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Aldehyde-Based Surface Disinfectants May Reduce Hepatitis A Virus Transmission, Study Finds
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Key Takeaways
- HAV is highly stable on surfaces, remaining infectious for up to 40 days with a half-life of 18.63 days.
- Only two aldehyde-based disinfectants effectively reduced HAV to undetectable levels, unlike other tested products.
Among the 9 surface disinfectants studied, only 2 demonstrated a reduction in viral titer below the limit of detection.
When used to prevent hepatitis A virus (HAV) via surface transmission, only 2 aldehyde-based surface disinfectants demonstrated a reduction in viral titer below the limit of detection, according to the authors of a new study. These findings have strong implications for evidence-based hygiene guideline recommendations to reduce the transmission of HAV, according to the investigators.1
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HAV is one of the leading causes of viral hepatitis. Annually, there are an estimated 159 million acute infections, and the virus is most prevalent in Africa, parts of Asia, and Latin America but can also be found in Central and Eastern Europe. The primary route of transmission is fecal-oral, through contaminated drinking water and food (eg, contaminated shellfish, berries, and lettuce). Typically, infections in children are asymptomatic, but symptoms can manifest in up to 70% of adult infections, with the most common ones including malaise, jaundice, vomiting, fever, and abdominal pain or discomfort. Extrahepatic manifestations (eg, kidney injury, mononeuritis, cholecystitis, Guillain-Barré syndrome) have also been reported in serious cases.1
Because there are currently no specific treatments available to treat HAV, prevention strategies are critical to lower transmission. There are limited data regarding its surface stability, and sensitivity to surface disinfectants is available. The investigators hypothesized that the implementation of effective disinfectants could have a significant impact on the prevention of HAV transmission; thus, the aim of their study was to evaluate HAV stability and sensitivity to surface disinfectants based on an established carrier assay.1
For this study, the stability of HAV on stainless steel discs over a period of 60 days and its sensitivity to different commercially available surface disinfectants were evaluated. The 9 studied disinfectants were subdivided into alcohol-based products (Bacillol, Antifect, Meliseptol), aldehyde-based products (Kohrsolin, Incidin Rapid, Melsept), a peracetic acid-based product (PAA), an oxygen-based product (Perform), and a hydrogen peroxide-based product (Incidin OxyFoam). Further, steel-disc carriers were inoculated with HAV particles and incubated over a respective period. HAV resistance against several groups of disinfectant agents was tested with varying concentrations and exposure times, as per the individual manufacturers’ guidelines.1
“We detected infectious particles on the surface for up to 40 days, which indicates a high stability of the virus,” study author Lilli Pottkämper, a doctoral student, said in a news release. “With the exception of the 2 aldehyde-based products, none of the disinfectants reduced the risk of infection to a sufficient extent.”2
More specifically, HAV was recoverable from stainless steel discs for up to 40 days with an estimated half-life of about 18.63 days. The evaluation of several surface disinfectants showed that, except for the aldehyde-based products, all other products insufficiently inactivated HAV. Similar to other pathogens, viruses are able to persist on surfaces for extended periods. The stability of this also varied depending on environmental factors (eg, temperature, pH, UV exposure) as well as virus-specific factors, such as the envelopment as well as the physical and chemical properties of the capsid.1
The authors noted that the translation of in vitro results to real-life scenarios requires careful assessment of certain limitations and differences. For this reason, accessing the potential of HAV transmission via contaminated fomites onto skin requires further investigation. The authors propose that a realistic touch-transfer assay—as previously shown for SARS-CoV-2 transmission—may offer more insight. Despite this limitation, the investigators believe that, based on these findings, aldehyde-based disinfectants may be a suitable method of HAV surface disinfection; however, more research is needed to further confirm these findings.1
“As matters stand, effective surface disinfection could help to prevent infection, especially in the case of high infection rates,” said Pottkämper in the news release.2
