Hepatitis A virus monitoring in wastewater: A complementary tool to clinical surveillance

• Published in: Water research (Oxford) Vol. 241; p. 120102
• Main Authors: Fantilli, Anabella, Cola, Guadalupe Di, Castro, Gonzalo, Sicilia, Paola, Cachi, Ariana Mariela, de los Ángeles Marinzalda, María, Ibarra, Gustavo, López, Laura, Valduvino, Celina, Barbás, Gabriela, Nates, Silvia, Masachessi, Gisela, Pisano, María Belén, Ré, Viviana
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2023
• Subjects: Argentina; Clinical surveillance; environmental monitoring; genotype; HAV; hepatitis A; Hepatitis A virus; Hepatovirus A; Latin America; monophyly; sewage; wastewater; wastewater treatment; Wastewater-based epidemiology; water; Argentina; Latin America; Argentina; Clinical surveillance; Hepatitis A virus; HAV; Wastewater-based epidemiology
• ISSN: 0043-1354; 1879-2448; 1879-2448
• DOI: 10.1016/j.watres.2023.120102

•Wastewater monitoring is an effective tool that complements HAV surveillance.•In this study, WBE constituted a replica of the HAV clinical-epidemiological scenario.•HAV variants from clinical and sewage samples were phylogenetically correlated.•In some cases, WBE was useful to predict the rise in hepatitis A clinical reports.•WBE might contribute to the knowledge of HAV in the post-vaccination era in LATAM. Monitoring wastewater is an effective tool for tracking information on trends of enteric viral dissemination. This study aimed to perform molecular detection and genetic characterization of HAV in wastewater and to correlate the results with those obtained from clinical surveillance. Wastewater samples (n=811) of the second most populous city in Argentina were collected from the main wastewater treatment plant (BG-WWTP, n=261), and at 7 local neighborhood collector sewers (LNCS, n=550) during 2017–2022. Clinical samples of acute hepatitis A cases (HA, n=54) were also analyzed. HAV molecular detection was performed by real time RT-PCR, and genetic characterization by RT-Nested PCR, sequencing and phylogenetic analysis. RNA-HAV was detected in sewage samples throughout the entire period studied, and detection frequencies varied according to the location and year (2.9% - 56.5%). In BG-WWTP, 23% of the samples were RNA-HAV+. The highest detection rates were in 2017 (30.0%), 2018 (41.7%) and 2022 (56.5%), which coincides with the highest number of HA cases reported. Twenty-eight (28) sequences were obtained (from clinical and sewage samples), and all were genotype IA. Two monophyletic clusters were identified: one that grouped clinical and wastewater samples from 2017–2018, and another with specimens from 2022, evidencing that environmental surveillance might constitute a replica of viral circulation in the population. These findings evidence that WBE, in a centralized and decentralized sewage monitoring, might be an effective strategy to track HAV circulation trends over time, contributing to the knowledge of HAV in the new post-vaccination epidemiological scenarios in Argentina and in Latin America. [Display omitted]