First report of a human autochthonous hepatitis E virus infection in Brazil

Lopes dos Santos, Debora Regina; Lewis-Ximenez, Lia Laura; da Silva, Marcelle Figueira Marques; de Sousa, Paulo Sérgio Fonseca; Gaspar, Ana Maria Coimbra; Pinto, Marcelo Alves

doi:10.1016/j.jcv.2009.12.021

« Previous Next »Journal of Clinical Virology
Volume 47, Issue 3 , Pages 276-279, March 2010

First report of a human autochthonous hepatitis E virus infection in Brazil

Debora Regina Lopes dos Santos
- Laboratório de Desenvolvimento Tecnológico em Virologia, IOC, Fiocruz, Rio de Janeiro, Brazil
- Corresponding author. Tel.: +55 21 25621846; fax: +55 21 22604866.
Lia Laura Lewis-Ximenez
- Laboratório de Hepatites Virais, IOC, Fiocruz, Rio de Janeiro, Brazil
Marcelle Figueira Marques da Silva
- Laboratório de Virologia Comparada e Ambiental, IOC, Fiocruz, Brazil
Paulo Sérgio Fonseca de Sousa
- Laboratório de Hepatites Virais, IOC, Fiocruz, Rio de Janeiro, Brazil
Ana Maria Coimbra Gaspar
- Laboratório de Desenvolvimento Tecnológico em Virologia, IOC, Fiocruz, Rio de Janeiro, Brazil
Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, IOC, Fiocruz, Rio de Janeiro, Brazil

Received 10 September 2009; received in revised form 22 December 2009; accepted 28 December 2009. published online 29 January 2010.

Abstract

Background

Sporadic acute hepatitis E cases occurring in non-endemic areas have been associated to genotypes 3 and 4 of hepatitis E virus. Several studies have demonstrated the relationship among human and animals strains, mostly pigs and deers, from respective areas characterizing zoonosis. Circulation of genotype 3 of HEV in Brazilian swine herds have already been demonstrated. Nevertheless, no confirmed human cases have been reported to date in Brazil.

Objectives

A study was developed to attempt the identification of hepatitis E acute cases in Brazil.

Study design

A retrospective study carried out with 64 serum samples from patients with acute non-A–C hepatitis was performed to identify human cases of acute hepatitis E.

Results

We could identify a confirmed case of acute hepatitis E. The patient seroconverted to hepatitis E virus-specific IgM and IgG antibody, HEV-RNA was amplified from serum, and the analysis of the sequence of a 242 nucleotide fragment from the ORF1 genome region classified the strain within genotype 3 and subgenotype 3b. Investigation of risk factors and results from phylogenetic analysis suggested a likely zoonotic origin for the infection.

Conclusions

The first report of a human autochthonous in Brazil contributes with new information for hepatitis E epidemiology in Latin America and to considerate further broadly epidemiological studies.

Keywords: Hepatitis E, Autochthonous human case, Genotype 3, Zoonosis, Brazil