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de Marguerite Nombot-Yazenguet MP, Doté JW, Koyaweda GW, Zemingui-Bembete PA, Selekon B, Vickos U, Manirakiza A, Nakoune E, Gouandjika-Vasilache I, Komas NPJ. Hepatitis E outbreak in the health district of Bocaranga-Koui, Central African Republic, 2018-2019. BMC Infect Dis 2024; 24:215. [PMID: 38374096 PMCID: PMC10875899 DOI: 10.1186/s12879-024-09116-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/08/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) is a major public health disease causing large outbreaks and sporadic cases of acute hepatitis. We investigated an outbreak of HEV infection that occurred in September 2018 in the health district (HD) of Bocaranga-Koui, located in the northwestern part of Central African Republic (CAR). METHODS Blood samples were collected from 352 patients aged 0-85 years suspected to be infected with yellow fever (YF), according to the World Health Organization YF case definition. The notification forms from recorded cases were used. Water consumed in the HD were also collected. Human samples found negative for anti-YF IgM were then tested by ELISA for anti-HEV IgM and IgG antibodies. Positive anti-HEV (IgM and/or IgG) samples and collected water were then subjected to molecular biology tests using a real time RT-PCR assay, followed by a nested RT-PCR assay for sequencing and phylogenetic analysis. RESULTS Of the 352 icterus patients included, anti-HEV IgM was found in 142 people (40.3%) and anti-HEV IgG in 175 (49.7%). Although HEV infection was detected in all age groups, there was a significant difference between the 0-10 age groups and others age groups (P = 0.001). Elevated levels of serum aminotransferase were observed in anti-HEV IgM-positive subjects. Phylogenetic analysis showed HEV genotype 1e in infected patients as well as in the contaminated water. CONCLUSION This epidemic showed that CAR remains an HEV-endemic area. The genotype 1e strain was responsible for the HEV outbreak in Bocaranga-Koui HD. It is necessary to implement basic conditions of hygiene and sanitation to prevent further outbreaks of a HEV epidemics, to facilitate access to clean drinking water for the population, to launch intensive health education for basic hygiene measures, to sett up targeted hygiene promotion activities and, finally, to ensure that formal health care is available.
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Affiliation(s)
| | - Joël Wilfried Doté
- Enteric Viruses and Measles Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Giscard Wilfried Koyaweda
- Laboratoire National de Biologie Clinique Et de Santé Publique, PO Box 1426, Bangui, Central African Republic
| | | | - Benjamin Selekon
- Arboviruses, Hemorragic Fever Viruses and Zoonosis Virus Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Ulrich Vickos
- Department of Medicine, Infectious and Tropical Diseases Unit, Hôpital de L'Amitié Sino-Centrafricaine, Bangui, Central African Republic
| | - Alexandre Manirakiza
- Epidemiological Service, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Emmanuel Nakoune
- Arboviruses, Hemorragic Fever Viruses and Zoonosis Virus Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Ionela Gouandjika-Vasilache
- Enteric Viruses and Measles Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
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Hinrichs JB, Kreitlow A, Plötz M, Schotte U, Becher P, Gremmel N, Stephan R, Kemper N, Abdulmawjood A. Development of a Sensitive and Specific Quantitative RT-qPCR Method for the Detection of Hepatitis E Virus Genotype 3 in Porcine Liver and Foodstuff. Foods 2024; 13:467. [PMID: 38338602 PMCID: PMC10855453 DOI: 10.3390/foods13030467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
As an international and zoonotic cause of hepatitis, hepatitis E virus (HEV) poses a significant risk to public health. However, the frequency of occurrence and the degree of contamination of food of animal origin require further research. The aim of this study was to develop and validate a highly sensitive quantitative RT-qPCR assay for the detection and quantification of HEV contamination in porcine liver and food. The focus was on genotype 3, which is most common as a food contaminant in developed countries and Europe. The selected assay has its target sequence in the open reading frame 1 (ORF1) of the HEV genome and showed good results in inclusivity testing, especially for HEV genotype 3. The developed assay seems to show high efficiency and a low intercept when compared to other assays, while having a comparable limit of detection (LOD). In addition, a standard curve was generated using artificially spiked liver to provide more accurate quantitative results for contamination assessment and tracking in this matrix. Application of the assay to test 67 pig livers from different origins resulted in a positivity rate of 7.5%, which is consistent with the results of numerous other prevalence studies. Quantitative detection of the viral genome in the food chain, particularly in pig livers, is essential for understanding the presence and evolution of HEV contamination and thus ensures consumer safety.
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Affiliation(s)
- Jan Bernd Hinrichs
- Institute of Food Quality and Food Safety, University of Veterinary Medicine Hannover, 30173 Hannover, Germany; (J.B.H.); (A.K.); (M.P.)
| | - Antonia Kreitlow
- Institute of Food Quality and Food Safety, University of Veterinary Medicine Hannover, 30173 Hannover, Germany; (J.B.H.); (A.K.); (M.P.)
| | - Madeleine Plötz
- Institute of Food Quality and Food Safety, University of Veterinary Medicine Hannover, 30173 Hannover, Germany; (J.B.H.); (A.K.); (M.P.)
| | - Ulrich Schotte
- Department C Animal Health and Zoonoses, Central Institute of the Bundeswehr Medical Service Kiel, 24119 Kronshagen, Germany;
| | - Paul Becher
- Institute of Virology, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (P.B.); (N.G.)
| | - Nele Gremmel
- Institute of Virology, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (P.B.); (N.G.)
| | - Roger Stephan
- Vetsuisse Faculty, Institute for Food Safety and Hygiene, University of Zurich, 8057 Zurich, Switzerland;
| | - Nicole Kemper
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviors, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
| | - Amir Abdulmawjood
- Institute of Food Quality and Food Safety, University of Veterinary Medicine Hannover, 30173 Hannover, Germany; (J.B.H.); (A.K.); (M.P.)
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3
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Sadio BD, Faye M, Kaiser M, Diarra M, Balique F, Diagne CT, Faye O, Diagne MM, Fall G, Ndiaye O, Loucoubar C, Sow A, Faye O, Faye A, Boye CSB, Sall AA. First hepatitis E outbreak in Southeastern Senegal. Sci Rep 2022; 12:17878. [PMID: 36284151 PMCID: PMC9596447 DOI: 10.1038/s41598-022-22491-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/14/2022] [Indexed: 01/20/2023] Open
Abstract
The Rapid proliferation of traditional gold mining sites in the Kedougou region has led to massive migration of people from neighbouring West African countries and the establishment of several small villages where poor hygiene and sanitation conditions exist. In this context, a Hepatitis E virus outbreak was reported in Kedougou in 2014 with several cases among the traditional mining workers. Herein, we described epidemiological and laboratory data collected during the outbreak's investigation from February 2012 to November 2014. Any suspected, contact or probable case was investigated, clinical and epidemiological data were collected. In our study, sera were collected and tested for viral RNA and anti-Hepatitis E virus (HEV) IgM. Archived serum samples from Kedougou were retrospectively screened by real-time polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). A total of 65 water samples collected from ponds and wells surrounding gold panners' sites and habitats and 75 tissues samples from rats captured in the environment of traditional gold mining sites were also tested. A total of 1617 sera were collected from 698 suspected cases, 862 contacts and 57 persons with missing information. The median age was 20 (1-88 years-old) and the sex ratio was 1.72. An overall rate of 64.62% (1045/1617) of these patients tested positive for HEV with a high case fatality rate in pregnant women. All water samples and animal tissues tested negative for HEV. Our data help not only determining of the beginning of the HEV outbreak to March 2012, but also identifying risk factors associated to its emergence. However, there is a need to implement routine diagnosis, surveillance and training of health personnel in order to reduce mortality especially among pregnant women. In addition, further studies are needed to identify the virus reservoir and environmental risk factors for HEV in the Kedougou region.
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Affiliation(s)
- Bacary Djilocalisse Sadio
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal ,grid.414371.4Service de Santé Publique et Appui à la Recherche (CHU Fann), Institut de Santé et Développement, Dakar, Senegal ,grid.8191.10000 0001 2186 9619Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Martin Faye
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | | | - Maryam Diarra
- grid.418508.00000 0001 1956 9596Epidemiology, Clinical Research and Data Science Unit, Institut Pasteur de Dakar, 220 Dakar, Senegal
| | - Fanny Balique
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal ,grid.437080.8OZ Biosciences SAS, 13288 Marseille Cedex 09, France
| | - Cheikh Tidiane Diagne
- MIVEGEC (Infectious Diseases and Vector: Ecology, Genetics, Evolution and Control), Univ. Montpelier, IRD, CNRS, 34394 Montpellier, France
| | - Oumar Faye
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Moussa Moïse Diagne
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Gamou Fall
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Oumar Ndiaye
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Cheikh Loucoubar
- grid.418508.00000 0001 1956 9596Epidemiology, Clinical Research and Data Science Unit, Institut Pasteur de Dakar, 220 Dakar, Senegal
| | - Abdourahmane Sow
- grid.464557.10000 0004 0647 3618West African Health Organisation, 175, Avenue Ouezzin Coulibaly, 01BP: 153, Bobo Dioulasso 01, Burkina Faso
| | - Ousmane Faye
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Adama Faye
- grid.414371.4Service de Santé Publique et Appui à la Recherche (CHU Fann), Institut de Santé et Développement, Dakar, Senegal ,grid.8191.10000 0001 2186 9619Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Cheikh Saad Bouh Boye
- grid.8191.10000 0001 2186 9619Université Cheikh Anta Diop de Dakar, Dakar, Senegal ,Unité de Recherche et Biotechnologie Microbienne, Faculté de Médecine, de Pharmacie et d’Odontostomatologie (FMPOS), Dakar, Senegal
| | - Amadou Alpha Sall
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
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Cook N, D’Agostino M, Wood A, Scobie L. Real-Time PCR-Based Methods for Detection of Hepatitis E Virus in Pork Products: A Critical Review. Microorganisms 2022; 10:microorganisms10020428. [PMID: 35208881 PMCID: PMC8877315 DOI: 10.3390/microorganisms10020428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/18/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
Standard methods for detection of hepatitis A virus and norovirus in at-risk foodstuffs are available, but currently there is no standard method for detection of hepatitis E virus (HEV) in pork products or other foods that can be contaminated with the virus. Detection assays for HEV are mainly based on nucleic acid amplification, particularly the reverse transcription polymerase chain reaction (RTPCR) in real-time format. RTPCR-based methods can be sensitive and specific, but they require a suite of controls to verify that they have performed correctly. There have been several RTPCR methods developed to detect HEV in pork products, varying in details of sample preparation and RTPCR target sequences. This review critically discusses published HEV detection methods, with emphasis on those that have been successfully used in subsequent studies and surveys. RTPCR assays have been used both qualitatively and quantitatively, although in the latter case the data acquired are only reliable if appropriate assay calibration has been performed. One particular RTPCR assay appears to be ideal for incorporation in a standard method, as it has been demonstrated to be highly specific and sensitive, and an appropriate control and calibration standard is available. The review focuses on the detection of HEV in pork products and similar foodstuffs (e.g., boar). The information may be useful to inform standardisation activities.
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Affiliation(s)
- Nigel Cook
- Jorvik Food Safety Services, York YO32 2GN, UK
- Correspondence: (N.C.); (L.S.)
| | | | - Ann Wood
- Campden BRI, Chipping Campden GL55 6LD, UK; (M.D.); (A.W.)
| | - Linda Scobie
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
- Correspondence: (N.C.); (L.S.)
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Broadly Reactive Real-Time RT-PCR Assay for the Detection of Hepatitis E Virus and Simultaneous Genotyping by Single Nucleotide Polymorphism Analysis. Microbiol Spectr 2022; 10:e0191221. [PMID: 35138152 PMCID: PMC8826742 DOI: 10.1128/spectrum.01912-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Hepatitis E virus (HEV) infection is a global public health concern. Although HEV infection is usually asymptomatic and self-limiting, extrahepatic manifestations and chronic infections in immunocompromised patients have been described. HEV strains infecting humans have been classified into four main genotypes. In this study we have developed and validated a novel sensitive real-time RT-PCR assay for the detection of all four HEV genotypes. Simultaneous discrimination of genotypes 1, 2, and 4 from genotype 3 by single nucleotide polymorphism (SNP) analysis was possible. In all, 201 serum samples from cases and carriers previously tested for HEV by nested RT-PCR were analyzed. Twenty-seven HEV-positive samples could not be typed by the nested RT-PCR and nucleotide sequencing, but were newly typed by SNP analysis. As polymorphisms were present at the primer or probe binding site, we adopted a degenerate primer and mixed probes. When a mixed probe was added, the fluorescence intensity increased, facilitating genotype determination. IMPORTANCE The distribution of HEV-3 and HEV-4 has been changing. HEV-4, which had been predominantly found in Asia, is now being detected in other parts of the world, and there are now reports of chronic infections. Additionally, neurological disorders have frequently been reported in patients with acute or chronic HEV infections. HEV-4 has also been shown to lead to a higher severity in terms of acute hepatitis than does HEV-3. Early typing can provide useful information regarding the route of infection and for tailoring treatment to the expected course of the disease. The present method afforded a good detection rate even when polymorphisms were present within the target region for viral gene detection. We believe that this method can be applied to the analysis of mutation-prone viral genes in the future.
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Tricou V, Bouscaillou J, Laghoe-Nguembe GL, Béré A, Konamna X, Sélékon B, Nakouné E, Kazanji M, Komas NP. Hepatitis E virus outbreak associated with rainfall in the Central African Republic in 2008-2009. BMC Infect Dis 2020; 20:260. [PMID: 32245368 PMCID: PMC7119096 DOI: 10.1186/s12879-020-04961-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 03/11/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Infection by hepatitis E virus (HEV) can cause a high burden of morbidity and mortality in countries with poor access to clean water and sanitation. Our study aimed to investigate the situation of HEV infections in the Central African Republic (CAR). METHODS A retrospective analysis of the blood samples and notification forms collected through the national yellow fever (YF) surveillance program, but for which a diagnosis of YF was discarded, was carried out using an anti-HEV IgM ELISA and a HEV-specific RT-PCR. RESULTS Of 2883 YF-negative samples collected between January 2008 and December 2012, 745 (~ 26%) tested positive by at least either of the 2 tests used to confirm HEV cases. The results revealed that the CAR was hit by a large HEV outbreak in 2008 and 2009. The results also showed a clear seasonal pattern with correlation between HEV incidence and rainfall in Bangui. A phylogenetic analysis showed that the circulating strains belonged to genotypes 1e and 2b. CONCLUSIONS Overall, this study provides further evidences that HEV can be a significant cause of acute febrile jaundice, particularly among adults during rainy season or flood, in a country from Sub-Saharan Africa.
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Affiliation(s)
- Vianney Tricou
- Laboratoire des Arbovirus, Institut Pasteur de Bangui, Bangui, Central African Republic, BP 923.
| | | | | | - Aubin Béré
- Laboratoire d'Analyses Médicales, Institut Pasteur, Bangui, Central African Republic
| | - Xavier Konamna
- Laboratoire des Arbovirus, Institut Pasteur de Bangui, Bangui, Central African Republic, BP 923
| | - Benjamin Sélékon
- Laboratoire des Arbovirus, Institut Pasteur de Bangui, Bangui, Central African Republic, BP 923
| | - Emmanuel Nakouné
- Laboratoire des Arbovirus, Institut Pasteur de Bangui, Bangui, Central African Republic, BP 923
| | - Mirdad Kazanji
- Institut Pasteur, Bangui, Central African Republic, and Institut Pasteur, Cayenne, French Guiana
| | - Narcisse P Komas
- Laboratoire des Hépatites Virales, Institut Pasteur, Bangui, Central African Republic
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Demi Sibiro OA, Manirakiza A, Komas NP. Seroprevalence of Hepatitis E Virus Infection Among People Living With HIV in the Central African Republic. Open Forum Infect Dis 2018; 5:ofy307. [PMID: 30568981 PMCID: PMC6291416 DOI: 10.1093/ofid/ofy307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/14/2018] [Indexed: 02/06/2023] Open
Abstract
Background Hepatitis E virus (HEV) is a waterborne virus that causes acute hepatitis in immunocompromised patients and those who are immunocompetent. Few cases of chronic HEV have been described in industrialized countries. The Central African Republic is 1 of the few countries in the world that is endemic for both HIV and HEV. The prevalence of HIV infection is estimated to be 4.9% among adults aged 15-49 years, and hepatitis E is epidemo-endemic. The aim of this study was to characterize the epidemiology of HEV infection in people living with HIV (PLHIV) in Bangui. Methods A cross-sectional study was conducted between April and September 2015 based on answers to a questionnaire, and blood samples were collected for determination of immunological markers by enzyme-linked immunosorbent assay and molecular tests. Results Of the 200 PLHIV included, 15 (7.5%) had the IgM that characterizes acute HEV infection; 8.9% were women, and 2.2% were men. The overall seroprevalence of IgG was 68% (48% women and 70.4% men), indicating that men are statistically significantly more exposed to HEV than women. HEV infection had no effect on transaminase or T-CD4+ lymphocyte cell levels. The origin of infection could not be identified. Conclusions The seroprevalence of HEV is very high among PLHIV and in the general population of Bangui. This must be taken into account in studies of the risk factors of PLHIV infected with HEV.
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Affiliation(s)
| | - Alexandre Manirakiza
- Epidemiological Service, Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Narcisse Patrice Komas
- Hepatitis viral Laboratory, Institut Pasteur de Bangui, Bangui, Central African Republic
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Ricci A, Allende A, Bolton D, Chemaly M, Davies R, Fernandez Escamez PS, Herman L, Koutsoumanis K, Lindqvist R, Nørrung B, Robertson L, Ru G, Sanaa M, Simmons M, Skandamis P, Snary E, Speybroeck N, Ter Kuile B, Threlfall J, Wahlström H, Di Bartolo I, Johne R, Pavio N, Rutjes S, van der Poel W, Vasickova P, Hempen M, Messens W, Rizzi V, Latronico F, Girones R. Public health risks associated with hepatitis E virus (HEV) as a food-borne pathogen. EFSA J 2017; 15:e04886. [PMID: 32625551 PMCID: PMC7010180 DOI: 10.2903/j.efsa.2017.4886] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Hepatitis E virus (HEV) is an important infection in humans in EU/EEA countries, and over the last 10 years more than 21,000 acute clinical cases with 28 fatalities have been notified with an overall 10-fold increase in reported HEV cases; the majority (80%) of cases were reported from France, Germany and the UK. However, as infection in humans is not notifiable in all Member States, and surveillance differs between countries, the number of reported cases is not comparable and the true number of cases would probably be higher. Food-borne transmission of HEV appears to be a major route in Europe; pigs and wild boars are the main source of HEV. Outbreaks and sporadic cases have been identified in immune-competent persons as well as in recognised risk groups such as those with pre-existing liver damage, immunosuppressive illness or receiving immunosuppressive treatments. The opinion reviews current methods for the detection, identification, characterisation and tracing of HEV in food-producing animals and foods, reviews literature on HEV reservoirs and food-borne pathways, examines information on the epidemiology of HEV and its occurrence and persistence in foods, and investigates possible control measures along the food chain. Presently, the only efficient control option for HEV infection from consumption of meat, liver and products derived from animal reservoirs is sufficient heat treatment. The development of validated quantitative and qualitative detection methods, including infectivity assays and consensus molecular typing protocols, is required for the development of quantitative microbial risk assessments and efficient control measures. More research on the epidemiology and control of HEV in pig herds is required in order to minimise the proportion of pigs that remain viraemic or carry high levels of virus in intestinal contents at the time of slaughter. Consumption of raw pig, wild boar and deer meat products should be avoided.
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Comparison of real-time reverse transcriptase PCR assays for detection of swine hepatitis E virus in fecal samples. J Clin Microbiol 2014; 52:1045-51. [PMID: 24430450 DOI: 10.1128/jcm.03118-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Hepatitis E virus (HEV) is a major cause of acute viral hepatitis in people in many developing countries and is also endemic in many industrialized countries. Mammalian HEV (mHEV) isolates can be divided into at least four recognized major genotypes. Several nucleic acid amplification techniques have been developed for mHEV detection, with great differences in sensitivity. The aim of this study was to compare the performances of two singleplex real-time reverse transcriptase (RT) PCR assays for broad detection of all four mHEV genotypes (assays A and B) and two duplex real-time RT-PCR assays for detection and differentiation of mHEV genotypes 3 and 4 (assays C and D). RNAs extracted from 28 fecal samples from pigs experimentally inoculated with HEV genotype 3 and 186 fecal samples from commercial pigs with unknown HEV exposure were tested by all four assays. In experimental samples, HEV RNA was detected in 96.4% (assay A), 39.2% (assay B), 14.2% (assay C), and 0% (assay D) of the samples. In field samples with unknown HEV exposure, HEV RNA was detected in 67.2% (assay A), 36.4% (assay B), 1.1% (assay C), and 0.5% (assay D) of the samples. The assays showed overall poor agreement (κ = 0.19 to 0.03), with differences in detection rates between assays (P < 0.01). Assays A and B, which broadly detect HEV genotypes 1 to 4, had significantly higher detection rates for HEV RNA than the duplex assays C and D, which were both designed to detect and differentiate between HEV genotypes 3 and 4.
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10
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Dreier J, Juhl D. Autochthonous hepatitis e virus infections: a new transfusion-associated risk? ACTA ACUST UNITED AC 2013; 41:29-39. [PMID: 24659945 DOI: 10.1159/000357098] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 07/05/2013] [Indexed: 12/16/2022]
Abstract
Hepatitis E virus (HEV) has been recognized since 2004 as a transfusion-transmissible infectious agent, and recent epidemiological data suggest that it may pose a safety threat to the blood supply. It has recently become obvious that hepatitis E is endemic in industrialized countries, and that more infections are autochthonous than travel-associated. Epidemiological and phylogenetic analysis suggests that HEV infection has to be considered as a zoonosis and that viral transmission from animals (pigs, wild animals) occurs through food or direct contact. The seroprevalence and incidence of HEV in the general population and blood donors in European countries indicate an underestimated risk for transfusion transmissions. Recently reported cases of transfusion transmission of HEV infection, and detection of viremic, asymptomatic blood donors in nucleic acid amplification technique screening programs give an indication of the importance of this virus. Diagnostic assays for detection of anti-HEV antibodies, HEV antigens and RNA are discussed. Recent studies support the idea that active immunization can prevent hepatitis E, highlighting the need for vaccination programs. Here we review current knowledge of HEV and its epidemiology, blood transmission and prevention of this disease with emphasis on blood supply.
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Affiliation(s)
- Jens Dreier
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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Bouscaillou J, Komas N, Tricou V, Nakouné E, Sélékon B, Fontanet A, Kazanji M. Imported hepatitis e virus, central african republic, 2011. Emerg Infect Dis 2013; 19:335-7. [PMID: 23347578 PMCID: PMC3559044 DOI: 10.3201/eid1902.120670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
Viruses are common causes of foodborne outbreaks. Viral diseases have low fatality rates but transmission to humans via food is important due to the high probability of consuming fecally contaminated food or water because of poor food handling. Because of the low infectious doses of some foodborne viruses, there is a need for standardization and the development of new sensitive methods for detecting viruses. The focus is on molecular and non-molecular approaches, and emerging methods for the detection of foodborne viruses. The detection of noroviruses, hepatitis A and E viruses, rotaviruses and adenoviruses will be discussed. The chapter will conclude with insights into future research directions.
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Minor groove binder modification of widely used TaqMan probe for hepatitis E virus reduces risk of false negative real-time PCR results. J Virol Methods 2012; 186:157-60. [DOI: 10.1016/j.jviromet.2012.07.027] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Revised: 07/22/2012] [Accepted: 07/24/2012] [Indexed: 11/18/2022]
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Merviel C, Mansuy JM, Dubois M, Izopet J. Mise au point d’une technique multiplex de dépistage génomique HEV–HAV. ACTA ACUST UNITED AC 2012; 60:95-105. [DOI: 10.1016/j.patbio.2010.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2010] [Accepted: 04/13/2010] [Indexed: 01/26/2023]
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15
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Tessé S, Lioure B, Fornecker L, Wendling MJ, Stoll-Keller F, Bigaillon C, Nicand E. Circulation of genotype 4 hepatitis E virus in Europe: first autochthonous hepatitis E infection in France. J Clin Virol 2012; 54:197-200. [PMID: 22405947 DOI: 10.1016/j.jcv.2012.02.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 02/05/2012] [Accepted: 02/13/2012] [Indexed: 01/10/2023]
Abstract
BACKGROUND Human HEV infections reported in Europe without previous travel to endemic regions are linked to exposure to genotype 3 Hepatitis E virus (HEV).Genotype 3 is widely distributed through human cases and zoonotic reservoir. The geographical distribution of genotype 4 is limited to Asian countries. OBJECTIVES The first human case of autochthonous genotype 4 hepatitis E infection was reported in France. STUDY DESIGN The HEV infection was described in an immunosuppressed patient, presenting an acute myeloblastic leukemia. Investigation of the case was performed on detection of HEV markers in the patient and in the environment. RESULTS Hepatitis E infection was diagnosed on the basis of HEV RNA viremia, and detection of anti-HEV IgM. The prognostic of leukemia was favorable and HEV was cleared without relapsing. HEV isolate was classified into genotype 4. CONCLUSIONS The recent characterization of genotype 4 HEV through swine surveillance in Europe and the description of the first human case in France open interesting questions about the circulation of this genotype: health risks in human population, transmission patterns, and zoonotic reservoir.
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Affiliation(s)
- Sophie Tessé
- Unit of Virology, Hopital Val de Grace, National Reference Center of Hepatitis E, Paris, France
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16
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Seo DJ, Tahk H, Lee KB, Lee MH, Son NR, Seo S, Cheon DS, Lee BH, Choi C. Detecting hepatitis E virus with a reverse transcription polymerase chain reaction enzyme-linked immunosorbent assay. FOOD AND ENVIRONMENTAL VIROLOGY 2012; 4:14-20. [PMID: 23412763 DOI: 10.1007/s12560-011-9073-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 11/29/2011] [Indexed: 06/01/2023]
Abstract
This study aimed to develop a specific and sensitive reverse transcription polymerase chain reaction enzyme-linked immunosorbent assay (RT-PCR-ELISA) for detecting hepatitis E virus (HEV). Eight sets of primers and biotinylated probes designed in the ORF2-ORF3 overlapping region of HEV were tested for sensitivity. The ability of nested reverse transcription polymerase chain reaction (RT-PCR) and RT-PCR-ELISA to detect HEV was compared. RT-PCR-ELISA was 10-100 times more sensitive than nested RT-PCR and could detect 0.01 ng/μl HEV in swine stool samples. In terms of specificity, RT-PCR-ELISA did not falsely detect HEV when other viruses such as hepatitis A virus, rotavirus, norovirus genotype I, norovirus genotype II, and Feline calicivirus were present. Therefore, RT-PCR-ELISA appears to be a sensitive and specific method for detecting HEV.
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Affiliation(s)
- Dong Joo Seo
- Department of Food and Nutrition, School of Food Science and Technology, Chung-Ang University, 72-1, Nae-ri, Daeduck-myun, Ansung-si, Kyounggi-do, 456-756, South Korea
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17
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Maylin S, Stephan R, Molina JM, Peraldi MN, Scieux C, Nicand E, Simon F, Delaugerre C. Prevalence of antibodies and RNA genome of hepatitis E virus in a cohort of French immunocompromised. J Clin Virol 2012; 53:346-9. [PMID: 22293627 DOI: 10.1016/j.jcv.2012.01.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 12/31/2011] [Accepted: 01/05/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recently, cases of chronic hepatitis E have been identified in immunocompromised patients. OBJECTIVES To evaluate the prevalence of anti-HEV IgG antibodies and the persistence of HEV-RNA in sera of immunocompromised patients with regular follow-up at Saint-Louis Hospital in Paris, France. STUDY DESIGN 307 samples collected from 261 HIV-infected patients and 46 kidney transplant (KT)-patients were retrospectively tested for the presence of the following hepatitis E virus (HEV) infection markers: anti-HEV IgM antibodies, anti-HEV IgG antibodies, anti-HEV IgG avidity index, and HEV-RNA. RESULTS Anti-HEV IgG positive serology was found in 4 HIV-infected patients (1.5%) and 3 KT-patients (6.5%), leading to an overall seroprevalence of 2.3%. HEV-RNA detection was not observed among 55 HIV-patients at higher risk of chronic HEV (<200 CD4 cells/mm(3), elevated alanine aminotransferase (ALT) levels, and/or positive anti-HEV antibodies) and among 44 KT-patients. None of the seven patients had anti-HEV IgM antibodies, thereby excluding any acute infection. The IgG avidity index confirmed past HEV infection among tested patients. CONCLUSIONS The low seroprevalence observed in the Paris region does not warrant a systematic evaluation of HEV infection in immunocompromised patients. However, HEV infection must be examined as a possibility if unexplained increases in ALT should occur and after more common viral hepatitis infections are excluded.
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Affiliation(s)
- Sarah Maylin
- Virology Dpt, Inserm U941-Paris 7 Diderot University, Saint-Louis Hospital-APHP, Paris, France.
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18
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Genotype 3 diversity and quantification of hepatitis E virus RNA. J Clin Microbiol 2012; 50:897-902. [PMID: 22205792 DOI: 10.1128/jcm.05942-11] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Genotype 3 hepatitis E viruses (HEVs) are distributed across the world and are now considered to be an emerging public health concern in industrialized countries. At least 10 genotype 3 subtypes have been identified in humans and animals worldwide. It was recently reported that the sensitivities of HEV RNA assays differ greatly. We have assessed the influence of genotype 3 diversity on the performances of two HEV RNA assays: one targeting the ORF3 gene and the other targeting the ORF2 gene. We tested a panel of 5 HEV-positive reference samples of genotypes 3a, 3b, 3c, 3e, and 3f at 10-fold serial dilutions. The HEV RNA concentrations obtained with both reverse transcription (RT)-PCRs were correlated, but the RT-PCR based on ORF2 underestimated the HEV RNA concentrations. The mean [ORF3 - ORF2] difference was 1.41 log copies/ml. We also tested 34 clinical specimens of genotypes 3c (n = 15), 3e (n = 4), and 3f (n = 15), representing the most prevalent subtypes in Europe. The mean [ORF3 - ORF2] differences were 1.41 log copies/ml for genotype 3c, 0.96 log copies/ml for genotype 3e, and 0.70 log copies/ml for genotype 3f. The bias between the 2 RT-PCR assays was significantly greater for genotype 3c than for genotype 3f (P = 0.007). We therefore recommend the use of an RT-PCR protocol based on ORF3 to quantify HEV RNA of genotype 3 strains.
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Vasickova P, Kralik P, Slana I, Pavlik I. Optimisation of a triplex real time RT-PCR for detection of hepatitis E virus RNA and validation on biological samples. J Virol Methods 2011; 180:38-42. [PMID: 22207081 DOI: 10.1016/j.jviromet.2011.12.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 12/06/2011] [Accepted: 12/13/2011] [Indexed: 01/29/2023]
Abstract
The aim of this study was to optimise a two-tube reverse transcription triplex quantitative real time PCR (qRT-PCR) combining amplification of two loci with an internal amplification control (IAC) for detection and quantitation of hepatitis E virus (HEV) RNA and to validate its performance on a pool of biological samples. Optimisation was performed on serially diluted "home-made" RNA standards. The limit of detection was determined experimentally as 10 copies/μl of the RNA standard for both amplification targets. The qRT-PCR was validated on a cohort of samples originating from 48 wild boars (Sus scrofa), 17 fallow deer (Dama dama) and 28 mouflons (Ovis musimon), with nested RT-PCR used as a reference method. qRT-PCR was found to be more specific for the detection of HEV RNA in examined samples. HEV RNA was detected in samples of five more animals (one wild boar and four mouflons) in comparison with nested RT-PCR.
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Affiliation(s)
- Petra Vasickova
- Veterinary Research Institute, Hudcova 70, 621 00 Brno, Czech Republic.
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20
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Zhang H, Mohn U, Prickett JR, Schalk S, Motz M, Halbur PG, Feagins AR, Meng XJ, Opriessnig T. Differences in capabilities of different enzyme immunoassays to detect anti-hepatitis E virus immunoglobulin G in pigs infected experimentally with hepatitis E virus genotype 3 or 4 and in pigs with unknown exposure. J Virol Methods 2011; 175:156-62. [PMID: 21596064 DOI: 10.1016/j.jviromet.2011.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 04/25/2011] [Accepted: 05/03/2011] [Indexed: 01/22/2023]
Abstract
Hepatitis E virus (HEV), a major cause of acute viral hepatitis in humans in many developing countries, is highly prevalent in the pig population worldwide. The objective of this study was to assess the capability of three porcine prototypes of a human enzyme-linked immunosorbent assay (ELISA), an in-house ELISA and a line-immunoassay (LIA) to detect anti-HEV antibodies in pigs infected experimentally with HEV (n = 57), known to be negative for HEV infection (n = 27), or with unknown exposure to HEV infection (field samples, n = 90). All 27 samples from non-infected pigs were negative with all five assays. The earliest detection of anti-HEV antibodies occurred at 14 days post-inoculation (dpi) with four of five assays. From 42 dpi, all samples from infected pigs were detected correctly as anti-HEV positive. Kappa analysis demonstrated substantial agreement among tests (0.62-1.00) at 14 dpi and complete agreement (1.00) at 56 dpi. The overall area under the curve for all quantitative tests as determined by receiver operator characteristic analysis ranged from 0.794 to 0.831 indicating moderate accuracy. The results showed that all five assays can detect anti-HEV IgG antibodies accurately in pigs infected experimentally with HEV. In field samples, a higher prevalence of anti-HEV IgG was found in breeding herds than in growing pigs (100% versus 66.7-93.9%). These serological assays should be very useful in veterinary diagnostic labs for HEV diagnosis in swine.
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Affiliation(s)
- H Zhang
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011-1250, USA
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21
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Chaillon A, Sirinelli A, De Muret A, Nicand E, d'Alteroche L, Goudeau A. Sustained virologic response with ribavirin in chronic hepatitis E virus infection in heart transplantation. J Heart Lung Transplant 2011; 30:841-3. [PMID: 21515077 DOI: 10.1016/j.healun.2011.03.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Revised: 03/09/2011] [Accepted: 03/09/2011] [Indexed: 10/18/2022] Open
Abstract
Hepatitis E virus (HEV) is an emerging problem amongst transplant recipients. We report a patient with chronic HEV hepatitis after a heart transplant. The patient received a 3-month course of oral ribavirin (17 mg/kg/day). HEV RNA became undetectable in the serum after 1 month of treatment and remained undetectable in serum and stool samples until the last follow-up, 2 months after completion of ribavirin therapy. The values of liver function indicators returned to normal reference ranges. The main ribavirin-induced side effect was a significant but well-tolerated anemia. We confirmed that ribavirin may induce a sustained virologic response (4 months after ribavirin cessation) in heart transplant patients with chronic HEV infection. Liver cytolysis is rather common in patients after heart transplantation. Rapid evolution to liver fibrosis lesions and available anti-viral therapy highlight the need to look for HEV infection in heart transplant recipients with unexplained hepatitis.
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Affiliation(s)
- Antoine Chaillon
- Service de Bactériologie-Virologie, CHRU Bretonneau, Tours, France; INSERM U966 Université François-Rabelais de Tours, UFR Médecine, Tours, France.
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22
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Sellier P, Mazeron MC, Tesse S, Badsi E, Evans J, Magnier JD, Sanson-Le-Pors MJ, Bergmann JF, Nicand E. Hepatitis E virus infection in HIV-infected patients with elevated serum transaminases levels. Virol J 2011; 8:171. [PMID: 21496215 PMCID: PMC3104369 DOI: 10.1186/1743-422x-8-171] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 04/15/2011] [Indexed: 02/08/2023] Open
Abstract
Increases in aminotransferases levels are frequently encountered in HIV-positive patients and often remain unexplained. The role in this setting and natural history of hepatitis E in HIV-infected patients are unknown. The aim of the study was to assess HEV infection in HIV-infected patients attending a Parisian hospital, with a current or previous cryptogenic hepatitis.191 plasma samples collected from 108 HIV-infected patients with elevated aminotransferases levels were retrospectively tested for the presence of hepatitis E virus (HEV) infection markers: anti-HEV IgM antibodies, anti-HEV IgG antibodies, anti-HEV IgG avidity index and plasma HEV RNA.One acute infection, documented by positive tests for anti-HEV IgM antibody, low anti-HEV IgG avidity index and plasma HEV RNA (genotype 3e), and three past infections were diagnosed, without any observed case of persistent infection. The acute hepatitis was benign and resolved spontaneously within two weeks. This infection was probably contracted locally. Acute HEV hepatitis can occur in HIV-infected patients but rarely explains cryptogenic hepatitis, at least in an urban HIV population, regardless geographic origin and CD4 counts.
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Affiliation(s)
- Pierre Sellier
- Unite des Maladies Infectieuses et Tropicales, Service de Medecine Interne A, Hopital Lariboisiere, 2, rue Ambroise Pare, 75010, Paris, France.
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23
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Epelboin L, Nicand E, Roussin C, Lernout T, Pettinelli ME, Tesse S, Ali R, Aubry P. A sporadic case of genotype 3f acute hepatitis E in Mayotte. Med Mal Infect 2011; 41:392-4. [PMID: 21493025 DOI: 10.1016/j.medmal.2011.02.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Revised: 01/14/2011] [Accepted: 02/25/2011] [Indexed: 11/26/2022]
Affiliation(s)
- L Epelboin
- Service de médecine polyvalente, centre hospitalier de Mayotte, Mamoudzou, Mayotte.
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24
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TaqMan real-time reverse transcription-PCR assay for universal detection and quantification of avian hepatitis E virus from clinical samples in the presence of a heterologous internal control RNA. J Clin Microbiol 2011; 49:1339-46. [PMID: 21307216 DOI: 10.1128/jcm.01626-10] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Avian hepatitis E virus (HEV) isolates could be separated into at least three genotypes. In this study, the development of the first duplex TaqMan real-time reverse transcription-PCR (RT-PCR) assay for detection and quantification of avian HEV is presented. Primers and probes binding within relatively conserved open reading frame 3 (ORF3) were designed. Tenfold dilution series of in vitro-transcribed avian HEV RNA were used as the standard for quantification. A 712-bp region of the green fluorescent protein gene was transcribed in vitro and used as a heterologous internal control for both RNA isolation and real-time RT-PCR. The duplex real-time RT-PCR for avian HEV had an efficiency of 1.04, a regression squared value of 0.996, and a sensitivity of approximately 3.6 × 10(3) copies per reaction mixture when in vitro-transcribed RNA was used as the template. The presence of in vitro-transcribed heterologous internal control RNA did not affect amplification of avian HEV RNA compared to that achieved by the single assay. The sensitivity of the real-time RT-PCR assay was comparable to that of conventional RT-PCR, and it was shown to be highly specific, as tissues from uninfected chickens, mammalian HEVs, and other viral genomes did not produce positive signals. All tested field samples with virus belonging to different avian HEV genotypes were successfully detected with this new duplex TaqMan real-time RT-PCR assay.
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25
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Rolfe KJ, Curran MD, Mangrolia N, Gelson W, Alexander GJM, L'estrange M, Vivek R, Tedder R, Ijaz S. First case of genotype 4 human hepatitis E virus infection acquired in India. J Clin Virol 2010; 48:58-61. [PMID: 20227909 DOI: 10.1016/j.jcv.2010.02.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 02/01/2010] [Accepted: 02/04/2010] [Indexed: 12/29/2022]
Abstract
This report describes a case of severe hepatitis in an individual returning from India which was found to be the result of infection with HEV genotype 4. HEV was diagnosed using a novel RT-PCR assay (with internal control) for HEV RNA detection/quantitation, described herein. This is the first documented report of zoonotic transmission of HEV genotype 4 infection acquired in India.
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Affiliation(s)
- K J Rolfe
- Clinical Microbiology and Public Health Laboratory, Health Protection Agency, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QW, UK.
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26
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Outbreak of hepatitis E virus infection in Darfur, Sudan: effectiveness of real-time reverse transcription-PCR analysis of dried blood spots. J Clin Microbiol 2009; 47:1931-3. [PMID: 19339474 DOI: 10.1128/jcm.02245-08] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Biological samples collected in refugee camps during an outbreak of hepatitis E were used to compare the accuracy of hepatitis E virus RNA amplification by real-time reverse transcription-PCR (RT-PCR) for sera and dried blood spots (concordance of 90.6%). Biological profiles (RT-PCR and serology) of asymptomatic individuals were also analyzed.
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27
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28
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Ward P, Poitras E, Leblanc D, Letellier A, Brassard J, Plante D, Houde A. Comparative analysis of different TaqMan real-time RT-PCR assays for the detection of swine Hepatitis E virus and integration of Feline calicivirus as internal control. J Appl Microbiol 2009; 106:1360-9. [PMID: 19187137 DOI: 10.1111/j.1365-2672.2008.04104.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS The aim of this study was to compare the performance of four TaqMan RT-PCR assays with a commonly used nested RT-PCR and to include the Feline calicivirus (FCV) as an internal control. METHODS AND RESULTS RNA extracted from 87 swine faecal samples and 103 swine blood samples was subjected to different detection systems. Faecal samples naturally contaminated with Hepatitis E virus (HEV) and negative samples were artificially inoculated with 3.2 x 10(3) PFU of FCV. Detection results obtained on faecal and plasma samples were 35.6% and 4.9% with the nested RT-PCR assay, 8.0% and 0%, 0% and 0%, 13.8% and 0% and 36.8% and 3.9% with TaqMan systems A, B, C and D respectively. The Ct means obtained with the multiplex TaqMan assay were 30.11 and 30.43 for the detection of FCV with HEV contaminated samples and negative samples. CONCLUSIONS The TaqMan system D was more suitable for the detection of swine HEV strains than the three others and FCV was integrated successfully as an internal control. SIGNIFICANCE AND IMPACT OF THE STUDY FCV was demonstrated as an efficient control to monitor the RNA extraction process and HEV amplification procedure in a multiplex HEV/FCV TaqMan assay. This control would be helpful in limiting false negative results.
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Affiliation(s)
- P Ward
- Agriculture and Agri-Food Canada, Food Research and Development Centre, St-Hyacinthe, QC, Canada
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29
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Hépatite E : bientôt un vaccin? Rev Med Interne 2008; 29:615-7. [DOI: 10.1016/j.revmed.2007.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Accepted: 08/15/2007] [Indexed: 11/23/2022]
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30
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Mushahwar IK. Hepatitis E virus: molecular virology, clinical features, diagnosis, transmission, epidemiology, and prevention. J Med Virol 2008; 80:646-58. [PMID: 18297720 DOI: 10.1002/jmv.21116] [Citation(s) in RCA: 200] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hepatitis E virus (HEV), the sole member of the genus Hepevirus in the family of Hepeviridae, is the major cause of several outbreaks of waterborne hepatitis in tropical and subtropical countries and of sporadic cases of viral hepatitis in endemic and industrialized countries. Transmission of HEV occurs predominantly by the fecal-oral route although parenteral and perinatal routes have been implicated. The overall death rate among young adults and pregnant women is 0.5-3% and 15-20%, respectively. HEV is a small non-enveloped particle that consists of a polyadenylated single-strand RNA molecule containing three discontinuous and partially overlapping open reading frames. There are four major genotypes of HEV and a single serotype. At present, there are approximately 1,600 sequences of HEV that are already available at INSDC of both human and animal isolates. Diagnostic and molecular assays have been described for the accurate differentiation of ongoing from remote infection of HEV. Identification and characterization of swine HEV in the United States, Japan, and many other countries and their close relationship to locally characterized human HEV found in the same geographic areas prove that HEV is indeed a zoonotic virus and that domestic swine, wild deer, and boars are reservoirs of HEV in nature. A cell culture system for the propagation of the virus has been described, and a very successful phase 2 vaccine trial has been completed. This review summarizes the current knowledge on the molecular biology, clinical features, transmission, diagnosis, epidemiology, and prevention of HEV.
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Affiliation(s)
- Isa K Mushahwar
- Infectious Disease Diagnostics, Tierra Verde, Florida 33715, USA.
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31
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Jiménez de Oya N, Escribano-Romero E, Blázquez AB, Saiz JC. [Hepatitis E virus: zoonotic implications]. GASTROENTEROLOGIA Y HEPATOLOGIA 2008; 30:408-18. [PMID: 17692200 DOI: 10.1157/13108819] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The Hepatitis E virus (HEV) is transmitted primarily by the feco-oral route throughout contaminated water and/or food, and is one of the main causes of acute hepatitis worldwide. Hepatitis E shows a high mobility but a low mortality rate, except in pregnant women, where it can be as high as 30%. HEV causes sporadic cases and epidemic outbreaks, mainly in Africa, Asia and Central America. In Europe, there is an increase in the number of reported autochthonous cases no related with travel to endemic areas. In addition, HEV also infects animals, including pigs, and its zoonotic potential has been recently demonstrated. In fact, porcine and human strains of the same area are genetically more closely related to each other than to strains of the same species but a different geographical region, and there are data suggesting that people in close contact with pigs presents a higher prevalence of specific anti-HEV antibodies. All together, these data have drove to an increase interest in determining the incidence of the disease in animals, its possible zoonotic risk, and its implications for human health. In the present article we revised the current knowledge about HEV, with special emphasis in the possible consequences of its zoonotic potential.
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Affiliation(s)
- Nereida Jiménez de Oya
- Laboratorio de Zoonosis y Virología Medioambiental, Departamento de Biotecnología, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Madrid, España
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32
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[Hepatitis E virus. Position of the Blood Study Circle of the Federal Ministry of Health]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008; 51:90-7. [PMID: 18185974 DOI: 10.1007/s00103-008-0423-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Pauli G, Blümel J, Burger R, Drosten C, Gröner A, Gürtler L, Heiden M, Hildebrandt M, Jansen B, Klamm H, Montag-Lessing T, Offergeld R, Seitz R, Schlenkrich U, Schottstedt V, Willkommen H, Wirsing von König CH. Hepatitis E Virus. Transfus Med Hemother 2008; 35:50-57. [PMID: 21547111 DOI: 10.1159/000113057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Accepted: 12/31/2007] [Indexed: 01/08/2023] Open
Affiliation(s)
- Georg Pauli
- Arbeitskreis Blut, Untergruppe «Bewertung Blutassoziierter Krankheitserreger»
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34
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Zhao C, Li Z, Yan B, Harrison TJ, Guo X, Zhang F, Yin J, Yan Y, Wang Y. Comparison of real-time fluorescent RT-PCR and conventional RT-PCR for the detection of hepatitis E virus genotypes prevalent in China. J Med Virol 2007; 79:1966-73. [PMID: 17935186 DOI: 10.1002/jmv.21040] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
To compare the specificity and sensitivity of a real-time fluorescent RT-PCR assay with conventional RT-PCR, sera from 110 healthy blood donors, 120 patients with a clinical diagnosis of chronic hepatitis B, and 416 patients with non-A-C acute hepatitis, as well as serial dilutions of HEV genotypes 1 and 4, were tested with both assays. All samples from healthy blood donors and patients with chronic hepatitis B were negative by both assays. Real-time RT-PCR could detect the same final dilution of genotype 1 as conventional RT-PCR but could detect a 10-fold lower concentration of genotype 4 than conventional RT-PCR. Of 416 samples from patients with a clinical diagnosis of non-A-C acute hepatitis, 127 (30.5%) and 83 (20.0%) were positive for HEV by real-time and conventional RT-PCR, respectively. The concordance of real-time and conventional RT-PCR was 80.8%. Furthermore, 96 and 57 of 171 samples were positive for anti-HEV IgM by real-time and conventional RT-PCR, respectively, and 31 and 26 of 245 samples negative for anti-HEV IgM, were positive by real-time and conventional RT-PCR, respectively. All amplicons positive by conventional RT-PCR were sequenced. Of 83 isolates, 7 and 76 belonged to genotypes 1 and 4, respectively. Thus, both assays have a high specificity, but the real-time RT-PCR assay is more sensitive than conventional RT-PCR. Furthermore, HEV genotype 4 is responsible for most sporadic cases of hepatitis E in the north of China.
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Affiliation(s)
- Chenyan Zhao
- Department of Cell Biology, National Institute for the Control of Pharmaceutical and Biological Products, Beijing, PR China
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35
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Gyarmati P, Mohammed N, Norder H, Blomberg J, Belák S, Widén F. Universal detection of hepatitis E virus by two real-time PCR assays: TaqMan® and Primer-Probe Energy Transfer. J Virol Methods 2007; 146:226-35. [PMID: 17825434 DOI: 10.1016/j.jviromet.2007.07.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Revised: 07/02/2007] [Accepted: 07/09/2007] [Indexed: 10/22/2022]
Abstract
Hepatitis E virus (HEV) is a major cause of food- and waterborne diseases in countries with poor sanitation. Furthermore, travellers to such countries are also at risk of contracting the virus. Noteworthily, during the last decade an increasing number of non-travel-related cases were recorded even in countries with high sanitary standards. An alternative, direct route of infection, from animals to humans (zoonotic transmission) is suspected to be the cause of recent cases of hepatitis E. In order to provide rapid and sensitive methods for detecting the virus in various hosts, two real-time PCR methods were developed and compared: a TaqMan and Primer-Probe Energy Transfer (PriProET) assay. These highly sensitive novel methods provide valuable diagnostic tools to investigate zoonotic transmission, to detect the virus in the food chain and in research related to the potential of hepatitis E virus to cross the species barrier. The results show that the two novel PCR assays are robust, highly sensitive and specific for broad range detection of the four genotypes of HEV. Compared to PriProET, the TaqMan assay appears to perform slightly better, with higher fluorescence values for positive samples. However, the PriProET has the benefit of better tolerating the point mutations in the target nucleic acids. Thus, it provides a more powerful tool to detect new virus variants. These new molecular diagnostic assays are practical tools that can be employed in the area of public health, for disease diagnosis and for tracking outbreaks. In basic research the methods provide new tools to study HEV biology, including virus-host interactions and transmission between various host species.
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Affiliation(s)
- Péter Gyarmati
- Joint R&D Division, Department of Virology, The National Veterinary Institute & Faculty of Veterinary Medicine and Animal Science, S-751 89 Uppsala, Sweden
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Abstract
Hepatitis E virus (HEV) is the main cause of enterically transmitted non-A hepatitis worldwide. Infection is endemic in developing countries. Disease course is benign, and severe jaundice is rarely reported. Three patients presented to our department with symptomatic acute hepatitis. Two of them had recently travelled to endemic areas. Jaundice was very marked in all patients. HEV infection was documented by HEV antibodies and by HEV-RNA detection in serum and stools. In the autochthonous case, immunoglobulin-M was absent, and diagnosis was established on HEV-RNA amplification by real-time reverse transcriptase-PCR. Comprehensive investigation for concomitant causes of liver disease was negative in all patients. Histological features showed marked cholestasis with multiple bile plugs in dilated canaliculi. In conclusion, acute hepatitis E may be autochthonous in developed countries and patients may present with severe jaundice. HEV-RNA detection by real-time reverse transcriptase-PCR is a very efficacious diagnostic tool in anti-HEV immunoglobulin-M-negative cases.
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Ducancelle A, Payan C, Nicand E, Le Guillou H, Calès P, Lunel-Fabiani F. Intrafamilial hepatitis E in France. J Clin Virol 2007; 39:51-3. [PMID: 17409020 DOI: 10.1016/j.jcv.2007.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Accepted: 02/27/2007] [Indexed: 11/18/2022]
Affiliation(s)
- A Ducancelle
- Laboratoire de Bactériologie-Virologie, CHU Angers, Paris
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