title: Acute sporadic hepatitis E virus infection in southern China.
abstract: OBJECTIVE
  The hepatitis E virus is responsible for epidemic and sporadic hepatitis in northwestern China, but its role as a cause of acute sporadic hepatitis in southern China has not been reported.
  
  
  METHODS
  We applied the most practical current methods for diagnosis of hepatitis E virus infection, IgM and IgG anti-HEV detection by enzyme linked immunosorbent assay, to investigate the prevalence of hepatitis E virus infection among acute sporadic hepatitis.
  
  
  RESULTS
  Anti-HEV IgM was found in 1 of 26 (3.8%), 4 of 20 (20.0%), 4 of 19 (21.1%), and 51 of 142 (35.9%), with acute hepatitis A, B, C and non-ABC, respectively. Anti-HEV IgM was not detectable in healthy subjects, while IgG anti-HEV was found in 14 of 77 healthy subjects (18.2%) and was long-lasting. Ninety-one cases without any evidence of hepatitis A, B or C infections and anti-HEV IgM were tentatively classified as non-A, B, C, D, E (non-ABCDE) hepatitis. By comparison with non-ABCDE, cases with hepatitis E were more frequently icteric and exhibited higher alanine aminotransferase levels (92.2% vs. 45.1%, 770 iu/l vs 377 iu/l, respectively, p < 0.005). Chronic cases were not observed in hepatitis E virus infections. However, 14 of 91 (15.4%) cases with non-ABCDE developed to chronicity (p < 0.005).
  
  
  CONCLUSIONS
  Hepatitis E virus infection is sporadic as well as endemic in southern China. Only IgM anti-HEV but not IgG anti-HEV can be used as an appropriate marker of acute hepatitis E virus infection. Superinfection of hepatitis E virus with other types of hepatitis viruses is frequent in this area. While the disease was associated with more severe clinical manifestations, patients usually recovered completely.
authors.affiliation: Department of Microbiology, University of Hong Kong, Hong Kong.
authors.forename: D
authors.initials: D
authors.lastname: Tan
authors.forename: S W
authors.initials: SW
authors.lastname: Im
authors.forename: J L
authors.initials: JL
authors.lastname: Yao
authors.forename: M H
authors.initials: MH
authors.lastname: Ng
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D002681:China / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016751:Hepatitis E / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D000410:Alanine Transaminase