title: HAV and HEV infection in hospitalised hepatitis patients in Alexandria, Egypt.
abstract: A total of 202 serum and stool samples from acute hepatitis patients attending the Fever Hospital of Alexandria, Egypt, have been studied to reveal markers of hepatitis virus infection. Anti-HAV IgM were detected in 21 out of 202 sera (10.4%), whereas 201 sera (99.5%) had anti-HAV IgG. The first age attack was in the class-age 0-9 years with 64.7% of anti-HAV IgM positive sera. Among 202 patients, anti-hepatitis E IgG (sample/over cut off > 1.0) was identified in 90 patients (44.5%). The anti-HEV seropositivity ranged from 17.6% to 60.0% in the different age groups, with the highest level in the class-age 20 29 years. Anti-hepatitis E IgM were identified in 49 patients with the first age attack in the class-age 10-19 years (39.4%). HAV RNA was identified by nested PCR in 7 samples out of 15, whereas HEV RNA was present in 4 out of 75 stool samples. Direct DNA sequence of the latter PCR products confirmed the presence of the HEV genome; comparison of the sequences of the isolates from Egypt with those in data banks revealed the highest homology to the Burma strain. Our data confirm that HAV and HEV are common causes of acute sporadic hepatitis in Alexandria but with different peak age positivity. Occasionally, but not infrequently, dual infections (HAV-HEV and HEV-enteric viruses) were also found. The risk analysis indicates that patients living in rural areas are exposed to a higher risk of hepatitis E infection compared to the urban population, whereas the presence of anti-HEV IgG was significantly associated with consumption of common village water and use of indoor dry pit and oral therapy for schistosomiasis.
authors.affiliation: Department of Public Health, University of Tor Vergata, Rome, Italy. divizia@med.uniroma2.it
authors.forename: M
authors.initials: M
authors.lastname: Divizia
authors.forename: R
authors.initials: R
authors.lastname: Gabrieli
authors.forename: M L
authors.initials: ML
authors.lastname: Stefanoni
authors.forename: E
authors.initials: E
authors.lastname: Renganathan
authors.forename: E
authors.initials: E
authors.lastname: El Ghazzawi
authors.forename: O A
authors.initials: OA
authors.lastname: Kader
authors.forename: F
authors.initials: F
authors.lastname: Gamil
authors.forename: G
authors.initials: G
authors.lastname: El Sawaf
authors.forename: E
authors.initials: E
authors.lastname: El Sherbini
authors.forename: E
authors.initials: E
authors.lastname: Saleh
authors.forename: A M
authors.initials: AM
authors.lastname: Degener
authors.forename: A
authors.initials: A
authors.lastname: Noce
authors.forename: L
authors.initials: L
authors.lastname: Zaratti
authors.forename: A
authors.initials: A
authors.lastname: Modesti
authors.forename: A
authors.initials: A
authors.lastname: Panà
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003625:Data Collection; D004534:Egypt / Q000453:epidemiology; D005243:Feces / Q000821:virology; D005260:Female; D006506:Hepatitis A / Q000175:diagnosis* / Q000453:epidemiology*; D016751:Hepatitis E / Q000175:diagnosis* / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000302:isolation & purification; D006507:Hepatovirus / Q000302:isolation & purification; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012698:Serologic Tests; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D012367:RNA, Viral