Key result
Genomic analysis of 6 patients with HAV-induced acute liver failure identified subgenotype IA in 4 patients and subgenotype IIIA in 2 patients, suggesting IIIA may be widespread in Japan.
Observational (n=6)
No
HAV subgenotype IIIA might be widespread in Japan, contributing to recent cases of acute liver failure.
Raises awareness of possible HAV IIIA circulation in Japan; hypothesis-generating for its role in acute liver failure and requires larger surveillance.
AIM: Recently, the number of acute hepatitis A cases has decreased in Japan. However, six patients with acute liver failure caused by hepatitis A virus (HAV) have been admitted to Chiba University Hospital, Japan, in the last 18 months, between 2010 and June 2011. The aim of this study is to characterize the recent HAV genotypes from an urban hospital in Japan and to compare the clinical differences. METHODS: Hepatitis A virus RNA was detected by strand-specific reverse transcription. Then, HAV VP1/2A regions were amplified by nested polymerase chain reaction (PCR). Sequences were directly determined and phylogenetic trees were constructed for determining HAV subgenotypes. RESULTS: Analysis of these HAV genomes revealed that 4 and 2 belonged to subgenotypes IA and IIIA, respectively. CONCLUSIONS: Fujiwara et al. reported a frequency of HAV subgenotype IIIA of only 2.1% in Japan. We conclude that HAV subgenotype IIIA might be widespread in our country.
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Miyamura et al. (2011) conducted an observational in Acute liver failure caused by hepatitis A virus (n=6). Hepatitis A virus genotypes was evaluated on HAV subgenotypes. Genomic analysis of 6 patients with HAV-induced acute liver failure identified subgenotype IA in 4 patients and subgenotype IIIA in 2 patients, suggesting IIIA may be widespread in Japan.
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