High clinical manifestation rate in an imported outbreak of hepatitis E genotype 1 infection in a german group of travellers returning from India



Título del documento: High clinical manifestation rate in an imported outbreak of hepatitis E genotype 1 infection in a german group of travellers returning from India
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000406025
ISSN: 1665-2681
Autores: 1
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2
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Instituciones: 1University Medical Center Hamburg-Eppendorf, Department of Medicine, Hamburgo. Alemania
2German Center for Infection Research, Hamburgo. Alemania
3University Medical Center Hamburg-Eppendorf, Institute for Microbiology, Hamburgo. Alemania
Año:
Periodo: Ene-Feb
Volumen: 16
Número: 1
Paginación: 57-57
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Aplicado
Resumen en inglés There are only few reports about travel-associated, imported tropical hepatitis E virus (HEV) genotype 1 infections within Western travellers. We describe the clinical course of a single outbreak of hepatitis E in a German travellers group returning from India and compare the results of two commercial HEV-seroassays. Material and methods. After identifying hepatitis E in an index patient returning from a journey to India all 24 members of this journey were tested for anti-HEV-IgG and IgM using two commercial seroassays (Wantai and Mikrogen), for HEV-RNA by PCR and HEV-Ag by an antigen-assay (Wantai). Results. 5/24 (21%) individuals were viraemic with viral loads between 580-4,800,000 IU/mL. Bilirubin and ALT levels in these patients ranged from 1.3-14.9 mg/dL (mean 7.3 mg/dL, SD 5.6 mg/dL) and 151-4,820 U/L (mean 1,832U/L, SD 1842U/L), respectively and showed significant correlations with viral loads (r = 0.863, p < 0.001; r = 0.890, p < 0.001). No risk factor for food-borne HEV-transmission was identified. All viraemic patients (5/5) tested positive for anti-HEV-IgG and IgM in the Wantai-assay but only 4/5 in the Mikrogen-assay. Wantai-HEV-antigen-assay was negative in all patients. Six months later all previously viraemic patients tested positive for anti-HEV-IgG and negative for IgM in both assays. However, two non-viremic individuals who initially tested Wantai-IgM-positive stayed positive indicating false positive results. Conclusions. Despite the exact number of exposed individuals could not be determined HEV genotype 1 infections have a high manifestation rate of more than 20%.The Wantai-antigen-test failed, the Wantai-IgMrapid-test and the Mikrogen-IgM-recomblot showed a better performance but still they cannot replace real-time PCR for diagnosing ongoing HEV-infections
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Gastroenterología,
Salud pública,
Hepatitis E,
Infecciones,
Viajeros,
Serología,
Manifestaciones clínicas,
Pruebas diagnósticas
Keyword: Medicine,
Diagnosis,
Gastroenterology,
Public health,
Hepatitis E,
Infections,
Travelers,
Serology,
Clinical manifestations,
Diagnostic tests
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