Matsui Takeshi, Kang Jong-Hon, Matsubayashi Keiji, Yamazaki Hajime, Nagai Kazumasa, Sakata Hidekatsu, Tsuji Kunihiko, Maguchi Hiroyuki
Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Department of Virology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Hepatol Res. 2015 Jun;45(6):698-704. doi: 10.1111/hepr.12390. Epub 2014 Oct 9.
The transfusion transmission of hepatitis E can occur even in non-endemic areas in the world as autochthonous hepatitis E has been increasingly reported in developed countries where the hepatitis E virus (HEV) is not prevalent. We investigated the post-transfusion transmission of hepatitis E in a patient by molecularly confirming its presence, and characterized the viral kinetics of HEV in this case.
A Japanese man underwent re-thoracotomy for hemostasis followed by platelet transfusion. After the transfusion, the blood donor was found to be HEV positive. The donated blood was re-examined and was found to contain HEV. Throughout the prospective follow up of the patient, we analyzed the viral kinetics, chronological anti-HEV antibody level changes and disease progression during the entire course of HEV infection from transfusion until the end of viremia.
Sequence analysis of the strains isolated from both the donor and the patient who contracted acute hepatitis E showed an identical match for 326 nucleotides in open reading frame 1. Two strains belonged to HEV genotype 3 indigenous to Japan.
To the best of our knowledge, this is the first detailed report on the entire natural course of hepatitis E from viral transmission, then clearance, to replication preceding liver injury caused by HEV genotype 3, which is responsible for autochthonous infection in developed countries. The findings provide valuable insights into the mechanism of the transfusion transmission of HEV and subsequent viral dynamics.
戊型肝炎的输血传播在世界非流行地区也可能发生，因为在戊型肝炎病毒（HEV）并不流行的发达国家，散发性戊型肝炎的报道日益增多。我们通过分子方法确认戊型肝炎在一名患者中的存在，对其输血后传播情况进行了调查，并对该病例中HEV的病毒动力学进行了特征分析。
一名日本男性因止血接受再次开胸手术，随后接受了血小板输血。输血后，发现献血者HEV呈阳性。对所献血液进行复查，发现其中含有HEV。在对该患者进行的前瞻性随访过程中，我们分析了从输血到病毒血症结束的整个HEV感染过程中的病毒动力学、抗HEV抗体水平随时间的变化以及疾病进展情况。
对从感染急性戊型肝炎的献血者和患者中分离出的毒株进行序列分析，结果显示开放阅读框1中的326个核苷酸完全匹配。两株毒株均属于日本本土的HEV基因型3。
据我们所知，这是第一份关于由HEV基因型3导致的戊型肝炎从病毒传播、清除到肝脏损伤前复制的整个自然病程的详细报告，HEV基因型3在发达国家导致散发性感染。这些发现为HEV的输血传播机制及后续病毒动态提供了有价值的见解。
