Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC.
MMWR Morb Mortal Wkly Rep. 2019 May 10;68(18):413-415. doi: 10.15585/mmwr.mm6818a2.
Hepatitis A virus (HAV) is primarily transmitted fecal-orally after close contact with an infected person (1); it is the most common cause of viral hepatitis worldwide, typically causing acute and self-limited symptoms, although rarely liver failure and death can occur (1). Rates of hepatitis A had declined by approximately 95% during 1996-2011; however, during 2016-2018, CDC received approximately 15,000 reports of HAV infections from U.S. states and territories, indicating a recent increase in transmission (2,3). Since 2017, the vast majority of these reports were related to multiple outbreaks of infections among persons reporting drug use or homelessness (4). In addition, increases of HAV infections have also occurred among men who have sex with men (MSM) and, to a much lesser degree, in association with consumption of imported HAV-contaminated food (5,6). Overall, reports of hepatitis A cases increased 294% during 2016-2018 compared with 2013-2015. During 2016-2018, CDC tested 4,282 specimens, of which 3,877 (91%) had detectable HAV RNA; 565 (15%), 3,255 (84%), and 57 (<1%) of these specimens were genotype IA, IB, or IIIA, respectively. Adherence to the Advisory Committee on Immunization Practices (ACIP) recommendations to vaccinate populations at risk can help control the current increases and prevent future outbreaks of hepatitis A in the United States (7).
甲型肝炎病毒（HAV）主要通过与感染者密切接触后经粪-口途径传播（1）；它是全世界最常见的病毒性肝炎病因，通常引起急性和自限性症状，尽管极少数情况下可能发生肝衰竭和死亡（1）。1996-2011 年间，甲型肝炎发病率下降了约 95%；然而，在 2016-2018 年期间，美国疾病控制与预防中心（CDC）收到了来自美国各州和领地的约 15,000 例甲型肝炎感染报告，表明近期传播有所增加（2,3）。自 2017 年以来，这些报告中的绝大多数与报告药物使用或无家可归的人群中发生的多起感染暴发有关（4）。此外，甲型肝炎感染也在男男性行为者（MSM）中增加，且在较小程度上与食用受污染的进口甲型肝炎食物有关（5,6）。总体而言，与 2013-2015 年相比，2016-2018 年甲型肝炎病例报告增加了 294%。在 2016-2018 年期间，CDC 测试了 4,282 个标本，其中 3,877 个（91%）可检测到甲型肝炎病毒 RNA；565 个（15%）、3,255 个（84%）和 57 个（<1%）标本分别为基因型 IA、IB 和 IIIA。遵守免疫实践咨询委员会（ACIP）关于为高危人群接种疫苗的建议，有助于控制当前的增长并预防美国未来的甲型肝炎暴发（7）。
