Detection of hepatitis E virus RNA in sera of patients with hepatitis E by polymerase chain reaction.
BACKGROUND
The duration of viremia during hepatitis E virus (HEV) infection has rarely been reported. This study was undertaken to detect HEV RNA in sera of patients with hepatitis E and to understand the process of HEV infection more thoroughly.


METHODS
HEV RNA was detected in the serum samples of hospitalized patients with acute hepatitis E by reverse transcriptase-nested polymerase chain reaction (RT-nPCR) using two pairs of primers from open reading frame (ORF) 1 of the HEV genome.


RESULTS
The serum samples from 44 (70%) of 62 patients were positive for HEV RNA. Thirty-two of these patients, with 288 serial serum specimens, were followed up for the whole process, and 24 patients (75%) were positive for HEV RNA. The positive rates declined with the course of the disease, serum HEV RNA persisting for 20.6 days on average after onset of illness. Serum HEV RNA remained positive in 36 (81.8%) of the 44 patients at the time their alanine aminotransferase (ALT) began to decrease. There was no difference in HEV RNA positivity between serum with high levels of HEV antibody (peak P/N ratio > or =4.0) and that with low levels (peak P/N ratio <4.0), with 25 out of 35 and 19 out of 27 (71.4% vs. 70.4%, P>0.05), respectively.


CONCLUSIONS
There is a relatively long period of HEV viremia in patients with hepatitis E. The proportion of HEV viremia and its duration are not directly related to serum ALT values or HEV antibody levels.
Zhao
Zhen-Yu
ZY
Department of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Infectious Diseases, Ministry of Public Health, Hangzhou 310003, China.
Ruan
Bing
B
Shao
Hui
H
Chen
Zhen-Juan
ZJ
Liu
She-Lan
SL
D000410:Alanine Transaminase / Q000097:blood; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000097:blood*; D016752:Hepatitis E virus / Q000302:isolation & purification*; D006801:Humans; D012367:RNA, Viral / Q000097:blood*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D014766:Viremia / Q000175:diagnosis
D006508:Hepatitis Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase