Endemic hepatitis E infections in South-East Hungary

INTRODUCTION: Hepatitis E virus (HEV) one of the most important infectious agent in acute hepatitis in tropical and subtropical areas. Recently, it has been demonstrated that HEV infection also occur in developed countries without travel history. In these regions, transmission thought to be zoonotic. In this work hepatitis E cases are detected in South East Hungary. AIMS: Aims of the authors were the detection of HEV infection in acute hepatitis patients by enzyme-immunoassay (ELISA), and the introduction of clinical and epidemiological features. METHODS: Between January 2001 and October 2004, acute sera samples were tested by serological methods (enzyme-immunoassay for HEV IgM and IgG antibodies) from patients with acute hepatitis observed in Department of Infectology Hospital of Szeged. Samples from non-A-B-C infections hepatitis were tested. CONCLUSIONS: In the mentioned period the detected HEV infections (27) showed a similar incidence as known in other hepatitis in our region. Based upon our results, hepatitis E virus is one of the etiological agent in acute endemic hepatitis in South East Hungary, with special clinical features, which are not entirely similar, found in available literature. The gained data, with their conclusions may have wilder professional interest.     

Seroprevalence of hepatitis E virus infection, rural southern People's Republic of China

Genotype 4 hepatitis E virus (HEV) is the dominant cause of hepatitis E in the People's Republic of China; swine are the principal reservoir. Our study was conducted in 8 rural communities of southern China, where families keep pigs near their homes. Phylogenetic analysis showed that 23 of 24 concurrent virus isolates from this region are genotype 4 strains. Among the study populations, immunoglobulin G anti-HEV seroprevalence accumulated with age at approximately equal to 1% per year for persons < or =60 years of age. After age 30 years, seroprevalence increased at higher rates for male than for female study participants. The overall seroprevalence was 43% (range 25%-66%) among the communities. Infection rates were higher for participants between 25 and 29 years of age. The results suggest that HEV infection probably has been endemic in southern China for at least 60 years, with swine being the principal reservoir of human HEV infection in recent years.     

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.     

广西地区猪、鼠、狗戊型肝炎病毒感染血清学分析

目的了解广西地区猪、鼠和狗血清中抗．戊型肝炎病毒（HEV）IgG抗体流行情况。方法应用HEV基因1型开放读码框（ORF）2和ORF3多肽包被酶标板，辣根过氧化物酶（HRP）标记的羊抗猪、羊抗鼠和羊抗狗建立的酶联免疫吸附试验（ELISA）法检测猪、鼠和狗血清中抗．HEV IgG。结果总抗．HEV IgG阳性率为31．84％（170／534），其中猪血清抗．HEV IgG阳性率为26．40％（66／250），鼠血清抗．HEV IgG阳性率为43．02％（77／179），狗血清抗．HEV IgG阳性率为25．71％（27／105）。结论猪、鼠和狗血清中存在HEV感染，鼠抗．HEV IgG阳性率最高。     

Genotype analysis of hepatitis E virus from sporadic hepatitis E cases in northern China

Hepatitis E is an important public health problem in many countries. However, there is no definite conclusion about the zoonotic reservoir, transmission patterns and risk factors of hepatitis E in the human population. The aim of this study was to analyze the epidemiological and viral genotype characteristics of hepatitis E cases in northern China. Surveillance was conducted in two hospitals in Liaoning and Hebei province from July 2010 to June 2012. Out of a total of 116 diagnosed patients, 88 (75.9%) were male and 28 (24.1%) were female and most (73%) were in the age group 40–70 years. In both hospitals, cases were diagnosed more frequently in March than in other months. HEV RNA was amplified from 41 patients and characterized by nucleotide sequencing and phylogenetic analysis. Most of the isolates (37 strains, 90.3%) were genotype 4, including subgenotypes 4a, 4b, 4d, 4h, 4i and a new subgenotype. One subgenotype 3a strain was isolated from Baoding, Hebei province. Three genotype 1b strains were found from patients in Jinzhou, Liaoning province. Most of the genotype 4 strains and the genotype 3 strains were phylogenetically related to known swine isolates. In conclusion, the finding that HEV infects mostly middle-aged and elderly men and that the incidence spiked in March may reflect the zoonotic transmission characteristics of HEV infection. Pigs, but not rabbits, were the important reservoirs in this area, because genotype 4 HEV was found to be responsible for the majority hepatitis E cases. However, genotype 1 is still present in northern China. Also, the first isolation of genotype 3 HEV in this area indicates that alternative routes of HEV transmission might exist.     

Genetic host specificity of hepatitis E virus

Hepatitis E virus (HEV) causes epidemic and sporadic cases of hepatitis worldwide. HEV genotypes 3 (HEV3) and 4 (HEV4) infect humans and animals, with swine being the primary reservoir. The relevance of HEV genetic diversity to host adaptation is poorly understood. We employed a Bayesian network (BN) analysis of HEV3 and HEV4 to detect epistatic connectivity among protein sites and its association with the host specificity in each genotype. The data imply coevolution among ∼70% of polymorphic sites from all HEV proteins and association of numerous coevolving sites with adaptation to swine or humans. BN models for individual proteins and domains of the nonstructural polyprotein detected the host origin of HEV strains with accuracy of 74–93% and 63–87%, respectively. These findings, taken together with lack of phylogenetic association to host, suggest that the HEV host specificity is a heritable and convergent phenotypic trait achievable through variety of genetic pathways (abundance), and explain a broad host range for HEV3 and HEV4.     

新疆猪戊型肝炎病毒株CHN-XJ-SW33全基因组序列分析

目的测定从新疆南部地区分离的猪戊型肝炎病毒(HEV)株全基因组序列,并在此基础上分析猪HEV与人源HEV的关系。方法设计HEV基因4型通用PCR引物,用逆转录巢式聚合酶链反应法(RT-nPCR)分段扩增猪HEV株CHN-XJ-SW33的全基因组序列;用cDNA末端快速扩增法(RACE)扩增其末端序列;对扩增的目的片段进行克隆测序,并对拼接后的基因组进行序列比对和进化分析。结果除3′poly(A)尾外,CHN-XJ-SW33基因组全长为7 238 nt,由3个开放读码框(ORF1-3)组成,分别编码1 706、674和114个氨基酸。CHN-XJ-SW33全基因组序列与HEV基因1-3型病毒株同源性仅为72.1%~74.9%,而与HEV基因4型病毒株同源性高达82.8%~95.5%,其中与日本人源中国输入型HEV株JKO-ChiSai98C同源性最高,为95.5%。基因进化分析显示,CHN-XJ-SW33属于HEV4a基因亚型。结论猪HEV与人HEV在全基因组核苷酸序列上高度同源,提示基因4型HEV可能由猪传染给人。     

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.     

First report of acute autochthonous hepatitis E in Portugal

Hepatitis E infection is usually a self-limiting disease. In industrialized countries, sporadic cases of acute hepatitis E virus (HEV) infections have been described; their number seems to be increasing in European countries. We report the first human case of autochthonous acute hepatitis E confirmed in Portugal. Patients with acute non-A-C hepatitis should be tested for HEV in Portugal and hepatitis E infection should be considered in the differential diagnosis of unexplained hepatitis cases.     

安徽省戊型肝炎基因分型及临床特征研究

目的研究安徽省戊型病毒性肝炎的基因型及其分布特点,为预防和控制戊型病毒性肝炎和疫苗的研制提供科学依据。方法按照戊型病毒性肝炎诊断标准及处理原则（GB17011-1997）于2006年12月～2007年12月从安徽省的4家综合性三甲医院收集戊型病毒性肝炎132例,分析临床特征,其中采集血清50份,用RT-nPCR法检测戊型肝炎病毒基因型。结果HEV RNA阳性率为22%（11/50）,经测序证实为戊型肝炎病毒（Hepatitis Evirus,HEV）的基因序列;用DNA STAR软件分析,11例的病毒株中2例为HEVⅠ型,9例为HEVⅣ型。Ⅳ型中又有ⅣA型3例和ⅣD型6例。结论安徽省急性散发性戊型肝炎的病毒基因型以HEVⅣ型为主,Ⅰ型次之,而Ⅳ型又有不同的亚型,主要为ⅣA和ⅣD型。     

中国南方某农村地区人与猪戊型肝炎病毒的检测和部分序列分析

目的调查中国南方某农村地区戊型肝炎病毒（HEV）人株与猪株的相关性。方法应用逆转录-巢式聚合酶链法（RT—nPCR）对一般人群中HEV-IgM阳性者、急性戊型肝炎患者和当地某养猪场的猪进行HEV RNA检测，并对HEV RNA阳性标本进行克隆测序和序列分析。结果132份猪粪便标本中13份为HEV RNA阳性；26份IgM阳性一般人群血清标本中有4份HEV RNA阳性；4例急性戊型肝炎患者中有1例的血清和粪便标本为阳性。序列分析发现该地区HEV人株与猪株在ORF2部分区域的核苷酸序列同源性为89．3％～100．0％，这10株HEV序列与HEVⅠ型、Ⅱ型、Ⅲ型和Ⅳ型在同一区域的核苷酸序列的同源性分别为78．7％～84．7％、83．3％～85．3％、76．0％～80．0％和84．7％～95．3％。结论该地区人群及猪群中流行的HEV同属基因Ⅳ型。     

The genetic divergences of codon usage shed new lights on transmission of hepatitis E virus from swine to human

Hepatitis E virus (HEV) is an important pathogen causing public health burden. Swine has been recognized as a main reservoir. Interestingly, genotype 1 HEV only infects human; whereas genotype 3 and 4 are zoonotic. However, there is a lack of in-depth understanding in respect to the transmission from swine to human. Codon usage patterns generally participate in viral survival and fitness towards its hosts. We have analyzed codon usage patterns of the three open reading frames (ORFs) for 243 full-length genomes of HEV genotypes 1, 3 and 4. The divergence of synonymous codon usage patterns is different in each ORF for genotypes 1, 3 and 4, but the genotype-specific codon usage bias in genotype 1 is stronger than those of genotypes 3 and 4. In respect to genotypes 3 and 4, compared with strains isolated from human, HEV isolated from swine shows appreciable variation in adaptation of codon usages to human or swine. These results may help to understand the transmission and host adaptation of HEV genotypes 3 and 4 from swine to human.     

戊型肝炎病毒的研究概况及进展

戊型肝炎病毒(HEV)是引起戊型肝炎(HE)的病原体。HE呈全球性分布,主要侵犯青壮年,其中孕妇死亡率高达20%。近些年来包括美国、中国、日本、印度在内的一些发达及发展中国家和地区,HE人群感染率呈上升趋势,控制该病刻不容缓。文中针对HEV的研究现状,从HEV的生物学特征、基因分型、细胞模型和动物模型、疫苗及诊断试剂的研究等方面进行综述。     

Hepatitis E virus infection in sheltered homeless persons, France

To determine the prevalence of hepatitis E virus (HEV) infection among sheltered homeless persons in Marseille, France, we retrospectively tested 490 such persons. A total of 11.6% had immunoglobulin (Ig) G and 2.5% had IgM against HEV; 1 person had HEV genotype 3f. Injection drug use was associated with IgG against HEV.     

戊型肝炎病毒跨物种感染的研究进展

HEV是引起经肠道传播的戊型肝炎的病原体,已经在多种动物体内检测到.最近,研究者们发现HEV可能跨越物种屏障感染人类,这就极大地提高了人群感染HEV的风险,威胁到人类的健康.因此,对于HEV种间感染的研究将为今后控制和预防HEV由动物经多种途径感染人类提供依据和方向.     

Close similarity between sequences of hepatitis E virus recovered from humans and swine, France, 2008-2009

Frequent zoonotic transmission of hepatitis E virus (HEV) has been suspected, but data supporting the animal origin of autochthonous cases are still sparse. We assessed the genetic identity of HEV strains found in humans and swine during an 18-month period in France. HEV sequences identified in patients with autochthonous hepatitis E infection (n = 106) were compared with sequences amplified from swine livers collected in slaughterhouses (n = 43). Phylogenetic analysis showed the same proportions of subtypes 3f (73.8%), 3c (13.4%), and 3e (4.7%) in human and swine populations. Furthermore, similarity of >99% was found between HEV sequences of human and swine origins. These results indicate that consumption of some pork products, such as raw liver, is a major source of exposure for autochthonous HEV infection.     

戊型肝炎病毒的动物宿主研究进展

戊型肝炎病毒 (hepatitisEvirus,HEV)是 1 982年发现的一种新型肝炎病毒[1 ] ,当时称为肠道传播的非甲非乙型肝炎病毒 ,1 989年正式命名为HEV。其基因组为单股正链RNA ,全长约 7.2kb,基因组编码区有 3个开放读码框架(ORFs)。HEV至少有 8个基因型[2 ] ;基因 1型和 2型分别为亚非型和墨西哥型 ;美国的猪和人HEV为基因 3型 ;中国的北京株和台湾株HEV属于基因 4型 ;欧洲株、意大利株和希腊株等属于HEV基因 5～ 8型。HEV主要经粪 口途径传播 ,有流行和散发两种形式。流行主要发生在发展中国家 ,多因水源被污染引起。散发主要发生在欧…     

山东省某地屠宰场猪肝内戊型肝炎病毒感染状况研究

目的研究商品猪肝脏内戊型肝炎（戊肝）病毒（HEV）的检出状况及其基因分型。方法采集35份山东省某个人屠宰场和某城镇大型屠宰场内的猪肝，处理后采用逆转录．巢式聚合酶链反应（nested RT·PCR）方法检测HEV RNA。并与GenBank中登录的HEV全长序列进行同源性分析。结果35份猪肝标本中共有3份检出HEVRNA，阳性率为8．57％。同源性分析显示这3株病毒均为Ⅳ型HEV。结论即将上市的商品猪肝脏内存在HEV感染，其基因型与中国大陆HEV流行株相同，均为基因Ⅳ型。     

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.