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2018 - 2022年佛罗里达州甲型肝炎疫情复发的基因组流行病学研究

Genomic epidemiology of resurgent hepatitis A in Florida, 2018-2022.

作者信息

Doyle Timothy J, Buck Brian H, Locksmith Timothy J, McGruder-Rawson Brenna M, Khudyakov Yury, Blackmore Carina

机构信息

Florida Department of Health, Division of Disease Control and Health Protection, Tallahassee, Florida, USA.

Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

出版信息

J Infect Dis. 2025 Mar 11. doi: 10.1093/infdis/jiaf127.

Abstract

During 2018-2022, a resurgence of hepatitis A occurred in Florida, with 5,491 cases reported. Genotyping was performed on a convenience sample of cases through amplification and sequencing of the HAV VP1-P2B junction region. Virus isolates from 1,190 (22%) cases were genotyped; 69% were subgenotype IB, 30% were subgenotype IA, and 1% were subgenotype IIIA. Subgenotype IB was more common among cases reporting recent drug use or homelessness, whereas IA was more common among those reporting recent international travel and among men who have sex with men. Genotype IB infection was associated with a more than 4-fold greater odds of death compared to IA infection. A network analysis revealed 11 genomic clusters of 10 or more cases, with distinct temporal and spatial distributions. Case reports in 2023 decreased to below pre-2018 numbers, likely due to high population immunity following natural infection and extensive vaccination activities in the highest risk groups.

摘要

2018年至2022年期间,佛罗里达州甲型肝炎疫情出现反弹,共报告了5491例病例。通过对甲型肝炎病毒(HAV)VP1-P2B连接区进行扩增和测序,对部分方便样本病例进行了基因分型。对1190例(22%)病例的病毒分离株进行了基因分型;其中69%为IB亚型,30%为IA亚型,1%为IIIA亚型。IB亚型在报告近期有吸毒史或无家可归的病例中更为常见,而IA亚型在报告近期有国际旅行史的人群以及男男性行为者中更为常见。与IA亚型感染相比,IB亚型感染导致死亡的几率高出4倍多。一项网络分析揭示了11个基因组集群,每个集群有10例或更多病例,且具有不同的时间和空间分布。2023年的病例报告数降至2018年之前的水平以下,这可能是由于自然感染后人群免疫力较高以及在高风险群体中广泛开展了疫苗接种活动。

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