BACKGROUND: The duration of viremia during hepatitis E virus (HEV) infection has rarely been reported. This study was undertaken to detect HEV RNA in sera of patients with hepatitis E and to understand the process of ...BACKGROUND: The duration of viremia during hepatitis E virus (HEV) infection has rarely been reported. This study was undertaken to detect HEV RNA in sera of patients with hepatitis E and to understand the process of HEV infection more thoroughly. METHODS: HEV RNA was detected in the serum samples of hospitalized patients with acute hepatitis E by reverse transcriptase-nested polymerase chain reaction (RT-nPCR) using two pairs of primers from open reading frame (ORF) I of the HEV genome. RESULTS: The serum samples from 44 (70%) of 62 patients were positive for HEV RNA. Thirty-two of these patients, with 288 serial serum specimens, were followed up for the whole process, and 24 patients (75%) were positive for HEV RNA. The positive rates declined with the course of the disease, serum HEV RNA persisting for 20.6 days on average after onset of illness. Serum HEV RNA remained positive in 36 (81.8%) of the 44 patients at the time their alanine aminotransferase (ALT) began to decrease. There was no difference in HEV RNA positivity between serum with high levels of HEV antibody (peak P/N ratio >= 4.0) and that with low levels (peak P/N ratio 4.0), with 25 out of 35 and 19 out of 27 (71.4% vs. 70.4%, P>0.05), respectively. CONCLUSIONS: There is a relatively long period of HEV viremia in patients with hepatitis E. The proportion of HEV viremia and its duration are not directly related to serum ALT values or HEV antibody levels.展开更多
Although hepatitis E virus(HEV)is the primary cause of enterically transmitted acute hepatitis and jaundice in developing countries,locally acquired HEV infections are increasing in nonendemic countries.As such,HEV is...Although hepatitis E virus(HEV)is the primary cause of enterically transmitted acute hepatitis and jaundice in developing countries,locally acquired HEV infections are increasing in nonendemic countries.As such,HEV is emerging as an underdiagnosed cause of infection.This report describes three clinically variable cases of HEV infection with unusual clinical presentations.These cases highlight the fact that HEV should be considered in the differential diagnosis of patients with unexplained hepatitis(acute or chronic)with or without extrahepatic manifestations.HEV should also be considered in patients with persistently elevated liver enzymes who have not travelled to known HEV-endemic regions.Lack of knowledge among physicians and an absence of standardized diagnostic tests may result in increased morbidity and mortality from HEV infection.展开更多
文摘BACKGROUND: The duration of viremia during hepatitis E virus (HEV) infection has rarely been reported. This study was undertaken to detect HEV RNA in sera of patients with hepatitis E and to understand the process of HEV infection more thoroughly. METHODS: HEV RNA was detected in the serum samples of hospitalized patients with acute hepatitis E by reverse transcriptase-nested polymerase chain reaction (RT-nPCR) using two pairs of primers from open reading frame (ORF) I of the HEV genome. RESULTS: The serum samples from 44 (70%) of 62 patients were positive for HEV RNA. Thirty-two of these patients, with 288 serial serum specimens, were followed up for the whole process, and 24 patients (75%) were positive for HEV RNA. The positive rates declined with the course of the disease, serum HEV RNA persisting for 20.6 days on average after onset of illness. Serum HEV RNA remained positive in 36 (81.8%) of the 44 patients at the time their alanine aminotransferase (ALT) began to decrease. There was no difference in HEV RNA positivity between serum with high levels of HEV antibody (peak P/N ratio >= 4.0) and that with low levels (peak P/N ratio 4.0), with 25 out of 35 and 19 out of 27 (71.4% vs. 70.4%, P>0.05), respectively. CONCLUSIONS: There is a relatively long period of HEV viremia in patients with hepatitis E. The proportion of HEV viremia and its duration are not directly related to serum ALT values or HEV antibody levels.
文摘Although hepatitis E virus(HEV)is the primary cause of enterically transmitted acute hepatitis and jaundice in developing countries,locally acquired HEV infections are increasing in nonendemic countries.As such,HEV is emerging as an underdiagnosed cause of infection.This report describes three clinically variable cases of HEV infection with unusual clinical presentations.These cases highlight the fact that HEV should be considered in the differential diagnosis of patients with unexplained hepatitis(acute or chronic)with or without extrahepatic manifestations.HEV should also be considered in patients with persistently elevated liver enzymes who have not travelled to known HEV-endemic regions.Lack of knowledge among physicians and an absence of standardized diagnostic tests may result in increased morbidity and mortality from HEV infection.
