Autochthonous hepatitis E in Scotland

Ramalingam, Sandeep; Smith, Donald B.; Wellington, Louise; Vanek, Jeff; Simmonds, Peter; MacGilchrist, Alastair; Bathgate, Andrew; Simpson, Kenneth J.; Johannessen, Ingólfur

doi:10.1016/j.jcv.2013.10.002

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…A previous study has documented a change in HEV genotype 3 variants over time [7] ; the present study is consistent with this finding, with genotype 3 “group 2” viruses predominating. We also detected genotype 1 viruses (3/30, 10%), although these were at a lower frequency than described in a previous study (3/10, 30%) [9] .…”

Section: Discussioncontrasting

confidence: 52%

Hepatitis E virus is the leading cause of acute viral hepatitis in Lothian, Scotland

Kokki

Smith

Simmonds

et al. 2016

New Microbes and New Infections

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Acute viral hepatitis affects all ages worldwide. Hepatitis E virus (HEV) is increasingly recognized as a major cause of acute hepatitis in Europe. Because knowledge of its characteristics is limited, we conducted a retrospective study to outline demographic and clinical features of acute HEV in comparison to hepatitis A, B and C in Lothian over 28 months (January 2012 to April 2014). A total of 3204 blood samples from patients with suspected acute hepatitis were screened for hepatitis A, B and C virus; 913 of these samples were also screened for HEV. Demographic and clinical information on patients with positive samples was gathered from electronic patient records. Confirmed HEV samples were genotyped. Of 82 patients with confirmed viral hepatitis, 48 (59%) had acute HEV. These patients were older than those infected by hepatitis A, B or C viruses, were more often male and typically presented with jaundice, nausea, vomiting and/or malaise. Most HEV cases (70%) had eaten pork or game meat in the few months before infection, and 14 HEV patients (29%) had a recent history of foreign travel. The majority of samples were HEV genotype 3 (27/30, 90%); three were genotype 1. Acute HEV infection is currently the predominant cause of acute viral hepatitis in Lothian and presents clinically in older men. Most of these infections are autochthonous, and further studies confirming the sources of infection (i.e. food or blood transfusion) are required.

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Section: Discussioncontrasting

confidence: 52%

Hepatitis E virus is the leading cause of acute viral hepatitis in Lothian, Scotland

Kokki

Smith

Simmonds

et al. 2016

New Microbes and New Infections

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“…Among individuals immigrating form Turkey to Europe, HEV seroprevalence was found 10.3% in Italy [ 38 ] and 33.4% in the Netherlands (Table 3 ) [ 39 ]. Four patients were reported with a travel history to Turkey [from Germany (n = 1), Sweden (n = 1), and UK (n = 2)] and one died of HEV fulminant hepatitis [ 40 – 43 ].…”

Section: Resultsmentioning

confidence: 99%

Hepatitis E virus infection in Turkey: a systematic review

Leblebicioğlu

Özaras²

2018

Ann Clin Microbiol Antimicrob

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Hepatitis E virus (HEV), a non-enveloped single stranded RNA virus causes sporadic cases of hepatitis or outbreaks. The disease is generally self-limited although it may cause fulminant hepatitis in pregnant women, elderly, those with underlying chronic hepatitis, immunosuppressed, and transplant recipients. It is transmitted through fecal–oral route and zoonotic transmission. Hepatitis is a main health care problem in Turkey; HBV and HCV prevalences are 4 and 1% respectively. Hepatitis D represents another considerable hepatitis etiology with a prevalence of 5–27%. The information about HEV is not clear. In this systematic review, we aimed to analyze HEV studies reported from Turkey, to determine the current situation of the disease in the country, to delineate the limits of the studies and to determine the future study areas. The prevalence of HEV ranged from 0 to 12.4%. Children had lower prevalence than the adults. The prevalence was determined as 7–8% in pregnant women, 13% in chronic HBV patients, 54% in chronic HCV patients, 13.9–20.6% in patients with chronic renal failure, and ≈ 35% in agriculture workers. Among individuals immigrating form Turkey to Europe, HEV seroprevalence was found 10.3% in Italy and 33.4% in the Netherlands. HEV prevalence seems high in certain risk groups. Although previous studies suggest that Turkey is among the endemic countries of HEV, there are some pitfalls for the analysis of data: the studies are not powered enough to represent the whole population; they did not include immunosuppressed patients and solid organ recipients; and the prevalence of non-A non-B hepatitis was not determined.

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“…Virus nucleotide sequences from anonymized hepatitis patient samples were obtained from hepatitis patients referred to the Edinburgh Royal Infirmary as part of ongoing epidemiological studies of patients with raised ALT (>100 U l − 1 ) or with other signs of unexplained hepatitis as described previously ( Ramalingam et al , 2013 ). Virus nucleotide sequences from patients referred to the West of Scotland Specialist Virology Centre, Glasgow were obtained from anonymized samples by reverse transcription-PCR using the ORF2 primers 3156 [5′-AAT(C)TATGCC(A)CAGTACCGGGTTG-3′], 3157 (5′-CCCTTATCCTGCTGAGCATTCTC-3′), 3158 [5′-GTT(C)ATGC(T)TT(C)TGCATACATGGCT-3′] and 3159 [5′-AGCCGACGAAATC(T)AATTCTGTC-3′] using standard procedures.…”

Section: Methodsmentioning

confidence: 99%

Variability and pathogenicity of hepatitis E virus genotype 3 variants

Smith

Ijaz

Tedder

et al. 2015

Journal of General Virology

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Infection with hepatitis E virus (HEV) can be clinically inapparent or produce symptoms and signs of hepatitis of varying severity and occasional fatality. This variability in clinical outcomes may reflect differences in host susceptibility or the presence of virally encoded determinants of pathogenicity. Analysis of complete genome sequences supports the division of HEV genotype 3 (HEV-3) variants into three major clades: 3ra comprising HEV isolates from rabbits, and 3efg and 3abchij comprising the corresponding named subtypes derived from humans and pigs. Using this framework, we investigated associations between viral genetic variability of HEV-3 in symptomatic and asymptomatic infections by comparing HEV-3 subgenomic sequences previously obtained from blood donors with those from patients presenting with hepatitis in the UK (54 blood donors, 148 hepatitis patients), the Netherlands (38 blood donors, 119 hepatitis patients), France (24 blood donors, 55 hepatitis patients) and Germany (14 blood donors, 36 hepatitis patients). In none of these countries was evidence found for a significant association between virus variants and patient group (P>0.05 Fisher's exact test). Furthermore, within a group of 123 patients in Scotland with clinically apparent HEV infections, we found no evidence for an association between variants of HEV-3 and disease severity or alanine aminotransferase level. The lack of detectable virally encoded determinants of disease outcomes in HEV-3 infection implies a more important role for host factors in its clinical phenotype.

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Autochthonous hepatitis E in Scotland

Cited by 6 publications

References 30 publications

Hepatitis E virus is the leading cause of acute viral hepatitis in Lothian, Scotland

Hepatitis E virus is the leading cause of acute viral hepatitis in Lothian, Scotland

Hepatitis E virus infection in Turkey: a systematic review

Variability and pathogenicity of hepatitis E virus genotype 3 variants

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