Genotypes of hepatitis a virus in Turkey: first report and clinical profile of children infected with sub-genotypes IA and IIIA

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dc.contributor.authorYilmaz, Huseyin
dc.contributor.authorKarakullukcu, Asiye
dc.contributor.authorTuran, Nuri
dc.contributor.authorCizmecigil, Utku Y.
dc.contributor.authorYilmaz, Aysun
dc.contributor.authorOzkul, Ayse A.
dc.contributor.authorAydin, Ozge
dc.date.accessioned2024-04-24T17:14:54Z
dc.date.available2024-04-24T17:14:54Z
dc.date.issued2017
dc.departmentDicle Üniversitesien_US
dc.description.abstractBackground: Hepatitis A virus (HAV) is a food and water-borne virus causing clinical (mainly hepatitis) and subclinical disease in humans. It is important to characterize circulating strains of HAV in order to prevent HAV infections using efficacious vaccines. The aim of this study was the detection and characterization of the circulating strains of HAV in Turkey by performing serology, RT-PCR, sequencing and phylogenetic analysis. Methods: In this study, 355 HAV suspected cases were analysed by ELISA for the presence of antibodies to HAV. RNA was extracted from 54 HAV IgM positive human sera. None of the suspect cases were vaccinated against HAV and they never received blood transfusions. Samples found positive by RT-PCR using primers targeting the VP1/VP2A junction and VP1/VP3 capsid region of HAV, were subjected to sequencing and phylogenetic analyses. Results: IgM type antibodies to HAV were detected in 54 patients. Twenty one of them were students. The age of IgM positive cases was between 3 and 60 years. IgM positivity differed in age groups and was higher in the age group 3 to 10 years. Phylogenetic analysis showed that the majority of HAV strains detected in this study belong to the HAV 1B cluster. In addition, the HAV sub-genotypes IA (KT874461.1) and IIIA (KT222963.1) were found in 2 children. These sub-genotypes were not previously reported in Turkey. The child who carried subgenotype IIIA travelled to Afghanistan and presented with abdominal pain, icterus and vomitus. He was positive for anti-HAV IgM and IgG but negative for hepatitis B and C. Liver enzymes like aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase and lactate dehydrogenase were severely elevated. Bilirubin levels were also increased. White blood cells, neutrophils and hemoglobin were decreased while lymphocytes and monocytes were increased. Similar clinical signs and laboratory findings were reported for the child infected with sub-genotype IA but aspartate aminotransferase and alanine aminotransferase were not severely elevated. Conclusions: The results indicate that molecular studies determining the HAV genotype variation in Turkey are timely and warranted. The majority of IgM positive cases in 3-10 year old patients indicate that childhood vaccination is important. Sub-genotype IB is the most prevalant genotype in Turkey. Surprisingly, sub-genotype IA and IIIA are also present in Turkey; future diagnostic efforts need to include diagnostic methods which can identify this emerging HAV genotypes. Our results also show that one important risk factor for contracting hepatitis A virus is international travel since genotype IIIA was detected in a child who had travelled to Afghanistan.en_US
dc.description.sponsorshipTurkish Scientific and Technical Research Council (TUBITAK) [113O390]en_US
dc.description.sponsorshipTurkish Scientific and Technical Research Council (TUBITAK); Project No: 113O390.en_US
dc.identifier.doi10.1186/s12879-017-2667-3
dc.identifier.endpage8en_US
dc.identifier.issn1471-2334
dc.identifier.pmid28800730
dc.identifier.startpage1en_US
dc.identifier.urihttps://doi.org/10.1186/s12879-017-2667-3
dc.identifier.urihttps://hdl.handle.net/11468/18248
dc.identifier.volume17en_US
dc.identifier.wosWOS:000407456000001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherBmcen_US
dc.relation.ispartofBmc Infectious Diseases
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectHepatitis A Virus Sequencingen_US
dc.subjectPhylogeneticen_US
dc.subjectVp1/Vp2aen_US
dc.subjectVp1/Vp3en_US
dc.subjectTurkeyen_US
dc.titleGenotypes of hepatitis a virus in Turkey: first report and clinical profile of children infected with sub-genotypes IA and IIIAen_US
dc.titleGenotypes of hepatitis a virus in Turkey: first report and clinical profile of children infected with sub-genotypes IA and IIIA
dc.typeArticleen_US

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