Prevalence of hepatitis viruses in patients with acute hepatitis and characterization of the detected genotype 4 hepatitis E virus sequences in Mongolia

• Published in: Journal of medical virology 2016-02, Vol.88 (2), p.282-291
• Main Authors: Tsatsralt-Od, Bira, Baasanjav, Nachin, Nyamkhuu, Dulmaa, Ohnishi, Hiroshi, Takahashi, Masaharu, Okamoto, Hiroaki
• Format: Article
• Language: English
• Subjects: acute hepatitis; Adolescent; Adult; Female; full genome; Genotype; Genotype & phenotype; genotype 4; Hepatitis; Hepatitis B virus; Hepatitis E virus; Hepatitis E virus - classification; Hepatitis E virus - genetics; Hepatitis E virus - isolation & purification; Hepatitis, Viral, Human - epidemiology; Hepatitis, Viral, Human - virology; Humans; Male; Mongolia; Mongolia - epidemiology; phylogenetic tree; Prevalence; Sequence Analysis, DNA; Virology; Young Adult
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.24319

Hepatitis E is considered to be a worldwide public health problem. Although the prevalence of hepatitis E virus (HEV) antibodies in healthy individuals is noted to be 11%, no patients with acute hepatitis E have previously been identified in Mongolia. Three hundred two consecutive patients (183 males and 119 females; median age of 22.0 [Interquartile range: 18.3–25.0] years) who were clinically diagnosed with sporadic acute hepatitis during 2012–2013 in Ulaanbaatar, Mongolia, were studied. By serological and/or molecular approaches, 77 (25.5%), 93 (30.8%), 19 (6.3%), 48 (15.9%), and 12 (4.0%) of the patients were diagnosed with acute hepatitis of types A, B, C, D (superinfection of hepatitis delta virus on a background of chronic hepatitis B virus infection) and E, respectively, while the cause of hepatitis was unknown in the remaining 53 patients (17.5%). The 12 hepatitis E patients had no history of travel abroad in the 3 months before the onset of disease, and lived separately in fixed or movable houses with water supplied via pipe, tank or well, denying transmission from a common water supply. The 12 HEV isolates obtained from the patients showed high nucleotide identities of 99.7–100%, and a representative HEV isolate, MNE13‐227, was closest to the Chinese isolates of genotype 4, with the highest identity of 97.3% in the 304‐nt ORF2 sequence and 92.1% over the entire genome. The present study revealed the occurrence of autochthonous acute hepatitis E in Mongolia, caused by a monophyletic genotype 4 HEV strain. J. Med. Virol. 88:282–291, 2016. © 2015 Wiley Periodicals, Inc.