TY - JOUR
T1 - Association of hepatitis E virus with an outbreak of hepatitis in Pakistan
T2 - Serologic responses and pattern of virus excretion
AU - Ticehurst, John
AU - Popkin, Terry J.
AU - Bryan, Joe P.
AU - Innis, Bruce L.
AU - Duncan, J. Fred
AU - Ahmed, Aftab
AU - Iqbal, Muhammad
AU - Malik, Iftikhar
AU - Kapikian, Albert Z.
AU - Legters, Llewellyn J.
AU - Purcell, Robert H.
PY - 1992/2
Y1 - 1992/2
N2 - Hepatitis E virus (HEV), a positive‐strand RNA agent, has been associated with enterically transmitted non‐A, non‐B hepatitis in Asia, Africa, and Mexico. To evaluate the role of HEV in an outbreak of hepatitis in Pakistan, we used immune electron microscopy to detect 1) antibody to HEV, for evidence of infection, and 2) virus, to determine the pattern of HEV excretion. Paired sera from 2 patients were assayed for antibody by using reference HEV: one seroconverted, an atypical finding for HEV infections; the other had high levels of anti‐HEV in both sera. Virus particles with the size (29 × 31 nm) and morphology of HEV were detected in feces from 10 of 85 patients and serologically identified as HEV by using reference antibodies from an HEV‐infected chimpanzee. One of these HEV‐containing specimens was collected 9 days before the onset of jaundice; it was among feces from 38 outpatients with nonspecific symptoms and biochemical hepatitis, 12 of whom subsequently developed jaundice. The other 9 feces with HEV were among 36 collected within 7 days of the onset of acute icteric hepatitis; all 11 feces from days 8 to 15 were negative for HEV. Fecal concentrations of HEV appeared t o be lower than those of many enteric viruses: only one specimen contained as many as 5 particles per EM grid square. It is concluded that HEV was etiologically associated with the epidemic and was predominantly excreted at very low levels during the first week of jaundice.
AB - Hepatitis E virus (HEV), a positive‐strand RNA agent, has been associated with enterically transmitted non‐A, non‐B hepatitis in Asia, Africa, and Mexico. To evaluate the role of HEV in an outbreak of hepatitis in Pakistan, we used immune electron microscopy to detect 1) antibody to HEV, for evidence of infection, and 2) virus, to determine the pattern of HEV excretion. Paired sera from 2 patients were assayed for antibody by using reference HEV: one seroconverted, an atypical finding for HEV infections; the other had high levels of anti‐HEV in both sera. Virus particles with the size (29 × 31 nm) and morphology of HEV were detected in feces from 10 of 85 patients and serologically identified as HEV by using reference antibodies from an HEV‐infected chimpanzee. One of these HEV‐containing specimens was collected 9 days before the onset of jaundice; it was among feces from 38 outpatients with nonspecific symptoms and biochemical hepatitis, 12 of whom subsequently developed jaundice. The other 9 feces with HEV were among 36 collected within 7 days of the onset of acute icteric hepatitis; all 11 feces from days 8 to 15 were negative for HEV. Fecal concentrations of HEV appeared t o be lower than those of many enteric viruses: only one specimen contained as many as 5 particles per EM grid square. It is concluded that HEV was etiologically associated with the epidemic and was predominantly excreted at very low levels during the first week of jaundice.
KW - antibody
KW - enterically transmitted non‐A
KW - immune electron microscopy (IEM)
KW - non‐B (ET‐NANB) hepatitis; epidemic
KW - virus particles
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U2 - 10.1002/jmv.1890360205
DO - 10.1002/jmv.1890360205
M3 - Article
C2 - 1583470
AN - SCOPUS:0026544332
SN - 0146-6615
VL - 36
SP - 84
EP - 92
JO - Journal of Medical Virology
JF - Journal of Medical Virology
IS - 2
ER -