Detection of hepatitis A viral RNA in sera of patients with acute hepatitis A

Background and Aims: The Detection of hepatitis A virus (HAV) is important for diagnosis and epidemiological studies of hepatitis A. The polymerase ch ain reaction (PCR) technique is a sensitive test to detect HAV-RNA in speci mens. The aims of the present study were to clarify the detection rate of s erum HAV-RNA by PCR and the natural history of HAV viraemia, and to determi ne the correlation between viraemia and the clinical characteristics in pat ients with acute hepatitis A. Methods: Hepatitis A virus RNA was tested in 74 serum samples which were se rially collected from 27 patients with acute hepatitis A. A nested reverse transcription (RT)-PCR for HAV-RNA was performed with primer sets located a t the VP1 region of the HAV genome and the PCR products were eletrophoresed on a 1.5% agarose gel. Results: Hepatitis A virus RNA was found in 18 of 27 (67%) patients with he patitis A. There were no significant differences between groups positive an d negative for HAV-RNA in clinical and laboratory data, except the time int erval between clinical onset and initial serum sampling for RT-PCR (10 +/- 6 vs 19 +/- 14 days) and the alanine aminotransferase (ALT) level at initia l serum sampling for RT-PCR (1436 +/- 1416 vs 518 +/- 432 IU/L). The mean d uration of HAV viraemia was 30 +/- 19 days (range, 5-59 days). The duration of HAV viraemia and duration of abnormal ALT levels from clinical onset we re positively correlated (r = 0.685, P = 0.007). Conclusion: In conclusion, HAV-RNA RT-PCR is a useful tool to detect HAV vi raemia and to study the molecular epidemiology of HAV infection. (C) 2000 B lackwell Science Asia Pty Ltd.