1
|
Casares-Jimenez M, Rivero-Juarez A, Lopez-Lopez P, Montes ML, Navarro-Soler R, Peraire J, Espinosa N, Alemán-Valls MR, Garcia-Garcia T, Caballero-Gomez J, Corona-Mata D, Perez-Valero I, Ulrich RG, Rivero A. Rat hepatitis E virus ( Rocahepevirus ratti) in people living with HIV. Emerg Microbes Infect 2024; 13:2295389. [PMID: 38095070 PMCID: PMC10763910 DOI: 10.1080/22221751.2023.2295389] [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: 07/17/2023] [Accepted: 12/12/2023] [Indexed: 12/31/2023]
Abstract
Rat hepatitis E virus (ratHEV; species Rocahepevirus ratti) is considered a newly emerging cause of acute hepatitis of zoonotic origin. ratHEV infection of people living with HIV (PLWH) might portend a worse, as with hepatitis E virus (HEV; species Paslahepevirus balayani), and consequently this group may constitute a high-risk population. We aimed to evaluate the prevalence of ratHEV by measuring viral RNA and specific IgG antibodies in a large Spanish cohort of PLWH. Multicentre study conducted in Spain evaluating PLWHIV included in the Spanish AIDS Research Network (CoRIS). Patients were evaluated for ratHEV infection using PCR at baseline and anti-ratHEV IgG by dot blot analysis to evaluate exposure to ratHEV strains. Patients with detectable ratHEV RNA were followed-up to evaluate persistence of viremia and IgG seroconversion. Eight-hundred and forty-two individuals were tested. A total of 9 individuals showed specific IgG antibodies against ratHEV, supposing a prevalence of 1.1 (95% CI; 0.5%-2.1%). Of these, only one was reactive to HEV IgG antibodies by ELISA. One sample was positive for ratHEV RNA (prevalence of infection: 0.1%; 95% CI: 0.08%-0.7%). The case was a man who had sex with men exhibiting a slightly increased alanine transaminase level (49 IU/L) as only biochemical alteration. In the follow-up, the patients showed undetectable ratHEV RNA and seroconversion to specific ratHEV IgG antibodies. Our study shows that ratHEV is geographical broadly distributed in Spain, representing a potential zoonotic threat.
Collapse
Affiliation(s)
- María Casares-Jimenez
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
| | - Antonio Rivero-Juarez
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| | - Pedro Lopez-Lopez
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| | - María Luisa Montes
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
- HIV Unit, Internal Medicine Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | | | - Joaquín Peraire
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
- Infectious Diseases Unit, Joan XXIII University Hospital, IISPV, Rovira i Virgili University, Tarragona, Spain
| | - Nuria Espinosa
- Infectious Diseases and Clinical Microbiology Unit, Virgen del Rocío University Hospital, CSIC, IbIS, University of Seville, Seville, Spain
| | | | - Tránsito Garcia-Garcia
- Immunogenomic and Molecular Pathogenesis, Zoonoses and Emerging diseases Unit (ENZOEM), Genetic Department, University of Cordoba, Cordoba, Spain
| | - Javier Caballero-Gomez
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
- Animal Health Unit, Zoonoses and Emerging diseases Unit (ENZOEM), University of Cordoba, Cordoba, Spain
| | - Diana Corona-Mata
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| | - Ignacio Perez-Valero
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| | - Rainer G. Ulrich
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Lübeck-Borstel-Riems, Greifswald-Insel Riems, Germany
| | - Antonio Rivero
- Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
- CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spain
| |
Collapse
|
2
|
Zhang H, Li X, Wang C, Shi T, Geng Y, Zhao C. Detection of Hepatitis E Virus in Rabbits and Rabbit Meat from Slaughterhouses in Hebei Province of China. Vector Borne Zoonotic Dis 2023; 23:588-594. [PMID: 37699252 DOI: 10.1089/vbz.2023.0010] [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] [Indexed: 09/14/2023] Open
Abstract
Background: Hepatitis E virus (HEV) is a zoonotic pathogen. HEV has been found to be widely prevalent in rabbits. Its isolates are classified into HEV-3, rabbit subgenotype (HEV-3ra). The routes of human infection with HEV-3ra remain unclear; however, foodborne transmission is possible when asymptomatically infected animals enter the food chain. The prevalence of HEV infection in slaughtered rabbits and the presence of HEV in rabbit meat were evaluated in this study. Materials and Methods: In three slaughterhouses in Hebei province, China, samples of rabbit blood were collected during the slaughter process, and muscle, liver, and cavity juice were collected from the rabbit carcasses. Anti-HEV antibody in serum samples was detected using enzyme-linked immunosorbent assay. HEV RNA was tested in all samples by reverse transcription nested PCR (RT-nested PCR). The final amplicons of RT-nested PCR were sequenced and phylogenetically analyzed. Results: Of the 459 serum samples, 50 [10.9%, 95% confidence interval (CI): 8.1-13.7] were positive for anti-HEV antibody, and 17 (3.7%, 95% CI: 2.0-5.4) were positive for HEV RNA. HEV RNA was detected in 7 of 60 liver samples (11.7%, 95% CI: 3.3-20) and 2 cavity juice samples from semi-eviscerated carcasses, but was not detected in any muscle sample from either the eviscerated or semi-eviscerated carcasses. All the detected HEV strains belonged to HEV-3ra and related most closely with the rabbit HEV sequence previously reported in China. Conclusion: A portion of rabbits were in the viremia period of HEV infection at the slaughter age, resulting in the possibility of HEV carriage by rabbit carcass, particularly semi-eviscerated carcass containing liver. These findings suggest a potential risk of HEV transmission from raw rabbit products entering the food chain, whereas the presence of HEV appeared to be lower in the eviscerated carcass than in the semi-eviscerated carcass.
Collapse
Affiliation(s)
- Hongxin Zhang
- Key Laboratory of Public Health Safety of Hebei Province, Department of Preventive Medicine, School of Public Health, Hebei University, Baoding, China
| | - Xueli Li
- Key Laboratory of Public Health Safety of Hebei Province, Department of Preventive Medicine, School of Public Health, Hebei University, Baoding, China
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Chunyan Wang
- Division of Epidemiology, Baoding Centre for Disease Control and Prevention, Baoding, China
| | - Tengfei Shi
- Key Laboratory of Public Health Safety of Hebei Province, Department of Preventive Medicine, School of Public Health, Hebei University, Baoding, China
| | - Yansheng Geng
- Key Laboratory of Public Health Safety of Hebei Province, Department of Preventive Medicine, School of Public Health, Hebei University, Baoding, China
| | - Chenyan Zhao
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| |
Collapse
|
3
|
De Sabato L, Ianiro G, Filipello V, Arnaboldi S, Righi F, Ostanello F, Giammarioli M, Lavazza A, Di Bartolo I. Absence of Hepatitis E Virus (HEV) in Italian Lagomorph Species Sampled between 2019 and 2021. Animals (Basel) 2023; 13:ani13030545. [PMID: 36766433 PMCID: PMC9913390 DOI: 10.3390/ani13030545] [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: 01/16/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
The zoonotic hepatitis E virus genotype 3 (HEV-3) causes most autochthonous human hepatitis E cases in Europe, which are due to the consumption of raw or undercooked food products of animal origin. Pigs and wild boars are considered the main reservoirs of this genotype, while rabbits are the reservoir of a distinct phylogenetic group named HEV-3ra, which is classified within the HEV-3 genotype but in a separate clade. Evidence for the zoonotic potential of HEV-3ra was suggested by its detection in immunocompromised patients in several European countries. HEV-3ra infection was found in farmed and feral rabbit populations worldwide and its circulation was reported in a few European countries, including Italy. Furthermore, Italy is one of the major rabbit meat producers and consumers across Europe, but only a few studies investigated the presence of HEV in this reservoir. The aim of this study was to assess the presence of HEV in 328 Italian hares and 59 farmed rabbits collected in 3 Italian macro-areas (North, North-Central, and South-Central), between 2019 and 2021. For this purpose, liver samples were used to detect HEV RNA using broad-range real-time RT-PCR and nested RT-PCR. Using 28 liver transudates from hares, the ELISA test for anti-HEV IgG detection was also performed. Neither HEV RNA nor anti-HEV antibodies were detected. Further studies will be conducted to assess the HEV presence in Italian lagomorphs to establish the role of this host and the possible risk of transmission for workers with occupational exposure, to pet owners and via food.
Collapse
Affiliation(s)
- Luca De Sabato
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy
| | - Giovanni Ianiro
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy
- Correspondence: (G.I.); (F.O.)
| | - Virginia Filipello
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna “Bruno Ubertini” (IZSLER), Via Antonio Bianchi, 7/9, 25124 Brescia, Italy
| | - Sara Arnaboldi
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna “Bruno Ubertini” (IZSLER), Via Antonio Bianchi, 7/9, 25124 Brescia, Italy
| | - Francesco Righi
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna “Bruno Ubertini” (IZSLER), Via Antonio Bianchi, 7/9, 25124 Brescia, Italy
| | - Fabio Ostanello
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50, 40064 Ozzano dell’ Emilia, Italy
- Correspondence: (G.I.); (F.O.)
| | - Monica Giammarioli
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati” (IZSUM), Via Salvemini, 1, 06126 Perugia, Italy
| | - Antonio Lavazza
- Department of Animal Health and Welfare, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna “Bruno Ubertini” (IZSLER), Via Antonio Bianchi, 7/9, 25124 Brescia, Italy
| | - Ilaria Di Bartolo
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy
| |
Collapse
|
4
|
Wang L, Wang Y, Zhuang H. Puzzles for Hepatitis E Virus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:247-256. [PMID: 37223871 DOI: 10.1007/978-981-99-1304-6_17] [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 an important but understudied virus that has been the major cause of acute viral hepatitis worldwide. In recent decades, our understanding of this neglected virus has changed greatly: novel forms of viral proteins and their functions have been discovered; HEV can transmit via blood transfusion and organ transplantation; HEV can infect many animal species and the number is still increasing; HEV can induce chronic hepatitis and extra-hepatic manifestations. However, we are short of effective treatment measures to counter the virus. In this chapter we tend to briefly introduce the puzzles and major knowledge gaps existed in the field of HEV research.
Collapse
Affiliation(s)
- Lin Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Youchun Wang
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Hui Zhuang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| |
Collapse
|
5
|
Liu T, Wang L, Wang L. Animal Models for Hepatitis E Virus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:171-184. [PMID: 37223866 DOI: 10.1007/978-981-99-1304-6_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Animal models are one of the most important tools in the study of human hepatitis E virus (HEV) infection. They are particularly important in light of the major limitations of the cell culture system for HEV. Besides nonhuman primates, which are extremely valuable because of their susceptibility to HEV genotypes 1-4, animals like swine, rabbit, and humanized mice are also potential models for studies of pathogenesis, cross-species infection, and the molecular biology of HEV. Identification of a useful animal model for human HEV infection studies is crucial to further investigations into this ubiquitous yet poorly understood virus and facilitate the development of antiviral therapeutics and vaccines.
Collapse
Affiliation(s)
- Tianxu Liu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Lin Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
| | - Ling Wang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
| |
Collapse
|
6
|
Updates on hepatitis E virus. Chin Med J (Engl) 2022; 135:1231-1233. [PMID: 35787530 PMCID: PMC9337248 DOI: 10.1097/cm9.0000000000001998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
7
|
Schemmerer M, Wenzel JJ, Stark K, Faber M. Molecular epidemiology and genotype-specific disease severity of hepatitis E virus infections in Germany, 2010-2019. Emerg Microbes Infect 2022; 11:1754-1763. [PMID: 35713010 PMCID: PMC9295818 DOI: 10.1080/22221751.2022.2091479] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Zoonotic hepatitis E virus (HEV) is endemic in Europe. Genotype 3 (HEV-3) is predominant but information on subtype distribution, trends and clinical implications in Germany is scarce. We analysed 936 HEV RNA positive samples of human origin and corresponding national surveillance data from 2010 to 2019. Samples were referred to the National Consultant Laboratory and sequenced in at least one of four genomic regions. Sequences were analysed using bioinformatics methods and compared to the latest HEV reference set. 1,656 sequences were obtained from 300 female, 611 male and 25 of unknown sex aged 3–92 years (median 55 years). HEV-3c was predominant (67.3%) followed by HEV-3f, HEV-3e and HEV-3i(-like) with 14.3%, 9.7% and 4.0% (other subtypes ≤1.1%). The proportion of HEV-3 group 2 (3abchijklm) strains increased over time. Jaundice, upper abdominal pain, fever, hospitalization, and death due to HEV were significantly more often reported for patients infected with HEV-3 group 1 (3efg) compared to group 2. Larger spatio-temporal clusters of identical sequences were not observed. HEV-3 group 1 infections are more severe as compared to the predominant group 2. Detection of group 2 strains increased over the last years, possibly due to more frequent diagnosis of asymptomatic and mild courses. The diversity of strains and the space–time distribution is compatible with a foodborne zoonosis with supra-regional distribution of the infection vehicle (pork products).
Collapse
Affiliation(s)
- Mathias Schemmerer
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Jürgen J Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - Klaus Stark
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Mirko Faber
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
8
|
Hepatitis A and E in the Mediterranean: A systematic review. Travel Med Infect Dis 2022; 47:102283. [DOI: 10.1016/j.tmaid.2022.102283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/05/2022] [Accepted: 02/23/2022] [Indexed: 11/23/2022]
|
9
|
Prevalence of Hepatitis E Virus Infection among Laboratory Rabbits in China. Pathogens 2021; 10:pathogens10060780. [PMID: 34205738 PMCID: PMC8233994 DOI: 10.3390/pathogens10060780] [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: 05/11/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/27/2022] Open
Abstract
Hepatitis E virus (HEV) is zoonotic and the leading cause of acute viral hepatitis worldwide. Rabbit HEV can infect humans and is prevalent globally. It is reported that laboratory rabbits are also naturally infected with HEV. Therefore, it is important to investigate in a large scale the prevalence of HEV in laboratory rabbits. Serum samples were collected from 649 laboratory rabbits of 13 different commercial vendors in Beijing, China, from 2017 to 2019, and anti-HEV and HEV antigen (Ag) were tested. Fecal samples were collected from 50 laboratory rabbits from one of the vendors for HEV RNA detection. Six laboratory rabbits with natural HEV infection were euthanized and their liver, kidney, bile and urine samples were collected for HEV RNA quantification. Liver tissues were subjected to histopathology analysis. The overall positive rates of anti-HEV antibodies and HEV-Ag are 2.6% (15/588) and 7.9% (51/649), respectively. HEV RNA was detected in 12.0% (6/50) of the rabbits. High viral load of HEV RNA was detected in liver and bile samples. Liver inflammation was observed. HEV is circulating in laboratory rabbit population in China. Strict screening is crucial to ensure experimental accuracy and prevent zoonotic transmission to research personnel.
Collapse
|