[Duration of viremia and fecal shedding of the virus in hepatitis A infected children].
Hepatitis A virus (HAV) infection is endemic in Argentina. Molecular tools have allowed HAV RNA detection to be extent to sera and feces from patients with different clinical backgrounds. We compare the sensitivity of the RT-PCR protocol we follow using primers targeting different genomic regions and VP3 C terminal was the most sensitive. Sequential sera and fecal samples were obtained from 20 children with acute self limited Hepatitis A. HAV RNA was detectable in 18/20 children if sera and stool specimens were collected at the onset of symptoms and in 19/20 if a later sample was considered. HAV RNA was detectable in serum from 9/20 patients until day 30 and in feces from 2 patients until day 60 and until day 90 in one. Genomic sequences from VP1/2A region in 8 samples showed they all belong to subgenotype IA although they were different between them. HAV RNA was detectable only in 1/11 sera from children with acute liver failure when VP3 C terminal fragment was searched and it belonged to genotype I. Universal vaccination in one year old children was recently implemented in Argentina and it will dramatically enable the decrease of the viral circulation, making new sources of infection emerge and allowing the introduction of new genotypes. The application of molecular tools to the study of the natural history of infection and to the epidemiologic surveillance may contribute to efficient control and lead to rational decisions in public health policies.
Munné
María S
MS
Laboratorio Nacional de Referencia de Hepatitis Virales, INEI-ANLIS - Dr Carlos G. Malbrán, Ciudad Autónoma de Bs. As. Argentina. smunne@anlis.gov.ar
Cañero Velasco
María C
MC
Moreiro
Rita
R
Vladimirsky
Sara
S
Otegui
Lucio
L
Castro
Raúl
R
Brajterman
Leonardo
L
Soto
Sonia
S
Mutti
Jorge
J
Nucifora
Silvia
S
Lara
Elena
E
Sosa
Aníbal
A
Godoy
Patricia
P
Ciocca
Mirta
M
Cuarterolo
Miram
M
Quarleri
Jorge F
JF
González
Jorge E
JE
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000821:virology*; D005260:Female; D006506:Hepatitis A / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D006507:Hepatovirus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D017114:Liver Failure, Acute / Q000097:blood / Q000821:virology; D008297:Male; D008969:Molecular Sequence Data; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013997:Time Factors; D014766:Viremia / Q000821:virology*; D017201:Virus Shedding
D012367:RNA, Viral