rome and Hepatitis-A

Vulnerable populations are being more severely impacted by the ongoing pandemic, and the recent release of vaccines for Coronavirus Disease 19 (COVID-19) may offer them protection. The aim of this study was to investigate the willingness of homeless persons to be vaccinated against COVID-19; secondary aims were to analyze the immunization coverage for other conditions.. The acceptance of COVID-19 vaccine and immunization coverage for other conditions were investigated through a form in 112 persons experiencing homelessness referring to the primary care medical services of the Eleemosynaria Apostolica, Holy See.. Most subjects, with a male preponderance, were willing to be vaccinated against COVID-19 (64.3%), 3.6% were unsure and 32.1% preferred not to be vaccinated. When answering questions on the immunization coverage for tuberculosis and hepatitis A and B, most subjects reported not to be vaccinated (48.2%, 56.2% and 55.3%, respectively) or did not know (33%, 28.6% and 27.7%).. A significant portion of our sample declared to be willing to be vaccinated against COVID-19. It would be auspicious that the recent statements from several countries on the importance to extend COVID-19 vaccination to fragile populations be followed by the distribution of the vaccine to these populations.

Topics: Adult; Aged; Attitude to Health; COVID-19; COVID-19 Vaccines; Female; Hepatitis A; Hepatitis A Vaccines; Hepatitis B; Hepatitis B Vaccines; Humans; Ill-Housed Persons; Influenza Vaccines; Influenza, Human; Male; Middle Aged; Patient Acceptance of Health Care; Rome; SARS-CoV-2; Tuberculosis; Tuberculosis Vaccines; Vaccination Coverage; Young Adult

Italy is a low-incidence region for hepatitis A; however, during the last 2 years an increase in the incidence of hepatitis A virus (HAV) infection was reported in Europe. The aim of this study was to describe this recent outbreak.. We retrospectively analysed all cases of acute hepatitis A diagnosed at our laboratory between January 2010 and June 2017. We evaluated the following variables at the time of diagnosis: sex, age, nationality, glutamic oxaloacetic transaminase (GOT/AST), glutamic pyruvic transaminase (GPT/ALT), bilirubin concentration, international normalized ratio (INR) and the presence or absence of anti-HIV-1/2 antibodies. Hospitalization was also considered. We analysed these parameters using the χ. A total of 225 cases were analysed; 82.7% were in male patients, 94.2% were in Italians and the median age of the patients was 36.4 years. At diagnosis, the median GOT value was 306 U/L, the median GPT was 1389 U/L, and the median total bilirubin value was 5.88 mg/dL. Hospitalization was required for 142 patients, with a median duration of hospital stay of 8.5 days. In 2016-2017 we registered 141 cases, with a higher prevalence of male patients, higher GPT values and a higher prevalence of patients aged 20-39 years compared with older (2010-2015) cases. Homosexual intercourse was reported as the HAV risk factor in 70.2% of patients. HIV serology was available for 120 patients: 24 were HIV-positive, four of whom represented new diagnoses. HIV-positive patients showed lower bilirubin and GPT values and fewer hospitalizations than HIV-negative patients.. In 2016-2017, we saw a rise in the number of hepatitis A cases, with a higher prevalence of adult male patients. No significant differences regarding the prevalence of HIV coinfection emerged.

Topics: Adult; Disease Outbreaks; Female; Health Promotion; Hepatitis A; Hepatitis A Vaccines; HIV Infections; Hospitals, Teaching; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Rome; Vaccination

Outbreaks of Acute Hepatitis A Virus (HAV) among men who have sex with men (MSM) have been reported in Europe and, recently, in Italy. From July 2008 through January 2010, 162 HAV infections were diagnosed at National Institute for Infectious Diseases, Rome, Italy, with high male-to-female ratio (M:F=7.5).. The aim of this study was to characterize viral strains involved in this outbreak.. The sequences of VP1-2A junction of HAV genome, obtained from 67/97 HAV-RNA-positive samples, were used for phylogenetic analysis.. All but 1 of the HAV sequences were genotype 1A, 1 was genotype 1B. A monophyletic cluster, including 59/66 genotype IA sequences, was identified by phylogenetic analysis. This cluster included also 2 HAV strains isolated in Germany (2007) and France (2008) from MSM, that, in turn, were reported to be genetically correlated to HAV strains circulating in Tuscany in 2008. Among the males harboring an HAV strain belonging to the cluster, 62% reported to be MSM, and 25% were HIV-positive, 2 with acute HIV infection.. The outbreak occurred in Rome in 2008-2010, involving high proportion of HIV-infected MSM, is sustained by a monophyletic HAV strain, circulating around the same period also in other European countries. Possible factors favouring HAV spread among HIV-infected persons, such as high risk behavior and prolonged fecal excretion, need to be further elucidated. Timely identification of outbreaks with one or the same source of infection may be helpful to implement preventive measures addressing at risk populations.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cluster Analysis; Disease Outbreaks; Female; Hepatitis A; Hepatitis A virus; HIV Infections; Homosexuality, Male; Humans; Male; Middle Aged; Molecular Epidemiology; Molecular Sequence Data; Phylogeny; RNA, Viral; Rome; Sequence Analysis, DNA; Young Adult

Several outbreaks of hepatitis A affecting homosexual men have been reported in Europe. However, the prevalence of HIV infection in patients affected by hepatitis A has not been extensively studied and hepatitis A is not considered as an indicator disease for routine HIV testing.. We retrospectively analyzed all adult cases of acute hepatitis A, reported by the National Institute of Infectious Disease "L. Spallanzani", Rome-Italy, in 2002-2008. Data on HIV infection were obtained by chart review and cross-linkage with laboratory. Information on exposure to risk factors were collected from the standard questionnaire of the Local Health Unit.. We analyzed a total of 473 cases of hepatitis A, 368 (77.2%) males that accounted for 75% of all reported cases in Rome, aged 25-64 years (same gender distribution). During the study period, we diagnosed a high proportion of cases among male individuals (78%). Among the male patients, HIV serology was available for 203/368 (55.2%). The overall HIV prevalence was 15.2% (56/368); it was significantly associated with same gender sex and was significantly higher than that observed among patients with hepatitis B (4.0%).. We found a high HIV prevalence, associated with same gender sex, among adult male patients diagnosed with hepatitis A in the period 2002-2008, except for 2006. Our data suggest that in a low incidence area for hepatitis A, with a constant high proportion of cases among male individuals, all individuals with acute hepatitis A should be routinely offered an HIV test.

Topics: Adult; Hepatitis A; HIV Infections; HIV Seroprevalence; Homosexuality, Male; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Risk-Taking; Rome

From April 28th to May 22nd, 1987, the Medical Authority identified 13 cases (6 symptomatic cases) of hepatitis A (HA) in a school and in a college of Rome. The principal risk factor was determined to be "full-time presence at the State school and boarders at the college". The distribution of HA cases suggested a person to person contact; anti-hepatitis A virus IgM were identified in 12 out of 13 cases with high levels of transaminases. During the disease epidemic, water samples were taken from the well of the college for bacteriological and virological analyses. The water was classified as undrinkable due to the presence of 16 total coliforms/100 ml and 35 total bacteria count at 36 degrees C. Fecal coliforms, fecal streptococci and sulfite reducing clostridia were absent. Two water samples of 100 liters were collected and concentrated by adsorption-elution method on electropositive membranes or by ultrafiltration using a Millipore apparatus. Infectious Hepatitis A virus was only isolated from samples concentrated by adsorption-elution method on electropositive membranes using tissue culture methods and subsequently HA virus was identified by other traditional methods (Elisa and immunofluorescence). In contrast, PCR test performed on the concentrated samples, was positive only for the ultraconcentrated sample. The positivity of the PCR test confirmed the presence of the Hepatitis A virus in the well water.

Topics: Adult; Base Sequence; Child; Disease Outbreaks; Female; Hepatitis A; Hepatitis Antibodies; Hepatovirus; Humans; Male; Molecular Sequence Data; Polymerase Chain Reaction; Rome

In the present work the Authors report the results of the research of HAAb in 383 subjects living in Rome with negative history for hepatitis (divided for age, sex and occupation) and in 64 acute non B hepatitis (HBsAg-). In the latter, the titer of HAAb was determined at the beginning and later during the course of the disease. A fractionation of 13 sera of these patients was done and the type of specific immunoglobulin was determined. Among the subject with negative history for hepatitis, 68.9% was positive during first 6 months of age 6.2% from 6 months to 5 y.o., 27.6% from 6 to 12 y.o., 45.4% from 12 to 17 y.o., 76.8% from 18 to 25 y.o., 82.2% from 26 to 45 y.o., 90.2% from 46 to 65 y.o.. There was no statistically significant difference either between males and females, or among various occupations. Among the 64 patients with non B hepatitis, 25 (39%) were hepatitis A (because they showed either a seroconversion for HAAb or a positive HAAb-IgM); 12 (18.7%) were non A-non B hepatitis because HAAb negative or HAAb positive but negative for HAAb-IgM; while 27 (42.2%) were impossible to classify because they showed a positivity for HAAb but not a seroconversion during the disease. The limit of the determination of HAAb and the utility of the research of IgM antibody for the diagnosis of hepatitis A are discussed.

Topics: Adolescent; Adult; Aged; Antibodies, Viral; Child; Child, Preschool; Female; Hepatitis A; Hepatitis B; Hepatitis C; Hepatovirus; Humans; Immunoglobulin M; Infant; Infant, Newborn; Male; Middle Aged; Rome

Topics: Hepatitis A; Hepatitis B Antigens; Humans; Liver; Rome

Topics: Age Factors; Child; Child, Preschool; Female; Hepatitis A; Humans; Infant; Male; Rome; Sex Factors