荷兰北布拉班特省甲型肝炎的分子流行病学

Molecular epidemiology of hepatitis A in Noord-Brabant, The Netherlands.

作者信息

Tjon G M S, Wijkmans C J, Coutinho R A, Koek A G, van den Hoek J A R, Leenders A C A P, Schneeberger P M, Bruisten S M

机构信息

Municipal Health Service of Amsterdam (Streeklaboratorium voor de Volksgezondheid), Nieuw Achtergracht 100, 1018 WT Amsterdam, The Netherlands.

出版信息

J Clin Virol. 2005 Feb;32(2):128-36. doi: 10.1016/j.jcv.2004.03.008.

DOI:10.1016/j.jcv.2004.03.008

PMID:15653415

Abstract

BACKGROUND

Previous studies on the molecular epidemiology of hepatitis A virus (HAV) in Amsterdam, The Netherlands, show that subgenotype 1A is mainly seen among homosexual men practising anonymous oral-anal sex in saunas and darkrooms, while subgenotype 1B is usually detected among children originating from Morocco, and subgenotype 3A is mostly found among travellers to Pakistan.

OBJECTIVE

We studied the genotype distribution in a more rural area of The Netherlands, Noord-Brabant, and compared it with Amsterdam.

STUDY DESIGN

We collected blood and feces samples from 34 HAV IgM(+) individuals who were reported from August 2001-March 2003 at the Municipal Health Service (MHS) Heart for Brabant (Brabant). We also collected feces samples from nine household contacts of whom the HAV IgM status was not known. HAV RNA was isolated and subsequently amplified by reverse transcriptase polymerase chain reaction (RT-PCR) at the VP1-P2a and the VP3-VP1 region, sequenced and analysed.

RESULTS AND CONCLUSIONS

In most cases, relations between risk groups and HAV subgenotypes in Noord-Brabant were similar to those in Amsterdam. Next to genotypes 1 and 3 we also detected a genotype 2/7 strain in a Noord-Brabant case. Also, in contrast to the Amsterdam study, sporadic transmission occurred among various risk groups. Children involved in a school-related outbreak were infected with strains identical to one that was previously isolated from a man who has sex with men (MSM). Also, Dutch patients having no epidemiological link with Turkish or Moroccan children harboured strains imported from high-endemic countries. Furthermore, we report a special case in which HAV may be causally involved in meningitis. The results of this study show that the molecular epidemiology of HAV in The Netherlands can be more complicated than previously anticipated and that HAV phylogenetic studies can provide important information for the design of appropriate public health measures.

摘要

背景

先前对荷兰阿姆斯特丹甲型肝炎病毒（HAV）分子流行病学的研究表明，1A 亚基因型主要见于在桑拿浴室和暗室中进行无保护口交的男同性恋者，而 1B 亚基因型通常在来自摩洛哥的儿童中检测到，3A 亚基因型大多在前往巴基斯坦的旅行者中发现。

目的

我们研究了荷兰一个更偏远地区北布拉班特省的基因型分布，并将其与阿姆斯特丹进行比较。

研究设计

我们收集了 2001 年 8 月至 2003 年 3 月期间向布拉班特市卫生局（MHS）布拉班特心脏中心报告的 34 例 HAV IgM(+)个体的血液和粪便样本。我们还收集了 9 名甲型肝炎病毒 IgM 状态未知的家庭接触者的粪便样本。分离出 HAV RNA，随后在 VP1-P2a 和 VP3-VP1 区域通过逆转录聚合酶链反应（RT-PCR）进行扩增、测序和分析。

结果与结论

在大多数情况下，北布拉班特省风险群体与 HAV 亚基因型之间的关系与阿姆斯特丹相似。除了 1 型和 3 型基因型外，我们还在北布拉班特省的一个病例中检测到了 2/7 型毒株。此外，与阿姆斯特丹的研究不同，散发性传播发生在不同的风险群体中。参与学校相关疫情的儿童感染的毒株与先前从一名男男性行为者（MSM）分离出的毒株相同。此外，与土耳其或摩洛哥儿童没有流行病学联系的荷兰患者携带从高流行国家输入的毒株。此外，我们报告了一个特殊病例，其中 HAV 可能与脑膜炎有因果关系。这项研究的结果表明，荷兰 HAV 的分子流行病学可能比以前预期的更为复杂，并且 HAV 系统发育研究可以为设计适当的公共卫生措施提供重要信息。