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Journal of Clinical Microbiology, November 2002, p. 4197-4202, Vol. 40, No. 11
0095-1137/02/$04.00+0 DOI: 10.1128/JCM.40.11.4197-4202.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Heterogeneity and Seroprevalence of a Newly Identified Avian Hepatitis E Virus from Chickens in the United States
F. F. Huang,1 G. Haqshenas,1 H. L. Shivaprasad,2 D. K. Guenette,1 P. R. Woolcock,2 C. T. Larsen,1 F. W. Pierson,1 F. Elvinger,1 T. E. Toth,1 and X. J. Meng1*
Center for Molecular Medicine and Infectious Diseases, College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061-0342,1
California Animal Health & Food Safety Laboratory System, Fresno Branch, School of Veterinary Medicine, University of California Davis, Fresno, California 937252
Received 12 April 2002/
Returned for modification 6 July 2002/
Accepted 4 August 2002

ABSTRACT
We recently identified and characterized a novel virus, designated
avian hepatitis E virus (avian HEV), from chickens with hepatitis-splenomegaly
syndrome (HS syndrome) in the United States. Avian HEV is genetically
related to but distinct from human and swine HEVs. To determine
the extent of genetic variation and the seroprevalence of avian
HEV infection in chicken flocks, we genetically identified and
characterized 11 additional avian HEV isolates from chickens
with HS syndrome and assessed the prevalence of avian HEV antibodies
from a total of 1,276 chickens of different ages and breeds
from 76 different flocks in five states (California, Colorado,
Connecticut, Virginia, and Wisconsin). An enzyme-linked immunosorbent
assay using a truncated recombinant avian HEV ORF2 antigen was
developed and used to determine avian HEV seroprevalence. About
71% of chicken flocks and 30% of chickens tested in the study
were positive for antibodies to avian HEV. About 17% of chickens
younger than 18 weeks were seropositive, whereas about 36% of
adult chickens were seropositive. By using a reverse transcription-PCR
(RT-PCR) assay, we tested 21 bile samples from chickens with
HS syndrome in California, Connecticut, New York, and Wisconsin
for the presence of avian HEV RNA. Of the 21 bile samples, 12
were positive for 30- to 35-nm HEV-like virus particles by electron
microscopy (EM). A total of 11 of the 12 EM-positive bile samples
and 6 of the 9 EM-negative bile samples were positive for avian
HEV RNA by RT-PCR. The sequences of a 372-bp region within the
helicase gene of 11 avian HEV isolates were determined. Sequence
analyses revealed that the 11 field isolates of avian HEV had
78 to 100% nucleotide sequence identities to each other, 79
to 88% identities to the prototype avian HEV, 76 to 80% identities
to chicken big liver and spleen disease virus, and 56 to 61%
identities to other known strains of human and swine HEV. The
data from this study indicated that, like swine and human HEVs,
avian HEV isolates are genetically heterogenic and that avian
HEV infection is enzoonotic in chicken flocks in the United
States.

INTRODUCTION
Human hepatitis E is an important public health disease in many
developing countries, and sporadic cases of hepatitis E have
also been reported in some industrialized countries including
the United States (
1,
16,
20,
24,
30-
33,
38,
40-
41,
44,
45).
The disease is generally transmitted by the fecal-oral route
via contaminated water (
1,
10,
22,
36). Hepatitis E virus (HEV),
the causative agent of hepatitis E, is a positive-sense, single-stranded
RNA virus (
1,
7,
16,
18). The HEV genome contains three open
reading frames (ORFs). ORF1 encodes viral nonstructural proteins,
ORF2 encodes the putative capsid protein, and ORF3 encodes a
small protein that may be involved in virus replication (
1,
42,
44,
45,
49).
Seroepidemiological studies revealed that anti-HEV antibodies are present in numerous animal species, including pigs, rodents, chickens, dogs, cows, sheep, and goats, from both developing and industrialized countries (2, 3, 8, 19, 23, 29-31, 48; N. T. Tien, H. T. Clayson, H. B. Khiem, P. K. Sac, A. L. Corwin, K. S. Myint, and D. W. Vaughn, Abstract, Am. Trop. Med. Hyg. 57:211, 1997; S. A. Tsarev, M. P. Shrestha, J. He, R. M. Scott, D. W. Vaughn, E. Clayson, S. Gigliotti, C. F. Longer, and B. L. Innis, Abstract, Am. J. Trop. Med. Hyg. 59:242, 1998), suggesting that these animal species have been exposed to HEV-like virus. The first animal strain of HEV, swine HEV, was identified and characterized in 1997 from a pig in the United States (26). The U.S. swine HEV strain is genetically more closely related to two U.S. human HEV strains than to strains of HEV from other geographic regions (7, 26-28, 38, 39). Recently, many swine HEV strains have been genetically identified from pigs in the United States, Taiwan, The Netherlands, and Japan (17, 18, 34, 36, 43, 47, 48). Phylogenetic analyses revealed that, like human HEV (25, 38, 39, 44, 45), these strains of swine HEV from different geographic regions are also genetically heterogenic (17, 18, 34, 36, 43, 47, 48). Interspecies HEV transmission has been documented: a U.S. strain of human HEV infected pigs, and swine HEV infected nonhuman primates (11, 28, 46). Recent seroepidemiological studies indicated that individuals working with swine have higher risks of HEV infection (6, 15, 21, 29, 32). Taken together, these data strongly suggest that HEV is zoonotic and that there exist animal reservoirs for HEV.
More recently, another animal strain of HEV, designated avian HEV, has been genetically identified and characterized from chickens with hepatitis-splenomegaly (HS) syndrome in the United States (13, 14). The newly discovered avian HEV is genetically related to but distinct from other known HEV strains. Unlike swine HEV, which causes only subclinical infection in pigs, avian HEV is associated with HS syndrome in chickens (13, 14). HS syndrome in chickens was first described in 1991 in western Canada and is now recognized in eastern Canada and the United States (37). HS syndrome is characterized by above-normal mortality in laying hens at the age of 30 to 72 weeks. Infected birds usually have red fluid in their abdomens and enlarged livers and spleens (37). Microscopically, liver lesions vary from multifocal patches to areas of extensive hepatic necrosis and hemorrhage (13, 37). We have now successfully reproduced HS syndrome in adult specific-pathogen-free (SPF) chickens by infection with avian HEV (F. F. Huang et al., unpublished data). Since avian HEV is a novel virus and only one strain of avian HEV has been identified in the United States thus far, the molecular and serological epidemiology of this new virus is not known. In this study, we genetically characterized 11 additional avian HEV isolates from chickens with HS syndrome in the United States and assessed the prevalence of anti-HEV antibodies in chickens of different ages from five different states.

MATERIALS AND METHODS
Clinical specimens.
Bile samples used for genetic identification and characterization
of avian HEV isolates in this study were collected from 21 chickens
with HS syndrome in California, Connecticut, New York, and Wisconsin
from 1993 to 2001 (Table
1). Twelve samples were positive by
electron microscopy (EM) examination for 30- to 35-nm avian
HEV-like virus particles, and nine samples were negative by
EM.
Serum samples used for the seroprevalence study were collected
from 1,276 chickens of different ages from 76 chicken flocks
located in California, Colorado, Connecticut, Virginia, and
Wisconsin (see Table
2).
ELISA to detect anti-HEV in chickens.
A truncated recombinant ORF2 protein of avian HEV was expressed
in
Escherichia coli and purified by affinity chromatography
(
14). The purified avian HEV truncated ORF2 protein was used
as the antigen to standardize an enzyme-linked immunosorbent
assay (ELISA) to detect anti-HEV immunoglobulin G (IgG) antibodies
in chickens essentially as previously described for the ELISAs
used to detect anti-HEV antibodies in humans and swine (
26-
29,
32). The purified ORF2 antigen of avian HEV was coated onto
96-well plates. A horseradish peroxidase-conjugated rabbit anti-chicken
IgG (Sigma Chemical Co., St. Louis, Mo.) was used as the secondary
antibody. The cutoff value was determined on the basis of the
optical density (OD) values of the 85 adult chicken sera collected
from a commercial SPF flock (Charles River Laboratory Inc.,
Wilmington, Mass.) and from two high-health university research
flocks. The cutoff value was set conservatively at 0.30, which
is about 6 standard deviations above the mean OD value of the
normal chicken sera. All sera from 76 chicken flocks in the
five states were tested in duplicate at a dilution of 1:100
in 0.05% Tween-phosphate-buffered saline blocking buffer containing
5% nonfat dried milk and 5% goat sera. Sera from SPF chickens
were used for negative controls, and convalescent-phase sera
from SPF chickens experimentally infected with avian HEV were
included as positive controls. In general, the OD values for
the positive sera from experimentally infected chickens were
above 1.0 whereas those from naturally infected birds were about
0.5.
RT-PCR assay for detection of field isolates of avian HEV.
To identify field isolates of avian HEV, it was necessary to develop a reverse transcription-PCR (RT-PCR) assay capable of detecting avian HEV strains with significant genetic variation. Our previous studies showed that the helicase gene is the most highly conserved between avian HEV and other known strains of HEV (13, 14); therefore, primers for RT-PCR were targeted in the helicase gene region. A short stretch of the helicase gene sequence of the Australian chicken big liver and spleen disease virus (BLSV) has been reported, and it had about 80% nucleotide sequence identity to avian HEV (13, 35). The primers were selected from conserved helicase gene regions based on a sequence alignment of BLSV (35), the prototype strain of avian HEV (13), and other HEV strains. The primer sequences were of BLSV origin: forward primer (B1), 5'-GCTAGGCGACCCGCACCAGAT-3'; reverse primer (B2), 5' GGTTAGCGCAACAATAGCATG-3'. The RT-PCR assay with this set of primers was able to detect the prototype strain of avian HEV and was therefore used to identify additional field isolates of avian HEV. Briefly, total RNAs were extracted with TriZol Reagent from 100 µl of bile samples from each of the 21 chickens with HS syndrome. Total RNAs were resuspended in DNase- and RNase-free water. RT was performed at 42°C for 60 min with Superscript II reverse transcriptase (GIBCO-BRL) using the reverse primer B2. A 5-µl volume of the resulting cDNA was amplified using AmpliTaq Gold DNA polymerase (Perkin-Elmer). The PCR parameters included a denaturation at 95°C for 9 min followed by 39 cycles of denaturation for 1 min at 94°C, annealing for 1 min at 42°C, and extension for 1 min at 72°C, with one final incubation at 72°C for 7 min. Negative and positive controls were included in each set of RT-PCR amplifications. The negative control was a water sample treated in the same way as the bile samples. The positive control was a fecal stock of avian HEV with a titer of about 104 genomic equivalents per ml.
Nucleotide sequencing.
The expected PCR products of field isolates of avian HEV were purified using the glassmilk procedure with a GENECLEAN kit (Bio 101 Inc., Carlsbad, Calif.). PCR products amplified from 11 chicken bile samples from chicken flocks in four states were directly sequenced at the Virginia Tech DNA Sequencing Facility. Sequences of the PCR products were determined for both DNA strands.
Development of a more sensitive RT-PCR assay for the detection of avian HEV.
The RT-PCR assay described above was based primarily on the helicase gene of BLSV (35) and the prototype strain of avian HEV (12). Therefore, it was possible that more genetically divergent field isolates of avian HEV would not be detected by the RT-PCR assay. With the availability of the sequence information from 11 additional field isolates of avian HEV, we attempted to develop a more sensitive RT-PCR assay that is capable of detecting genetically divergent field strains of avian HEV. Briefly, the resulting sequences of the 11 field isolates of avian HEV and the prototype strain of avian HEV were aligned and a set of degenerate primers were designed based on the sequence alignment: forward primer (helicase F), 5'-TGGCGCACC(T)GTT(A)TCC(T)CACCG-3'; reverse primer (helicase R), 5'-CCTCA(G)TGGACCGTA(T)ATCGACCC-3'. The parameters for the RT-PCR assay with the degenerate primers helicase F and helicase R included a denaturation at 95°C for 9 min followed by 39 cycles of denaturation for 50 s at 94°C, annealing for 50 s at 46°C, and extension for 50 s at 72°C, with one final incubation at 72°C for 7 min. Positive and negative controls were the same as the ones described above.
Sequence and phylogenetic analyses.
The primer sequences used to amplify the avian HEV isolates were excluded from the sequence and phylogenetic analyses. The resulting 330-bp sequences of the helicase genes of the 11 field isolates of avian HEV were analyzed and compared with the corresponding regions of the prototype avian HEV, BLSV, and other known strains of swine and human HEVs available in the GenBank database by the MacVector computer program (Oxford Molecular Inc.). Phylogenetic analysis was conducted with the aid of the PAUP program (David Swofford, Smithsonian Institute, Washington, D.C., distributed by Sinauer Associate Inc. Sunderland, Mass.). A heuristic search with 1,000 replicates was used to produce a phylogenetic tree.
The geographic origins and the GenBank accession numbers of the nucleotide sequences of the HEV strains used in the phylogenetic and sequence analyses are as follows: JRA1 (Japan, AP003430), SWJ570 (Japan, AB073912), swine HEV (United States, AF082843), US1 (United States, AF060668), US2 (United States, AF060669), T1 (China, AJ272108), Burma (Burma, M73218), Myanmar (Myanmar, D10330), Hyderabad (India, AF076239), Madras (India, X99441), Nepal (Nepal, AF020486), hev037 (India, X98292), Xinjiang (China, D11092), Uigh179 (China, D11093), Hetian (China, L08816), Sar-55 (Pakistan, M80581), and Mexico (Mexico, M74506).
Nucleotide sequence accession numbers.
The sequences of the helicase gene region of the 11 avian HEV isolates have been deposited in the GenBank database with accession numbers AF531898 through AF531908.

RESULTS AND DISCUSSION
Avian HEV is enzoonotic in chicken flocks in the United States.
The prevalence of anti-HEV in commercial pig herds in the United
States has been reported previously (
26,
29). Seropositivity
for swine HEV in pigs is age dependent: most pigs younger than
2 months were seronegative, whereas most pigs older than 3 months
were seropositive (
26,
29). In this study, we tested 1,276 serum
samples from chickens of various ages in five states for the
presence of antibodies to avian HEV (Table
2). The percentage
of seropositive chickens varied greatly from flock to flock,
ranging from 0% to 100%. Of the 76 flocks tested, 54 (71%) were
positive for anti-HEV IgG. Similar to swine HEV, the prevalence
of avian HEV antibodies in adult chickens (older than 18 weeks)
was higher than that in younger ones: about 17% of chickens
younger than 18 weeks were seropositive, whereas about 36% of
adult chickens were seropositive. However, the age-related difference
in avian HEV seropositivity in chickens is less definitive than
that previously observed in swine (data not shown). Several
flocks of adult chickens were also found to be negative for
antibodies to avian HEV. It is possible that these negative
flocks may have better biosecurity measures that could prevent
the transmission of avian HEV. The antibodies to avian HEV detected
in some 1-day-old chickens are probably maternal antibodies,
which usually wane at about 3 weeks of age. So far, avian HEV
has been isolated only from chickens in the United States. The
BLSV identified in Australia is genetically and antigenically
related to HEV (
12,
13,
14), and it is likely that the big liver
and spleen disease in Australia (
4,
5,
12,
35) and the HS syndrome
in North America (
13,
14,
37) are caused by variant strains
of the same virus.
Detection of avian HEV by RT-PCR.
Twenty-one bile samples from chickens with HS syndrome (increased mortality and decreased egg production) were examined for avian HEV-like virus particles by EM and for avian HEV RNA by RT-PCR. Twelve of them were positive for 30- to 35-nm virus particles by EM. RT-PCR results with the B1 and B2 primers, based primarily on BLSV sequence, showed that 7 of the 12 EM-positive bile samples and 4 of the 9 EM-negative bile samples were positive for avian HEV RNA (Table 1). The bile samples that tested negative with the B1 and B2 primers were further tested by a more sensitive RT-PCR assay with degenerate primers helicase F and helicase R based on the sequence alignment of 11 avian HEV isolates and the prototype avian HEV. Another four EM-positive and two EM-negative bile samples turned out to be positive for avian HEV RNA (Table 1). The six additional positive bile samples detected by the more sensitive RT-PCR assay with the degenerate primers were confirmed by sequencing (data not shown). Overall, 11 of 12 EM-positive and 6 of 9 EM-negative bile samples from chickens with HS syndrome were positive for avian HEV RNA by RT-PCR, indicating that RT-PCR is a more sensitive method than EM for detection of avian HEV. The RT-PCR assay developed in this study should be very useful for future avian HEV studies.
Field isolates of avian HEV are genetically heterogenic.
It has been reported that swine and human HEV isolates from different geographic regions are genetically heterogenic (17, 39, 44). The extent of genetic variation of avian HEV is not known, since only one strain of avian HEV has been characterized. The PCR products from the 11 avian HEV isolates amplified by the B1 and B2 primers were sequenced. The 330-bp sequences within the helicase genes were analyzed and compared to each other and to the corresponding regions of the prototype avian HEV, BLSV, and other known strains of HEV. Sequence analyses revealed that the avian HEV isolates identified in this study had 78 to 100% nucleotide sequence identities to each other, 79 to 88% identities to the prototype avian HEV, 76 to 80% identities to BLSV, and 56 to 61% identities to other known strains of human and swine HEVs (Table 3). At the amino acid sequence level, the 11 avian HEV isolates identified in this study displayed 90 to 100% sequence identities to each other, 89 to 98% identities to the prototype avian HEV, 78 to 79% identities to BLSV, and 55 to 62% identities to other known strains of human and swine HEVs.
View this table:
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TABLE 3. Pairwise comparison of the nucleotide sequences of the partial helicase gene of 11 avian HEV isolates identified in this study and other virusesa
|
Phylogenetic analyses revealed that all the U.S. avian HEV isolates
identified in this study clustered with the prototype avian
HEV and BLSV but are distinct from other known strains of HEV
(Fig.
1). Minor branches, indicating heterogeneity, also exist
among avian HEV isolates. Whether avian HEV represents a fifth
HEV genotype or belongs to a separate genus remains to be determined.
An increasing amount of data suggested that HEV infection is
zoonotic. Recently it was reported that swine veterinarians
(
29,
32) and other pig handlers (
6) may be at higher risk of
HEV infection than normal blood donors. Therefore, it will be
important to determine if avian HEV infection is also zoonotic
and if chicken handlers have a higher risk of HEV infection,
as swine handlers do.

ACKNOWLEDGMENTS
We thank the Virginia Tech DNA Sequencing Facility for assistance
with DNA sequencing.
This study was supported in part by a grant from the USDA-NRICGP program NRI 2002-35204-12531 and by grants from the National Institutes of Health (AI01653, AI46505, and AI50611).

FOOTNOTES
* Corresponding author. Mailing address: Center for Molecular Medicine and Infectious Diseases, Virginia Polytechnic Institute and State University, 1410 Price's Fork Rd., Blacksburg, VA 24061-0342. Phone: (540) 231-6912. Fax: (540) 231-3426. E-mail:
xjmeng{at}vt.edu.


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Journal of Clinical Microbiology, November 2002, p. 4197-4202, Vol. 40, No. 11
0095-1137/02/$04.00+0 DOI: 10.1128/JCM.40.11.4197-4202.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
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