Epidemiology ReserchUnit (EPIUnit), Institute of Public Health, University of Porto, 4050-313 Porto, Portugal. Instituto Politécnico de Viseu, Viseu, Portugal.
Laboratório de Patologia Clínica Centro Hospitalar Lisboa Central (CHLC) - Hospital Curry Cabral, 1069-166 Lisboa, Portugal.
Ann Hepatol. 2018 Mar 1;17(2):335-338. doi: 10.5604/01.3001.0010.8667.
Hepatitis E in industrialized countries is mainly associated with genotype 3 hepatitis E virus (HEV) and normally causes a sporadic self-limiting disease in immunocompetent individuals. Unlike genotype 3, genotypes 1 and 2 circulate in developing countries, produce severe disease and occur in the epidemic form. Hepatitis E occurring in travellers returning from endemic areas in developing countries is not a novel epidemiological occurrence, however the vast majority of cases remain to be genetically studied. The present study describes two cases of severe acute hepatitis E that required hospitalization for 6 and 9 days in two individuals of Indian nationality that had recently migrated to Portugal to work. The retrieved HEV sequences both belonged to genotype 1 and had a high degree of nucleotide sequence identity, clustering with strains isolated in India and Nepal, in 2013 and 2014. Confirmed HEV genotypes of increased pathogenicity like genotype 1 are being introduced into otherwise naïve populations of industrialized countries such as European countries with consequences difficult to predict. As far as we know the present study is the first in Portugal to describe and genetically characterize imported cases of hepatitis E infection caused by HEV genotype 1.
在工业化国家，戊型肝炎主要与基因型 3 戊型肝炎病毒（HEV）相关，通常在免疫功能正常的个体中引起散发性自限性疾病。与基因型 3 不同，基因型 1 和 2 在发展中国家流行，可导致严重疾病，并以流行形式出现。在从发展中国家流行地区返回的旅行者中发生的戊型肝炎并不是一种新的流行病学现象，然而，绝大多数病例仍有待进行基因研究。本研究描述了两例严重急性戊型肝炎病例，两名印度籍移民到葡萄牙工作的个体分别住院 6 天和 9 天。所获得的 HEV 序列均属于基因型 1，核苷酸序列高度同源，与 2013 年和 2014 年在印度和尼泊尔分离的菌株聚类。像基因型 1 这样具有较高致病性的确认 HEV 基因型正在被引入工业化国家（如欧洲国家）原本没有接触过的人群中，其后果难以预测。据我们所知，本研究是葡萄牙首次描述和基因特征分析由基因型 1 引起的输入性戊型肝炎感染病例。
