1
|
Geng Y, Shi T, Wang Y. Transmission of Hepatitis E Virus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:73-92. [PMID: 37223860 DOI: 10.1007/978-981-99-1304-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Transmission of hepatitis E virus (HEV) occurs predominantly by the fecal-oral route. Large epidemics of hepatitis E in the developing countries of Asia and Africa are waterborne and spread through contaminated drinking water. The reservoir of HEV in developed countries is believed to be in animals with zoonotic transmission to humans, possibly through direct contact or the consumption of undercooked contaminated meat. And HEV transmission through blood transfusion, organ transplantation, and vertical transmission has been reported.
Collapse
Affiliation(s)
- Yansheng Geng
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Tengfei Shi
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Youchun Wang
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China.
| |
Collapse
|
2
|
You S, Zhu B, Xin S. Clinical Manifestations of Hepatitis E. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:185-197. [PMID: 37223867 DOI: 10.1007/978-981-99-1304-6_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The clinical manifestations of hepatitis E are similar to those of other types of viral hepatitis. While acute hepatitis E is usually self-limited, pregnant women and chronic liver disease patients suffering from acute hepatitis E usually present with severe clinical manifestations that may develop into fulminant hepatic failure. Chronic HEV infection is typically seen in organ transplant patients; most HEV cases are asymptomatic and rarely display jaundice, fatigue, abdominal pain, fever, fatigue, or ascites. The clinical manifestations of HEV infection in neonates are diverse and have varied clinical signs, biochemistry, and virus-biomarkers. Lastly, the extrahepatic manifestations and complications of hepatitis E are in need of further study.
Collapse
Affiliation(s)
- Shaoli You
- Senior Department of Hepatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Bing Zhu
- Senior Department of Hepatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shaojie Xin
- Senior Department of Hepatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
3
|
Boonyai A, Thongput A, Sisaeng T, Phumchan P, Horthongkham N, Kantakamalakul W, Chaimayo C. Prevalence and clinical correlation of hepatitis E virus antibody in the patients' serum samples from a tertiary care hospital in Thailand during 2015-2018. Virol J 2021; 18:145. [PMID: 34247642 PMCID: PMC8273939 DOI: 10.1186/s12985-021-01616-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 07/02/2021] [Indexed: 02/02/2023] Open
Abstract
Background Prevalence and incidence of hepatitis caused by HEV infection are usually higher in developing countries. This study demonstrated the HEV seroprevalence and incidence of HEV infection in patients with clinical hepatitis in a tertiary hospital in Thailand. Methods A laboratory-based cross-sectional study was conducted using 1106 serum samples from patients suspected of HEV infection sent to the Serology laboratory, Siriraj Hospital, for detecting HEV antibodies during 2015–2018. Prevalence of anti-HEV IgG and IgM antibodies in general patients, including organ transplant recipients and pregnant women in a hospital setting, were determined using indirect enzyme-linked immunosorbent assay (ELISA) kits. Comparison of laboratory data between groups with different HEV serological statuses was performed. Results HEV IgG antibodies were detected in 40.82% of 904 serum samples, while HEV IgM antibodies were detected in 11.75% of 1081 serum samples. Similar IgG and IgM antibody detection rates were found in pregnant women. Interestingly, anti-HEV IgM antibodies were detected in 38.5% of patients who underwent organ transplantation. Patients who tested positive for anti-HEV IgM antibodies had higher alanine aminotransferase levels than those who had not. In contrast, patients who tested positive for anti-HEV IgG had more elevated levels of total bilirubin than those who tested negative. Conclusions HEV seroprevalence and incidence in patients with clinical hepatitis were relatively high in the Thai population, including the pregnancy and organ transplant subgroups. The results potentially benefit the clinicians in decision-making to investigate HEV antibodies and facilitating proper management for patients.
Collapse
Affiliation(s)
- Atiporn Boonyai
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Anchalee Thongput
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thidarat Sisaeng
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Parisut Phumchan
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Navin Horthongkham
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wannee Kantakamalakul
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chutikarn Chaimayo
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
4
|
Seroprevalence of Hepatitis A and Hepatitis E Viruses among Pregnant Women in Northern Iran. Infect Dis Obstet Gynecol 2021; 2021:5130586. [PMID: 34305391 PMCID: PMC8272671 DOI: 10.1155/2021/5130586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/28/2021] [Indexed: 01/14/2023] Open
Abstract
Background Hepatitis A (HAV) and hepatitis E viruses (HEV) are endemic in Iran and are known major causes of acute viral hepatitis. Also, during pregnancy, they are associated with severe outcomes. Therefore, it is vital to evaluate the antibody levels against HAV and HEV in pregnant women to avoid severe outcomes incidence. Study design and methods. A total of 247 pregnant women were enrolled in this prospective cross-sectional study. In addition to completing the questionnaire and interviewing all participants, the serum samples were tested for anti-HAV and anti-HEV IgG using the enzyme-linked immunosorbent assay (ELISA). The association between anti-HAV and anti-HEV antibodies status and risk factors was evaluated. Results The mean age of patients was 28.06 ± 5.29 years. Anti-HAV antibody was found in 111 patients (44.9%), while anti-HEV antibody was detected in only two pregnant women (0.8%). The seroprevalence of HAV was inversely related to the level of education. There was no significant correlation between HAV antibody levels and age, marital status, residence location, and pregnancy trimesters. Conclusion Considering many complications of these diseases in pregnancy, the detection of enteroviral hepatitis, especially HAV in pregnant women, is necessary, and therefore, proactive measures, such as promoting education, improving people awareness, and vaccination, are recommended.
Collapse
|
5
|
Porea D, Anita A, Vata A, Teodor D, Crivei L, Raileanu C, Gotu V, Ratoi I, Cozma A, Anita D, Oslobanu L, Pavio N, Savuta G. Common European Origin of Hepatitis E Virus in Human Population From Eastern Romania. Front Public Health 2020; 8:578163. [PMID: 33392130 PMCID: PMC7773928 DOI: 10.3389/fpubh.2020.578163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
The purpose of this research was to improve the epidemiological data on HEV infection in the human population in Romania. The analysis targeted hospitalized subjects with acute hepatitis (n = 94) of unknown etiology from the Infectious Diseases Regional Hospital in Iasi. Moreover, patients without liver disease (n = 40) from a different county hospital located in Eastern Romania were included. The presence of HEV infection and first characterization of human HEV strains was determined using serological and molecular assays. The apparent HEV seroprevalence varied between 29.16% (95% CI, 16.31–42.03) and 32.5% (95% CI, 17.98–47.02) according to patient grouping. Molecular analysis enhanced the detection of two HEV isolates, that clustered in subtype HEV-3c, the most commonly identified subtype in Europe. Identification of acute hepatitis E cases, together with the first detection and molecular characterization of human HEV in Romania represent the originality attributes of the present study.
Collapse
Affiliation(s)
- Daniela Porea
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania.,Center for the Study of Transborder and Emergent Diseases and Zoonoses Department, Danube Delta National Institute for Research and Development, Tulcea, Romania
| | - Adriana Anita
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania
| | - Andrei Vata
- "Sfanta Parascheva" Infectious Diseases Hospital of Iasi, Iaşi, Romania
| | - Danut Teodor
- "Sfanta Parascheva" Infectious Diseases Hospital of Iasi, Iaşi, Romania
| | - Luciana Crivei
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania
| | - Cristian Raileanu
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania.,Laboratory of Vector Capacity, Institute of Infectology, Friedrich-Loeffler-Institut, Greifswald, Germany
| | - Vasilica Gotu
- Department of Parasitology and Parasitic Diseases and Animal Biology, Faculty of Veterinary Medicine, University of Agronomical Sciences and Veterinary Medicine of Bucharest, Bucharest, Romania
| | - Ioana Ratoi
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania
| | - Andreea Cozma
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania
| | - Dragos Anita
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania
| | - Luanda Oslobanu
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania
| | - Nicole Pavio
- UMR Virologie 1161, ENVA, INRAE, Anses, Maisons-Alfort, France
| | - Gheorghe Savuta
- Department of Public Health, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Iasi, Iaşi, Romania
| |
Collapse
|
6
|
Bigna JJ, Modiyinji AF, Nansseu JR, Amougou MA, Nola M, Kenmoe S, Temfack E, Njouom R. Burden of hepatitis E virus infection in pregnancy and maternofoetal outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:426. [PMID: 32723309 PMCID: PMC7388479 DOI: 10.1186/s12884-020-03116-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 07/16/2020] [Indexed: 12/27/2022] Open
Abstract
Background There is still a dearth of knowledge on the burden of HEV infection in the global population of pregnant women. Therefore, we conducted a systematic review and meta-analysis to estimate the global burden of HEV infection in pregnancy. Methods We searched PubMed, Embase, Web of Knowledge, and Global Index Medicus to identify articles published until January 26, 2020. We considered cross-sectional, case-control, and cohort studies reporting the immunoglobulins M HEV seroprevalence in asymptomatic and symptomatic (jaundice or elevated transaminases) pregnant women or investigating the association between HEV infection and maternofoetal outcomes. We used a random-effects model to pool studies. This review was registered with PROSPERO, CRD42018093820. Results For HEV prevalence estimates, we included 52 studies (11,663 pregnant women). The seroprevalence was 3.5% (95% confidence interval: 1.4–6.4) in asymptomatic women (most of whom from high endemic areas). The prevalence in symptomatic women was 49.6% (42.6–56.7) with data only from HEV high endemic countries. In the multivariable meta-regression model, the prevalence was higher in symptomatic women compared to asymptomatic (adjusted prevalence odds ratio [aPOR]: 1.76; 95%CI: 1.61–1.91) and decreased with increasing year of publication (by 10-year) (aPOR: 0.90; 95%CI: 0.84–0.96). The proportion of HEV vertical transmission was 36.9% (13.3–64.2). Risk of bias was low, moderate and high respectively in 12 (23%), 37 (70%), and 4 studies (7%) addressing HEV prevalence estimation. HEV infection was associated with maternal deaths (pooled OR 7.17; 3.32–15.47), low birth weight (OR: 3.23; 1.71–6.10), small for gestational age (OR: 3.63; 1.25–10.49), preterm < 32 weeks (OR: 4.18; 1.23–14.20), and preterm < 37 weeks (OR: 3.45; 2.32–5.13), stillbirth (OR: 2.61; 1.64–4.14), intrauterine deaths (OR: 3.07; 2.13–4.43), and not with miscarriage (OR: 1.74; 0.77–3.90). All studies which assessed the association between HEV infection and maternofoetal outcomes had a moderate risk of bias. Conclusions Findings from this study are suggestive of a high burden of HEV infection in pregnancy in high endemic countries, its association with poor maternofoetal outcomes, and a high rate of vertical transmission. This study supports the need for specific strategies to prevent exposure of pregnant women to HEV infection, especially in high endemic areas.
Collapse
Affiliation(s)
- Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, P.O. Box 1274, Yaoundé, Cameroon.
| | - Abdou Fatawou Modiyinji
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon.,Department of Animals Biology and Physiology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Jobert Richie Nansseu
- Department for the Control of Disease, Epidemics and Pandemics, Ministry of Public Health, Yaoundé, Cameroon.,Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Marie A Amougou
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon.,Department of Biochemistry, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Moise Nola
- Department of Animals Biology and Physiology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Sébastien Kenmoe
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Elvis Temfack
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Richard Njouom
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| |
Collapse
|
7
|
Elsharkawy SS, Elgazayerli WS. Sero-Prevalence of HBV, HCV and HEV among the Egyptian Pregnant Females. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojog.2019.910138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
8
|
Hepatitis E in High-Income Countries: What Do We Know? And What Are the Knowledge Gaps? Viruses 2018; 10:v10060285. [PMID: 29799485 PMCID: PMC6024799 DOI: 10.3390/v10060285] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/16/2018] [Accepted: 05/23/2018] [Indexed: 12/11/2022] Open
Abstract
Hepatitis E virus (HEV) is a positive-strand RNA virus transmitted by the fecal–oral route. HEV genotypes 1 and 2 infect only humans and cause mainly waterborne outbreaks. HEV genotypes 3 and 4 are widely represented in the animal kingdom, and are mainly transmitted as a zoonosis. For the past 20 years, HEV infection has been considered an imported disease in developed countries, but now there is evidence that HEV is an underrecognized pathogen in high-income countries, and that the incidence of confirmed cases has been steadily increasing over the last decade. In this review, we describe current knowledge about the molecular biology of HEV, its clinical features, its main routes of transmission, and possible therapeutic strategies in developed countries.
Collapse
|
9
|
Farshadpour F, Taherkhani R, Ravanbod MR, Eghbali SS, Taherkhani S, Mahdavi E. Prevalence, risk factors and molecular evaluation of hepatitis E virus infection among pregnant women resident in the northern shores of Persian Gulf, Iran. PLoS One 2018; 13:e0191090. [PMID: 29329329 PMCID: PMC5766211 DOI: 10.1371/journal.pone.0191090] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/29/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Although Iran is reported to be an endemic country for hepatitis E virus (HEV), data on the prevalence of HEV infection among pregnant women are scarce and the epidemiology of HEV is unknown in most parts of the country. Therefore, this study was conducted to elucidate the prevalence, risk factors and genotypic pattern of HEV infection among pregnant women resident in the northern shores of Persian Gulf. This is the first report on the epidemiology of HEV infection among pregnant women in this territory. METHODS From October 2016 to May 2017, 1331 pregnant women participated in this study. The mean age ± SD of participants was 27.93±5.7 years with a range of 14-45 years. Serum samples of pregnant women were screened for the presence of anti-HEV total antibodies, anti-HEV IgG and anti-HEV IgM using commercially available ELISA kits (DIA.PRO, Milan, Italy). All anti-HEV IgG and anti-HEV IgM positive samples were tested for HEV RNA using two independent reverse transcriptase polymerase chain reaction (RT-PCR) assays, targeting ORF2 and ORF3 of HEV genome. In addition, 92 anti-HEV seronegative samples as well as 50 pooled seronegative samples were evaluated by two independent RT-PCR assays for validation of results. RESULTS Of the 1331 pregnant women, 84 women (6.3%, 95% CI: 5.1%-7.7%) were positive for anti-HEV antibodies, of which 83 women had anti-HEV IgG, and 11 women (0.83%, 95% CI: 0.47%-1.47%) had anti-HEV IgM. The highest rate of HEV seroprevalence was observed among Afghan immigrants (68.0%), uneducated pregnant women (46.51%) and those residents in Bushehr city (8.75%). All anti-HEV IgG and/or IgM positive samples were found to be negative for HEV RNA. In addition, all of the evaluated anti-HEV seronegative samples were negative for HEV RNA. HEV seropositivity among pregnant women was statistically associated with age, ethnicity, place of residence, number of pregnancies, and level of education. So that, low education levels, Afghan, residence in Bushehr city, age group >34 years, and more parities were risk factors for exposure to HEV. In contrast, HEV seropositivity was not associated with stage of gestation, history of abortion, and time of sampling. CONCLUSION The northern shores of Persian Gulf in Iran, with HEV seroprevalence of 6.3%, can be classified as an endemic geographical region for hepatitis E, and residents of Bushehr city, Afghan immigrants and uneducated women are the main at-risk populations in this territory.
Collapse
Affiliation(s)
- Fatemeh Farshadpour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Taherkhani
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
- * E-mail: ,
| | - Mohamad Reza Ravanbod
- Department of Internal Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Seyed Sajjad Eghbali
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Sakineh Taherkhani
- Reproductive Health and Midwifery Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Easa Mahdavi
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| |
Collapse
|
10
|
Ifeorah IM, Faleye TOC, Bakarey AS, Adewumi MO, Akere A, Omoruyi EC, Ogunwale AO, Adeniji JA. Acute Hepatitis E Virus Infection in Two Geographical Regions of Nigeria. J Pathog 2017; 2017:4067108. [PMID: 29387489 PMCID: PMC5745689 DOI: 10.1155/2017/4067108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/23/2017] [Indexed: 12/23/2022] Open
Abstract
Hepatitis E virus (HEV) remains a major public health concern in resource limited regions of the world. Yet data reporting is suboptimal and surveillance system is inadequate. In Nigeria, there is dearth of information on prevalence of acute HEV infection. This study was therefore designed to describe acute HEV infection among antenatal clinic attendees and community dwellers from two geographical regions in Nigeria. Seven hundred and fifty plasma samples were tested for HEV IgM by Enzyme Linked Immunosorbent Assay (ELISA) technique. The tested samples were randomly selected from a pool of 1,115 blood specimens previously collected for viral hepatitis studies among selected populations (pregnant women, 272; Oyo community dwellers, 438; Anambra community dwellers, 405) between September 2012 and August 2013. One (0.4%) pregnant woman in her 3rd trimester had detectable HEV IgM, while community dwellers from the two study locations had zero prevalence rates of HEV IgM. Detection of HEV IgM in a pregnant woman, especially in her 3rd trimester, is of clinical and epidemiological significance. The need therefore exists for establishment of a robust HEV surveillance system in Nigeria and especially amidst the pregnant population in a bid to improve maternal and child health.
Collapse
Affiliation(s)
- I. M. Ifeorah
- Department of Medical Laboratory Sciences, Faculty of Health Science and Technology, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - T. O. C. Faleye
- Department of Microbiology, Faculty of Science, Ekiti State University, Ado Ekiti, Nigeria
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A. S. Bakarey
- Institute for Advanced Medical Research & Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - M. O. Adewumi
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A. Akere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - E. C. Omoruyi
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A. O. Ogunwale
- Oyo State College of Agriculture and Technology, Igboora, Nigeria
| | - J. A. Adeniji
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
11
|
Xin S, Xiao L. Clinical Manifestations of Hepatitis E. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 948:175-189. [PMID: 27738985 DOI: 10.1007/978-94-024-0942-0_10] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The clinical manifestations of hepatitis E are similar to those of other types of viral hepatitis. While acute hepatitis E is usually self-limited, pregnant women and chronic liver disease patients suffering from acute hepatitis E usually present with severe clinical manifestations that may develop into fulminant hepatic failure. Chronic HEV infection is typically only seen in organ transplant patients; most HEV cases are asymptomatic and rarely display jaundice, fatigue, abdominal pain, fever, fatigue, or ascites. The clinical manifestations of HEV infection in neonates are diverse and have varied clinical signs, biochemistry, and virus biomarkers. Lastly, the extrahepatic manifestations and complications of hepatitis E are in need of further study.
Collapse
Affiliation(s)
- Shaojie Xin
- Liver Failure Treatment and Research Center, 302 Hospital, No.100 West 4th middle Road, Fengtai District, Beijing, 100039, China.
| | - Long Xiao
- Liver Failure Treatment and Research Center, 302 Hospital, No.100 West 4th middle Road, Fengtai District, Beijing, 100039, China
| |
Collapse
|
12
|
Baptista-González H, Trueba-Gómez R, Rosenfeld-Mann F, Roque-Álvarez E, Méndez-Sánchez N. Low prevalence of IgG antibodies against antigens of HEV genotypes 1 and 3 in women with a high-risk pregnancy. J Med Virol 2017; 89:2051-2054. [PMID: 28617960 DOI: 10.1002/jmv.24878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/06/2017] [Indexed: 12/28/2022]
Abstract
The aim of the study was to assess whether high-risk pregnant women have a higher prevalence of HEV during the perinatal period. This was a cross-sectional study of 428 patients: Group 1, 127 women with a high-risk pregnancy; Group 2, 97 asymptomatic people with reactivity to HCV or HBV; Group 3, 94 patients with clinical symptoms suggestive of HEV infection; and Group 4, 110 healthy blood donors from an urban area of Mexico City. ELISA was used to measure antibody to HEV genotypes 1 and 3. The prevalence rates of anti-HEV IgG antibodies were 0.79% in Group 1, 2.1% in Group 2, 7.4% in Group 3, and 0% in Group 4. Women with a high-risk pregnancy did not have a higher prevalence of HEV infection in this clinical setting.
Collapse
Affiliation(s)
| | - Rocío Trueba-Gómez
- Perinatal Hematology, National Institute of Perinatology, Mexico City, Mexico
| | | | - Elsa Roque-Álvarez
- Medica Sur Clinic & Foundation, Liver Research Unit, Mexico City, Mexico
| | | |
Collapse
|
13
|
Abstract
Background Hepatitis E virus (HEV) is highly endemic in several African countries with high mortality rate among pregnant women. The prevalence of antibodies to HEV in Ethiopian pregnant women is not known. The study was conducted to investigate the prevalence of anti-HEV IgG and anti-HEV IgM among pregnant women. Material and methods A total of 386 serum samples were collected from pregnant women between April 2014 to January 2015 in Gandhi Memorial Hospital and four selected Health centers in Addis Ababa, Ethiopia. Data were collected for socio demographic characteristics using a structured questionnaire. Serum samples were examined for anti-HEV IgG and anti- HEV IgM using ELISA. The association of anti-HEV status with risk factors was assessed. Factors demonstrating significant association in bivariate analysis were included in multivariate logistic regression models. Analyses were performed using SPSS version 21. Results Anti- HEV IgG antibody was detected in 122 (31.6%) women and two women (0.5%) were positive for anti-HEV IgM from the total 386 women. Age and educational status had statistically significant association with HEV infection. There was no significant association between anti-HEV antibody seroprevalence rate with trimester, parity, HIV status and other risk factors. Conclusion In this study we found a high seroprevalence rate of anti-HEV IgG among pregnant women in Addis Ababa Ethiopia. Preventive measures like improvement of education and creating awareness may reduce the risk in pregnant women. Moreover nationwide surveillance of HEV especially in rural setting should be conducted to establish a national estimate and validate our findings.
Collapse
|
14
|
Pérez-Gracia MT, Suay-García B, Mateos-Lindemann ML. Hepatitis E and pregnancy: current state. Rev Med Virol 2017; 27:e1929. [PMID: 28318080 DOI: 10.1002/rmv.1929] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 02/23/2017] [Accepted: 02/24/2017] [Indexed: 12/17/2022]
Abstract
Hepatitis E virus (HEV) is responsible for more than 50% of acute viral hepatitis cases in endemic countries. Approximately 2 billion individuals live in hepatitis E-endemic areas and, therefore, are at risk of infection. According to World Health Organization, HEV causes about 20.1 million infections and 70 000 deaths every year. In developing countries with poor sanitation, this disease is transmitted through contaminated water and is associated with large outbreaks, affecting hundreds or thousands of people. In developed countries, autochthonous cases of HEV have been increasingly recognized in the past several years. Hepatitis E virus typically causes an acute, self-limiting illness similar to other acute viral hepatitis, such as hepatitis A or B, with about 0.2% to 1% mortality rate in the general population. However, the course of hepatitis E in pregnancy is different than the mild self-constraining infection described in other populations. During pregnancy, HEV infection can take a fulminant course, resulting in fulminant hepatic failure, membrane rupture, spontaneous abortions, and stillbirths. Studies from various developing countries have shown a high incidence of HEV infection in pregnancy with a significant proportion of pregnant women progressing to fulminant hepatitis with a fatality rate of up to 30%. The present review will highlight new aspects of the HEV infection and pregnancy.
Collapse
Affiliation(s)
- María Teresa Pérez-Gracia
- Área de Microbiología, Departamento de Farmacia, Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Moncada, Spain
| | - Beatriz Suay-García
- Área de Microbiología, Departamento de Farmacia, Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Moncada, Spain
| | | |
Collapse
|
15
|
Hepatitis E Virus in Industrialized Countries: The Silent Threat. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9838041. [PMID: 28070522 PMCID: PMC5192302 DOI: 10.1155/2016/9838041] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/07/2016] [Accepted: 11/15/2016] [Indexed: 12/11/2022]
Abstract
Hepatitis E virus (HEV) is the main cause of acute viral hepatitis worldwide. Its presence in developing countries has been documented for decades. Developed countries were supposed to be virus-free and initially only imported cases were detected in those areas. However, sporadic and autochthonous cases of HEV infection have been identified and studies reveal that the virus is worldwide spread. Chronic hepatitis and multiple extrahepatic manifestations have also been associated with HEV. We review the data from European countries, where human, animal, and environmental data have been collected since the 90s. In Europe, autochthonous HEV strains were first detected in the late 90s and early 2000s. Since then, serological data have shown that the virus infects quite frequently the European population and that some species, such as pigs, wild boars, and deer, are reservoirs. HEV strains can be isolated from environmental samples and reach the food chain, as shown by the detection of the virus in mussels and in contaminated pork products as sausages or meat. All these data highlight the need of studies directed to control the sources of HEV to protect immunocompromised individuals that seem the weakest link of the HEV epidemiology in industrialized regions.
Collapse
|
16
|
Geng Y, Wang Y. Transmission of Hepatitis E Virus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 948:89-112. [DOI: 10.1007/978-94-024-0942-0_6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
17
|
Huang H, Xu C, Zhou X, Liu L, Dai Y, Xu B, Yang J, Chen T, Hu Y, Zhou YH. Incidence and seroprevalence of hepatitis E virus infection in pregnant women infected with hepatitis B virus and antibody placental transfer in infants. J Clin Virol 2016; 82:84-88. [PMID: 27467017 DOI: 10.1016/j.jcv.2016.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 07/15/2016] [Accepted: 07/20/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Hepatitis E has poor outcomes in pregnant women. Superinfection of hepatitis E virus (HEV) in patients infected with hepatitis B virus (HBV) may worsen liver disease. OBJECTIVES To estimate the incidence and seroprevalence of HEV infection among HBV-infected pregnant women, to investigate the transplacental transfer of maternal anti-HEV IgG, and to compare the maternal and neonatal outcomes in anti-HEV positive and negative pregnant women. STUDY DESIGN Totally 391 HBV-infected pregnant women were recruited from April 2012 to October 2014. Paired mothers and infants were followed up at an average 9.8 months postpartum. Anti-HEV IgG and IgM were tested by ELISA. RESULTS Of the pregnant women, none was anti-HEV IgM positive and 42 (10.7%) were IgG positive. At the follow-up, 3 seronegative women converted to anti-HEV IgG positive, with an estimated incidence of 17 per 1000 person-years. No significant differences of gestational age, preterm birth rate, Apgar score and birthweight were observed between newborns of anti-HEV IgG positive and negative mothers. Of the 42 neonates born to anti-HEV IgG positive mothers, 38 (90.5%) had anti-HEV IgG in their cord blood. The neonatal and maternal anti-HEV IgG levels were positively correlated (r=0.827, p<0.05). All infants were negative for both anti-HEV IgM and IgG at the follow-up. CONCLUSIONS HBV-infected pregnant women rarely have novel HEV infection during late pregnancy in Jiangsu, China. Maternal anti-HEV IgG efficiently transfers into the fetuses, and disappears in infants before 10 months old.
Collapse
Affiliation(s)
- Hongyu Huang
- Department of Experimental Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China.
| | - Chenyu Xu
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang 212000, China.
| | - Xuan Zhou
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
| | - Lanhua Liu
- Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou 225400, China.
| | - Yimin Dai
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
| | - Biao Xu
- Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou 225400, China.
| | - Jishi Yang
- Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou 225400, China.
| | - Tingmei Chen
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang 212000, China.
| | - Yali Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
| | - Yi-Hua Zhou
- Department of Experimental Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China; Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
| |
Collapse
|
18
|
Senosiain C, González-Tallón A A, López-Sanromán A, Mateos ML, Pérez-Gracia MT, García-Sánchez MC, Maroto M, Garrido E. Hepatitis E seroprevalence in inflammatory bowel disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2016; 39:185-90. [DOI: 10.1016/j.gastrohep.2015.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 06/10/2015] [Accepted: 06/11/2015] [Indexed: 02/07/2023]
|
19
|
Gu G, Huang H, Zhang L, Bi Y, Hu Y, Zhou YH. Hepatitis E virus seroprevalence in pregnant women in Jiangsu, China, and postpartum evolution during six years. BMC Infect Dis 2015; 15:560. [PMID: 26653888 PMCID: PMC4675061 DOI: 10.1186/s12879-015-1308-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/03/2015] [Indexed: 11/10/2022] Open
Abstract
Background China is an endemic area for hepatitis E virus (HEV). The previous surveys of anti-HEV seroprevalence are cross-sectional. This study aimed to investigate the prevalence of infection among pregnant women and their children in Jiangsu, China, and to observe postpartum anti-HEV evolution. Methods Sera from 497 women collected during pregnancy and 6-year postpartum and from their 497 children were screened for anti-HEV by ELISA and confirmed by Western blotting. HEV RNA was detected by reverse transcription-nested PCR. Results Of the pregnant women, 3 (0.6 %) were anti-HEV IgM positive and 55 (11.1 %) were IgG positive. At 6-year postpartum, 18 anti-HEV IgG positive samples became negative and 18 others became IgG positive; the accumulated prevalence in this cohort of women was at least 14.7 % (73/497). Of the 497 children, the positive rates of anti-HEV IgM and IgG were 0.2 % and 0.4 %, respectively. None of the 18 children from mothers with anti-HEV IgG seroconversion was anti-HEV IgG positive. Conclusions Our data indicate that the constant seroprevalence of anti-HEV IgG in adults may be resulted from the balance of negative seroconversion due to waning immunity and positive seroconversion due to novel infections, and the risk of intra-family transmission of HEV was low. The data also imply that cross-sectional seroepidemiological survey may underestimate the prevalence of HEV infection, due to the natural decay of pathogen-specific IgG.
Collapse
Affiliation(s)
- Guangyu Gu
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China.
| | - Hongyu Huang
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China. .,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, 210008, China.
| | - Le Zhang
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China. .,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, 210008, China.
| | - Yongchun Bi
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China.
| | - Yali Hu
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, 210008, China. .,Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China.
| | - Yi-Hua Zhou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China. .,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, 210008, China. .,Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China.
| |
Collapse
|
20
|
Prasad GS, Prasad S, Bhupali A, Patil AN, Parashar K. A Study of Hepatitis E in Pregnancy: Maternal and Fetal Outcome. J Obstet Gynaecol India 2015; 66:18-23. [PMID: 27651572 DOI: 10.1007/s13224-015-0749-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 07/10/2015] [Indexed: 01/15/2023] Open
Abstract
PURPOSE HEV infection, a major public health concern, is known to cause large-scale epidemic and sporadic cases of acute viral hepatitis in developing countries. The infection occurs primarily in young adults and is generally mild and self-limiting; however, the case fatality rate is reportedly higher among women, especially during the second or third trimesters of pregnancy. METHODS This study, a prospective observational study, was conducted at the Dr. D. Y. Patil Medical College Hospital and Apple Saraswati Multispeciality hospital, in Kolhapur for over a period of 3 years (Jan 2010 to Jan 2013) to find out the prevalence and clinical outcome in a series of HEV-infected pregnant women. RESULTS A total of fifty-five symptomatic Anti-HEV IgM-positive women were included, and the maternal-fetal outcome was analyzed. The maternal mortality was 5 % including one antenatal death. Prematurity (80 %) and PROM (11 %) were the commonest fetal complications noted with a vertical transmission rate of 28 %. CONCLUSION Variations in maternal morbidity and mortality between different studies indicate a need to subtype the viral genotype according to its virulence and morbidity.
Collapse
Affiliation(s)
- Gowri Sayi Prasad
- Department of Obstetrics and Gynaecology, Dr. D. Y. Patil Hospital and Research Center, Kadamwadi, Kolhapur, Maharashtra 416003 India
| | - Sayi Prasad
- Apple Saraswati Multispeciality Hospital and Research Center, Kolhapur, Maharashtra India
| | - Ashok Bhupali
- Apple Saraswati Multispeciality Hospital and Research Center, Kolhapur, Maharashtra India
| | - Ajit N Patil
- Department of Obstetrics and Gynaecology, Dr. D. Y. Patil Hospital and Research Center, Kadamwadi, Kolhapur, Maharashtra 416003 India
| | - Kanishtha Parashar
- Department of Obstetrics and Gynaecology, Dr. D. Y. Patil Hospital and Research Center, Kadamwadi, Kolhapur, Maharashtra 416003 India
| |
Collapse
|
21
|
Sayed IM, Vercauteren K, Abdelwahab SF, Meuleman P. The emergence of hepatitis E virus in Europe. Future Virol 2015. [DOI: 10.2217/fvl.15.29] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
ABSTRACT Hepatitis E virus (HEV) infections appear to be an emerging problem in Europe. Infections are mainly caused by viruses of genotype 3. Pigs and wild boar are the main reservoirs of HEV in Europe and most autochthonous infections are probably caused by the consumption of uncooked or undercooked infected meat. Nevertheless, transfusion-associated transmission has been described in different European countries but the efficiency of this route of transmission need to be further investigated. Most acute infections are asymptomatic or the induced symptoms are rather nonspecific. Although people that are otherwise completely healthy can spontaneously clear an HEV infection, people with underlying liver disease and/or suffering from immune deficiencies may require treatment to avoid chronicity and exacerbation of liver disease. In this review, we give an epidemiological overview of HEV in Europe and the potential complications.
Collapse
Affiliation(s)
- Ibrahim M Sayed
- Center for Vaccinology, Ghent University, Ghent University Hospital, B-9000 Gent, Belgium
- Microbiology & Immunology Department, Faculty of Medicine, Assuit University, Assuit 71515, Egypt
| | - Koen Vercauteren
- Center for Vaccinology, Ghent University, Ghent University Hospital, B-9000 Gent, Belgium
| | - Sayed F Abdelwahab
- Microbiology and Immunology Department, Faculty of Medicine, Minia University, Minia 61511, Egypt
| | - Philip Meuleman
- Center for Vaccinology, Ghent University, Ghent University Hospital, B-9000 Gent, Belgium
| |
Collapse
|
22
|
Echevarría JM, Fogeda M, Avellón A. Epidemiología de la infección por el virus de la hepatitis E en España. Enferm Infecc Microbiol Clin 2015; 33:281-6. [DOI: 10.1016/j.eimc.2013.11.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/04/2013] [Accepted: 11/08/2013] [Indexed: 02/08/2023]
|
23
|
Kmush BL, Nelson KE, Labrique AB. Risk factors for hepatitis E virus infection and disease. Expert Rev Anti Infect Ther 2014; 13:41-53. [DOI: 10.1586/14787210.2015.981158] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
24
|
Tabatabai J, Wenzel JJ, Soboletzki M, Flux C, Navid MH, Schnitzler P. First case report of an acute hepatitis E subgenotype 3c infection during pregnancy in Germany. J Clin Virol 2014; 61:170-2. [PMID: 24996764 DOI: 10.1016/j.jcv.2014.06.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 06/06/2014] [Accepted: 06/09/2014] [Indexed: 01/18/2023]
Abstract
Hepatitis E is usually a self-limiting disease and an important cause of acute hepatitis in endemic countries in Asia and Africa. However, the mortality rate for pregnant women infected with hepatitis E virus (HEV) in this area is about 25%. In Germany, sporadic cases of acute hepatitis E infections have been described and the number of autochthonous infections is increasing. Here we report an autochthonous HEV subgenotype 3c infection in a 27-year old pregnant woman. This is the first documented case of a hepatitis E infection during pregnancy in Germany. The patient presented in week 26 of gestation with acute hepatitis and elevated transaminases. During follow-up, she tested positive for anti-HEV antibodies. HEV viral load during the acute hepatitis was 2.3×10(6) copies/ml serum, however viremia declined and cleared rapidly. Sequence analysis revealed a HEV subgenotype 3c closely related to European isolates. The patient had not travelled outside Germany, had regular contact to animals, but the source of infection remains unclear. The newborn was delivered in week 40 of gestation in good health, HEV was not transmitted and liver enzymes were normal. In conclusion, hepatitis E should be considered in differential diagnosis in patients with acute hepatitis especially during pregnancy, even without travel history to countries with high endemicity.
Collapse
Affiliation(s)
- J Tabatabai
- Department of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany
| | - J J Wenzel
- Institute of Clinical Microbiology and Hygiene, Regensburg University Medical Center, Regensburg, Germany
| | - M Soboletzki
- Department of Internal Medicine IV, University of Heidelberg, Heidelberg, Germany
| | - C Flux
- Schwetzinger Str. 51, Heidelberg, Germany
| | - M Heidary Navid
- Department of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany
| | - P Schnitzler
- Department of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany.
| |
Collapse
|
25
|
Renou C, Gobert V, Locher C, Moumen A, Timbely O, Savary J, Roque-Afonso AM. Prospective study of Hepatitis E Virus infection among pregnant women in France. Virol J 2014; 11:68. [PMID: 24716485 PMCID: PMC4011159 DOI: 10.1186/1743-422x-11-68] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 04/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatitis E Virus (HEV) infection has a poor prognosis among pregnant women from high endemic countries. HEV-prevalence and incidence among pregnant women is unknown in high-income countries such as France. This prospective study was conducted to assess HEV infection in this setting. FINDINGS An overall HEV prevalence of 7.74% was observed among 315 pregnant women. Seroprevalence was higher in south than in north of France (29.3% vs. 3.6%, p < 0.0001), and women with detectable IgG were older. No IgG seroconversion or IgM detection were observed during pregnancy. CONCLUSIONS Data suggest that HEV infection is a rare occurrence during pregnancy even in regions of western countries with high seroprevalence rates.
Collapse
|
26
|
Rostamzadeh Khameneh Z, Sepehrvand N, Khalkhali HR. Seroprevalence of hepatitis e among pregnant women in urmia, iran. HEPATITIS MONTHLY 2013; 13:e10931. [PMID: 24348644 PMCID: PMC3858979 DOI: 10.5812/hepatmon.10931] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 06/27/2013] [Accepted: 10/18/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND While hepatitis E virus (HEV) mostly causes self-limited disease in general population, it is more severe in pregnant women. OBJECTIVES This study aimed to investigate the seroprevalence of anti-HEV IgG among a population of pregnant women in West Azerbaijan of Iran . PATIENTS AND METHODS One hundred thirty six pregnant women referred to urban health centers of Urmia for pursuing pregnancy-related health services were enrolled in a descriptive, cross-sectional study. Anti-HEV IgG antibody was evaluated using enzyme-linked immunosorbent assay (enzyme-linked immunosorbent assay, ELISA; Dia.Pro; Diagnostic Bioprobes). RESULTS Only five (3.6%) of 136 cases had positive results for anti-HEV IgG. There was no significant difference between age (P=0.88), and income level (P = 0.19) of the two seropositive and seronegative groups. All seropositive cases were from urban areas. CONCLUSIONS The seroprevalence of anti-HEV IgG is low in the population of pregnant women in , similar to the rates reported from developed countries. Effective health services and provision of safe water supplies in Urmia may take role in this low prevalence rate.
Collapse
Affiliation(s)
| | - Nariman Sepehrvand
- Students’ Research Committee, Urmia University of Medical Sciences, Urmia, IR Iran
- Corresponding author: Nariman Sepehrvand, Students’ Research Committee, Deputy for Research Affairs, Urmia University of Medical Sciences, Resalat Ave. Djahad Square, Urmia, IR Iran. Tel: +98-9125936372, Fax: +98-4412231930, E-mail:
| | - Hamid-Reza Khalkhali
- Department of Epidemiology and Biostatistics, Urmia University of Medical Sciences, Urmia, IR Iran
| |
Collapse
|
27
|
Mateos-Lindemann ML, Diez-Aguilar M, Galdamez ALG, Galán JC, Moreno A, Pérez-Gracia MT. Patients infected with HIV are at high-risk for hepatitis E virus infection in Spain. J Med Virol 2013; 86:71-4. [PMID: 24136591 DOI: 10.1002/jmv.23804] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 11/08/2022]
Abstract
Hepatitis E virus is responsible for sporadic cases of acute, self-limited viral hepatitis not only in endemic but also in industrialized countries. In addition, some reports confirm that it can cause chronic infection and even cirrhosis in immunosuppressed and also in patients infected with HIV. There are few data about prevalence and incidence of HEV chronic infection in HIV-HEV coinfected individuals in Spain. The aim of this study is to investigate the prevalence of anti-HEV IgG in a representative sample of 448 patients infected with HIV and determine the role of age, gender, and CD4 counts in the detection of anti-HEV IgG antibodies in blood. In addition, the clinical features and ALT levels in relation to the presence of anti-HEV IgM and/or HEV-RNA in the blood of these patients were investigated. Anti-HEV IgG antibodies were detected in serum using a commercial enzyme immunoassay. All positive samples were studied further for the presence of anti-HEV IgM antibodies. In addition, HEV RNA was amplified by reverse transcriptase (RT)-nested PCR in all serum samples with IgM anti-HEV. The overall prevalence of anti-HEV IgG was 10.4% (45/448, 95% C.I. 7.2-12.8%). HEV-RNA was found in only one patient out of the 45 anti-HEV IgG positive samples studied. Regarding to gender and CD4 count, no difference in seroprevalence could be observed. This prevalence data suggest that patients infected with HIV can be considered a risk group for HEV infection and that chronic coinfection HEV-HIV seems to be a very rare event.
Collapse
|
28
|
Shalimar, Acharya SK. Hepatitis e and acute liver failure in pregnancy. J Clin Exp Hepatol 2013; 3:213-24. [PMID: 25755503 PMCID: PMC3940148 DOI: 10.1016/j.jceh.2013.08.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 08/19/2013] [Indexed: 12/12/2022] Open
Abstract
Hepatitis E virus is a positive strand RNA virus with three open reading frames which is transmitted predominantly through the fecal contamination of water and food. It is the most common cause of acute liver failure in endemic areas. Pregnant women especially from the Indian subcontinent and Africa are at increased risk of contracting acute HEV infection as well as developing severe complications including ALF. Transmission of HEV occurs from mother to unborn child. Both maternal and fetal complications may occur, including abortion, fetal demise, preterm labor and maternal or neonatal death. The precise reasons for increased susceptibility to HEV infection during pregnancy and associated severe disease are still an enigma. Management is supportive and termination of pregnancy is not recommended as a general rule. Prevention of infection is of vital importance, as availability of clean drinking water can reduce the burden of this disease in the community. There is a need for future research to focus on prevention of ALF in pregnancy and to study the disease pathogenesis, which is not explicitly understood at present. The availability of a vaccine may alter the natural course of the disease in this select population which is at risk.
Collapse
Key Words
- ALF, acute liver failure
- AVH, acute viral hepatitis
- CTL, cytotoxic T lymphocytes
- HEV, hepatitis E virus
- NANE, non A, non E
- NK, not known
- NP, non-pregnant
- NR, not reported
- OR, odds ratio
- ORF, open reading frame
- P, pregnant
- fetal transmission
- mortality
- pathogenesis
Collapse
Affiliation(s)
| | - Subrat K. Acharya
- Address for correspondence: Subrat K. Acharya, Professor and Head, Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi 110029, India. Tel.: +91 11 26594934.
| |
Collapse
|
29
|
Pérez-Gracia MT, Mateos Lindemann ML, Caridad Montalvo Villalba M. Hepatitis E: current status. Rev Med Virol 2013; 23:384-98. [PMID: 24038432 DOI: 10.1002/rmv.1759] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/22/2013] [Accepted: 07/26/2013] [Indexed: 12/19/2022]
Abstract
Acute hepatitis E is a very common disease in developing countries, to the point that, according to World Health Organization estimates, one third of the world's population has been exposed to HEV. It also causes outbreaks in refugee camps or after natural disasters such as floods or earthquakes. Sporadic cases of acute hepatitis have been observed in practically all European countries and other developed geographical areas, not only in travelers from endemic countries but also in people with no risk factors. But, lately, new aspects of this infection are appearing in industrialized countries such as the possibility of the disease becoming chronic in transplant patients, the immunocompromised in general, and even in patients with previous liver disease who are immunocompetent. In this comprehensive review, we summarize the current knowledge on HEV infection.
Collapse
Affiliation(s)
- María Teresa Pérez-Gracia
- Área de Microbiología. Departamento Farmacia. Instituto de Ciencias Biomédicas. Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Moncada Valencia, Spain
| | | | | |
Collapse
|
30
|
Mateos-Lindemann ML, Diez-Aguilar M, González-Galdamez A, Graus-Morales J, Moreno-Zamora A, Perez-Gracia MT. [Acute, chronic and fulminant hepatitisE: seven years of experience (2004-2011)]. Enferm Infecc Microbiol Clin 2013; 31:595-8. [PMID: 23642282 DOI: 10.1016/j.eimc.2013.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 02/18/2013] [Accepted: 03/08/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To study the clinical and epidemiological profiles of in 43cases of acute hepatitis, 5cases of fulminant hepatitis, and one of chronic hepatitis due to hepatitis E virus (HEV), detected over a 7-year period. PATIENTS Forty-nine individuals (33male and 10female) treated between 2004 and 2011 in the Hospital Ramón y Cajal (Comunidad de Madrid, Spain). The diagnosis was made by the detection of IgG and IgM anti-HEV and RNA HEV in serum samples. Acute hepatitisE was defined by the presence of IgM anti-HEV and/or RNA HEV in serum, and chronic hepatitisE if the ARN was detectable more than 6months. Fulminant hepatitisE was diagnosed if encephalopathy was observed in addition to IgM anti-HEV and/or RNA HEV in serum. RESULTS The median age was 46.67 and 49.6years in acute hepatitisE and fulminant hepatitisE, respectively. The risk factors recorded were travel to endemic areas in 13patients, 4were in contact with animals, 4suffered from hepatic steatosis due to alcohol consumption, 3consumed uncontrolled foods, and 2drank water from streams. DISCUSSION HEV is the cause of acute self-limited hepatitis, although 36.73% of the studied cases had to be hospitalised. However a small number of patients, 10.2%, had fulminant hepatitis requiring liver transplant. Chronic hepatitisE is very infrequent in immunocompetent individuals. The increase in incidence of hepatitisE is due to the introduction of better diagnostic tests in recent years.
Collapse
|
31
|
Cheng Y, Du L, Shi Q, Jiao H, Zhang X, Hao Y, Rong H, Zhang J, Jia X, Guo S, Kuang W, Zhang H, Chen C, Wang F. Identification of miR-221 and -222 as important regulators in genotype IV swine hepatitis E virus ORF3-expressing HEK 293 cells. Virus Genes 2013; 47:49-55. [PMID: 23579640 DOI: 10.1007/s11262-013-0912-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
Hepatitis E virus (HEV) has emerged as an important cause of epidemic and sporadic acute viral hepatitis worldwide, which is a major public health challenge. A better understanding of the interaction between the virus and the host cell would be very helpful for its therapy. Swine HEV (SHEV) open reading frame 3 (ORF3) is a regulatory protein that alters the activity of selected transcription factors and cytoplasmic signaling pathways. MicroRNAs (miRNAs) are potent post-transcriptional regulators of protein-coding genes and represent an interesting lead to study SHEV infection and to identify new therapeutic targets. To explore how SHEV ORF3 affects miRNAs in host cells, we used miRNA array analysis to compare the expression patterns of miRNAs in stable cell lines that expressed or did not express SHEV ORF3. We found a significant down-regulation of miR-221 and -222 in ORF3 expressing human embryonic kidney 293 cell line. Among the 116 candidate targets genes of miR-221 and -222 that we detected in silico, we demonstrated that the expression of the cyclin-dependent kinase inhibitor 1B, also named p27(kip1), was directly regulated by these miRNAs. We hypothesize that SHEV ORF3-induced miR-221/222 downregulation enhances p27(kip1) expression in HEK293 cells. This provides new avenues for future exploration of the precise roles of miRNAs in SHEV infection.
Collapse
Affiliation(s)
- Ying Cheng
- College of Agriculture, Hainan University, Hainan Key Lab of Tropical Animal Reproduction & Breeding and Epidemic Disease Research, Haidian Island, Haikou 570228, People's Republic of China
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Riveiro-Barciela M, Rodríguez-Frías F, Buti M. [Hepatitis E: scale of the problem in Spain]. GASTROENTEROLOGIA Y HEPATOLOGIA 2012; 35:719-24. [PMID: 22608490 DOI: 10.1016/j.gastrohep.2012.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 03/06/2012] [Indexed: 02/07/2023]
Abstract
Hepatitis E virus (HEV) infection is one of the most frequent causes of acute hepatitis worldwide. However, in Spain, HEV causes only a tiny number of cases of acute hepatitis, the most prevalent cause being hepatitis A. Most cases of HEV in Spain are "imported", being acquired through travel to areas where this infection is endemic. Nevertheless, in the last few years a growing number of "autochthonous cases" have been reported in persons with no history of travelling to HEV-endemic areas. The prevalence of IgG antibodies against HEV, indicating exposure to this virus, is approximately 0.6-7.3% in the general population in Spain and is 19% in persons with risk factors such as exposure to pigs.
Collapse
Affiliation(s)
- Mar Riveiro-Barciela
- Departamento de Medicina Interna, Hospital Universitario Vall d'Hebron, Barcelona, España
| | | | | |
Collapse
|
33
|
Mateos-Lindemann ML, Gonzalez-Galdámez A, Bordallo-Cardona M, Pérez-Gracia MT. Are HIV-infected patients a high-risk population for hepatitis E virus infection in Spain? Enferm Infecc Microbiol Clin 2012; 30:582-3. [PMID: 22591605 DOI: 10.1016/j.eimc.2012.03.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 03/16/2012] [Indexed: 10/27/2022]
|
34
|
Pérez-Gracia MT, Mateos-Lindemann ML. [Hepatitis E. Current perspectives]. Med Clin (Barc) 2012; 139:404-11. [PMID: 22538059 DOI: 10.1016/j.medcli.2012.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Revised: 02/14/2012] [Accepted: 02/23/2012] [Indexed: 01/19/2023]
Abstract
Infection with hepatitis E virus (HEV) is highly prevalent in developing countries and the WHO estimates one third of the world population has had contact with the virus. Its diagnosis and epidemiology are well known in endemic countries but, recently, there have been sporadic cases in developed countries in patients with no history of travel. Currently in these countries, hepatitis E is considered a zoonosis yet there remain to be known other routes of transmission. Another interesting aspect is that HEV can cause chronic hepatitis in transplanted patients, other immunocompromised patients and even in immunocompetent people. There have also been reported cases of fulminant hepatitis and other extrahepatic manifestations. The diagnosis is based on serological studies and detection of viral RNA in blood and feces. The vaccine is a good option to prevent this infection that affects a large number of people in deprived geographical areas but unfortunately it is not available yet.
Collapse
Affiliation(s)
- María Teresa Pérez-Gracia
- Departamento de Microbiología, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Moncada, Valencia, Spain.
| | | |
Collapse
|
35
|
Nelson KE, Kmush B, Labrique AB. The epidemiology of hepatitis E virus infections in developed countries and among immunocompromised patients. Expert Rev Anti Infect Ther 2012; 9:1133-48. [PMID: 22114964 DOI: 10.1586/eri.11.138] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hepatitis E virus (HEV) is an important cause of acute hepatitis in humans worldwide, both as epidemic and sporadic disease. Since the virus was identified in 1983, epidemics have occurred regularly in many countries across South and Southeast Asia when seasonal floods have contaminated drinking water supplies and in Africa during humanitarian crises among refugee populations without access to clean water. In addition, sporadic cases and small clusters of HEV infections have been recognized throughout the world in developed countries over the past couple of decades. This review will focus on emerging evidence of HEV infection as an under-recognized pathogen in Europe, the USA and other industrialized countries. We will discuss some of the issues associated with the recognition, diagnosis and treatment of these sporadic cases. We will also summarize the recent literature on autochthonous HEV infection among populations in developed countries in industrialized Europe, the USA, Japan and other industrialized Asian countries. We will review recent reports of acute and chronic HEV infections among transplant recipients and other immunocompromised individuals including HIV/AIDS patients.
Collapse
Affiliation(s)
- Kenrad E Nelson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | | |
Collapse
|
36
|
Anty R, Ollier L, Péron JM, Nicand E, Cannavo I, Bongain A, Giordanengo V, Tran A. First case report of an acute genotype 3 hepatitis E infected pregnant woman living in South-Eastern France. J Clin Virol 2012; 54:76-8. [PMID: 22336086 DOI: 10.1016/j.jcv.2012.01.016] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 01/21/2012] [Accepted: 01/23/2012] [Indexed: 01/13/2023]
Abstract
In European countries, epidemiology of hepatitis E virus (HEV) infection is not well known. Although, seroprevalence of HEV Immunoglobulin G reached a few percent in European women, no acute hepatitis E during pregnancy has been described so far. Here, we report a case of an autochthonous HEV genotype 3 infection in a 41-years-old pregnant woman living in a non-endemic country. The acute hepatitis had a spontaneous good outcome for the mother and the child. In non-endemic areas where Hepatitis E infections are emerging, unexplained cytolysis, whatever its level, in a pregnant woman could be investigated for HEV, using biological molecular and serology tools.
Collapse
Affiliation(s)
- R Anty
- Institut National de la Santé et de la Recherche Médicale (INSERM), U895, Nice F-06204, Cedex 3, France.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Jardi R, Crespo M, Homs M, van den Eynde E, Girones R, Rodriguez-Manzano J, Caballero A, Buti M, Esteban R, Rodriguez-Frias F. HIV, HEV and cirrhosis: evidence of a possible link from eastern Spain. HIV Med 2012; 13:379-83. [PMID: 22257075 DOI: 10.1111/j.1468-1293.2011.00985.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2011] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of the study was to assess the seroprevalence of hepatitis E virus (HEV) infection in an HIV-infected population, as determined by HEV immunoglobulin G (IgG) antibodies (anti-HEV). METHODS The design of the study was cross-sectional. Serum anti-HEV IgG was determined by enzyme immunoassay in 238 HIV-infected patients consecutively attending our out-patient clinic between April and May 2011. In HEV-seropositive patients, HEV RNA was analysed by nested reverse transcriptase-polymerase chain reaction (RT-PCR). Associations between anti-HEV and liver cirrhosis, route of HIV infection, hepatitis B virus (HBV) and hepatitis C virus (HCV) serological markers, age, sex and alanine aminotransferase (ALT) levels were examined by univariate and multivariate analysis. RESULTS One hundred and forty patients (59%) had chronic liver disease (99% were HBV- and/or HCV-coinfected). Liver cirrhosis was detected in 44 individuals (19%). Two hundred and twelve patients (89%) were on antiretroviral treatment; the median CD4 T-cell count was 483 cells/μL [interquartile range (IQR) 313-662 cells/μL] and the HIV viral load was <25 HIV-1 RNA copies/mL. Overall, 22 patients (9%) were anti-HEV positive. Liver cirrhosis was the only factor independently associated with the presence of anti-HEV, which was documented in 23% of patients with cirrhosis and 6% of patients without cirrhosis (P=0.002; odds ratio 5.77). HEV RNA was detected in three seropositive patients (14%), two of whom had liver cirrhosis. CONCLUSIONS Our findings show a high prevalence of anti-HEV in HIV-infected patients, strongly associated with liver cirrhosis. Chronic HEV infection was detected in a significant number of HEV-seropositive patients. Further research is needed to ascertain whether cirrhosis is a predisposing factor for HEV infection and to assess the role of chronic HEV infection in the pathogeneses of cirrhosis in this population.
Collapse
Affiliation(s)
- R Jardi
- Department of Biochemistry, Vall d'Hebron Hospital, University "Autonoma" of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Hepatitis E: are psychiatric patients on special risk? Med Microbiol Immunol 2011; 201:171-5. [DOI: 10.1007/s00430-011-0218-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Indexed: 01/08/2023]
|
39
|
González Tallón AI, Moreira Vicente V, Mateos Lindemann ML. [Chronic hepatitis E]. Med Clin (Barc) 2011; 138:69-72. [PMID: 21458830 DOI: 10.1016/j.medcli.2011.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 02/01/2011] [Indexed: 01/18/2023]
Abstract
The hepatitis E virus is an RNA virus with 4 genotypes. Genotypes 1 and 2 only affect humans and produce epidemic acute hepatitis in endemic regions (Asia and Africa). Genotypes 3 and 4 are considered a zoonosis and produce episodic acute hepatitis in non-endemic areas (America and Europe). However, in the last 3 years there have been cases of chronic HEV hepatitis, mainly in immunosuppressed patients. Here we review the known data of chronic hepatitis E in terms of evolution and treatment.
Collapse
|
40
|
Liu T, Lei M, Jiao H, Du L, Cheng Y, Zhang D, Hao Y, Man C, Wang F. RNA interference induces effective inhibition of mRNA accumulation and protein expression of SHEV ORF3 gene in vitro. Curr Microbiol 2011; 62:1355-62. [PMID: 21225263 DOI: 10.1007/s00284-010-9863-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Accepted: 12/23/2010] [Indexed: 11/25/2022]
Abstract
RNA interference (RNAi) provides a powerful promising approach to inhibit viral infection specifically. To explore the possibility of using RNAi as a strategy against HEV infection, which is a serious public health problem in developing countries of Asia, Middle East, Africa, and in Mexico, after the fusion protein expression plasmids pEGFP-ORF3 which contain the EGFP reporter gene and SHEV ORF3 as silencing target, were constructed; EGFP-ORF3 fusion protein expressing HEK 293 cell lines were established; and four siRNAs targeting ORF3 gene were designed, synthesized, and used to transfect the stable cell lines. At 24, 48, and 72 h after transfection, flow cytometry, real-time quantitative PCR, and Western blot were used to assess the expression level of ORF3. The results demonstrated that specific siRNAs which are sequence dependant effectively inhibited mRNA accumulation and protein expression of SHEV ORF3 in HEK 293 cells. These findings provide useful information for the development of RNAi-based prophylaxis and therapy for SHEV infection.
Collapse
Affiliation(s)
- Tao Liu
- Hainan Key Lab of Tropical Animal Reproduction & Breeding and Epidemic Disease Research (Construction Period), Animal Genetic Engineering Key Lab of Haikou, College of Agriculture, Hainan University, Haidian Island, Haikou 570228, People's Republic of China
| | | | | | | | | | | | | | | | | |
Collapse
|