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Orf GS, Bbosa N, Berg MG, Downing R, Weiss SL, Ssemwanga D, Ssekagiri A, Ashraf S, da Silva Filipe A, Kiiza R, Buule J, Namagembe HS, Nabirye SE, Kayiwa J, Deng LL, Wani G, Maror JA, Baguma A, Mogga JJH, Kamili S, Thomson EC, Kaleebu P, Cloherty GA. The 2023 South Sudanese outbreak of Hepatitis E emphasizes ongoing circulation of genotype 1 in North, Central, and East Africa. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2024; 124:105667. [PMID: 39251076 PMCID: PMC11413618 DOI: 10.1016/j.meegid.2024.105667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/23/2024] [Accepted: 09/06/2024] [Indexed: 09/11/2024]
Abstract
In April 2023, an outbreak of acute hepatitis was reported amongst internally displaced persons in the Nazareth community of South Sudan. IgM serology-based screening suggested the likely etiologic agent to be Hepatitis E virus (HEV). In this study, plasma specimens collected from anti-HEV IgM-positive cases were subjected to additional RT-qPCR testing and sequencing of extracted nucleic acids, resulting in the recovery of five full and eight partial HEV genomes. Maximum likelihood phylogenetic reconstruction confirmed the genomes belong to HEV genotype 1. Using distance-based methods, we show that genotype 1 is best split into three sub-genotypes instead of the previously proposed seven, and that these sub-genotypes are geographically restricted. The South Sudanese sequences confidently cluster within sub-genotype 1e, endemic to northeast, central, and east Africa. Bayesian Inference of phylogeny incorporating sampling dates shows that this new outbreak is not directly descended from other recent local outbreaks for which sequence data is available. However, the analysis suggests that sub-genotype 1e has been consistently and cryptically circulating locally for at least the past half century and that the known outbreaks are often not directly descended from one another. The ongoing presence of HEV, combined with poor sanitation and hygiene in the conflict-affected areas in the region, place vulnerable populations at risk for infection and its more serious effects, including progression to fulminant hepatitis.
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Affiliation(s)
- Gregory S Orf
- Core Diagnostics, Abbott Laboratories, Abbott Park, IL, USA; Abbott Pandemic Defense Coalition, Abbott Park, IL, USA.
| | - Nicholas Bbosa
- Abbott Pandemic Defense Coalition, Abbott Park, IL, USA; Uganda Virus Research Institute, Entebbe, Uganda; MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Michael G Berg
- Core Diagnostics, Abbott Laboratories, Abbott Park, IL, USA; Abbott Pandemic Defense Coalition, Abbott Park, IL, USA
| | - Robert Downing
- Abbott Pandemic Defense Coalition, Abbott Park, IL, USA; Uganda Virus Research Institute, Entebbe, Uganda
| | - Sonja L Weiss
- Core Diagnostics, Abbott Laboratories, Abbott Park, IL, USA; Abbott Pandemic Defense Coalition, Abbott Park, IL, USA
| | - Deogratius Ssemwanga
- Uganda Virus Research Institute, Entebbe, Uganda; MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
| | | | - Shirin Ashraf
- MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, UK
| | | | - Ronald Kiiza
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Joshua Buule
- Uganda Virus Research Institute, Entebbe, Uganda
| | | | | | - John Kayiwa
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Lul Lojok Deng
- National Public Health Laboratory (NPHL), Ministry of Health, Juba, South Sudan
| | - Gregory Wani
- National Public Health Laboratory (NPHL), Ministry of Health, Juba, South Sudan
| | - James A Maror
- National Public Health Laboratory (NPHL), Ministry of Health, Juba, South Sudan
| | - Andrew Baguma
- World Health Organization, Juba, South Sudan; Department of Microbiology, Kabale University School of Medicine, Kabale, Uganda
| | | | - Saleem Kamili
- Epidemiology and Surveillance Branch, U.S. Centers for Disease Control, Atlanta, GA, USA
| | - Emma C Thomson
- MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, UK; Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - Pontiano Kaleebu
- Uganda Virus Research Institute, Entebbe, Uganda; MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Gavin A Cloherty
- Core Diagnostics, Abbott Laboratories, Abbott Park, IL, USA; Abbott Pandemic Defense Coalition, Abbott Park, IL, USA
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2
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Abravanel F, Vignon C, Mercier A, Gaumery JB, Biron A, Filisetti C, Goujart MA, Colot J, Chamillard X, Demortier J, Raz M, Boutet C, Dupont L, Duval S, Castric C, Desoutter D, Desoutter A, Verge M, De Smet C, Demmou S, Lhomme S, Gourinat AC, Nicot F, Izopet J. Large-scale HEV genotype 3 outbreak on New Caledonia Island. Hepatology 2024:01515467-990000000-01013. [PMID: 39212522 DOI: 10.1097/hep.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND AND AIMS Several symptomatic cases of HEV infections were reported to the New Caledonia Island Public Health Service between August and December 2023. This prompted epidemiological and virological investigations to identify the source of infection. APPROACH AND RESULTS HEV RNA was assessed in symptomatic patients, various food items, and pig farms on the Island. HEV strains were characterized by sequencing. A seroprevalence study was also conducted on asymptomatic blood donors before and after the outbreak. One hundred twenty-seven symptomatic cases were reported. Hospitalization was required for 29/127 patients (22.8%). Hospitalized patients presented more frequently with comorbidities, including liver and cardiovascular diseases (80.7% vs. 27%, p < 0.01), and 3 persons died (2.3%). Among the 100 HEV RNA-positive samples received at the French National Reference Centre for HEV, viral sequencing was possible for 76 samples. All strains were identified as HEV genotype 3, and 74/76 strains were grouped together (nucleotide identity: 98%-100%). Full-length sequencing indicated a new HEV-3 subtype within HEV-3 subclade abk. Only genotype 3f strains were detected on the Island's pig farms. No food items tested positive for HEV RNA. The seroprevalence of HEV IgG and IgM in blood donors was 9.2% (9/98) and 0%, respectively, in 2020, rising to 17.3% (17/98) and 2% (2/98) in 2024. CONCLUSIONS Although all previous large-scale epidemics in Asia and Africa were associated with HEV-1 or 2, the New Caledonia outbreak was linked to HEV-3. A high number of symptomatic cases were admitted to the hospital, with a case-fatality rate of 2.3%.
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Affiliation(s)
- Florence Abravanel
- Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Laboratoire de Virologie, National Reference Centre for Hepatitis E, Toulouse, France
- Inserm UMR 1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Toulouse
| | - Clémence Vignon
- Toulouse University Hospital, Hopital Rangueil Service d'hépatologie - 1 Avenue du Pr J. Poulhes- Université Paul Sabatier III, Toulouse France, Nouvelle-Calédonie
| | - Ambroise Mercier
- Territorial Hospital Centre Gaston-Bourret, Service de Transfusion Sanguine 110, boulevard Joseph-Wamytan, Nouméa Cedex
| | - Jean-Baptiste Gaumery
- Direction des Affaires Sanitaire et Sociale, 7 avenue Paul DOUMER, BP M2, NOUMÉA Cedex, Nouvelle-Calédonie
| | - Antoine Biron
- Territorial Hospital Centre Gaston-Bourret, Service de Transfusion Sanguine 110, boulevard Joseph-Wamytan, Nouméa Cedex
| | - Clément Filisetti
- Direction des Affaires Sanitaire et Sociale, 7 avenue Paul DOUMER, BP M2, NOUMÉA Cedex, Nouvelle-Calédonie
| | - Marie-Amélie Goujart
- Territorial Hospital Centre Gaston-Bourret, Service de Transfusion Sanguine 110, boulevard Joseph-Wamytan, Nouméa Cedex
| | - Julien Colot
- Territorial Hospital Centre Gaston-Bourret, Service de Transfusion Sanguine 110, boulevard Joseph-Wamytan, Nouméa Cedex
| | - Xavier Chamillard
- Territorial Hospital Centre Gaston-Bourret, Service de Transfusion Sanguine 110, boulevard Joseph-Wamytan - BP J5, Nouméa Cedex
| | - Justine Demortier
- Territorial Hospital Centre Gaston-Bourret, Service de Transfusion Sanguine 110, boulevard Joseph-Wamytan - BP J5, Nouméa Cedex
| | - Maxime Raz
- Territorial Hospital Centre Gaston-Bourret, Service de Transfusion Sanguine 110, boulevard Joseph-Wamytan - BP J5, Nouméa Cedex
| | - Catherine Boutet
- Direction des Affaires Sanitaire et Sociale, 7 avenue Paul DOUMER, BP M2, NOUMÉA Cedex, Nouvelle-Calédonie
| | - Laura Dupont
- Direction des Affaires Sanitaire et Sociale, 7 avenue Paul DOUMER, BP M2, NOUMÉA Cedex, Nouvelle-Calédonie
| | - Sylvie Duval
- Direction des affaires vétérinaires, alimentaires et rurales 2 Rue Felix Russeil, Nouméa, Nouvelle-Calédonie
| | - Catherine Castric
- Direction des affaires vétérinaires, alimentaires et rurales 2 Rue Felix Russeil, Nouméa, Nouvelle-Calédonie
| | - Denise Desoutter
- Direction des affaires vétérinaires, alimentaires et rurales 2 Rue Felix Russeil, Nouméa, Nouvelle-Calédonie
| | - Anais Desoutter
- Direction des affaires vétérinaires, alimentaires et rurales 2 Rue Felix Russeil, Nouméa, Nouvelle-Calédonie
| | - Marjorie Verge
- Direction des affaires vétérinaires, alimentaires et rurales 2 Rue Felix Russeil, Nouméa, Nouvelle-Calédonie
| | - Clémentine De Smet
- Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Laboratoire de Virologie, National Reference Centre for Hepatitis E, Toulouse, France
| | - Sofia Demmou
- Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Laboratoire de Virologie, National Reference Centre for Hepatitis E, Toulouse, France
| | - Sébastien Lhomme
- Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Laboratoire de Virologie, National Reference Centre for Hepatitis E, Toulouse, France
- Inserm UMR 1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Toulouse
| | - Ann-Claire Gourinat
- Direction des Affaires Sanitaire et Sociale, 7 avenue Paul DOUMER, BP M2, NOUMÉA Cedex, Nouvelle-Calédonie
| | - Florence Nicot
- Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Laboratoire de Virologie, National Reference Centre for Hepatitis E, Toulouse, France
| | - Jacques Izopet
- Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Laboratoire de Virologie, National Reference Centre for Hepatitis E, Toulouse, France
- Inserm UMR 1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France Toulouse University Hospital, Hôpital Purpan, Place du Dr Baylac, Toulouse
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Suluku R, Jabaty J, Fischer K, Diederich S, Groschup MH, Eiden M. Hepatitis E Seroprevalence and Detection of Genotype 3 Strains in Domestic Pigs from Sierra Leone Collected in 2016 and 2017. Viruses 2024; 16:558. [PMID: 38675900 PMCID: PMC11054517 DOI: 10.3390/v16040558] [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: 03/11/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Hepatitis E virus (HEV) is the main cause of acute hepatitis in humans worldwide and is responsible for a large number of outbreaks especially in Africa. Human infections are mainly caused by genotypes 1 and 2 of the genus Paslahepevirus, which are exclusively associated with humans. In contrast, viruses of genotypes 3 and 4 are zoonotic and have their main reservoir in domestic and wild pigs, from which they can be transmitted to humans primarily through the consumption of meat products. Both genotypes 3 and 4 are widespread in Europe, Asia, and North America and lead to sporadic cases of hepatitis E. However, there is little information available on the prevalence of these genotypes and possible transmission routes from animal reservoirs to humans in African countries. We therefore analysed 1086 pig sera collected in 2016/2017 in four districts in Sierra Leone for antibodies against HEV using a newly designed in-house ELISA. In addition, the samples were also analysed for HEV RNA by quantitative real-time RT-PCR. The overall seroprevalence in Sierra Leone was low with only 44 positive sera and a prevalence of 4.0%. Two serum pools were RT-PCR-positive and recovered partial sequences clustered into the genotype 3 (HEV-3) of the order Paslahepevirus, species Paslahepevirus balayani. The results are the first evidence of HEV-3 infection in pigs from Sierra Leone and demonstrate a low circulation of the virus in these animals to date. Further studies should include an examination of humans, especially those with close contact with pigs and porcine products, as well as environmental sampling to evaluate public health effects within the framework of a One Health approach.
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Affiliation(s)
- Roland Suluku
- Animal Science, Serology and Molecular Laboratory, Njala University, Bo, Sierra Leone;
| | - Juliet Jabaty
- Sierra Leone Agricultural Research Institute, Teko Livestock Research Centre, Teko, Sierra Leone;
| | - Kerstin Fischer
- Institute of Novel and Emerging Infectious Diseases (INNT), Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany; (K.F.); (S.D.); (M.H.G.)
| | - Sandra Diederich
- Institute of Novel and Emerging Infectious Diseases (INNT), Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany; (K.F.); (S.D.); (M.H.G.)
| | - Martin H. Groschup
- Institute of Novel and Emerging Infectious Diseases (INNT), Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany; (K.F.); (S.D.); (M.H.G.)
- Partner Site Hamburg-Lübeck-Borstel-Riems, German Centre for Infection Research (DZIF), 17493 Greifswald-Insel Riems, Germany
| | - Martin Eiden
- Institute of Novel and Emerging Infectious Diseases (INNT), Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany; (K.F.); (S.D.); (M.H.G.)
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Abravanel F, Lhomme S. Hecolin vaccine: long-term efficacy against HEV for a three-dose regimen. Lancet 2024; 403:782-783. [PMID: 38387471 DOI: 10.1016/s0140-6736(23)02455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Florence Abravanel
- Inserm UMR 1291, CNRS UMR5051, Université Toulouse III, 31000 Toulouse, France.
| | - Sébastien Lhomme
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Centre for Hepatitis E, Toulouse, France
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5
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de Marguerite Nombot-Yazenguet MP, Doté JW, Koyaweda GW, Zemingui-Bembete PA, Selekon B, Vickos U, Manirakiza A, Nakoune E, Gouandjika-Vasilache I, Komas NPJ. Hepatitis E outbreak in the health district of Bocaranga-Koui, Central African Republic, 2018-2019. BMC Infect Dis 2024; 24:215. [PMID: 38374096 PMCID: PMC10875899 DOI: 10.1186/s12879-024-09116-3] [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: 11/03/2023] [Accepted: 02/08/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) is a major public health disease causing large outbreaks and sporadic cases of acute hepatitis. We investigated an outbreak of HEV infection that occurred in September 2018 in the health district (HD) of Bocaranga-Koui, located in the northwestern part of Central African Republic (CAR). METHODS Blood samples were collected from 352 patients aged 0-85 years suspected to be infected with yellow fever (YF), according to the World Health Organization YF case definition. The notification forms from recorded cases were used. Water consumed in the HD were also collected. Human samples found negative for anti-YF IgM were then tested by ELISA for anti-HEV IgM and IgG antibodies. Positive anti-HEV (IgM and/or IgG) samples and collected water were then subjected to molecular biology tests using a real time RT-PCR assay, followed by a nested RT-PCR assay for sequencing and phylogenetic analysis. RESULTS Of the 352 icterus patients included, anti-HEV IgM was found in 142 people (40.3%) and anti-HEV IgG in 175 (49.7%). Although HEV infection was detected in all age groups, there was a significant difference between the 0-10 age groups and others age groups (P = 0.001). Elevated levels of serum aminotransferase were observed in anti-HEV IgM-positive subjects. Phylogenetic analysis showed HEV genotype 1e in infected patients as well as in the contaminated water. CONCLUSION This epidemic showed that CAR remains an HEV-endemic area. The genotype 1e strain was responsible for the HEV outbreak in Bocaranga-Koui HD. It is necessary to implement basic conditions of hygiene and sanitation to prevent further outbreaks of a HEV epidemics, to facilitate access to clean drinking water for the population, to launch intensive health education for basic hygiene measures, to sett up targeted hygiene promotion activities and, finally, to ensure that formal health care is available.
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Affiliation(s)
| | - Joël Wilfried Doté
- Enteric Viruses and Measles Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Giscard Wilfried Koyaweda
- Laboratoire National de Biologie Clinique Et de Santé Publique, PO Box 1426, Bangui, Central African Republic
| | | | - Benjamin Selekon
- Arboviruses, Hemorragic Fever Viruses and Zoonosis Virus Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Ulrich Vickos
- Department of Medicine, Infectious and Tropical Diseases Unit, Hôpital de L'Amitié Sino-Centrafricaine, Bangui, Central African Republic
| | - Alexandre Manirakiza
- Epidemiological Service, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Emmanuel Nakoune
- Arboviruses, Hemorragic Fever Viruses and Zoonosis Virus Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Ionela Gouandjika-Vasilache
- Enteric Viruses and Measles Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
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Modiyinji AF, Tankeu LTA, Monamele CG, Yifomnjou Moumbeket MH, Tagnouokam Ngoupo PA, Tchetgna Simo H, Njei Ngu A, Mirdad K, Njouom R. Hepatitis E virus infections among patients with acute febrile jaundice in two regions of Cameroon: First molecular characterization of hepatitis E virus genotype 4. PLoS One 2024; 19:e0298723. [PMID: 38346054 PMCID: PMC10861035 DOI: 10.1371/journal.pone.0298723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Febrile jaundice is a common indicator of certain infectious diseases, including hepatitis E. In Cameroon, the yellow fever virus is the only pathogen that is monitored in patients who present with this symptom. However, more than 90% of the samples received as part of this surveillance are negative for yellow fever. This study aimed to describe the prevalence and hepatitis E virus (HEV) genotype among yellow fever-negative patients in the Far North and West regions of Cameroon. METHODS In a cross-sectional study, yellow fever surveillance-negative samples collected between January 2021 and January 2023 were retrospectively analyzed. Anti-HEV IgM and IgG antibodies were tested using commercially available ELISA kits. Anti-HEV IgM and/or IgG positive samples were tested for HEV RNA by real-time RT-PCR, followed by nested RT-PCR, sequencing and phylogenetic analysis. RESULTS Overall, 121 of the 543 samples (22.3%, 95% CI: 19.0% - 26.0%) were positive for at least one anti-HEV marker. Amongst these, 8.1% (44/543) were positive for anti-HEV IgM, 5.9% (32/543) for anti-HEV IgG, and 8.3% (45/544) for both markers. A total of 15.2% (12/79) samples were positive for HEV RNA real-time RT-PCR and 8 samples were positive for HEV RNA by nested RT-PCR. Phylogenetic analysis showed that the retrieved sequences clustered within HEV genotypes/subtypes 1/1e, 3/3f and 4/4b. CONCLUSION Our results showed that HEV is one of the causes of acute febrile jaundice in patients enrolled in the yellow fever surveillance program in two regions of Cameroon. We described the circulation of three HEV genotypes, including two zoonotic genotypes. Further studies will be important to elucidate the transmission routes of these zoonotic HEV genotypes to humans in Cameroon.
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Affiliation(s)
| | | | | | | | | | | | - Abanda Njei Ngu
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Kazanji Mirdad
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Richard Njouom
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
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7
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Guo H, Liu D, Liu K, Hou Y, Li C, Li Q, Ding X, Verstegen MMA, Zhang J, Wang L, Ding Y, Tang R, Pan X, Zheng K, van der Laan LJW, Pan Q, Wang W. Drug repurposing screen identifies vidofludimus calcium and pyrazofurin as novel chemical entities for the development of hepatitis E interventions. Virol Sin 2024; 39:123-133. [PMID: 37984761 PMCID: PMC10877426 DOI: 10.1016/j.virs.2023.11.006] [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: 08/05/2023] [Accepted: 11/16/2023] [Indexed: 11/22/2023] Open
Abstract
Hepatitis E virus (HEV) infection can cause severe complications and high mortality, particularly in pregnant women, organ transplant recipients, individuals with pre-existing liver disease and immunosuppressed patients. However, there are still unmet needs for treating chronic HEV infections. Herein, we screened a best-in-class drug repurposing library consisting of 262 drugs/compounds. Upon screening, we identified vidofludimus calcium and pyrazofurin as novel anti-HEV entities. Vidofludimus calcium is the next-generation dihydroorotate dehydrogenase (DHODH) inhibitor in the phase 3 pipeline to treat autoimmune diseases or SARS-CoV-2 infection. Pyrazofurin selectively targets uridine monophosphate synthetase (UMPS). Their anti-HEV effects were further investigated in a range of cell culture models and human liver organoids models with wild type HEV strains and ribavirin treatment failure-associated HEV strains. Encouragingly, both drugs exhibited a sizeable therapeutic window against HEV. For instance, the IC50 value of vidofludimus calcium is 4.6-7.6-fold lower than the current therapeutic doses in patients. Mechanistically, their anti-HEV mode of action depends on the blockage of pyrimidine synthesis. Notably, two drugs robustly inhibited ribavirin treatment failure-associated HEV mutants (Y1320H, G1634R). Their combination with IFN-α resulted in synergistic antiviral activity. In conclusion, we identified vidofludimus calcium and pyrazofurin as potent candidates for the treatment of HEV infections. Based on their antiviral potency, and also the favorable safety profile identified in clinical studies, our study supports the initiation of clinical studies to repurpose these drugs for treating chronic hepatitis E.
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Affiliation(s)
- Hongbo Guo
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China.
| | - Dan Liu
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Kuan Liu
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, NL-3015 CN, the Netherlands; Department of Surgery, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, 3015CE, NL-3015 CN, the Netherlands
| | - Yao Hou
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Chunyang Li
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Qiudi Li
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Xiaohui Ding
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Monique M A Verstegen
- Department of Surgery, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, 3015CE, NL-3015 CN, the Netherlands
| | - Jikai Zhang
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Lingli Wang
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Yibo Ding
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Renxian Tang
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Xiucheng Pan
- Department of Infectious Diseases, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China
| | - Kuiyang Zheng
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China
| | - Luc J W van der Laan
- Department of Surgery, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, 3015CE, NL-3015 CN, the Netherlands
| | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, NL-3015 CN, the Netherlands.
| | - Wenshi Wang
- Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, 221004, China.
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8
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Mumin FI, Fenton A, Osman AY, Mor SM. Zoonoses research in Somalia: A scoping review using a One Health approach. One Health 2023; 17:100626. [PMID: 38024257 PMCID: PMC10665144 DOI: 10.1016/j.onehlt.2023.100626] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/31/2023] [Indexed: 12/01/2023] Open
Abstract
Zoonoses are likely to cause a substantial burden on both human and animal health systems in Somalia, given the close proximity between the pastoralist majority and their livestock. However, decades of instability leading to weak disease surveillance have meant that data on the burden of zoonoses is lacking. The aim of this scoping review was to assess and synthesize the available literature on the presence and burden of zoonoses in Somalia. We used keywords to search Web of Science for relevant publications. Studies were included if they contained relevant data on a zoonosis and were undertaken in Somalia or were undertaken in another country where exposure could reasonably be assumed to have occurred in Somalia (e.g., migrants/refugees, returning soldiers, exported animals). Studies were not included if they focused on Somali ethnic communities permanently living elsewhere or if zoonotic aspects were not considered. We extracted data on disease(s) reported, geographic focus, data reported (human, animal, environment), study design and author affiliation. A total of 22 zoonotic infections were documented in 76 publications. The most frequently studied diseases were Rift Valley Fever (n = 15, 17%), brucellosis (n = 13, 14%) and hepatitis E (n = 10, 11%). Around 30% of papers reported data from relevant populations outside Somalia. Only 18 papers undertook laboratory analysis within Somalia. Most papers reported data on humans (45%) and animals (36%) with limited research on the environmental domain. Descriptive studies (47%) dominated and most were led by non-Somali researchers (89% in first authors and 95% of last authors). This study highlights the need for well-designed zoonoses research in Somalia supported by capacity building of local researchers and investments in diagnostic laboratories.
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Affiliation(s)
- Farah I. Mumin
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
- International Livestock Research Institute, Addis Ababa, Ethiopia
- Faculty of Veterinary Medicine, Red Sea University, Bosaso, Puntland State, Somalia
| | - Andy Fenton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Abdinasir Yusuf Osman
- Royal Veterinary College, University of London, London, United Kingdom
- National Institute of Health, Ministry of Health, Mogadishu, Somalia
| | - Siobhan M. Mor
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
- International Livestock Research Institute, Addis Ababa, Ethiopia
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Oluremi AS, Casares-Jimenez M, Opaleye OO, Caballero-Gomez J, Ogbolu DO, Lopez-Lopez P, Corona-Mata D, Rivero-Juarez A, Rivero A. Butchering activity is the main risk factor for hepatitis E virus ( Paslahepevirus balayani) infection in southwestern Nigeria: a prospective cohort study. Front Microbiol 2023; 14:1247467. [PMID: 37822752 PMCID: PMC10562583 DOI: 10.3389/fmicb.2023.1247467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/05/2023] [Indexed: 10/13/2023] Open
Abstract
Introduction Paslahepevirus balayani (Hepatitis E virus; HEV) is an emerging virus that poses as a public health threat. The virus is now reported to be the leading cause of acute viral hepatitis, with a unique impact on African settings. Our aim was to evaluate the prevalence and risk factors for HEV infection in three cohorts (animal handlers, villagers, and students). Methods A prospective cross-sectional study was carried out on a total of 752 subjects from southwestern Nigeria. In all individuals, anti-HEV IgG and anti-HEV IgM antibodies were evaluated by using ELISA (confirming positive results via immunoblotting), and serum viral RNA was evaluated by using two RT-PCR assays. Results The overall seroprevalence of HEV IgG and HEV IgM was 14.9% (95% CI: 12.5-17.6%) and 1.3% (95% CI: 0.7-2.5%), respectively. We observed the highest seroprevalence among animal contact individuals, with butchers being the population with the highest HEV IgG seroprevalence (31.1%). Similarly, HEV IgM was higher in the animal contact group (2.2%) than in the non-animal contact cohort (0%). Discussions Viral RNA was not detected in any of the samples. Butchering was significantly associated with higher HEV prevalence. Although all efforts to prevent HEV in Africa have focused on the chlorination of water, our study suggests that most new infections could currently be linked to animal manipulation. Therefore, education and guidelines must be provided in southwest Nigeria to ensure that animal handling and processing methods are safe.
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Affiliation(s)
- Adeolu S. Oluremi
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Maria Casares-Jimenez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
| | - Oluyinka O. Opaleye
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Javier Caballero-Gomez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - David Olusoga Ogbolu
- Department of Medical Laboratory Science, Osun State University, Ogbomoso, Nigeria
| | - Pedro Lopez-Lopez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Diana Corona-Mata
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
| | - Antonio Rivero-Juarez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Rivero
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
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Viera-Segura O, Calderón-Flores A, Batún-Alfaro JA, Fierro NA. Tracing the History of Hepatitis E Virus Infection in Mexico: From the Enigmatic Genotype 2 to the Current Disease Situation. Viruses 2023; 15:1911. [PMID: 37766316 PMCID: PMC10536485 DOI: 10.3390/v15091911] [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: 08/24/2023] [Revised: 09/09/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Hepatitis E virus (HEV) is the major cause of acute viral hepatitis worldwide. This virus is responsible for waterborne outbreaks in low-income countries and zoonosis transmission in industrialized regions. Initially, considered self-limiting, HEV may also lead to chronic disease, and evidence supports that infection can be considered a systemic disease. In the late 1980s, Mexico became a hot spot in the study of HEV due to one of the first virus outbreaks in Latin America related to enterically transmitted viral non-A, non-B hepatitis. Viral stool particles recovered from Mexican viral hepatitis outbreaks represented the first identification of HEV genotype (Gt) 2 (Gt2) in the world. No new findings of HEV-Gt2 have been reported in the country, whereas this genotype has been found in countries on the African continent. Recent investigations in Mexico have identified other strains (HEV-Gt1 and -Gt3) and a high frequency of anti-HEV antibodies in animal and human populations. Herein, the potential reasons for the disappearance of HEV-Gt2 in Mexico and the advances in the study of HEV in the country are discussed along with challenges in studying this neglected pathogen. These pieces of information are expected to contribute to disease control in the entire Latin American region.
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Affiliation(s)
- Oliver Viera-Segura
- Laboratorio de Diagnóstico de Enfermedades Emergentes y Reemergentes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Arturo Calderón-Flores
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Julio A. Batún-Alfaro
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Nora A. Fierro
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
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Lopez-Lopez P, Frias M, Perez-Jimenez AB, Freyre-Carrillo C, Pineda JA, Aguilera A, Fuentes A, Alados JC, Reina G, Ramirez-Arellano E, Viciana I, Mesquita J, Caballero-Gomez J, Rivero-Juarez A, Rivero A. Optimization of the molecular diagnosis of the acute hepatitis E virus infection. Microb Biotechnol 2023; 16:1325-1332. [PMID: 36965117 DOI: 10.1111/1751-7915.14247] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 03/27/2023] Open
Abstract
To evaluate the diagnostic value of the combination of two broad-range PCR assays targeting two different and conserved regions of the viral genome for the diagnosis of acute Hepatitis E virus (HEV) infection. Patients with acute hepatitis were prospectively recruited. In all, HEV-IgM antibodies were tested together with evaluation of HEV viraemia by two PCR assays (ORF3 and ORF1). The number of individuals exhibiting negative IgM antibody results but carrying viral RNA was calculated by each PCR assay. Four-hundred and seventy individuals were included, of whom 145 (30.8%) were diagnosed as having acute HEV. Of them, 122 (84.1%) exhibited HEV-IgM antibodies, and 81 (55.8%) had detectable viral RNA for at least one PCR. Using the ORF3 molecular assay, 70 (48.3%) individuals were identified with HEV infection. When the ORF1 molecular assay was applied, 49 (33.8%) individuals were identified. The ORF3 assay detected viral RNA in 32 patients not detected by the ORF1 assay. In contrast, the ORF1 assay could amplify viral RNA in 11 patients who were not detected by the ORF3 assay. The parallel use of two broad-range PCR assays significantly increased the performance of the molecular diagnosis of HEV.
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Affiliation(s)
- Pedro Lopez-Lopez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Mario Frias
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Belén Perez-Jimenez
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Clinical Microbiology Unit, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | | | - Juan A Pineda
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Unit of Infectious Diseases and Microbiology. Hospital Universitario de Valme, Seville, Spain
| | - Antonio Aguilera
- Microbiology Department, Hospital Clínico Universitario & University of Santiago de Compostela (USC)/IDIS, Santiago de Compostela, Spain
| | - Ana Fuentes
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Instituto de Investigacion Biosanitaria Ibs., Granada, Spain
| | - Juan Carlos Alados
- Clinical Microbiology Unit, Hospital Universitario de Jerez, Cádiz, Spain
| | - Gabriel Reina
- Microbiology Department, Clínica Universidad de Navarra, ISTUN, Institute of Tropical Health, Universidad de Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Encarnación Ramirez-Arellano
- Infectious Diseases, Microbiology and Preventive Medicine Unit, Department of Medicine, Virgen Macarena Univ. Hospital, University of Sevilla/Biomedicine Institute of Sevilla, Sevilla, Spain
| | - Isabel Viciana
- Infectious Diseases, Microbiology and Preventive Medicine Unit, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Joao Mesquita
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Javier Caballero-Gomez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Departamento Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Antonio Rivero-Juarez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Rivero
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
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Ahmed A, Ali Y, Mohamed NS, Zinsstag J, Siddig EE, Khairy A. Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan. Emerg Infect Dis 2023; 29:460-461. [PMID: 36692354 PMCID: PMC9881795 DOI: 10.3201/eid2902.221796] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Geng Y, Shi T, Wang Y. Transmission of Hepatitis E Virus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:73-92. [PMID: 37223860 DOI: 10.1007/978-981-99-1304-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Transmission of hepatitis E virus (HEV) occurs predominantly by the fecal-oral route. Large epidemics of hepatitis E in the developing countries of Asia and Africa are waterborne and spread through contaminated drinking water. The reservoir of HEV in developed countries is believed to be in animals with zoonotic transmission to humans, possibly through direct contact or the consumption of undercooked contaminated meat. And HEV transmission through blood transfusion, organ transplantation, and vertical transmission has been reported.
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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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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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Hepatitis E Virus Seroprevalence and Associated Risk Factors in Pregnant Women Attending Antenatal Consultations in Senegal. Viruses 2022; 14:v14081742. [PMID: 36016364 PMCID: PMC9416362 DOI: 10.3390/v14081742] [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: 07/08/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
In West Africa, research on the hepatitis E virus (HEV) is barely covered, despite the recorded outbreaks. The low level of access to safe water and adequate sanitation is still one of the main factors of HEV spread in developing countries. HEV infection induces acute or sub-clinical liver diseases with a mortality rate ranging from 0.5 to 4%. The mortality rate is more alarming (15 to 25%) among pregnant women, especially in the last trimester of pregnancy. Herein, we conducted a multicentric socio-demographic and seroepidemiological survey of HEV in Senegal among pregnant women. A consecutive and non-redundant recruitment of participants was carried out over the period of 5 months, from March to July 2021. A total of 1227 consenting participants attending antenatal clinics responded to a standard questionnaire. Plasma samples were collected and tested for anti-HEV IgM and IgG by using the WANTAI HEV-IgM and IgG ELISA assay. The overall HEV seroprevalence was 7.8% (n = 96), with 0.5% (n = 6) and 7.4% (n = 91) for HEV IgM and HEV IgG, respectively. One of the participant samples was IgM/IgG-positive, while four were declared indeterminate to anti-HEV IgM as per the manufacturer’s instructions. From one locality to another, the seroprevalence of HEV antibodies varied from 0 to 1% for HEV IgM and from 1.5 to 10.5% for HEV IgG. The data also showed that seroprevalence varied significantly by marital status (p < 0.0001), by the regularity of income (p = 0.0043), and by access to sanitation services (p = 0.0006). These data could serve as a basis to setup national prevention strategies focused on socio-cultural, environmental, and behavioral aspects for a better management of HEV infection in Senegal.
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