Kristinsdóttir Hallfridur, Löve Arthur, Bjornsson Einar Stefan
Faculty of Medicine, University of Iceland.
Faculty of Medicine, University of Iceland. Department of Virology, Landspitali, The National University Hospital of Iceland.
Laeknabladid. 2018;104(3):127-131. doi: 10.17992/lbl.2018.03.176.
Hepatitis A virus (HAV) epidemics occurred repeatedly in Iceland in the early 20th century, but since then few cases have been reported and no epidemics since 1952. The latest Icelandic studies on HAV from around 1990 showed low incidence of infection and de-- creasing prevalence of antibodies. The objective of this study was to determine the incidence, clinical presentation and origin of HAV, abroad or in Iceland.
A retrospective search was undertaken on all patients with positive anti-HAV IgM during the 11 years period of 2006-2016 in the virological database of the National University Hospital of Iceland. Clinical data was collected from medical records on symptoms at diagnosis, blood test results and possible route of transmission.
A total of 12 individuals were diagnosed with acute hepatitis A during the period and 6691 HAV total andibody tests and 1984 HAV IgM antibody tests were performed. Nine (75%) had been abroad within 7 weeks from initial symptoms. The most common symptoms were jaundice (83%), fever (67%) and nausea and/or vomiting (58%). 50% were admitted to a hospital. 42% had elevated INR/PT. Everyone sur-vived without complications.
Annually, approximately one case of acute hepatitis A was diagnosed in Iceland during the study period but a very high number of antibody tests were performed. The majority of cases occurred among individuals who had recently been abroad. If patients have jaundice, fever and nausea, testing for HAV infection should be undertaken. HAV is not endemic in Iceland.
20世纪初，冰岛反复出现甲型肝炎病毒（HAV）疫情，但自那时以来，报告的病例很少，自1952年以来未再发生疫情。冰岛大约在1990年进行的关于HAV的最新研究显示，感染率较低且抗体流行率呈下降趋势。本研究的目的是确定HAV在国外或冰岛的发病率、临床表现及来源。
对冰岛国立大学医院病毒学数据库中2006年至2016年11年间抗-HAV IgM呈阳性的所有患者进行回顾性检索。从病历中收集临床数据，包括诊断时的症状、血液检测结果以及可能的传播途径。
在此期间，共有12人被诊断为急性甲型肝炎，共进行了6691次HAV总抗体检测和1984次HAV IgM抗体检测。9人（75%）在出现初始症状后的7周内曾出国。最常见的症状是黄疸（83%）、发热（67%）以及恶心和/或呕吐（58%）。50%的患者住院治疗。42%的患者国际标准化比值/凝血酶原时间（INR/PT）升高。所有患者均康复，无并发症。
在研究期间，冰岛每年约诊断出1例急性甲型肝炎，但进行的抗体检测数量非常多。大多数病例发生在近期出过国的人当中。如果患者出现黄疸、发热和恶心症状，应进行HAV感染检测。冰岛并非HAV的地方性流行区。
