Epidemiological and clinical study of sporadic acute hepatitis E caused by indigenous strains of hepatitis E virus in Japan compared with acute hepatitis A

Sainokami, Shigehiko; Abe, Koichi; Kumagai, Ichiro; Miyasaka, Akio; Endo, Ryujin; Takikawa, Yasuhiro; Suzuki, Kazuyuki; Mizuo, Hitoshi; Sugai, Yoshiki; Akahane, Yoshihiro; Koizumi, Yukio; Yajima, Yoshiaki; Okamoto, Hiroaki

doi:10.1007/s00535-003-1359-5

Cited by 49 publications

(44 citation statements)

References 38 publications

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“…The remaining two isolates, HE-0624074 and HE-0624158, which had been obtained from the same area in Iwate Prefecture (Tohoku) in 2006, were 99.0% identical to each other. However, they were only 86.4-93.4% similar to eight human and nine swine genotype 3 HEV isolates that had been obtained thus far in Iwate Prefecture [Mizuo et al, 2002;Suzuki et al, 2002;Sainokami et al, 2004;Takahashi et al, 2005b], and were closest to an HEV isolate (HE-JO-1982) that had been obtained in Ibaraki Prefecture (Kanto) in 1982, with identities of 94.7-95.1%.…”

Section: Genetic Analysis Of Hev Isolates Recoveredmentioning

confidence: 89%

A nationwide survey of hepatitis E virus infection in the general population of Japan

Takahashi

Tamura

Hoshino

et al. 2009

Journal of Medical Virology

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To investigate nationwide the prevalence of hepatitis E virus (HEV) infection in the general population of Japan, serum samples were collected from 22,027 individuals (9,686 males and 12,341 females; age, mean +/- standard deviation: 56.8 +/- 16.7 years; range: 20-108 years) who lived in 30 prefectures located in Hokkaido, mainland Honshu, Shikoku, and Kyushu of Japan and underwent health check-ups during 2002-2007, and were tested for the presence of IgG, IgM, and IgA classes of antibodies to HEV (anti-HEV) by in-house ELISA and HEV RNA by nested RT-PCR. Overall, 1,167 individuals (5.3%) were positive for anti-HEV IgG, including 753 males (7.8%) and 414 females (3.4%), the difference being statistically significant (P < 0.0001). The prevalence of anti-HEV IgG generally increased with age and was significantly higher among individuals aged >or=50 years than among those aged <50 years (6.6% vs. 2.7%, P < 0.0001). Although 13 individuals with anti-HEV IgG also had anti-HEV IgM and/or anti-HEV IgA, none of them had detectable HEV RNA. The presence of HEV RNA was further tested in 50 or 49-sample minipools of sera from the remaining 22,014 individuals, and three individuals without anti-HEV antibodies tested positive for HEV RNA. The HEV isolates obtained from the three viremic individuals segregated into genotype 3 and were closest to Japan-indigenous HEV strains. When stratified by geographic region, the prevalence of anti-HEV IgG as well as the prevalence of HEV RNA or anti-HEV IgM and/or anti-HEV IgA was significantly higher in northern Japan than in southern Japan (6.7% vs. 3.2%, P < 0.0001; 0.11% vs. 0.01%, P = 0.0056; respectively).

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Section: Genetic Analysis Of Hev Isolates Recoveredmentioning

confidence: 89%

A nationwide survey of hepatitis E virus infection in the general population of Japan

Takahashi

Tamura

Hoshino

et al. 2009

Journal of Medical Virology

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“…This result might support the fi nding that the peak values of ALT, AST were signifi cantly higher in AH-A patients than in AH-E patients. Furthermore, we expected that the cholestasis score, which indirectly indicates the presence of increased biliary tract enzymes, might be higher in AH-E than in AH-A, because the peak values of serum GTP and ALP have been found to be higher in AH-E patients than in AH-A patients [25][26][27]. However, the cholestasis score did not show a signifi cant difference between AH-A and AH-E.…”

Section: Discussionmentioning

confidence: 68%

“…Additionally, the majority of patients with AH-E have been male, and the mean age has been >50 years except in imported cases [25][26][27]. These fi ndings suggest that the immunological reaction in the liver may be different between AH-A and AH-E.…”

Section: Introductionmentioning

confidence: 85%

Hepatic histological comparison between Acute Self-limiting Hepatitis A and Hepatitis E

Suzuki¹,

Tatemichi²,

Yoshida³

et al. 2017

Arch Hepat Res

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Background: Histological fi ndings of the liver in acute liver injury are basically affected by degree of liver damage. However, the differences in liver histology between acute self-limiting hepatitis A (AH-A) and hepatitis E (AH-E) have not yet been clarifi ed. This study aimed to clarify the differences in histological fi ndings of the liver between AH-A and AH-E.Methods: Fourteen patients with AH-A and 11 patients with AH-E matched with the period between the onset of AH and the performance of liver biopsy and with the degree of liver function impairment were studied. The activity grade and fi brosis stage were evaluated using the METAVIR scoring system and the semiquantitative scores using 9 items from histological fi ndings: interface hepatitis, portal lymphocytes, portal neutrophils, lobular necrosis, lobular infl ammation, steatosis, ballooning, Mallory bodies, and cholestasis. Results:The patients with AH-E were signifi cantly older and had a higher proportion of males than the patients with AH-A. Although liver function test values and prothrombin time on admission signifi cantly differed between AH-A and AH-E, these values on the day of liver biopsy were not signifi cantly different between AH-A and AH-E. Among the histological scores studied, lobular necrosis score was signifi cantly higher in AH-A than in AH-E. Alcohol abuse did not affect the histological differences between AH-A and AH-E. Among the AH-E patients, activity grade, lobular necrosis, and lobular infl ammation scores were signifi cantly high in patients showing positive drug-induced lymphocyte stimulation tests. Conclusions:The lobular necrosis score among the histological fi ndings of the liver was signifi cantly higher in AH-A than in AH-E. Aging and immunoreaction against drugs might contribute to the histological changes in AH-E.

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“…However, HEV infection can also take a more severe or even fatal course, resulting in liver failure [33,37]. In particular, a mortality of up to 75% in patients with pre-existing chronic liver disease was described [38].…”

Section: Clinical Picture Of Hev Infectionmentioning

confidence: 99%

“…After an incubation period of several weeks, HEV infection manifests itself by symptoms comparable to that of acute hepatitis induced by other hepatitic viruses: abdominal pain, nausea, vomiting and anorexia can occur, as well as pyrexia, jaundice, and hepatomegaly [32,33]. However, the clinical picture of HEV infection varies broadly and many HEV infections are self-limited without any symptoms [34].…”

Section: Clinical Picture Of Hev Infectionmentioning

confidence: 99%

Autochthonous Hepatitis E Virus Infections: A New Transfusion-Associated Risk?

Dreier

Juhl²

2013

Transfus Med Hemother

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Hepatitis E virus (HEV) has been recognized since 2004 as a transfusion-transmissible infectious agent, and recent epidemiological data suggest that it may pose a safety threat to the blood supply. It has recently become obvious that hepatitis E is endemic in industrialized countries, and that more infections are autochthonous than travel-associated. Epidemiological and phylogenetic analysis suggests that HEV infection has to be considered as a zoonosis and that viral transmission from animals (pigs, wild animals) occurs through food or direct contact. The seroprevalence and incidence of HEV in the general population and blood donors in European countries indicate an underestimated risk for transfusion transmissions. Recently reported cases of transfusion transmission of HEV infection, and detection of viremic, asymptomatic blood donors in nucleic acid amplification technique screening programs give an indication of the importance of this virus. Diagnostic assays for detection of anti-HEV antibodies, HEV antigens and RNA are discussed. Recent studies support the idea that active immunization can prevent hepatitis E, highlighting the need for vaccination programs. Here we review current knowledge of HEV and its epidemiology, blood transmission and prevention of this disease with emphasis on blood supply.

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Epidemiological and clinical study of sporadic acute hepatitis E caused by indigenous strains of hepatitis E virus in Japan compared with acute hepatitis A

Abstract: Our results suggest that there are geographical differences between HEV strains in Japan, and that AH-E is more common in males and older patients than AH-A. Laboratory data indicate a weak immunological reaction and early appearance of jaundice in AH-E.

Cited by 49 publications

References 38 publications

A nationwide survey of hepatitis E virus infection in the general population of Japan

A nationwide survey of hepatitis E virus infection in the general population of Japan

Hepatic histological comparison between Acute Self-limiting Hepatitis A and Hepatitis E

Autochthonous Hepatitis E Virus Infections: A New Transfusion-Associated Risk?

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