Abstract
BackgroundThe impact of hepatitis E in developed countries, like Italy, still requires a clear definition. In the present study, we evaluated HEV infection in patients with acute non-A-C hepatitis by an approach comparing data from Real-time PCR and serological assays.MethodsIn a first analysis, sera from 52 patients hospitalized with a diagnosis of acute viral non-A-C hepatitis in Italy were tested by in-house Real-Time PCR assay for identification of Hepatitis E Virus (HEV) RNA and by anti-HEV IgM and IgG assays. In a subsequent analysis, selected samples were evaluated by additional IgM tests to confirm diagnosis.ResultsAmong the 52 samples, 21 showed positive results for all three markers (IgM, IgG and HEV RNA). One patient showed HEV RNA as single marker. Uncertain results were found in 8 samples while the remaining 22 were negative for all markers. Further analysis of the 8 undefined samples by additional IgM tests confirmed HEV infection in 1 patient. Overall, acute HEV infections were reliably identified in 23 (44.2%) out of 52 patients.ConclusionsIn the present paper, we performed a study evaluating HEV infection in 52 sporadic non-A-C acute hepatitis cases. All samples were collected from 2004 to 2010 in Italy. By a diagnostic strategy based on genomic and serological assays we identified HEV infections in 23 out of 52 patients (44.2%), a percentage higher than previous estimates. Thus, the actual impact of HEV infections in Italy needs to be further evaluated on a national scale by a diagnostic strategy based on multiple and last generation assays.
Highlights
The impact of hepatitis E in developed countries, like Italy, still requires a clear definition
Over the last one decade, identification and characterization of swine Hepatitis E virus (HEV) in the United States, Europe and many other countries as well as their close relationship with human HEV found in the same geographic areas prove that HEV is a
HEV sequences have been classified into four genotypes divided into several subtypes
Summary
The impact of hepatitis E in developed countries, like Italy, still requires a clear definition. Hepatitis E virus (HEV) is the major cause of several outbreaks of water-borne hepatitis in countries with poor sanitation and of sporadic cases of acute viral hepatitis in endemic and industrialized countries. Over the last one decade, identification and characterization of swine HEV in the United States, Europe and many other countries as well as their close relationship with human HEV found in the same geographic areas prove that HEV is a Hepatitis E is caused by a non-enveloped, singlestranded, positive sense RNA virus that is the only member of the genus Hepevirus in the family Hepeviridae. An increasingly number of autochthonous cases has been recently reported in Western Europe, especially in the UK [8,9], the Netherlands [10], France [11,12] and Spain [13] suggesting that hepatitis E is an emerging disease in developed countries
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