1
|
Sottil P, Lhomme S, Saune K, El Hayani S, Oliveira-Mendes K, Peron JM, Kamar N, Izopet J, Abravanel F. Evaluation of an automated platform for the detection of HEV RNA in plasma and stool. J Virol Methods 2024; 327:114920. [PMID: 38574772 DOI: 10.1016/j.jviromet.2024.114920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/14/2024] [Accepted: 03/24/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION We evaluated the performance of the automated Altostar HEV RNA platform for detecting HEV RNA. METHODS AND RESULTS Clinical performance was determined by testing 81 plasma samples and 10 fecal samples manually quantified previously with the Realstar RT-PCR assay using the Magnapure instrument for extraction. The assays were concordant for 79/81 plasma samples (97.5%) and 10/10 (100%) fecal samples. The two plasma samples that tested negative with the Altostar assay had a very low HEV RNA concentration (1.6 and 1.4 log10 IU/ml). Quantitative results obtained with the automated platform and the manual workflow were highly correlated (ρ= 0.98, p<0.01). The intra-run and inter-run standard deviation were 0.09 IU/ml and 0.13 IU/ml respectively. The assay was linear from 2 to 6 log IU/ml. The limit of detection determined by Probit analysis with the WHO HEV RNA standard was 7.6 [95% CI: 4.4-52.5] IU/ml. CONCLUSIONS The Altostar platform enables highly accurate testing for the detection of HEV RNA in stool and the quantification of HEV RNA in plasma. This allowed us to shorten turnaround times and to save time for the technical staff.
Collapse
Affiliation(s)
- Pauline Sottil
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, Toulouse 31300, France
| | - Sébastien Lhomme
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, Toulouse 31300, France; Inserm UMR 1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France
| | - Karine Saune
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, Toulouse 31300, France; Inserm UMR 1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France
| | - Soheil El Hayani
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, Toulouse 31300, France
| | - Kévin Oliveira-Mendes
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, Toulouse 31300, France
| | - Jean-Marie Peron
- CHU Toulouse, Hôpital Purpan, Département de Gastroentérologie, 31300, France
| | - Nassim Kamar
- CHU Toulouse, Hôpital Rangueil, Département de Néphrologie, Dialyse et Transplantation multi-organe, 31300, France
| | - Jacques Izopet
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, Toulouse 31300, France; Inserm UMR 1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France
| | - Florence Abravanel
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, Toulouse 31300, France; Inserm UMR 1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France.
| |
Collapse
|
2
|
Abravanel F, Lhomme S. Hecolin vaccine: long-term efficacy against HEV for a three-dose regimen. Lancet 2024; 403:782-783. [PMID: 38387471 DOI: 10.1016/s0140-6736(23)02455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Florence Abravanel
- Inserm UMR 1291, CNRS UMR5051, Université Toulouse III, 31000 Toulouse, France.
| | - Sébastien Lhomme
- CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Centre for Hepatitis E, Toulouse, France
| |
Collapse
|
3
|
Cottu A, Kante A, Megherbi A, Lhomme S, Maisonneuve L, Santoli F. A frantic confusion: beyond rabies and anti-N-methyl-D-aspartate encephalitis. J Neurovirol 2023; 29:358-363. [PMID: 37171751 DOI: 10.1007/s13365-023-01146-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/12/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
Hepatitis E virus (HEV) is a leading cause of acute hepatitis worldwide. In rare cases, HEV may generate neurologic lesions such as neuralgic amyotrophy, Guillain-Barré syndrome, and meningoencephalitis. Thirteen cases of HEV meningoencephalitis have been reported over 20 years. The clinical landscape varied from mild symptoms to coma and seizures. Most of patients were immunocompetent adults and spontaneously recovered. We report here the case of a 44-year-old immunocompetent adult with HEV meningoencephalitis presenting with aggressiveness and then coma. The evolution was spontaneously favorable without any specific treatment. This clinical case aims to draw attention on this emerging and probably under-recognized cause of meningoencephalitis.
Collapse
Affiliation(s)
- Adrien Cottu
- Service de Réanimation Médicale, Centre Hospitalo-Universitaire Robert Ballanger, Aulnay-Sous-Bois, France.
- Université Pierre et Marie Curie, Sorbonne Universités, Paris 6, Paris, France.
| | - Aïcha Kante
- Service de Réanimation Médicale, Centre Hospitalo-Universitaire Robert Ballanger, Aulnay-Sous-Bois, France
- Université Pierre et Marie Curie, Sorbonne Universités, Paris 6, Paris, France
| | - Alexandre Megherbi
- Service de Réanimation Médicale, Centre Hospitalo-Universitaire Robert Ballanger, Aulnay-Sous-Bois, France
- Université Pierre et Marie Curie, Sorbonne Universités, Paris 6, Paris, France
| | - Sébastien Lhomme
- Laboratoire de Virologie, Hôpital Purpan, CHU Toulouse, 31300, Toulouse, France
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), UMR1291-CNRS UMR5051, INSERM, 31300, Toulouse, France
- Université Toulouse III Paul-Sabatier, 31062, Toulouse, France
| | - Lydia Maisonneuve
- Service de Biologie Médicale, Centre Hospitalo-Universitaire Robert Ballanger, Aulnay-Sous-Bois, France
| | - Francesco Santoli
- Service de Réanimation Médicale, Centre Hospitalo-Universitaire Robert Ballanger, Aulnay-Sous-Bois, France
| |
Collapse
|
4
|
Lhomme S, Magne S, Perelle S, Vaissière E, Abravanel F, Trelon L, Hennechart-Collette C, Fraisse A, Martin-Latil S, Izopet J, Figoni J, Spaccaferri G. Clustered Cases of Waterborne Hepatitis E Virus Infection, France. Viruses 2023; 15:v15051149. [PMID: 37243235 DOI: 10.3390/v15051149] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/06/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
The identification of seven cases of hepatitis E virus infection in a French rural hamlet in April 2015 led to investigations confirming the clustering and identifying the source of the infection. Laboratories and general practitioners in the area actively searched for other cases based on RT-PCR and serological tests. The environment, including water sources, was also checked for HEV RNA. Phylogenetic analyses were performed to compare HEV sequences. No other cases were found. Six of the seven patients lived in the same hamlet, and the seventh used to visit his family who lived there. All HEV strains were very similar and belonged to the HEV3f subgenotype, confirming the clustering of these cases. All the patients drank water from the public network. A break in the water supply to the hamlet was identified at the time the infection probably occurred; HEV RNA was also detected in a private water source that was connected to the public water network. The water flowing from the taps was quite turbid during the break. The private water supply containing HEV RNA was the likely source of the contamination. Private water supplies not disconnected from the public network are still frequent in rural areas, where they may contribute to public water pollution.
Collapse
Affiliation(s)
- Sébastien Lhomme
- Centre National de Référence (CNR) des Virus des Hépatites à Transmission Entériques (Hépatite A et E), Laboratoire de Virologie, CHU Toulouse, 31300 Toulouse, France
- Infinity, Université Toulouse, CNRS, Inserm, UPS, 31024 Toulouse, France
| | - Sébastien Magne
- Regional Health Agency of Auvergne-Rhône-Alpes, 15000 Aurillac, France
| | - Sylvie Perelle
- Laboratory for Food Safety, Université Paris-Est, Anses, 94700 Maisons-Alfort, France
| | - Emmanuelle Vaissière
- Santé Publique France (French National Public Health Agency), 63000 Clermont-Ferrand, France
| | - Florence Abravanel
- Centre National de Référence (CNR) des Virus des Hépatites à Transmission Entériques (Hépatite A et E), Laboratoire de Virologie, CHU Toulouse, 31300 Toulouse, France
- Infinity, Université Toulouse, CNRS, Inserm, UPS, 31024 Toulouse, France
| | - Laetitia Trelon
- Regional Health Agency of Auvergne-Rhône-Alpes, 15000 Aurillac, France
| | | | - Audrey Fraisse
- Laboratory for Food Safety, Université Paris-Est, Anses, 94700 Maisons-Alfort, France
| | - Sandra Martin-Latil
- Laboratory for Food Safety, Université Paris-Est, Anses, 94700 Maisons-Alfort, France
| | - Jacques Izopet
- Centre National de Référence (CNR) des Virus des Hépatites à Transmission Entériques (Hépatite A et E), Laboratoire de Virologie, CHU Toulouse, 31300 Toulouse, France
- Infinity, Université Toulouse, CNRS, Inserm, UPS, 31024 Toulouse, France
| | - Julie Figoni
- Santé Publique France (French National Public Health Agency), 94410 Saint-Maurice, France
| | - Guillaume Spaccaferri
- Santé Publique France (French National Public Health Agency), 63000 Clermont-Ferrand, France
| |
Collapse
|
5
|
Laperche S, Maugard C, Lhomme S, Lecam S, Ricard C, Dupont I, Richard P, Tiberghien P, Abravanel F, Morel P, Izopet J, Gallian P. Seven years (2015-2021) of blood donor screening for HEV-RNA in France: lessons and perspectives. Blood Transfus 2023; 21:110-118. [PMID: 35969132 PMCID: PMC10072995 DOI: 10.2450/2022.0052-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The French health authorities are considering expanding the current selective hepatitis E virus (HEV)-RNA testing procedure to include all donations in order to further reduce transfusion-transmitted HEV infection. Data obtained from blood donors (BDs) tested for HEV-RNA between 2015 and 2021 were used to assess the most efficient nucleic acid testing (NAT) strategy. MATERIALS AND METHODS Viral loads (VLs) and the plasma volume of blood components, as well as an HEV-RNA dose of 3.85 log IU as the infectious threshold and an assay with a 95% limit of detection (LOD) at 17 IU/mL, were used to assess the proportion of: (i) HEV-RNA-positive BDs that would remain undetected; and (ii) blood components associated with these undetected BDs with an HEV-RNA dose >3.85 log IU, considering 4 NAT options (Individual testing [ID], MP-6, MP-12, and MP-24). RESULTS Of the 510,118 BDs collected during the study period, 510 (0.10%) were HEV-RNA-positive. Based on measurable VLs available in 388 cases, 1%, 15.2%, 21.8%, and 32.6% of BDs would theoretically pass undetected due to a VL below the LOD of ID, MP-6, MP-12, and MP-24 testing, respectively. All BDs associated with a potentially infectious blood component would be detected with ID-NAT while 13% of them would be undetected with MP-6, 19.6% with MP-12, and 30.4% with MP-24 depending on the plasma volume. No red blood cell (RBC) components with an HEV-RNA dose >3.85 log IU would enter the blood supply, regardless of the NAT strategy used. DISCUSSION A highly sensitive ID-NAT would ensure maximum safety. However, an MP-based strategy can be considered given that: (i) the risk of transmission is closely related to the plasma volume of blood components; (ii) RBC are the most commonly transfused components and have a low plasma content; and (iii) HEV-RNA doses transmitting infection exceed 4 log IU. To minimise the potential risk associated with apheresis platelet components and fresh frozen plasma, less than 12 donations should be pooled using an NAT assay with a LOD of approximately 20 IU/mL.
Collapse
Affiliation(s)
- Syria Laperche
- Etablissement Français du Sang, La Plaine St-Denis, France
- Unité des Virus Émergents (UVE) Aix-Marseille-IRD 190-Inserm 1207-Marseille, France
| | - Claude Maugard
- Etablissement Français du Sang Occitanie, Montpellier, France
| | - Sébastien Lhomme
- Infinity, Université Toulouse III, CNRS, INSERM, Toulouse, France
- Laboratoire de Virologie, Hôpital Purpan, CHU, Toulouse, France
| | - Sophie Lecam
- Etablissement Français du Sang, La Plaine St-Denis, France
- Etablissement Français du Sang, Centre Pays de la Loire, Angers, France
| | - Céline Ricard
- Etablissement Français du Sang Hauts de France Normandie, Loos, France
| | | | | | - Pierre Tiberghien
- Etablissement Français du Sang, La Plaine St-Denis, France
- UMR 1098 RIGHT INSERM Université de Franche-Comté Etablissement Français du Sang, Besançon, France
| | - Florence Abravanel
- Infinity, Université Toulouse III, CNRS, INSERM, Toulouse, France
- Laboratoire de Virologie, Hôpital Purpan, CHU, Toulouse, France
| | - Pascal Morel
- Etablissement Français du Sang, La Plaine St-Denis, France
- UMR 1098 RIGHT INSERM Université de Franche-Comté Etablissement Français du Sang, Besançon, France
| | - Jacques Izopet
- Infinity, Université Toulouse III, CNRS, INSERM, Toulouse, France
- Laboratoire de Virologie, Hôpital Purpan, CHU, Toulouse, France
| | - Pierre Gallian
- Etablissement Français du Sang, La Plaine St-Denis, France
- Unité des Virus Émergents (UVE) Aix-Marseille-IRD 190-Inserm 1207-Marseille, France
| |
Collapse
|
6
|
Migueres M, Dimeglio C, Mansuy JM, Abravanel F, Raymond S, Latour J, Jeanne N, Ranger N, Lhomme S, Saune K, Tremeaux P, Izopet J. Influence of Nasopharyngeal Viral Load on the Spread of the Omicron BA.2 Variant. Clin Infect Dis 2023; 76:e514-e517. [PMID: 35796540 DOI: 10.1093/cid/ciac563] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 11/14/2022] Open
Abstract
We used variant typing polymerase chain reaction to describe the evolution of severe acute respiratory syndrome coronavirus 2 Omicron sublineages between December 2021 and mid-March 2022. The selective advantage of the BA.2 variant over BA.1 is not due to greater nasopharyngeal viral loads.
Collapse
Affiliation(s)
- Marion Migueres
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291-CNRS UMR5051, 31300 Toulouse, France.,Université Toulouse III Paul-Sabatier, 31062 Toulouse, France
| | - Chloé Dimeglio
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291-CNRS UMR5051, 31300 Toulouse, France.,Université Toulouse III Paul-Sabatier, 31062 Toulouse, France
| | - Jean-Michel Mansuy
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France
| | - Florence Abravanel
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291-CNRS UMR5051, 31300 Toulouse, France.,Université Toulouse III Paul-Sabatier, 31062 Toulouse, France
| | - Stéphanie Raymond
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291-CNRS UMR5051, 31300 Toulouse, France.,Université Toulouse III Paul-Sabatier, 31062 Toulouse, France
| | - Justine Latour
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France
| | - Nicolas Jeanne
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France
| | - Noémie Ranger
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France
| | - Sébastien Lhomme
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291-CNRS UMR5051, 31300 Toulouse, France.,Université Toulouse III Paul-Sabatier, 31062 Toulouse, France
| | - Karine Saune
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291-CNRS UMR5051, 31300 Toulouse, France.,Université Toulouse III Paul-Sabatier, 31062 Toulouse, France
| | - Pauline Tremeaux
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France
| | - Jacques Izopet
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291-CNRS UMR5051, 31300 Toulouse, France.,Université Toulouse III Paul-Sabatier, 31062 Toulouse, France
| |
Collapse
|
7
|
Abravanel F, Lhomme S, Marion O, Péron JM, Kamar N, Izopet J. Diagnostic and management strategies for chronic hepatitis E infection. Expert Rev Anti Infect Ther 2023; 21:143-148. [PMID: 36625025 DOI: 10.1080/14787210.2023.2166932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Hepatitis E Virus (HEV) was initially thought to cause only acute infections, but the discovery of chronic hepatitis E in immunocompromised patients has profoundly changed our understanding of the virus. AREAS COVERED We describe the physiopathology, diagnosis, and clinical management of chronic HEV infection. The virus can persist in nearly two-thirds of immunosuppressed patients. Reducing immunosuppression is the first immunomodulatory strategy to cure chronic hepatitis E. But this may not always be feasible or effective. Ribavirin monotherapy for 3 months has been recommended as first-line treatment for chronically infected patients. Ribavirin is around 80% effective at eradicating HEV in retrospective studies. Apart from ribavirin, interferon has been successfully used in liver transplants recipients, but if the patient does not respond, no other alternative drug is available. The vaccine available to prevent HEV infection is one available only in China. EXPERT OPINION HEV infection is a major concern in immunocompromised patients. But the therapeutic arsenal is limited to ribavirin and interferon. Both produce several side effects and new drugs are urgently needed. Moreover, preventive strategies to limit HEV transmission and/or evolution to a chronic infection are also required.
Collapse
Affiliation(s)
- Florence Abravanel
- Inserm UMR 1291 - CNRS UMR5051, Université Toulouse III, Toulouse, France.,CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, Toulouse, France
| | - Sébastien Lhomme
- Inserm UMR 1291 - CNRS UMR5051, Université Toulouse III, Toulouse, France.,CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, Toulouse, France
| | - Olivier Marion
- Inserm UMR 1291 - CNRS UMR5051, Université Toulouse III, Toulouse, France.,CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, Toulouse, France.,CHU Toulouse, Hôpital Rangueil, département de Néphrologie et transplantation d'organe, Toulouse, France
| | - Jean Marie Péron
- CHU Toulouse, Hôpital Rangueil, département de Gastroentérologie, Toulouse, France
| | - Nassim Kamar
- Inserm UMR 1291 - CNRS UMR5051, Université Toulouse III, Toulouse, France.,CHU Toulouse, Hôpital Rangueil, département de Néphrologie et transplantation d'organe, Toulouse, France
| | - Jacques Izopet
- Inserm UMR 1291 - CNRS UMR5051, Université Toulouse III, Toulouse, France.,CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, Toulouse, France
| |
Collapse
|
8
|
Migueres M, Dimeglio C, Trémeaux P, Abravanel F, Raymond S, Lhomme S, Mansuy JM, Izopet J. Influence of immune escape and nasopharyngeal virus load on the spread of SARS-CoV-2 Omicron variant. J Infect 2022; 84:e7-e9. [PMID: 35143815 PMCID: PMC8820095 DOI: 10.1016/j.jinf.2022.01.036] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/21/2022]
Affiliation(s)
- Marion Migueres
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France; Université Toulouse III Paul-Sabatier, Toulouse, France.
| | - Chloé Dimeglio
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France
| | - Pauline Trémeaux
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31300, France
| | - Florence Abravanel
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Stéphanie Raymond
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Sébastien Lhomme
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Jean-Michel Mansuy
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31300, France
| | - Jacques Izopet
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, CHU Toulouse, 330 avenue de Grande Bretagne, Toulouse 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| |
Collapse
|
9
|
Dimeglio C, Loubes JM, Migueres M, Sauné K, Trémeaux P, Lhomme S, Ranger N, Latour J, Mansuy JM, Izopet J. Influence of vaccination and prior immunity on the dynamics of Omicron BA.1 and BA.2 sub-variants. J Infect 2022; 84:834-872. [PMID: 35307410 PMCID: PMC8926943 DOI: 10.1016/j.jinf.2022.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/05/2023]
|
10
|
Lhomme S, Latour J, Jeanne N, Trémeaux P, Ranger N, Migueres M, Salin G, Donnadieu C, Izopet J. Prediction of SARS-CoV-2 Variant Lineages Using the S1-Encoding Region Sequence Obtained by PacBio Single-Molecule Real-Time Sequencing. Viruses 2021; 13:v13122544. [PMID: 34960813 PMCID: PMC8707593 DOI: 10.3390/v13122544] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/20/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the causal agent of the COVID-19 pandemic that emerged in late 2019. The outbreak of variants with mutations in the region encoding the spike protein S1 sub-unit that can make them more resistant to neutralizing or monoclonal antibodies is the main point of the current monitoring. This study examines the feasibility of predicting the variant lineage and monitoring the appearance of reported mutations by sequencing only the region encoding the S1 domain by Pacific Bioscience Single Molecule Real-Time sequencing (PacBio SMRT). Using the PacBio SMRT system, we successfully sequenced 186 of the 200 samples previously sequenced with the Illumina COVIDSeq (whole genome) system. PacBio SMRT detected mutations in the S1 domain that were missed by the COVIDseq system in 27/186 samples (14.5%), due to amplification failure. These missing positions included mutations that are decisive for lineage assignation, such as G142D (n = 11), N501Y (n = 6), or E484K (n = 2). The lineage of 172/186 (92.5%) samples was accurately determined by analyzing the region encoding the S1 domain with a pipeline that uses key positions in S1. Thus, the PacBio SMRT protocol is appropriate for determining virus lineages and detecting key mutations.
Collapse
Affiliation(s)
- Sébastien Lhomme
- Infinity, Université Toulouse, CNRS, INSERM, UPS, 31300 Toulouse, France; (M.M.); (J.I.)
- Laboratoire de Virologie, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France; (J.L.); (N.J.); (P.T.); (N.R.)
- Correspondence: ; Tel.: +33-5-67-69-04-24
| | - Justine Latour
- Laboratoire de Virologie, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France; (J.L.); (N.J.); (P.T.); (N.R.)
| | - Nicolas Jeanne
- Laboratoire de Virologie, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France; (J.L.); (N.J.); (P.T.); (N.R.)
| | - Pauline Trémeaux
- Laboratoire de Virologie, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France; (J.L.); (N.J.); (P.T.); (N.R.)
| | - Noémie Ranger
- Laboratoire de Virologie, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France; (J.L.); (N.J.); (P.T.); (N.R.)
| | - Marion Migueres
- Infinity, Université Toulouse, CNRS, INSERM, UPS, 31300 Toulouse, France; (M.M.); (J.I.)
- Laboratoire de Virologie, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France; (J.L.); (N.J.); (P.T.); (N.R.)
| | - Gérald Salin
- INRAE, US 1426, GeT-PlaGe, Genotoul, 31326 Castanet-Tolosan, France; (G.S.); (C.D.)
| | - Cécile Donnadieu
- INRAE, US 1426, GeT-PlaGe, Genotoul, 31326 Castanet-Tolosan, France; (G.S.); (C.D.)
| | - Jacques Izopet
- Infinity, Université Toulouse, CNRS, INSERM, UPS, 31300 Toulouse, France; (M.M.); (J.I.)
- Laboratoire de Virologie, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France; (J.L.); (N.J.); (P.T.); (N.R.)
| |
Collapse
|
11
|
Lhomme S, Abravanel F, Cintas P, Izopet J. Hepatitis E Virus Infection: Neurological Manifestations and Pathophysiology. Pathogens 2021; 10:pathogens10121582. [PMID: 34959537 PMCID: PMC8705630 DOI: 10.3390/pathogens10121582] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatitis E virus (HEV) is the first cause of viral hepatitis in the world. While the water-borne HEV genotypes 1 and 2 are found in developing countries, HEV genotypes 3 and 4 are endemic in developed countries due to the existence of animal reservoirs, especially swine. An HEV infection produces many extra-hepatic manifestations in addition to liver symptoms, especially neurological disorders. The most common are neuralgic amyotrophy or Parsonage–Turner syndrome, Guillain–Barré syndrome, myelitis, and encephalitis. The pathophysiology of the neurological injuries due to HEV remains uncertain. The immune response to the virus probably plays a role, but direct virus neurotropism could also contribute to the pathophysiology. This review describes the main neurological manifestations and their possible pathogenic mechanisms.
Collapse
Affiliation(s)
- Sébastien Lhomme
- Infinity, Université Toulouse, CNRS, INSERM, UPS, 31300 Toulouse, France; (F.A.); (J.I.)
- Laboratoire de Virologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France
- Correspondence: ; Tel.: +33-(0)-5-67-69-04-24
| | - Florence Abravanel
- Infinity, Université Toulouse, CNRS, INSERM, UPS, 31300 Toulouse, France; (F.A.); (J.I.)
- Laboratoire de Virologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France
| | - Pascal Cintas
- Service de Neurologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France;
| | - Jacques Izopet
- Infinity, Université Toulouse, CNRS, INSERM, UPS, 31300 Toulouse, France; (F.A.); (J.I.)
- Laboratoire de Virologie, Hôpital Purpan, CHU Toulouse, 31300 Toulouse, France
| |
Collapse
|
12
|
Parraud D, Lhomme S, Péron JM, Da Silva I, Tavitian S, Kamar N, Izopet J, Abravanel F. Rat Hepatitis E Virus: Presence in Humans in South-Western France? Front Med (Lausanne) 2021; 8:726363. [PMID: 34540871 PMCID: PMC8448288 DOI: 10.3389/fmed.2021.726363] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/10/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Hepatitis E Virus (HEV) is one of the most common causes of hepatitis worldwide, and South-Western France is a high HEV seroprevalence area. While most cases of HEV infection are associated with the species Orthohepevirus-A, several studies have reported a few cases of HEV infections due to Orthohepevirus-C (HEV-C) that usually infects rats. Most of these human cases have occurred in immunocompromised patients. We have screened for the presence of HEV-C in our region. Methods and Results: We tested 224 sera, mostly from immunocompromised patients, for HEV-C RNA using an in-house real time RT-PCR. Liver function tests gave elevated results in 63% of patients: mean ALT was 159 IU/L (normal < 40 IU/L). Anti-HEV IgG (49%) and anti-HEV IgM (9.4%) were frequently present but none of the samples tested positive for HEV-C RNA. Conclusion: HEV-C does not circulate in the human population of South-Western France, despite the high seroprevalence of anti-HEV IgG.
Collapse
Affiliation(s)
- Delphine Parraud
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital, Toulouse, France
| | - Sébastien Lhomme
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital, Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM UMR1291-CNRS UMR5051-Université Toulouse III, Toulouse, France
| | - Jean Marie Péron
- Department of Gastroenterology, Rangueil University Hospital, Toulouse, France
| | - Isabelle Da Silva
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital, Toulouse, France
| | - Suzanne Tavitian
- Department of Hematology, Cancer University Institute of Toulouse, Toulouse, France
| | - Nassim Kamar
- Departments of Nephrology and Organ Transplantation, Rangueil University Hospital, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France
| | - Jacques Izopet
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital, Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM UMR1291-CNRS UMR5051-Université Toulouse III, Toulouse, France
| | - Florence Abravanel
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital, Toulouse, France.,Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM UMR1291-CNRS UMR5051-Université Toulouse III, Toulouse, France
| |
Collapse
|
13
|
Migueres M, Lhomme S, Trémeaux P, Dimeglio C, Ranger N, Latour J, Dubois M, Nicot F, Miedouge M, Mansuy JM, Izopet J. Evaluation of two RT-PCR screening assays for identifying SARS-CoV-2 variants. J Clin Virol 2021; 143:104969. [PMID: 34509927 PMCID: PMC8411575 DOI: 10.1016/j.jcv.2021.104969] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 01/26/2023]
Abstract
Background The recent emergence of new SARS CoV-2 variants (variants of concern, VOC) that spread rapidly and may lead to immune escape has emphasized the urgent need to monitor and control their spread. Methods We analyzed 2018 SARS-CoV-2 positive specimens collected between February 9 and March 22, 2021 using the Thermofisher® TaqPath™ COVID-19 CE-IVD RT-PCR kit (TaqPath) and the ID solutions® ID™ SARS-CoV-2/UK/SA Variant Triplex RT-PCR (ID triplex) assay to screen for VOCs. Results The ID triplex assay identified 62.8% of them as VOCs: 61.8% B.1.1.7 and 0.9% B.1.351/P.1. The agreement between the ID triplex results for B.1.1.7 and the TaqPath S gene target failure (SGTF)/ S gene target late detection (SGTL) profile for this variant agreed very well (k = 0.86). A low virus load was the main cause of discrepancies. Sequencing discordant results with both assays indicated that the TaqPath assay detected the B.1.1.7 lineage slightly better. Both assays suggested that the virus loads of B.1.1.7 variants were significantly higher than those of non-B.1.1.7 strains. Only 10/20 B1.351/P.1 strains detected with the ID triplex assay were confirmed by sequencing. Conclusions We conclude that the SGTF/SGTL profiles identified using the TaqPath assay and ID triplex results are suitable for detecting the B.1.1.7 lineage. The ID triplex assay, which rapidly determines all three current VOCs simultaneously, could be a valuable tool for limiting virus spread by supporting contact-tracing and isolation.
Collapse
Affiliation(s)
- M Migueres
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France; Université Toulouse III Paul-Sabatier, Toulouse, France.
| | - S Lhomme
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| | - P Trémeaux
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France
| | - C Dimeglio
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France
| | - N Ranger
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France
| | - J Latour
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France
| | - M Dubois
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France
| | - F Nicot
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France
| | - M Miedouge
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France
| | - J M Mansuy
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France
| | - J Izopet
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051, Toulouse 31300, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| |
Collapse
|
14
|
Gallian P, Lhomme S, Morel P, Gross S, Mantovani C, Hauser L, Tinard X, Pouchol E, Djoudi R, Assal A, Abravanel F, Izopet J, Tiberghien P. Risk for Hepatitis E Virus Transmission by Solvent/Detergent-Treated Plasma. Emerg Infect Dis 2021; 26:2881-2886. [PMID: 33219652 PMCID: PMC7706953 DOI: 10.3201/eid2612.191482] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Hepatitis E has emerged as a major transfusion-transmitted infectious risk. Two recipients of plasma from 2 lots (A and B) of pooled solvent/detergent-treated plasma were found to be infected by hepatitis E virus (HEV) that was determined to have been transmitted by the solvent/detergent-treated plasma. HEV RNA viral loads were 433 IU in lot A and 55 IU in lot B. Retrospective studies found that 100% (13/13) of evaluable lot A recipients versus 18% (3/17) of evaluable lot B recipients had been infected by HEV (p<0.001), albeit not necessarily at time of transfusion. Among evaluable recipients, 86% with a transfused HEV RNA load >50,000 IU were infected, most likely by the HEV-containing solvent/detergent-treated plasma, versus only 7% with a transfused HEV RNA load <50,000 IU (p<0.001). Overall, solvent/detergent-treated plasma might harbor HEV. Such an occurrence might result in a dose-dependent risk for transfusion-transmitted hepatitis E.
Collapse
|
15
|
Izopet J, Marion O, Kamar N, Lhomme S. [Hepatitis E virus replication in intestinal cells: A new facet of this virus revealed]. Med Sci (Paris) 2021; 37:320-322. [PMID: 33908846 DOI: 10.1051/medsci/2021024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jacques Izopet
- Inserm UMR1291/CNRS UMR5051, INFINITY - Institut toulousain des maladies infectieuses et inflammatoires, 31024 Toulouse, France. - CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie de Purpan, 31059 Toulouse, France
| | - Olivier Marion
- Inserm UMR1291/CNRS UMR5051, INFINITY - Institut toulousain des maladies infectieuses et inflammatoires, 31024 Toulouse, France. - CHU Toulouse, Hôpital Rangueil, Service de néphrologie-hypertension artérielle-dialyse-transplantation, 31059 Toulouse, France
| | - Nassim Kamar
- Inserm UMR1291/CNRS UMR5051, INFINITY - Institut toulousain des maladies infectieuses et inflammatoires, 31024 Toulouse, France. - CHU Toulouse, Hôpital Rangueil, Service de néphrologie-hypertension artérielle-dialyse-transplantation, 31059 Toulouse, France
| | - Sébastien Lhomme
- Inserm UMR1291/CNRS UMR5051, INFINITY - Institut toulousain des maladies infectieuses et inflammatoires, 31024 Toulouse, France. - CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie de Purpan, 31059 Toulouse, France
| |
Collapse
|
16
|
Kamar N, Abravanel F, Behrendt P, Hofmann J, Pageaux GP, Barbet C, Moal V, Couzi L, Horvatits T, De Man RA, Cassuto E, Elsharkawy AM, Riezebos-Brilman A, Scemla A, Hillaire S, Donnelly MC, Radenne S, Sayegh J, Garrouste C, Dumortier J, Glowaki F, Matignon M, Coilly A, Figueres L, Mousson C, Minello A, Dharancy S, Rerolle JP, Lebray P, Etienne I, Perrin P, Choi M, Marion O, Izopet J, Cointault O, Del Bello A, Espostio L, Hebral AL, Lavayssière L, Lhomme S, Mansuy JM, Wedemeyer H, Nickel P, Bismuth M, Stefic K, Büchler M, D’Alteroche L, Colson P, Bufton S, Ramière C, Trimoulet P, Pischke S, Todesco E, Sberro Soussan R, Legendre C, Mallet V, Johannessen I, Simpson K. Ribavirin for Hepatitis E Virus Infection After Organ Transplantation: A Large European Retrospective Multicenter Study. Clin Infect Dis 2021; 71:1204-1211. [PMID: 31793638 DOI: 10.1093/cid/ciz953] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 10/01/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Ribavirin is currently recommended for treating chronic hepatitis E virus (HEV) infection. This retrospective European multicenter study aimed to assess the sustained virological response (SVR) in a large cohort of solid organ transplant (SOT) recipients with chronic HEV infection treated with ribavirin monotherapy (N = 255), to identify the predictive factors for SVR, and to evaluate the impact of HEV RNA mutations on virological response. METHODS Data from 255 SOT recipients with chronic HEV infection from 30 European centers were analyzed. Ribavirin was given at the median dose of 600 (range, 29-1200) mg/day (mean, 8.6 ± 3.6 mg/kg/day) for a median duration of 3 (range, 0.25-18) months. RESULTS After a first course of ribavirin, the SVR rate was 81.2%. It increased to 89.8% when some patients were offered a second course of ribavirin. An increased lymphocyte count at the initiation of therapy was a predictive factor for SVR, while poor hematological tolerance of ribavirin requiring its dose reduction (28%) and blood transfusion (15.7%) were associated with more relapse after ribavirin cessation. Pretreatment HEV polymerase mutations and de novo mutations under ribavirin did not have a negative impact on HEV clearance. Anemia was the main adverse event. CONCLUSIONS This large-scale retrospective study confirms that ribavirin is highly efficient for treating chronic HEV infection in SOT recipients and shows that the predominant HEV RNA polymerase mutations found in this study do not affect the rate of HEV clearance.This large-scale retrospective study that included 255 solid organ transplant recipients confirms that ribavirin is highly efficient for treating chronic hepatitis E virus (HEV) infection and shows that HEV RNA polymerase mutations do not play a role in HEV clearance.
Collapse
Affiliation(s)
- Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, Centre Hospitalier Universitaire (CHU) Rangueil, Institut National de la Santé et de la Recherche Médicale (INSERM) U1043, Institut Fédératif de Recherche Bio-médicale de Toulouse (IFR-BMT), University Paul Sabatier, Toulouse, France
| | - Florence Abravanel
- Department of Virology, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France
| | - Patrick Behrendt
- Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, and Institute of Experimental Virology, TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture between the Medical School Hannover and the Helmholtz Centre for Infection Research, German Centre for Infection Research, Hannover, Germany
| | - Jörg Hofmann
- Charité Universitätsmedizin Berlin, Department of Nephrology and Intensive Care and Institute of Virology, Labor Berlin Charité-Vivantes-GmbH, Berlin, Germany
| | | | - Christelle Barbet
- Department of Nephrology and Clinical Immunology, Bretonneau Hospital, University Hospital, Tours, France
| | - Valérie Moal
- Aix Marseille Université, Asistance Publique Hôpitaux de Marseille, Institut Pour la Recherche Pour le Développement, Microbes, Evolution, Phylogénie et Infection, Institut Hospitalo-Universitaire-Méditerranée Infection, Hôpital Conception, Centre de Néphrologie et Transplantation Rénale, Marseille, France
| | - Lionel Couzi
- Department of Nephrology and Transplantation, CHU Bordeaux, Bordeaux, France
| | - Thomas Horvatits
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert A De Man
- Departments of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | | | - Annelies Riezebos-Brilman
- Department of Medical Microbiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anne Scemla
- Service de néphrologie-transplantation, Hôpital Necker, Assitance publique- Hôpitaux de Paris (AP-HP), Paris et Université Paris Descartes, Paris, France
| | | | - Mhairi C Donnelly
- Department of Hepatology and Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Sylvie Radenne
- Department of Hepatology and Liver Transplantation, CHU de la Croix Rousse, Lyon, France
| | - Johnny Sayegh
- Department of Nephrology and Transplantation, CHU Angers, Angers, France
| | - Cyril Garrouste
- Department of Nephrology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Jérôme Dumortier
- Department of Hepatology, Edouard Herriot Hospital, CHU Lyon, Lyon, France
| | | | - Marie Matignon
- Assistance Publique-Hôpitaux de Paris, Nephrology and Renal Transplantation Department, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Université Paris-Est-Créteil, Département Hospitalo-Universitaire Virus-Immunité-Cancer, Institut Mondor de Recherche Biomédicale, Equipe 21, INSERM U 955, Créteil, France
| | - Audrey Coilly
- Centre Hépato-Biliaire, Hôpital Paul Brousse, AP-HP, INSERM U1193, Université Paris-Sud Paris-Saclay, Villejuif, France
| | - Lucile Figueres
- Department of Nephrology and Clinical Immunology, CHU Nantes, Nantes, France
| | | | - Anne Minello
- Department of Hepatogastroenterology and Digestive Oncology, CHU François Mitterrand, Dijon, France
| | - Sébastien Dharancy
- Hôpital Claude Huriez, Services Maladies de l'Appareil Digestif, INSERM Unité 995, Lille, France
| | | | - Pascal Lebray
- Department of Hepatology, Pitié Salpétrière Hospital, Paris, France
| | | | - Peggy Perrin
- Department of Nephrology, CHU Strasbourg, Strasbourg, France
| | - Mira Choi
- Charité Universitätsmedizin Berlin, Department of Nephrology and Intensive Care and Institute of Virology, Labor Berlin Charité-Vivantes-GmbH, Berlin, Germany
| | - Olivier Marion
- Department of Virology, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France
| | - Jacques Izopet
- Department of Virology, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Dimeglio C, Collot S, Abravanel F, Sauné K, Lhomme S, Faruch M, Sans N, Izopet J. Diagnosis options in patients suffering from COVID-19-like symptoms. J Med Virol 2021; 93:4076-4077. [PMID: 33300117 DOI: 10.1002/jmv.26724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/25/2020] [Accepted: 12/08/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Chloé Dimeglio
- Center de Physiopathologie de Toulouse Purpan (CPTP), UMR, INSERM U1043, CNRS U5282, Toulouse, France.,Virology Laboratory, Hôpital Purpan, CHU Toulouse, Toulouse, France
| | - Samia Collot
- Radiology Laboratory, Hôpital Rangueil, CHU Toulouse, Toulouse, France
| | - Florence Abravanel
- Center de Physiopathologie de Toulouse Purpan (CPTP), UMR, INSERM U1043, CNRS U5282, Toulouse, France.,Virology Laboratory, Hôpital Purpan, CHU Toulouse, Toulouse, France
| | - Karine Sauné
- Center de Physiopathologie de Toulouse Purpan (CPTP), UMR, INSERM U1043, CNRS U5282, Toulouse, France.,Virology Laboratory, Hôpital Purpan, CHU Toulouse, Toulouse, France
| | - Sébastien Lhomme
- Center de Physiopathologie de Toulouse Purpan (CPTP), UMR, INSERM U1043, CNRS U5282, Toulouse, France.,Virology Laboratory, Hôpital Purpan, CHU Toulouse, Toulouse, France
| | - Marie Faruch
- Radiology Laboratory, Hôpital Rangueil, CHU Toulouse, Toulouse, France
| | - Nicolas Sans
- Radiology Laboratory, Hôpital Rangueil, CHU Toulouse, Toulouse, France
| | - Jacques Izopet
- Center de Physiopathologie de Toulouse Purpan (CPTP), UMR, INSERM U1043, CNRS U5282, Toulouse, France.,Virology Laboratory, Hôpital Purpan, CHU Toulouse, Toulouse, France
| |
Collapse
|
18
|
Micas F, Suin V, Péron JM, Scholtes C, Tuaillon E, Vanwolleghem T, Bocket L, Lhomme S, Dimeglio C, Izopet J, Abravanel F. Analyses of Clinical and Biological Data for French and Belgian Immunocompetent Patients Infected With Hepatitis E Virus Genotypes 4 and 3. Front Microbiol 2021; 12:645020. [PMID: 33936003 PMCID: PMC8079808 DOI: 10.3389/fmicb.2021.645020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/22/2021] [Indexed: 12/01/2022] Open
Abstract
Hepatitis E virus (HEV) genotypes 3 and 4 are the major causes of acute hepatitis in industrialized countries. Genotype 3 is mainly found in Europe and America, while genotype 4 is predominant in Asia. Several Japanese studies have suggested that genotype 4 is more virulent than genotype 3. We investigated this aspect by analyzing the clinical and biological data for 27 French and Belgian immunocompetent patients infected with HEV genotype 4. Their infections were probably acquired locally, since none of these patients reported traveling outside France or Belgium during the 2–8 weeks before symptoms onset. Each patient was matched for age (±5 years) and gender with two patients infected with HEV genotype 3. Bivariate analysis indicated that the HEV genotype 4-infected patients had significantly higher alanine aminotransferase (ALT) (2067 IU/L) and aspartate aminotransferase (AST) (1581 IU/L) activities and total bilirubin concentrations (92.4 μmol/L) than did those infected with HEV genotype 3 (1566 IU/L, p = 0.016; 657 IU/L, p = 0.003 and 47 μmol/L, p = 0.046) at diagnosis. In contrast, more patients infected with HEV genotype 3 reported dark urine (71% vs. 39%, p = 0.02) and experienced asthenia (89% vs. 58%, p < 0.01) than did those infected with HEV genotype 4. Two HEV genotype 4-infected patients died of multi-organ failure, while none of the genotype 3-infected patients died (p = 0.035). Finally, stepwise regression analysis retained only a greater increase in ALT (odds-ratio: 1.0005, 95% confidence interval: 1.00012–1.00084) and less frequent fever (odds-ratio = 0.1244; 95% confidence interval: 0.01887–0.82020) for patients infected with HEV genotype 4. We conclude that HEV-4 infections are likely to be associated with higher ALT activity than HEV-3 infections. Additional immunological and virological studies are required to confirm these findings and better understand the influence, if any, of genotype on HEV pathophysiology.
Collapse
Affiliation(s)
- Florence Micas
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital Center, Toulouse, France
| | - Vanessa Suin
- National Reference Centre of Hepatitis Viruses, Sciensano, Brussels, Belgium
| | - Jean-Marie Péron
- Department of Gastroenterology, Rangueil University Hospital, Toulouse, France
| | - Caroline Scholtes
- INSERM U1052-Cancer Research Center of Lyon (CRCL), Lyon, France.,University of Lyon, University Claude Bernard Lyon 1 (UCBL1), Lyon, France.,Department of Virology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, CHU Montpellier, Montpellier, France
| | - Thomas Vanwolleghem
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.,Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
| | - Laurence Bocket
- Virology Laboratory EA3610, Faculty of Medicine, University Hospital Center, Lille, France
| | - Sébastien Lhomme
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital Center, Toulouse, France.,UMR Inserm U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France
| | - Chloé Dimeglio
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital Center, Toulouse, France.,UMR Inserm U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France
| | - Jacques Izopet
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital Center, Toulouse, France.,UMR Inserm U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France
| | - Florence Abravanel
- Virology Laboratory, National Reference Centre of Hepatitis E Viruses, Federal Institute of Biology, University Hospital Center, Toulouse, France.,UMR Inserm U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France
| |
Collapse
|
19
|
Nicot F, Dimeglio C, Migueres M, Jeanne N, Latour J, Abravanel F, Ranger N, Harter A, Dubois M, Lameiras S, Baulande S, Chapuy-Regaud S, Kamar N, Lhomme S, Izopet J. Classification of the Zoonotic Hepatitis E Virus Genotype 3 Into Distinct Subgenotypes. Front Microbiol 2021; 11:634430. [PMID: 33584599 PMCID: PMC7875884 DOI: 10.3389/fmicb.2020.634430] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 12/30/2020] [Indexed: 12/27/2022] Open
Abstract
Hepatitis E virus (HEV) genotype 3 is the most common genotype linked to HEV infections in Europe and America. Three major clades (HEV-3.1, HEV-3.2, and HEV-3.3) have been identified but the overlaps between intra-subtype and inter-subtype p-distances make subtype classification inconsistent. Reference sequences have been proposed to facilitate communication between researchers and new putative subtypes have been identified recently. We have used the full or near full-length HEV-3 genome sequences available in the Genbank database (April 2020; n = 503) and distance analyses of clades HEV-3.1 and HEV-3.2 to determine a p-distance cut-off (0.093 nt substitutions/site) in order to define subtypes. This could help to harmonize HEV-3 genotyping, facilitate molecular epidemiology studies and investigations of the biological and clinical differences between HEV-3 subtypes.
Collapse
Affiliation(s)
- Florence Nicot
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France
| | - Chloé Dimeglio
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France.,INSERM, U1043, Toulouse, France
| | - Marion Migueres
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France.,INSERM, U1043, Toulouse, France
| | - Nicolas Jeanne
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France
| | - Justine Latour
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France
| | - Florence Abravanel
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France.,INSERM, U1043, Toulouse, France.,Department of Virology, Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Noémie Ranger
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France
| | - Agnès Harter
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France
| | - Martine Dubois
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France
| | - Sonia Lameiras
- Institut Curie Genomics of Excellence Platform, Institut Curie Research Center, Paris, France
| | - Sylvain Baulande
- Institut Curie Genomics of Excellence Platform, Institut Curie Research Center, Paris, France
| | - Sabine Chapuy-Regaud
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France.,INSERM, U1043, Toulouse, France.,Department of Virology, Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Nassim Kamar
- INSERM, U1043, Toulouse, France.,Department of Virology, Université Toulouse III Paul-Sabatier, Toulouse, France.,CHU de Toulouse, Hôpital Rangueil, Service de Néphrologie, Dialyse et Transplantation d'Organe, Toulouse, France
| | - Sébastien Lhomme
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France.,INSERM, U1043, Toulouse, France.,Department of Virology, Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Jacques Izopet
- CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de l'Hépatite E, Toulouse, France.,INSERM, U1043, Toulouse, France.,Department of Virology, Université Toulouse III Paul-Sabatier, Toulouse, France
| |
Collapse
|
20
|
Trémeaux P, Lhomme S, Abravanel F, Raymond S, Mengelle C, Mansuy JM, Izopet J. Evaluation of the Aptima™ transcription-mediated amplification assay (Hologic®) for detecting SARS-CoV-2 in clinical specimens. J Clin Virol 2020; 129:104541. [PMID: 32659713 PMCID: PMC7336924 DOI: 10.1016/j.jcv.2020.104541] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/05/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which appeared in late 2019, has been limited by isolating infected individuals. However, identifying such individuals requires accurate diagnostic tools. OBJECTIVE This study evaluates the capacity of the Aptima™ Transcription-Mediated Amplification (TMA) assay (Hologic® Panther System) to detect the virus in clinical samples. STUDY DESIGN We compared the Aptima™ assay to two in-house real-time RT-PCR techniques, one running on the Panther Fusion™ module and the other on the MagNA Pure 96 and Light-Cycler 480 instruments. We included a total of 200 respiratory specimens: 100 tested prospectively and 100 retrospectively (25 -ve/75 +ve). RESULTS The final Cohen's kappa coefficients were: κ = 0.978 between the Aptima™ and Panther Fusion™ assays, κ = 0.945 between the Aptima™ and MagNA/LC480 assays and κ = 0.956 between the MagNA/LC480 and Panther Fusion™ assays. CONCLUSION These findings indicate that the Aptima™ SARS-CoV-2 TMA assay data agree well with those obtained with our routine methods and that this assay can be used to diagnose coronavirus disease 2019 (COVID-19).
Collapse
Affiliation(s)
| | - Sébastien Lhomme
- Department of Virology, CHU Purpan, Toulouse, France; INSERM UMR1043/CNRS UMR5282, Center for Pathophysiology of Toulouse Purpan, France, Toulouse III University Paul Sabatier, Toulouse, France
| | - Florence Abravanel
- Department of Virology, CHU Purpan, Toulouse, France; INSERM UMR1043/CNRS UMR5282, Center for Pathophysiology of Toulouse Purpan, France, Toulouse III University Paul Sabatier, Toulouse, France
| | - Stéphanie Raymond
- Department of Virology, CHU Purpan, Toulouse, France; INSERM UMR1043/CNRS UMR5282, Center for Pathophysiology of Toulouse Purpan, France, Toulouse III University Paul Sabatier, Toulouse, France
| | | | | | - Jacques Izopet
- Department of Virology, CHU Purpan, Toulouse, France; INSERM UMR1043/CNRS UMR5282, Center for Pathophysiology of Toulouse Purpan, France, Toulouse III University Paul Sabatier, Toulouse, France
| |
Collapse
|
21
|
Belbézier A, Deroux A, Sarrot-Reynauld F, Colombe B, Bosseray A, Wintenberger C, Dumanoir P, Lugosi M, Boccon-Gibod I, Leroy V, Maignan M, Collomb-Muret R, Viglino D, Vaillant M, Minotti L, Lagrange E, Epaulard O, Dumestre-Perard C, Lhomme S, Lupo J, Larrat S, Morand P, Schwebel C, Vilotitch A, Bosson JL, Bouillet L. Screening of hepatitis E in patients presenting for acute neurological disorders. J Infect Public Health 2020; 13:1047-1050. [PMID: 32224109 DOI: 10.1016/j.jiph.2019.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/13/2019] [Accepted: 12/21/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Hepatitis E virus (HEV) infection has been reported to be associated with neurological disorders. However, the real prevalence of acute hepatitis E in those diseases is still unknown. We determined the prevalence of anti-HEV IgM antibody in a population with acute non-traumatic, non-metabolic, non-vascular neurological injury. METHOD A registry was created in Grenoble Hospital University from 2014 to 2018 to collect data on patients with acute (<3 months) non-traumatic, non-metabolic, non-vascular neurological injuries. Acute hepatitis E was defined as anti-HEV IgM-positive serum in immunocompetent patient, and as anti-HEV IgM-positive serum or HEV RNA-positive serum in immunocompromised patients. RESULTS One hundred fifty-nine patients were included. Anti-HEV IgM seroprevalence in our cohort of non-traumatic, non-metabolic, non-vascular neurological injuries was 6.9% (eleven patients, including 4 Parsonage-Turner syndrome (PTS) and 2 Guillain-Barré syndrome (GBS)). Elevated transaminases were observed in only 64% of hepatitis E patients and cholestasis in 64%. CONCLUSION In this study, 6·9% of patients with acute non-traumatic, non-metabolic, non-vascular neurological injuries had a probable recent HEV infection. HEV serology should be systematically performed in this population, even in patients with normal transaminase level.
Collapse
Affiliation(s)
- Aude Belbézier
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France.
| | - Alban Deroux
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | | | - Barbara Colombe
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | - Annick Bosseray
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | - Claire Wintenberger
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | - Perrine Dumanoir
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | - Maxime Lugosi
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | | | - Vincent Leroy
- Department of Hepatology, Grenoble University Hospital, Grenoble, France
| | - Maxime Maignan
- Department of Emergency, Grenoble University Hospital, Grenoble, France
| | | | - Damien Viglino
- Department of Emergency, Grenoble University Hospital, Grenoble, France
| | - Mathieu Vaillant
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | - Lorella Minotti
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | - Emeline Lagrange
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | - Olivier Epaulard
- Univ. Grenoble Alpes, Department of Infectious Disease, Grenoble University Hospital, Grenoble, France
| | - Chantal Dumestre-Perard
- Univ. Grenoble Alpes, CNRS, Laboratory of Immunology CHU Grenoble Alpes, TIMC-IMAG, 38000 Grenoble, France
| | - Sébastien Lhomme
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Julien Lupo
- Univ. Grenoble Alpes, CEA, CNRS, Virology Laboratory CHU Grenoble Alpes, IBS, 38000 Grenoble, France
| | - Sylvie Larrat
- Univ. Grenoble Alpes, CEA, CNRS, Virology Laboratory CHU Grenoble Alpes, IBS, 38000 Grenoble, France
| | - Patrice Morand
- Univ. Grenoble Alpes, CEA, CNRS, Virology Laboratory CHU Grenoble Alpes, IBS, 38000 Grenoble, France
| | - Carole Schwebel
- Univ. Grenoble Alpes, Laboratory of Bioclinical Pharmaceutic CHU Grenoble Alpes, INSERM U1039, 38000 Grenoble, France
| | - Antoine Vilotitch
- Department of Public Health, Grenoble University Hospital, Grenoble, France
| | - Jean-Luc Bosson
- Department of Public Health, Grenoble University Hospital, Grenoble, France; Univ. Grenoble Alpes, CNRS, Public Health Department CHU Grenoble Alpes, TIMC-IMAG, 38000 Grenoble, France
| | - Laurence Bouillet
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France; Univ. Grenoble Alpes, Department of Internal Medicine CHU Grenoble, Inserm (U1036), CEA, BIG-BCI, France
| |
Collapse
|
22
|
Abravanel F, Dimeglio C, Castanier M, Péron JM, Kamar N, Lhomme S, Izopet J. Does HEV-3 subtype play a role in the severity of acute hepatitis E? Liver Int 2020; 40:333-337. [PMID: 31837187 DOI: 10.1111/liv.14329] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 12/14/2022]
Abstract
Hepatitis E virus genotype 3 (HEV-3) is a major aetiologic agent of acute hepatitis in industrialized countries. Two main HEV-3 subtypes are found in Europe: subtypes 3c and 3f. We have analysed the clinical and biological parameters from 100 French immunocompetent patients with an HEV subtype 3f or subtype 3c infection, included in a prospective multicentre study. Stepwise regression analysis found that infections with HEV subtype 3f were associated with fever (OR: 6.1 95%CI: 1.4-26.1), have a greater virus load (OR: 7.4; 95%CI: 1.3-42.2) and require more frequent hospitalization (OR: 7.6; 95%CI: 1.1-51.4) than those infected with subtype 3c. The directed acyclic graph strengthens the multivariate analyses indicating a direct link between the HEV subtype, HEV RNA concentration, fever and hospitalization. Further studies on patients in other European countries are needed to confirm this relationship and determine the underlying mechanism.
Collapse
Affiliation(s)
- Florence Abravanel
- UMR Inserm, U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France.,Laboratoire de virologie, CHU Toulouse, Hôpital Purpan, Centre national de référence du virus de l'hépatite E, Toulouse, France
| | - Chloé Dimeglio
- UMR Inserm, U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France.,Laboratoire de virologie, CHU Toulouse, Hôpital Purpan, Centre national de référence du virus de l'hépatite E, Toulouse, France
| | - Mathilde Castanier
- Département de Gastroentérologie, CHU Toulouse, Hôpital Rangueil, Toulouse, France
| | - Jean-Marie Péron
- Département de Gastroentérologie, CHU Toulouse, Hôpital Rangueil, Toulouse, France
| | - Nassim Kamar
- UMR Inserm, U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France.,Département de Néphrologie-Transplantation d'organe, CHU Toulouse, Hôpital Rangueil, Toulouse, France
| | - Sébastien Lhomme
- UMR Inserm, U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France.,Laboratoire de virologie, CHU Toulouse, Hôpital Purpan, Centre national de référence du virus de l'hépatite E, Toulouse, France
| | - Jacques Izopet
- UMR Inserm, U1043, UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France.,Laboratoire de virologie, CHU Toulouse, Hôpital Purpan, Centre national de référence du virus de l'hépatite E, Toulouse, France
| |
Collapse
|
23
|
Lhomme S, Nicot F, Jeanne N, Dimeglio C, Roulet A, Lefebvre C, Carcenac R, Manno M, Dubois M, Peron JM, Alric L, Kamar N, Abravanel F, Izopet J. Insertions and Duplications in the Polyproline Region of the Hepatitis E Virus. Front Microbiol 2020; 11:1. [PMID: 32082274 PMCID: PMC7004952 DOI: 10.3389/fmicb.2020.00001] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/03/2020] [Indexed: 12/27/2022] Open
Abstract
Recombinant strains of hepatitis E virus (HEV) with insertions of human genomic fragments or HEV sequence duplications in the sequence encoding the polyproline region (PPR) were previously described in chronically infected patients. Such genomic rearrangements confer a replicative advantage in vitro but little is known about their frequency, location, or origin. As the sequences of only a few virus genomes are available, we analyzed the complete genomes of 114 HEV genotype 3 strains from immunocompromised (n = 85) and immunocompetent (n = 29) patients using the single molecular real-time sequencing method to determine the frequency, location, and origin of inserted genomic fragments, plus the proportions of variants with genomic rearrangements in each virus quasispecies. We also examined the amino acid compositions and post-translational modifications conferred by these rearrangements by comparing them to sequences without human gene insertions or HEV gene duplications. We found genomic rearrangements in 7/114 (6.1%) complete genome sequences (4 HEV-3f, 1 HEV-3e, 1 HEV-3 h, and 1 HEV-3chi-new), all from immunocompromised patients, and 3/7 were found at the acute phase of infection. Six of the seven patients harbored virus-host recombinant variants, including one patient with two different recombinant variants. We also detected three recombinant variants with genome duplications of the PPR or PPR + X domains in a single patient. All the genomic rearrangements (seven human fragment insertions of varying origins and three HEV genome duplications) occurred in the PPR. The sequences with genomic rearrangements had specific characteristics: increased net load (p < 0.001) and more ubiquitination (p < 0.001), phosphorylation (p < 0.001), and acetylation (p < 0.001) sites. The human fragment insertions and HEV genome duplications had slightly different characteristics. We believe this is the first description of HEV strains with genomic rearrangements in patients at the acute phase of infection; perhaps these strains are directly transmitted. Clearly, genomic rearrangements produce a greater net load with duplications and insertions having different features. Further studies are needed to clarify the mechanisms by which such modifications influence HEV replication.
Collapse
Affiliation(s)
- Sébastien Lhomme
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France.,INSERM, U1043, Toulouse, France.,Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Florence Nicot
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Nicolas Jeanne
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Chloé Dimeglio
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Alain Roulet
- Plateforme Génomique, Centre INRA Occitanie-Toulouse, Castanet-Tolosan, France
| | - Caroline Lefebvre
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Romain Carcenac
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Maxime Manno
- Plateforme Génomique, Centre INRA Occitanie-Toulouse, Castanet-Tolosan, France
| | - Martine Dubois
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Jean-Marie Peron
- Service de Gastroentérologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Laurent Alric
- Service de médecine interne, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Nassim Kamar
- INSERM, U1043, Toulouse, France.,Université Toulouse III-Paul Sabatier, Toulouse, France.,Service de néphrologie, Dialyse et Transplantation d'Organe, Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | - Florence Abravanel
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France.,INSERM, U1043, Toulouse, France.,Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Jacques Izopet
- Laboratoire de Virologie, Centre National de Référence du virus de l'hépatite E, Hôpital Purpan, CHU de Toulouse, Toulouse, France.,INSERM, U1043, Toulouse, France.,Université Toulouse III-Paul Sabatier, Toulouse, France
| |
Collapse
|
24
|
Capelli N, Dubois M, Pucelle M, Da Silva I, Lhomme S, Abravanel F, Chapuy-Regaud S, Izopet J. Optimized Hepatitis E Virus (HEV) Culture and its Application to Measurements of HEV Infectivity. Viruses 2020; 12:v12020139. [PMID: 31991673 PMCID: PMC7077187 DOI: 10.3390/v12020139] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/08/2020] [Accepted: 01/21/2020] [Indexed: 02/07/2023] Open
Abstract
Hepatitis E virus (HEV) is a major concern in public health worldwide. Infections with HEV genotypes 3, 4, or 7 can lead to chronic hepatitis while genotype 1 infections can trigger severe hepatitis in pregnant women. Infections with all genotypes can worsen chronic liver diseases. As virions are lipid-associated in blood and naked in feces, efficient methods of propagating HEV clinical strains in vitro and evaluating the infectivity of both HEV forms are needed. We evaluated the spread of clinical strains of HEV genotypes 1 (HEV1) and 3 (HEV3) by quantifying viral RNA in culture supernatants and cell lysates. Infectivity was determined by endpoint dilution and calculation of the tissue culture infectious dose 50 (TCID50). An enhanced HEV production could be obtained varying the composition of the medium, including fetal bovine serum (FBS) and dimethylsulfoxide (DMSO) content. This increased TCID50 from 10 to 100-fold and allowed us to quantify HEV1 infectivity. These optimized methods for propagating and measuring HEV infectivity could be applied to health safety processes and will be useful for testing new antiviral drugs.
Collapse
Affiliation(s)
- Nicolas Capelli
- Department of Virology, National Reference Center for HEV, CHU Purpan, 31059 Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Institut National de la Santé et de la Recherche Médicale, Inserm UMR1043, Centre National de la Recherche Scientifique, CNRS UMR5282, Université de Toulouse, 31024 Toulouse, France
| | - Martine Dubois
- Department of Virology, National Reference Center for HEV, CHU Purpan, 31059 Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Institut National de la Santé et de la Recherche Médicale, Inserm UMR1043, Centre National de la Recherche Scientifique, CNRS UMR5282, Université de Toulouse, 31024 Toulouse, France
| | - Mélanie Pucelle
- Department of Virology, National Reference Center for HEV, CHU Purpan, 31059 Toulouse, France
| | - Isabelle Da Silva
- Department of Virology, National Reference Center for HEV, CHU Purpan, 31059 Toulouse, France
| | - Sébastien Lhomme
- Department of Virology, National Reference Center for HEV, CHU Purpan, 31059 Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Institut National de la Santé et de la Recherche Médicale, Inserm UMR1043, Centre National de la Recherche Scientifique, CNRS UMR5282, Université de Toulouse, 31024 Toulouse, France
| | - Florence Abravanel
- Department of Virology, National Reference Center for HEV, CHU Purpan, 31059 Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Institut National de la Santé et de la Recherche Médicale, Inserm UMR1043, Centre National de la Recherche Scientifique, CNRS UMR5282, Université de Toulouse, 31024 Toulouse, France
| | - Sabine Chapuy-Regaud
- Department of Virology, National Reference Center for HEV, CHU Purpan, 31059 Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Institut National de la Santé et de la Recherche Médicale, Inserm UMR1043, Centre National de la Recherche Scientifique, CNRS UMR5282, Université de Toulouse, 31024 Toulouse, France
- Correspondence: ; Tel.: +33-567-690-431
| | - Jacques Izopet
- Department of Virology, National Reference Center for HEV, CHU Purpan, 31059 Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Institut National de la Santé et de la Recherche Médicale, Inserm UMR1043, Centre National de la Recherche Scientifique, CNRS UMR5282, Université de Toulouse, 31024 Toulouse, France
| |
Collapse
|
25
|
Lhomme S, Marion O, Abravanel F, Izopet J, Kamar N. Clinical Manifestations, Pathogenesis and Treatment of Hepatitis E Virus Infections. J Clin Med 2020; 9:E331. [PMID: 31991629 PMCID: PMC7073673 DOI: 10.3390/jcm9020331] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/14/2020] [Accepted: 01/22/2020] [Indexed: 02/07/2023] Open
Abstract
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis throughout the world. Most infections are acute but they can become chronic in immunocompromised patients, such as solid organ transplant patients, patients with hematologic malignancy undergoing chemotherapy and those with a human immunodeficiency virus (HIV) infection. Extra-hepatic manifestations, especially neurological and renal diseases, have also been described. To date, four main genotypes of HEV (HEV1-4) were described. HEV1 and HEV2 only infect humans, while HEV3 and HEV4 can infect both humans and animals, like pigs, wild boar, deer and rabbits. The real epidemiology of HEV has been underestimated because most infections are asymptomatic. This review focuses on the recent advances in our understanding of the pathophysiology of acute HEV infections, including severe hepatitis in patients with pre-existing liver disease and pregnant women. It also examines the mechanisms leading to chronic infection in immunocompromised patients and extra-hepatic manifestations. Acute infections are usually self-limiting and do not require antiviral treatment. Conversely, a chronic HEV infection can be cleared by decreasing the dose of immunosuppressive drugs or by treating with ribavirin for 3 months. Nevertheless, new drugs are needed for those cases in which ribavirin treatment fails.
Collapse
Affiliation(s)
- Sébastien Lhomme
- Virology Laboratory, National Reference Center for Hepatitis E Virus, Toulouse Purpan University Hospital, 31300 Toulouse, France; (F.A.); (J.I.)
- INSERM UMR1043, Center for Pathophysiology of Toulouse Purpan, 31300 Toulouse, France;
- Université Toulouse III Paul Sabatier, 31330 Toulouse, France
| | - Olivier Marion
- INSERM UMR1043, Center for Pathophysiology of Toulouse Purpan, 31300 Toulouse, France;
- Université Toulouse III Paul Sabatier, 31330 Toulouse, France
- Department of Nephrology and Organs Transplantation, Toulouse Rangueil University Hospital, 31400 Toulouse, France
| | - Florence Abravanel
- Virology Laboratory, National Reference Center for Hepatitis E Virus, Toulouse Purpan University Hospital, 31300 Toulouse, France; (F.A.); (J.I.)
- INSERM UMR1043, Center for Pathophysiology of Toulouse Purpan, 31300 Toulouse, France;
- Université Toulouse III Paul Sabatier, 31330 Toulouse, France
| | - Jacques Izopet
- Virology Laboratory, National Reference Center for Hepatitis E Virus, Toulouse Purpan University Hospital, 31300 Toulouse, France; (F.A.); (J.I.)
- INSERM UMR1043, Center for Pathophysiology of Toulouse Purpan, 31300 Toulouse, France;
- Université Toulouse III Paul Sabatier, 31330 Toulouse, France
| | - Nassim Kamar
- INSERM UMR1043, Center for Pathophysiology of Toulouse Purpan, 31300 Toulouse, France;
- Université Toulouse III Paul Sabatier, 31330 Toulouse, France
- Department of Nephrology and Organs Transplantation, Toulouse Rangueil University Hospital, 31400 Toulouse, France
| |
Collapse
|
26
|
Abravanel F, Lhomme S, Trémeaux P, Migueres M, Harter A, Haslé C, Bruel P, Alric L, Métivier S, Raymond S, Izopet J. Performance of the Xpert HBV Viral Load assay versus the Aptima Quant assay for quantifying hepatitis B virus DNA. Diagn Microbiol Infect Dis 2019; 96:114946. [PMID: 31771903 DOI: 10.1016/j.diagmicrobio.2019.114946] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/07/2019] [Accepted: 11/13/2019] [Indexed: 02/02/2023]
Abstract
Quantification of HBV DNA is used for initiating and monitoring antiviral treatment. We have evaluated the Xpert HBV Viral Load (VL) assay on the GeneXpert instrument. We estimated its limit of detection to be 7.5 IU/mL. Reproducibility was 1.1-12.7% as assessed by the coefficients of variation for 3 different samples. The assay was linear from 2 to 8 log10 IU/mL for HBV genotypes A to F. Its clinical performance was evaluated by testing prospectively 100 HBV DNA-positive samples with the Xpert HBV VL and Aptima Quant HBV assays. The results from the 2 assays were correlated, with a modest bias (-0.10 log10 IU/mL) between them by Bland-Altman analysis. Patient monitoring with 80 samples performed with both assays gave similar patient profiles with trends in the same direction. The Xpert HBV Viral load assay is reliable enough for quantifying HBV DNA in clinical practice.
Collapse
Affiliation(s)
- Florence Abravanel
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France.
| | - Sébastien Lhomme
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Pauline Trémeaux
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Marion Migueres
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Agnès Harter
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France
| | - Catherine Haslé
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France
| | - Patrick Bruel
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France
| | - Laurent Alric
- CHU Toulouse, Hôpital Purpan, Fédération digestive, F-31300, France
| | - Sophie Métivier
- CHU Toulouse, Hôpital Purpan, Fédération digestive, F-31300, France
| | - Stéphanie Raymond
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Jacques Izopet
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| |
Collapse
|
27
|
Lhomme S, Legrand-Abravanel F, Kamar N, Izopet J. Screening, diagnosis and risks associated with Hepatitis E virus infection. Expert Rev Anti Infect Ther 2019; 17:403-418. [DOI: 10.1080/14787210.2019.1613889] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Sébastien Lhomme
- Department of Virology, National reference center for Hepatitis E Virus, CHU Purpan, Toulouse, France
- Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France
- Université de Toulouse, Toulouse III, Toulouse, France
| | - Florence Legrand-Abravanel
- Department of Virology, National reference center for Hepatitis E Virus, CHU Purpan, Toulouse, France
- Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France
- Université de Toulouse, Toulouse III, Toulouse, France
| | - Nassim Kamar
- Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France
- Université de Toulouse, Toulouse III, Toulouse, France
- Department of Nephrology and Organs Transplantation, CHU Rangueil, Toulouse, France
| | - Jacques Izopet
- Department of Virology, National reference center for Hepatitis E Virus, CHU Purpan, Toulouse, France
- Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France
- Université de Toulouse, Toulouse III, Toulouse, France
| |
Collapse
|
28
|
Del Bello A, Abravanel F, Alric L, Lavayssiere L, Lhomme S, Bellière J, Izopet J, Kamar N. No evidence of occult hepatitis C or E virus infections in liver-transplant patients with sustained virological response after therapy with direct acting agents. Transpl Infect Dis 2019; 21:e13093. [PMID: 30972874 DOI: 10.1111/tid.13093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/21/2019] [Accepted: 04/07/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS It has been recently suggested that occult hepatitis C virus (HCV) infection and hepatitis E virus (HEV) reactivation might occur after direct acting antiviral agent-induced (DAA-induced) sustained virological response (SVR). The aim of our study was to identify occult HCV and HEV infection in a cohort of organ transplant patients who had achieved SVR and had persistent elevation in liver-enzyme levels. PATIENTS AND METHOD Sixty-six liver and/or kidney transplant patients were treated with DAAs. All but one achieved SVR12. Twenty-nine (8-39) months post-SVR12, 8 of the 65 patients (12.3%) who achieved SVR12 had persistently elevated liver enzyme levels. In 1 patient, this was related to hepatitis B virus reactivation. In the 7 remaining patients, blood samples (n = 7), liver biopsies (n = 4), and peripheral blood mononuclear cells (PBMCs) (n = 7) were collected simultaneously in order to identify occult HCV or HEV infection. RESULTS Hepatitis C virus RNA and HEV RNA were not detected in serum, liver tissues, or PBMCs. No HEV reactivation was observed after HCV clearance in patients who had anti-HEV IgG. CONCLUSION Our study suggests that there is no occult HCV or HEV infection in transplant patients after successful treatment of HCV infection with DAAs, even in patients with a persistent elevation of liver enzyme levels. However, due to the small number of patients included in our study, this finding should be confirmed in a larger cohort.
Collapse
Affiliation(s)
- Arnaud Del Bello
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - Florence Abravanel
- Department of Virology, Institut Fédératif de Biologie de Purpan, CHU Toulouse, France.,Centre de Physiopathologie de Toulouse Purpan, CHU Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France
| | - Laurent Alric
- Department of Internal Medicine and Digestive Diseases, CHU Purpan, UMR 152 Pharma Dev, IRD Toulouse 3 University, Toulouse, France
| | - Laurence Lavayssiere
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Sébastien Lhomme
- Department of Virology, Institut Fédératif de Biologie de Purpan, CHU Toulouse, France.,Centre de Physiopathologie de Toulouse Purpan, CHU Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France
| | - Julie Bellière
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - Jacques Izopet
- Department of Virology, Institut Fédératif de Biologie de Purpan, CHU Toulouse, France.,Centre de Physiopathologie de Toulouse Purpan, CHU Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,Université Paul Sabatier, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France
| |
Collapse
|
29
|
Marion O, Lhomme S, Abravanel F, Izopet J, Kamar N. Should 12‐ or 24‐week post‐ribavirin follow‐up be considered to define sustained virological response in transplant patients treated for chronic hepatitis E virus infection? Transpl Infect Dis 2019; 21:e13065. [DOI: 10.1111/tid.13065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Olivier Marion
- Department of Nephrology, Dialysis and Organs Transplantation, INSERM U1043, IFR –BMT, CHU Rangueil University Paul Sabatier Toulouse France
| | - Sébastien Lhomme
- Department of Virology, INSERM U1043, IFR –BMT University Paul Sabatier Toulouse France
| | - Florence Abravanel
- Department of Virology, INSERM U1043, IFR –BMT University Paul Sabatier Toulouse France
| | - Jacques Izopet
- Department of Virology, INSERM U1043, IFR –BMT University Paul Sabatier Toulouse France
| | - Nassim Kamar
- Department of Nephrology, Dialysis and Organs Transplantation, INSERM U1043, IFR –BMT, CHU Rangueil University Paul Sabatier Toulouse France
| |
Collapse
|
30
|
Charre C, Ramière C, Dumortier J, Abravanel F, Lhomme S, Gincul R, Scholtès C. Chronic Genotype 3 Hepatitis E in Pregnant Woman Receiving Infliximab and Azathioprine. Emerg Infect Dis 2019; 24:941-943. [PMID: 29664396 PMCID: PMC5938778 DOI: 10.3201/eid2405.171845] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Acute hepatitis E virus infection during pregnancy has a high fatality rate in developing countries. Little data are available on chronic infection in pregnant women. We report a case of chronic hepatitis E during treatment with infliximab and azathioprine, without adverse event during pregnancy and with spontaneous resolution after delivery.
Collapse
|
31
|
Marion O, Lhomme S, Del Bello A, Abravanel F, Esposito L, Hébral AL, Lavayssière L, Cointault O, Ribes D, Izopet J, Kamar N. Monitoring hepatitis E virus fecal shedding to optimize ribavirin treatment duration in chronically infected transplant patients. J Hepatol 2019; 70:206-209. [PMID: 30563687 DOI: 10.1016/j.jhep.2018.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Olivier Marion
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France; Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France
| | - Sébastien Lhomme
- Laboratory of Virology, CHU Purpan, Toulouse, France; Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France; Université Paul Sabatier, Toulouse, France
| | - Arnaud Del Bello
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Florence Abravanel
- Laboratory of Virology, CHU Purpan, Toulouse, France; Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France; Université Paul Sabatier, Toulouse, France
| | - Laure Esposito
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Anne Laure Hébral
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Laurence Lavayssière
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Olivier Cointault
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - David Ribes
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Jacques Izopet
- Laboratory of Virology, CHU Purpan, Toulouse, France; Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France; Université Paul Sabatier, Toulouse, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France; Inserm UMR1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| |
Collapse
|
32
|
Abravanel F, Lacipière A, Lhomme S, Dubois M, Minier L, Peron JM, Alric L, Kamar N, Izopet J. Performance of a commercial assay for detecting and quantifying HEV RNA in faeces. J Clin Virol 2018; 109:1-5. [PMID: 30336371 PMCID: PMC7106495 DOI: 10.1016/j.jcv.2018.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 01/11/2023]
Abstract
No commercial HEV RNA assay is validated for use in faecal samples. Monitoring HEV faecal excretion is recommended for managing chronic HEV infection in solid-organ transplant recipients. We evaluated the Altona assay by testing patients on ribavirin therapy.
Background Detecting hepatitis E virus (HEV) RNA in faeces is useful for diagnosing and monitoring HEV infections, particularly in immunocompromised patients requiring ribavirin therapy. Objectives This study evaluated the performance of the Altona RealStar HEV RNA kit for detecting and quantifying HEV in faeces. Study design RNA was extracted from 94 stool samples by two methods: QIAamp Viral RNA Mini kit and MagNA Pure 96 automate. The Altona results were compared to a reference laboratory-developed accredited ISO15189 RT-PCR assay. Results The Altona and reference assays detect HEV RNA in 77/93 (82.8%) and 83/93 (89.2%) of the QIAamp extracted samples, respectively, after exclusion of invalid result; they detected HEV RNA in 67/92 (72.8%) and 66/92 (71.7%) of the MagNA Pure extracted samples, respectively, which emphasizes the importance of the RNA extraction method. The HEV RNA concentrations obtained with Altona RT-PCR and the reference RT-PCR were well correlated whatever the extraction method, and Bland Altman analyses indicated that the Altona values were higher than the reference assay values. The Altona values for QIAamp-extracted and MagNA Pure-extracted HEV RNA were very similar. Conclusions The Altona RealStar assay is suitable for quantifying HEV RNA in the faeces and monitoring HEV RNA shedding during ribavirin therapy. Extraction is critical for detecting faecal HEV with high performance RT-PCR assays.
Collapse
Affiliation(s)
- Florence Abravanel
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, F-31300, France.
| | - Audrey Lacipière
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, F-31300, France
| | - Sébastien Lhomme
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, F-31300, France
| | - Martine Dubois
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, F-31300, France
| | - Luce Minier
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, F-31300, France
| | - Jean-Marie Peron
- CHU Toulouse, Hôpital Purpan, Département de Gastroentérologie, F-31300, France
| | - Laurent Alric
- CHU Toulouse, Hôpital Purpan, Service de médecine interne, F-31300, France
| | - Nassim Kamar
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Rangueil, Département de Néphrologie, Dialyse et Transplantation multi-organe, F-31300 France
| | - Jacques Izopet
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E, F-31300, France
| |
Collapse
|
33
|
Abravanel F, Pique J, Couturier E, Nicot F, Dimeglio C, Lhomme S, Chiabrando J, Saune K, Péron JM, Kamar N, Evrard S, de Valk H, Cintas P, Izopet J. Acute hepatitis E in French patients and neurological manifestations. J Infect 2018; 77:220-226. [PMID: 29966614 DOI: 10.1016/j.jinf.2018.06.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/07/2018] [Accepted: 06/21/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Hepatitis E virus (HEV) is a major cause of acute hepatitis worldwide. However, our understanding of the source of contamination is incomplete and the frequency of neurological manifestations in still unknown. METHODS 200 eligible cases reported to the French National Reference Center from January 2015 to December 2015 were prospectively included in this case-control study (1 case: 1 control, matched for sex, age and area of living) to investigate the risk of infection. We documented the factors associated with their HEV infection and clinical manifestations. RESULTS The 200 HEV-infected patients included 137 who were immunocompetent and 63 immunocompromised. The factors associated with an HEV infection were contact with farm animals, eating pork liver sausage and eating unpeeled fruit. The 33 patients (16.5%) who reported neurological symptoms included 14 with neuropathic pain suggesting small fiber neuropathy, 9 with painless sensory disorders, 6 with Parsonage-Turner syndrome, one Guillain-Barre syndrome, one meningitis, one encephalitis and one diplopia. Neurological manifestations were more frequent in immunocompetent patients (22.6% vs 3.2%, p < 0.001). CONCLUSIONS This study highlights the risk of HEV transmission by the environment in industrialized countries. The higher frequency of neurological disorders in immunocompetent patients suggests pathophysiological mechanisms involving the immune system.
Collapse
Affiliation(s)
- Florence Abravanel
- UMR Inserm, U1043; UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, Toulouse, F-31300 France.
| | - Julie Pique
- CHU Toulouse, Hôpital Purpan, Département de Neurologie, Toulouse, F-31300 France
| | | | - Florence Nicot
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, Toulouse, F-31300 France
| | - Chloé Dimeglio
- CHU Toulouse, Unité de soutien méthodologique à la recherche, Toulouse, F-31300 France; Inserm U1027, Université Toulouse III, Toulouse, F-31300 France
| | - Sébastien Lhomme
- UMR Inserm, U1043; UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, Toulouse, F-31300 France
| | - Julie Chiabrando
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, Toulouse, F-31300 France
| | - Karine Saune
- UMR Inserm, U1043; UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, Toulouse, F-31300 France
| | - Jean-Marie Péron
- CHU Toulouse, Hôpital Purpan, Département de Gastroentérologie, Toulouse, F-31300 France
| | - Nassim Kamar
- UMR Inserm, U1043; UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, F-31300, France; CHU de Toulouse, Hôpital Rangueil, Service de néphrologie, Dialyse et Transplantation d'Organe, Toulouse, F-31300 France
| | - Solène Evrard
- CHU Toulouse, Institut Universitaire du Cancer, Département d'Anatomie et Cytologie Pathologiques, Toulouse, F-31300 France
| | | | - Pascal Cintas
- CHU Toulouse, Hôpital Purpan, Département de Neurologie, Toulouse, F-31300 France
| | - Jacques Izopet
- UMR Inserm, U1043; UMR CNRS, U5282, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre national de référence du virus de l'hépatite E, Toulouse, F-31300 France
| | | |
Collapse
|
34
|
Mansuy JM, Lhomme S, Cazabat M, Pasquier C, Martin-Blondel G, Izopet J. Detection of Zika, dengue and chikungunya viruses using single-reaction multiplex real-time RT-PCR. Diagn Microbiol Infect Dis 2018; 92:284-287. [PMID: 30029808 DOI: 10.1016/j.diagmicrobio.2018.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/25/2018] [Accepted: 06/19/2018] [Indexed: 01/08/2023]
Abstract
Zika (ZIKV), Dengue (DENV) and Chikungunya viruses (CHIKV) co-circulate in the same geographical areas during the same seasonal period through the same biting arthropods. Therefore a rapid sensitive and specific molecular assay for these viruses would be a considerable help in the disease management and the epidemiological survey. We developed a one-step multiplex real-time PCR for the simultaneous detection of these viruses. Intra and inter-reproducibilities varied from 0.41% to 3.29% and from 1.13% to 4.93% for each virus respectively. The specificity was 100%. Whole blood, plasma and urines were used for comparison with commercially available monoplex assays (RealStar® kits, Altona Diagnostics GmbH, Hamburg, Germany). The concordance was 96%, 92.9% and 95.7% for ZIKV, DENV and CHIKV respectively. No cross reaction and no PCR inhibition were observed for any of the clinical samples. This test can thus be used as a rapid molecular assay for ZIKV, DENV1-4 and CHIKV infections.
Collapse
Affiliation(s)
| | - Sébastien Lhomme
- Department of Virology, CHU Purpan, Toulouse, France; INSERM, UMR1043, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| | - Michelle Cazabat
- Department of Virology, CHU Purpan, Toulouse, France; INSERM, UMR1043, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| | - Christophe Pasquier
- Department of Virology, CHU Purpan, Toulouse, France; INSERM, UMR1043, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| | - Guillaume Martin-Blondel
- INSERM, UMR1043, Toulouse, France; Department of Infectious and Tropical Diseases, CHU Purpan, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| | - Jacques Izopet
- Department of Virology, CHU Purpan, Toulouse, France; INSERM, UMR1043, Toulouse, France; Université Paul Sabatier, Toulouse, France.
| |
Collapse
|
35
|
Nicot F, Jeanne N, Roulet A, Lefebvre C, Carcenac R, Manno M, Dubois M, Kamar N, Lhomme S, Abravanel F, Izopet J. Diversity of hepatitis E virus genotype 3. Rev Med Virol 2018; 28:e1987. [PMID: 29939461 DOI: 10.1002/rmv.1987] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/12/2018] [Accepted: 05/21/2018] [Indexed: 12/27/2022]
Abstract
Hepatitis E virus genotype 3 (HEV-3) can lead to chronic infection in immunocompromised patients, and ribavirin is the treatment of choice. Recently, mutations in the polymerase gene have been associated with ribavirin failure but their frequency before treatment according to HEV-3 subtypes has not been studied on a large data set. We used single-molecule real-time sequencing technology to sequence 115 new complete genomes of HEV-3 infecting French patients. We analyzed phylogenetic relationships, the length of the polyproline region, and mutations in the HEV polymerase gene. Eighty-five (74%) were in the clade HEV-3efg, 28 (24%) in HEV-3chi clade, and 2 (2%) in HEV-3ra clade. Using automated partitioning of maximum likelihood phylogenetic trees, complete genomes were classified into subtypes. Polyproline region length differs within HEV-3 clades (from 189 to 315 nt). Investigating mutations in the polymerase gene, distinct polymorphisms between HEV-3 subtypes were found (G1634R in 95% of HEV-3e, G1634K in 56% of HEV-3ra, and V1479I in all HEV-3efg, clade HEV-3ra, and HEV-3k strains). Subtype-specific polymorphisms in the HEV-3 polymerase have been identified. Our study provides new complete genome sequences of HEV-3 that could be useful for comparing strains circulating in humans and the animal reservoir.
Collapse
Affiliation(s)
- Florence Nicot
- Centre National de Référence du virus de l'hépatite E, Laboratoire de Virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Nicolas Jeanne
- Centre National de Référence du virus de l'hépatite E, Laboratoire de Virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Alain Roulet
- Plateforme Génomique, Centre INRA Occitanie-Toulouse, Castanet-Tolosan, France
| | - Caroline Lefebvre
- Centre National de Référence du virus de l'hépatite E, Laboratoire de Virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Romain Carcenac
- Centre National de Référence du virus de l'hépatite E, Laboratoire de Virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Maxime Manno
- Plateforme Génomique, Centre INRA Occitanie-Toulouse, Castanet-Tolosan, France
| | - Martine Dubois
- Centre National de Référence du virus de l'hépatite E, Laboratoire de Virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France
| | - Nassim Kamar
- Center of Pathophysiology, Toulouse Purpan, INSERM, U1043, Toulouse, France.,Université Toulouse III Paul-Sabatier, Toulouse, France.,Service de néphrologie, Dialyse et Transplantation d'Organe, Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | - Sébastien Lhomme
- Centre National de Référence du virus de l'hépatite E, Laboratoire de Virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France.,Center of Pathophysiology, Toulouse Purpan, INSERM, U1043, Toulouse, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Florence Abravanel
- Centre National de Référence du virus de l'hépatite E, Laboratoire de Virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France.,Center of Pathophysiology, Toulouse Purpan, INSERM, U1043, Toulouse, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Jacques Izopet
- Centre National de Référence du virus de l'hépatite E, Laboratoire de Virologie, Hôpital Purpan, CHU de Toulouse, Toulouse, France.,Center of Pathophysiology, Toulouse Purpan, INSERM, U1043, Toulouse, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| |
Collapse
|
36
|
Abravanel F, Lhomme S, Chapuy-Regaud S, Mansuy JM, Boineau J, Sauné K, Izopet J. A fully automated system using transcription-mediated amplification for the molecular diagnosis of hepatitis E virus in human blood and faeces. J Clin Virol 2018; 105:109-111. [PMID: 29957544 DOI: 10.1016/j.jcv.2018.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES We evaluated the performance of the Procleix HEV RNA assay implemented on the Panther automated platform for detecting HEV RNA. STUDY DESIGN AND RESULTS Analytical specificity was 100% and there was no cross contamination, as assessed by assaying 122 plasma samples from HEV RNA-negative blood donors. The limits of detection were determined by Probit analysis with the WHO HEV standard (HEV subtype 3a) and subtype 3f and 3c reference strains. The limit of detection was 24 [CI 95%: 19-33] IU/ml for subtype 3a, 34 [28-44] IU/ml for subtype 3c and 53 [41-76] IU/ml for subtype 3f. Inclusivity was assessed by testing 91 samples: HEV genotype 3 subtypes 3c (n = 29), 3e (n = 8), 3f (n = 50), genotype 4 (n = 3), and genotype 1 (n = 1). All the samples tested positive. Clinical performance was determined by testing prospectively 500 consecutive plasma samples and 19 faecal samples with the Procleix assay and a reference accredited quantitative RT-PCR assay. The assays were concordant for 492/500 plasma samples (98.4%) and 18/19 (94.7%) fecal samples. We also tested 92 IgM-positive/HEV RNA-negative samples with the reference assay. The IgM-positive samples included 43 (46%) that tested negative with the reference RT-PCR assay and positive with the Procleix HEV assay. CONCLUSIONS The Procleix HEV assay performed well and appears to be suitable for molecular diagnosis of HEV infection, monitoring HEV infections, and facilitating epidemiological investigations.
Collapse
Affiliation(s)
- Florence Abravanel
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie,Institut fédératif de biologie de Purpan, F-31300, France.
| | - Sébastien Lhomme
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie,Institut fédératif de biologie de Purpan, F-31300, France
| | - Sabine Chapuy-Regaud
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie,Institut fédératif de biologie de Purpan, F-31300, France
| | - Jean-Michel Mansuy
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie,Institut fédératif de biologie de Purpan, F-31300, France
| | - Jérôme Boineau
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie,Institut fédératif de biologie de Purpan, F-31300, France
| | - Karine Sauné
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie,Institut fédératif de biologie de Purpan, F-31300, France
| | - Jacques Izopet
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie,Institut fédératif de biologie de Purpan, F-31300, France
| |
Collapse
|
37
|
Abravanel F, Goutagny N, Lhomme S, Perret C, Chenet M, Vischi F, Aversenq A, Bourg S, Chapel A, Dehainault N, Mercier L, Luciani F, Pothion C, Eichenlaub E, Bénet T, Zhang X, Roques P, Dugua JM, Izopet J. Performance evaluation of new automated VIDAS anti-HEV immunoassay tests. J Virus Erad 2018. [DOI: 10.1016/s2055-6640(20)30400-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
38
|
Belliere J, Abravanel F, Nogier MB, Martinez S, Cintas P, Lhomme S, Lavayssière L, Cointault O, Faguer S, Izopet J, Kamar N. Transfusion-acquired hepatitis E infection misdiagnosed as severe critical illness polyneuromyopathy in a heart transplant patient. Transpl Infect Dis 2017; 19. [PMID: 28963742 DOI: 10.1111/tid.12784] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/18/2017] [Accepted: 06/19/2017] [Indexed: 12/17/2022]
Abstract
This is the case of a 56-year-old man who underwent heart transplantation. Within the first postoperative days, his respiratory and limb muscles weakened, which was attributed to critical illness polyneuromyopathy (CIPM). At day 70 post transplantation, he had increased liver enzyme levels and acute hepatitis E virus (HEV) infection was diagnosed. HEV RNA was found in the serum, stools, and cerebrospinal fluid. Results of further investigations suggested a possible HEV-related polyradiculoneuropathy. At transplantation, the patient was negative for immunoglobulin (Ig)G, IgM, and HEV RNA. A trace-back procedure identified the source of infection and concluded that HEV infection was contracted from blood transfusion 12 days prior to transplantation from an HEV RNA-positive donor. Tests of the organ donor for HEV were negative. Phylogenetic analysis revealed sequence homology between the HEV-3 strain of the patient and the HEV-3 strain of the blood donor. Despite ribavirin treatment, the patient died on day 153 post transplantation from multiorgan failure. In conclusion, patients with hepatitis or neuropathic illness who have received blood products should be screened for HEV.
Collapse
Affiliation(s)
- Julie Belliere
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Florence Abravanel
- INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France.,Laboratory of Virology, CHU Purpan, Toulouse, France
| | | | | | - Pascal Cintas
- Explorations neurophysiologiques, Centre SLA, Centre de référence de pathologie neuromusculaire, CHU Toulouse, Hôpital Pierre Paul Riquet, Toulouse, France
| | - Sébastien Lhomme
- INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France.,Laboratory of Virology, CHU Purpan, Toulouse, France
| | - Laurence Lavayssière
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Olivier Cointault
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Stanislas Faguer
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - Jacques Izopet
- INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France.,Laboratory of Virology, CHU Purpan, Toulouse, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| |
Collapse
|
39
|
Izopet J, Lhomme S, Chapuy-Regaud S, Mansuy JM, Kamar N, Abravanel F. HEV and transfusion-recipient risk. Transfus Clin Biol 2017; 24:176-181. [PMID: 28690036 DOI: 10.1016/j.tracli.2017.06.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 06/08/2017] [Indexed: 01/14/2023]
Abstract
HEV infections are mainly food- and water-borne but transfusion-transmission has occurred in both developing and developed countries. The infection is usually asymptomatic but it can lead to fulminant hepatitis in patients with underlying liver disease and pregnant women living in developing countries. It also causes chronic hepatitis E, with progressive fibrosis and cirrhosis, in approximately 60% of immunocompromised patients infected with HEV genotype 3. The risk of a transfusion-transmitted HEV infection is linked to the frequency of viremia in blood donors, the donor virus load and the volume of plasma in the final transfused blood component. Several developed countries have adopted measures to improve blood safety based on the epidemiology of HEV.
Collapse
Affiliation(s)
- J Izopet
- Department of virology, National reference center for hepatitis E virus, CHU Purpan, IFB, 330, avenue de Grande-Bretagne, TSA 40031, 31059 Toulouse, France; Inserm UMR 1043/CNRS UMR 5282, CPTP, center for pathophysiology of toulouse-Purpan, Toulouse university Paul-Sabatier, 31024 Toulouse, France.
| | - S Lhomme
- Department of virology, National reference center for hepatitis E virus, CHU Purpan, IFB, 330, avenue de Grande-Bretagne, TSA 40031, 31059 Toulouse, France; Inserm UMR 1043/CNRS UMR 5282, CPTP, center for pathophysiology of toulouse-Purpan, Toulouse university Paul-Sabatier, 31024 Toulouse, France
| | - S Chapuy-Regaud
- Department of virology, National reference center for hepatitis E virus, CHU Purpan, IFB, 330, avenue de Grande-Bretagne, TSA 40031, 31059 Toulouse, France; Inserm UMR 1043/CNRS UMR 5282, CPTP, center for pathophysiology of toulouse-Purpan, Toulouse university Paul-Sabatier, 31024 Toulouse, France
| | - J-M Mansuy
- Department of virology, National reference center for hepatitis E virus, CHU Purpan, IFB, 330, avenue de Grande-Bretagne, TSA 40031, 31059 Toulouse, France
| | - N Kamar
- Inserm UMR 1043/CNRS UMR 5282, CPTP, center for pathophysiology of toulouse-Purpan, Toulouse university Paul-Sabatier, 31024 Toulouse, France; Department of nephrology and organ transplantation, CHU Rangueil, 31059 Toulouse, France
| | - F Abravanel
- Department of virology, National reference center for hepatitis E virus, CHU Purpan, IFB, 330, avenue de Grande-Bretagne, TSA 40031, 31059 Toulouse, France; Inserm UMR 1043/CNRS UMR 5282, CPTP, center for pathophysiology of toulouse-Purpan, Toulouse university Paul-Sabatier, 31024 Toulouse, France
| |
Collapse
|
40
|
Abstract
Hepatitis E virus (HEV) has been detected in rabbits, but whether rabbit HEV strains can be transmitted to humans is not known. Of 919 HEV-infected patients in France during 2015-2016, five were infected with a rabbit HEV strain. None of the patients had direct contact with rabbits, suggesting foodborne or waterborne infections.
Collapse
|
41
|
Chapuy-Regaud S, Dubois M, Plisson-Chastang C, Bonnefois T, Lhomme S, Bertrand-Michel J, You B, Simoneau S, Gleizes PE, Flan B, Abravanel F, Izopet J. Characterization of the lipid envelope of exosome encapsulated HEV particles protected from the immune response. Biochimie 2017; 141:70-79. [PMID: 28483690 DOI: 10.1016/j.biochi.2017.05.003] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 05/03/2017] [Indexed: 02/08/2023]
Abstract
The hepatitis E virus (HEV) is the most common cause of acute hepatitis worldwide. Although HEV is a small, naked RNA virus, HEV particles become associated with lipids in the blood of infected patients and in the supernatant of culture systems. The egress of these particles from cells implies the exocytosis pathway but the question of the role of the resulting HEV RNA containing exosomes and the nature of the lipids they contain has not been fully addressed. We determined the lipid proportions of exosomes from uninfected and HEV-infected cells and their role in HEV spreading. We cultured a suitable HEV strain on HepG2/C3A cells and analyzed the population of exosomes containing HEV RNA using lipidomics methods and electron microscopy. We also quantified HEV infectivity using an infectivity endpoint method based on HEV RNA quantification to calculate the tissue culture infectious dose 50. Exosomes produced by HEV-infected HepG2/C3A cells contained encapsidated HEV RNA. These HEV RNA-containing exosomes were infectious but ten times less than stools. HEV from stools, but not exosome-associated HEV from culture supernatant, was neutralized by anti-HEV antibodies in a dose-dependent manner. HEV infection did not influence the morphology or lipid proportions of the bulk of exosomes. These exosomes contained significantly more cholesterol, phosphatidylserine, sphingomyelin and ceramides than the parent cells, but less phosphoinositides and polyunsaturated fatty acids. Exosomes play a major role in HEV egress but HEV infection does not modify the characteristics of the bulk of exosomes produced by infected cells. PS and cholesterol enriched in these vesicles could then be critical for HEV entry. HEV particles in exosomes are protected from the immune response which could lead to the wide circulation of HEV in its host.
Collapse
Affiliation(s)
- Sabine Chapuy-Regaud
- INSERM, UMR1043, Toulouse, France; Department of Virology, CHU Purpan, Toulouse, France; Toulouse University, Toulouse, France.
| | - Martine Dubois
- INSERM, UMR1043, Toulouse, France; Department of Virology, CHU Purpan, Toulouse, France
| | | | - Tiffany Bonnefois
- INSERM, UMR1043, Toulouse, France; Department of Virology, CHU Purpan, Toulouse, France
| | - Sébastien Lhomme
- INSERM, UMR1043, Toulouse, France; Department of Virology, CHU Purpan, Toulouse, France; Toulouse University, Toulouse, France
| | - Justine Bertrand-Michel
- Toulouse University, Toulouse, France; MetaToul-Lipidomic Core Facility, INSERM, UMR1048, Toulouse, France
| | - Bruno You
- LFB, Laboratoire Français du Fractionnement et des Biotechnologies, Courtaboeuf, France
| | - Steve Simoneau
- LFB, Laboratoire Français du Fractionnement et des Biotechnologies, Courtaboeuf, France
| | | | - Benoît Flan
- LFB, Laboratoire Français du Fractionnement et des Biotechnologies, Courtaboeuf, France
| | - Florence Abravanel
- INSERM, UMR1043, Toulouse, France; Department of Virology, CHU Purpan, Toulouse, France; Toulouse University, Toulouse, France
| | - Jacques Izopet
- INSERM, UMR1043, Toulouse, France; Department of Virology, CHU Purpan, Toulouse, France; Toulouse University, Toulouse, France
| |
Collapse
|
42
|
Yin X, Li X, Ambardekar C, Hu Z, Lhomme S, Feng Z. Hepatitis E virus persists in the presence of a type III interferon response. PLoS Pathog 2017; 13:e1006417. [PMID: 28558073 PMCID: PMC5466342 DOI: 10.1371/journal.ppat.1006417] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 06/09/2017] [Accepted: 05/17/2017] [Indexed: 12/23/2022] Open
Abstract
The RIG-I-like RNA helicase (RLR)-mediated interferon (IFN) response plays a pivotal role in the hepatic antiviral immunity. The hepatitis A virus (HAV) and the hepatitis C virus (HCV) counter this response by encoding a viral protease that cleaves the mitochondria antiviral signaling protein (MAVS), a common signaling adaptor for RLRs. However, a third hepatotropic RNA virus, the hepatitis E virus (HEV), does not appear to encode a functional protease yet persists in infected cells. We investigated HEV-induced IFN responses in human hepatoma cells and primary human hepatocytes. HEV infection resulted in persistent virus replication despite poor spread. This was companied by a type III IFN response that upregulated multiple IFN-stimulated genes (ISGs), but type I IFNs were barely detected. Blocking type III IFN production or signaling resulted in reduced ISG expression and enhanced HEV replication. Unlike HAV and HCV, HEV did not cleave MAVS; MAVS protein size, mitochondrial localization, and function remained unaltered in HEV-replicating cells. Depletion of MAVS or MDA5, and to a less extent RIG-I, also diminished IFN production and increased HEV replication. Furthermore, persistent activation of the JAK/STAT signaling rendered infected cells refractory to exogenous IFN treatment, and depletion of MAVS or the receptor for type III IFNs restored the IFN responsiveness. Collectively, these results indicate that unlike other hepatotropic RNA viruses, HEV does not target MAVS and its persistence is associated with continuous production of type III IFNs.
Collapse
Affiliation(s)
- Xin Yin
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Xinlei Li
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Charuta Ambardekar
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Zhimin Hu
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Sébastien Lhomme
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Zongdi Feng
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| |
Collapse
|
43
|
Velay A, Kack-Kack W, Abravanel F, Lhomme S, Leyendecker P, Kremer L, Chamouard P, Izopet J, Fafi-Kremer S, Barth H. Parsonage-Turner syndrome due to autochthonous acute genotype 3f hepatitis E virus infection in a nonimmunocompromised 55-year-old patient. J Neurovirol 2017; 23:615-620. [PMID: 28439773 DOI: 10.1007/s13365-017-0525-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 03/06/2017] [Accepted: 03/13/2017] [Indexed: 01/05/2023]
Abstract
Hepatitis E virus (HEV) infection is an emerging autochthonous disease in industrialized countries. Extra-hepatic manifestations, in particular neurologic manifestations, have been reported in HEV infection. Only a few cases of hepatitis E-associated Parsonage-Turner syndrome have been reported, and HEV genotypes were rarely determined. Here, we report the case of a Parsonage-Turner syndrome associated with an acute autochthonous HEV infection in a 55-year-old immunocompetent patient. HEV genomic RNA was detected in serum and cerebrospinal fluid samples (CSF), and molecular phylogenetic analysis of HEV was performed. The interest of this case lies in its detailed description notably the molecular analysis of HEV RNA isolated from serum and CSF. HEV infection should be considered in diagnostic investigations of neurologic manifestations associated with liver function perturbations.
Collapse
Affiliation(s)
- A Velay
- Virology Laboratory, University Hospital of Strasbourg, F-67000, Strasbourg, France. .,INSERM, IRM UMR-S 1109, F-67000, Strasbourg, France.
| | - W Kack-Kack
- Virology Laboratory, University Hospital of Strasbourg, F-67000, Strasbourg, France.,INSERM, IRM UMR-S 1109, F-67000, Strasbourg, France
| | - F Abravanel
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, F-31300, Toulouse, France.,CHU Toulouse Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie de Purpan, F-31300, Toulouse, France
| | - S Lhomme
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, F-31300, Toulouse, France.,CHU Toulouse Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie de Purpan, F-31300, Toulouse, France
| | - P Leyendecker
- Department of Neuroradiology, University Hospital of Strasbourg, F-67098, Strasbourg, France
| | - L Kremer
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, UMR_S INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - P Chamouard
- Department of Gastroenterology and Hepatology, University Hospital of Strasbourg, F-67098, Strasbourg, France
| | - J Izopet
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, F-31300, Toulouse, France.,CHU Toulouse Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie de Purpan, F-31300, Toulouse, France
| | - S Fafi-Kremer
- Virology Laboratory, University Hospital of Strasbourg, F-67000, Strasbourg, France.,INSERM, IRM UMR-S 1109, F-67000, Strasbourg, France
| | - H Barth
- Virology Laboratory, University Hospital of Strasbourg, F-67000, Strasbourg, France.,INSERM, IRM UMR-S 1109, F-67000, Strasbourg, France
| |
Collapse
|
44
|
Carré M, Thiebaut-Bertrand A, Larrat S, Leroy V, Pouzol P, Sturm N, Lhomme S, Cahn JY, Garban F, Morand P. Fatal autochthonous fulminant hepatitis E early after allogeneic stem cell transplantation. Bone Marrow Transplant 2017; 52:643-645. [PMID: 28067868 DOI: 10.1038/bmt.2016.337] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- M Carré
- Clinique Universitaire d'Hématologie, CHU de Grenoble Alpes, La Tronche, France
| | - A Thiebaut-Bertrand
- Clinique Universitaire d'Hématologie, CHU de Grenoble Alpes, La Tronche, France
| | - S Larrat
- Laboratoire de Virologie, Institut de Biologie Structurale (UMR 5075), Univ. Grenoble Alpes, CEA, CNRS, Grenoble, France
| | - V Leroy
- Clinique Universitaire d'Hépato-gastro-entérologie, CHU de Grenoble Alpes, La Tronche, France
| | - P Pouzol
- Unité d'hémovigilance et sécurité transfusionnelle, pôle de santé publique, CHU de Grenoble Alpes, La Tronche, France
| | - N Sturm
- Département d'Anatomie et de Cytologie Pathologiques, pôle de Biologie CHU de Grenoble Alpes, La Tronche, France
| | - S Lhomme
- INSERM UMR 1043/CNRS UMR 5282, Université Toulouse III, National Reference Center HEV, CHU Toulouse, Toulouse, France
| | - J-Y Cahn
- Clinique Universitaire d'Hématologie, CHU de Grenoble Alpes, La Tronche, France.,UMR CNRS 5525 équipe THEREX Université de Grenoble Alpes, Grenoble, France
| | - F Garban
- Clinique Universitaire d'Hématologie, CHU de Grenoble Alpes, La Tronche, France.,UMR CNRS 5525 équipe THEREX Université de Grenoble Alpes, Grenoble, France.,Etablissement Français du Sang, site de Grenoble, La Tronche, France
| | - P Morand
- Laboratoire de Virologie, Institut de Biologie Structurale (UMR 5075), Univ. Grenoble Alpes, CEA, CNRS, Grenoble, France
| |
Collapse
|
45
|
Abravanel F, Lhomme S, Fougère M, Saune K, Alvarez M, Péron JM, Delobel P, Izopet J. HEV infection in French HIV-infected patients. J Infect 2016; 74:310-313. [PMID: 27998748 DOI: 10.1016/j.jinf.2016.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/08/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The reported prevalence of anti-hepatitis E virus antibodies in HIV-positive patients from industrialized countries varies greatly. It is also difficult to compare these data with the anti-IgG prevalence in the general population because age and sex are not matched in most studies. Moreover, MSM are at increased risk of viral hepatitis. METHODS HEV is endemic in southwestern France. We investigated therefore 300 HIV-infected patients consecutively attending the out-patient clinic of Toulouse University Hospital. Each HIV-infected patient was matched for sex and age with 2 healthy blood donors from the same area. They were tested for anti-HEV IgM and IgG. RESULTS Anti-HEV IgG was found in 116 HIV-infected patients (38.7%) and in 284 matched controls (47.3%, p = 0.027). However, anti-HEV IgG concentration tended to be lower in HIV-patients than in controls. Anti-HEV IgM prevalence was similar HIV-infected patients (3.6%) and in matched controls (3.8%, p = 0.85). CONCLUSION The prevalence and concentrations of anti-HEV IgG in HIV-infected patients from Southern-France were lower than in controls, suggesting a weaker humoral response. But their prevalences of anti-HEV IgM were similar, indicating a high incidence of HEV infection. These data do not indicate that HEV is transmitted sexually.
Collapse
Affiliation(s)
- Florence Abravanel
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, F-31024, Toulouse, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre National de Référence Hépatite E, Institut Fédératif de Biologie, F-31300, Toulouse, France.
| | - Sébastien Lhomme
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, F-31024, Toulouse, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre National de Référence Hépatite E, Institut Fédératif de Biologie, F-31300, Toulouse, France
| | - Mélanie Fougère
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, F-31024, Toulouse, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre National de Référence Hépatite E, Institut Fédératif de Biologie, F-31300, Toulouse, France
| | - Karine Saune
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, F-31024, Toulouse, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre National de Référence Hépatite E, Institut Fédératif de Biologie, F-31300, Toulouse, France
| | - Muriel Alvarez
- CHU Toulouse, Hôpital Purpan, Service des maladies infectieuses et tropicales, F-31049, Toulouse, France
| | - Jean-Marie Péron
- CHU Toulouse, Hôpital Purpan, Service de Gastroentérologie, F-31300, Toulouse, France
| | - Pierre Delobel
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, F-31024, Toulouse, France; CHU Toulouse, Hôpital Purpan, Service des maladies infectieuses et tropicales, F-31049, Toulouse, France
| | - Jacques Izopet
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043/CNRS UMR5282/Université Toulouse III Paul-Sabatier, F-31024, Toulouse, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Centre National de Référence Hépatite E, Institut Fédératif de Biologie, F-31300, Toulouse, France
| |
Collapse
|
46
|
Miura T, Lhomme S, Le Saux JC, Le Mehaute P, Guillois Y, Couturier E, Izopet J, Abranavel F, Le Guyader FS. Detection of Hepatitis E Virus in Sewage After an Outbreak on a French Island. Food Environ Virol 2016; 8:194-9. [PMID: 27165600 DOI: 10.1007/s12560-016-9241-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 04/28/2016] [Indexed: 05/18/2023]
Abstract
A hepatitis E outbreak, which occurred on a small isolated island, provided an opportunity to evaluate the association between the number of hepatitis E cases in the community and the concentration of virus detected in sewage. Samples were collected from the different sewage treatment plants from the island and analyzed for the presence of hepatitis E (HEV) virus using real-time RT-PCR. We demonstrated that if 1-4 % of inhabitants connected to a WWTP were infected with HEV, raw sewage contained HEV at detectable levels. The finding that such a small number of infected people can contaminate municipal sewage works raises the potential of the further distribution of the virus. Indeed, investigating the routes of transmission of HEV, including the potential for sewage effluent to contain infectious HEV, may help us to better understand the epidemiology of this pathogen, which is considered to be an emerging concern in Europe.
Collapse
Affiliation(s)
- Takayuki Miura
- Laboratoire de Microbiologie, LSEM-SG2M, IFREMER, BP 21105, 44311, Nantes Cedex 03, France
- New Industry Creation Hatchery Center (NICHe), Tohoku University, 6-6-04 Aoba, Aramaki, Aoba-Ku, Sendai, 980-8579, Japan
| | - Sébastien Lhomme
- National Reference Center for HEV, Centre Hospitalier Universitaire, Toulouse, France
| | - Jean-Claude Le Saux
- Laboratoire de Microbiologie, LSEM-SG2M, IFREMER, BP 21105, 44311, Nantes Cedex 03, France
| | | | - Yvonnick Guillois
- Regional Epidemiology Unit for the Brittany region, Institut de veille sanitaire, Rennes, France
| | - Elizabeth Couturier
- Department of Infectious Diseases, Institut de Veille Sanitaire, Saint-Maurice, France
| | - Jacques Izopet
- National Reference Center for HEV, Centre Hospitalier Universitaire, Toulouse, France
| | - Florence Abranavel
- National Reference Center for HEV, Centre Hospitalier Universitaire, Toulouse, France
| | - Françoise S Le Guyader
- Laboratoire de Microbiologie, LSEM-SG2M, IFREMER, BP 21105, 44311, Nantes Cedex 03, France.
| |
Collapse
|
47
|
Nicot F, Cazabat M, Lhomme S, Marion O, Sauné K, Chiabrando J, Dubois M, Kamar N, Abravanel F, Izopet J. Quantification of HEV RNA by Droplet Digital PCR. Viruses 2016; 8:v8080233. [PMID: 27548205 PMCID: PMC4997595 DOI: 10.3390/v8080233] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/13/2016] [Accepted: 08/16/2016] [Indexed: 12/11/2022] Open
Abstract
The sensitivity of real-time PCR for hepatitis E virus (HEV) RNA quantification differs greatly among techniques. Standardized tools that measure the real quantity of virus are needed. We assessed the performance of a reverse transcription droplet digital PCR (RT-ddPCR) assay that gives absolute quantities of HEV RNA. Analytical and clinical validation was done on HEV genotypes 1, 3 and 4, and was based on open reading frame (ORF)3 amplification. The within-run and between-run reproducibilities were very good, the analytical sensitivity was 80 HEV RNA international units (IU)/mL and linearities of HEV genotype 1, 3 and 4 were very similar. Clinical validation based on 45 samples of genotype 1, 3 or 4 gave results that correlated well with a validated reverse transcription quantitative PCR (RT-qPCR) assay (Spearman rs = 0.89, p < 0.0001). The RT-ddPCR assay is a sensitive method and could be a promising tool for standardizing HEV RNA quantification in various sample types.
Collapse
Affiliation(s)
- Florence Nicot
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie, Toulouse F-31300, France.
| | - Michelle Cazabat
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie, Toulouse F-31300, France.
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse F-31300, France.
| | - Sébastien Lhomme
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie, Toulouse F-31300, France.
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse F-31300, France.
- Université Toulouse III Paul-Sabatier, Faculté de Médecine Toulouse, Toulouse F-31300, France.
| | - Olivier Marion
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse F-31300, France.
- CHU Toulouse, Hôpital Rangueil, Département de Néphrologie, Dialyse et Transplantation multi-organe, Toulouse F-31300, France.
| | - Karine Sauné
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie, Toulouse F-31300, France.
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse F-31300, France.
- Université Toulouse III Paul-Sabatier, Faculté de Médecine Toulouse, Toulouse F-31300, France.
| | - Julie Chiabrando
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie, Toulouse F-31300, France.
| | - Martine Dubois
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie, Toulouse F-31300, France.
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse F-31300, France.
| | - Nassim Kamar
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse F-31300, France.
- CHU Toulouse, Hôpital Rangueil, Département de Néphrologie, Dialyse et Transplantation multi-organe, Toulouse F-31300, France.
| | - Florence Abravanel
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie, Toulouse F-31300, France.
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse F-31300, France.
- Université Toulouse III Paul-Sabatier, Faculté de Médecine Toulouse, Toulouse F-31300, France.
| | - Jacques Izopet
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, Institut fédératif de biologie, Toulouse F-31300, France.
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse F-31300, France.
- Université Toulouse III Paul-Sabatier, Faculté de Médecine Toulouse, Toulouse F-31300, France.
| |
Collapse
|
48
|
Trémeaux P, Lhomme S, Chapuy-Regaud S, Peron JM, Alric L, Kamar N, Izopet J, Abravanel F. Performance of an antigen assay for diagnosing acute hepatitis E virus genotype 3 infection. J Clin Virol 2016; 79:1-5. [DOI: 10.1016/j.jcv.2016.03.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/11/2016] [Accepted: 03/20/2016] [Indexed: 12/17/2022]
|
49
|
Guillois Y, Abravanel F, Miura T, Pavio N, Vaillant V, Lhomme S, Le Guyader FS, Rose N, Le Saux JC, King LA, Izopet J, Couturier E. High Proportion of Asymptomatic Infections in an Outbreak of Hepatitis E Associated With a Spit-Roasted Piglet, France, 2013. Clin Infect Dis 2015; 62:351-7. [PMID: 26429341 DOI: 10.1093/cid/civ862] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/22/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND On 11 December 2013, 3 clustered cases of hepatitis E were reported on a French coastal island. Individuals had taken part in a wedding meal that included a spit-roasted piglet. The piglet had been stuffed with a raw stuffing partly made from the liver. Investigations were carried out to identify the vehicle of contamination and evaluate the dispersion of the hepatitis E virus (HEV) in the environment. METHODS A questionnaire was administered to 98 wedding participants who were asked to give a blood sample. Cases were identified by reverse transcription-polymerase chain reaction and serological tests. A retrospective cohort study was conducted among 38 blood-sampled participants after the exclusion of 14 participants with evidence of past HEV infection. Relative risks (RR) and 95% confidence intervals were calculated based on food consumed at the wedding meal using univariate and multivariable Poisson regressions. Phylogenetic analyses were performed to compare the clinical HEV strains. Strains were detected in the liquid manure sampled at the farm where the piglet was born and in the untreated island wastewater. RESULTS Seventeen cases were identified, 70.6% were asymptomatic. Acute HEV infection was independently associated with piglet stuffing consumption (RR = 1.69 [1.04-2.73], P = .03). Of clinical strains from the index cases, veterinary and environmental HEV strains were identical. CONCLUSIONS Our investigation attributed this large HEV outbreak to the consumption of an undercooked pig liver-based stuffing. After infection, the cases became a temporary reservoir for HEV, which was detected in the island's untreated wastewater.
Collapse
Affiliation(s)
- Yvonnick Guillois
- Regional Epidemiology Unit for the Brittany region, Institut de veille sanitaire, Rennes
| | - Florence Abravanel
- National Reference Center for Hepatitis E virus, Centre hospitalier universitaire, Toulouse
| | - Takayuki Miura
- Laboratoire de Microbiologie, LSEM-SG2M, Ifremer, Nantes
| | - Nicole Pavio
- UMR 1161 Virology, Animal Health Laboratory, Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail, Maisons-Alfort
| | - Véronique Vaillant
- Department of Infectious diseases, Institut de veille sanitaire, Saint-Maurice
| | - Sébastien Lhomme
- National Reference Center for Hepatitis E virus, Centre hospitalier universitaire, Toulouse
| | | | - Nicolas Rose
- Swine Epidemiology and Welfare unit, Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail, Ploufragan/Plouzané laboratory, Ploufragan, France
| | | | - Lisa A King
- Regional Epidemiology Unit for the Brittany region, Institut de veille sanitaire, Rennes
| | - Jacques Izopet
- National Reference Center for Hepatitis E virus, Centre hospitalier universitaire, Toulouse
| | - Elisabeth Couturier
- Department of Infectious diseases, Institut de veille sanitaire, Saint-Maurice
| |
Collapse
|
50
|
Sauné K, Haslé C, Boineau J, Lhomme S, Mengelle C, Izopet J. Analytical performance of VERIS MDx system HBV assay for quantifying HBV DNA. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|