The aim of the present study was to investigate the seroprevalence of Hepatitis A virus antibodies in patients with clinical symptoms of viral hepatitis and molecular characterization of the detected isolates. The present study deals with the seroprevalence and the genetic diversity of HAV in 400 Tunisian patients presenting in dispensaries (160 patients) and in University Hospitals (240 patients) with hepatitis symptoms between 2006 and 2008. The patients with acute hepatitis were mainly from rural regions. However, the total number of patients was decreased over time. The collected samples were from patients with hepatitis symptoms occurring mainly during January-March (36.7, 26, and 35.5%) and SeptemberDecember (39.4, 43.4,and 35.5%) during the three years of study, respectively. However, HAV infection was established for only 110 among 400 patients. The detected isolates were clustered within sub-genotype IA. The present study constituted another report of the continued surveillance of HAV infection in the region of Monastir and the molecular characterisation of the detected strains.
In the present study, epidemiological survey and molecular characterization of hepatitis A virus during an outbreak in five Tunisian childcare centers in El-Mahres during October and November 2006 were carried out. Five well-water and five drinking water samples were included in the present study. Serological investigation and molecular characterization were carried out. All patients were IgM seropositive and the viral genome was detected in all clinical and well-water samples whereas it was not detected in drinking water from the five childcare centers. Sequence analysis showed that all Tunisian strains belong to subgenotype IA. The genetic profile of the VP1/2A junction showed that the outbreak isolates underwent an amino acid substitution which was absent in virus's strains detected previously in Tunisia. Further studies need to be conducted to evaluate the emergence of the virus's strains in clinical and water samples and more epidemiological data need to be collected about the risk factors which may contribute to acute hepatitis.
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