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Two 71-year-old males (Case 1 and 2) with liver dysfunction were admitted to our hospital and diagnosed with acute hepatitis E due to detection of hepatitis E virus (HEV) RNA or IgM class anti-HEV in their sera. Since they ate the same rare wild boar meat at the same ritual, the boar meat was considered to be the infection source. Phylogenetic analysis showed that HEV strain identified in Case 1 segregated to a cluster of "Aichi/Shizuoka Strains". It seems that the "Aichi/Shizuoka Strain", an atypical genotype 4 strain compared to those found in other part of Japan, is prevailing within this small geographic area.

ペグインターフェロン（PEG-IFN）α2aまたはグリチルリチン製剤（強力ネオミノファーゲンC：SNMC）を投与開始し，24週以上継続可能であったC型慢性肝炎64例を対象とし，有効性・安全性をretrospectiveに比較検討した．平均観察期間（中央値，週）はPEG群154，SNMC群145，ALT値（中央値，IU/L）は投与前，24週，48週時点において，PEG群64，34，30，SNMC群80，47，52，AFP値（中央値，ng/mL）は投与前，24週，48週時点において，PEG群12，9.2，7.2，SNMC群12，12.5，18であった．投与中の血小板，Hb，好中球数はSNMC群と比較しPEG群で有意に低値を示したが，減量により全例継続可能であった．PEG群で3例（8％），SNMC群で3例（11％）にHCCが発現した．肝発癌抑制を目的としたPEG-IFNα2a少量及びSNMC療法は，共に肝機能改善効果を認めたが，PEG群で有意にALT値，AFP値が改善した．

シカ及びイノシシの生食により感染したと思われるE型急性肝炎3例を経験したので報告する．症例1，2は71歳と48歳の男性で発症の約2カ月前に，偶然同一飲食店で別々にイノシシの肝を生食していた．症例3は69歳の男性で，発症の2カ月前から息子が狩猟で捕獲した複数頭のシカ生肉を頻回に自宅で調理し摂取していた．3症例とも入院時，肝逸脱酵素は著明に上昇していたが補液や安静で改善した．3症例の病初期血清におけるIgM-HEV抗体，IgG-HEV抗体，HEV-RNAが陽性でHEV genotypeは4型，塩基配列は相互に99.8％以上一致した．愛知県のヒト及びイノシシから分離されている「4型HEV愛知株」との間にも98.5％-99.8％の一致率を示し，北海道に蔓延するgenotype 4とは明らかに別系統であることが注目された．

We encountered a series of sporadic cases of hepatitis E (n=8) from late September to middle of October 2009 in Sapporo and its suburbs. Surprisingly, HEV sequences from these patients segregated to a very compact cluster, suggesting a single-source epidemic. Moreover, they are closely related to the "Sapporo strain" or the "Kitami/Abashiri strain" which is known to have caused severe hepatitis in Kitami and Abashiri area, far from Sapporo, several years before. Advanced livestock marketing and food-distribution system might have caused the spread of this HEV strain.

A partial ORF2 protein of hepatitis E virus (HEV) was expressed in E. coli, purified, and used as solid-phase ligand as well as tracer-ligand labeled with peroxidase, in an antigen-antibody-antigen Sandwich ELISA system, to detect antibodies to HEV. This new system showed higher sensitivity of detecting anti-HEV than conventional ELISA system which needs specific antibodies against IgG, IgM, or IgA of concerned animal species as tracer-ligands. Since our new ELISA system is universally applicable to any animal species without needing specific antibodies, it will be useful in further elucidating the animal reservoirs of HEV.