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1.
BMC Infect Dis ; 21(1): 288, 2021 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-33743628

RESUMO

BACKGROUND: Many clinicians are aware that certain therapies administered to their patients can have downstream consequences in the form of clinical laboratory test interferences. This is particularly true of laboratory tests that depend on, or directly involve the use of, antibody-based methodology. Intravenously-administered immunoglobulin therapy is one such treatment that can in theory directly impact the results of particular tests in the area of viral serology. This study can help serve as a reference for clinicians researching the impact of intravenously-administered immunoglobulin therapy in the context of positive results that do not reflect the clinical background of the patient. CASE PRESENTATION: We describe a case whereby an intravenously-administered immunoglobulin therapy led to a series of clinical false positives in viral serology, inconsistent with the known patient history as well as recent laboratory results. The patient presented to hospital with petechiae-type bleeding rashes and was investigated for thrombocytopenia after initial blood investigations indicated very low platelets. Subsequent testing of the potential causes for low-platelet involved several viral serology investigations, including hepatitis, cytomegalovirus and human immunodeficiency virus. Initial testing indicated patient exhibited negative status for all viral antibodies and antigens (except immunity for hepatitis B surface antigen antibody). As part of the thrombocytopenia treatment, intravenously-administered immunoglobulin therapy was administered, and subsequent viral serology was ordered. These investigations indicated a positive status for several hepatitis antibodies as well as cytomegalovirus. CONCLUSIONS: This case study illustrates the potential for improper diagnosis of previous or ongoing infection status in patients administered IVIg therapy. Caution should be exercised particularly when interpreting results involving cytomegalovirus and hepatitis.


Assuntos
Anticorpos Antivirais/sangue , Reações Falso-Positivas , Imunoglobulinas Intravenosas/uso terapêutico , Adulto , Citomegalovirus , Feminino , Anticorpos Anti-Hepatite/sangue , Vírus de Hepatite , Humanos
2.
Viruses ; 13(2)2021 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-33546482

RESUMO

European Association of the Study of the Liver (EASL) guidelines specify HEV RNA, as well as anti-HEV IgG and IgM as positive markers for acute HEV infection. HEV RNA assay sensitivity limitations may lead to false negative test results in patients with low levels of viremia. Moreover, anti-HEV IgM positivity is not a reliable indicator for distinguishing between acute and resolved infections given the ability of this antibody to persist several months after a resolved infection. Our study aims were to assess HEV IgG avidity for diagnosing acute and resolved infections, regardless of the anti-HEV IgM serostatus, and examine assay reliability when evaluating different genotype 3 (GT3) HEV subtypes. Patient serum samples (n = 104) were tested for HEV IgG avidity by utilizing the DIA.PRO kit on a DSX automated instrument. Among patients identified with acute HEV infections, 32 were infected with GT3: GT3c (n = 5), GT3e (n = 8), 3f (n = 17) and GT3-unsubtyped (n = 2). Avidity sensitivity was 91.2% and specificity was 100%. For patients with long-lasting anti-HEV IgM persistence, an Avidity Index >70% was observed. Thus, the DIA.PRO avidity assay may be utilized to distinguish between recently acquired and resolved HEV GT3 infections. However, for equivocal results (Avidity Index > 40-70%), HEV RNA molecular testing will be required to confirm a recent infection.


Assuntos
Anticorpos Anti-Hepatite/imunologia , Vírus da Hepatite E/imunologia , Hepatite E/diagnóstico , Hepatite E/imunologia , Imunoglobulina G/imunologia , Afinidade de Anticorpos , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite E/sangue , Hepatite E/virologia , Vírus da Hepatite E/genética , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Imunoglobulina M/imunologia , Masculino , Filogenia , RNA Viral/genética
3.
Int J Infect Dis ; 104: 482-490, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33460834

RESUMO

OBJECTIVES: To determine IgG immune responses and hepatitis E virus (HEV) viral load, and to explore the associations with pregnancy. METHODS: A total of 121 HEV-infected women (57 pregnant, 64 non-pregnant) were analysed. Quantitative reverse transcription PCR (RT-qPCR) was done for 78 HEV IgM-positive patients to determine viral load, and Sanger sequencing was performed for 62 HEV-RNA-positive patients to confirm genotyping. ELISA was conducted to determine HEV antibody and avidity indices. RESULTS: The HEV genotype was identified as variant 1. Significant negative correlations were observed between log HEV copy number and log hepatitis E virus IgG antibody index in the late acute phase of jaundice for both pregnant women (r = -0.7971, p = 0.0002) and non-pregnant women (r = -0.9117, p = 0.0002). Pregnant women had significantly higher serum log viral copy numbers and lower IgG antibody indices than non-pregnant women in the late acute phase of HEV-induced jaundice (p = 0.0196 and p = 0.0303, respectively). Moreover, pregnant women with acute HEV hepatitis had higher cross-reactive IgG antibodies compared to the non-pregnant women (p = 0.0017). Five patients with HEV hepatitis died, of whom four were pregnant. CONCLUSIONS: Pregnancy might be associated with higher viral loads and a lower IgG response in the HEV-induced late acute phase of jaundice.


Assuntos
Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/genética , Hepatite E/imunologia , Imunoglobulina G/sangue , Carga Viral , Doença Aguda , Adolescente , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Genótipo , Hepatite E/virologia , Vírus da Hepatite E/imunologia , Humanos , Imunoglobulina M/sangue , Icterícia/virologia , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/virologia , Reação em Cadeia da Polimerase em Tempo Real , Adulto Jovem
4.
PLoS One ; 15(10): e0239825, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027305

RESUMO

BACKGROUND AND AIMS: The incidence of hepatitis E virus (HEV)-infections in industrialized nations has been increasing over the past years. Patients suffering from inflammatory bowel diseases (IBD) may be more prone to transmission. Data on HEV seroprevalence in IBD patients is scarce and has not been reported in German IBD patients. The German Health Examination Survey for Adults 2008-2011, which included 4.422 samples, found a HEV seroprevalence of 16.8%, increasing with age. The aim of the present study was to determine the seroprevalence of anti-HEV IgG in a German cohort of IBD patients, and to explore which parameters have an impact on HEV seroprevalence. MATERIAL AND METHODS: This is an uncontrolled, cross-sectional, retrospective monocentric study. Among the patients visiting the IBD outpatient clinic between 25 January, 2019 and 24 September, 2019, 328 patients with Crohn's disease (CD) and 150 patients with ulcerative colitis (UC) were included in the study. IgG antibodies against HEV were determined by enzyme-linked immunosorbent assay. Positive antibody titers were verified using immunoblot analysis. Medical records were reviewed for demographic and clinical parameters to identify potential risk factors for HEV infection. RESULTS: The prevalence of anti-HEV IgG antibodies was 17.4% in CD patients and 24.7% in UC patients. No patient with positive HEV PCR was detected. Greater age of CD und UC patients and longer duration of anti-interleukin 12/23 treatment in CD patients were associated with higher anti-HEV IgG antibody rates. CONCLUSIONS: In summary, we conclude that patients with UC have a higher anti-HEV IgG antibody prevalence than the general population in Germany, and that immunosuppressive therapy may carry no higher risk for HEV infection.


Assuntos
Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Anticorpos Anti-Hepatite/sangue , Hepatite E/epidemiologia , Imunoglobulina G/sangue , Adolescente , Adulto , Idoso , Colite Ulcerativa/virologia , Doença de Crohn/virologia , Estudos Transversais , Feminino , Alemanha , Vírus da Hepatite E , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem
5.
Arch Virol ; 165(10): 2361-2365, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32743697

RESUMO

In this study, we investigated the seroprevalence of anti-hepatitis D virus (HDV) antibodies in hepatitis B surface antigen (HBsAg)-positive children after 25 years of obligatory vaccination of infants against hepatitis B virus. This cross-sectional study included 120 treatment-naïve HBsAg-positive children, with a male-to-female ratio of 1.8:1 and a mean age of 7.8 ± 3.8 years (range, 1-17 years). Mothers were positive for HBsAg in 96.6% of the cases. HBeAg-positive chronic infection was observed in 60% of the cases, HBeAg-positive chronic hepatitis in 12.5%, and HBeAg-negative chronic infection in 26.7%. Anti-HDV antibodies were not detected in any of the cases. Thus, there is a lack of anti-HDV antibodies in HBsAg-positive children, despite the current burden in adults.


Assuntos
Anticorpos Anti-Hepatite/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite D Crônica/epidemiologia , Vírus Delta da Hepatite/imunologia , Adolescente , Criança , Pré-Escolar , Coinfecção , Estudos Transversais , Egito/epidemiologia , Feminino , Hepatite B/imunologia , Hepatite B/prevenção & controle , Hepatite B/virologia , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/patogenicidade , Hepatite D Crônica/sangue , Hepatite D Crônica/imunologia , Hepatite D Crônica/virologia , Vírus Delta da Hepatite/patogenicidade , Humanos , Lactente , Masculino , Estudos Soroepidemiológicos
6.
PLoS One ; 15(8): e0236993, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760100

RESUMO

In 1991, Peru launched the first vaccination program against hepatitis B in children aged under 5 years in the hyperendemic [hepatitis B virus (HBV) and hepatitis D virus (HDV)] province of Abancay. We conducted a cross-sectional study to determine the prevalence of HBV and HDV infections, 23 years after the launch of the vaccination program, as well as the post-vaccine response against hepatitis B in terms of prevalence of hepatitis B surface antibody (anti-HBs ≥10 mUI/ml). Among 3165 participants aged from 0 to 94 years, the prevalence rates of hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (total anti-HBc) were 1.2% [95% confidence interval (CI) 0.85-1.64%], and 41.67% (95% CI 39.95-43.41%), respectively. The prevalence rate of anti-HBs at protective levels (≥10 mUI/ml) in individuals who HBsAg and anti-HBc negative was 66.36% (95% CI 64.15-68.51%). The prevalence rate of HBsAg in children aged <15 years was nil, and among adult HBsAg carriers, the prevalence of hepatitis D antibody (anti-HDV) was 5.26% (2/38; 95% CI 0.64-17.74). These findings showed that HBV prevalence has changed from high to low endemicity, 23 years following implementation of the vaccination program against hepatitis B, and HDV infection was not detected in those aged <30 years.


Assuntos
Vacinas contra Hepatite B/história , Hepatite B/prevenção & controle , Hepatite D/epidemiologia , Programas de Imunização/história , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Doenças Endêmicas , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite B/epidemiologia , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/farmacologia , Vírus da Hepatite B/imunologia , Hepatite D/imunologia , Vírus Delta da Hepatite/imunologia , História do Século XX , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Projetos Piloto , Prevalência , Adulto Jovem
7.
Pol J Microbiol ; 69(2): 217-222, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32548990

RESUMO

Clinical diagnosis of hepatitis E viral (HEV) infection mainly relies on serological assays, and the current status of misdiagnoses regarding HEV infection is uncertain. In this study, patients with acute HEV infection were tested for anti-HEV IgM and IgG, a HEV antigen (Ag), and viral loads (HEV RNA). Serology was performed using four commercial HEV ELISA kits: Wantai, Kehua, Lizhu, and Genelabs IgM and IgG. The HEV RNA was detected using RT-PCR assays. The sensitivities of different kits for anti-HEV IgM ranged from 82.6% to 86%. Each kit for anti-HEV IgM was highly specific (97.8-100%). The sensitivities of all kits to detect anti-HEV IgG with (87.2-91.9%) had a substantial agreement, but the Kehua and Genelabs tests were more specific than the Wantai and Lizhu tests. The Wantai tests for the HEV Ag and HEV RNA were also important for acute HEV infections (Kappa = 0.787). Furthermore, a total of 6.98% of HEV infections were positive for HEV RNA but negative for both the HEV Ag and anti-HEV antibodies of IgM and IgG classes. Our findings demonstrate that the diagnosis of hepatitis E may be missed if only serological assays are used. Thus, a combination of serological and nucleic acid testing provides the optimal sensitivity and specificity to the diagnostic process.Clinical diagnosis of hepatitis E viral (HEV) infection mainly relies on serological assays, and the current status of misdiagnoses regarding HEV infection is uncertain. In this study, patients with acute HEV infection were tested for anti-HEV IgM and IgG, a HEV antigen (Ag), and viral loads (HEV RNA). Serology was performed using four commercial HEV ELISA kits: Wantai, Kehua, Lizhu, and Genelabs IgM and IgG. The HEV RNA was detected using RT-PCR assays. The sensitivities of different kits for anti-HEV IgM ranged from 82.6% to 86%. Each kit for anti-HEV IgM was highly specific (97.8­100%). The sensitivities of all kits to detect anti-HEV IgG with (87.2­91.9%) had a substantial agreement, but the Kehua and Genelabs tests were more specific than the Wantai and Lizhu tests. The Wantai tests for the HEV Ag and HEV RNA were also important for acute HEV infections (Kappa = 0.787). Furthermore, a total of 6.98% of HEV infections were positive for HEV RNA but negative for both the HEV Ag and anti-HEV antibodies of IgM and IgG classes. Our findings demonstrate that the diagnosis of hepatitis E may be missed if only serological assays are used. Thus, a combination of serological and nucleic acid testing provides the optimal sensitivity and specificity to the diagnostic process.


Assuntos
Ensaio de Imunoadsorção Enzimática/normas , Hepatite E/diagnóstico , Kit de Reagentes para Diagnóstico/normas , Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/genética , Humanos , RNA Viral/análise , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
8.
PLoS One ; 15(5): e0233256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32421697

RESUMO

Hepatitis E virus (HEV) is an important global public health concern. Several studies reported a higher HEV prevalence in patients undergoing regular hemodialysis (HD). In Lebanon, the epidemiology of HEV among HD patients has never been investigated previously. In this study, we examine the seroprevalence of HEV infection among 171 HD patients recruited from three hospital dialysis units in Tripoli, North Lebanon. Prevalence of anti-HEV IgG antibodies was evaluated in participant's sera using a commercial enzyme-linked immunosorbent assay (ELISA). The association of socio-demographic and clinical parameters with HEV infection in patients was also evaluated. Overall, 96 women and 75 men were enrolled in this study. Anti-HEV IgG antibodies were found positive in 37/171 HD patients showing a positivity rate of 21.63%. Among all examined variables, only the age of patients was significantly associated with seropositivity (P = 0.001). This first epidemiological study reveals a high seroprevalence of HEV infection among Lebanese HD patients. However, further evaluations that enroll larger samples and include control groups are required to identify exact causative factors of the important seropositivity rate in this population.


Assuntos
Anticorpos Anti-Hepatite/análise , Vírus da Hepatite E/imunologia , Imunoglobulina G/análise , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite E/epidemiologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Líbano , Masculino , Pessoa de Meia-Idade , Prevalência , Diálise Renal , Fatores de Risco , Estudos Soroepidemiológicos
9.
BMC Infect Dis ; 20(1): 368, 2020 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-32448132

RESUMO

BACKGROUND: Hepatitis E virus (HEV) infection is an important cause of acute hepatitis worldwide. In pregnant women, HEV can cause more severe symptoms, with high rates of fatal hepatic failure in endemic countries. However, HEV prevalence and circulation among pregnant women from South America is almost unknown. We aimed to investigate HEV infection in pregnant women for the first time in Argentina. METHODS: IgG and IgM anti-HEV antibodies and RNA-HEV were investigated (by ELISA assays and RT-Nested-PCR, respectively) in 202 serum samples from pregnant women collected in the central region of Argentina between 2015 and 2017. A control group of 155 non-pregnant women was included (year 2018). RESULTS: The IgG anti-HEV positivity rate was 8.4% (17/202), higher than the 2.6% (4/155) obtained for the non-pregnant women control group, and showing association between pregnancy and HEV infection (p = 0.023, OR = 3.5, CI95% = 1.1-10.5). Women younger than 25 years old presented higher levels of antibodies, and there were no differences in the prevalences between trimesters of pregnancy. Two samples were reactive for IgM anti-HEV, showing recent infections, although no symptoms were registered in these patients. All samples were negative for RNA-HEV amplification. CONCLUSIONS: HEV produces infections in pregnant women from Argentina, alerting health teams to consider it as a possible cause of liver disease.


Assuntos
Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Hepatite E/diagnóstico , Hepatite E/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Adolescente , Adulto , Argentina/epidemiologia , Grupos Controle , Ensaio de Imunoadsorção Enzimática , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite E/virologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Reação em Cadeia da Polimerase , Gravidez , Prevalência , RNA Viral/genética , RNA Viral/imunologia , Estudos Retrospectivos , Estudos Soroepidemiológicos , Adulto Jovem
10.
BMC Infect Dis ; 20(1): 260, 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32245368

RESUMO

BACKGROUND: Infection by hepatitis E virus (HEV) can cause a high burden of morbidity and mortality in countries with poor access to clean water and sanitation. Our study aimed to investigate the situation of HEV infections in the Central African Republic (CAR). METHODS: A retrospective analysis of the blood samples and notification forms collected through the national yellow fever (YF) surveillance program, but for which a diagnosis of YF was discarded, was carried out using an anti-HEV IgM ELISA and a HEV-specific RT-PCR. RESULTS: Of 2883 YF-negative samples collected between January 2008 and December 2012, 745 (~ 26%) tested positive by at least either of the 2 tests used to confirm HEV cases. The results revealed that the CAR was hit by a large HEV outbreak in 2008 and 2009. The results also showed a clear seasonal pattern with correlation between HEV incidence and rainfall in Bangui. A phylogenetic analysis showed that the circulating strains belonged to genotypes 1e and 2b. CONCLUSIONS: Overall, this study provides further evidences that HEV can be a significant cause of acute febrile jaundice, particularly among adults during rainy season or flood, in a country from Sub-Saharan Africa.


Assuntos
Surtos de Doenças , Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Hepatite E/diagnóstico , Hepatite E/epidemiologia , Chuva , Doenças Transmitidas pela Água/epidemiologia , Adolescente , Adulto , República Centro-Africana/epidemiologia , Criança , Ensaio de Imunoadsorção Enzimática , Feminino , Inundações , Genótipo , Anticorpos Anti-Hepatite/sangue , Hepatite E/complicações , Hepatite E/virologia , Vírus da Hepatite E/isolamento & purificação , Humanos , Imunoglobulina M/sangue , Incidência , Icterícia/etiologia , Estudos Longitudinais , Masculino , Filogenia , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Doenças Transmitidas pela Água/virologia , Adulto Jovem
11.
Transplant Proc ; 52(3): 926-931, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32139278

RESUMO

BACKGROUND: In past decades, liver transplant (LT) patients were not routinely screened for hepatitis E virus (HEV) infection, and thus it might have been misdiagnosed as an acute rejection episode. Our aim was to analyze a real-world cohort of LT patients who presented with at least 1 episode of biopsy-proven acute rejection (BPAR) and suffered from persistent elevated transaminases, to evaluate the frequency of HEV infection misdiagnosed as a rejection episode. METHODS: Data from 306 patients transplanted between 1997 and 2017, including 565 liver biopsies, were analyzed. Biopsies from patients suffering from hepatitis C (n = 79; 25.8%) and from patients who presented with a Rejection Activity Index <5 (n = 134; 43.8%) were excluded. A subgroup of 74 patients (with 134 BPAR) with persistently elevated liver enzymes was chosen for further HEV testing. RESULTS: Positive HEV IgG was detectable in 18 of 73 patients (24.7%). Positive HEV RNA was diagnosed in 3 of 73 patients with BPAR (4.1%). Patients with HEV infection showed no difference in etiology of the liver disease, type of immunosuppression, or median Rejection Activity Index. CONCLUSION: Few HEV infections were misdiagnosed as acute rejection episodes in this real-world cohort. Thus, HEV infection is an infrequent diagnosis in cases with persistent elevated liver enzymes and BPAR after LT.


Assuntos
Rejeição de Enxerto/diagnóstico , Hepatite E/complicações , Hepatite E/diagnóstico , Transplante de Fígado , Adulto , Estudos de Coortes , Diagnóstico Diferencial , Feminino , Anticorpos Anti-Hepatite/sangue , Humanos , Masculino , Pessoa de Meia-Idade
13.
Euro Surveill ; 25(5)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32046820

RESUMO

BackgroundHepatitis E virus (HEV) is an emerging zoonotic pathogen and an important cause of acute viral hepatitis in European countries. Corsica Island has been previously identified as a hyperendemic area for HEV.AimOur aim was to characterise the prevalence and titres of IgG antibodies to HEV among blood donors on Corsica and establish a model of the annual force of infection.MethodsBetween September 2017 and January 2018, 2,705 blood donations were tested for anti-HEV IgG using the Wantai HEV IgG enzyme immunoassay.ResultsThe overall seroprevalence was 56.1%. In multivariate analysis, seroprevalence was higher in men than in women (60.0% vs 52.2%; p < 0.01), increased with age and was significantly higher among donors born on Corsica (60.6% vs 53.2%; p < 0.01). No significant difference was observed between the five districts of the island. IgG anti-HEV titres were mostly low (70% of positive donors had titres < 3 IU/mL). In Corsican natives, increasing seroprevalence by age could be explained by models capturing a loss of immunity (annual probability of infection: 4.5%; duration of immunity: 55 years) or by age-specific probabilities of infection (3.8% for children, 1.3% for adults).ConclusionWe confirmed the high HEV seroprevalence on Corsica and identified three aspects that should be further explored: (i) the epidemiology in those younger than 18 years, (ii) common sources of contamination, in particular drinking water, that may explain the wide exposure of the population, and (iii) the actual protection afforded by the low IgG titres observed and the potential susceptibility to secondary HEV infection.


Assuntos
Doadores de Sangue , Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/isolamento & purificação , Hepatite E/epidemiologia , Imunoglobulina G/sangue , Adolescente , Adulto , Idoso , Feminino , França/epidemiologia , Hepatite E/sangue , Hepatite E/diagnóstico , Vírus da Hepatite E/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Soroepidemiológicos , Adulto Jovem
15.
PLoS One ; 15(2): e0229073, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32040501

RESUMO

BACKGROUND: Hepatitis E virus (HEV) is a zoonotic pathogen of which pigs have been established as reservoirs. In the present study, we investigated the presence of HEV among pigs in the Center and Littoral regions of Cameroon and performed the molecular characterization of positive strains. METHODOLOGY: A total of 453 serum and stool samples were randomly collected from pigs in slaughterhouses in Obala, Douala and Yaounde. All samples were examined for the presence of anti-HEV IgG and IgM antibodies using ELISA assays. IgM positive stool samples were tested for HEV RNA using an RT-PCR assay, followed by a nested PCR assay for sequencing and phylogenetic analysis. RESULTS: Overall, 216 samples (47.7%, 95% CI: 43.1%-52.3%) were positive for at least one of the serological markers of HEV infection. Amongst these, 21.0% were positives for anti-HEV IgM, 17.7% for anti-HEV IgG, and 9.1% for both. A total of eight stool samples (5.9%) were positive for HEV RNA by nested RT-PCR. Phylogenetic analysis showed that the retrieved sequences clustered within HEV genotype 3. CONCLUSION: This study shows a high prevalence of anti-HEV antibodies and the circulation of genotype 3 in the swine population in Cameroon. Subsequent studies will be needed to elucidate the zoonotic transmission of HEV from pigs to humans in Cameroon.


Assuntos
Reservatórios de Doenças/virologia , Genótipo , Vírus da Hepatite E/classificação , Hepatite E/veterinária , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/virologia , Animais , Camarões/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Vigilância em Saúde Pública , Estudos Soroepidemiológicos , Suínos , Doenças dos Suínos/diagnóstico , Doenças dos Suínos/imunologia , Zoonoses
16.
Vox Sang ; 115(3): 120-132, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32030767

RESUMO

BACKGROUND: Hepatitis E virus (HEV) is usually transmitted by faecal-oral route. Recent reports have documented HEV viraemia in donated blood units and HEV transmission through blood transfusion. This systematic review summarizes the available data on prevalence of HEV viraemia in blood donors. METHODS: Electronic databases were searched on 17 December 2018 to identify full-text English papers reporting original data on prevalence of HEV RNA in donated blood units. Two authors independently extracted the relevant data, which were pooled using simple aggregation as well as a random-effects meta-analysis; heterogeneity was assessed using the I2 method. RESULTS: In all, 59 data sets from 28 countries were identified. The available data showed marked heterogeneity. Of a total of 2 127 832 units studied, 561 (263·6 [95% confidence intervals = 242·7-286·4] per million units) tested positive for HEV RNA. On random-effects meta-analysis, the pooled prevalence was 60·9 [6·7-155·4] per million units. In the viraemic units, HEV RNA titre varied by nearly one million-fold, and most had genotype 3 HEV. The prevalence was higher in blood units with anti-HEV antibodies or elevated alanine aminotransferase. Only nearly one-fourth of viraemic units had anti-HEV antibodies. CONCLUSIONS: The prevalence of HEV viraemia among healthy blood donors is low, though the available data had limited geographical representation and marked heterogeneity. There is a need for further data on HEV viraemia in blood donors from areas with non-3 HEV genotype preponderance.


Assuntos
Doadores de Sangue , Hepatite E/epidemiologia , África/epidemiologia , América/epidemiologia , Ásia/epidemiologia , Austrália/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite E/sangue , Humanos , Masculino , Prevalência , Viremia/epidemiologia
17.
Vet Microbiol ; 240: 108531, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31902495

RESUMO

The hepatitis E virus (HEV) is known to have 4 genotypes but only one serotype. Genotype 1 and 2 infect humans only and genotype 3 and 4 infect humans, pigs and other animal species. Pig and wild boar are also known as reservoirs of HEV infection. Of the 2736 wild boars captured from 2011 to 2016 to investigate the HEV prevalence among Korean wild boars, 1041 serum samples were high seropositive (38.1%; 95% CI: 35.5-40.5) for HEV, which were detected using the anti-HEV antibody ELISA and the highest prevalence rate was 40.6% (684/1683) in 2016. Twenty four HEV strains were also identified from 1859 wild boar bloods captured between 2015 and 2016. The phylogenetic tree constructed based on the partial ORF2 gene revealed that the 23 Korean wild boar HEV strains belonged to genotype 4 (4a and 4d) showing the nucleotide sequences identities 83.4-100 %. The one Korean wild boar HEV strain belonged to genotype 3, segregated into subgenotype 3a. This suggested that major circulating in Korean wild boars is genotype 4a whereas genotype 3a and -4d is minor. It is important to the human public health that HEV with wild boar have potential high risk factor for transmission to human due to eating culture of Korean people with undercooked wild boar gallbladder.


Assuntos
Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/classificação , Hepatite E/veterinária , Sus scrofa/virologia , Doenças dos Suínos/epidemiologia , Animais , Genótipo , Hepatite E/epidemiologia , Hepatite E/transmissão , Vírus da Hepatite E/isolamento & purificação , Humanos , Filogenia , Prevalência , Saúde Pública , RNA Viral/genética , República da Coreia/epidemiologia , Suínos , Doenças dos Suínos/transmissão , Doenças dos Suínos/virologia
18.
Int J Infect Dis ; 91: 188-195, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31756566

RESUMO

OBJECTIVES: The prevalence of active, chronic, and former hepatitis E virus (HEV) infections was investigated in a cohort of immunocompromised patients. The association with transfusion transmitted HEV was evaluated, and the HEV seroprevalence was compared with that in healthy blood donors. STUDY DESIGN AND METHODS: Serum samples from 4023 immunocompromised patients at Rigshospitalet, Denmark were retrospectively tested for HEV RNA and anti-HEV IgG. HEV RNA-positive patients were followed up by HEV testing, clinical symptoms, and transfusion history. Factors associated with anti-HEV were explored by multivariable logistic regression analysis. Samples from 1226 blood donors were retrospectively tested for anti-HEV IgG. RESULTS: HEV RNA was detected in six patients (0.15%) with no indications of chronic HEV infection. HEV RNA prevalence rates among recipients of allogeneic haematopoietic stem cell transplantation (allo-HSCT) and solid organ transplantation (SOT) were 0.58% and 0.21%, respectively. Transfusion transmitted infections were refuted, and transfusion history was not associated with anti-HEV positivity. The difference in HEV seroprevalence between patients (22.0%) and blood donors (10.9%) decreased when adjusting for age and sex (odds ratio 1.20, 95% confidence interval 0.97-1.48). CONCLUSIONS: HEV viremia among allo-HSCT and SOT recipients suggests that clinicians should be aware of this diagnosis. The lack of association of blood transfusion with anti-HEV positivity supports food-borne transmission as the main transmission route of HEV common to both patients and blood donors.


Assuntos
Vírus da Hepatite E/isolamento & purificação , Hepatite E/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doadores de Sangue , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite E/sangue , Hepatite E/imunologia , Hepatite E/virologia , Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/genética , Estudos Retrospectivos , Estudos Soroepidemiológicos , Viremia/epidemiologia , Adulto Jovem
19.
Vox Sang ; 115(1): 11-17, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31709559

RESUMO

BACKGROUND AND OBJECTIVES: In Hong Kong, the dominant circulating hepatitis E virus (HEV) genotype is type 4, which can cause more severe clinical consequences than type 3. The aim of this study was to determine the HEV prevalence in Hong Kong blood donors. MATERIALS AND METHODS: Unlinked donation samples (n = 10 000) collected in March to May 2015 were tested for HEV RNA using the Procleix HEV assay in an individual donation format (IDT). A subset of 2000 samples were tested for IgG and IgM anti-HEV using the Wantai enzyme-linked immunosorbent assay (ELISA). Nucleic acid testing (NAT) initial reactive results were retested once, and repeatedly reactive donations were subjected to alternative molecular procedures as confirmation tests. RESULTS: One in 5000 Hong Kong blood donors was positive for HEV RNA (0·02%). The two RNA positive samples were also IgG and IgM anti-HEV positive. One of the two RNA positive donors could be sequenced revealing genotype type 4. Anti-HEV seroprevalence was estimated as 15·5% among all donors. IgG anti-HEV positive rate for age group 16-20 was 3·1%, and it increased with age to 43·1% for age group 51-60. Sero-positivity was higher in males (male donors 18·1% vs. female donors 13·2%), but it was mostly due to the difference in a specific age group (41-50). CONCLUSION: Hepatitis E virus RNA positive rate of 0·02% was within the reported range of HEV RNA frequency in developed countries. One donor was confirmed to be genotype 4, which is the dominant genotype in circulation in Hong Kong.


Assuntos
Doadores de Sangue , Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/imunologia , Hepatite E/epidemiologia , Adolescente , Adulto , Fatores Etários , Ensaio de Imunoadsorção Enzimática , Feminino , Hong Kong/epidemiologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/sangue , Estudos Soroepidemiológicos , Adulto Jovem
20.
J Pharm Biomed Anal ; 177: 112880, 2020 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-31546137

RESUMO

Hepatitis E, which is caused by infection with hepatitis E virus (HEV), is a global health problem in both developed and developing countries. An efficacious hepatitis E vaccine was licensed (by China) in 2011 with a trade name of Hecolin®. The antigen contained in this vaccine is a truncated version of the sole capsid protein encoded by open reading frame 2, which is designated p239. In this study, the real-time and real-condition stability and accelerated stability of five lots of hepatitis E vaccine products at the end of the designated shelf life, were assessed by a well-established quality analysis platform. The protein integrity of p239 that was recovered from the vaccine lots was demonstrated using CE-SDS, LC-MS and MALDI-TOF MS. The particle characteristics of the recovered vaccine antigen were assessed by TEM and HPSEC. The immunogenicity of hepatitis E vaccines was assessed by a mouse potency assay, which is part of product release and stability testing. Several methods were employed to assess the antigenicity of vaccines with or without adjuvant dissolution. Specifically, the well-established methods of sandwich ELISA and surface plasma resonance (SPR)-based BIAcore were used with unique murine monoclonal antibodies. Most interesting, two 'dissolution-free' immunoassays were also used for in situ antigenicity assessment of the vaccines. In addition to the confirmation of vaccine stability at the end of expiry dating, i.e., after storage in recommended conditions (2-8 °C) for 36 months, the mouse potency assay and sandwich ELISA were used to assess the accelerated stability of prefilled syringes to demonstrate the feasibility of out-of-cold-chain storage. In summary, molecular and functional characterization confirmed the shelf life stability of the vaccine at the end of expiry dating and the feasibility of transporting the hepatitis E vaccine for a given period of time out of cold chains.


Assuntos
Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/imunologia , Hepatite E/prevenção & controle , Vacinas Sintéticas/imunologia , Vacinas contra Hepatite Viral/imunologia , Animais , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Estudos de Viabilidade , Feminino , Anticorpos Anti-Hepatite/imunologia , Antígenos de Hepatite/imunologia , Hepatite E/virologia , Humanos , Imunoensaio/métodos , Imunogenicidade da Vacina , Camundongos , Modelos Animais , Temperatura , Fatores de Tempo , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/química , Vacinas contra Hepatite Viral/administração & dosagem , Vacinas contra Hepatite Viral/química
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