title: Hepatitis A virus sequence detected in clotting factor concentrates associated with disease transmission.
abstract: Since the early 1990s hepatitis A virus (HAV) infections among recipients of solvent-detergent treated factor VIII concentrates have occurred in Europe, South Africa and the United States. A review of the epidemiological and laboratory-based investigations of the outbreaks in Germany and Ireland were consistent with transmission by factor concentrates but limited information about transmission based upon nucleic acid sequences was obtained, and no clear chain of transmission could be established. Within the United States, hepatitis A infections associated with solvent detergent concentrate occurred in a single patient in 1993, and a cluster of cases in 1995. Although the 1993 factor concentrate was positive for virus, samples from the patient were not available. The virus present in the cluster of 1995 factor VIII patients, the factor concentrate they received, and the original plasma pool was identical, while the virus identified in the factor IX patient differed by a single base.
authors.affiliation: Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: B H
authors.initials: BH
authors.lastname: Robertson
authors.forename: M J
authors.initials: MJ
authors.lastname: Alter
authors.forename: B P
authors.initials: BP
authors.lastname: Bell
authors.forename: B
authors.initials: B
authors.lastname: Evatt
authors.forename: K A
authors.initials: KA
authors.lastname: McCaustland
authors.forename: C N
authors.initials: CN
authors.lastname: Shapiro
authors.forename: S D
authors.initials: SD
authors.lastname: Sinha
authors.forename: J M
authors.initials: JM
authors.lastname: Souci
mesh_terms: D003902:Detergents; D004196:Disease Outbreaks; D005164:Factor IX / Q000009:adverse effects / Q000302:isolation & purification; D005169:Factor VIII / Q000009:adverse effects* / Q000302:isolation & purification*; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D006467:Hemophilia A / Q000628:therapy; D006506:Hepatitis A / Q000097:blood* / Q000453:epidemiology / Q000635:transmission*; D006507:Hepatovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D012367:RNA, Viral / Q000097:blood* / Q000235:genetics; D012997:Solvents; D014481:United States / Q000453:epidemiology
chemical_list: D003902:Detergents; D012367:RNA, Viral; D012997:Solvents; D005169:Factor VIII; D005164:Factor IX