1
|
Molini U, Franzo G, de Villiers L, van Zyl L, de Villiers M, Khaiseb S, Busch F, Knauf S, Dietze K, Eiden M. Serological survey on Hepatitis E virus in Namibian dogs, cats, horses, and donkeys. Front Vet Sci 2024; 11:1422001. [PMID: 39091395 PMCID: PMC11292797 DOI: 10.3389/fvets.2024.1422001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/04/2024] [Indexed: 08/04/2024] Open
Abstract
The present study investigated the seropositivity rate of Hepatitis E virus (HEV) in domestic and working animals in Namibia, which included dogs, cats, horses, and donkeys. HEV poses a growing threat as a significant cause of human hepatitis globally and has several genotypes of varying zoonotic potential. As epidemiological data on the seroprevalence of HEV in Namibia is scarce, a serosurvey was conducted on archived serum samples of 374 dogs, 238 cats, 98 horses, and 60 donkeys collected between 2018 and 2022 from different regions, to assess the potential of these animals as sources of HEV infection. The findings revealed that 10.43% (n = 39/374) canine and 5.88% (n = 14/238) feline samples tested positive for HEV antibodies, whereas no seropositivity was detected in horses and donkeys. The study further examined the risk factors associated with HEV seropositivity, including animal sex, age, and geographical region, and noted a higher prevalence in dogs living in areas with intensive pig farming. Although there is no direct evidence indicating that these animals served as major reservoirs for HEV transmission to humans, the study underscores the importance of preventive measures to minimize contact exposure with pets considering the potential zoonotic risk, especially for susceptible risk groups. Further research is needed to explore the zoonotic potential of domestic animals and the epidemiological links between animal and human HEV transmissions in Namibia.
Collapse
Affiliation(s)
- Umberto Molini
- School of Veterinary Medicine, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek, Namibia
- Central Veterinary Laboratory (CVL), Windhoek, Namibia
| | - Giovanni Franzo
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - Lourens de Villiers
- School of Veterinary Medicine, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek, Namibia
| | - Leandra van Zyl
- School of Veterinary Medicine, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek, Namibia
| | - Mari de Villiers
- School of Veterinary Medicine, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek, Namibia
| | | | - Frank Busch
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Federal Institute for Animal Health, Greifswald – Insel Riems, Germany
| | - Sascha Knauf
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Federal Institute for Animal Health, Greifswald – Insel Riems, Germany
- One Health/International Animal Health, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany
| | - Klaas Dietze
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut, Federal Institute for Animal Health, Greifswald – Insel Riems, Germany
| | - Martin Eiden
- Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
| |
Collapse
|
2
|
Geng Y, Shi T, Wang Y. Epidemiology of Hepatitis E. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:33-48. [PMID: 37223857 DOI: 10.1007/978-981-99-1304-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Hepatitis E virus (HEV) is globally prevalent with relatively high percentages of anti-HEV immunoglobulin G-positive individuals in the populations of developing and developed countries. There are two distinct epidemiological patterns of hepatitis E. In areas with high disease endemicity, primarily developing countries in Asia and Africa, this disease is caused mainly by genotypes HEV-1 or HEV-2; both genotypes transmit predominantly through contaminated water and occur as either outbreaks or sporadic cases of acute hepatitis. The acute hepatitis has the highest attack rate in young adults and is particularly severe among pregnant women. In developed countries, sporadic cases of locally acquired HEV-3 or HEV-4 infection are observed. The reservoir of HEV-3 and HEV-4 is believed to be animals, such as pigs, with zoonotic transmission to humans. The affected persons are often elderly, and persistent infection has been well documented among immunosuppressed persons. A subunit vaccine has been shown to be effective in preventing clinical disease and has been licensed in China.
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
|
3
|
Khuroo MS. Hepatitis E and Pregnancy: An Unholy Alliance Unmasked from Kashmir, India. Viruses 2021; 13:1329. [PMID: 34372535 PMCID: PMC8310059 DOI: 10.3390/v13071329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 12/23/2022] Open
Abstract
The adverse relationship between viral hepatitis and pregnancy in developing countries had been interpreted as a reflection of retrospectively biased hospital-based data collection by the West. However, the discovery of hepatitis E virus (HEV) as the etiological agent of an epidemic of non-A, non-B hepatitis in Kashmir, and the documenting of the increased incidence and severity of hepatitis E in pregnancy via a house-to-house survey, unmasked this unholy alliance. In the Hepeviridae family, HEV-genotype (gt)1 from genus Orthohepevirus A has a unique open reading frame (ORF)4-encoded protein which enhances viral polymerase activity and viral replication. The epidemics caused by HEV-gt1, but not any other Orthohepevirus A genotype, show an adverse relationship with pregnancy in humans. The pathogenesis of the association is complex and at present not well understood. Possibly multiple factors play a role in causing severe liver disease in the pregnant women including infection and damage to the maternal-fetal interface by HEV-gt1; vertical transmission of HEV to fetus causing severe fetal/neonatal hepatitis; and combined viral and hormone related immune dysfunction of diverse nature in the pregnant women, promoting viral replication. Management is multidisciplinary and needs a close watch for the development and management of acute liver failure. (ALF). Preliminary data suggest beneficial maternal outcomes by early termination of pregnancy in patients with lower grades of encephalopathy.
Collapse
Affiliation(s)
- Mohammad Sultan Khuroo
- Digestive Diseases Centre, Dr. Khuroo's Medical Clinic, Srinagar, Jammu and Kashmir 190010, India
| |
Collapse
|
4
|
Dimeglio C, Kania D, Mantono JM, Kagoné T, Zida S, Tassembedo S, Dicko A, Tinto B, Yaro S, Hien H, Rouamba J, Bicaba B, Medah I, Meda N, Traoré O, Tuaillon E, Abravanel F, Izopet J. Hepatitis E Virus Infections among Patients with Acute Febrile Jaundice in Burkina Faso. Viruses 2019; 11:E554. [PMID: 31207982 PMCID: PMC6630816 DOI: 10.3390/v11060554] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/06/2019] [Accepted: 06/12/2019] [Indexed: 12/24/2022] Open
Abstract
Hepatitis E virus infection is a significant public health problem in many parts of the world including Africa. We tested serum samples from 900 patients in Burkina Faso presenting with febrile icterus. They all tested negative for yellow fever, but those from 23/900 (2.6%) patients contained markers of acute HEV infection (anti-HEV IgM and HEV RNA positive). Genotyping indicated that 14 of the strains were HEV genotype 2b. There was an overall HEV IgG seroprevalence of 18.2% (164/900). In a bivariate analysis, the factors linked to HEV exposure were climate and patient age. Older patients and those living in arid regions were more likely to have HEV infection. HEV genotype 2b circulating only in humans can be involved in some acute febrile icterus cases in Burkina Faso. Better access to safe water, sanitation, and improved personal hygiene should improve control of HEV infection in this country.
Collapse
Affiliation(s)
- Chloé Dimeglio
- Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France.
| | | | - Judith Mbombi Mantono
- Centre MURAZ, Bobo-Dioulasso, Burkina Faso.
- Université Catholique d'Afrique de l'Ouest, Bobo-Dioulasso, Burkina Faso.
| | | | - Sylvie Zida
- Centre MURAZ, Bobo-Dioulasso, Burkina Faso.
- Institut de recherche en sciences de la santé (IRSS), Ouagadougou, Burkina Faso.
| | | | | | | | | | - Hervé Hien
- Centre MURAZ, Bobo-Dioulasso, Burkina Faso.
| | - Jérémi Rouamba
- Centre MURAZ, Bobo-Dioulasso, Burkina Faso.
- Université Ouaga I Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso.
| | - Brice Bicaba
- Institut de recherche en sciences de la santé (IRSS), Ouagadougou, Burkina Faso.
| | - Isaïe Medah
- Ministère de la Santé, Ouagadougou, Burkina Faso.
| | - Nicolas Meda
- Ministère de la Santé, Ouagadougou, Burkina Faso.
| | - Oumar Traoré
- Agence nationale de biosécurité, Ouagadougou, Burkina Faso.
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections., Etablissement Français du Sang, CHU Montpellier, INSERM, University of Montpellier, 34090 Montpellier, France.
| | - Florence Abravanel
- Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France.
- Centre de Physiopathologie de Toulouse Purpan (CPTP), UMR Inserm, U1043, UMR CNRS, U5282, 31300 Toulouse, France.
| | - Jacques Izopet
- Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France.
- Centre de Physiopathologie de Toulouse Purpan (CPTP), UMR Inserm, U1043, UMR CNRS, U5282, 31300 Toulouse, France.
| |
Collapse
|
5
|
Abstract
Hepatitis E virus (HEV) is globally prevalent with relatively high percentages of anti-HEV immunoglobulin G-positive individuals in the populations of developing and developed countries. There are two distinct epidemiologic patterns of hepatitis E. In areas with high disease endemicity, primarily developing countries in Asia and Africa, this disease is caused mainly by genotype 1 or 2 HEV, both of which transmit predominantly through contaminated water and occur as either outbreaks or as sporadic cases of acute hepatitis. The acute hepatitis caused by either of these two genotypes has the highest attack rate in young adults, and the disease is particularly severe among pregnant women. In developed countries, sporadic cases of locally acquired genotype 3 or 4 HEV infection are observed. The reservoir of genotype 3 and 4 HEV is believed to be animals, such as pigs, with zoonotic transmission to humans. The affected persons are often elderly, and persistent infection has been well documented among immunosuppressed persons. A subunit vaccine has been shown to be effective in preventing clinical disease and has been licensed in China.
Collapse
Affiliation(s)
- Yansheng Geng
- School of Public Health, Hebei University, No. 342 Yuhuadonglu, Baoding, 071000, China.
| | - Youchun Wang
- Division of HIV/AIDS and Sex-transmitted Virus Vaccines, National Institutes for Food and Drug Control, No. 2 Tiantanxili, Dongcheng District, Beijing, 100050, China
| |
Collapse
|
6
|
Pelosi E, Clarke I. Hepatitis E: a complex and global disease. EMERGING HEALTH THREATS JOURNAL 2017. [DOI: 10.3402/ehtj.v1i0.7069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- E Pelosi
- Department of Microbiology and Virology, Health Protection Agency, Southeast Regional Laboratory, Southampton General Hospital, Southampton, UK; and
| | - I Clarke
- Department of Molecular Microbiology, Southampton Medical School, Southampton General Hospital, Southampton, UK
| |
Collapse
|
7
|
Wu X, Chen P, Lin H, Hao X, Liang Z. Hepatitis E virus: Current epidemiology and vaccine. Hum Vaccin Immunother 2016; 12:2603-2610. [PMID: 27184971 DOI: 10.1080/21645515.2016.1184806] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatitis E virus infections have been continuously reported in Indian subcontinent, Africa, southeast and central Asia, posing great health threats to the public, especially to pregnant women. Hecolin® is the only licensed HEV vaccine developed by Xiamen Innovax Biotech Co., Ltd. Extensive characterizations on antigenicity, physicochemical properties, efficacy in clinical trials, and manufacturing capability have made Hecolin® a promising vaccine for HEV control. However, there are many obstacles in large scale application of Hecolin®. Efforts are needed to further evaluate safety and efficacy in HEV risk populations, and to complement HEV standards for quality control. Passing World Health Organization prequalification and licensing outside China are priorities as these are also hindering Hecolin® promotion. Multilateral cooperation among Chinese vaccine manufacturers, Chinese National Regulatory Authorization (NRA) and WHO will expedite the entrance of Hecolin® into international market, so that Hecolin® could play its due role in global hepatitis E control.
Collapse
Affiliation(s)
- Xing Wu
- a National Institutes for Food and Drug Control , Beijing , PR China
| | - Pan Chen
- a National Institutes for Food and Drug Control , Beijing , PR China
| | - Huijuan Lin
- b R&D Department , Shanghai Institute of Biological Products Co., Ltd. , Shanghai , PR China
| | - Xiaotian Hao
- a National Institutes for Food and Drug Control , Beijing , PR China
| | - Zhenglun Liang
- a National Institutes for Food and Drug Control , Beijing , PR China
| |
Collapse
|
8
|
Kim JH, Nelson KE, Panzner U, Kasture Y, Labrique AB, Wierzba TF. A systematic review of the epidemiology of hepatitis E virus in Africa. BMC Infect Dis 2014; 14:308. [PMID: 24902967 PMCID: PMC4055251 DOI: 10.1186/1471-2334-14-308] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 05/28/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Hepatitis E Virus (HEV) infection is a newly recognized serious threat to global public health and Africa is suspected to be among the most severely affected regions in the world. Understanding HEV epidemiology in Africa will expedite the implementation of evidence-based control policies aimed at preventing the spread of HEV including policies for the use of available resources such as HEV vaccines. METHODS Here we present a comprehensive review of HEV epidemiology in Africa based on published data. We searched for articles on HEV epidemiology in Africa from online databases such as PubMed, Scopus, and ISI Web of Science and critically reviewed appropriate publications to extract consistent findings, identify knowledge gaps, and suggest future studies. RESULTS Taking a particularly high toll in pregnant women and their fetuses, HEV has infected human populations in 28 of 56 African countries. Since 1979, 17 HEV outbreaks have been reported about once every other year from Africa causing a reported 35,300 cases with 650 deaths. CONCLUSIONS In Africa, HEV infection is not new, is widespread, and the number of reported outbreaks are likely a significant underestimate. The authors suggest that this is a continent-wide public health problem that deserves the attention of local, regional and international agencies to implement control policies that can save numerous lives, especially those of pregnant women and their fetuses.
Collapse
Affiliation(s)
- Jong-Hoon Kim
- International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul 151-919, South Korea
| | - Kenrad E Nelson
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Ursula Panzner
- International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul 151-919, South Korea
| | - Yogita Kasture
- International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul 151-919, South Korea
| | - Alain B Labrique
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Thomas F Wierzba
- International Vaccine Institute, SNU Research Park, San 4-8, Nakseongdae-dong, Gwanak-gu, Seoul 151-919, South Korea
| |
Collapse
|
9
|
El Sayed Zaki M, El Razek MMA, El Razek HMA. Maternal-Fetal Hepatitis E Transmission: Is It Underestimated? J Clin Transl Hepatol 2014; 2:117-23. [PMID: 26356414 PMCID: PMC4521258 DOI: 10.14218/jcth.2014.00006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/03/2014] [Accepted: 03/06/2014] [Indexed: 12/27/2022] Open
Abstract
Hepatitis E virus (HEV) is an enterically transmitted virus; and several modes of transmission have been proposed, including blood transfusion, person to person transmission, and transplacental transmission. HEV during pregnancy is associated with an unfavorable prognosis for mothers and in severe cases can cause acute fulminate hepatitis and death. Transplacental transmission of HEV usually results in unfavorable outcomes of pregnancy, mainly fetal loss, preterm labor, and hepatic dysfunction in neonates. In this review, we will summarize the effects of HEV on maternal-fetal health in various clinical situations.
Collapse
|
10
|
Hepatitis E: an emerging disease. INFECTION GENETICS AND EVOLUTION 2014; 22:40-59. [PMID: 24434240 DOI: 10.1016/j.meegid.2014.01.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 12/09/2013] [Accepted: 01/04/2014] [Indexed: 02/07/2023]
Abstract
Currently, the infection with the hepatitis E virus represents the most frequent cause for acute hepatitis and jaundice in the world. According to WHO estimations, around two billion people, representing one third of the world's population, live in endemic areas for HEV and, therefore, are at risk of infection. In developed countries, the circulation of the virus in both human and animal (swine, boar, deer) sewage has been confirmed; however, the incidence rate is low compared to that of developing countries where outbreaks of acute hepatitis transmitted via the fecal-oral route are originated, more frequently in the flooding season or after natural disasters, combined with deficient sanitary conditions. There are currently 4 known genotypes of HEV. Genotypes 1 and 2 are isolated in all human epidemic outbreaks in developing countries, while genotypes 3 and 4 are isolated not only in humans but also in animals, in both developing and industrialized countries. These data support genotypes 3 and 4 having zoonotic nature. The diagnosis of this disease is based in the detection of anti-HEV IgG and IgM in blood serum using enzyme-linked immunosorbent methods. However, the method that best confirms the diagnosis is the RT-PCR, which detects HEV RNA in blood serum and also provides the genotype. The clinical course is generally that of an acute hepatitis which in some cases may require hospitalization and that, in transplant patients or HIV infected individuals can become a chronic hepatitis. Furthermore, the virus constitutes an important risk for pregnant women. The hepatitis E can present a wide range of symptoms, from a subclinical case to chronic liver disease with extrahepatic manifestations. For this reason, the diagnostic is challenging if no differential diagnosis is included. There is no specific antiviral drug for hepatitis E, but satisfactory results have been observed in some patients treated with pegylated interferon alfa2a and/or ribavirin. This revision is an update of all the molecular, epidemiological, clinic and preventive knowledge on this emergent disease up to date.
Collapse
|
11
|
Salete de Paula V, Wiele M, Mbunkah AH, Daniel AM, Kingsley MT, Schmidt-Chanasit J. Hepatitis E virus genotype 3 strains in domestic pigs, Cameroon. Emerg Infect Dis 2013; 19:666-8. [PMID: 23751099 PMCID: PMC3647720 DOI: 10.3201/eid1904.121634] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
12
|
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
|
13
|
Fatal outbreaks of jaundice in pregnancy and the epidemic history of hepatitis E. Epidemiol Infect 2012; 140:767-87. [PMID: 22273541 DOI: 10.1017/s0950268811002925] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Space-time clustering of people who fall acutely ill with jaundice, then slip into coma and death, is an alarming phenomenon, more markedly so when the victims are mostly or exclusively pregnant. Documentation of the peculiar, fatal predisposition of pregnant women during outbreaks of jaundice identifies hepatitis E and enables construction of its epidemic history. Between the last decade of the 18th century and the early decades of the 20th century, hepatitis E-like outbreaks were reported mainly from Western Europe and several of its colonies. During the latter half of the 20th century, reports of these epidemics, including those that became serologically confirmed as hepatitis E, emanated from, first, the eastern and southern Mediterranean littoral and, thereafter, Southern and Central Asia, Eastern Europe, and the rest of Africa. The dispersal has been accompanied by a trend towards more frequent and larger-scale occurrences. Epidemic and endemic hepatitis E still beset people inhabiting Asia and Africa, especially pregnant women and their fetuses and infants. Their relief necessitates not only accelerated access to potable water and sanitation but also vaccination against hepatitis E.
Collapse
|
14
|
Sugitani M, Tamura A, Shimizu YK, Sheikh A, Kinukawa N, Shimizu K, Moriyama M, Komiyama K, Li TC, Takeda N, Arakawa Y, Suzuki K, Ishaque SM, Roy PK, Raihan ASMA, Hasan M. Detection of hepatitis E virus RNA and genotype in Bangladesh. J Gastroenterol Hepatol 2009; 24:599-604. [PMID: 19054262 DOI: 10.1111/j.1440-1746.2008.05677.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIMS Hepatitis E virus (HEV) in Bangladesh has not been adequately documented. We report HEV RNA and genotype detection in Bangladesh. METHODS In total, 82 samples were used; 36 sporadic acute hepatitis (AH), 12 fulminant hepatitis (FH), 14 chronic liver disease (CLD) and 20 from an apparently healthy population (HP) positive for both immunoglobulin (Ig) M and IgG specific anti-HEV antibodies (anti-HEV). The male/female ratio was 61/21, ages 12-67 (mean 30.4) years. RNA was extracted, transcribed to cDNA and amplified in nt 6345-6490 (ORF2) of HEV. Nucleic and amino acid sequences were determined. Homology comparison between Bangladesh clones and other representative HEV clones and phylogenetic tree analyses were done. Relations between HEV RNA-positivity and clinical factors were analyzed. RESULTS HEV RNA was positive in 9/36 (25.0%) of AH cases, 4/12 (33.3%) FH, 3/14 (21.4%) CLD and 0/20 (0%) HP samples; total 16/82 (19.5%). Four factors correlated significantly with HEV RNA-positivity (Mann-Whitney U test); alanine aminotransferase (ALT) (P = 0.0229), aspartate aminotransferase (AST) (P = 0.0448), and titers of IgG (P = 0.0208) and IgM (P = 0.0095) specific anti-HEV. The 16 HEV clones were divided mainly into two groups, A and B, including six different cDNA sub-groups. CONCLUSION HEV RNA was found in sporadic AH and FH and sub-clinical CLD cases, but not in HP. HEV RNA-positivity was significantly related to values of ALT and AST and titers of IgG and IgM specific anti-HEV, with IgM specific anti-HEV showing the most significant relationship. All clones were genotype I, which is prevalent in South Asia.
Collapse
Affiliation(s)
- Masahiko Sugitani
- Department of Pathology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Pelosi E, Clarke I. Hepatitis E: a complex and global disease. EMERGING HEALTH THREATS JOURNAL 2008; 1:e8. [PMID: 22460217 PMCID: PMC3167588 DOI: 10.3134/ehtj.08.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 03/12/2008] [Accepted: 04/10/2008] [Indexed: 12/13/2022]
Abstract
Thirty years after its discovery, the hepatitis E virus (HEV) continues to represent a major public health problem in developing countries. In developed countries, it has emerged as a significant cause of non-travel-associated acute hepatitis. HEV infects a wide range of mammalian species and a key reservoir worldwide appears to be swine. Genomic sequence similarity between some human HEV genotypes and swine HEV strains has been identified and we know that humans can acquire HEV infection from animals. Although for the most part the clinical course of HEV infection is asymptomatic or mild, significant risk of serious disease exists in pregnant women and those with chronic liver disease. In addition, there are data on the threat of chronic infections in immunocompromised patients. Beyond management of exposure by public health measures, recent data support that active immunisation can prevent hepatitis E, highlighting the need for vaccination programmes. Here we review the current knowledge on HEV, its epidemiology, and the management and prevention of human disease.
Collapse
Affiliation(s)
- E Pelosi
- Department of Microbiology and Virology, Health Protection Agency, Southeast Regional Laboratory, Southampton General Hospital, Southampton, UK
| | | |
Collapse
|
16
|
He J, Kuschner RA, Dewar V, Voet P, Asher LV, Vaughn DW. Characterization of monoclonal antibodies to hepatitis E virus (HEV) capsid protein and identification of binding activity. J Biomed Sci 2007; 14:555-63. [PMID: 17487571 DOI: 10.1007/s11373-007-9172-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 03/26/2007] [Indexed: 12/21/2022] Open
Abstract
Twenty-seven monoclonal antibodies (Mabs) recognizing the open reading frame 2 structural protein of the Pakistan strain of hepatitis E virus (HEV) were generated by conventional hybridoma technique. These Mabs were characterized by ELISA, affinity-capture reverse transcriptase-polymerase chain reaction (AC/RT-PCR), immune electron microscopy (IEM), and a RT-PCR based seroneutralization assay. Twenty-seven Mabs were positive by ELISA. By AC/RT-PCR, 24 Mabs bound to Pakistan and Namibia HEV strains. Thirteen Mabs were examined by IEM. Nine Mabs, positive by ELISA and AC/RT-PCR, bound and aggregated to Mexican HEV strain. We tested five Mabs that were positive by ELISA, AC/RT/PCR, and IEM by a RT-PCR based seroneutralization assay. Only one Mab (Mab 7) showed activity that inhibited the ability of HEV to attach to Alexander hepatoma cells (PLC-PRF-5). When Mab 7 was diluted to 1: 160, its inhibition activity persisted suggesting that Mab 7 might be a potential candidate for further evaluation in primates (passive protection experiments).
Collapse
Affiliation(s)
- Junkun He
- Armed Forces Institute of Pathology, 1413 Research Boulevard, Rockville, MD 20850, USA.
| | | | | | | | | | | |
Collapse
|
17
|
Lu L, Li C, Hagedorn CH. Phylogenetic analysis of global hepatitis E virus sequences: genetic diversity, subtypes and zoonosis. Rev Med Virol 2006; 16:5-36. [PMID: 16175650 DOI: 10.1002/rmv.482] [Citation(s) in RCA: 623] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nucleotide sequences from a total of 421 HEV isolates were retrieved from Genbank and analysed. Phylogenetically, HEV was classified into four major genotypes. Genotype 1 was more conserved and classified into five subtypes. The number of genotype 2 sequences was limited but can be classified into two subtypes. Genotypes 3 and 4 were extremely diverse and can be subdivided into ten and seven subtypes. Geographically, genotype 1 was isolated from tropical and several subtropical countries in Asia and Africa, and genotype 2 was from Mexico, Nigeria, and Chad; whereas genotype 3 was identified almost worldwide including Asia, Europe, Oceania, North and South America. In contrast, genotype 4 was found exclusively in Asia. It is speculated that genotype 3 originated in the western hemisphere and was imported to several Asian countries such as Japan, Korea and Taiwan, while genotype 4 has been indigenous and likely restricted to Asia. Genotypes 3 and 4 were not only identified in swine but also in wild animals such as boar and a deer. Furthermore, in most areas where genotypes 3 and 4 were characterised, sequences from both humans and animals were highly conserved, indicating they originated from the same infectious sources. Based upon nucleotide differences from five phylogenies, it is proposed that five, two, ten and seven subtypes for HEV genotypes 1, 2, 3 and 4 be designated alphabetised subtypes. Accordingly, a total of 24 subtypes (1a, 1b, 1c, 1d, 1e, 2a, 2b, 3a, 3b, 3c, 3d, 3e, 3f, 3g, 3h, 3i, 3j, 4a, 4b, 4c, 4d, 4e, 4f and 4g) were given.
Collapse
Affiliation(s)
- Ling Lu
- Division of Gastroenterology/Hepatology, Department of Medicine, Kansas University Medical Center, Kansas City, Kansas 66160, USA.
| | | | | |
Collapse
|
18
|
van Cuyck H, Fan J, Robertson DL, Roques P. Evidence of recombination between divergent hepatitis E viruses. J Virol 2005; 79:9306-14. [PMID: 15994825 PMCID: PMC1168788 DOI: 10.1128/jvi.79.14.9306-9314.2005] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Phylogenetic and recombination analysis was performed on 32 complete hepatitis E virus (HEV) genomes from infected humans and pigs. For the first time, evidence for recombination between divergent HEV strains was obtained, with at least two strains being found to have discordant phylogenetic relationships consistent with the occurrence of intragenotype recombination. This finding confirms that humans can be dually infected with divergent HEV strains and has implications for the emergence and evolution of new HEV epidemics.
Collapse
Affiliation(s)
- Hélène van Cuyck
- Etat Major des Armées, Maîtrise des Armements, Cellule d'analyse des risques biologiques it chimiques, Paris, France
| | | | | | | |
Collapse
|
19
|
Maila HT, Bowyer SM, Swanepoel R. Identification of a new strain of hepatitis E virus from an outbreak in Namibia in 1995. J Gen Virol 2004; 85:89-95. [PMID: 14718623 DOI: 10.1099/vir.0.19587-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Endemic circulation of hepatitis E virus (HEV) in Namibia was suspected from serological data during an outbreak of non-A, non-B hepatitis in Rundu in 1995. The source of the outbreak was suspected to be the water supply, which had been compromised approximately 6 months earlier. Four HEV isolates from four different persons in this outbreak were successfully amplified, sequenced and analysed over a 451 bp region of a subgenomic fragment from the 3' end of the genome in ORF2. Phylogenetic analysis showed that the four Namibian HEV isolates clustered with a Mexican isolate in genotype II and shared 85.8-86.3 % nucleotide identity with the 1987 Mexican isolate, but were only 77.6-79.6 % similar to other African isolates. HEV isolated from the same region of Namibia in 1983 was reported to cluster in genotype I. However, virus isolates from sporadic cases of HEV isolated in 1997/8 in Nigeria were also from genotype II.
Collapse
Affiliation(s)
- Hazel T Maila
- National Institute for Communicable Diseases and Department of Medical Virology, University of Witwatersrand, Private Bag X4, Sandringham 2131, South Africa
| | - Sheila M Bowyer
- National Institute for Communicable Diseases and Department of Medical Virology, University of Witwatersrand, Private Bag X4, Sandringham 2131, South Africa
| | - Robert Swanepoel
- National Institute for Communicable Diseases and Department of Medical Virology, University of Witwatersrand, Private Bag X4, Sandringham 2131, South Africa
| |
Collapse
|
20
|
van Cuyck H, Juge F, Roques P. Phylogenetic analysis of the first complete hepatitis E virus (HEV) genome from Africa. ACTA ACUST UNITED AC 2003; 39:133-9. [PMID: 14625096 DOI: 10.1016/s0928-8244(03)00241-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hepatitis E virus (HEV) is globally distributed, transmitted enterically and between humans and animals. Phylogenetic analysis has identified five distinct HEV genotypes. The first full-length sequence of an African strain (Chad) is presented and compared to 31 complete HEV genomes available, including the fulminant hepatitis strain from India, swine strains and a strain from Morocco. The two African strains are more closely related to genotype 1 than to any other genotypes and together they possibly form a sub-genotype or sixth genotype. The first evidence for recombination between divergent HEV strains is presented.
Collapse
Affiliation(s)
- Hélène van Cuyck
- Weapons of Mass Destruction Centre (WMD Centre), NATO, AB310, Bd. Leopold III, 1110, Brussels, Belgium.
| | | | | |
Collapse
|
21
|
He J, Innis BL, Shrestha MP, Clayson ET, Scott RM, Linthicum KJ, Musser GG, Gigliotti SC, Binn LN, Kuschner RA, Vaughn DW. Evidence that rodents are a reservoir of hepatitis E virus for humans in Nepal. J Clin Microbiol 2002; 40:4493-8. [PMID: 12454141 PMCID: PMC154618 DOI: 10.1128/jcm.40.12.4493-4498.2002] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Hepatitis E virus (HEV) is an important cause of enterically transmitted hepatitis in developing countries. Sporadic autochthonous cases of hepatitis E have been reported recently in the United States and other industrialized countries. The source of HEV infection in these cases is unknown; zoonotic transmission has been suggested. Antibodies to HEV have been detected in many animals in areas where HEV is endemic and in domestic swine and rats in the United States. There is evidence supporting HEV transmission between swine and humans. Nevertheless, HEV has not been detected in wild rodents. We tested murid rodents and house shrews trapped in Nepal's Kathmandu Valley, where hepatitis E is hyperendemic, for HEV infection. The most commonly trapped species was Rattus rattus brunneusculus. Serum samples from 675 animals were tested for immunoglobulin G against HEV by enzyme-linked immunosorbent assay; 78 (12%) were positive, indicating acute or past infection. Antibody prevalence was higher among R. rattus brunneusculus and Bandicota bengalensis than in Suncus murinus. Forty-four specimens from 78 antibody-positive animals had sufficient residual volume for detection of HEV RNA (viremia) by reverse transcription-PCR. PCR amplification detected four animals (9%; three were R. rattus brunneusculus and one was B. bengalensis) with viremia. Phylogenetic analysis of the four genome sequences (405 bp in the capsid gene) recovered showed that they were identical, most closely related to two human isolates from Nepal (95 and 96% nucleotide homology, respectively), and distinct from HEV sequences isolated elsewhere. These data prove that certain peridomestic rodents acquire HEV in the wild and suggest that cross-species transmission occurs, with rodents serving as a virus reservoir for humans.
Collapse
Affiliation(s)
- Junkun He
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Bruce L. Innis
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Mrigendra P. Shrestha
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Edward T. Clayson
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Robert M. Scott
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Kenneth J. Linthicum
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Guy G. Musser
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Scott C. Gigliotti
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Leonard N. Binn
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - Robert A. Kuschner
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
| | - David W. Vaughn
- Walter Reed Army Institute of Research, Silver Spring, Maryland, Walter Reed Army Institute of Research/Armed Forces Research Institute of Medical Sciences Research Unit—Nepal, Kathmandu, Nepal, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, American Museum of Natural History, New York, New York
- Corresponding author. Present address: Military Infectious Diseases Research Program, U.S. Army Medical Research and Materiel Command, 504 Scott St., Fort Detrick, MD 21702-5012. Phone: (301) 619-7882. Fax: (301) 619-2416. E-mail:
| |
Collapse
|
22
|
Arankalle VA, Chobe LP, Joshi MV, Chadha MS, Kundu B, Walimbe AM. Human and swine hepatitis E viruses from Western India belong to different genotypes. J Hepatol 2002; 36:417-25. [PMID: 11867187 DOI: 10.1016/s0168-8278(01)00297-5] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS Hepatitis E is endemic in India. Earlier, we showed prevalence of IgG antibodies to hepatitis E virus (IgG-anti-HEV) in different animal species and inability of at least one human hepatitis E virus (HEV) strain to infect pigs. In the US where hepatitis E is not endemic in humans, zoonotic spread of HEV was suspected as swine and human HEV were closely related and cross-species infection was documented. The present study attempts to identify and partially characterize swine HEV from India. METHODS Serum samples from 284 pigs were screened for the presence of HEV-RNA (nested polymerase chain reaction; PCR) and IgG-anti-HEV (enzyme-linked immunosorbent assay; ELISA). PCR products (Open Reading Frame-2 region) were sequenced and subjected to phylogenetic analysis. Two sero-negative pigs were inoculated with swine HEV-positive serum pool. RESULTS ELISA and PCR positivity were 42.9 and 4.6%, respectively. All Indian swine HEV sequences clustered with genotype IV. Pigs could be experimentally infected with swine HEV. CONCLUSIONS Swine HEV circulates in Indian pigs. In contrast to US and Taiwan wherein both human and swine HEV isolates belong to same genotype, Indian human HEV isolates belong to genotype I whereas genotype IV circulates in swine. Though experimental infection with Indian swine HEV was possible, at least one human HEV strain could not infect pigs.
Collapse
Affiliation(s)
- Vidya A Arankalle
- Hepatitis Division, National Institute of Virology, 20-A, Dr Ambedkar Road, 411001, Pune, India.
| | | | | | | | | | | |
Collapse
|
23
|
Biomedical vignette. J Biomed Sci 2000. [DOI: 10.1007/bf02253245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|