Year 2020 / Volume 112 / Number 3
Original
A new pattern in hepatitis A virus infection in an urban population

178-182

DOI: 10.17235/reed.2020.6526/2019

Helena Martínez Lozano, Andrés Conthe Alonso, Rafael Bañares,

Abstract
Introduction: hepatitis A virus (HAV) infection is a common cause of acute hepatitis worldwide. Since the generalization of vaccination, its incidence had markedly declined. Nevertheless, several HAV-outbreaks have been described in the last decade, mainly related to contaminated alimentary products. In recent years, a new pattern of acute HAV infection has been described with changes in the demographic profile of the infected population, which is more common in healthy young men. Patients and methods: a retrospective case series study was performed to evaluate this possible change in the pattern of HAV infection. The case series included all patients with a diagnosis of HAV acute infection in our hospital between January 2005 and May 2017. Results: a total of 196 cases were diagnosed which were comprised of two probable outbreaks: one starting in November 2008 of 26 cases and one starting in 2016 with 69 cases at the time of data collection. The two outbreak populations were comparable. While the sporadic cases group was predominantly formed by pediatric and third-age patients with a slight male tendency, the outbreak related cases showed a clear predominance for young males (proportion of males: 63.2% vs 85.3%, p < 0.001). A possible chronological relationship with the national gay festivity celebrated in Madrid was observed. Outbreak related cases had higher bilirubin, alanine aminotransferase and longer APPT at diagnosis as well as a lower albumin concentration. The clinical relevance was minimal with a similar hospitalization rate and clinical outcome in both groups. There were no related deaths, acute liver failure or need for liver transplantation in our cohort. Conclusion: these epidemiological findings emphasize the importance of implementing preventive measures as well as social awareness campaigns.
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References
Centers for Disease Control and Prevention (CDC). Viral Hepatitis Statistics and Surveillance (2014). [Internet]. [retrieved May 2019]. Available from: http://www.cdc.gov/hepatitis/Statistics/2011Surveillance/index.htm
Zhou F, Shefer A, Weinbaum C, McCauley M, Kong Y. Impact of hepatitis A vaccination on health care utilization in the United States, 1996-2004. Vaccine. 2007;25(18):3581-7.
Klevens RM, Miller JT, Iqbal K, Thomas A, Rizzo EM, Hanson H, et al. The evolving epidemiology of hepatitis a in the United States: incidence and molecular epidemiology from population-based surveillance, 2005-2007. Arch Intern Med. 2010;170(20):1811-8.
Collier MG, Khudyakov YE, Selvage D, Adams-Cameron M, Epson E, Cronquist A, et al. Outbreak of hepatitis A in the USA associated with frozen pomegranate arils imported from Turkey: an epidemiological case study. Lancet Infect Dis. 2014;14(10):976-81.
Centers for Disease Control and Prevention (CDC). Multistate outbreak of hepatitis A linked to frozen strawberries 2017. [Internet]. [retrieved May 2019]. Available from: https://www.cdc.gov/hepatitis/outbreaks/2016/hav-strawberries.htm
Centers for Disease Control and Prevention (CDC). Outbreak of hepatitis A in Hawaii linked to raw scallops 2016. [Internet]. [retrieved May 2019]. Available from: https://www.cdc.gov/hepatitis/outbreaks/2016/hav-hawaii.htm
Desenclos JC, Klontz KC, Wilder MH, Nainan OV, Margolis HS, Gunn RA. A multistate outbreak of hepatitis A caused by the consumption of raw oysters. Am J Public Health. 1991;81(10):1268-72.
Hutin YJ, Pool V, Cramer EH, Nainan OV, Weth J, Williams IT, et al. A multistate, foodborne outbreak of hepatitis A. National Hepatitis A Investigation Team. N Engl J Med. 1999;340(8):595-602.
Beebeejaun K, Degala S, Balogun K, Simms I, Woodhall SC, Heinsbroek E, et al. Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017. Euro Surveill. 2017;22(5).
Freidl GS, Sonder GJ, Bovee LP, Friesema IH, van Rijckevorsel GG, Ruijs WL, et al. Hepatitis A outbreak among men who have sex with men (MSM) predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017. Euro Surveill. 2017;22(8).
Werber D, Michaelis K, Hausner M, Sissolak D, Wenzel J, Bitzegeio J, et al. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 - linked to other German cities and European countries. Euro Surveill. 2017;22(5).
Charre C, Ramiere C, Roque-Afonso AM, Chidiac C, Zoulim F, Godinot M, et al. Hepatitis A outbreak in HIV-infected MSM and in PrEP-using MSM despite a high level of immunity, Lyon, France, January to June 2017. Euro Surveill. 2017;22(48).
Rodriguez-Tajes S, Perpinan E, Caballol B, Lens S, Marino Z, Costa J, et al. Hepatitis A outbreak in Barcelona among men who have sex with men (MSM), January-June 2017: A hospital perspective. Liver Int. 2018;38(4):588-93.
Ndumbi P, Freidl GS, Williams CJ, Mardh O, Varela C, Avellon A, et al. Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017. Euro Surveill. 2018;23(33).
Fraile M, Barreiro Alonso E, de la Vega J, Rodriguez M, Garcia-Lopez R, Rodriguez M. Acute hepatitis due to hepatitis A virus during the 2017 epidemic expansion in Asturias. Spain. Med Clin (Barc). 2019;152(10):391-4.
Garcia Ferreira AJ, Ortega Alonso A, Cobos Rodriguez J, Bardon de Tena P, Calderon Cid M, Garcia Garcia AM, et al. Outbreak of acute hepatitis A in the health area served by the Hospital Universitario Virgen de la Victoria (HUVV): a change in epidemiology. Rev Esp Enferm Dig. 2018;110(6):380-5.
Comelli A, Izzo I, Casari S, Spinetti A, Bergamasco A, Castelli F. Hepatitis A outbreak in men who have sex with men (MSM) in Brescia (Northern Italy), July 2016-July 2017. Infez Med. 2018;26(1):46-51.
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Martínez Lozano H, Conthe Alonso A, Bañares R. A new pattern in hepatitis A virus infection in an urban population. 6526/2019


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Publication history

Received: 24/07/2019

Accepted: 17/10/2019

Online First: 21/02/2020

Published: 05/03/2020

Article revision time: 83 days

Article Online First time: 212 days

Article editing time: 225 days


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