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Yeom H, Seo S, Yoon Y, Lee J, Han MG, Lee DY, Park SW, Park SA, Jeong SH, Gwack J. The first reported hepatitis E outbreak in a food manufacturing factory: Korea, 2022. Osong Public Health Res Perspect 2023; 14:15-22. [PMID: 36944341 DOI: 10.24171/j.phrp.2022.0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/30/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES On February 16, 2022, 12 cases of hepatitis E virus (HEV) infection were reported in a food manufacturing factory in Korea. The aim of this study was to identify additional cases and to determine the source of this HEV outbreak. METHODS This study was an in-depth investigation of 12 HEV immunoglobulin M (IgM)-positive cases and their demographic, clinical, and epidemiological characteristics. On-site specimens were collected from the environment and from humans, and a follow-up investigation was conducted 2 to 3 months after the outbreak. RESULTS Among 80 production workers in the factory, 12 (15.0%) had acute HEV infection, all of whom were asymptomatic. The follow-up investigation showed that 3 cases were HEV IgMpositive, while 6 were HEV IgG-positive. HEV genes were not detected in the HEV IgM-positive specimens. HEV genes were not detected in the food products or environmental specimens collected on-site. HEV was presumed to be the causative pathogen. However, it could not be confirmed that the source of infection was common consumption inside the factory. CONCLUSIONS This was the first domestic case of an HEV infection outbreak in a food manufacturing factory in Korea. Our results provide information for the future control of outbreaks and for the preparation of measures to prevent domestic outbreaks of HEV infection.
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Affiliation(s)
- Hansol Yeom
- Division of Infectious Disease Response, Capital Regional Center for Disease Control and Prevention, Seoul, Korea
| | - Soonryu Seo
- Division of Infectious Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Youngsil Yoon
- Division of Infectious Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jaeeun Lee
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Myung-Guk Han
- Division of Viral Disease, Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Deog-Yong Lee
- Division of Viral Disease, Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sun-Whan Park
- Division of Viral Disease, Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Song A Park
- Division of Viral Disease, Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jin Gwack
- Division of Infectious Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Cheongju, Korea
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Choi JW, Son HJ, Lee SS, Jeon H, Cho JK, Kim HJ, Cha RR, Lee JM, Kim HJ, Jung WT, Lee OJ. Acute hepatitis E virus superinfection increases mortality in patients with cirrhosis. BMC Infect Dis 2022; 22:62. [PMID: 35042464 PMCID: PMC8767750 DOI: 10.1186/s12879-022-07050-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/12/2022] [Indexed: 12/20/2022] Open
Abstract
Background Although acute hepatitis E is not fatal in healthy individuals, it is unclear whether hepatitis E superinfection increases the mortality in patients with pre-existing liver disease. Thus, we investigated the prognosis of patients with acute hepatitis E according to their cirrhosis diagnosis, and the prognosis according to the development of acute-on-chronic liver failure (ACLF) in patients with cirrhosis and chronic liver disease (CLD).
Methods This study included 74 consecutive patients who were diagnosed with acute viral hepatitis E between January 2007 and December 2019. Of them, 39 patients without CLD, 13 patients with non-cirrhotic CLD, and 22 patients with cirrhotic CLD were analyzed.
Results Among the 74 patients with HEV infection, 7 (9.5%) died within 180 days: 5 with underlying cirrhosis (71.4%) and 2 without cirrhosis (28.6%). The 180-day mortality was significant higher for patients with cirrhosis than for patients without cirrhosis (22.7% vs. 3.8%, P = 0.013). The age- and sex-adjusted proportional-hazard model revealed an approximately eightfold increase in the 180-day mortality risk in patients with cirrhosis compared to patients without cirrhosis. In addition, development of hepatitis E virus-related ACLF due to acute liver function deterioration in patients with pre-existing CLD or cirrhosis worsened the 180-day mortality rate. Conclusions Our findings suggest that the acute hepatitis E mortality rate was low in healthy individuals but higher in patients with cirrhosis, and especially high in those with ACLF. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07050-w.
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Choe S, Song S, Park GN, Shin J, Kim KS, Cha RM, Hyun BH, Park BK, An DJ. Detection of subtypes (3a, 4a and 4d) and high prevalence of hepatitis E virus in Korean wild boar. Vet Microbiol 2019; 240:108531. [PMID: 31902495 DOI: 10.1016/j.vetmic.2019.108531] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 11/15/2022]
Abstract
The hepatitis E virus (HEV) is known to have 4 genotypes but only one serotype. Genotype 1 and 2 infect humans only and genotype 3 and 4 infect humans, pigs and other animal species. Pig and wild boar are also known as reservoirs of HEV infection. Of the 2736 wild boars captured from 2011 to 2016 to investigate the HEV prevalence among Korean wild boars, 1041 serum samples were high seropositive (38.1%; 95% CI: 35.5-40.5) for HEV, which were detected using the anti-HEV antibody ELISA and the highest prevalence rate was 40.6% (684/1683) in 2016. Twenty four HEV strains were also identified from 1859 wild boar bloods captured between 2015 and 2016. The phylogenetic tree constructed based on the partial ORF2 gene revealed that the 23 Korean wild boar HEV strains belonged to genotype 4 (4a and 4d) showing the nucleotide sequences identities 83.4-100 %. The one Korean wild boar HEV strain belonged to genotype 3, segregated into subgenotype 3a. This suggested that major circulating in Korean wild boars is genotype 4a whereas genotype 3a and -4d is minor. It is important to the human public health that HEV with wild boar have potential high risk factor for transmission to human due to eating culture of Korean people with undercooked wild boar gallbladder.
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Affiliation(s)
- SeEun Choe
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea
| | - Sok Song
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea
| | - Gyu-Nam Park
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea
| | - Jihye Shin
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea
| | - Ki-Sun Kim
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea
| | - Ra Mi Cha
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea
| | - Bang-Hun Hyun
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea
| | - Bong-Kyun Park
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea; College of Veterinary Medicine, Seoul University, Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
| | - Dong-Jun An
- Virus Disease Division, Animal and Plant Quarantine Agency, Gimchen, Gyeongbuk-do, 39660, South Korea.
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Heo NY. [Hepatitis E Virus: Epidemiology, Diagnosis, and Management]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2019; 74:130-136. [PMID: 31554028 DOI: 10.4166/kjg.2019.74.3.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 01/08/2023]
Abstract
The HEV is a known cause of water-borne outbreaks of acute non-A non-B hepatitis in developing countries, which affects young people and may result in high mortality in pregnant women. In recent decades, however, HEV genotypes 3 and 4 have been known as a cause of sporadic zoonotic infections in older males from swine HEV worldwide. Most acute HEV infections are self-limited. On the other hand, in immunosuppressed patients, including solid organ transplant recipients, chronic HEV infections may exist and progress to liver cirrhosis or decompensation. Therefore, physicians need to recognize HEV as a major pathogen for acute and chronic hepatitis of unknown causes and investigate this disease.
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Affiliation(s)
- Nae-Yun Heo
- Division of Gastroenterology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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Jeong SH, Park BJ, Kim YH, Choi YS, Ahn HS, Han SH, Choi IS. Isolation of hepatitis E virus genotype 4 from patients with acute cryptogenic hepatitis in Korea. J Clin Virol 2017; 89:10-13. [PMID: 28189935 DOI: 10.1016/j.jcv.2017.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 01/23/2017] [Accepted: 02/05/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Autochthonous hepatitis E occurs sporadically in developed countries. The consumption of undercooked pork containing hepatitis E virus genotype 3 (HEV-3) or 4 (HEV-4) is the major risk factor for infection. The serological diagnostic kits currently used in hospitals sometimes produce false-negative or -positive results. Therefore, detection of both HEV RNA and antibodies to the virus is required for confirmative diagnosis of hepatitis E. OBJECTIVES We aimed to detect HEV in serum samples from patients with cryptogenic hepatitis and to determine the origin of HEV. STUDY DESIGN A nested polymerase chain reaction (PCR) method was developed for detection of HEV-3 and HEV-4 in patients with hepatitis. A total of 23 serum samples, deposited in 2006-2012, from patients with acute cryptogenic hepatitis who were serologically negative for hepatitis A, B, C, and E were examined using this method. The amplified PCR products were genetically analyzed. RESULTS Four HEV-4 isolates were detected from the 23 serum samples. Phylogenetic analysis indicated that three of the four isolates were closely related to HEV-4 isolates found in pigs in Korea and in patients with hepatitis E in Japan. CONCLUSIONS The newly developed nested PCR method was useful for detection of HEV in patients with cryptogenic hepatitis. The close relationship between the human HEV-4 isolates identified in this study and swine isolates implied that zoonotic transmission of HEV might be a source of infection in patients with hepatitis.
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Affiliation(s)
- Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Gyeonggi 13620, Republic of Korea
| | - Byung-Joo Park
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Yong-Hyun Kim
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Yun Suk Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Gyeonggi 13620, Republic of Korea
| | - Hee-Seop Ahn
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Sang-Hoon Han
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - In-Soo Choi
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea.
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Nakano T, Takahashi K, Takahashi M, Nishigaki Y, Watanabe N, Ishida S, Fujimoto S, Kato H, Okano H, Takei Y, Ayada M, Tomita E, Arai M, Okamoto H, Mishiro S. Investigating the origin and global dispersal history of hepatitis E virus genotype 4 using phylogeographical analysis. Liver Int 2016; 36:31-41. [PMID: 26037061 DOI: 10.1111/liv.12880] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 05/26/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Hepatitis E virus (HEV) genotype 4 has mainly been isolated from sporadic hepatitis cases and swine in Asian countries. We analysed the origin and global dispersal history of genotype 4 using a Bayesian phylogeographical approach. METHODS The 412-nucleotide sequences of open reading frame 2 of genotype 4 (47 Japanese, 40 Chinese, 1 Indian, 8 Indonesian, 1 Korean, 1 Taiwanese, 2 Danish and 2 Italian), of which sampling date and location were known, were collected. Evolutionary rate, divergence time, demographic growth and phylogeography were co-estimated in the Bayesian statistical inference framework implemented in the BEAST package to model spatial dispersal on a time-scaled genealogy. RESULTS The most probable origin of genotype 4 was Japan and the time of origin was 1909 (95% highest posterior density, 1871-1940). Seven lineages of genotype 4 migrated from Japan to China. The analysis also showed the migration of genotype 4 from Japan or China to India and Indonesia and from China to Indonesia, Taiwan, Korea and a few European countries. CONCLUSIONS Swine trade between countries coincided with the migration time and direction of genotype 4 in some cases and was considered the primary cause of dispersal. However, there was no clear cause of dispersal for some cases, for which no records of pig trade were found. Future research should analyse additional nucleotide sequences paired with epidemiological data from various countries to improve our understanding of HEV dispersal.
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Affiliation(s)
- Tatsunori Nakano
- Department of Internal Medicine, Fujita Health University Nanakuri Sanatorium, Mie, Japan
| | - Kazuaki Takahashi
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yoichi Nishigaki
- Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, Japan
| | - Naoki Watanabe
- Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, Japan
| | - Satoshi Ishida
- Department of Internal Medicine, Kuwana West Medical Center, Kuwana, Japan
| | - Shino Fujimoto
- Department of Internal Medicine, Kuwana West Medical Center, Kuwana, Japan
| | - Hideaki Kato
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Hiroshi Okano
- Department of Gastroenterology, Suzuka General Hospital, Mie, Japan
| | - Yoshiyuki Takei
- Department of Gastroenterology and Hepatology, Division of Clinical Medicine and Biomedical Science, Institute of Medical Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Minoru Ayada
- Department of Gastroenterology, Chutoen General Medical Center, Shizuoka, Japan
| | - Eiichi Tomita
- Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, Japan
| | - Masahiro Arai
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Shunji Mishiro
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
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Yoon Y, Jeong HS, Yun H, Lee H, Hwang YS, Park B, Lee CJ, Lee S, Hyeon JY. Hepatitis E Virus (HEV) seroprevalence in the general population of the Republic of Korea in 2007-2009: a nationwide cross-sectional study. BMC Infect Dis 2014; 14:517. [PMID: 25248488 PMCID: PMC4262127 DOI: 10.1186/1471-2334-14-517] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 09/18/2014] [Indexed: 01/28/2023] Open
Abstract
Background Hepatitis E virus (HEV) is an emerging pathogen associated with endemic and acute viral hepatitis. In this study, we investigate the HEV seroprevalence and putative risk factors by a nationwide cross-sectional study in the Republic of Korea. Methods The prevalence of anti-HEV antibody was investigated in 2,450 serum samples collected in fourth Korea National Health and Nutrition Examination Survey. In addition, epidemiological information on possible risk factors including gender, age, education, occupation, and residence location for exposure to HEV was obtained. Results The frequency of anti-EIA reactive sample was 5.9% (144/2450). The individuals in groups with male, older age, low education level and living in rural or coastal regions had high seroprevalence estimates (P ≤ 0.001). In addition, seroprevalence was significantly higher among individuals with self-identified skilled agricultural, forestry, and fishery workers (31.3%, P < 0.001). Conclusions This study provides valuable data that could be used to investigate associations of HEV seroprevalence and putative risk factors by a nationwide cross-sectional study. The high HEV seroprevalence of skilled agricultural, forestry, and fishery workers and individuals lived in coastal and rural area indicated that zoonotic transmission is an important risk factor for HEV infection in the republic of Korea. Further studies that include detailed and continuous nationwide surveys are required to identify unrecognized risk factors and to monitor the HEV infection prevalence. Electronic supplementary material The online version of this article (doi:10.1186/1471-2334-14-517) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ji-Yeon Hyeon
- Division of Vaccine Research, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Osong-eup, CheongJu, Chungcheongbuk-do 363-951, Republic of Korea.
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Bouamra Y, Gérolami R, Arzouni JP, Grimaud JC, Lafforgue P, Nelli M, Tivoli N, Ferretti A, Motte A, Colson P. Emergence of autochthonous infections with hepatitis E virus of genotype 4 in Europe. Intervirology 2013; 57:43-8. [PMID: 24157452 DOI: 10.1159/000354801] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 07/25/2013] [Indexed: 12/26/2022] Open
Abstract
In Europe, autochthonous hepatitis E is caused by genotype 3 hepatitis E virus (HEV) in almost all cases. A total of 15 infections with genotype 4 HEV were diagnosed in France from May 2009 to April 2012, and all but one of the HEV-4 strains implicated in these infections were genetically related and highly similar to HEV-4 sequences isolated from swine in Belgium. In addition, 5 autochthonous HEV-4 infections have been described in the region of Lazio, Italy, during March and April 2011, and these HEV sequences were 100% identical to one another but showed relatively low similarity (74-85%) to HEV-4 RNA samples collected in France. We report 6 additional HEV-4 infections that were diagnosed from May to July 2012 which represented 50% of the HEV infections diagnosed during this period in our clinical microbiology laboratory. Five of these HEV-4 strains were associated with autochthonous infections and were clustered together and with the majority of HEV-4 previously described in France, whereas the sixth strain was genetically divergent. Taken together with reports from other teams, these observations indicate that autochthonous infections with HEV-4 are emerging in Europe and have been transmitted by at least two distinct sources.
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Affiliation(s)
- Yanis Bouamra
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique - Hôpitaux Marseille (AP-HM), Marseille, France
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Choi JY, Lee JM, Jo YW, Min HJ, Kim HJ, Jung WT, Lee OJ, Yun H, Yoon YS. Genotype-4 hepatitis E in a human after ingesting roe deer meat in South Korea. Clin Mol Hepatol 2013; 19:309-14. [PMID: 24133670 PMCID: PMC3796682 DOI: 10.3350/cmh.2013.19.3.309] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 09/01/2012] [Accepted: 09/07/2012] [Indexed: 12/13/2022] Open
Abstract
The recent increase in the number of cases of indigenous hepatitis E virus (HEV) infection highlights the importance of identifying the transmission routes for the prevention of such infections. Presented herein is the first case of acute HEV infection after ingesting wild roe deer meat in South Korea. A 43-year-old male presented with abdominal discomfort and jaundice. He had not recently traveled abroad, but had eaten raw roe-deer meat 6-8 weeks before the presentation. On the 7th day of hospitalization the patient was diagnosed with acute viral hepatitis E. Phylogenetic analysis of his serum revealed genotype-4 HEV. This case supports the possibility of zoonotic transmission of HEV because the patient appears to have been infected with genotype-4 HEV after ingesting raw deer meat.
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Affiliation(s)
- Ja Yoon Choi
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
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Park HK, Jeong SH, Kim JW, Woo BH, Lee DH, Kim HY, Ahn S. Seroprevalence of anti-hepatitis E virus (HEV) in a Korean population: comparison of two commercial anti-HEV assays. BMC Infect Dis 2012; 12:142. [PMID: 22726615 PMCID: PMC3447697 DOI: 10.1186/1471-2334-12-142] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 06/22/2012] [Indexed: 12/12/2022] Open
Abstract
Background Hepatitis E virus (HEV) has emerged as an important cause of epidemic and sporadic acute viral hepatitis worldwide. This study investigated the seroprevalence of anti-HEV in a Korean population and compared the performance of two commercially available anti-HEV assays. Methods A total 147 health-check examinees were randomly sampled as matched to the age- and sex- adjusted standard population based on the Korean National Census of 2007. Serum immunoglobulin G anti-HEV was determined by using the Genelabs assay (Genelabs, Singapore) and the Wantai assay (Wantai, Beijing, China). Results The overall anti-HEV seroprevalence was 23.1% (95% CI, 16.1-30.1%) using the Wantai assay and 14.3% (95% CI, 8.3-20.3%) using the Genelabs assay. Only 12 samples (8.1%) were positive for anti-HEV as measured by both assays; agreement between the two assays was poor (kappa value of 0.315). The anti-HEV seroprevalence increased with age from 2% and 3% in the people younger than 20-years-of-age to 34.6% and 42.3% in those over 59-years-of-age by the Genelabs and Wantai assay, respectively. Conclusions The HEV seroprevalence in Korean population is about 20% overall, with seroprevalence increasing in this population with increasing age. There was poor concordance in the results of the Genelabs and Wantai assays, which warrants further study concerning a reliable diagnostic test for the diagnosis of hepatitis E.
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Affiliation(s)
- Hyun Kyung Park
- Department of Internal Medicine, Gumi-dong 300, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea
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Ozeki I, Kang JH, Mizuo H, Akaike J, Ohmura T, Karino Y, Matsui T, Saga A, Watanabe M, Miura Y, Kura T, Tsunematsu I, Matsubayashi K, Sakata H, Okamoto H, Takahashi K, Arai M. Small epidemic of hepatitis E in the fall 2009 in Sapporo, Hokkaido. ACTA ACUST UNITED AC 2012. [DOI: 10.2957/kanzo.53.78] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Hepatitis E virus (HEV) is an emerging pathogen associated with acute viral hepatitis, and HEV is becoming increasingly recognized. Approximately 2% of acute viral hepatitis is caused by HEV, and 18 cases of hepatitis E have been reported in Korea. Of these cases, only two have involved a history of travel from India, which suggests that they were imported cases. The remaining reported cases include a sporadic case of acute hepatitis E with genotype 4 HEV isolates and identification of the full genome sequence, as well as another case of genotype 4 HEV hepatitis that developed after ingestion of the raw bile juice of a wild bear living on a mountain in southern Korea. Moreover, genotype 3 HEV, which shows close genetic homology with swine HEV in Korea, has been detected in collected human serum samples. Therefore, genotypes 3 and 4 HEV are currently circulating in the Korean community and may be related to zoonotic transmission and food-borne infection. The reported anti-HEV seroprevalence of 17% to 27% in the Korean population suggests that HEV infection has been autochthonously circulating, thereby resulting in subclinical infection in Korea. Given the discrepancies among anti-HEV assays, the diagnosis of hepatitis E should be made with caution using adequate antibody assays, and HEV RNA should be preferably detected from the stool. Further virological characterization and epidemiological study of the virus are warranted.
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Affiliation(s)
- Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Tahk H, Lee MH, Lee KB, Cheon DS, Choi C. Development of duplex RT-PCR-ELISA for the simultaneous detection of hepatitis A virus and hepatitis E virus. J Virol Methods 2011; 175:137-40. [PMID: 21565222 DOI: 10.1016/j.jviromet.2011.04.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 04/19/2011] [Accepted: 04/27/2011] [Indexed: 11/26/2022]
Abstract
This study aimed to develop a specific and sensitive duplex reverse transcription polymerase chain reaction enzyme-linked immunosorbent assay (duplex RT-PCR-ELISA) for hepatitis A virus (HAV) and hepatitis E virus (HEV). Duplex RT-PCR-ELISA could detect and differentiate HAV and HEV with specific probes. When ELISA technique was used to detect probe-bound RT-PCR products, duplex RT-PCR-ELISA could detect as little as 0.1 ng/μL HAV and HEV from clinical samples. Human norovirus, enterovirus, poliovirus, murine norovirus and feline calicivirus were used for the specificity test; all were negative. Therefore duplex RT-PCR-ELISA can be used for the simultaneous detection of HAV and HEV in contaminated fecal samples.
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Affiliation(s)
- Hongmin Tahk
- School of Food Science and Technology, College of Natural Science, Chung-Ang University, Republic of Korea
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Seroprevalence of hepatitis a and e viruses based on the third Korea national health and nutrition survey in Korea. Osong Public Health Res Perspect 2011; 2:46-50. [PMID: 24159450 PMCID: PMC3766912 DOI: 10.1016/j.phrp.2011.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 03/02/2011] [Accepted: 03/11/2011] [Indexed: 02/07/2023] Open
Abstract
Objectives The purpose of this study was to investigate the seroprevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) in Korea during 2005. Methods Study subjects were selected from across Korea using a stratified multistage probability sampling design, and HAV and HEV seroprevalence was compared on the basis of sex, age, and residency. A total of 497 rural and urban people aged 10–99 years of age (mean ± SD age = 28.87 ± 17.63 years) were selected by two-stage cluster sampling and tested serologically for anti-HAV and anti-HEV IgG using an enzyme-linked immunosorbent assay. Results Among this population, the overall seroprevalence of HAV was 63.80% (55.21% aged in their 20s and 95.92% in their 30s, p < 0.01) and that of HEV was 9.40% (5.21% aged in their 20s and 7.14% in their 30s, p < 0.01). Seroprevalence also varied according to area of residence. HEV prevalence in rural areas was higher than that of urban regions based on the anti-HEV antibody, odds ratio 3.22 (95% confidence interval: 1.46–7.10, p < 0.01). There were no significant differences between male and female against anti-HAV/HEV antibodies. Conclusion Our study suggested that the seropositive rates of HAV and HEV might be related to age and environmental conditions.
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