Istituto Superiore di Sanità, Department of Infectious, Parasitic and Immune-Mediated Disease, Rome, Italy.
J Clin Virol. 2011 Feb;50(2):142-7. doi: 10.1016/j.jcv.2010.10.011. Epub 2010 Nov 20.
Acute Hepatitis A Virus (HAV) is reported to be an emergent problem in several developed countries.
The aim of this study was to analyse the HAV strains circulating among individuals with acute HAV infection, apparently transmitted by different routes, in several districts of Tuscany in central Italy, during the year 2008.
An outbreak of acute HAV infection occurred from May to August 2008 in Arezzo; 32 individuals were admitted to the hospital, in 25 of them at least a linkage with an infected food handler and/or household contacts was reported and in 3 homosexuality was a possible risk factor. In Florence, from January 2008 to August 2008, 41 individuals mainly homosexual men were admitted to two hospitals with the diagnosis of acute HAV. The phylogenetic analysis of VP1/2A region of HAV was used to characterize these HAV isolates. All viral sequences were assigned to genotype IA. All clustered in the same branch (bootstrap 82%) of phylogenetic tree, thus indicating the same circulating isolate. Apart of one isolate from France and one from Germany which were similar with the "Tuscany" strain reported here, high heterogeneity with the other European HAV strains reported in the GenBank in the last years, was observed.
The detection of a unique HAV isolate circulating in different Tuscany districts, suggests sequential transmission of HAV infection in this geographical area through possible links among acute hepatitis cases. The application of safe food handling practices and vaccination of homosexual men may contribute to the prevention of HAV infection.
甲型肝炎病毒（HAV）在一些发达国家被报道为一个新出现的问题。
本研究的目的是分析 2008 年在意大利中部托斯卡纳的几个地区中，通过不同途径传播的急性 HAV 感染个体中循环的 HAV 株。
2008 年 5 月至 8 月，阿雷佐爆发了急性 HAV 感染，32 人住院，其中至少有 25 人与受感染的食品处理者和/或家庭接触者有关联，3 人同性恋可能是危险因素。在佛罗伦萨，从 2008 年 1 月至 8 月，41 名主要是同性恋男性的人因急性 HAV 被两家医院收治。使用 HAV 的 VP1/2A 区的系统进化分析来描述这些 HAV 分离株。所有病毒序列均被分配到基因型 IA。所有序列均聚集在系统进化树的同一分支（82%的自举值），这表明存在相同的循环分离株。除了一个来自法国和一个来自德国的分离株与这里报道的“托斯卡纳”株相似外，与近年来在 GenBank 中报道的其他欧洲 HAV 株存在高度异质性。
在不同的托斯卡纳地区检测到相同的 HAV 分离株，提示 HAV 感染在该地理区域通过急性肝炎病例之间的可能联系进行连续传播。实施安全的食品处理实践和为同性恋男性接种疫苗可能有助于预防 HAV 感染。
