Reuter Gábor, Pankovics Péter, Stefler Dénes, Löveyné Dr Móricz, Varga Edit, Kiss Gabriella, Szucs Mária, Fekete Zsuzsanna, Szucs György
Allami Népegészségügyi és Tisztiorvosi Szolgálat Baranya Megyei Intézete Regionális Virológiai Laboratórium Pécs.
Orv Hetil. 2007 Jun 3;148(22):1023-31. doi: 10.1556/OH.2007.28096.
Hepatitis A virus (HAV) is one of the most important cause of fecally transmitted acute infectious hepatitis worldwide. In Hungary, beside the sporadic HAV infections, outbreaks also occur, particularly in Northeast part of the country where the subgenotype IA is endemic. The reported number of HAV cases was less than 10 per year in Southwest Hungary.
A part of the European HAV surveillance, the author's aims were to follow and to analyze the outbreak of hepatitis A in Transdanubia (Southwest Hungary) in 2006 by molecular epidemiological methods.
Sera samples from symptomatic patients were tested prospectively by enzyme-immunoassay (EIA) and reverse transcription-polymerase chain reaction (RT-PCR) followed by sequence- and phylogenetic analysis.
Between June and December 2006, a total of 115 serum samples were positive for HAV IgM antibody in Southwest Hungary. Thirty (76.9%) of the 39 samples were RT-PCR-positive and contain genetically identical subgenotype IB hepatitis A virus (HAV/Transdanubia/2006/HUN) which has 100% nucleotide identity to strain IT-MAR-02 from Italy in 2002. Until now, approximately 1200-1300 persons have been infected with the probably imported strain. The average age of patients was 18 years (years 1 to 80). In this study, detailed clinical and epidemiological data of the outbreak are presented.
Only a prospective molecular epidemiological study could verify the connection between the first sporadic HAV cases in June, the outbreak in August and the endemic spread of the virus since September in Southwest Hungary. This epidemic calls attention to how a hepatitis A outbreak can develop anywhere and at any time in Hungary and to the importance of active HAV immunization in the primary prevention.
甲型肝炎病毒（HAV）是全球粪口传播急性感染性肝炎最重要的病因之一。在匈牙利，除了散发性甲型肝炎病毒感染外，还会发生疫情，特别是在该国东北部，IA亚基因型为地方流行。匈牙利西南部报告的甲型肝炎病毒病例数每年少于10例。
作为欧洲甲型肝炎病毒监测的一部分，作者旨在通过分子流行病学方法追踪并分析2006年匈牙利西南部多瑙河地区（Transdanubia）的甲型肝炎疫情。
对有症状患者的血清样本进行前瞻性酶免疫测定（EIA）和逆转录聚合酶链反应（RT-PCR）检测，随后进行序列和系统发育分析。
2006年6月至12月期间，匈牙利西南部共有115份血清样本的甲型肝炎病毒IgM抗体呈阳性。39份样本中有30份（76.9%）RT-PCR呈阳性，且含有基因相同的IB亚基因型甲型肝炎病毒（HAV/Transdanubia/2006/HUN），该病毒与2002年来自意大利的IT-MAR-02毒株具有100%的核苷酸同一性。到目前为止，大约有1200 - 1300人感染了这种可能是输入性的毒株。患者的平均年龄为18岁（1至80岁）。本研究展示了此次疫情详细的临床和流行病学数据。
只有前瞻性分子流行病学研究才能证实匈牙利西南部6月首例散发性甲型肝炎病毒病例、8月疫情以及9月以来该病毒的地方性传播之间的联系。此次疫情提醒人们注意匈牙利任何地方随时都可能发生甲型肝炎疫情，以及主动进行甲型肝炎病毒免疫接种在一级预防中的重要性。
