Protracted viremia during acute sporadic hepatitis E virus infection.
OBJECTIVE
Hepatitis E virus (HEV) is associated with epidemic and sporadic hepatitis in developing countries. The disease is largely self-limited with no long-term sequelae. The source of HEV for maintenance of the disease in an endemic area is unknown. This study investigated the occurrence and duration of viremia in patients with acute sporadic HEV infection.


METHODS
In 26 of 37 patients with sporadic acute non-A, non-B viral hepatitis, HEV infection was diagnosed based on positivity for immunoglobulin M anti-HEV and/or presence of viremia as shown by reverse-transcription polymerase chain reaction. In 4 patients, fecal samples were analyzed for presence of virus using polymerase chain reaction. Multiple samples were studied at varying times in 20 patients.


RESULTS
Viremia was detected in 19 of 26 patients. Two patients had viremia in the absence of immunoglobulin M anti-HEV. Four patients had protracted viremia of 45-112 days' duration. One patient showed fecal virus shedding up to the 52nd day of illness.


CONCLUSIONS
Protracted viremia and prolonged fecal shedding of HEV were shown in a small group of patients. These patients may serve as temporary virus carriers responsible for continuous contamination of the sewage water.
Nanda
S K
SK
Department of Pathology, All India Institute of Medical Sciences, New Delhi.
Ansari
I H
IH
Acharya
S K
SK
Jameel
S
S
Panda
S K
SK
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005243:Feces / Q000382:microbiology; D005260:Female; D006508:Hepatitis Antibodies / Q000032:analysis; D016751:Hepatitis E / Q000821:virology*; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014766:Viremia / Q000821:virology*; D017201:Virus Shedding
D006508:Hepatitis Antibodies; D007075:Immunoglobulin M