Lin Wang1, Lin Liu1, Yongli Wei2, Qianhui Wang3, Qing Tian2, Ling Wang4, Hui Zhuang1. 1. Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China. 2. Department of Infectious Diseases, Linyi People's Hospital, Shandong Province, China. 3. Department of Infectious Diseases, Taiyuan No.3 Hospital, Shanxi Province, China. 4. Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China. Electronic address: lingwang@bjmu.edu.cn.
Abstract
OBJECTIVES: Recently, genotype 4 HEV (HEV-4) associated hepatitis E has overtaken HEV-1 infections in China, but few studies reported the clinical and virological features of HEV-4 infection. METHODS: Sixty-two patients with acute hepatitis E (AHE) were enrolled from three hospitals in China. Clinical profiles and epidemiological records were analyzed. Patients' serum samples were tested for anti-HEV IgM/IgG and fecal samples were screened for HEV RNA. Representative HEV isolates were partially sequenced and analyzed phylogenetically. RESULTS: A high median age (57.5 years) and an overwhelming proportion of males (51/62, 82%) were found. Most patients presented with symptoms of jaundice (56/62, 90%), malaise (44/62, 71%), anorexia (44/62, 71%) and nausea (41/62, 66%). Elevated mean values of total bilirubin (186 μmol/L), direct bilirubin (109 μmol/L), ALT (997 IU/L), AST (583 IU/L), ALP (159 IU/L) and GGT (170 IU/L) and reduced albumin level (32 g/L) were observed. The positive rate for anti-HEV IgM/IgG was 100% (62/62)/76% (47/62), for HEV RNA was 58% (25/43). Twelve HEV-4 isolates were obtained. CONCLUSION: All HEV isolates belonged to HEV-4 and showed high sequence similarity to swine HEV-4. Most of the sporadic cases had typical clinical symptoms, signs of AHE, and elevated levels of serum bilirubin and liver enzymes.
OBJECTIVES: Recently, genotype 4 HEV (HEV-4) associated hepatitis E has overtaken HEV-1 infections in China, but few studies reported the clinical and virological features of HEV-4 infection. METHODS: Sixty-two patients with acute hepatitis E (AHE) were enrolled from three hospitals in China. Clinical profiles and epidemiological records were analyzed. Patients' serum samples were tested for anti-HEV IgM/IgG and fecal samples were screened for HEV RNA. Representative HEV isolates were partially sequenced and analyzed phylogenetically. RESULTS: A high median age (57.5 years) and an overwhelming proportion of males (51/62, 82%) were found. Most patients presented with symptoms of jaundice (56/62, 90%), malaise (44/62, 71%), anorexia (44/62, 71%) and nausea (41/62, 66%). Elevated mean values of total bilirubin (186 μmol/L), direct bilirubin (109 μmol/L), ALT (997 IU/L), AST (583 IU/L), ALP (159 IU/L) and GGT (170 IU/L) and reduced albumin level (32 g/L) were observed. The positive rate for anti-HEV IgM/IgG was 100% (62/62)/76% (47/62), for HEV RNA was 58% (25/43). Twelve HEV-4 isolates were obtained. CONCLUSION: All HEV isolates belonged to HEV-4 and showed high sequence similarity to swine HEV-4. Most of the sporadic cases had typical clinical symptoms, signs of AHE, and elevated levels of serum bilirubin and liver enzymes.