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阿根廷中部男男性行为者(MSM)中发生的甲型肝炎疫情,发生在 2017 年 7 月至 2018 年 4 月,晚于欧洲疫情。

Hepatitis A outbreak affecting men who have sex with men (MSM) in central Argentina, occurred in July 2017-April 2018, later than the European outbreak.

机构信息

Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, Argentina.

Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, Argentina.

出版信息

J Clin Virol. 2019 Aug;117:49-53. doi: 10.1016/j.jcv.2019.05.014. Epub 2019 May 31.

DOI:10.1016/j.jcv.2019.05.014
PMID:31202104
Abstract

BACKGROUND

During June-2016-May-2017, several outbreaks of HA were recorded in Europe, especially described in MSM. In our area since July-2017, an increase of hepatitis A (HA) notification was reported.

OBJECTIVE

In order to understand the unusual increase of cases occurred in the central region of Argentina, the aim of this study was to describe, characterize and contextualize epidemiologically the HA outbreak occurred this area, until April2018.

STUDY DESIGN

HA cases (positive anti-HAV IgM) obtained from the calendar week 29/2017 in which the first case of MSM was recognized were included in our study. HAV RNA detection and molecular characterization was performed from serum samples and/or stool by RT - PCR of VP1/2A genomic region (360bp).

RESULTS

Of the 32 cases notified, 87.5% of them were unvaccinated men and 69.6% were MSM (mean age 31.9 years). All MSM associated HAV sequences were genotyped as IA, and clustered with the VRD 521-2016 strain, responsible of causing outbreaks mostly in MSM in Europe since mid-2016.

CONCLUSION

As a consequence of the implementation of immunization in children, and the improvement in socio-economic, hygienic and sanitation factors, young adults are becoming increasingly susceptible to HAV infections. Here we add evidence in South America to the HA outbreaks described worldwide among young MSM, demonstrating the need to reinforce official policy of vaccination, in this group and adjust epidemiological surveillance, catch-up vaccination for adolescents, young adults and immunosuppressed patients.

摘要

背景

在 2016 年 6 月至 2017 年 5 月期间,欧洲记录了几起甲型肝炎(HA)爆发事件,尤其是在男男性行为者(MSM)中。自 2017 年 7 月以来,我们所在地区报告了甲型肝炎(HA)的通知数量增加。

目的

为了解阿根廷中部地区异常增加的病例情况,本研究旨在描述、描述和从流行病学上分析该地区发生的甲型肝炎(HA)爆发情况,直至 2018 年 4 月。

研究设计

我们的研究纳入了 2017 年第 29 周首次发现 MSM 病例的日历周内报告的甲型肝炎(HA)病例(抗-HAV IgM 阳性)。通过 RT-PCR 检测血清样本和/或粪便中的 HAV RNA,并对 VP1/2A 基因组区域(360bp)进行分子特征分析。

结果

报告的 32 例病例中,87.5%为未接种疫苗的男性,69.6%为 MSM(平均年龄 31.9 岁)。所有与 MSM 相关的 HAV 序列均为 IA 基因型,与 VRD 521-2016 株聚类,该毒株自 2016 年年中以来在欧洲主要导致 MSM 中爆发。

结论

由于儿童免疫接种的实施以及社会经济、卫生和环境卫生因素的改善,年轻人越来越容易感染 HAV。在此,我们在南美洲增加了与全球范围内描述的年轻 MSM 之间的 HA 爆发相关的证据,表明需要加强针对该人群的疫苗接种政策,并调整青少年、年轻成年人和免疫抑制患者的流行病学监测、补种疫苗。

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