Reuter Gábor, Juhász Agnes, Kosztolányi Lászlóné, Lefler Eva
Allami Népegészségügyi es Tisztiorvosi Szolgálat Baranya Megyei Intézete, Regionáblis Virológiai Laboratórium, Pécs.
Orv Hetil. 2005 Oct 30;146(44):2257-62.
Hepatitis A virus (HAV) is the most important cause of acute infectious hepatitis worldwide. In Hungary, the reported number of HAV infections decreasing in the last decades, however, in every year approximately 500-800 new cases occur. In Hungary, particularly in North East region not only sporadic cases but also outbreaks of HAV are happen from time to time. Serology is routinely used laboratory method for diagnosis of HAV infections, although, there was no direct molecular detection and sequence analysis for the circulating HAV strains in Hungary.
Author's aims were to detection and genetic characterization of hepatitis A virus in outbreaks of hepatitis by molecular methods for reason of molecular epidemiology in Hungary.
Sera samples from symptomatic patients were tested from two acute hepatitis outbreaks in two settlements (Hajdúböszörmény and Kázsmárk) in North East Hungary in 2004 by enzim-immunoassay (EIA) and reverse transcription-polymerase chain reaction (RT-PCR).
Sera in 58 (100%) and 4 (28.6%) symptomatic patients were positive in outbreaks of Hajdúböszörmény and Kázsmárk by HAV IgM EIA, however, 4 (57.1%) and 2 (66.6%) HAV IgM positive samples were positive by RT-PCR. By sequence analysis, outbreaks caused by the same hepatitis A virus which belongs to genotype I, subtype IA. These viruses had 98.4% nucleotide identity to IT-SCH-00 virus detected in year 2000 in Italy the closest match in GenBank.
Methods of molecular biology give new opportunity for surveillance of infectious diseases in public health. Firstly characterized hepatitis A viruses in Hungary show that the subtype IA have an important epidemiological role in outbreaks. It is also suggested that genotype IA HAV play a part in sporadic HAV cases in endemic region in Hungary, too.
甲型肝炎病毒(HAV)是全球急性传染性肝炎的最重要病因。在匈牙利,过去几十年中报告的HAV感染病例数呈下降趋势,然而,每年仍有大约500 - 800例新病例出现。在匈牙利,特别是在东北部地区,不仅时有散发病例,还不时发生HAV疫情。血清学是诊断HAV感染的常规实验室方法,不过,匈牙利尚未对流行的HAV毒株进行直接分子检测和序列分析。
作者旨在通过分子方法对匈牙利肝炎疫情中的甲型肝炎病毒进行检测和基因特征分析,以开展分子流行病学研究。
2004年,对匈牙利东北部两个定居点(豪伊杜比豪尔毛兹和卡兹马尔克)的两起急性肝炎疫情中的有症状患者的血清样本进行了酶免疫测定(EIA)和逆转录聚合酶链反应(RT-PCR)检测。
在豪伊杜比豪尔毛兹和卡兹马尔克疫情中,58例(100%)和4例(28.6%)有症状患者的血清通过HAV IgM EIA检测呈阳性,然而,4例(57.1%)和2例(66.6%)HAV IgM阳性样本通过RT-PCR检测呈阳性。通过序列分析,疫情由同一株甲型肝炎病毒引起,该病毒属于I基因型,IA亚型。这些病毒与2000年在意大利检测到的IT - SCH - 00病毒具有98.4%的核苷酸同一性,是GenBank中最接近的匹配序列。
分子生物学方法为公共卫生领域的传染病监测提供了新机遇。匈牙利首次鉴定的甲型肝炎病毒表明,IA亚型在疫情中具有重要的流行病学作用。也有人认为,IA基因型HAV在匈牙利流行地区的散发性HAV病例中也起作用。