First detection of hepatitis E virus genotype 3 as a common infectious agent in patients with chronic liver damage in Mexico

Viera-Segura, Oliver; Realpe, Mauricio; Panduro, Arturo; Román, Sonia; José-Ábrego, Alexis; González-Aldaco, Karina; Trujillo-Ochoa, Jorge L; Fierro, Nora A.

doi:10.1016/j.aohep.2019.03.005

Cited by 12 publications

(8 citation statements)

References 39 publications

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“…In this study, viral RNA was detected in 23.7% of obese individuals but genomic variability was not determined due to the limited volume of samples available. However, taking into account that we previously reported the circulation of HEV-Gt3 in patients with chronic liver disease from the same geographical region (38), our study underscores that the genetic characterization of circulating HEV strains in risk groups, including the obese population, is necessary for handling the infection on specific geographic regions.…”

Section: Discussionsupporting

confidence: 53%

“…In this study, 136 serum samples from unrelated patients (>16 years of age) with liver disease, determined by clinical history and biochemical markers as previously reported (38) were retrospectively analyzed. Liver disease was considered when clinical findings, including hepatomegaly and jaundice and at least one abnormality in conjugated bilirubin (CB >0.3 mg/dL), gamma-glutamyl transferase (GGT >30 IU/L), aspartate aminotransferase (AST >38 IU/L), and alanine aminotransferase (ALT >35 IU/L) values was found.…”

Section: Study Populationmentioning

confidence: 99%

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Evidence for Increased Inflammatory Cytokine Profile in Hepatitis E Virus-Infected Obese Patients: Implications for Chronic Liver Disease

et al. 2020

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We aimed to characterize the contribution of hepatitis E virus (HEV) in perpetuating the cytokine-mediated inflammatory setting related to liver damage in the context of obesity. Herein, serum samples from patients with liver disease were retrospectively analyzed and categorized as normal-weight patients (NW), overweight patients (OW), obese patients (ObP), and high alcohol consumer patients (HAC), and biochemical, anthropometrical, and transient elastography measurements were obtained. The positivity for immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-HEV antibodies in samples was determined by enzyme-linked immunosorbent assay. Available samples from ObP were tested by reverse transcription-nested polymerase chain reaction for the presence of HEV-RNA. Cytokine profile in the serum of ObP was identified using a multiplexed immune assay. Globally, the highest frequency of IgG anti-HEV was found in ObP (57.5%), followed by HAC (20%), OW (15%), and NW (7.5%). A strong association between HEV serology and obesity was found (odds ratio = 4.21, confidence interval = 1.91.9.27) with a cutoff of 29.3 kg/m 2 (area under curve [AUC] = 0-66; p = 0.003) and, a 23.7% of available samples of ObP provided amplification of HEV genome. Cytokine analysis revealed significantly higher levels of proinflammatory cytokines (interleukin [IL]-12, interferon [IFN]-c, and IL-1b) in IgG anti-HEV-positive ObP than in IgG anti-HEV-negative ObP. Moreover, a high proportion of patients with positive serology showed advanced liver damage. In conclusion, the high percentage of anti-HEV antibodies and viral RNA detection in the setting of an excess of fat, along with an associated proinflammatory cytokine profile found in IgG anti-HEV-positive ObP with more severe liver disease, support an interplay between HEV and obesity.

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Section: Discussionsupporting

confidence: 53%

Section: Study Populationmentioning

confidence: 99%

Evidence for Increased Inflammatory Cytokine Profile in Hepatitis E Virus-Infected Obese Patients: Implications for Chronic Liver Disease

et al. 2020

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“…A smaller cohort in the UK found that 12% of patients suspected of DILI were likely acutely infected with HEV (25). In another cohort of patients with suspected viral hepatitis of unknown etiology, 30% had HEV viremia (26). Underscreening for HEV is likely due to previous assumptions that HEV infection is restricted to endemic regions and exclusively a cause of acute hepatitis, though today we know that both these assumptions are untrue (27).…”

Section: A Disguised Liver Diseasementioning

confidence: 99%

Undiagnosed liver diseases

Gao¹,

Hercun²,

Heller³

et al. 2021

Transl Gastroenterol Hepatol

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The landscape of chronic liver disease has drastically changed over the past 20 years, largely due to advances in antiviral therapy and the rise of metabolic syndrome and associated non-alcoholic fatty liver disease (NAFLD). Despite advances in the diagnosis and treatment of a variety of liver diseases, the burden of chronic liver disease is increasing worldwide. The first step to addressing any disease is accurate diagnosis.Here, we discuss liver diseases that remain undiagnosed, either because they are difficult to diagnose or due to hepatic manifestations of an unrecognized systemic disease. Additionally, their underlying etiology may remain unknown or they represent previously uncharacterized and therefore novel liver diseases. Our goal is to provide a framework for approaching undiagnosed liver diseases which elude standard hepatic diagnostic work-up and whose patterns of disease are often overlooked.

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“…Molecular detection of HEV-RNA in clinical and epidemiological contexts pursues two main goals: diagnosis of active infections and genome sequencing for genotyping. In Mexico, only scientific studies have been published addressing molecular HEV detection, and for most Latin American countries, short partial sequences of the HEV genome are commonly reported (Supplementary Table S1) [25,[27][28][29]40,89,.…”

Section: The Molecular Epidemiology Of Hev In Mexico: a Challenge To ...mentioning

confidence: 99%

Tracing the History of Hepatitis E Virus Infection in Mexico: From the Enigmatic Genotype 2 to the Current Disease Situation

Viera-Segura,

Calderón-Flores,

Batún-Alfaro

et al. 2023

Viruses

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Hepatitis E virus (HEV) is the major cause of acute viral hepatitis worldwide. This virus is responsible for waterborne outbreaks in low-income countries and zoonosis transmission in industrialized regions. Initially, considered self-limiting, HEV may also lead to chronic disease, and evidence supports that infection can be considered a systemic disease. In the late 1980s, Mexico became a hot spot in the study of HEV due to one of the first virus outbreaks in Latin America related to enterically transmitted viral non-A, non-B hepatitis. Viral stool particles recovered from Mexican viral hepatitis outbreaks represented the first identification of HEV genotype (Gt) 2 (Gt2) in the world. No new findings of HEV-Gt2 have been reported in the country, whereas this genotype has been found in countries on the African continent. Recent investigations in Mexico have identified other strains (HEV-Gt1 and -Gt3) and a high frequency of anti-HEV antibodies in animal and human populations. Herein, the potential reasons for the disappearance of HEV-Gt2 in Mexico and the advances in the study of HEV in the country are discussed along with challenges in studying this neglected pathogen. These pieces of information are expected to contribute to disease control in the entire Latin American region.

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First detection of hepatitis E virus genotype 3 as a common infectious agent in patients with chronic liver damage in Mexico

Cited by 12 publications

References 39 publications

Evidence for Increased Inflammatory Cytokine Profile in Hepatitis E Virus-Infected Obese Patients: Implications for Chronic Liver Disease

Evidence for Increased Inflammatory Cytokine Profile in Hepatitis E Virus-Infected Obese Patients: Implications for Chronic Liver Disease

Undiagnosed liver diseases

Tracing the History of Hepatitis E Virus Infection in Mexico: From the Enigmatic Genotype 2 to the Current Disease Situation

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