title: First report of a human autochthonous hepatitis E virus infection in Brazil.
abstract: BACKGROUND
  Sporadic acute hepatitis E cases occurring in non-endemic areas have been associated to genotypes 3 and 4 of hepatitis E virus. Several studies have demonstrated the relationship among human and animals strains, mostly pigs and deers, from respective areas characterizing zoonosis. Circulation of genotype 3 of HEV in Brazilian swine herds have already been demonstrated. Nevertheless, no confirmed human cases have been reported to date in Brazil.
  
  
  OBJECTIVE
  A study was developed to attempt the identification of hepatitis E acute cases in Brazil.
  
  
  METHODS
  A retrospective study carried out with 64 serum samples from patients with acute non-A-C hepatitis was performed to identify human cases of acute hepatitis E.
  
  
  RESULTS
  We could identify a confirmed case of acute hepatitis E. The patient seroconverted to hepatitis E virus-specific IgM and IgG antibody, HEV-RNA was amplified from serum, and the analysis of the sequence of a 242 nucleotide fragment from the ORF1 genome region classified the strain within genotype 3 and subgenotype 3b. Investigation of risk factors and results from phylogenetic analysis suggested a likely zoonotic origin for the infection.
  
  
  CONCLUSIONS
  The first report of a human autochthonous in Brazil contributes with new information for hepatitis E epidemiology in Latin America and to considerate further broadly epidemiological studies.
authors.affiliation: Laboratório de Desenvolvimento Tecnológico em Virologia, IOC, Fiocruz, Rio de Janeiro, Brazil. santosdl@ioc.fiocruz.br
authors.forename: Debora Regina
authors.initials: DR
authors.lastname: Lopes Dos Santos
authors.forename: Lia Laura
authors.initials: LL
authors.lastname: Lewis-Ximenez
authors.forename: Marcelle Figueira Marques
authors.initials: MF
authors.lastname: da Silva
authors.forename: Paulo Sérgio Fonseca
authors.initials: PS
authors.lastname: de Sousa
authors.forename: Ana Maria Coimbra
authors.initials: AM
authors.lastname: Gaspar
authors.forename: Marcelo Alves
authors.initials: MA
authors.lastname: Pinto
mesh_terms: D001938:Brazil; D016000:Cluster Analysis; D005838:Genotype; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000175:diagnosis*; D016752:Hepatitis E virus / Q000276:immunology* / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008969:Molecular Sequence Data; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D017385:Sequence Homology
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral