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Host immune response to hepatitis A virus

J T Stapleton1

  • 1Department of Internal Medicine, University of Iowa, Iowa City 52242.

The Journal of Infectious Diseases
|March 1, 1995
PubMed
Summary

Hepatitis A virus (HAV) spreads through contaminated food or water. Lifelong IgG antibodies develop after infection, offering protection, while immunoglobulin (ISG) provides effective post-exposure prophylaxis.

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Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Hepatitis A virus (HAV) transmission occurs via the fecal-oral route.
  • HAV replicates in hepatocytes after crossing the gastrointestinal tract through an unknown mechanism.
  • The virus is released into the bloodstream, bile, and feces, with peak shedding and viremia coinciding with liver dysfunction.

Purpose of the Study:

  • To describe the transmission, replication, and immune response to Hepatitis A virus.
  • To evaluate the efficacy of immunoglobulin (ISG) in preventing Hepatitis A.
  • To correlate anti-HAV antibody levels with protection against reinfection.

Main Methods:

  • Observational analysis of HAV infection and immune response.
  • Assessment of fecal shedding, viremia, and antibody profiles (IgM, IgA, IgG).
  • Evaluation of pre- and post-exposure prophylaxis using pooled human serum immunoglobulin (ISG).

Main Results:

  • Humoral immunity, marked by anti-HAV antibodies (IgM, IgA, IgG), is detected around 28 days post-exposure, coinciding with the termination of viral shedding and viremia.
  • IgM anti-HAV antibodies typically become undetectable within 6 months.
  • Lifelong persistence of IgG anti-HAV antibodies confers protection against reinfection.
  • Immunization with ISG demonstrates approximately 90% effectiveness in preventing Hepatitis A, with recipients showing low anti-HAV antibody levels.

Conclusions:

  • Hepatitis A infection elicits a protective immune response characterized by long-lasting IgG antibodies.
  • Immunoglobulin (ISG) is a highly effective prophylactic measure against Hepatitis A.
  • Vaccine development should aim to induce anti-HAV antibody levels comparable to those achieved with ISG for similar protective efficacy.

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