Hepatitis E virus genotype 3 in humans and Swine, Bolivia

We determined the seroprevalence of hepatitis E virus (HEV) in persons in 2 rural communities in southeastern Bolivia and the presence of HEV in human and swine fecal samples. HEV seroprevalence was 6.3%, and HEV genotype 3 strains with high sequence homology were detected.     

Hepatitis E antibodies in Egyptian adolescent females: their prevalence and possible relevance

Hepatitis E virus has been implicated as a frequent cause of acute sporadic hepatitis among Egyptian children. Moreover, an extraordinarily high seroprevalence rate was previously reported in a semiurban Nile Delta population. A conspicuous feature of hepatitis E is the high morbidity and mortality it can cause among infected pregnant women. We therefore evaluated the prevalence of HEV antibodies in adolescent females using a solid-phase enzyme linked immunoassay based on two recombinant hepatitis E virus antigens. A high prevalence rate (38.9%) was found in 95 apparently healthy adolescent females. The mean age of the study subjects was 21.81 +/- 2.5 (SD) range 16-25 years. Eighty (84.2%) subjects resided in Alexandria, while 15 (15.8%) came from semiurban villages of Alexandria Governorate. An increased prevalence was noted with age, as anti-HEV antibodies were detected in 32.1% and 41.8% of study participants in the second and third decades of life, respectively. Similarly, those illiterate or having received less than primary education exhibited a higher HEV prevalence than those with higher education (46.3% vs 29.3%). The majority of subjects having serological evidence of HEV infection denied previous history of jaundice which shows that HEV infection was subclinical in those cases. Ten (55.6%) pregnant females participating in the study, as well as 48 (62.3%) non pregnant females lacked serological evidence of HEV infection; i.e., 60.01% (10 + 48 out of 95) of women in the childbearing age may be susceptible to infection. This report suggests that HEV is endemic in Alexandria, Egypt; the epidemiologic risk factors associated with HEV infection need further exploration.     

Hepatitis E Virus Seroprevalence among Adults, Germany

We assessed hepatitis E virus (HEV) antibody seroprevalence in a sample of the adult population in Germany. Overall HEV IgG prevalence was 16.8% (95% CI 15.6%–17.9%) and increased with age, leveling off at >60 years of age. HEV is endemic in Germany, and the lifetime risk for exposure is high.     

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。     

Anti-HEV seroprevalence in the area of Lecce

Hepatitis E virus (HEV) is the causative agent of an enterically transmitted viral hepatitis associated with inadequate hygienic conditions. Hepatitis E is endemic in developing countries where it occurs both in sporadic and epidemic form. Outbreaks have been reported in different areas of the world. The aim of the present work was to assess the seroprevalence of HEV infection in the general population and in different risk groups in the area of Lecce. The presence of anti-HEV antibodies was ascertained by qualitative ELISA (Abbott HEV EIA) and Western Blot (Recomblot HEV IgG/IgM, Mikrogen). The prevalence of anti-HEV in the general population was 2.9% while in intravenous drug users, hemodialized patients and immigrants the seroprevalence rates were 0.7%, 4.3% and 15.3% respectively. Our data show a circulation of HEV at low level in the area of Lecce which is endemic for hepatitis A. Higher seroprevalence rates were found in hemodialized patients and remarkably in immigrants coming from endemic areas like Turkey.     

Hepatitis E Virus Antibodies in Patients with Chronic Liver Disease

In the United States, the seroprevalence rate for hepatitis E virus (HEV) is ≈20%. This study examined HEV seroprevalence in persons with and without chronic liver disease. Our data indicate that HEV seropositivity is high in patients with chronic liver disease and that HEV seroprevalence increases significantly with age.     

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。     

Randomized-controlled phase II clinical trial of a bacterially expressed recombinant hepatitis E vaccine

The candidate recombinant hepatitis E vaccine, HEV 239, protect monkeys against infection by hepatitis E virus (HEV). The safety and immunogenicity of the vaccine for humans was assessed in a randomized controlled phase II clinical trial. The study was conducted in an endemic area of southern China and consisted of a dose scheduling, involving 457 adults and a dose escalation component involving 155 high school students. The results showed that the vaccine is safe and immunogenic for humans and suggest that it could prevent new HEV infection.     

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.     

华东地区猪基因4型戊肝病毒的季节变化及与人同源性的分析

目的 戊型肝炎病毒的人兽共患特征被认可,本研究检测华东地区猪群在不同季节中基因4型戊肝病毒(HEV)的感染情况,了解猪病毒株之间以及与人病毒株的同源性关系.方法2007年9月-2008年6月在华东地区浙江、安徽和江苏的3家屠宰场中共采集猪胆汁标本1200份,应用巢式RT-PCR方法检测HEV RNA,对阳性标本测序并结合同一地区人HEV序列进行同源性分析.结果猪胆汁标本中HEV RNA总检出率为4.5%,各季节猪群的检出率为9-10月平均检出率6%,12-1月4.33%,3-4月4.33%,5-6月3.33%,各地区的平均检出率为江苏6%、安徽5%、浙江2.5%.不同地区猪与猪、猪与人基因4型HEV病毒株的同源性都较高(猪株之间核苷酸序列约为80%～100%,氨基酸序列约为96%～100%;猪与人株之间核苷酸序列约为76%～99%,氨基酸序列约为95%～100%).部分猪HEV与人HEV构成独立的同源性分支,进化起源关系密切.结论 基因4型HEV在华东地区猪群中常年广泛流行,且可能拥有共同的进化与传播起源.猪群携带HEV可能会对人群戊肝的流行趋势产生影响.     

Prevalence of hepatitis E virus antibodies in pigs: implications for human infections in village-based subsistence pig farming in the Lao PDR

We report a high seroprevalence of hepatitis E virus (HEV) in pigs in the Lao PDR. HEV seroprevalence was 51.2% (300/586) amongst abattoir pigs and 15.3% (46/301) amongst village pigs. The age distribution suggested previous in-village HEV pig infections. These findings suggest a zoonotic risk associated with village-based smallholder pig farming.     

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.     

Seroprevalence and distribution of hepatitis E virus in various ethnic groups in Gansu province,China

Gansu province is located in northwestern China and is home to 45 ethnic groups including Han, Hui, Zang and others. Different ethnic groups have varying involvement with livestock and meat consumption, especially pork. To investigate the prevalence of hepatitis E virus (HEV) infection and the distribution of HEV genotypes among the major ethnic groups in Gansu province, 2090 serum samples were collected from individuals from four regions and three ethnic groups, the Han, Hui and Zang. All serum samples were tested for anti-HEV IgG and IgM antibodies, as well as HEV antigen, and selected samples were then tested for HEV RNA. The data showed that the seroprevalence of anti-HEV IgG in the Hui, Han and Zang ethnic groups from the four regions was 8.9%, 18.7% and 32.9%, respectively, and these differed significantly (P < 0.05). The seroprevalence of anti-HEV antibody for each ethnic group varied among the different regions. In general, within the same region, the three ethnic groups also show differences. Genomic analysis indicated that HEV isolated from humans belonged to genotype 4, and resembled closely swine HEV isolates from Gansu province. The seroprevalence of anti-HEV antibodies was in accordance with the amount of contact with pigs in the different regions. Pigs are the primary host for HEV, so people in frequent contact with pigs may be at risk of zoonotic infection. However, populations that have rare contact with pigs are more likely to be susceptible to HEV when exposed, suggesting that should be the target of vaccination.     

Seroprevalence for Hepatitis E and Other Viral Hepatitides among Diverse Populations,Malawi

Data on prevalence of hepatitis E virus (HEV) in Malawi is limited. We tested blood samples from HIV-uninfected and -infected populations of women and men enrolled in research studies in Malawi during 1989–2008 to determine the seroprevalence of HEV, hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Samples were tested for IgG against HEV, total antibodies against HAV and HCV, and presence of HBV surface antigens. Of 800 samples tested, 16.5% were positive for HEV IgG, 99.6% were positive for HAV antibodies, 7.5% were positive for HBV surface antigen, and 7.1% were positive for HCV antibodies. No clear trends over time were observed in the seroprevalence of HEV, and HIV status was not associated with hepatitis seroprevalence. These preliminary data suggest that the seroprevalence of HEV is high in Malawi; the clinical effects may be unrecognized or routinely misclassified.     

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.     

武汉市普通人群戊型肝炎血清学及影响因素分析

目的 评估武汉市普通人群戊型病毒性肝炎病毒（戊型肝炎病毒,hepatitis E virus,HEV）感染状况及影响因素。方法 采用多阶段随机抽样方法,对抽取的3 890名0~59岁普通人群开展调查与血样采集,应用酶联免疫吸附法（enzyme-linked immunosorbent assay,ELISA）检测抗-HEV IgG,采用χ2检验、精确二项式公式法与非条件Logistic回归等方法进行统计学分析。结果 武汉市0~59岁普通人群抗-HEV IgG标化阳性率为35.01%,男性标化阳性率与女性的差异无统计学意义（χ2=3.18,P=0.075）,随着年龄增长阳性率升高（χ2=542.32,P<0.001）,城区人群标化阳性率高于郊区（χ2=11.32,P=0.001）;18岁以上人群抗-HEV IgG多因素分析显示,男性、年龄较大者（30~59岁）、居住于城区、喜食鱼类的人群感染HEV的风险更高（均有P<0.05）。结论 武汉市普通人群HEV感染率较高,男性、年龄较大者（30~59岁）、居住于城区、喜食鱼类的居民是高危人群。     

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.