Occurrence of hepatitis A virus genotype III in Germany requires the adaptation of commercially available diagnostic test systems.
BACKGROUND
A blood donation, obtained in 2003 in Germany during the preseroconversion diagnostic window period of a hepatitis A virus (HAV) infection, tested HAV-negative by commercially available HAV reverse transcription-polymerase chain reaction (RT-PCR) detection assays.


METHODS
The virus responsible for this infection was identified as HAV genotype IIIA by characterization of the nearly complete genome sequence.


RESULTS
Thereby, this HAV variant, which was named strain HMH, was detected in Germany for the first time. Because the commercially available HAV RNA detection systems failed to detect this genotype, a real-time RT-PCR kit was developed that allows quantification and detection of all HAV genotypes. The first nearly full-length nucleotide sequence so far available for HAV genotype IIIA is also provided.


CONCLUSIONS
This case demonstrates that owing to the genetic variability of HAV, constant monitoring and adaptation of the diagnostic nucleic acid assays are required to guarantee the safety of blood and blood products.
Heitmann
Alke
A
artus GmbH, Hamburg, Germany. heitmann@artus-biotech.de
Laue
Thomas
T
Schottstedt
Volkmar
V
Dotzauer
Andreas
A
Pichl
Lutz
L
D000410:Alanine Transaminase / Q000097:blood; D001483:Base Sequence; D001782:Blood Donors; D003955:Diagnostic Tests, Routine; D004196:Disease Outbreaks; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D006506:Hepatitis A / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D030041:Hepatitis A virus / Q000235:genetics* / Q000302:isolation & purification*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D012689:Sequence Homology, Nucleic Acid; D013997:Time Factors; D014766:Viremia
D007075:Immunoglobulin M; D012367:RNA, Viral; D000410:Alanine Transaminase