Male-Dominant Hepatitis A Outbreak Observed among Non-HIV-Infected Persons in the Northern Part of Tokyo, Japan
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. Clinical and Laboratory Assessments
2.3. Definition and Classification of Acute Liver Failure
2.4. Detection of HAV RNA, Sequence Analysis and Phylogenetic Tree Analysis of HAV Isolates
2.5. Statistical Analysis
3. Results
3.1. Patient Characteristics and Comparison of ALF and Non-ALF Patients
3.2. Comparison of MSM with Non-MSM Groups’ Characteristics
3.3. Factors of Administration for 20 Days or More in Japanese Patients with Acute Hepatitis A
3.4. Molecular Analysis of HAV Isolates from Some Patients with Acute Hepatitis A in the Present Study
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Total (n = 21) | ALF (n = 5) | Non-ALF (n = 16) | 1P-Values |
---|---|---|---|---|
Male/female (n) | 19/2 | 4/1 | 15/1 | 0.9668 |
Age (years) | 40.7 ± 12.1 | 46.2 ± 5.5 | 39.4 ± 13.2 | 0.2824 |
BMI (kg/m2) | 21.7 ± 3.0 | 21.0 ± 2.0 | 21.9 ± 3.3 | 0.5773 |
AST (IU/L) | 3506 ± 3406 | 7215 ± 4228 | 2346 ± 2164 | 0.002510 |
ALT (IU/L) | 3692 ± 2372 | 5789 ± 2809 | 3036 ± 1864 | 0.01913 |
γ-GTP (IU/L) | 416 ± 199 | 415 ± 119 | 416 ± 222 | 0.9924 |
LDH (IU/L) | 2002 ± 2660 | 4838 ± 3841 | 1116 ± 1410 | 0.00329 |
Albumin (g/dL) | 3.9 ± 0.4 | 3.5 ± 0.6 | 3.9 ± 0.3 | 0.0558 |
Total bilirubin (mg/dL) | 7.7 ± 5.1 | 6.7 ± 2.2 | 8.0 ± 5.8 | 0.6344 |
CRP (mg/dL) | 1.6 ± 1.1 | 2.2 ± 1.6 | 1.4 ± 0.9 | 0.1665 |
Platelet counts (×104/μL) | 17.9 ± 5.4 | 16.8 ± 6.7 | 18.2 ± 5.2 | 0.6280 |
Atypical lymphocytes (/μL) | 410 ± 555 | 644 ± 971 | 337 ± 367 | 0.2913 |
IgM (mg/dL) | 280 ± 115 | 236 ± 124 | 291 ± 114 | 0.3679 |
MSM group (yes/no) | 7/14 | 1/4 | 6/10 | 0.8562 |
Duration from onset to admission (days) | 7.2 ± 4.7 | 4.6 ± 2.1 | 8.1 ± 5.0 | 0.1493 |
Duration from admission to discharge (days) | 19.1 ± 9.0 | 20 ± 2.4 | 18.9 ± 10.3 | 0.8183 |
Case No. | Admission Date (Year/Month) | Age (Years)/Sex | Fever/ALF/MSM | IgM-HAV (S/CO) | Duration of Admission (Days) | History of Syphilis/HBV/Eating of Raw Oysters or Fish | Subgroup/Accession Number of HAV Isolate |
---|---|---|---|---|---|---|---|
1 | 2018/January | 27/male | +/−/− | 1.7 | 22 | −/−/− | S9/LC597558 |
2 | 2018/February | 48/male | +/+/− | 6.12 | 22 | −/−/− | S13/LC597557 |
3 | 2018/February | 56/male | −/−/− | 7.47 | 15 | −/−/+ | S13/LC597559 |
4 | 2018/March | 56/male | +/−/− | 5.41 | 20 | −/−/− | S13/LC597560 |
5 | 2018/April | 24/male | +/−/+ | 8.98 | 20 | +/−/− | S13/LC597561 |
6 | 2018/May | 37/male | +/−/+ | 6.9 | 21 | −/−/− | S13/LC597562 |
7 | 2018/June | 39/male | −/+/+ | 4.61 | 21 | +/+/− | S13/LC597563 |
8 | 2018/June | 54/male | +/+/− | 8.5 | 21 | −/−/− | S13/LC597564 |
9 | 2018/July | 23/male | −/−/− | 7.42 | 37 | −/−/− | S13/LC597566 |
10 | 2018/July | 24/male | −/−/+ | 8.22 | 9 | −/+/− | S13/LC597565 |
11 | 2018/September | 44/male | +/+/− | 6.26 | 16 | −/−/+ | S13/LC597567 |
12 | 2018/October | 58/male | +/−/+ | 11.3 | 11 | +/−/− | S13/LC597568 |
13 | 2018/November | 46/female | +/+/− | 3.43 | 20 | −/−/− | S13/LC597569 |
14 | 2018/December | 53/male | +/−/− | 12.7 | 20 | −/−/− | S13/LC597570 |
15 | 2018/December | 32/male | −/−/− | 5.25 | 10 | −/−/− | S13/LC597571 |
16 | 2019/February | 35/male | +/−/+ | 5.07 | 10 | −/−/− | S13LC597572 |
17 | 2019/March | 52/male | +/−/− | 8.77 | 14 | −/−/− | S9/LC597573 |
18 | 2019/May | 24/male | +/−/− | 7.57 | 14 | −/−/− | S13/LC597574 |
19 | 2019/August | 34/male | −/−/+ | 10.8 | 15 | +/+/− | S13/LC597575 |
20 | 2019/October | 38/male | −/−/− | 8.98 | 48 | −/−/+ | S13/LC597576 |
21 | 2020/April | 51/female | −/−/− | 11.2 | 16 | −/−/− | N/A |
Characteristic | MSM Group (n = 7) | Non-MSM Group (n = 14) | 1P-Values |
---|---|---|---|
Male/female (n) | 7/0 | 12/2 | 0.7926 |
Age (years) | 35.9 ± 11.5 | 43.1 ± 12.1 | 0.2001 |
BMI (kg/m2) | 21.4 ± 1.8 | 21.8 ± 3.5 | 0.9314 |
AST (IU/L) | 3599 ± 3767 | 3458 ± 3360 | 0.8718 |
ALT (IU/L) | 3569 ± 2716 | 3753 ± 2289 | 0.8718 |
γ-GTP (IU/L) | 405 ± 212 | 421 ± 201 | 0.8675 |
LDH (IU/L) | 2319 ± 2791 | 1844 ± 2686 | 0.7101 |
Albumin (g/dL) | 4.0 ± 0.3 | 3.8 ± 0.5 | 0.3455 |
Total bilirubin (mg/dL) | 5.6 ± 2.1 | 8.7 ± 5.9 | 0.1980 |
CRP (mg/dL) | 1.3 ± 1.0 | 1.8 ± 1.2 | 0.3555 |
Platelet counts (×104/μL) | 15.5 ± 3.4 | 19.1 ± 6.0 | 0.1599 |
Atypical lymphocytes (/μL) | 399 ± 328 | 416 ± 651 | 0.9492 |
IgM (mg/dL) | 281 ± 91 | 280 ± 130 | 0.9857 |
ALF (yes/no) | 1/6 | 4/10 | 0.8562 |
Duration from onset to admission (days) | 5.4 ± 3.0 | 7.4 ± 5.2 | 0.3614 |
Duration from admission to discharge (days) | 15.3 ± 5.4 | 21 ± 10.0 | 0.1783 |
Characteristic | Fewer than 20 Days (n = 10) | 20 Days or More (n = 11) | 1P-Values |
---|---|---|---|
Male/female (n) | 9/1 | 10/1 | 0.5007 |
Age (years) | 41.0 ± 12.9 | 40.5 ± 12.0 | 0.9213 |
BMI (kg/m2) | 22.2 ± 3.5 | 21.2 ± 2.7 | 0.4700 |
AST (IU/L) | 2429 ± 3525 | 4484 ± 3131 | 0.1732 |
ALT (IU/L) | 3090 ± 2491 | 4238 ± 2231 | 0.2790 |
γ-GTP (IU/L) | 347 ± 118 | 478 ± 240 | 0.1351 |
LDH (IU/L) | 1334 ± 2649 | 2609 ± 2643 | 0.2838 |
Albumin (g/dL) | 3.8 ± 0.5 | 3.9 ± 0.5 | 0.6523 |
Total bilirubin (mg/dL) | 7.7 ± 3.6 | 7.6 ± 6.4 | 0.9657 |
CRP (mg/dL) | 1.4 ± 1.3 | 1.8 ± 1.0 | 0.4365 |
Platelet counts (×104/μL) | 18.0 ± 4.9 | 17.8 ± 6.1 | 0.9352 |
Atypical lymphocytes (/μL) | 486 ± 371 | 342 ± 693 | 0.5657 |
IgM (mg/dL) | 279 ± 99.5 | 281 ± 131 | 0.9692 |
ALF (yes/no) | 2/8 | 3/8 | 0.9692 |
MSM group (yes/no) | 4/6 | 3/8 | 0.5366 |
Duration from onset to admission (days) | 7.7 ± 5.7 | 5.8 ± 7.0 | 0.5061 |
Duration from admission to discharge (days) | 13.0 ± 2.7 | 24.7 ± 9.2 | 0.001042 |
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Honda, M.; Asakura, H.; Kanda, T.; Somura, Y.; Ishii, T.; Yamana, Y.; Kaneko, T.; Mizutani, T.; Takahashi, H.; Kumagawa, M.; et al. Male-Dominant Hepatitis A Outbreak Observed among Non-HIV-Infected Persons in the Northern Part of Tokyo, Japan. Viruses 2021, 13, 207. https://doi.org/10.3390/v13020207
Honda M, Asakura H, Kanda T, Somura Y, Ishii T, Yamana Y, Kaneko T, Mizutani T, Takahashi H, Kumagawa M, et al. Male-Dominant Hepatitis A Outbreak Observed among Non-HIV-Infected Persons in the Northern Part of Tokyo, Japan. Viruses. 2021; 13(2):207. https://doi.org/10.3390/v13020207
Chicago/Turabian StyleHonda, Masayuki, Hiroyuki Asakura, Tatsuo Kanda, Yoshiko Somura, Tomotaka Ishii, Yoichiro Yamana, Tomohiro Kaneko, Taku Mizutani, Hiroshi Takahashi, Mariko Kumagawa, and et al. 2021. "Male-Dominant Hepatitis A Outbreak Observed among Non-HIV-Infected Persons in the Northern Part of Tokyo, Japan" Viruses 13, no. 2: 207. https://doi.org/10.3390/v13020207