Clinical significance of genetic diversity of hepatitis A virus


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Abstract

Aim: to identify features of the clinical course of hepatitis A (HA) caused by viruses of different subtypes. Patients and methods: In the study there were included 195 patients with hepatitis A (130 males and 65 females) at the age from 15 to 72 years residing in the territories with various manifestations of the epidemic process of HA (Moscow, the Khabarovsk region, the Republic of Sakha (Yakutia), the Republic of Tajikistan and Ukraine). All patients were examined for the presence of Hepatitis A virus (HAV) RNA in blood, with following determination of the genotype of the virus by PCR. Biochemical blood tests (concentration of total and direct bilirubin, ALT activity) were performed from 2 to 9 times depending on the duration of hospital stay and severity of infection. The dynamics of biochemical indices was evaluated in accordance with the period of the disease: the first period -from the 1 st to 10 th day, the second -from 11 th to 20 th day, the third -from the 21 st day and later. Results: A direct moderate correlation (The Spearman correlation coefficient r = 0,3; p = 0,002) between the duration of jaundice and patients ’ age has been revealed. A significant relationship was observed in the group ofpatients with subtype IIIA (r = 0,4; p = 0,003) and was absent in patients with subtype IA. There were no statistically significant differences between the groups of patients with subtypes IA and IIIA, in dependence on the duration of hospitalization, the variant of the course ofprejaundice period, severity of the course disease, duration of the persistent jaundice and symptoms of intoxication. Absolute values and the dynamics of the reduction of total and direct bilirubin, as well as the dynamics of decrease of ALT activity in groups of patients with various subtypes were not differed significantly. Cholestatic forms of HA were observed only in patients with HAV isolates belonging to subtype IIIA. Conclusion: HAV subtype has no effect on the severity of the course of the disease neither major clinical symptoms and laboratory indices in patients from different age groups. A direct correlationship between the duration ofjaundice syndrome and age in patients with subtype IIIA may indicate a trend towards the formation of cholestatic forms of HA in patients with this subtype of the virus in older age groups.

About the authors

V. P Chulanov

Central Research Institute of Epidemiology of The Federal Service on Customers’ Rights Protection and Human Well-being Surveillance

Email: vladimir.chulanov@pcr.ru
доктор мед. наук, зав. научно-консультативным клиникодиагностическим центром 3a, Novogireevskaya Str., Moscow, Russian Federation, 111123

I. V Karandashova

Central Research Institute of Epidemiology of The Federal Service on Customers’ Rights Protection and Human Well-being Surveillance

Email: inga.karadashova@pcr.ru
канд. биол. науч., ст. науч. сотр. лаб. вирусных гепатитов отдела молекулярной диагностики и эпидемиологии 3a, Novogireevskaya Str., Moscow, Russian Federation, 111123

N. N Pimenov

Central Research Institute of Epidemiology of The Federal Service on Customers’ Rights Protection and Human Well-being Surveillance

Email: n.pimenov@mail.ru
мл. науч. сотр. лаб. вирусных гепатитов отдела молекулярной диагностики и эпидемиологии 3a, Novogireevskaya Str., Moscow, Russian Federation, 111123

V. P Molochniy

The Far Eastern State Medical University

Email: mvp@mail.fesmu.ru
доктор мед. наук, проф., зав. каф. детских инфекционных болезней 35, Murav’eva-Amurskogo Str., Khabarovsk, Russian Federation, 680000

G. S Tomilka

The Far Eastern State Medical University

Email: mvp@mail.fesmu.ru
доктор мед. наук, проф., зав. каф. инфекционных болезней и эпидемиологии ДВГМУ, проректор по учебной и воспитательной работе 35, Murav’eva-Amurskogo Str., Khabarovsk, Russian Federation, 680000

S. S Sleptsova

North-Eastern Federal University name after M.K. Ammosov

Email: sssleptsova@yandex.ru
канд. мед. наук, доцент каф. инфекционных болезней, фтизиатрии и дерматовенерологии медицинского института 58, Belinskiy str., Yakutsk, Republic of Sakha (Yakutia) Russia, 677980

V. K Semenova

North-Eastern Federal University name after M.K. Ammosov

Email: svk.valia@yandex.ru
ст. преподаватель каф. инфекционных болезней, фтизиатрии и дерматовенерологии медицинского института 58, Belinskiy str., Yakutsk, Republic of Sakha (Yakutia) Russia, 677980

V. P Malyi

Kharkiv Medical Academy of Post-graduate Education

Email: tanya-07-07@mail.ru
доктор мед. наук, проф., зав. каф. инфекционных болезней 58, Korchagintsiv Str., Kharkov, Ukraine, 61176

V. V Boiko

Regional military hospital

Email: tanya-07-07@mail.ru
врач-инфекционист 5, Kultury Str., Kharkov, Ukraine, 61022

B. D Kamolov

Municipalpolyclinic № 220 of the City of Moscow

Email: bd.59@inbox.ru
врач-инфекционист, филиал № 2 27, Zamorenova Str., Moscow, Russian Federation, 123022

E. V Volchkova

I.M. Sechenov First Moscow State Medical University

Email: antolonina@rambler.ru
доктор мед. наук, проф., зав. каф. инфекционных болезней 8-2, Trubetskaya Str., Moscow, Russian Federation, 119991

References

  1. Yotsuyanagi H., Koike K., Yasuda K. et al. Prolonged fecal excretion of hepatitis A virus in adult patients with hepatitis A as determined by polymerase chain reaction. Hepatology. 1996; 24 (1): 10-3.
  2. Fujiwara K., Yokosuka O., Ehata T. et al. Frequent detection of hepatitis A viral RNA in serum during the early convalescent phase of acute hepatitis A. Hepatology. 1997; 26 (6): 1634-39.
  3. Chironna M., Grottola A., Lanave C. et al. Genetic analysis of HAV strains recovered from patients with acute hepatitis from Southern Italy. J. Med. Virol. 2003; 70 (3): 343-9.
  4. Byun K.S., Kim J.H., Song K.J. et al. Molecular epidemiology of hepatitis A virus in Korea. J. Gastroenterol. Hepatol. 2001; 16 (5): 519-24.
  5. Cohen J.I., Rosenblum B., Feinstone S.M. et al. Attenuation and cell culture adaptation of hepatitis A virus (HAV): a genetic analysis with HAV cDNA. J. Virol. 1989; 63 (12): 5364-70.
  6. Emerson S.U., Huang Y.K., Nguyen H. et al. Identification of VP1/2A and 2C as virulence genes of hepatitis A virus and demonstration of genetic instability of 2C. J. Virol. 2002; 76 (17): 8551-9.
  7. Fujiwara K., Yokosuka O., Fukai K. et al. Analysis of full-length hepatitis A virus genome in sera from patients with fulminant and self-limited acute type A hepatitis. J. Hepatol. 2001; 35 (1): 112-9.
  8. Fujiwara K., Yokosuka O., Ehata T. et al. 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. Gut. 2002; 51 (1): 82-8.
  9. Rezende G., Roque-Afonso A.M., Samuel D. et al. Viral and clinical factors associated with the fulminant course of hepatitis A infection. Hepatology. 2003; 38 (3): 613-8.
  10. Fujiwara K., Yokosuka O., Imazeki F. et al. Analysis of the genotype-determining region of hepatitis A viral RNA in relation to disease severities. Hepatol. Res. 2003; 25 (2): 124-34.
  11. Yun H., Lee H.J., Jang J.H. et al. Hepatitis A virus genotype and its correlation with the clinical outcome of acute hepatitis A in Korea: 2006-2008. J. Med. Virol. 2011; 83 (12): 2073-81.
  12. Yoon Y.K., Yeon J.E., Kim J.H. et al. Comparative analysis of disease severity between genotypes IA and IIIA of hepatitis A virus. J. Med. Virol. 2011; 83 (8): 1308-14.

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