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Prevalence of hepatitis viruses in patients with acute hepatitis and characterization of the detected genotype 4 hepatitis E virus sequences in Mongolia
Author(s) -
TsatsraltOd Bira,
Baasanjav Nachin,
Nyamkhuu Dulmaa,
Ohnishi Hiroshi,
Takahashi Masaharu,
Okamoto Hiroaki
Publication year - 2016
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24319
Subject(s) - virology , medicine , hepatitis e virus , superinfection , hepatitis , hepatitis e , genotype , interquartile range , virus , serology , transmission (telecommunications) , hepatitis a , immunology , antibody , biology , gene , biochemistry , electrical engineering , engineering
Hepatitis E is considered to be a worldwide public health problem. Although the prevalence of hepatitis E virus (HEV) antibodies in healthy individuals is noted to be 11%, no patients with acute hepatitis E have previously been identified in Mongolia. Three hundred two consecutive patients (183 males and 119 females; median age of 22.0 [Interquartile range: 18.3–25.0] years) who were clinically diagnosed with sporadic acute hepatitis during 2012–2013 in Ulaanbaatar, Mongolia, were studied. By serological and/or molecular approaches, 77 (25.5%), 93 (30.8%), 19 (6.3%), 48 (15.9%), and 12 (4.0%) of the patients were diagnosed with acute hepatitis of types A, B, C, D (superinfection of hepatitis delta virus on a background of chronic hepatitis B virus infection) and E, respectively, while the cause of hepatitis was unknown in the remaining 53 patients (17.5%). The 12 hepatitis E patients had no history of travel abroad in the 3 months before the onset of disease, and lived separately in fixed or movable houses with water supplied via pipe, tank or well, denying transmission from a common water supply. The 12 HEV isolates obtained from the patients showed high nucleotide identities of 99.7–100%, and a representative HEV isolate, MNE13‐227, was closest to the Chinese isolates of genotype 4, with the highest identity of 97.3% in the 304‐nt ORF2 sequence and 92.1% over the entire genome. The present study revealed the occurrence of autochthonous acute hepatitis E in Mongolia, caused by a monophyletic genotype 4 HEV strain. J. Med. Virol. 88:282–291, 2016 . © 2015 Wiley Periodicals, Inc.