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Hepatitis E Virus Species C Infection in Humans, Hong Kong
- Source :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 75(2)
- Publication Year :
- 2021
-
Abstract
- Background Hepatitis E virus (HEV) variants belonging to Orthohepevirus species A (HEV-A) are the primary cause of human hepatitis E. However, we previously reported that Orthohepevirus species C genotype 1 (HEV-C1), a divergent HEV variant commonly found in rats, also causes hepatitis in humans. Here, we present a clinical-epidemiological investigation of human HEV-C1 infections detected in Hong Kong, with an emphasis on outcomes in immunocompromised individuals. Methods A surveillance system for detecting human HEV-C1 infections was established in Hong Kong. Epidemiological and clinical characteristics of HEV-C1 cases identified via this system between 1 August 2019 and 31 December 2020 were retrieved. Phylogenetic analysis of HEV-C1 strain sequences was performed. Infection outcomes of immunocompromised individuals with HEV-A and HEV-C1 infections were analyzed. Results HEV-C1 accounted for 8 of 53 (15.1%) reverse-transcription polymerase chain reaction (RT-PCR)–confirmed HEV infections in Hong Kong during the study period, raising the total number of HEV-C1 infections detected in the city to 16. Two distinct HEV-C1 strain groups caused human infections. Patients were elderly and/or immunocompromised; half tested negative for HEV immunoglobulin M. Cumulatively, HEV-C1 accounted for 9 of 21 (42.9%) cases of hepatitis E recorded in immunocompromised patients in Hong Kong. Immunocompromised HEV-C1 patients progressed to persistent hepatitis at similar rates (7/9 [77.8%]) as HEV-A patients (10/12 [75%]). HEV-C1 patients responded to oral ribavirin, although response to first course was sometimes poor or delayed. Conclusions Dedicated RT-PCR–based surveillance detected human HEV-C1 cases that evade conventional hepatitis E diagnostic testing. Immunosuppressed HEV-C1–infected patients frequently progress to persistent HEV-C1 infection, for which ribavirin is a suitable treatment option.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
viruses
Orthohepevirus
medicine.disease_cause
chemistry.chemical_compound
Hepatitis E virus
Internal medicine
Epidemiology
Ribavirin
medicine
Animals
Humans
Phylogeny
Aged
Hepatitis
biology
business.industry
Zoonosis
virus diseases
biology.organism_classification
medicine.disease
Hepatitis E
Hepatitis C
digestive system diseases
Rats
Chronic infection
Infectious Diseases
chemistry
Hong Kong
RNA, Viral
business
Subjects
Details
- ISSN :
- 15376591
- Volume :
- 75
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
- Accession number :
- edsair.doi.dedup.....1f6bf58bc1b413bc1fcdb8431ac2e228