This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mizuo, H.
Right arrow Articles by Okamoto, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mizuo, H.
Right arrow Articles by Okamoto, H.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, September 2002, p. 3209-3218, Vol. 40, No. 9
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.9.3209-3218.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Polyphyletic Strains of Hepatitis E Virus Are Responsible for Sporadic Cases of Acute Hepatitis in Japan

Hitoshi Mizuo,1 Kazuyuki Suzuki,2 Yasuhiro Takikawa,2 Yoshiki Sugai,3 Hajime Tokita,4 Yoshihiro Akahane,5 Keiichi Itoh,6 Yuhko Gotanda,7 Masaharu Takahashi,8 Tsutomu Nishizawa,8 and Hiroaki Okamoto8*

Department of Internal Medicine, Kin-ikyo Chuo Hospital, Hokkaido 007-0870,1 First Department of Internal Medicine, Iwate Medical University, Iwate-Ken 020-8505,2 Department of Internal Medicine, Iwaki Kyoritsu General Hospital, Fukushima-Ken 973-8555,3 Department of Gastroenterology, National Tokyo Hospital, Tokyo 204-0023,4 First Department of Internal Medicine, Yamanashi Medical University, Yamanashi-Ken 409-3898,5 Japanese Red Cross Yamaguchi Blood Center, Yamaguchi-Ken 753-8534,6 Japanese Red Cross Saitama Blood Center, Saitama-Ken 338-0001,7 Immunology Division and Division of Molecular Virology, Jichi Medical School, Tochigi-Ken 329-0498, Japan8

Received 3 April 2002/ Returned for modification 23 May 2002/ Accepted 15 June 2002

Among 87 patients who were previously treated for acute hepatitis of unknown etiology between 1992 and 2001 at five hospitals in Japan, 11 (13%) patients were positive for immunoglobulin M-class antibodies to hepatitis E virus (HEV) by enzyme immunoassay and had detectable HEV RNA by reverse transcription-PCR with two independent sets of primers derived from well-conserved genomic areas in open reading frames 1 and 2. Clinical HEV infection was significantly associated with male sex (9 of 11 versus 29 of 76 patients [P < 0.01]) and older age (52 ± 11 [mean ± standard deviation] versus 41 ± 17 years [P < 0.05]), and its prevalence differed by geographic region (6 to 25%), with a higher rate in the northern part of Japan. At admission, the 11 patients with HEV-associated hepatitis had elevated alanine aminotransferase levels of 914 to 4,850 IU/liter, and all but 1 had elevated bilirubin levels of 1.5 to 24.0 mg/dl. The 11 HEV isolates were of genotype III or IV and were segregated into three groups with intergroup nucleotide differences of 9.5 to 22.0%. Phylogenetic analysis revealed that four isolates of genotype III were closely related to a Japanese isolate, while the other four isolates of the same genotype were nearest those from the United States. The remaining three isolates were close to known isolates of genotype IV in China and Taiwan but shared less than 88% identity with them. These results indicate that multiple genotypes of HEV cocirculate in Japan and contribute to the development of sporadic acute hepatitis, with the prevalence differing by age, sex, and geographic region.

* Corresponding author. Mailing address: Immunology Division and Division of Molecular Virology, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi-Machi, Tochigi-Ken 329-0498, Japan. Phone: 81-285-58-7404. Fax: 81-285-44-1557. E-mail: hokamoto{at}jichi.ac.jp.

Journal of Clinical Microbiology, September 2002, p. 3209-3218, Vol. 40, No. 9
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.9.3209-3218.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Takahashi, M., Tanaka, T., Azuma, M., Kusano, E., Aikawa, T., Shibayama, T., Yazaki, Y., Mizuo, H., Inoue, J., Okamoto, H. (2007). Prolonged Fecal Shedding of Hepatitis E Virus (HEV) during Sporadic Acute Hepatitis E: Evaluation of Infectivity of HEV in Fecal Specimens in a Cell Culture System. J. Clin. Microbiol. 45: 3671-3679 [Abstract] [Full Text]  
  • Tanaka, T., Takahashi, M., Kusano, E., Okamoto, H. (2007). Development and evaluation of an efficient cell-culture system for Hepatitis E virus. J. Gen. Virol. 88: 903-911 [Abstract] [Full Text]  
  • Inoue, J., Takahashi, M., Ito, K., Shimosegawa, T., Okamoto, H. (2006). Analysis of human and swine hepatitis E virus (HEV) isolates of genotype 3 in Japan that are only 81-83 % similar to reported HEV isolates of the same genotype over the entire genome.. J. Gen. Virol. 87: 2363-2369 [Abstract] [Full Text]  
  • Nishizawa, T., Takahashi, M., Endo, K., Fujiwara, S., Sakuma, N., Kawazuma, F., Sakamoto, H., Sato, Y., Bando, M., Okamoto, H. (2005). Analysis of the full-length genome of hepatitis E virus isolates obtained from wild boars in Japan. J. Gen. Virol. 86: 3321-3326 [Abstract] [Full Text]  
  • Takahashi, M., Nishizawa, T., Tanaka, T., Tsatsralt-Od, B., Inoue, J., Okamoto, H. (2005). Correlation between positivity for immunoglobulin A antibodies and viraemia of swine hepatitis E virus observed among farm pigs in Japan. J. Gen. Virol. 86: 1807-1813 [Abstract] [Full Text]  
  • Takahashi, M., Kusakai, S., Mizuo, H., Suzuki, K., Fujimura, K., Masuko, K., Sugai, Y., Aikawa, T., Nishizawa, T., Okamoto, H. (2005). Simultaneous Detection of Immunoglobulin A (IgA) and IgM Antibodies against Hepatitis E Virus (HEV) Is Highly Specific for Diagnosis of Acute HEV Infection. J. Clin. Microbiol. 43: 49-56 [Abstract] [Full Text]  
  • Sonoda, H., Abe, M., Sugimoto, T., Sato, Y., Bando, M., Fukui, E., Mizuo, H., Takahashi, M., Nishizawa, T., Okamoto, H. (2004). Prevalence of Hepatitis E Virus (HEV) Infection in Wild Boars and Deer and Genetic Identification of a Genotype 3 HEV from a Boar in Japan. J. Clin. Microbiol. 42: 5371-5374 [Abstract] [Full Text]  
  • Koizumi, Y., Isoda, N., Sato, Y., Iwaki, T., Ono, K., Ido, K., Sugano, K., Takahashi, M., Nishizawa, T., Okamoto, H. (2004). Infection of a Japanese Patient by Genotype 4 Hepatitis E Virus While Traveling in Vietnam. J. Clin. Microbiol. 42: 3883-3885 [Abstract] [Full Text]  
  • Takahashi, M., Nishizawa, T., Gotanda, Y., Tsuda, F., Komatsu, F., Kawabata, T., Hasegawa, K., Altankhuu, M., Chimedregzen, U., Narantuya, L., Hoshino, H., Hino, K., Kagawa, Y., Okamoto, H. (2004). High Prevalence of Antibodies to Hepatitis A and E Viruses and Viremia of Hepatitis B, C, and D Viruses among Apparently Healthy Populations in Mongolia. CVI 11: 392-398 [Abstract] [Full Text]  
  • Shrestha, S. M., Shrestha, S., Tsuda, F., Nishizawa, T., Takahashi, M., Gotanda, Y., Okamoto, H. (2004). Genetic changes in hepatitis E virus of subtype 1a in patients with sporadic acute hepatitis E in Kathmandu, Nepal, from 1997 to 2002. J. Gen. Virol. 85: 97-104 [Abstract] [Full Text]  
  • Yazaki, Y., Mizuo, H., Takahashi, M., Nishizawa, T., Sasaki, N., Gotanda, Y., Okamoto, H. (2003). Sporadic acute or fulminant hepatitis E in Hokkaido, Japan, may be food-borne, as suggested by the presence of hepatitis E virus in pig liver as food. J. Gen. Virol. 84: 2351-2357 [Abstract] [Full Text]  
  • Nishizawa, T., Takahashi, M., Mizuo, H., Miyajima, H., Gotanda, Y., Okamoto, H. (2003). Characterization of Japanese swine and human hepatitis E virus isolates of genotype IV with 99 % identity over the entire genome. J. Gen. Virol. 84: 1245-1251 [Abstract] [Full Text]  
  • Takahashi, M., Nishizawa, T., Miyajima, H., Gotanda, Y., Iita, T., Tsuda, F., Okamoto, H. (2003). Swine hepatitis E virus strains in Japan form four phylogenetic clusters comparable with those of Japanese isolates of human hepatitis E virus. J. Gen. Virol. 84: 851-862 [Abstract] [Full Text]  
  • Takahashi, M., Nishizawa, T., Okamoto, H. (2003). Identification of a Genotype III Swine Hepatitis E Virus That Was Isolated from a Japanese Pig Born in 1990 and That Is Most Closely Related to Japanese Isolates of Human Hepatitis E Virus. J. Clin. Microbiol. 41: 1342-1343 [Full Text]  
  • Tokita, H., Harada, H., Gotanda, Y., Takahashi, M., Nishizawa, T., Okamoto, H. (2003). Molecular and serological characterization of sporadic acute hepatitis E in a Japanese patient infected with a genotype III hepatitis E virus in 1993. J. Gen. Virol. 84: 421-427 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»