{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:37:11Z","timestamp":1781721431436,"version":"3.54.5"},"reference-count":21,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfeicoamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["not available"],"award-info":[{"award-number":["not available"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Outbreaks of hepatitis A may occur in countries of medium and high socioeconomic levels in which the population generally exhibits an increased susceptibility in young adults to this infection if they are not vaccinated against the hepatitis A virus (HAV). In Europe, an outbreak involved approximately 22 European countries with 4475 cases reported from 2016 to 2018; most of them were men who have sex with men (MSM). This outbreak expanded to North and South America, including Brazil, particularly in S\u00e3o Paulo city with 1547 reported cases from 2016 to 2019. In the present study, we characterized the HAV strains involved in the acute hepatitis A cases identified in the reference centers of S\u00e3o Paulo city during this outbreak. A total of 51 cases with positive anti-HAV IgM were included, 80.4% male, 68.6% of them between 20 and 40 years old and 41.7% MSM. HAV RNA was detected in 92% (47\/51) of the cases. Subgenotype IA of HAV was identified and most of the strains were closely related to that isolated in outbreaks that occurred in different European countries in 2016. These results showed the epidemiological relation between these outbreaks and reinforce the need to implement vaccination against hepatitis A for the adult population, particularly for a population with a high-risk behavior.<\/jats:p>","DOI":"10.3390\/v14010073","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T23:35:09Z","timestamp":1641771309000},"page":"73","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Molecular Characterization of Hepatitis A Virus Strains Circulating during Hepatitis A Outbreaks in S\u00e3o Paulo, Brazil, from September 2017 to May 2019"],"prefix":"10.3390","volume":"14","author":[{"given":"Samira","family":"Chuffi","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Gastroenterologia e Hepatologia Tropical\u2014LIM\/07, Departamento de Gastroenterologia, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de S\u00e3o Paulo, Universidade de S\u00e3o Paulo, Av. Dr. En\u00e9as Carvalho de Aguiar, 500, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5932-2360","authenticated-orcid":false,"given":"Michele S.","family":"Gomes-Gouv\u00eaa","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Gastroenterologia e Hepatologia Tropical\u2014LIM\/07, Departamento de Gastroenterologia, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de S\u00e3o Paulo, Universidade de S\u00e3o Paulo, Av. Dr. En\u00e9as Carvalho de Aguiar, 500, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8341-8960","authenticated-orcid":false,"given":"Luciana V. B.","family":"Casadio","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas, Departamento de Mol\u00e9stias Infecciosas e Parasit\u00e1rias, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Catharina S. S.","family":"Nastri","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas, Departamento de Mol\u00e9stias Infecciosas e Parasit\u00e1rias, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario P.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Instituto de Infectologia Emilio Ribas, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 L. F.","family":"Cotia","sequence":"additional","affiliation":[{"name":"Instituto de Infectologia Emilio Ribas, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda G. D.","family":"Aranda","sequence":"additional","affiliation":[{"name":"Instituto de Infectologia Emilio Ribas, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone B.","family":"Tenore","sequence":"additional","affiliation":[{"name":"Centro de Refer\u00eancia e Treinamento\u2014CRT DST-AIDS, S\u00e3o Paulo 05403-000, SP, Brazil"},{"name":"Hospital S\u00e3o Paulo, Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzane K.","family":"Ono","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas, Departamento de Gastroenterologia, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda M.","family":"Malta","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de T\u00e9cnicas Especiais, Hospital Israelita Albert Einstein, Albert Einstein Medicina Diagn\u00f3stica, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Madalosso","sequence":"additional","affiliation":[{"name":"Epidemiological Surveillance Center, Disease Control Coordination, State of S\u00e3o Paulo Department of Health, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo R. A.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Paulo, Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flair J.","family":"Carrilho","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas, Departamento de Gastroenterologia, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3999-0489","authenticated-orcid":false,"given":"Jo\u00e3o R. R.","family":"Pinho","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Gastroenterologia e Hepatologia Tropical\u2014LIM\/07, Departamento de Gastroenterologia, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de S\u00e3o Paulo, Universidade de S\u00e3o Paulo, Av. Dr. En\u00e9as Carvalho de Aguiar, 500, S\u00e3o Paulo 05403-000, SP, Brazil"},{"name":"Laborat\u00f3rio de T\u00e9cnicas Especiais, Hospital Israelita Albert Einstein, Albert Einstein Medicina Diagn\u00f3stica, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"a031716","DOI":"10.1101\/cshperspect.a031716","article-title":"Globalization and the Changing Epidemiology of Hepatitis A Virus","volume":"8","author":"Jacobsen","year":"2018","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1093\/epirev\/mxj012","article-title":"Hepatitis A in the era of vaccination","volume":"28","author":"Wasley","year":"2006","journal-title":"Epidemiol. 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