Hepatitis A is one of the leading causes of acute viral hepatitis in India. There are major geographical variations in hepatitis A endemicity which could be attributed to hygiene and sanitary conditions and other indicators of the level of socio-economic development.

A study published in the April issue of the Indian Journal of Medical Research sought to ascertain the seropositivity prevalence and the dominant circulating strain of HAV in north India.

Investigators recruited patients with acute viral hepatitis in the study and blood samples were collected from June 2016 to May 2017. Samples were tested for anti-immunoglobulin M (IgM) HAV antibodies. Seropositive samples were analyzed for HAV-RNA using real-time reverse transcription-polymerase chain reaction (RT-PCR) and the samples detected on molecular assay underwent conventional semi-nested RT-PCR testing for VP1 gene. Further sequencing of amplified RT-PCR products was done and the data were assessed.

In all, 1615 patients were enrolled in the study, with a male:female ratio of 1.3:1 and mean age of 24.31±17.02 yr (range 0-83 yr). About 7.93% were positive for anti-HAV IgM antibodies, with 41.63% of seropositive patients being in their childhood or early adolescence. Of the seropositive samples, 46.09% were positive for HAV RNA. Genotyping sequencing of 10 representative strains revealed the circulating genotype as IIIA.

Hepatitis A was found to be common among children with IIIA as the circulating genotype in this region. HAV RNA was detected in nearly 50% of cases. The study demonstrated a higher number of HAV IgM-seropositive cases during monsoon period.

Source: Prakash S, Shukla S, Shukla R, et al. Molecular Characterization of Hepatitis A Virus Circulating in Uttar Pradesh, India: A Hospital-Based Study. Indian J Med Res. 2020 Apr;151(4):375-379.