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Article: Transmission of rat hepatitis E virus infection to humans in Hong Kong: a clinical and epidemiological analysis

TitleTransmission of rat hepatitis E virus infection to humans in Hong Kong: a clinical and epidemiological analysis
Authors
Keywordsrodent
zoonosis
public health
epidemiology
liver disease
Issue Date2021
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
Hepatology, 2021, v. 73 n. 1, p. 10-22 How to Cite?
AbstractBackground & aims: Hepatitis E virus (HEV) variants causing human infection predominantly belong to HEV species A (HEV‐A). HEV species C genotype 1 (HEV‐C1) circulates in rats and is highly divergent from HEV‐A. It was previously considered unable to infect humans, but the first case of human HEV‐C1 infection was recently discovered in Hong Kong. The aim of this study is to further describe the features of this novel zoonosis in Hong Kong. Approach & results: We conducted a territory‐wide prospective screening study for HEV‐C1 infection over a 31‐month period. Blood samples from 2,860 patients with abnormal liver function (n = 2,201) or immunosuppressive conditions (n = 659) were screened for HEV‐C1 RNA. In addition, 186 captured commensal rats were screened for HEV‐C1 RNA. Sequences of human‐derived and rat‐derived HEV‐C1 isolates were compared. Epidemiological and clinical features of HEV‐C1 infection were analyzed. HEV‐C1 RNA was detected in 6/2,201 (0·27%) patients with hepatitis and 1/659 (0·15%) immunocompromised persons. Including the previously reported case, eight HEV‐C1 infections were identified including five in immunosuppressed patients. Three patients had acute hepatitis, four had persistent hepatitis while one had subclinical infection without hepatitis. One patient died of meningoencephalitis and HEV‐C1 was detected in cerebrospinal fluid. HEV‐C1 hepatitis was generally milder than HEV‐A hepatitis. 7/186 (3·76%) rats tested positive for HEV‐C1. One HEV‐C1 isolate obtained from a rat captured near the residences of patients was closely related to the major outbreak strain. Conclusions: HEV‐C1 is a cause of hepatitis E in humans in Hong Kong. Immunosuppressed individuals are susceptible to persistent HEV‐C1 infection and extrahepatic manifestations. Subclinical HEV‐C1 infection threatens blood safety. Tests for HEV‐C1 are required in clinical laboratories.
Persistent Identifierhttp://hdl.handle.net/10722/284101
ISSN
2020 Impact Factor: 17.425
2020 SCImago Journal Rankings: 5.488
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorSridhar, S-
dc.contributor.authorYip, CCY-
dc.contributor.authorWu, S-
dc.contributor.authorChew, NFS-
dc.contributor.authorLeung, KH-
dc.contributor.authorChan, JFW-
dc.contributor.authorZhao, PS-
dc.contributor.authorChan, WM-
dc.contributor.authorPoon, RWS-
dc.contributor.authorTsoi, HW-
dc.contributor.authorCai, JP-
dc.contributor.authorChan, HSY-
dc.contributor.authorLeung, AWS-
dc.contributor.authorTse, CWS-
dc.contributor.authorZee, JST-
dc.contributor.authorTSang, OTY-
dc.contributor.authorCheng, VCC-
dc.contributor.authorLau, SKP-
dc.contributor.authorWoo, PCY-
dc.contributor.authorTsang, DNC-
dc.contributor.authorYuen, KY-
dc.date.accessioned2020-07-20T05:56:06Z-
dc.date.available2020-07-20T05:56:06Z-
dc.date.issued2021-
dc.identifier.citationHepatology, 2021, v. 73 n. 1, p. 10-22-
dc.identifier.issn0270-9139-
dc.identifier.urihttp://hdl.handle.net/10722/284101-
dc.description.abstractBackground & aims: Hepatitis E virus (HEV) variants causing human infection predominantly belong to HEV species A (HEV‐A). HEV species C genotype 1 (HEV‐C1) circulates in rats and is highly divergent from HEV‐A. It was previously considered unable to infect humans, but the first case of human HEV‐C1 infection was recently discovered in Hong Kong. The aim of this study is to further describe the features of this novel zoonosis in Hong Kong. Approach & results: We conducted a territory‐wide prospective screening study for HEV‐C1 infection over a 31‐month period. Blood samples from 2,860 patients with abnormal liver function (n = 2,201) or immunosuppressive conditions (n = 659) were screened for HEV‐C1 RNA. In addition, 186 captured commensal rats were screened for HEV‐C1 RNA. Sequences of human‐derived and rat‐derived HEV‐C1 isolates were compared. Epidemiological and clinical features of HEV‐C1 infection were analyzed. HEV‐C1 RNA was detected in 6/2,201 (0·27%) patients with hepatitis and 1/659 (0·15%) immunocompromised persons. Including the previously reported case, eight HEV‐C1 infections were identified including five in immunosuppressed patients. Three patients had acute hepatitis, four had persistent hepatitis while one had subclinical infection without hepatitis. One patient died of meningoencephalitis and HEV‐C1 was detected in cerebrospinal fluid. HEV‐C1 hepatitis was generally milder than HEV‐A hepatitis. 7/186 (3·76%) rats tested positive for HEV‐C1. One HEV‐C1 isolate obtained from a rat captured near the residences of patients was closely related to the major outbreak strain. Conclusions: HEV‐C1 is a cause of hepatitis E in humans in Hong Kong. Immunosuppressed individuals are susceptible to persistent HEV‐C1 infection and extrahepatic manifestations. Subclinical HEV‐C1 infection threatens blood safety. Tests for HEV‐C1 are required in clinical laboratories.-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/-
dc.relation.ispartofHepatology-
dc.rightsPostprint This is the peer reviewed version of the following article: [Hepatology, 2021, v. 73 n. 1, p. 10-22], which has been published in final form at [http://dx.doi.org/10.1002/hep.31138]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectrodent-
dc.subjectzoonosis-
dc.subjectpublic health-
dc.subjectepidemiology-
dc.subjectliver disease-
dc.titleTransmission of rat hepatitis E virus infection to humans in Hong Kong: a clinical and epidemiological analysis-
dc.typeArticle-
dc.identifier.emailSridhar, S: sid8998@hku.hk-
dc.identifier.emailWu, S: wss2017@hku.hk-
dc.identifier.emailChew, NFS: chewnf@hku.hk-
dc.identifier.emailLeung, KH: khl17@hku.hk-
dc.identifier.emailChan, JFW: jfwchan@hku.hk-
dc.identifier.emailChan, WM: mbally@hku.hk-
dc.identifier.emailTsoi, HW: hwtsoi@hkucc.hku.hk-
dc.identifier.emailCai, JP: caijuice@hku.hk-
dc.identifier.emailLau, SKP: skplau@hkucc.hku.hk-
dc.identifier.emailWoo, PCY: pcywoo@hkucc.hku.hk-
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hk-
dc.identifier.authoritySridhar, S=rp02249-
dc.identifier.authorityChan, JFW=rp01736-
dc.identifier.authorityTsoi, HW=rp00439-
dc.identifier.authorityLau, SKP=rp00486-
dc.identifier.authorityWoo, PCY=rp00430-
dc.identifier.authorityYuen, KY=rp00366-
dc.description.naturepostprint-
dc.identifier.doi10.1002/hep.31138-
dc.identifier.pmid31960460-
dc.identifier.scopuseid_2-s2.0-85081129563-
dc.identifier.hkuros310921-
dc.identifier.volume73-
dc.identifier.issue1-
dc.identifier.spage10-
dc.identifier.epage22-
dc.identifier.eissn1527-3350-
dc.identifier.isiWOS:000576691300001-
dc.publisher.placeUnited States-
dc.identifier.issnl0270-9139-

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