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EVIDENCE OF HEPATITIS A VIRUS PERSON-TO-PERSON TRANSMISSION IN HOUSEHOLD OUTBREAKS
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Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Desenvolvimento Tecnológico em Virologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Ambulatório de Hepatites Virais. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Hospital Universitário Gaffrée Guinle. Setor de Hematologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Desenvolvimento Tecnológico em Virologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Ambulatório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Ambulatório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Desenvolvimento Tecnológico em Virologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Ambulatório de Hepatites Virais. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Hospital Universitário Gaffrée Guinle. Setor de Hematologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Desenvolvimento Tecnológico em Virologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Ambulatório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Ambulatório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Desenvolvimento Tecnológico em Virologia. Rio de Janeiro, RJ, Brasil.
Abstract
The person-to-person transmission of the hepatitis A virus primarily occurs in enclosed spaces, particularly in the presence
of inadequate hygiene conditions and a high proportion of susceptible individuals. Thus, intimate family contact stands out
as a risk factor for HAV infection dissemination. The present study aimed to evaluate the occurrence of household HAV
transmission. Blood samples were collected from patients with hepatitis A (index cases) and their family members (contacts)
that were referred to an ambulatory care clinic specializing in viral hepatitis. A total of 97 samples were collected from 30
families with a confirmed hepatitis A case (index case). Serological and molecular techniques for the diagnosis of hepatitis A
were conducted on all samples. HAV infection (anti-HAV IgM + and/or HAV RNA +) was detected in 34.3% (23/67) of the
contacts; 34.3% (23/67) of the contacts were immune to HAV, and 31.4% (21/67) were susceptible. In the household
contacts, HAV immunity was significantly associated with older age; susceptibility to infection and HAV infection were
associated with younger age. Household outbreaks were detected in 16/30 families studied. Co-circulation of subgenotypes
IA and IB was found in the household outbreaks, and person-to-person transmission was evidenced in six of the household
outbreaks, with 100% homology between the index case and contact strains. The results demonstrated the relevance of
HAV household transmission, reaffirming the need for hepatitis A vaccine administration in susceptible contacts and
effective infection control procedures to prevent the extension of household outbreaks.
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