Hepatitis E Virus Mixed Infection in Immunocompetent Patient

Abstract

We detected 2 hepatitis E virus (HEV) strains in an acutely infected immunocompetent patient. Two populations of genotype 3 virus were observed in the hypervariable regions and open reading frames 2 and 3, indicating multiple infection with hepatitis E virus. Persons with mixed infections may provide the opportunity for virus recombination.

The use of human sewage screening for community surveillance of hepatitis E virus in the UK

“…After removal of solid matter by centrifugation, 20 ml samples were passed through a 0.45 µM filter before concentrating (×20) using a Centriplus YM‐50 spin column (Millipore 4310) and then (×10) with an Amicon filter (UFC5000324). Virus nucleic acid was extracted using the QiaAmp viral RNA kit and HEV RNA detected at limiting dilution by RT‐PCR using the Access kit (Promega) followed by nested PCR as described previously [Smith et al, ]. Up to 2 μl in aggregate of nucleic was tested from each sample, equivalent to 400 μl of filtered sewage.…”

“…This protocol was capable of detecting 11.5 IU of the QCMID subtype 3f standard and 230 IU of the QCMID subtype 3c standard. Nucleotide sequences (ORF2 positions 6069‐6370 relative to AF082843) were deducted, aligned, and subjected to phylogenetic analysis using MEGA6, as described previously [Smith et al, ]. Phylogenetic relationships between complete genome reference sequences in this region were congruent with those displayed by complete genome sequences.…”

Host Immune Status and Response to Hepatitis E Virus Infection

“…An additional genotype 3 coinfection was detected in an immunocompetent man in Scotland who developed severe icteric hepatitis. The coinfection was identified by the presence of 18 nucleotide substitutions within the ORF1 hypervariable region and fewer substitutions within ORF2 and ORF3, which resulted in clustering of his coinfecting strains into two phylogenetically distinct populations within genotype 3 (254).…”

“…It has been recognized recently that patients who have had solid-organ or bone marrow transplants are at risk of developing chronic HEV infection if they are infected after their transplant while being treated with immunosuppressive drugs to prevent rejection of the allograft (76,(254)(255)(256)(257). Kamar and colleagues evaluated the factors associated with chronic hepatitis in 85 patients with HEV infection from 17 transplant centers in Europe and North America (275) (Fig.…”

Determinación de anticuerpos totales (IgG/IgM) y específicos (IgM) para el virus de la hepatitis E y detección molecular del virus en heces de humanos con o sin exposición ocupacional a porcinos en 10 municipios de Antioquia

“…El amplio espectro de síntomas dificulta el diagnóstico médico. En mujeres embarazadas y personas inmunocomprometidas, la hepatitis E puede tener complicaciones fatales (7). Se ha observado que la infección crónica por VHE puede llevar a enfermedad hepática progresiva en pacientes inmunodeprimidos y al desarrollo de hepatitis crónica aproximadamente en el 60% de los pacientes receptores de trasplante de órgano infectado con el virus (8).…”