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Hafkesbrink M, Schemmerer M, Wenzel JJ, Isenmann S. Acute hepatitis E virus infection presenting as meningo-encephalitis. Infection 2024:10.1007/s15010-024-02361-3. [PMID: 39143435 DOI: 10.1007/s15010-024-02361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 07/22/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Acute hepatitis E infection (HEV), with its high incidence in Europe, should be considered as a differential diagnosis of acute viral hepatitis and can in some cases manifest with pronounced neurological symptoms. CLINICAL CASE We report on a 33-year-old female patient with severe arthralgia, myalgia, headache and psychomotor deterioration. Laboratory analyses showed elevated transaminases without signs of cholestasis. Acute hepatitis E virus infection was detected in serum. She reported fatigue and dysesthesias not responsive to analgesics. Cerebrospinal fluid (CSF) analysis revealed an inflammatory syndrome. HEV RNA was detected in the CSF. The infection remained mild, but dysesthesias persisted. Eight weeks after the first admission, the symptoms worsened again. Complete and sustained remission was achieved following intravenous corticosteroid treatment. CONCLUSION In patients with acute neurological symptoms and liver enzyme elevation, HEV infection should be considered. Neurologic symptoms such as fatigue, arthralgia, myalgia and dysesthesia along with psychomotor retardation should prompt CSF analysis.
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Affiliation(s)
- Moritz Hafkesbrink
- Department of Neurology and Clinical Neurophysiology, GFO Kliniken Niederrhein, St. Josef Hospital, Moers, Germany.
| | - M Schemmerer
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - J J Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - S Isenmann
- Department of Neurology and Clinical Neurophysiology, GFO Kliniken Niederrhein, St. Josef Hospital, Moers, Germany
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2
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Salemane K, Coetzee LZ, Pocock G, Genthe B, Taylor MB, Mans J. Water-Based Epidemiological Investigation of Hepatitis E Virus in South Africa. FOOD AND ENVIRONMENTAL VIROLOGY 2024:10.1007/s12560-024-09596-1. [PMID: 38613652 DOI: 10.1007/s12560-024-09596-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/08/2024] [Indexed: 04/15/2024]
Abstract
Hepatitis E virus (HEV) is an emerging zoonotic pathogen that exhibits great host diversity. The primary means of transmission of the virus in low- and middle-income countries is contaminated water, often due to a lack of access to proper sanitation, which leads to faecal contamination of water sources. Environmental surveillance is an important tool that can be used to monitor virus circulation and as an early warning system for outbreaks. This study was conducted to determine the prevalence and genetic diversity of HEV in wastewater, surface water (rivers and standpipe/ablution water), and effluent from a piggery in South Africa. A total of 536 water samples were screened for HEV using real-time reverse transcription-polymerase chain reaction. Overall, 21.8% (117/536) of the wastewater, river, and ablution water samples tested positive for HEV, whereas 74.4% (29/39) of the samples from the piggery tested positive. Genotyping revealed sequences belonging to HEV genotypes 3 (98%, 53/54) and 4 (2%, 1/54), with subtypes 3c, 3f, and 4b being identified.
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Affiliation(s)
- Karabo Salemane
- Department of Medical Virology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, Pretoria, 0031, South Africa
| | - Leanne Z Coetzee
- , Waterlab, Techno Park, 23B De Havilland Cres, Persequor, Pretoria, 0020, South Africa
| | - Gina Pocock
- , Waterlab, Techno Park, 23B De Havilland Cres, Persequor, Pretoria, 0020, South Africa
| | - Bettina Genthe
- Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602, South Africa
| | - Maureen B Taylor
- Department of Medical Virology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, Pretoria, 0031, South Africa
| | - Janet Mans
- Department of Medical Virology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, Pretoria, 0031, South Africa.
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La Bella G, Basanisi MG, Nobili G, D’Antuono AM, Suffredini E, La Salandra G. Duplex Droplet Digital PCR Assay for Quantification of Hepatitis E Virus in Food. Viruses 2024; 16:413. [PMID: 38543778 PMCID: PMC10975721 DOI: 10.3390/v16030413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 05/23/2024] Open
Abstract
Hepatitis E virus (HEV) represents an emerging risk in industrialized countries where the consumption of contaminated food plays a pivotal role. Quantitative real-time RT-PCR (RT-qPCR) is one of the most suitable methods for the detection and quantification of viruses in food. Nevertheless, quantification using RT-qPCR has limitations. Droplet digital PCR (ddPCR) provides the precise quantification of nucleic acids without the need for a standard curve and a reduction in the effect on virus quantification due to the presence of inhibitors. The objectives of the present work were (i) to develop a method for the absolute quantification of HEV in swine tissues based on ddPCR technology and provide internal process control for recovery assessment and (ii) to evaluate the performance of the method by analyzing a selection of naturally contaminated wild boar muscle samples previously tested using RT-qPCR. The method was optimized using a set of in vitro synthesized HEV RNA and quantified dsDNA. The limit of detection of the developed ddPCR assay was 0.34 genome copies/µL. The analysis of the wild boar samples confirmed the validity of the ddPCR assay. The duplex ddPCR method showed no reduction in efficiency compared to individual assays. The method developed in the present study could represent a sensitive assay for the detection and absolute quantification of HEV RNA in food samples with the advantage of presenting the co-amplification of internal process control.
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Affiliation(s)
- Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| | - Maria Grazia Basanisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| | - Gaia Nobili
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| | - Anna Mattea D’Antuono
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| | - Elisabetta Suffredini
- Department of Food Safety Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
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4
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Subramaniam S, Fares-Gusmao R, McGivern DR. Quantification of Hepatitis E Virus ORF2 Protein by a Novel Sandwich ELISA. Viruses 2024; 16:393. [PMID: 38543759 PMCID: PMC10974087 DOI: 10.3390/v16030393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/21/2024] [Accepted: 02/28/2024] [Indexed: 05/23/2024] Open
Abstract
Hepatitis E virus (HEV) causes acute hepatitis in humans, which can progress to chronicity in immunosuppressed individuals. Almost all reported HEV infections are caused by Paslahepevirus balayani genotypes 1-4. The structural ORF2 protein is the major antigen detected in the blood of HEV-infected individuals. ELISA assays to detect IgM antibodies to HEV are the first-line diagnostic tests; however, they showed variable performance with frequently discordant results. A qualitative HEV antigen (ORF2) ELISA is currently available for research use. Here, we report a novel quantitative sandwich ELISA to measure HEV ORF2 protein in 3 matrix types. An optimal pair of capture and detection antibodies was selected among 12 unique combinations tested. A sandwich ELISA protocol was developed using these mAbs and biotin-streptavidin technology. The protocol was further optimized to quantify ORF2 antigen in different matrices by interpolating from a standard curve with a linear range of 3.17 to 50.8 femtomoles/mL. Using this method, ORF2 protein was detected in the cell culture medium of Huh7 cells as early as 2-3 days after transfection with HEV genome RNA and in a medium of human hepatocytes infected with HEV. ORF2 antigen was readily detected in the first 2 weeks post-HEV infection in gerbil sera. In immunosuppressed gerbils, ORF2 was detected up to 6 weeks, and the levels were significantly higher between 3 and 6 weeks post-infection. HEV ORF2 antigen levels showed a strong positive correlation with HEV RNA levels in both cell culture medium and gerbil sera. Our novel sandwich ELISA detected at least 7.3 femtomoles/mL ORF2 protein in human plasma spiked with cell culture propagated HEV and detected ORF2 protein in human plasma samples that tested positive for HEV RNA but negative for anti-HEV antibodies. Further, the assay was nonreactive, with negative human plasma, and HBV or HCV-positive human plasma demonstrating specificity. Overall, our ORF2 antigen ELISA will be useful for quantifying ORF2 antigen in cell culture medium, gerbil serum, and human plasma. Further studies are warranted to evaluate its utility in HEV clinical diagnosis.
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Affiliation(s)
| | | | - David R. McGivern
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD 20993, USA; (S.S.); (R.F.-G.)
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Schmitz J, Kracht J, Evert K, Wenzel JJ, Schemmerer M, Lehmann U, Panning M, Pape L, Pohl M, Bräsen JH. Hepatitis E virus infection of transplanted kidneys. Am J Transplant 2024; 24:491-497. [PMID: 38072120 DOI: 10.1016/j.ajt.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/02/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
Immunocompromised patients are at risk of chronic hepatitis E (HEV) infection. Recurrent T cell and borderline rejections in a pediatric patient with high HEV copy numbers led us to study HEV infection within renal transplants. To investigate the frequency of renal HEV infection in transplanted patients, 15 samples from patients with contemporaneous diagnoses of HEV infection were identified at our center. Ten samples had sufficient residual paraffin tissue for immunofluorescence (IF) and RNA-fluorescence-in-situ-hybridization (RNA-FISH). The biopsy of the pediatric index patient was additionally sufficient for tissue polymerase chain reaction and electron microscopy. HEV RNA was detected in paraffin tissue of the index patient by tissue polymerase chain reaction. Subsequently, HEV infection was localized in tubular epithelial cells by IF, RNA-FISH, and electron microscopy. One additional biopsy from an adult was positive for HEV by RNA-FISH and IF. Focal IF positivity for HEV peptide was observed in 7 additional allografts. Ribavirin therapy was not successful in the pediatric index patient; after relapse, ribavirin is still administered. In the second patient, successful elimination of HEV was achieved after short-course ribavirin therapy. HEV infection is an important differential diagnosis for T cell rejection within transplanted kidneys. Immunostaining of HEV peptide does not necessarily prove acute infection. RNA-FISH seems to be a reliable method to localize HEV.
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Affiliation(s)
- Jessica Schmitz
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Julia Kracht
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Katja Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Jürgen J Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Mathias Schemmerer
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Ulrich Lehmann
- Molecular Pathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Marcus Panning
- Institute of Virology, University Clinics Freiburg, Freiburg, Germany
| | - Lars Pape
- Department of Pediatrics II, University Hospital of Essen, Essen, Germany
| | - Martin Pohl
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Jan Hinrich Bräsen
- Nephropathology Unit, Institute of Pathology, Hannover Medical School, Hannover, Germany.
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Bennett C, Coughlan S, Hunt K, Butler F, Fanning S, Ryan E, De Gascun C, O'Gorman J. Detection of hepatitis E RNA in pork products at point of retail in Ireland - Are consumers at risk? Int J Food Microbiol 2024; 410:110492. [PMID: 37988969 DOI: 10.1016/j.ijfoodmicro.2023.110492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
Hepatitis E (HEV), a zoonotic virus, is the leading cause of acute viral hepatitis in Europe. The presence of HEV in domestic pigs can result in infections in humans through consumption of pork products which are undercooked or where processing methods are insufficient to inactivate the virus. In Ireland, pork accounts for 34 % of all meat consumption (CSO, 2022) and the prevalence of HEV in products at point of retail has not previously been characterised. A sampling strategy was designed in which high pork content sausages, fresh pork liver and raw fermented sausages were systematically purchased from three types of retailers between May 2018 and March 2019. In total, 200 pork products were tested using a lysing agent to release the HEV from the product for detection. RT-PCR for HEV was performed on samples with an extraction efficiency >1 % (n = 188/200) (94 %). Low level HEV RNA was detected in 9/188 (4.8 %) pork products tested. The highest incidence of HEV RNA was in pork liver where 6/25 (24 %) samples were positive. The concentration of HEV ranged from 0.02 - to 9.4 genome copies/g of pork. Based on these data an exposure assessment was performed which found that if consumers followed advice from the Food Safety Authority of Ireland to achieve core temperatures of 70 °C or higher when cooking, the risk was likely to be negligible.
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Affiliation(s)
- Charlene Bennett
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Suzie Coughlan
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
| | - Kevin Hunt
- UCD-School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, Ireland
| | - Francis Butler
- UCD-School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, Ireland
| | - Séamus Fanning
- UCD-Centre for Food Safety, School of Public Health, Physiotherapy & Sports Science, Belfield, Dublin 4, Ireland
| | - Eoin Ryan
- Central Veterinary Research Laboratory, Department Agriculture Food and the Marine (DAFM), Backweston, Kildare, Ireland
| | - Cillian De Gascun
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
| | - Joanne O'Gorman
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
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Mesquita JR, Santos-Silva S, Ferreira N, Rivero-Juarez A, Gonçalves G, São José Nascimento M. Hepatitis E Virus in Individuals Undergoing Heparin Therapy: An Observational Serological and Molecular Study. Curr Drug Saf 2024; 19:377-381. [PMID: 38204276 DOI: 10.2174/0115748863272272231122114732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION Heparin is derived from swine and has been suggested as a possible source of HEV. To study the potential risk of HEV infection associated with heparin treatment, two groups of individuals were compared. Sera from heparinized (N=93) and non-heparinized individuals (N=111) were tested for markers of acute HEV infection and anti-HEV IgG seroprevalence. METHODS An acute HEV case was defined by the presence of anti-HEV IgM and/or HEV RNA. From the 93 heparinized individuals, one was positive for IgM and IgG anti-HEV and two were positive for HEV RNA (for both ORF3 and ORF2), and there were a total of two (2.2%) cases of current or recent HEV infection. From the 111 non-heparinized individuals, three were positive for IgM anti-HEV, one was positive for both IgM and IgG anti-HEV, and none was positive for HEV RNA, and there were a total of three (2.7%) cases of current or recent HEV infection. The difference between HEV cases in the heparinized individuals and the non-heparinized individuals was not statistically significant (2.2% vs. 2.7%; p = 0.799). RESULTS Concerning IgG anti-HEV, it was detected in 32 individuals from the heparinized group and in 18 from the non-heparinized control group. A statistically significant difference was observed in the presence of anti-HEV IgG in heparinized individuals and controls (p = 0.003). CONCLUSION This study has not found any association between heparin treatment and acute HEV infection, but has shown the use of therapeutic heparin as a risk factor for IgG anti-HEV seropositivity.
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Affiliation(s)
- João R Mesquita
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Sérgio Santos-Silva
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
| | - Nanci Ferreira
- Faculdade de Farmácia, Universidade do Porto (FFUP), Porto, Portugal
| | - Antonio Rivero-Juarez
- CIBER Infectious Diseases (CIBERINFEC), Health Institute Carlos III, 28029 Madrid, Spain
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
| | - Guilherme Gonçalves
- Unidade de Saúde Pública do ACES Ave-Famalicão, ARS Norte, Ministério da Saúde, Portugal
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Treagus S, Lowther J, Longdon B, Gaze W, Baker-Austin C, Ryder D, Batista FM. Metabarcoding of Hepatitis E Virus Genotype 3 and Norovirus GII from Wastewater Samples in England Using Nanopore Sequencing. FOOD AND ENVIRONMENTAL VIROLOGY 2023; 15:292-306. [PMID: 37910379 PMCID: PMC7615314 DOI: 10.1007/s12560-023-09569-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023]
Abstract
Norovirus is one of the largest causes of gastroenteritis worldwide, and Hepatitis E virus (HEV) is an emerging pathogen that has become the most dominant cause of acute viral hepatitis in recent years. The presence of norovirus and HEV has been reported within wastewater in many countries previously. Here we used amplicon deep sequencing (metabarcoding) to identify norovirus and HEV strains in wastewater samples from England collected in 2019 and 2020. For HEV, we sequenced a fragment of the RNA-dependent RNA polymerase (RdRp) gene targeting genotype three strains. For norovirus, we sequenced the 5' portion of the major capsid protein gene (VP1) of genogroup II strains. Sequencing of the wastewater samples revealed eight different genotypes of norovirus GII (GII.2, GII.3, GII.4, GII.6, GII.7, GII.9, GII.13 and GII.17). Genotypes GII.3 and GII.4 were the most commonly found. The HEV metabarcoding assay was able to identify HEV genotype 3 strains in some samples with a very low viral concentration determined by RT-qPCR. Analysis showed that most HEV strains found in influent wastewater were typed as G3c and G3e and were likely to have originated from humans or swine. However, the small size of the HEV nested PCR amplicon could cause issues with typing, and so this method is more appropriate for samples with high CTs where methods targeting longer genomic regions are unlikely to be successful. This is the first report of HEV RNA in wastewater in England. This study demonstrates the utility of wastewater sequencing and the need for wider surveillance of norovirus and HEV within host species and environments.
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Affiliation(s)
- Samantha Treagus
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK.
- Centre for Ecology and Conservation, Faculty of Environment, Science and Economy, University of Exeter, Penryn Campus, Cornwall, UK.
- UK Health Security Agency, Manor Farm Road, Porton Down, SP4 0JG, Wiltshire, UK.
| | - James Lowther
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
| | - Ben Longdon
- Centre for Ecology and Conservation, Faculty of Environment, Science and Economy, University of Exeter, Penryn Campus, Cornwall, UK
| | - William Gaze
- Faculty of Health and Life Sciences, University of Exeter Medical School, Penryn Campus, Cornwall, UK
| | | | - David Ryder
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
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La Bella G, Basanisi MG, Nobili G, Coppola R, Damato AM, Donatiello A, Occhiochiuso G, Romano AC, Toce M, Palazzo L, Pellegrini F, Fanelli A, Di Martino B, Suffredini E, Lanave G, Martella V, La Salandra G. Evidence of Circulation and Phylogenetic Analysis of Hepatitis E Virus (HEV) in Wild Boar in South-East Italy. Viruses 2023; 15:2021. [PMID: 37896798 PMCID: PMC10611066 DOI: 10.3390/v15102021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Hepatitis E virus (HEV) is an important cause of acute viral hepatitis in humans worldwide. The food-borne transmission of HEV appears to be a major route in Europe through the consumption of pork and wild boar meat. HEV epidemiology in wild boars has been investigated mainly in Northern and Central Italian regions, whilst information from Southern Italy is limited. We investigated the occurrence of HEV in wild boar in the Apulia and Basilicata regions (Southern Italy). Thirteen (10.4%) out of one hundred and twenty-five wild boar samples tested positive for HEV using a quantitative reverse transcription PCR. HEV prevalence was 12% in Apulia and 9.3% in Basilicata. Seven samples were genotyped, and different subtypes (c, f, m) of genotype 3 were identified. The complete genome of a 3m strain was determined, and the virus showed the highest nucleotide identity to a human HEV strain identified in France in 2017. These findings demonstrate the substantial circulation of HEV in the wild boar population in Italian Southern regions. Gathering information on the HEV strains circulating in different geographical areas is useful for tracking the origin of HEV outbreaks and assessing the epidemiological role of wild boar as a potential virus reservoir for domestic pigs.
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Affiliation(s)
- Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Maria Grazia Basanisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Gaia Nobili
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Rosa Coppola
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Annita Maria Damato
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Adelia Donatiello
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Gilda Occhiochiuso
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | | | - Mariateresa Toce
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Lucia Palazzo
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Francesco Pellegrini
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Angela Fanelli
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Barbara Di Martino
- Department of Veterinary Medicine, Università degli Studi di Teramo, 64100 Teramo, Italy
| | - Elisabetta Suffredini
- Department of Food Safety Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Gianvito Lanave
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Vito Martella
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
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10
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Subramaniam S, Fares-Gusmao R, Sato S, Cullen JM, Takeda K, Farci P, McGivern DR. Distinct disease features of acute and persistent genotype 3 hepatitis E virus infection in immunocompetent and immunosuppressed Mongolian gerbils. PLoS Pathog 2023; 19:e1011664. [PMID: 37703304 PMCID: PMC10519604 DOI: 10.1371/journal.ppat.1011664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/25/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023] Open
Abstract
Hepatitis E virus (HEV) causes self-limited acute hepatitis in immunocompetent individuals and can establish chronic infection in solid organ transplant recipients taking immunosuppressive drugs. A well characterized small animal model is needed to understand HEV pathogenesis. In this study, we established a robust model to study acute and persistent HEV infection using Mongolian gerbils (Meriones unguiculatus) with or without immunosuppression. Gerbils were implanted subcutaneously with continuous release tacrolimus pellet to induce immunosuppression. Gerbils with or without tacrolimus treatment were inoculated with HEV intraperitoneally. Viremia, fecal virus shedding, serum antibody and ALT levels, liver histopathological lesions, hepatocyte apoptosis, and liver macrophage distribution were assessed. Mild to moderate self-limited hepatitis and IgM and IgG antibody responses against HEV ORF2 were observed in immunocompetent gerbils. Levels of HEV-specific IgM responses were higher and lasted longer in immunocompetent gerbils with higher peak viremia. Persistent viremia and fecal virus shedding with either weak, or absent HEV antibody levels were seen in immunosuppressed gerbils. Following HEV infection, serum ALT levels were increased, with lower and delayed peaks observed in immunosuppressed compared to immunocompetent gerbils. In immunocompetent gerbils, foci of apoptotic hepatocytes were detected that were distributed with inflammatory infiltrates containing CD68+ macrophages. However, these foci were absent in immunosuppressed gerbils. The immunosuppressed gerbils showed no inflammation with no increase in CD68+ macrophages despite high virus replication in liver. Our findings suggest adaptive immune responses are necessary for inducing hepatocyte apoptosis, CD68+ macrophage recruitment, and inflammatory cell infiltration in response to HEV infection. Our studies show that Mongolian gerbils provide a promising model to study pathogenesis during acute and persistent HEV infection.
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Affiliation(s)
- Sakthivel Subramaniam
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Rafaelle Fares-Gusmao
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Shinya Sato
- Hepatic Pathogenesis Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - John M. Cullen
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Kazuyo Takeda
- Microscopy and Imaging Core Facility, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Patrizia Farci
- Hepatic Pathogenesis Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - David R. McGivern
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
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11
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Bennett C, Hunt K, Butler F, Keaveney S, Fanning S, De Gascun C, Coughlan S, O'Gorman J. Detection of Hepatitis A RNA, Hepatitis E RNA, Human Adenovirus F DNA, and Norovirus RNA in Fresh and Frozen Berry Products at Point of Retail in Ireland. FOOD AND ENVIRONMENTAL VIROLOGY 2023; 15:246-254. [PMID: 37528267 PMCID: PMC10499670 DOI: 10.1007/s12560-023-09561-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/22/2023] [Indexed: 08/03/2023]
Abstract
Soft fruits are at particular risk of contamination with enteric viruses such as Hepatitis A virus (HAV), Hepatitis E Virus (HEV), Norovirus (NoV), Human Adenovirus (HAdV) and Sapovirus (SaV). The aim of this study was to investigate, for the first time, the presence of these biological agents in ready to eat (RTE) berries at point of retail in Ireland. A sampling strategy was designed in which RTE fresh and frozen strawberries and raspberries were purchased from five retailers between May and October 2018. Reverse Transcriptase Polymerase Chain Reaction (RT-qPCR) assays for HEV RNA, Nov RNA, SaV RNA, and human Adenovirus species F DNA (HAdV-F) were performed on 239 samples (25g portions). Viral nucleic acid was present in 6.7% (n = 16) of samples tested as follows: HAV RNA (n = 5), HAdV-F DNA (n = 5), HEV RNA (n = 3) and NoV GII RNA (n = 3). Sapovirus RNA was not detected in any product. No significant differences were found between berry type, fresh/frozen status, or supermarket source. This study suggests a risk that exists across all retail outlets however only low levels of nucleic acid ranging from 0 to 16 genome copies/g were present. Although these findings may reflect non-viable/non-infectious virus the continued provision of risk mitigation advice to consumers is warranted and further work is required to ensure control measures to reduce contamination are implemented and enforced.
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Affiliation(s)
- Charlene Bennett
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin, 4, Ireland.
| | - Kevin Hunt
- UCD-School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin, 4, Ireland
| | - Francis Butler
- UCD-School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin, 4, Ireland
| | | | - Séamus Fanning
- UCD-Centre for Food Safety, School of Public Health, Physiotherapy & Sports Science, Belfield, Dublin, 4, Ireland
| | - Cillian De Gascun
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin, 4, Ireland
| | - Suzie Coughlan
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin, 4, Ireland
| | - Joanne O'Gorman
- UCD-National Virus Reference Laboratory, University College Dublin, Belfield, Dublin, 4, Ireland
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12
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Songtanin B, Molehin AJ, Brittan K, Manatsathit W, Nugent K. Hepatitis E Virus Infections: Epidemiology, Genetic Diversity, and Clinical Considerations. Viruses 2023; 15:1389. [PMID: 37376687 DOI: 10.3390/v15061389] [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: 06/02/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
According to the World Health Organization, approximately 20 million people worldwide are infected annually with the hepatitis E virus (HEV). There are four main genotypes of HEV. Genotype 1 and genotype 2 are common in developing countries and are transmitted by contaminated water from a fecal-oral route. Genotype 3 and genotype 4 are common in developed countries and can lead to occasional transmission to humans via undercooked meat. Hepatitis E virus 1 and HEV3 can lead to fulminant hepatitis, and HEV3 can lead to chronic hepatitis and cirrhosis in immunocompromised patients. The majority of patients with HEV infection are asymptomatic and usually have spontaneous viral clearance without treatment. However, infection in immunocompromised individuals can lead to chronic HEV infection. Both acute and chronic HEV infections can have extrahepatic manifestations. No specific treatment is required for acute HEV infection, no treatment has been approved in chronic infection, and no HEV vaccine has been approved by the (United States) Food and Drug Administration. This review focuses on the molecular virology (HEV life cycle, genotypes, model systems, zoonosis), pathogenesis, clinical manifestation, and treatment of chronic HEV infection, especially in immunocompromised patients, to provide clinicians a better understanding of the global distribution of these infections and the significant effect they can have on immunocompromised patients.
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Affiliation(s)
- Busara Songtanin
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Adebayo J Molehin
- Department of Microbiology & Immunology, College of Graduate Studies, Midwestern University, Glendale, AZ 85308, USA
| | - Kevin Brittan
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Wuttiporn Manatsathit
- Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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13
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Kupke P, Adenugba A, Schemmerer M, Bitterer F, Schlitt HJ, Geissler EK, Wenzel JJ, Werner JM. Immunomodulation of Natural Killer Cell Function by Ribavirin Involves TYK-2 Activation and Subsequent Increased IFN-γ Secretion in the Context of In Vitro Hepatitis E Virus Infection. Cells 2023; 12:cells12030453. [PMID: 36766795 PMCID: PMC9913562 DOI: 10.3390/cells12030453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 02/01/2023] Open
Abstract
Hepatitis E virus (HEV) is a major cause of acute hepatitis globally. Chronic and fulminant courses are observed especially in immunocompromised transplant recipients since administration of ribavirin (RBV) does not always lead to a sustained virologic response. By in vitro stimulation of NK cells through hepatoma cell lines inoculated with a full-length HEV and treatment with RBV, we analyzed the viral replication and cell response to further elucidate the mechanism of action of RBV on immune cells, especially NK cells, in the context of HEV infection. Co-culture of HEV-infected hepatoma cells with PBMCs and treatment with RBV both resulted in a decrease in viral replication, which in combination showed an additive effect. An analysis of NK cell functions after stimulation revealed evidence of reduced cytotoxicity by decreased TRAIL and CD107a degranulation. Simultaneously, IFN-ɣ production was significantly increased through the IL-12R pathway. Although there was no direct effect on the IL-12R subunits, downstream events starting with TYK-2 and subsequently pSTAT4 were upregulated. In conclusion, we showed that RBV has an immunomodulatory effect on the IL-12R pathway of NK cells via TYK-2. This subsequently leads to an enhanced IFN-ɣ response and thus, to an additive antiviral effect in the context of an in vitro HEV infection.
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Affiliation(s)
- Paul Kupke
- Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Akinbami Adenugba
- Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Mathias Schemmerer
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Florian Bitterer
- Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Hans J. Schlitt
- Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Edward K. Geissler
- Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Jürgen J. Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Jens M. Werner
- Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
- Correspondence:
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14
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Fares-Gusmao R, Jiang Z, Subramaniam S, Visser BJ, Scott A, Ishida Y, Saito T, Baylis SA, McGivern DR. Development and characterization of secondary standards for nucleic acid amplification technology (NAAT) assays for detection of hepatitis E virus. J Clin Virol 2022; 157:105325. [PMID: 36395548 PMCID: PMC9714074 DOI: 10.1016/j.jcv.2022.105325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/17/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND To harmonize assays for detection of HEV RNA, a World Health Organization International Standard (WHO IS) was established. The WHO IS represents the highest order standard for HEV RNA but is limited in quantity. Secondary standards are needed to limit the use of WHO IS and minimize the need to replace it. OBJECTIVE Establish secondary standards for HEV NAAT assays and to calibrate these against the WHO IS. METHODS Stocks of genotype 3 HEV were prepared using both cell lysates and cell culture supernatants to produce non-enveloped and quasi-enveloped virus stocks, respectively. Both stocks were heat-inactivated, diluted in negative human plasma, and lyophilized to produce two candidate secondary standards: HEV-RR (non-enveloped virus) and HEV-RR.1 (quasi-enveloped virus). Both candidate standards were characterized and calibrated against the WHO IS for HEV RNA in an international collaborative study. RESULTS The collaborative study returned a total of 15 data sets, with different RNA extraction and amplification methods. The estimated mean values relative to the WHO IS (250,000 IU/ml) are 229,000 IU/ml and 355,000 IU/ml for HEV-RR and HEV-RR.1, respectively. CONCLUSION We have established two secondary standards for HEV RNA calibrated against the WHO IS. These standards are non-infectious and stable under different storage temperatures.
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Affiliation(s)
- Rafaelle Fares-Gusmao
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Zhen Jiang
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Sakthivel Subramaniam
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Bryan J Visser
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Alysia Scott
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Yuji Ishida
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, University of Southern California, Keck School of Medicine, Los Angeles, California, USA.; Research and Development Department, PhoenixBio, Co., Ltd, Kagamiyama, Higashi-Hiroshima, Hiroshima, Japan
| | - Takeshi Saito
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, University of Southern California, Keck School of Medicine, Los Angeles, California, USA.; Department of Molecular Microbiology and Immunology, University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Sally A Baylis
- Viral Safety Section, Paul-Ehrlich-Institut, Langen, Germany
| | - David R McGivern
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA..
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15
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Cardeti G, Cersini A, Manna G, De Santis P, Scicluna MT, Albani A, Simula M, Sittinieri S, De Santis L, De Liberato C, Ngakan PO, Wahid I, Carosi M. Detection of viruses from feces of wild endangered Macaca maura: a potential threat to moor macaque survival and for zoonotic infection. BMC Vet Res 2022; 18:418. [PMID: 36447236 PMCID: PMC9706849 DOI: 10.1186/s12917-022-03506-y] [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: 08/04/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND To date, there is a scarcity of information and literature on Macaca maura health status relative to viral diseases. The objectives of the present study were to investigate on the potential spread of enteric and non-enteric viruses shed in the environment through a wild macaque feces and to understand the possible interrelation in the spread of zoonotic viruses in a poorly studied geographical area, the Sulawesi Island. This study will also contribute providing useful information on potential threats to the health of this endangered species. METHODS The sampling was conducted between 2014 and 2016 in the Bantimurung Bulusaraung National Park, in the south of the Sulawesi Island and non-invasive sampling methods were used to collect fresh stools of the M. maura, one of the seven macaque species endemic to the island of Sulawesi, Indonesia. The population under study consisted in two wild, neighboring social macaque groups with partially overlapping home ranges; twenty-four samples were collected and examined using negative staining electron microscopy and a panel of PCR protocols for the detection of ten RNA and two DNA viruses. RESULTS Viral particles resembling parvovirus (5 samples), picornavirus (13 samples) and calicivirus (13 samples) were detected by electron microscopy whereas the PCR panel was negative for the 12 viruses investigated, except for one sample positive for a mosquito flavivirus. The results did not correlate with animal sex; furthermore, because all of the animals were clinically healthy, it was not possible to correlate feces consistency with viral presence. CONCLUSIONS As information on viral infections in wild moor macaques remains limited, further studies are yet required to identify the fecal-oral and blood transmitted potentially zoonotic viruses, which may infect the moor macaque and other macaque species endemic to the South Sulawesi Island.
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Affiliation(s)
- Giusy Cardeti
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Antonella Cersini
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Giuseppe Manna
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Paola De Santis
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Maria Teresa Scicluna
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Alessandro Albani
- grid.8509.40000000121622106Department of Sciences, Roma Tre University, Rome, Italy ,Royal Society for the Protection of Birds/Gola Rainforest National Park, Kenema, Sierra Leone
| | - Massimiliano Simula
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Stefania Sittinieri
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Laura De Santis
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Claudio De Liberato
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Rome, Italy
| | - Putu Oka Ngakan
- grid.412001.60000 0000 8544 230XFaculty of Forestry, Hasanuddin University, Makassar, Sulawesi Indonesia
| | - Isra Wahid
- grid.412001.60000 0000 8544 230XFaculty of Medicine, Hasanuddin University, Makassar, Sulawesi Indonesia
| | - Monica Carosi
- grid.8509.40000000121622106Department of Sciences, Roma Tre University, Rome, Italy
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16
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Pellerin M, Trabucco B, Capai L, Laval M, Maestrini O, Jori F, Falchi A, Doceul V, Charrier F, Casabianca F, Pavio N. Low prevalence of hepatitis E virus in the liver of Corsican pigs slaughtered after 12 months despite high antibody seroprevalence. Transbound Emerg Dis 2022; 69:e2706-e2718. [PMID: 35689821 PMCID: PMC9796636 DOI: 10.1111/tbed.14621] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/20/2022] [Accepted: 06/03/2022] [Indexed: 01/01/2023]
Abstract
Hepatitis E virus (HEV) infection can be acute and benign or evolve to chronic hepatitis with rapid progression toward cirrhosis or liver failure in humans. Hence, hepatitis E (HE) disease is a major public health concern. In countries where pig populations are highly contaminated with HEV, human cases of HE are mainly foodborne, occurring frequently after consumption of raw or undercooked pork products or liver. Among factors associated to the presence of HEV in pork livers from intensive rearing systems, early slaughter (≤6 months) seems to be major. In Corsica, local pigs are raised in extensive farming systems and slaughtered after 12 months. To evaluate if slaughter of pigs over 12 months reduces the risk of HEV presence in livers, 1197 liver samples were randomly collected in 2 Corsican slaughterhouses. Presence of HEV RNA was detected in liver and HEV seroprevalence was determined in paired serum. The sampling included 1083 livers from animals between 12 and 48 months and 114 livers from animals <12 months. The samples were predominantly from semi-extensive and extensive farms (n = 1154). Estimated HEV seroprevalence was high, that is, >88%, and HEV RNA prevalence in adult pig livers (>12 months old) was low, that is, 0.18%. However, in livers from younger animals (<12 months), including piglets below 6 months old, 5.3% (6/114) of the samples were positive for HEV RNA. Sequences recovered from positive livers belonged to HEV genotype 3c and 3f. The presence of infectious HEV was confirmed in two livers by the detection of HEV replication in HepaRG cell cultures. Thus, this study demonstrates the low prevalence of HEV in livers of pigs over 12 months, even in farms with high HEV circulation. This observation may open new perspectives on the preferential use of livers from animals older than 12 months in raw pork liver products.
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Affiliation(s)
- Marie Pellerin
- UMR VirologieANSES, INRAE, ENVALaboratoire de Santé AnimaleMaisons‐AlfortFrance
| | | | - Lisandru Capai
- Laboratoire de VirologieUniversité de Corse Pasquale PaoliUR BIOSCOPE 7310CorteFrance,Institute of Virology, University of Charité BerlinAG Junglen10117BerlinGermany
| | | | | | - Ferran Jori
- UMR ASTRE (Animaux, Santé, Territoire, Risques et Ecosystèmes), CIRADINRAEUniversité de MontpellierCampus International de BaillarguetMontpellierFrance
| | - Alessandra Falchi
- Laboratoire de VirologieUniversité de Corse Pasquale PaoliUR BIOSCOPE 7310CorteFrance
| | - Virginie Doceul
- UMR VirologieANSES, INRAE, ENVALaboratoire de Santé AnimaleMaisons‐AlfortFrance
| | - François Charrier
- UR SELMET‐LRDEINRAECorteFrance,UMR LISIS, Université Gustave EiffelINRAECNRSMarne‐la‐ValléeFrance
| | | | - Nicole Pavio
- UMR VirologieANSES, INRAE, ENVALaboratoire de Santé AnimaleMaisons‐AlfortFrance
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17
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Ghandili S, Lindhauer C, Pischke S, zur Wiesch JS, von Kroge PH, Polywka S, Bokemeyer C, Fiedler W, Kröger N, Ayuk F, Adjallé R, Modemann F. Clinical features of hepatitis E infections in patients with hematologic disorders. Haematologica 2022; 107:2870-2883. [PMID: 35770534 PMCID: PMC9713558 DOI: 10.3324/haematol.2022.280853] [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: 02/13/2022] [Indexed: 12/14/2022] Open
Abstract
Hepatitis E virus is increasingly being reported to cause chronic infection in immunocompromised patients. However, less is known about patients with an underlying hematologic disease. In particular, the impact of hepatitis E infection on oncological therapy has been poorly described. In this retrospective single-center study, we analyzed 35 hematologic patients with hepatitis E, including 20 patients under active oncological treatment and 15 patients who were in the posttreatment follow-up or under active surveillance. The primary aim was to describe the clinical courses with particular focus on any hepatitis E-related therapy modifications of cancer-directed therapy. In the majority (60%) of patients who were under active oncological treatment, hepatitis E-related therapy modifications were made, and 25% of deaths were due to progression of the hematologic disease. In patients receiving concomitant oncological treatment, no hepatitis Erelated deaths occurred. In contrast, two patients in the follow-up group died from hepatitis E-associated acute-onchronic liver failure. Chronic hepatitis E was observed in 34% of all cases and 43% received ribavirin therapy; of those, 27% achieved a sustained virological response. CD20-directed therapy was the only independent risk factor for developing chronic hepatitis E. We conclude that CD20-directed treatment at any time point is a risk factor for developing chronic hepatitis E. Nevertheless, since mortality from the progression of hematologic disease was higher than hepatitis E-related mortality, we suggest careful case-by-case decisions on modifications of cancer treatment. Patients in the posttreatment follow-up phase may also suffer from severe courses and hepatitis E chronicity occurs as frequently as in patients undergoing active therapy.
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Affiliation(s)
- Susanne Ghandili
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf,*SG and CL contributed equally as co-first authors
| | - Cecilia Lindhauer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf,*SG and CL contributed equally as co-first authors
| | - Sven Pischke
- The I. Department of Internal Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf
| | - Julian Schulze zur Wiesch
- The I. Department of Internal Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf
| | - Philipp H. von Kroge
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf
| | - Susanne Polywka
- The Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf
| | - Walter Fiedler
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf and
| | - Francis Ayuk
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf and
| | - Raissa Adjallé
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf and ,RA and FM contributed equally as co-last authors
| | - Franziska Modemann
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf,Mildred Scheel Cancer Career Center, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,RA and FM contributed equally as co-last authors
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18
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Schemmerer M, Wenzel JJ, Stark K, Faber M. Molecular epidemiology and genotype-specific disease severity of hepatitis E virus infections in Germany, 2010-2019. Emerg Microbes Infect 2022; 11:1754-1763. [PMID: 35713010 PMCID: PMC9295818 DOI: 10.1080/22221751.2022.2091479] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Zoonotic hepatitis E virus (HEV) is endemic in Europe. Genotype 3 (HEV-3) is predominant but information on subtype distribution, trends and clinical implications in Germany is scarce. We analysed 936 HEV RNA positive samples of human origin and corresponding national surveillance data from 2010 to 2019. Samples were referred to the National Consultant Laboratory and sequenced in at least one of four genomic regions. Sequences were analysed using bioinformatics methods and compared to the latest HEV reference set. 1,656 sequences were obtained from 300 female, 611 male and 25 of unknown sex aged 3–92 years (median 55 years). HEV-3c was predominant (67.3%) followed by HEV-3f, HEV-3e and HEV-3i(-like) with 14.3%, 9.7% and 4.0% (other subtypes ≤1.1%). The proportion of HEV-3 group 2 (3abchijklm) strains increased over time. Jaundice, upper abdominal pain, fever, hospitalization, and death due to HEV were significantly more often reported for patients infected with HEV-3 group 1 (3efg) compared to group 2. Larger spatio-temporal clusters of identical sequences were not observed. HEV-3 group 1 infections are more severe as compared to the predominant group 2. Detection of group 2 strains increased over the last years, possibly due to more frequent diagnosis of asymptomatic and mild courses. The diversity of strains and the space–time distribution is compatible with a foodborne zoonosis with supra-regional distribution of the infection vehicle (pork products).
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Affiliation(s)
- Mathias Schemmerer
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Jürgen J Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Klaus Stark
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Mirko Faber
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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19
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No Evidence for Orthohepevirus C in Archived Human Samples in Germany, 2000–2020. Viruses 2022; 14:v14040742. [PMID: 35458471 PMCID: PMC9029421 DOI: 10.3390/v14040742] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 12/12/2022] Open
Abstract
Orthohepevirus C1, also known as rat hepatitis E virus (HEV), has been shown to sporadically cause disease in immunocompromised and immunocompetent adults. While routine serological assays vary in reactivity, rat HEV is not detected in routine HEV RT-PCR. Thus, such infections could be either missed or misclassified as conventional HEV (Orthohepevirus A) infections. We conducted a retrospective screening study among serum and plasma samples from patients suspected of having HEV infection, which were archived at the national consultant laboratory for HAV and HEV between 2000 and 2020. We randomly selected n = 200 samples, which were initially tested reactive (positive or borderline) for HEV-IgM and negative for HEV RNA and re-examined them using a highly sensitive Orthohepevirus C genotype 1-specific in-house RT-qPCR (LoD 95: 6.73 copies per reaction) and a nested RT-PCR broadly reactive for Orthohepevirus A and C. Conventional sanger sequencing was conducted for resulting PCR products. No atypical HEV strains were detected (0 of 200 [0.0%; 95% confidence interval: 0.0%–1.89%], indicating that Orthohepevirus C infections in the investigated population (persons with clinical suspicion of hepatitis E and positive HEV-IgM) are very rare.
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20
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Cook N, D’Agostino M, Wood A, Scobie L. Real-Time PCR-Based Methods for Detection of Hepatitis E Virus in Pork Products: A Critical Review. Microorganisms 2022; 10:microorganisms10020428. [PMID: 35208881 PMCID: PMC8877315 DOI: 10.3390/microorganisms10020428] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/18/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
Standard methods for detection of hepatitis A virus and norovirus in at-risk foodstuffs are available, but currently there is no standard method for detection of hepatitis E virus (HEV) in pork products or other foods that can be contaminated with the virus. Detection assays for HEV are mainly based on nucleic acid amplification, particularly the reverse transcription polymerase chain reaction (RTPCR) in real-time format. RTPCR-based methods can be sensitive and specific, but they require a suite of controls to verify that they have performed correctly. There have been several RTPCR methods developed to detect HEV in pork products, varying in details of sample preparation and RTPCR target sequences. This review critically discusses published HEV detection methods, with emphasis on those that have been successfully used in subsequent studies and surveys. RTPCR assays have been used both qualitatively and quantitatively, although in the latter case the data acquired are only reliable if appropriate assay calibration has been performed. One particular RTPCR assay appears to be ideal for incorporation in a standard method, as it has been demonstrated to be highly specific and sensitive, and an appropriate control and calibration standard is available. The review focuses on the detection of HEV in pork products and similar foodstuffs (e.g., boar). The information may be useful to inform standardisation activities.
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Affiliation(s)
- Nigel Cook
- Jorvik Food Safety Services, York YO32 2GN, UK
- Correspondence: (N.C.); (L.S.)
| | | | - Ann Wood
- Campden BRI, Chipping Campden GL55 6LD, UK; (M.D.); (A.W.)
| | - Linda Scobie
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
- Correspondence: (N.C.); (L.S.)
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21
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Broadly Reactive Real-Time RT-PCR Assay for the Detection of Hepatitis E Virus and Simultaneous Genotyping by Single Nucleotide Polymorphism Analysis. Microbiol Spectr 2022; 10:e0191221. [PMID: 35138152 PMCID: PMC8826742 DOI: 10.1128/spectrum.01912-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Hepatitis E virus (HEV) infection is a global public health concern. Although HEV infection is usually asymptomatic and self-limiting, extrahepatic manifestations and chronic infections in immunocompromised patients have been described. HEV strains infecting humans have been classified into four main genotypes. In this study we have developed and validated a novel sensitive real-time RT-PCR assay for the detection of all four HEV genotypes. Simultaneous discrimination of genotypes 1, 2, and 4 from genotype 3 by single nucleotide polymorphism (SNP) analysis was possible. In all, 201 serum samples from cases and carriers previously tested for HEV by nested RT-PCR were analyzed. Twenty-seven HEV-positive samples could not be typed by the nested RT-PCR and nucleotide sequencing, but were newly typed by SNP analysis. As polymorphisms were present at the primer or probe binding site, we adopted a degenerate primer and mixed probes. When a mixed probe was added, the fluorescence intensity increased, facilitating genotype determination. IMPORTANCE The distribution of HEV-3 and HEV-4 has been changing. HEV-4, which had been predominantly found in Asia, is now being detected in other parts of the world, and there are now reports of chronic infections. Additionally, neurological disorders have frequently been reported in patients with acute or chronic HEV infections. HEV-4 has also been shown to lead to a higher severity in terms of acute hepatitis than does HEV-3. Early typing can provide useful information regarding the route of infection and for tailoring treatment to the expected course of the disease. The present method afforded a good detection rate even when polymorphisms were present within the target region for viral gene detection. We believe that this method can be applied to the analysis of mutation-prone viral genes in the future.
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22
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Withenshaw SM, Grierson SS, Smith RP. Study of Animal Mixing and the Dynamics of Hepatitis E Virus Infection on a Farrow-to-Finish Pig Farm. Animals (Basel) 2022; 12:ani12030272. [PMID: 35158596 PMCID: PMC8833537 DOI: 10.3390/ani12030272] [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: 10/31/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 02/05/2023] Open
Abstract
In Europe, swine are a livestock reservoir for Hepatitis E virus genotype 3 (HEV-3). Consumption of food containing HEV-3 can cause zoonotic human infection, though risk is reduced by heat treatment. Implementing controls that limit infection in slaughter pigs may further reduce foodborne transmission risk but knowledge of infection dynamics on commercial farms is limited. This study addressed this knowledge gap and in particular investigated the influence of group mixing. Faeces were collected from grower (n = 212) and fattener (n = 262) pigs on a farrow-to-finish farm on four occasions. HEV RNA was detected on all occasions, and prevalence was higher in growers (85.8%) than fatteners (26.0%; p < 0.001). HEV-positive samples were also collected from the wider farm environment (n = 67; 64.7% prevalence), indicating potential sources for HEV re-circulation within the herd. Timing of infection in a cohort was also investigated. HEV was absent from all piglet faeces (n = 98) and first detected at weaner stage (25.7% prevalence), but only in groups weaned earlier or comprising pigs from many different litters. Farrowing sow faeces (n = 75) were HEV-negative but antibodies were detected in blood from two sows. Results suggest that multiple factors influence HEV infection dynamics on pig farms, and potential foci for further study into practical control solutions are highlighted.
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Affiliation(s)
- Susan M. Withenshaw
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge KT15 3NB, UK;
- Correspondence:
| | - Sylvia S. Grierson
- Department of Virology, Animal and Plant Health Agency, Weybridge KT15 3NB, UK;
| | - Richard P. Smith
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Weybridge KT15 3NB, UK;
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23
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Genetic Diversity of Hepatitis E Virus Type 3 in Switzerland-From Stable to Table. Animals (Basel) 2021; 11:ani11113177. [PMID: 34827909 PMCID: PMC8614342 DOI: 10.3390/ani11113177] [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: 10/20/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 12/21/2022] Open
Abstract
Simple Summary The main hosts of hepatitis E virus (HEV) genotype 3 are porcine species. Transmission of the virus to humans, for example via undercooked meat, may cause acute or chronic hepatitis. To determine sources and routes of infection, comparing the viruses present in humans to the ones present in main hosts is a helpful tool. However, it requires knowledge of the genetic diversity of the circulating viruses. Therefore, we tested Swiss pigs and wild boars for HEV and determined the virus subtype and part of its genome. In addition, we determined the HEV subtype present in 11 positive meat products. One pig liver from the slaughterhouses (0.3%) and seven livers from a carcass collection (13%) as well as seven wild boar livers (5.8%) were found HEV positive. The same virus subtypes were found in Swiss pigs, wild boars, and meat products. Most of the viruses belonged to a Swiss-specific cluster within the subtype 3h. In addition, one pig liver and one wild boar liver were found positive for 3l and two meat products from Germany for 3c. Our data indicate that Switzerland has its “own” HEV viruses that circulate independent from the rest of Europe. Abstract Hepatitis E caused by hepatitis E viruses of the genotype 3 (HEV-3) is a major health concern in industrialized countries and due to its zoonotic character requires a “One Health” approach to unravel routes and sources of transmission. Knowing the viral diversity present in reservoir hosts, i.e., pigs but also wild boars, is an important prerequisite for molecular epidemiology. The aim of this study was to gain primary information on the diversity of HEV-3 subtypes present along the food chain in Switzerland, as well as the diversity within these subtypes. To this end, samples of domestic pigs from slaughterhouses and carcass collection points, as well as from hunted wild boars, were tested for HEV RNA and antibodies. HEV positive meat products were provided by food testing labs. The HEV subtypes were determined using Sanger and next generation sequencing. The genetic analyses confirmed the predominance of a Swiss-specific cluster within subtype HEV-3h in pigs, meat products, and wild boars. This cluster, which may result from local virus evolution due to the isolated Swiss pig industry, supports fast differentiation of domestic and imported infections with HEV.
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24
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Lienhard J, Vonlanthen-Specker I, Sidler X, Bachofen C. Screening of Swiss Pig Herds for Hepatitis E Virus: A Pilot Study. Animals (Basel) 2021; 11:3050. [PMID: 34827782 PMCID: PMC8614339 DOI: 10.3390/ani11113050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 12/14/2022] Open
Abstract
Hepatitis E virus (HEV) is an important cause of acute hepatitis in humans worldwide. In industrialised countries, most infections are caused by the zoonotic genotype 3. The main reservoir was found in pigs, with fattening pigs as the main shedders. The aim of this study was to establish a screening tool to detect HEV in pig farms. HEV-positive samples were sequenced using Sanger sequencing. First, different sample materials, including floor swabs, slurry, dust swabs and faeces were tested for HEV. Floor swabs turned out to give the best results and, in the form of sock swabs, were used for the screening of Swiss pig herds. A total of 138 pig farms were tested, with a focus on fattening pigs. Overall, 81 farms (58.8%) were HEV positive. Most sequences belonged to subtype 3h, in which they formed a specific cluster (Swiss cluster). In addition, subtype 3l and two unassigned sequences were detected. As a conclusion, sock swabs were found to be a helpful tool to screen pig herds for HEV and establish a sequence collection that may enable molecular epidemiology and support outbreak investigation and prevention.
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Affiliation(s)
- Julia Lienhard
- Institute of Virology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (J.L.); (I.V.-S.)
| | | | - Xaver Sidler
- Division of Swine Medicine, Department of Farm Animals, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland;
| | - Claudia Bachofen
- Institute of Virology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (J.L.); (I.V.-S.)
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25
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Occurrence of Human Enteric Viruses in Shellfish along the Production and Distribution Chain in Sicily, Italy. Foods 2021; 10:foods10061384. [PMID: 34203938 PMCID: PMC8232761 DOI: 10.3390/foods10061384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/11/2022] Open
Abstract
Contamination of bivalve mollusks with human pathogenic viruses represents a recognized food safety risk. Thus, monitoring programs for shellfish quality along the entire food chain could help to finally preserve the health of consumers. The aim of the present study was to provide up-to-date data on the prevalence of enteric virus contamination along the shellfish production and distribution chain in Sicily. To this end, 162 batches of mollusks were collected between 2017 and 2019 from harvesting areas, depuration and dispatch centers (n = 63), restaurants (n = 6) and retail stores (n = 93) distributed all over the island. Samples were processed according to ISO 15216 standard method, and the presence of genogroup GI and GII norovirus (NoV), hepatitis A and E viruses (HAV, HEV), rotavirus and adenovirus was investigated by real-time reverse transcription polymerase chain reaction (real-time-RT PCR), nested (RT)-PCR and molecular genotyping. Our findings show that 5.56% of samples were contaminated with at least one NoV, HAV and/or HEV. Contaminated shellfish were sampled at production sites and retail stores and their origin was traced back to Spain and several municipalities in Italy. In conclusion, our study highlights the need to implement routine monitoring programs along the whole food chain as an effective measure to prevent foodborne transmission of enteric viruses.
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26
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Arnaboldi S, Righi F, Carta V, Bonardi S, Pavoni E, Bianchi A, Losio MN, Filipello V. Hepatitis E Virus (HEV) Spread and Genetic Diversity in Game Animals in Northern Italy. FOOD AND ENVIRONMENTAL VIROLOGY 2021; 13:146-153. [PMID: 33630244 DOI: 10.1007/s12560-021-09467-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
Hepatitis E virus (HEV) is the causative agent of hepatitis E, an emerging public health infection which has an increasing incidence across Europe. Because of the apparent lack of species barriers, HEV was characterized as a zoonotic agent. Swine are recognized as the main reservoir, but HEV is also found in wild animals such as ungulates, lagomorphs, and bats. Our work aimed at detecting the HEV presence in wild fauna in two hunting areas of Northern Italy (Parma and Sondrio areas) with different environmental and anthropic characteristics to investigate its possible role as reservoir. Liver samples were collected from wild boars, red deer, roe deer and chamois, and viral identification was carried out by One-Step RT Real-time PCR. Positive samples were genotyped, and phylogenetic analysis was performed. The virus was found only in the wild boar population, with different prevalence and subtypes in the two areas (14% HEV3a and 1.2% close to HEV3f in Parma and Sondrio, respectively). Wild ruminants seem otherwise to pose a marginal risk. Given the high pig farm density in the Parma area, and expansion of the wild boar population, continuous monitoring of the strains circulating in wildlife is crucial.
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Affiliation(s)
- Sara Arnaboldi
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), via A. Bianchi 9, 25124, Brescia, Italy
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), National Reference Centre for Emerging Risks in Food Safety (CRESA), 20133, Milan, Italy
| | - Francesco Righi
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), via A. Bianchi 9, 25124, Brescia, Italy
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), National Reference Centre for Emerging Risks in Food Safety (CRESA), 20133, Milan, Italy
| | - Valentina Carta
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), via A. Bianchi 9, 25124, Brescia, Italy
| | - Silvia Bonardi
- Department of Veterinary Science, Università degli Studi di Parma, 43100, Parma, Italy
| | - Enrico Pavoni
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), via A. Bianchi 9, 25124, Brescia, Italy
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), National Reference Centre for Emerging Risks in Food Safety (CRESA), 20133, Milan, Italy
| | - Alessandro Bianchi
- Lombardy Territorial Area Department, Istituto Zooprofilattico della Lombardia e dell'Emilia Romagna (IZSLER), 23100, Sondrio, Italy
| | - Marina Nadia Losio
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), via A. Bianchi 9, 25124, Brescia, Italy
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), National Reference Centre for Emerging Risks in Food Safety (CRESA), 20133, Milan, Italy
| | - Virginia Filipello
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), via A. Bianchi 9, 25124, Brescia, Italy.
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), National Reference Centre for Emerging Risks in Food Safety (CRESA), 20133, Milan, Italy.
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27
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Taylor A, Ebert E, McMahon J, Britton L, Siebert D, Slinko V, Vasant B. Locally acquired, human hepatitis E infection in Queensland. Intern Med J 2021; 50:643-644. [PMID: 32431030 DOI: 10.1111/imj.14825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/10/2019] [Accepted: 08/11/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Andrew Taylor
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Erin Ebert
- Metro South Public Health Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Jamie McMahon
- Public Health Virology Laboratory, Forensic and Scientific Services, Brisbane, Queensland, Australia
| | - Laurence Britton
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - David Siebert
- Department of Infectious Diseases, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Pathology Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Vicki Slinko
- West Moreton Public Health Unit, Ipswich, Queensland, Australia.,School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Bhakti Vasant
- Metro South Public Health Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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28
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Elaswad A, Fawzy M. Mutations in Animal SARS-CoV-2 Induce Mismatches with the Diagnostic PCR Assays. Pathogens 2021; 10:371. [PMID: 33808783 PMCID: PMC8003424 DOI: 10.3390/pathogens10030371] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023] Open
Abstract
Recently, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was detected in several animal species. After transmission to animals, the virus accumulates mutations in its genome as adaptation to the new animal host progresses. Therefore, we investigated whether these mutations result in mismatches with the diagnostic PCR assays and suggested proper modifications to the oligo sequences accordingly. A comprehensive bioinformatic analysis was conducted using 28 diagnostic PCR assays and 793 publicly available SARS-CoV-2 genomes isolated from animals. Sixteen out of the investigated 28 PCR assays displayed at least one mismatch with their targets at the 0.5% threshold. Mismatches were detected in seven, two, two, and six assays targeting the ORF1ab, spike, envelope, and nucleocapsid genes, respectively. Several of these mismatches, such as the deletions and mismatches at the 3' end of the primer or probe, are expected to negatively affect the diagnostic PCR assays resulting in false-negative results. The modifications to the oligo sequences should result in stronger template binding by the oligos, better sensitivity of the assays, and higher confidence in the result. It is necessary to monitor the targets of diagnostic PCR assays for any future mutations that may occur as the virus continues to evolve in animals.
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Affiliation(s)
- Ahmed Elaswad
- Department of Animal Wealth Development, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Mohamed Fawzy
- Department of Virology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
- Middle East for Vaccines (ME VAC®), Sharquia 44813, Egypt
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29
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Pellerin M, Hirchaud E, Blanchard Y, Pavio N, Doceul V. Characterization of a Cell Culture System of Persistent Hepatitis E Virus Infection in the Human HepaRG Hepatic Cell Line. Viruses 2021; 13:406. [PMID: 33806591 PMCID: PMC8001476 DOI: 10.3390/v13030406] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/19/2021] [Accepted: 02/26/2021] [Indexed: 12/12/2022] Open
Abstract
Hepatitis E virus (HEV) is considered as an emerging global health problem. In most cases, hepatitis E is a self-limiting disease and the virus is cleared spontaneously without the need of antiviral therapy. However, immunocompromised individuals can develop chronic infection and liver fibrosis that can progress rapidly to cirrhosis and liver failure. The lack of efficient and relevant cell culture system and animal models has limited our understanding of the biology of HEV and the development of effective drugs for chronic cases. In the present study, we developed a model of persistent HEV infection in human hepatocytes in which HEV replicates efficiently. This HEV cell culture system is based on differentiated HepaRG cells infected with an isolate of HEV-3 derived from a patient suffering from acute hepatitis E. Efficient replication was maintained for several weeks to several months as well as after seven successive passages on HepaRG naïve cells. Moreover, after six passages onto HepaRG, we found that the virus was still infectious after oral inoculation into pigs. We also showed that ribavirin had an inhibitory effect on HEV replication in HepaRG. In conclusion, this system represents a relevant and efficient in vitro model of HEV replication that could be useful to study HEV biology and identify effective antiviral drugs against chronic HEV infection.
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Affiliation(s)
- Marie Pellerin
- UMR 1161 Virologie, INRAE, ANSES, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94700 Maisons-Alfort, France; (M.P.); (N.P.)
| | - Edouard Hirchaud
- Agence Nationale de Sécurité Sanitaire, De L’environnement et du Travail (ANSES), Laboratory of Ploufragan-Plouzané-Niort, Viral Genetic and Biosafety (GVB) Unit, 22440 Ploufragan, France; (E.H.); (Y.B.)
| | - Yannick Blanchard
- Agence Nationale de Sécurité Sanitaire, De L’environnement et du Travail (ANSES), Laboratory of Ploufragan-Plouzané-Niort, Viral Genetic and Biosafety (GVB) Unit, 22440 Ploufragan, France; (E.H.); (Y.B.)
| | - Nicole Pavio
- UMR 1161 Virologie, INRAE, ANSES, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94700 Maisons-Alfort, France; (M.P.); (N.P.)
| | - Virginie Doceul
- UMR 1161 Virologie, INRAE, ANSES, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94700 Maisons-Alfort, France; (M.P.); (N.P.)
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30
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Anis E, Turner G, Ellis JC, Di Salvo A, Barnard A, Carroll S, Murphy L. Evaluation of a real-time RT-PCR panel for detection of SARS-CoV-2 in bat guano. J Vet Diagn Invest 2021; 33:331-335. [PMID: 33522461 DOI: 10.1177/1040638721990333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which is an ongoing global health concern. The exact source of the virus has not been identified, but it is believed that this novel coronavirus originated in animals; bats in particular have been implicated as the primary reservoir of the virus. SARS-CoV-2 can also be transmitted from humans to other animals, including tigers, cats, and mink. Consequently, infected people who work directly with bats could transfer the virus to a wild North American bat, resulting in a new natural reservoir for the virus, and lead to new outbreaks of human disease. We evaluated a reverse-transcription real-time PCR panel for detection of SARS-CoV-2 in bat guano. We found the panel to be highly specific for SARS-CoV-2, and able to detect the virus in bat guano samples spiked with SARS-CoV-2 viral RNA. Our panel could be utilized by wildlife agencies to test bats in rehabilitation facilities prior to their release to the wild, minimizing the risk of spreading this virus to wild bat populations.
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Affiliation(s)
- Eman Anis
- Department of Pathobiology, University of Pennsylvania, School of Veterinary Medicine, New Bolton Center, Kennett Square, PA.,Department of Virology, Faculty of Veterinary Medicine, University of Sadat, El Beheira Governorate, Sadat City, Egypt
| | - Greg Turner
- Pennsylvania Game Commission, Bureau of Wildlife Management, Harrisburg, PA
| | - Julie C Ellis
- Northeast Wildlife Disease Cooperative, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA
| | - Andrew Di Salvo
- Pennsylvania Game Commission, Bureau of Wildlife Management, Harrisburg, PA
| | - Amanda Barnard
- Department of Pathobiology, University of Pennsylvania, School of Veterinary Medicine, New Bolton Center, Kennett Square, PA
| | - Susan Carroll
- Department of Pathobiology, University of Pennsylvania, School of Veterinary Medicine, New Bolton Center, Kennett Square, PA
| | - Lisa Murphy
- Department of Pathobiology, University of Pennsylvania, School of Veterinary Medicine, New Bolton Center, Kennett Square, PA
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31
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Ankcorn M, Said B, Morgan D, Elsharkawy AM, Maggs J, Ryder S, Valliani T, Gordon F, Abeysekera K, Suri D, McPherson S, Galliford J, Smith B, Pelosi E, Bansal S, Bethune C, Sheridan D, Vine L, Tedder RS, Ijaz S, Zuckerman M, Dalton H, Healy B, Donati M, Bicknell K, Evans C, Poller B, Smit E, Halsema C, Williams E, Raza M, McGann H, Irving W, Douthwaite S, Ch'ng CL, McCaughey C, Irish D. Persistent Hepatitis E virus infection across England and Wales 2009-2017: Demography, virology and outcomes. J Viral Hepat 2021; 28:420-430. [PMID: 33073452 DOI: 10.1111/jvh.13424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/20/2020] [Accepted: 10/02/2020] [Indexed: 01/11/2023]
Abstract
The first clinical case of persistent HEV infection in England was reported in 2009. We describe the demography, virology and outcomes of patients identified with persistent HEV infection in England and Wales between 2009 and 2017. A series of 94 patients with persistent HEV infection, defined by HEV viraemia of more than 12 weeks, was identified through routine reference laboratory testing. Virology, serology and clinical data were recorded through an approved PHE Enhanced Surveillance System. Sixty-six cases (70.2%) were transplant recipients, 16 (17.0%) had an underlying haematological malignancy without stem cell transplantation, six (6.4%) had advanced HIV infection, five (5.3%) were otherwise immunosuppressed, and one patient (1.1%) had no identified immunosuppression. Retrospective analysis of 46 patients demonstrated a median 38 weeks of viraemia before diagnostic HEV testing. At initial diagnosis, 16 patients (17.0%) had no detectable anti-HEV serological response. Of 65 patients treated with ribavirin monotherapy, 11 (16.9%) suffered virological relapse despite undetectable RNA in plasma or stool at treatment cessation. Persistent HEV infection remains a rare diagnosis, but we demonstrate that a broad range of immunocompromised patients are susceptible. Both lack of awareness and the pauci-symptomatic nature of persistent HEV infection likely contribute to significant delays in diagnosis. Diagnosis should rely on molecular testing since anti-HEV serology is insufficient to exclude persistent HEV infection. Finally, despite treatment with ribavirin, relapses occur even after cessation of detectable faecal shedding of HEV RNA, further emphasising the requirement to demonstrate sustained virological responses to treatment.
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Affiliation(s)
- Michael Ankcorn
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK.,Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - Bengü Said
- Emerging Infections and Zoonoses, National Infection Service, Public Health England, London, UK
| | - Dilys Morgan
- Emerging Infections and Zoonoses, National Infection Service, Public Health England, London, UK
| | | | - James Maggs
- Department of Gastroenterology, Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK
| | - Stephen Ryder
- Department of Hepatology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Talal Valliani
- North Bristol Liver Unit, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Fiona Gordon
- Department of Hepatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Kushala Abeysekera
- Department of Hepatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Deepak Suri
- Department of Hepatology, University College London Hospitals, London, UK
| | - Stuart McPherson
- Liver Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, & Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - Jack Galliford
- Department of Nephrology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Belinda Smith
- Department of Hepatology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Emanuela Pelosi
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sanjay Bansal
- Department of Paediatric Hepatology, Gastroenterology & Nutrition Center, King's College Hospital NHS Foundation Trust, London, UK
| | - Claire Bethune
- Department of Immunology and Allergy, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - David Sheridan
- South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Louisa Vine
- South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK.,Transfusion Microbiology, National Health Service Blood and Transplant, London, UK.,Department of Medicine, Imperial College London, London, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
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Davis CA, Haywood B, Vattipally S, Da Silva Filipe A, AlSaeed M, Smollet K, Baylis SA, Ijaz S, Tedder RS, Thomson EC, Abdelrahman TT. Hepatitis E virus: Whole genome sequencing as a new tool for understanding HEV epidemiology and phenotypes. J Clin Virol 2021; 139:104738. [PMID: 33933822 DOI: 10.1016/j.jcv.2021.104738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/28/2020] [Accepted: 01/12/2021] [Indexed: 12/24/2022]
Abstract
Hepatitis E Virus (HEV) is emerging as a public health concern across Europe and tools for complete genome data to aid epidemiological and virulence analysis are needed. The high sequence heterogeneity observed amongst HEV genotypes has restricted most analyses to subgenomic regions using PCR-based methods, which can be unreliable due to poor primer homology. We designed a panel of custom-designed RNA probes complementary to all published HEV full genome NCBI sequences. A target enrichment protocol was performed according to the NimbleGen® standard protocol for Illumina® library preparation. Optimisation of this protocol was performed using 40 HEV RNA-positive serum samples and the World Health Organization International Reference Panel for Hepatitis E Virus RNA Genotypes for Nucleic Acid Amplification Technique (NAT)-Based Assays and related reference materials. Deep sequencing using this target enrichment protocol resulted in whole genome consensus sequences from samples with a viral load range of 1.25 × 104-1.17 × 107 IU/mL. Phylogenetic analysis of these sequences recapitulated and extended the partial genome results obtained from genotyping by Sanger sequencing (genotype 1, ten samples and genotype 3, 30 samples). The protocol is highly adaptable to automation and could be used to sequence full genomes of large sample numbers. A more comprehensive understanding of hepatitis E virus transmission, epidemiology and viral phenotype prediction supported by an efficient method of sequencing the whole viral genome will facilitate public health initiatives to reduce the prevalence and mitigate the harm of HEV infection in Europe.
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Affiliation(s)
| | - Becky Haywood
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | | | | | - Mariam AlSaeed
- Life Science & Environment Research Institute, National Center for Genome Technology, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | | | | | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK; University College London, London, UK; Microbiology Services, NHS Blood and Transplant, Colindale, UK
| | - Emma C Thomson
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Tamir T Abdelrahman
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK; Microbiology Department, Laboratoire National de Sante, Dudelange, Luxembourg.
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Hepatitis E Virus Occurrence in Pigs Slaughtered in Italy. Animals (Basel) 2021; 11:ani11020277. [PMID: 33499160 PMCID: PMC7911034 DOI: 10.3390/ani11020277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Hepatitis E is now recognized as an emerging zoonotic disease in Europe caused by an RNA virus (HEV) and foodborne is the main route of transmission. Human cases have been linked to the consumption of contaminated pig liver sausages, raw venison, or undercooked wild boar meat. The zoonotic genotype HEV-3 is widespread in pigs at farm level but little information is available on the occurrence of HEV-positive pigs at the slaughterhouse. The aim of this study was to investigate the prevalence of HEV-positive pigs during slaughtering, to understand which biological samples (feces and organs) were more frequently HEV positive. Our results showed that pigs positive for HEV can be slaughtered and that the percentage of positive animals depends on the age of animals. The other main result is the presence of the virus in the plasma of animals, which may contribute to the contamination of meat (muscle). Nevertheless, muscles are rarely contaminated by HEV-RNA compared to liver, which is the organ of replication. Abstract In Europe, foodborne transmission has been clearly associated to sporadic cases and small clusters of hepatitis E in humans linked to the consumption of contaminated pig liver sausages, raw venison, or undercooked wild boar meat. In Europe, zoonotic HEV-genotype 3 strains are widespread in pig farms but little information is available on the prevalence of HEV positive pigs at slaughterhouse. In the present study, the prevalence of HEV-RNA positive pigs was assessed on 585 animals from 4 abattoirs located across Italy. Twenty-one pigs (3.6%) tested positive for HEV in either feces or liver by real-time RT-PCR. In these 21 pigs, eight diaphragm muscles resulted positive for HEV-RNA. Among animals collected in one abattoir, 4 out of 91 plasma tested positive for HEV-RNA. ELISA tests for the detection of total antibodies against HEV showed a high seroprevalence (76.8%), confirming the frequent exposure of pigs to the virus. The phylogenetic analyses conducted on sequences of both ORF1 and ORF2 fragments, shows the circulation of HEV-3c and of a novel unclassified subtype. This study provides information on HEV occurrence in pigs at the slaughterhouse, confirming that muscles are rarely contaminated by HEV-RNA compared to liver, which is the most frequently positive for HEV.
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Battistini R, Listorti V, Squadrone S, Pederiva S, Abete MC, Mua R, Ciccotelli V, Suffredini E, Maurella C, Baioni E, Orlandi M, Ercolini C, Serracca L. Occurrence and persistence of enteric viruses, arsenic and biotoxins in Pacific oysters farmed in an Italian production site. MARINE POLLUTION BULLETIN 2021; 162:111843. [PMID: 33223135 DOI: 10.1016/j.marpolbul.2020.111843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/07/2020] [Accepted: 11/11/2020] [Indexed: 06/11/2023]
Abstract
The presence of Norovirus (NoV) and Hepatitis E virus (HEV) in non-depurated and depurated oysters raised in the north-west Italian coast was investigated by quantitative real-time RT-PCR. Total and inorganic arsenic (As) and the presence of marine biotoxins (DSP, ASP, PSP) by LC-MS were also investigated. NoV was detected through all the sampling period in non depurated and depurated oysters with highest levels during wintertime (>104 genome copies per gram, gc/g) and minimum values in summer below the LOQ (<130/140 gc/g). HEV has never been found as well as biotoxins. Total As concentration was found in oysters in the range 0.45-3.0 mg/kg, while inorganic As was found in all samples in concentrations below the LOQ (<0.020 mg/kg). The study highlights how the 24 h depuration process didn't reduce significantly NoV levels and therefore the high concentration of NoV in oysters could represent a risk for consumers especially during winter and spring months.
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Affiliation(s)
- Roberta Battistini
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy.
| | - Valeria Listorti
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Stefania Squadrone
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Sabina Pederiva
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Maria Cesarina Abete
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Roberto Mua
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Valentina Ciccotelli
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Cristiana Maurella
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Elisa Baioni
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Mino Orlandi
- Liguria Local Health Unit-ASL 5, Complex Unit of Hygiene of Foods and Animal Origin, La Spezia, Italy
| | - Carlo Ercolini
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Laura Serracca
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
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Milovanov A, Savenkova D, Radchenko V, Zvyagin A, Troshin L. Study of the VvMybA1 gene allele state of some colored and uncolored grapevine varieties. BIO WEB OF CONFERENCES 2021. [DOI: 10.1051/bioconf/20213402008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
As a result of the work, genetic markers were created that were used to identify alleles of the VvMybA1 genes, which control the anthocyanin color of berries in grape varieties. Using these markers, alleles were identified in grape varieties belonging to different ecologicalgeographical groups. In the process of work, alleles were sequenced and compared with the NCBI database in order to identify their state and their belonging to a specific type of structure. In addition, these sequences were compared with each other to reveal the structural features of varieties with and without color of berries. Single nucleotide polymorphisms, structural features, and deletions in the structure of alleles were revealed.
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Phylogenetic analysis and epidemiological history of Hepatitis E virus 3f and 3c in swine and wild boar, Italy. Heliyon 2020; 6:e05110. [PMID: 33088938 PMCID: PMC7567929 DOI: 10.1016/j.heliyon.2020.e05110] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 05/11/2020] [Accepted: 09/25/2020] [Indexed: 12/27/2022] Open
Abstract
Background Hepatitis E virus (HEV) genotype 3 has a worldwide distribution. The food-borne transmission of HEV associated with the consumption of products derived from domestic pig, wild boar has been reported in various countries. In this study the genetic diversity, evolutionary rates of HEV 3f, 3c among swine and wild boar in Italy were estimated. Methods Sampling was performed on a wild boar population living in an area located in Abruzzo region. The HEV RNA amplification was performed by real-time RT-PCR. Nested RT-PCR and sequencing of the ORF2 region were carried out by the Super Script III First-Strand Synthesis System. Sequencing of purified PCR products was carried out by the Genome Lab Dye Terminator Cycle Sequencing (DTCS) Quick Start Kit. The maximum likelihood trees were generated by using Phyml. The mean evolutionary rates and the dated trees were co-estimated by BEAST. Results The phylogenetic analysis showed that the HEV ORF2 isolates from Abruzzo region belonged to 3f subtype. The prevalent subtypes in Italy were those belonging to 3f and 3c. The estimated mean values of the HEV ORF2 capsid gene evolutionary rates were 1.915 × 10−2 substitutions/site/year (95% HPD: 1.64 × 10−3 – 3.97 × 10−2) and 2.81 × 10−2 substitutions/site/year (1.83 × 10−2 - 3.8 × 10−2) for 3f and 3c subtype datasets, respectively. The HEV 3f dated back to 1985 (1960–2000), whereas the 3c subtype entered in Italy during the year 2006 (2005–2006). The majority of the HEV 3f sequences collected from swine didn't appear intermixed, except in two cases. The HEV 3c population circulating in Italy remained segregated without significant transfer to swine. Conclusion Our study provide insight into the evolution, circulation of HEV 3f and 3c in Italy. Continued genomic surveillance of HEV in animal reservoir, as well as improving sanitary control measures are required.
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37
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Maponga TG, Lopes T, Cable R, Pistorius C, Preiser W, Andersson MI. Prevalence and risks of hepatitis E virus infection in blood donors from the Western Cape, South Africa. Vox Sang 2020; 115:695-702. [PMID: 32597542 DOI: 10.1111/vox.12966] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Transfusion-transmitted hepatitis E virus (HEV) infection is a potential risk to recipients of blood transfusions. Infection with HEV poses a high risk to immunocompromised recipients with an increased likelihood of developing chronic infection. The aims of this study were to determine the prevalence of past and active HEV infections in donors from the Western Cape and to identify the risk factors associated with infection. MATERIALS AND METHODS We prospectively tested 10 250 blood donors for HEV infection. A risk factor sub-study investigated 250 donors who completed a questionnaire, and plasma samples were tested for HEV IgG antibodies and pooled for HEV RNA detection. The demographic and risk factors associated with HEV infection were assessed. The molecular study tested 10 000 individual donations using a commercial assay to detect viraemia. HEV viral load and genotype were also determined. RESULTS The overall anti-HEV IgG seroprevalence was 42·8% (107/250) among donors participating in the risk factor sub-study. The likelihood of past HEV infection was higher with an increase in age. Of the 10 000 donor samples individually tested for HEV RNA, one sample was positive with a viral load of 7·9 x 104 IU/ml and belonged to HEV genotype 3. CONCLUSION We found a high seroprevalence of anti-HEV IgG but a low HEV RNA prevalence among donors in the Western Cape, South Africa. The study provides evidence for a potential risk of HEV contamination in the blood supply in South Africa. A cost-benefit analysis is needed before considering the introduction of routine donor screening in our setting.
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Affiliation(s)
- Tongai G Maponga
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
| | - Tatum Lopes
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
| | | | | | - Wolfgang Preiser
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa.,Tygerberg Business Unit, National Health Laboratory Service, Cape Town, South Africa
| | - Monique I Andersson
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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38
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Ledesma J, Williams D, Stanford FA, Hewitt PE, Zuckerman M, Bansal S, Dhawan A, Mbisa JL, Tedder R, Ijaz S. Resolution by deep sequencing of a dual hepatitis E virus infection transmitted via blood components. J Gen Virol 2020; 100:1491-1500. [PMID: 31592753 DOI: 10.1099/jgv.0.001302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Hepatitis E virus (HEV) is a zoonotic infection, with consumption of processed pork products thought to be the major route of transmission in England. The clinical features of HEV infection range from asymptomatic infection to mild hepatitis to fulminant liver failure. Persistent, chronic hepatitis is increasingly recognized in immunocompromised patients. Infection via HEV-containing blood components and organs has been reported and measures to reduce this transmission risk were introduced into the blood service in England in 2016. We report here the sequence and phylogenetic findings from investigations into a transmission event from an HEV-infected donor to two recipients. Phylogenetic analysis of HEV genome sequence fragments obtained by Sanger sequencing showed that, whilst most of the sequences from both recipients' samples grouped with the sequence from the blood donor sample, the relationship of five sequences from recipient 2 were unresolved. Analysis of Illumina short-read deep sequence data demonstrated the presence of two divergent viral populations in the donor's sample that were also present in samples from both recipients. A clear phylogenetic relationship was established, indicating a probable transmission of both populations from the donor to each of the immunocompromised recipients. This study demonstrates the value of the application of new sequencing technologies combined with bioinformatic data analysis when Sanger sequencing is not able to clarify a proper phylogenetic relationship in the investigation of transmission events.
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Affiliation(s)
- Juan Ledesma
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, London, UK.,Antiviral Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - David Williams
- Bioinformatics, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - Felicia Adelina Stanford
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | | | - Mark Zuckerman
- South London Specialist Virology Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - Sanjay Bansal
- Paediatric Liver, GI and Nutrition Centre and Mowat Labs, King's College Hospital, London, UK
| | - Anil Dhawan
- Paediatric Liver, GI and Nutrition Centre and Mowat Labs, King's College Hospital, London, UK
| | - Jean Lutamyo Mbisa
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, London, UK.,Antiviral Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - Richard Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK.,National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, London, UK
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39
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Beyer S, Szewzyk R, Gnirss R, Johne R, Selinka HC. Detection and Characterization of Hepatitis E Virus Genotype 3 in Wastewater and Urban Surface Waters in Germany. FOOD AND ENVIRONMENTAL VIROLOGY 2020; 12:137-147. [PMID: 32172512 PMCID: PMC7225198 DOI: 10.1007/s12560-020-09424-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/04/2020] [Indexed: 05/18/2023]
Abstract
In highly populated areas, environmental surveillance of wastewater and surface waters is a key factor to control the circulation of viruses and risks for public health. Hepatitis E virus (HEV) genotype 3 is considered as an emerging pathogen in industrialized countries. Therefore, this study was carried out to determine the prevalence of HEV in environmental waters in urban and suburban regions in Germany. HEV was monitored in water samples using quantitative RT-PCR (RT-qPCR) and nested RT-PCR without or with virus concentration via polyethylene glycol precipitation or ultracentrifugation. By RT-qPCR, 84-100% of influent samples of wastewater treatment plants were positive for HEV RNA. Genotypes HEV-3c and 3f were identified in wastewater, with HEV-3c being the most prevalent genotype. These data correlate with subtypes identified earlier in patients from the same area. Comparison of wastewater influent and effluent samples revealed a reduction of HEV RNA of about 1 log10 during passage through wastewater treatment plants. In addition, combined sewer overflows (CSOs) after heavy rainfalls were shown to release HEV RNA into surface waters. About 75% of urban river samples taken during these CSO events were positive for HEV RNA by RT-qPCR. In contrast, under normal weather conditions, only around 30% of river samples and 15% of samples from a bathing water located at an urban river were positive for HEV. Median concentrations of HEV RNA of all tested samples at this bathing water were below the limit of detection.
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Affiliation(s)
- Sophia Beyer
- Section II 1.4 Microbiological Risks, German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - Regine Szewzyk
- Section II 1.4 Microbiological Risks, German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - Regina Gnirss
- Berliner Wasserbetriebe (BWB), Cicerostr. 24, 10709, Berlin, Germany
| | - Reimar Johne
- German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589, Berlin, Germany
| | - Hans-Christoph Selinka
- Section II 1.4 Microbiological Risks, German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany.
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Khan KA, Cheung P. Presence of mismatches between diagnostic PCR assays and coronavirus SARS-CoV-2 genome. ROYAL SOCIETY OPEN SCIENCE 2020; 7:200636. [PMID: 32742701 PMCID: PMC7353963 DOI: 10.1098/rsos.200636] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/27/2020] [Indexed: 05/29/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; initially named as 2019-nCoV) is responsible for the recent COVID-19 pandemic and polymerase chain reaction (PCR) is the current standard method for its diagnosis from patient samples. This study conducted a reassessment of published diagnostic PCR assays, including those recommended by the World Health Organization (WHO), through the evaluation of mismatches with publicly available viral sequences. An exhaustive evaluation of the sequence variability within the primer/probe target regions of the viral genome was performed using more than 17 000 viral sequences from around the world. The analysis showed the presence of mutations/mismatches in primer/probe binding regions of 7 assays out of 27 assays studied. A comprehensive bioinformatics approach for in silico inclusivity evaluation of PCR diagnostic assays of SARS-CoV-2 was validated using freely available software programs that can be applied to any diagnostic assay of choice. These findings provide potentially important information for clinicians, laboratory professionals and policy-makers.
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Affiliation(s)
- Kashif Aziz Khan
- Department of Biology, York University, 4700 Keele Street, Toronto, CanadaM3 J 1P3
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41
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Horvatits T, Varwig-Janssen D, Schulze Zur Wiesch J, Lübke R, Reucher S, Frerk S, Addo MM, Schneider SW, Lohse AW, Luetgehetmann M, Pischke S. No link between male infertility and HEV genotype 3 infection. Gut 2020; 69:1150-1151. [PMID: 31118248 DOI: 10.1136/gutjnl-2019-319027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Thomas Horvatits
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Germany
| | - Domenica Varwig-Janssen
- Department of Dermatology and Venerology, University Medical Centre Hamburg-Eppendorf, Hamburg, Hamburg, Germany
| | - Julian Schulze Zur Wiesch
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Germany
| | - Rabea Lübke
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Svenja Reucher
- Institute of Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Frerk
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marylyn M Addo
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Germany
| | - Stefan W Schneider
- Department of Dermatology and Venerology, University Medical Centre Hamburg-Eppendorf, Hamburg, Hamburg, Germany
| | - Ansgar W Lohse
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Germany
| | - Marc Luetgehetmann
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Germany.,Institute of Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Pischke
- Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Germany
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42
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Iaconelli M, Bonanno Ferraro G, Mancini P, Suffredini E, Veneri C, Ciccaglione AR, Bruni R, Della Libera S, Bignami F, Brambilla M, De Medici D, Brandtner D, Schembri P, D’Amato S, La Rosa G. Nine-Year Nationwide Environmental Surveillance of Hepatitis E Virus in Urban Wastewaters in Italy (2011-2019). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2059. [PMID: 32244915 PMCID: PMC7143501 DOI: 10.3390/ijerph17062059] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 12/19/2022]
Abstract
Hepatitis E virus (HEV) is an emerging causative agent of acute hepatitis worldwide. To provide insights into the epidemiology of HEV in Italy, a large-scale investigation was conducted into urban sewage over nine years (2011-2019), collecting 1374 sewage samples from 48 wastewater treatment plants located in all the 20 regions of Italy. Broadly reactive primers targeting the ORF1 and ORF2 regions were used for the detection and typing of HEV, followed by Sanger and next generation sequencing (NGS). Real-time RT-qPCR was also used to attempt quantification of positive samples. HEV RNA detection occurred in 74 urban sewage samples (5.4%), with a statistically significant higher frequency (7.1%) in central Italy. Fifty-six samples were characterized as G3 strains and 18 as G1. While the detection of G3 strains occurred in all the surveillance period, G1 strains were mainly detected in 2011-2012, and never in 2017-2019. Typing was achieved in 2 samples (3f subtype). Viral concentrations in quantifiable samples ranged from 1.2 × 103 g.c./L to 2.8 × 104 g.c./L. Our results suggest the considerable circulation of the virus in the Italian population, despite a relatively small number of notified cases, a higher occurrence in central Italy, and a noteworthy predominance of G3 strains.
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Affiliation(s)
- Marcello Iaconelli
- Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy; (M.I.); (G.B.F.); (P.M.); (C.V.); (S.D.L.); (F.B.)
| | - Giusy Bonanno Ferraro
- Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy; (M.I.); (G.B.F.); (P.M.); (C.V.); (S.D.L.); (F.B.)
| | - Pamela Mancini
- Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy; (M.I.); (G.B.F.); (P.M.); (C.V.); (S.D.L.); (F.B.)
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (E.S.); (D.D.M.)
| | - Carolina Veneri
- Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy; (M.I.); (G.B.F.); (P.M.); (C.V.); (S.D.L.); (F.B.)
| | - Anna Rita Ciccaglione
- Department Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.R.C.); (R.B.)
| | - Roberto Bruni
- Department Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.R.C.); (R.B.)
| | - Simonetta Della Libera
- Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy; (M.I.); (G.B.F.); (P.M.); (C.V.); (S.D.L.); (F.B.)
| | - Francesco Bignami
- Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy; (M.I.); (G.B.F.); (P.M.); (C.V.); (S.D.L.); (F.B.)
| | - Massimo Brambilla
- Consiglio per la ricerca in agricoltura e l’analisi dell’economia agraria (CREA), Research Centre for Engineering and Agri Food Processing, 24047 Treviglio, BG, Italy;
| | - Dario De Medici
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (E.S.); (D.D.M.)
| | | | - Pietro Schembri
- Regional Department for Health Activities and Epidemiological Observatory of the Sicilian Region, 90146 Palermo, Italy;
| | - Stefania D’Amato
- Ministry of Health, Directorate-General for Prevention, 00144 Rome, Italy;
| | - Giuseppina La Rosa
- Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy; (M.I.); (G.B.F.); (P.M.); (C.V.); (S.D.L.); (F.B.)
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Ankcorn MJ, Tedder RS, Cairns J, Sandmann FG. Cost-Effectiveness Analysis of Screening for Persistent Hepatitis E Virus Infection in Solid Organ Transplant Patients in the United Kingdom: A Model-Based Economic Evaluation. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:309-318. [PMID: 32197726 DOI: 10.1016/j.jval.2019.09.2751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Despite potentially severe and fatal outcomes, recent studies of solid organ transplant (SOT) recipients in Europe suggest that hepatitis E virus (HEV) infection is underdiagnosed, with a prevalence of active infection of up to 4.4%. OBJECTIVES To determine the cost-effectiveness of introducing routine screening for HEV infection in SOT recipients in the UK. METHODS A Markov cohort model was developed to evaluate the cost-utility of 4 HEV screening options over the lifetime of 1000 SOT recipients. The current baseline of nonsystematic testing was compared with annual screening of all patients by polymerase chain reaction (PCR; strategy A) or HEV-antigen (HEV-Ag) detection (strategy B) and selective screening of patients who have a raised alanine aminotransferase (ALT) value by PCR (strategy C) or HEV-Ag (strategy D). The primary outcome was the incremental cost per quality-adjusted life-year (QALY). We adopted the National Health Service (NHS) perspective and discounted future costs and benefits at 3.5%. RESULTS At a willingness-to-pay of £20 000/QALY gained, systematic screening of SOT patients by any method (strategy A-D) had a high probability (77.9%) of being cost-effective. Among screening strategies, strategy D is optimal and expected to be cost-saving to the NHS; if only PCR testing strategies are considered, then strategy C becomes cost-effective (£660/QALY). These findings were robust against a wide range of sensitivity and scenario analyses. CONCLUSIONS Our model showed that routine screening for HEV in SOT patients is very likely to be cost-effective in the UK, particularly in patients presenting with an abnormal alanine aminotransferase.
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Affiliation(s)
- Michael J Ankcorn
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, England, UK; Transfusion Microbiology, National Health Service Blood and Transplant, London, England, UK.
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, England, UK; Transfusion Microbiology, National Health Service Blood and Transplant, London, England, UK; Department of Medicine, Imperial College London, London, England, UK
| | - John Cairns
- London School of Hygiene and Tropical Medicine, London, England, UK
| | - Frank G Sandmann
- London School of Hygiene and Tropical Medicine, London, England, UK; Statistics, Modelling and Economics Department, National Infection Service, Public Health England, Colindale, London, England, UK
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Suffredini E, Le Q, Di Pasquale S, Pham T, Vicenza T, Losardo M, To K, De Medici D. Occurrence and molecular characterization of enteric viruses in bivalve shellfish marketed in Vietnam. Food Control 2020. [DOI: 10.1016/j.foodcont.2019.106828] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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45
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Santos-Ferreira N, Mesquita JR, Rivadulla E, Inácio ÂS, Martins da Costa P, Romalde JL, Nascimento MSJ. Hepatitis E virus genotype 3 in echinoderms: First report of sea urchin (Paracentrotus lividus) contamination. Food Microbiol 2020; 89:103415. [PMID: 32138985 DOI: 10.1016/j.fm.2020.103415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 11/28/2022]
Abstract
Hepatitis E virus (HEV) deriving from manure application runoffs and faecal waste spill over of swine and human origin bypass wastewater treatment plants and contaminate coastal waters. Shellfish bioaccumulate enteric viruses such as HEV from fecally contaminated coastal waters and under current European Regulations, shellfish sanitary status surveillance is mandatory but only by means of bacterial faecal indicators. The sea urchins are under the same regulations and their vulnerability to fecal contamination has been pointed out. Since they are consumed raw and with no steps to control/reduce hazards, sea urchin contamination with enteric viruses can represent a food safety risk. Hence, the aim of the present study was to screen sea urchin gonads destined for human consumption for the presence of HEV. HEV was detected and quantified in gonads of sea urchins collected in north Portugal by a reverse transcription-quantitative PCR (RT-qPCR) assay targeting the ORF3 region, followed by genotyping by a nested RT-PCR targeting the ORF2 region. Sequencing and phylogenetic analysis clustered the HEV sequence within genotype 3, subgenotype e. This the first study reporting HEV contamination of sea urchins. We hypothesize that like shellfish, sea urchins can also be a food vehicle for HEV transmission to humans.
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Affiliation(s)
- Nânci Santos-Ferreira
- Interdisciplinary Centre of Marine and Environmental Research, University of Porto (CIIMAR/CIMAR), Matosinhos, Portugal.
| | - João Rodrigo Mesquita
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade Do Porto, Porto, Portugal; Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública, Universidade Do Porto, Portugal.
| | - Enrique Rivadulla
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain.
| | - Ângela S Inácio
- Interdisciplinary Centre of Marine and Environmental Research, University of Porto (CIIMAR/CIMAR), Matosinhos, Portugal.
| | - Paulo Martins da Costa
- Interdisciplinary Centre of Marine and Environmental Research, University of Porto (CIIMAR/CIMAR), Matosinhos, Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade Do Porto, Porto, Portugal.
| | - Jesus L Romalde
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain.
| | - Maria São José Nascimento
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública, Universidade Do Porto, Portugal; Faculdade de Farmácia, Universidade Do Porto (FFUP), Porto, Portugal.
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46
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Montone AMI, De Sabato L, Suffredini E, Alise M, Zaccherini A, Volzone P, Di Maro O, Neola B, Capuano F, Di Bartolo I. Occurrence of HEV-RNA in Italian Regional Pork and Wild Boar Food Products. FOOD AND ENVIRONMENTAL VIROLOGY 2019; 11:420-426. [PMID: 31512058 DOI: 10.1007/s12560-019-09403-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
Hepatitis E is an emerging threat in industrialized countries. The foodborne transmission linked to consumption of pork and game meat is considered the main source of autochthonous infection. In Europe, small outbreaks have been reported linked to the consumption of pork liver sausages and wild boar meat. Based on previous findings and on increasing evidence of pork and game meat as a vehicle for HEV infections, the present study investigated the occurrence of HEV in 99 pork and 63 wild boar sausages and salami sold in Southern Italy. The HEV genome was detected in four wild boar sausages. Sequencing from 2 wild boar sausages confirmed that the HEV strains detected belonged to HEV-3 genotype, not assigned to any defined subtype. Data obtained confirmed the possible occurrence of HEV in pork products and in game. Although the detection rate is low, these products are frequently consumed raw after curing, whose effect on virus viability is still unknown.
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Affiliation(s)
| | - Luca De Sabato
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Mosè Alise
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Alessandra Zaccherini
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Palmiero Volzone
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Orlandina Di Maro
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Benedetto Neola
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Federico Capuano
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Ilaria Di Bartolo
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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47
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Development of a World Health Organization International Reference Panel for different genotypes of hepatitis E virus for nucleic acid amplification testing. J Clin Virol 2019; 119:60-67. [DOI: 10.1016/j.jcv.2019.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 12/27/2022]
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Yin W, Han Y, Xin H, Liu W, Song Q, Li Z, Gao S, Jiang F, Cao J, Bi S, Liu H. Hepatitis E outbreak in a mechanical factory in Qingdao City, China. Int J Infect Dis 2019; 86:191-196. [DOI: 10.1016/j.ijid.2019.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/06/2019] [Accepted: 07/09/2019] [Indexed: 01/17/2023] Open
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49
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Quantification and genetic diversity of Hepatitis E virus in wild boar (Sus scrofa) hunted for domestic consumption in Central Italy. Food Microbiol 2019; 82:194-201. [DOI: 10.1016/j.fm.2019.02.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 12/19/2022]
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50
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Yaşar O, Karatayli E, Cengiz G, Kızılpınar M, Yurdcu E, Albayrak R, Güven A, Arslan Ö, Karahan C, Otlu B, Güdücüoğlu H, Gökahmetoğlu S, Berk E, Kirişci Ö, Sertöz R, Yurdaydin C, Bozdayi AM, Karatayli SC. HEV seroprevalence in blood donors in Turkey by two commercial total anti-HEV Ab ELISA kits. J Med Virol 2019; 91:2174-2181. [PMID: 31403185 DOI: 10.1002/jmv.25567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 08/07/2019] [Indexed: 12/24/2022]
Abstract
Previous hepatitis E virus (HEV) seroprevalence studies in Turkey have shown high variabilities, leading to conflicting results. We aimed to re-evaluate HEV seroprevalence among blood donors in Turkey using the Wantai (Beijing, China) and the Dia.Pro (Milan, Italy) total anti-HEV antibody (Ab) enzyme-linked immunosorbent assay (ELISA) kits and compare their performances and to investigate the presence of HEV RNA in blood donors. Serum total anti-HEV antibodies were determined in a total of 2011 volunteer blood donor samples collected from different regions of Turkey (807 from Ankara, 243 from Kayseri, 284 from İzmir, 200 from Malatya, 200 from Kahramanmaraş, and 277 from Van). HEV RNA was evaluated by a real-time polymerase chain reaction in a total of 272 anti-HEV seropositive samples. The country-wide HEV seroprevalence was calculated as 11.5% (Dia.Pro) and 12.2% (Wantai) with seropositivity rates of 12.0%-12.5% in Ankara, 7.4%-8.2% in Kayseri, 14.5%-15.5% in Malatya, 8.1%-8.8% in İzmir, 15.0%-16.0% in Kahramanmaraş, and 12.6%-13.4% in Van by Dia.Pro and Wantai kits, respectively. The lowest detectable Ab concentrations were 0.16 and 0.14 units/mL WHO, for the Dia.Pro and the Wantai assays, respectively, showing no significant difference between assays. HEV RNA was not detected in any of the anti-HEV seropositive samples. Compared with previous studies, HEV was shown to have a higher overall seroprevalence in Turkey. Despite its limitation, the current study represents the most comprehensive HEV seroprevalence study in Turkey performed with two different commercial ELISA assays with high sensitivities so far. Further investigation is required to determine HEV genotypes in Turkey.
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Affiliation(s)
- Osman Yaşar
- Institute of Hepatology, Ankara University, Ankara, Turkey
| | | | - Güniz Cengiz
- Institute of Hepatology, Ankara University, Ankara, Turkey
| | | | - Esra Yurdcu
- Institute of Hepatology, Ankara University, Ankara, Turkey
| | - Rabia Albayrak
- Department of Biometry and Genetics, Faculty of Agriculture, Ankara University, Ankara, Turkey
| | - Aysel Güven
- Vocational School of Health, Başkent University, Ankara, Turkey
| | - Önder Arslan
- Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey
| | - Ceren Karahan
- Department of Microbiology and Clinical Microbiology, School of Medicine, Ankara University, Ankara, Turkey
| | - Barış Otlu
- Department of Medical Microbiology, School of Medicine, Inönü University, Malatya, Turkey
| | - Hüseyin Güdücüoğlu
- Department of Medical Microbiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Selma Gökahmetoğlu
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Elife Berk
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Özlem Kirişci
- Laboratory of Medical Microbiology, Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Rüçhan Sertöz
- Department of Medical Microbiology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Cihan Yurdaydin
- Institute of Hepatology, Ankara University, Ankara, Turkey.,Department of Gastroenterology and Hepatology, Koc University Medical School, Istanbul, Turkey
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