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Khongviwatsathien S, Thaweerat W, Atthakitmongkol T, Chotiyaputta W, Tanwandee T. A Comparison of Clinical Manifestations and Outcomes between Acute Sporadic Hepatitis A and Hepatitis E Infections in Thailand. Viruses 2023; 15:1888. [PMID: 37766294 PMCID: PMC10538055 DOI: 10.3390/v15091888] [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: 08/01/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Hepatitis A virus (HAV) and hepatitis E virus (HEV) infections often present as acute hepatitis with prodromal symptoms. These infections, transmitted via the oral-enteral route, constitute significant public health challenges, particularly in developing countries with subpar sanitary systems. The aim of the study was to describe the clinical manifestations, laboratory findings, and outcomes of hepatitis A and hepatitis E infections in Thailand. We conducted a retrospective chart review and analysis of 152 patients diagnosed with acute hepatitis A or hepatitis E from January 2007 to August 2018 at Siriraj Hospital. The hepatitis E cohort was older with a greater prevalence of comorbidities (hypertension, diabetes mellitus, chronic kidney disease, chronic hepatitis B, and post-kidney transplantation status) than the hepatitis A cohort. While the majority of hepatitis A patients presented with fever (98%) and jaundice (96%), these symptoms were less pronounced in hepatitis E patients. Furthermore, hepatitis A patients exhibited significantly higher aminotransferase and total bilirubin levels. However, clinical outcomes, such as hospitalization rates, progression to acute liver failure, and mortality, were comparable across both groups. In conclusion, although the clinical manifestations of hepatitis A and hepatitis E were similar, fever and jaundice were more prevalent and aminotransferase and bilirubin levels were higher in the HAV-infected group.
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Affiliation(s)
| | | | | | | | - Tawesak Tanwandee
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand (W.T.); (W.C.)
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Kaps L, Limeres MJ, Schneider P, Svensson M, Zeyn Y, Fraude S, Cacicedo ML, Galle PR, Gehring S, Bros M. Liver Cell Type-Specific Targeting by Nanoformulations for Therapeutic Applications. Int J Mol Sci 2023; 24:11869. [PMID: 37511628 PMCID: PMC10380755 DOI: 10.3390/ijms241411869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/21/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Hepatocytes exert pivotal roles in metabolism, protein synthesis and detoxification. Non-parenchymal liver cells (NPCs), largely comprising macrophages, dendritic cells, hepatic stellate cells and liver sinusoidal cells (LSECs), serve to induce immunological tolerance. Therefore, the liver is an important target for therapeutic approaches, in case of both (inflammatory) metabolic diseases and immunological disorders. This review aims to summarize current preclinical nanodrug-based approaches for the treatment of liver disorders. So far, nano-vaccines that aim to induce hepatitis virus-specific immune responses and nanoformulated adjuvants to overcome the default tolerogenic state of liver NPCs for the treatment of chronic hepatitis have been tested. Moreover, liver cancer may be treated using nanodrugs which specifically target and kill tumor cells. Alternatively, nanodrugs may target and reprogram or deplete immunosuppressive cells of the tumor microenvironment, such as tumor-associated macrophages. Here, combination therapies have been demonstrated to yield synergistic effects. In the case of autoimmune hepatitis and other inflammatory liver diseases, anti-inflammatory agents can be encapsulated into nanoparticles to dampen inflammatory processes specifically in the liver. Finally, the tolerance-promoting activity especially of LSECs has been exploited to induce antigen-specific tolerance for the treatment of allergic and autoimmune diseases.
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Affiliation(s)
- Leonard Kaps
- I. Department of Medicine, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - María José Limeres
- Children's Hospital, University Medical Center, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Paul Schneider
- I. Department of Medicine, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Malin Svensson
- Children's Hospital, University Medical Center, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Yanira Zeyn
- Department of Dermatology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Silvia Fraude
- Children's Hospital, University Medical Center, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Maximiliano L Cacicedo
- Children's Hospital, University Medical Center, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Peter R Galle
- I. Department of Medicine, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Stephan Gehring
- Children's Hospital, University Medical Center, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Matthias Bros
- Department of Dermatology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
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Sahi PK, Mazhari MYA, Mandal A. Benign polyserositis and acalculous cholecystitis, a rare presentation of acute viral hepatitis A and E co-infection. Trop Doct 2023:494755231170245. [PMID: 37093845 DOI: 10.1177/00494755231170245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Affiliation(s)
- Puneet Kaur Sahi
- Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
| | | | - Anirban Mandal
- Sitaram Bhartia Institute of Research and Science, New Delhi, India
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Kumar D, Peter RM, Joseph A, Kosalram K, Kaur H. Prevalence of viral hepatitis infection in India: A systematic review and meta-analysis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:103. [PMID: 37288405 PMCID: PMC10243455 DOI: 10.4103/jehp.jehp_1005_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/03/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Nowadays, Viral Hepatitis can be comparable to the big three communicable diseases: tuberculosis, HIV/AIDS, and malarial infections. The main purpose of this study was to summarize the prevalence of viral Hepatitis in India from peer-reviewed articles published from February 2000 to February 2021. MATERIALS AND METHODS We conducted a systematic search on Science Direct, Scopus, Medline, PubMed, Web of Science, Google Scholar, and other open access journals. We evaluated all relevant papers that looked into the prevalence of viral Hepatitis systematically. Finally, 28 studies on viral Hepatitis published from February 2000 to February 2021 have been selected. These studies have been conducted across the northern, southern, central, eastern, and western regions of India. RESULTS Twenty-eight full-text publications were obtained and evaluated consisting of 45,608 research participants. Hepatitis A was found to range from 2.1% to 52.5%. Hepatitis B was found in a wide range of individuals, ranging from 0.87% to 21.4% of the population. Hepatitis C was found to range from 0.57% to 53.7%. The majority of the children were affected by hepatitis A, and 47.4% of third-trimester pregnant mothers were affected by hepatitis E. Diabetes, hospital admission, history of jaundice, history of surgeries, and heterosexual contact were the leading modes of acquiring HBV and HCV infections. As a result of its great magnitude, this disease poses a severe threat to the national healthcare system. CONCLUSION Effective public health measures are urgently needed to minimize the burden of viral Hepatitis and eliminate the disease.
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Affiliation(s)
- Dhasarathi Kumar
- Research Scholar, School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Roshni M. Peter
- Department of Community Medicine, SRM Medical College and Research Centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Alex Joseph
- Division of Epidemiology, School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Kalpana Kosalram
- Division of Health Policy and Management, School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Harpreet Kaur
- Scientist F, ICMR Headquarters, Department of Infectious Diseases, Tribal Health Research, New Delhi, India
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Dual Infection of Hepatitis A Virus and Hepatitis E Virus- What Is Known? Viruses 2023; 15:v15020298. [PMID: 36851512 PMCID: PMC9965669 DOI: 10.3390/v15020298] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Viral hepatitis is an infection of human hepatocytes resulting in liver damage. Dual infection of two hepatotropic viruses affects disease outcomes. The hepatitis A virus (HAV) and hepatitis E virus (HEV) are two enterically transmitted viruses; they are single-stranded RNA viruses and have common modes of transmission. They are transmitted mainly by the fecal-oral route and ingestion of contaminated food, though the HAV has no animal reservoirs. The HAV and HEV cause acute self-limiting disease; however, the HEV, but not HAV, can progress to chronic and extrahepatic infections. The HAV/HEV dual infection was reported among acute hepatitis patients present in developing countries. The impact of the HAV/HEV on the prognosis for acute hepatitis is not completely understood. Studies showed that the HAV/HEV dual infection increased abnormalities in the liver leading to fulminant hepatic failure (FHF) with a higher mortality rate compared to infection with a single virus. On the other hand, other reports showed that the clinical symptoms of the HAV/HEV dual infection were comparable to symptoms associated with the HAV or HEV monoinfection. This review highlights the modes of transmission, the prevalence of the HAV/HEV dual infection in various countries and among several study subjects, the possible outcomes of this dual infection, potential model systems for studying this dual infection, and methods of prevention of this dual infection and its associated complications.
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Comparative prevalence of different types of viral hepatitis in the district Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan. EGYPTIAN LIVER JOURNAL 2022. [DOI: 10.1186/s43066-022-00203-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Viral hepatitis causes both liver inflammation and damage and is a serious health problem.
Methods
The indoor data of different types of hepatitis were collected from the official records of the administration of District Head Quarter Hospital Dera Ismail Khan for 2 years (2020–2021).
Results
A total of 1193 cases of viral hepatitis during the study period were found including viral hepatitis C accounted for 547 (45.9%) cases, followed by the co-infection of viral hepatitis A and E 367 (30.8%) cases, and viral hepatitis B 279 (23.4%) cases. March showed the highest prevalence of hepatitis (33.2%), followed by February (10.2%). The co-infection of hepatitis A and E showed a relatively higher prevalence in 6 months from May to November except September including a peak in June (76.5%) during the study period. While viral hepatitis B demonstrated a comparatively higher percentage prevalence in both February and September with a peak in February (68%), and viral hepatitis C is dominant in January, March, and December with a peak in March (83.8%).
Conclusion
All types of viral hepatitis showed variation in prevalence over months and monthly variation concerning peak prevalence exists among different types of hepatitis. Both viral hepatitis A and E demonstrated similar trend in relative prevalence in both 2020 and 2021. Nevertheless, viral hepatitis A and B showed monthly and seasonal variation in relatively prevalence in both years. The study help in adopting strategies for the prevention of viral hepatitis in the study area.
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Sadio BD, Faye M, Kaiser M, Diarra M, Balique F, Diagne CT, Faye O, Diagne MM, Fall G, Ndiaye O, Loucoubar C, Sow A, Faye O, Faye A, Boye CSB, Sall AA. First hepatitis E outbreak in Southeastern Senegal. Sci Rep 2022; 12:17878. [PMID: 36284151 PMCID: PMC9596447 DOI: 10.1038/s41598-022-22491-8] [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: 08/05/2022] [Accepted: 10/14/2022] [Indexed: 01/20/2023] Open
Abstract
The Rapid proliferation of traditional gold mining sites in the Kedougou region has led to massive migration of people from neighbouring West African countries and the establishment of several small villages where poor hygiene and sanitation conditions exist. In this context, a Hepatitis E virus outbreak was reported in Kedougou in 2014 with several cases among the traditional mining workers. Herein, we described epidemiological and laboratory data collected during the outbreak's investigation from February 2012 to November 2014. Any suspected, contact or probable case was investigated, clinical and epidemiological data were collected. In our study, sera were collected and tested for viral RNA and anti-Hepatitis E virus (HEV) IgM. Archived serum samples from Kedougou were retrospectively screened by real-time polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). A total of 65 water samples collected from ponds and wells surrounding gold panners' sites and habitats and 75 tissues samples from rats captured in the environment of traditional gold mining sites were also tested. A total of 1617 sera were collected from 698 suspected cases, 862 contacts and 57 persons with missing information. The median age was 20 (1-88 years-old) and the sex ratio was 1.72. An overall rate of 64.62% (1045/1617) of these patients tested positive for HEV with a high case fatality rate in pregnant women. All water samples and animal tissues tested negative for HEV. Our data help not only determining of the beginning of the HEV outbreak to March 2012, but also identifying risk factors associated to its emergence. However, there is a need to implement routine diagnosis, surveillance and training of health personnel in order to reduce mortality especially among pregnant women. In addition, further studies are needed to identify the virus reservoir and environmental risk factors for HEV in the Kedougou region.
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Affiliation(s)
- Bacary Djilocalisse Sadio
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal ,grid.414371.4Service de Santé Publique et Appui à la Recherche (CHU Fann), Institut de Santé et Développement, Dakar, Senegal ,grid.8191.10000 0001 2186 9619Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Martin Faye
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | | | - Maryam Diarra
- grid.418508.00000 0001 1956 9596Epidemiology, Clinical Research and Data Science Unit, Institut Pasteur de Dakar, 220 Dakar, Senegal
| | - Fanny Balique
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal ,grid.437080.8OZ Biosciences SAS, 13288 Marseille Cedex 09, France
| | - Cheikh Tidiane Diagne
- MIVEGEC (Infectious Diseases and Vector: Ecology, Genetics, Evolution and Control), Univ. Montpelier, IRD, CNRS, 34394 Montpellier, France
| | - Oumar Faye
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Moussa Moïse Diagne
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Gamou Fall
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Oumar Ndiaye
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Cheikh Loucoubar
- grid.418508.00000 0001 1956 9596Epidemiology, Clinical Research and Data Science Unit, Institut Pasteur de Dakar, 220 Dakar, Senegal
| | - Abdourahmane Sow
- grid.464557.10000 0004 0647 3618West African Health Organisation, 175, Avenue Ouezzin Coulibaly, 01BP: 153, Bobo Dioulasso 01, Burkina Faso
| | - Ousmane Faye
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
| | - Adama Faye
- grid.414371.4Service de Santé Publique et Appui à la Recherche (CHU Fann), Institut de Santé et Développement, Dakar, Senegal ,grid.8191.10000 0001 2186 9619Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Cheikh Saad Bouh Boye
- grid.8191.10000 0001 2186 9619Université Cheikh Anta Diop de Dakar, Dakar, Senegal ,Unité de Recherche et Biotechnologie Microbienne, Faculté de Médecine, de Pharmacie et d’Odontostomatologie (FMPOS), Dakar, Senegal
| | - Amadou Alpha Sall
- grid.418508.00000 0001 1956 9596Virology Department, Institut Pasteur de Dakar, 36, Avenue Pasteur, 220 Dakar, Senegal
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Jelicic P, Ferenc T, Mrzljak A, Jemersic L, Janev-Holcer N, Milosevic M, Bogdanic M, Barbic L, Kolaric B, Stevanovic V, Vujica M, Jurekovic Z, Pavicic Saric J, Vilibic M, Vilibic-Cavlek T. Insights into hepatitis E virus epidemiology in Croatia. World J Gastroenterol 2022; 28:5494-5505. [PMID: 36312833 PMCID: PMC9611701 DOI: 10.3748/wjg.v28.i37.5494] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/15/2022] [Accepted: 09/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) is an emerging virus of global health concern. The seroprevalence rates differ greatly according to geographic region and population group.
AIM To analyze the seroprevalence of HEV in exposed (animal-related professions) and nonexposed populations, as well as solid organ and hematopoietic stem cell transplant patients.
METHODS Forestry workers (n = 93), hunters (n = 74), and veterinarians (n = 151) represented the exposed population. The general population (n = 126) and pregnant women (n = 118) constituted the control group. Transplant patients included liver transplant recipients (LTRs) (n = 83), kidney transplant recipients (KTRs) (n = 43), and hematopoietic stem cell transplant recipients (HSCRs) (n = 39). HEV immunoglobulin G antibodies were detected using the enzyme-linked immunosorbent assay and confirmed by the immunoblot test.
RESULTS The HEV seroprevalence significantly differed between groups: Veterinarians 15.2%, hunters 14.9%, forestry workers 6.5%, general population 7.1%, and pregnant women 1.7%. In transplant patients, the seropositivity was highest in LTRs (19.3%), while in KTRs and HSCRs, the seroprevalence was similar to the general population (6.9% and 5.1%, respectively). A significant increase in seropositivity with age was observed from 2.9% in individuals less than 30 years to 23.5% in those older than 60 years. Sociodemographic characteristics (sex, educational level, area of residence, and number of household members), eating habits (game meat, offal, and pork products consumption), and environmental and housing conditions (drinking water supply, type of water drainage/sewer, waste disposal, domestic animals) were not associated with HEV seropositivity. However, individuals who reported a pet ownership were more often seropositive compared to those who did not have pet animals (12.5% vs 7.0%).
CONCLUSION The results of this study showed that individuals in professional contact with animals and LTRs are at higher risk for HEV infection. In addition, age is a significant risk factor for HEV seropositivity.
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Affiliation(s)
- Pavle Jelicic
- Department of Environmental Health, Croatian Institute of Public Health, Zagreb 10000, Croatia
| | - Thomas Ferenc
- Department of Radiology, Merkur University Hospital, Zagreb 10000, Croatia
| | - Anna Mrzljak
- Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Lorena Jemersic
- Department of Virology, Croatian Veterinary Institute, Zagreb 10000, Croatia
| | - Natasa Janev-Holcer
- Department of Environmental Health, Croatian Institute of Public Health, Zagreb 10000, Croatia
- Department of Social Medicine and Epidemiology, Faculty of Medicine University of Rijeka, Rijeka 51000, Croatia
| | - Milan Milosevic
- Department of Occupational and Environmental Health, Andrija Stampar School of Public Health, Zagreb 10000, Croatia
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine University of Zagreb, Zagreb 10000, Croatia
| | - Branko Kolaric
- Department of Gerontology and Social Medicine, Andrija Stampar Teaching Institute of Public Health, Zagreb 10000, Croatia
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine University of Zagreb, Zagreb 10000, Croatia
| | - Mateja Vujica
- Institute of Emergency Medicine of Krapina-Zagorje County, Krapina 49000, Croatia
| | - Zeljka Jurekovic
- Department of Nephrology, Merkur University Hospital, Zagreb 10000, Croatia
| | | | - Maja Vilibic
- Department for Social Psychiatry, Psychotherapy and Psychodiagnostics, University Clinical Hospital Center “Sestre Milosrdnice”, Zagreb 10000, Croatia
| | - Tatjana Vilibic-Cavlek
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
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First Report of the HEV Seroprevalence and the Risk Factor Assessment in the West Bank, Palestine, during the Period of 2015-2017. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2022; 2022:4935811. [PMID: 35178134 PMCID: PMC8847015 DOI: 10.1155/2022/4935811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/07/2022] [Accepted: 01/18/2022] [Indexed: 12/17/2022]
Abstract
Hepatitis E virus is emerging viral hepatitis with hyperendemicity in many countries. Data on the burden of disease is not available in Palestine. This study aims to determine the seroprevalence and the risk factors of the HEV among the general population of the West Bank, Palestine. In this cross-sectional study, a total of 432 sera samples from 40 localities in the eleven districts of the West Bank and Jerusalem, Palestine, during the period of March 2015 to March 2017, were tested for HEV-IgG. A structured questionnaire was used to collect data of the participants' demographics and disease risk factors. The overall seroprevalence was 3.7%. Level of education was significantly inversely associated with HEV seropositivity (P=0.04). Purely spatial analysis did not detect any significant cluster related to the distribution of HEV-IgG cases; however, living in the southern West Bank is shown to be significantly associated with HEV. Age was also associated with HEV seropositivity. The young (<19 years) and adults (>40 years) had the highest prevalence, compared to those between 20 to 39 years old (P=0.12). Furthermore, males and those in contact with animals were associated with HEV seropositivity (P=0.1 and 0.3, respectively). In conclusion, the seroprevalence of HEV IgG in the West Bank, Palestine is low. Several well-investigated risk factors cannot be supported by our results due to the small number of the positive HEV-IgG samples. Finally, this study is useful for providing a first look into the seroepidemiology of HEV in Palestine.
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Singla N, Bansal Y, Garg K, Sharma G, Gill M, Chander J. Seroprevalence of hepatitis A and hepatitis E in patients at a teaching hospital of northern India over a period of 8 years. J Family Med Prim Care 2022; 11:567-572. [PMID: 35360807 PMCID: PMC8963652 DOI: 10.4103/jfmpc.jfmpc_1212_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/12/2021] [Accepted: 10/16/2021] [Indexed: 11/04/2022] Open
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Molecular characterisation of Hepatitis E virus isolates from north India. Indian J Med Microbiol 2021; 40:91-95. [PMID: 34600752 DOI: 10.1016/j.ijmmb.2021.09.004] [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: 07/23/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Hepatitis E virus (HEV) is responsible for >50% of acute viral hepatitis (AVH) in developing countries. It has 4 major genotypes and various subtypes which vary in geographical distribution, clinical manifestations and epidemiological patterns. This study was conducted to characterise HEV isolates from north India to study the effect of host and viral factors on HEV infection. METHODS Serum samples collected from 536 AVH patients admitted to Department of Medicine, King George's Medical University, Lucknow from July 2016 to June 2017 were screened for anti HEV IgM, anti HAV IgM, HBsAg and anti HCV antibodies using commercial ELISA kits. Samples either positive for anti HEV IgM antibodies (n = 204) or negative for all 4 hepatotropic viruses (n = 37) were enrolled and tested by real time PCR for HEV RNA. HEV RNA positive samples with high viral load were further subjected to nested PCR for amplification of capsid gene. Sequencing and phylogenetic analysis were performed. HEV strains isolated from this study were deposited to GenBank under accession numbers MG571274 to MG571283. RESULTS Anti HEV IgM positivity was observed among 38% clinically suspected AVH cases. HEV RNA was detected in 31.8% seropositive HEV cases and additional 3 seronegative cases. Males outnumbered females and the most affected age group was of young adults. Maximum number of cases were seen during the months of June to September. Phylogenetic analysis showed that HEV strains in our study belonged to genotype 1a. Mortality in HEV infected pregnant females was 23.5% as compared to 2.4% in non-pregnant females. Adverse fetal outcome was recorded in 51% of HEV infected pregnancies. CONCLUSIONS HEV genotype 1a is prevalent in our setting. HEV during pregnancy is associated with adverse maternal and fetal outcome.
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Advances in Hepatitis E Virus Biology and Pathogenesis. Viruses 2021; 13:v13020267. [PMID: 33572257 PMCID: PMC7915517 DOI: 10.3390/v13020267] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/21/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
Hepatitis E virus (HEV) is one of the causative agents for liver inflammation across the world. HEV is a positive-sense single-stranded RNA virus. Human HEV strains mainly belong to four major genotypes in the genus Orthohepevirus A, family Hepeviridae. Among the four genotypes, genotype 1 and 2 are obligate human pathogens, and genotype 3 and 4 cause zoonotic infections. HEV infection with genotype 1 and 2 mainly presents as acute and self-limiting hepatitis in young adults. However, HEV infection of pregnant women with genotype 1 strains can be exacerbated to fulminant hepatitis, resulting in a high rate of case fatality. As pregnant women maintain the balance of maternal-fetal tolerance and effective immunity against invading pathogens, HEV infection with genotype 1 might dysregulate the balance and cause the adverse outcome. Furthermore, HEV infection with genotype 3 can be chronic in immunocompromised patients, with rapid progression, which has been a challenge since it was reported years ago. The virus has a complex interaction with the host cells in downregulating antiviral factors and recruiting elements to generate a conducive environment of replication. The virus-cell interactions at an early stage might determine the consequence of the infection. In this review, advances in HEV virology, viral life cycle, viral interference with the immune response, and the pathogenesis in pregnant women are discussed, and perspectives on these aspects are presented.
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Kalita D, Paul M, Deka S, Badoni G, Gupta P. Simultaneous infection of Hepatitis A and Hepatitis E viruses amongst acute viral hepatitis patients: A hospital-based study from Uttarakhand. J Family Med Prim Care 2020; 9:6130-6134. [PMID: 33681052 PMCID: PMC7928157 DOI: 10.4103/jfmpc.jfmpc_1373_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/12/2020] [Accepted: 10/14/2020] [Indexed: 11/04/2022] Open
Abstract
Background Enterically transmitted viral agents like Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are common causes of viral hepatitis in developing countries. Double infections by both agents, as their routes of entry are similar, are common. Overall this is a major health issue for our country. This study was carried out to learn about the seroprevalence of HAV & HEV (and double infections if any) infections in acute viral hepatitis (AVH) cases attending our hospital. Materials and Methods This is a retrospective cross-sectional study of a 2-years duration carried out in the serology lab of Dept. of Microbiology, AIIMS Rishikesh. Continuously collected samples totaling 617 cases, presenting with Acute Viral Hepatitis was included in the study. Cases with suggestive history were tested for IgM anti-HAV and IgM anti-HEVrespectively. Commercially available ELISA kits were put into use. Standard Statistical Package (SPSS 23) was put to use for statistical analysis. Results HAV & HEV seroprevalence in AVH cases were found to be 14.7% (91/617) and 28.04% (173/617), respectively. Dual infection of HAV and HEV was found in 5.9% (32/617) of study subjects. The prevalence of HAV and HEV among males were14.2% and 34.26%, respectively while that in female were 15.36% and 21.16%, respectively. Infection was predominantly found in young adults. Distinct seasonal variation was observed, period towards the end of monsoon, and beginning of winter recorded more cases. Both year, most of the positive cases are seen in the months of August and September. Conclusion The infection rate of HEV is higher than HAV amongst AVH cases. This and relatively high co-infection rate (5.9%) is significant in terms of the need for regular screening of HEV in pregnant women as well as the urgent need to improve hygiene amongst the population. This data will help in future vaccine strategies and sanitation programs in this part of the country.
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Affiliation(s)
- Deepjyoti Kalita
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manisha Paul
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sangeeta Deka
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Gaurav Badoni
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pratima Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Co-infection of Hepatitis A and Hepatitis E Viruses among the Acute Viral Hepatitis Cases in Tertiary Care Hospital –A Four Years Retrospective Study. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.3.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Acute viral hepatitis(AVH) is caused by Hepatitis A (HAV) and Hepatitis E(HEV). It is major health burden in India. Both the viruses HAV and HEV are primarily transmitted via the faeco-oral course. Study was conducted to determine the seroprevalence of HAV, HEV and rate of co-infection in AVH patients attending rural tertiary care centre. A retrospective laboratory record based study was carried out in rural tertiary health care center located in Western Maharashtra. Laboratory and Medical records of suspected acute viral infection patients were analyzed during study. Study period was June 2014 to July 2018. Commercially available ELISA kits of IgM anti-HAV and IgM anti-HEV were used to analyze serum samples of suspected study participants. Tests were carried out as per the manufacturer’s instructions. A total of 778 acute viral hepatitis cases were included in the study from July 2014 to July 2018 among which 85/778 (10.9 %) detected positive for HAV and 121/778 (15.6%) detected positive for HEV. Co-infection was identified in 6/778(0.8 %). Jaundice, fever fatigue and hepatomegaly were common clinical presentation in HAV, HEV and confection with both viruses in acute viral hepatitis patients. Study indicated low exposure to HAV in childhood bellow 16 years. Co-infection rate was detected high in 16-25 years age group. Vaccination policy against HAV in adolescent age group needed as there is change epidemiological shift of HAV which has been observed in the current study. These data will helps for planning future vaccination strategies, better implementation sanitation program, and safe water supply in this geographic area.
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Kaur M, Sidhu SK, Singh K, Devi P, Kaur M, Singh NJ. Hepatitis E virus: A leading cause of waterborne viral hepatitis in Northwest Districts of Punjab, India. J Lab Physicians 2020; 9:121-124. [PMID: 28367028 PMCID: PMC5320875 DOI: 10.4103/0974-2727.199636] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Acute viral hepatitis (AVH) caused by enterically transmitted hepatitis A virus (HAV) and hepatitis E virus (HEV) poses a major health problem in developing countries such as India. Despite improving sanitation, heath awareness, and socioeconomic conditions, these infections continue to occur both in sporadic as well as in epidemic forms in different parts of India. AIMS The aim of this study is to determine the total as well as age-specific prevalence rates of HAV and HEV in the outbreaks of waterborne hepatitis in districts surrounding Amritsar region of Punjab. MATERIALS AND METHODS The study was conducted in the Virology Research and Diagnostic Laboratory, Government Medical College, Amritsar, during the study period of January 2015-March 2016. Samples from suspected outbreaks of AVH occurring in various districts around Amritsar were included as a part of the study. A total of 95 sera were tested for IgM antibody to HEV and HAV using IgM capture ELISA kit. RESULTS Out of the total 95 samples received, 73 samples (76.84%) were positive for HAV/HEV. Out of the total positive cases, 65 (68.42%) had HEV infection, 2 (2.1%) had HAV, and 6 cases (6.31%) were coinfected with both HAV and HEV. The 21-30 years age group (25 cases) was identified as the most susceptible group for HEV infection. The coinfected subjects presented a wider range of age distribution (1-10 years: 1; 11-20 years: 3; 21-30 years: 1; 31-40 years: 1). Seasonal distribution of data revealed bimodal peaks for HEV infection. CONCLUSION There should be some surveillance system to regularly monitor the portability of drinking water from time to time to avoid such preventable outbreaks in future.
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Affiliation(s)
- Maninder Kaur
- Department of Microbiology, Government Medical College, Amritsar, Punjab, India
| | - Shailpreet K Sidhu
- Department of Microbiology, Government Medical College, Amritsar, Punjab, India
| | - Kanwardeep Singh
- Department of Microbiology, Government Medical College, Amritsar, Punjab, India
| | - Pushpa Devi
- Department of Microbiology, Government Medical College, Amritsar, Punjab, India
| | - Manpreet Kaur
- Department of Microbiology, Government Medical College, Amritsar, Punjab, India
| | - Nachhatar Jit Singh
- Department of Microbiology, Government Medical College, Amritsar, Punjab, India
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Mehta N, Gupta M, Mishra M, Singh SK. Hepatitis E Genotype 1 Outbreak in Jharkhand, India: A Descriptive Analysis. Infect Disord Drug Targets 2020; 21:99-104. [PMID: 31957617 DOI: 10.2174/1871526520666200117112813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/23/2019] [Accepted: 12/30/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION A waterborne outbreak of hepatitis E virus occurred in the Jamshedpur city of Jharkhand from March 2018 to October 2018. The aim of the present study is to study the hepatitis E virus outbreak clinically, serologically and etiologically. METHODS Five hundred and eighty-four clinically and biochemically documented cases were screened for the hepatotropic viral markers (HepatitisA, B, C, and E) by the ELISA. Demographic data such as gender, age, clinical diagnosis, location, outcome and time of admission were extracted from the online hospital management system. Water samples from the affected area were tested for HEV RNA detection. Genotyping of HEV virus was carried out by sequencing and phylogenetic analysis. RESULTS Hepatitis E genotype 1 was confirmed as the major etiological agent in this outbreak due to the faecal contamination of drinking water supply while establishing illegal water connections. Mixed infection of HEV-HAV (5.31%) or HEV-HBV (0.91%) was also detected in the present series of acute viral hepatitis. CONCLUSION The study highlights the importance of screening for both enterically transmitted hepatotropic viral markers as well as the parenterally transmitted hepatotropic viral markers during the outbreaks of acute viral hepatitis.
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Affiliation(s)
- Neelam Mehta
- TATA Main Hospital, Jamshedpur-831001, Jharkhand, India
| | | | | | - Santosh Kumar Singh
- School of Health & allied Sciences, ARKA Jain University, Jamshedpur-832108, Jharkhand, India
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Agrawal A, Singh S, Kolhapure S, Hoet B, Arankalle V, Mitra M. Increasing Burden of Hepatitis A in Adolescents and Adults and the Need for Long-Term Protection: A Review from the Indian Subcontinent. Infect Dis Ther 2019; 8:483-497. [PMID: 31679118 PMCID: PMC6856242 DOI: 10.1007/s40121-019-00270-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Indexed: 02/06/2023] Open
Abstract
Hepatitis A, an acute inflammatory liver disease caused by hepatitis A virus (HAV) infection from close contact with infected people, is highly endemic in the Indian subcontinent. Due to poor sanitary conditions, most of the population is exposed to the virus in childhood. At this age, the disease is asymptomatic and provides life-long protection against the disease. Due to rapid socioeconomic development in some areas, however, pockets of the population are reaching adolescence/adulthood without prior exposure to the virus and are thus susceptible to infection. At these ages, infection carries a higher risk of symptomatic disease and complications including mortality. This review of epidemiology and burden of disease studies in the Indian subcontinent, published since 2005, shows increasing evidence of a shift from high to intermediate endemicity in high-income-typically urban-populations. The prevalence of anti-HAV antibodies (previously reported at > 90%) is lower now in adolescents and young adults (e.g., around 80% in Bangladesh and 55% in 5-15 years in India). As a result, HAV is responsible for more acute viral hepatitis predominantly in this age group (e.g., > 15 years: 3.4% in 1999 to 12.3% in 2003 or high socioeconomic status 13-20 years: 27% in 1999 to 62% in 2003), with a greater clinical and economic burden. Numerous outbreaks due to HAV have been reported [e.g., Sri Lanka (2009-2010): > 13,000 affected; Kashmir (2015-2017): 12 outbreaks; Kerala (2012-2016): 84 outbreaks] from water or food contamination. Due to current shifts in endemicity, a growing proportion of the population is no longer exposed in childhood. As the disease remains highly endemic, it also provides a source for more severe disease in susceptible people at an older age and for outbreaks. Well-tolerated and effective vaccines are available and help prevent disease burden and provide long-term protection. These should now be used more widely to protect more patients from the growing disease burden of hepatitis A. FUNDING: GlaxoSmithKline Biologicals SA. Plain language summary available for this article-please see Fig. 1 and the following link: https://doi.org/10.6084/m9.figshare.9963044.Fig. 1Plain Language Summary. Highlights the context of the article, the endemicity shift and the burden of hepatitis A in adolescents and adults and steps to be taken to address the impact of this disease.
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Gupta R, Sanjeev RK, Agarwal A, Tomar RPS, Kumar N, Dutt V, Gupta S. A study of hepatitis A virus seropositivity among children aged between 1 and 5 years of age: Implications for universal immunization. Med J Armed Forces India 2019; 75:335-338. [PMID: 31388240 DOI: 10.1016/j.mjafi.2018.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/20/2018] [Indexed: 11/26/2022] Open
Abstract
Background Hepatitis A virus (HAV) causes an enterically transmitted viral disease mainly affecting children and endemic in many developing countries, including India. There is an epidemiological shift with an increased incidence of symptomatic cases among children. This study was conducted to assess the seroprevalence of HAV among young children aged below 5 years and the need for universal immunization. Method This cross-sectional study was conducted at two tertiary care hospitals in Northern India, from Apr 2014 to Jul 2015, among healthy children aged between 1 and 5 years. The sample size was calculated based on the prevalence of HAV seropositivity of 40% among children aged <10 years [16-60%] and alpha error of 5%. Analysis of serum IgG against HAV was performed by enzyme-linked immunosorbent assay method, and results were analyzed. Results A total of 1084 children aged between 12 and 60 months were enrolled, with male-to-female ratio of 1.86:1. A total of 471 children (43.5%) were found to be positive for IgG against HAV. The seroprevalence of HAV was lower among younger children aged 12-23 months (odds ratio [OR] = 0.73, 95% confidence interval [CI] = 0.52-0.87, p = 0.03), which was statistically significant. Seropositivity of HAV was lower among boys and families consuming safe drinking water and having improved sanitation facilities. Conclusion The study observed lower seropositivity against HAV among younger children, making them susceptible of contracting the disease. Possible underlying risk factors were younger age, unsafe drinking water, poor sanitation, and low education status of parents. Therefore, vaccination may be recommended as optional vaccine at one year of age, along with improved public health efforts for safe drinking water, hygiene practices, and food safety.
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Affiliation(s)
- Rakesh Gupta
- Director, Government Institute of Medical Sciences, Greater Noida, Gautam Buddha Nagar 201310, India
| | - R K Sanjeev
- Assistant Professor (Pediatrics), Pravara Institute of Medical Sciences, Loni, Ahmadnagar, India
| | - A Agarwal
- Professor, Department of Microbiology, Armed Forces Medical College, Pune 411040, India
| | - R P S Tomar
- Senior Advisor (Pediatrics), Military Hospital Secundrabad, India
| | - N Kumar
- Professor & Head (Pathology), TS Mishra Medical College, Lucknow, India
| | | | - Shishir Gupta
- Ex Medical Officer, INHS Kalyani, Visakhapatnam, India
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19
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Monette A, Mouland AJ. T Lymphocytes as Measurable Targets of Protection and Vaccination Against Viral Disorders. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2019; 342:175-263. [PMID: 30635091 PMCID: PMC7104940 DOI: 10.1016/bs.ircmb.2018.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Continuous epidemiological surveillance of existing and emerging viruses and their associated disorders is gaining importance in light of their abilities to cause unpredictable outbreaks as a result of increased travel and vaccination choices by steadily growing and aging populations. Close surveillance of outbreaks and herd immunity are also at the forefront, even in industrialized countries, where previously eradicated viruses are now at risk of re-emergence due to instances of strain recombination, contractions in viral vector geographies, and from their potential use as agents of bioterrorism. There is a great need for the rational design of current and future vaccines targeting viruses, with a strong focus on vaccine targeting of adaptive immune effector memory T cells as the gold standard of immunity conferring long-lived protection against a wide variety of pathogens and malignancies. Here, we review viruses that have historically caused large outbreaks and severe lethal disorders, including respiratory, gastric, skin, hepatic, neurologic, and hemorrhagic fevers. To observe trends in vaccinology against these viral disorders, we describe viral genetic, replication, transmission, and tropism, host-immune evasion strategies, and the epidemiology and health risks of their associated syndromes. We focus on immunity generated against both natural infection and vaccination, where a steady shift in conferred vaccination immunogenicity is observed from quantifying activated and proliferating, long-lived effector memory T cell subsets, as the prominent biomarkers of long-term immunity against viruses and their associated disorders causing high morbidity and mortality rates.
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20
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Najar S, Naghavi NS. Molecular Detection of Hepatitis A Virus in Urban Sewage in Isfahan, Iran. MEDICAL LABORATORY JOURNAL 2018. [DOI: 10.29252/mlj.12.4.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Bradanini L, Youkee D, Fabris P, Romanò L, Brunetti E, Giordani MT. Acute hepatitis E virus infection in a migrant population in North East Italy: A retrospective analysis. Travel Med Infect Dis 2017; 20:37-42. [PMID: 28411095 DOI: 10.1016/j.tmaid.2017.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 03/23/2017] [Accepted: 03/28/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To study the epidemiological and clinical features of Hepatitis E Virus (HEV) infection in a migrant population. METHODS We performed a retrospective chart review, identifying a cohort of 21 symptomatic patients of migrant origin with confirmed HEV infection admitted in the period between January 1995-November 2014. RESULTS 20 (95%) patients came from South Asian countries highly endemic for HEV, all positive for HEV genotype 1. Recent travel to a highly endemic country was the most consistent risk factor identified in 90% of cases, duration from return to Italy to hospitalization ranged from 10 to 120 days. Nausea and vomiting (100%), jaundice (95.2%), and anorexia (85.7%) were the most common reported symptoms. Fever was present in 57.1% of cases. Transaminase values were elevated in all patients and serum bilirubin was raised in 86% of patients. We found no statistically significant differences between clinical symptoms, laboratory results or duration of hospitalization in patients with co-morbidities compared to those without. We also report a secondary case of HEV genotype 1 transmitted within Italy. CONCLUSION Our study highlights the epidemiological risk factors and clinical features of HEV infection in a migrant population in Italy and should stimulate further research regarding the prevalence and morbidity of HEV within migrant populations in Europe.
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Affiliation(s)
- Lucia Bradanini
- Infectious and Tropical Diseases Unit, San Bortolo Hospital, Vicenza, Italy
| | - Daniel Youkee
- King's Centre for Global Health, King's College London, London, UK.
| | - Paolo Fabris
- Infectious and Tropical Diseases Unit, San Bortolo Hospital, Vicenza, Italy
| | - Luisa Romanò
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Enrico Brunetti
- Department of Infectious Diseases, San Matteo Hospital Foundation, Pavia, Italy
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22
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Murphy H, Abuova G, Pandey P. South Central Asia. Infect Dis (Lond) 2017. [DOI: 10.1002/9781119085751.ch14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Holy Murphy
- CIWEC Hospital and CIWEC Clinic Travel Medicine Center; Kathmandu Nepal
| | - Gulzhan Abuova
- Department of Infectious Diseases; South-Kazakhstan State Pharmaceutical Academy; Shymkent Kazakhstan
| | - Prativa Pandey
- CIWEC Hospital and CIWEC Clinic Travel Medicine Center; Kathmandu Nepal
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High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo. J Clin Microbiol 2017; 55:1299-1312. [PMID: 28202798 PMCID: PMC5405249 DOI: 10.1128/jcm.01847-16] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 02/02/2017] [Indexed: 12/22/2022] Open
Abstract
The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, enzyme-linked immunosorbent assay (ELISA) techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-hepatitis B core protein [HBc] IgM, respectively), HCV, and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. The seroprevalences were 16.7% for HAV, 24.6% for HBV, 2.3% for HCV, and 10.4% for HEV, and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 × 105 IU/ml for HBV (range, 769 to 9.82 × 109 IU/ml) and 1.4 × 106 IU/ml for HDV (range, 3.1 × 102 to 2.9 × 108 IU/ml). Genotypes A, E, and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC.
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Rendon J, Hoyos MC, di Filippo D, Cortes-Mancera F, Mantilla C, Velasquez MM, Sepulveda ME, Restrepo JC, Jaramillo S, Arbelaez MP, Correa G, Navas MC. Hepatitis E Virus Genotype 3 in Colombia: Survey in Patients with Clinical Diagnosis of Viral Hepatitis. PLoS One 2016; 11:e0148417. [PMID: 26886728 PMCID: PMC4757071 DOI: 10.1371/journal.pone.0148417] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/18/2016] [Indexed: 01/23/2023] Open
Abstract
Background Hepatitis E virus is a major cause of outbreaks as well as sporadic hepatitis cases worldwide. The epidemiology of this enterically transmitted infection differs between developing and developed countries. The aims of this study were to describe HEV infection in Colombian patients and to characterize the genotype. Methods A prospective study was carried out on 40 patients aged over 15 with a clinical diagnosis of viral hepatitis, recruited from five primary health units in the city of Medellin, Colombia. Fecal samples obtained from the 40 consecutives cases were analyzed for HEV RNA using nested reverse transcription PCR for both ORF1 and ORF2-3. The amplicons were sequenced for phylogenetic analyses. Results Nine (22.5%) cases of HEV infection were identified in the study population. Three HEV strains obtained from patients were classified as genotype 3. No significant association was found between cases of Hepatitis E and the variables water drinking source, garbage collection system and contact with pigs. Conclusions This is the first prospective study of hepatitis E in Colombian patients. The circulation of the genotype 3 in this population is predictable considering the reports of the region and the identification of this genotype from pigs in the state of Antioquia, of which Medellin is the capital. Further studies are necessary to establish whether zoonotic transmission of HEV is important in Colombia.
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Affiliation(s)
- Julio Rendon
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
| | - Maria Cristina Hoyos
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
| | - Diana di Filippo
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
| | - Fabian Cortes-Mancera
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
- Grupo de Investigación e Innovación Biomédica GIB, Facultad de Ciencias Exactas y Aplicadas, Instituto Tecnologico Metropolitano, Medellin, Colombia
| | - Carolina Mantilla
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
| | | | - Maria Elsy Sepulveda
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
- Hospital Pablo Tobon Uribe, Medellin, Colombia
| | - Juan Carlos Restrepo
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
- Hospital Pablo Tobon Uribe, Medellin, Colombia
| | | | - Maria Patricia Arbelaez
- Grupo de Epidemiología. Facultad Nacional de Salud Publica, Universidad de Antioquia, Medellín, Colombia
| | - Gonzalo Correa
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
| | - Maria-Cristina Navas
- Grupo de Gastrohepatologia. Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
- * E-mail:
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Vilibic-Cavlek T, Vilibic M, Kolaric B, Jemersic L, Kucinar J, Barbic L, Bagaric A, Stevanovic V, Tabain I, Sviben M, Jukic V, Mlinaric-Galinovic G. Seroepidemiology of Hepatitis E in Selected Population Groups in Croatia: A Prospective Pilot Study. Zoonoses Public Health 2016; 63:494-502. [PMID: 26776465 DOI: 10.1111/zph.12254] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Indexed: 12/16/2022]
Abstract
Hepatitis E has become an emerging infection in many European countries. We analysed the prevalence of hepatitis E virus (HEV) infection in selected population groups in Croatia. Overall HEV IgG seropositivity was 5.6%, while 1.9% participants showed IgM antibodies suggestive of recent infection. No IgM-positive sample was positive for HEV RNA. HEV IgG antibodies were most prevalent in alcohol abusers (8.9%) and war veterans (8.6%), compared with 6.1% among injecting drug users and 2.7% in healthcare professionals. No individual with high-risk sexual behaviour tested HEV seropositive. HEV IgG positivity increased significantly with age from 1.8% to 2.3% in individuals younger than 40 years to 11.3% in individuals older than 50 years (P = 0.023). The mean age of HEV-positive participants was significantly higher than that of HEV-negative participants (50.9 ± 11.8 years versus 41.2 ± 11.8 years, P = 0.008). Seroprevalence rates were significantly higher in residents of suburban and rural areas compared with residents of urban areas (14.5% versus 2.5%, P = 0.003). Additionally, an increasing prevalence of HEV IgG antibodies was observed from 1.8% in participants living in families with two household members to 12.1% in those living with more than four members (P = 0.046). Gender, marital status, educational level, sexual orientation, source of drinking water, history of blood transfusions, surgical procedures, tattooing and travelling were not associated with HEV seroprevalence. Logistic regression showed that living in suburban/rural areas was the main risk factor for HEV seropositivity (OR = 6.67; 95%CI = 1.89-25.0; AOR = 7.14, 95%CI = 1.89-25.0).
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Affiliation(s)
- T Vilibic-Cavlek
- Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - M Vilibic
- Vrapce University Psychiatric Hospital, Zagreb, Croatia
| | - B Kolaric
- Department of Epidemiology, Teaching Institute 'Dr Andrija Stampar', Zagreb, Croatia.,School of Medicine, University of Rijeka, Rijeka, Croatia
| | - L Jemersic
- Department of Virology, Croatian Veterinary Institute, Zagreb, Croatia
| | - J Kucinar
- Department of Microbiology, Istria County Institute of Public Health, Pula, Croatia
| | - L Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - A Bagaric
- Vrapce University Psychiatric Hospital, Zagreb, Croatia
| | - V Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - I Tabain
- Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia
| | - M Sviben
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - V Jukic
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Vrapce University Psychiatric Hospital, Zagreb, Croatia
| | - G Mlinaric-Galinovic
- Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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Coinfection of hepatitis E virus and other hepatitis virus in Colombia and its genotypic characterization. BIOMEDICA 2015; 36:69-78. [PMID: 27622794 DOI: 10.7705/biomedica.v36i0.2957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/22/2015] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Hepatitis E virus has emerged as a public health problem, particularly in developing countries. The four genotypes identified in mammals include the G3 found in indigenous hepatitis in countries and regions with high porcine population, and the G1, associated with maternal deaths. OBJECTIVE To determine coinfection by hepatitis E virus and the circulating genotypes in Colombia in 1,097 samples using serological markers for hepatitis A, B and C. MATERIALS AND METHODS Serum samples of 1,097 patients from different regions of Colombia stored at the Laboratorio de Virología of the Instituto Nacional de Salud were selected to detect IgG and IgM anti-hepatitis E virus antibodies. The viral genomes of positive samples were amplified by RT-PCR, and the products were sequenced and phylogenetically analyzed by comparing ORF2 sequences deposited in the GenBank. RESULTS IgG anti-hepatitis E virus antibodies were found in 278 samples, IgM in 62, and both markers in 64. Hepatitis E virus and hepatitis A virus coinfection determined by IgG anti-hepatitis E virus was 33.6% and 16.1% by IgM; hepatitis E virus and hepatitis B virus coinfection was 23.4% and 8.1%, and hepatitis E virus and hepatitis C virus coinfection was 35.4% and 5.83%, respectively. Among the 52 positive samples by PCR nine were sequenced and grouped within genotype 3A of the American porcine strain. CONCLUSIONS The highest seropositivity was observed for hepatitis A and E. The incidence of hepatitis E virus coinfection with other hepatotropic viruses indicated that this pathogen is more frequent than expected. The circulation of genotype 3A implies that this disease may occur in outbreaks and as zoonosis in Colombia.
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