title: Molecular detection and sequence analysis of hepatitis E virus in patients with viral hepatitis from North India.
abstract: Viral hepatitis is a major cause of mortality and morbidity in developing countries. Hepatitis E virus (HEV) is responsible for both sporadic and epidemic outbreaks of viral hepatitis in India. Here a total of 843 samples were collected: 685 from patients with acute viral hepatitis (AVH), 70 from patients with fulminant hepatic failure (FHF), 53 from patients with chronic liver disease (CLD), 11 from patients with antituberculosis therapy (ATT)-induced jaundice, and 24 from pregnant women. When tested for anti-HEV IgM, 58.3% of the pregnant women, 41.4% of the patients with FHF, 38.6% of the patients with AVH, 9.4% of the patients with CLD, and 18.2% of the patients with ATT-induced jaundice tested positive. We found that 34% and 16% of the acute hepatitis patients and fulminant hepatitis patients, respectively, showed no reactivity to the existing viral hepatitis markers and were thus grouped as non A to E. Among the HEV IgM-positive cases, males outnumbered females (62.8% versus 37.1%). HEV RNA was found in 35% of fulminant and 9.4% of acute hepatitis patients. From phylogenetic analysis, we observed that all the isolates were clustered within genotype 1. Critical analysis placed the acute isolates along with strains under subtype Ia, while the fulminant isolates clustered along with the FHF strain (X98292) under subtype Ic. The segregation of HEV isolates from AVH and FHF patients into different subtypes raises interesting questions on the molecular basis of HEV disease severity.
authors.affiliation: College of Veterinary Medicine, University of Maryland, MD 20742, USA. subrat_kumar@yahoo.com
authors.forename: Subrat
authors.initials: S
authors.lastname: Kumar
authors.forename: Sujit Kumar
authors.initials: SK
authors.lastname: Pujhari
authors.forename: Yogesh Kumar
authors.initials: YK
authors.lastname: Chawla
authors.forename: Anuradha
authors.initials: A
authors.lastname: Chakraborti
authors.forename: Radha Kanta
authors.initials: RK
authors.lastname: Ratho
mesh_terms: D000208:Acute Disease; D000914:Antibodies, Viral / Q000097:blood; D002908:Chronic Disease; D003906:Developing Countries; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005838:Genotype; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology; D016751:Hepatitis E / Q000175:diagnosis / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000302:isolation & purification; D007194:India / Q000453:epidemiology; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D010802:Phylogeny; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D012367:RNA, Viral / Q000235:genetics*; D012189:Retrospective Studies; D017423:Sequence Analysis, RNA
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral