Circulation of genotype 4 hepatitis E virus in Europe: First autochthonous hepatitis E infection in France

Tessé, Sophie; Lioure, Bruno; Fornecker, Luc; Wendling, Marie-Josée; Stoll‐Keller, Françoise; Bigaillon, C.; Nicand, Élisabeth

doi:10.1016/j.jcv.2012.02.007

Cited by 58 publications

(41 citation statements)

References 22 publications

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“…More recently, both imported and locally acquired HEV-4 strains have been detected in Europe and the Americas (118)(119)(120)(121)(122)(123)(124).…”

Section: Epidemiologic Patterns Of Hepatitis E Virus Infectionmentioning

confidence: 99%

Host Immune Status and Response to Hepatitis E Virus Infection

2014

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SUMMARY Hepatitis E virus (HEV), identified over 30 years ago, remains a serious threat to life, health, and productivity in developing countries where access to clean water is limited. Recognition that HEV also circulates as a zoonotic and food-borne pathogen in developed countries is more recent. Even without treatment, most cases of HEV-related acute viral hepatitis (with or without jaundice) resolve within 1 to 2 months. However, HEV sometimes leads to acute liver failure, chronic infection, or extrahepatic symptoms. The mechanisms of pathogenesis appear to be substantially immune mediated. This review covers the epidemiology of HEV infection worldwide, the humoral and cellular immune responses to HEV, and the persistence and protection of antibodies produced in response to both natural infection and vaccines. We focus on the contributions of altered immune states (associated with pregnancy, human immunodeficiency virus [HIV], and immunosuppressive agents used in cancer and transplant medicine) to the elevated risks of chronic infection (in immunosuppressed/immunocompromised patients) and acute liver failure and mortality (among pregnant women). We conclude by discussing outstanding questions about the immune response to HEV and interactions with hormones and comorbid conditions. These questions take on heightened importance now that a vaccine is available.

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“…More recently, both imported and locally acquired HEV-4 strains have been detected in Europe and the Americas (118)(119)(120)(121)(122)(123)(124).…”

Section: Epidemiologic Patterns Of Hepatitis E Virus Infectionmentioning

confidence: 99%

Host Immune Status and Response to Hepatitis E Virus Infection

2014

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“…Four major HEV genotypes belonging to a single serotype have been identified (11). Genotype 1 is detected in most cases of human HEV disease (waterborne epidemics and sporadic cases), genotype 2 is rare and has been found in several epidemics in Mexico and central Africa, and genotypes 3 and 4 are detected in swine and in autochthonous HEV infections in industrial countries (5,19,20,30,34,39,45,49).HEV is a significant fecally and orally transmitted human pathogen of worldwide distribution, causing self-limited disease with mortality rates of 1 to 3% in the general population and up to 20 to 25% in pregnant women. In developing countries, HEV outbreaks have been attributed to feces-contaminated water supplies.…”

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confidence: 99%

High Hepatitis E Virus Seroprevalence in Forestry Workers and in Wild Boars in France

et al. 2012

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f Hepatitis E virus (HEV) is a fecally and orally transmitted human pathogen of worldwide distribution. In industrial countries, HEV is observed in an increasing number of autochthonous cases and is considered to be an emerging pathogen. A growing body of evidence suggests that HEV is a zoonotic disease, and pig handlers and pig veterinarians have been reported to be high-risk groups for HEV infection. The aims of the present study were to establish the prevalence of anti-HEV in wild boars in France and to identify whether forestry workers are at a higher risk of HEV infection. Three different anti-HEV tests were used to compare their effectiveness in detecting anti-HEV in the general population. The most sensitive test was then used to investigate HEV seroprevalence in 593 forestry workers and 421 wild boars. Anti-HEV was detected in 31% of the forestry workers and 14% of the wild boars. Detection of anti-HEV in humans was correlated with age, geographical location, and occupational activity and in wild boars was correlated with geographical location. HEV infection is frequent in woodcutters in France, and it varies geographically. Further studies are needed to confirm these findings and to elucidate the transmission route and the exact virus reservoirs.H epatitis E virus (HEV) is a nonenveloped, single-strand RNA virus that has been classified as the prototype and sole member in the Hepevirus genus of the Hepeviridae family (29). The viral genome of about 7.2 kb contains 3 partially overlapping open reading frames (ORFs). ORF1 encodes nonstructural viral proteins, ORF2 encodes the capsid protein, and ORF3 encodes a small multifunctional protein. Four major HEV genotypes belonging to a single serotype have been identified (11). Genotype 1 is detected in most cases of human HEV disease (waterborne epidemics and sporadic cases), genotype 2 is rare and has been found in several epidemics in Mexico and central Africa, and genotypes 3 and 4 are detected in swine and in autochthonous HEV infections in industrial countries (5,19,20,30,34,39,45,49).HEV is a significant fecally and orally transmitted human pathogen of worldwide distribution, causing self-limited disease with mortality rates of 1 to 3% in the general population and up to 20 to 25% in pregnant women. In developing countries, HEV outbreaks have been attributed to feces-contaminated water supplies. In industrial countries, HEV is observed in travelers returning from countries where HEV is endemic and in an increasing number of individuals with no history of traveling to regions where HEV is endemic, particularly in France (5, 6, 20). Molecular analysis of HEV strains has revealed that the strains identified in nonimported HEV cases form a group of genetically divergent isolates compared to HEV strains in regions where HEV is endemic (31, 39). The modes of transmission of sporadic nonimported cases and of autochthonous cases have rarely been determined, with the exception of zoonotic food-borne transmission from pigs, wild boars, and wild deer (19,25,40,41,4...

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“…HEV infection is generally acute [7,8,9] (table 1), and in most of the cases it is spontaneously cleared and, therefore, remains clinically silent. Acute viral hepatitis is manifested by typical symptoms, such as vomiting, myalgia, weakness, jaundice, uncolored stool and darkened urine.…”

Section: Chronic Hev Infectionmentioning

confidence: 99%

“…In contrast, genotypes 3 and 4 are zoonotic and primarily infect pigs and some other mammals, in addition to humans [1]. Genotype 3 and 4 are mainly limited to Eastern Asian countries, Eastern and Western Europe and North America [1,9,23]. Although less pathogenic than genotypes 1 and 2, genotypes 3 and 4 have been implicated in the European locally acquired hepatitis E sporadic cases [9,24].…”

Section: Risk Factors and Transmission Routesmentioning

confidence: 99%

“…Genotype 3 and 4 are mainly limited to Eastern Asian countries, Eastern and Western Europe and North America [1,9,23]. Although less pathogenic than genotypes 1 and 2, genotypes 3 and 4 have been implicated in the European locally acquired hepatitis E sporadic cases [9,24]. Of note, human and swine HEV are genetically very close with approximately 99% sequence homology, in cases where direct zoonotic transmission is assumed [25,26].…”

Section: Risk Factors and Transmission Routesmentioning

confidence: 99%

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Chronic Hepatitis E Infection: Risks and Controls

Parvez¹

2013

Intervirology

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Very recently, an unusual clinical presentation with an altered natural history associated with hepatitis E virus (HEV) infection has emerged in high-income industrialized nations. Although HEV infection does not develop into chronicity in general, viremia can persist for long periods of time in immunocompromised solid organ, bone marrow and stem cell transplant patients. Conceivably, the atypical clinical and virological outcomes in these cases could be related to immunosuppressive chemotherapy, resulting in suboptimal HEV-specific immune responses. In the absence of travel to endemic regions, foodborne autochthonous HEV infection due to viral genotypes 3 and 4 has been implicated in the chronic cases. Presently, pegIFN-α-2a and ribavirin, the commonly used drugs to treat chronic viral hepatitis, are proving very promising in hepatitis E patients. Nevertheless, the most-awaited HEV vaccine could be protective in naïve travelers or high-risk group populations. The mechanisms of establishing chronic HEV infection and the disease severity have hitherto not been clearly understood.Therefore,a comprehensive clinical, virological and molecular study is needed to understand and control the disease.

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Circulation of genotype 4 hepatitis E virus in Europe: First autochthonous hepatitis E infection in France

Cited by 58 publications

References 22 publications

Host Immune Status and Response to Hepatitis E Virus Infection

Host Immune Status and Response to Hepatitis E Virus Infection

High Hepatitis E Virus Seroprevalence in Forestry Workers and in Wild Boars in France

Chronic Hepatitis E Infection: Risks and Controls

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