Health Science Center, Hebei University, No. 342 Yuhuadonglu, Baoding 071000, China.
Infect Genet Evol. 2013 Dec;20:413-7. doi: 10.1016/j.meegid.2013.10.003. Epub 2013 Oct 16.
Hepatitis E is an important public health problem in many countries. However, there is no definite conclusion about the zoonotic reservoir, transmission patterns and risk factors of hepatitis E in the human population. The aim of this study was to analyze the epidemiological and viral genotype characteristics of hepatitis E cases in northern China. Surveillance was conducted in two hospitals in Liaoning and Hebei province from July 2010 to June 2012. Out of a total of 116 diagnosed patients, 88 (75.9%) were male and 28 (24.1%) were female and most (73%) were in the age group 40-70 years. In both hospitals, cases were diagnosed more frequently in March than in other months. HEV RNA was amplified from 41 patients and characterized by nucleotide sequencing and phylogenetic analysis. Most of the isolates (37 strains, 90.3%) were genotype 4, including subgenotypes 4a, 4b, 4d, 4h, 4i and a new subgenotype. One subgenotype 3a strain was isolated from Baoding, Hebei province. Three genotype 1b strains were found from patients in Jinzhou, Liaoning province. Most of the genotype 4 strains and the genotype 3 strains were phylogenetically related to known swine isolates. In conclusion, the finding that HEV infects mostly middle-aged and elderly men and that the incidence spiked in March may reflect the zoonotic transmission characteristics of HEV infection. Pigs, but not rabbits, were the important reservoirs in this area, because genotype 4 HEV was found to be responsible for the majority hepatitis E cases. However, genotype 1 is still present in northern China. Also, the first isolation of genotype 3 HEV in this area indicates that alternative routes of HEV transmission might exist.
戊型肝炎是许多国家重要的公共卫生问题。然而，关于戊型肝炎在人类中的动物宿主、传播模式和危险因素仍没有明确的结论。本研究旨在分析中国北方地区戊型肝炎病例的流行病学和病毒基因型特征。本研究于 2010 年 7 月至 2012 年 6 月在辽宁和河北两省的两家医院进行监测。在总共 116 例确诊的患者中，88 例（75.9%）为男性，28 例（24.1%）为女性，大多数（73%）年龄在 40-70 岁之间。在这两家医院，3 月的病例诊断均多于其他月份。从 41 例患者中扩增出 HEV RNA，并进行核苷酸测序和系统进化分析。大多数分离株（37 株，90.3%）为基因型 4，包括亚基因型 4a、4b、4d、4h、4i 和一个新的亚基因型。来自河北保定的一株为 3a 基因型。从辽宁锦州的患者中发现 3 株 1b 基因型。大多数基因型 4 株和基因型 3 株与已知的猪分离株在系统进化上密切相关。总之，戊型肝炎感染主要发生在中年和老年男性，且 3 月发病率较高，这可能反映了戊型肝炎感染的人畜共患病传播特征。猪而不是兔是该地区的重要宿主，因为大多数戊型肝炎病例是由基因型 4 HEV 引起的。然而，基因型 1 仍存在于中国北方。此外，该地区首次分离到基因型 3 HEV，表明戊型肝炎的传播途径可能存在其他途径。
