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Hepatitis E in Italy: a long-term prospective study.
J Hepatol. 2011 Jan; 54(1):34-40.JH

Abstract

BACKGROUND & AIMS

In developed countries, hepatitis E is usually associated with travelling to endemic areas, but a growing number of sporadic cases are also seen in patients with no travel history. The aim of this study was to assess the impact and the molecular epidemiology of hepatitis E in Italy.

METHODS

Between January 1994 and October 2009, we analyzed 651 patients with acute non-A-C hepatitis. Diagnosis of hepatitis E was based on the presence of IgM anti-HEV and/or the detection of HEV RNA by RT-PCR. Viral isolates were sequenced and phylogenetically characterized.

RESULTS

A total of 134 out of 651 (20.6%) patients tested had acute hepatitis E. All were anti-HEV IgM and IgG positive and 96 (71.6%) were also positive for HEV RNA. Moreover, 39 (6%) patients were anti-HEV IgG positive but negative for both IgM anti-HEV and HEV RNA. A total of 109 (81.3%) patients developed hepatitis E travelling to endemic areas, 3 (2.3%) acquired intra-familial infection from relatives who developed travel-related disease, while 22 (16.4%) patients denied having travelled abroad. In all patients, acute disease had a self-limited course with ALT normalization within 3-6 weeks. Phylogenetic analysis of 39 isolates from patients with a travel-related disease showed that they belonged to genotype 1, while sequences from five patients with autochthonous hepatitis E belonged to genotype 3.

CONCLUSIONS

In Italy, most cases of hepatitis E are travel related, caused by viral genotype 1, while autochthonous cases are caused by genotype 3. The prevalence of genotype 3 among pigs and boars suggests that HEV infection may have zoonotic origins in non-endemic countries.

Authors+Show Affiliations

Dipartimento di Sanità Pubblica-Microbiologia-Virologia, Università degli Studi di Milano, Via C. Pascal 36, 20133 Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20888660

Citation

Romanò, Luisa, et al. "Hepatitis E in Italy: a Long-term Prospective Study." Journal of Hepatology, vol. 54, no. 1, 2011, pp. 34-40.
Romanò L, Paladini S, Tagliacarne C, et al. Hepatitis E in Italy: a long-term prospective study. J Hepatol. 2011;54(1):34-40.
Romanò, L., Paladini, S., Tagliacarne, C., Canuti, M., Bianchi, S., & Zanetti, A. R. (2011). Hepatitis E in Italy: a long-term prospective study. Journal of Hepatology, 54(1), 34-40. https://doi.org/10.1016/j.jhep.2010.06.017
Romanò L, et al. Hepatitis E in Italy: a Long-term Prospective Study. J Hepatol. 2011;54(1):34-40. PubMed PMID: 20888660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatitis E in Italy: a long-term prospective study. AU - Romanò,Luisa, AU - Paladini,Sara, AU - Tagliacarne,Catia, AU - Canuti,Marta, AU - Bianchi,Silvia, AU - Zanetti,Alessandro Remo, Y1 - 2010/08/20/ PY - 2010/02/05/received PY - 2010/06/07/revised PY - 2010/06/09/accepted PY - 2010/10/5/entrez PY - 2010/10/5/pubmed PY - 2011/3/25/medline SP - 34 EP - 40 JF - Journal of hepatology JO - J Hepatol VL - 54 IS - 1 N2 - BACKGROUND & AIMS: In developed countries, hepatitis E is usually associated with travelling to endemic areas, but a growing number of sporadic cases are also seen in patients with no travel history. The aim of this study was to assess the impact and the molecular epidemiology of hepatitis E in Italy. METHODS: Between January 1994 and October 2009, we analyzed 651 patients with acute non-A-C hepatitis. Diagnosis of hepatitis E was based on the presence of IgM anti-HEV and/or the detection of HEV RNA by RT-PCR. Viral isolates were sequenced and phylogenetically characterized. RESULTS: A total of 134 out of 651 (20.6%) patients tested had acute hepatitis E. All were anti-HEV IgM and IgG positive and 96 (71.6%) were also positive for HEV RNA. Moreover, 39 (6%) patients were anti-HEV IgG positive but negative for both IgM anti-HEV and HEV RNA. A total of 109 (81.3%) patients developed hepatitis E travelling to endemic areas, 3 (2.3%) acquired intra-familial infection from relatives who developed travel-related disease, while 22 (16.4%) patients denied having travelled abroad. In all patients, acute disease had a self-limited course with ALT normalization within 3-6 weeks. Phylogenetic analysis of 39 isolates from patients with a travel-related disease showed that they belonged to genotype 1, while sequences from five patients with autochthonous hepatitis E belonged to genotype 3. CONCLUSIONS: In Italy, most cases of hepatitis E are travel related, caused by viral genotype 1, while autochthonous cases are caused by genotype 3. The prevalence of genotype 3 among pigs and boars suggests that HEV infection may have zoonotic origins in non-endemic countries. SN - 1600-0641 UR - https://www.unboundmedicine.com/medline/citation/20888660/Hepatitis_E_in_Italy:_a_long_term_prospective_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8278(10)00707-5 DB - PRIME DP - Unbound Medicine ER -