Key result
Molecular diagnosis of HAV and anti-HAV IgG avidity measurement are helpful in cases of positive IgM without laboratory evidence of acute hepatitis or epidemiologic links.
Molecular diagnosis and anti-HAV IgG avidity measurement are helpful adjuncts to IgM serology for diagnosing acute hepatitis A, while molecular epidemiology aids in outbreak investigation.
The diagnosis of hepatitis A virus (HAV) infection is based on the detection of anti-HAV IgM. Shortcomings of this serological approach include the persistence of IgM after normalization of liver enzymes or its detection during polyclonal activation of the immune system due to unrelated viral infection or autoimmune diseases. Molecular diagnosis of HAV along with anti-HAV IgG avidity measurement are helpful in case of positive IgM where laboratory evidence of acute hepatitis is absent and there is no epidemiologic link to other cases. Molecular epidemiology allows us to determine whether viruses from different locations are related to each other and provides further understanding of viral epidemiology by identifying sources and transmission modes. It has been demonstrated that the rapid turnover of HAV strains in low-endemicity countries is caused by their introduction by travelers. Growing sequence databases allow for the identification of geographic origin of viral strains. Collaboration between surveillance laboratories, including database sharing, should be promoted for deeper investigation of outbreaks and improved prevention approaches.
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Roque‐Afonso et al. (2010) conducted a review in Hepatitis A virus infection. Serology and Molecular Diagnostics was evaluated. Molecular diagnosis of HAV and anti-HAV IgG avidity measurement are helpful in cases of positive IgM without laboratory evidence of acute hepatitis or epidemiologic links.
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