Department of Gastroenterology, SMS Medical College and Hospital, Jaipur (Rajasthan), India.
Virol J. 2010 Sep 6;7:213. doi: 10.1186/1743-422X-7-213.
There is paucity of data regarding duration of fecal excretion and viremia on sequential samples from individual patients and its correlation with serum transaminases and antibody responses in patients with acute hepatitis E. This prospective study was undertaken at a tertiary care center in Northern India over 15 months. Only those patients of sporadic acute hepatitis E who were in their first week of illness and followed up weekly for liver function tests, IgM anti HEV antibody and HEV RNA in sera and stool were included. HEV RNA was done by RT - nPCR using two pairs of primers from RdRp region of ORF 1 of the HEV genome.
Over a period of 15 months 60 patients met the inclusion criterion and were enrolled for the final analysis. The mean age of the patients was 29.2 ± 8.92 years, there were 39 males. The positivity of IgM anti HEV was 80% at diagnosis and 18.3% at 7th week, HEV RNA 85% at diagnosis and 6.6% at 7th week and fecal RNA 70% at the time of diagnosis and 20% at 4th week. The maximum duration of viremia detected was 42 days and fecal viral shedding was 28 days after the onset of illness.
Present study reported HEV RNA positivity in sera after normalization of transaminases. Fecal shedding was not seen beyond normalization of transaminases. However, viremia lasted beyond normalization of transaminases suggesting that liver injury is independent of viral replication.
关于个体患者连续样本中粪便排泄和病毒血症的持续时间及其与血清转氨酶和急性戊型肝炎患者抗体反应的相关性，数据匮乏。本前瞻性研究在印度北部的一家三级护理中心进行，历时 15 个月。仅纳入患有散发性急性戊型肝炎且处于发病第一周、每周进行肝功能检查、血清和粪便中 IgM 抗 HEV 抗体和 HEV RNA 随访的患者。使用 HEV 基因组 ORF1 的 RdRp 区的两对引物通过 RT-nPCR 进行 HEV RNA 检测。
在 15 个月期间，有 60 名符合纳入标准的患者被纳入最终分析。患者的平均年龄为 29.2±8.92 岁，其中 39 名男性。诊断时 IgM 抗 HEV 的阳性率为 80%，第 7 周时为 18.3%，诊断时 HEV RNA 的阳性率为 85%，第 7 周时为 6.6%，粪便 RNA 的阳性率为 70%，第 4 周时为 20%。检测到的病毒血症最长持续时间为 42 天，粪便病毒脱落持续时间为发病后 28 天。
本研究报告了血清转氨酶正常后 HEV RNA 阳性。粪便脱落未超过转氨酶正常化。然而，病毒血症持续时间超过转氨酶正常化，表明肝损伤与病毒复制无关。
