Evidence for a Virus in Non-A, Non-B Hepatitis Transmitted via the Fecal-Oral Route

Abstract

Typical acute hepatitis was reproduced in a human volunteer immune to hepatitis A virus (HAV) after oral administration of pooled stool extracts from presumed cases of epidemic non-A, non-B hepatitis. Markers of hepatitis B infection, anti-HAV IgM, and increase in total anti-HAV level were not detectable in the volunteer’s sera during the course of infection. Spherical 27- to 30-nm virus-like particles were visualized by immune electron microscopy (IEM) in stool samples collected during preclinical and early postclinical phases. These particles banded in CsCl at a buoyant density of 1.35 g/cm³. They reacted in the IEM test with sera from individuals who had experienced two non-B hepatitis episodes but did not react with sera from routine anti-HAV IgM-positive hepatitis patients. Intravenous inoculation of cynomolgus monkeys with the virus-containing stool extract resulted in histopathologically and enzymatically confirmed hepatitis, excretion of virus-like particles, and antibody response to them.

Hepatitis E: Epidemiology and Natural History

“…5 The confirmation of these observations came in 1983 through demonstration at immune electron microscopy of spherical virus-like particles in stool specimens collected from a human volunteer who had ingested a pooled fecal suspension from patients with acute hepatitis in Afghanistan. 6 For nearly 15 years after its discovery, HEV was believed to infect only humans, and to circulate only in areas with weak water supply and sanitation systems that facilitate fecal-oral transmission. This seemed to fit well with the observations that hepatitis E was endemic in several developing countries, and that nearly all the cases with HEV infection in the developed countries were related to travel to disease-endemic countries.…”

Hepatitis-E-Virus

“…Den experimentellen Nachweis, dass neben HAV ein zweites fäkal-oral über-tragbares Virus eine Hepatitis verursacht, lieferten Übertragungsversuche von Balayan et al [4] und Chauhan et al [5]. In (Selbst-)Versuchen wurden Freiwillige, deren HBV-und HAV-Immunstatus bekannt war, mit Stuhlsuspensionen von Patienten mit einer Hepatitis-A-ähn-lichen Erkrankung infiziert ( [4]: Infektion mit einer Suspension aus einem Pool von Stühlen von 9 Patienten nach Auftreten eines Ikterus, [5]: Infektion mit einer 10 % Stuhlsuspension eines Patienten aus Nordindien). Nach den heutigen epidemiologischen Erkenntnissen kann man davon ausgehen, dass die Selbstversuche mit HEV Genotyp 1 durchgeführt wurden.…”

“…Balayan et al [4] konnten aus dem Stuhl der infizierten Freiwilligen sphä-rische, 27-30 nm große, virus-ähnliche Partikel isolieren, die im CsCl-Gradienten eine Dichte von 1,35 g/cm 3 aufwiesen und auf Grund der Morphologie zur Familie der Caliciviridae eingruppiert wurden. Mit Hilfe der Immunelektronenmikroskopie unter Verwendung von Rekonvaleszentenseren konnten diese Partikel sowohl in der prä-(ab 27.…”

Hepatitis E – A new era in understanding

“…HEV was first visualised in 1983 by using immunoelectron microscopy [5]. HEV belongs to the genus Hepevirus, in the Hepeviridae family, which is a positive-sense small [27-34 nm] single-stranded RNA non-enveloped virus with an icosahedral capsid.…”

“…Zoonotic transmission of HEV may spread via the consumption of uncooked or undercooked infected pork and meat. Experts for the European Food Safety Authority Biohazard have acknowledged that additional studies on HEV circulation are essential to clarify farm-totable risk assessments [22,23].…”