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    High and persistent excretion of hepatitis A virus in immunocompetent patients.

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    Authors
    Tjon, Grace M S
    Coutinho, Roel A
    Hoek, Anneke van den
    Esman, Sylvia
    Wijkmans, Clementine J
    Hoebe, Christian J P A
    Wolters, Bert
    Swaan, Corien
    Geskus, Ronald B
    Dukers, Nicole H T M
    Bruisten, Sylvia M
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    Language
    en
    
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    Title
    High and persistent excretion of hepatitis A virus in immunocompetent patients.
    Publiekssamenvatting
    The duration and level of virus excretion in blood and faeces of patients with hepatitis A virus (HAV) infection were studied in relation to levels of alanine aminotransferase (ALT), disease severity and HAV genotype. Clinical data, blood and faeces were collected from 27 patients with acute hepatitis A (median age: 33 years) for a maximum of 26 weeks. Single blood donations from 55 other patients with acute HAV (median age: 32 years) were also used. Virus loads were quantified by competitive nested RT-PCR. HAV was excreted in faeces for a median period of 81 days after disease onset, with 50% of patients still excreting high levels at Day 36 (2 x 10(6) - 2 x 10(8) copies/ml faeces suspension). Viraemia was detected, but not quantifiable, for a median period of 42 days. In the first 10 days of illness, higher ALT levels were correlated with higher viraemia levels. Comparison of patients infected with genotype 1a with those infected with type 1b did not differ significantly in terms of the duration of HAV excretion or jaundice. In conclusion, faecal excretion of HAV is at a high titre in the first month, perhaps making patients infectious for a longer period than assumed currently. Blood banks should be aware that viraemia may be present for more than 1 month, and genotype did not affect the duration of virus excretion or jaundice.
    DOI
    10.1002/jmv.20711
    PMID
    16998883
    URI
    http://hdl.handle.net/10029/6269
    ae974a485f413a2113503eed53cd6c53
    10.1002/jmv.20711
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