Polyphyletic strains of hepatitis E virus are responsible for sporadic cases of acute hepatitis in Japan

被引:212
作者
Mizuo, H
Suzuki, K
Takikawa, Y
Sugai, Y
Tokita, H
Akahane, Y
Itoh, K
Gotanda, Y
Takahashi, M
Nishizawa, T
Okamoto, H
机构
[1] Jichi Med Sch, Div Immunol, Minami Kawachi, Tochigi 3290498, Japan
[2] Jichi Med Sch, Div Mol Virol, Minami Kawachi, Tochigi 3290498, Japan
[3] Iwate Med Univ, Dept Internal Med 1, Morioka, Iwate 0208505, Japan
[4] Iwaki Kyoritsu Gen Hosp, Dept Internal Med, Iwaki, Fukushima 9738555, Japan
[5] Natl Tokyo Hosp, Dept Gastroenterol, Tokyo 2040023, Japan
[6] Yamanashi Med Univ, Dept Internal Med 1, Yamanashi 4093898, Japan
[7] Japanese Red Cross Yamaguchi Blood Ctr, Yamaguchi 7538534, Japan
关键词
D O I
10.1128/JCM.40.9.3209-3218.2002
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Among 87 patients who were previously treated for acute hepatitis of unknown etiology between 1992 and 2001 at five hospitals in Japan, 11 (13%) patients were positive for immunoglobulin M-class antibodies to hepatitis E virus (HEV) by enzyme immunoassay and had detectable HEV RNA by reverse transcription-PCR with two independent sets of primers derived from well-conserved genomic areas in open reading frames 1 and 2. Clinical HEV infection was significantly associated with male sex (9 of 11 versus 29 of 76 patients [P < 0.01]) and older age (52 +/- 11 [mean standard deviation] versus 41 +/- 17 years [P < 0.05]), and its prevalence differed by geographic region (6 to 25%), with a higher rate in the northern part of Japan. At admission, the 11 patients with HEV-associated hepatitis had elevated alanine aminotransferase levels of 914 to 4,850 IU/liter, and all but 1 had elevated bilirubin levels of 1.5 to 24.0 mg/dl. The 11 HEV isolates were of genotype III or IV and were segregated into three groups with intergroup nucleotide differences of 9.5 to 22.0%. Phylogenetic analysis revealed that four isolates of genotype III were closely related to a Japanese isolate, while the other four isolates of the same genotype were nearest those from the United States. The remaining three isolates were close to known isolates of genotype IV in China and Taiwan but shared less than 88% identity with them. These results indicate that multiple genotypes of HEV cocirculate in Japan and contribute to the development of sporadic acute hepatitis, with the prevalence differing by age, sex, and geographic region.
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页码:3209 / 3218
页数:10
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