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Miao Z, Cao K, Wu X, Zhang C, Gao J, Chen Y, Sun Z, Ren X, Chen Y, Yang M, Chen C, Jiang D, Du Y, Lv X, Yang S. An outbreak of hepatitis E virus genotype 4d caused by consuming undercooked pig liver in a nursing home in Zhejiang Province, China. Int J Food Microbiol 2024; 417:110682. [PMID: 38626694 DOI: 10.1016/j.ijfoodmicro.2024.110682] [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: 11/05/2023] [Revised: 02/29/2024] [Accepted: 03/14/2024] [Indexed: 04/18/2024]
Abstract
Hepatitis E infection is typically caused by contaminated water or food. In July and August 2022, an outbreak of hepatitis E was reported in a nursing home in Zhejiang Province, China. Local authorities and workers took immediate actions to confirm the outbreak, investigated the sources of infection and routes of transmission, took measures to terminate the outbreak, and summarized the lessons learned. An epidemiological investigation was conducted on all individuals in the nursing home, including demographic information, clinical symptoms, history of dietary, water intake and contact. Stool and blood samples were collected from these populations for laboratory examinations. The hygiene environment of the nursing home was also investigated. A case-control study was conducted to identify the risk factors for this outbreak. Of the 722 subjects in the nursing home, 77 were diagnosed with hepatitis E, for an attack rate of 10.66 %. Among them, 18 (23.38 %, 18/77) individuals had symptoms such as jaundice, fever, and loss of appetite and were defined as the population with hepatitis E. The average age of people infected with hepatitis E virus (HEV) was 59.96 years and the attack rate of hepatitis E among women (12.02 %, 59/491) was greater than that among men (7.79 %, 18/231). The rate was the highest among caregivers (22.22 %, 32/144) and lowest among logistics personnel (6.25 %, 2/32); however, these differences were not statistically significant (P > 0.05). Laboratory sequencing results indicated that the genotype of this hepatitis E outbreak was 4d. A case-control study showed that consuming pig liver (odds ratio (OR) = 7.50; 95 % confidence interval [CI]: 3.84-16.14, P < 0.001) and consuming raw fruits and vegetables (OR = 5.92; 95 % CI: 1.74-37.13, P = 0.017) were risk factors for this outbreak of Hepatitis E. Moreover, a monitoring video showed that the canteen personnel did not separate raw and cooked foods, and pig livers were cooked for only 2 min and 10 s. Approximately 1 month after the outbreak, an emergency vaccination for HEV was administered. No new cases were reported after two long incubation periods (approximately 4 months). The outbreak of HEV genotype 4d was likely caused by consuming undercooked pig liver, resulting in an attack rate of 10.66 %. This was related to the rapid stir-frying cooking method and the hygiene habit of not separating raw and cooked foods.
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Affiliation(s)
- Ziping Miao
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Kexin Cao
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyue Wu
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Chenye Zhang
- Hangzhou Gongshu District Center for Disease Control and Prevention, Hangzhou, China
| | - Jian Gao
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Yin Chen
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Zhou Sun
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaobin Ren
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Yijuan Chen
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Mengya Yang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Can Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Daixi Jiang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuxia Du
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Lv
- Hangzhou Gongshu District Center for Disease Control and Prevention, Hangzhou, China.
| | - Shigui Yang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China.
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Li M, Wang Y, Li K, Hao X, Zhou H. Establishment and Characterization of the First Chinese National Standard for Nucleic Acid Amplification Technology Assays for Hepatitis E Virus Nucleic Acid Detection. Pathogens 2023; 12:1195. [PMID: 37887711 PMCID: PMC10610164 DOI: 10.3390/pathogens12101195] [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: 08/01/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
The detection of hepatitis E virus (HEV) RNA is the gold standard for HEV infection diagnosis. In order to address the quality control requirements for HEV RNA detection kits within China, we aimed to establish the first Chinese national standard for HEV RNA detection through a collaborative study. The candidate standard was quantified using digital PCR (dPCR). A total of five laboratories were invited to determine the estimated mean value of this national standard relative to the World Health Organization International Standard (WHO IS). Additionally, four commercial kits were used to assess the applicability of the candidate standard. The stability was determined by freeze-thaw cycles and storage at 37 °C, 25 °C and 4 °C. The estimated mean value of this national standard relative to the WHO IS was 5.67 log10 IU/mL. Two out of the four commercial kits can detect as low as the estimated limit of detection (LOD). The degradation rates of samples in the stability study ranged from 4% to 19%. In conclusion, we have established the first Chinese national standard for HEV nucleic acid detection against WHO IS, which can be employed to evaluate the quality of HEV RNA detection kits.
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Affiliation(s)
- Manyu Li
- Division I of In Vitro Diagnostics for Infectious Diseases, Institute for In Vitro Diagnostics Control, National Institutes for Food and Drug Control, 2 Tiantanxili Rd, Dongcheng District, Beijing 100050, China
| | - Yan Wang
- Department of Hepatobiliary and Pancreatic Surgery, First Hospital/First Clinical College of Shanxi Medical University, Taiyuan 030000, China
| | - Kejian Li
- Division I of In Vitro Diagnostics for Infectious Diseases, Institute for In Vitro Diagnostics Control, National Institutes for Food and Drug Control, 2 Tiantanxili Rd, Dongcheng District, Beijing 100050, China
| | - Xiaotian Hao
- Division I of In Vitro Diagnostics for Infectious Diseases, Institute for In Vitro Diagnostics Control, National Institutes for Food and Drug Control, 2 Tiantanxili Rd, Dongcheng District, Beijing 100050, China
| | - Haiwei Zhou
- Division I of In Vitro Diagnostics for Infectious Diseases, Institute for In Vitro Diagnostics Control, National Institutes for Food and Drug Control, 2 Tiantanxili Rd, Dongcheng District, Beijing 100050, China
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Cao K, Wu X, Yang M, Chen C, Zhang X, Jiang D, Du Y, Chen M, You Y, Zhou W, Qi J, Chen D, Yan R, Miao Z, Yang S. Prevalence of hepatitis E virus in China from 1997 to 2022: a systematic review and meta-analysis. Front Public Health 2023; 11:1243408. [PMID: 37744517 PMCID: PMC10512461 DOI: 10.3389/fpubh.2023.1243408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Several studies have reported on hepatitis E virus (HEV) prevalence in various regions of China, but the results vary widely. Herein, we conducted a systematic review and meta-analysis to assess the seroprevalence, RNA-positive rate, genotype distribution of HEV in China, and its risk factors. Methods We included 208 related studies involving 1,785,569 participants published between 1997 and 2022. Random-effects models were used to pool prevalence, and subgroup analyses were conducted by population, gender, age, study period, regions, and rural-urban distribution. The meta regression models and pooled odds ratios (OR) were performed to identify risk factors for HEV infections. Results The pooled anti-HEV IgG, IgM, and Ag seroprevalence, and RNA detection rates in China from 1997 to 2022 were 23.17% [95% confidence interval (CI): 20.23-26.25], 0.73% (95% CI: 0.55-0.93), 0.12% (95% CI: 0.01-0.32), and 6.55% (95% CI: 3.46-12.05), respectively. The anti-HEV IgG seropositivity was higher in the occupational population (48.41%; 95% CI: 40.02-56.85) and older adult aged 50-59 years (40.87%; 95% CI: 31.95-50.11). The dominant genotype (GT) of hepatitis E in China was GT4. Notably, drinking non-tap water (OR = 1.82; 95% CI: 1.50-2.20), consumption of raw or undercooked meat (OR = 1.47; 95% CI: 1.17-1.84), and ethnic minorities (OR = 1.50; 95% CI: 1.29-1.73) were risk factors of anti-HEV IgG seroprevalence. Discussions Overall, the prevalence of hepatitis E was relatively high in China, especially among older adults, ethnic minorities, and humans with occupational exposure to pigs. Thus, there is a need for preventive measures, including HEV infection screening and surveillance, health education, and hepatitis E vaccine intervention in high-risk areas and populations. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023397036.
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Affiliation(s)
- Kexin Cao
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyue Wu
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengya Yang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Can Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaobao Zhang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Daixi Jiang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuxia Du
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengsha Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yue You
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenkai Zhou
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaxing Qi
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Dingmo Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Rui Yan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ziping Miao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shigui Yang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
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Guo J, Zhang J, Li L, Gao X. Hepatitis E virus seroprevalence among employees in catering and public place industries in Nanjing, China. Epidemiol Infect 2023; 151:e122. [PMID: 37439201 PMCID: PMC10468814 DOI: 10.1017/s0950268823001097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/21/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023] Open
Abstract
This study aimed to assess the prevalence of anti-hepatitis E virus (HEV) immunoglobulin (Ig) M and elevated serum alanine aminotransferase (ALT) levels among employees in catering and public place industries. Blood samples were collected between January and December 2020 from 26,790 employees working in the Qinhuai district of Nanjing, China. Anti-HEV IgM in the serum samples was tested by the capture ELISA method and ALT was tested by the IFCC method. Samples positive for anti-HEV IgM or with ALT levels over 200 U/L were subjected to PCR screening of HEV RNA. The overall seroprevalence of anti-HEV IgM was 0.41%, and the seroprevalence was slightly higher in males (0.47%) than in females (0.37%); however, the difference was not substantial (p = 0.177). Seroprevalence of anti-HEV IgM increased with age, reaching its peak level after 48 years of age. The prevalence of elevated ALT levels was 4.24%, and males exhibited a higher prevalence than females (6.78% vs 2.65%, p < 0.001). Prevalence of elevated ALT levels differed in age groups and the 26-36-year-old group had the highest rate of elevated ALT levels. Employees with elevated ALT levels had a higher prevalence of positive anti-HEV IgM than those with normal ALT (0.57% vs 0.31%, p < 0.001). Positive HEV RNA was detected in one anti-HEV IgM-negative employee with ALT higher than 200 U/L. In our study, all the HEV RNA-positive and IgM-positive individuals are asymptomatic, and a combination of ALT tests, serological methods, and molecular methods is recommended to screen asymptomatic HEV carriers and reduce the risk of transmission.
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Affiliation(s)
- Jinlei Guo
- Microbiological laboratory, Qinhuai District Centre for Disease Control and Prevention, Nanjing, China
| | - Juansheng Zhang
- Microbiological laboratory, Xi’an Centre for Disease Control and Prevention, Xi’an, China
| | - Lingling Li
- Microbiological laboratory, Qinhuai District Centre for Disease Control and Prevention, Nanjing, China
| | - Xingli Gao
- Microbiological laboratory, Qinhuai District Centre for Disease Control and Prevention, Nanjing, China
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Geng Y, Shi T, Wang Y. Epidemiology of Hepatitis E. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:33-48. [PMID: 37223857 DOI: 10.1007/978-981-99-1304-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Hepatitis E virus (HEV) is globally prevalent with relatively high percentages of anti-HEV immunoglobulin G-positive individuals in the populations of developing and developed countries. There are two distinct epidemiological patterns of hepatitis E. In areas with high disease endemicity, primarily developing countries in Asia and Africa, this disease is caused mainly by genotypes HEV-1 or HEV-2; both genotypes transmit predominantly through contaminated water and occur as either outbreaks or sporadic cases of acute hepatitis. The acute hepatitis has the highest attack rate in young adults and is particularly severe among pregnant women. In developed countries, sporadic cases of locally acquired HEV-3 or HEV-4 infection are observed. The reservoir of HEV-3 and HEV-4 is believed to be animals, such as pigs, with zoonotic transmission to humans. The affected persons are often elderly, and persistent infection has been well documented among immunosuppressed persons. A subunit vaccine has been shown to be effective in preventing clinical disease and has been licensed in China.
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Affiliation(s)
- Yansheng Geng
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Tengfei Shi
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Youchun Wang
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China.
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Wu JY, Meng XX, Wei YR, Bolati H, Lau EHY, Yang XY. Prevalence of Hepatitis E Virus (HEV) in Feral and Farmed Wild Boars in Xinjiang, Northwest China. Viruses 2022; 15:78. [PMID: 36680118 PMCID: PMC9867238 DOI: 10.3390/v15010078] [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: 10/22/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Hepatitis E virus (HEV) causes infections in humans and a wide range of animal hosts. Wild boar is an important natural reservoir of HEV genotypes 3−6 (HEV-3−HEV-6), but comparative analysis of HEV infections in both feral and farmed wild boars remains limited. In this study, samples from 599 wild boars were collected during 2017−2020, including 121 feral wild boars (collected 121 fecal, 121 serum, and 89 liver samples) and 478 farmed wild boars (collected 478 fecal and 478 serum samples). The presence of anti-HEV IgG antibodies were detected by the HEV-IgG enzyme-linked immunosorbent assay (ELISA) kit. HEV RNA was detected by reverse transcription polymerase chain reaction (RT-PCR), targeting the partial ORF1 genes from fecal and liver samples, and the obtained genes were further genotyped by phylogenetic analysis. The results showed that 76.2% (95% CI 72.1−79.9) of farmed wild boars tested anti-HEV IgG seropositive, higher than that in feral wild boars (42.1%, 95% CI 33.2−51.5, p < 0.001). HEV seropositivity increased with age. Wild boar HEV infection presented a significant geographical difference (p < 0.001), but not between sex (p = 0.656) and age (p = 0.347). HEV RNA in fecal samples was detected in 13 (2.2%, 95% CI 1.2−3.7) out of 599 wild boars: 0.8% (95% CI 0.0−4.5, 1/121) of feral wild boars and 2.5% (95% CI 1.3−4.3, 12/478) of farmed wild boars. Phylogenetic analysis showed that all these viruses belonged to genotype HEV-4, and further grouped into sub-genotypes HEV-4a, HEV-4d, and HEV-4h, of which HEV-4a was first discovered in the wild boar populations in China. Our results suggested that farms could be a setting for amplification of HEV. The risk of HEV zoonotic transmission via rearing and consumption of farmed wild boars should be further assessed.
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Affiliation(s)
- Jian-Yong Wu
- Xinjiang Key Laboratory of Animal Infectious Diseases, Institute of Veterinary Medicine, Xinjiang Academy of Animal Science, Urumqi 830013, China
- School of Public Health, Xinjiang Medical University, Urumqi 830016, China
| | - Xiao-Xiao Meng
- Xinjiang Key Laboratory of Animal Infectious Diseases, Institute of Veterinary Medicine, Xinjiang Academy of Animal Science, Urumqi 830013, China
| | - Yu-Rong Wei
- Xinjiang Key Laboratory of Animal Infectious Diseases, Institute of Veterinary Medicine, Xinjiang Academy of Animal Science, Urumqi 830013, China
| | - Hongduzi Bolati
- Xinjiang Key Laboratory of Animal Infectious Diseases, Institute of Veterinary Medicine, Xinjiang Academy of Animal Science, Urumqi 830013, China
| | - Eric H. Y. Lau
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong SAR, China
| | - Xue-Yun Yang
- Xinjiang Key Laboratory of Animal Infectious Diseases, Institute of Veterinary Medicine, Xinjiang Academy of Animal Science, Urumqi 830013, China
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Bahoussi AN, Guo YY, Wang PH, Dahdouh A, Wu C, Xing L. Genomic characteristics and recombination patterns of swine hepatitis E virus in China. Transbound Emerg Dis 2022; 69:e3273-e3281. [PMID: 35511197 DOI: 10.1111/tbed.14585] [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: 03/01/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 11/28/2022]
Abstract
Zoonotic hepatitis E, mainly caused by swine hepatitis E virus (sHEV), is endemic in China, causing great economic disruption and public health threats. Although recombination is critical for the evolution of viruses, there is a limited assessment of its occurrence among sHEVs. Herein, we analyzed all available sHEV full-length genomes isolated in China during the past two decades (40 isolates) compared to 72 other sHEV strains isolated in different countries and determined that sHEV genotype 4 (sHEV4) dominates China. Eight potential natural recombination events were identified, four of which occurred in China and were mainly between sHEV4 strains, indicating the distinct character of China sHEV. One intergenotype recombination event was found in China, alarming the emergence of a new sHEV lineage that could become a critical threat to human health. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Amina Nawal Bahoussi
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, Shanxi Province, 030006, China
| | - Yan-Yan Guo
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, Shanxi Province, 030006, China
| | - Pei-Hua Wang
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, Shanxi Province, 030006, China
| | - Amina Dahdouh
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, Shanxi Province, 030006, China
| | - Changxin Wu
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, Shanxi Province, 030006, China.,Shanxi Provincial Key Laboratory of Medical Molecular Cell Biology, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, China.,Shanxi Provincial Key Laboratory for Prevention and Treatment of Major Infectious Diseases, 92 Wucheng Road, Taiyuan, 030006, China
| | - Li Xing
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, Shanxi Province, 030006, China.,Shanxi Provincial Key Laboratory of Medical Molecular Cell Biology, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, China.,Shanxi Provincial Key Laboratory for Prevention and Treatment of Major Infectious Diseases, 92 Wucheng Road, Taiyuan, 030006, China
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Liu B, Chen Y, Zhang M, Chen T, Zhang Y, DanBaZhaXi, Xu S, Zhao Q, Zhou EM. Identification and pathogenicity of hepatitis E Virus from laboratory Bama miniature pigs. BMC Vet Res 2022; 18:99. [PMID: 35292024 PMCID: PMC8922083 DOI: 10.1186/s12917-022-03206-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/07/2022] [Indexed: 11/11/2022] Open
Abstract
Background Hepatitis E virus (HEV) genotypes 3 and 4 are zoonotic. In this study, HEV infection in laboratory Bama miniature pigs in Sichuan Province of China was investigated. Firstly, one hundred rectal swabs were collected for HEV RNA testing, and chose positive samples for sequence analysis. Concurrently, for pathogenicity study, six healthy Bama miniature pigs were randomly divided into two groups of 3 pigs each. A total of 500 μL of HEV stock (positive fecal samples identified in this study) was inoculated intravenously into each pig in the experimental group, and the three pigs in the other group served as negative controls. Serum and fecal samples were collected at 1 to 10 weeks post-inoculation (wpi) for alanine aminotransferase (ALT) levels, anti-HEV antibodies and HEV RNA detection, respectively. During necropsies, liver lesions and HEV antigen in liver were observed at 10 wpi. Results The rate of fecal sample HEV RNA-positivity was 12% (12/100). Sequence comparisons indicated that partial ORF1 and ORF2 gene sequences of this isolate shared highest identities with corresponding sequences of genotype 4a HEV isolates (81.4%-96.1% and 89.9%-97.1%, respectively). Phylogenetic tree analysis further demonstrated that sequences of this isolate clustered together with sub-genotype 4a HEV isolate sequences. Experimentally, the pathogenicity of Bama miniature pigs infected with this isolate exhibited viremia, fecal virus shedding, seroconversion, ALT level increasing, liver lesions and HEV antigen in liver. Conclusions This is the first study to confirm that HEV is currently circulating in laboratory Bama miniature pigs in China and this isolate can successfully infect Bama miniature pigs experimentally. More importantly, this study suggested HEV screening of laboratory pigs should be conducted to prevent research personnel from acquiring zoonotic HEV infections.
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Affiliation(s)
- Baoyuan Liu
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China. .,Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, China.
| | - Yiyang Chen
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China
| | - Meimei Zhang
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China
| | - Tianxiang Chen
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China
| | - Yuan Zhang
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China
| | - DanBaZhaXi
- General Station of Animal Husbandry and Veterinary Technology Promotion, Naqu, Tibet, China
| | - Shixuan Xu
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China
| | - Qin Zhao
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China.,Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, China
| | - En-Min Zhou
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China. .,Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, China.
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Sun Y, Yan W, Chen X, Liu Q, Ji P, Zhu J, Gai L, Li X, Zhao J, Zhang L, Zhang H, Liu B, Zhou EM, Zhao Q. Antigenic cross-reactivity among human, swine, rabbit and avian hepatitis E virus capsid proteins. Vet Microbiol 2022; 265:109331. [PMID: 34999311 DOI: 10.1016/j.vetmic.2022.109331] [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: 10/22/2021] [Revised: 12/29/2021] [Accepted: 01/02/2022] [Indexed: 11/25/2022]
Abstract
Hepatitis E virus (HEV), a zoonotic virus, infects many animal species, including humans. Capsid proteins of human, swine, rabbit and avian HEVs share 48 %-100 % amino acid identity. In the present study, antigenic cross-reactivity among human, swine, rabbit and avian HEV capsid proteins were analyzed in detail using indirect and blocking enzyme-linked immunosorbent assays (ELISAs). The C-terminal 268 amino acids of genotype 1 human, genotype 4 swine, genotype 3 rabbit and genotype B3 avian HEV capsid proteins served as coating antigens for ELISA. Hyperimmune rabbit antisera (against four HEV capsid proteins) and human, pig, rabbit and chicken clinical sera were as primary antibodies. Closely correlated and statistically indistinguishable results were obtained for detection of anti-HEV antibodies in human and pig sera using human, swine and rabbit HEV capsid proteins as coating antigens. Moderately correlated differences in detection of anti-HEV antibodies in rabbit sera were obtained using the three capsid proteins. Statistically significant differences with no correlations were obtained for anti-HEV antibodies detection in chicken sera between avian HEV capsid protein and human, swine and rabbit ones. Blocking ELISA results demonstrated that two common epitopes among the four species HEVs were immunodominant in avian HEV, but were non-immunodominant in human, swine and rabbit HEVs. Nevertheless, three epitopes common to human, swine and rabbit HEVs were all immunodominant epitopes for the three species HEVs. Collectively, these results demonstrate that anti-HEV antibodies in human and pig sera can be detected using human, swine and rabbit HEV capsid proteins. By contrast, for optimal detection of anti-HEV antibodies in rabbit and chicken sera, the respective rabbit and avian HEV capsid proteins should be used. These results provide insights to guide future development of serological assays for diagnosing HEV infections in various animal species.
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Affiliation(s)
- Yani Sun
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Wenlong Yan
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Xu Chen
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Qianqian Liu
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Pinpin Ji
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Jiahong Zhu
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Lili Gai
- Shandong Bluetown Analysis and Test Co., Ltd, Jinan, Shandong, 250102, China
| | - Xiaoxuan Li
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Jiakai Zhao
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Lu Zhang
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Hao Zhang
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Baoyuan Liu
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - En-Min Zhou
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China
| | - Qin Zhao
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100, China; Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Yangling, Shaanxi, 712100, China.
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10
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Development of a competitive ELISA for detecting antibodies against genotype 1 hepatitis E virus. Appl Microbiol Biotechnol 2021; 105:8505-8516. [PMID: 34633486 DOI: 10.1007/s00253-021-11621-3] [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: 08/07/2021] [Revised: 09/19/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
Hepatitis E, a significant global public health issue in China, is caused by sporadic infections with regional hepatitis E virus (HEV) genotypes 1, 3, and 4. To date, most immunoassays currently used to test human sera for the presence of anti-HEV antibodies cannot identify HEV at the genotype level. However, such information would be useful for identifying the source of infecting virus. Therefore, here we describe the development of a competitive enzyme-linked immunosorbent assay (ELISA) for detecting anti-genotype 1 HEV antibodies in human sera. Using recombinant genotype 1 HEV ORF3 protein as immunogen, traditional hybridoma technology was employed to generate seven monoclonal antibodies (mAbs), of which two mAbs specifically reacted with the immunogen. One of these two mAbs, 1D2, was labeled with horseradish peroxidase (HRP) for use in competitive ELISA (cELISA). After cELISA optimization using a checkerboard assay design, the amount of ORF3SAR-55 as coating antigen (100 ng/well), HRP-1D2 mAb concentration (1 μg/mL), and test serum dilution (1:10) were selected and a result ≥ 19.5 was used as the cutoff for a positive result. Importantly, cross-genotype cELISA results indicated that the cELISA could not detect anti-genotype 3 rabbit and 4 swine HEV antibodies. Moreover, human sera confirmed as negative for anti-HEV antibodies using the commercial ELISA kit were all negative via cELISA. However, because the commercial ELISA kit detects anti-all genotypes HEV antibodies and the cELISA only detects anti-genotype 1 HEV antibodies, the consistence rate of two assays detecting positive sera is low. In summary, here a cELISA for detecting anti-genotype 1 HEV antibodies was developed for use in epidemiological investigations of genotype 1 HEV infections in humans. KEY POINTS: • Seven mAbs were produced using genotype 1 HEV ORF3 protein as immunogen. • One mAb that specifically bound to genotype 1 HEV ORF3 protein was selected and labeled for use in a cELISA to detect anti-genotype 1 HEV antibodies. • The competitive ELISA developed here will aid clinical diagnosis of HEV infections and will be useful for large-scale serological testing of genotype 1 HEV infections in humans.
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11
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Li S, He Q, Yan L, Li M, Liang Z, Shu J, Zhang F, Wang L, Wang L. Infectivity and pathogenicity of different hepatitis E virus genotypes/subtypes in rabbit model. Emerg Microbes Infect 2021; 9:2697-2705. [PMID: 33251979 PMCID: PMC7781933 DOI: 10.1080/22221751.2020.1858178] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The pathogenicity of each hepatitis E virus (HEV) genotypes/subtypes may be different. This study aimed to investigate the infectivity and pathogenicity of different HEV genotypes/subtypes from different mammalian sources especially human in rabbits, and to assess whether rabbits are an appropriate animal model to study different HEV genotypes/subtypes. Thirty-seven rabbits were randomly divided into nine groups and inoculated with eight different HEV strains, including human-derived HEV3b (hHEV-3b), hHEV-4a, hHEV-4d and hHEV-4h, swine-derived HEV4d (sHEV-4d) and sHEV-4h, rabbit-derived HEV3 (HEV-3ra) and camel-derived HEV8. HEV RNA, antigen, anti-HEV and alanine aminotransferase (ALT) in serum or/and feces were monitored weekly. One rabbit from each group was euthanized at seven weeks post inoculation and the liver specimens were taken for histopathological analysis and immunofluorescence staining of HEV ORF2 proteins. hHEV-4d, sHEV-4d and HEV-3ra infections were successfully established in rabbits and typical acute hepatitis symptoms were observed, including viraemia/antigenemia, fecal virus/antigen shedding, elevated ALT level and liver histopathological changes. One rabbit infected with HEV-3ra showed chronic infection. hHEV-4d and sHEV-4d are less infectious and pathogenic than HEV-3ra in rabbits. hHEV-3b and HEV8 only caused inapparent infection in rabbits as 60% (3/5) and 20% (1/5) of the rabbits seroconverted to anti-HEV, respectively. No obvious signs of HEV infection in rabbits inoculated with hHEV-4a, hHEV-4h and sHEV-4h. The infectivity and pathogenicity of different HEV genotypes/subtypes in rabbits is different, which may be related to the species specificity of HEV. Rabbit can be used as an animal model for the study of HEV-3ra and more importantly human HEV-4d.
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Affiliation(s)
- Shuangshuang Li
- Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, People's Republic of China
| | - Qiyu He
- Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, People's Republic of China
| | - Li Yan
- Department of Severe Hepatology, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, People's Republic of China
| | - Manyu Li
- Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, People's Republic of China
| | - Zhaochao Liang
- Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, People's Republic of China
| | - Jingyi Shu
- Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, People's Republic of China
| | - Fan Zhang
- Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, People's Republic of China
| | - Ling Wang
- Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, People's Republic of China
| | - Lin Wang
- Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, People's Republic of China
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12
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Fan H, Fan J, Chen S, Chen Y, Gao H, Shan L, Li X, Gu F, Zhuang H, Sun L. Prognostic Significance of End-Stage Liver Diseases, Respiratory Tract Infection, and Chronic Kidney Diseases in Symptomatic Acute Hepatitis E. Front Cell Infect Microbiol 2021; 10:593674. [PMID: 33520734 PMCID: PMC7843426 DOI: 10.3389/fcimb.2020.593674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/25/2020] [Indexed: 01/06/2023] Open
Abstract
Symptomatic hepatitis E virus (HEV) infection is sporadic, and usually occurs in a limited number of infected patients, which hinders the investigation of risk factors for clinical outcomes in patients with acute HEV infection. A retrospective cohort study enrolling 1913 patients with symptomatic acute hepatitis E in Beijing 302 Hospital from January 1, 2001 to December 31, 2018 was conducted. The baseline characteristics, clinical features and laboratory data of these HEV infection cases were analyzed. Albumin (ALB), platelet (PLT), alanine aminotransferase (ALT), total bilirubin (T-BiL), international normalized ratio (INR) and serum creatinine (SCR) levels, along with the model for end-stage liver disease (MELD) score, hospitalization days, co-morbidity number and mortality were taken as major parameters for comparing the clinical manifestations in our study. We found that not all pre-existing chronic liver diseases exacerbate clinical manifestations of acute hepatitis E. Alcoholic hepatitis, fatty liver hepatitis, hepatic cyst, drug-induced hepatitis and hepatocellular carcinoma were not significantly associated with mortality of HEV patients. Among all of the comorbidities, end-stage liver diseases (ESLDs, including ascites, cirrhosis, hepatic coma and hepatorenal syndrome), respiratory tract infection and chronic kidney diseases (CKDs, including renal insufficiency and renal failure) were found to remarkably increase the mortality of patients with symptomatic HEV infection. Furthermore, the severity evaluation indexes (SEI), such as MELD score, duration of hospital stay, and co-morbidity number in HEV patients with underlying comorbidities were much worse than that of their counterparts without relevant comorbidities.
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Affiliation(s)
- Huahao Fan
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Junfen Fan
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Suming Chen
- The Medical Center of Clinical Laboratory, Beijing 302 Hospital/The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Yangzhen Chen
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Huiru Gao
- The Medical Center of Clinical Laboratory, Beijing 302 Hospital/The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Liying Shan
- The Medical Center of Clinical Laboratory, Beijing 302 Hospital/The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Xue Li
- The Medical Center of Clinical Laboratory, Beijing 302 Hospital/The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Fengjun Gu
- Medical Information Center, Beijing 302 Hospital/The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Hui Zhuang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Lijun Sun
- Research Center for Clinical and Translational Medicine, Beijing 302 Hospital/The Fifth Medical Center of PLA General Hospital, Beijing, China
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13
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Lu J, Li Q, Jiang J, Li Z, Wang P, Sheng Z, Lai R, Zhou H, Cai W, Wang H, Guo Q, Gui H, Xie Q. Laboratory-based Surveillance and Clinical Profile of Sporadic HEV Infection in Shanghai, China. Virol Sin 2021; 36:644-654. [PMID: 33433848 DOI: 10.1007/s12250-020-00336-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/30/2020] [Indexed: 12/17/2022] Open
Abstract
The study aimed to describe the epidemiological, virological and clinical features of sporadic HEV infection in eastern China. A total of 6112 patient sera were tested for anti-HEV IgG or anti-HEV IgM during one consecutive year (between August 2018 and July 2019). HEV RNA presence was evaluated by RT-PCR and HEV sequences were phylogenetically analyzed. Clinical features of confirmed HEV-infected patients were delineated. The sero-positivity rate of anti-HEV IgG maintained stable around 40%, while an obvious winter spike of anti-HEV IgM prevalence was observed. A total of 111 patients were confirmed of HEV viremia by molecular diagnosis. Subtype 4d was predominant. Phylogenetic analyses suggest that certain strains circulate across species and around the country. Subjects with confirmed current HEV infection had a high median age (58 years) and males were predominant (62.2%). Most patients presented with jaundice (75.7%) and anorexia (68.0%). Significantly elevated levels of liver enzymes and bilirubin were observed. Remarkably, the baseline bilirubin level was positively correlated with illness severity. Pre-existing HBV carriage may deteriorate illness. The clinical burden caused by locally acquired HEV infection is increasing. Surveillance should be enforced especially during the transition period from winter to spring. Patients with higher level of bilirubin at disease onset had slower recovery from HEV infection.
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Affiliation(s)
- Jie Lu
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qing Li
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jiayuan Jiang
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ziqiang Li
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Peiyun Wang
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zike Sheng
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Rongtao Lai
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Huijuan Zhou
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Wei Cai
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hui Wang
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qing Guo
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Honglian Gui
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Qing Xie
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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Chanmanee T, Ajawatanawong P, Louisirirotchanakul S, Chotiyaputta W, Chainuvati S, Wongprompitak P. Phylogenetic analysis of two new complete genomes of the hepatitis E virus (HEV) genotype 3 from Thailand. Mol Biol Rep 2020; 47:8657-8668. [PMID: 33058031 PMCID: PMC7674359 DOI: 10.1007/s11033-020-05908-3] [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: 11/11/2019] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
Hepatitis E virus (HEV) is a causative agent of acute viral hepatitis globally. Evolutionary phylogeny classifies the HEV into eight genotypes that correlate with the viral transmission. Only four genotypes have been proven to be responsible for transmission in humans. However, there has been no report on the genomics and genotyping of HEV in Thailand during the past ten years. Here, we identified the genotype distributions of the Thai isolates of HEV and we sequenced two HEV genomes. We screened for 18 Thai isolates of HEV from Siriraj Hospital in Bangkok, from 2014–2016. The HEV genomes were sequenced from the serum and feces of a patient. The results showed that all Thai isolates of HEV were identified as genotype 3 (HEV-3). The ORF2 and genome phylogenies suggested two subgenotypes, called 3.1 and 3.2. The Thai isolates of HEV were frequently found in the subgenotype 3.1. The genome sequences of the two Thai isolates of HEV from the serum and fecal samples of the same patient showed 91% nucleotide similarity with the HEV genotype 3. Comparisons between the HEV genome and the ORF2 phylogenies illustrated that the ORF2 tree can be used to identify HEV genotypes, but it has less phylogenetic power for the HEV evolution. The two new genome sequences of HEV-3 from Thailand could contribute valuable information to the HEV genome study. (226 words)
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Affiliation(s)
- Tipsuda Chanmanee
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pravech Ajawatanawong
- Division of Bioinformatics and Data Management for Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suda Louisirirotchanakul
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Watcharasak Chotiyaputta
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Siwaporn Chainuvati
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Patimaporn Wongprompitak
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Muñoz-Chimeno M, Cenalmor A, Garcia-Lugo MA, Hernandez M, Rodriguez-Lazaro D, Avellon A. Proline-Rich Hypervariable Region of Hepatitis E Virus: Arranging the Disorder. Microorganisms 2020; 8:microorganisms8091417. [PMID: 32942608 PMCID: PMC7564002 DOI: 10.3390/microorganisms8091417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/21/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022] Open
Abstract
The hepatitis E virus (HEV) hypervariable region (HVR) presents the highest divergence of the entire HEV genome. It is characteristically rich in proline, and so is also known as the “polyproline region” (PPR). HEV genotype 3 (HEV-3) exhibits different PPR lengths due to insertions, PPR and/or RNA-dependent RNA polymerase (RdRp) duplications and deletions. A total of 723 PPR-HEV sequences were analyzed, of which 137 HEV-3 sequences were obtained from clinical specimens (from acute and chronic infection) by Sanger sequencing. Eight swine stool/liver samples were also analyzed. N- and C-terminal fragments were confirmed as being conserved, but they harbored differences between genotypes and were not proline-plentiful regions. The genuine PPR is the intermediate region between them. HEV-3 PPR contains a higher percentage (30.4%) of prolines than other genotypes. We describe for the first time: (1) the specific placement of HEV-3 PPR rearrangements in sites 1 to 14 of the PPR, noting that duplications are more frequently attached to sites 11 and 12 (AAs 74–79 and 113–118, respectively); (2) the cadence of repetitions follows a circular-like pattern of blocks A to J, with F, G, H, and I being the most frequent; (3) a previously unreported insertion homologous to apolipoprotein C1; and (4) the increase in frequency of potential N-glycosylation sites and differences in AAs composition related to duplications.
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Affiliation(s)
- Milagros Muñoz-Chimeno
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, 28220 Madrid, Spain; (M.M.-C.); (A.C.); (M.A.G.-L.)
| | - Alejandro Cenalmor
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, 28220 Madrid, Spain; (M.M.-C.); (A.C.); (M.A.G.-L.)
| | - Maira Alejandra Garcia-Lugo
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, 28220 Madrid, Spain; (M.M.-C.); (A.C.); (M.A.G.-L.)
| | - Marta Hernandez
- Laboratorio de Biología Molecular y Microbiología, Instituto Tecnológico Agrario de Castilla y León (ITACyL), 47071 Valladolid, Spain;
- Microbiology Division, Faculty of Sciences, University of Burgos, 09001 Burgos, Spain;
| | | | - Ana Avellon
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, 28220 Madrid, Spain; (M.M.-C.); (A.C.); (M.A.G.-L.)
- CIBER Epidemiology and Public Health, 28029 Madrid, Spain
- Correspondence:
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16
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Lee HS, Dao DT, Bui VN, Bui NA, Le TD, Nguyen-Viet H, Grace D, Thakur KK, Hagiwara K. Prevalence and phylogenetic analysis of hepatitis E virus in pigs in Vietnam. BMC Vet Res 2020; 16:333. [PMID: 32928220 PMCID: PMC7489210 DOI: 10.1186/s12917-020-02537-7] [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: 05/07/2020] [Accepted: 08/23/2020] [Indexed: 01/26/2023] Open
Abstract
Background Hepatitis E virus (HEV) is a zoonotic disease and has been reported around the world. The main objective of this study was to evaluate the sero-prevalence and phylogenetic analysis of HEV in Vietnam. Pig blood and fecal pooled samples were collected to assess the prevalence of HEV. We assessed the true prevalence (TP) of HEV from apparent prevalence (AP) by taking into account the sensitivity and specificity of diagnostic tests using a Bayesian approach. For phylogenetic analysis, the data compared with worldwide HEV reference strains including all eight genotypes (G1-G8) which were identified in previous study. Results A total of 475 sera and 250 fecal pooled samples were collected at slaughterhouses and pig farms from five provinces, in Viet Nam. Overall, the sero-AP of HEV was 58.53% (95% confidence interval: 53.95–62.70) while the sero-TP was slightly higher (65.43, 95% credible interval: 47.19–84.70). In terms of pooled samples, overall, the RNA-AP was 6.80% (95% confidence interval: 4.01–10.66). One strain in Hanoi, two strains in Dak Lak, seven strains in An Giang, four strains in Son La and two strains in Nghe An were isolated. The phylogenetic tree demonstrated that 19 Vietnamese strains were clustered into HEV 3 and 4. Conclusions This study provided evidence that HEV is circulating in domestic pigs in Vietnam. From a public health perspective, it is very important to raise public awareness for high-risk groups (e.g. slaughterhouse workers, pig traders, farmers and market sellers) who have more opportunities to come in contact with pig and contaminated meats.
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Affiliation(s)
- Hu Suk Lee
- International Livestock Research Institute (ILRI), Regional Office for East and Southeast Asia, Room 301-302, B1 Building, Van Phuc Diplomatic Compound, 298 Kim Ma Street, Ba Dinh District, Hanoi, Vietnam.
| | - Duy Tung Dao
- National Institute of Veterinary Research, Hanoi, Vietnam
| | | | - Ngoc Anh Bui
- National Institute of Veterinary Research, Hanoi, Vietnam
| | - Thanh Duy Le
- National Institute of Veterinary Research, Hanoi, Vietnam
| | - Hung Nguyen-Viet
- International Livestock Research Institute (ILRI), Regional Office for East and Southeast Asia, Room 301-302, B1 Building, Van Phuc Diplomatic Compound, 298 Kim Ma Street, Ba Dinh District, Hanoi, Vietnam
| | - Delia Grace
- International Livestock Research Institute (ILRI), Nairobi, Kenya.,Natural Resources Institute, Chatham, UK
| | - Krishna K Thakur
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Canada
| | - Katsuro Hagiwara
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Bunkyodai, Ebetsu, Hokkaido, 069-8501, Japan.
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17
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Wen J, Lu W, Meng J. Establishment of competitive binding assay to detect and differentiate hepatitis E virus infection. Ann Hepatol 2020; 18:590-594. [PMID: 31126881 DOI: 10.1016/j.aohep.2019.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES This study was undertaken to demonstrate a promising approach for detection and differentiation the serum immunoglobulin G (IgG) against hepatitis E virus (anti-HEV IgG) using a competitive binding assay established with known genotype-specific monoclonal antibodies (mAbs) 2B1 and 4C5. MATERIALS AND METHODS The mAb 2B1 derived from genotype 1 hepatitis E virus (HEV) antigen and specifically reacted with genotype 1, 2 antigens; 4C5 induced by genotype 4 HEV antigen was specific to genotypes 3, 4 antigens. The 2B1 and 4C5 were labeled with Horseradish peroxidase (HRP), respectively. Subsequently, the titers of coated antigens and HRP-conjugated mAbs for establishment of competitive binding assay were determined by enzyme linked immunosorbent assay (ELISA). And then, the competitive binding assay was performed to assess the inhibition percentage of mAbs binding to antigens inhibited by different genotypes anti-HEV IgG. RESULTS The results of competitive binding assay revealed that genotype 1 anti-HEV IgG could inhibit the binding of mAb 2B1 to genotype 1 antigen more strongly than that of mAb 4C5 to genotype 4 antigen. Whereas, the genotype 3 or 4 anti-HEV IgG could inhibit the binding of mAb 4C5 to genotype 4 antigen more remarkably than that of mAb 2B1 to genotype 1 antigen. CONCLUSIONS These findings provided us a valuable approach for detection and differentiation the HEV infection derived from genotypes 1, 2 (human) or genotypes 3, 4 (zoonosis).
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Affiliation(s)
- Jiyue Wen
- Department of Pharmacology, Anhui Medical University, Hefei, Anhui, China
| | - Weizhuo Lu
- Department of Medical Branch, Hefei Technology College, Hefei, Anhui, China
| | - Jihong Meng
- Department of Microbiology and Immunology, Southeast University School of Medicine, Nanjing, China.
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18
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Synthetic Peptides Containing Three Neutralizing Epitopes of Genotype 4 Swine Hepatitis E Virus ORF2 induced Protection against Swine HEV Infection in Rabbit. Vaccines (Basel) 2020; 8:vaccines8020178. [PMID: 32294910 PMCID: PMC7348971 DOI: 10.3390/vaccines8020178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/05/2020] [Accepted: 04/09/2020] [Indexed: 12/12/2022] Open
Abstract
Genotype 4 hepatitis E virus (HEV) is a zoonotic pathogen transmitted to humans through food and water. Previously, three genotype 4 swine HEV ORF2 peptides (407EPTV410, 410VKLYTS415, and 458PSRPF462) were identified as epitopes of virus-neutralizing monoclonal antibodies that partially blocked rabbit infection with swine HEV. Here, individual and tandem fused peptides were synthesized, conjugated to keyhole limpet hemocyanin (KLH), then evaluated for immunoprotection of rabbits against swine HEV infection. Forty New Zealand White rabbits were randomly assigned to eight groups; groups 1 thru 5 received three immunizations with EPTV-KLH, VKLYTS-KLH, PSRPF-KLH, EPTVKLYTS-KLH, or EPTVKLYTSPSRPF-KLH, respectively; group 6 received truncated swine HEV ORF2 protein (sp239), and group 7 received phosphate-buffered saline. After an intravenous swine HEV challenge, all group 7 rabbits exhibited viremia and fecal virus shedding by 2–4 weeks post challenge (wpc), seroconversion by 4–9 wpc, elevated alanine aminotransferase (ALT) at 2 wpc, and severe liver lymphocytic venous periphlebitis. Only 1–2 rabbits/group in groups 1–4 exhibited delayed viremia, fecal shedding, seroconversion, increased ALT levels, and slight liver lymphocytic venous periphlebitis; groups 5–6 showed no pathogenic effects. Collectively, these results demonstrate that immunization with a polypeptide containing three genotype 4 HEV ORF2 neutralizing epitopes completely protected rabbits against swine HEV infection.
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19
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Noninvasive models for predicting poor prognosis of chronic HBV infection patients precipitating acute HEV infection. Sci Rep 2020; 10:2753. [PMID: 32066795 PMCID: PMC7026406 DOI: 10.1038/s41598-020-59670-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 02/03/2020] [Indexed: 12/23/2022] Open
Abstract
Hepatitis E virus (HEV) infection contributes to a considerable proportion of acute-on-chronic liver failure (ACLF) in patients with chronic hepatitis B virus (HBV) infection. This study aimed to predict the prognosis of chronic HBV infection patients precipitating acute HEV infection. A total of 193 patients were enrolled in this study. The performances of three chronic liver disease prognostic models (CTP score, MELD score, and CLIF-C ADs) were analyzed for predicting the development of ACLF following HEV superimposing chronic HBV infection. Subsequently, the performances of five ACLF prognostic assessment models (CTP score, MELD score, CLIF-C ACLFs, CLIF-C OFs, and COSSH-ACLFs) were analyzed for predicting the outcome of those ACLF patients. Of 193 chronic HBV infection patients precipitating acute HEV infection, 13 patients were diagnosed ACLF on admission, 54 patients developed to ACLF after admission, and 126 patients had non-ACLF during the stay in hospital. For predicting the development of ACLF, CTP score yielded a significantly higher AUROC compared with MELD score and CLIF-C ADs (0.92, 0.88, and 0.86, respectively; all p < 0.05). For predicting the poor prognosis of ACLF patients, the COSSH-ACLFs yielded a significantly higher AUROC compared with CLIF-C ACLFs, CLIF-C OFs, MELD score, and CTP score (0.89, 0.83, 0.81, 0.67, and 0.58, respectively; all p < 0.05). In conclusion, the stepwise application of CTP score and COSSH-ACLFs can predict the prognosis of chronic HBV infection patients precipitating acute HEV infection.
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20
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Hepatitis E virus in Tibetan pigs on the Qinghai-Tibetan Plateau: detection, molecular characterization and infection of BALB/c mice. Arch Virol 2019; 164:2943-2951. [PMID: 31549302 DOI: 10.1007/s00705-019-04410-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 08/20/2019] [Indexed: 12/24/2022]
Abstract
This study was performed to investigate the prevalence and genetic variation of hepatitis E virus (HEV) in Tibetan pigs and to determine its ability to infect mice. A total of 38 out of 229 (16.59%; 95% CI = 12.00%-22.10%) fecal samples from Tibetan pigs from the Qinghai-Tibetan Plateau in 2018 were positive for HEV RNA, which was detected by RT-nPCR. Significantly different detection rates were observed between samples from diarrheic and clinically healthy animals (OR = 9.56; 95% CI, 2.84-32.14; p < 0.001), suggesting a potential association between HEV infection and diarrhea in Tibetan pigs. Phylogenetic analysis showed that the HEV isolates were clustered into subtypes 4a (31 samples), 4b (1), 4d (2), and 4j (4). HEV-4a was the predominant subtype, indicating that it might be circulating in Tibetan pigs. Nine complete HEV genome sequences obtained from Tibetan pigs were found by phylogenetic analysis to be closely related to those of genotype 4 HEV isolates from humans. Two recombinant events were identified in both HEV-4a strains; a novel recombination breakpoint was first identified at the 3' end of the ORF2 region in the SWU/L9/2018 strain, and a common recombination region was found at the junction of the ORF1 and ORF2 regions in the SWU/31-12/2018 strain. Furthermore, HEV-4a could be detected in all BALB/c mice that were experimentally infected by gavage and contact exposure. The information presented here about the prevalence and genotype diversity of HEV from Tibetan pigs provides important insights into the epidemic features of HEV on the Qinghai-Tibetan Plateau.
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21
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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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22
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Parisi F, Mazzei M, Verin R, Forzan M, Rocchigiani G, Roper C, Bertelloni G, Poli A. Hepatitis E virus infection in wild rabbit (Oryctolagus cuniculus) in Italy and in the UK: a serological, molecular, and pathological study. EUR J WILDLIFE RES 2019. [DOI: 10.1007/s10344-019-1314-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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23
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Shu Y, Chen Y, Zhou S, Zhang S, Wan Q, Zhu C, Zhang Z, Wu H, Zhan J, Zhang L. Cross-sectional Seroprevalence and Genotype of Hepatitis E Virus in Humans and Swine in a High-density Pig-farming Area in Central China. Virol Sin 2019; 34:367-376. [PMID: 31264049 DOI: 10.1007/s12250-019-00136-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/29/2019] [Indexed: 12/16/2022] Open
Abstract
Hepatitis E virus (HEV) infection is a common public health problem in developing countries. However, the current prevalence of HEV and the relationship of HEV genotype between swine and human within high-density pig-farming areas in central China are still inadequately understood. Here, cross-sectional serological and genotypic surveys of HEV among the 1232 general population, 273 workers occupationally exposed to swine, and 276 pigs in a high-density pig-breeding area, were undertaken by ELISA and nested RT-PCR methods. Anti-HEV IgG was detected in 26.22% of general population and 48.35% of occupational workers. The prevalence of swine serum HEV-Ag was 6.52%. The prevalence of anti-HEV IgG was significantly higher among the workers occupationally exposed to swine than among the general population. An increased HEV seropositivity risk among the general population was associated with either being a peasant or male and was very strongly associated with the increase of age. Among the occupationally exposed group, the prevalence of anti-HEV IgG antibodies increased with age and working years. Among the 30 HEV-IgM-positive people, the infection rates of clerks in the public, peasants, pork retailers, and pig farmers were higher than those of others. A phylogenetic analysis revealed that all the isolates belonged to subgenotype 4d, and four people and four pigs shared 97.04%-100% sequence homology. This study revealed a high HEV seroprevalence among the general population and workers occupationally exposed to swine in the Anlu City, and supports the notion that swine are a source of human HEV infection.
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Affiliation(s)
- Yilin Shu
- College of Life Sciences, Anhui Normal University, Wuhu, 421000, China
- Anlu Center for Disease Control and Prevention, Anlu, 432600, China
| | - Yameng Chen
- School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Sheng Zhou
- Anlu Center for Disease Control and Prevention, Anlu, 432600, China
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Shoude Zhang
- Anlu Center for Disease Control and Prevention, Anlu, 432600, China
| | - Qin Wan
- Anlu Center for Disease Control and Prevention, Anlu, 432600, China
| | - Changcai Zhu
- School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Zhijiang Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Hailong Wu
- College of Life Sciences, Anhui Normal University, Wuhu, 421000, China
| | - Jianbo Zhan
- Division for Viral Disease with Detection, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430065, China.
| | - Ling Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China.
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
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24
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Geng Y, Zhao C, Guo T, Xu Y, Wang X, Huang W, Liu H, Wang Y. Detection of Hepatitis E Virus in Raw Pork and Pig Viscera As Food in Hebei Province of China. Foodborne Pathog Dis 2019; 16:325-330. [DOI: 10.1089/fpd.2018.2572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Yansheng Geng
- Health Science Center, Hebei University, Baoding, China
| | - Chenyan Zhao
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Tingyu Guo
- Health Science Center, Hebei University, Baoding, China
| | - Ying Xu
- Health Science Center, Hebei University, Baoding, China
| | - Xuanpu Wang
- Health Science Center, Hebei University, Baoding, China
| | - Weijin Huang
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Huan Liu
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Youchun Wang
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
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25
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Chen X, Gong P, Wagner AL, Li Y, Wang G, Lu Y. Identification of hepatitis E virus subtype 4f in blood donors in Shanghai, China. Virus Res 2019; 265:30-33. [PMID: 30836112 DOI: 10.1016/j.virusres.2019.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/25/2022]
Abstract
Hepatitis E virus (HEV) has been divided into eight genotypes and approximately thirty subtypes. Past studies of blood donors have revealed a substantial prevalence of HEV infection. We examined anti-HEV antibodies and HEV RNA in Chinese voluntary blood donors (VBDs). Blood specimens were collected during 2010-2011, 2014-2015, and 2018, and tested for anti-HEV IgG and IgM antibodies. HEV RNA was tested using real-time PCR and nested reverse transcription PCR (RT-PCR). Phylogenetic analysis determined the genotype using MEGA 7.0. Among 4044 VBDs, 2774 were men (68.6%). In total, 19.8% and 1.1% of the VBDs were reactive to anti-HEV IgG and IgM, respectively. The seroprevalence of anti-HEV IgG was significantly associated with age and time period (P < 0.05), whereas anti-HEV IgM was associated with anti-Treponema pallidum and time period (P < 0.05). A total of five specimens were positive for HEV RNA with normal ALT levels. Subtype 4f (n=1; in the specimens reactive to anti-HEV IgM) and 4d (n=3; 1 in the specimens reactive to anti-HEV IgM and 2 in the anti-HEV negative specimens) were found. The last specimen positive for HEV RNA was not genotyped due to failure in amplifying the partial sequence. In conclusion, our study identified HEV subtype 4f for the first time in China. Additionally, we confirmed the high prevalence of HEV in Chinese VBDs. These findings suggest a substantial risk of transfusion-transmitted HEV. Therefore, screening for HEV among Chinese VBDs might be warranted to prevent further transfusion-mediated spread of HEV.
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Affiliation(s)
- Xiangxiang Chen
- Key Laboratory of Public Health Safety (Ministry of Education), Fudan University School of Public Health, Shanghai, 200032, China.
| | - Ping Gong
- Pudong New Area Blood Center, Shanghai, 200127, China.
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Yixuan Li
- Key Laboratory of Public Health Safety (Ministry of Education), Fudan University School of Public Health, Shanghai, 200032, China.
| | - Guanhong Wang
- Key Laboratory of Public Health Safety (Ministry of Education), Fudan University School of Public Health, Shanghai, 200032, China.
| | - Yihan Lu
- Key Laboratory of Public Health Safety (Ministry of Education), Fudan University School of Public Health, Shanghai, 200032, China; Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China.
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26
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Hepatitis E virus was not detected in feces and milk of cows in Hebei province of China: No evidence for HEV prevalence in cows. Int J Food Microbiol 2019; 291:5-9. [DOI: 10.1016/j.ijfoodmicro.2018.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/03/2018] [Accepted: 11/04/2018] [Indexed: 01/10/2023]
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27
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Huang X, Huang Y, Wagner AL, Chen X, Lu Y. Hepatitis E virus infection in swine workers: A meta-analysis. Zoonoses Public Health 2018; 66:155-163. [PMID: 30548110 DOI: 10.1111/zph.12548] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/29/2018] [Accepted: 11/14/2018] [Indexed: 12/27/2022]
Abstract
Hepatitis E virus (HEV) infects both humans and animals. Swine has been confirmed to be the principal natural reservoir, which raises a concern that HEV infection would be substantially increasing among swine workers. The present study calculated the pooled prevalence of IgG antibodies against HEV among swine workers and the general population in previous cross-sectional studies. We conducted a meta-analysis comparing the prevalence of HEV infection between swine workers and the general population, including local residents, blood donors and non-swine workers. Through searches in three databases (PubMed and OVID in English, and CNKI in Chinese) and after study selection, a total of 32 studies from 16 countries (from 1999 through 2018) were included in the meta-analysis. A random-effect model was employed in the study; an I 2 statistic assessed heterogeneity, and the Egger's test detected publication bias. The comparative prevalence of anti-HEV IgG was pooled from the studies. Compared to the general population, the prevalence ratio (PR) for swine workers was estimated to be 1.52 (95% CI 1.38-1.76) with the I 2 being 71%. No publication bias was detected (p = 0.40). A subgroup analysis further indicated increased prevalence of anti-HEV IgG in the swine workers in Asia (PR = 1.49, 95% CI: 1.35-1.64), in Europe (PR = 1.93, 95% CI: 1.49-2.50) and in all five swine-related occupations, including swine farmers, butchers, meat processors, pork retailers and veterinarians (PR ranged between 1.19 and 1.75). In summary, swine workers have a relatively higher prevalence of past HEV infection, and this finding is true across swine-related occupations, which confirms zoonotic transmission between swine and swine workers.
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Affiliation(s)
- Xiangyuan Huang
- Department of Epidemiology, Fudan University School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China
| | - Yu Huang
- Department of Epidemiology, Fudan University School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Xiangxiang Chen
- Department of Epidemiology, Fudan University School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, Fudan University School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China.,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
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28
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Hepatitis E virus: reasons for emergence in humans. Curr Opin Virol 2018; 34:10-17. [PMID: 30497051 DOI: 10.1016/j.coviro.2018.11.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/08/2018] [Accepted: 11/13/2018] [Indexed: 12/11/2022]
Abstract
Hepatitis E virus (HEV) infects both humans and other animal species. Recently, we have seen a steady increase in autochthonous cases of human HEV infection in certain areas especially in Europe, and large outbreaks in several African countries among the displaced population. This mini-review critically analyzes potential host, environmental, and viral factors that may be associated with the emergence of hepatitis E in humans. The existence of numerous HEV reservoir animals such as pig, deer and rabbit results in human exposure to infected animals via direct contact or through animal meat consumption. Contamination of drinking, irrigation and coastal water by animal and human wastes lead to emergence of endemic cases in industrialized countries and outbreaks in displaced communities especially in war-torn countries.
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29
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Hepatitis E virus infection in Wuhan, Central China. Arch Virol 2018; 164:27-32. [PMID: 30229302 DOI: 10.1007/s00705-018-4036-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 09/06/2018] [Indexed: 01/28/2023]
Abstract
Hepatitis E virus (HEV) is an emergent virus of global importance. Previous studies of HEV infection in China mainly focused on the rural areas. This work aims to study the epidemiology of HEV in a large urban environment. With a registered population of 10 million, the dense city of Wuhan presents itself as a prime opportunity to better understand this emergent virus. The epidemiological data from 2011 to 2016 were analyzed. A cross-sectional study on the seroprevalence of anti-HEV IgG was conducted among the general population (age range 0-59) in 2013. Serum and fecal samples of hepatitis E patients were collected over a period of two years: serum samples were tested for anti-HEV IgM and IgG, and fecal samples were tested for HEV-RNA. The overall seroprevalence of anti-HEV IgG was 35% in Wuhan. Among 415 hepatitis E patients, 286 cases (68.9%) were positive for HEV-IgM, 108 cases (26%) were positive for HEV-IgG alone, and 21 cases (5.1%) were negative for both IgM and IgG. Phylogenetic analysis showed that the detected genotype of HEV was genotype 4. Reported cases occurred sporadically throughout the year with the peak value appearing in the first quarter and a large proportion of male cases (2.1:1). The incidence increased with age for persons under 60 years, reaching its peak level after 60 years of age. Wuhan is endemic for HEV with its currently detected genotype being genotype 4. It is estimated that 68.9% hepatitis E cases were due to primary infection between 2012 and 2013 in Wuhan.
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30
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Smith DB, Simmonds P. Classification and Genomic Diversity of Enterically Transmitted Hepatitis Viruses. Cold Spring Harb Perspect Med 2018; 8:a031880. [PMID: 29530950 PMCID: PMC6120691 DOI: 10.1101/cshperspect.a031880] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Hepatitis A virus (HAV) and hepatitis E virus (HEV) are significant human pathogens and are responsible for a substantial proportion of cases of severe acute hepatitis worldwide. Genetically, both viruses are heterogeneous and are classified into several genotypes that differ in their geographical distribution and risk group association. There is, however, little evidence that variants of HAV or HEV differ antigenically or in their propensity to cause severe disease. Genetically more divergent but primarily hepatotropic variants of both HAV and HEV have been found in several mammalian species, those of HAV being classified into eight species within the genus Hepatovirus in the virus family Picornaviridae. HEV is classified as a member of the species Orthohepevirus A in the virus family Hepeviridae, a species that additionally contains viruses infecting pigs, rabbits, and a variety of other mammalian species. Other species (Orthohepevirus B-D) infect a wide range of other mammalian species including rodents and bats.
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Affiliation(s)
- Donald B Smith
- Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh EH9 3JT, United Kingdom
- Nuffield Department of Medicine, University of Oxford, Oxford OX1 3SY, United Kingdom
| | - Peter Simmonds
- Nuffield Department of Medicine, University of Oxford, Oxford OX1 3SY, United Kingdom
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31
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Li H, Wu J, Sheng Y, Lu Q, Liu B, Chen Y, Sun Y, Zhou E, Zhao Q. Prevalence of hepatitis E virus (
HEV
) infection in various pig farms from Shaanxi Province, China: First detection of
HEV RNA
in pig semen. Transbound Emerg Dis 2018; 66:72-82. [DOI: 10.1111/tbed.12966] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 06/05/2018] [Accepted: 06/28/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Huixia Li
- Department of Preventive Veterinary Medicine College of Veterinary Medicine Northwest A&F University Yangling Shaanxi China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology Ministry of Agriculture Yangling Shaanxi China
| | - Junyuan Wu
- College of Animal Science Tarim University Alar City Xinjiang China
| | - Yamin Sheng
- Department of Preventive Veterinary Medicine College of Veterinary Medicine Northwest A&F University Yangling Shaanxi China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology Ministry of Agriculture Yangling Shaanxi China
| | - Qizhong Lu
- Department of Preventive Veterinary Medicine College of Veterinary Medicine Northwest A&F University Yangling Shaanxi China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology Ministry of Agriculture Yangling Shaanxi China
| | - Baoyuan Liu
- Department of Preventive Veterinary Medicine College of Veterinary Medicine Northwest A&F University Yangling Shaanxi China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology Ministry of Agriculture Yangling Shaanxi China
| | - Yiyang Chen
- Department of Preventive Veterinary Medicine College of Veterinary Medicine Northwest A&F University Yangling Shaanxi China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology Ministry of Agriculture Yangling Shaanxi China
| | - Yani Sun
- Department of Preventive Veterinary Medicine College of Veterinary Medicine Northwest A&F University Yangling Shaanxi China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology Ministry of Agriculture Yangling Shaanxi China
| | - En‐Min Zhou
- Department of Preventive Veterinary Medicine College of Veterinary Medicine Northwest A&F University Yangling Shaanxi China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology Ministry of Agriculture Yangling Shaanxi China
| | - Qin Zhao
- Department of Preventive Veterinary Medicine College of Veterinary Medicine Northwest A&F University Yangling Shaanxi China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology Ministry of Agriculture Yangling Shaanxi China
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32
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Characterization of Three Novel Linear Neutralizing B-Cell Epitopes in the Capsid Protein of Swine Hepatitis E Virus. J Virol 2018; 92:JVI.00251-18. [PMID: 29669835 DOI: 10.1128/jvi.00251-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/10/2018] [Indexed: 01/13/2023] Open
Abstract
Hepatitis E virus (HEV) causes liver disease in humans and is thought to be a zoonotic infection, with domestic animals, including swine and rabbits, being a reservoir. One of the proteins encoded by the virus is the capsid protein. This is likely the major immune-dominant protein and a target for vaccination. Four monoclonal antibodies (MAbs), three novel, 1E4, 2C7, and 2G9, and one previously characterized, 1B5, were evaluated for binding to the capsid protein from genotype 4 swine HEV. The results indicated that 625DFCP628, 458PSRPF462, and 407EPTV410 peptides on the capsid protein comprised minimal amino acid sequence motifs recognized by 1E4, 2C7, and 2G9, respectively. The data suggested that 2C7 and 2G9 epitopes were partially exposed on the surface of the capsid protein. Truncated genotype 4 swine HEV capsid protein (sp239, amino acids 368 to 606) can exist in multimeric forms. Preincubation of swine HEV with 2C7, 2G9, or 1B5 before addition to HepG2 cells partially blocked sp239 cell binding and inhibited swine HEV infection. The study indicated that 2C7, 2G9, and 1B5 partially blocked swine HEV infection of rabbits better than 1E4 or normal mouse IgG. The cross-reactivity of antibodies suggested that capsid epitopes recognized by 2C7 and 2G9 are common to HEV strains infecting most host species. Collectively, MAbs 2C7, 2G9, and 1B5 were shown to recognize three novel linear neutralizing B-cell epitopes of genotype 4 HEV capsid protein. These results enhance understanding of HEV capsid protein structure to guide vaccine and antiviral design.IMPORTANCE Genotype 3 and 4 HEVs are zoonotic viruses. Here, genotype 4 HEV was studied due to its prevalence in human populations and pig herds in China. To improve HEV disease diagnosis and prevention, a better understanding of the antigenic structure and neutralizing epitopes of HEV capsid protein are needed. In this study, the locations of three novel linear B-cell recognition epitopes within genotype 4 swine HEV capsid protein were characterized. Moreover, the neutralizing abilities of three MAbs specific for this protein, 2C7, 2G9, and 1B5, were studied in vitro and in vivo Collectively, these findings reveal structural details of genotype 4 HEV capsid protein and should facilitate development of applications for the design of vaccines and antiviral drugs for broader prevention, detection, and treatment of HEV infection of diverse human and animal hosts.
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Shuai JB, Li LH, Li AY, He YQ, Zhang XF. Full genome analysis of swine genotype 3 hepatitis E virus isolated from eastern China. J Zhejiang Univ Sci B 2018; 18:549-554. [PMID: 28585432 DOI: 10.1631/jzus.b1600419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hepatitis E is believed to occur in both endemic and sporadic forms in developing countries, which causes a major public health problem in Asia and Africa (Meng, 2010; Wang et al., 2016a). Recent studies have documented that the disease is also endemic in many industrialized countries (Wenzel et al., 2011). The causative agent, hepatitis E virus (HEV), belonging to the genus Orthohepevirus, is a non-enveloped RNA virus with a single-stranded, positive-sense genome of approximately 7.2 kb (Smith et al., 2014). The genome consists of a short 5' un-translated region (UTR), three open reading frames (ORFs), and a 3' UTR containing a poly(A) tail (Meng, 2011). Four recognized major genotypes of HEV are identified: genotype 1 (Asian and African strains), genotype 2 (a Mexican strain), genotype 3 (primarily from America and Europe, and some Asian countries), and genotype 4 (mainly Asian strains) (Smith et al., 2016). Previous study revealed that HEV genotype 4 is the dominant zoonotic HEV genotype in China (Wang et al., 2016a). However, infections with HEV 3 have been found more commonly in recent years in China (Liu et al., 2012; Zhang et al., 2013). To date, only one full genome of Chinese swine genotype 3 HEV strain from Shanghai has been documented (Si et al., 2009). We report here the first full genome sequence of a genotype 3 swine HEV strain from Zhejiang, China.
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Affiliation(s)
- Jiang-Bing Shuai
- Zhejiang Academy of Science and Technology for Inspection and Quarantine, Hangzhou 310016, China
| | - Lu-Huan Li
- Department of Cardiopulmonary Rehabilitation, Hangzhou 128 Hospital, Hangzhou 310007, China
| | - Ai-Yun Li
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Yong-Qiang He
- Zhejiang Academy of Science and Technology for Inspection and Quarantine, Hangzhou 310016, China
| | - Xiao-Feng Zhang
- Zhejiang Academy of Science and Technology for Inspection and Quarantine, Hangzhou 310016, China
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Liu Q, Xu W, Lu S, Jiang J, Zhou J, Shao Z, Liu X, Xu L, Xiong Y, Zheng H, Jin S, Jiang H, Cao W, Xu J. Landscape of emerging and re-emerging infectious diseases in China: impact of ecology, climate, and behavior. Front Med 2018; 12:3-22. [PMID: 29368266 PMCID: PMC7089168 DOI: 10.1007/s11684-017-0605-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/24/2017] [Indexed: 10/26/2022]
Abstract
For the past several decades, the infectious disease profile in China has been shifting with rapid developments in social and economic aspects, environment, quality of food, water, housing, and public health infrastructure. Notably, 5 notifiable infectious diseases have been almost eradicated, and the incidence of 18 additional notifiable infectious diseases has been significantly reduced. Unexpectedly, the incidence of over 10 notifiable infectious diseases, including HIV, brucellosis, syphilis, and dengue fever, has been increasing. Nevertheless, frequent infectious disease outbreaks/events have been reported almost every year, and imported infectious diseases have increased since 2015. New pathogens and over 100 new genotypes or serotypes of known pathogens have been identified. Some infectious diseases seem to be exacerbated by various factors, including rapid urbanization, large numbers of migrant workers, changes in climate, ecology, and policies, such as returning farmland to forests. This review summarizes the current experiences and lessons from China in managing emerging and re-emerging infectious diseases, especially the effects of ecology, climate, and behavior, which should have merits in helping other countries to control and prevent infectious diseases.
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Affiliation(s)
- Qiyong Liu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Wenbo Xu
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, 102206, China
| | - Shan Lu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Jiafu Jiang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, China
| | - Jieping Zhou
- The Institute of Remote Sensing and Digital Earth, Chinese Academy of Sciences, Beijing, 100094, China.,State Key Laboratory of Remote Sensing Science, Jointly Sponsored by Institute of Remote Sensing and Digital Earth of Chinese Academy of Sciences and Beijing Normal University, Beijing, 100094, China
| | - Zhujun Shao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Xiaobo Liu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Lei Xu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yanwen Xiong
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Han Zheng
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Sun Jin
- The Institute of Remote Sensing and Digital Earth, Chinese Academy of Sciences, Beijing, 100094, China.,State Key Laboratory of Remote Sensing Science, Jointly Sponsored by Institute of Remote Sensing and Digital Earth of Chinese Academy of Sciences and Beijing Normal University, Beijing, 100094, China
| | - Hai Jiang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Wuchun Cao
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, China
| | - Jianguo Xu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
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Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infection. Emerg Microbes Infect 2017; 6:e115. [PMID: 29259325 PMCID: PMC5750461 DOI: 10.1038/emi.2017.107] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/04/2017] [Accepted: 11/07/2017] [Indexed: 12/20/2022]
Abstract
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in China. Recently, a shift in molecular epidemiology from hepatitis E genotype 1 (HEV-1) to hepatitis E genotype 4 (HEV-4) has been observed in Northern China, marking a switch from human-to-human transmission to zoonosis. However, similar data from cities in Southern China are lacking. This observational study of human hepatitis E cases in Shenzhen, a metropolitan city in the Pearl River Delta region, aimed to describe the clinical features and molecular epidemiology of hepatitis E in Southern China. Over a 55-month period, we identified 20 patients with acute hepatitis E. Most were middle-aged men, and 50% of patients had concomitant liver disease, of whom 70% were identified to have non-alcoholic fatty liver disease; such patients had a trend toward higher liver enzymes. Quantitative real-time RT-PCR using archived serum samples showed that 12 patients had hepatitis E viremia at presentation. Sequencing of the RNA-dependent RNA polymerase gene was performed for five of these patients, and phylogenetic analysis revealed that these five HEV isolates belonged to subgenotype 4b and were clustered with swine HEV isolates from Southern China. Combined with other studies showing similar findings, this suggests that the molecular epidemiology of hepatitis E in China is evolving toward low-level endemicity driven by foodborne transmission from seafood or pork products. The importance of concomitant liver disease, in particular non-alcoholic fatty liver disease, as a risk factor for severe hepatitis E requires further study.
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Abstract
Hepatitis E virus (HEV) is globally prevalent with relatively high percentages of anti-HEV immunoglobulin G-positive individuals in the populations of developing and developed countries. There are two distinct epidemiologic patterns of hepatitis E. In areas with high disease endemicity, primarily developing countries in Asia and Africa, this disease is caused mainly by genotype 1 or 2 HEV, both of which transmit predominantly through contaminated water and occur as either outbreaks or as sporadic cases of acute hepatitis. The acute hepatitis caused by either of these two genotypes has the highest attack rate in young adults, and the disease is particularly severe among pregnant women. In developed countries, sporadic cases of locally acquired genotype 3 or 4 HEV infection are observed. The reservoir of genotype 3 and 4 HEV is believed to be animals, such as pigs, with zoonotic transmission to humans. The affected persons are often elderly, and persistent infection has been well documented among immunosuppressed persons. A subunit vaccine has been shown to be effective in preventing clinical disease and has been licensed in China.
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Affiliation(s)
- Yansheng Geng
- School of Public Health, Hebei University, No. 342 Yuhuadonglu, Baoding, 071000, China.
| | - Youchun Wang
- Division of HIV/AIDS and Sex-transmitted Virus Vaccines, National Institutes for Food and Drug Control, No. 2 Tiantanxili, Dongcheng District, Beijing, 100050, China
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Zhao C, Geng Y, Huang W, Ma H, Wang Y. Valuable antibody detection method for classifying hepatitis E virus genotypes. J Med Virol 2017; 90:142-147. [DOI: 10.1002/jmv.24915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 07/31/2017] [Indexed: 01/26/2023]
Affiliation(s)
- Chenyan Zhao
- Division of HIV/AIDS and Sex-transmitted Virus Vaccines; National Institutes for Food and Drug Control; Tiantanxili Beijing China
| | - Yansheng Geng
- Health Science Center; Hebei University; Yuhuadonglu Baoding China
| | - Weijing Huang
- Division of HIV/AIDS and Sex-transmitted Virus Vaccines; National Institutes for Food and Drug Control; Tiantanxili Beijing China
| | - Hongxia Ma
- Henan Provincial Center for Disease Prevention and Control; Nongyenanlu Zhengzhou China
| | - Youchun Wang
- Division of HIV/AIDS and Sex-transmitted Virus Vaccines; National Institutes for Food and Drug Control; Tiantanxili Beijing China
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Molecular Epidemiology and Strain Comparison between Hepatitis E Viruses in Human Sera and Pig Livers during 2014 to 2016 in Hong Kong. J Clin Microbiol 2017; 55:1408-1415. [PMID: 28202801 DOI: 10.1128/jcm.02020-16] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/08/2017] [Indexed: 12/21/2022] Open
Abstract
Hepatitis E virus (HEV) causes substantial morbidity and mortality in developing countries and is considered an emerging foodborne pathogen in developed countries in which it was previously not endemic. To investigate genetic association between human HEV infection and HEV-contaminated high-risk food in Hong Kong, we compared local virus strains obtained from hepatitis E patient sera with those surveyed from high-risk food items during 2014 to 2016. Twenty-four cases of laboratory-confirmed human HEV infections were identified from January 2014 to March 2016 in our hospitals. Five types of food items at risk of HEV contamination were purchased on a biweekly basis from April 2014 to March 2016 in two local market settings: supermarkets (lamb, oyster, and pig liver) and wet markets (oyster, pig blood curd, pig large intestine, and pig liver). HEV RNA detection was performed by a real-time reverse transcription-PCR assay. HEV RNA was detected in pig liver, pig intestine, and oyster samples with prevalences of 1.5%, 0.4%, and 0.2%, respectively. Neighbor-joining phylogenetic inference showed that all human and swine HEV strains belonged to genotype 4. HEV subtype distributions in humans and swine were highly comparable: subtype 4b predominated, while subtype 4d was the minority. Local human and swine HEV genotype 4 strains shared over 95% nucleotide identity and were genetically very similar, implicating swine as an important foodborne source of autochthonous human HEV infections in Hong Kong. Action should be taken to raise the awareness among public and health care professionals of hepatitis E as an emerging foodborne disease.
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Cao Y, Zhu L, Liu D, Guo C, Yuan Y, Shi C, Liu Z, Wang X. A novel subgenotype 3a hepatitis E virus isolated from pigs in China. Virus Genes 2017; 53:483-486. [PMID: 28205052 DOI: 10.1007/s11262-017-1435-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 02/06/2017] [Indexed: 10/20/2022]
Abstract
Hepatitis E virus (HEV) infection is an emerging disease with zoonotic transmission that represents a serious public health concern, especially in developing countries. Here we characterize a novel HEV strain CCST-517, which possesses a complete genome sequence of 7284 bp with typical HEV genome organization including 5' and 3' non-coding regions and three open reading frames. The sequence identities of CCST-517 with known HEV genotype 1, 2, 3, and 4 were 73.4-73.7, 73.2, 80.4-90.4, and 75.1-75.7%, respectively. Phylogenetic analysis clustered CCST-517 to the clade of HEV genotype 3a, together with the Japanese human HEV isolate (HE-JA10) and United States human HEV isolate (HEV-US2). Similarity plot analysis indicated that the fragment extending from 4500 to 5500 nt included evidence of one intra-genotype recombination event in the genome sequence of the CCST-517 strain. To our knowledge, this is the first report of HEV genotype 3a with its complete genome sequence revealed in China. Our findings revealed a close phylogenetic relationship of CCST-517 to human HEV-US2 and HE-JA10, implying cross-species transmission of HEV between pigs and humans.
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Affiliation(s)
- Yufeng Cao
- College of Veterinary Medicine, Jilin University, 5333 Xian Road, Changchun, 130062, Jilin, China.,Changchun Institute of Biological Products Co. Ltd., 3456 Xian Road, Changchun, 130062, Jilin, China
| | - Lisai Zhu
- College of Veterinary Medicine, Jilin University, 5333 Xian Road, Changchun, 130062, Jilin, China
| | - Dan Liu
- College of Veterinary Medicine, Jilin University, 5333 Xian Road, Changchun, 130062, Jilin, China
| | - Changming Guo
- College of Veterinary Medicine, Jilin University, 5333 Xian Road, Changchun, 130062, Jilin, China
| | - Yue Yuan
- College of Veterinary Medicine, Jilin University, 5333 Xian Road, Changchun, 130062, Jilin, China
| | - Chengbo Shi
- Changchun Institute of Biological Products Co. Ltd., 3456 Xian Road, Changchun, 130062, Jilin, China
| | - Zhaohui Liu
- Changchun Institute of Biological Products Co. Ltd., 3456 Xian Road, Changchun, 130062, Jilin, China.
| | - Xinping Wang
- College of Veterinary Medicine, Jilin University, 5333 Xian Road, Changchun, 130062, Jilin, China. .,Key Laboratory for Zoonosis, Ministry of Education, Institute for Zoonosis of Jilin University, Changchun, 130062, China.
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Wang L, Liu L, Wei Y, Wang Q, Tian Q, Wang L, Zhuang H. Clinical and virological profiling of sporadic hepatitis E virus infection in China. J Infect 2016; 73:271-9. [PMID: 27343562 DOI: 10.1016/j.jinf.2016.06.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Recently, genotype 4 HEV (HEV-4) associated hepatitis E has overtaken HEV-1 infections in China, but few studies reported the clinical and virological features of HEV-4 infection. METHODS Sixty-two patients with acute hepatitis E (AHE) were enrolled from three hospitals in China. Clinical profiles and epidemiological records were analyzed. Patients' serum samples were tested for anti-HEV IgM/IgG and fecal samples were screened for HEV RNA. Representative HEV isolates were partially sequenced and analyzed phylogenetically. RESULTS A high median age (57.5 years) and an overwhelming proportion of males (51/62, 82%) were found. Most patients presented with symptoms of jaundice (56/62, 90%), malaise (44/62, 71%), anorexia (44/62, 71%) and nausea (41/62, 66%). Elevated mean values of total bilirubin (186 μmol/L), direct bilirubin (109 μmol/L), ALT (997 IU/L), AST (583 IU/L), ALP (159 IU/L) and GGT (170 IU/L) and reduced albumin level (32 g/L) were observed. The positive rate for anti-HEV IgM/IgG was 100% (62/62)/76% (47/62), for HEV RNA was 58% (25/43). Twelve HEV-4 isolates were obtained. CONCLUSION All HEV isolates belonged to HEV-4 and showed high sequence similarity to swine HEV-4. Most of the sporadic cases had typical clinical symptoms, signs of AHE, and elevated levels of serum bilirubin and liver enzymes.
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Affiliation(s)
- Lin Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Lin Liu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Yongli Wei
- Department of Infectious Diseases, Linyi People's Hospital, Shandong Province, China
| | - Qianhui Wang
- Department of Infectious Diseases, Taiyuan No.3 Hospital, Shanxi Province, China
| | - Qing Tian
- Department of Infectious Diseases, Linyi People's Hospital, Shandong Province, China
| | - Ling Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China.
| | - Hui Zhuang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
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Immunogenicity difference between two hepatitis E vaccines derived from genotype 1 and 4. Antiviral Res 2016; 128:36-42. [PMID: 26850829 DOI: 10.1016/j.antiviral.2016.02.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/26/2016] [Accepted: 02/01/2016] [Indexed: 01/14/2023]
Abstract
We investigated the immunogenicity difference between hepatitis E vaccine p239 derived from hepatitis E virus (HEV) genotype 1 and vaccine p179 derived from HEV genotype 4; and the presence of genotype-specific neutralizing epitopes. HEV ORF2 recombinant proteins (p166W01, p166Mex, p166US and p166Chn) derived from the four HEV genotypes were used to detect anti-HEV IgGs in sera of mice and humans vaccinated with p179 or p239 and in sera of rhesus monkey challenged with HEV genotype 1 or 4 strains. Then monoclonal antibodies (mAbs) against genotype 1 or 4 ORF2 recombinant proteins were prepared and their immunoreactivity was assessed using ELISA and Western blotting; their neutralizing activity was evaluated by an in vitro PCR-based neutralization assay. The results revealed significant immunogenicity difference between the two vaccines: p239-induced IgGs reacted more strongly against p166W01 and p166Mex than against p166US and p166Chn in mice and humans. By contrast, p179-induced IgGs showed a stronger reactivity against p166US and p166Chn than against p166W01 and p166Mex. This difference has also been observed in the sera of rhesus monkeys challenged with HEV genotype 1 or 4 strains. Moreover, besides the two common neutralizing mAbs 3G1 and 5G5, two genotype-specific neutralizing mAbs, 2B1 and 4C5, were obtained. 2B1 could specifically bind to recombinant proteins derived from genotypes 1 and 2 and neutralized only genotypes 1 and 2 strains, while 4C5 immunoreacted specifically against recombinant proteins derived from genotypes 3 and 4 and neutralized only genotypes 3 and 4 strains. These findings revealed the existence of immunogenicity difference between the p179 and p239 vaccines and demonstrated that this difference could be due to the presence of HEV genotype-specific neutralization epitopes.
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Smith DB, Simmonds P, Izopet J, Oliveira-Filho EF, Ulrich RG, Johne R, Koenig M, Jameel S, Harrison TJ, Meng XJ, Okamoto H, Van der Poel WHM, Purdy MA. Proposed reference sequences for hepatitis E virus subtypes. J Gen Virol 2016; 97:537-542. [PMID: 26743685 DOI: 10.1099/jgv.0.000393] [Citation(s) in RCA: 306] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The nomenclature of hepatitis E virus (HEV) subtypes is inconsistent and makes comparison of different studies problematic. We have provided a table of proposed complete genome reference sequences for each subtype. The criteria for subtype assignment vary between different genotypes and methodologies, and so a conservative pragmatic approach has been favoured. Updates to this table will be posted on the International Committee on Taxonomy of Viruses website (http://talk.ictvonline.org/r.ashx?C). The use of common reference sequences will facilitate communication between researchers and help clarify the epidemiology of this important human pathogen. This subtyping procedure might be adopted for other taxa of the genus Orthohepevirus.
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Affiliation(s)
- Donald B Smith
- University of Edinburgh, Centre for Immunity, Infection and Evolution, Edinburgh, Scotland, UK
| | - Peter Simmonds
- University of Edinburgh, Centre for Immunity, Infection and Evolution, Edinburgh, Scotland, UK
| | | | - Edmilson F Oliveira-Filho
- Veterinary Virology and Animal Viral Diseases, Department of Infectious and Parasitic Diseases, Fundamental and Applied Research for Animal Health Centre, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Rainer G Ulrich
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute for Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany.,German Center for Infection Research DZIF, partner site Hamburg-Luebeck-Borstel-Insel Riems, Germany
| | - Reimar Johne
- Federal Institute for Risk Assessment, Berlin, Germany
| | | | - Shahid Jameel
- The Wellcome Trust/DBT India Alliance, Hyderabad, India
| | | | - Xiang-Jin Meng
- College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi-ken, Japan
| | - Wim H M Van der Poel
- Central Veterinary Institute, Wageningen University and Research Centre, Lelystad, The Netherlands
| | - Michael A Purdy
- Centers for Disease Control and Prevention, National Center for HIV/Hepatitis/STD/TB Prevention, Division of Viral Hepatitis, Atlanta, GA, USA
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Geng Y, Zhao C, Huang W, Harrison TJ, Zhang H, Geng K, Wang Y. Detection and assessment of infectivity of hepatitis E virus in urine. J Hepatol 2016; 64:37-43. [PMID: 26362822 DOI: 10.1016/j.jhep.2015.08.034] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/27/2015] [Accepted: 08/31/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Hepatitis E virus (HEV) is known to be excreted in the stool but there has been no report of its presence in urine. This study investigated the presence of HEV RNA and antigen (HEV-Ag) in urine and its possible transmission. METHODS Serum and urine samples from patients with chronic or acute HEV infection and HEV infected monkeys were tested for viral and biochemical markers. Liver and kidney biopsies from the infected monkeys were analyzed by histopathology and immunohistochemistry. The infectivity of HEV from urine was assessed by inoculation into monkeys. RESULTS HEV RNA and HEV-Ag were detected persistently in the urine of a patient with chronic HEV infection. Subsequently, HEV RNA was detected in the urine of three of the eight (37.5%) acute patients, all of whom had detectable HEV-Ag in their urine. HEV RNA and HEV-Ag were also detectable in the urine of HEV infected monkeys. The ratio of HEV-Ag to RNA in the urine of the infected monkeys was significantly higher than in their sera and feces. The parameters of routine urinalysis remained within the normal ranges in the hepatitis E patients and infected monkeys, however, pathological changes and HEV-Ag were observed in the kidneys of the infected monkeys. Furthermore, one of two monkeys became infected with HEV after inoculation with urine from another infected monkey. CONCLUSIONS HEV infection may result in kidney injury and the urine may pose a risk of transmission. HEV-Ag detection in urine may be valuable for diagnosis of ongoing HEV infection.
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Affiliation(s)
- Yansheng Geng
- Health Science Center, Hebei University, No. 342 Yuhuadonglu, Baoding 071000, China
| | - Chenyan Zhao
- Division of HIV/AIDS and Sex-transmitted Virus Vaccines, National Institutes for Food and Drug Control, No. 2 Tiantanxili, Beijing 100050, China
| | - Weijin Huang
- Division of HIV/AIDS and Sex-transmitted Virus Vaccines, National Institutes for Food and Drug Control, No. 2 Tiantanxili, Beijing 100050, China
| | - Tim J Harrison
- Division of Medicine, University College London Medical School, Cruciform Building, 90 Gower Street, London WC1E 6BT, UK
| | - Hongxin Zhang
- Health Science Center, Hebei University, No. 342 Yuhuadonglu, Baoding 071000, China
| | - Kunjing Geng
- Baoding Hospital for Infectious Disease, Baoding, China
| | - Youchun Wang
- Division of HIV/AIDS and Sex-transmitted Virus Vaccines, National Institutes for Food and Drug Control, No. 2 Tiantanxili, Beijing 100050, China.
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Nakano T, Takahashi K, Takahashi M, Nishigaki Y, Watanabe N, Ishida S, Fujimoto S, Kato H, Okano H, Takei Y, Ayada M, Tomita E, Arai M, Okamoto H, Mishiro S. Investigating the origin and global dispersal history of hepatitis E virus genotype 4 using phylogeographical analysis. Liver Int 2016; 36:31-41. [PMID: 26037061 DOI: 10.1111/liv.12880] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 05/26/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Hepatitis E virus (HEV) genotype 4 has mainly been isolated from sporadic hepatitis cases and swine in Asian countries. We analysed the origin and global dispersal history of genotype 4 using a Bayesian phylogeographical approach. METHODS The 412-nucleotide sequences of open reading frame 2 of genotype 4 (47 Japanese, 40 Chinese, 1 Indian, 8 Indonesian, 1 Korean, 1 Taiwanese, 2 Danish and 2 Italian), of which sampling date and location were known, were collected. Evolutionary rate, divergence time, demographic growth and phylogeography were co-estimated in the Bayesian statistical inference framework implemented in the BEAST package to model spatial dispersal on a time-scaled genealogy. RESULTS The most probable origin of genotype 4 was Japan and the time of origin was 1909 (95% highest posterior density, 1871-1940). Seven lineages of genotype 4 migrated from Japan to China. The analysis also showed the migration of genotype 4 from Japan or China to India and Indonesia and from China to Indonesia, Taiwan, Korea and a few European countries. CONCLUSIONS Swine trade between countries coincided with the migration time and direction of genotype 4 in some cases and was considered the primary cause of dispersal. However, there was no clear cause of dispersal for some cases, for which no records of pig trade were found. Future research should analyse additional nucleotide sequences paired with epidemiological data from various countries to improve our understanding of HEV dispersal.
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Affiliation(s)
- Tatsunori Nakano
- Department of Internal Medicine, Fujita Health University Nanakuri Sanatorium, Mie, Japan
| | - Kazuaki Takahashi
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yoichi Nishigaki
- Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, Japan
| | - Naoki Watanabe
- Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, Japan
| | - Satoshi Ishida
- Department of Internal Medicine, Kuwana West Medical Center, Kuwana, Japan
| | - Shino Fujimoto
- Department of Internal Medicine, Kuwana West Medical Center, Kuwana, Japan
| | - Hideaki Kato
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Hiroshi Okano
- Department of Gastroenterology, Suzuka General Hospital, Mie, Japan
| | - Yoshiyuki Takei
- Department of Gastroenterology and Hepatology, Division of Clinical Medicine and Biomedical Science, Institute of Medical Sciences, Mie University Graduate School of Medicine, Mie, Japan
| | - Minoru Ayada
- Department of Gastroenterology, Chutoen General Medical Center, Shizuoka, Japan
| | - Eiichi Tomita
- Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, Japan
| | - Masahiro Arai
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Shunji Mishiro
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
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45
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Mesquita J, Abreu-Silva J, Sousa J, Aguiar A, Nascimento M. Evidence of autochthonous hepatitis E in a Portuguese pediatric cohort, 1992-1995. J Med Virol 2015; 88:919-21. [DOI: 10.1002/jmv.24414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2015] [Indexed: 12/17/2022]
Affiliation(s)
| | - J. Abreu-Silva
- Laboratory of Microbiology; Faculty of Farmacy of University of Porto; Porto Portugal
| | - J.C. Sousa
- CEBIMED, Faculty of Health Sciences; University Fernando Pessoa; Porto Portugal
| | - A. Aguiar
- Faculty of Medicine of University of Porto; Porto Portugal
| | - M.S.J. Nascimento
- Laboratory of Microbiology; Faculty of Farmacy of University of Porto; Porto Portugal
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46
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[Hepatitis E virus: opinions of the Working Group of the Federal Ministry of Health Blood]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 58:198-218. [PMID: 25608627 DOI: 10.1007/s00103-014-2103-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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47
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Swine and rabbits are the main reservoirs of hepatitis E virus in China: detection of HEV RNA in feces of farmed and wild animals. Arch Virol 2015; 160:2791-8. [PMID: 26303139 DOI: 10.1007/s00705-015-2574-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 08/16/2015] [Indexed: 01/13/2023]
Abstract
Hepatitis E virus (HEV) infection is recognized as a zoonosis. The prevalence of HEV RNA and anti-HEV antibodies in many animal species has been reported, but the host range of HEV is unclear. The aims of this study were to investigate HEV infection in various animal species and to determine the reservoirs of HEV. Eight hundred twenty-two fecal samples from 17 mammal species and 67 fecal samples from 24 avian species were collected in China and tested for HEV RNA by RT-nPCR. The products of PCR were sequenced and analyzed phylogenetically. The positive rates of HEV RNA isolated from pigs in Beijing, Shandong, and Henan were 33%, 30%, and 92%, respectively, and that from rabbits in Beijing was 5%. HEV RNA was not detectable in farmed foxes, sheep or sika deer, or in wild animals in zoos, including wild boars, yaks, camels, Asiatic black bears, African lions, red pandas, civets, wolves, jackals and primates. Sequence analysis revealed that swine isolates had 97.8%-98.4% nucleotide sequence identity to genotype 4d isolates from patients in Shandong and Jiangsu of China. Phylogenetic analysis showed that swine HEV isolates belong to genotype 4, including subgenotype 4h in Henan and 4d in Beijing and Shandong. The rabbit HEV strains shared 93%-99% nucleotide sequence identity with rabbit strains isolated from Inner Mongolia. In conclusion, swine and rabbits have been confirmed to be the main reservoirs of HEV in China.
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48
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Zhang Y, Zeng H, Liu P, Liu L, Xia J, Wang L, Zou Q, Wang L, Zhuang H. Hepatitis E vaccine immunization for rabbits to prevent animal HEV infection and zoonotic transmission. Vaccine 2015. [PMID: 26212003 DOI: 10.1016/j.vaccine.2015.07.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Hepatitis E virus (HEV) infection has become a significant global public health concern as increasing cases of acute and chronic hepatitis E are reported. HEV of animal origin was proved to be a possible source of human infection and a previous study showed that the recent licensed HEV 239 vaccine can serve as a candidate vaccine to manage animal sources of HEV infection. However, previous immunization strategy for rabbits was the same as that for human, which is too costly to conduct large-scale animal vaccination. In an effort to reduce the costs, three vaccination schemes were assessed in the present study. Forty specific pathogen-free (SPF) rabbits were divided randomly into five groups with eight animals for each and inoculated intramuscularly with different doses of HEV 239 and placebo, respectively. All animals were challenged intravenously with swine HEV-4 and rabbit HEV of different titers 7 weeks after the initial immunization and then fecal virus excretion was monitored for 10 weeks. The results indicated that immunizing rabbits with two 10μg doses of the vaccine is superior to vaccination with two 20μg doses or a single 30μg dose, which can protect rabbits against homologous and heterologous HEV infection. These findings could enable implementation of large-scale animal vaccination to prevent rabbit HEV infection and zoonotic transmission.
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Affiliation(s)
- Yulin Zhang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Hang Zeng
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Peng Liu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Lin Liu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Junke Xia
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Lin Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Qinghua Zou
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Ling Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
| | - Hui Zhuang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
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49
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Tsatsralt-Od B, Baasanjav N, Nyamkhuu D, Ohnishi H, Takahashi M, Okamoto H. Prevalence of hepatitis viruses in patients with acute hepatitis and characterization of the detected genotype 4 hepatitis E virus sequences in Mongolia. J Med Virol 2015; 88:282-91. [PMID: 26147664 DOI: 10.1002/jmv.24319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2015] [Indexed: 01/14/2023]
Abstract
Hepatitis E is considered to be a worldwide public health problem. Although the prevalence of hepatitis E virus (HEV) antibodies in healthy individuals is noted to be 11%, no patients with acute hepatitis E have previously been identified in Mongolia. Three hundred two consecutive patients (183 males and 119 females; median age of 22.0 [Interquartile range: 18.3-25.0] years) who were clinically diagnosed with sporadic acute hepatitis during 2012-2013 in Ulaanbaatar, Mongolia, were studied. By serological and/or molecular approaches, 77 (25.5%), 93 (30.8%), 19 (6.3%), 48 (15.9%), and 12 (4.0%) of the patients were diagnosed with acute hepatitis of types A, B, C, D (superinfection of hepatitis delta virus on a background of chronic hepatitis B virus infection) and E, respectively, while the cause of hepatitis was unknown in the remaining 53 patients (17.5%). The 12 hepatitis E patients had no history of travel abroad in the 3 months before the onset of disease, and lived separately in fixed or movable houses with water supplied via pipe, tank or well, denying transmission from a common water supply. The 12 HEV isolates obtained from the patients showed high nucleotide identities of 99.7-100%, and a representative HEV isolate, MNE13-227, was closest to the Chinese isolates of genotype 4, with the highest identity of 97.3% in the 304-nt ORF2 sequence and 92.1% over the entire genome. The present study revealed the occurrence of autochthonous acute hepatitis E in Mongolia, caused by a monophyletic genotype 4 HEV strain.
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Affiliation(s)
- Bira Tsatsralt-Od
- National Institute of Medicine, Ministry of Health and Ministry of Science Education, Ulaanbaatar, Mongolia.,National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Nachin Baasanjav
- National Institute of Medicine, Ministry of Health and Ministry of Science Education, Ulaanbaatar, Mongolia
| | - Dulmaa Nyamkhuu
- National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Hiroshi Ohnishi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi-Ken, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi-Ken, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi-Ken, Japan
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50
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Qi Y, Fan J, Huang W, Zhao C, Wang Y, Kong FT, Kong W, Jiang C. Expression and characterization of hepatitis E virus-like particles and non-virus-like particles from insect cells. Biotechnol Appl Biochem 2015; 63:362-70. [PMID: 25824972 DOI: 10.1002/bab.1379] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 03/27/2015] [Indexed: 02/05/2023]
Abstract
The hepatitis E virus (HEV) capsid antigen expressed in insect cell has been proposed as a candidate subunit vaccine for the prevention of hepatitis E. However, the expression and purification of HEV virus-like particles (VLPs) from insect cells have not been explored. We aimed to optimize the procedure to obtain HEV VLPs. In this study, two conformations of the HEV capsid proteins were expressed in insect cells, VLPs and non-VLPs, and they were purified separately. The physicochemical properties and the humoral immune responses induced by the two forms were analyzed and compared. We found that HEV VLPs were more immunogenic in mice than HEV non-VLPs. Therefore, we optimized the conditions that yielded high VLPs expression in insect cell cultures and developed an efficient purification method. The results suggest that the distinction and isolation of VLPs from non-VLPs are essential to generate a more immunogenic vaccine.
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Affiliation(s)
- Ying Qi
- School of Life Science, Jinlin University, Changchun, People's Republic of China.,National Engineering Laboratory for AIDS Vaccine, Jilin University, Changchun, People's Republic of China.,Division of HIV/AIDS and Sexually-Transmitted Virus Vaccines of the National Institutes for Food and. Drug Control, Beijing, People's Republic of China
| | - Jinping Fan
- Division of HIV/AIDS and Sexually-Transmitted Virus Vaccines of the National Institutes for Food and. Drug Control, Beijing, People's Republic of China
| | - Weijin Huang
- Division of HIV/AIDS and Sexually-Transmitted Virus Vaccines of the National Institutes for Food and. Drug Control, Beijing, People's Republic of China
| | - Chenyan Zhao
- Division of HIV/AIDS and Sexually-Transmitted Virus Vaccines of the National Institutes for Food and. Drug Control, Beijing, People's Republic of China
| | - Youchun Wang
- Division of HIV/AIDS and Sexually-Transmitted Virus Vaccines of the National Institutes for Food and. Drug Control, Beijing, People's Republic of China
| | - Franklin T Kong
- Ann Arbor Pioneer High School, 601 West Stadium Blvd, Ann Arbor
| | - Wei Kong
- School of Life Science, Jinlin University, Changchun, People's Republic of China.,National Engineering Laboratory for AIDS Vaccine, Jilin University, Changchun, People's Republic of China
| | - Chunlai Jiang
- School of Life Science, Jinlin University, Changchun, People's Republic of China.,National Engineering Laboratory for AIDS Vaccine, Jilin University, Changchun, People's Republic of China
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