1
|
Zahmanova G, Takova K, Lukov GL, Andonov A. Hepatitis E Virus in Domestic Ruminants and Virus Excretion in Milk-A Potential Source of Zoonotic HEV Infection. Viruses 2024; 16:684. [PMID: 38793568 PMCID: PMC11126035 DOI: 10.3390/v16050684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/21/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
The hepatitis E virus is a serious health concern worldwide, with 20 million cases each year. Growing numbers of autochthonous HEV infections in industrialized nations are brought on via the zoonotic transmission of HEV genotypes 3 and 4. Pigs and wild boars are the main animal reservoirs of HEV and play the primary role in HEV transmission. Consumption of raw or undercooked pork meat and close contact with infected animals are the most common causes of hepatitis E infection in industrialized countries. However, during the past few years, mounting data describing HEV distribution has led experts to believe that additional animals, particularly domestic ruminant species (cow, goat, sheep, deer, buffalo, and yak), may also play a role in the spreading of HEV. Up to now, there have not been enough studies focused on HEV infections associated with animal milk and the impact that they could have on the epidemiology of HEV. This critical analysis discusses the role of domestic ruminants in zoonotic HEV transmissions. More specifically, we focus on concerns related to milk safety, the role of mixed farming in cross-species HEV infections, and what potential consequences these may have on public health.
Collapse
Affiliation(s)
- Gergana Zahmanova
- Department of Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
- Department of Technology Transfer and IP Management, Center of Plant Systems Biology and Biotechnology, 4000 Plovdiv, Bulgaria
| | - Katerina Takova
- Department of Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Georgi L. Lukov
- Faculty of Sciences, Brigham Young University–Hawaii, Laie, HI 96762, USA
| | - Anton Andonov
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
| |
Collapse
|
2
|
Tanaka A, Matsubayashi K, Odajima T, Sakata H, Iida J, Kai K, Goto N, Satake M. Universal nucleic acid donor screening revealed epidemiological features of hepatitis E and prevented transfusion-transmitted infection in Japan. Transfusion 2024; 64:335-347. [PMID: 38152964 DOI: 10.1111/trf.17696] [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: 06/12/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND More than 45 cases of transfusion-transmitted hepatitis E virus infection (TT-HEV) have been reported in Japan. Therefore, in 2020, universal individual donation nucleic acid amplification testing (ID-NAT) was implemented for HEV. STUDY DESIGN AND METHODS We characterized HEV NAT-positive blood donors. The number of new HEV infections and the asymptomatic infection rate were estimated using the HEV NAT-positive rate. HEV RNA quantitation, phylogenetic analysis, and antibody tests were performed, and the residual risk of TT-HEV was assessed based on the lookback study results. RESULTS A total of 5,075,100 blood donations were screened with ID-NAT during the first year of implementation, among which 2804 (0.055%; males: 0.060%, females: 0.043%) were NAT-positive with regional differences. Approximately 270,000 new HEV infection cases were estimated to occur annually in Japan, with an asymptomatic infection rate of 99.9%. The median HEV RNA concentration, excluding cases below the limit of quantification, was 205 IU/mL. Among the 1113 cases where the genotype could be determined, HEV-3 and HEV-4 accounted for 98.8% (1100) and 1.2% (13), respectively. The maximum duration of HEV viremia, including the pre- and post-ID-NAT window periods, was estimated to be 88.2 days. Within the 3 years since ID-NAT implementation, no confirmed cases of breakthrough TT-HEV were observed. DISCUSSION Multiple indigenous HEV strains are prevalent in Japan, infecting a significant number of individuals. However, since the implementation of ID-NAT, TT-HEV has been prevented due to the test's high sensitivity.
Collapse
Affiliation(s)
- Ami Tanaka
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Keiji Matsubayashi
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Takeshi Odajima
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | | | - Juri Iida
- Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan
| | - Kazuhiro Kai
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Naoko Goto
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Masahiro Satake
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| |
Collapse
|
3
|
Yoshida Y, Ito A, Eto H, Suzuki A, Abe T, Endo K, Kakisaka K, Oikawa T, Kuroda H, Miyasaka A, Matsumoto T, Takahashi M, Okamoto H. Seroprevalence and incidence of hepatitis E virus infection in the general population of Iwate prefecture, Japan: A retrospective cohort study. Hepatol Res 2024; 54:24-31. [PMID: 37635642 DOI: 10.1111/hepr.13961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023]
Abstract
AIM Hepatitis E virus (HEV) causes subclinical or acute self-limiting hepatitis. We surveyed the current seroprevalence and incidence of HEV infection among the general population in Iwate Prefecture, Japan, where the endemic infection is presumed to be low. METHODS Between 2014 and 2016, we recruited individuals from Iwate Prefecture, Japan, who visited a general medical work-up program. Serum anti-HEV antibody and HEV RNA were measured twice, with an interval of 2 years. Anti-HEV antibody was measured with enzyme-linked immunosorbent assay and HEV RNA with reverse transcription-polymerase chain reaction. RESULTS Study participants comprised 1284 Japanese (650 men and 634 women) with age ranging 20-89 years. A total of 90 participants were found to be positive for anti-HEV immunoglobulin G on the first visit, with a prevalence of 7.0% (95% confidence interval [CI] 5.6%-8.4%). Seroprevalence was higher in men than in women (10.1% vs. 3.7%, p < 0.001), and in those aged in their 50s-80s than in those aged in their 20s-40s (p = 0.006). Positive seroconversion indicating new HEV infection was found in seven of 1194 seronegative participants (0.59%; 95% CI 0.15%-1.0%), indicating the incidence of HEV infection to be 272 per 100 000 person-years (95% CI 109-561). CONCLUSIONS Our observations suggest that the incidence of HEV infection is high and that it is a leading cause of hepatitis virus infection in Iwate Prefecture, Japan.
Collapse
Affiliation(s)
- Yuichi Yoshida
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Asami Ito
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Hisashi Eto
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Akiko Suzuki
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Tamami Abe
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Kei Endo
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Keisuke Kakisaka
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Takayoshi Oikawa
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Hidekatsu Kuroda
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Akio Miyasaka
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| |
Collapse
|
4
|
Takahashi M, Kunita S, Nishizawa T, Ohnishi H, Primadharsini PP, Nagashima S, Murata K, Okamoto H. Infection Dynamics and Genomic Mutations of Hepatitis E Virus in Naturally Infected Pigs on a Farrow-to-Finish Farm in Japan: A Survey from 2012 to 2021. Viruses 2023; 15:1516. [PMID: 37515202 PMCID: PMC10385168 DOI: 10.3390/v15071516] [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: 06/23/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Hepatitis E virus (HEV) causes acute or chronic hepatitis in humans. Pigs are the primary reservoir for zoonotic HEV genotypes 3 and 4 worldwide. This study investigated the infection dynamics and genomic mutations of HEV in domestic pigs on a farrow-to-finish pig farm in Japan between 2012 and 2021. A high prevalence of anti-HEV IgG antibodies was noted among pigs on this farm in 2012, when the survey started, and persisted for at least nine years. During 2012-2021, HEV RNA was detected in both serum and fecal samples, indicating active viral replication. Environmental samples, including slurry samples in manure pits, feces on the floor, floor and wall swabs in pens, and dust samples, also tested positive for HEV RNA, suggesting potential sources of infection within the farm environment. Indeed, pigs raised in HEV-contaminated houses had a higher rate of HEV infection than those in an HEV-free house. All 104 HEV strains belonged to subgenotype 3b, showing a gradual decrease in nucleotide identities over time. The 2012 (swEJM1201802S) and 2021 (swEJM2100729F) HEV strains shared 97.9% sequence identity over the entire genome. Importantly, the swEJM2100729F strain efficiently propagated in human hepatoma cells, demonstrating its infectivity. These findings contribute to our understanding of the prevalence, transmission dynamics, and genetic characteristics of HEV in domestic pigs, emphasizing the potential risks associated with HEV infections and are crucial for developing effective strategies to mitigate the risk of HEV infection in both animals and humans.
Collapse
Affiliation(s)
- Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Satoshi Kunita
- Center for Experimental Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Tsutomu Nishizawa
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Hiroshi Ohnishi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Putu Prathiwi Primadharsini
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Kazumoto Murata
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| |
Collapse
|
5
|
Xiang K, Zhuang H. Liver Organoid Potential Application for Hepatitis E Virus Infection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:133-139. [PMID: 37223863 DOI: 10.1007/978-981-99-1304-6_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Despite the advances in hepatitis E virus (HEV) cell infection models' development, HEV infection efficacy in these cell models is still low, which hampers the further study of molecular mechanism of HEV infection and replication and even the interaction between HEV and host. Along with the advances in the technology for liver organoids generation, major efforts will be made to develop liver organoids for HEV infection. Here, we summarize the entire new and impressive cell culture system of liver organoids and discuss their potential application in HEV infection and pathogenesis. Liver organoids can be generated from tissue-resident cells isolated from biopsies of adult tissues or from iPSCs/ESCs differentiation, which can expand the large-scale experiments such as antiviral drug screening. Different types of liver cells working together can recapitulate the liver organ maintaining the physiological and biochemical microenvironments to support cell morphogenesis, migration, and response to viral infections. Efforts to optimize the protocols for liver organoids generation will speed up the research for HEV infection and pathogenesis and even the antiviral drug identification and evaluation.
Collapse
Affiliation(s)
- Kuanhui Xiang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
| | - Hui Zhuang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| |
Collapse
|
6
|
Takakusagi S, Takagi H, Yamazaki Y, Kosone T, Nagashima S, Takahashi M, Murata K, Okamoto H. Chronic hepatitis E in an elderly immunocompetent patient who achieved a sustained virologic response with ribavirin treatment. Clin J Gastroenterol 2022; 16:206-215. [PMID: 36403172 DOI: 10.1007/s12328-022-01733-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/04/2022] [Indexed: 11/21/2022]
Abstract
A woman in her late 70 s was diagnosed with liver injury at a health examination. Despite treatment with ursodeoxycholic acid at a nearby hospital, her transaminase levels elevated in two peaks. She was transferred to our hospital 77 days after the health examination. She weighed 42 kg and had a low body mass index of 19.8 kg/m2. Viral markers, including immunoglobulin A (IgA) against hepatitis E virus (anti-HEV IgA), were negative. Drug-induced liver injury was negligible. We suspected autoimmune hepatitis because of the patient's female gender and positive antinuclear antibody. However, prednisolone and azathioprine failed to completely improve her hepatitis. On day 643, anti-HEV IgA was re-evaluated and found to be positive. She was diagnosed with autochthonous chronic hepatitis E because the virus strains in the preserved serum on day 77 and the serum on day 643 had identical nucleotide sequences (genotype 3a). Following prednisolone and azathioprine discontinuation, ribavirin (RBV) was administered for 3 months. HEV RNA disappeared and remained negative for more than 6 months after the cessation of RBV. The HEV RNA titer of 6.2 log10 copies/mL on day 77 was unusually high 2.5 months after the onset, suggesting that hepatitis E had already been chronic before immunosuppressive treatment for possible autoimmune hepatitis. After getting married at 23 years old, she had been a housewife and had no comorbidities that might deteriorate her immunity. Chronicity should be kept in mind when encountering HEV infection in elderly and underweight patients.
Collapse
Affiliation(s)
- Satoshi Takakusagi
- Department of Gastroenterology and Hepatology, Kusunoki Hospital, 607-22 Fujioka, Fujioka, Gunma, 375-0024, Japan
| | - Hitoshi Takagi
- Department of Gastroenterology and Hepatology, Kusunoki Hospital, 607-22 Fujioka, Fujioka, Gunma, 375-0024, Japan.
| | - Yuichi Yamazaki
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-15 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Takashi Kosone
- Department of Gastroenterology and Hepatology, Kusunoki Hospital, 607-22 Fujioka, Fujioka, Gunma, 375-0024, Japan
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Kazumoto Murata
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| |
Collapse
|
7
|
Subclinical hepatitis E virus (HEV) infection detected by nucleic acid amplification test on blood donation: short-term positivity for immunoglobulin G class of antibody against HEV. Clin J Gastroenterol 2022; 15:750-754. [PMID: 35507275 DOI: 10.1007/s12328-022-01635-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
A case of subclinical hepatitis E virus (HEV) infection was detected by nucleic acid amplification test on blood donation. The patient was followed-up until day 220 after the blood donation but showed no symptoms throughout the observation period. Aspartate aminotransferase and alanine aminotransferase levels reached the maximum values on day 37 with a slight increase but remained in normal ranges from day 67 to 220. The quantity of HEV RNA at the initial examination on day 13 was 1.1 × 102 copies/mL, which increased to 2.8 × 103 copies/mL by day 37. It was not detected from day 67 to 220. Immunoglobulin G class antibody to HEV (anti-HEV IgG) was below the cut-off value until day 37 and exceeded the cut-off value to positive on day 67, accompanied by normalization of liver function and negative conversion of HEV RNA. Thereafter, the titer decreased gradually, falling below the cut-off value on day 163, and continuing negative until day 220. Although the persistent duration of anti-HEV IgG positive is believed to be generally long, it was within only 126 days for this subclinical case. Further investigation is needed to determine whether short-term positivity for anti-HEV IgG is typical in subclinical HEV infection.
Collapse
|
8
|
Hibiya K, Iwata H, Kinjo T, Shinzato A, Tateyama M, Ueda S, Fujita J. Incidence of common infectious diseases in Japan during the COVID-19 pandemic. PLoS One 2022; 17:e0261332. [PMID: 35020724 PMCID: PMC8754328 DOI: 10.1371/journal.pone.0261332] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
Recent reports indicate that respiratory infectious diseases were suppressed during the novel coronavirus disease-2019 (COVID-19) pandemic. COVID-19 led to behavioral changes aimed to control droplet transmission or contact transmission. In this study, we examined the incidence of common infectious diseases in Japan during the COVID-19 pandemic. COVID-19 data were extracted from the national data based on the National Epidemiological Surveillance of Infectious Diseases (NESID). Common infectious diseases were selected from notifiable infectious diseases under the NESID. The epidemic activity of the diseases during 2015-2020 was evaluated based on the Infectious Disease Weekly Reports published by the National Institute of Infectious Diseases. Each disease was then categorized according to the route of transmission. Many Japanese people had adopted hygienic activities, such as wearing masks and hand washing, even before the COVID-19 pandemic. We examined the correlation between the time-series of disease counts of common infectious diseases and COVID-19 over time using cross-correlation analysis. The weekly number of cases of measles, rotavirus, and several infections transmitted by droplet spread, was negatively correlated with the weekly number of cases of COVID-19 for up to 20 weeks in the past. According to the difference-in-differences analysis, the activity of influenza and rubella was significantly lower starting from the second week in 2020 than that in 2015-2019. Only legionellosis was more frequent throughout the year than in 2015-2019. Lower activity was also observed in some contact transmitted, airborne-transmitted, and fecal-oral transmitted diseases. However, carbapenem-resistant Enterobacteriaceae, exanthema subitum, showed the same trend as that over the previous 5 years. In conclusion, our study shows that public health interventions for the COVID-19 pandemic may have effectively prevented the transmission of most droplet-transmitted diseases and those transmitted through other routes.
Collapse
Affiliation(s)
- Kenji Hibiya
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
- Department of Diagnostic Pathology, University of the Ryukyus Hospital, Nishihara-cho, Okinawa, Japan
- * E-mail:
| | - Hiroyoshi Iwata
- Clinical Pharmacology & Therapeutics, University of The Ryukyus School of Medicine, Nishihara-cho, Okinawa, Japan
| | - Takeshi Kinjo
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
| | - Akira Shinzato
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
| | - Masao Tateyama
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
| | - Shinichiro Ueda
- Clinical Pharmacology & Therapeutics, University of The Ryukyus School of Medicine, Nishihara-cho, Okinawa, Japan
| | - Jiro Fujita
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
| |
Collapse
|
9
|
Identification of hepatitis E virus in wild sika deer in Japan. Virus Res 2022; 308:198645. [PMID: 34822952 DOI: 10.1016/j.virusres.2021.198645] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/12/2022]
Abstract
Hepatitis E virus (HEV) is a zoonotic agent mainly transmitted through the consumption of uncooked or undercooked meat products derived from infected animals. In Japan, domestic pigs and wild boars are the major animal reservoirs, and whether or not deer are an HEV reservoir remains controversial. We analyzed 395 serum and 199 liver samples from 405 sika deer (Cervus nippon) caught in the wild between 1997 and 2020 in 11 prefectures of Japan for markers of HEV infection. Overall, 17 deer had anti-HEV IgG (4.3%), while 1 (0.2%) had HEV RNA (genotype 3b), indicating the occurrence of ongoing HEV infection in wild deer in Japan. An analysis of the complete HEV genome (deJOI_14) recovered from a viremic deer in Oita Prefecture revealed only 88.8% identity with the first HEV strain in sika deer (JDEER-Hyo03L) in Japan, being closest (96.3%) to the HEV obtained from a hepatitis patient living in the same prefecture. Of note, the deJOI_14 strain was 8.7-9.0% different from the wild boar HEV strains obtained in the same habitat and the same year, suggesting that difference in infected HEV strains between boar and deer may be explained by the limited possibility of close contact with each other, although boars are a known source of HEV infection. Increased numbers of hepatitis E cases after consumption of raw or undercooked meat products of wild deer have been reported in Japan. These results suggest a low but nonnegligible zoonotic risk of HEV infection in wild deer in this country.
Collapse
|
10
|
Characterization of rabbit hepatitis E virus isolated from a feral rabbit. Vet Microbiol 2021; 263:109275. [PMID: 34798367 DOI: 10.1016/j.vetmic.2021.109275] [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] [Received: 06/09/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 01/10/2023]
Abstract
Rabbit hepatitis E virus (HEV) has been detected among rabbits and recently isolated from immunocompromised patients, suggesting zoonotic transmission. In this study, HEV infection among feral rabbits (Oryctolagus cuniculus) was assessed by detection of anti-HEV antibodies and HEV RNA. The prevalence of anti-HEV antibodies in sera was of 33 % (20/60) and HEV RNA was detected from only one of fecal swabs (1.7 %, 1/58). Furthermore, one naïve rabbit was intravenously inoculated with the suspension of the HEV-positive fecal specimen, exhibiting persistent HEV shedding in feces, intermittent viremia, seroconversion to anti-HEV IgM and IgG, and high alanine aminotransferase (ALT) values, indicating persistent HEV infection. The isolate JP-59 had a length of 7,282 bp excluding a poly (A) tail and possessed the characteristic 93 bp-insertion in ORF1. Phylogenetic analysis indicated that JP-59 formed a cluster with other rabbit HEV isolates from rabbits and human origin. The JP-59 shared the nucleotide sequence identities less than 87 % with other rabbit HEVs, suggesting that a novel rabbit HEV strain was circulating in Japan.
Collapse
|
11
|
Sakata H, Matsubayashi K, Iida J, Nakauchi K, Kishimoto S, Sato S, Ikuta K, Satake M, Kino S. Trends in hepatitis E virus infection: Analyses of the long-term screening of blood donors in Hokkaido, Japan, 2005-2019. Transfusion 2021; 61:3390-3401. [PMID: 34632593 DOI: 10.1111/trf.16700] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 08/30/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND After experiencing several cases of transfusion-transmitted hepatitis E (TT-HE) in Hokkaido, Northern Japan, hepatitis E virus (HEV) screening in blood donors, using a nucleic acid amplification test (NAT), was introduced in 2005. STUDY DESIGN AND METHODS The frequency of HEV RNA-positive donations (2005-2019) was investigated, and the HEV RNA-positive specimens were phylogenetically analyzed. In August 2014, the 20-pooled NAT (20P-NAT) was replaced with an individual-NAT (ID-NAT) system. RESULTS Until 2019, the frequency of HEV RNA-positive donors was 0.011% (289/2,638,685) with 20P-NAT and 0.043% (597/1,379,750) with ID-NAT, and no TT-HE cases were observed in Hokkaido. The prevalence among male, but not female donors, increased significantly between 2015 and 2019. Eighty-nine percent of HEV isolates from donors were genotype 3 and the remainder were genotype 4, and many clusters existed in each genotype. ALT levels at the time of donation were significantly higher in donors with genotype 4. Four subgenotypes, namely 3a (37%), 3b (41%), 3e (6%), and 4c (10%), comprised 94% of the total. During this period, the most identified subgenotype, 3a, transitioned to 3b. Majority of the HEV strains within the same clusters were detected in the same geographical region around the same period. Many of the human HEV isolates were shown to coexist closely with animal HEV isolates phylogenetically. CONCLUSION In Hokkaido, multiple divergent HEV strains have been circulating, and small outbreaks of hepatitis E have occurred in the last 15 years. The results suggested that HEV NAT can contribute significantly in ensuring safety during blood transfusions.
Collapse
Affiliation(s)
| | - Keiji Matsubayashi
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Juri Iida
- Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan
| | - Kenta Nakauchi
- Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan
| | | | - Shinichiro Sato
- Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan
| | - Katsuya Ikuta
- Japanese Red Cross Hokkaido Blood Center, Sapporo, Japan
| | - Masahiro Satake
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Shuichi Kino
- Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan
| |
Collapse
|
12
|
Velavan TP, Pallerla SR, Johne R, Todt D, Steinmann E, Schemmerer M, Wenzel JJ, Hofmann J, Shih JWK, Wedemeyer H, Bock CT. Hepatitis E: An update on One Health and clinical medicine. Liver Int 2021; 41:1462-1473. [PMID: 33960603 DOI: 10.1111/liv.14912] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 03/09/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022]
Abstract
The hepatitis E virus (HEV) is one of the main causes of acute hepatitis and the de facto global burden is underestimated. HEV-related clinical complications are often undetected and are not considered in the differential diagnosis. Convincing findings from studies suggest that HEV is clinically relevant not only in developing countries but also in industrialized countries. Eight HEV genotypes (HEV-1 to HEV-8) with different human and animal hosts and other HEV-related viruses are in circulation. Transmission routes vary by genotype and location, with large waterborne outbreaks in developing countries and zoonotic food-borne infections in developed countries. An acute infection can be aggravated in pregnant women, organ transplant recipients, patients with pre-existing liver disease and immunosuppressed patients. HEV during pregnancy affects the fetus and newborn with an increased risk of vertical transmission, preterm and stillbirth, neonatal jaundice and miscarriage. Hepatitis E is associated with extrahepatic manifestations that include neurological disorders such as neuralgic amyotrophy, Guillain-Barré syndrome and encephalitis, renal injury and haematological disorders. The risk of transfusion-transmitted HEV is increasingly recognized in Western countries where the risk may be because of a zoonosis. RNA testing of blood components is essential to determine the risk of transfusion-transmitted HEV. There are currently no approved drugs or vaccines for HEV infections. This review focuses on updating the latest developments in zoonoses, screening and diagnostics, drugs in use and under development, and vaccines.
Collapse
Affiliation(s)
- Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Srinivas R Pallerla
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
| | - Reimar Johne
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - Daniel Todt
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany.,European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - Eike Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Mathias Schemmerer
- Institute of Clinical Microbiology and Hygiene, National Consultant Laboratory for HAV and HEV, University Medical Center Regensburg, Regensburg, Germany
| | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, National Consultant Laboratory for HAV and HEV, University Medical Center Regensburg, Regensburg, Germany
| | - Jörg Hofmann
- Institute of Virology, Charité Universitätsmedizin Berlin, Labor Berlin-Charité-Vivantes GmbH, Berlin, Germany
| | | | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research, Partner Hannover-Braunschweig, Braunschweig, Germany
| | - Claus-Thomas Bock
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
13
|
Koyama M, Yamazaki T, Joshita S, Ito A, Ono K, Watanabe T, Yamashita Y, Sugiura A, Kobayashi M, Sato Y, Takahashi M, Okamoto H, Umemura T. An Autopsy Case of Primary Biliary Cholangitis with Histological Submassive Hepatic Necrosis Caused by Acute Hepatitis E Virus Infection. Intern Med 2021; 60:1863-1870. [PMID: 33518570 PMCID: PMC8263169 DOI: 10.2169/internalmedicine.6337-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 59-year-old woman who had been diagnosed with cirrhotic primary biliary cholangitis (PBC) 5 years earlier was admitted for severe jaundice (total bilirubin: 30.1 mg/dL). We suspected that her cirrhotic PBC had deteriorated acutely for some reason. Her general condition deteriorated quickly, and she passed away on day 18 of admission. Hepatitis E virus (HEV)-IgA antibodies were positive, and Genotype 3b HEV involvement was confirmed from a blood sample taken on admission. Histopathological findings revealed cirrhosis and submassive loss and necrosis of hepatocytes. Clinicians should consider the possibility of acute HEV infection as a trigger for acute PBC exacerbation.
Collapse
Affiliation(s)
- Mizuki Koyama
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
| | - Tomoo Yamazaki
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
| | - Satoru Joshita
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
| | - Akihiro Ito
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
| | - Kazuyuki Ono
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
| | - Takayuki Watanabe
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
| | - Yuki Yamashita
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
| | - Ayumi Sugiura
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
| | - Mikiko Kobayashi
- Department of Pathology, Shinshu University School of Medicine, Japan
| | - Yoshinori Sato
- Department of Pathology, Shinshu University School of Medicine, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Japan
| | - Takeji Umemura
- Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan
- Department of Life Innovation, Institute for Biomedical Sciences, Shinshu University, Japan
| |
Collapse
|
14
|
Mechanism of Cross-Species Transmission, Adaptive Evolution and Pathogenesis of Hepatitis E Virus. Viruses 2021; 13:v13050909. [PMID: 34069006 PMCID: PMC8157021 DOI: 10.3390/v13050909] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 12/17/2022] Open
Abstract
Hepatitis E virus (HEV) is the leading cause of acute hepatitis worldwide. While the transmission in developing countries is dominated by fecal-oral route via drinking contaminated water, the zoonotic transmission is the major route of HEV infection in industrialized countries. The discovery of new HEV strains in a growing number of animal species poses a risk to zoonotic infection. However, the exact mechanism and the determinant factors of zoonotic infection are not completely understood. This review will discuss the current knowledge on the mechanism of cross-species transmission of HEV infection, including viral determinants, such as the open reading frames (ORFs), codon usage and adaptive evolution, as well as host determinants, such as host cellular factors and the host immune status, which possibly play pivotal roles during this event. The pathogenesis of hepatitis E infection will be briefly discussed, including the special forms of this disease, including extrahepatic manifestations, chronic infection, and fulminant hepatitis in pregnant women.
Collapse
|
15
|
Nishizawa T, Takahashi M, Tsatsralt-Od B, Nyamdavaa K, Dulmaa N, Osorjin B, Tseren-Ochir EO, Sharav T, Bayasgalan C, Sukhbaatar B, Nagashima S, Murata K, Okamoto H. Identification and a full genome analysis of novel camel hepatitis E virus strains obtained from Bactrian camels in Mongolia. Virus Res 2021; 299:198355. [PMID: 33662492 DOI: 10.1016/j.virusres.2021.198355] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 12/27/2022]
Abstract
Hepatitis E virus (HEV) infects humans and a wide variety of other mammalian hosts. Recently, HEV strains belonging to genotype 8 (G8) within the Orthohepevirus A species of the Hepeviridae family, were identified in Bactrian camels (Camelus bactrianus) in China. The Bactrian camel (also known as the Mongolian camel) is native to the steppes of Central Asia. However, the HEV strains of Mongolian camels have not been examined. Among 200 serum samples from domestic Bactrian camels raised on 6 farms, in 6 soums in 3 provinces; 71 (35.5 %) were positive for anti-HEV IgG, with prevalence differing by farm (soum) (4.2-75.0 %); and 2 camels (1.0 %) that had been raised in Bogd, Bayankhongor Province, which had the highest seroprevalence among the six studied areas, were positive for HEV RNA. The two HEV strains (BcHEV-MNG140 and BcHEV-MNG146) obtained from the viremic camels in the present study shared 97.7 % nucleotide identity. They were closest to the reported G8 Chinese camel HEV strains but differed from them by 13.9-14.3 % over the entire genome, with a nucleotide difference of 24.0-26.5 % from the reported G1-G7 HEV strains. A phylogenetic tree indicated that the BcHEV-MNG140 and BcHEV-MNG146 strains were located upstream of a clade consisting of the Chinese camel HEV strains and formed a cluster with them, with a bootstrap value of 100 %, suggesting that they may represent a novel subtype within G8. These results indicate a high prevalence of HEV infection in Mongolian camels and suggest that the variability of camel HEV genomes is markedly high.
Collapse
Affiliation(s)
- Tsutomu Nishizawa
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, 329-0498, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, 329-0498, Japan
| | - Bira Tsatsralt-Od
- National Center for Communicable Diseases, Ministry of Health Mongolia, Ulaanbaatar, 210648, Mongolia
| | | | - Nyamkhuu Dulmaa
- National Center for Communicable Diseases, Ministry of Health Mongolia, Ulaanbaatar, 210648, Mongolia
| | | | - Erdene-Ochir Tseren-Ochir
- Department of Infectious Diseases and Microbiology, School of Veterinary Medicine, Mongolian University of Life Sciences, Ulaanbaatar, 17024, Mongolia
| | - Tumenjargal Sharav
- Department of Infectious Diseases and Microbiology, School of Veterinary Medicine, Mongolian University of Life Sciences, Ulaanbaatar, 17024, Mongolia
| | - Chimedtseren Bayasgalan
- Department of Infectious Diseases and Microbiology, School of Veterinary Medicine, Mongolian University of Life Sciences, Ulaanbaatar, 17024, Mongolia
| | - Boldbaatar Sukhbaatar
- Sector of Surveillance and Diagnosis of Infectious Diseases, State Central Veterinary Laboratory, Ulaanbaatar, 17024, Mongolia
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, 329-0498, Japan
| | - Kazumoto Murata
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, 329-0498, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, 329-0498, Japan.
| |
Collapse
|
16
|
Sato N, Watanabe S, Miura K, Morimoto N, Takaoka Y, Nomoto H, Isoda N, Nagashima S, Takahashi M, Okamoto H, Yamamoto H. Clinical and virologic features of hepatitis E virus infection at a university hospital in Japan between 2000 and 2019. J Med Virol 2020; 92:3572-3583. [PMID: 32609895 DOI: 10.1002/jmv.26248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/28/2020] [Indexed: 12/27/2022]
Abstract
The clinical and virologic features of hepatitis E virus (HEV) infection seem to vary among regions even in developed countries. However, we have little information on the diversity of HEV infection. Here, we investigated the characteristics of 26 patients in our hospital located in Tochigi prefecture, 90 km north of Tokyo, between 2000 and 2019. The reported number of patients with acute hepatitis E is increasing in Japan because measurement of IgA-class anti-HEV antibody was commercially available from 2011. In contrast, the numbers at our hospital were 1.5/y and 1.0/y in 2000 to 2011 and 2012 to 2019, respectively. This is attributed to the fact that we have been investigating HEV as a cause of unknown hepatitis before 2011. Among isolated HEV subgenotypes, including 3a, 3b, 4b, 4c, and 4d, all three patients with subgenotype 4c infection presented acute liver failure. Four HEV strains shared more than or equal to 99% identity within the 412-nucleotide partial sequence, in which the time and place of HEV infection varied, except for one intrafamilial infection. In addition, some strains were similar to HEV strains isolated far from Tochigi prefecture. In conclusion, the number of patients with acute hepatitis E was not increasing at Jichi Medical University Hospital and some strains were found to circulate in Japan.
Collapse
Affiliation(s)
- Naoto Sato
- Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Shunji Watanabe
- Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Kouichi Miura
- Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Naoki Morimoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yoshinari Takaoka
- Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Hiroaki Nomoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Norio Isoda
- Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Hironori Yamamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| |
Collapse
|
17
|
A Nationwide Survey of Hepatitis E Virus Infection and Chronic Hepatitis in Heart and Kidney Transplant Recipients in Japan. Transplantation 2020; 104:437-444. [PMID: 31205267 PMCID: PMC7004465 DOI: 10.1097/tp.0000000000002801] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background. Recently, chronic hepatitis E has been reported in solid organ transplant (SOT) recipients in European countries. Previously, we clarified the prevalence of hepatitis E virus (HEV) infection in Japanese liver transplant recipients and identified 2 chronic hepatitis E patients infected by blood transfusion. However, the rate of HEV infection in recipients of SOTs other than liver in Japan remains unclear, so we conducted a nationwide survey to clarify the prevalence of chronic HEV infection in Japanese heart and kidney transplant recipients. Methods. A total of 99 heart and 2526 kidney transplant recipients in 17 hospitals in Japan were examined for the presence of the IgG class of anti-HEV antibodies as well as for serum HEV RNA. Results. The prevalence of anti-HEV IgG among heart and kidney transplant recipients was 7.07% (7/99) and 4.08% (103/2526), respectively. One heart transplant patient (1.01%) and 11 kidney transplant patients (0.44%) were found to be positive for HEV RNA. The HEV isolates from all viremic patients were typed as genotype 3. Four patients developed chronic hepatitis E after transplantation. Three patients were treated with ribavirin; their liver enzymes normalized, and HEV RNA became negative immediately. Sustained virologic response was achieved in all cases. Conclusions. This is the first nationwide survey of HEV infection in Japanese heart and kidney transplant recipients. The prevalence of anti-HEV IgG and HEV RNA in heart and kidney transplant recipients in Japan was lower than that in European countries. Of note, 42% of viremic transplant patients developed chronic hepatitis.
Collapse
|
18
|
Prevalence and genotype/subtype distribution of hepatitis E virus (HEV) among wild boars in Japan: Identification of a genotype 5 HEV strain. Virus Res 2020; 287:198106. [PMID: 32777387 DOI: 10.1016/j.virusres.2020.198106] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023]
Abstract
To further investigate the prevalence of hepatitis E virus (HEV) infection and characterize HEV genomes among Japanese wild boars (Sus scrofa leucomystax), 1880 boars captured in 17 prefectures in Japan from 2013 to 2019 were studied. Overall, anti-HEV IgG was detected in 8.9 % and HEV RNA was detected in 3.9 % of boars, which was comparable with our previous studies during 2003-2013 (10.3 % and 3.5 %, respectively). Among 74 boar HEV strains obtained from infected boars in the present study, 50 (68 %) were classified into genotype 3 (3a and 3b), 23 (31 %) were classified into genotype 4 (4i), and the remaining strain (wbJGF_19-1) was classified into genotype 5. The wbGF_19-1 strain shared 92.7 % identity over the entire genome with the prototype genotype 5 strain (JBOAR135-Shiz09). The identification of the second genotype 5 HEV strain in a place that is located only 100 km from the site at which JBOAR135-Shiz09 was identified, suggests that genotype 5 HEV circulates within a relatively close range in Japan. Genetically similar HEV strains forming a clade were identified from wild boars living in each area during the observation period of 11-13 years, although the nucleotide sequence changed gradually, accounting for up to 3.4-3.6 % within the 412-nucleotide ORF2 sequence. Eight groups of boars with a cluster of HEV infections were observed, consisting of two, three or four infected offspring, presumably born to the same mother or offspring with their mother. These results suggest that wild boars continue to be important reservoirs for HEV infection in humans in Japan.
Collapse
|
19
|
Kitaura S, Wakabayashi Y, Okazaki A, Okada Y, Okamoto K, Ikeda M, Okugawa S, Moriya K. The First Case Report of Acute Symptomatic HEV Genotype 4 Infection in an HIV-positive Patient in Japan. Intern Med 2020; 59:1655-1658. [PMID: 32269193 PMCID: PMC7402963 DOI: 10.2169/internalmedicine.4505-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hepatitis E virus (HEV) is a common cause of acute hepatitis. Four major genotypes of HEV have been studied, with genotype 4 being the predominant genotype across Asia. We herein describe the case of a 50-year-old man with a history of human immunodeficiency virus (HIV) infection who was admitted with acute transaminitis. Serum anti-HEV-IgA and HEV-RNA were detected at the time of presentation and further testing revealed HEV genotype 4. To the best of our knowledge, this represents the first clinical case report of acute symptomatic HEV genotype 4 infection in an HIV-positive patient in Japan.
Collapse
Affiliation(s)
- Satoshi Kitaura
- Department of Infectious Diseases, The University of Tokyo Hospital, Japan
| | - Yoshitaka Wakabayashi
- Department of Infectious Diseases, The University of Tokyo Hospital, Japan
- Department of Internal Medicine, Teikyo University, Japan
| | - Aiko Okazaki
- Department of Infectious Diseases, The University of Tokyo Hospital, Japan
| | - Yuta Okada
- Department of Infectious Diseases, The University of Tokyo Hospital, Japan
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Japan
| | - Mahoko Ikeda
- Department of Infection Control and Prevention, The University of Tokyo, Japan
| | - Shu Okugawa
- Department of Infectious Diseases, The University of Tokyo Hospital, Japan
| | - Kyoji Moriya
- Department of Infectious Diseases, The University of Tokyo Hospital, Japan
- Department of Infection Control and Prevention, The University of Tokyo, Japan
| |
Collapse
|
20
|
Sooryanarain H, Meng XJ. Swine hepatitis E virus: Cross-species infection, pork safety and chronic infection. Virus Res 2020; 284:197985. [PMID: 32333941 DOI: 10.1016/j.virusres.2020.197985] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/11/2020] [Accepted: 04/17/2020] [Indexed: 12/12/2022]
Abstract
Swine hepatitis E virus (swine HEV) belongs to the species Orthohepevirus A within the genus Orthohepevirus in the family Hepeviridae. Four different genotypes of swine HEV within the species Orthohepevirus A have been identified so far from domesticated and wild swine population: genotypes 3 (HEV-3) and 4 (HEV-4) swine HEVs are zoonotic and infect humans, whereas HEV-5 and HEV-6 are only identified from swine. As a zoonotic agent, swine HEV is an emerging public health concern in many industrialized countries. Pigs are natural reservoir for HEV, consumption of raw or undercooked pork is an important route of foodborne HEV transmission. Occupational risks such as direct contact with infected pigs also increase the risk of HEV transmission in humans. Cross-species infection of HEV-3 and HEV-4 have been documented under experimental and natural conditions. Both swine HEV-3 and swine HEV-4 infect non-human primates, the surrogates of man. Swine HEV, predominantly HEV-3, can establish chronic infection in immunocompromised patients especially in solid organ transplant recipients. The zoonotic HEV-3, and to lesser extent HEV-4, have also been shown to cause neurological diseases and kidney injury. In this review, we focus on the epidemiology of swine HEV, host and viral determinants influencing cross-species HEV infection, zoonotic infection and its associated pork safety concern, as well as swine HEV-associated chronic infection and neurological diseases.
Collapse
Affiliation(s)
- Harini Sooryanarain
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Xiang-Jin Meng
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
| |
Collapse
|
21
|
Takaoka Y, Morimoto N, Miura K, Nomoto H, Watanabe S, Tsukui M, Maeda H, Goka R, Isoda N, Muroi K, Yamamoto H. A case of acute hepatitis E caused by HEV-contaminated blood transfusion in a patient with anti-HEV IgG. ACTA ACUST UNITED AC 2020. [DOI: 10.2957/kanzo.61.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yoshinari Takaoka
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Naoki Morimoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Kouichi Miura
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Hiroaki Nomoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Shunji Watanabe
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Mamiko Tsukui
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Hiroshi Maeda
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Rie Goka
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Norio Isoda
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| | - Kazuo Muroi
- Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital
| | - Hironori Yamamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University
| |
Collapse
|
22
|
|
23
|
Tsoi WC, Zhu X, To APC, Holmberg J. Hepatitis E virus infection in Hong Kong blood donors. Vox Sang 2019; 115:11-17. [PMID: 31709559 DOI: 10.1111/vox.12846] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVES In Hong Kong, the dominant circulating hepatitis E virus (HEV) genotype is type 4, which can cause more severe clinical consequences than type 3. The aim of this study was to determine the HEV prevalence in Hong Kong blood donors. MATERIALS AND METHODS Unlinked donation samples (n = 10 000) collected in March to May 2015 were tested for HEV RNA using the Procleix HEV assay in an individual donation format (IDT). A subset of 2000 samples were tested for IgG and IgM anti-HEV using the Wantai enzyme-linked immunosorbent assay (ELISA). Nucleic acid testing (NAT) initial reactive results were retested once, and repeatedly reactive donations were subjected to alternative molecular procedures as confirmation tests. RESULTS One in 5000 Hong Kong blood donors was positive for HEV RNA (0·02%). The two RNA positive samples were also IgG and IgM anti-HEV positive. One of the two RNA positive donors could be sequenced revealing genotype type 4. Anti-HEV seroprevalence was estimated as 15·5% among all donors. IgG anti-HEV positive rate for age group 16-20 was 3·1%, and it increased with age to 43·1% for age group 51-60. Sero-positivity was higher in males (male donors 18·1% vs. female donors 13·2%), but it was mostly due to the difference in a specific age group (41-50). CONCLUSION Hepatitis E virus RNA positive rate of 0·02% was within the reported range of HEV RNA frequency in developed countries. One donor was confirmed to be genotype 4, which is the dominant genotype in circulation in Hong Kong.
Collapse
Affiliation(s)
- Wai-Chiu Tsoi
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - Xiaomei Zhu
- Grifols Diagnostic Solutions Inc, Emeryville, CA, USA
| | - Amanda Pui-Chi To
- Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong, China
| | | |
Collapse
|
24
|
Nakano T, Okano H, Takahashi M, Nagashima S, Shiraki K, Oya Y, Inoue H, Ohmori S, Tsukimoto M, Ishida S, Fujimoto S, Kobayashi M, Yamawaki M, Kumagai M, Ninomiya J, Maegawa T, Kojima Y, Araki J, Hamaoka S, Horiike S, Yoshimura H, Takeuchi K, Itoh K, Akachi S, Uraki S, Yamamoto N, Ogura S, Sugimoto K, Yoshikawa K, Hasegawa H, Iwasa M, Takei Y, Okamoto H. Changing clinical and molecular characteristics of hepatitis E virus infection in Mie Prefecture, Japan: Disappearance of indigenous subtype 3e strains. Hepatol Res 2019; 49:1003-1014. [PMID: 31026368 DOI: 10.1111/hepr.13357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/09/2019] [Accepted: 04/19/2019] [Indexed: 02/08/2023]
Abstract
AIM To evaluate the clinical and molecular characteristics of hepatitis E virus (HEV) infection in Mie Prefecture, Japan, from 2004 through 2018. METHODS The clinical information of hepatitis E cases was collected from 21 medical institutions in Mie Prefecture. The nucleotide sequences of infecting HEV strains were determined for cases with available serum samples. The origins or transmission routes were inferred from phylogenetic analyses of the nucleotide sequences. RESULTS Fifty-three patients were diagnosed with HEV infection. The number of cases increased each year through 2012 and then decreased. Analyses of the clinical characteristics of the cases indicated that even mild cases were detected in the latter 10 years of the study. Nucleotide sequence analyses were undertaken on 38 of the 53 cases. The HEV subtype 3e (HEV-3e) strains identified for 13 cases were closely related to a swine HEV-3e strain that was isolated from the liver of a pig bred in Mie Prefecture. The number of cases infected with the indigenous Mie HEV-3e strains increased until 2012 but have not been reported since 2014. In the latter half of the study, cases involving various HEV strains of different genotypes and subtypes emerged. CONCLUSIONS The disappearance of indigenous Mie HEV-3e strains appeared to be the primary cause for the decrease in hepatitis E cases in Mie Prefecture. The disappearance might have been associated with improved hygienic conditions on pig farms or the closure of contaminated farms. The results suggest that indigenous HEV strains can be eradicated by appropriate management.
Collapse
Affiliation(s)
- Tatsunori Nakano
- Department of Internal Medicine, Fujita Health University Nanakuri Memorial Hospital, Mie, Japan
| | - Hiroshi Okano
- Department of Gastroenterology, Suzuka General Hospital, Mie, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Katsuya Shiraki
- Department of Gastroenterology, Mie Prefectural General Medical Center, Mie, Japan
| | - Yumi Oya
- Department of Gastroenterology, Mie Prefectural General Medical Center, Mie, Japan
| | - Hidekazu Inoue
- Department of Gastroenterology, Mie Prefectural General Medical Center, Mie, Japan
| | - Shigeru Ohmori
- Department of Gastroenterology, Kuwana City Medical Center, Mie, Japan
| | - Mone Tsukimoto
- Department of Gastroenterology, Kuwana City Medical Center, Mie, Japan
| | - Satoshi Ishida
- Department of Gastroenterology, Kuwana City Medical Center, Mie, Japan
| | - Shino Fujimoto
- Department of Gastroenterology, Kuwana City Medical Center, Mie, Japan
| | - Makoto Kobayashi
- Department of Gastroenterology, Yokkaichi Municipal Hospital, Mie, Japan
| | - Makoto Yamawaki
- Department of Gastroenterology, Yokkaichi Municipal Hospital, Mie, Japan
| | - Masanari Kumagai
- Department of Gastroenterology, Yokkaichi Municipal Hospital, Mie, Japan
| | - Jun Ninomiya
- Department of Gastroenterology, Yokkaichi Municipal Hospital, Mie, Japan
| | - Tadashi Maegawa
- Department of Gastroenterology, Yokkaichi Municipal Hospital, Mie, Japan
| | - Yuji Kojima
- Department of Hepatology, Ise Red Cross Hospital, Mie, Japan
| | - Jun Araki
- Department of Hepatology, Ise Red Cross Hospital, Mie, Japan
| | - Shima Hamaoka
- Department of Hepatology, Ise Red Cross Hospital, Mie, Japan
| | - Shinichiro Horiike
- Department of Internal Medicine, Suzuka Kaisei Hospital, Suzuka, Mie, Japan
| | | | - Keisuke Takeuchi
- Department of Gastroenterology, Mie Chuo Medical Center, Mie, Japan
| | - Keiichi Itoh
- Department of Gastroenterology, Mie Prefectural Shima Hospital, Mie, Japan
| | - Shigehiro Akachi
- Mie Prefectural Institute of Public Health and Environmental Sciences, Mie, Japan
| | - Satoko Uraki
- Department of Internal Medicine, Sakakibara Onsen Hospital, Mie, Japan.,Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan
| | - Norihiko Yamamoto
- Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan.,Department of Hepatology, Tohyama Hospital, Mie, Japan
| | - Suguru Ogura
- Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan
| | - Kazushi Sugimoto
- Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan
| | - Kyoko Yoshikawa
- Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan
| | - Hiroshi Hasegawa
- Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan
| | - Yoshiyuki Takei
- Department of Gastroenterology and Hepatology, Mie University School of Medicine, Mie, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| |
Collapse
|
25
|
Murata K, Kang JH, Nagashima S, Matsui T, Karino Y, Yamamoto Y, Atarashi T, Oohara M, Uebayashi M, Sakata H, Matsubayashi K, Takahashi K, Arai M, Mishiro S, Sugiyama M, Mizokami M, Okamoto H. IFN-λ3 as a host immune response in acute hepatitis E virus infection. Cytokine 2019; 125:154816. [PMID: 31465972 DOI: 10.1016/j.cyto.2019.154816] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 07/31/2019] [Accepted: 08/19/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM Hepatitis E virus (HEV) is mainly transmitted orally, either waterborne or zoonotic foodborne. Intestinal viruses such as rotavirus are known to induce type III interferon (IFN) in the gastrointestinal (GI) tract where type III IFN dominantly functions in comparison with type I IFN. Therefore, the aim of this study is to investigate the significance of type III IFN (IFN-λ3) in acute hepatitis E. METHODS IFN-λ3 and HEV RNA levels in the sera of patients with acute HEV infection and in the supernatant of HEV-inoculated cells were measured, using an in-house high-sensitivity method and reverse transcription-polymerase chain reaction, respectively. RESULTS High serum IFN-λ3 levels were found in the early phase of acute HEV infection, which normalized after resolution. Interestingly, serum IFN-λ3 levels correlated well with serum HEV RNA titers in the same sera, both of which showed the peak before the robust increase of transaminases. In vitro experiments demonstrated that HEV replicated well in the cells with little IFN-λ3 induction (Caco-2, A549) and recombinant IFN-λ3 inhibited HEV replication in a dose-dependent manner. In contrast, in HT-29 cells, a colon cancer cell line, HEV poorly replicated and induced IFN-λ3 in a titer-dependent manner. CONCLUSIONS These clinical and experimental observations suggest that HEV induced IFN-λ3 as a host innate immune response, which may play a protective role against HEV.
Collapse
Affiliation(s)
- Kazumoto Murata
- Department of Gastroenterology, Graduate School of Medical Sciences, International University of Health and Welfare, Nasushiobara, Japan; Genome Medical Science Project, National Center for Global Health and Medicine, Ichikawa, Japan.
| | - Jong-Hon Kang
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Takeshi Matsui
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yoshiyasu Karino
- Department of Hepatology, Sapporo Kosei General Hospital, Sapporo, Japan
| | - Yoshiya Yamamoto
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Tomofumi Atarashi
- Department of Gastroenterology, Obihiro Kosei Hospital, Obihiro, Japan
| | - Masatsugu Oohara
- Department of Gastroenterology and Oncology, Kitami Red Cross Hospital, Kitami, Japan
| | - Minoru Uebayashi
- Department of Gastroenterology and Oncology, Kitami Red Cross Hospital, Kitami, Japan
| | | | - Keiji Matsubayashi
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Kazuaki Takahashi
- Department of Medical Sciences, Tokyo Shinagawa Hospital, Tokyo, Japan
| | - Masahiro Arai
- Department of Medical Sciences, Tokyo Shinagawa Hospital, Tokyo, Japan
| | - Shunji Mishiro
- Department of Medical Sciences, Tokyo Shinagawa Hospital, Tokyo, Japan
| | - Masaya Sugiyama
- Genome Medical Science Project, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Masashi Mizokami
- Genome Medical Science Project, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| |
Collapse
|
26
|
Kadohira M, Phiri BJ, Hill G, Yoshizaki R, Takai S. Game Meat Consumption and Foodborne Illness in Japan: A Web-Based Questionnaire Survey. J Food Prot 2019; 82:1224-1232. [PMID: 31233358 DOI: 10.4315/0362-028x.jfp-18-502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
HIGHLIGHTS Game meat represents a unique source of foodborne illness in humans. A Web-based survey about game meat consumption was completed by 50,000 respondents. The odds of illness were greater among consumers of raw game meat than processed meat. The greater the number of game meat types consumed, the higher the prevalence of illness. Those who hunted and prepared bear, boar, and deer meat were likely to get ill.
Collapse
Affiliation(s)
- Mutsuyo Kadohira
- 1 Obihiro University of Agriculture and Veterinary Medicine, Inada-cho Nishi 2-11, Obihiro 080-8555, Japan (ORCID: https://orcid.org/0000-0002-1473-9864 [G.H.])
| | - Bernard J Phiri
- 2 Biosecurity Surveillance and Incursion Investigation Team, Ministry for Primary Industries, P.O. Box 40742, 66 Ward Street, Upper Hutt 5140, New Zealand (ORCID: https://orcid.org/0000-0003-1768-6048 [B.J.P.])
| | - Glen Hill
- 1 Obihiro University of Agriculture and Veterinary Medicine, Inada-cho Nishi 2-11, Obihiro 080-8555, Japan (ORCID: https://orcid.org/0000-0002-1473-9864 [G.H.])
| | - Rika Yoshizaki
- 3 Technological Information Business Department, Frontier Business Division, Toray Research Center, Inc., Sonoyama 3-3-7, Otsu, Shiga 520-8567, Japan
| | - Shinji Takai
- 4 Laboratory of Animal Hygiene, School of Veterinary Medicine, Kitasato University, Higashi 23-35-1, Towada, Aomori 034-8628, Japan
| |
Collapse
|
27
|
Hoan NX, Huy PX, Sy BT, Meyer CG, Son TV, Binh MT, Giang DP, Tu Anh D, Bock CT, Wang B, Tong HV, Kremsner PG, Song LH, Toan NL, Velavan TP. High Hepatitis E virus (HEV) Positivity Among Domestic Pigs and Risk of HEV Infection of Individuals Occupationally Exposed to Pigs and Pork Meat in Hanoi, Vietnam. Open Forum Infect Dis 2019; 6:ofz306. [PMID: 31660396 PMCID: PMC6735913 DOI: 10.1093/ofid/ofz306] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 06/25/2019] [Indexed: 01/08/2023] Open
Abstract
Background Hepatitis E virus (HEV) infection can occur through consumption of undercooked pork meat or exposure to animal feces. Because there are scarce data only in developing countries, we assessed whether pigs might be a potential source of human HEV infections in Vietnam. In addition, we determined anti-HEV seroprevalences in the general population and in individuals professionally exposed to pigs and pork meat. Methods The study took place in Hanoi, Vietnam. Liver tissues from domestic pigs (n = 210) and serum samples obtained from individuals occupationally exposed to pigs and pork meat (n = 283) and from unexposed healthy controls (n = 168) were screened for HEV-ribonucleic acid (RNA) by reverse-transcription polymerase chain reaction. The exposed group was divided into pork meat vendors (n = 81), pig farmers (n = 96), and slaughterers (n = 106). Serum samples were subjected to HEV immunoglobulin (Ig)G and IgM enzyme-linked immunosorbent assays. The HEV genotypes were assessed by direct sequencing, followed by phylogenetic analyses. Results Hepatitis E virus seroprevalence was higher among persons occupationally exposed to pigs/pork meat compared with unexposed individuals (anti-HEV IgM 11% vs 6%, P = .07; anti-HEV IgG 53% vs 31%, P < .0001). Positivity of anti-HEV IgG among slaughterhouse staff was 66%, followed by 51% in pig-farmers and 38% in pork meat vendors (P = .00073). A similar trend was observed for IgM positivity. Of the pig liver tissues, 26 of 210 (12.4%) were positive for HEV-RNA and assessed to be HEV genotype 3. Conclusions Hepatitis E virus circulates in domestic pigs in Hanoi and constitutes a permanent zoonotic disease risk. The high HEV seroprevalence among occupationally exposed individuals indicates an associated risk of HEV infection.
Collapse
Affiliation(s)
- Nghiem Xuan Hoan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Institute of Clinical Infectious Diseases, Hanoi, Vietnam.,Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Pham Xuan Huy
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Bui Tien Sy
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam.,Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Christian G Meyer
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Center for Medical Research, Hanoi, Vietnam.,Duy Tan University, Da Nang, Vietnam
| | - Trinh Van Son
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam.,Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Mai Thanh Binh
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Dao Phuong Giang
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam.,Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Dam Tu Anh
- Department of Immunology and Pathophysiology, Hanoi Medical University, Vietnam
| | - C-Thomas Bock
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Bo Wang
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Hoang Van Tong
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam.,Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Peter G Kremsner
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Le Huu Song
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam.,Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Nguyen Linh Toan
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam.,Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Center for Medical Research, Hanoi, Vietnam.,Duy Tan University, Da Nang, Vietnam
| |
Collapse
|
28
|
Primadharsini PP, Nagashima S, Okamoto H. Genetic Variability and Evolution of Hepatitis E Virus. Viruses 2019; 11:v11050456. [PMID: 31109076 PMCID: PMC6563261 DOI: 10.3390/v11050456] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 12/16/2022] Open
Abstract
Hepatitis E virus (HEV) is a single-stranded positive-sense RNA virus. HEV can cause both acute and chronic hepatitis, with the latter usually occurring in immunocompromised patients. Modes of transmission range from the classic fecal–oral route or zoonotic route, to relatively recently recognized but increasingly common routes, such as via the transfusion of blood products or organ transplantation. Extrahepatic manifestations, such as neurological, kidney and hematological abnormalities, have been documented in some limited cases, typically in patients with immune suppression. HEV has demonstrated extensive genomic diversity and a variety of HEV strains have been identified worldwide from human populations as well as growing numbers of animal species. The genetic variability and constant evolution of HEV contribute to its physiopathogenesis and adaptation to new hosts. This review describes the recent classification of the Hepeviridae family, global genotype distribution, clinical significance of HEV genotype and genomic variability and evolution of HEV.
Collapse
Affiliation(s)
- Putu Prathiwi Primadharsini
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi 329-0498, Japan.
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi 329-0498, Japan.
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi 329-0498, Japan.
| |
Collapse
|
29
|
Geng Y, Zhao C, Guo T, Xu Y, Wang X, Huang W, Liu H, Wang Y. Detection of Hepatitis E Virus in Raw Pork and Pig Viscera As Food in Hebei Province of China. Foodborne Pathog Dis 2019; 16:325-330. [DOI: 10.1089/fpd.2018.2572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Yansheng Geng
- Health Science Center, Hebei University, Baoding, China
| | - Chenyan Zhao
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Tingyu Guo
- Health Science Center, Hebei University, Baoding, China
| | - Ying Xu
- Health Science Center, Hebei University, Baoding, China
| | - Xuanpu Wang
- Health Science Center, Hebei University, Baoding, China
| | - Weijin Huang
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Huan Liu
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Youchun Wang
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| |
Collapse
|
30
|
Yugo DM, Cossaboom CM, Heffron CL, Huang YW, Kenney SP, Woolums AR, Hurley DJ, Opriessnig T, Li L, Delwart E, Kanevsky I, Meng XJ. Evidence for an unknown agent antigenically related to the hepatitis E virus in dairy cows in the United States. J Med Virol 2018; 91:677-686. [PMID: 30318625 DOI: 10.1002/jmv.25339] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/11/2018] [Indexed: 01/31/2023]
Abstract
Genotypes 3 and 4 hepatitis E virus (HEV) strains within the species Orthohepevirus A in the family Hepeviridae are zoonotic. Recently, a genotype 4 HEV was reportedly detected in fecal samples of cows, although independent confirmation is lacking. In this study, we first tested serum samples from 983 cows in different regions in the United States for the presence of immunoglobulin G (IgG) anti-HEV and found that 20.4% of cows were seropositive. The highest seroprevalence rate (68.4%) was from a herd in Georgia. In an attempt to genetically identify HEV in cattle, a prospective study was conducted in a known seropositive dairy herd by monitoring 10 newborn calves from birth to 6 months of age for evidence of HEV infection. At least 3 of the 10 calves seroconverted to IgG anti-HEV, and importantly the antibodies presented neutralized genotype 3 human HEV, thus, indicating the specificity of IgG anti-HEV in the cattle. However, our extensive attempts to identify HEV-related sequences in cattle using broad-spectrum reverse transcription-polymerase chain reaction assays and MiSeq deep-sequencing technology failed. The results suggest the existence of an agent antigenically related to HEV in cattle, although, contrary to published reports, we showed that the IgG recognizing HEV in cattle was not caused by HEV infection.
Collapse
Affiliation(s)
- Danielle M Yugo
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Caitlin M Cossaboom
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Connie Lynn Heffron
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Yao-Wei Huang
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Scott P Kenney
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Amelia R Woolums
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Starkville, Mississippi
| | - David J Hurley
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Tanja Opriessnig
- Division of Infection and Immunity, The Roslin Institute, University of Edinburgh, Midlothian, UK
| | - Linlin Li
- Department of Laboratory Medicine, Blood Systems Research Institute, San Francisco, California
| | - Eric Delwart
- Department of Laboratory Medicine, Blood Systems Research Institute, San Francisco, California
| | - Isis Kanevsky
- Department of Dairy Sciences, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Xiang-Jin Meng
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| |
Collapse
|
31
|
King NJ, Hewitt J, Perchec-Merien AM. Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries. FOOD AND ENVIRONMENTAL VIROLOGY 2018; 10:225-252. [PMID: 29623595 DOI: 10.1007/s12560-018-9342-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
Historically in developed countries, reported hepatitis E cases were typically travellers returning from countries where hepatitis E virus (HEV) is endemic, but now there are increasing numbers of non-travel-related ("autochthonous") cases being reported. Data for HEV in New Zealand remain limited and the transmission routes unproven. We critically reviewed the scientific evidence supporting HEV transmission routes in other developed countries to inform how people in New Zealand may be exposed to this virus. A substantial body of indirect evidence shows domesticated pigs are a source of zoonotic human HEV infection, but there is an information bias towards this established reservoir. The increasing range of animals in which HEV has been detected makes it important to consider other possible animal reservoirs of HEV genotypes that can or could infect humans. Foodborne transmission of HEV from swine and deer products has been proven, and a large body of indirect evidence (e.g. food surveys, epidemiological studies and phylogenetic analyses) support pig products as vehicles of HEV infection. Scarce data from other foods suggest we are neglecting other potential sources of foodborne HEV infection. Moreover, other transmission routes are scarcely investigated in developed countries; the role of infected food handlers, person-to-person transmission via the faecal-oral route, and waterborne transmission from recreational contact or drinking untreated or inadequately treated water. People have become symptomatic after receiving transfusions of HEV-contaminated blood, but it is unclear how important this is in the overall hepatitis E disease burden. There is need for broader research efforts to support establishing risk-based controls.
Collapse
Affiliation(s)
- Nicola J King
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand
| | - Joanne Hewitt
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand.
| | - Anne-Marie Perchec-Merien
- New Zealand Ministry for Primary Industries, Pastoral House, 25 The Terrace, Wellington, New Zealand
| |
Collapse
|
32
|
Tanggis, Kobayashi T, Takahashi M, Jirintai S, Nishizawa T, Nagashima S, Nishiyama T, Kunita S, Hayama E, Tanaka T, Mulyanto, Okamoto H. An analysis of two open reading frames (ORF3 and ORF4) of rat hepatitis E virus genome using its infectious cDNA clones with mutations in ORF3 or ORF4. Virus Res 2018; 249:16-30. [DOI: 10.1016/j.virusres.2018.02.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/14/2018] [Accepted: 02/14/2018] [Indexed: 01/13/2023]
|
33
|
Sasaki Y, Haruna M, Uema M, Noda M, Yamada Y. Prevalence and Phylogenetic Analysis of Hepatitis E Virus among Pigs in Japan. Jpn J Infect Dis 2018; 71:75-78. [DOI: 10.7883/yoken.jjid.2017.235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Yoshimasa Sasaki
- Food Safety and Consumer Affairs Bureau, Ministry of Agriculture, Forestry and Fisheries
- Division of Biomedical Food Research, National Institute of Health Sciences
| | - Mika Haruna
- Food Safety and Consumer Affairs Bureau, Ministry of Agriculture, Forestry and Fisheries
| | - Masashi Uema
- Division of Biomedical Food Research, National Institute of Health Sciences
| | - Mamoru Noda
- Division of Biomedical Food Research, National Institute of Health Sciences
| | - Yukiko Yamada
- Food Safety and Consumer Affairs Bureau, Ministry of Agriculture, Forestry and Fisheries
| |
Collapse
|
34
|
Shimata K, Sugawara Y, Yamamoto H, Okamoto H, Uchida K, Kawabata S, Isono K, Hayashida S, Inomata Y. A Case Report of Living Donor Liver Transplantation for Fulminant Hepatitis Related to Hepatitis E Virus Infection. Prog Transplant 2017; 28:91-92. [PMID: 29226766 DOI: 10.1177/1526924817746912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hepatitis E virus (HEV) infection which may become fulminant, especially in elderly people is more common than previously recognized in develop countries. Here we report successful living-donor liver transplantation (LDLT) in a case of acute liver failure due to HEV. A 63-year-old Japanese man with no previous history of liver disease was admitted for severe acute hepatitis. Detection of anti-HEV immunoglobulin A established a diagnosis of this virus-related liver failure. The patient suffered from hepatic encephalopathy 10 days after symptom onset and underwent LDLT. The patient had an uneventful course. The HEV RNA showed spontaneous negative conversion 10 weeks after LDLT. LDLT led to a successful outcome in a patient with acute liver failure due to HEV infection and regular testing for HEV RNA should be performed until HEV RNA is undetectable.
Collapse
Affiliation(s)
- Keita Shimata
- 1 Department of Transplantation and Pediatric Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Yasuhiko Sugawara
- 1 Department of Transplantation and Pediatric Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Hidekazu Yamamoto
- 1 Department of Transplantation and Pediatric Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Hiroaki Okamoto
- 2 Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Koushi Uchida
- 1 Department of Transplantation and Pediatric Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Seiichi Kawabata
- 1 Department of Transplantation and Pediatric Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Kaori Isono
- 1 Department of Transplantation and Pediatric Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Shintaro Hayashida
- 1 Department of Transplantation and Pediatric Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Yukihiro Inomata
- 1 Department of Transplantation and Pediatric Surgery, Kumamoto University, Chuo-ku, Kumamoto, Japan
| |
Collapse
|
35
|
Nishizawa T, Primadharsini PP, Namikawa M, Yamazaki Y, Uraki S, Okano H, Horiike S, Nakano T, Takaki S, Kawakami M, Nagashima S, Takahashi M, Okamoto H. Full-length genomic sequences of new subtype 1g hepatitis E virus strains obtained from four patients with imported or autochthonous acute hepatitis E in Japan. INFECTION GENETICS AND EVOLUTION 2017; 55:343-349. [PMID: 28987806 DOI: 10.1016/j.meegid.2017.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/16/2017] [Accepted: 10/04/2017] [Indexed: 12/27/2022]
Abstract
Hepatitis E virus (HEV) causes acute or chronic hepatitis in humans worldwide and can be transmitted via the fecal-oral route. Four HEV strains (HE-JA14-2173, HE-JA15-1335, HE-JA15-1920 and HE-JA16-0610) obtained from patients with imported (from Pakistan or India) or autochthonous acute hepatitis E in Japan were most closely related to the Nepalese and Mongolian genotype 1 HEV strains of unassigned subtype within the partial ORF2 sequence. To investigate whether a putative novel subtype (1g) of genotype 1 can be assigned, full-length genomic sequences were determined for the four HEV strains. They shared 95.4-99.2% nucleotide identity over the entire genome, and differed by 6.3-11.7% from the reported HEV strains of subtypes 1a-1f and by only 0.6-4.7% from a Mongolian genotype 1 HEV strain (MNE15-072) of unassigned subtype. A phylogenetic analysis showed that the four HEV strains obtained in the present study formed a cluster with MNE15-072, with a bootstrap value of 100%. Although the p-distance between subtypes 1a and 1f was 0.048-0.083, these five strains showed a higher nucleotide p-distance value of 0.068-0.138 with the genotype 1 HEV strains of subtypes 1a-1f. A BLAST search revealed the presence of candidate members of subtype 1g HEV in at least five other countries, including France, Israel, the Netherlands, Portugal, and the UK, sharing identities of 95.4-99.6% with the HE-JA16-0610 strain within the common sequence of 294-867 nucleotides. These results support the assignment of a new subtype 1g within genotype 1 and suggest a global distribution of subtype 1g strains. Subtype 1g strains found in Europe can be imported from Asia. Further studies are needed to confirm the global distribution of HEV subtype 1g.
Collapse
Affiliation(s)
- Tsutomu Nishizawa
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi 329-0498, Japan
| | - Putu Prathiwi Primadharsini
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi 329-0498, Japan
| | - Masashi Namikawa
- Department of Internal Medicine, Kiryu Kosei General Hospital, Kiryu, Gunma 376-0024, Japan
| | - Yuichi Yamazaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Satoko Uraki
- Department of Gastroenterology and Hepatology, Mie University School of Medicine, Tsu, Mie 514-8507, Japan; Department of Internal Medicine, Sakakibara Onsen Hospital, Tsu, Mie 514-1293, Japan
| | - Hiroshi Okano
- Department of Gastroenterology, Suzuka General Hospital, Suzuka, Mie 513-8630, Japan
| | - Shinichiro Horiike
- Department of Internal Medicine, Suzuka Kaisei Hospital, Suzuka, Mie 513-8505, Japan
| | - Tatsunori Nakano
- Department of Internal Medicine, Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie 514-1295, Japan
| | - Shintaro Takaki
- Department of Gastroenterology/Liver Center, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Hiroshima 730-8619, Japan
| | - Manri Kawakami
- Department of Internal Medicine/Liver Disease Center, Okayama Saiseikai General Hospital, Okayama, Okayama 700-8511, Japan
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi 329-0498, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi 329-0498, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi 329-0498, Japan.
| |
Collapse
|
36
|
Full-length genome of a novel genotype 3 hepatitis E virus strain obtained from domestic pigs in Japan. Virus Res 2017; 240:147-153. [DOI: 10.1016/j.virusres.2017.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 12/27/2022]
|
37
|
Abstract
Hepatitis E virus (HEV) is a globally important pathogen of acute and chronic hepatitis in humans. The HEV ORF1 gene encodes a nonstructural polyprotein, essential for RNA replication and virus infectivity. Expression and processing of ORF1 polyprotein are shown in prokaryotic and eukaryotic systems, however, its proteolysis into individual proteins is still debated. While molecular or biochemical characterization of methyltransferase, protease, hypervariable region, helicase and RNA polymerase domains in ORF1 has been achieved, the role of the X and Y domains in the HEV life cycle has only been demonstrated very recently. Clinically, detection of a number of ORF1 mutants in infected patients is implicated in disease severity, mortality and drug nonresponse. Moreover, several artificial lethal mutations in ORF1 offer a potential basis for developing live-attenuated vaccines for HEV. This article intends to present the molecular and clinical updates on the HEV ORF1 polyprotein.
Collapse
Affiliation(s)
- Mohammad Khalid Parvez
- Department of Pharmacognosy, King Saud University College of Pharmacy, Riyadh 11451, Saudi Arabia
| |
Collapse
|
38
|
Suzuki K, Kumagai I, Yoshida Y, Miyasaka A, Takikawa Y, Kamiya R, Kondo K, Kato A, Chiba T, Okamoto H. Asymptomatic acute hepatitis E in a female patient with ulcerative colitis. Clin J Gastroenterol 2017; 10:255-260. [PMID: 28353200 DOI: 10.1007/s12328-017-0730-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/02/2017] [Indexed: 02/05/2023]
Abstract
We present a 60-year-old female patient with asymptomatic acute hepatitis E that was fortuitously detected during the course of ulcerative colitis (UC). She was admitted to hospital on October 30, 2015. Endoscopy and histological examination of the colon showed typical findings of UC. All parameters of liver function tests were normal on this date. Combination therapy with oral prednisolone and mesalazine was started and intravenous administration of infliximab once every 8 weeks was added later. Her symptoms gradually improved after these treatments, and she was discharged on February 7, 2016. In a periodic check-up on July 7, 2016, high levels of serum transaminases were detected in liver function tests. Although drug-induced liver injury was first suspected, anti-hepatitis E virus (HEV) immunoglobulin A was positive. The genotype and subgenotype of this HEV are 3 and 3a, respectively, although the infectious route of the HEV was unclear. Within 2 weeks after the onset of acute liver injury, the HEV viremia disappeared and her liver function tests improved. Examination of serum anti-HEV immunoglobulin A should be added at the time of abnormal liver function tests in patients with UC receiving immunosuppressive and biological drugs.
Collapse
Affiliation(s)
- Kazuyuki Suzuki
- Department of Nutritional Science, Morioka University, 808 Sunakomi, Takizawa, Iwate, 020-0694, Japan.
- Department of Gastroenterology, Morioka City Hospital, 5-15-1 Motomiya, Morioka, Iwate, 020-0866, Japan.
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
| | - Ichiro Kumagai
- Department of Gastroenterology, Morioka City Hospital, 5-15-1 Motomiya, Morioka, Iwate, 020-0866, Japan
| | - Yuichi Yoshida
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Akio Miyasaka
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Yasuhiro Takikawa
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Ryoichi Kamiya
- Department of Gastroenterology, Morioka City Hospital, 5-15-1 Motomiya, Morioka, Iwate, 020-0866, Japan
| | - Kouryo Kondo
- Department of Gastroenterology, Morioka City Hospital, 5-15-1 Motomiya, Morioka, Iwate, 020-0866, Japan
| | - Akinobu Kato
- Department of Gastroenterology, Morioka City Hospital, 5-15-1 Motomiya, Morioka, Iwate, 020-0866, Japan
| | - Toshimi Chiba
- Division of Internal Medicine, Department of Oral Medicine, Iwate Medical University School of Dentistry, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| |
Collapse
|
39
|
Yamazaki Y, Naganuma A, Arai Y, Takeuchi S, Kobayashi T, Takakusagi S, Hatanaka T, Hoshino T, Namikawa M, Hashizume H, Takizawa D, Ohyama T, Suzuki H, Horiguchi N, Takagi H, Sato K, Kakizaki S, Kusano M, Nagashima S, Takahashi M, Okamoto H, Yamada M. Clinical and virological features of acute hepatitis E in Gunma prefecture, Japan between 2004 and 2015. Hepatol Res 2017; 47:435-445. [PMID: 27322051 DOI: 10.1111/hepr.12765] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the clinical and virological features of acute hepatitis E (AH-E) in Gunma prefecture and focus on the hepatitis E virus (HEV) infection in immunocompromised patients. METHODS A total of 30 patients with AH-E diagnosed at our Gunma University Hospital, and located in 3-39-15 Showa-machi, Maebashi, Gunma 371-8511 Japan, and its affiliated hospitals from 2004 to 2015, were studied. We evaluated the detailed medical histories, laboratory examinations and virological features of these participants. RESULTS Of the 30 patients, 21 patients were men, with a median age of 61 years. Three of these patients had a history of recent oversea travel. A total of 14 patients had eaten raw or undercooked meat/viscera from animals, and two patients had contracted transfusion-transmitted AH-E. Eight patients were immunocompromised, including those with hematological disease, cancer receiving systemic chemotherapy and kidney transplant or connective tissue disease undergoing immunosuppressive medications. The alanine aminotransferase and total bilirubin levels were more significantly reduced in these immunocompromised patients than in the non-immunocompromised patients. Severe thrombocytopenia, an extra-hepatic manifestation of AH-E, occurred in one case. Among the 22 HEV strains whose subgenotype was determined, two were imported strains (1a and 1f), and 11 strains formed four distinct phylogenetic clusters within subgenotype 3b. The remaining nine strains differed from each other by 9.8-22.4%, and were classified into four subgenotypes (3a, 3b, 3e and 3f). CONCLUSION Markedly divergent HEV strains (3a, 3b, 3e and 3f) were found to circulate in Gunma. Although immunosuppression appears to play a crucial role in establishing chronic sequels, AH-E in eight immunocompromised patients, including transfusion-transmitted HEV infection in two patients, did not become chronic.
Collapse
Affiliation(s)
- Yuichi Yamazaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Atsushi Naganuma
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.,Department of Internal Medicine, Kiryu Kosei General Hospital Kiryu, Japan
| | - Yosuke Arai
- Department of Internal Medicine, Kiryu Kosei General Hospital Kiryu, Japan
| | - Suguru Takeuchi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan.,Department of Internal Medicine, Isesaki Municipal Hospital, Isesaki, Japan
| | - Takeshi Kobayashi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Satoshi Takakusagi
- Department of Gastroenterology and Hepatology, Kusunoki Hospital Fujioka, Japan
| | - Takeshi Hatanaka
- Department of Internal Medicine, Isesaki Municipal Hospital, Isesaki, Japan
| | - Takashi Hoshino
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - Masashi Namikawa
- Department of Internal Medicine, Kiryu Kosei General Hospital Kiryu, Japan
| | - Hiroaki Hashizume
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Daichi Takizawa
- Department of Internal Medicine, Isesaki Municipal Hospital, Isesaki, Japan
| | - Tatsuya Ohyama
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hideyuki Suzuki
- Department of Internal Medicine, Haramachi Red Cross Hospital, Higashiagatsuma, Japan
| | - Norio Horiguchi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hitoshi Takagi
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.,Department of Gastroenterology and Hepatology, Kusunoki Hospital Fujioka, Japan
| | - Ken Sato
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan.,Department of Internal Medicine, Heisei Hidaka Clinic, Takasaki, Japan
| | - Satoru Kakizaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Motoyasu Kusano
- Department of Endoscopy and Endoscopic Surgery, Gunma University Hospital
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan
| |
Collapse
|
40
|
Emmoth E, Rovira J, Rajkovic A, Corcuera E, Wilches Pérez D, Dergel I, Ottoson JR, Widén F. Inactivation of Viruses and Bacteriophages as Models for Swine Hepatitis E Virus in Food Matrices. FOOD AND ENVIRONMENTAL VIROLOGY 2017; 9:20-34. [PMID: 27783334 DOI: 10.1007/s12560-016-9268-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/19/2016] [Indexed: 06/06/2023]
Abstract
Hepatitis E virus has been recognised as a food-borne virus hazard in pork products, due to its zoonotic properties. This risk can be reduced by adequate treatment of the food to inactivate food-borne viruses. We used a spectrum of viruses and bacteriophages to evaluate the effect of three food treatments: high pressure processing (HPP), lactic acid (LA) and intense light pulse (ILP) treatments. On swine liver at 400 MPa for 10 min, HPP gave log10 reductions of ≥4.2, ≥5.0 and 3.4 for feline calicivirus (FCV) 2280, FCV wildtype (wt) and murine norovirus 1 (MNV 1), respectively. Escherichia coli coliphage ϕX174 displayed a lower reduction of 1.1, while Escherichia coli coliphage MS2 was unaffected. For ham at 600 MPa, the corresponding reductions were 4.1, 4.4, 2.9, 1.7 and 1.3 log10. LA treatment at 2.2 M gave log10 reductions in the viral spectrum of 0.29-2.1 for swine liver and 0.87-3.1 for ham, with ϕX174 and MNV 1, respectively, as the most stable microorganisms. The ILP treatment gave log10 reductions of 1.6-2.8 for swine liver, 0.97-2.2 for ham and 1.3-2.3 for sausage, at 15-60 J cm-2, with MS2 as the most stable microorganism. The HPP treatment gave significantly (p < 0.05) greater virus reduction on swine liver than ham for the viruses at equivalent pressure/time combinations. For ILP treatment, reductions on swine liver were significantly (p < 0.05) greater than on ham for all microorganisms. The results presented here could be used in assessments of different strategies to protect consumers against virus contamination and in advice to food producers. Conservative model indicators for the pathogenic viruses could be suggested.
Collapse
Affiliation(s)
- Eva Emmoth
- Department of Microbiology, National Veterinary Institute (SVA), 751 89, Uppsala, Sweden.
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - Jordi Rovira
- Department of Biotechnology and Food Science, Faculty of Sciences, University of Burgos, Pza. Misael Bañuelos s/n, 09001, Burgos, Spain
| | - Andreja Rajkovic
- Laboratory of Food Microbiology and Food Preservation, Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Food2Know, Coupure Links 653, 9000, Ghent, Belgium
- Department of Food Safety and Quality Management, Faculty of Agriculture, Belgrade University, Nemanjina 6, Zemun-Belgrade, 11080, Serbia
| | - Elena Corcuera
- Department of Biotechnology and Food Science, Faculty of Sciences, University of Burgos, Pza. Misael Bañuelos s/n, 09001, Burgos, Spain
| | - Diego Wilches Pérez
- Hiperbaric España Polígono Industrial Villalonquéjar, C/Condado de Treviño, 6, 09001, Burgos, Spain
| | - Irene Dergel
- Department of Microbiology, National Veterinary Institute (SVA), 751 89, Uppsala, Sweden
| | - Jakob R Ottoson
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
- Department of Risk-Benefit Analysis, National Food Agency, Uppsala, Sweden
| | - Frederik Widén
- Department of Microbiology, National Veterinary Institute (SVA), 751 89, Uppsala, Sweden
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| |
Collapse
|
41
|
Autochthonous sporadic acute hepatitis E caused by two distinct subgenotype 3b hepatitis E virus strains with only 90% nucleotide identity. Clin J Gastroenterol 2017; 10:168-173. [PMID: 28205112 DOI: 10.1007/s12328-017-0718-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/31/2017] [Indexed: 12/18/2022]
|
42
|
Satake M, Matsubayashi K, Hoshi Y, Taira R, Furui Y, Kokudo N, Akamatsu N, Yoshizumi T, Ohkohchi N, Okamoto H, Miyoshi M, Tamura A, Fuse K, Tadokoro K. Unique clinical courses of transfusion-transmitted hepatitis E in patients with immunosuppression. Transfusion 2017; 57:280-288. [PMID: 28144952 DOI: 10.1111/trf.13994] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 11/28/2016] [Accepted: 12/01/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND The high prevalence of specific immunoglobulin G for hepatitis E virus (HEV) in Japanese people raises the possibility of a high incidence of HEV-viremic blood donors and therefore frequent transfusion-transmitted HEV (TT-HEV). STUDY DESIGN AND METHODS TT-HEV cases established in Japan through hemovigilance and those published in the literature were collected. Infectivity of HEV-contaminated blood components and disease severity in relation to immunosuppression were investigated. RESULTS Twenty established TT-HEV cases were recorded over the past 17 years. A lookback study verified that five of 10 patients transfused with known HEV-contaminated blood components acquired HEV infection. The minimal infectious dose of HEV through transfusion was 3.6 × 104 IU. Nine of the 19 TT-HEV cases analyzed had hematologic diseases. Only two cases showed the maximal alanine aminotransferase level of more than 1000 U/L. Two patients with hematologic malignancy and two liver transplant recipients had chronic liver injury of moderate severity. CONCLUSION The infectivity of HEV-contaminated components was 50%. Immunosuppression likely causes the moderate illness of TT-HEV, but it may lead to the establishment of chronic sequelae. Transfusion recipients, a population that is variably immunosuppressed, are more vulnerable to chronic liver injury as a result of TT-HEV than the general population is as a result of food-borne infection.
Collapse
Affiliation(s)
| | | | - Yuji Hoshi
- Japanese Red Cross Central Blood Institute
| | | | | | - Norihiro Kokudo
- Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Nobuhisa Akamatsu
- Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuhiro Ohkohchi
- Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Masato Miyoshi
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University
| | - Akinori Tamura
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nihon University School of Medicine.,Tamura Medical Clinic, Tokyo, Japan
| | - Kyoko Fuse
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | | |
Collapse
|
43
|
Teo ECY, Tan BH, Purdy MA, Wong PS, Ting PJ, Chang PEJ, Oon LLE, Sue A, Teo CG, Tan CK. Hepatitis E in Singapore: A Case-Series and Viral Phylodynamics Study. Am J Trop Med Hyg 2017; 96:922-928. [PMID: 28093535 DOI: 10.4269/ajtmh.16-0482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AbstractThe incidence of hepatitis E in Singapore appears to be increasing. A retrospective case-series study of patients diagnosed with hepatitis E in a tertiary hospital from 2009 to 2013 was conducted. Of 16 cases, eight (50%) were solid-organ transplant recipients (SOTRs), and 14 (88%) were found infected by genotype 3 hepatitis E virus (HEV-3). Bayesian inferences based on HEV subgenomic sequences from seven cases suggest that HEV-3 strains were introduced to Singapore as two principal lineages. Within limitations of the study, it can be inferred that one lineage, in the 3efg clade, emerged about 83 years ago, probably originating from Japan, whereas the other, in the 3abchij clade, emerged about 40 years ago, from the United States. Establishment and subsequent transmissions of strains from these two lineages likely contribute to the current endemicity of hepatitis E in Singapore.
Collapse
Affiliation(s)
| | | | - Michael A Purdy
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Pik-Eu Jason Chang
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, National University of Singapore, Singapore
| | | | - Amanda Sue
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chong-Gee Teo
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chee-Kiat Tan
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, National University of Singapore, Singapore
| |
Collapse
|
44
|
Miura M, Inoue J, Tsuruoka M, Nishizawa T, Nagashima S, Takahashi M, Shimosegawa T, Okamoto H. Full-length genomic sequence analysis of new subtype 3k hepatitis E virus isolates with 99.97% nucleotide identity obtained from two consecutive acute hepatitis patients in a city in northeast Japan. J Med Virol 2016; 89:1116-1120. [PMID: 27922191 DOI: 10.1002/jmv.24743] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 12/27/2022]
Abstract
Full-length genomic sequences of hepatitis E virus (HEV) obtained from two consecutive cases of acute self-limiting hepatitis E in a city in northeast Japan were determined. Interestingly, two HEV isolates from each patient shared nucleotide identity of 99.97% in 7 225 nucleotides, and a phylogenetic analysis showed that they formed a cluster of Japanese isolates that is considered as a new HEV subtype 3k. The high similarity of HEV sequences of two isolates from these patients in this study suggested that a subtype 3k HEV strain had spread via a commonly distributed food in the city, possibly pig liver.
Collapse
Affiliation(s)
- Masahito Miura
- Department of Gastroenterology, Omagari Kousei Medical Center, Omagari, Japan
| | - Jun Inoue
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mio Tsuruoka
- Department of Gastroenterology, Omagari Kousei Medical Center, Omagari, Japan
| | - Tsutomu Nishizawa
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Tooru Shimosegawa
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| |
Collapse
|
45
|
Nagashima S, Kobayashi T, Tanaka T, Tanggis, Jirintai S, Takahashi M, Nishizawa T, Okamoto H. Analysis of adaptive mutations selected during the consecutive passages of hepatitis E virus produced from an infectious cDNA clone. Virus Res 2016; 223:170-80. [DOI: 10.1016/j.virusres.2016.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/23/2016] [Accepted: 07/29/2016] [Indexed: 02/08/2023]
|
46
|
Affiliation(s)
- Xiang-Jin Meng
- Department of Biomedical Sciences and Pathobiology, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, Virginia, United States of America
- * E-mail:
| |
Collapse
|
47
|
A hepatitis E outbreak by genotype 4 virus in Shandong province, China. Vaccine 2016; 34:3715-8. [DOI: 10.1016/j.vaccine.2016.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 05/23/2016] [Accepted: 06/01/2016] [Indexed: 12/20/2022]
|
48
|
Minagi T, Okamoto H, Ikegawa M, Ideno S, Takahashi K, Sakai K, Hagiwara K, Yunoki M, Wakisaka A. Hepatitis E virus in donor plasma collected in Japan. Vox Sang 2016; 111:242-246. [DOI: 10.1111/vox.12425] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 05/17/2016] [Accepted: 05/17/2016] [Indexed: 01/18/2023]
Affiliation(s)
- T. Minagi
- Quality Control; Kyoto Plant; Japan Blood Products Organization; Kyoto Japan
| | - H. Okamoto
- Quality Control; Kyoto Plant; Japan Blood Products Organization; Kyoto Japan
| | - M. Ikegawa
- Quality Control; Kyoto Plant; Japan Blood Products Organization; Kyoto Japan
| | - S. Ideno
- R & D Division; Japan Blood Products Organization; Tokyo Japan
| | - K. Takahashi
- R & D Division; Japan Blood Products Organization; Tokyo Japan
| | - K. Sakai
- R & D Division; Japan Blood Products Organization; Tokyo Japan
| | - K. Hagiwara
- Graduate School of Veterinary Medicine; Rakuno Gakuen University; Ebetsu Hokkaido Japan
| | - M. Yunoki
- R & D Division; Japan Blood Products Organization; Tokyo Japan
- Graduate School of Veterinary Medicine; Rakuno Gakuen University; Ebetsu Hokkaido Japan
| | - A. Wakisaka
- R & D Division; Japan Blood Products Organization; Tokyo Japan
| |
Collapse
|
49
|
Kurihara T, Yoshizumi T, Itoh S, Harimoto N, Harada N, Ikegami T, Inagaki Y, Oshiro Y, Ohkohchi N, Okamoto H, Maehara Y. Chronic hepatitis E virus infection after living donor liver transplantation via blood transfusion: a case report. Surg Case Rep 2016; 2:32. [PMID: 27059470 PMCID: PMC4826363 DOI: 10.1186/s40792-016-0159-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/04/2016] [Indexed: 12/12/2022] Open
Abstract
Although it occurs worldwide, hepatitis E virus (HEV) infection in developed countries is generally foodborne. HEV infection is subclinical in most individuals. Although fulminant liver failure may occur, progression to chronic hepatitis is rare. This study describes a 41-year-old man with liver cirrhosis caused by non-alcoholic steatohepatitis and hepatocellular carcinoma within the Milan criteria. His liver function was classified as Child-Pugh grade C. Living donor liver transplantation (LDLT) was performed, and he was discharged from the hospital on postoperative day (POD) 22. However, his alanine aminotransferase concentration began to increase on POD 60 and HEV infection was detected on POD 81. Retrospective assessments of stored blood samples showed that this patient became positive for HEV RNA on POD 3. The liver donor was negative for anti-HEV antibodies and HEV RNA. However, the platelet concentrate transfused into the liver recipient the day after LDLT was positive for HEV RNA. The patient remained positive for HEV infection for 10 months. Treatment with 800 mg/day ribavirin for 20 weeks reduced HEV RNA to an undetectable level. In conclusion, this report describes a patient infected with HEV through a blood transfusion after LDLT, who progressed to chronic hepatitis probably due to his immunosuppressed state and was treated well with ribavirin therapy.
Collapse
Affiliation(s)
- Takeshi Kurihara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Shinji Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Norifumi Harimoto
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Toru Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yuki Inagaki
- Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Tsukuba, Ibaragi, Japan
| | - Yukio Oshiro
- Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Tsukuba, Ibaragi, Japan
| | - Nobuhiro Ohkohchi
- Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Tsukuba, Ibaragi, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yoshihiko Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| |
Collapse
|
50
|
Abstract
Among the wide variety of viral agents liable to be found as food contaminants, noroviruses and hepatitis A virus are responsible for most well characterized foodborne virus outbreaks. Additionally, hepatitis E virus has emerged as a potential zoonotic threat. Molecular methods, including an ISO standard, are available for norovirus and hepatitis A virus detection in foodstuffs, although the significance of genome copy detection with regard to the associated health risk is yet to be determined through viability assays. More precise and rapid methods for early foodborne outbreak investigation are being developed and they will need to be validated versus the ISO standard. In addition, protocols for next-generation sequencing characterization of outbreak-related samples must be developed, harmonized and validated as well.
Collapse
Affiliation(s)
- Albert Bosch
- Enteric Virus Group, Department of Microbiology, University of Barcelona, Avda Diagonal 643, 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), University of Barcelona, Avda Prat de la Riba 171, 08921 Santa Coloma de Gramanet, Spain
| | - Rosa M Pintó
- Enteric Virus Group, Department of Microbiology, University of Barcelona, Avda Diagonal 643, 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), University of Barcelona, Avda Prat de la Riba 171, 08921 Santa Coloma de Gramanet, Spain
| | - Susana Guix
- Enteric Virus Group, Department of Microbiology, University of Barcelona, Avda Diagonal 643, 08028 Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), University of Barcelona, Avda Prat de la Riba 171, 08921 Santa Coloma de Gramanet, Spain
| |
Collapse
|