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Acute hepatitis related to Hepatitis E Virus genotype 3f infection in Brazil
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  • Leidiane Barbosa Ribeiro,
  • Luciana Aguiar Reche,
  • Ana Catharina Nastri ,
  • Fernanda Malta,
  • Deyvid Emanuel Amgarten,
  • Luciana Vilas Boas Casadio,
  • Mario Peribanez Gonzalez,
  • Suzane Kioko Ono,
  • Maria Cássia Mendes-Corrêa ,
  • Flair Jose Carrilho,
  • João Renato Rebello Pinho,
  • Michele Gomes-Gouvea
Leidiane Barbosa Ribeiro
Universidade de Sao Paulo Instituto de Medicina Tropical de Sao Paulo

Corresponding Author:[email protected]

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Luciana Aguiar Reche
Sociedade Beneficente Israelita Brasileira Albert Einstein
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Ana Catharina Nastri
Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo
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Fernanda Malta
Sociedade Beneficente Israelita Brasileira Albert Einstein
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Deyvid Emanuel Amgarten
Sociedade Beneficente Israelita Brasileira Albert Einstein
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Luciana Vilas Boas Casadio
Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo
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Mario Peribanez Gonzalez
Instituto de Infectologia Emilio Ribas
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Suzane Kioko Ono
Universidade de Sao Paulo Departamento de Gastroenterologia
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Maria Cássia Mendes-Corrêa
Universidade de Sao Paulo Instituto de Medicina Tropical de Sao Paulo
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Flair Jose Carrilho
Universidade de Sao Paulo Departamento de Gastroenterologia
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João Renato Rebello Pinho
Universidade de Sao Paulo Instituto de Medicina Tropical de Sao Paulo
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Michele Gomes-Gouvea
Universidade de Sao Paulo Instituto de Medicina Tropical de Sao Paulo
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Abstract

not-yet-known not-yet-known not-yet-known unknown The hepatitis E virus (HEV) is an important causative agent of acute hepatitis (AH). Despite reports of human infection in Brazil, the investigation is not routinely conducted, even in cases of elevated liver enzymes. In this study, two groups were evaluated: group 1 - patients with acute hepatitis A (n=48); group 2 - patients with non-A-C AH (n=47). They were tested by enzyme immunoassay for anti-HEV IgM/IgG and by real-time PCR for HEV RNA detection. The positive sample for HEV RNA was submitted for sequencing. The seroprevalence of anti-HEV IgM and IgG in group 1 was 4% (2/48) and 14.5% (7/48), respectively. Viral RNA was not detected in any sample. In group 2, the anti-HEV IgM positivity was 4.3% (2/47) and IgG 14.9% (7/47). RNA was detectable in one case, which presented a viral load of 222.4 IU/μL and positive anti-HEV IgM/IgG. In the phylogenetic analysis, the genotype identified was HEV-3f. These results indicate that HEV infection should be considered a possible diagnosis in cases of non-A-C AH. The patient identified with acute hepatitis E had recently traveled to Northeast region of Brazil (Garanhuns city in Pernambuco state), where there are reports of high HEV seroprevalence among pigs. The close phylogenetic relationship observed between the sequence characterized in this study and strains isolated from pigs in nearby cities where the patient went suggested a possible zoonotic transmission in this region. This study highlights the importance of expanding studies and improving surveillance to understand and manage HEV infections nationwide better.
Submitted to Journal of Medical Virology
Submission Checks Completed
Assigned to Editor
Reviewer(s) Assigned
26 Jun 2024Review(s) Completed, Editorial Evaluation Pending
04 Jul 2024Reviewer(s) Assigned
06 Aug 2024Editorial Decision: Revise Major
27 Sep 20241st Revision Received
28 Sep 2024Submission Checks Completed
28 Sep 2024Assigned to Editor
28 Sep 2024Review(s) Completed, Editorial Evaluation Pending
28 Sep 2024Reviewer(s) Assigned
12 Oct 2024Editorial Decision: Accept