Key result
Combining HAV-RNA with anti-HAV IgM testing increased the diagnostic yield by 7.2% in the early phase of acute hepatitis A infection (less than 5 days) during a large-scale outbreak.
Why the study?
Does a combination of HAV-RNA and anti-HAV IgM tests improve diagnostic yield during the early phase of acute hepatitis A infection?
Observational (n=205)
No
Does a combination of HAV-RNA and anti-HAV IgM tests improve diagnostic yield during the early phase of acute hepatitis A infection?
Combining HAV-RNA and anti-HAV IgM tests increases diagnostic yield in the early phase of acute hepatitis A infection, aiding in rapid outbreak control.
This is the authors' abstract. We don't add key points for this paper.
INTRODUCTION: Acute hepatitis A is a worldwide public health problem especially in developing countries. Recently, a large, community-wide outbreak of hepatitis A occurred in the northeast part of Thailand. METHODS: Demographic and clinical data as well as blood samples were collected and analyzed from patients with acute hepatitis who attended the Buengkan Provincial Hospital from June to September 2012. About 1619 patients with clinical symptoms of hepatitis A visited the hospital during the outbreak which manifested in three waves. Blood samples were collected from 205 patients. RESULTS: One hundred and seventy eight patients had hepatitis A confirmed by the presence of anti-hepatitis A virus (HAV) IgM and/or HAV-RNA. The sensitivities for anti-HAV IgM and HAV-RNA were 95·5% (170/178) and 61·8% (110/178), respectively. When HAV-RNA was combined with anti-HAV IgM test, this increased the diagnostic yield by 7·2% (8/111) in the early phase of the acute infection (less than 5 days). Investigation of the molecular structure of the detected viruses indicated that all of the infections were caused by HAV genotype IA. There were no fatalities from this outbreak. Rapid detection, health education, sanitation campaigns, and vaccination offered on a voluntary basis have steadily reduced the number of infected patients and stopped the outbreak. CONCLUSION: Occasionally a large-scale outbreak of HAV genotype IA can occur. A combination of HAV-RNA and anti-HAV IgM tests can increase the diagnostic yield during the early phase of the acute infection. Early diagnosis and preventive management campaigns can slow down and stop the outbreak.
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May support combined HAV-RNA/IgM testing for early hepatitis A detection in outbreaks; leaves open need for prospective validation before practice change.
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Poovorawan et al. (2013) conducted an observational in Acute hepatitis A (n=205). Combined HAV-RNA and anti-HAV IgM testing vs. Anti-HAV IgM testing alone was evaluated on Diagnostic yield in the early phase of acute infection (< 5 days) (7.2% increase). Combining HAV-RNA with anti-HAV IgM testing increased the diagnostic yield by 7.2% in the early phase of acute hepatitis A infection (less than 5 days) during a large-scale outbreak.
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