunisia was considered a country of high endemicity for hepatitis A virus (HAV). Since 2000, an epidemiologic shift has led to an increased incidence of symptomatic and severe forms of HAV infection. In 2015, we conducted a cross-sectional nationwide household-based hepatitis A virus (HAV) seroprevalence study in the total population regardless of age, sex, or geographic origin using a stratified sampling design to make an overview of the HAV epidemiologic situation in Tunisia before vaccine implementation. A total of 6,322 individuals were enrolled. The HAV prevalence was 78.8%. The anti-HAV IgG seropositivity rate increased from 16% for ages 5-9 years to 45% for ages 10-14 years, 67% for ages 15-19 years, 87% for ages 20-24 years, and >90% for older age groups, which suggested an age at midpoint of population immunity (AMPI) in late adolescence. It was significantly higher in rural areas (P < 10-3) and varied significantly between and within regions (P < 10-4). In this study, although the overall AMPI suggestsintermediate endemicity, the regional AMPI varies from intermediate to very high endemicity profiles attributable to different socioeconomic determinants and conditions of sanitation and hygiene. In addition, it provides insights for the best decisions in terms of vaccination strategies.

HAV infection in Brazilian men who have sex with men: The importance of surveillance to avoid outbreaks.

BackgroundHepatitis A is a fecal-oral infection caused by hepatitis A virus (HAV). Men who have sex with men (MSM) and transgender women (TW) have been reported as target groups for HAV infection. This study aimed to determine the seroprevalence, risk factors, and circulating strains associated with HAV infection among MSM and TW in Central Brazil.MethodsA cross-sectional study was conducted from November 2011 to September 2013. Serum samples were collected from 425 individuals for anti-HAV antibody testing and HAV molecular characterization. Of them, 149 (35.1%) participants were self-identified as transgender women. Statistical analysis was performed to evaluate the risk factors of HAV seropositivity.ResultsThe seroprevalence of HAV exposure was 69.7% (95% Confidence Interval: 65.3–74.0%). Serological evidence of HAV was significantly higher in participants who self-identified as transgender women (83.2%) than MSM (62.3%). Increasing age, non-white race, and lower monthly household income were independently associated with HAV exposure among MSM. Only lower monthly household income was independently associated with HAV exposure among TW. One anti-HAV IgM positive sample, from a transgender woman (0.2%), was detected and classified as subgenotype IA.ConclusionsHigh HAV prevalence was observed, markedly among TW. Considering the risky sexual behaviors this population is exposed to, HAV vaccination and prevention programs targeting this population should be considered to prevent outbreaks and the burden of the disease.

Monitoring of human enteric virus and coliphages throughout water reuse system of wastewater treatment plants to irrigation endpoint of leafy greens

One solution to current water scarcity is the reuse of treated wastewater. Water reuse systems have to be examined as a whole, including the efficacy of water-reclamation treatments and the operation steps from the wastewater inlet into the WWTP to the irrigation endpoint, including the irrigated crop. In this study, the monitoring of human enteric viruses and coliphages were assessed in two water reused systems. The presence of hepatitis A virus (HAV) and human noroviruses genogroups I and II (GI and GII) were analyzed by real-time RT-PCR (RT-qPCR) in water (n = 475) and leafy green samples (n = 95). Total coliphages were analyzed by the double-layer agar plaque technique. The prevalence of HAV in water samples was very low (c.a. 2%), mostly linked to raw sewage, while for leafy green samples, none was positive for HAV. In leafy greens, prevalence of norovirus was low (less than 5–6%). The highest reductions for norovirus were observed in samples taken from the water reservoirs used by the growers near the growing field. The virus die-off during water storage due to solar radiation could be considered as an additional improvement. Reclamation treatments significantly reduced the prevalence and the counts of noroviruses GI and GII and coliphages in reclaimed water. However, the coliphage reductions (c.a. 5 log) do not comply with the specifications included in the new European regulation on reclaimed water (≥6.0 log). Correlations between noroviruses GI and GII and coliphages were found only in positive samples with high concentrations (>4.5 log PFU/100 mL). A high percentage of samples (20–25%) negative for total coliphages showed moderate norovirus counts (1–3 logs), indicating that coliphages are not the most suitable indicator for the possible presence of human enteric viruses.

Hepatitis A related to foods

Hepatitis A is caused by hepatitis A virus (HAV). Hepatitis A virus (HAV) is classified as a picornavirus. Hepatitis A virus infection occurs globally and is causing a public health concern, primarily in developing countries due to its persistent circulation in the environment. The improved sanitary condition and increase in awareness of personal hygiene have led to the marked reduction of HAV prevalence in industrialized countries during childhood and to a shift of the infection towards adulthood. HAV is an environmentally stable, positive single stranded RNA virus that is primarily transmitted by the fecal-oral route, person to person contact or ingestion of contaminated food and drink. One of the main causes leading to HAV infection is epidemiologically linked to the consumption of raw or undercooked shellfish particularly oysters and clams. Due to their filter-feeding style, these shellfishes readily concentrate viruses from the surrounding water containing municipal sewage, and as a consequence pose a health threat to consumers. Therefore, development of detection techniques possessing the requisite sensitivity and specificity for the practical routine monitoring purposes is of great importance necessary for the protection of shellfish-consuming public. Nucleic acid based method such as reverse transcription PCR has emerged as the popular method of choice in view of rapidity, accuracy and sensitivity in contrary of the time-consuming conventional cell culture and hybridization techniques. The low concentration of viral genome present in the environmental sample which requires effective isolation and concentration of virions and the labor-extensive purification, removal of PCR inhibitors will be unfavorable

Prevalence of HAV and HEV in Patients Presenting with Acute Viral Hepatitis in Silchar Medical College & Hospital

Background: Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are both enterically transmitted, resulting in acute viral hepatitis (AVH) in developing countries. Both are self-limiting viral infection, transmitted by feco-oral route. Exposure rate of HAV and HEV over a period are different in different parts of country. Aim: This study was done to determine prevalence of HAV and HEV in patients presenting with AVH and the co-infection of HAV and HEV in these patients. Materials and Methods: A cross sectional study of 2 years duration was conducted in the Department of Microbiology, SMCH, Silchar. A non random sampling of 200 patients presenting with AVH was considered in the study. On the basis of history, serum sample were analyzed for IgM anti HAV and IgM anti HEV for the detection of HAV and HEV, respectively using commercially available ELISA kits. Results: The prevalence of HAV and HEV co-infection in patients with acute viral hepatitis was 32.5% (65 cases). HAV and HEV were most prevalent between 20 to 35years age group. Hepatitis A samples only 60 were positive and Hepatitis E samples only 5 were positive. Conclusion: Almost all HAV and HEV infectious are spread by feco-oral route. The best means of reducing the spread of infection is by promoting simple measures of personal and community hygiene such as hand washing before eating and after defecation, the sanitary disposal of excreta which will prevent contamination of water, food and milk, during epidemics, boiled water should be advocated for drinking purposes.

Characterisation of the environmental presence of hepatitis A virus in low-income and middle-income countries: a systematic review and meta-analysis.

ObjectiveTo characterise the environmental presence of hepatitis A virus (HAV) in low- and middle-income countries (LMICs).DesignSystematic review and meta-analysis.Data sourcesEBSCOhost, PubMed, Scopus, ScienceDirect, Clinical Key and Web of Science were searched. Grey literature was sourced by searching the following electronic databases: Open Grey, National Health Research Database and Mednar.Eligibility criteria for including studiesCross-sectional and ecological studies reporting HAV environmental presence and conducted in LMICs between January 2005 and May 2019, irrespective of language of publication.Data extraction and data synthesisRelevant data were extracted from articles meeting the inclusion criteria, and two reviewers independently assessed the studies for risk of bias. High heterogeneity of the extracted data led to the results being reported narratively.ResultsA total of 2092 records were retrieved, of which 33 met the inclusion criteria. 21 studies were conducted in Tunisia, India and South Africa, and the rest were from Philippines, Pakistan, Morocco, Chad, Mozambique, Kenya and Uganda. In Tunisian raw sewage samples, the prevalence of HAV ranged from 12% to 68%, with an estimated average detection rate of 50% (95% CI 25 to 75), whereas HAV detection in treated sewage in Tunisia ranged from 23% to 65%, with an estimated average detection rate of 38% (95% CI 20 to 57). The prevalence of HAV detection in South African treated sewage and surface water samples ranged from 4% to 37% and from 16% to 76%, with an estimated average detection rates of 15% (95% CI 1 to 29) and 51% (95% CI 21 to 80), respectively. Over the review period, the estimated average detection rate of environmental HAV presence appeared to have declined by 10%.ConclusionThe quality of included studies was fair, but sampling issues and paucity of data limited the strength of the review findings.PROSPERO registration numberCRD42019119592.

Hepatitis A infections from food.

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.

Hepatitis A hospitalizations among kidney transplant recipients in the United States: nationwide inpatient sample 2005–2014

This study aimed to evaluate the hospitalization rate for Hepatitis A virus (HAV) among kidney transplant (KTx) recipients and its outcomes as well as resource utilization. The 2005-2014 National Inpatient Sample database was used to identify all hospitalized KTx recipients with an associated diagnosis of HAV. The hospital mortality, resource utilization, and associated liver conditions were compared between patients with and without HAV, adjusting for potential confounders. Of 871 024 KTx recipients identified, 204 had HAV. The overall inpatient prevalence of HAV in KTx recipients over 10 years in the United States was 23.42 cases per 100 000 admissions. There were no statistically significant changes in the inpatient prevalence of HAV in KTx recipients during the study period (P = 0.77), ranging from 9.2 to 34.3 per 100 000 admissions. Among hospitalized KTx recipients with HAV, 27.9% were from Northeast, 29.2% were from Midwest, 23.8% were from South, and 19.1% were from West. HAV was not significantly associated with increased hospital mortality, multiorgan failure, need for abdominal ultrasound, hospital length of stay, and total hospitalization costs and charges when compared with those without HAV. However, it is significantly associated with increased ICU stay, coexisting hepatitis B and C infection, and liver failure. Overall, inpatient prevalence of HAV in KTx recipients in the United States (years 2005-2014) was 23.42 cases per 100 000 admissions. Hospitalization for HAV after KTx is associated with increased ICU stay, coexisting hepatitis B and C infection, and liver failure.

Nationwide Hospital-Based Seroprevalence of Hepatitis A and Hepatitis E Virus in Bangladesh.

Background:Hepatitis A virus (HAV) and hepatitis E virus (HEV) are transmitted by the fecal-oral route and are responsible for epidemic and sporadic outbreaks of acute hepatitis in low-income countries like Bangladesh.Objective:The purpose of this study was to describe the seroprevalence of acute hepatitis due to HAV and HEV infection in Bangladesh.Methods:The nationwide food-borne illness surveillance started in 2014 at 10 different hospitals which covered seven divisions of Bangladesh. Blood samples were collected from suspected acute hepatitis cases and screened for the anti-HAV IgM and anti-HEV IgM using enzyme-linked immunosorbent assay (ELISA). Participants’ socioeconomic status, clinical, sanitation and food history were recorded. Multivariate logistic regression was performed to determine the risk factors associated with HAV and HEV infection.Findings:A total of 998 patients were enrolled and tested for both HAV and HEV. Among these, 19% (191/998) were identified as HAV positive and 10% (103/998) were HEV positive. The median age was 12 years and 25 years for HAV and HEV positive patients, respectively. The prevalence of HAV was higher among the females (24.9%), whereas HEV was higher among males (11.2%). The highest occurrence of HAV was observed among children while HEV was most prevalent in the 15–60 years age group (12.4%).Conclusion:Through our nationwide surveillance, it is evident that hepatitis A and hepatitis E infection is common in Bangladesh. These data will be useful towards planning preventive and control measures by strengthening the sanitation programs and vaccination strategies in Bangladesh.

Poor response to hepatitis A vaccination in hematopoietic stem cell transplant recipients.

Hepatitis A virus (HAV) infection is highly prevalent in developing countries. In countries experiencing a shift from intermediate/high endemicity to low endemicity, the World Health Organization recommends the incorporation of HAV vaccine into the national vaccination calendar for children aged ≥1year. Since HAV antibodies wane over time, most HSCT revaccination guidelines advise vaccination as optional, following the country recommendation. However, no study has evaluated the serological response to HAV vaccine in allogeneic HSCT recipients. We conducted a prospective study in 46 HSCT recipients who received two doses of inactivated HAV vaccine. Blood samples were taken before vaccination to determine HAV prevalence rates, and before and 4-6weeks after the second dose. Specific anti-HAV antibodies were detected by a competitive commercial enzyme immune assay. Patients received the first dose of vaccine at a median of 332.5 (120-4134) days after HSCT. Median absolute lymphocyte count at vaccination was 1947 (696-12500)/mm3 . The seroprevalence rate was 93.5% at inclusion. Although safe and well tolerated, the serological response to HAV vaccine in susceptible patients was poor (33%), and no boost effect was observed in seropositive patients. In areas with intermediate/high seroprevalence of HAV, serology should be recommended prior to referral to vaccination. The mechanisms of antibody interference and how to overcome T-cell function deficiency need to be better understood in transplant populations receiving HAV vaccine. Alternative schedules of HAV vaccination should be evaluated in prospective trials.

Simultaneous infection of Hepatitis A and Hepatitis E viruses amongst acute viral hepatitis patients: A hospital-based study from Uttarakhand.

Background:Enterically transmitted viral agents like Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are common causes of viral hepatitis in developing countries. Double infections by both agents, as their routes of entry are similar, are common. Overall this is a major health issue for our country. This study was carried out to learn about the seroprevalence of HAV & HEV (and double infections if any) infections in acute viral hepatitis (AVH) cases attending our hospital.Materials and Methods:This is a retrospective cross-sectional study of a 2-years duration carried out in the serology lab of Dept. of Microbiology, AIIMS Rishikesh. Continuously collected samples totaling 617 cases, presenting with Acute Viral Hepatitis was included in the study. Cases with suggestive history were tested for IgM anti-HAV and IgM anti-HEVrespectively. Commercially available ELISA kits were put into use. Standard Statistical Package (SPSS 23) was put to use for statistical analysis.Results:HAV & HEV seroprevalence in AVH cases were found to be 14.7% (91/617) and 28.04% (173/617), respectively. Dual infection of HAV and HEV was found in 5.9% (32/617) of study subjects. The prevalence of HAV and HEV among males were14.2% and 34.26%, respectively while that in female were 15.36% and 21.16%, respectively. Infection was predominantly found in young adults. Distinct seasonal variation was observed, period towards the end of monsoon, and beginning of winter recorded more cases. Both year, most of the positive cases are seen in the months of August and September.Conclusion:The infection rate of HEV is higher than HAV amongst AVH cases. This and relatively high co-infection rate (5.9%) is significant in terms of the need for regular screening of HEV in pregnant women as well as the urgent need to improve hygiene amongst the population. This data will help in future vaccine strategies and sanitation programs in this part of the country.