Pina Sonia, Buti Maria, Jardí Rosend, Clemente-Casares Pilar, Jofre Joan, Girones Rosina
Department of Microbiology, University of Barcelona, Avd. Diagonal 645, 08028 Barcelona, Spain1.
Liver Unit2 and Department of Biochemistry3, Hospital General Universitario Valle Hebron, 08035 Barcelona, Spain.
J Gen Virol. 2001 Dec;82(Pt 12):2955-2963. doi: 10.1099/0022-1317-82-12-2955.
The molecular epidemiology of hepatitis A virus (HAV) was studied by analysing HAV strains recovered from environmental water samples over a 7 year period and strains recovered from patients with acute hepatitis over a 5 year period. A total of 54 samples of raw domestic sewage and 66 samples of river water were collected. HAV particles were concentrated and detected by nested RT-PCR. HAV infection in patients with acute hepatitis was serologically diagnosed in 26 of 74 serum samples, which were also analysed by nested RT-PCR. HAV RNA was detected in 57.4% of sewage samples, 39.2% of Llobregat river water samples, 20% of Ter river water samples and 61.6% of serum samples. The HAV genomes detected were characterized further by directly sequencing a region of the 5' non-translated region, the VP1/2A junction region and, in some samples, the 2B region. Results showed a 95% prevalence of genotype I, with nearly 50% being either subgenotype IA or subgenotype IB. Various strains were found simultaneously in both environmental and clinical samples. These strains were closely related to those described in distant geographical areas. Genotype IIIA was also found in 5% of sewage samples and in 12.5% of serum samples. Strains belonging to a common endemic genotype were not identified. The abundance of HAV in the environment produces a situation of sanitary risk, especially considering the low prevalence of antibodies in the young population.
通过分析7年期间从环境水样中分离出的甲型肝炎病毒（HAV）毒株以及5年期间从急性肝炎患者中分离出的毒株，对HAV的分子流行病学进行了研究。共收集了54份生活污水原水样和66份河水样。通过巢式逆转录聚合酶链反应（nested RT-PCR）对HAV颗粒进行浓缩和检测。74份血清样本中的26份通过血清学诊断为急性肝炎患者感染HAV，这些样本也通过巢式RT-PCR进行了分析。在57.4%的污水样本、39.2%的略夫雷加特河水样本、20%的特尔河水样本和61.6%的血清样本中检测到HAV RNA。通过对5'非翻译区、VP1/2A连接区的一个区域以及部分样本中的2B区域进行直接测序，进一步对检测到的HAV基因组进行了特征分析。结果显示，I型基因型的流行率为95%，其中近50%为IA亚型或IB亚型。在环境样本和临床样本中同时发现了多种毒株。这些毒株与遥远地理区域描述的毒株密切相关。在5%的污水样本和12.5%的血清样本中也发现了IIIA型基因型。未鉴定出属于共同地方流行基因型的毒株。环境中HAV的大量存在产生了卫生风险状况，尤其是考虑到年轻人群中抗体的低流行率。
