title: Distinct changing profiles of hepatitis A and E virus infection among patients with acute hepatitis, patients on maintenance hemodialysis and healthy individuals in Japan.
abstract: To compare the epidemiologic profiles of hepatitis A virus (HAV) and hepatitis E virus (HEV) infections in Japan, the prevalence of clinical or subclinical HAV and HEV infections was investigated serologically and molecularly among 128 consecutive patients (age, mean +/- standard deviation, 37.5 +/- 14.7 years) who contracted acute hepatitis between 1989 and 2005 in a city hospital, and among 416 hemodialysis patients (60.1 +/- 12.6 years) and 266 medical staff members (34.6 +/- 11.4 years) at the same hospital, using stored periodic serum samples collected since the start of hemodialysis or employment, respectively. Between 1989 and 1995, among 93 patients with acute hepatitis, 51 (54.8%) were diagnosed with hepatitis A and only one patient with hepatitis E. Between 1996 and 2005, however, among 35 patients, only 3 (8.6%) were diagnosed with hepatitis A and 2 (5.7%) with hepatitis E. Although subclinical HEV infection was recognized in four hemodialysis patients (one each in 1979, 1980, 1988, and 2003) and two medical staff members (1978 and 2003) in previous studies, none of the 191 hemodialysis patients who had been negative for anti-HAV at the start of hemodialysis contracted HAV infection during the observation period of 7.6 +/- 6.4 years. Only one (0.4%) of the 246 medical staff members who had been negative for anti-HAV at the start of employment acquired hepatitis A during the observation period of 7.9 +/- 8.0 years: none had subclinical HAV infection. Clinical or subclinical HEV infection has occurred rarely during the last three decades, while HAV infection has markedly decreased at least since 1996.
authors.affiliation: Masuko Memorial Hospital and Masuko Institute for Medical Research, Nagoya, Aichi-Ken, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Mitsui
authors.forename: Yukie
authors.initials: Y
authors.lastname: Tsukamoto
authors.forename: Akinori
authors.initials: A
authors.lastname: Hirose
authors.forename: Shigeru
authors.initials: S
authors.lastname: Suzuki
authors.forename: Chikao
authors.initials: C
authors.lastname: Yamazaki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Masuko
authors.forename: Fumio
authors.initials: F
authors.lastname: Tsuda
authors.forename: Kazunori
authors.initials: K
authors.lastname: Endo
authors.forename: Masaharu
authors.initials: M
authors.lastname: Takahashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Okamoto
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D002648:Child; D005260:Female; D006262:Health; D006282:Health Personnel; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology; D030041:Hepatitis A virus / Q000235:genetics; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data*
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G