First report of a human autochthonous hepatitis E virus infection in Brazil.
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.
Lopes Dos Santos
Debora Regina
DR
Laboratório de Desenvolvimento Tecnológico em Virologia, IOC, Fiocruz, Rio de Janeiro, Brazil. santosdl@ioc.fiocruz.br
Lewis-Ximenez
Lia Laura
LL
da Silva
Marcelle Figueira Marques
MF
de Sousa
Paulo Sérgio Fonseca
PS
Gaspar
Ana Maria Coimbra
AM
Pinto
Marcelo Alves
MA
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
D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral