title: SEN virus infection in children in Taiwan: transmission route and role in blood transfusion and liver diseases.
abstract: BACKGROUND
  SEN virus (SENV) is a newly discovered DNA virus. We conducted this study to evaluate potential modes of SENV transmission and the pathogenic effect of SENV on liver diseases in children.
  
  
  METHODS
  Polymerase chain reaction was used to detect 2 SENV variant (SENV-D and SENV-H) DNA in sera from healthy individuals and diseased children. Nucleotide sequence of SENV was determined by direct sequencing.
  
  
  RESULTS
  SENV infection was assessed in healthy individuals, including 50 newborns (sera collected from the umbilical cord), 24 infants, 46 preschool children (aged 1-6 years), 42 school children of an age before that of the first sexual experience (aged 7-12 years), 62 adolescents (13-18 years), 72 young adults (19-30 years) and 32 adults (>30 years). The prevalence of SENV-D and/or SENV-H (SENV-D/H) viremia in each group was 0%, 17%, 24%, 24%, 27%, 33% and 40%, respectively. The prevalence of SENV-D/H viremia in 18 children with non-A to E hepatitis, 64 thalassemic children, 80 children transfused during cardiac surgery, 30 children with chronic hepatitis B, 9 children with chronic hepatitis C and 32 infants with biliary atresia was 11%, 61%, 80%, 83%, 67% and 50%, respectively. SENV was found more frequently in all patient groups than in 174 age-matched controls (P < 0.01), with the exception of non-A to E hepatitis (11% versus 24% in the control group; P = 0.27). In 2 infants with proven intrauterine hepatitis B viral infection, identical SENV-D nucleotide sequence existed in both the maternal and neonate serum. Elevated alanine aminotransferase concentrations were rarely observed in children who acquired isolated SENV viremia because of transfusion for surgery. Infection with SENV in children with chronic hepatitis C virus or hepatitis B viral infection was not associated with higher peak alanine aminotransferase values.
  
  
  CONCLUSIONS
  SENV is transmitted mainly via nonparenteral daily contact and frequently occurs early in life. Transfusion can significantly increase the rate of SENV viremia. SENV does not appear to cause hepatitis in children.
authors.affiliation: Department of Pediatrics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei.
authors.forename: Hong-Yuan
authors.initials: HY
authors.lastname: Hsu
authors.forename: Yen-Hsuan
authors.initials: YH
authors.lastname: Ni
authors.forename: Cheng Lun
authors.initials: CL
authors.lastname: Chiang
authors.forename: Ming-Kwang
authors.initials: MK
authors.lastname: Shyu
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: Mei-Hwei
authors.initials: MH
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004266:DNA Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000150:complications* / Q000821:virology; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology; D022783:Torque teno virus / Q000145:classification / Q000302:isolation & purification / Q000472:pathogenicity; D065227:Transfusion Reaction; D014766:Viremia / Q000453:epidemiology / Q000635:transmission / Q000821:virology