Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infection
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in China. Recently, a shift in molecular epidemiology from hepatitis E genotype 1 (HEV-1) to hepatitis E genotype 4 (HEV-4) has been observed in Northern China, marking a switch from human-to-human transmission to zoonosis. Ho...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2017-01-01
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| Series: | Emerging Microbes and Infections |
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| Online Access: | https://www.tandfonline.com/doi/10.1038/emi.2017.107 |
| _version_ | 1797676923538636800 |
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| author | Siddharth Sridhar Simon KF Lo Fanfan Xing Jin Yang Haiyan Ye Jasper FW Chan Jade LL Teng Chuan Huang Cyril CY Yip Susanna KP Lau Patrick CY Woo |
| author_facet | Siddharth Sridhar Simon KF Lo Fanfan Xing Jin Yang Haiyan Ye Jasper FW Chan Jade LL Teng Chuan Huang Cyril CY Yip Susanna KP Lau Patrick CY Woo |
| author_sort | Siddharth Sridhar |
| collection | DOAJ |
| description | Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in China. Recently, a shift in molecular epidemiology from hepatitis E genotype 1 (HEV-1) to hepatitis E genotype 4 (HEV-4) has been observed in Northern China, marking a switch from human-to-human transmission to zoonosis. However, similar data from cities in Southern China are lacking. This observational study of human hepatitis E cases in Shenzhen, a metropolitan city in the Pearl River Delta region, aimed to describe the clinical features and molecular epidemiology of hepatitis E in Southern China. Over a 55-month period, we identified 20 patients with acute hepatitis E. Most were middle-aged men, and 50% of patients had concomitant liver disease, of whom 70% were identified to have non-alcoholic fatty liver disease; such patients had a trend toward higher liver enzymes. Quantitative real-time RT-PCR using archived serum samples showed that 12 patients had hepatitis E viremia at presentation. Sequencing of the RNA-dependent RNA polymerase gene was performed for five of these patients, and phylogenetic analysis revealed that these five HEV isolates belonged to subgenotype 4b and were clustered with swine HEV isolates from Southern China. Combined with other studies showing similar findings, this suggests that the molecular epidemiology of hepatitis E in China is evolving toward low-level endemicity driven by foodborne transmission from seafood or pork products. The importance of concomitant liver disease, in particular non-alcoholic fatty liver disease, as a risk factor for severe hepatitis E requires further study.Emerging Microbes & Infections (2017) 6, e115 doi:10.1038/emi.2017.107; published online 20 December 2017 |
| first_indexed | 2024-03-11T22:36:58Z |
| format | Article |
| id | doaj.art-7ed99b896b5f4be1a46a8ecb06142524 |
| institution | Directory Open Access Journal |
| issn | 2222-1751 |
| language | English |
| last_indexed | 2024-03-11T22:36:58Z |
| publishDate | 2017-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Emerging Microbes and Infections |
| spelling | doaj.art-7ed99b896b5f4be1a46a8ecb061425242023-09-22T12:08:35ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512017-01-01611610.1038/emi.2017.107Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infectionSiddharth Sridhar0Simon KF Lo1Fanfan Xing2Jin Yang3Haiyan Ye4Jasper FW Chan5Jade LL Teng6Chuan Huang7Cyril CY Yip8Susanna KP Lau9Patrick CY Woo10State Key Laboratory of Emerging Infectious Diseases, Hong Kong, ChinaDepartment of Clinical Microbiology and Infection ControlThe University of Hong Kong – Shenzhen Hospital, Shenzhen 518053, ChinaDepartment of Clinical Microbiology and Infection ControlThe University of Hong Kong – Shenzhen Hospital, Shenzhen 518053, ChinaDepartment of Clinical Microbiology and Infection ControlThe University of Hong Kong – Shenzhen Hospital, Shenzhen 518053, ChinaDepartment of Clinical Microbiology and Infection ControlThe University of Hong Kong – Shenzhen Hospital, Shenzhen 518053, ChinaState Key Laboratory of Emerging Infectious Diseases, Hong Kong, ChinaDepartment of Microbiology, Li Ka Shing Faculty of MedicineThe University of Hong Kong, Hong Kong, ChinaDepartment of Microbiology, Li Ka Shing Faculty of MedicineThe University of Hong Kong, Hong Kong, ChinaDepartment of Microbiology, Li Ka Shing Faculty of MedicineThe University of Hong Kong, Hong Kong, ChinaState Key Laboratory of Emerging Infectious Diseases, Hong Kong, ChinaState Key Laboratory of Emerging Infectious Diseases, Hong Kong, ChinaHepatitis E virus (HEV) is the most common cause of acute viral hepatitis in China. Recently, a shift in molecular epidemiology from hepatitis E genotype 1 (HEV-1) to hepatitis E genotype 4 (HEV-4) has been observed in Northern China, marking a switch from human-to-human transmission to zoonosis. However, similar data from cities in Southern China are lacking. This observational study of human hepatitis E cases in Shenzhen, a metropolitan city in the Pearl River Delta region, aimed to describe the clinical features and molecular epidemiology of hepatitis E in Southern China. Over a 55-month period, we identified 20 patients with acute hepatitis E. Most were middle-aged men, and 50% of patients had concomitant liver disease, of whom 70% were identified to have non-alcoholic fatty liver disease; such patients had a trend toward higher liver enzymes. Quantitative real-time RT-PCR using archived serum samples showed that 12 patients had hepatitis E viremia at presentation. Sequencing of the RNA-dependent RNA polymerase gene was performed for five of these patients, and phylogenetic analysis revealed that these five HEV isolates belonged to subgenotype 4b and were clustered with swine HEV isolates from Southern China. Combined with other studies showing similar findings, this suggests that the molecular epidemiology of hepatitis E in China is evolving toward low-level endemicity driven by foodborne transmission from seafood or pork products. The importance of concomitant liver disease, in particular non-alcoholic fatty liver disease, as a risk factor for severe hepatitis E requires further study.Emerging Microbes & Infections (2017) 6, e115 doi:10.1038/emi.2017.107; published online 20 December 2017https://www.tandfonline.com/doi/10.1038/emi.2017.107Chinahepatitis Emolecular epidemiologynon-alcoholic fatty liver disease |
| spellingShingle | Siddharth Sridhar Simon KF Lo Fanfan Xing Jin Yang Haiyan Ye Jasper FW Chan Jade LL Teng Chuan Huang Cyril CY Yip Susanna KP Lau Patrick CY Woo Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infection Emerging Microbes and Infections China hepatitis E molecular epidemiology non-alcoholic fatty liver disease |
| title | Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infection |
| title_full | Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infection |
| title_fullStr | Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infection |
| title_full_unstemmed | Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infection |
| title_short | Clinical characteristics and molecular epidemiology of hepatitis E in Shenzhen, China: a shift toward foodborne transmission of hepatitis E virus infection |
| title_sort | clinical characteristics and molecular epidemiology of hepatitis e in shenzhen china a shift toward foodborne transmission of hepatitis e virus infection |
| topic | China hepatitis E molecular epidemiology non-alcoholic fatty liver disease |
| url | https://www.tandfonline.com/doi/10.1038/emi.2017.107 |
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