van Steenbergen Jim E, Tjon Grace, van den Hoek Anneke, Koek Alex, Coutinho Roel A, Bruisten Sylvia M
Division of Public Health, Gemeentelijke Geneeskundige en Gezondheidsdienst Amsterdam, The Netherlands.
J Infect Dis. 2004 Feb 1;189(3):471-82. doi: 10.1086/381152. Epub 2004 Jan 23.
We performed a viral sequencing study on samples representing all reported primary cases of acute hepatitis A virus (HAV) infection reported for 2 years in Amsterdam. Two regions of HAV RNA were amplified, sequenced, and used for phylogenetic analysis. Of 156 cases, strains of 104 isolates (66.6%) clustered into 3 genotypes: 1A, 1B, and 3. Two separate transmission circles occurred, without mutual interrelation. In genotype 1A, 4 clusters occurred in men having sex with men (MSM), and the fifth cluster was related to a virus from Morocco. In genotype 1B, 6 small clusters were directly related to the Moroccan virus. In genotype 3, strains were related to a virus from Pakistan. Our analysis indicates that, to stop transmission of HAV in Amsterdam, the entire MSM population and travelers to countries where HAV is endemic, especially children, should be vaccinated. Prevention strategies need not include the vaccination of all children living in Amsterdam.
我们对代表阿姆斯特丹2年内报告的所有急性甲型肝炎病毒（HAV）感染原发性病例的样本进行了病毒测序研究。对HAV RNA的两个区域进行了扩增、测序，并用于系统发育分析。在156例病例中，104株分离株（66.6%）的毒株聚为3个基因型：1A、1B和3。出现了两个独立的传播圈，彼此没有相互关联。在基因型1A中，4个簇出现在男男性行为者（MSM）中，第五个簇与来自摩洛哥的一种病毒有关。在基因型1B中，6个小簇与摩洛哥病毒直接相关。在基因型3中，毒株与来自巴基斯坦的一种病毒有关。我们的分析表明，为了在阿姆斯特丹阻止HAV传播，应给整个男男性行为人群以及前往甲型肝炎流行国家的旅行者（尤其是儿童）接种疫苗。预防策略无需包括给所有居住在阿姆斯特丹的儿童接种疫苗。
