抗HEV-IgA在急性戊型肝炎诊断中的意义

目的建立酶联免疫吸附法检测血清抗HEV-IgA的方法,了解戊型肝炎患者血清中抗HEV-IgA的动态变化规律及探讨其诊断中的意义。方法应用北京万泰公司基因重组HEV ORF-2/ORF-3抗原预包被的酶标板,HRP标记羊抗人IgA建立检测血清抗HEV-IgA的方法。酶联免疫试验检测60例HEV RNA阳性戊型肝炎患者不同时间段血清抗HEV-IgA、抗HEV-IgM(捕获法)、抗HEV-IgG水平。结果60例戊型肝炎患者血清抗HEV-IgA、抗HFV-IgM均为阳性,而对照组410例非戊型肝炎病人中,5例抗HEV-IgA阳性,6例抗HEV-IgM,且抗HEV-IgG和HEV RNA均阴性,其中仅有一例出现抗HEV-IgA和HEV-IgM双阳性(隐性感染)。动态检测戊型肝炎患者血清HEV RNA、抗HEV-IgA、抗HEV-IgM和抗HEV-IgG,发现急性戊型肝炎血清HEV RNA持续至发病后(20±11)d,抗HEV-IgA阳性持续至(120±23)d、抗HEV-IgM阳性持续至(90±15)d,自发病后第2个月开始,抗HEV-IgA、抗HEV-IgM阳性率百分比差异有统计学意义(P<0.05)。结论戊型肝炎患者抗HEV-IgA阳性较抗HEV-IgM阳性持续时间长,抗HEV-IgA检测弥补了抗HEV-IgM阴性急性戊型肝炎的诊断,同时检测抗HEV-IgM和抗HEV-IgA,可提高急性型肝炎诊断的特异性。     

北京市急性散发性戊型肝炎血清学分析

目的 了解北京市散发性戊型肝炎(HEY)的流行病学特征.方法 回顾性分析2002年7月-2007年7月首都医科大学附属北京佑安医院就诊的患者17 324例,用酶联免疫吸附试验方法检测血清抗-HEV IgM/IgG的戊型肝炎感染标志物.结果 2002-2007年的抗-HEV检测阳性率分别是6.26%,8.83%,11.30%,8.38%,9.36%,各年间比较差异有统计学意义(χ~2=56.69,P<0.000);17 324例患者血清抗-HEV共有1 541例阳性(8.94%);抗-HEV阳性患者中男性为1 256例(81.51%),女性285例(18.49%);单纯抗HEV IgM阳性617例(40.04%),单纯抗HEV IgG阳性329例(21.35%),抗-HEV IgM与HEV IgG阳性均为阳性595例(38.61%);戊型肝炎抗体阳性患者中单纯急性戊型肝炎1 067例(69.24%),戊型肝炎病毒重叠感染乙型肝炎患者350例(22.71%),戊型肝炎重叠其他型肝病患者感染124例(8.05%);随着年龄增长抗-HEV阳性率逐渐增加.结论 北京市2002～2007年散发性戊型肝炎发病率有波动,并呈明显的年龄特征.     

既往有偿献血人群戊型肝炎流行因素及HEV基因型特征分析

目的:了解既往有偿献血人群戊型肝炎的流行特征,为采取有效防控措施提供依据。方法:采用流行病学问卷调查方式收集研究人群的一般资料,利用ELISA和RT-PCR检测血清抗HEV-IgG抗体、抗HEV-IgM抗体和HEVRNA,并分析HEV基因型特征。结果:调查的人群戊型肝炎感染率为22.7%,男性高于女性。抗HEV-IgM阳性率为1.8%。献血次数超过20次以上HEV-IgG抗体阳性率高于献血次数10次(P0.01)。戊型肝炎感染率有随年龄增长而上升的趋势,其中60岁组感染率高达30.6%。随着献血次数的增加,戊型肝炎的感染率呈上升趋势。10例抗HEV-IgM阳性者的血清进行检测显示本地区HEV均为Ⅳ型。结论:既往有偿献血人群中存在较高水平的HEV感染率,男性、年龄大、有偿献血次数多为危险因素,流行毒株均为Ⅳ型HEV且存在较大变异度。     

综合医院散发性戊型肝炎的流行病学分析

目的调查我院2002~2004年间住院患者中散发性戊型肝炎的存在现状,分析其流行病学特征,为流行病防治提供依据。方法对我院2002年1月~2004年12月间,住院患者中血清抗HEV-IgM阳性并确诊为戊型肝炎患者的病历资料进行统计学分析。结果在被检测的4 641例住院患者中血清HEV-IgM阳性329例,其中男239例(72.64%),女90例(27.36%),农村患者HEV-IgM阳性272例(82.67%),城镇患者HEV-IgM阳性57例(17.33%);2002年检测1 443例抗HEV-IgM阳性71例(4.92%),2003年检测1 574例抗HEV-IgM阳性109例(6.93%),2004年检测1 624例抗HEV-IgM阳性149例(9.17%)。结论近3年来我院住院患者中的戊型肝炎病毒患病率呈逐年上升趋势,男性戊型肝炎患者比例显著高于女性,农村戊型肝炎患者比例高于城镇。     

2020年浙江省丽水市无偿献血人群戊型肝炎感染人群特征分析

目的 分析丽水地区无偿献血者戊型肝炎感染人群特征,为献血者招募工作提供依据。 方法 对丽水市2020年常规筛查合格34 746例无偿献血者标本进行酶联免疫吸附法(ELISA)抗-HEV IgM和IgG检测,采用χ² 检验分析不同特征人群戊型肝炎感染情况。 结果 34 746人份献血者样品中,共检测出HEV-IgG阳性8 621例(24.81%),HEV-IgM阳性580例(1.67%);男性HEV-IgG阳性率25.87%,HEV-IgM阳性率1.79%;女性HEV-IgG阳性率23.25%,HEV-IgM阳性率1.49%;男性HEV-IgG阳性率和HEV-IgM阳性率均明显高于女性,差异均有统计学意义(P<0.05)。χ²趋势性检验结果显示,随着年龄的增加,HEV-IgG阳性率和HEV-IgM阳性率随之增加(P<0.005);不同职业间,HEV-IgM阳性率和HEV-IgG阳性率差异有统计学意义(P<0.001)。农民HEV-IgG阳性率最高为42.81%,学生HEV-IgG阳性率最低,占7.38%;农民HEV-IgM阳性率最高为2.58%,医务人员HEV-IgM阳性率最低,占1.22%。χ²趋势性检验结果显示,随着学历的增加,HEV-IgM阳性率和HEV-IgG阳性率随之降低(P<0.05)。 结论 丽水地区无偿献血人群存在一定比例的戊型肝炎病毒携带者,HEV阳性人群性别、年龄、职业和学历分布特征,可作为无偿献血筛查工作的参考依据,降低HEV病毒经输血途径传播的风险。     

常州市天宁区公共卫生从业人员HAV和HEV的感染状况及防治策略

目的了解本辖区从业人员中甲型肝炎病毒(HAV)和戊型肝炎病毒(HEV)的感染情况,以便更有效地防止甲型肝炎病毒和戊型肝炎病毒的传播。方法 2011年-2013年对辖区内84 990名从业人员进行抗甲型肝炎病毒Ig M抗体和抗戊型肝炎病毒Ig M抗体检测,同时对Ig M抗体阳性标本进行抗甲型肝炎病毒Ig G抗体和抗戊型肝炎病毒Ig G抗体检测,并对想继续从事服务行业的阳性人员进行Ig M抗体复检,同时皆做Ig G抗体检测,直到Ig M抗体不能检出时发放健康证明。结果 2011年-2013年从业人员中HAV感染率为0.061%,HEV感染率为0.16%,两者差异有统计学意义(P0.05);抗甲型肝炎病毒Ig M抗体阳性转阴复检次数最多为5次,抗戊型肝炎病毒Ig M抗体阳性转阴复检次数最多为6次。结论 HEV感染率明显高于HAV感染率。加强对甲型肝炎病毒和戊型肝炎病毒Ig M抗体阳性从业人员的管理,提高从业人员的卫生意识,严格控制甲型肝炎病毒和戊型肝炎病毒的传播途径。     

马鞍山地区戊型肝炎病毒分型及流行病学分析

目的 调查安徽省马鞍山地区戊型肝炎感染状况及危险因素,为预防和控制戊型肝炎提供依据.方法 采用分层整群抽样方法抽取马鞍山市3区1县共1 616名常住人口为调查对象进行问卷调查,利用酶联免疫吸附实验和逆转录巢式PCR检测血清抗HEV-IgG抗体、抗HEV-IgM抗体和病毒RNA,并比较马鞍山地区戊型肝炎病毒基因型.结果 总体抗-HEYIgG抗体阳性率为4.76%,男性为4.77%,女性为4.76%,感染率有随年龄增长而上升的趋势;多因素非条件Logistic模型分析结果表明,农民、学龄前儿童和有输血史为戊型肝炎的危险因素,而初中文化程度为保护因素;马鞍山地区戊型肝炎均由Ⅳ型HEV引起.结论 安徽省马鞍山地区戊型肝炎感染率较低,男性略高于女性,存在年龄差异,且马鞍山地区HEV流行株核酸内部的同源性较高.     

2011年天津市和平区从业人员戊型肝炎病毒IgM抗体携带情况

目的通过检测从业人员血液中戊型肝炎病毒IgM（HEV—IgM）抗体,了解戊型肝炎（以下简称戊肝）在正常人群中的隐性感染情况,为预防和控制戊肝的流行提供依据。方法对2011年到天津市和平区疾病预防控制中心进行健康检查的天津市从业人员共33211人的HEV-IgM抗体进行检测,并对检验结果进行分析。结果2011年天津市从业人员33211人中HEV-IgM抗体阳性为22人,阳性率为0．66％;高于临床报病发病率的47．8倍。在检测人群中以31—40岁年龄组HEV—IgM抗体检出比例最高,被检出人员均无肝炎相关症状和其他阳性体征;经X^2检验,不同性别、不同职业的HEV—IgM抗体阳性率差异无统计学意义。结论加强对从事服务领域的人员隐形感染的筛查,对保护人群具有十分重要的意义。     

安徽某市吸毒人群HEV感染的现况调查分析

目的了解吸毒人群戊型肝炎病毒(HEV)感染情况,分析此人群高危行为方式与HEV感染之间的联系,为预防和控制戊型肝炎提供依据。方法采用横断面研究,从戒毒所和美沙酮门诊选择379名吸毒者,调查其吸毒行为方式、性行为特点,用ELISA法检测HEV-IgG抗体,分析吸毒人群戊型肝炎感染的影响因素。结果调查人群静脉注射吸毒的比例为52.8%,吸毒人群戊肝感染率为8.4%,40岁以上年龄组人群HEV感染率为16.3%,高于其他年龄组感染率(χ2=10.580,P=0.005);吸食海洛因的人群HEV感染率为12.0%,高于吸食冰毒人群的3.4%和吸食其他毒品人群的6.3%,差异有统计学意义(χ2=8.542,P=0.014);静脉吸毒人群的感染率为12.5%,高于非静脉吸毒人群的3.9%,差异有统计学意义(χ2=9.015,P=0.003)。结论静脉注射吸毒和年龄因素可能是吸毒人群HEV高感染的重要因素。     

戊型肝炎病毒IgG抗体诊断试剂盒的研制及初步应用

目的 应用大肠杆菌表达的戊型肝炎病毒(HEV)重组抗原建立HEV IgG抗体诊断(ELISA)试剂盒.方法 应用大肠杆菌表达的具有戊型肝炎主要抗原表位的表达蛋白HEV ORF23作为包被抗原,建立检测血清中抗HEV IgG的间接ELISA试剂盒.通过HEV IgG试剂盒对100份戊型肝炎患者血清和150份正常人阴性血清测定结果进行比较,评价本试剂盒的特异性、敏感性及稳定性.另选临床500份肝炎患者血清进行检测,评价本试剂盒的临床应用价值.结果 建立的抗HEV IgG间接ELISA试剂盒特异性、敏感性均为100%,重复性较好,在4℃至少可稳定存放6个月,与同类试剂的符合率为95%以上.500份血清样本中,戊型肝炎患者150例,检出HEV145份,阳性符合率为96.67%.结论 应用大肠杆菌表达的HEV重组抗原建立的检测试剂盒对血清抗HEV IgG的检测具有良好的特异性和敏感性,在戊型肝炎的临床诊断和流行病学调查中具有潜在的应用价值.     

湖北省HIV感染人群戊型肝炎流行病学调查

  目的  了解湖北省人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染人群中戊型肝炎病毒(hepatitis E virus,HEV)的流行情况,为戊型肝炎和艾滋病防治提供有效依据。  方法  于2017年1~6月在湖北省不同地域收集335例HIV感染人群血清样本并进行抗-HEV IgM、抗-HEV IgG检测。  结果  335名HIV感染人群的抗-HEV IgG阳性率为41.49%(139/335),抗-HEV IgM阳性率为0.89%(3/335)。抗-HEV IgG阳性率与年龄无线性相关(χ_趋势2=0.756,P=0.385),各年龄组间差异均无统计学意义(均有P>0.05)。男女性抗-HEV IgG阳性率差异无统计学意义(χ2=0.085,P=0.771)。CD4 ≤ 200 cell/μl与CD4>200 cell/μl两组间抗-HEV IgG阳性率差异无统计学意义(χ2=1.016,P=0.314)。三例抗-HEV IgM阳性CD4值分别为222 cell/μl,446 cell/μl和198 cell/μl。湖北省东部(30.77%,32/1 041)与中部(47.92%,46/96)HIV感染人群抗-HEV IgG阳性率差异有统计学意义(χ2=6.169,P=0.013),与东南部抗-HEV IgG阳性率差异有统计学意义(χ2=5.034,P=0.025)。  结论  湖北省HEV病毒在HIV感染人群中流行度较高,需要进行进一步研究并及时采取有效措施进行预防控制。     

HAV and HEV infection in hospitalised hepatitis patients in Alexandria, Egypt

A total of 202 serum and stool samples from acute hepatitis patients attending the Fever Hospital of Alexandria, Egypt, have been studied to reveal markers of hepatitis virus infection. Anti-HAV IgM were detected in 21 out of 202 sera (10.4%), whereas 201 sera (99.5%) had anti-HAV IgG. The first age attack was in the class-age 0–9 years with 64.7% of anti-HAV IgM positive sera. Among 202 patients, anti-hepatitis E IgG (sample/over cut off>1.0) was identified in 90 patients (44.5%). The anti-HEV seropositivity ranged from 17.6% to 60.0% in the different age groups, with the highest level in the class-age 20–29 years. Anti-hepatitis E IgM were identified in 49 patients with the first age attack in the class-age 10–19 years (39.4%). HAV RNA was identified by nested PCR in 7 samples out of 15, whereas HEV RNA was present in 4 out of 75 stool samples. Direct DNA sequence of the latter PCR products confirmed the presence of the HEV genome; comparison of the sequences of the isolates from Egypt with those in data banks revealed the highest homology to the Burma strain. Our data confirm that HAV and HEV are common causes of acute sporadic hepatitis in Alexandria but with different peak age positivity. Occasionally, but not infrequently, dual infections (HAV–HEV and HEV-enteric viruses) were also found. The risk analysis indicates that patients living in rural areas are exposed to a higher risk of hepatitis E infection compared to the urban population, whereas the presence of anti-HEV IgG was significantly associated with consumption of common village water and use of indoor dry pit and oral therapy for schistosomiasis.     

First documented outbreak of hepatitis E virus transmission in Java,Indonesia

A suspected hepatitis outbreak occurred in Bondowoso District, East Java Province, Indonesia, in March-May 1998. An investigation was initiated in April 1998, involving a retrospective review of hospital records, a community-based cross-sectional study, and a health service-based case detection and household follow-up. Sera and epidemiological information were collected from 962 individuals: 235 from 3 outbreak-affected communities along the same rural stretch of river, 101 from community controls living distant from the river, 151 cases detected in health centres, 141 family members of the cases, and 334 subjects from neighbouring families. The prevalence of acute hepatitis E virus (HEV), based on anti-HEV IgM, total antibody (Ig) to HEV and polymerase chain reaction (PCR), was significantly (P < 0.00001) higher (52.4%) among the outbreak communities than among the community controls (3%). The background prevalence of HEV, based on anti-HEV IgG, was also significantly (P < 0.00001) higher (47%) among the outbreak communities than among the community controls (3%). None of the 476 sera screened for anti-HAV (hepatitis A virus) IgM was positive. These results indicate that HEV was the aetiological agent responsible for the outbreak. The overall attack rate (AR) for the 3 outbreak-affected communities surveyed was 19%, with AR determined on the basis of clinically recognized, acute jaundice illness. The usage of river water as primary source for bathing, human-waste disposal, and drinking purposes differed significantly (P < 0.00001) between the communities in outbreak areas and those in non-outbreak areas. There is no significant influence attributed to 'boiling water' on acute HEV. No climatic influences (flooding or drought) predisposed this instance of epidemic HEV transmission. This outbreak represents the first documented evidence of epidemic HEV transmission in Java, Indonesia.     

孝感市HIV感染人群的戊肝血清流行病学特征分析

目的 了解孝感市人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染人群的戊型肝炎病毒（hepatitis E viral,HEV）流行情况,为更有效地开展艾滋病和戊肝防治工作提供科学依据。方法 采集2015年5月~2016年9月203份HIV感染人群的血清样本,从中国疾病控制信息系统收集孝感市203名HIV感染人群的人口学资料、其他疾病感染史、实验室数据,血清进行抗-HEV IgG、抗-HEV IgM、HEV抗原（HEV antigen,HEV-Ag）筛查,并对抗-HEV IgM阳性进行肝功能筛查。结果 203名HIV感染人群抗-HEV IgM阳性率为2.46%,抗-HEV IgG阳性率为46.31%（94/203）。抗-HEV IgG阳性率在性别上差异无统计学意义（χ2=0,P=0.996）。离异组抗-HEV IgG阳性率高达80%,与其他婚姻状况组的差异有统计学意义（均有P<0.05）。CD4值≤ 200 cell/μl的人群抗-HEV IgG阳性率与CD4>200 cell/μl的人群抗-HEV IgG阳性率差异无统计学意义（χ2=0.286,P=0.593）;2个抗-HEV IgM阳性患者的CD4值分别为189 cell/μl和199 cell/μl,且1个肝功能异常。7个县市区抗-HEV IgG阳性率差异无统计学意义（χ2=5.906,P=0.551）。结论 孝感市HIV感染人群HEV感染较高,积极开展两病双向筛查的同时需采取有针对性地预防和治疗措施。     

套式逆转录PCR检测戊型肝炎病毒RNA的临床应用

目的 评价套式逆转录PCR检测血清戊肝病毒(HEV) RNA的临床意义.方法 对GenBank数据库中的戊型肝炎病毒全基因组序列进行分析比对,并针对国内流行的HEV株序列,选择位于ORF2的保守区域设计引物,建立套式逆转录聚合酶链式反应(nRT-PCR)方法,并检测126例急性戊型肝炎患者,并与检测抗-HEV IgM的方法进行比较.结果 126例急性戊型肝炎患者血清中有67例HEV-RNA阳性,对照组血清HEV-RNA检测均为阴性;与血清抗HEV IgM检测结果比较,HEV RNA检测的总符合率为80.91％,两种方法的检测结果具有良好的一致性;nRT-PCR方法检测HEV-RNA与血清抗-HEV IgM检测方法存在明显的差异,不能相互替代,而有一定的互补性;3例患者的首份血清检测为HEV-RNA阳性,但抗-HEV IgM为阴性,系列追踪检测,均相继出现抗HEV IgM,急性戊型肝炎患者血清HEV-RNA的检出多在发病的1～12 d.结论 应用nRT-PCR方法能对急性散发戊型肝炎患者血清中的HEV RNA进行定性检测,且有较高的特异性和敏感性,临床使用可以提高对HEV早期诊断的水平,具有一定的临床应用价值.     

Seroepidemiology and genetic characterization of hepatitis E virus in the northeast of china

The aim of this study was to analyze the prevalence of infection and genotype of hepatitis E virus (HEV) in people and animals in the northeast of China (Heilongjiang, Jilin and Liaoning provinces). This seroepidemiological study was conducted using enzyme immunoassays and human sera positive for HEV antigen or anti-HEV IgM, and animal sera positive for HEV antigen or with an S/CO ≤10 for anti-HEV were tested for HEV RNA using real-time RT-PCR and nested RT-PCR. In humans, the overall prevalence of anti-HEV IgG was 31.6% (311/985), 28.6% (147/514) and 21.1% (841/3994) in individuals frequent, infrequent, and very rare contact with swine, respectively. The overall prevalence of anti-HEV was 81.6% (1737/2127) in pigs above 3 months of age, 66.4% (1644/2473) in pigs below 3 months of age, 18.7% (301/1612) in cattle and 12.4% (162/1302) in sheep. 1211 samples were tested for HEV RNA using real-time RT-PCR and 71 were positive. 30 of the 71 samples also were positive for HEV RNA using nested RT-PCR. These 30 isolates shared 81.2–100% sequence identity with each other at the nucleotide level and belonged to HEV genotype 4, regardless whether from human or animals. The results indicate that HEV infection is widely spread in the northeast of China. The prevalence of anti-HEV in individuals with frequent contact with pigs was significantly higher than those without and the HEV sequences isolated from such individuals were related more closely to isolates from pigs. These support strongly the hypothesis of a zoonotic origin of hepatitis E.     

住院肝炎患者病毒检测及重叠感染状况分析

目的了解上海地区以往肝炎患者的肝炎型别和重叠感染状况。方法采用ELISA法对从复旦大学公共卫生学院血清库中抽取的上海某区医院90年代初期肝炎患者的血清进行HAV IgM、HCV IgG、HEV IgM和HEV IgG的检测。结果在上海1143名肝炎患者中，HAV IgM、HBV、HCV IgG、HEV IgM和HEV IgG的阳性率分别为52．1％，53．6％，1．3％，17．8％和70．4％，有多重感染的患者数为746人，约占总病例数的65．4％，其中甲、乙、丙、戊型肝炎的重叠感染率分别为61．4％，69．3％，0．9和17．4％。结论肝炎患者的多重感染情况普遍存在。甲乙型重叠感染可能影响乙型肝炎病毒感染的复制，对健康的危害较为严重。     

天津铁路疾病预防控制所辖区内戊型肝炎病毒感染状况的血清分析

目的了解北京铁路局天津铁路疾病预防控制所辖区内人群戊型肝炎病毒IgM(HEV-IgM)抗体的水平和分布状况及丙氨酸转氨酶(ALT)和总胆红素(TBil)2项生化指标的基本情况,为今后预防工作提供科学依据。方法采用血清流行病学调查方法,对辖区内9 297名参加预防性健康检查的观察对象,利用酶联免疫吸附试验(ELISA),对其血清中HEV-IgM抗体进行检测,同时利用生化分析仪检测其ALT和TBil水平,并进行统计分析。结果 9 297名观察者中,HEV-IgM抗体阳性率为0.25%。HEV-IgM抗体阳性者平均ALT及TBil水平无显著增高。对1例HEV-IgM抗体阳性者进行跟踪检测,其HEV-IgM抗体在8个月内未见下降,其ALT及TBil水平也无显著增高。结论该辖区内HEV呈隐性潜伏感染,健康人群内有传播HEV病毒的风险。     

Seroepidemiology of hepatitis A and E virus infections in Tehran, Iran: a population based study

Hepatitis A virus (HAV) and hepatitis E virus (HEV) are enteric hepatotropic viruses and their prevalence is related to the sanitary conditions of the region under investigation. There are only a few studies on the seroepidemiology of these two viruses in the general Iranian population. The purpose of this investigation was to measure the prevalence of hepatitis A and E infections in the general population. Between 2006 and 2007, a cross sectional study was performed in Tehran, Iran. Blood specimens were collected and questionnaires were filled in for 551 persons. Patient sera were tested by ELISA for anti-HEV and anti-HAV IgGs. The χ(2) test and independent t-test were used for statistical analysis and p<0.05 was considered significant. The overall seroprevalence rates of anti-HEV IgG and anti-HAV IgG were 9.3% and 90%, respectively. The prevalence of antibodies to HAV and HEV was greater among men than women and increased with age. However, there was no significant relationship between age and gender with the existence of anti- HAV and HEV IgG antibodies. Our results show the seroprevalence of HAV and HEV antibodies are high and both viruses are endemic in this region. These findings are in accordance with results obtained from previous studies. We recommend that foreign travelers to Iran are vaccinated against HAV.     

Role of hepatitis E and other hepatotropic virus in aetiology of sporadic acute viral hepatitis: A hospital based study from urban Delhi

Major hepatotropic virus continues to be an important cause of acute viral hepatitis (AVH) in developing countries like India. While epidemics of AVH have been well studied few serious sporadic cases from developing countries have been reviewed. We studied prospectively 75 cases of sporadic AVH who reported to our hospital and were evaluated for the presence of various hepatotropic viruses. The seroprevalence of IgG anti-HEV antibodies was studied in the general population as a control. We found 53.3% (40/75) of sporadic AVH cases were due to hepatitis E virus while 11% (8/75) were due to hepatitis B virus. Hepatitis C virus was responsible for 8% (6/75) of the sporadic AVH cases and hepatitis A was found in 5% (4/75) of the cases. No causative agent was found in 23% (17/75) of the sporadic AVH cases. The sporadic AVH cases due to HEV were not clinically or biochemically not different from AVH due to other viruses. We found a high prevalence of IgG anti-HEV in 35.6% (178/500) among the general population of urban Delhi. The study suggested that hepatitis E was the most common cause of sporadic AVH in urban Delhi. High seroprevalence of IgG anti-HEV antibodies in the general population and amongst the sporadic AVH cases suggests that it is unlikely to be protective antibody. IgM anti-HEV positive serology is considered diagnostic of acute hepatitis E infection in India, where hepatitis E is endemic.