Ren Hong, Li Yan-ting, Zhou Xin, Wang Ye, Zheng Ying-jie, Zhu Yi-yi, Lu Yi-han
Department of Acute Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2013 May;34(5):419-23.
The aim of this study was to systemically analyze the epidemiologic, serological and genetic characteristics of hepatitis E virus (HEV) in Shanghai from 1997 to 2012.
We analyzed the data related to the epidemics of hepatitis E from China Information System for Disease Control and Prevention. We implemented serological surveillance program, based on community healthy population with enzyme-linked immunosorbent assay method and estimated the standardized sero-prevalence. We also obtained nucleotide sequences of hepatitis E patients using the nested RT-PCT assays, together with prototype sequences in the GenBank to construct a HEV genetic database in Shanghai.
In this paper, we found that the distribution of hepatitis E patients was sporadic in the past 16 years in Shanghai. The morbidity kept declining, but with seasonal and periodical fluctuation. Morbidity in males was significantly higher than in females, with the hard hit population between 30 and 65 year-olds. In total, 3979 sera samples were collected through the serological surveillance programs in 2001, 2004, 2007 and 2012. The standardized sero-prevalence rates of the said years were 22.32%, 18.56%, 10.22% and 34.43% which all showing strong relationship with age groups and the regions where the populations were being monitored. 73 nucleotide sequences of hepatitis E patients from hospitals were identified, during 2004 and 2008.
from phylogenetic analysis revealed that all HEV isolates belonged to genotype IV and including 4 known subtypes 4a, 4d, 4h and 4i which sharing 83.09% - 97.96%, 85.87% - 97.26% and 83.80% - 95.10% nucleotide sequence identities with the swine HEV genotype IV of GU188851, DQ450072 and EF570133. Meanwhile, 59 HEV isolates from different districts shared 99% nucleotide sequence identities with each other.
Hepatitis E would still be a challenge for long time and the zoonotic questions that related to hepatitis E, need to be explored and explained in the future.
本研究旨在系统分析1997年至2012年上海戊型肝炎病毒（HEV）的流行病学、血清学和遗传学特征。
我们分析了来自中国疾病预防控制信息系统的戊型肝炎疫情相关数据。我们实施了血清学监测项目，基于社区健康人群采用酶联免疫吸附测定法，并估算标准化血清流行率。我们还使用巢式RT - PCT测定法获得戊型肝炎患者的核苷酸序列，连同GenBank中的原型序列构建上海的HEV遗传数据库。
在本文中，我们发现上海过去16年戊型肝炎患者的分布呈散发性。发病率持续下降，但有季节性和周期性波动。男性发病率显著高于女性，30至65岁人群为发病高峰人群。2001年、2004年、2007年和2012年通过血清学监测项目共收集3979份血清样本。上述年份的标准化血清流行率分别为22.32%、18.56%、10.22%和34.43%，均与年龄组和受监测人群所在地区有密切关系。2004年至2008年期间，从医院鉴定出73例戊型肝炎患者的核苷酸序列。
系统发育分析显示，所有HEV分离株均属于基因IV型，包括4个已知亚型4a、4d、4h和4i，它们与GU188851、DQ450072和EF570133的猪HEV基因IV型分别具有83.09% - 97.96%、85.87% - 97.26%和83.80% - 95.10%的核苷酸序列同一性。同时，来自不同区的59株HEV分离株彼此间具有99%的核苷酸序列同一性。
戊型肝炎在很长一段时间内仍将是一个挑战，与戊型肝炎相关的人畜共患病问题，未来需要探索和解释。
