Genotype Distribution and Sequence Variation of Hepatitis E Virus, Hong Kong

Most acute cases of infection with hepatitis E virus (HEV) in Hong Kong were autochthonous, sporadic, and occurred in older adults. All except 1 isolate belonged to genotype 4; most were phylogenetically related to swine isolates. The epidemiology is similar to that in industrialized countries, where zoonosis is the major source of HEV infection in humans.     

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。     

Virulent Strain of Hepatitis E Virus Genotype 3, Japan

Hepatitis E virus (HEV) genotype 3, which usually causes asymptomatic infection in Japan, induced severe hepatitis in 8 patients. To better understand genetic features of HEV associated with increased virulence, we determined the complete or near-complete nucleotide sequences of HEV from these 8 patients and from 5 swine infected with genotype 3 strain swJ19. Phylogenetic analysis showed that the isolates from the 8 patients and the 5 swine grouped separately from the other genotype 3 isolates to create a unique cluster, designated JIO. The human JIO-related viruses encoded 18 amino acids different from those of the other HEV genotype 3 strains. One substitution common to almost all human HEV strains in the JIO cluster was located in the helicase domain (V239A) and may be associated with increased virulence. A zoonotic origin of JIO-related viruses is suspected because the isolates from the 5 swine also possessed the signature V239A substitution in helicase.     

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.     

北京市郊区八种动物戊型肝炎病毒抗体流行率调查及病毒基因型研究

目的 调查北京地区与人密切接触的猪、牛、羊、马、驴、犬、鸡、鸭8种动物血清中戊型肝炎病毒(HEV)抗体流行率及该地区猪HEV基因型和亚型.方法 收集8种动物的血清标本及幼猪粪便标本,用双抗原夹心ELISA法检测血清中抗-HEV;用巢式反转录聚合酶链反应法(RT-nPCR)检测HEV RNA;对部分PCR产物进行克隆和测序,并对测序结果进行基因分型.结果 在8种动物中抗-HEV阳性率分别为猪80.43%(481/598),其中成猪(>6月龄)为87.86%(369/420),幼猪(2～3月龄)为62.92%(112/178);牛15.02%(52/346);马14.29%(40/280);驴0(0/26);羊9.88%(33/334);犬0(0/21);鸭3.03%(7/231);鸡2.53%(8/316).RT-nPCR检测3月龄以下猪粪便标本HEVRNA阳性率为66.67%(74/111).HEV RNA阳性的标本测序后可归为6株(分别命名为bjsw1、bjsw2、bjsw3、bjsw4、bjsw5和bjsw6),6株HEV开放读码框2(ORF2)部分核苷酸序列的相似性为94.5%～99.6%,与1、2、3、4型HEV的相似性分别为75.6%～78.6%、75.6%～76.2%、77.1%～80.7%和83.7%～94.5%.6株HEV与人HEV 4d亚型的同源性最高,为90.0%～94.5%.结论 北京市郊区猪、牛、马、羊、鸭、鸡中均存在HEV感染,其中猪抗-HEV流行率最高,驴、犬抗-HEV的流行率最低;6株猪HEV属于基因4型、4d亚型.     

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.     

Autochthonous infections with hepatitis e virus genotype 4, france

During January-March 2011, diagnoses of hepatitis E virus (HEV) infection increased in Marseille University hospitals in southeastern France. HEV genotype 4, which is described almost exclusively in Asia, was recovered from 2 persons who ate uncooked pork liver sausage. Genetic sequences were 96.7% identical to those recently described in swine in Europe.     

Hepatitis E virus and neurologic disorders

Information about the spectrum of disease caused by hepatitis E virus (HEV) genotype 3 is emerging. During 2004-2009, at 2 hospitals in the United Kingdom and France, among 126 patients with locally acquired acute and chronic HEV genotype 3 infection, neurologic complications developed in 7 (5.5%): inflammatory polyradiculopathy (n = 3), Guillain-Barre syndrome (n = 1), bilateral brachial neuritis (n = 1), encephalitis (n = 1), and ataxia/proximal myopathy (n = 1). Three cases occurred in nonimmunocompromised patients with acute HEV infection, and 4 were in immunocompromised patients with chronic HEV infection. HEV RNA was detected in cerebrospinal fluid of all 4 patients with chronic HEV infection but not in that of 2 patients with acute HEV infection. Neurologic outcomes were complete resolution (n = 3), improvement with residual neurologic deficit (n = 3), and no improvement (n = 1). Neurologic disorders are an emerging extrahepatic manifestation of HEV infection.     

Human and porcine hepatitis E virus strains, United Kingdom

We describe a case of acquired infection of a strain of hepatitis E virus (HEV) with a 100% amino acid identity to the analogous region in strains of HEV circulating in a United Kingdom pig herd. This case further supports the theory that autochthonous HEV infection in industrialized countries is zoonotic.     

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.     

Analysis of the complete genome sequences of one swine and two human hepatitis E virus genotype 4 strains isolated in Beijing,China

Full-length sequences were determined and analyzed for two human (MO and W3) and one swine (W2–5) hepatitis E virus (HEV) isolates from Beijing, China. The genomes of the three strains were composed of 7242, 7239, 7239 nucleotides, respectively, excluding the poly (A) tails, and were 84% identical to each other. All were classified into genotype 4. Sequence analysis shows that the 2 human isolates have up to 91–94% nucleotide identity in full length genome with swine strains isolated in China, while the swine isolate share 92% identity with the human strain T1 from Beijing. At the amino acid level, the three strains share 94%, 97% and 89–92% identity in the ORF1, ORF2 and ORF3, proteins respectively. The human strains MO and W3 have the highest identity, 97%, 98–99% and 96–98% in ORFs 1–3, respectively, to swine strains CHN-XJ-SW13 and CHN-XJ-SW33 from Xinjiang, China, while swine strain W2–5 has highest identity with the human strain HE-JA2, 96%, 99% and 91% in ORFs 1–3, respectively. Genotype specific amino acid substitutions were found at a single site in all three ORFs by sequences alignment, and genotype specific short sequences (5–10aa in length) were found in ORF1 and the C-terminus of ORF3. However, no difference was found at any amino acid position that discriminates between human and swine HEVs within genotype 4 for any of the three ORFs. These results indicated that the genotype 4 HEV strains from humans and pigs in China may evolve from the common ancestor.     

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.     

Case–Control Study of Risk Factors for Acquired Hepatitis E Virus Infections in Blood Donors,United Kingdom, 2018–2019

Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in England. Substantial yearly increases of autochthonous infections were observed during 2003–2016 and again during 2017–2019. Previous studies associated acute HEV cases with consumption of processed pork products, we investigated risk factors for autochthonous HEV infections in the blood donor population in England. Study participants were 117 HEV RNA–positive blood donors and 564 HEV RNA–negative blood donors. No persons with positive results were vegetarian; 97.4% of persons with positive results reported eating pork products. Consuming bacon (OR 3.0, 95% CI 1.7–5.5; p<0.0001), cured pork meats (OR 3.5, 95% CI 2.2–5.4; p<0.0001), and pigs’ liver (OR 2.9, 95% CI 1.0–8.3; p = 0.04) were significantly associated with HEV infection. Our findings confirm previous links to pork products and suggest that appropriate animal husbandry is essential to reduce the risk for HEV infection.     

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。     

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.     

淮安市戊型病毒性肝炎人畜共患性及病毒基因型研究

目的探讨淮安市戊型病毒性肝炎病例与猪之间的联系,为控制HEV在人畜间的传播提供依据。方法在淮安市收集急性戊肝、肝炎未分型病例血液标本193份,同期在屠宰场收集生猪胆囊标本510份,采用Real-time RT-PCR和RT-PCR提取目标核苷酸,测定序列后进行分析。结果所有标本共分离出HEV-4型毒株20株,分4个亚型,HEV-4d型为优势流行毒株亚型;人源与猪源HEV毒株间的同源性为:80.3%～97.7%。结论淮安市戊肝病例与生猪感染的HEV高度同源,生猪是戊肝传播过程中一种重要的动物宿主。