Coexistence of IgM antihepatitis A virus and IgM antihepatitis E virus in acute viral hepatitis: a prospective, multicentre study in Korea

Jang, Jeong Hun; Jung, Yoon; Kim, J. S.; Lee, Seung Hoo; Kim, J.-W.; Hwang, Seong Gyu; Rim, Kyu Sung; Park, S. J.; Park, Y. M.; Kang, Sook-Kyoung; Lee, H. S.; Yun, Haesun; Kim, J.-H.; Jeong, Sook Hyang

doi:10.1111/j.1365-2893.2011.01477.x

Cited by 15 publications

(8 citation statements)

References 13 publications

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“…17-20 In the interpretation of HEV serological test, we should consider the possibility of false-positive result especially in nonendemic areas. The detection of IgM anti-HEV in serial samples as well as serum or stool HEV RNA detection is helpful to confirm diagnosis 21. Two Korean cases of genotype 4 hepatitis E reported in 2010 and 2011 are similar to our case with a nucleotide similarity of 97 and 98%, respectively 8,22.…”

Section: Discussionsupporting

confidence: 65%

Genotype-4 hepatitis E in a human after ingesting roe deer meat in South Korea

Choi

Lee

et al. 2013

Clin Mol Hepatol

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The recent increase in the number of cases of indigenous hepatitis E virus (HEV) infection highlights the importance of identifying the transmission routes for the prevention of such infections. Presented herein is the first case of acute HEV infection after ingesting wild roe deer meat in South Korea. A 43-year-old male presented with abdominal discomfort and jaundice. He had not recently traveled abroad, but had eaten raw roe-deer meat 6-8 weeks before the presentation. On the 7th day of hospitalization the patient was diagnosed with acute viral hepatitis E. Phylogenetic analysis of his serum revealed genotype-4 HEV. This case supports the possibility of zoonotic transmission of HEV because the patient appears to have been infected with genotype-4 HEV after ingesting raw deer meat.

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Section: Discussionsupporting

confidence: 65%

Genotype-4 hepatitis E in a human after ingesting roe deer meat in South Korea

Choi

Lee

et al. 2013

Clin Mol Hepatol

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“…The investigators hypothesized that alternative infectious agents may cause cross-reactivity of HEV EIAs, resulting in false positives. Other research has demonstrated EIA cross reactivity between EBV and CMV [13–14], hepatitis A [15], and HIV [16–17], suggesting a ‘molecular mimicry’ phenomenon. Our findings of a significant association between HIV and HEV IgM positivity, lack of HEV RNA, and lower rates of HEV EIA positivity among healthy control residents may be suggestive of such a process.…”

Section: Discussionmentioning

confidence: 99%

Serologic evidence for hepatitis E virus infection among patients with undifferentiated acute febrile illness in Kibera, Kenya

Furukawa

Teshale

Cosmas

et al. 2016

Journal of Clinical Virology

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Background Hepatitis E (HEV) is an emerging cause of viral hepatitis mainly transmitted through the fecal-oral route. Residents of the Kibera slum of Nairobi, Kenya are at risk for fecal-orally transmitted infections. Objective To quantify the incidence and prevalence of HEV infection among acute febrile illness (AFI) cases using a population-based infectious disease surveillance network. Study Design Cross-sectional serum samples from AFI case-patients between 2009 and 2012 were matched to the age and gender distribution of the Kibera population and tested by IgM and IgG enzyme immunoassays (EIA) and nucleic acid testing (NAT). Serum from healthy residents was also tested by EIA. Results Of the 482 AFI serum samples tested, 124 (25.7%) and 182 (37.8%) were IgM and IgG reactive, respectively. On multivariate analysis, IgM reactivity was associated with HIV (RR 1.66, 95%CI 1.07, 2.60; p=0.024) while IgG reactivity was associated with increasing age (p<0.001) and HIV (RR 1.93, 95%CI 1.52, 2.46; p<0.001). AFI case-patients were more likely to be IgM (p=0.002) and IgG (p<0.001) reactive compared to healthy residents. The seroincidence by HEV-specific IgM was 84.0 per 1,000 person years, however, all 482 samples were negative by NAT. Conclusions Serologic evidence for HEV in Kibera suggests a high burden of infection, but NAT did not confirm HEV viremia. Additional testing is needed to determine whether EIAs are susceptible to false positivity in undifferentiated AFI populations before their widespread use.

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“…In the 1980 s, 62% of patients with acute viral hepatitis were infected with HBV [Lee et al, ]. This has now decreased to approximately 5% of recent acute viral hepatitis cases in Korean adults [Choi et al, ; Jang et al, ]. In addition, the majority of acute hepatitis B patients in the early 1980 s were aged 10–29 years.…”

Section: Discussionmentioning

confidence: 99%

Analysis of HBV genotype, drug resistant mutations, and pre‐core/basal core promoter mutations in Korean patients with acute hepatitis B

Lee

Hong

Jang

et al. 2015

Journal of Medical Virology

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Acute hepatitis B, caused by hepatitis B virus (HBV) strains with drug resistant mutations or pre-core/basal core promoter (PC/BCP) mutations, is a public health concern, because this infection is often associated with poor disease outcome or difficulty in therapeutic choice. The HBV genotype, the prevalence of drug resistant mutations, and PC/BCP mutations in Korean patients with acute hepatitis B were studied. From 2006 to 2008, 36 patients with acute hepatitis B were enrolled prospectively in four general hospitals. Among them, 20 showed detectable HBV DNA (median value was 4.8 log copies/mL). HBV genotyping and analysis of HBV mutations that conferred resistance against lamivudine, adefovir, or entecavir and of PC/BCP mutations were performed using highly sensitive restriction fragment mass polymorphism (RFMP) analysis. All 20 patients were infected with HBV genotype C, which causes almost all cases of chronic hepatitis B in Korea. No patient showed mutations that conferred resistance against lamivudine (L180M, M204V/I), adefovir (A181T, N236S), or entecavir (I169M, A184T/V, S202I/G, M250V/I/L). However, four patients had BCP mutations, and two had PC mutations. Platelet counts were significantly lower in the four patients with PC/BCP mutations compared to those with wild type. In this study, all acute hepatitis B patients had genotype C HBV strains with no drug resistant mutations. However, 20% showed PC/BCP mutations. This highlights the need for further study on the significance of PC/BCP mutations.

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Coexistence of IgM antihepatitis A virus and IgM antihepatitis E virus in acute viral hepatitis: a prospective, multicentre study in Korea

Cited by 15 publications

References 13 publications

Genotype-4 hepatitis E in a human after ingesting roe deer meat in South Korea

Genotype-4 hepatitis E in a human after ingesting roe deer meat in South Korea

Serologic evidence for hepatitis E virus infection among patients with undifferentiated acute febrile illness in Kibera, Kenya

Analysis of HBV genotype, drug resistant mutations, and pre‐core/basal core promoter mutations in Korean patients with acute hepatitis B

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