Serum samples collected periodically from a 40-year-old Japanese woman who had not travelled abroad and who had contracted sporadic acute hepatitis E in 1993 were semi-quantitatively tested by enzyme immunoassay for IgM, IgA and IgG antibodies to hepatitis E virus (HEV). Anti-HEV IgM and IgA antibody levels were the highest (1 : 2400 dilution and 1 : 3400 dilution, respectively) on day 9 after the onset of hepatitis and then decreased rapidly in a parallel manner. Anti-HEV IgG antibody levels were the highest (1 : 17000 dilution) on day 145 and then decreased gradually but remained at high titres (1 : 2200 dilution) even 8?7 years after the onset of hepatitis. An HEV isolate, HE-JA10, recovered from the patient's serum at admission was closely related to a genotype III strain isolated in the United States (US1), with 92?2% identity over the full-length genome, and was most closely related to the JMY-Haw isolate of Japanese origin (95?4% identity).Hepatitis E virus (HEV) is a major cause of epidemic and sporadic, enterically transmitted non-A, non-B hepatitis in many developing countries in Asia, Africa and Latin America (Purcell & Emerson, 2001a). Recently, there is growing consensus that (i) HEV-associated hepatitis also occurs among individuals in industrialized countries with no history of travel to areas endemic for HEV (Harrison, 1999;Purcell & Emerson, 2001a;Schlauder & Mushahwar, 2001) and (ii) HEV is a zoonotic virus, as suggested by the close genetic relationship between human and swine viruses (Erker et al., 1999; Hsieh et al., 1999;Meng et al., 1997Meng et al., , 1998. The genome of HEV is a single-stranded, positivesense RNA of approximately 7?2 kb and contains a short 59 untranslated region (UTR), three open reading frames (ORFs 1-3) and a short 39 UTR terminated by a poly(A) tract (Reyes et al., 1990;Tam et al., 1991). HEV sequences have been classified tentatively into four major genetic groups (genotypes I-IV) (Schlauder & Mushahwar, 2001). Worldwide, the majority of HEV infections are caused by genotype I, while only isolated cases of infection with HEV of genotype III or IV have been described in the United States, Europe, Argentina, Taiwan and China (Hsieh et al., 1999; Kwo et al., 1997;Pina et al., 2000;Schlauder et al., 1998Schlauder et al., , 1999Schlauder et al., , 2000Wang et al., 1999Wang et al., , 2000Wang et al., , 2001Worm et al., 2000;Zanetti et al., 1999). In Japan, multiple HEV strains of genotype III or IV have been isolated from patients with acute hepatitis of non-ABC aetiology who had never been abroad (Takahashi et al., , 2002aMizuo et al., 2002), and swine HEV strains of genotype III have been isolated from farm pigs in Japan (Okamoto et al., 2001). These results indicate that heterogeneous HEV strains are circulating in Japan and that domestically infected hepatitis E occurs in Japan, where HEV infection had been considered to be non-endemic. However, the molecular and serological characteristics of sporadic acute hepatitis E in industrialized countries, including Japan, a...