Serial passage of west-European sporadic non-A non-B hepatitis in rhesus monkeys by inoculation with fecal extracts

Discovery of Hepatitis E and Its Impact on Global Health: A Journey of 44 Years about an Incredible Human-Interest Story

The story of the discovery of hepatitis E originated in the late 1970s with my extreme belief that there was a hidden saga in the relationship between jaundice and pregnancy in developing countries and the opportunity for a massive epidemic of viral hepatitis, which hit the Gulmarg Kashmir region in November 1978. Based on data collected from a door-to-door survey, the existence of a new disease, epidemic non-A, non-B hepatitis, caused by a hitherto unknown hepatitis virus, was announced. This news was received by the world community with hype and skepticism. In the early 1980s, the world watched in awe as an extreme example of human self-experimentation led to the identification of VLP. In 1990, a cDNA clone from the virus responsible for epidemic non-A, non-B hepatitis was isolated. Over the years, we traversed three eras of ambiguity, hope, and hype of hepatitis E research and conducted several seminal studies to understand the biology of HEV and manifestations of hepatitis E. Many milestones have been reached on the long and winding road of hepatitis E research to understand the structure, biology, and diversity of the agent, changing the behavior of the pathogen in developed countries, and the discovery of a highly effective vaccine.

Isolation of the novel agent from human stool samples that is associated with sporadic non-A, non-B hepatitis

The agent(s) responsible for sporadic non-A, non-B hepatitis in humans was serially transmitted in rhesus monkeys by intravenous inoculation of the stool extract from a patient. A novel agent called HFV (hepatitis French [origin] virus) was present as 27- to 37-nm particles in the infectious stool extract. Hepatopathic lesions were noticed in infected monkeys during the acute phase of illness. The purified viral 27- to 37-nm particles consist of a double-stranded DNA of approximately 20 kb and are detected in infected monkey liver. Analysis of cell culture detects the approximately 20-kb-long viral DNA in stool samples from infected monkeys and sporadic enteric non-A, non-B hepatitis patients. Furthermore, the 27- to 37-nm viral particles were able to protect monkeys challenged with infectious stool extract. Our results indicate that 27- to 37-nm virus like particles are responsible for sporadic non-A, non-B hepatitis in rhesus monkeys.

An epidemic of non-A, non-B hepatitis in south Delhi: epidemiological studies and transmission of the disease to rhesus monkeys

In November 1987 an epidemic of NANB-hepatitis broke out in a residential colony of South Delhi which lasted for nearly two months. The epidemic was caused due to the sewage contamination of the drinking water supply. Analysis of the epidemiological data showed that the disease was more common in the younger age group of 11-20 years and that both sexes were equally prone to the disease. The disease could be transmitted to rhesus monkeys by intravenous inoculation of the stool extracts from the patients. Experimentally infected monkeys showed elevated levels of serum aminotransferases and excreted the infectious agent in the stools. Hepatic lesions characteristic of enteric non-A, non-B hepatitis were observed in an infected monkey.