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Molecular characterization of hepatitis A virus in children with fulminant hepatic failure in Argentina
María Silvina Munné1, Sara Vladimirsky, Rita Moreiro
1National Reference Laboratory in Viral Hepatitis, National Institute of Infectious Diseases, Buenos Aires, Argentina. smunne@anlis.gov.ar
Insights
Hepatitis A virus (HAV) strains from children with severe liver failure in Argentina differed genetically from typical strains. These viral factors may contribute to disease severity in pediatric hepatitis A.
Area of Science:
- Hepatology
- Virology
- Pediatric Infectious Diseases
Background:
- Hepatitis A infection is a vaccine-preventable disease and a significant cause of fulminant hepatic failure (FHF) in children in Argentina.
- Universal vaccination against Hepatitis A in 1-year-olds began in June 2005.
- Research on the link between Hepatitis A virus (HAV) characteristics and FHF is limited, particularly in pediatric populations.
Purpose of the Study:
- To analyze the genetic characteristics of Hepatitis A virus (HAV) strains from children who developed fulminant hepatic failure (FHF).
- To investigate potential viral factors contributing to severe clinical outcomes in pediatric Hepatitis A infections.
Main Methods:
- Studied samples from 41 children diagnosed with FHF between September 2003 and January 2006.
- Detected, sequenced, and analyzed Hepatitis A virus (HAV) RNA in the 5' non-coding region and VP1/2A region.
Main Results:
- Characterized 18 HAV strains, revealing nucleotide-level differences compared to strains causing self-limited acute infections in Argentina.
- Observed no distinct temporal or geographical clustering of the FHF-associated HAV strains.
- Identified some strains with identical largest characterized fragments and others with closer temporal and/or geographical relationships.
Conclusions:
- The genetic characteristics of HAV strains isolated from children with FHF in Argentina differ from those causing self-limited infections.
- Viral factors may play a role in the severity of Hepatitis A virus (HAV) infection and the development of fulminant hepatic failure in pediatric cases.
Background:
Hepatitis A infection, a vaccine-preventable disease, is an important cause of fulminant hepatic failure (FHF) in children in Argentina. Universal vaccination in 1-year-old children was implemented in June 2005. The limited studies about the correlation between the characteristics of the hepatitis A virus (HAV) and FHF have been carried out in adults.
Methods:
Samples from 41 children with FHF were studied from September 2003 to January 2006 and HAV RNA was detected, sequenced and analysed in the 5' non-coding region and VP1/2A region.
Results:
Eighteen HAV strains were characterized and found to be different at the nucleotide level from the self-limited acute infection strains that have been circulating in Argentina with no temporal or geographical pattern. They did not form a genetic cluster, but some of them were identical in the largest fragment characterized and some of them seemed to be more closely related in time and/or geographically.
Conclusion:
Our results suggest that viral factors could be involved in the severity of the clinical presentation of HAV infection in children in Argentina.
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