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Abanto J, Sanchez Boluarte AN, Castillo Y, Perez E, Saavedra H, Gonzales I, Bustos JA, Abravanel F, Izopet J, Madden RG, Garcia HH, Dalton HR. Increased Prevalence of Antibodies to Hepatitis E Virus in Patients with Neurocysticercosis. Am J Trop Med Hyg 2024; 110:1210-1213. [PMID: 38653231 PMCID: PMC11154044 DOI: 10.4269/ajtmh.23-0856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/24/2024] [Indexed: 04/25/2024] Open
Abstract
We explored the association between serological status for hepatitis E and neurocysticercosis (NCC) in neurologic patients attending a national neurological referral center in Lima, Perú, between the years 2008 and 2012. Anti-hepatitis E antibodies were evaluated in patients with and without NCC, and a control group of rural general population. Anti-hepatitis E IgG was found in 23.8% of patients with NCC, compared with 14.3% in subjects without NCC from a general rural population (P = 0.023) and 14.4% in subjects with neurological complaints without NCC (P = 0.027). Seropositive patients had a median age of 44 years compared with 30 years in seronegative patients (P <0.001). No significant differences in sex, region of residence, or liver enzyme values were found. Seropositivity to hepatitis E was frequent in this Peruvian population and higher in patients with NCC, suggesting shared common routes of infection.
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Affiliation(s)
- Jesus Abanto
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Perú
- Department of Neurology, University of Cincinnati, Cincinnati, Ohio
| | - Arantxa N. Sanchez Boluarte
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
- Department of Global Health, University of Washington, Seattle, Washington
| | - Yesenia Castillo
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Erika Perez
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | - Herbert Saavedra
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | - Isidro Gonzales
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | - Javier A. Bustos
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Perú
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | | | | | - Richie G. Madden
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, University of Adelaide, South Australia
- HEV International Direct Action Group (HEViDrAG)
| | - Hector H. Garcia
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Perú
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | - Harry R. Dalton
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, University of Adelaide, South Australia
- HEV International Direct Action Group (HEViDrAG)
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Aisha A, Abbas S, Eed EM, Ahmed D, Irfan S, Rehman FU, Siddique S, Naeem M. Hepatitis E associated determinants and diagnostic biomarkers during pregnancy and its prenatal consequences in Multan, Punjab tertiary care setting (Pakistan). Am J Transl Res 2024; 16:2049-2058. [PMID: 38883386 PMCID: PMC11170620 DOI: 10.62347/slwm5449] [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: 02/08/2024] [Accepted: 05/13/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in the world. Hepatitis E infection is commonly widespread by the fecal oral routes and contaminated water. This study was designed to explore the prevalence and risk factors of hepatitis E infection in pregnant women of the Multan district, Pakistan. METHODS The study comprised of a total of 500 enrolled patients, among which, 105 pregnant females with hepatitis E infection fulfilled the criteria for anti-HEV antibodies. Pregnant women without significant complications and without hepatitis E infection were excluded from this study. Hepatic profile, complete blood count, coagulation markers, and standard protocol were also assessed for fetal maternal hemorrhage. RESULTS Our results showed that 105 patients (66.66%, CI 95%) had HEV infection with mean age 25±5 years. Serum bilirubin levels were increased in 74 patients (70.47%), aspartate transaminase was elevated > 200 IU/L in 71 patients (67.61%), alanine transaminase was above the 100 IU/L in 65 patients (245 IU/L), and low platelet counts were found in 45 patients (42.85%). Moreover, fetal distress cases were 9 (10.84%) and maternal distress cases were about 11 (13.25%). Fetal mortality cases were 39 (37.14%), and maternal mortality cases were about 22 (20.95%) due to hepatic comma, intravascular coagulation, and hepatic failure. CONCLUSION It was concluded that the prevalence of Hepatitis E during pregnancy is associated with high risk factors of unhygienic practices, blood transfusion, and noncompliance with universal infection control techniques. Maternal fatalities and fetal consequences were exacerbated by HEV infection.
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Affiliation(s)
- Ambreen Aisha
- Department of Biochemistry, Punjab Medical College, Faisalabad Medical University Faisalabad 38000, Pakistan
| | - Shafqat Abbas
- Faculty of Allied Health Sciences, Superior University Lahore Lahore 54000, Pakistan
| | - Emad M Eed
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University Taif, Saudi Arabia
| | - Dildar Ahmed
- Department of Biochemistry, Riphah International University Islamabad Islamabad 44000, Pakistan
| | - Sabahat Irfan
- Department of Biochemistry, University of Agriculture Faisalabad 38000, Pakistan
| | - Fariha Ur Rehman
- Institute of Microbiology, University of Agriculture Faisalabad Faisalabad 38000, Pakistan
| | - Sara Siddique
- Department of Biochemistry, University of Agriculture Faisalabad 38000, Pakistan
| | - Muhammad Naeem
- College of Life Science, Hebei Normal University Shijiazhuang 050024, Hebei, China
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Wu H, Li B, Yu B, Hu L, Zhou L, Yin J, Lu Y. Genomic characterization of Rocahepevirus ratti hepatitis E virus genotype C1 in Yunnan province of China. Virus Res 2024; 341:199321. [PMID: 38242291 PMCID: PMC10831724 DOI: 10.1016/j.virusres.2024.199321] [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: 12/07/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/21/2024]
Abstract
The Rocahepevirus ratti hepatitis E virus genotype C1 (HEV-C1) has been documented to infect humans. However, the understanding of HEV-C1 remains constrained. This study aims to determine the prevalence and genomic characteristics of HEV-C1 in small animals in Yunnan province of southwestern China. A total of 444 liver tissues were collected from animals covering the orders Rodentia, Soricomorpha, Scandentia and Erinaceomorpha in three regions in Yunnan. Then Paslahepevirus balayani and Rocahepevirus were examined using RT-qPCR. The detection rate of Rocahepevirus was 12.95 % (36/278) in animals of order Rodentia, with 14.77 % (35/237) in Rattus tanezumi and 33.33 % (1/3) in Niviventer fulvescens. No Paslahepevirus balayani was detected. Additionally, two full-length Rocahepevirus sequences (MSE-17 and LHK-54) and thirty-three partial ORF1 sequences were amplified and determined to be HEV-C1. MSE-17 and LHK-54 shared moderate nucleotide identity (78.9 %-80.3 %) with HEV-C1 isolated in rats and humans. The HEV-C1 isolated from Niviventer fulvescens demonstrated a 100 % nucleotide identity with that from Rattus tanezumi. The rat HEV-C1 sequences isolated in our study and other Asian HEV-C1 sequences were phylogenetically distant from those isolated in North America and Europe. Furthermore, the two full-length sequences isolated in our study had less amino acid substitutions in the motifs of RNA-dependent RNA polymerase domain (F204L and L238F), compared with other Asian sequences. In summary, HEV-C1 commonly spreads in rats in Yunnan province of China. Our findings suggest a spatially associated phylogeny, and potential cross-species transmission of HEV-C1.
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Affiliation(s)
- Han Wu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China
| | - Bingzhe Li
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China
| | - Bowen Yu
- Department of Immunology, School of Basic Medical Sciences, Weifang Medical University, Weifang 261000, Shandong, China
| | - Linjie Hu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China
| | - Lu Zhou
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China
| | - Jiaxiang Yin
- Department of Epidemiology, School of Public Health, Dali University, Dali, Yunnan 671003, China.
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China.
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Sen ES, Ramanan AV. Cytokine Storm Syndrome Associated with Hemorrhagic Fever and Other Viruses. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1448:249-267. [PMID: 39117819 DOI: 10.1007/978-3-031-59815-9_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
A wide variety of infections can trigger cytokine storm syndromes including those caused by bacteria, viruses, fungi and parasites. The most frequent viral trigger is Epstein-.Barr virus which is covered in Chapter 16. CSS associated with COVID-19 is also discussed separately (Chapter 22). This chapter will focus on other viruses including the hemorrhagic fever viruses, influenza, parainfluenza, adenovirus, parvovirus, hepatitis viruses, measles, mumps, rubella, enterovirus, parechovirus, rotavirus, human metapneumovirus and human T-lymphotropic virus. The published literature consists of many single case reports and moderate-sized case series reporting CSS, in most circumstances meeting the 2004 diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). There is no published clinical trial evidence specifically for management of HLH associated with these viruses. In some situations, patients received supportive therapy and blood product transfusions only but in most cases, they were treated with one or more of intravenous corticosteroids, intravenous immunoglobulin and/or etoposide. These were successful in many patients although in significant numbers progression of infection to CSS was associated with mortality.
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Affiliation(s)
- Ethan S Sen
- Consultant in Paediatric Rheumatology, Great North Children's Hospital, Newcastle upon Tyne, UK
| | - A V Ramanan
- Consultant in Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
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Dong R, Chang D, Luo Z, Zhang M, Guan Q, Shen C, Chen Y, Huang P, Wang J. The burden of HEV-related acute liver failure in Bangladesh, China and India: a systematic review and meta-analysis. BMC Public Health 2023; 23:2369. [PMID: 38031080 PMCID: PMC10688087 DOI: 10.1186/s12889-023-17302-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Hepatitis E can potentially progress to HEV-related acute liver failure (HEV-ALF). East and South Asia bear a substantial burden of HEV infection, with Bangladesh, China, and India facing the most severe threat in this region. Therefore, we conducted a systematic review and meta-analysis to evaluate the burden of HEV-ALF in these three high-risk countries. METHODS A systematic literature search was performed utilizing PubMed, the Cochrane Library, Medline, Embase, and Web of Science databases. Studies in English or Chinese that reported data on the burden of HEV-ALF in Bangladesh, China and India were included. Outcomes were pooled with meta-analysis utilizing R software. Estimates were calculated with random-effects models, and subgroup analysis and sensitivity analysis were conducted to address heterogeneity. Egger's test and Begg's test were performed to assess publication bias. RESULTS A total of 20 eligible studies were included in this study. The pooled HEV-attributable proportion of viral-related acute liver failure was estimated to be 40.0% (95% CI: 0.28-0.52), 30.0% (95% CI: 0.18-0.44), and 61.0% (95% CI: 0.49-0.72) among non-pregnant individuals in India, China and Bangladesh, while in Indian pregnant females, it was 71.0% (95% CI: 0.62-0.79). The combined prevalence among non-pregnant HEV-infected participants was 28.0% (95% CI: 0.20-0.37) and 10.0% (95% CI: 0.01-0.28) in India and China, and it was 34.0% (95% CI: 0.27-0.42) in Indian pregnant females with HEV infection. The overall mortality of HEV-ALF was estimated to be 32.0% (95% CI: 0.23-0.42) and 64.0% (95% CI: 0.50-0.77) among the non-pregnant and the pregnant participants in India, and it was 23.0% (95% CI: 0.14-0.34) in Chinese non-pregnant participants. CONCLUSIONS The burden of HEV-ALF in Bangladesh, China, and India is non-negligible despite geographic and population heterogeneity. The prevention of HEV infection and early recognition of HEV-ALF are of great significance, especially in high-risk countries and populations. REGISTRATION PROSPERO registration ID is CRD42022382101.
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Affiliation(s)
- Rui Dong
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Dongchun Chang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Zhenghan Luo
- East China Institute of Biomedical Technology, Nanjing, China
| | - Mengting Zhang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Qing Guan
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Chao Shen
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Yue Chen
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China
| | - Peng Huang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China.
| | - Jie Wang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China.
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Rodrigues RA, Sequeira M, Barros F, Alves T, Gonçalves J. Acute Hepatitis E-Associated Guillain-Barré Syndrome. Cureus 2023; 15:e48778. [PMID: 38098894 PMCID: PMC10719760 DOI: 10.7759/cureus.48778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Guillain-Barré syndrome (GBS) is a rare autoimmune disorder of the peripheral nervous system that causes progressive weakness and sensory disturbances, usually following an infection or immunization. It has been associated with multiple causes, including bacterial and viral infections. Hepatitis E virus (HEV) is a common cause of acute viral hepatitis that can rarely develop neurological complications. We report a case of a 72-year-old man who developed GBS secondary to an acute HEV infection. He presented with numbness and weakness of the lower limbs that rapidly evolved into respiratory failure requiring mechanical ventilation and intravenous immunoglobulin therapy (IVIg). This case adds to the literature on the association between HEV infection and GBS and the importance of early detection of this rapidly progressive condition.
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Affiliation(s)
| | - Miguel Sequeira
- Intensive Medicine, University Hospital Center of Coimbra, Coimbra, PRT
| | | | - Telma Alves
- Internal Medicine, University Hospital Center of Coimbra, Coimbra, PRT
| | - João Gonçalves
- Internal Medicine, University Hospital Center of Coimbra, Coimbra, PRT
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Zajkowska M, Mroczko B. Chemokines in Primary Liver Cancer. Int J Mol Sci 2022; 23:ijms23168846. [PMID: 36012108 PMCID: PMC9408270 DOI: 10.3390/ijms23168846] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
The liver is responsible for extremely important functions in the human body. In the liver’s structure, we distinguish between connective tissue (stroma) and parenchyma, the latter of which is formed from the basic structural and functional units of the liver—hepatocytes. There are many factors, that negatively affect the liver cells, contributing to their damage. This may lead to fibrosis, liver failure and, in consequence, primary liver cancer, which is the sixth most commonly diagnosed malignancy and the fourth leading cause of cancer death worldwide. Chemokines are a large family of secreted proteins. Their main role is to direct the recruitment and migration of cells to sites of inflammation or injury. Some authors suggest that these proteins might play a potential role in the development of many malignancies, including primary liver cancer. The aim of this study was to evaluate and summarize the knowledge regarding liver diseases, especially primary liver cancer (HCC) and the participation of chemokines in the development of this malignancy. Chemokines involved in the initiation of this type of tumor belong mainly to the CC and CXC chemokines. Their significant role in the course of hepatocellular carcinoma proves their usefulness in detecting and monitoring the course and treatment in patients with this disease.
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Affiliation(s)
- Monika Zajkowska
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
- Correspondence: ; Tel.: +48-686-5168; Fax: +48-686-5169
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
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Boukhrissa H, Mechakra S, Mahnane A, Boussouf N, Gasmi A, Lacheheb A. Seroprevalence of hepatitis E virus among blood donors in eastern Algeria. Trop Doct 2022; 52:479-483. [PMID: 35791644 DOI: 10.1177/00494755221112212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hepatitis E virus (HEV) is recognized worldwide as the leading cause of orofecal-transmitted hepatitis. However, blood transmission has been increasingly implicated in recent years raising health concerns. In Algeria, updated prevalence data are lacking. We aimed to determine the prevalence of anti-HEV antibodies in the sera of volunteer blood donors from the Setif region in eastern Algeria. A total of 434 Samples were analyzed for anti-HEV IgG and IgM antibodies using an enzyme-linked immunosorbent assay (Wantai). Logistic regression modelling was used to identify associated risk factors. The IgG seroprevalence rate was 17.05%. Seven sera (0.16%) were weakly positive for IgM. No HEV RNA was detected. The IgG prevalence was significantly correlated with increasing age (p < 1p.1000). Our data demonstrate a relatively high prevalence of anti-HEV IgG, indicating a possible risk of HEV blood transmission which requires vireamic seroprevalence studies to assess the real risk.
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Affiliation(s)
- Houda Boukhrissa
- Faculty of Medicine, Department of Infectious Diseases, 277693University Ferhat Abbas Setif 1, Algeria
| | - Saleh Mechakra
- Faculty of Medicine, Department of Infectious Diseases, 277693University Ferhat Abbas Setif 1, Algeria
| | - Abbes Mahnane
- Faculty of Medicine, Department of Infectious Diseases, 277693University Ferhat Abbas Setif 1, Algeria
| | - Nadir Boussouf
- Faculty of Medicine, Department of epidemiology and preventive medicine, 389767University of Constantine 3, Algeria
| | - Abdelkader Gasmi
- Faculty of Medicine, Department of Infectious Diseases, 277693University Ferhat Abbas Setif 1, Algeria
| | - Abdelmadjid Lacheheb
- Faculty of Medicine, Department of Infectious Diseases, 277693University Ferhat Abbas Setif 1, Algeria
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Damiris K, Aghaie Meybodi M, Niazi M, Pyrsopoulos N. Hepatitis E in immunocompromised individuals. World J Hepatol 2022; 14:482-494. [PMID: 35582299 PMCID: PMC9055194 DOI: 10.4254/wjh.v14.i3.482] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/15/2021] [Accepted: 02/13/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatitis E virus (HEV) originally identified as a cause of acute icteric hepatitis in developing countries has grown to be a cause of zoonotic viral hepatitis in developed countries such as the United States. While there are eight identified genotypes to date, genotype 1 (HEV1), HEV2, HEV3, HEV4 are the most common to infect humans. HEV1 and HEV2 are most common in developing countries including Latina America, Africa and Asia, and are commonly transmitted through contaminated water supplies leading to regional outbreaks. In contrast HEV3 and HEV4 circulate freely in many mammalian animals and can lead to occasional transmission to humans through fecal contamination or consumption of undercooked meat. The incidence and prevalence of HEV in the United States is undetermined given the absence of FDA approved serological assays and the lack of commercially available testing. In majority of cases, HEV infection is a self-limiting hepatitis requiring only symptomatic treatment. However, this is not the case in immunocompromised individuals, including those that have undergone solid organ or stem cell transplantation. In this subset of patients, chronic infection can be life threatening as hepatic insult can lead to inflammation and fibrosis with subsequent cirrhosis and death. The need for re-transplantation as a result of post-transplant hepatitis is of great concern. In addition, there have been many reported incidents of extrahepatic manifestations, for which the exact mechanisms remain to be elucidated. The cornerstone of treatment in immunocompromised solid organ transplant recipients is reduction of immunosuppressive therapies, while attempting to minimize the risk of organ rejection. Subsequent treatment options include ribavirin, and pegylated interferon alpha in those who have demonstrated ribavirin resistance. Further investigation assessing safety and efficacy of anti-viral therapy is imperative given the rising global health burden. Given this concern, vaccination has been approved in China with other investigations underway throughout the world. In this review we introduce the epidemiology, diagnosis, clinical manifestations, and treatment of HEV, with emphasis on immunocompromised individuals in the United States.
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Affiliation(s)
- Konstantinos Damiris
- Department of Medicine, Rutgers - New Jersey Medical School, Newark, NJ 07103, United States
| | - Mohamad Aghaie Meybodi
- Department of Medicine, Rutgers - New Jersey Medical School, Newark, NJ 07103, United States
| | - Mumtaz Niazi
- Department of Medicine - Gastroenterology and Hepatology, Rutgers - New Jersey Medical School, Newark, NJ 07103, United States
| | - Nikolaos Pyrsopoulos
- Department of Medicine - Gastroenterology and Hepatology, Rutgers - New Jersey Medical School, Newark, NJ 07103, United States
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Raji YE, Toung OP, Taib NM, Sekawi ZB. Hepatitis E Virus: An emerging enigmatic and underestimated pathogen. Saudi J Biol Sci 2022; 29:499-512. [PMID: 35002446 PMCID: PMC8716866 DOI: 10.1016/j.sjbs.2021.09.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 08/31/2021] [Accepted: 09/05/2021] [Indexed: 02/07/2023] Open
Abstract
Hepatitis E virus (HEV) is an RNA virus causing hepatitis E disease. The virus is of one serotype but has diverse genotypes infecting both humans and animals. Based on evidence from seroprevalence studies, about 2 billion people are estimated to have been infected with HEV globally. HEV, therefore, poses a significant public health and economic challenge worldwide. HEV was discovered in the 1980s and was traced back to the 1955 - 1956 outbreak of hepatitis that occurred in India. Subsequently, several HEV epidemics involving thousands of individuals have occurred nearly annually in different countries in Asia and Africa. Initially, the virus was thought to be only enterically transmitted, and endemic in developing countries. Due to the environmental hygiene and sanitation challenges in those parts of the world. However, recent studies have suggested otherwise with the report of autochthonous cases in industrialised countries with no history of travel to the so-called endemic countries. Thus, suggesting that HEV has a global distribution with endemicity in both developing and industrialised nations. Studies have also revealed that HEV has multiple risk factors, and modes of transmission as well as zoonotic potentials. Additionally, recent findings have shown that HEV leads to severe disease, particularly among pregnant women. In contrast to the previous narration of a strictly mild and self-limiting infection. Studies have likewise demonstrated chronic HEV infection among immunocompromised persons. Consequent to these recent discoveries, this pathogen is considered a re - emerging virus, particularly in the developed nations. However, despite the growing public health challenges of this pathogen, the burden is still underestimated. The underestimation is often attributed to poor awareness among clinicians and a lack of routine checks for the disease in the hospitals. Thus, leading to misdiagnosis and underdiagnosis. Hence, this review provides a concise overview of epidemiology, diagnosis, and prevention of hepatitis E.
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Affiliation(s)
- Yakubu Egigogo Raji
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia 1, Malaysia
- Faculty of Natural and Applied Sciences Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Ooi Peck Toung
- Department of Veterinary Clinical Studies Faculty of Veterinary Medicine, Universiti Putra Malaysia 2, Malaysia
| | - Niazlin Mohd Taib
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia 1, Malaysia
| | - Zamberi Bin Sekawi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia 1, Malaysia
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11
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Valor-Méndez L, Manger B, Schett G, Kleyer A. [Severe Hepatitis E virus infection in a patient with rheumatoid arthritis treated with baricitinib]. Z Rheumatol 2021; 80:980-983. [PMID: 34097102 PMCID: PMC8651578 DOI: 10.1007/s00393-021-01020-4] [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] [Accepted: 04/30/2021] [Indexed: 11/28/2022]
Abstract
Es wurde ein Patient mit rheumatoider Arthritis (RA) vorgestellt, der unter der Therapie mit dem Januskinase-1/2-Inhibitor Baricitinib eine Infektion mit dem Hepatitis-E-Virus (HEV) entwickelte. Unser Patient hatte bei seiner vierteljährlichen Routineuntersuchung deutlich erhöhte Transaminasen bei einer unauffälligen körperlichen Untersuchung. Es fanden sich Antikörper der IgM- und IgG-Klasse gegen HEV und ein erhöhtes C‑reaktives Protein (CRP) sowie HEV-RNA mittels Real-Time-PCR, was auf eine frische HEV-Infektion hinwies. Baricitinib wurde sofort abgesetzt. Die ausführliche Anamnese ergab, dass der Patient Tage vor der Konsultation Rindertartar verzehrt hatte, ohne dass gastrointestinale Symptome oder Fieber aufgetreten waren. Im weiteren Verlauf erholte sich der Patient vollständig, und die Leberfunktionstests und das CRP normalisierten sich innerhalb von 3 Monaten. Baricitinib wurde daraufhin wieder eingenommen. Bisher wurden nur wenige Daten zu HEV-Infektionen bei RA-Patienten, die mit JAK-Inhibitoren behandelt wurden, publiziert.
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Affiliation(s)
- Larissa Valor-Méndez
- Medizinische Klinik 3, Rheumatologie und Immunologie, Friedrich-Alexander-Universität Erlangen-Nürnberg und Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland. .,Deutsches Zentrum für Immuntherapie (DZI) FAU Erlangen-Nürnberg und Universitätsklinikum Erlangen, Erlangen, Deutschland.
| | - Bernhard Manger
- Medizinische Klinik 3, Rheumatologie und Immunologie, Friedrich-Alexander-Universität Erlangen-Nürnberg und Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland.,Deutsches Zentrum für Immuntherapie (DZI) FAU Erlangen-Nürnberg und Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Georg Schett
- Medizinische Klinik 3, Rheumatologie und Immunologie, Friedrich-Alexander-Universität Erlangen-Nürnberg und Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland.,Deutsches Zentrum für Immuntherapie (DZI) FAU Erlangen-Nürnberg und Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Arnd Kleyer
- Medizinische Klinik 3, Rheumatologie und Immunologie, Friedrich-Alexander-Universität Erlangen-Nürnberg und Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland.,Deutsches Zentrum für Immuntherapie (DZI) FAU Erlangen-Nürnberg und Universitätsklinikum Erlangen, Erlangen, Deutschland
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12
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The Risk of Transfusion-Transmitted Hepatitis E Virus: Evidence from Seroprevalence Screening of Blood Donations. Indian J Hematol Blood Transfus 2021; 38:145-152. [PMID: 33879981 PMCID: PMC8050642 DOI: 10.1007/s12288-021-01428-7] [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: 01/28/2021] [Accepted: 03/18/2021] [Indexed: 01/04/2023] Open
Abstract
Throughout the world, there has been growing concern over the risk of hepatitis E virus (HEV) transmission via blood transfusion. The present study screened blood donor samples for anti-HEV immunoglobulin M (IgM) and immunoglobulin G (IgG). The prevalence of HEV infection was assessed on a total of 1,003 archived serum samples obtained from the National Blood Centre, Malaysia. The samples were collected from healthy blood donor from Klang Valley between 2017 and 2018. All samples were tested for IgM and IgG antibodies to HEV using enzyme-linked immunosorbent assays (ELISA). HEV-specific IgG antibodies were detected in 31/1003 (3.1%; 95% confidence interval [CI] 2.1%–4.4%) and IgM in 9/1003 (0.9%; 95% CI 0.4%–1.7%) samples. In bivariate analysis, there was no significant difference in the prevalence of anti-HEV IgG with respect to gender and district of origin. Although not statistically significant, males had higher odds of having anti-HEV IgG than females (odds ratio [OR] = 2.86; 95% CI 0.95–8.64). All anti-HEV IgG positive individuals were people of Chinese descent. Anti-HEV IgG increased significantly with age, from 0.6% (95% CI 0.1%–2.6%) of 18–30-year-old donors to 7.4% (95% CI 2.7%–17.0%) of donors older than 50 years and was highest among non-professional workers (5.3%; 95% CI 2.5%–10.5%). Increasing age and a non-professional occupation remained significant predictors for anti-HEV IgG in the multivariable analysis. Screening of blood donations for HEV in Malaysia is important to safeguard the health of transfusion recipients. The higher rates of HEV infection in blood from older donors and donors who are non-professional workers may provide insights into targeted groups for blood screening.
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Abstract
Hepatitis E virus (HEV) is a cosmopolitan foodborne pathogen. The viral agent infects humans through the consumption of contaminated food (uncooked or undercooked). Most cases of infection are asymptomatic and for this reason, this pathology is considered underdiagnosed. Domestic and wild animals are considered natural reservoirs: that is, domestic pig, wild boar, sheep, goat, deer, rabbit, and so on. Therefore, various work categories are at risk: that is, veterinarians, farmers, hunters, slaughterhouse workers, and so on. In these last decades, researchers found a high percentage of positivity to the molecular viral detection in several food matrices included: ready-to-eat products, processed meat products, milk, and shellfish. This review aims to provide an international scenario regarding HEV ribonucleic acid (RNA) detection in several foodstuffs. From this investigative perspective, the study aims to highlight various gaps of the current knowledge about technologies treatments' impact on viral loads. The purpose was also to provide an innovative point of view "One Health"-based, pointing out the strategic role of environmental safety.
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Affiliation(s)
- Gianluigi Ferri
- Faculty of Veterinary Medicine, Department of Food Inspection, University of Teramo, Teramo, Italy
| | - Alberto Vergara
- Post-Graduate Specialization School in Food Inspection "G. Tiecco," Faculty of Veterinary Medicine, Department of Food Inspection, University of Teramo, Teramo, Italy
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14
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Moodley P, Whyte AF, Dhanda A. Recurrent Chronic HEV in Severe Combined Immunodeficiency. J Clin Immunol 2021; 41:1103-1105. [PMID: 33619683 DOI: 10.1007/s10875-021-00999-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/15/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Prebashan Moodley
- South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK.
| | - Andrew F Whyte
- Department of Clinical Immunology, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Ashwin Dhanda
- South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
- Faculty of Health, University of Plymouth, Plymouth, UK
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15
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Mihai IF, Manciuc C, Hunea IM, Lacatusu GA, Leonte GE, Luca S, Harja-Alexa IA, Vata A, Luca MC. Enterically transmitted hepatitis in the third millennium in northeastern Romania. Exp Ther Med 2021; 21:274. [PMID: 33603881 DOI: 10.3892/etm.2021.9705] [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: 09/25/2020] [Accepted: 10/27/2020] [Indexed: 11/05/2022] Open
Abstract
While the incidence of hepatitis A virus (HAV) infections has decreased in the last few years, the incidence of hepatitis E virus (HEV) is increasing in developed countries. Both infections remain a worldwide reality, strongly related to socio-economic conditions. We retrospectively analyzed the medical files of patients with viral hepatitis hospitalized in the Infectious Disease Hospital Iasi, Romania between 2018 and 2019. The serological confirmed cases of HAV and HEV infections were included in the analysis; included in our analysis were 269 HAV-infected patients. The most affected were males (53.9% cases) aged between 8 and 15 years (53.6% cases). Severe infections were recorded at admission in 2.24% cases and evolution was favorable under supportive and symptomatic treatment. Only three adult males, with no recent history of travel, were confirmed with HEV infection. Even though we have identified a small number of cases, recent studies performed in our region found a seroprevalence of 32.5% in the general population, possibly related to zoonotic transmission. While outbreaks of HAV infection are still noted in our region, a lack of hospitalized HEV-infected patients suggest that most cases are asymptomatic or underdiagnosed. HEV infection remains an underreported disease, possibly due to misdiagnosis, subclinical or dual hepatitis infection, but with a significant risk in vulnerable categories, such as pregnant women or immunosuppressed patients.
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Affiliation(s)
- Ioana Florina Mihai
- Department of Infectious Diseases, 'Sf. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania.,Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Carmen Manciuc
- Department of Infectious Diseases, 'Sf. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania.,Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ioana Maria Hunea
- Department of Infectious Diseases, 'Sf. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania.,Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Georgiana Alexandra Lacatusu
- Department of Infectious Diseases, 'Sf. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania
| | - Georgiana Enache Leonte
- Department of Infectious Diseases, 'Sf. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania.,Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Stefana Luca
- Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ioana Alina Harja-Alexa
- Department of Infectious Diseases, 'Sf. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania.,Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andrei Vata
- Department of Infectious Diseases, 'Sf. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania.,Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihaela Catalina Luca
- Department of Infectious Diseases, 'Sf. Parascheva' Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania.,Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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16
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Aslan AT, Balaban HY. Hepatitis E virus: Epidemiology, diagnosis, clinical manifestations, and treatment. World J Gastroenterol 2020; 26:5543-5560. [PMID: 33071523 PMCID: PMC7545399 DOI: 10.3748/wjg.v26.i37.5543] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/11/2020] [Accepted: 09/09/2020] [Indexed: 02/06/2023] Open
Abstract
The hepatitis E virus (HEV) is the fifth known form of viral hepatitis and was first recognized as the cause of an epidemic of unexplained acute hepatitis in the early 1980s. Globally, it is one of the most frequent causes of acute viral hepatitis. The majority of HEV infections are asymptomatic and lead to the spontaneous clearance of the virus. Among the eight different genotypes identified to date, HEV genotype 1 (HEV1), HEV2, HEV3, and HEV4 are the most frequent genotypes causing infections in humans. HEV1 and HEV2 are prevalent in developing regions and able to result in large-scale outbreaks originating from contaminated water supplies. They are also responsible for severe hepatitis in pregnant patients and infants. In contrast, HEV3 and HEV4 are zoonotic, and the transmission of these genotypes to humans occurs mainly through the fecal contamination of water and consumption of contaminated meat from infected animals. Their main reservoir is the pig, and they are mostly encountered in developed countries. The major risk groups for HEV infection and its ensuing adverse consequences are pregnant women, infants, older people, immunocompromised individuals, patients with underlying chronic liver diseases, and workers that come into close contact with HEV-infected animals. In the clinical perspective, HEV infections have diverse clinical manifestations including acute and self-limiting hepatitis, acute-on-chronic liver disease, chronic hepatitis, cirrhosis, and liver failure. Although HEV mainly results in acute self-limiting infection, chronic HEV infection may occur among immunocompromised patients (e.g., solid-organ transplant recipients). Additionally, HEV-associated extrahepatic manifestations involving various organs have been reported in the last decade, although the causal link for many of them still needs to be proven. Ribavirin and interferon-alpha are the most widely used agents for the treatment of HEV infections with a certain level of success. However, ribavirin is contraindicated in pregnant patients, and interferon-alpha cannot be used in most transplant recipients. Therefore, there is an urgent need for novel antiviral compounds that are safe and effective particularly for patients having contraindications for ribavirin or interferon-alpha and infected by the ribavirin-resistant HEV. In this review article, a literature search using PubMed and MEDLINE databases was performed, up to March 2020. Only the articles published in English were reviewed.
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Affiliation(s)
| | - Hatice Yasemin Balaban
- Department of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey
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17
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Di Bartolomeo S, Carubbi F, Cipriani P. Hepatitis E Virus and rheumatic diseases: what do rheumatologists need to know? BMC Rheumatol 2020; 4:51. [PMID: 32974609 PMCID: PMC7504648 DOI: 10.1186/s41927-020-00149-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/26/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) represents the most common cause of acute hepatitis and jaundice in the world. About 2 million of infection cases occur each year in Europe, mainly as autochthonous anthropozoonosis, and HEV can be transmitted through undercooked pork meat. This infection has been linked to various extra-hepatic manifestations, while chronic infections with a rapid development of liver failure have been described in heavily immunosuppressed patients undergoing solid organ transplantations (SOTs), in patients with hematological diseases or with immunodeficiency virus infection. MAIN BODY OF ABSTRACT The purpose of this review article is to describe rheumatic manifestations related to HEV infection and their implications for rheumatologists in the daily clinical practice. Despite recent accumulating literature in this field, little is known about the course of the infection in patients with rheumatic diseases (RDs) and about the impact of immunosuppressive drugs. Moreover, HEV infection can mimic RDs' manifestations or drugs toxicity. Specific guidelines on management are lacking and the majority of data are referred to SOTs receivers. CONCLUSIONS More studies are needed to better understand the real impact of HEV infection in patients with RDs, regarding both clinical outcomes and their management.
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Affiliation(s)
- Salvatore Di Bartolomeo
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L’Aquila, L’Aquila, Italy
- Department of Medicine, ASL1 Avezzano-Sulmona-L’Aquila, L’Aquila and Sulmona, Italy
| | - Francesco Carubbi
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L’Aquila, L’Aquila, Italy
- Department of Medicine, ASL1 Avezzano-Sulmona-L’Aquila, L’Aquila and Sulmona, Italy
| | - Paola Cipriani
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L’Aquila, L’Aquila, Italy
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18
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Murphy EG, Williams NJ, Jennings D, Chantrey J, Verin R, Grierson S, McElhinney LM, Bennett M. First detection of Hepatitis E virus (Orthohepevirus C) in wild brown rats (Rattus norvegicus) from Great Britain. Zoonoses Public Health 2019; 66:686-694. [PMID: 31033238 PMCID: PMC6767579 DOI: 10.1111/zph.12581] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/21/2019] [Accepted: 04/06/2019] [Indexed: 12/20/2022]
Abstract
In the United Kingdom, there has been an increase in the number of hepatitis E virus (HEV) infections in people annually since 2010. Most of these are thought to be indigenously acquired Orthohepevirus A genotype 3 (HEV G3), which has been linked to pork production and consumption. However, the dominant subgroup circulating in British pigs differs from that which is found in people; therefore, an alternative, potentially zoonotic, source is suspected as a possible cause of these infections. Rodents, brown rats (Rattus norvegicus) in particular, have been shown to carry HEV, both the swine HEV G3 genotype and Orthohepevirus C, genotype C1 (rat HEV). To investigate the prevalence of HEV in British rodents, liver tissue was taken from 307 rodents collected from pig farms (n = 12) and other locations (n = 10). The RNA from these samples was extracted and tested using a pan‐HEV nested RT‐PCR. Limited histopathology was also performed. In this study, 8/61 (13%, 95% CI, 5–21) of brown rat livers were positive for HEV RNA. Sequencing of amplicons demonstrated all infections to be rat HEV with 87%–92% nucleotide identity to other rat HEV sequences circulating within Europe and China (224 nt ORF‐1). Lesions and necrosis were observed histologically in 2/3 samples examined. No rat HEV RNA was detected in any other species, and no HEV G3 RNA was detected in any rodent in this study. This is the first reported detection of rat HEV in Great Britain. A human case of rat HEV infection has recently been reported in Asia, suggesting that rat HEV could pose a risk to public health.
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Affiliation(s)
- Ellen G Murphy
- NIHR Health Protection Research Unit in Emerging Zoonotic Infections, Institute of Infection and Global Health, NCZR, Neston, UK.,Epidemiology and Population Health, Institute of Global Health, NCZR, Neston, UK
| | - Nicola J Williams
- NIHR Health Protection Research Unit in Emerging Zoonotic Infections, Institute of Infection and Global Health, NCZR, Neston, UK.,Epidemiology and Population Health, Institute of Global Health, NCZR, Neston, UK
| | - Daisy Jennings
- Wildlife Zoonoses and Vector Borne Disease Research Group, Animal and Plant Health Agency, Weybridge, UK
| | - Julian Chantrey
- Department of Veterinary Pathology & Public Health, School of Veterinary Science, University of Liverpool, Liverpool, UK
| | - Ranieri Verin
- Department of Veterinary Pathology & Public Health, School of Veterinary Science, University of Liverpool, Liverpool, UK
| | - Sylvia Grierson
- Department of Virology, Animal and Plant Health Agency, Addlestone, UK
| | - Lorraine M McElhinney
- NIHR Health Protection Research Unit in Emerging Zoonotic Infections, Institute of Infection and Global Health, NCZR, Neston, UK.,Wildlife Zoonoses and Vector Borne Disease Research Group, Animal and Plant Health Agency, Weybridge, UK
| | - Malcolm Bennett
- School of Veterinary Science, University of Nottingham, Leicestershire, UK
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19
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Li M, Bu Q, Gong W, Li H, Wang L, Li S, Sridhar S, Cy Woo P, Wang L. Hepatitis E virus infection and its associated adverse feto-maternal outcomes among pregnant women in Qinhuangdao, China. J Matern Fetal Neonatal Med 2019; 33:3647-3651. [PMID: 30760069 DOI: 10.1080/14767058.2019.1582630] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background and aims: The aim of this study was to investigate the positive rate of hepatitis E virus (HEV) infection and the possible adverse outcomes in pregnant women of Qinhuangdao, China.Methods: Serum samples of 946 pregnant women were collected from July 2017 to October 2017 in Qinhuangdao First Hospital. All samples were tested for anti-HEV IgM and IgG antibodies by enzyme-linked immunosorbent assay (ELISA). HEV RNA was tested by reverse transcription-nested polymerase chain reaction (RT-nPCR) and the PCR products were sequenced.Results: Of the 946 samples, the positive rate of anti-HEV IgM (15/365, 4.11%), anti-HEV IgG (74/365, 20.27%) and both anti-HEV IgM and IgG (12/365, 3.29%) were significantly higher (p < .05) in third trimester pregnant women than in the first (3/288, 1.04%; 36/288, 12.5%; 4/288, 1.39%), and second trimesters (6/293, 2.05%; 29/293, 9.90%; 2/293, 0.68%). The average alanine transaminase (ALT) level (34.49 ± 10.15) and the incidence of adverse pregnancy outcomes (13/18, 72.22%) in the both anti-HEV IgM and IgG positive group were significantly higher than other groups (p < .05). HEV RNA was detected in 1/181 (0.55%) of pregnant women with a history of HEV infection and the detected HEV strain belonged to subgenotype 4a.Conclusions: This study showed that pregnant women who have HEV infection can possibly lead to adverse pregnancy outcomes.
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Affiliation(s)
- Manyu Li
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, PR China
| | - Qiuning Bu
- Department of Clinical Laboratory, Qinhuangdao First Hospital, Hebei, PR China
| | - Wanyun Gong
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, PR China
| | - Haomin Li
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, PR China
| | - Lin Wang
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, PR China
| | - Shuangshuang Li
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, PR China
| | - Siddharth Sridhar
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, ROC
| | - Patrick Cy Woo
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, ROC
| | - Ling Wang
- Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, PR China
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20
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Hao X, Cao W, Situ J, Zhao Y, Huang F, Yu W. Hepatitis E Virus Detected in Pork Products. FOOD AND ENVIRONMENTAL VIROLOGY 2018; 10:391-393. [PMID: 30128980 DOI: 10.1007/s12560-018-9354-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 08/16/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Xianhui Hao
- Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Wentao Cao
- Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Jianwen Situ
- Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Yongqin Zhao
- Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Fen Huang
- Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China.
| | - Wenhai Yu
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, 935 Jiaoling Road, Kunming, People's Republic of China.
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21
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Agrawal P, Kumar V, Kumar A, Sachdeva MUS, Malhotra P, Nada R. Monoclonal Gammopathy of Renal Significance Triggered by Viral E Hepatitis. Indian J Nephrol 2018; 29:50-52. [PMID: 30814794 PMCID: PMC6375020 DOI: 10.4103/ijn.ijn_417_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Monoclonal gammopathy of undetermined significance does not have end organ damage, but a proportion of cases manifest with renal injury when it is called monoclonal gammopathy of renal significance (MGRS). Herein, we describe a case of acute hepatitis E infection, which precipitated the development of MGRS. The patient underwent kidney biopsy for elevated creatinine with clinical suspicion of drug-induced interstitial nephritis. On light microscopy, there were periodic acid–Schiff negative-fractured casts in tubules with giant cell reaction around them. The tubular epithelial cells showed intracytoplasmic bile pigment. On direct immunofluorescence, casts showed kappa restriction. A diagnosis of bilirubin proximal tubulopathy and light chain cast nephropathy was made, and possibility of myeloma was suggested. On further evaluation, κ:λ ratio was 27, β2 microglobulin was 8036 ng/ml, and bone marrow examination showed 5% plasma cells. There were no bony lesions, and serum calcium was 8.6 mg/dl. The present case is unique in two aspects. First, the patient developed MGRS triggered by acute hepatitis E in less than a month. Second, the MGRS lesion was manifested in the form of light chain cast nephropathy.
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Affiliation(s)
- P Agrawal
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - V Kumar
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Kumar
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - M U S Sachdeva
- Department of Hematopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Malhotra
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Nada
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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