Hepatitis A Outbreaks and Environmental Circulation of Genotype IA Strains in the São Paulo City, 2017–2018

Prado, Tatiana; Barbosa, Mikaela Renata Funada; Araújo, Ronalda Silva de; Garcia, Suzi Cristina; Melo, Adalgisa Jesus; Galvani, Ana Tereza; Brandão, Carlos Jesus; Silva, Renan Lourenço Oliveira; Sato, Maria Inês Zanoli

doi:10.1007/s12560-021-09497-7

Cited by 7 publications

(10 citation statements)

References 20 publications

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“…A similar proportion has been observed in a study conducted in Sâo Paulo [38] and in European HAV outbreaks, where the VRD_521_2016 strain was present in most cases [13]. Moreover, the strain VRD_521_2016 was identified in sewage samples from São Paulo during the outbreak [42]. It demonstrated that, although this strain may have been spread through sexual practices among MSM, it is not restricted to this route or this group.…”

Section: Discussionsupporting

confidence: 81%

Increase in Hepatitis A Cases Linked to Imported Strains to Rio de Janeiro, Brazil: A Cross-Sectional Study

Mello

Bianchi

Sousa

et al. 2022

Viruses

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This study aims to evaluate the epidemiological and molecular features associated with HAV transmission in adults in Rio de Janeiro during a period of increased registered cases of HAV (2017–2018). Socio-epidemiological data and serum samples from anti-HAV IgM+ individuals were obtained. HAV RNA was RT-PCR amplified and sequenced for further phylogenetic and phylogeographic analyses. From fifty-two HAV IgM+ individuals, most were men (78.85%; p = 0.024), aged 20–30 years old (84.61%; p < 0.001), resided in the Rio de Janeiro north zone (31/52; 59.62%; p = 0.001), and are men who have sex with men (MSM) (57.69%; p = 0.002). Sexual practices were more frequent (96%) than others risk factors (food-borne (44%), water-borne (42.31%), and parenteral (34.62%)). Individuals who traveled to endemic regions had a 7.19-fold (1.93–36.04; p < 0.01) increased risk of HAV. Phylogenetic analysis revealed four distinct clades of subgenotype IA, three of them comprised sequences from European/Asian MSM outbreaks and one from Brazilian endemic strains. Bayesian Inference showed that the imported strains were introduced to Brazil during large mass sportive events. Sexual orientation and sexual practices may play a role in acquiring HAV infection. Public policies targeting key populations must be implemented to prevent further dissemination of HAV and other STIs.

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Section: Discussionsupporting

confidence: 81%

Increase in Hepatitis A Cases Linked to Imported Strains to Rio de Janeiro, Brazil: A Cross-Sectional Study

Mello

Bianchi

Sousa

et al. 2022

Viruses

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“…Experimental infection using animal models and environment surveillance studies are scarce in Brazil and other South American countries, mainly due to the high cost and limited financial support dedicated to research projects in these research fields. Furthermore, contrasting with the considerable increase in HAV outbreaks affecting young adults (18−39 years old) [ 118 ], there have been few sporadic cases of HEV infection, mainly in immunocompromised persons [ 118 ]. In 2014, we compared the virulence of HEV-3 recovered from swine feces and viremic patient sera.…”

Section: Experimental Hev Infection Using Animal Modelsmentioning

confidence: 99%

Hepatitis E Virus Research in Brazil: Looking Back and Forwards

Oliveira

Santos

Pinto

2023

Viruses

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Hepatitis E virus (HEV) has emerged as a public health concern in Brazil. From the first identification and characterization of porcine and human HEV-3 strains in the 2000s, new HEV subtypes have been identified from animal, human, and environmental isolates. As new potential animal reservoirs have emerged, there is a need to compile evidence on the zoonotic dissemination of the virus in animal hosts and the environment. The increasing amount of seroprevalence data on sampled and randomly selected populations must be systematically retrieved, interpreted, and considered under the One Health concept. This review focused on HEV seroprevalence data in distinct animal reservoirs and human populations reported in the last two decades. Furthermore, the expertise with experimental infection models using non-human primates may provide new insights into HEV pathogenesis, prevention, and environmental surveillance.

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“…HAV subgenotype IA was identified, with most strains closely related to those isolated during outbreaks in the same demographic group across various European countries in 2016. 16,17 A cross-sectional study conducted in Rio de Janeiro state revealed a notable increase in HAV incidence, rising from 0.3 cases per 100,000 inhabitants in 2016 to 9.0 cases in 2018 Among those affected, individuals aged 20-29 years constituted the majority (46.15%), with males comprising a significant proportion (78.85%), and a substantial portion of this demographic being MSM (57.69%). 18 Phylogenetic analysis of HAV strains revealed that all samples belonged to HAV subgenotype IA, consistent with the most prevalent genotype previously reported in Brazil.…”

Section: Epidemiology: Brief History Of the Circulation Pattern Chang...mentioning

confidence: 99%

“…A similar trend was observed in São Paulo, where the VRD_521_2016 strain predominated. 17,18 Data from the Brazilian Ministry of Health showed a 128% increase in HAV infection incidence among men aged 20-39 years in 2017 ( 20,21 reported an increase of the number of cases of HA in this population in which sexual practices involving hand-anusmouth were identified as the primary mean of transmission within this group 20,21 Similarly, in Chile, an outbreak started in November 2016, with a total of 2227 confirmed cases registered from January to October 2017. It predominantly affected men, and among them, a large proportion of MSM.…”

Section: Epidemiology: Brief History Of the Circulation Pattern Chang...mentioning

confidence: 99%

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Hepatitis A in Latin America: The current scenario

Ré,

Ridruejo,

Fantilli

et al. 2024

Reviews in Medical Virology

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This review aims to gather and disseminate updated information regarding hepatitis A virus (HAV) in Latin America (LA) in the last 11 years, including seroprevalence, post‐vaccination studies, virus detection in aqueous matrices and food samples, and outbreak reports. Only 24 seroprevalence studies were published between 2012 and 2023 with 55%–100% reported prevalences of anti‐HAV IgG. Among the 25 LA countries, only eight of them have introduced HAV vaccines into their immunisation programs. Outbreaks of hepatitis A occurred between 2017–2019, mainly affecting men who have sex with men in Argentina, Brazil and Chile, probably as a consequence of the abrupt decline of young adults' immunity. This could be due to that young adult have never been infected in childhood (due to socio‐health improvements) and are above the cut‐off ages to be included when the vaccination programs were introduced. Although scarce, studies focused on environmental and food HAV surveillance have shown viral presence in these samples. Surface waters presented HAV detections between 1.2% and 86.7%, and untreated wastewaters between 2.8% and 70.9%. Genotypes found in all cases were IA and IC. The only wastewater‐based epidemiology study showed to be a useful tool as a complement of traditional epidemiological surveillance. Only four LA countries have looked for HAV in food samples, with genome detection rates between 9% and 33%. Latin American HAV circulation scenario is changing. In countries where socioeconomic and sanitary conditions have not improved, the virus persists with high endemicity and the access to the vaccine should be re‐evaluated by local governments. In countries where access to clean water, better sanitary conditions and HAV immunisation programs have been implemented, the number of cases among young adults seems to be increasing, alerting health authorities.

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Hepatitis A Outbreaks and Environmental Circulation of Genotype IA Strains in the São Paulo City, 2017–2018

Cited by 7 publications

References 20 publications

Increase in Hepatitis A Cases Linked to Imported Strains to Rio de Janeiro, Brazil: A Cross-Sectional Study

Increase in Hepatitis A Cases Linked to Imported Strains to Rio de Janeiro, Brazil: A Cross-Sectional Study

Hepatitis E Virus Research in Brazil: Looking Back and Forwards

Hepatitis A in Latin America: The current scenario

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