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Shun EHK, Situ J, Tsoi JYH, Wu S, Cai J, Lo KHY, Chew NFS, Li Z, Poon RWS, Teng JLL, Cheng VCC, Yuen KY, Sridhar S. Rat hepatitis E virus (Rocahepevirus ratti) exposure in cats and dogs, Hong Kong. Emerg Microbes Infect 2024; 13:2337671. [PMID: 38551320 PMCID: PMC11018080 DOI: 10.1080/22221751.2024.2337671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
Hepatitis E virus (HEV) variants infecting humans belong to two species: Paslahepevirus balayani (bHEV) and Rocahepevirus ratti (rat hepatitis E virus; rHEV). R. ratti is a ubiquitous rodent pathogen that has recently been recognized to cause hepatitis in humans. Transmission routes of rHEV from rats to humans are currently unknown. In this study, we examined rHEV exposure in cats and dogs to determine if they are potential reservoirs of this emerging human pathogen. Virus-like particle-based IgG enzymatic immunoassays (EIAs) capable of differentiating rHEV & bHEV antibody profiles and rHEV-specific real-time RT-PCR assays were used for this purpose. The EIAs could detect bHEV and rHEV patient-derived IgG spiked in dog and cat sera. Sera from 751 companion dogs and 130 companion cats in Hong Kong were tested with these IgG enzymatic immunoassays (EIAs). Overall, 13/751 (1.7%) dogs and 5/130 (3.8%) cats were sero-reactive to HEV. 9/751 (1.2%) dogs and 2/130 (1.5%) cats tested positive for rHEV IgG, which was further confirmed by rHEV immunoblots. Most rHEV-seropositive animals were from areas in or adjacent to districts reporting human rHEV infection. Neither 881 companion animals nor 652 stray animals carried rHEV RNA in serum or rectal swabs. Therefore, we could not confirm a role for cats and dogs in transmitting rHEV to humans. Further work is required to understand the reasons for low-level seropositivity in these animals.
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Affiliation(s)
- Estie Hon-Kiu Shun
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Jianwen Situ
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - James Yiu-Hung Tsoi
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Shusheng Wu
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Jianpiao Cai
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Kelvin Hon-Yin Lo
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Nicholas Foo-Siong Chew
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Zhiyu Li
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Rosana Wing-Shan Poon
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Jade Lee-Lee Teng
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, People’s Republic of China
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Kwok-Yung Yuen
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
- Centre for Virology, Vaccinology and Therapeutics, Health@InnoHK, The University of Hong Kong, Hong Kong, People’s Republic of China
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Pokfulam, People’s Republic of China
- Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
| | - Siddharth Sridhar
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, People’s Republic of China
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Lorusso P, Pandiscia A, Manfredi A, Tantillo GM, Terio V. Evaluation of hepatitis E virus RNA persistence in experimentally contaminated cured pork liver sausages. Ital J Food Saf 2024; 13:12286. [PMID: 38846049 PMCID: PMC11154169 DOI: 10.4081/ijfs.2024.12286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/11/2024] [Indexed: 06/09/2024] Open
Abstract
Hepatitis E is a disease sustained by RNA viruses, which have four different genotypes, all of which are responsible for acute forms of hepatitis. Genotypes 1 and 2 infect only humans, causing epidemics mainly transmitted by contaminated water, while geno-types 3 and 4 are zoonotic, and the infection is linked to the consumption of raw or undercooked meat or meat products. Hepatitis E virus (HEV) genotypes 3 and 4 have been detected in domestic Suidae, considered the asymptomatic reservoir of HEV, and in wild animals such as wild boar and deer. Despite scientific studies that have highlighted the presence of HEV in cured meat products, such as pork liver sausages, the viral persistence in the different production steps of curing has not been evaluated. Therefore, this study aimed to evaluate the persistence of HEV genotype 3 during the different curing and storage times of experimentally contaminated pork liver sausages using biomolecular methods. The sausages tested positive at all curing and storage times. This study confirms the potential risk attributed to pork liver sausages in HEV transmission. However, to guarantee an efficient risk assessment, future studies will be performed to correlate the presence of HEV RNA with infectious viral particles.
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Ren M, Lu C, Zhou M, Jiang X, Li X, Liu N. The intersection of virus infection and liver disease: A comprehensive review of pathogenesis, diagnosis, and treatment. WIREs Mech Dis 2024; 16:e1640. [PMID: 38253964 DOI: 10.1002/wsbm.1640] [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: 10/05/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024]
Abstract
Liver disease represents a significant global burden, placing individuals at a heightened risk of developing cirrhosis and liver cancer. Viral infections act as a primary cause of liver diseases on a worldwide scale. Infections involving hepatitis viruses, notably hepatitis B, C, and E viruses, stand out as the most prevalent contributors to acute and chronic intrahepatic adverse outcome, although the hepatitis C virus (HCV) can be effectively cured with antiviral drugs, but no preventative vaccination developed. Hepatitis B virus (HBV) and HCV can lead to both acute and chronic liver diseases, including liver cirrhosis and hepatocellular carcinoma (HCC), which are principal causes of worldwide morbidity and mortality. Other viruses, such as Epstein-Barr virus (EBV) and cytomegalovirus (CMV), are capable of causing liver damage. Therefore, it is essential to recognize that virus infections and liver diseases are intricate and interconnected processes. A profound understanding of the underlying relationship between virus infections and liver diseases proves pivotal in the effective prevention, diagnosis, and treatment of these conditions. In this review, we delve into the mechanisms by which virus infections induce liver diseases, as well as explore the pathogenesis, diagnosis, and treatment of liver diseases. This article is categorized under: Infectious Diseases > Biomedical Engineering.
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Affiliation(s)
- Meng Ren
- Clinical College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
- Institute of Liver Diseases, Hubei Key Laboratory of Theoretical and Applied Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Chenxia Lu
- Institute of Liver Diseases, Hubei Key Laboratory of Theoretical and Applied Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Institute of Liver Diseases, Hubei Province Academy of Traditional Chinese Medicine, Wuhan, China
| | - Mingwei Zhou
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Xiaobing Jiang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Xiaodong Li
- Clinical College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
- Institute of Liver Diseases, Hubei Key Laboratory of Theoretical and Applied Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Institute of Liver Diseases, Hubei Province Academy of Traditional Chinese Medicine, Wuhan, China
| | - Ningning Liu
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
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Ianiro G, Pavoni E, De Sabato L, Monini M, Delibato E, Perrone V, Ostanello F, Niine T, Di Bartolo I. Investigation of Salmonella, hepatitis E virus (HEV) and viral indicators of fecal contamination in four Italian pig slaughterhouses, 2021-2022. Res Vet Sci 2024; 171:105209. [PMID: 38460205 DOI: 10.1016/j.rvsc.2024.105209] [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: 11/30/2023] [Revised: 01/26/2024] [Accepted: 03/03/2024] [Indexed: 03/11/2024]
Abstract
In the pork production chain, the control at slaughterhouse aims to ensure safe food thanks to proper hygienic conditions during all steps of the slaughtering. Salmonella is one of the main foodborne pathogens in the EU causing a great number of human cases, and pigs also contribute to its spreading. Pig is the main reservoir of the zoonotic hepatitis E virus (HEV) that can be present in liver, bile, feces and even rarely in blood and muscle. The aim of this study was to assess the presence of both Salmonella and HEV in several points of the slaughtering chain, including pig trucks. Other viruses hosted in the gut flora of pigs and shed in feces were also assayed (porcine adenovirus PAdV, rotavirus, norovirus, and mammalian orthoreovirus MRV). Torque teno sus virus (TTSuV) present in both feces, liver and blood was also considered. Four Italian pig abattoirs were sampled in 12 critical points, 5 of which were the outer surface of carcasses before processing. HEV and rotavirus (RVA) were not detected. Norovirus was detected once. Salmonella was detected in two of the 4 abattoirs: in the two lairage pens, in the site of evisceration and on one carcass, indicating the presence of Salmonella if carcass is improper handled. The sampling sites positive for Salmonella were also positive for PAdV. MRV was detected in 10 swabs, from only two abattoirs, mainly in outer surface of carcasses. TTSuV was also detected in all abattoirs. Our study has revealed a diverse group of viruses, each serving as indicator of either fecal (NoV, RVA, PAdV, MRV) or blood contamination (TTSuV). TTSuV could be relevant as blood contamination indicators, crucial for viruses with a viremic stage, such as HEV. The simultaneous presence of PAdV with Salmonella is relevant, suggesting PAdV as a promising indicator for fecal contamination for both bacterial and viruses. In conclusion, even in the absence of HEV, the widespread presence of Salmonella at various points in the chain, underscores the need for vigilant monitoring and mitigation strategies which could be achieved by testing not only bacteria indicators as expected by current regulation, but also some viruses (PAdV, TTSuV, MRV) which could represent other sources of fecal contamination.
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Affiliation(s)
- Giovanni Ianiro
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Enrico Pavoni
- Department of Food Safety, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna "Bruno Ubertini" (IZSLER), Brescia, Italy
| | - Luca De Sabato
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marina Monini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Elisabetta Delibato
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Fabio Ostanello
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy.
| | - Tarmo Niine
- Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences (EMU), Tartu, Estonia
| | - Ilaria Di Bartolo
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
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Thornton CS, Waddell BJ, Congly SE, Svishchuk J, Somayaji R, Fatovich L, Isaac D, Doucette K, Fonseca K, Drews SJ, Borlang J, Osiowy C, Parkins MD. Porcine-derived pancreatic enzyme replacement therapy may be linked to chronic hepatitis E virus infection in cystic fibrosis lung transplant recipients. Gut 2024:gutjnl-2023-330602. [PMID: 38621922 DOI: 10.1136/gutjnl-2023-330602] [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: 07/01/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES In high-income countries hepatitis E virus (HEV) is an uncommonly diagnosed porcine-derived zoonoses. After identifying disproportionate chronic HEV infections in persons with cystic fibrosis (pwCF) postlung transplant, we sought to understand its epidemiology and potential drivers. DESIGN All pwCF post-transplant attending our regional CF centre were screened for HEV. HEV prevalence was compared against non-transplanted pwCF and with all persons screened for suspected HEV infection from 2016 to 2022 in Alberta, Canada. Those with chronic HEV infection underwent genomic sequencing and phylogenetic analysis. Owing to their swine derivation, independently sourced pancreatic enzyme replacement therapy (PERT) capsules were screened for HEV. RESULTS HEV seropositivity was similar between transplanted and non-transplanted pwCF (6/29 (21%) vs 16/83 (19%); p=0.89). Relative to all other Albertans investigated for HEV as a cause of hepatitis (n=115/1079, 10.7%), pwCF had a twofold higher seropositivity relative risk and this was four times higher than the Canadian average. Only three chronic HEV infection cases were identified in all of Alberta, all in CF lung transplant recipients (n=3/29, 10.3%). Phylogenetics confirmed cases were unrelated porcine-derived HEV genotype 3a. Ninety-one per cent of pwCF were taking PERT (median 8760 capsules/person/year). HEV RNA was detected by RT-qPCR in 44% (47/107) of PERT capsules, and sequences clustered with chronic HEV cases. CONCLUSION PwCF had disproportionate rates of HEV seropositivity, regardless of transplant status. Chronic HEV infection was evident only in CF transplant recipients. HEV may represent a significant risk for pwCF, particularly post-transplant. Studies to assess HEV incidence and prevalence in pwCF, and potential role of PERT are required.
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Affiliation(s)
- Christina S Thornton
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Barbara J Waddell
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Stephen E Congly
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Julianna Svishchuk
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Ranjani Somayaji
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Linda Fatovich
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Debra Isaac
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karen Doucette
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin Fonseca
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Jamie Borlang
- Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Carla Osiowy
- Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michael D Parkins
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
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Salemane K, Coetzee LZ, Pocock G, Genthe B, Taylor MB, Mans J. Water-Based Epidemiological Investigation of Hepatitis E Virus in South Africa. FOOD AND ENVIRONMENTAL VIROLOGY 2024:10.1007/s12560-024-09596-1. [PMID: 38613652 DOI: 10.1007/s12560-024-09596-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/08/2024] [Indexed: 04/15/2024]
Abstract
Hepatitis E virus (HEV) is an emerging zoonotic pathogen that exhibits great host diversity. The primary means of transmission of the virus in low- and middle-income countries is contaminated water, often due to a lack of access to proper sanitation, which leads to faecal contamination of water sources. Environmental surveillance is an important tool that can be used to monitor virus circulation and as an early warning system for outbreaks. This study was conducted to determine the prevalence and genetic diversity of HEV in wastewater, surface water (rivers and standpipe/ablution water), and effluent from a piggery in South Africa. A total of 536 water samples were screened for HEV using real-time reverse transcription-polymerase chain reaction. Overall, 21.8% (117/536) of the wastewater, river, and ablution water samples tested positive for HEV, whereas 74.4% (29/39) of the samples from the piggery tested positive. Genotyping revealed sequences belonging to HEV genotypes 3 (98%, 53/54) and 4 (2%, 1/54), with subtypes 3c, 3f, and 4b being identified.
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Affiliation(s)
- Karabo Salemane
- Department of Medical Virology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, Pretoria, 0031, South Africa
| | - Leanne Z Coetzee
- , Waterlab, Techno Park, 23B De Havilland Cres, Persequor, Pretoria, 0020, South Africa
| | - Gina Pocock
- , Waterlab, Techno Park, 23B De Havilland Cres, Persequor, Pretoria, 0020, South Africa
| | - Bettina Genthe
- Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602, South Africa
| | - Maureen B Taylor
- Department of Medical Virology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, Pretoria, 0031, South Africa
| | - Janet Mans
- Department of Medical Virology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, Pretoria, 0031, South Africa.
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Borlang J, Murphy D, Harlow J, Osiowy C, Nasheri N. The molecular epidemiology of hepatitis E virus genotype 3 in Canada. Epidemiol Infect 2024; 152:e55. [PMID: 38487841 PMCID: PMC11022259 DOI: 10.1017/s0950268824000475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/26/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024] Open
Abstract
Autochthonous hepatitis E virus (HEV) infection is increasingly reported in industrialized countries and is mostly associated with zoonotic HEV genotype 3 (HEV-3). In this study, we examined the molecular epidemiology of 63 human clinical HEV-3 isolates in Canada between 2014 and 2022. Fifty-five samples were IgM positive, 45 samples were IgG positive and 44 were IgM and IgG positive. The majority of the isolates belong to the subtypes 3a, 3b, and 3j, with high sequence homology to Canadian swine and pork isolates. There were a few isolates that clustered with subtypes 3c, 3e, 3f, 3h, and 3g, and an isolate from chronic infection with a rabbit strain (3ra). Previous studies have demonstrated that the isolates from pork products and swine from Canada belong to subtypes 3a and 3b, therefore, domestic swine HEV is likely responsible for the majority of clinical HEV cases in Canada and further support the hypothesis that swine serve as the main reservoirs for HEV-3 infections. Understanding the associated risk of zoonotic HEV infection requires the establishment of sustainable surveillance strategies at the interface between humans, animals, and the environment within a One-Health framework.
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Affiliation(s)
- Jamie Borlang
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Donald Murphy
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, QC, Canada
| | - Jennifer Harlow
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Food Directorate, Health Canada, Ottawa, ON, Canada
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Neda Nasheri
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Food Directorate, Health Canada, Ottawa, ON, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Rau F, Elsner C, Meister TL, Gömer A, Kallies R, Dittmer U, Steinmann E, Todt D. Monitoring of hepatitis E virus in wastewater can identify clinically relevant variants. Liver Int 2024; 44:637-643. [PMID: 38291853 DOI: 10.1111/liv.15842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/24/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
Hepatitis E virus (HEV) is prevalent worldwide and can cause persistent infection with severe morbidity. Antiviral treatment approaches can lead to the emergence of viral variants encoding escape mutations that may impede viral clearance. The frequency of these variants remains unknown in the human population as well as environment due to limited comprehensive data on HEV diversity. In this study, we investigated the HEV prevalence and diversity of circulating variants in environmental samples, that is, wastewater and rivers from North-Rhine Westphalia, Germany. HEV prevalence could be determined with 73% of samples tested positive for viral RNA via qRT-PCR. Using high-throughput sequencing, we were able to assess the overall genetic diversity in these samples and identified the presence of clinically relevant variants associated with drug resistance. In summary, monitoring variants from environmental samples could provide valuable insights into estimating HEV prevalence and identifying circulating variants that can impact treatment outcome.
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Affiliation(s)
- Fiona Rau
- Medical Faculty, Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Carina Elsner
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Toni Luise Meister
- Medical Faculty, Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
- Institute for Infection Research and Vaccine Development, University Medical Centre Hamburg Eppendorf, Hamburg, Germany
- Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Partner siteHamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - André Gömer
- Medical Faculty, Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - René Kallies
- Department of Environmental Microbiology, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Eike Steinmann
- Medical Faculty, Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
- German Centre for Infection Research (DZIF), External Partner Site, Bochum, Germany
| | - Daniel Todt
- Medical Faculty, Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
- European Virus Bioinformatics Center (EVBC), Jena, Germany
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de Araújo LRMG, Batista AD, Côelho MRCD, Santos JC, Cunha GG, Leal GRA, Pinho JRR, Domingues ALC, Lopes EP. Seroprevalence of hepatitis E virus in patients with chronic liver disease. Braz J Microbiol 2024; 55:357-364. [PMID: 38123902 PMCID: PMC10920483 DOI: 10.1007/s42770-023-01197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION The seroprevalence of hepatitis E virus (HEV) in patients with chronic liver disease (CLD) is little known in Brazil. Studies have suggested that HEV may harmfully influence the course of CLD, with a higher risk of progression to cirrhosis. OBJECTIVE To estimate the prevalence of the anti-HEV antibody (IgG) in patients with CLD and to describe demographic data and risk factors, as well as clinical-laboratory and ultrasound parameters. PATIENTS AND METHODS Cross-sectional study that included 227 patients with CLD followed at a referral outpatient clinic from June 2022 to March 2023. The patients were investigated clinically and tested for liver functions, anti-HEV IgG and, in positive cases, for HEV-RNA. Ultrasonography of the upper abdomen was also carried out. RESULTS Investigation of 227 patients (50 with hepatitis B, 49 with nonalcoholic fatty liver disease, 33 with hepatitis C, 17 with alcoholic liver disease, 16 with schistosomiasis and 62 with mixed disease), 55.5% were female, with an average age of 57 ± 13 years; 37.9% had liver cirrhosis. Seven patients (3.08%) presented anti-HEV positive and HEV-RNA negative. Ultrasound identified association between anti-HEV and contact with pigs, presence of gynecomastia or palmar erythema, lower platelet count, higher APRI and FIB-4 values, and splenomegaly. CONCLUSION Although the prevalence of anti-HEV in patients with CLD was low in this study, the antibody was observed more frequently in cases with a history of contact with pigs and with clinical-laboratory or imaging evidence of more advanced chronic liver disease.
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Affiliation(s)
- Lílian Rose Maia Gomes de Araújo
- Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.
- Gastroenterology Division, Hospital das Clínicas - Universidade Federal de Pernambuco (UFPE), Avenida Professor Moraes Rego, 135, Recife, Pernambuco, 50670-901, Brazil.
| | - Andrea Dória Batista
- Gastroenterology Division, Hospital das Clínicas - Universidade Federal de Pernambuco (UFPE), Avenida Professor Moraes Rego, 135, Recife, Pernambuco, 50670-901, Brazil
| | - Maria Rosângela Cunha Duarte Côelho
- Laboratory of Virology, Keizo Asami Institute (LIKA), Departament of Phisiology and Pharmacology, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | | | - Gabriel Galindo Cunha
- Laboratory of Virology, Keizo Asami Institute (LIKA), Departament of Phisiology and Pharmacology, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Gabriela Rodrigues Aguiar Leal
- Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
- Laboratory of Virology, Keizo Asami Institute (LIKA), Departament of Phisiology and Pharmacology, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - João Renato Rebello Pinho
- Laboratory of Gastroenterology and Tropical Hepatology, Institute of Tropical Medicine and Department of Gastroenterology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ana Lúcia Coutinho Domingues
- Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
- Gastroenterology Division, Hospital das Clínicas - Universidade Federal de Pernambuco (UFPE), Avenida Professor Moraes Rego, 135, Recife, Pernambuco, 50670-901, Brazil
| | - Edmundo Pessoa Lopes
- Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.
- Gastroenterology Division, Hospital das Clínicas - Universidade Federal de Pernambuco (UFPE), Avenida Professor Moraes Rego, 135, Recife, Pernambuco, 50670-901, Brazil.
- Department of Internal Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.
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10
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Olaimat AN, Taybeh AO, Al-Nabulsi A, Al-Holy M, Hatmal MM, Alzyoud J, Aolymat I, Abughoush MH, Shahbaz H, Alzyoud A, Osaili T, Ayyash M, Coombs KM, Holley R. Common and Potential Emerging Foodborne Viruses: A Comprehensive Review. Life (Basel) 2024; 14:190. [PMID: 38398699 PMCID: PMC10890126 DOI: 10.3390/life14020190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
Human viruses and viruses from animals can cause illnesses in humans after the consumption of contaminated food or water. Contamination may occur during preparation by infected food handlers, during food production because of unsuitably controlled working conditions, or following the consumption of animal-based foods contaminated by a zoonotic virus. This review discussed the recent information available on the general and clinical characteristics of viruses, viral foodborne outbreaks and control strategies to prevent the viral contamination of food products and water. Viruses are responsible for the greatest number of illnesses from outbreaks caused by food, and risk assessment experts regard them as a high food safety priority. This concern is well founded, since a significant increase in viral foodborne outbreaks has occurred over the past 20 years. Norovirus, hepatitis A and E viruses, rotavirus, astrovirus, adenovirus, and sapovirus are the major common viruses associated with water or foodborne illness outbreaks. It is also suspected that many human viruses including Aichi virus, Nipah virus, tick-borne encephalitis virus, H5N1 avian influenza viruses, and coronaviruses (SARS-CoV-1, SARS-CoV-2 and MERS-CoV) also have the potential to be transmitted via food products. It is evident that the adoption of strict hygienic food processing measures from farm to table is required to prevent viruses from contaminating our food.
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Affiliation(s)
- Amin N. Olaimat
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan; (M.A.-H.); (M.H.A.)
| | - Asma’ O. Taybeh
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan; (A.O.T.); (A.A.-N.); (T.O.)
| | - Anas Al-Nabulsi
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan; (A.O.T.); (A.A.-N.); (T.O.)
| | - Murad Al-Holy
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan; (M.A.-H.); (M.H.A.)
| | - Ma’mon M. Hatmal
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan;
| | - Jihad Alzyoud
- Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan; (J.A.); (I.A.)
| | - Iman Aolymat
- Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan; (J.A.); (I.A.)
| | - Mahmoud H. Abughoush
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan; (M.A.-H.); (M.H.A.)
- Science of Nutrition and Dietetics Program, College of Pharmacy, Al Ain University, Abu Dhabi P.O. Box 64141, United Arab Emirates
| | - Hafiz Shahbaz
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan;
| | - Anas Alzyoud
- Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan;
| | - Tareq Osaili
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan; (A.O.T.); (A.A.-N.); (T.O.)
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Mutamed Ayyash
- Department of Food Science, College of Agriculture and Veterinary Medicine, United Arab Emirates University, P.O. Box 15551, Al Ain 53000, United Arab Emirates;
| | - Kevin M. Coombs
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
| | - Richard Holley
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
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11
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Anwar T, Ismail S, Parvaiz F, Abbasi SW, A. Al-Abbasi F, M. Alghamdi A, Al-Regaiey K, Ul-Haq A, Kaleem I, Bashir S, Waheed Y. Computational design of experimentally validated multi-epitopes vaccine against hepatitis E virus: An immunological approach. PLoS One 2023; 18:e0294663. [PMID: 38096182 PMCID: PMC10721065 DOI: 10.1371/journal.pone.0294663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/07/2023] [Indexed: 12/17/2023] Open
Abstract
Hepatitis E virus (HEV) is one of the leading acute liver infections triggered by viral hepatitis. Patients infected with HEV usually recover and the annual death rate is negligible. Currently, there is no HEV licensed vaccine available globally. This study was carried out to design a multi-epitope HEV peptide-based vaccine by retrieving already experimentally validated epitopes from ViPR database leading to epitope prioritization. Epitopes selected as potential vaccine candidates were non-allergen, immunogenic, soluble, non-toxic and IFN gamma positive. The epitopes were linked together by AAY linkers and the linker EAAAK was used to join adjuvant with epitopes. Toll-like receptor (TLR)-4 agonist was used as an adjuvant to boost efficacy of the vaccine. Furthermore, codon optimization followed by disulfide engineering was performed to analyse the designed vaccine's structural stability. Computational modeling of the immune simulation was done to examine the immune response against the vaccine. The designed vaccine construct was docked with TLR-3 receptor for their interactions and then subjected to molecular dynamic simulations. The vaccine model was examined computationally towards the capability of inducing immune responses which showed the induction of both humoral and cell mediated immunity. Taken together, our study suggests an In-silico designed HEV based multi-epitope peptide-based vaccine (MEPV) that needs to be examined in the wet lab-based data that can help to develop a potential vaccine against HEV.
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Affiliation(s)
- Tasneem Anwar
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
| | - Saba Ismail
- Department of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Fahed Parvaiz
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
| | - Sumra Wajid Abbasi
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Fahad A. Al-Abbasi
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amira M. Alghamdi
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid Al-Regaiey
- Department of Physiology, King Saud University, Riyadh, Saudi Arabia
| | - Asad Ul-Haq
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Imdad Kaleem
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
| | - Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Yasir Waheed
- Office of Research, Innovation & Commercialization, Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, Pakistan
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
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12
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Colomer-Castell S, Gregori J, Garcia-Cehic D, Riveiro-Barciela M, Buti M, Rando-Segura A, Vico-Romero J, Campos C, Ibañez-Lligoña M, Adombi CM, Cortese MF, Tabernero D, Esteban JI, Rodriguez-Frias F, Quer J. In-Host HEV Quasispecies Evolution Shows the Limits of Mutagenic Antiviral Treatments. Int J Mol Sci 2023; 24:17185. [PMID: 38139013 PMCID: PMC10743355 DOI: 10.3390/ijms242417185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/01/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
Here, we report the in-host hepatitis E virus (HEV) quasispecies evolution in a chronically infected patient who was treated with three different regimens of ribavirin (RBV) for nearly 6 years. Sequential plasma samples were collected at different time points and subjected to RNA extraction and deep sequencing using the MiSeq Illumina platforms. Specifically, we RT-PCR amplified a single amplicon from the core region located in the open-reading frame 2 (ORF2). At the nucleotide level (genotype), our analysis showed an increase in the number of rare haplotypes and a drastic reduction in the frequency of the master (most represented) sequence during the period when the virus was found to be insensitive to RBV treatment. Contrarily, at the amino acid level (phenotype), our study revealed conservation of the amino acids, which is represented by a high prevalence of the master sequence. Our findings suggest that using mutagenic antivirals concomitant with high viral loads can lead to the selection and proliferation of a rich set of synonymous haplotypes that express the same phenotype. This can also lead to the selection and proliferation of conservative substitutions that express fitness-enhanced phenotypes. These results have important clinical implications, as they suggest that using mutagenic agents as a monotherapy treatment regimen in the absence of sufficiently effective viral inhibitors can result in diversification and proliferation of a highly diverse quasispecies resistant to further treatment. Therefore, such approaches should be avoided whenever possible.
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Affiliation(s)
- Sergi Colomer-Castell
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Plaça Cívica, 08193 Bellaterra, Spain
| | - Josep Gregori
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
| | - Damir Garcia-Cehic
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
| | - Mar Riveiro-Barciela
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Plaça Cívica, 08193 Bellaterra, Spain
| | - Maria Buti
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Plaça Cívica, 08193 Bellaterra, Spain
| | - Ariadna Rando-Segura
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Judit Vico-Romero
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
| | - Carolina Campos
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Plaça Cívica, 08193 Bellaterra, Spain
| | - Marta Ibañez-Lligoña
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Plaça Cívica, 08193 Bellaterra, Spain
| | - Caroline Melanie Adombi
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Institute of Agropastoral Management, University Peleforo Gon Coulibaly, Korhogo BP 1328, Côte d’Ivoire
| | - Maria Francesca Cortese
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Biochemistry Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - David Tabernero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Biochemistry Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Juan Ignacio Esteban
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Plaça Cívica, 08193 Bellaterra, Spain
| | - Francisco Rodriguez-Frias
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Biochemistry Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Josep Quer
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (S.C.-C.); (D.G.-C.); (M.R.-B.); (M.B.); (J.V.-R.); (C.C.); (M.I.-L.); (C.M.A.); (J.I.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain; (A.R.-S.); (M.F.C.); (D.T.); (F.R.-F.)
- Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Plaça Cívica, 08193 Bellaterra, Spain
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13
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Yin X, Kan F. Hepatitis E virus infection and risk of hepatocellular carcinoma: A systematic review and meta-analysis. Cancer Epidemiol 2023; 87:102457. [PMID: 37797398 DOI: 10.1016/j.canep.2023.102457] [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: 06/15/2023] [Revised: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND The potential role of hepatitis E virus (HEV) infection in developing hepatocellular carcinoma (HCC) is controversial and poorly investigated. We conducted a meta-analysis of observational studies to evaluate whether HEV infection increases the risk of HCC. METHODS We searched international databases (PubMed/Medline, Web of Science Collection, Embase, and Scopus) for peer-reviewed research articles published from inception to May 1, 2023. The pooled estimates of the odds ratios (ORs) and corresponding 95% confidence intervals (95%CIs) were calculated using random-effects models. Between-study heterogeneity was measured using I² and Q-statistic. Sensitivity and cumulative analyses were performed to examine the stability of our results. RESULTS We identified seven eligible studies involving 1873 HCC cases and 8679 control subjects; the latter included 7382 healthy controls and 1297 patients with chronic liver diseases (CLD). Overall, we observed statistically significant associations between HEV infection and risk of HCC (OR 1.94; 95%CI 1.26-3.0). According to the types of the controls, the association was significant when healthy individuals were the controls (OR 2.28, 95%CI 1.43-3.64), whereas the association was not significant when the patients had CLD (OR 1.66, 95%CI 0.76-3.61). The Egger's test and funnel plot indicated that there is no publication bias (p = 0.1) in the studies included in the meta-analysis. Sensitivity and cumulative analyses also indicated stability of our results. CONCLUSIONS Our findings indicate that individuals with HEV infection had an increased risk of HCC; however, further well-designed clinical and experimental studies are needed to confirm these observations. Furthermore, whether various genotypes of HEV differ in promoting HCC also needs to be investigated.
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Affiliation(s)
- Xia Yin
- Department of Interventional Therapy, Zibo First Hospital, Zibo 255200, China
| | - Fanggong Kan
- Department of Oncology, Zibo First Hospital, Zibo 255200, China.
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14
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Gremmel N, Keuling O, Eiden M, Groschup MH, Johne R, Becher P, Baechlein C. Hepatitis E virus neutralization by porcine serum antibodies. J Clin Microbiol 2023; 61:e0037323. [PMID: 37823649 PMCID: PMC10662371 DOI: 10.1128/jcm.00373-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/26/2023] [Indexed: 10/13/2023] Open
Abstract
The consumption of raw or undercooked meat products poses a serious risk for human hepatitis E virus (HEV) infections. In many high-income countries, domestic pigs and wild boars represent the main animal reservoirs for HEV and are usually identified by reverse transcription-PCR and antibody enzyme-linked immunosorbent assay (ELISA). In order to characterize the humoral immune response in more detail, a cell culture-based serum neutralization assay using a culture-adapted HEV strain was established here. Measurement of neutralizing antibodies was only possible after removing the viral quasi-envelope by detergent treatment. Serum samples of 343 wild boars from Northern Germany were first analyzed for anti-HEV IgG using an in-house ELISA, resulting in 19% positive samples. Subsequently, a subset of 41 representative samples was tested with the neutralization assay, and the results correlated well with those obtained by ELISA. Not only the human HEV strain 47832c but also two porcine HEV strains were shown to be neutralized by porcine serum antibodies. Neutralizing activity was also found in samples containing both HEV-specific antibodies and HEV RNA. Testing of serum samples derived from two experimentally infected domestic pigs showed a steep increase in neutralizing activity at 24 or 51 days post infection, dependent on the used infectious dose. The developed assay can be useful for characterization of the humoral immune response after HEV infection and for assessing the efficiency of HEV vaccine candidates.
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Affiliation(s)
- Nele Gremmel
- Department of Infectious Diseases, Institute of Virology, University of Veterinary Medicine, Hannover, Germany
| | - Oliver Keuling
- Institute for Terrestrial and Aquatic Wildlife Research, University of Veterinary Medicine, Hannover, Germany
| | - Martin Eiden
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Insel Riems, Germany
| | - Martin H. Groschup
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Insel Riems, Germany
| | - Reimar Johne
- Department of Biological Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Paul Becher
- Department of Infectious Diseases, Institute of Virology, University of Veterinary Medicine, Hannover, Germany
| | - Christine Baechlein
- Department of Infectious Diseases, Institute of Virology, University of Veterinary Medicine, Hannover, Germany
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15
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Younes N, Yassine HM, Nizamuddin PB, Kourentzi K, Tang P, Ayoub HH, Khalili M, Coyle PV, Litvinov D, Willson RC, Abu-Raddad LJ, Nasrallah GK. Seroprevalence of hepatitis E virus (HEV) among male craft and manual workers in Qatar (2020-2021). Heliyon 2023; 9:e21404. [PMID: 38027884 PMCID: PMC10660033 DOI: 10.1016/j.heliyon.2023.e21404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background The rapid growth of Qatar in the last two decades has attracted a large influx of immigrant craft and manual workers (CMWs) seeking employment in jobs associated with food handling, domestic service, and construction. Nearly 60 % of Qatar's population are expatriates CMWs, including many from hyperendemic countries for HEV. Thus, estimating the seroprevalence of HEV in Qatar and understanding its epidemiology is essential for public health efforts to control HEV transmission in Qatar. Methods Blood samples from 2670 CMWs were collected between 2020 and 2021. All samples were tested for HEV-IgG antibodies. Positive HEV-IgG samples were tested for HEV-IgM antibodies, and those positives were also tested for viral antigens using an HEV-Ag ELISA kit and HEV-RNA by RT-PCR to confirm current HEV infections. Results The seroprevalence of HEV-IgG was 27.3 % (729/2670; 95 % CI: 25.6-29.0). Of those HEV-IgG positive, 8.23 % (60/729; 95 % CI: 6.30-10.5) were HEV-IgM positive. Of the IgM-positive samples, 2 were HEV-RNA positive (3.39 %; 95 % CI: 0.40-11.7), and 1 was HEV-Ag positive (1.69 %; 95 % CI: 0.04-9.09). In addition, HEV-IgG seroprevalence was associated with age and nationality, with the highest seroprevalence in participants from Egypt (IgG 60.0 %; IgM 5.56 %), Pakistan (IgG 59.0 %; IgM 2.24 %), Nepal (IgG 29.3 %; IgM 2.70 %), Bangladesh (IgG 27.8 %; IgM 2.45 %), and India (IgG 23.9 %; IgM 2.43 %). Conclusion In this study, we showed that the seroprevalence of HEV among CMWs was slightly higher than what was previously reported among the urban population in Qatar (2013-2016).
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Affiliation(s)
- Nadin Younes
- Biomedical Research Center, Qatar University, Doha, 2713, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, 2713, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center, Qatar University, Doha, 2713, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, 2713, Qatar
| | | | - Katerina Kourentzi
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX 77204, USA
| | - Patrick Tang
- Division of Microbiology, Sidra Medicine, Doha, 26999, Qatar
| | - Houssein H. Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, 2713, Qatar
| | - Makiyeh Khalili
- Department of Laboratory Medicine, Hamad Medical Corporation, Doha, 3050, Qatar
| | - Peter V. Coyle
- Department of Pediatrics, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, 3050, Qatar
| | - Dmitri Litvinov
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX 77204, USA
- Center for Integrated Bio & Nano Systems, University of Houston, Houston, TX 77204, USA
| | - Richard C. Willson
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX 77204, USA
- Department of Biology and Biochemistry, University of Houston, Houston, TX 77204, USA
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Gheyath K. Nasrallah
- Biomedical Research Center, Qatar University, Doha, 2713, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, 2713, Qatar
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16
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Namdeo D, Shrivastava P, Garg G, Vyas AK, Nema RK, Singhai A, Nema S, Biswas D. Role of real-time polymerase chain reaction in diagnosing Hepatitis E, the commonest cause of acute hepatitis in adult patients seeking institutional care. INDIAN J PATHOL MICR 2023; 66:810-814. [PMID: 38084537 DOI: 10.4103/ijpm.ijpm_693_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background This cross-sectional study was performed with the aim of determining the prevalence of hepatitis E virus (HEV) infection among acute hepatitis patients attending a tertiary care teaching hospital in a developing country and to determine the relative performance of prevalent diagnostic assays in establishing its diagnosis. Materials and Methods A total of 46 adult patients were included in this study, all of whom presented with jaundice of <4 weeks' duration and elevation of AST and ALT above 500 U/L. The prevalence of HEV among patients with acute hepatitis was calculated on the basis of the proportion of recruited patients reacting positively in serum anti-HEV immunoglobulin M (IgM) and real-time polymerase chain reaction (RT-PCR) assays. Results Among the recruited patients, 11 (23.91%) and 15 (32.6%) patients were positive for anti-HEV IgM and RT-PCR, respectively. The two tests demonstrated poor inter-test agreement, thereby implying the necessity of performing both tests for reliable diagnosis of acute HEV virus infection. We also observed a significant difference in the duration of illness between RT-PCR positive and negative patients (P = 0.008). The mean (±SD) duration of illness in the two groups was 8.6 (±3.50) and 11.66 (± 5.15) days, respectively. Combining the results of IgM ELISA and RT-PCR, we observed that 23 out of 46 patients (50%) had evidence of acute HEV virus infection among our patients. Conclusion Our study suggests that HEV is the commonest cause of acute hepatitis in adult patients attending a tertiary care teaching hospital and that the diagnostic algorithm for its confirmation should include both IgM ELISA and RT-PCR assays.
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Affiliation(s)
- Divya Namdeo
- Regional Virology Lab, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Pratima Shrivastava
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Garima Garg
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Ashish K Vyas
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Ram K Nema
- Regional Virology Lab, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Abhishek Singhai
- Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Shashwati Nema
- Regional Virology Lab; Departments of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Debasis Biswas
- Regional Virology Lab; Departments of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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17
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Cao K, Wu X, Yang M, Chen C, Zhang X, Jiang D, Du Y, Chen M, You Y, Zhou W, Qi J, Chen D, Yan R, Miao Z, Yang S. Prevalence of hepatitis E virus in China from 1997 to 2022: a systematic review and meta-analysis. Front Public Health 2023; 11:1243408. [PMID: 37744517 PMCID: PMC10512461 DOI: 10.3389/fpubh.2023.1243408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Several studies have reported on hepatitis E virus (HEV) prevalence in various regions of China, but the results vary widely. Herein, we conducted a systematic review and meta-analysis to assess the seroprevalence, RNA-positive rate, genotype distribution of HEV in China, and its risk factors. Methods We included 208 related studies involving 1,785,569 participants published between 1997 and 2022. Random-effects models were used to pool prevalence, and subgroup analyses were conducted by population, gender, age, study period, regions, and rural-urban distribution. The meta regression models and pooled odds ratios (OR) were performed to identify risk factors for HEV infections. Results The pooled anti-HEV IgG, IgM, and Ag seroprevalence, and RNA detection rates in China from 1997 to 2022 were 23.17% [95% confidence interval (CI): 20.23-26.25], 0.73% (95% CI: 0.55-0.93), 0.12% (95% CI: 0.01-0.32), and 6.55% (95% CI: 3.46-12.05), respectively. The anti-HEV IgG seropositivity was higher in the occupational population (48.41%; 95% CI: 40.02-56.85) and older adult aged 50-59 years (40.87%; 95% CI: 31.95-50.11). The dominant genotype (GT) of hepatitis E in China was GT4. Notably, drinking non-tap water (OR = 1.82; 95% CI: 1.50-2.20), consumption of raw or undercooked meat (OR = 1.47; 95% CI: 1.17-1.84), and ethnic minorities (OR = 1.50; 95% CI: 1.29-1.73) were risk factors of anti-HEV IgG seroprevalence. Discussions Overall, the prevalence of hepatitis E was relatively high in China, especially among older adults, ethnic minorities, and humans with occupational exposure to pigs. Thus, there is a need for preventive measures, including HEV infection screening and surveillance, health education, and hepatitis E vaccine intervention in high-risk areas and populations. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023397036.
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Affiliation(s)
- Kexin Cao
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyue Wu
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengya Yang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Can Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaobao Zhang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Daixi Jiang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuxia Du
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengsha Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yue You
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenkai Zhou
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaxing Qi
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Dingmo Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Rui Yan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ziping Miao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shigui Yang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
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Boukhrissa H, Mechakra S, Mahnane A, Lacheheb A. Viral hepatitis E, zoonotic transmission in Algeria. Virusdisease 2023; 34:389-394. [PMID: 37780902 PMCID: PMC10533760 DOI: 10.1007/s13337-023-00840-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/05/2023] [Indexed: 10/03/2023] Open
Abstract
Viral hepatitis E, a major cause of acute viral hepatitis in adults, is a global public health problem. The zoonotic potential of the virus is currently accepted in developed countries. In developing countries, where transmission is mainly enteric, data on the animal reservoir are very limited. Our objective was to identify a possible risk of zoonotic transmission in our region (eastern Algeria). Four hundred and thirty four sera from blood donors were analysed by an-ti-HEV IgG antibodies detection using a commercial ELISA kit. Study participants were asked about demographics, contact with farm animals, pets, rats, and with live or shot game during a hunting activity. The anti-HEV IgG seroprevalence was 17.05%. Two risk factors were identified; rat contact with a seroprevalence rate at 51.2% (p < 1p.1000), OR = 6.736 [95% CI 3, 42-13.26] and game contact with a seroprevalence at 33% (p = 0.003), OR = 2.76 [95% CI 1.37-5.56]. In summary, zoonotic transmission is possible in our region. Rats and game should be investigated for a probable animal reservoir.
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Affiliation(s)
- Houda Boukhrissa
- Department of Infectious Diseases, Faculty of Medicine, University Ferhat Abbas Setif 1, Sétif, Algeria
| | - Salah Mechakra
- Department of Infectious Diseases, Faculty of Medicine, University Ferhat Abbas Setif 1, Sétif, Algeria
| | - Abbes Mahnane
- Department of Infectious Diseases, Faculty of Medicine, University Ferhat Abbas Setif 1, Sétif, Algeria
| | - Abdelmadjid Lacheheb
- Department of Infectious Diseases, Faculty of Medicine, University Ferhat Abbas Setif 1, Sétif, Algeria
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19
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Ánosi N, Kenyeres B, Szentgyörgyi V, Mátyus M, Orosz L, Bosnyákovits T, Bányai K, Burián K, Lengyel G. Seroprevalence of emerging hepatitis E virus in patients with acute hepatitis between 2004 and 2018 in Csongrád County, Hungary. Cent Eur J Public Health 2023; 31:166-170. [PMID: 37934479 DOI: 10.21101/cejph.a7406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/03/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES Hepatitis E virus (HEV) has recently become endemic in Europe, however, it is often a remnant neglected by clinicians as the causative agent of acute and chronic hepatitis and is often misdiagnosed as a drug-induced liver injury. The infection rate in European pig farms is estimated to be around 15-20%, therefore, the primary source of HEV infections might be poorly prepared pork meat. As HEV infections may occur more often in clinical practice than previously thought, the present paper aims to analyse the seroprevalence of HEV in patients with acute hepatitis over a period of 14 years in Csongrád County, Hungary. METHODS The sera of 4,270 hepatitis patients collected between 2004-2018 were tested for cumulative anti-HEV IgG/IgM. Furthermore, 170 IgM positive sera were tested for the presence of viral RNA by RT-qPCR. RESULTS Between 2012-2018, the cumulative seroprevalence has increased 9.18 times, and between 2013-2018, IgM prevalence has increased 12.49 times. Viral RNA was detectable in 12.35% of IgM positive sera. CONCLUSION The present paper presents data showing that the seroprevalence of hepatitis E virus has increased markedly over the course of the last decade in Hungary and in other European countries as well. The exact reason behind this phenomenon is yet to be determined. To assess the dynamics and the reason for this increase in prevalence, pan-European, multicentre studies should be conducted.
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Affiliation(s)
- Noel Ánosi
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Bence Kenyeres
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | | | - Mária Mátyus
- Military Medical Centre of Hungarian Defence Forces, Budapest, Hungary
| | - László Orosz
- Department of Medical Microbiology and Immunobiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Tünde Bosnyákovits
- Public Health and Food Chain Safety Service of Government Office for Csongrad County, Szeged, Hungary
| | - Krisztián Bányai
- Institute for Veterinary Medical Research, Hungarian Academy of Sciences, Budapest, Hungary
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, Budapest, Hungary
| | - Katalin Burián
- Department of Medical Microbiology and Immunobiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - György Lengyel
- Infection Control Department, Clinical Centre, Semmelweis University, Budapest, Hungary
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20
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Santos-Silva S, da Silva Dias Moraes DF, López-López P, Rivero-Juarez A, Mesquita JR, Nascimento MSJ. Hepatitis E Virus in the Iberian Peninsula: A Systematic Review. FOOD AND ENVIRONMENTAL VIROLOGY 2023; 15:193-211. [PMID: 37434079 PMCID: PMC10499749 DOI: 10.1007/s12560-023-09560-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
One of the most frequent causes of acute viral hepatitis is hepatitis E virus (HEV) causing 20 million infections worldwide each year and 44,000 deaths. Studies on HEV in the Iberian Peninsula have been increasing through time with HEV infection being identified in humans and animals. The aim of the present systematic review was to compile and evaluate all the published data on HEV from studies performed in humans, animals and environmental samples in the Iberian Peninsula. The electronic databases Mendeley, PubMed, Scopus, and Web of Science were thoroughly searched, and research published up until February 01, 2023 were included. Resulting in a total of 151 eligible papers by full reading and application of PRISMA exclusion/inclusion criteria. Overall, the present review shows that several HEV genotypes, namely HEV-1, 3, 4, and 6 as well as Rocahepevirus, are circulating in humans, animals, and in the environment in the Iberian Peninsula. HEV-3 was the most common genotype circulating in humans in Portugal and Spain, as expected for developed countries, with HEV-1 only being detected in travelers and emigrants from HEV endemic regions. Spain is the biggest pork producer in Europe and given the high circulation of HEV in pigs, with HEV-3 being primarily associated to zoonotic transmission through consumption of swine meat and meat products, in our opinion, the introduction of an HEV surveillance system in swine and inclusion of HEV in diagnostic routines for acute and chronic human hepatitis would be important. Additionally, we propose that establishing a monitoring mechanism for HEV is crucial in order to gain a comprehensive understanding of the prevalence of this illness and the various strains present in the Iberian Peninsula, as well as their potential impact on public health.
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Affiliation(s)
- Sérgio Santos-Silva
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | | | - Pedro López-López
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - António Rivero-Juarez
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - João R Mesquita
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
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Das A, Rivera-Serrano EE, Yin X, Walker CM, Feng Z, Lemon SM. Cell entry and release of quasi-enveloped human hepatitis viruses. Nat Rev Microbiol 2023; 21:573-589. [PMID: 37185947 PMCID: PMC10127183 DOI: 10.1038/s41579-023-00889-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 05/17/2023]
Abstract
Infectious hepatitis type A and type E are caused by phylogenetically distinct single-stranded, positive-sense RNA viruses that were once considered to be non-enveloped. However, studies show that both are released nonlytically from hepatocytes as 'quasi-enveloped' virions cloaked in host membranes. These virion types predominate in the blood of infected individuals and mediate virus spread within the liver. They lack virally encoded proteins on their surface and are resistant to neutralizing anti-capsid antibodies induced by infection, yet they efficiently enter cells and initiate new rounds of virus replication. In this Review, we discuss the mechanisms by which specific peptide sequences in the capsids of these quasi-enveloped virions mediate their endosomal sorting complexes required for transport (ESCRT)-dependent release from hepatocytes through multivesicular endosomes, what is known about how they enter cells, and the impact of capsid quasi-envelopment on host immunity and pathogenesis.
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Affiliation(s)
- Anshuman Das
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lentigen Technology, Inc., Gaithersburg, MD, USA
| | - Efraín E Rivera-Serrano
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biology, Elon University, Elon, NC, USA
| | - Xin Yin
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute of Chinese Academy of Agricultural Sciences, Harbin, China
| | - Christopher M Walker
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Paediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Zongdi Feng
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Department of Paediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Stanley M Lemon
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Microbiology & Immunology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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22
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Ștefan I, Cristea IM, Ștefan AT, Ranetti AE, Sirbu CA, Rusu E, Moldovan CA, Leru PM, Nistor CE. A Surprising Case of Triple Acute Hepatitis Infection. Life (Basel) 2023; 13:1761. [PMID: 37629618 PMCID: PMC10455544 DOI: 10.3390/life13081761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/10/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Viral hepatitis continues to be the leading cause of morbidity and mortality worldwide, but the burden has significantly diminished thanks to the large-scale use of vaccines and antivirals. However, there are still challenges regarding viral hepatitis management, especially when more than one pathogenic agent is involved. We present the case of a 45-year-old woman who had a simultaneous infection involving three hepatitis viruses: HAV, HBV, and HEV.
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Affiliation(s)
- Ion Ștefan
- Department of Infectious Diseases, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 134 Calea Plevnei, 010242 Bucharest, Romania
- Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University, 040441 Bucharest, Romania
| | - Ioana-Mădălina Cristea
- Department of Infectious Diseases, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 134 Calea Plevnei, 010242 Bucharest, Romania
| | - Alexia-Teodora Ștefan
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Aurelian-Emil Ranetti
- Endocrinologic Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Carmen Adella Sirbu
- Clinical Neurosciences Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Academy of Romanian Scientists, 50044 Bucharest, Romania
| | - Elena Rusu
- Department of Preclinical Disciplines, Titu Maiorescu University, 040441 Bucharest, Romania;
| | - Cosmin Alec Moldovan
- Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University, 040441 Bucharest, Romania
| | - Polliana M. Leru
- Clinical Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Claudiu-Eduard Nistor
- Thoracic Surgery Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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23
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Guterres A. Viral load: We need a new look at an old problem? J Med Virol 2023; 95:e29061. [PMID: 37638475 DOI: 10.1002/jmv.29061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/22/2023] [Accepted: 08/17/2023] [Indexed: 08/29/2023]
Abstract
The concept of viral load was introduced in the 1980s to measure the amount of viral genetic material in a person's blood, primarily for human immunodeficiency virus (HIV). It has since become crucial for monitoring HIV infection progression and assessing the efficacy of antiretroviral therapy. However, during the coronavirus disease 2019 pandemic, the term "viral load" became widely popularized, not only for the scientific community but for the general population. Viral load plays a critical role in both clinical patient management and research, providing valuable insights for antiviral treatment strategies, vaccination efforts, and epidemiological control measures. As measuring viral load is so important, why don't researchers discuss the best way to do it? Is it simply acceptable to use raw Ct values? Relying solely on Ct values for viral load estimation can be problematic due to several reasons. First, Ct values can vary between different quantitative polymerase chain reaction assays, platforms, and laboratories, making it difficult to compare data across studies. Second, Ct values do not directly measure the quantity of viral particles in a sample and they can be influenced by various factors such as initial viral load, sample quality, and assay sensitivity. Moreover, variations in viral RNA extraction and reverse-transcription steps can further impact the accuracy of viral load estimation, emphasizing the need for careful interpretation of Ct values in viral load assessment. Interestingly, we did not observe scientific articles addressing different strategies to quantify viral load. The absence of standardized and validated methods impedes the implementation of viral load monitoring in clinical management. The variability in cell quantities within samples and the variation in viral particle numbers within infected cells further challenge accurate viral load measurement and interpretation. To advance the field and improve patient outcomes, there is an urgent need for the development and validation of tailored, standardized methods for precise viral load quantification.
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Affiliation(s)
- Alexandro Guterres
- Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório de Tecnologia Imunológica, Instituto de Tecnologia em Imunobiológicos, Vice-Diretoria de Desenvolvimento Tecnológico, Bio-Manguinhos, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
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Bhatti TK, Singal AK, Kwo PY. Viral Hepatitis and Acute-on-Chronic Liver Failure. Clin Liver Dis 2023; 27:617-630. [PMID: 37380286 DOI: 10.1016/j.cld.2023.03.006] [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: 06/30/2023]
Abstract
Acute-on-chronic liver failure (ACLF) is a potentially reversible syndrome that develops in patients with cirrhosis or with underlying chronic liver disease (CLD) and is characterized by acute decompensation, organ failure, and high short-term mortality. Hepatitis A and hepatitis E are major causes of ACLF. Hepatitis B may also cause ACLF through a flare of hepatitis B, acute infection, or reactivation. Besides supportive care, nucleoside/nucleotide analog therapy should also be initiated in this setting. Nonhepatotropic viruses may rarely also cause ACLF with the severe acute respiratory syndrome coronavirus 2 virus recently being identified with poorer outcomes in those with underlying CLD.
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Affiliation(s)
| | - Ashwani K Singal
- University of SD Sanford School of Medicine, Sioux Falls, SD, USA
| | - Paul Y Kwo
- Stanford University School of Medicine, Palo Alto, CA, USA.
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25
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Zahmanova G, Takova K, Tonova V, Koynarski T, Lukov LL, Minkov I, Pishmisheva M, Kotsev S, Tsachev I, Baymakova M, Andonov AP. The Re-Emergence of Hepatitis E Virus in Europe and Vaccine Development. Viruses 2023; 15:1558. [PMID: 37515244 PMCID: PMC10383931 DOI: 10.3390/v15071558] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Hepatitis E virus (HEV) is one of the leading causes of acute viral hepatitis. Transmission of HEV mainly occurs via the fecal-oral route (ingesting contaminated water or food) or by contact with infected animals and their raw meat products. Some animals, such as pigs, wild boars, sheep, goats, rabbits, camels, rats, etc., are natural reservoirs of HEV, which places people in close contact with them at increased risk of HEV disease. Although hepatitis E is a self-limiting infection, it could also lead to severe illness, particularly among pregnant women, or chronic infection in immunocompromised people. A growing number of studies point out that HEV can be classified as a re-emerging virus in developed countries. Preventative efforts are needed to reduce the incidence of acute and chronic hepatitis E in non-endemic and endemic countries. There is a recombinant HEV vaccine, but it is approved for use and commercially available only in China and Pakistan. However, further studies are needed to demonstrate the necessity of applying a preventive vaccine and to create conditions for reducing the spread of HEV. This review emphasizes the hepatitis E virus and its importance for public health in Europe, the methods of virus transmission and treatment, and summarizes the latest studies on HEV vaccine development.
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Affiliation(s)
- Gergana Zahmanova
- Department of Plant Physiology and 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 Plant Physiology and Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Valeria Tonova
- Department of Plant Physiology and Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Tsvetoslav Koynarski
- Department of Animal Genetics, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
| | - Laura L Lukov
- Faculty of Sciences, Brigham Young University-Hawaii, Laie, HI 96762, USA
| | - Ivan Minkov
- Department of Technology Transfer and IP Management, Center of Plant Systems Biology and Biotechnology, 4000 Plovdiv, Bulgaria
- Institute of Molecular Biology and Biotechnologies, 4108 Markovo, Bulgaria
| | - Maria Pishmisheva
- Department of Infectious Diseases, Pazardzhik Multiprofile Hospital for Active Treatment, 4400 Pazardzhik, Bulgaria
| | - Stanislav Kotsev
- Department of Infectious Diseases, Pazardzhik Multiprofile Hospital for Active Treatment, 4400 Pazardzhik, Bulgaria
| | - Ilia Tsachev
- Department of Microbiology, Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
| | - Magdalena Baymakova
- Department of Infectious Diseases, Military Medical Academy, 1606 Sofia, Bulgaria
| | - Anton P Andonov
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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Takakusagi S, Kakizaki S, Takagi H. The Diagnosis, Pathophysiology, and Treatment of Chronic Hepatitis E Virus Infection-A Condition Affecting Immunocompromised Patients. Microorganisms 2023; 11:1303. [PMID: 37317277 DOI: 10.3390/microorganisms11051303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/01/2023] [Accepted: 05/13/2023] [Indexed: 06/16/2023] Open
Abstract
Hepatitis E is a zoonosis caused by hepatitis E virus (HEV), which was first discovered 40 years ago. Twenty million HEV infections worldwide are estimated each year. Most hepatitis E cases are self-limiting acute hepatitis, but the virus has been recognized to cause chronic hepatitis. Following the first case report of chronic hepatitis E (CHE) in a transplant recipient, CHE has recently been identified as associated with chronic liver damage induced by HEV genotypes 3, 4, and 7-usually in immunocompromised patients such as transplant recipients. In addition, patients infected with HIV and those receiving chemotherapy for malignancy, along with patients with rheumatic disease and COVID-19, have recently been reported as having CHE. CHE can be easily misdiagnosed by usual diagnostic methods of antibody response, such as anti-HEV IgM or IgA, because of the low antibody response in the immunosuppressive condition. HEV RNA should be evaluated in these patients, and appropriate treatments-such as ribavirin-should be given to prevent progression to liver cirrhosis or liver failure. While still rare, cases of CHE in immunocompetent patients have been reported, and care must be taken not to overlook these instances. Herein, we conduct an overview of hepatitis E, including recent research developments and management of CHE, in order to improve our understanding of such cases. The early diagnosis and treatment of CHE should be performed to decrease instances of hepatitis-virus-related deaths around the world.
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Affiliation(s)
- Satoshi Takakusagi
- Department of Gastroenterology and Hepatology, Kusunoki Hospital, 607-22 Fujioka, Fujioka 375-0024, Gunma, Japan
| | - Satoru Kakizaki
- Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki 370-0829, Gunma, Japan
| | - Hitoshi Takagi
- Department of Gastroenterology and Hepatology, Kusunoki Hospital, 607-22 Fujioka, Fujioka 375-0024, Gunma, Japan
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Mahsoub HM, Heffron CL, Hassebroek AM, Sooryanarain H, Wang B, LeRoith T, Rodríguez GR, Tian D, Meng XJ. Fetal Loss in Pregnant Rabbits Infected with Genotype 3 Hepatitis E Virus Is Associated with Altered Inflammatory Responses, Enhanced Virus Replication, and Extrahepatic Virus Dissemination with Positive Correlations with Increased Estradiol Level. mBio 2023; 14:e0041823. [PMID: 36939322 PMCID: PMC10128027 DOI: 10.1128/mbio.00418-23] [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: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/21/2023] Open
Abstract
Hepatitis E virus (HEV) causes adverse clinical outcomes in pregnant women, but the underlying mechanisms remain poorly understood. To delineate the mechanisms of pregnancy-associated adverse effects during HEV infection, we utilized a genotype 3 HEV from rabbit (HEV-3ra) and its cognate host (rabbits) to systematically investigate the clinical consequences, viral replication dynamics, and host immune and hormonal responses of HEV infection during pregnancy. We found a significant fetal loss of 23% in HEV-infected pregnant rabbits, indicating an early-stage miscarriage. HEV infection in pregnant rabbits was characterized by higher viral loads in feces, intestinal contents, liver, and spleen tissues, as well as a longer and earlier onset of viremia than in infected nonpregnant rabbits. HEV infection altered the pattern of cytokine gene expressions in the liver of pregnant rabbits and caused a transient increase of serum interferon gamma (IFN-γ) shortly after a notable increase in viral replication, which may contribute to early fetal loss. Histological lesions in the spleen were more pronounced in infected pregnant rabbits, although moderate liver lesions were seen in both infected pregnant and nonpregnant rabbits. Total bilirubin was elevated in infected pregnant rabbits. The serum levels of estradiol (E2) in HEV-infected pregnant rabbits were significantly higher than those in mock-infected pregnant rabbits at 14 days postinoculation (dpi) and correlated positively with higher viral loads in feces, liver, and spleen tissues at 28 dpi, suggesting that it may play a role in extrahepatic virus dissemination. The results have important implications for understanding the severe diseases associated with HEV infection during pregnancy. IMPORTANCE HEV causes adverse pregnancy outcomes, with a mortality rate of >30% in pregnant women, but the underlying mechanisms are poorly understood. In this study, we utilized HEV-3ra and its cognate host (pregnant rabbit) to delineate the potential underlying mechanisms of pregnancy-associated adverse outcomes during HEV infection. We found that infected pregnant rabbits had a fetal loss of 23%, which coincided with enhanced viral replication and an elevated systemic IFN-γ response, followed by longer viremia duration and extrahepatic viral dissemination. Estradiol levels were increased in infected pregnant rabbits and correlated positively with higher fecal viral shedding and higher viral loads in liver and spleen tissues. Infected pregnant rabbits had more pronounced splenic lesions, higher serum total bilirubin, and an altered cytokine gene expression profile in the liver. The results will contribute to our understanding of the mechanisms of HEV-associated adverse pregnancy outcomes.
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Affiliation(s)
- Hassan M. Mahsoub
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - C. Lynn Heffron
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Anna M. Hassebroek
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Harini Sooryanarain
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Bo Wang
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Tanya LeRoith
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Guillermo Raimundi Rodríguez
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Debin Tian
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Xiang-Jin Meng
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
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Zuo J, Meng T, Wang Y, Tang W. A Review of the Antiviral Activities of Glycyrrhizic Acid, Glycyrrhetinic Acid and Glycyrrhetinic Acid Monoglucuronide. Pharmaceuticals (Basel) 2023; 16:ph16050641. [PMID: 37242424 DOI: 10.3390/ph16050641] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/28/2023] Open
Abstract
Licorice, a natural medicine derived from the roots and rhizomes of Glycyrrhiza species, possesses a wide range of therapeutic applications, including antiviral properties. Glycyrrhizic acid (GL) and glycyrrhetinic acid (GA) are the most important active ingredients in licorice. Glycyrrhetinic acid 3-O-mono-β-d-glucuronide (GAMG) is the active metabolite of GL. GL and its metabolites have a wide range of antiviral activities against viruses, such as, the hepatitis virus, herpes virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and so on. Although their antiviral activity has been widely reported, the specific mechanism of action involving multiple links such as the virus itself, cells, and immunity are not clearly established. In this review, we will give an update on the role of GL and its metabolites as antiviral agents, and detail relevant evidence on the potential use and mechanisms of actions. Analyzing antivirals, their signaling, and the impacts of tissue and autoimmune protection may provide promising new therapeutic strategies.
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Affiliation(s)
- Jiawei Zuo
- Department of Pharmacy, The Second Affiliated Hospital of Anhui Medical University, Hefei 230011, China
- School of Pharmacy, Anhui Medical University, Hefei 230032, China
| | - Tao Meng
- Department of General Surgery, The Third Affiliated Hospital of Anhui Medical University, Hefei 230061, China
| | - Yuanyuan Wang
- Department of Pharmacy, The Second Affiliated Hospital of Anhui Medical University, Hefei 230011, China
| | - Wenjian Tang
- School of Pharmacy, Anhui Medical University, Hefei 230032, China
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Hu Y, Wu W. Application of Membrane Filtration to Cold Sterilization of Drinks and Establishment of Aseptic Workshop. FOOD AND ENVIRONMENTAL VIROLOGY 2023:10.1007/s12560-023-09551-6. [PMID: 36933166 PMCID: PMC10024305 DOI: 10.1007/s12560-023-09551-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/27/2023] [Indexed: 06/01/2023]
Abstract
Aseptic packaging of high quality beverage is necessary and its cold-pasteurization or sterilization is vital. Studies on application of ultrafiltration or microfiltration membrane to cold- pasteurization or sterilization for the aseptic packaging of beverages have been reviewed. Designing and manufacturing ultrafiltration or microfiltration membrane systems for cold-pasteurization or sterilization of beverage are based on the understanding of size of microorganisms and theoretical achievement of filtration. It is concluded that adaptability of membrane filtration, especially its combination with other safe cold method, to cold- pasteurization and sterilization for the aseptic packaging of beverages should be assured without a shadow of doubt in future.
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Affiliation(s)
- Yunhao Hu
- College of Food Science, Southwest University, No.2 Tian Shengqiao, Beibei, Chongqing, People's Republic of China
| | - Wenbiao Wu
- College of Food Science, Southwest University, No.2 Tian Shengqiao, Beibei, Chongqing, People's Republic of China.
- Research Center of Grains, Oils and Foods Engineering Design, Industrial Research Institute, Southwest University, No.2 Tian Shengqiao, Beibei, Chongqing, People's Republic of China.
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Unravelling the tripartite interactions among Hepatitis E virus RNA, miR-140 and hnRNP K: Running title: Interactions between HEV-RNA, miR-140 and hnRNP K. J Mol Biol 2023; 435:168050. [PMID: 36933825 DOI: 10.1016/j.jmb.2023.168050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
In the present investigation, we have identified the functional significance of the highly conserved miR-140 binding site on the Hepatitis E Virus (HEV) genome. Multiple sequence alignment of the viral genome sequences along with RNA folding prediction indicated that the putative miR-140 binding site has significant conservation for sequence and secondary RNA structure among HEV genotypes. Site-directed mutagenesis and reporter assays indicated that an intact sequence of the miR-140 binding site is essential for HEV translation. Provision of mutant miR-140 oligos carrying same mutation as on mutant HEV successfully rescued mutant HEV replication. In vitro cell-based assays with modified oligos proved that host factor-miR-140 is a critical requirement for HEV replication. Biotinylated RNA pulldown and RNA immunoprecipitation assays proved that the predicted secondary RNA structure of the miR-140 binding site allows the recruitment of hnRNP K, which is a key protein of the HEV replication complex. We predicted the model from the obtained results that the miR-140 binding site can serve as a platform for recruitment of hnRNP K and other proteins of HEV replication complex only in the presence of miR-140.
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Specific Plasma MicroRNA Signatures Underlying the Clinical Outcomes of Hepatitis E Virus Infection. Microbiol Spectr 2023; 11:e0466422. [PMID: 36695578 PMCID: PMC9927377 DOI: 10.1128/spectrum.04664-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The pathogenic mechanisms determining the diverse clinical outcomes of HEV infection (e.g., self-limiting versus chronic or symptomatic versus asymptomatic) are not yet understood. Because specific microRNA signatures during viral infection inform the cellular processes involved in virus replication and pathogenesis, we investigated plasma microRNA profiles in 44 subjects, including patients with symptomatic acute (AHE, n = 7) and chronic (CHE, n = 6) hepatitis E, blood donors with asymptomatic infection (HEV BDs, n = 9), and anti-HEV IgG+ IgM- (exposed BDs, n = 10) and anti-HEV IgG- IgM- (naive BDs, n = 12) healthy blood donors. By measuring the abundance of 179 microRNAs in AHE patients and naive BDs by reverse transcription-quantitative PCR (RT-qPCR), we identified 51 potential HEV-regulated microRNAs (P value adjusted for multiple testing by the Benjamini-Hochberg correction [PBH] < 0.05). Further analysis showed that HEV genotype 3 infection is associated with miR-122, miR-194, miR-885, and miR-30a upregulation and miR-221, miR-223, and miR-27a downregulation. AHE patients showed significantly higher levels of miR-122 and miR-194 and lower levels of miR-221, miR-27a, and miR-335 than HEV BDs. This specific microRNA signature in AHE could promote virus replication and reduce antiviral immune responses, contributing to the development of clinical symptoms. We found that miR-194, miR-335, and miR-221 can discriminate between asymptomatic HEV infections and those developing acute symptoms, whereas miR-335 correctly classifies AHE and CHE patients. Our data suggest that diverse outcomes of HEV infection result from different HEV-induced microRNA dysregulations. The specific microRNA signatures described offer novel information that may serve to develop biomarkers of HEV infection outcomes and improve our understanding of HEV pathogenesis, which may facilitate the identification of antiviral targets. IMPORTANCE There is increasing evidence that viruses dysregulate the expression and/or secretion of microRNAs to promote viral replication, immune evasion, and pathogenesis. In this study, we evaluated the change in microRNA abundance in patients with acute or chronic HEV infection and asymptomatic HEV-infected blood donors. Our results suggest that different HEV-induced microRNA dysregulations may contribute to the diverse clinical manifestations of HEV infection. The specific microRNA signatures identified in this study hold potential as predictive markers of HEV infection outcomes, which would improve the clinical management of hepatitis E patients, particularly of those developing severe symptoms or chronic infections. Furthermore, this study provides new insights into HEV pathogenesis that may serve to identify antiviral targets, which would have a major impact because no effective treatments are yet available.
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Fernández Villalobos NV, Kessel B, Torres Páez JC, Strömpl J, Kerrinnes T, de la Hoz Restrepo FP, Strengert M, Krause G. Seroprevalence of Hepatitis E virus in children and adolescents living in urban Bogotá: An explorative cross-sectional study. Front Public Health 2023; 11:981172. [PMID: 36844812 PMCID: PMC9943700 DOI: 10.3389/fpubh.2023.981172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/06/2023] [Indexed: 02/09/2023] Open
Abstract
The majority of Hepatitis E Virus (HEV)-related studies are carried out in adults whereas information about HEV seroprevalence, clinical disease manifestation, molecular epidemiology, and transmission patterns in children is limited. To estimate HEV seroprevalence among scholar children living in an urban setting and to analyze risk factors for an infection, we invited children aged 5-18 years from Bogotá (Colombia) for a cross-sectional survey. We collected self-reported data on demographics, social, clinical, and exposure variables in a structured interview. Venous blood samples were analyzed with two commercially available ELISAs for HEV-specific IgG antibodies. Among the 263 participants, we found three HEV IgG-reactive samples (1.1%) using both assays. We additionally characterized the samples for HEV IgM using a commercially available IgM ELISA and for HEV RNA. Here, we found one IgM-reactive sample, which was also reactive for IgG. In contrast, none of the IgM- and IgG-reactive sera samples showed detectable RNA levels indicating HEV exposure had not been recently. All participants reported access to drinking water and sanitary systems in their households and frequent hand washing routines (76-88%). Eighty percent of children reported no direct contact with pigs, but occasional pork consumption was common (90%). In contrast to the majority of studies performed in Colombian adults, we found a low unadjusted HEV seroprevalence of 1.1% (95% CI: 0.3-3.6%) for both HEV IgG ELISAs in our study population. While the majority of participants reported pork consumption, we speculate in the absence of viral RNA for genotyping in the affected individuals, that existing access to drinking water and sanitary systems within our study group contribute to the low HEV seroprevalence.
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Affiliation(s)
| | - Barbora Kessel
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Johanna Carolina Torres Páez
- Department of Epidemiology, PhD Programme, Helmholtz Centre for Infection Research (HZI), Braunschweig-Hannover, Hannover, Germany
| | - Julia Strömpl
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Tobias Kerrinnes
- Department of RNA-Biology of Bacterial Infections, Helmholtz Institute for RNA-based Infection Research (HIRI), Würzburg, Germany
| | | | - Monika Strengert
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany,Twincore, Centre for Experimental and Clinical Infection Research, A Joint Venture of the Hannover Medical School and Helmholtz Centre for Infection Research, Hannover, Germany,*Correspondence: Monika Strengert ✉
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany,Twincore, Centre for Experimental and Clinical Infection Research, A Joint Venture of the Hannover Medical School and Helmholtz Centre for Infection Research, Hannover, Germany,German Center for Infection Research (DZIF), partner site: Braunschweig-Hannover, Braunschweig, Germany
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Xia Y, Yang W, Li Y, Qian Z, Chen S, Zhang Y, Cong C, Li T, Liu H, Chen D, Zhao W, Zhong G, Wei D, Yu W, Huang F. Severe maternal-fetal pathological damage and inflammatory responses contribute to miscarriage caused by hepatitis E viral infection during pregnancy. Liver Int 2023; 43:317-328. [PMID: 36305303 DOI: 10.1111/liv.15468] [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: 04/16/2022] [Revised: 09/04/2022] [Accepted: 10/25/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) infection causes serious adverse pregnancy outcomes during pregnancy. However, the maternal and fetal damage induced by HEV infection is rarely reported. METHODS A BALB/c pregnant mouse model was established to explore the maternal and fetal pathological damage and inflammatory responses caused by HEV infection. RESULTS Notably, miscarriages and stillbirths were observed in HEV-infected pregnant mice. HEV infections were identified by qRT-PCR, immunohistochemical analysis and immunofluorescence assay in the uterus, placenta, umbilical cords and livers and brains of fetuses. Serious inflammatory responses and pathological damage were triggered in the uterus and placenta of HEV-infected pregnant mice. Vertical transmission of HEV resulted in severe pathological damage and inflammatory responses in the livers and brains of fetuses, as well as emerging apoptosis cells in the brains of fetuses. Most of the cytokines/chemokines in the sera were significantly increased in the HEV-infected pregnant mice. Remarkably, cytokines/chemokines were significantly different between HEV-infected pregnant and miscarriage mice; IL9, GM-CSF and IL1α were the most important three cytokines/chemokines in determining the pregnancy outcomes. CONCLUSION HEV infections cause serious maternal/fetal pathological damage, inflammatory responses and apoptosis, which may be responsible for adverse pregnancy outcomes.
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Affiliation(s)
- Yueping Xia
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Weimin Yang
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Yi Li
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Zhongyao Qian
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Shuangfeng Chen
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Yike Zhang
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Chao Cong
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Tengyuan Li
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Huichan Liu
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Dongxue Chen
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Wanqiu Zhao
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Guo Zhong
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Daqiao Wei
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Wenhai Yu
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, People's Republic of China
| | - Fen Huang
- Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, People's Republic of China.,Yunnan Provincial Key Laboratory of Clinical Virology, Kunming, People's Republic of China
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Øverbø J, Aziz A, Zaman K, Clemens J, Halle Julin C, Qadri F, Stene-Johansen K, Biswas R, Islam S, Rahman Bhuiyan T, Haque W, Sandbu S, Elahee ME, Ali M, Dembinski JL, Dudman S. Immunogenicity and safety of a two-dose regimen with hepatitis E virus vaccine in healthy adults in rural Bangladesh: A randomized, double-blind, controlled, phase 2/pilot trial. Vaccine 2023; 41:1059-1066. [PMID: 36599736 DOI: 10.1016/j.vaccine.2022.12.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) is a major cause of acute viral hepatitis worldwide and it contributes to considerable maternal and neonatal mortality and morbidity in many low-income countries like Bangladesh. A three-dose regimen of a vaccine against HEV (HEV 239) has shown promising results in China. The effects and safety of this vaccine in other populations and with different dosing regimens remains uncertain. OBJECTIVES Investigate the immune response and safety of a two-dose regimen with the HEV 239 vaccine among healthy adults. Examine the feasibility of conducting a larger HEV 239 vaccine trial in rural Bangladesh. METHODS One-hundred healthy men and non-pregnant women 16-39 years old were randomized in a 1:1 ratio to receive two doses of either the study (HEV) or control (Hepatitis B virus, HBV) vaccine (at 0, 1 month). Blood samples were collected at day 0, day 60 and 2 years after vaccination. The primary endpoints were the proportion and severity of adverse events up to 2 months after dose one and the longitudinal shift in anti-HEV IgG levels from day 0 to day 60 and 2 years after vaccination. RESULTS Adverse events to HEV 239 were comparable to the control vaccine, mild in severity and resolved within one to nine days. All participants in the study group seroconverted and achieved high levels of HEV IgG antibodies that remained positive for two years in all but one. A T-cell response was detected one month after HEV 239 vaccination. CONCLUSION Our results show that two doses of the HEV 239 vaccine produces broad and likely functional immune responses against HEV that remain for at least two years. The safety profile was acceptable and a phase four study of HEV 239 in rural Bangladesh is feasible. CLINICALTRIALS gov Identifier: NCT02759991.
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Affiliation(s)
- Joakim Øverbø
- Norwegian Institute of Public Health, Oslo, Norway; University of Oslo, Oslo, Norway.
| | - Asma Aziz
- University of Oslo, Oslo, Norway; International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh; International Vaccine Institute, Seoul, Republic of Korea
| | - K Zaman
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | - John Clemens
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh; International Vaccine Institute, Seoul, Republic of Korea; UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | | | - Firdausi Qadri
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | | | - Rajib Biswas
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | - Shaumik Islam
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | | | - Warda Haque
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | - Synne Sandbu
- Norwegian Institute of Public Health, Oslo, Norway
| | - Manzoor E Elahee
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | | | | | - Susanne Dudman
- University of Oslo, Oslo, Norway; Oslo University Hospital, Oslo, Norway
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A Randomized Large-Scale Cross-Sectional Serological Survey of Hepatitis E Virus Infection in Belgian Pig Farms. Microorganisms 2023; 11:microorganisms11010129. [PMID: 36677421 PMCID: PMC9863458 DOI: 10.3390/microorganisms11010129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
Hepatitis E virus (HEV) is the causative agent of hepatitis E disease in humans. While sporadic HEV infections, which occur in industrialised countries and are typically due to HEV genotypes 3 or 4, are asymptomatic and self-limiting, a chronic form of the disease can lead to liver cirrhosis in immunocompromised individuals. Pigs share HEV 3 and 4 genotypes and are thus considered a major animal reservoir for human infection. A subset of animals has been shown to carry HEV particles at the age of slaughter, rendering raw or undercooked pig products potential vectors for human infection. To provide an overview of the current dissemination of HEV in Belgian pig herds, this study was designed as a randomized, robust, large-scale, cross-sectional, serological survey. HEV genotypes and subtypes recently circulating in Belgium (2020-2021) were investigated. Sample stratification as well as epidemiological investigation through the available demographic data of the sampled herds showed that HEV widely circulated in the Belgian pig population during this time and that a change in the circulating HEV strains may have occurred in the last decade. Herd size and type were identified as risk factors for HEV herd-seropositivity. Identifying farms at risk of being HEV-positive is an important step in controlling HEV spread and human infection.
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36
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High prevalence of hepatitis A and E viruses in environmental and clinical samples from West Argentina. Braz J Infect Dis 2023; 27:102738. [PMID: 36603828 PMCID: PMC9926214 DOI: 10.1016/j.bjid.2022.102738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/28/2022] [Accepted: 12/19/2022] [Indexed: 01/04/2023] Open
Abstract
Environmental surveillance of water sources is important to monitoring viral hepatitis transmission in clinical settings. This study investigated the circulation of hepatitis A (HAV) and E (HEV) viruses in sewage and clinical samples from Argentina. Between 2016 and 2017, 80 raw sewage samples and 86 clinical samples (stool and serum) from suspected cases of hepatitis A and hepatitis E were obtained. HAV and HEV were tested by both real-time and nested PCR. Positive samples were sequenced for genotype determination and phylogenetic analysis. Overall, HAV was recovered in 39% of sewage samples and 61.1% of clinical samples. HEV was detected in 22.5% of sewage samples and 15.9% of clinical samples. HAV was found more frequently in sewage during the winter and in clinical samples in spring; HEV was more prevalent in sewage during summer and in clinical samples in autumn. All HAV isolates belonged to genotype IA and HEV isolates belonged to genotype 3, the most prevalent genotypes in South America. High prevalence of HAV and HEV in environmental and clinical samples in Mendoza, Argentina was observed. These findings reinforce the importance of environmental surveillance and implementation of health strategies to control the spread of HAV and HEV in developing countries.
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Hui W, Wei L. Treatment of Hepatitis E. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:215-226. [PMID: 37223869 DOI: 10.1007/978-981-99-1304-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Hepatitis E virus (HEV) infections are the most common cause of acute hepatitis, but they can also take a chronic course. There is no specific therapy for acute hepatitis, and current treatment is supportive. Choosing ribavirin as the first-line therapy for chronic HEV is advisable, especially immunosuppressed individuals. Moreover, ribavirin therapy in the acute phase of infection provides major benefits for those at high risk of acute liver failure (ALF)/acute-on-chronic liver failure (ACLF). Pegylated interferon α has been used successfully for treatment of hepatitis E but is associated with major side effects. Cholestasis is one of the most common, but devastating, manifestations in hepatitis E. Current therapy for HEV aims to treat symptoms. Therapy generally involves several measures, such as vitamins, albumin, and plasma for supporting treatment, symptomatic treatment for cutaneous pruritus, ursodeoxycholic acid, Obeticholic acid, S-adenosylmethionine, etc. for removing jaundice. HEV infection during pregnancy and patients with underlying liver disease may develop liver failure. For these patients, active monitoring, standard care, and supportive treatment are the foundations. Ribavirin has successfully been used to prevent liver transplantation (LT). Prevention and treatment of complications are important for treatment of liver failure. Liver support devices are intended to support liver function until such time as native liver function recovers, or until LT. LT is widely considered as irreplaceable and definitive treatment for liver failure, particularly for patients who do not improve with supportive measures to sustain life.
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Affiliation(s)
- Wei Hui
- Chronic Disease Management Center, Youan Hospital, Capital Medical University, Beijing, China
| | - Linlin Wei
- The Second Department of Liver Disease Center, Youan Hospital, Capital Medical University, Beijing, China.
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Low mortality despite temporary liver dysfunction in severe courses of acute hepatitis E. Wien Klin Wochenschr 2023; 135:57-66. [PMID: 36547761 PMCID: PMC9938023 DOI: 10.1007/s00508-022-02126-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/10/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hepatitis E virus (HEV) infection can cause severe viral hepatitis and eventually liver failure. We aim to provide novel data on the epidemiology and the course of HEV infections from Q1/2008 to Q3/2018 at the Vienna General Hospital. METHODS Of the 88,945 people tested, we identified HEV-IgM positive (+) or HEV-PCR (+) patients and retrospectively collated information on the course of infection from patient records. RESULTS Among 151 HEV-IgM or PCR (+) (median age 51 years, 45.8% female), 7 (4.6%) had non-severe acute HEV infection (ALT ≥ 2-5-fold upper limit of normal, ULN), 11 (7.3%) had severe HEV infection without liver dysfunction (LD) (ALT > 5-fold ULN), and 9 (6.0%) with LD (ikterus or bilirubin > 5 mg/dL, OR coagulopathy or INR > 1.5, OR encephalopathy or ammonia > 100 µmol/L). HEV-RNA-PCR was performed in 58/190 (30.5%) HEV-IgM (+) patients and was positive in 19 (30.6%). Rates of HEV IgM/PCR positivity remained stable over the observation period. The HEV genotype (GT) was GT‑1 in 71.4% (n = 5) and GT‑3 in 28.6% (n = 2). Travel history was recorded for 9/20 (45.0%) of severe HEV and 12/20 (60.0%) patients with severe HEV infection were hospitalized. One patient with pre-existing liver disease and concomitant EBV infection required intensive care. No patient required transplantation and the 30-day mortality was 3/151 (1.9%). Despite the increased testing rates, the absolute number of diagnosed HEV infections at Vienna General Hospital remained constant between 2008 to 2018. CONCLUSION Although approximately half of the patients with severe acute HEV infection required hospitalization, admissions to the intensive care unit (ICU) and short-term mortality were low.
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Peeters M, Schenk J, De Somer T, Roskams T, Locus T, Klamer S, Subissi L, Suin V, Delwaide J, Stärkel P, De Maeght S, Willems P, Colle I, Van Hoof M, Van Acker J, Van Steenkiste C, Moreno C, Janssens F, Reynders M, Steverlynck M, Verlinden W, Lasser L, de Galocsy C, Geerts A, Maus J, Gallant M, Van Outryve S, Marot A, Reynaert H, Decaestecker J, Bottieau E, Schreiber J, Mulkay JP, de Goeij S, Salame M, Dooremont D, Dastis SN, Boes J, Nijs J, Beyls J, Hens N, Nevens F, Van Gucht S, Vanwolleghem T. Viral clade is associated with severity of symptomatic genotype 3 hepatitis E virus infections in Belgium, 2010-2018. J Hepatol 2023; 78:67-77. [PMID: 36075495 DOI: 10.1016/j.jhep.2022.08.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 07/29/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND & AIMS HEV genotype (gt) 3 infections are prevalent in high-income countries and display a wide spectrum of clinical presentations. Host - but not viral - factors are reported to be associated with worse clinical outcomes. METHODS Demographic, clinical, and biochemical data laboratory-confirmed HEV infections (by PCR and/or a combination of IgM and IgG serology) at the Belgian National Reference Centre between January 2010 and June 2018 were collected using standardised case report forms. Genotyping was based on HEV open reading frame 2 sequences. Serum CXCL10 levels were measured by a magnetic bead-based assay. H&E staining was performed on liver biopsies. RESULTS A total of 274 HEV-infected individuals were included. Subtype assignment was possible for 179/218 viraemic cases, confirming gt3 as dominant with an almost equal representation of clades abchijklm and efg. An increased hospitalisation rate and higher peak serum levels of alanine aminotransferase, bilirubin, and alkaline phosphatase were found in clade efg-infected individuals in univariate analyses. In multivariable analyses, clade efg infections remained more strongly associated with severe disease presentation than any of the previously identified host risk factors, being associated with a 2.1-fold higher risk of hospitalisation (95% CI 1.1-4.4, p = 0.034) and a 68.2% higher peak of bilirubin levels (95% CI 13.3-149.9, p = 0.010), independently of other factors included in the model. In addition, acute clade efg infections were characterised by higher serum CXCL10 levels (p = 0.0005) and a more pronounced liver necro-inflammatory activity (p = 0.022). CONCLUSIONS In symptomatic HEV gt3 infections, clade efg is associated with a more severe disease presentation, higher serum CXCL10 levels, and liver necro-inflammatory activity, irrespective of known host risk factors. CLINICAL TRIAL REGISTRATION The protocol was submitted to clinicaltrials.gov (NCT04670419). IMPACT AND IMPLICATIONS HEV genotype (gt) 3 infections display a wide spectrum of clinical presentations currently ascribed to host factors. Here we examined the role of viral factors on liver disease outcomes by combining viral phylogeny with clinical, biochemical, cytokine, and histological data from 274 Belgian adults infected with HEV presenting between 2010 and 2018. HEV gt 3 clade efg infections were associated with a more severe disease presentation, higher serum CXCL10 levels and liver necro-inflammatory activity, irrespective of known host risk factors. HEV gt3 clade-dependent clinical outcomes call for broad HEV gt3 subtyping in clinical practice and research to help identify those at higher risk for worse outcomes and to further unravel underlying virus-host interactions.
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Affiliation(s)
- Michael Peeters
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium
| | - Julie Schenk
- University of Antwerp, Faculty of Medicine and Health Sciences, Vaccine & Infectious Disease Institute, Centre for Health Economic Research and Modelling Infectious Diseases, Antwerp, Belgium; Hasselt University, Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt, Belgium
| | - Thomas De Somer
- University Hospital Antwerp, Gastroenterology & Hepatology, Antwerp, Belgium; Maria Middelares Hospital, Gastroenterology & Hepatology, Ghent, Belgium
| | - Tania Roskams
- KU Leuven, Pathology, Translational Cell and Tissue Research, Leuven, Belgium
| | - Tatjana Locus
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium
| | - Sofieke Klamer
- Sciensano, Epidemiology of Infectious Diseases, Brussels, Belgium
| | - Lorenzo Subissi
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium; European Public Health Microbiology Training Program (EUPHEM), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Vanessa Suin
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium
| | - Jean Delwaide
- University Hospital Liege, Gastroenterology & Hepatology, Liege, Belgium
| | - Peter Stärkel
- Cliniques Universitaires Saint-Luc (CUSL), Gastroenterology & Hepatology, Brussels, Belgium
| | | | | | - Isabelle Colle
- A.S.Z. Aalst, Gastroenterology & Hepatology, Aalst, Belgium; Ghent University Hospital, Department of Hepatology and Gastroenterology, Ghent, Belgium
| | - Marc Van Hoof
- Clinique Saint-Luc, Gastroenterology & Hepatology, Bouge, Belgium
| | - Jos Van Acker
- AZ Sint-Lucas, Clinical Microbiology, Ghent, Belgium
| | - Christophe Van Steenkiste
- University Hospital Antwerp, Gastroenterology & Hepatology, Antwerp, Belgium; Maria Middelares Hospital, Gastroenterology & Hepatology, Ghent, Belgium
| | - Christophe Moreno
- CUB Hôpital Erasme, Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Université Libre de Bruxelles, Brussels, Belgium
| | - Filip Janssens
- Jessa Hospital, Gastroenterology & Hepatology, Hasselt, Belgium
| | - Marijke Reynders
- AZ Sint-Jan Brugge-Oostende AV, Medical Microbiology, Laboratory Medicine, Brugge, Belgium
| | | | - Wim Verlinden
- University Hospital Antwerp, Gastroenterology & Hepatology, Antwerp, Belgium; Vitaz, Gastroenterology & Hepatology, Sint-Niklaas, Belgium; University of Antwerp, Laboratory of Experimental Medicine and Pediatrics, Viral Hepatitis Research Group, Antwerp, Belgium
| | - Luc Lasser
- CHU Brugmann, Gastroenterology & Hepatology, Brussels, Belgium
| | | | - Anja Geerts
- Ghent University Hospital, Gastroenterology & Hepatology, Ghent, Belgium
| | - Jeroen Maus
- ZNA Middelheim, Gastroenterology & Hepatology, Antwerp, Belgium
| | - Marie Gallant
- Jan Yperman Ziekenhuis, Gastroenterology & Hepatology, Ieper, Belgium
| | | | - Astrid Marot
- CHU UCL Namur, Université Catholique de Louvain, Department of Gastroenterology and Hepatology, Yvoir, Belgium
| | - Hendrik Reynaert
- University Hospital UZ Brussel, Gastroenterology & Hepatology, Brussels, Belgium
| | | | | | - Jonas Schreiber
- CHIREC Delta Hospital, Gastroenterology & Hepatology, Brussels, Belgium
| | | | | | - Mikhaël Salame
- Centre Hospitalier Régional Haute Senne, Soignies, Belgium
| | | | | | | | - Jochen Nijs
- Sint-Trudo Ziekenhuis, Department of Gastroenterology, Sint-Truiden, Belgium
| | - Jan Beyls
- Sint-Andriesziekenhuis, Department of Gastroenterology, Tielt, Belgium
| | - Niel Hens
- University of Antwerp, Faculty of Medicine and Health Sciences, Vaccine & Infectious Disease Institute, Centre for Health Economic Research and Modelling Infectious Diseases, Antwerp, Belgium; Hasselt University, Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt, Belgium
| | - Frederik Nevens
- University Hospitals KU Leuven, Gastroenterology & Hepatology, Leuven, Belgium
| | - Steven Van Gucht
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium.
| | - Thomas Vanwolleghem
- University Hospital Antwerp, Gastroenterology & Hepatology, Antwerp, Belgium; University of Antwerp, Laboratory of Experimental Medicine and Pediatrics, Viral Hepatitis Research Group, Antwerp, Belgium.
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McLEOD M, Belford G, Harlow J, Nasheri N. Examining the Effect of Organic Acids on Inactivation of Hepatitis E Virus. J Food Prot 2022; 85:1690-1695. [PMID: 36048964 DOI: 10.4315/jfp-22-164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
ABSTRACT Infection with hepatitis E virus genotype 3 (HEV-3) is an emerging cause of illness in developed countries. In North America and Europe, HEV-3 has been increasingly detected in swine, and exposure to pigs and pork products is considered the primary source of infection. We have previously demonstrated the prevalence of the HEV-3 genome in commercial pork products in Canada. In this study, we investigated the application of citric acid and acetic acid to inactivate HEV-3 on food and on food contact surfaces. For this purpose, plastic, stainless steel, and pork pâté surfaces were inoculated with HEV-3 and were treated with acetic acid or citric acid at 1, 3, or 5%. The infectivity of posttreatment viral particles was determined by cell culture. A greater than 2-log reduction in viral infectivity was observed on plastic and stainless steel treated with the organic acids, but the treatment was less effective on HEV infectivity on pork pâté (average reductions of 0.47 log citric acid and 0.63 log acetic acid). Therefore, we conclude that citric acid and acetic acid have potential application to control HEV-3 on food contact surfaces but are not suitable for food. HIGHLIGHTS
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Affiliation(s)
- Madison McLEOD
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Health Canada, Ottawa, Ontario, Canada K1A 0K9
| | - Genevieve Belford
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Health Canada, Ottawa, Ontario, Canada K1A 0K9
| | - Jennifer Harlow
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Health Canada, Ottawa, Ontario, Canada K1A 0K9
| | - Neda Nasheri
- National Food Virology Reference Centre, Bureau of Microbial Hazards, Health Canada, Ottawa, Ontario, Canada K1A 0K9.,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1A 0K9
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Calibrating Hepatitis E Virus Serological Assays Using Asymptomatic Specimens Obtained in Japan. Microbiol Spectr 2022; 10:e0214622. [PMID: 36125314 PMCID: PMC9603090 DOI: 10.1128/spectrum.02146-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This study aimed to calibrate hepatitis E virus (HEV) serological assays. We optimized the previously developed in-house HEV antibody enzyme-linked immunosorbent assay (ELISA) by setting the cutoff with an in-house serological performance panel consisting of broad HEV antibody titers and subtracting nonspecific background values for anti-HEV IgM, IgA, and IgG. We also compared the assay's performance with that of commercial serological assay kits (four kits for IgM, one for IgA, and two for IgG). Although all serological assays readily detected HEV antibodies at high titers in the symptomatic hepatitis E population, considerable variations between assays were observed in the asymptomatic population. The in-house ELISA showed a higher sensitivity for HEV IgM, IgA, and IgG than the commercial kits and detected the seroconversion of HEV IgM and IgG earlier when testing a commercially available HEV seroconversion panel. The low sensitivity of the commercial kits was due to the high setting of the original cutoff, which was demonstrated by receiver operating characteristic analysis. However, the corrected cutoff value reduced assay specificity. Background subtraction is essential to achieve high specificity because the in-house ELISA without background subtraction reduced its specificity. These results indicate that asymptomatic specimens and background subtraction contribute to the optimization of HEV serological assays. IMPORTANCE Accurate diagnosis of hepatitis E virus (HEV) infection is essential for public health surveillance and for preventing HEV-contaminated blood transfusion. Anti-HEV IgM or IgA is used as a reliable marker of recent HEV infection. However, considerable variability in the sensitivity and specificity of HEV antibody detection is observed among several commercially available assay kits. In addition, none of the HEV antibody detection methods have been approved by the U.S. Food and Drug Administration (FDA). Here, we show that the in-house enzyme-linked immunosorbent assay (ELISA) could detect HEV IgM and IgA more sensitively than commercial kits in the asymptomatic population. We also suggest that the assay performance of commercial kits might be improved by optimizing the cutoff and reducing nonspecific background noise. A sensitive serological (IgM or IgA) assay in addition to HEV RNA testing will contribute to accurate diagnosis of acute HEV infection because HEV RNA-positive duration is relatively short.
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Virus-Associated Nephropathies: A Narrative Review. Int J Mol Sci 2022; 23:ijms231912014. [PMID: 36233315 PMCID: PMC9569621 DOI: 10.3390/ijms231912014] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/23/2022] [Accepted: 10/06/2022] [Indexed: 12/13/2022] Open
Abstract
While most viral infections cause mild symptoms and a spontaneous favorable resolution, some can lead to severe or protracted manifestations, specifically in immunocompromised hosts. Kidney injuries related to viral infections may have multiple causes related to the infection severity, drug toxicity or direct or indirect viral-associated nephropathy. We review here the described virus-associated nephropathies in order to guide diagnosis strategies and treatments in cases of acute kidney injury (AKI) occurring concomitantly with a viral infection. The occurrence of virus-associated nephropathy depends on multiple factors: the local epidemiology of the virus, its ability to infect renal cells and the patient's underlying immune response, which varies with the state of immunosuppression. Clear comprehension of pathophysiological mechanisms associated with a summary of described direct and indirect injuries should help physicians to diagnose and treat viral associated nephropathies.
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Current Knowledge of Hepatitis E Virus (HEV) Epidemiology in Ruminants. Pathogens 2022; 11:pathogens11101124. [PMID: 36297181 PMCID: PMC9609093 DOI: 10.3390/pathogens11101124] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 12/20/2022] Open
Abstract
Hepatitis E virus (HEV) infection represents an emerging public health concern worldwide. In industrialized countries, increasing numbers of autochthonous cases of human HEV infection are caused by zoonotic transmission of genotypes 3 and 4, mainly through the consumption of contaminated raw or undercooked meat of infected pigs and wild boars, which are considered the main reservoirs of HEV. However, in the last few years, accumulating evidence seems to indicate that several other animals, including different ruminant species, may harbor HEV. Understanding the impact of HEV infection in ruminants and identifying the risk factors affecting transmission among animals and to humans is critical in order to determine their role in the epidemiological cycle of HEV. In this review, we provide a summary of current knowledge on HEV ecology in ruminants. A growing body of evidence has revealed that these animal species may be potential important hosts of HEV, raising concerns about the possible implications for public health.
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Unmet Needs for the Treatment of Chronic Hepatitis E Virus Infection in Immunocompromised Patients. Viruses 2022; 14:v14102116. [PMID: 36298671 PMCID: PMC9611326 DOI: 10.3390/v14102116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
Hepatitis E virus (HEV) is the most prevalent hepatitis virus worldwide. Genotypes 3 (HEV3) and 4 (HEV4) as well as rat HEV can lead to chronic hepatitis E and cirrhosis in immunosuppressed patients. Within the last decade, several options for treating chronic hepatitis have been developed and have achieved a sustained virological response. However, there are still unmet needs such as optimizing immunosuppression to allow HEV clearance with or without ribavirin, as well as alternative therapies to ribavirin that are discussed in this paper.
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Sero-epidemiology and Risk Assessment of Hepatitis E Virus Among Blood Donors in North Lebanon. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid-129115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Hepatitis E virus (HEV) is the causative agent of over 50% of acute viral hepatitis cases. The blood transfusion route has emerged as a possible route of transmission of HEV. Objectives: This study aimed to determine the seroprevalence of IgM and IgG anti-HEV among blood donors in North Lebanon and to assess the risk factors associated with its occurrence. Methods: A cross-sectional study was conducted from November to December 2020. Blood samples were collected from 78 healthy blood donors. A standardized questionnaire containing sociodemographic, food consumption, lifestyle, and health-related characteristics, was filled out to assess the risk factors of HEV exposure. Serum samples were tested for IgM and IgG anti-HEV by an enzyme-linked immunosorbent assay (ELISA). Results: The seroprevalence of IgM and IgG anti-HEV antibodies was reported in our study, and it reached 1.09% (1/78) and 12.82% (10/78), respectively. The use of private wells as a drinking source and the travel history to endemic countries have been identified as risk factors for HEV infections (P
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López‐López P, Frias M, Camacho A, Machuca I, Caballero‐Gómez J, Risalde MA, García‐Bocanegra I, Pérez‐Valero I, Gomez‐Villamandos JC, Rivero‐Juárez A, Rivero A. Seroreversion of IgG anti-HEV in HIV cirrhotic patients: A long-term multi-sampling longitudinal study. Transbound Emerg Dis 2022; 69:e1541-e1548. [PMID: 35184415 PMCID: PMC9790577 DOI: 10.1111/tbed.14486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/02/2022] [Accepted: 02/17/2022] [Indexed: 12/30/2022]
Abstract
The aim of our study was to evaluate HEV antibody kinetics in HIV/HCV-coinfected patients with cirrhosis. A longitudinal retrospective study was designed. Patients were followed up every 6 months; anti-HEV IgG and IgM antibodies levels and HEV-RNA by qPCR were analysed. The prevalence and incidence of every HEV infection marker were calculated. The kinetics of anti-HEV IgG and IgM during the follow-up were evaluated. Seventy-five patients comprised the study population. The seroprevalence observed was 17.3%. None showed IgM antibodies or HEV-RNA at baseline. None showed detectable HEV viral load during the study period. After a median follow-up of 5.1 years, two of 62 seronegative patients (3.2%) seroconverted to IgG antibody. The incidence for IgM was 2.7%. Of the 13 patients with IgG seropositivity at baseline, five (38.5%) seroreverted. Meanwhile, of the two patients who exhibited IgM positivity during the study, one (50%) showed intermittent positivity. We found that HEV seropositivity is common in HIV/HCV-coinfected cirrhotic patients. A remarkable rate of IgG seroreversions and IgM intermittence was found, limiting the use of antibodies for the diagnosis of HEV infection in this population.
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Affiliation(s)
- Pedro López‐López
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC
| | - Mario Frias
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC
| | - Angela Camacho
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC
| | - Isabel Machuca
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC
| | - Javier Caballero‐Gómez
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC,Animal Health and Zoonoses Research Group (GISAZ), Animal Health DepartmentUniversity of CordobaCordobaSpain
| | - María A. Risalde
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC,Animal Health and Zoonoses Research Group (GISAZ), Animal Pathology and Toxicology DepartmentUniversity of CordobaCordobaSpain
| | - Ignacio García‐Bocanegra
- CIBERINFEC,Animal Health and Zoonoses Research Group (GISAZ), Animal Health DepartmentUniversity of CordobaCordobaSpain
| | - Ignacio Pérez‐Valero
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC
| | - Jose C. Gomez‐Villamandos
- CIBERINFEC,Animal Health and Zoonoses Research Group (GISAZ), Animal Pathology and Toxicology DepartmentUniversity of CordobaCordobaSpain
| | - Antonio Rivero‐Juárez
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC
| | - Antonio Rivero
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia HospitalUniversity of CordobaCordobaSpain,CIBERINFEC
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Waqar K, Akhtar H, Khan MM, Umar M, Malik B, Faheem M. A case report of dengue shock syndrome complicated with multiorgan failure and hepatitis E virus superinfection. Future Virol 2022. [DOI: 10.2217/fvl-2021-0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dengue fever is a vector borne viral disease. It is more prevalent in Southeast Asia. The main symptoms include myalgia, nausea, vomiting and rash, hence, subsequently lead to dengue hemorrhagic fever and dengue shock syndrome. In the current report, we are presenting a case of a 50-year-old female patient who was presented in hospital with the symptoms of fever, vomiting, abdominal pain, productive cough and sore throat. Her serology came positive for dengue NSP1, and she was shifted to intensive care unit because of her aggravating condition. On day 4, the hepatitis E virus infection also was detected and she died after developing hepatic shock and multiorgan failure. This report states the superinfection of hepatitis E and dengue virus and highlights the significance of its early detection for better clinical management.
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Affiliation(s)
- Kinza Waqar
- Department of Multidisciplinary Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Hashaam Akhtar
- Yusra Institute of Pharmaceutical Sciences, Yusra Medical & Dental College, Islamabad, Pakistan
| | - Muhammad Mujeeb Khan
- Department of infectious diseases, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Muhammad Umar
- Department of infectious diseases, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Bisma Malik
- Department of Biomedical Engineering, University of Engineering and Technology (UET) Lahore, Narowal Campus, Narowal, 51601, Pakistan
| | - Muhammad Faheem
- Department of Biological Sciences, National University of Medical Sciences, The Mall, 46000, Rawalpindi, Pakistan
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A ribavirin-induced ORF2 single-nucleotide variant produces defective hepatitis E virus particles with immune decoy function. Proc Natl Acad Sci U S A 2022; 119:e2202653119. [PMID: 35969792 PMCID: PMC9407633 DOI: 10.1073/pnas.2202653119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hepatitis E virus (HEV) has increasing prevalence worldwide. However, little is known about the impact of single-nucleotide variants (SNV) on the replication cycle. Here, we report a ribavirin-induced open reading frame 2 (ORF2) SNV that demonstrats reduced RNA copies released in the supernatant and an impairment in the production of infectious particles. Furthermore, the P79S variant displays an altered subcellular distribution of the ORF2 protein and is able to impair antibody-mediated neutralization of HEV in a competition assay potentially acting as an immune decoy. These findings provide insights in understanding the biology of circulating HEV variants and may guide development of personalized antiviral strategies in the future. Hepatitis E virus (HEV) is the causative agent of hepatitis E in humans and is the leading cause of enterically transmitted viral hepatitis worldwide. Ribavirin (RBV) is currently the only treatment option for many patients; however, cases of treatment failures or posttreatment relapses have been frequently reported. RBV therapy was shown to be associated with an increase in HEV genome heterogeneity and the emergence of distinct HEV variants. In this study, we analyzed the impact of eight patient-derived open reading frame 2 (ORF2) single-nucleotide variants (SNVs), which occurred under RBV treatment, on the replication cycle and pathogenesis of HEV. The parental HEV strain and seven ORF2 variants showed comparable levels of RNA replication in human hepatoma cells and primary human hepatocytes. However, a P79S ORF2 variant demonstrated reduced RNA copy numbers released in the supernatant and an impairment in the production of infectious particles. Biophysical and biochemical characterization revealed that this SNV caused defective, smaller HEV particles with a loss of infectiousness. Furthermore, the P79S variant displayed an altered subcellular distribution of the ORF2 protein and was able to interfere with antibody-mediated neutralization of HEV in a competition assay. In conclusion, an SNV in the HEV ORF2 could be identified that resulted in altered virus particles that were noninfectious in vitro and in vivo, but could potentially serve as immune decoys. These findings provide insights in understanding the biology of circulating HEV variants and may guide development of personalized antiviral strategies in the future.
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Pisano MB, Campbell C, Anugwom C, Ré VE, Debes JD. Hepatitis E virus infection in the United States: Seroprevalence, risk factors and the influence of immunological assays. PLoS One 2022; 17:e0272809. [PMID: 35930611 PMCID: PMC9355204 DOI: 10.1371/journal.pone.0272809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 07/26/2022] [Indexed: 11/19/2022] Open
Abstract
In the United States (U.S.), a hepatitis E virus (HEV) seroprevalence between 6 and 21% has been described, with a decreasing trend. We aimed to investigate HEV infection in the U.S. population from 2009 to 2016, and examine the differences in seroprevalence using different assays. We used data from the National Health and Nutrition Examination Survey (NHANES-CDC) to estimate HEV seroprevalence and analyze demographic variables related to the infection. Additionally, we compared 4 serological tests used. The estimated HEV seroprevalence between 2009–2016 was 6.1% (95% CI: 5.6%-7.0%) for IgG and 1.02% (0.8%-1.2%) for IgM. Higher HEV IgG prevalences were found in older people, females, non-Hispanic Asians and those born outside of the U.S. The in-house immunoassay and the Wantai HEV-IgG ELISA presented the highest sensitivity values in the tested population. The highest specificity values corresponded to the DSI-EIA-ANTI-HEV-IgG assay. The kappa statistical values showed concordances no greater than 0.64 between the assays. HEV prevalence in our study was similar to previously reported, and a decline in the prevalence was observed through the NHANES assessments (from 1988 to 2016). The sensitivity and specificity of the assays varied widely, making comparisons difficult and highlighting the need to develop a gold standard assay.
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Affiliation(s)
- María Belén Pisano
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, CONICET, Córdoba, Argentina
- * E-mail: (JDD); (MBP)
| | - Christopher Campbell
- Cancer Control Section, Minnesota Department of Health, St. Paul, MN, United States of America
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Chimaobi Anugwom
- Department of Medicine, Division of Infectious Diseases and International Medicine and Division of Gastroenterology and Hepatology, University of Minnesota, Minneapolis, MN, United States of America
| | - Viviana Elizabeth Ré
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, CONICET, Córdoba, Argentina
| | - José D. Debes
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, United States of America
- Department of Medicine, Division of Infectious Diseases and International Medicine and Division of Gastroenterology and Hepatology, University of Minnesota, Minneapolis, MN, United States of America
- * E-mail: (JDD); (MBP)
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Characteristics of hepatitis E viral infections in Hungary. J Clin Virol 2022; 155:105250. [DOI: 10.1016/j.jcv.2022.105250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022]
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