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Younes N, Yassine HM, Nizamuddin PB, Kourentzi K, Tang P, Ayoub HH, Khalili M, Coyle PV, Litvinov D, Willson RC, Abu-Raddad LJ, Nasrallah GK. Seroprevalence of hepatitis E virus (HEV) among male craft and manual workers in Qatar (2020-2021). Heliyon 2023; 9:e21404. [PMID: 38027884 PMCID: PMC10660033 DOI: 10.1016/j.heliyon.2023.e21404] [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: 03/27/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background The rapid growth of Qatar in the last two decades has attracted a large influx of immigrant craft and manual workers (CMWs) seeking employment in jobs associated with food handling, domestic service, and construction. Nearly 60 % of Qatar's population are expatriates CMWs, including many from hyperendemic countries for HEV. Thus, estimating the seroprevalence of HEV in Qatar and understanding its epidemiology is essential for public health efforts to control HEV transmission in Qatar. Methods Blood samples from 2670 CMWs were collected between 2020 and 2021. All samples were tested for HEV-IgG antibodies. Positive HEV-IgG samples were tested for HEV-IgM antibodies, and those positives were also tested for viral antigens using an HEV-Ag ELISA kit and HEV-RNA by RT-PCR to confirm current HEV infections. Results The seroprevalence of HEV-IgG was 27.3 % (729/2670; 95 % CI: 25.6-29.0). Of those HEV-IgG positive, 8.23 % (60/729; 95 % CI: 6.30-10.5) were HEV-IgM positive. Of the IgM-positive samples, 2 were HEV-RNA positive (3.39 %; 95 % CI: 0.40-11.7), and 1 was HEV-Ag positive (1.69 %; 95 % CI: 0.04-9.09). In addition, HEV-IgG seroprevalence was associated with age and nationality, with the highest seroprevalence in participants from Egypt (IgG 60.0 %; IgM 5.56 %), Pakistan (IgG 59.0 %; IgM 2.24 %), Nepal (IgG 29.3 %; IgM 2.70 %), Bangladesh (IgG 27.8 %; IgM 2.45 %), and India (IgG 23.9 %; IgM 2.43 %). Conclusion In this study, we showed that the seroprevalence of HEV among CMWs was slightly higher than what was previously reported among the urban population in Qatar (2013-2016).
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Affiliation(s)
- Nadin Younes
- Biomedical Research Center, Qatar University, Doha, 2713, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, 2713, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center, Qatar University, Doha, 2713, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, 2713, Qatar
| | | | - Katerina Kourentzi
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX 77204, USA
| | - Patrick Tang
- Division of Microbiology, Sidra Medicine, Doha, 26999, Qatar
| | - Houssein H. Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, 2713, Qatar
| | - Makiyeh Khalili
- Department of Laboratory Medicine, Hamad Medical Corporation, Doha, 3050, Qatar
| | - Peter V. Coyle
- Department of Pediatrics, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, 3050, Qatar
| | - Dmitri Litvinov
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX 77204, USA
- Center for Integrated Bio & Nano Systems, University of Houston, Houston, TX 77204, USA
| | - Richard C. Willson
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX 77204, USA
- Department of Biology and Biochemistry, University of Houston, Houston, TX 77204, USA
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Gheyath K. Nasrallah
- Biomedical Research Center, Qatar University, Doha, 2713, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, 2713, Qatar
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Lautredou CC, Dao B, Gounder P. Epidemiology of Suspected and Confirmed Acute Hepatitis E Cases Reported Among Los Angeles County Residents, 2017-2019. Clin Infect Dis 2023; 77:589-592. [PMID: 37092697 DOI: 10.1093/cid/ciad242] [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: 01/31/2023] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 04/25/2023] Open
Abstract
In a 3-year period, 38 of 48 persons testing positive for hepatitis E virus (HEV) immunoglobulin M in Los Angeles County did not meet the acute HEV case definition. Healthcare providers should restrict HEV serologic testing for persons with clinically compatible symptoms or epidemiologic risk factors.
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Affiliation(s)
- Cassandra C Lautredou
- Division of Infectious Diseases and Preventive Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Bonnie Dao
- Acute Communicable Disease Control Program, County of Los Angeles Public Health, Los Angeles, USA
| | - Prabhu Gounder
- Acute Communicable Disease Control Program, County of Los Angeles Public Health, Los Angeles, USA
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Cao X, Jiang W, Shi L, Wang Y, Chen J, Huang W, Zhang S. Acalculous cholecystitis is a common extrahepatic manifestation of hepatitis E and suggests a more serious condition. Virol J 2023; 20:77. [PMID: 37095526 PMCID: PMC10124029 DOI: 10.1186/s12985-023-02045-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/18/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND This study aimed to understand the incidence and clinical significance of acalculous cholecystitis in patients with acute hepatitis E (HE). PATIENTS AND METHODS A single center enrolled 114 patients with acute HE. All patients underwent imaging of the gallbladder, and patients with gallstones and cholecystectomy were excluded. RESULTS Acalculous cholecystitis was found in 66 patients (57.89%) with acute HE. The incidence in males was 63.95%, which was significantly higher than in females (39.29%) (P = 0.022). The mean length of hospital stay and the incidence of spontaneous peritonitis in patients with cholecystitis (20.12 ± 9.43 days and 9.09%, respectively) were significantly higher than those in patients without cholecystitis (12.98 ± 7.26 days and 0%, respectively) (P < 0.001 and P = 0.032). Albumin, total bile acid, bilirubin, cholinesterase, and prothrombin activity in patients with cholecystitis were significantly inferior to those in patients without cholecystitis (P < 0.001, P < 0.001, P < 0.001, P < 0.001 and P = 0.003, respectively). After correction by multivariate analysis, albumin and total bile acid were found to be closely related to acalculous cholecystitis in HE. CONCLUSION Acalculous cholecystitis is very common in patients with acute HE, and may serve as a predictor of increased peritonitis, synthetic decompensation, and longer hospital stay.
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Affiliation(s)
- Xuemei Cao
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Wei Jiang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Lingfeng Shi
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
- Department of Infectious Diseases, Youyang Hospital, A Branch of The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanping Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Chen
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Wenxiang Huang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Shujun Zhang
- Chongqing Key Laboratory of Infectious Diseases and Parasitic Diseases, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
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Unravelling the tripartite interactions among Hepatitis E virus RNA, miR-140 and hnRNP K: Running title: Interactions between HEV-RNA, miR-140 and hnRNP K. J Mol Biol 2023; 435:168050. [PMID: 36933825 DOI: 10.1016/j.jmb.2023.168050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
In the present investigation, we have identified the functional significance of the highly conserved miR-140 binding site on the Hepatitis E Virus (HEV) genome. Multiple sequence alignment of the viral genome sequences along with RNA folding prediction indicated that the putative miR-140 binding site has significant conservation for sequence and secondary RNA structure among HEV genotypes. Site-directed mutagenesis and reporter assays indicated that an intact sequence of the miR-140 binding site is essential for HEV translation. Provision of mutant miR-140 oligos carrying same mutation as on mutant HEV successfully rescued mutant HEV replication. In vitro cell-based assays with modified oligos proved that host factor-miR-140 is a critical requirement for HEV replication. Biotinylated RNA pulldown and RNA immunoprecipitation assays proved that the predicted secondary RNA structure of the miR-140 binding site allows the recruitment of hnRNP K, which is a key protein of the HEV replication complex. We predicted the model from the obtained results that the miR-140 binding site can serve as a platform for recruitment of hnRNP K and other proteins of HEV replication complex only in the presence of miR-140.
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Ostankova YV, Shchemelev AN, Boumbaly S, Balde TAL, Zueva EB, Valutite DE, Serikova EN, Davydenko VS, Skvoroda VV, Vasileva DA, Semenov AV, Esaulenko EV, Totolian AA. Prevalence of HIV and Viral Hepatitis Markers among Healthcare Workers in the Republic of Guinea. Diagnostics (Basel) 2023; 13:diagnostics13030378. [PMID: 36766482 PMCID: PMC9914033 DOI: 10.3390/diagnostics13030378] [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: 10/04/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Healthcare workers are much more likely to be infected with HIV and hepatitis viruses compared to the general population. Although healthcare workers are more aware of HIV and hepatitis viruses, several countries in Africa lack a comprehensive grasp of disease routes and transmission risks. The aim of this study was to assess the prevalence of the serological and molecular biological markers of HIV and viral hepatitis among healthcare workers in the Republic of Guinea. The study material was 74 blood serum samples collected from healthcare workers who received additional training at the Institute of Applied Biological Research of Guinea (IRBAG, Kindia, Republic of Guinea). The markers examined included HBsAg, HBeAg, anti-HBs IgG, anti-HBcore IgG, anti-HCV qualitative determination, anti-HEV IgM and IgG, anti-HAV IgM and IgG, and anti-HIV. For viral DNA and RNA detection, nucleic acids were extracted from blood serum, and viral presence was inferred using real-time PCR with hybridization fluorescence detection. A high prevalence of viral hepatitis B markers was shown, and significantly fewer cases of viral hepatitis C and HIV were detected. Almost all examined medical workers had anti-HAV IgG antibodies, but no antibodies to hepatitis E virus. Apparently, the identified markers depend on the general prevalence of certain pathogens in the region and are associated with the traditions and characteristics of the country's residents.
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Affiliation(s)
- Yulia V Ostankova
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Alexander N Shchemelev
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Sanaba Boumbaly
- Institute of Applied Biological Research of Guinea (IRBAG), Kindia 100 BP 75, Guinea
- Centre International de Recherche sur les Infections Tropicales en Guinée, Nzerekore 400 BP, Guinea
| | - Thierno A L Balde
- Institute of Applied Biological Research of Guinea (IRBAG), Kindia 100 BP 75, Guinea
| | - Elena B Zueva
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Diana E Valutite
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Elena N Serikova
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Vladimir S Davydenko
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Vsevolod V Skvoroda
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Daria A Vasileva
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Alexander V Semenov
- Ekaterinburg Research Institute of Viral Infections, State Research Center of Virology and Biotechnology Vector of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 620030 Ekaterinburg, Russia
| | - Elena V Esaulenko
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
| | - Areg A Totolian
- Saint Petersburg Pasteur Institut of the Federal Service for Surveillance of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), 197101 Saint Petersburg, Russia
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6
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Hui W, Wei L. Treatment of Hepatitis E. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:215-226. [PMID: 37223869 DOI: 10.1007/978-981-99-1304-6_15] [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) infections are the most common cause of acute hepatitis, but they can also take a chronic course. There is no specific therapy for acute hepatitis, and current treatment is supportive. Choosing ribavirin as the first-line therapy for chronic HEV is advisable, especially immunosuppressed individuals. Moreover, ribavirin therapy in the acute phase of infection provides major benefits for those at high risk of acute liver failure (ALF)/acute-on-chronic liver failure (ACLF). Pegylated interferon α has been used successfully for treatment of hepatitis E but is associated with major side effects. Cholestasis is one of the most common, but devastating, manifestations in hepatitis E. Current therapy for HEV aims to treat symptoms. Therapy generally involves several measures, such as vitamins, albumin, and plasma for supporting treatment, symptomatic treatment for cutaneous pruritus, ursodeoxycholic acid, Obeticholic acid, S-adenosylmethionine, etc. for removing jaundice. HEV infection during pregnancy and patients with underlying liver disease may develop liver failure. For these patients, active monitoring, standard care, and supportive treatment are the foundations. Ribavirin has successfully been used to prevent liver transplantation (LT). Prevention and treatment of complications are important for treatment of liver failure. Liver support devices are intended to support liver function until such time as native liver function recovers, or until LT. LT is widely considered as irreplaceable and definitive treatment for liver failure, particularly for patients who do not improve with supportive measures to sustain life.
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Affiliation(s)
- Wei Hui
- Chronic Disease Management Center, Youan Hospital, Capital Medical University, Beijing, China
| | - Linlin Wei
- The Second Department of Liver Disease Center, Youan Hospital, Capital Medical University, Beijing, China.
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Ahmad T, Jin H, Dhama K, Yatoo MI, Tiwari R, Bilal M, Dhawan M, Emran TB, Alestad JH, Alhani HM, BinKhalaf HK, Rabaan AA. Hepatitis E virus in pigs and the environment: An updated review of public health concerns. NARRA J 2022; 2:e78. [PMID: 38449702 PMCID: PMC10914032 DOI: 10.52225/narra.v2i2.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/22/2022] [Indexed: 09/01/2023]
Abstract
Hepatitis E virus (HEV) is an important public health problem and is responsible for both acute and chronic viral hepatitis. Public health implications of HEV are derived from its transmission route, either water-borne or food-borne, and its zoonotic potential. Not only in developing countries, but HEV cases are also found in a high number in developed countries. The spread of HEV to the environment might pollute surface waters, which could act as the source of infection for both humans and animals. Identification of the virus in animal products suggests the circulation of HEV within water and food chains. High seroprevalence and circulation of HEV in livestock, in particular pigs, as well as in environmental samples warrants further investigation into pig markets. HEV virulence in different environments and meat supply chains could shed light on the possible sources of infection in humans and the degree of occupational risk. The purpose of this review is to discuss HEV infections with an emphasis on livestock- and environment-related risk factors, and food-borne, water-borne, and zoonotic transmissions.
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Affiliation(s)
- Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing,Chinas
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing,Chinas
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Mohd. Iqbal Yatoo
- Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Srinagar, Jammu and Kashmir, Indias
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - Muhammad Bilal
- School of Life Science and Food Engineering, Huaiyin Institute of Technology, Huaian, China
| | - Manish Dhawan
- Department of Microbiology, Punjab Agricultural University, Ludhiana, India
- The Trafford Group of Colleges, Manchester, United Kingdom
| | - Talha B. Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
| | - Jeehan H. Alestad
- Immunology and Infectious Microbiology, Glasgow, United Kingdom
- Collage of medicine, Microbiology, Jabriya, Kuwait
- Kuwait Chair Madam in Antimicrobial Resistance Committee, Alternative Permanent Representative of Kuwait to the United Nation Agencies, Rome, Italys
| | - Hatem M. Alhani
- Department of Pediatric Infectious Disease, Maternity and Children Hospital, Dammam, Saudi Arabia
- Department of Infection Control, Maternity and Children Hospital, Dammam, Saudi Arabia
- Department of Preventive Medicine and Infection Prevention and Control, Directorate of Ministry of Health, Eastern Region, Dammam, Saudi Arabia
| | - Habib K. BinKhalaf
- Department of Molecular Laboratory, King Fahad Hospital, Hofuf, Saudi Arabia
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
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8
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Ahmed Z, Shetty A, Victor DW, Kodali S. Viral hepatitis: A narrative review of hepatitis A–E. World J Meta-Anal 2022; 10:99-121. [DOI: 10.13105/wjma.v10.i3.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/27/2022] [Accepted: 06/24/2022] [Indexed: 02/06/2023] Open
Abstract
Viral hepatitis continues to be a major health concern leading to hepatic decompensation ranging from acute hepatitis to cirrhosis and hepatocellular carcinoma. The hepatic and extrahepatic manifestations are not only debilitating but also associated with a significant economic burden. Over the last two decades, the field of virology has made significant breakthroughs leading to a better understanding of the pathophysiology of viral hepatitis, which in turn has led to new therapeutic options. The advent of direct-acting antiviral agents changed the landscape of hepatitis C virus (HCV) therapy, and new drugs are in the pipeline for chronic hepatitis B virus (HBV) treatment. There has also been a significant emphasis on screening and surveillance programs, widespread availability of vaccines, and linkage of care. Despite these efforts, significant gaps persist in care, and there is a pressing need for increased collaboration and teamwork across the globe to achieve a reduction of disease burden and elimination of HBV and HCV.
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Affiliation(s)
- Zunirah Ahmed
- Division of Gastroenterology and Hepatology, Underwood Center for Digestive Disorders, Houston Methodist Hospital, Houston, TX 77030, United States
| | - Akshay Shetty
- Department of Gastroenterology and Hepatology, University of California, Los Angeles, CA 90095, United States
| | - David W Victor
- Department of Hepatology, J C Walter Jr Transplant Center, Sherrie and Alan Conover Center for Liver Disease and Transplantation, Weill Cornell Medical College, Houston, TX 77030, United States
| | - Sudha Kodali
- Department of Hepatology, J C Walter Jr Transplant Center, Sherrie and Alan Conover Center for Liver Disease and Transplantation, Weill Cornell Medical College, Houston, TX 77030, United States
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9
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Potential zoonotic swine enteric viruses: The risk ignored for public health. Virus Res 2022; 315:198767. [PMID: 35421434 DOI: 10.1016/j.virusres.2022.198767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/30/2022] [Accepted: 04/03/2022] [Indexed: 12/28/2022]
Abstract
Swine could serve as a natural reservoir for a large variety of viruses, including potential zoonotic enteric viruses. The presence of viruses with high genetic similarity between porcine and human strains may result in the emergence of zoonotic or xenozoonotic infections. Furthermore, the globalization and intensification of swine industries exacerbate the transmission and evolution of zoonotic viruses among swine herds and individuals working in swine-related occupations. To effectively prevent the public health risks posed by zoonotic swine enteric viruses, designing, and implementing a comprehensive measure for early diagnosis, prevention, and mitigation, requires interdisciplinary a collaborative ''One Health" approach from veterinarians, environmental and public health professionals, and the swine industry. In this paper, we reviewed the current knowledge of selected potential zoonotic swine enteric viruses and explored swine intensive production and its associated public health risks.
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Sultana R, Bhuiyan TR, Sathi AS, Sharmin S, Yeasmin S, Uddin MI, Bhuiyan MS, Mannoor K, Karim MM, Zaman K, Qadri F. Developing and validating a modified enzyme linked immunosorbent assay method for detecting HEV IgG antibody from dried blood spot (DBS) samples in endemic settings. Microbes Infect 2022; 24:104890. [PMID: 34628012 PMCID: PMC8960178 DOI: 10.1016/j.micinf.2021.104890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 12/20/2022]
Abstract
Serological analysis is an integral part of laboratory practice nowadays. The present study was aimed to develop and validate a modified Enzyme linked Immunosorbent Assay (ELISA) for determination of IgG antibody against Hepatitis E Virus (HEV) using dried blood spots (DBS) and corresponding plasma samples. A total of 65 samples (45 HEV patients, 20 healthy controls) were analyzed. DBS and plasma samples demonstrated equivalent optical densities for detecting anti-HEV IgG. A highly significant correlation was observed between plasma and DBS sample absorbances (R2 = 0.98; p < 0.001) at dilution 1:200, indicating true agreement between the two procedures. The assay exhibited decent linearity and showed no effect of physiological hematocrit on assay performance. Data suggested recommendable promise in using DBS as a suitable alternative to plasma samples to determine HEV IgG antibody evidenced by significant correlation with plasma results. Therefore, identical method for processing DBS specimens including it's proper storage is recommended for implementation of a modified ELISA in different settings.
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Affiliation(s)
- Rosy Sultana
- Institute for Developing Science and Health Initiatives (ideSHi), Mohakhali, Dhaka, Bangladesh; Department of Microbiology, University of Dhaka, Dhaka, Bangladesh; Department of Immunology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Taufiqur Rahman Bhuiyan
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Afsana Shirin Sathi
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Salma Sharmin
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Sharmina Yeasmin
- Department of Gynecology and Obstetrics, Bangladesh Institute of Health Sciences and General Hospital, Dhaka, Bangladesh
| | - Muhammad Ikhtear Uddin
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Md Saruar Bhuiyan
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Kaiissar Mannoor
- Institute for Developing Science and Health Initiatives (ideSHi), Mohakhali, Dhaka, Bangladesh
| | | | - K Zaman
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Firdausi Qadri
- Institute for Developing Science and Health Initiatives (ideSHi), Mohakhali, Dhaka, Bangladesh; Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh; Department of Immunology, Bangladesh University of Health Sciences, Dhaka, Bangladesh.
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11
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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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12
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Trongtorsak A, Chaisidhivej N, Yadav K, Kim J, Thongprayoon C, Cheungpasitporn W, Hansrivijit P. Hepatitis E virus infection in hematopoietic stem cell transplant recipients: a systematic review and meta-analysis. J Investig Med 2021; 70:853-858. [PMID: 34930797 DOI: 10.1136/jim-2021-002102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2021] [Indexed: 01/30/2023]
Abstract
Although most patients with hepatitis E virus (HEV) infection are asymptomatic or have mild symptoms, its infection is generally underdiagnosed and overlooked. In immunocompromised patients, HEV infection can lead to acute liver failure and death. However, the clinical evidence of HEV infection in hematopoietic stem cell transplant (HSCT) recipients is scarce; thus, we conducted this systematic review and meta-analysis to assess the prevalence of HEV infection in this population. We searched MEDLINE, EMBASE, and the Cochrane Library databases from inception through October 2020 to identify studies that reported the prevalence of HEV infection among HSCT recipients. HEV infections were confirmed by HEV-IgG/IgM or HEV-RNA assay. A total of 1977 patients from nine studies with a follow-up time up to 40 months were included in the final analysis. The pooled prevalence of positive HEV-RNA was 3.0% (95% CI 2.3% to 4.0%). The pooled prevalence of positive HEV-IgG was 10.3% (95% CI 4.5% to 21.8%). The pooled prevalence of de novo HEV infection was 2.9% (95% CI 1.8% to 4.5%). Age and male gender were not associated with HEV-RNA or HEV-IgG positivity in the meta-regression analysis. In conclusion, the prevalence of HEV-IgG in HSCT recipients was about 10%, while the prevalence of HEV-RNA was only 3%. However, further studies that focus on the clinical outcomes in this population are warranted.
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Affiliation(s)
- Angkawipa Trongtorsak
- Department of Internal Medicine, Amita Health Saint Francis Hospital, Evanston, Illinois, USA
| | - Natapat Chaisidhivej
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
| | - Kritika Yadav
- Department of Internal Medicine, Amita Health Saint Francis Hospital, Evanston, Illinois, USA
| | - Jinah Kim
- Department of Internal Medicine, UPMC Pinnacle Harrisburg, Harrisburg, Pennsylvania, USA
| | | | | | - Panupong Hansrivijit
- Department of Internal Medicine, UPMC Pinnacle Harrisburg, Harrisburg, Pennsylvania, USA
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13
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Kamani L, Padhani ZA, Das JK. Hepatitis E: Genotypes, strategies to prevent and manage, and the existing knowledge gaps. JGH Open 2021; 5:1127-1134. [PMID: 34621997 PMCID: PMC8485408 DOI: 10.1002/jgh3.12646] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 08/02/2021] [Accepted: 08/14/2021] [Indexed: 12/23/2022]
Abstract
Hepatitis E virus (HEV) is considered an emergent source of viral hepatitis worldwide, with an increasing burden of jaundice, liver failure, extrahepatic illnesses, and deaths in developed countries. With the scarcity of data from efficient animal models, there are still open-ended questions about designing new models to study pathogenesis, types, virology, and evolution of these viruses. With an emphasis on available data and updates, there is still enough information to understand the HEV life cycle, pathogen interaction with the host, and the valuation of the role of vaccine and new anti-HEV therapies. However, the World Health Organization (WHO) and the European Association for the Study of the Liver (EASL) preferred to stress prevention and control measures of HEV infections in animals, zoonotic transmission, and foodborne transmission. It is being reviewed that with current knowledge on HEV and existing prevention tools, there is an excellent room for in-depth information about the virus strains, their replication, pathogenicity, and virulence. The current knowledge set also has gaps regarding standardized and validated diagnostic tools, efficacy and safety of the vaccine, and extrahepatic manifestations specifically in pregnant females, immunocompromised patients, and others. This review highlights the areas for more research exploration, focusing on enlisted research questions based on HEV infection to endorse the need for significant improvement in the current set of knowledge for this public health problem.
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Affiliation(s)
- Lubna Kamani
- Associate Professor & Director, GI Residency Program, Department of GastroenterologyLiaquat National Hospital and Medical CollegeKarachiPakistan
- ConsultantAga Khan University HospitalKarachiPakistan
| | - Zahra Ali Padhani
- Health Policy and Management, Manager (Research)Aga Khan University HospitalKarachiPakistan
| | - Jai K Das
- Assistant Professor and Head, Section of Public Health and EpidemiologyAga Khan University HospitalKarachiPakistan
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14
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Arce LP, Raya Tonetti MF, Raimondo MP, Müller MF, Salva S, Álvarez S, Baiker A, Villena J, Vizoso Pinto MG. Oral Vaccination with Hepatitis E Virus Capsid Protein and Immunobiotic Bacterium-Like Particles Induce Intestinal and Systemic Immunity in Mice. Probiotics Antimicrob Proteins 2021; 12:961-972. [PMID: 31630331 DOI: 10.1007/s12602-019-09598-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The hepatitis E virus (HEV) genotype 3 (GT3) is an emergent pathogen in industrialized countries. It is transmitted zoonotically and may lead to chronic hepatitis in immunocompromised individuals. We evaluated if the major antigen of HEV, the capsid protein, can be used in combination with immunobiotic bacterium-like particles (IBLP) for oral vaccination in a mouse model. We have cloned and expressed the RGS-His5-tagged HEV GT3 capsid protein (ORF2) in E. coli and purified it by NiNTA. IBLP were obtained from two immunobiotic Lactobacillus rhamnosus strains acid- and heat-treated. ORF2 and the IBLP were orally administered to Balb/c mice. After three oral immunizations (14-day intervals), blood, intestinal fluid, Peyer´s patches, and spleen samples were drawn. IgA- and IgG-specific antibodies were determined by ELISA. Mononuclear cell populations from Peyer's patches and spleen were analyzed by flow cytometry, and the cytokine profiles were determined by ELISA to study cellular immunity. Orally administered recombinant ORF2 and IBLP from two L. rhamnosus strains (CRL1505 and IBL027) induced both antigen-specific humoral and cellular immune responses in mice. IBLP027 was more effective in inducing specific secretory IgA in the gut. IFN-γ, TNF-α, and IL-4 were produced by Peyer's plaques lymphocytes stimulated with ORF2 ex vivo suggesting a mixed Th1/Th2-type adaptive immune response in immunized mice. Oral vaccines are not invasive, do not need to be administered by specialized personal, and elicit both systemic and local immune responses at the port of entry. Here, we present an experimental oral vaccine for HEV GT3, which could be further developed for human and/or veterinary use.
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Affiliation(s)
- L P Arce
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Facultad de Medicina, UNT, Av. Kirchner 2100, (4000) San Miguel de Tucumán, Tucumán, Argentina.,Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina
| | - M F Raya Tonetti
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Facultad de Medicina, UNT, Av. Kirchner 2100, (4000) San Miguel de Tucumán, Tucumán, Argentina.,Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina
| | - M P Raimondo
- Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina
| | - M F Müller
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Facultad de Medicina, UNT, Av. Kirchner 2100, (4000) San Miguel de Tucumán, Tucumán, Argentina.,Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina
| | - S Salva
- Laboratorio de Inmunobiotecnología, CERELA (CONICET), Chacabuco 145, (4000) San Miguel de Tucumán, Tucumán, Argentina
| | - S Álvarez
- Laboratorio de Inmunobiotecnología, CERELA (CONICET), Chacabuco 145, (4000) San Miguel de Tucumán, Tucumán, Argentina
| | - A Baiker
- LGL, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany
| | - J Villena
- Laboratorio de Inmunobiotecnología, CERELA (CONICET), Chacabuco 145, (4000) San Miguel de Tucumán, Tucumán, Argentina.
| | - M G Vizoso Pinto
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Facultad de Medicina, UNT, Av. Kirchner 2100, (4000) San Miguel de Tucumán, Tucumán, Argentina. .,Laboratorio de Ciencias Básicas. OR. Genética. Facultad de Medicina de la Universidad Nacional de Tucumán, Tucumán, Argentina.
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15
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Al Absi ES, Al-Sadeq DW, Khalili M, Younes N, Al-Dewik N, Abdelghany SK, Abouzid SS, Al Thani AA, Yassine HM, Coyle PV, Nasrallah GK. The prevalence of HEV among non-A-C hepatitis in Qatar and efficiency of serological markers for the diagnosis of hepatitis E. BMC Gastroenterol 2021; 21:266. [PMID: 34130641 PMCID: PMC8207580 DOI: 10.1186/s12876-021-01841-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 06/08/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The rapid growth of Qatar in the last two decades has attracted a large influx of immigrant workers who mostly come from HEV-hyperendemic countries. Thus, we aim to investigate the prevalence of HEV among acute non-A-C hepatitis patients in Qatar; and to evaluate the performance of four dominant commercial serological assays for HEV diagnosis. METHODS 259 patients with non-A-C hepatitis were tested using the Wantai HEV-IgM, HEV-IgG, HEV-Ag ELISA kits, and the MP Biomedical HEV-Total Ab ELISA kit. ALT levels were tested and HEV RNA (viral loads) was performed using Taqman AmpliCube HEV RT-PCR kit (Mikrogen, Neuried, Germany). The performance of each kit was assessed according to the RT-PCR results. RESULTS HEV-RNA was detected in 23.1% of the samples. Most of these HEV-RNA-positive cases belonged to non-Qatari residents from the Indian subcontinent; India, Pakistan, etc. HEV-Ag, HEV-IgM, HEV-IgG, HEV-Total Ab were detected in 5.56%, 8.65%, 32.1%, and 34.2% of all tested samples, respectively. Elevated ALT levels were highly correlated with the HEV-Ag, HEV-IgM, HEV-RNA but not with the HEV-IgG and HEV-Total Ab. Although HEV-Ag was very specific (100%), yet its sensitivity was poor (36.7%). HEV-IgM demonstrated the best second marker for diagnosis of acute HEV after RT-PCR as jugged by the overall performance parameters: specificity (96.2%), sensitivity (71.4%), PPV (83.3%), NPP (92.7%), agreement with RT-PCR (91.0%), and Kappa-value (0.71). CONCLUSION Our study demonstrated a high prevalence of HEV virus in Qatar, mostly among immigrants from the Indian subcontinent. The HEV-IgM represents the best marker for detecting the acute HEV infection, where RT-PCR cannot be performed.
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Affiliation(s)
- Enas S Al Absi
- Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Duaa W Al-Sadeq
- Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar.,College of Medicine, Member of QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Makiyeh Khalili
- Department of Laboratory Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Nadin Younes
- Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Nader Al-Dewik
- Clinical and Metabolic Genetics Section, Pediatrics Department, Hamad General Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar.,Qatar Medical Genetic Center and Interim Translational Research Institute, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar.,College of Health and Life Science, Hamad Bin Khalifa University, P.O. Box 34110, Doha, Qatar.,Department of Pediatrics, Women's Wellness and Research Center, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Sara K Abdelghany
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Women's Science Building, C01, P.O. Box 2713, Doha, Qatar
| | - Somaia S Abouzid
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Women's Science Building, C01, P.O. Box 2713, Doha, Qatar
| | - Asma A Al Thani
- Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Women's Science Building, C01, P.O. Box 2713, Doha, Qatar
| | - Hadi M Yassine
- Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Women's Science Building, C01, P.O. Box 2713, Doha, Qatar
| | - Peter V Coyle
- Virology Laboratory, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar. .,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Women's Science Building, C01, P.O. Box 2713, Doha, Qatar.
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16
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Keatts LO, Robards M, Olson SH, Hueffer K, Insley SJ, Joly DO, Kutz S, Lee DS, Chetkiewicz CLB, Lair S, Preston ND, Pruvot M, Ray JC, Reid D, Sleeman JM, Stimmelmayr R, Stephen C, Walzer C. Implications of Zoonoses From Hunting and Use of Wildlife in North American Arctic and Boreal Biomes: Pandemic Potential, Monitoring, and Mitigation. Front Public Health 2021; 9:627654. [PMID: 34026707 PMCID: PMC8131663 DOI: 10.3389/fpubh.2021.627654] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has re-focused attention on mechanisms that lead to zoonotic disease spillover and spread. Commercial wildlife trade, and associated markets, are recognized mechanisms for zoonotic disease emergence, resulting in a growing global conversation around reducing human disease risks from spillover associated with hunting, trade, and consumption of wild animals. These discussions are especially relevant to people who rely on harvesting wildlife to meet nutritional, and cultural needs, including those in Arctic and boreal regions. Global policies around wildlife use and trade can impact food sovereignty and security, especially of Indigenous Peoples. We reviewed known zoonotic pathogens and current risks of transmission from wildlife (including fish) to humans in North American Arctic and boreal biomes, and evaluated the epidemic and pandemic potential of these zoonoses. We discuss future concerns, and consider monitoring and mitigation measures in these changing socio-ecological systems. While multiple zoonotic pathogens circulate in these systems, risks to humans are mostly limited to individual illness or local community outbreaks. These regions are relatively remote, subject to very cold temperatures, have relatively low wildlife, domestic animal, and pathogen diversity, and in many cases low density, including of humans. Hence, favorable conditions for emergence of novel diseases or major amplification of a spillover event are currently not present. The greatest risk to northern communities from pathogens of pandemic potential is via introduction with humans visiting from other areas. However, Arctic and boreal ecosystems are undergoing rapid changes through climate warming, habitat encroachment, and development; all of which can change host and pathogen relationships, thereby affecting the probability of the emergence of new (and re-emergence of old) zoonoses. Indigenous leadership and engagement in disease monitoring, prevention and response, is vital from the outset, and would increase the success of such efforts, as well as ensure the protection of Indigenous rights as outlined in the United Nations Declaration on the Rights of Indigenous Peoples. Partnering with northern communities and including Indigenous Knowledge Systems would improve the timeliness, and likelihood, of detecting emerging zoonotic risks, and contextualize risk assessments to the unique human-wildlife relationships present in northern biomes.
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Affiliation(s)
- Lucy O. Keatts
- Wildlife Conservation Society Health Program, Bronx, NY, United States
| | - Martin Robards
- Wildlife Conservation Society, Arctic Beringia Program, Fairbanks, AK, United States
| | - Sarah H. Olson
- Wildlife Conservation Society Health Program, Bronx, NY, United States
| | - Karsten Hueffer
- Department of Veterinary Medicine & Arctic and Northern Studies Program, University of Alaska Fairbanks, Fairbanks, AK, United States
| | - Stephen J. Insley
- Wildlife Conservation Society Canada, Toronto, ON, Canada
- Department of Biology, University of Victoria, Victoria, BC, Canada
| | | | - Susan Kutz
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - David S. Lee
- Department of Wildlife and Environment, Nunavut Tunngavik Inc., Ottawa, ON, Canada
| | | | - Stéphane Lair
- Canadian Wildlife Health Cooperative, Université de Montréal, Montreal, QC, Canada
| | | | - Mathieu Pruvot
- Wildlife Conservation Society Health Program, Bronx, NY, United States
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Justina C. Ray
- Wildlife Conservation Society Canada, Toronto, ON, Canada
| | - Donald Reid
- Wildlife Conservation Society Canada, Toronto, ON, Canada
| | - Jonathan M. Sleeman
- United States Geological Survey National Wildlife Health Center, Madison, WI, United States
| | - Raphaela Stimmelmayr
- North Slope Department of Wildlife Management, Utqiagvik, AK, United States
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, United States
| | - Craig Stephen
- University of British Columbia, Vancouver, BC, Canada
- Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Chris Walzer
- Wildlife Conservation Society Health Program, Bronx, NY, United States
- Conservation Medicine Unit, Department of Interdisciplinary Life Sciences, Research Institute of Wildlife Ecology, University of Veterinary Medicine, Vienna, Austria
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17
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Garsow AV, Campbell E, Closs G, Kowalcyk BB. Food Safety Challenges in Refugee Camps: What Do We Know? J Food Prot 2021; 84:876-884. [PMID: 33411925 DOI: 10.4315/jfp-20-316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/23/2020] [Indexed: 01/21/2023]
Abstract
ABSTRACT Refugee camps provide basic necessities such as food, water, shelter, and medical treatment for displaced persons. Unsanitary conditions in refugee camps due to overcrowding, poor sanitation systems, lack of clean water, and minimal ways to cook and store food can lead to an increased risk of foodborne illness. This article reviews the limited literature on the epidemiology of foodborne illness in refugee camps, effective risk mitigation strategies, and opportunities for future research. Eleven relevant articles were identified, suggesting that research in this area is limited. Identified research focused on three pathogens-Vibrio cholerae, Salmonella, and hepatitis E virus-that can cause serious diseases such as cholera, salmonellosis, typhoid fever, and hepatitis E. Storage and handling of clean water for personal hygiene and food preparation were critical components for ensuring food safety. Knowledge pertaining to best practices for hygiene and food preparation also were identified as important. Gaps in current research include determination of the prevalence of pathogens in food sold in refugee camps and development of culturally relevant food safety supply chain quality management systems. More research that focuses on burden and attribution of foodborne illness and food safety interventions in refugee camps is necessary. HIGHLIGHTS
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Affiliation(s)
| | - Emily Campbell
- Department of Food Science and Technology.,(ORCID: https://orcid.org/0000-0002-7562-5035 [E.C.])
| | - Gary Closs
- Department of Food Science and Technology
| | - Barbara B Kowalcyk
- Department of Food Science and Technology.,Translational Data Analytics Institute, The Ohio State University, Columbus, Ohio 43210, USA
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18
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Dalton B, Cunnane G, Conway R. Acute hepatitis E in an immunocompromised patient with seropositive rheumatoid arthritis on rituximab and long-term methotrexate. Mod Rheumatol Case Rep 2021; 5:226-228. [PMID: 33783311 DOI: 10.1080/24725625.2021.1905204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We report the case of a 61-year old female with a 20-year history of seropositive rheumatoid arthritis (RA) who developed acute hepatitis. Her arthritis had been treated with methotrexate (MTX) since 2003 and, following an increase in disease activity, Rituximab (RTX) was commenced in January 2017. In May 2020, routine blood tests showed a new elevation in her liver profile, although synthetic function was preserved. A standard liver screen found no cause for her acutely abnormal lab values. Upon additional serological testing, the patient was confirmed to have acute hepatitis E virus (HEV). Her primary complaint at the time was fatigue. Within a month, her liver blood tests spontaneously improved and her symptoms resolved with conservative management.
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Affiliation(s)
- Bryan Dalton
- Rheumatology Department, St James' Hospital, Dublin, Ireland
| | - Gaye Cunnane
- Rheumatology Department, St James' Hospital, Dublin, Ireland
| | - Richard Conway
- Rheumatology Department, St James' Hospital, Dublin, Ireland
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19
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Kirkwood CD, Dobscha KR, Steele AD. Hepatitis E should be a global public health priority: recommendations for improving surveillance and prevention. Expert Rev Vaccines 2021; 19:1129-1140. [PMID: 33441054 DOI: 10.1080/14760584.2020.1874930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Hepatitis E virus (HEV) is an important cause of enterically transmitted viral hepatitis and a significant contributor to maternal mortality in endemic regions around the world, yet the global response has been limited. HEV is a disease of poverty, and the populations experiencing the greatest burden of HEV-associated illness are not benefitting from existing interventions, including WASH strategies and immunization. AREAS COVERED Though a vaccine exists (HEV 239, Hecolin®, Xiamen Innovax Biotech, China), it is only licensed and available in the private market in China and has yet to be prequalified by the WHO for use in endemic settings and outbreaks. This review of the current state of HEV disease and subsequent recommendations for a coordinated public health response are intended to guide the global health community towards breaking the current 'vicious cycle,' in which a lack of data prevents actions that would improve health outcomes. EXPERT OPINION Vaccine implementation in future outbreaks, targeted studies assessing vaccine effectiveness and immunogenicity in endemic regions and populations, improved understanding of the global burden, and improvements in diagnostic and epidemiologic tools are urgently needed. Strategies for implementing routine vaccination programs, improving water, sanitation, and hygiene in endemic regions.
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Affiliation(s)
- Carl D Kirkwood
- Enteric and Diarrheal Diseases, Global Health, Bill & Melinda Gates Foundation , Seattle, WA, USA
| | - Katherine R Dobscha
- Enteric and Diarrheal Diseases, Global Health, Bill & Melinda Gates Foundation , Seattle, WA, USA
| | - A Duncan Steele
- Enteric and Diarrheal Diseases, Global Health, Bill & Melinda Gates Foundation , Seattle, WA, USA
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20
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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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Paternostro R, Traussnigg S, Staufer K, Mandorfer M, Halilbasic E, Lagler H, Stift J, Wrba F, Munda P, Trauner M. Prevalence of anti-Hepatitis E antibodies and impact on disease severity in non-alcoholic fatty liver disease. Hepatol Res 2021; 51:69-79. [PMID: 33037853 DOI: 10.1111/hepr.13581] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 01/23/2023]
Abstract
AIM In most immune-competent individuals, hepatitis E (HEV) infections appear silent. It is unclear whether past HEV infections deteriorate disease severity in patients with non-alcoholic fatty liver disease (NAFLD). METHODS Patients with biopsy-proven NAFLD and data on anti-HEV immunoglobulin M (HEV-IgM) and anti-HEV IgG antibodies (HEV-IgG) were included. The NAFLD activity score (NAS) was used to grade and stage all liver biopsy samples. The HEV-IgG prevalence was compared to a healthy cohort of 997 subjects. RESULTS One hundred sixty-seven patients with NAFLD were included with the following characteristics: age, 50 ± 13 years; NAS ≤4, 89 (53.3%); NAS 5-8, 78 (46.7%); cirrhosis, 16 (9.6%). Two patients (1.2%) were HEV-IgM-positive, however HEV polymerase chain reaction remained negative and no signs of acute hepatitis were seen. Forty-four patients (26.3%) were HEV-IgG-positive and they were significantly older (55 ± 10 years vs. 48 ± 13 years, P < 0.001) and predominantly men (31 [70.5%] vs.13 [29.5%], P = 0.022). Distribution across NAS (P = 0.610) was not different. However, HEV-IgG-positive patients were significantly more often found with cirrhosis (8 [18.2%] vs. 8 [6.5%], P = 0.024) and liver stiffness values >10 kPa (14 [58.2%] vs. 29 [43.3%], P = 0.026). Multivariable analyses revealed age (odds ratio [OR], 1.054 [1.022-1.086]) and male sex (OR 2.77 [1.27-6.04]) associated with HEV-IgG positivity. Presence of diabetes (OR 3.86 [1.18-12.59]), higher aspartate aminotransferase levels (OR, 1.02 [1.006-1.033]), and HEV-IgG seropositivity (OR 3.52 [1.11-11.13]) were independently linked to cirrhosis. Finally, HEV-IgG positivity was not independently associated with NAFLD patients in a case-control study including healthy subjects. CONCLUSIONS Prevalence of anti-HEV-IgG antibodies in patients with NAFLD is linked to age and male sex. Furthermore, previous HEV infection was an independent risk factor for cirrhosis. Whether this finding is causal or solely associative is unclear and should be elucidated in future studies.
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Affiliation(s)
- Rafael Paternostro
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Stefan Traussnigg
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Katharina Staufer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Mattias Mandorfer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Emina Halilbasic
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Heimo Lagler
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Judith Stift
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Fritz Wrba
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Petra Munda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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Hepatitis E Virus Infection: Circulation, Molecular Epidemiology, and Impact on Global Health. Pathogens 2020; 9:pathogens9100856. [PMID: 33092306 PMCID: PMC7589794 DOI: 10.3390/pathogens9100856] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/09/2020] [Accepted: 10/16/2020] [Indexed: 12/11/2022] Open
Abstract
Infection with hepatitis E virus (HEV) represents the most common source of viral hepatitis globally. Although infecting over 20 million people annually in endemic regions, with major outbreaks described since the 1950s, hepatitis E remains an underestimated disease. This review gives a current view of the global circulation and epidemiology of this emerging virus. The history of HEV, from the first reported enteric non-A non-B hepatitis outbreaks, to the discovery of the viral agent and the molecular characterization of the different human pathogenic genotypes, is discussed. Furthermore, the current state of research regarding the virology of HEV is critically assessed, and the challenges towards prevention and diagnosis, as well as clinical risks of the disease described. Together, these points aim to underline the significant impact of hepatitis E on global health and the need for further in-depth research to better understand the pathophysiology and its role in the complex disease manifestations of HEV infection.
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Chanmanee T, Ajawatanawong P, Louisirirotchanakul S, Chotiyaputta W, Chainuvati S, Wongprompitak P. Phylogenetic analysis of two new complete genomes of the hepatitis E virus (HEV) genotype 3 from Thailand. Mol Biol Rep 2020; 47:8657-8668. [PMID: 33058031 PMCID: PMC7674359 DOI: 10.1007/s11033-020-05908-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
Hepatitis E virus (HEV) is a causative agent of acute viral hepatitis globally. Evolutionary phylogeny classifies the HEV into eight genotypes that correlate with the viral transmission. Only four genotypes have been proven to be responsible for transmission in humans. However, there has been no report on the genomics and genotyping of HEV in Thailand during the past ten years. Here, we identified the genotype distributions of the Thai isolates of HEV and we sequenced two HEV genomes. We screened for 18 Thai isolates of HEV from Siriraj Hospital in Bangkok, from 2014–2016. The HEV genomes were sequenced from the serum and feces of a patient. The results showed that all Thai isolates of HEV were identified as genotype 3 (HEV-3). The ORF2 and genome phylogenies suggested two subgenotypes, called 3.1 and 3.2. The Thai isolates of HEV were frequently found in the subgenotype 3.1. The genome sequences of the two Thai isolates of HEV from the serum and fecal samples of the same patient showed 91% nucleotide similarity with the HEV genotype 3. Comparisons between the HEV genome and the ORF2 phylogenies illustrated that the ORF2 tree can be used to identify HEV genotypes, but it has less phylogenetic power for the HEV evolution. The two new genome sequences of HEV-3 from Thailand could contribute valuable information to the HEV genome study. (226 words)
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Affiliation(s)
- Tipsuda Chanmanee
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pravech Ajawatanawong
- Division of Bioinformatics and Data Management for Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suda Louisirirotchanakul
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Watcharasak Chotiyaputta
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Siwaporn Chainuvati
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Patimaporn Wongprompitak
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Sharifipour S, Davoodi Rad K. Seroprevalence of hepatitis E virus among different age groups in Tehran, Iran. New Microbes New Infect 2020; 34:100638. [PMID: 31993207 PMCID: PMC6976942 DOI: 10.1016/j.nmni.2019.100638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/30/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022] Open
Abstract
Hepatitis E virus (HEV) is considered to be a public health problem on a global scale, especially in developing countries. This study aims to investigate the seroprevalence of HEV in the Tehrani population. This descriptive-analytical study was carried out between the years 2017 and 2018 in Tehran, Iran. A total of 493 individuals whose blood samples and demographic data were collected via questionnaires through random cluster sampling were selected. To determine the presence of specific IgG antibody against HEV, commercial kits were used through ELISA. Chi-squared tests, logistic regression and t test were also required to conduct the statistical analysis. Of the 493 participants, with a mean age of 40.98 ± 17.10 years, included in this study, 180 were men and 313 were women. Of these, 48 (9.7%) had IgG antibodies against HEV. No significant difference was observed between the sexes (or different age groups) and positive antibody. It has been reported that the prevalence rate of this infection is high in Tehran, which is indicative of the endemic nature of this infection in society. The results of this study are similar to those obtained from the east of Golestan province, Iran but different from those obtained from Isfahan province, Iran. As a high percentage of people are susceptible to the infection in society, it is likely to have the prevalence of an epidemic.
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Affiliation(s)
- S. Sharifipour
- Department of Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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25
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Farshadpour F, Taherkhani S, Taherkhani R. Hepatitis E Virus Infection During Pregnancy: The Overlooked Cause of Maternal and Fetal Mortality. Infect Disord Drug Targets 2020; 19:334-336. [PMID: 29848282 DOI: 10.2174/1871526518666180530075523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/16/2018] [Accepted: 05/18/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Hepatitis E virus (HEV) is one the leading causes of maternal and fetal mortality. Nevertheless, in some geographical locations, especially Egypt, despite having high frequency of HEV seropositivity, HEV infection follows an asymptomatic or mild course during pregnancy. These anomalous observations have distracted attention from the importance of HEV infection in pregnant women. METHODS While tragic cases of HEV-infected pregnant women cannot be neglected any longer. CONCLUSION These circumstances create a strong demand for the increasing awareness of HEV infection through training programs, appropriate management of HEV infection among pregnant women, routine screening of pregnant women for timely diagnosis of HEV infection, proper treatment of HEVinfected patients, optimal preventive measures, and development of a prophylactic vaccine against HEV infection.
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Affiliation(s)
- Fatemeh Farshadpour
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Sakineh Taherkhani
- Reproductive Health and Midwifery Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Taherkhani
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
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26
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Engmann C, Fleming JA, Khan S, Innis BL, Smith JM, Hombach J, Sobanjo-ter Meulen A. Closer and closer? Maternal immunization: current promise, future horizons. J Perinatol 2020; 40:844-857. [PMID: 32341454 PMCID: PMC7223555 DOI: 10.1038/s41372-020-0668-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
This state-of-the art manuscript highlights our current understanding of maternal immunization-the practice of vaccinating pregnant women to confer protection on them as well as on their young infants, and thereby reduce vaccine-preventable morbidity and mortality. Advances in our understanding of the immunologic processes that undergird a normal pregnancy, studies from vaccines currently available and recommended for pregnant women, and vaccines for administration in special situations are beginning to build the case for safe scale-up of maternal immunization. In addition to well-known diseases, new diseases are emerging which pose threats. Several new vaccines are currently under development and increasingly include pregnant women. In this manuscript, targeted at clinicians, vaccinologists, scientists, public health practitioners, and policymakers, we also outline key considerations around maternal immunization introduction and delivery, discuss noninfectious horizons for maternal immunization, and provide a framework for the clinician faced with immunizing a pregnant woman.
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Affiliation(s)
- Cyril Engmann
- Maternal, Newborn, Child Health and Nutrition, PATH, Seattle, WA, USA. .,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA. .,Department of Global Health, University of Washington School of Public Health, Seattle, WA, USA.
| | - Jessica A. Fleming
- 0000 0000 8940 7771grid.415269.dCenter for Vaccine Innovation and Access, PATH, Seattle, WA USA
| | - Sadaf Khan
- 0000 0000 8940 7771grid.415269.dMaternal, Newborn, Child Health and Nutrition, PATH, Seattle, WA USA
| | - Bruce L. Innis
- 0000 0000 8940 7771grid.415269.dCenter for Vaccine Innovation and Access, PATH, Seattle, WA USA
| | - Jeffrey M. Smith
- 0000 0000 8990 8592grid.418309.7Maternal, Newborn and Child Health, Bill & Melinda Gates Foundation, Seattle, WA USA
| | - Joachim Hombach
- 0000000121633745grid.3575.4Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Ajoke Sobanjo-ter Meulen
- 0000 0000 8990 8592grid.418309.7Maternal Immunization and Pneumonia, Bill & Melinda Gates Foundation, Seattle, WA USA
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27
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Cui T, Zhang X, Wang Q, Yue N, Zheng M, Wang D, Duan C, Yu X, Bao C, Jiang R, Xu S, Yuan Z, Qian Y, Chen L, Hang H, Zhang Z, Sun H, Jin H. Disease burden concerning hepatitis E-infected inpatients in Jiangsu province, China. Vaccine 2019; 38:673-679. [PMID: 31668822 DOI: 10.1016/j.vaccine.2019.10.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 09/23/2019] [Accepted: 10/16/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aimed to determine the disease burden of hepatitis E virus (HEV)-infected inpatients in Jiangsu province, China. METHODS Between July 1, 2016 and October 31, 2018, 1152 HEV-infected inpatients were identified from four cities in Jiangsu province, namely, Nanjing, Suzhou, Yancheng, and Zhenjiang. The disease burden comprised the economic burden and loss of health due to HEV infection. Factors influencing the disease burden were analyzed using univariate and multivariate analyses. RESULTS The average direct, indirect, and total economic burden for 1152 HEV-infected inpatients was US$ 4,986.40, US$ 1,507.28, and US$ 6,493.68, respectively, accounting for 46.66%, 14.11%, and 60.77% of per capita disposable income (PCDI) in Jiangsu province, respectively. The disease burden for HEV-infected inpatients with hepatitis B was significantly higher than that for other inpatients. The average EQ-5D utility value of 1152 HEV-infected inpatients was 0.72 ± 0.18 quality-adjusted life years (QALYs) and the average EQ-visual analogue score (EQ-VAS) was 0.66 ± 0.17 points. Multivariate analysis showed that the direct economic burden and the total economic burden were influenced by variables such as hospitalization days, outcomes, past history of other diseases, and regions (P < 0.05). It was estimated the direct economic burden, the indirect economic burden, and the total economic burden for all HEV-infected inpatients in Jiangsu province in 2018 was approximately US$ 9.2 million, US$ 2.8 million and US$ 12.0 million, respectively. CONCLUSION The disease burden of HEV infection in Jiangsu province is severe, and more attention should be paid to the prevention of hepatitis E and the treatment of comorbidities.
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Affiliation(s)
- Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Xuefeng Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Na Yue
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Mengyun Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Donglei Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Chunxiao Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Xiaoge Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Renjie Jiang
- Yancheng Center for Disease Control and Prevention, Yancheng 224001, China
| | - Shilin Xu
- Yancheng Center for Disease Control and Prevention, Yancheng 224001, China
| | - Zhaohu Yuan
- Zhenjiang Center for Disease Control and Prevention, Zhenjiang 212004, China
| | - Yunke Qian
- Zhenjiang Center for Disease Control and Prevention, Zhenjiang 212004, China
| | - Liling Chen
- Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - Hui Hang
- Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - Zhong Zhang
- Nanjing Center for Disease Control and Prevention, Nanjing 210003, China
| | - Hongmin Sun
- Nanjing Center for Disease Control and Prevention, Nanjing 210003, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China.
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Bisayher S, Barennes H, Nicand E, Buisson Y. Seroprevalence and risk factors of hepatitis E among women of childbearing age in the Xieng Khouang province (Lao People’s Democratic Republic), a cross-sectional survey. Trans R Soc Trop Med Hyg 2019; 113:298-304. [DOI: 10.1093/trstmh/try143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/14/2018] [Accepted: 12/18/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Syxiong Bisayher
- Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR
- Mahosot Hospital, Vientiane, Lao PDR
| | - Hubert Barennes
- Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR
- ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Université de Bordeaux, Bordeaux, France
| | - Elisabeth Nicand
- National Reference Laboratory for Hepatitis E, Hospital Val-de-Grâce, Paris, France
| | - Yves Buisson
- Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR
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The Current Host Range of Hepatitis E Viruses. Viruses 2019; 11:v11050452. [PMID: 31108942 PMCID: PMC6563279 DOI: 10.3390/v11050452] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/08/2019] [Accepted: 05/14/2019] [Indexed: 01/01/2023] Open
Abstract
Hepatitis E virus (HEV) is an emerging zoonotic pathogen transmitting both human to human via the fecal oral route and from animals to humans through feces, direct contact, and consumption of contaminated meat products. Understanding the host range of the virus is critical for determining where potential threats to human health may be emerging from and where potential reservoirs for viral persistence in the environment may be hiding. Initially thought to be a human specific disease endemic to developing countries, the identification of swine as a primary host for genotypes 3 and 4 HEV in industrialized countries has begun a long journey of discovering novel strains of HEV and their animal hosts. As we continue identifying new strains of HEV in disparate animal species, it is becoming abundantly clear that HEV has a broad host range and many of these HEV strains can cross between differing animal species. These cross-species transmitting strains pose many unique challenges to human health as they are often unrecognized as sources of viral transmission.
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30
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Kumar T, Shrivastava A, Bhatia D, Mitra Y, Kumar A, Hussain S, Chauhan LS, Laserson KF, Narain JP, Kumar R, Francisco A. Jaundice outbreak likely caused by HEV in Amritsar, Punjab, India, 2013. BMC Public Health 2019; 19:464. [PMID: 32326917 PMCID: PMC6696666 DOI: 10.1186/s12889-019-6786-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Hepatitis-E Virus (HEV) infection is endemic in Punjab, India. On 4th April 2013, public officials of Labour Colony, Amritsar reported > 20 jaundice cases occurring within several days. Methods We performed a case-control study to identify the cause and prevent additional cases of jaundice cases in Amritsar, Punjab, India in 2013. Results A total of 159 cases (attack rate 3.6%) and 1 death were identified in Labour and 5 adjoining colonies from January 1 to June 5, 2013. Persons with jaundice were more likely to report foul-smelling piped water (adjusted odds ratio [AOR], 4.0, 95% confidence interval [CI], 2.2–7.2) and used piped water for drinking (AOR, 5.1; 95% CI, 2.2–11.4) than persons without jaundice. Among 14 cases tested, all had anti-hepatitis E virus IgM, and none had anti-hepatitis A virus IgM. Additionally, 21/23 tap water samples from affected households had detectable fecal coliforms. An environmental investigation found that water pipelines were damaged during sewer construction and likely led to contamination of drinking water with hepatitis E virus. Conclusions Hepatitis E outbreaks are common in India, to curb future outbreaks of hepatitis E; measures to ensure safe drinking water are urgently needed.
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Affiliation(s)
- Tripurari Kumar
- National Centre for Disease Control, 22-Sham Nath Marg, Delhi, 110054, India.
| | - Aakash Shrivastava
- National Centre for Disease Control, 22-Sham Nath Marg, Delhi, 110054, India
| | - Deepak Bhatia
- Department of Health and Family Welfare, Chandigarh, Punjab, India
| | - Yash Mitra
- Department of Health and Family Welfare, Chandigarh, Punjab, India
| | - Anil Kumar
- National Centre for Disease Control, 22-Sham Nath Marg, Delhi, 110054, India
| | | | | | - Kayla F Laserson
- India-Centers for Disease Control and Prevention, Delhi, India.,Centers for Disease Control and Prevention, Atlanta, USA
| | - Jai Prakash Narain
- National Centre for Disease Control, 22-Sham Nath Marg, Delhi, 110054, India
| | - Rajesh Kumar
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
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Yonemitsu K, Minami S, Noguchi K, Kuwata R, Shimoda H, Maeda K. Detection of anti-viral antibodies from meat juice of wild boars. J Vet Med Sci 2018; 81:155-159. [PMID: 30473571 PMCID: PMC6361650 DOI: 10.1292/jvms.18-0576] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Wild boars are a reservoir for many zoonotic pathogens and a good sentinel for surveillance of zoonotic viral infections, but collection of serum samples from wild boars in the field is sometimes difficult and requires special equipment and techniques. In this study, ELISA using meat juices extracted from the heart and diaphragm of wild boars, instead of serum samples, was performed to detect antibodies against zoonotic pathogens, Japanese encephalitis virus and hepatitis E virus. The results of ELISA using meat juice samples were significantly correlated with those using serum samples and meat juice contained one-fifth the antibodies of serum samples. As meat juice is easily collected from wild animals in the field without special equipment and techniques, ELISA using meat juice is a simple and superior method for serological survey of zoonosis among wild animals.
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Affiliation(s)
- Kenzo Yonemitsu
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
| | - Shohei Minami
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
| | - Keita Noguchi
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
| | - Ryusei Kuwata
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
| | - Hiroshi Shimoda
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
| | - Ken Maeda
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8515, Japan
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Jefferies M, Rauff B, Rashid H, Lam T, Rafiq S. Update on global epidemiology of viral hepatitis and preventive strategies. World J Clin Cases 2018; 6:589-599. [PMID: 30430114 PMCID: PMC6232563 DOI: 10.12998/wjcc.v6.i13.589] [Citation(s) in RCA: 167] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/07/2018] [Accepted: 10/16/2018] [Indexed: 02/05/2023] Open
Abstract
Viral hepatitis is one of the major public health concerns around the world but until recently it has drawn little attention or funding from global health policymakers. Every year 1.4 million people die from viral hepatitis-related cirrhosis and liver cancer. However, the majority of the infected population are unaware of their condition. This population have significant obstacles to overcome such as lack of awareness, vulnerability, increased migration, disease stigma, discrimination, as well as poor health resources, conflict in policy development and program implementation. Despite implementing infection control measures over the last few decades eradication or significant disease reduction remains elusive. This study aims to present the current global prevalence status and examines potential elimination strategies. The information for this research were obtained through a systematic review, published scientific literatures, the official websites of various government organisations, international public health organisations and internationally recognised regulatory bodies over a period of 40 years between 1978 and 2018.
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Affiliation(s)
- Meryem Jefferies
- Drug Health, Western Sydney Local Health District, North Parramatta NSW 2151, Australia
| | - Bisma Rauff
- Westmead Institute for Medical Research, Westmead Hospital, Sydney Medical School University of Sydney, Westmead NSW 2145, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, the Children’s Hospital at Westmead, and the Discipline of Child and Adolescent Health, Sydney Medical School, Westmead, NSW 2145, Australia
| | - Thao Lam
- Drug Health, Western Sydney Local Health District, North Parramatta NSW 2151, Australia
| | - Shafquat Rafiq
- Croydon University Hospital NHS Trust, Croydon SE23 2SP, United Kingdom
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Ingesting Self-Grown Produce and Seropositivity for Hepatitis E in the United States. Gastroenterol Res Pract 2018; 2018:7980413. [PMID: 30116267 PMCID: PMC6079431 DOI: 10.1155/2018/7980413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/25/2018] [Indexed: 02/07/2023] Open
Abstract
Background Hepatitis E virus (HEV) is a major cause of hepatitis in developing and industrialized countries worldwide. The modes of HEV transmission in industrialized countries, including the United States, remain largely unknown. This study is aimed at evaluating the association between HEV seropositivity and consumption of self-grown foods in the United States. Methods Cross-sectional data was extracted from the 2009–2012 National Health and Nutrition Examination Survey (NHANES). Data from the dietary interview and the serum HEV IgG and IgM enzyme immunoassay test results were linked and examined. Univariate and multivariable logistic regression models were used to evaluate the significance and effect size of an association between self-grown food consumption and hepatitis E seropositivity. Results The estimated HEV seroprevalence in the civilian, noninstitutionalized US population was 6.6% in 2009–2012, which corresponds to an estimated hepatitis E national seroprevalence of 17,196,457 people. Overall, 10.9% of participants who ingested self-grown foods had positive HEV antibodies versus 6.1% of participants who did not consume self-grown foods (P < 0.001; odds ratio (OR) 1.87; 95% CI 1.41–2.48). In the age-stratified multivariable analysis, the correlation between ingesting self-grown foods and HEV seropositivity was significant for participants 40–59 years old, but not overall, or for those < 40 years or ≥60 years. Conclusions Ingesting self-grown food, or simply the process of gardening/farming, may be a source of zoonotic HEV transmission.
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Abstract
Hepatitis E virus (HEV) infection is an emerging zoonotic disease posing a severe threat to public health in the world, especially to pregnant women. Currently, no specific treatments are available for HEV infection. Therefore, it is crucial to develop vaccine to prevent this infection. Although several potential candidate vaccines against HEV have been studied for their immunogenicity and efficacy, only Hecolin® which is developed by Xiamen Innovax Biotech Co., Ltd. and approved by China Food and Drug Administration (CFDA) in 2012, is the licensed HEV vaccine in the world so far. Extensive studies on safety, immunogenicity and efficacy in phase III clinical trials have shown that Hecolin® is a promising vaccine for HEV prevention and control. In this article, the advances on HEV vaccine development and research are briefly reviewed.
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Affiliation(s)
- Yufeng Cao
- a College of Veterinary Medicine, Jilin University , Changchun , Jilin , PR China.,b Changchun Institute of Biological Products Co. Ltd. , Changchun , Jilin , PR China
| | - Zhenhong Bing
- c Changchun Institute of Biological Products , Changchun , Jilin , PR China
| | - Shiyu Guan
- c Changchun Institute of Biological Products , Changchun , Jilin , PR China
| | - Zecai Zhang
- a College of Veterinary Medicine, Jilin University , Changchun , Jilin , PR China.,d Key laboratory for Zoonosis , Ministry of Education, and Institute for Zoonosis of Jilin University , Changchun , Jilin , PR China
| | - Xinping Wang
- a College of Veterinary Medicine, Jilin University , Changchun , Jilin , PR China.,d Key laboratory for Zoonosis , Ministry of Education, and Institute for Zoonosis of Jilin University , Changchun , Jilin , PR China
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Imagawa T, Sugiyama R, Shiota T, Li TC, Yoshizaki S, Wakita T, Ishii K. Evaluation of Heating Conditions for Inactivation of Hepatitis E Virus Genotypes 3 and 4. J Food Prot 2018; 81:947-952. [PMID: 29745758 DOI: 10.4315/0362-028x.jfp-17-290] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Hepatitis E virus (HEV) is a causative agent of acute hepatitis throughout the world. HEV genotypes 1 through 4 infect humans, whereas genotypes 3 and 4 (Gt3 and Gt4) also infect other animals. In developed countries, the main HEV infection route is by foodborne transmission, resulting from the consumption of undercooked meat. It is important to know the criteria for HEV control in daily cooking. In this study, we assessed the heat conditions required to inactivate HEV Gt3 and Gt4 in culture supernatants and spiked minced pork meat. HEV inactivation was determined by measuring viral RNA amplification in PLC/PRF/5 cell culture. In our cell culture assay, an inoculum containing HEV titer that is equivalent to >105 genome RNA copies can be determined as infectious. The internal temperature of pork during heating was measured to represent that achieved during cooking. Both HEV Gt3 and Gt4 were inactivated in culture supernatants heated at >65°C for 5 min and at >80°C for 1 min and in minced meat at 70°C for 5 min. Inoculated culture supernatant contained 108 HEV genome RNA copies (103 infectious units [IU]); therefore, it was indicated that HEV titer decreased >3 log IU after heating. In a comparison of Gt3 and Gt4, Gt4 showed slightly greater heat stability than Gt3. Boiling showed superior heating efficacy compared with roasting, and pork liver was slightly easier to heat than pork loin. Heating for 5 min by both boiling and roasting increased the internal temperature of pork products to more than 70°C. Although our data revealed that HEV Gt4 was slightly more heat stable than Gt3, both genotypes were inactivated by the appropriate heating conditions. Therefore, the risk of HEV foodborne infection could be mitigated by the appropriate cooking of pork meat. It is also important that both the supplier and the consumer are cognizant of the risk of HEV foodborne infection from livestock products.
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Affiliation(s)
- Toshifumi Imagawa
- 1 Department of Virology and Parasitology, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi, Hamamatsu, Shizuoka 431-3192, Japan.,2 Department of Virology II, National Institute of Infectious Disease, 4-7-1, Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Ryuichi Sugiyama
- 2 Department of Virology II, National Institute of Infectious Disease, 4-7-1, Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Tomoyuki Shiota
- 2 Department of Virology II, National Institute of Infectious Disease, 4-7-1, Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Tian-Cheng Li
- 2 Department of Virology II, National Institute of Infectious Disease, 4-7-1, Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Sayaka Yoshizaki
- 2 Department of Virology II, National Institute of Infectious Disease, 4-7-1, Gakuen, Musashimurayama, Tokyo 208-0011, Japan
| | - Takaji Wakita
- 3 Department of Virology II, National Institute of Infectious Disease, 1-23-1, Toyama, Shinjuku, Tokyo 162-8640, Japan
| | - Koji Ishii
- 2 Department of Virology II, National Institute of Infectious Disease, 4-7-1, Gakuen, Musashimurayama, Tokyo 208-0011, Japan
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Harrison L, DiCaprio E. Hepatitis E Virus: An Emerging Foodborne Pathogen. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2018. [DOI: 10.3389/fsufs.2018.00014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Comparison of hepatitis E virus seroprevalence between HBsAg-positive population and healthy controls in Shandong province, China. BMC Infect Dis 2018; 18:75. [PMID: 29433428 PMCID: PMC5810058 DOI: 10.1186/s12879-018-2974-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 01/23/2018] [Indexed: 02/07/2023] Open
Abstract
Background Persons with chronic hepatitis B (CHB) infection were reported to suffer severe disease after hepatitis E virus (HEV) superinfection, but the studies regarding HEV seroprevalence in this population were limited. A recent study in Vietnam found higher HEV seroprevalence among CHB patients compared with healthy controls. Methods A community-based case-control study was conducted in two counties of Shandong province, China, where hepatitis E incidence was at the highest (Rushan) and lowest (Zhangqiu) in the province based on data from routine public health surveillance. Four townships were selected randomly from each county and all residents in these townships were tested for hepatitis B surface antigen (HBsAg). Those tested positive for HBsAg (CHB group) and the 1:1 age and sex-matched HBsAg-negative residents (control group) were included. Anti-HEV IgM and IgG were tested and positive rates of IgG and IgM were compared between the CHB group and the control group. Results In total, 2048 CHB participants and 2054 controls were included in the study. In the CHB group, HEV IgG seroprevalence was 9.16% (95% CI: 7.47–11.09) in Zhangqiue and 38.06% (95% CI: 35.07–41.19) in Rushan (P < 0.001); the corresponding rates of IgM were 0.1% (95% CI: 0.002–0.54) and 1.57% (95% CI: 0.90–2.53), respectively (P < 0.001). HEV IgG seroprevalence was similar between CHB group and the control group in both counties (P = 0.21, P = 0.47, respectively) and the same results were found for the positive rate of IgM (P = 0.103, P = 0.262, respectively). Multivariable analysis showed the status of HBsAg was not independently associated with the status of anti-HEV IgG in either Zhangqiu or Rushan [P = 0.187, OR = 1.23(95% CI: 0.90, 1.68); P = 0.609, OR = 1.05 (95% CI: 0.87, 1.26)]. Conclusions The seroprevalence of HEV varies greatly in different geographic areas, but the seroprevalence is similar between populations with and without CHB. CHB patients residing in high HEV endemic areas might be at higher risk for HBV-HEV superinfection.
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Farshadpour F, Taherkhani R, Ravanbod MR, Eghbali SS, Taherkhani S, Mahdavi E. Prevalence, risk factors and molecular evaluation of hepatitis E virus infection among pregnant women resident in the northern shores of Persian Gulf, Iran. PLoS One 2018; 13:e0191090. [PMID: 29329329 PMCID: PMC5766211 DOI: 10.1371/journal.pone.0191090] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/29/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Although Iran is reported to be an endemic country for hepatitis E virus (HEV), data on the prevalence of HEV infection among pregnant women are scarce and the epidemiology of HEV is unknown in most parts of the country. Therefore, this study was conducted to elucidate the prevalence, risk factors and genotypic pattern of HEV infection among pregnant women resident in the northern shores of Persian Gulf. This is the first report on the epidemiology of HEV infection among pregnant women in this territory. METHODS From October 2016 to May 2017, 1331 pregnant women participated in this study. The mean age ± SD of participants was 27.93±5.7 years with a range of 14-45 years. Serum samples of pregnant women were screened for the presence of anti-HEV total antibodies, anti-HEV IgG and anti-HEV IgM using commercially available ELISA kits (DIA.PRO, Milan, Italy). All anti-HEV IgG and anti-HEV IgM positive samples were tested for HEV RNA using two independent reverse transcriptase polymerase chain reaction (RT-PCR) assays, targeting ORF2 and ORF3 of HEV genome. In addition, 92 anti-HEV seronegative samples as well as 50 pooled seronegative samples were evaluated by two independent RT-PCR assays for validation of results. RESULTS Of the 1331 pregnant women, 84 women (6.3%, 95% CI: 5.1%-7.7%) were positive for anti-HEV antibodies, of which 83 women had anti-HEV IgG, and 11 women (0.83%, 95% CI: 0.47%-1.47%) had anti-HEV IgM. The highest rate of HEV seroprevalence was observed among Afghan immigrants (68.0%), uneducated pregnant women (46.51%) and those residents in Bushehr city (8.75%). All anti-HEV IgG and/or IgM positive samples were found to be negative for HEV RNA. In addition, all of the evaluated anti-HEV seronegative samples were negative for HEV RNA. HEV seropositivity among pregnant women was statistically associated with age, ethnicity, place of residence, number of pregnancies, and level of education. So that, low education levels, Afghan, residence in Bushehr city, age group >34 years, and more parities were risk factors for exposure to HEV. In contrast, HEV seropositivity was not associated with stage of gestation, history of abortion, and time of sampling. CONCLUSION The northern shores of Persian Gulf in Iran, with HEV seroprevalence of 6.3%, can be classified as an endemic geographical region for hepatitis E, and residents of Bushehr city, Afghan immigrants and uneducated women are the main at-risk populations in this territory.
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Affiliation(s)
- Fatemeh Farshadpour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Taherkhani
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
- * E-mail: ,
| | - Mohamad Reza Ravanbod
- Department of Internal Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Seyed Sajjad Eghbali
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Sakineh Taherkhani
- Reproductive Health and Midwifery Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Easa Mahdavi
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
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Melgaço JG, Gardinali NR, de Mello VDM, Leal M, Lewis-Ximenez LL, Pinto MA. Hepatitis E: Update on Prevention and Control. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5769201. [PMID: 29546064 PMCID: PMC5818934 DOI: 10.1155/2018/5769201] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/28/2017] [Accepted: 12/13/2017] [Indexed: 12/20/2022]
Abstract
Hepatitis E virus (HEV) is a common etiology of acute viral hepatitis worldwide. Recombinant HEV vaccines have been developed, but only one is commercially available and licensed in China since 2011. Epidemiological studies have identified genotype 3 as the major cause of chronic infection in immunocompromised individuals. Ribavirin has been shown to be effective as a monotherapy to induce HEV clearance in chronic patients who have undergone solid organ transplant (SOT) under immunosuppressive therapy. Efforts and improvements in prevention and control have been made to reduce the instances of acute and chronic hepatitis E in endemic and nonendemic countries. However, this review shows that further studies are required to demonstrate the importance of preventive vaccination and treatment worldwide, with emphasis on hepatitis E infection in the public health system.
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Affiliation(s)
- Juliana Gil Melgaço
- Ambulatório/Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Noemi Rovaris Gardinali
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Vinicius da Motta de Mello
- Ambulatório/Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Mariana Leal
- Ambulatório/Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Lia Laura Lewis-Ximenez
- Ambulatório/Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Ifeorah IM, Faleye TOC, Bakarey AS, Adewumi MO, Akere A, Omoruyi EC, Ogunwale AO, Adeniji JA. Acute Hepatitis E Virus Infection in Two Geographical Regions of Nigeria. J Pathog 2017; 2017:4067108. [PMID: 29387489 PMCID: PMC5745689 DOI: 10.1155/2017/4067108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/23/2017] [Indexed: 12/23/2022] Open
Abstract
Hepatitis E virus (HEV) remains a major public health concern in resource limited regions of the world. Yet data reporting is suboptimal and surveillance system is inadequate. In Nigeria, there is dearth of information on prevalence of acute HEV infection. This study was therefore designed to describe acute HEV infection among antenatal clinic attendees and community dwellers from two geographical regions in Nigeria. Seven hundred and fifty plasma samples were tested for HEV IgM by Enzyme Linked Immunosorbent Assay (ELISA) technique. The tested samples were randomly selected from a pool of 1,115 blood specimens previously collected for viral hepatitis studies among selected populations (pregnant women, 272; Oyo community dwellers, 438; Anambra community dwellers, 405) between September 2012 and August 2013. One (0.4%) pregnant woman in her 3rd trimester had detectable HEV IgM, while community dwellers from the two study locations had zero prevalence rates of HEV IgM. Detection of HEV IgM in a pregnant woman, especially in her 3rd trimester, is of clinical and epidemiological significance. The need therefore exists for establishment of a robust HEV surveillance system in Nigeria and especially amidst the pregnant population in a bid to improve maternal and child health.
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Affiliation(s)
- I. M. Ifeorah
- Department of Medical Laboratory Sciences, Faculty of Health Science and Technology, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - T. O. C. Faleye
- Department of Microbiology, Faculty of Science, Ekiti State University, Ado Ekiti, Nigeria
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A. S. Bakarey
- Institute for Advanced Medical Research & Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - M. O. Adewumi
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A. Akere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - E. C. Omoruyi
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A. O. Ogunwale
- Oyo State College of Agriculture and Technology, Igboora, Nigeria
| | - J. A. Adeniji
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Roth NJ, Schäfer W, Alexander R, Elliott K, Elliott-Browne W, Knowles J, Wenzel JJ, Simon TL. Low hepatitis E virus RNA prevalence in a large-scale survey of United States source plasma donors. Transfusion 2017; 57:2958-2964. [PMID: 28833188 DOI: 10.1111/trf.14285] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/12/2017] [Accepted: 07/05/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) is a small, nonenveloped, single-stranded, RNA virus of emerging concern in industrialized countries. HEV transmission through transfusion of blood components has been reported, but not via plasma-derived medicinal products (PDMPs) manufactured with virus inactivation and/or removal steps. This study aimed to determine the prevalence of HEV among US source plasma donors. STUDY DESIGN AND METHODS Samples were collected from US source plasma donors at centers across the United States and were initially screened for HEV RNA in 96-sample minipools using the Roche cobas HEV test on the cobas 8800 system. Assuming a sensitivity of 18.6 IU/mL, the minipool screening strategy allowed for reliable detection of individual donations with HEV RNA titers of more than 2 × 103 IU/mL. Reactive minipools were resolved to individual donations, which were further analyzed to quantify viral RNA concentration, determine HEV genotype, and immunoglobulin (Ig)G and IgM HEV antibody status. RESULTS A total of 128,020 samples were collected from 96 CSL Plasma centers in the United States, representing 27 states. The prevalence of HEV RNA-positive samples was 0.002% with three unique HEV-positive donors identified, all HEV Subgenotype 3a. Virus titers of HEV-positive samples were relatively low (103 -104 IU HEV RNA/mL). One positive donation was HEV IgG seropositive. CONCLUSION Routine screening of US source plasma donations for HEV would not substantially improve the safety of most PDMPs. The low prevalence and potential viral load of HEV, together with effective virus reduction steps in manufacturing processes, results in a low residual risk and acceptable safety margins for PDMPs derived from US plasma donors.
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Affiliation(s)
| | | | | | | | | | | | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
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Ikram A, Hakim MS, Zhou JH, Wang W, Peppelenbosch MP, Pan Q. Genotype-specific acquisition, evolution and adaptation of characteristic mutations in hepatitis E virus. Virulence 2017; 9:121-132. [PMID: 28727933 PMCID: PMC5955438 DOI: 10.1080/21505594.2017.1358349] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Hepatitis E virus (HEV) infection is a major cause of acute hepatitis but also provokes chronic infection in immunocompromised patients. Although the pathogenesis and treatment outcome involve complex interplay between the virus and host, the nature of adaptive responses of HEV to the host immune system remain obscure at best. In this study, we used large-scale proteomic bioinformatics to profile characteristic mutations in human HEV isolates associated to ribavirin treatment failure, chronic hepatitis, hepatic failure or altered immunoreactivity. The prevalence of specific mutations was examined in a large number of protein sequences of ORF1 and ORF2 regions of the 3 major human-derived HEV genotypes (1, 3 and 4). By analyzing potential B, CD4+ and CD8+ T cell epitopes, we found that many of these mutations overlap with the predicted epitopes and are frequently present among the 3 HEV genotypes. These overlapping mutations mediate reduced antigenicity. Finally, by delineation of diversification and evolution of the underlying epitopes, we observe that most of these variants apparently evolved earlier in genotype 1 when compared with genotypes 3 and 4. These results indicate that HEV is under substantial evolutionary pressure to develop mutations enabling evasion of the host immune response and resistance to antiviral treatment. This indicates the existence of an ongoing evolutionary arms race between human immunity, antiviral medication and HEV.
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Affiliation(s)
- Aqsa Ikram
- a Department of Gastroenterology and Hepatology , Erasmus MC-University Medical Center , Rotterdam , the Netherlands.,b Atta Ur Rahman School of Applied Biosciences, National University of Science and Technology , Islamabad , Pakistan
| | - Mohamad S Hakim
- a Department of Gastroenterology and Hepatology , Erasmus MC-University Medical Center , Rotterdam , the Netherlands.,c Department of Microbiology , Faculty of Medicine, Universitas Gadjah Mada , Yogyakarta , Indonesia
| | - Jian-Hua Zhou
- a Department of Gastroenterology and Hepatology , Erasmus MC-University Medical Center , Rotterdam , the Netherlands.,d State Key Laboratory of Veterinary Etiological Biology, National Foot-and-Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences , Lanzhou , Gansu , P.R. China
| | - Wenshi Wang
- a Department of Gastroenterology and Hepatology , Erasmus MC-University Medical Center , Rotterdam , the Netherlands
| | - Maikel P Peppelenbosch
- a Department of Gastroenterology and Hepatology , Erasmus MC-University Medical Center , Rotterdam , the Netherlands
| | - Qiuwei Pan
- a Department of Gastroenterology and Hepatology , Erasmus MC-University Medical Center , Rotterdam , the Netherlands
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Mancinelli S, Pirillo MF, Liotta G, Andreotti M, Jere H, Sagno JB, Amici R, Marazzi MC, Vella S, Palombi L, Giuliano M. Hepatitis E virus infection in HIV-infected pregnant women and their children in Malawi. Infect Dis (Lond) 2017; 49:708-711. [DOI: 10.1080/23744235.2017.1311418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Sandro Mancinelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Giuseppe Liotta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Mauro Andreotti
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Haswel Jere
- DREAM Program, Community of S. Egidio, Blantyre, Malawi
| | | | - Roberta Amici
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Stefano Vella
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Marina Giuliano
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
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Hakim MS, Wang W, Bramer WM, Geng J, Huang F, de Man RA, Peppelenbosch MP, Pan Q. The global burden of hepatitis E outbreaks: a systematic review. Liver Int 2017; 37:19-31. [PMID: 27542764 DOI: 10.1111/liv.13237] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/15/2016] [Indexed: 12/12/2022]
Abstract
Hepatitis E virus (HEV) is responsible for repeated water-borne outbreaks since the past century, representing an emerging issue in public health. However, the global burden of HEV outbreak has not been comprehensively described. We performed a systematic review of confirmed HEV outbreaks based on published literatures. HEV outbreaks have mainly been reported from Asian and African countries, and only a few from European and American countries. India represents a country with the highest number of reported HEV outbreaks. HEV genotypes 1 and 2 were responsible for most of the large outbreaks in developing countries. During the outbreaks in developing countries, a significantly higher case fatality rate was observed in pregnant women. In fact, outbreaks have occurred both in open and closed populations. The control measures mainly depend upon improvement of sanitation and hygiene. This study highlights that HEV outbreak is not new, yet it is a continuous global health problem.
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Affiliation(s)
- Mohamad S Hakim
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Microbiology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Wenshi Wang
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jiawei Geng
- Department of Infectious Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Fen Huang
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Robert A de Man
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maikel P Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
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Elduma AH, Zein MMA, Karlsson M, Elkhidir IME, Norder H. A Single Lineage of Hepatitis E Virus Causes Both Outbreaks and Sporadic Hepatitis in Sudan. Viruses 2016; 8:E273. [PMID: 27782061 PMCID: PMC5086609 DOI: 10.3390/v8100273] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 09/30/2016] [Indexed: 12/11/2022] Open
Abstract
Few studies have reported sporadic hepatitis E virus (HEV) infections during non-outbreak periods in Africa. In this study, the prevalence of HEV infection in Sudan was investigated in 432 patients with acute hepatitis from 12 localities in North Kordofan, and from 152 patients involved in smaller outbreaks of hepatitis in the neighbouring Darfur. HEV infection was diagnosed in 147 (25%) patients: 98 from Kordofan and 49 from Darfur. The mortality was 10%; six of the patients who died from the infection were pregnant women. HEV RNA was detected by quantitative real-time polymerase chain reaction (RT-qPCR) in 38 (26%) patients: 22 from Kordofan and 16 from Darfur. Partial open reading frame (ORF) 1 and ORF2 were sequenced from HEV from nine and three patients, respectively. Phylogenetic analysis showed that the Sudanese strains belonged to genotype 1 (HEV1), and confirmed the segregation of African HEV1 strains into one branch divergent from Asian HEV1. It also revealed that the Sudanese strains from this study and from an outbreak in 2004 formed a separate clade with a common ancestor, distinct from strains from the neighbouring Chad and Egypt. This HEV strain has thus spread in a large area of Sudan, where it has caused both sporadic hepatitis E and outbreaks from at least 2004 and onwards. These data demonstrate that hepatitis E is a constant, on-going public health problem in Sudan and that there is a need for hepatitis E surveillance, outbreak preparedness, and general improvements of the sanitation in these remote areas of the country.
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Affiliation(s)
- Adel Hussein Elduma
- National Public Health Laboratory, Ministry of Health-Sudan, 11111 Khartoum, Sudan.
| | - Mai Mohammed Adam Zein
- Public Health Laboratory, Ministry of Health North Kordofan State-Sudan, 51111 Obeid, Sudan.
| | - Marie Karlsson
- Department of Infectious Diseases, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
| | - Isam M E Elkhidir
- Department of Microbiology and Parasitology, Faculty of Medicine, University of Khartoum-Sudan, Khartoum, Sudan.
| | - Heléne Norder
- Department of Infectious Diseases, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
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Taherkhani R, Farshadpour F. Epidemiology of Hepatitis E in Pregnant Women and Children in Iran: A General Overview. J Clin Transl Hepatol 2016; 4:269-276. [PMID: 27777896 PMCID: PMC5075011 DOI: 10.14218/jcth.2016.00013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/01/2016] [Accepted: 08/18/2016] [Indexed: 02/06/2023] Open
Abstract
From an epidemiological point of view, hepatitis E is an old infection in Iran, but only recently has its importance as a public health concern been considered from research and public health standpoints. As such, there is still a long road ahead to clarify the real burden of hepatitis E virus (HEV) infection in Iran. According to the available epidemiological studies, the seroprevalence of HEV infection among pregnant women is between 3.6% and 7.4%, and among Iranian children is between 0.9% to 8.5%, varying by geographic regions within the country and directly dependent upon the sanitary status of each. In addition to evaluating the sanitation level of a society, community-based seroprevalence studies of HEV infection demonstrate the most prevalent risk factors, the major routes of transmission, and the epidemiological patterns of HEV among that country's population. In this review, the current knowledge about the pathogenesis and epidemiology of HEV infection in pregnant women and children in Iran, as well as the recent advances in diagnosis, prevention and treatment of HEV infection have been summarized.
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Affiliation(s)
- Reza Taherkhani
- Department of Microbiology and Parasitology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Persian Gulf Biomedical Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Fatemeh Farshadpour
- Department of Microbiology and Parasitology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
- *Correspondence to: Fatemeh Farshadpour, Department of Microbiology and Parasitology, School of Medicine, Bushehr University of Medical Sciences, Moallem Street, P. O. Box 3631, Bushehr 7514633341, Iran. Tel: +98-9171712653, Fax: +98-7714550235, E-mail:
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Abstract
BACKGROUND Hepatitis E virus (HEV) is endemic in large parts of the developing world. Waterborne transmission of genotypes 1 or 2 commonly causes acute hepatitis, which is usually self-limited in healthy individuals. In addition, acute HEV infections also occur outside endemic areas, mostly related to foodborne transmission of HEV genotype 3. A growing number of publications in the last decade have reported chronic infection progressing to cirrhosis in immunosuppressed patients. It has also been suggested that HEV transmission may occur via contaminated blood products. This publication aims to provide recommendations for diagnosis, prevention, and treatment of HEV infection, particularly in children after solid organ transplantation. METHODS A systematic PubMed literature search on HEV infection from 1990 to January 2016 was performed focusing on pediatric studies. The existing body of evidence was reviewed and recommendations were agreed upon following discussion and unanimous agreement by all members of the ESPGHAN Hepatology Committee during a consensus meeting in January 2016. In the absence of randomized controlled studies these recommendations were considered to be expert opinions. KEY RECOMMENDATIONS Immunocompetent children with increased transaminases and/or extrahepatic manifestations should be considered for testing for evidence of HEV infection. Immunocompromised children with increased aminotransferases should be repeatedly tested for HEV and may require therapeutic intervention.
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Chingwaru W, Vidmar J. A novel porcine cell culture based protocol for the propagation of hepatitis E virus. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2016. [DOI: 10.1016/s2222-1808(16)61092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Berebichez-Fridman R, Vázquez-Campuzano R, Galnares-Olalde J, Blachman-Braun R. Hepatitis E virus incidence in patients with non-identified acute viral hepatitis in Mexico. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2016. [DOI: 10.1016/j.hgmx.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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50
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Taherkhani R, Farshadpour F. Epidemiology of hepatitis E virus in Iran. World J Gastroenterol 2016; 22:5143-5153. [PMID: 27298557 PMCID: PMC4893461 DOI: 10.3748/wjg.v22.i22.5143] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 04/22/2016] [Accepted: 05/04/2016] [Indexed: 02/07/2023] Open
Abstract
Iran is known as an endemic country for hepatitis E virus (HEV) infection, while there are variations in the epidemiology of HEV infection throughout the country. The available epidemiological studies in different regions of Iran show HEV seroprevalence of 1.1%-14.2% among general population, 4.5% -14.3% among blood donors, 6.1%-22.8% among injecting drug users, 6.3%-28.3% among hemodialysis patients, 1.6%-11.3% among patients infected with other hepatitis viruses, 27.5% among patients with chronic liver disease, 30.8% among kidney transplant recipient patients, and 10%-16.4% among human immunodeficiency virus-infected patients. These variations reflect differences in the status of public health and hygiene, risk factors, and routes of transmission in different regions and groups. Therefore, it is necessary to review the epidemiology of HEV infection to determine the most prevalent risk factors and routes of transmission, and to evaluate the effectiveness of preventive strategies employed in the public health services of the country. Moreover, the other epidemiological aspects of HEV, including the genotypic pattern, extra hepatic manifestations, and incidence of chronic infection need to be investigated among Iranian population to expand the current knowledge on the epidemiology of HEV and to clarify the real burden of HEV infection. Therefore, this review was performed to provide a general overview regarding the epidemiology of HEV in Iran.
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