Oliver Viera-Segura1, Mauricio Realpe-Quintero2, Arturo Panduro3, Sonia Roman3, Alexis Jose-Abrego3, Karina Gonzalez-Aldaco3, Jorge L Trujillo-Ochoa4, Nora A Fierro5. 1. Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico; Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara, 44280 Jalisco, Mexico. 2. Department of Veterinarian Medicine, Biological-Agricultural Sciences, University of Guadalajara, Nextipac, Zapopan, 44600 Jalisco, Mexico. 3. Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara "Fray Antonio Alcalde", and Health Sciences Center, University of Guadalajara, Hospital #278, Col. El Retiro, Guadalajara, 44280 Jalisco, Mexico. 4. Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara, 44280 Jalisco, Mexico. 5. Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara, 44280 Jalisco, Mexico. Electronic address: noraalma@iibiomedicas.unam.mx.
Abstract
INTRODUCTION AND OBJECTIVES: To characterize the virological features of hepatitis E virus (HEV) in serum from patients exhibiting chronic liver damage. METHODS: A data-base of 513 unrelated individuals from West-Mexico with liver-disease determined by clinical and biochemical tests and transient elastography between 2011 and 2016 were retrospectively analyzed. According to infectious etiologies, patients were classified as hepatitis B virus (HBV)-, hepatitis C virus (HCV)-infected patients, and patients exhibiting chronic liver damage with non-identified infectious etiological agent (NIIEA). Available serum samples from NIIEA-patients were tested by RT-nPCR for the presence of HEV-RNA and partially sequenced for genotyping. RESULTS: Out of the 513 cases, 5.85% were patients infected with HBV, 67.64% with HCV, and 26.51% were NIIEA-patients. Among 76 available samples from NIIEA-cases, 30.26% tested positive for HEV-RNA. Twelve (15.79%) partial HEV sequences allowed phylogenetic analysis, revealing the classification of HEV as HEV-Gt3. Advanced fibrosis (F3-F4 stage) was found in a 26.1% of patients with HEV-active infection. CONCLUSION: Although HCV is the main infectious agent related to chronic liver disease in Mexico, liver damage without an infectious etiology is common. Our findings reveal that an elevated rate of chronic liver disease might be represented by autochthonous infection of HEV-Gt3, whose detection makes Mexico unique in Latin-America with the circulation of HEV strains belonging to three genotypes (Gt1, Gt2, and Gt3). Thus, HEV infection should be a matter of health concern, and mandates for HEV screening to properly handle this commonly undiagnosed disease.
INTRODUCTION AND OBJECTIVES: To characterize the virological features of hepatitis E virus (HEV) in serum from patients exhibiting chronic liver damage. METHODS: A data-base of 513 unrelated individuals from West-Mexico with liver-disease determined by clinical and biochemical tests and transient elastography between 2011 and 2016 were retrospectively analyzed. According to infectious etiologies, patients were classified as hepatitis B virus (HBV)-, hepatitis C virus (HCV)-infectedpatients, and patients exhibiting chronic liver damage with non-identified infectious etiological agent (NIIEA). Available serum samples from NIIEA-patients were tested by RT-nPCR for the presence of HEV-RNA and partially sequenced for genotyping. RESULTS: Out of the 513 cases, 5.85% were patients infected with HBV, 67.64% with HCV, and 26.51% were NIIEA-patients. Among 76 available samples from NIIEA-cases, 30.26% tested positive for HEV-RNA. Twelve (15.79%) partial HEV sequences allowed phylogenetic analysis, revealing the classification of HEV as HEV-Gt3. Advanced fibrosis (F3-F4 stage) was found in a 26.1% of patients with HEV-active infection. CONCLUSION: Although HCV is the main infectious agent related to chronic liver disease in Mexico, liver damage without an infectious etiology is common. Our findings reveal that an elevated rate of chronic liver disease might be represented by autochthonous infection of HEV-Gt3, whose detection makes Mexico unique in Latin-America with the circulation of HEV strains belonging to three genotypes (Gt1, Gt2, and Gt3). Thus, HEV infection should be a matter of health concern, and mandates for HEV screening to properly handle this commonly undiagnosed disease.
Authors: Marten Schulz; Mira Choi; Friederike Bachmann; Nadine Koch; Theresa Maria Holtmann; Raphael Mohr; Frank Tacke; Alexander Wree Journal: Quant Imaging Med Surg Date: 2022-07