Laboratório de Desenvolvimento Tecnológico em Virologia, IOC, Fiocruz, Rio de Janeiro, Brazil.
J Clin Virol. 2010 Mar;47(3):276-9. doi: 10.1016/j.jcv.2009.12.021. Epub 2010 Jan 29.
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.
A study was developed to attempt the identification of hepatitis E acute cases in Brazil.
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.
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.
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.
非流行地区散发的急性戊型肝炎病例与戊型肝炎病毒的基因型 3 和 4 有关。多项研究表明，人类和动物株之间存在联系，主要是来自各自地区的猪和鹿，具有动物源性传染病的特征。巴西猪群中已证实存在基因型 3 的 HEV 循环。然而，迄今为止，巴西尚未报告确诊的人类病例。
开展了一项研究，试图在巴西确定急性戊型肝炎病例。
对 64 份来自急性非 A-C 型肝炎患者的血清样本进行了回顾性研究，以确定急性戊型肝炎的人类病例。
我们可以确定一个确诊的急性戊型肝炎病例。患者血清中戊型肝炎病毒特异性 IgM 和 IgG 抗体转阳，从血清中扩增出 HEV-RNA，对 ORF1 基因组区域的 242 个核苷酸片段的序列分析将该株分类为基因型 3 和 3b 亚组。对危险因素的调查和系统进化分析结果提示感染可能具有动物源性。
巴西首例本土感染病例提供了拉丁美洲戊型肝炎流行病学的新信息，并考虑进一步开展更广泛的流行病学研究。
