Virology Laboratory, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France.
Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291-CNRS UMR5051, 31300 Toulouse, France.
Viruses. 2021 Sep 22;13(10):1900. doi: 10.3390/v13101900.
The hepatitis A virus (HAV) is a leading cause of acute viral hepatitis worldwide. It is transmitted mainly by direct contact with patients who have been infected or by ingesting contaminated water or food. The virus is endemic in low-income countries where sanitary and sociodemographic conditions are poor. Paradoxically, improving sanitary conditions in these countries, which reduces the incidence of HAV infections, can lead to more severe disease in susceptible adults. The populations of developed countries are highly susceptible to HAV, and large outbreaks can occur when the virus is spread by globalization and by increased travel and movement of foodstuffs. Most of these outbreaks occur among high-risk groups: travellers, men who have sex with men, people who use substances, and people facing homelessness. Hepatitis A infections can be prevented by vaccination; safe and effective vaccines have been available for decades. Several countries have successfully introduced universal mass vaccination for children, but high-risk groups in high-income countries remain insufficiently protected. The development of HAV antivirals may be important to control HAV outbreaks in developed countries where a universal vaccination programme is not recommended.
甲型肝炎病毒 (HAV) 是全球急性病毒性肝炎的主要病因。它主要通过与已感染者的直接接触或摄入受污染的水或食物传播。该病毒在卫生和社会人口条件较差的低收入国家流行。具有讽刺意味的是，这些国家改善卫生条件会降低 HAV 感染的发生率，但会导致易感成年人的病情更严重。发达国家的人群对 HAV 高度易感，随着全球化以及食品运输和流通的增加，病毒传播会导致大规模暴发。这些暴发大多发生在高风险人群中：旅行者、男男性行为者、使用物质的人以及无家可归者。甲型肝炎感染可以通过疫苗接种预防；几十年来，已经有安全有效的疫苗。一些国家已经成功地为儿童实施了普遍的大规模疫苗接种，但高收入国家的高风险人群仍未得到充分保护。HAV 抗病毒药物的开发对于控制发达国家的 HAV 暴发可能很重要，因为这些国家不建议实施普遍疫苗接种计划。
