Seroepidemiological study of hepatitis E virus infection in Japan using a newly developed antibody assay

Tanaka, Eiji; Takeda, Naokazu; Tian-Chen, LI; Orii, Koji; Ichijo, Tetsuya; Matsumoto, Akihiro; Yoshizawa, Kaname; T, Iijima; Takayama, Tetsuo; Miyamura, Tatsuo; Kiyosawa, Kendo

doi:10.1007/s005350170097

Cited by 34 publications

(18 citation statements)

References 25 publications

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“…In the present study conducted in Japan, where HEV infection is not considered endemic, 11 (12.6%) of 87 patients who had previously been diagnosed with sporadic acute hepatitis of non-ABC etiology were found to be infected with HEV. The prevalence of HEV RNA differed by age, sex, and geographic region, being consistent with the reported age-, sex-, and region-dependent prevalence of anti-HEV IgG in healthy individuals in Japan (21,41). Interestingly, in our present study, the prevalence of HEV-associated hepatitis among sporadic acute hepatitis cases of non-ABC etiology was significantly associated with male sex, older age (Ն40 years), and living in the northern part of Japan (Hokkaido and Iwate) (P Ͻ 0.01, P Ͻ 0.005, and P Ͻ 0.05, respectively).…”

Section: Discussionsupporting

confidence: 86%

Polyphyletic Strains of Hepatitis E Virus Are Responsible for Sporadic Cases of Acute Hepatitis in Japan

et al. 2002

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, and its prevalence differed by geographic region (6 to 25%), with a higher rate in the northern part of Japan. At admission, the 11 patients with HEV-associated hepatitis had elevated alanine aminotransferase levels of 914 to 4,850 IU/liter, and all but 1 had elevated bilirubin levels of 1.5 to 24.0 mg/dl. The 11 HEV isolates were of genotype III or IV and were segregated into three groups with intergroup nucleotide differences of 9.5 to 22.0%. Phylogenetic analysis revealed that four isolates of genotype III were closely related to a Japanese isolate, while the other four isolates of the same genotype were nearest those from the United States. The remaining three isolates were close to known isolates of genotype IV in China and Taiwan but shared less than 88% identity with them. These results indicate that multiple genotypes of HEV cocirculate in Japan and contribute to the development of sporadic acute hepatitis, with the prevalence differing by age, sex, and geographic region.

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Section: Discussionsupporting

confidence: 86%

Polyphyletic Strains of Hepatitis E Virus Are Responsible for Sporadic Cases of Acute Hepatitis in Japan

et al. 2002

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“…Furthermore, there was no appreciable difference in the prevalence of anti-HEV IgG at the start of hemodialysis between the patients who did or did not have a past history of blood transfusion (8.3% [9/109] vs. 10.7% [33/307], P ¼ 0.5776), suggesting that the HEV infection in our hemodialysis patients that was acquired before the initiation of hemodialysis, had not been acquired by blood transfusion in the majority of cases. Of note, the prevalence of anti-HEV IgG at the start of hemodialysis tended to be higher among males than among females (11.7 vs. 7.0%), similar to the reported higher prevalence of anti-HEV IgG among males in the general population and the higher prevalence of HEVassociated hepatitis among male patients who had no history of blood transfusion within one or more years before the onset of disease [Tanaka et al, 2001;Mizuo et al, 2002]. Therefore, we would consider the possibility that our patients who were positive for anti-HEV IgG at the start of hemodialysis had acquired HEV infection in the community.…”

Section: Discussionsupporting

confidence: 83%

Prevalence of hepatitis E virus infection among hemodialysis patients in Japan: Evidence for infection with a genotype 3 HEV by blood transfusion

Mitsui¹,

Tsukamoto²,

Yamazaki³

et al. 2004

Journal of Medical Virology

153

144

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To investigate the prevalence of hepatitis E virus (HEV) infection among patients on maintenance hemodialysis, serum samples collected in January 2003 from 416 patients who had been undergoing hemodialysis for 7.6 +/- 6.3 (mean +/- standard deviation) (range, 0.3-26.0) years in a dialysis unit in Japan and serum samples that had been collected from these patients at the start of hemodialysis were tested for IgG antibodies to HEV (anti-HEV IgG) by an "in-house" enzyme-linked immunosorbent assay (ELISA). Overall, 39 patients (9.4%) had anti-HEV IgG in January 2003, and included 35 patients (8.4%) who had already been positive for anti-HEV IgG at the start of hemodialysis and 4 patients (1%) who seroconverted after initiation of hemodialysis. Periodic serum samples that had been collected from the four seroconverted patients were tested for HEV antibodies and HEV RNA. The four patients became positive for anti-HEV IgG in 1979, 1980, 1988, or 2003, and continued to be seropositive until the end of the observation period. Although anti-HEV IgM was not detectable in the four patients, three were infected transiently with apparently Japanese indigenous HEV strains of genotype 3. The patient who contracted HEV infection in 1979 had been transfused with 2 U of blood 21 days before the transient viremia: one of the two stored pilot serum samples had detectable HEV RNA with 100% identity to that recovered from the patient. Our study provides evidence of transfusion-transmitted HEV infection in Japan in 1979, and that the prevalence of de novo HEV infection during hemodialysis was low (1.1% or 4/374).

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“…Although the results cannot simply be generalized for the whole country, previous studies on the age-specific prevalence of HAV and/or HEV infections revealed similar changing trends in other urban and rural areas including Metropolitan Tokyo, a small district of South Kiso town located between Aichi and Tokyo, and Okinawa in Japan [Furusyo et al, 1998;Tanaka et al, 2001Tanaka et al, , 2005Malaty et al, 2003].…”

Section: Discussionsupporting

confidence: 62%

Distinct changing profiles of hepatitis A and E virus infection among patients with acute hepatitis, patients on maintenance hemodialysis and healthy individuals in Japan

et al. 2006

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To compare the epidemiologic profiles of hepatitis A virus (HAV) and hepatitis E virus (HEV) infections in Japan, the prevalence of clinical or subclinical HAV and HEV infections was investigated serologically and molecularly among 128 consecutive patients (age, mean +/- standard deviation, 37.5 +/- 14.7 years) who contracted acute hepatitis between 1989 and 2005 in a city hospital, and among 416 hemodialysis patients (60.1 +/- 12.6 years) and 266 medical staff members (34.6 +/- 11.4 years) at the same hospital, using stored periodic serum samples collected since the start of hemodialysis or employment, respectively. Between 1989 and 1995, among 93 patients with acute hepatitis, 51 (54.8%) were diagnosed with hepatitis A and only one patient with hepatitis E. Between 1996 and 2005, however, among 35 patients, only 3 (8.6%) were diagnosed with hepatitis A and 2 (5.7%) with hepatitis E. Although subclinical HEV infection was recognized in four hemodialysis patients (one each in 1979, 1980, 1988, and 2003) and two medical staff members (1978 and 2003) in previous studies, none of the 191 hemodialysis patients who had been negative for anti-HAV at the start of hemodialysis contracted HAV infection during the observation period of 7.6 +/- 6.4 years. Only one (0.4%) of the 246 medical staff members who had been negative for anti-HAV at the start of employment acquired hepatitis A during the observation period of 7.9 +/- 8.0 years: none had subclinical HAV infection. Clinical or subclinical HEV infection has occurred rarely during the last three decades, while HAV infection has markedly decreased at least since 1996.

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Seroepidemiological study of hepatitis E virus infection in Japan using a newly developed antibody assay

Abstract: Our results suggest the possibility that HEV infection is circulating in Japan at a low level. HEV infection was associated with male sex, but not with HAV infection.

Cited by 34 publications

References 25 publications

Polyphyletic Strains of Hepatitis E Virus Are Responsible for Sporadic Cases of Acute Hepatitis in Japan

Polyphyletic Strains of Hepatitis E Virus Are Responsible for Sporadic Cases of Acute Hepatitis in Japan

Prevalence of hepatitis E virus infection among hemodialysis patients in Japan: Evidence for infection with a genotype 3 HEV by blood transfusion

Distinct changing profiles of hepatitis A and E virus infection among patients with acute hepatitis, patients on maintenance hemodialysis and healthy individuals in Japan

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