[Autochthonous hepatitis E virus in Southeastern France. 2 cases].
BACKGROUND
Hepatitis E virus is endemic in developing countries where it is especially lethal among pregnant women. As the circulation of goods and people grows between these countries and the industrialized nations, this virus is emerging as a cause of imported acute hepatitis in the latter, where authentic autochthonous cases also exist.


METHODS
We report two cases observed in Marseille, in men aged 27 and 81 years; no mode of contamination was detected, and both outcomes were positive.


CONCLUSIONS
This virus is circulating in non-endemic areas (as shown by its seroprevalence, which ranges from 0.4 to 2.6%, its identification in urban sewage, and the autochthonous cases reported). This dissemination, combined with its high mortality rate, even outside pregnancy (up to 12%), show the need for systematic consideration of and an early search for the often-fleeting presence of the virus and of IgM and IgG type serum antibodies in plasma and (when necessary) feces in cases of acute hepatitis, because of their often transient nature. Prophylaxis is based on improving water hygiene and is thus more difficult in industrialized countries where the level of hygiene is already high, especially when no risk factors can be identified in the autochthonous cases. Recombinant vaccines are under development.
Service de pathologie digestive, HIA Laveran, Marseille-armées. gastro@hia-laveran.fr
Thierry
T
Coton
René
R
Delpy
Pierre
P
Hance
Dominique
D
Carré
Michel
M
Guisset
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D021821:Communicable Diseases, Emerging / Q000453:epidemiology; D042241:Early Diagnosis; D005243:Feces / Q000821:virology; D005602:France / Q000453:epidemiology; D016751:Hepatitis E / Q000453:epidemiology* / Q000821:virology; D016752:Hepatitis E virus / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D012367:RNA, Viral / Q000097:blood; D014766:Viremia / Q000175:diagnosis
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral