HEPATOLOGY Vol. 22, No. 4, P t . 2, 1995 A A S L D A B S T R A C T S 3 8 7 A

1121 HEPATITIS A VIRUS INFECTION: IS THE RISK OF INFECTION INCREASING ? S Albloushi; E Raian B OVarrell*_ AG Shattoek*: JF Fielding and MG Courtne3L Department of Medical Microbiology, University College Dublin* and Hepatology Unit, Beaumont Hospital, Dublin. Ireland.

Hepatitis A virus (HAV) infection is the commonest form of viral hepatitis worldwide.

Aim:The purpose of the study was to determine the current prevalence rates for HAV infection in definable populations from areas of varying endemicity. Methods: Serum was obtained from 708 medical students and staff from the Royal College of Surgeons in Ireland and from nurses in Beaumont Hospital, Dublin, Ireland and was tested for total Ig antibody to HAV using an ELISA technique. All positive samples were tested for IgM antibody to HAV. 108 individuals came from the Middle East, 488 from Ireland and 112 from South East Asia. Results: Antibody to HAV was detected in 68 (63%) of the Middle East students, (mean age 21 years, range 17-28 years); 102 (21%) of the Irish students and staff(mean age 22 years, range 17-28 years ) and 17 (15%) of the South East Asian students (mean age 23 years, range 17-28 years). All samples tested for IgM antibody to HAV were seronegative. Conclusions: This study confirms that HAV prevalence rates are declining in the three distinct geographical regions compared with previous surveys. This decline is most marked in South East Asia followed by the Middle East With Ireland showing least change from a low base. With this decline in prevalence rates comes an increased risk of acquiring HAV infection as an adult when such infection is associated with a higher morbidity and mortality. Ideally, all seronegative teenagers and young adults should receive HAV vaccination but at least, those individuals at higher risk of acquiring HAV infection because of occupation or travel should be vaccinated.

1122 HEPATITIS A VIRUS SEROPREVALENCE IN THE UNITED ARAB EMIRATES. g Alhlo, rhi; b, Daiani*, E Banaheela **;2LPobletf,~, AG Shattoek ***: MQ Courtney. Hepatology Unit~ Beaumont Hospital, Sharjah Medical Area*, Zayed Military Hospital **, Abu Dahbi, UAE and the Department of Medical Microbiology, University College Dublin ***, Ireland.

Hepatitis A virus (HAV) is an RNA virus and it is the commonest cause of viral hepatitis worldwide. AIM: To determine the seroprevalenee of HAV antibodies in the United Arab Emirates (UAE) which as one of the Middle Eastern Countries is considered a high endemicity area. METHODS: 1583 volunteers (1157 men and 426 women) were recruited and each donated 10 mls of venous blood and completed a questionnaire. This group included both military and civilian populations distributed uniformly between all ranks and socio-economic groupings. The serum was tested for total immunoglobulin to HAV using an ELISA technique (Abbott Diagnostics, USA). RESULTS: 1227 tested positive for HAV Ig giving an overall seroprevalence rate of 77.5% in the UAE. 970 of 1157 men tested positive (83.8%) and 257 of 426 women tested positive (60.3%), revealing a noticeably increased seroprevalenee in men versus women. CONCLUSION: The above study clearly shows that HAV seroprevalence in the UAE is high but decreasing from previously recorded levels of approximately 90-100% probably due to improving living standards, With this reduction in seroprevalence the risk of clinically significant HAV infection in adulthood is increased and may cause enhanced morbidity and mortality. During the transition period from high to intermediate endemicity it may be advisable to commence a vaccination program against Hepatitis A.

1123 HEPATITIS E VIRUS SURVEILLANCE IN IRISH HOMOSEXUAL, HAEMODIALYSIS, INTRAVENOUS DRUG ABUSING AND HEPATITIS C PATIENTS. S Alhlou~hi: S ~achlthanandan, J Walsh~ M Carmndy; J Donohoe~ .l O'Conno L M O'Mahnnev B O'Farre]l~ AG Shaltock; N Part'rev MG Co.rUmy. National Virus Roi;erenee

Laboratory, Trinity Court Drug Treatment Centre and Hepatology Unit, Beaumont Hospital, Dublin. Ireland.

Epidemiologieal studies have suggested that Hepatitis E Virus (HEV) is a water borne, enterically transmitted hepatotropie virus which causes acute hepatitis and does not progress to chronieity. HEV is distinctly uncommon outside Southern Europe, North Africa and Asia. It has been suggested that HEV transmission may occur at least partially by parenterul routes 1. AIM: To test this theory, we have surveyed haemodialysis patients, intravenous drug abusing (IVDA) and Hepatitis C patients in our hospital for evidence of previous HEV infection using arecently devised indirect enzyme immunoassay for total Ig to HEV (Abbott Diagnostics, Wiesbaden, Germany). As control groups we surveyed homosexual men and hospital staff nurses. METHODS: 45 haemodialysis patients (20 males, 25 females, mean age 56,3 years, range 17 - 83 years); 30 IVDA patients (22 males, 8 females, mean age 29.0 years, range 19-59 years); 30 hepatitis C infected women (mean age 43.9 years, range 25 - 58years); 30 homosexual men (mean age 34.3 years, range 23-57 years) and 30 female staff nurses (mean age 33 years, range 24 to 60 years) were screened for HEv antibodies. RESULTS: Three patients (two Hepatitis C infected women and 1 male homosexual) tested positive for HEV Ig antibodies suggesting previous exposure to HEV. This is the first report of HEV antibody testing in Northern European haemodialysis, IVDA, homosexual, Hepatitis C and nursing staff populations and is significantly lower than the 11% in the French haemodialysis study.1 This may indicate a pronounced north-south gradient in Europe for HEV positivity in haemodialysis patients, or the high prevalence in the southern French study may be due to localized influences. CONCLUSION:The result leaves open the possibility that parenteral transmission of HEV may occur. 1. Halfon Ph, et al. High prevalence of Hepatitis E Virus antibody in haemodialysis patients. Lancet 1994; 344 : 746

1124 CYPERMETHRIN INDUCES SUBACUTE LIVER DAMAGE AND INCREASES APO A-I AND APO B mRNA LEVELS BUT NOT HYPERLIPIDEMIA. L Aldana. E Gonzaiez de M0if~, AR Rinc6n, ,I Armend~riz-Borund8 and A Panduro. DIPA-University of Quer6taro, and Institute of Molecular Biology in Medicine, CUCS-University of Guadaiajara, M(~xico.

Synthetic pyrethroid insecticides (SPI) have been considered among the safest classes of insecticides available and therefore are widely utilized in the world. Several reports have indicated that SPI such as cypermethrin (Cyp) originate an increase in transaminases in some studies but not in others. The aim of this study was to analyze the hepatotoxic effect of Cyp at the histological, biochemical and molecular level. Male wistar rats (280-300 g) were treated with 300 mg/Kg of (-Cis 49.9%) Cyp everyday during a week. A few hours after each injection, the animals displayed scratching, ataxia and convulsions, thereafter anorexia and at the end of the treatment loss of body weight. A statistically significant decrease of serum albumin was present from 4 to 7 days of treatment but not total serum proteins. At the same expedmental time points transaminases and alcaline phosphatases increased reaching not more than double normaJ values. Serum cholesterol and tdglycaddes values dropped 61% and 44% at 5th day of Cyp treatment respectively. At the same time, HDL and VLDL dropped to 40-60 % compared to normal values and remained decreased until the last day of treatment in spite of an increase of 3-4 times in apo A-I and apo B mRNA levels, principal constituents of HDL and VLDL respectively. Hepatic tissue blocks were fixed in paraformaidehyde for histopathologicai analyses. Edema, sinusoidai congestion and steatosis from light to moderate was observed as a function of time. Furthermore, a ligth fibrosis was noted at the 7th day of Cyp treatment. In this study we have shown a hepatotoxic effect of Cyp causing subacute liver damage as indicated by the histopathologicai and biochemical studies. Furthermore, under these pathological conditions, hypedipidemia is not present despite high levels of apo A-I and apo B mRNA, suggesting translational or posttranlational regulation in the expression of these genes.