Title:	Increase in Hepatitis A Cases Linked to Imported Strains to Rio de Janeiro, Brazil: A Cross-Sectional Study
Authors:	Mello, Vinicius M. Bianchi, Lucas M. Sousa, Paulo Sergio F. Tavares, Pedro S. Di Salvo, Daniel R. G. Ginuino, Cleber F. Almeida, Nathalia A. A. Fernandes, Carlos A. S. Mello, Francisco C. A. Villar, Livia M. Lewis-Ximenez, Lia L. Lago, Barbara V.
Affilliation:	Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil. Universidade Dederal do Rio de Janeiro. Instituto de Geociências. Grupo de Pesquisa em Território e Política. Rio de Janeiro, RJ, Brasil. Universidade Dederal do Rio de Janeiro. Instituto de Geociências. Laboratório de Cartografia. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Virologia Molecular. Rio de Janeiro, RJ, Brasil. Secretaria Estadual de Saúde do Rio de Janeiro. Divisão de Hepatites. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos - Bio -Manguinhos. Rio de Janeiro, RJ, Brasil. .
Abstract:	This study aims to evaluate the epidemiological and molecular features associated with HAV transmission in adults in Rio de Janeiro during a period of increased registered cases of HAV (2017–2018). Socio-epidemiological data and serum samples from anti-HAV IgM+ individuals were obtained. HAV RNA was RT-PCR amplified and sequenced for further phylogenetic and phylogeographic analyses. From fifty-two HAV IgM+ individuals, most were men (78.85%; p = 0.024), aged 20–30 years old (84.61%; p < 0.001), resided in the Rio de Janeiro north zone (31/52; 59.62%; p = 0.001), and are men who have sex with men (MSM) (57.69%; p = 0.002). Sexual practices were more frequent (96%) than others risk factors (food-borne (44%), water-borne (42.31%), and parenteral (34.62%)). Individuals who traveled to endemic regions had a 7.19-fold (1.93–36.04; p < 0.01) increased risk of HAV. Phylogenetic analysis revealed four distinct clades of subgenotype IA, three of them comprised sequences from European/Asian MSM outbreaks and one from Brazilian endemic strains. Bayesian Inference showed that the imported strains were introduced to Brazil during large mass sportive events. Sexual orientation and sexual practices may play a role in acquiring HAV infection. Public policies targeting key populations must be implemented to prevent further dissemination of HAV and other STIs.
Keywords:	Hepatitis A virus Hepatitis A in Brazil Molecular epidemiology Outbreak strains Endemics strains Sexual transmission
keywords:	Vírus da Hepatite A Hepatite A no Brasil Epidemiologia molecular Cepas de surto Cepas endêmicas Transmissão sexual Rio de Janeiro
Issue Date:	2022
Publisher:	MDPI
Citation:	MELLO, Vinicius M. et al. Increase in Hepatitis A Cases Linked to Imported Strains to Rio de Janeiro, Brazil: A Cross-Sectional Study. Viruses, v. 14, n. 303, p. 1 -19, Feb. 2022.
DOI:	10.3390/v14020303
ISSN:	1999-4915
Copyright:	open access
Appears in Collections:	IOC - Artigos de Periódicos

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