Abstract

Equine parvovirus hepatitis (EqPV‐H) was first described in 2018 in a fatal case of Theiler's disease which followed the administration of an equine‐origin biological product. The virus has since been frequently identified in serum and liver tissue of horses affected by Theiler's disease—an acute, severe hepatitis characterised by fulminant hepatic necrosis with a fatal outcome in most cases. EqPV‐H is hepatotropic, appears to be associated with subclinical to severe hepatitis in horses, and is a likely cause of Theiler's disease. Although this disease is most frequently reported following the administration of equine‐origin biological products, it can also occur among in‐contact horses. Horizontal transmission may be iatrogenic, via contaminated equine‐origin biological products such as equine serum, botulism or tetanus antitoxin, and mesenchymal stem cells or by means of the oral route of infection. Other horizontal transmission routes, for example, arthropod vectors, warrant further investigation. A worldwide prevalence of EqPV‐H antibodies and DNA has been reported in asymptomatic horses. EqPV‐H‐positive horses suffering from acute, severe hepatitis have reportedly developed clinical signs including icterus, lethargy, inappetence, and neurological abnormalities and have had increased liver‐associated biochemistry parameters recorded. The most common histopathological abnormalities of the liver have been hepatocellular necrosis, collapse of the lobular architecture, and lymphocytic infiltration. Most horses infected experimentally with EqPV‐H have developed subclinical hepatitis, and close temporal associations between peak viraemia, seroconversion, and the onset of hepatitis have been observed. Based on strong evidence indicating that EqPV‐H causes hepatitis in horses, veterinarians should consider this virus an important differential diagnosis in such cases. Potential risks associated with the administration of equine‐origin biological products must be emphasised.

Highlights

  • Equine parvovirus hepatitis (EqPV-­H) was first described in 2018 in a fatal case of Theiler's disease which followed the administration of an equine-o­ rigin biological product

  • The condition of equine acute hepatitis has been reported worldwide in association with the administration of various equine-­origin biological products, including equine plasma, tetanus antitoxin, botulism antitoxin, antiserum against Streptococcus equi, and allogenic stem cells.4-­14 The condition has been reported in horses with no history of receiving biological products and in horses that were in contact with cases of acute hepatitis.[3,14,15]

  • TDAV was identified as a possible cause of Theiler's disease in 2013,13 and it was later shown that all TDAV-­positive horses in the original study were coinfected with EqPV-­H.16

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Summary

Epidemiological surveillance Viral genetic analysis

Note: This table illustrates the chronological order of publication of research studies and case reports pertaining to equine parvovirus hepatitis (EqPV-­H), since the initial report of the virus by Divers et al in February 2018. All 12 publicly available complete coding sequences (CDS) of the species Ungulate copiparvovirus 6—­obtained in China and the United States—­were compared with the CDS of four Austrian variants and found to be closely related.[33] The genetic diversity of the NS and VP genes appears to be low among different EqPV-­H variants in the United States, China, Canada, New Zealand, Italy, and Germany, indicating high conservation and low genetic variability of variants circulating globally.[16,25,32,35,37] Eleven years after the first outbreak of Theiler's disease on a farm in Canada, the same partial NS1 sequence was obtained from a horse that died of Theiler's disease 8 weeks after arrival on the farm This suggests that highly similar EqPV-H­ variants were circulating on this farm for an extended period of time.[25] Based on unique nucleotide. TA B L E 2 EqPV-­H DNA and antibodies reported worldwide in (A) horse populations and (B) individual horses with nonexperimental EqPV-­H infection

Clinically healthy horse populations
Findings
Bile acids
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