Background: Fulminant hepatitis and biliary atresia are serious problems and their causes have not been explained well. We investigated whether or not erythrovirus B19 is a candidate etiologic agent in such liver disease patients who had undergone liver transplantation. Methods: Liver tissues from 47 patients consisted of 28 fulminant hepatitis and 19 biliary atresia were examined to detect B19 genes by PCR and further analyzed their genomic characterization. Results: B19 DNA was detected by nested PCR in 10 of 28 cases (35.7%) livers in the fulminant hepatitis group and 7 of 19 (36.8%) livers in the biliary atresia group, respectively (statistically not significant). Importantly, among the 8 hepatic B19 DNA-positive patients who had paired samples of liver and serum, the serum B19 genome was detectable in only one case. B19 mRNA was identified in all of 10 fulminant hepatitis cases with hepatic B19 DNA, but only 1 out of 7 (14.3%) cases in biliary atresia tested. Furthermore, we obtained ten isolates having the B19 genome with nearly full-length sequences. Interestingly, phylogenetic analysis based on the NS1 gene revealed three different clusters: two for isolates from fulminant hepatitis and the other for isolates from biliary atresia. Conclusions: Our results presented here suggested that B19 may be an etiologic agent of fulminant hepatitis.

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We analyzed full-length sequence of hepatitis B virus (HBV) recovered from two pileated gibbons (Hylobates pileatus) originally born in East Asia. Two animals possessed a viral genome of 3182 nt in length with a 33 nt deletion in the pre-S1 region, and designated HBV PG-Makiko and HBV PG-Yohko, respectively. Both sequences had 65-90% similarity to type A-G of human HBV isolates. Phylogenetic analysis demonstrated that both isolates were distinct from the human and other nonhuman primate HBV isolates, but could be classified into gibbon isolates that were previously reported by others. Small spherical and tubular particles and large particles with outer envelopes were observed in the serum under immunoelectron microscopic examination. By immunohistochemical staining, HBsAg and HBcAg were detected in the cytoplasm and nuclei of hepatocytes, respectively. Our results suggested that HBV found in these animals is indigenous to their respective hosts and not recent acquisitions from human.