The Molecular Characterization of Hepatitis A Virus Strains Circulating during Hepatitis A Outbreaks in São Paulo, Brazil, from September 2017 to May 2019
Samira Chuffi,
Michele S. Gomes-Gouvêa,
Luciana V. B. Casadio,
Ana Catharina S. S. Nastri,
Mario P. Gonzalez,
André L. F. Cotia,
Amanda G. D. Aranda,
Simone B. Tenore,
Suzane K. Ono,
Fernanda M. Malta,
Geraldine Madalosso,
Paulo R. A. Ferreira,
Flair J. Carrilho,
João R. R. Pinho
Affiliations
Samira Chuffi
Laboratório de Gastroenterologia e Hepatologia Tropical—LIM/07, Departamento de Gastroenterologia, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 500, São Paulo 05403-000, SP, Brazil
Michele S. Gomes-Gouvêa
Laboratório de Gastroenterologia e Hepatologia Tropical—LIM/07, Departamento de Gastroenterologia, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 500, São Paulo 05403-000, SP, Brazil
Luciana V. B. Casadio
Hospital das Clínicas, Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
Ana Catharina S. S. Nastri
Hospital das Clínicas, Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
Mario P. Gonzalez
Instituto de Infectologia Emilio Ribas, São Paulo 05403-000, SP, Brazil
André L. F. Cotia
Instituto de Infectologia Emilio Ribas, São Paulo 05403-000, SP, Brazil
Amanda G. D. Aranda
Instituto de Infectologia Emilio Ribas, São Paulo 05403-000, SP, Brazil
Simone B. Tenore
Centro de Referência e Treinamento—CRT DST-AIDS, São Paulo 05403-000, SP, Brazil
Suzane K. Ono
Hospital das Clínicas, Departamento de Gastroenterologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
Fernanda M. Malta
Laboratório de Técnicas Especiais, Hospital Israelita Albert Einstein, Albert Einstein Medicina Diagnóstica, São Paulo 05403-000, SP, Brazil
Geraldine Madalosso
Epidemiological Surveillance Center, Disease Control Coordination, State of São Paulo Department of Health, São Paulo 05403-000, SP, Brazil
Paulo R. A. Ferreira
Hospital São Paulo, Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 05403-000, SP, Brazil
Flair J. Carrilho
Hospital das Clínicas, Departamento de Gastroenterologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
João R. R. Pinho
Laboratório de Gastroenterologia e Hepatologia Tropical—LIM/07, Departamento de Gastroenterologia, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 500, São Paulo 05403-000, SP, Brazil
Outbreaks of hepatitis A may occur in countries of medium and high socioeconomic levels in which the population generally exhibits an increased susceptibility in young adults to this infection if they are not vaccinated against the hepatitis A virus (HAV). In Europe, an outbreak involved approximately 22 European countries with 4475 cases reported from 2016 to 2018; most of them were men who have sex with men (MSM). This outbreak expanded to North and South America, including Brazil, particularly in São Paulo city with 1547 reported cases from 2016 to 2019. In the present study, we characterized the HAV strains involved in the acute hepatitis A cases identified in the reference centers of São Paulo city during this outbreak. A total of 51 cases with positive anti-HAV IgM were included, 80.4% male, 68.6% of them between 20 and 40 years old and 41.7% MSM. HAV RNA was detected in 92% (47/51) of the cases. Subgenotype IA of HAV was identified and most of the strains were closely related to that isolated in outbreaks that occurred in different European countries in 2016. These results showed the epidemiological relation between these outbreaks and reinforce the need to implement vaccination against hepatitis A for the adult population, particularly for a population with a high-risk behavior.
