Is Hepatitis E Virus a Neglected or Emerging Pathogen in Egypt?

Sayed, Ibrahim M.; Abdelwahab, Sayed F.

doi:10.3390/pathogens11111337

Cited by 7 publications

(5 citation statements)

References 124 publications

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“…The Hepatitis E distinctive zone is still limited to Egypt, as the infection pattern differs from other world regions [ 61 ]. In this zone, the prevalence is higher (60–80% seropositivity), especially in the first decade of life [ 62 ], and most young people develop HEV IgG antibodies with a seroprevalence resembling that of HAV. Interestingly, the incidence is lower among pregnant women, and the infection is either asymptomatic or very mild with no fulminant course.…”

Section: Epidemiologymentioning

confidence: 99%

Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh

Aziz

Øverbø

Julin

et al. 2022

Viruses

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HEV is the most common cause of acute hepatitis globally. This review summarizes the latest knowledge on the epidemiology, clinical characteristics, testing, and treatment of HEV infection. We also focused on Bangladesh to highlight the distinct challenges and the possible remedies. In low-income settings, the virus is mainly transmitted between people by fecal contamination of drinking water causing large outbreaks, and sporadic cases. The disease is usually mild and self-limiting acute hepatitis. Still, pregnant women and their offspring in low-income countries are at particular risk for severe disease, with up to 20% maternal mortality. Despite the high burden of the disease, HEV remains a relatively neglected virus, with detection hampered by costly tests and a lack of suitable treatments. Molecular PCR diagnostics, together with ELISA antibody tests, remain the preferred methods for diagnosis of HEV; however, rapid bedside diagnostics are available and could offer a practical alternative, especially in low-income countries. One vaccine (HEV 239) is only available in China and Pakistan, as efficacy against the other genotypes remains uncertain. The effectiveness trial conducted in Bangladesh might lead the way in gathering more efficacy data and could, together with improved surveillance and raised awareness, dramatically reduce the global burden of HEV.

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Section: Epidemiologymentioning

confidence: 99%

Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh

Aziz

Øverbø

Julin

et al. 2022

Viruses

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“…HEV contamination has been detected in dry-cured pork products and pork liver sausages (consisting of raw liver) in European countries with heavy pork diets. Contamination of water bodies with ground water or sewage from pig farms has also been shown to spread HEV-3 and HEV-4 [ 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

Repurposing of artesunate, an antimalarial drug, as a potential inhibitor of hepatitis E virus

et al. 2023

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Hepatitis E virus (HEV) is endemic in several developing countries of Africa and Asia. It mainly causes self-limiting waterborne infections, in either sporadic or outbreak form. Recently, HEV was shown to cause chronic infections in immunosuppressed individuals. Ribavirin and interferon, the current off-label treatment options for hepatitis E, have several side effects. Hence, there is a need for new drugs. We evaluated the antimalarial drug artesunate (ART) against genotype 1 HEV (HEV-1) and HEV-3 using a virus-replicon-based cell culture system. ART exhibited 59% and 43% inhibition of HEV-1 and HEV-3, respectively, at the highest nontoxic concentration. Computational molecular docking analysis showed that ART can bind to the helicase active site (affinity score, -7.4 kcal/mol), indicating its potential to affect ATP hydrolysis activity. An in vitro ATPase activity assay of the helicase indeed showed 24% and 55% inhibition at 19.5 µM (EC 50 ) and 78 µM concentrations of ART, respectively. Since ATP is a substrate of RNA-dependent RNA polymerase (RdRp) as well, we evaluated the effect of ART on the enzymatic activity of the viral polymerase. Interestingly, ART showed 26% and 40% inhibition of the RdRp polymerase activity at 19.5 µM and 78 µM concentrations of ART, respectively. It could be concluded from these findings that ART inhibited replication of both HEV-1 and HEV-3 by directly targeting the activities of the viral enzymes helicase and RdRp. Considering that ART is known to be safe in pregnant women, we think this antimalarial drug deserves further evaluation in animal models. Supplementary Information The online version contains supplementary material available at 10.1007/s00705-023-05770-1.

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“…Several studies in the last two decades revealed that HEV infection is endemic in Egypt [ 18 , 19 ]. A high rate of anti-HEV IgG seroprevalence is reported in rural communities, especially among villagers and pregnant women [ 18 , 19 , 20 , 21 ]. HEV-infected patients were either asymptomatic or developed the acute self-limiting disease [ 20 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…A high rate of anti-HEV IgG seroprevalence is reported in rural communities, especially among villagers and pregnant women [ 18 , 19 , 20 , 21 ]. HEV-infected patients were either asymptomatic or developed the acute self-limiting disease [ 20 , 22 , 23 , 24 ]. The actual prevalence of HEV infection in Egypt is not known due to either silent infection and/or the infection not being documented or monitored.…”

Section: Introductionmentioning

confidence: 99%

Evidence of a Link between Hepatitis E Virus Exposure and Glomerulonephritis Development

El‐Mokhtar

Kamel

El-Sabaa

et al. 2023

Viruses

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Viruses can trigger glomerulonephritis (GN) development. Hepatitis viruses, especially Hepatitis C virus and Hepatitis B viruses, are examples of the viruses that trigger GN initiation or progression. However, the proof of a correlation between GN and Hepatitis E virus infection is not clear. Some studies confirmed the development of GN during acute or chronic HEV infections, mainly caused by genotype 3. While others reported that there is no relation between HEV exposure and GN development. A recent study showed that a reduced glomerular filtration rate was developed in 16% of acute HEV genotype 1 (HEV-1) infections that returned to normal during recovery. HEV-1 is endemic in Egypt with a high seroprevalence among villagers and pregnant women. There is no available data about a link between HEV and GN in Egypt. Methods: GN patients (n = 43) and matched healthy subjects (n = 36) enrolled in Assiut University hospitals were included in this study. Blood samples were screened for hepatotropic pathogens. Tests for HEV markers such as HEV RNA and anti-HEV antibodies (IgM and IgG) were performed. Laboratory parameters were compared in HEV-seropositive and HEV-seronegative GN patients. Results: Anti-HEV IgG was detected in 26 (60.5%) out of 43 GN patients. HEV seroprevalence was significantly higher in GN than in healthy controls, suggesting that HEV exposure is a risk factor for GN development. None of the GN patients nor the healthy subjects were positive for anti-HEV IgM or HEV RNA. There was no significant difference between seropositive and seronegative GN patients in terms of age, gender, albumin, kidney function profiles, or liver transaminases. However, anti-HEV IgG positive GN patients had higher bilirubin levels than anti-HEV IgG negative GN patients. HEV-seropositive GN patients had a significantly elevated AST level compared to HEV-seropositive healthy subjects. Conclusion: exposure to HEV infection could be complicated by the development of GN.

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Is Hepatitis E Virus a Neglected or Emerging Pathogen in Egypt?

Cited by 7 publications

References 124 publications

Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh

Hepatitis E Virus (HEV) Synopsis: General Aspects and Focus on Bangladesh

Repurposing of artesunate, an antimalarial drug, as a potential inhibitor of hepatitis E virus

Evidence of a Link between Hepatitis E Virus Exposure and Glomerulonephritis Development

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