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The impact of traveling to endemic areas on the spread of hepatitis E virus infection: Epidemiological and molecular analyses
Author(s) -
Wu JawChing,
Sheen IJane,
Chiang TzenYuh,
Sheng WenYung,
Wang YuanJen,
Chan ChoYu,
Lee ShouDong
Publication year - 1998
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510270532
Subject(s) - hepatitis e virus , virology , hepatitis e , caliciviridae , odds ratio , biology , molecular epidemiology , epidemiology , virus , genotype , medicine , viral disease , gene , genetics
Traveling to endemic areas carries a risk of hepatitis E virus (HEV) infection, but no molecular analysis to document sources of infection is available. Eighteen (38%) of 47 patients with acute non‐A, non‐B, non‐C hepatitis were positive for antibody to HEV (anti‐HEV), and 9 (50%) of these were also positive for serum HEV RNA by polymerase chain reaction following reverse transcription. Only 1 (5%) of the 21 patients with acute hepatitis A was positive for HEV RNA. Travel to endemic areas (mostly to China; odds ratio, 22.2; 95% confidence interval, 4.7‐105.8) and deeper jaundice (odds ratio, 5.2; 95% confidence interval, 1.01‐27.2) were the only factors associated with HEV infection in multivariate analysis. The two HEV isolates from two patients who had traveled to China and the HEV isolate from a patient whose travel history was obscure formed a monophyletic group with the isolates from Guangzhou. The HEV isolates from our patients show a homology of 72% to 78% in nucleotide sequence with the Burma, Beijing, India, Pakistan, and Xiangjiang strains; a homology of 81% to 91% with the Guangzhou strains; and a homology of 76% with the Mexico strain. The close relationship between the Taiwan isolates and the Guangzhou strains was further supported by the short Kimura's two‐parameter distances among them. In summary, HEV infection does occur in this area. Epidemiological and molecular analyses strongly indicate that most cases of HEV infection originated from travel to HEV‐endemic areas.