Association between severity of type A hepatitis and nucleotide variations in the 5` non-translated region of hepatitis A virus RNA: strains from fulminant hepatitis have fewer nucleotide substitutions

Fujiwara, Keiichi; Yokosuka, Osamu; Ehata, Toshiki; Saisho, Hiromitsu; Saotome, N; Suzuki, Kazuyuki; Okita, Kiwamu; Kiyosawa, Kendo; Omata, Masao

doi:10.1136/gut.51.1.82

Cited by 84 publications

(98 citation statements)

References 29 publications

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“…On the other hand, increased disease severity may be associated with viral factors, such as genotype and nucleotide changes in, for example the 5 0 -nontranslated-region of the virus [Fujiwara et al, 2002]. No indication was found in this study that genotype influenced duration of jaundice or HAV excretion, nor did other studies looking for an association between HAV genotype and disease severity [Fujiwara et al, 2003;Rezende et al, 2003;Normann et al, 2004].…”

Section: Discussioncontrasting

confidence: 64%

High and persistent excretion of hepatitis A virus in immunocompetent patients

et al. 2006

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The duration and level of virus excretion in blood and faeces of patients with hepatitis A virus (HAV) infection were studied in relation to levels of alanine aminotransferase (ALT), disease severity and HAV genotype. Clinical data, blood and faeces were collected from 27 patients with acute hepatitis A (median age: 33 years) for a maximum of 26 weeks. Single blood donations from 55 other patients with acute HAV (median age: 32 years) were also used. Virus loads were quantified by competitive nested RT-PCR. HAV was excreted in faeces for a median period of 81 days after disease onset, with 50% of patients still excreting high levels at Day 36 (2 Â 10 6 -2 Â 10 8 copies/ml faeces suspension). Viraemia was detected, but not quantifiable, for a median period of 42 days. In the first 10 days of illness, higher ALT levels were correlated with higher viraemia levels. Comparison of patients infected with genotype 1a with those infected with type 1b did not differ significantly in terms of the duration of HAV excretion or jaundice. In conclusion, faecal excretion of HAV is at a high titre in the first month, perhaps making patients infectious for a longer period than assumed currently. Blood banks should be aware that viraemia may be present for more than 1 month, and genotype did not affect the duration of virus excretion or jaundice.

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Section: Discussioncontrasting

confidence: 64%

High and persistent excretion of hepatitis A virus in immunocompetent patients

et al. 2006

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“…The deletion found in the present study had never been identified in HAV isolates and therefore we could not predict an alteration in secondary structure or HAV translation. Fujiwara et al (12) reported a possible association between the severity of type A hepatitis and nucleotide substitutions in the middle part of 5'NTR. However, in our study the presence or absence of symptoms was not associated with the mutations in this part of genome.…”

Section: Vp1 2amentioning

confidence: 99%

“…Recently, it was demonstrated that the central part of the 5' non-translated region (5'NTR) of HAV might be correlated with the severity of HAV infection (11,12). In order to study the variability of the nucleotide sequence in both regions of the HAV genome and to identify the genotypes circulating in the Northeast region of Brazil, direct nucleotide sequencing and phylogenetic analysis were performed on HAV strains obtained from patients reported to the Public …”

Section: Introductionmentioning

confidence: 99%

Co-circulation of genotypes IA and IB of hepatitis A virus in Northeast Brazil

Villar

Morais

Aloise

et al. 2006

Braz J Med Biol Res

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The Northeast region is the location of most cases of acute hepatitis A virus (HAV) in Brazil. In the present study, the genotypes of HAV strains from Pernambuco State, one of most populous states in the Northeast region, were characterized. Blood samples positive for anti-HAV IgM from 145 individuals (mean age = 29.1 years), collected during 2002 and 2003, were submitted to nested RT-PCR for amplification of the 5'non-translated region (5'NTR) and VP1/2A regions of the HAV genome. The VP1/2A and 5'NTR regions were amplified in 39 and 21% of the samples, respectively. Nucleotide sequencing was carried out in 46% of VP1/2A and in 53% of 5'NTR isolates. The identity in nucleotide sequence of the VP1/2A region ranged from 93.6 to 100.0%. Phylogenetic analysis of the VP1/2A sequences showed that 65% belong to sub-genotype IA and 35% to sub-genotype IB. Co-circulation of both sub-genotypes was observed in the two years studied. Distinct clusters of highly related sequences were observed in both sub-genotypes, suggesting endemic circulation of HAV strains in this area. In the 5'NTR isolates, 92.7-99.2% identity was observed and two isolates presented one deletion at position 413. Phylogenetic analysis showed that genotype IA strains cluster in the tree in the same way as genotype IB strains, but one IIIA isolate from Spain clusters with genotype IB strains. These results do not allow us to state that 5'NTR could be used to genotype HAV sequences. This is the first report of co-circulation of sub-genotypes IA and IB in this region, providing additional information about the molecular epidemiology of HAV strains in Brazil.

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“…Among these viral factors it may be pointed that some mutations at the 5'NCR of HAV or at the VP1X2A and 2C regions have been associated with fulminant hepatitis (Fujiwara et al, 2002;Fujiwara et al, 2001;Fujiwara et al, 2003) or higher virulence in tamarinds (Emerson et al, 2002), respectively. However, there is no consensus whether the VP1X2A-derived genotypes are clinically different, although some strains belonging to the former genotype VII now included in genotype II were associated with fulminant cases (Ching et al, 2002;Costa-Mattioli et al, 2002;Mackiewicz et al, 2010).…”

Section: Hepatitis a Virus (Hav)mentioning

confidence: 99%

Scientific Opinion on an update on the present knowledge on the occurrence and control of foodborne viruses

2011

EFS2

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A review of the biology, epidemiology, diagnosis and public health importance of foodborne viruses was performed. Data needs to support a risk assessment were also identified. In addition possible control options and their anticipated impact to prevent or reduce the number of foodborne viral human infections were identified, including the scientific reasons for and against the establishment of food safety criteria and process hygiene criteria for viruses for certain food categories. Food may be contaminated by virus during all stages of the food supply chain, and transmission can occur by consumption of food contaminated during the production process (primary production, or during further processing), or contaminated by infected food handlers. Transmission of zoonotic viruses (e.g. HEV) can also occur by consumption of products of animal origin. Viruses do not multiply in foods, but may persist for extended periods of time as infectious particles in the environment, or in foods. At the EU-level it is unknown how much viral disease can be attributed to foodborne spread. The relative contribution of different sources (shellfish, fresh produce, food handler including asymptomatic shedders, food handling environment) to foodborne illness has not been determined. The Panel recommends focusing controls on preventive measures to avoid viral contamination rather than trying to remove/inactivate these viruses from food. Also, it is recommended to introduce a microbiological criteria for viruses in bivalve molluscs, unless they are labelled "to be cooked before consumption". The criteria could be used by food business operators to validate their control options. Furthermore, it is recommended to refine the regulatory standards and monitoring approaches in order to improve public health protection. Introduction of virus microbiological criteria for classification of bivalve molluscs production areas should be considered. A virus monitoring programme for compliance with these criteria should be risk based according to the findings of a sanitary survey. KEY WORDSFood borne viruses, Norovirus, Hepatitis, Microbiological criteria, molluscs, fresh produce. SUMMARYThe European Food Safety Authority (EFSA) asked the Panel on Biological Hazards to initiate a self tasking issue with the purpose to provide up-to-date information on the present knowledge on the occurrence and control of foodborne viruses. The BIOHAZ Panel carried out a review of the available information in the scientific literature with regards to the biology, epidemiology, diagnosis and public health importance of foodborne viruses. Where possible the review covered primary production, food harvesting, food processing, and storage/retail until consumption. Data needs to support a risk assessment were also identified. In addition possible control options and their anticipated impact to prevent or reduce the number of foodborne viral human infections were identified including the scientific reasons for and against the establishment of microbiological criteri...

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Association between severity of type A hepatitis and nucleotide variations in the 5` non-translated region of hepatitis A virus RNA: strains from fulminant hepatitis have fewer nucleotide substitutions

Cited by 84 publications

References 29 publications

High and persistent excretion of hepatitis A virus in immunocompetent patients

High and persistent excretion of hepatitis A virus in immunocompetent patients

Co-circulation of genotypes IA and IB of hepatitis A virus in Northeast Brazil

Scientific Opinion on an update on the present knowledge on the occurrence and control of foodborne viruses

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