Dynamics of HEV viremia, fecal shedding and its relationship with transaminases and antibody response in patients with sporadic acute hepatitis E.
Dynamics of HEV viremia, fecal shedding and its relationship with transaminases and antibody response in patients with sporadic acute hepatitis E.
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DOI：
10.1186/1743-422x-7-213
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发表时间：
2010-09-06
期刊：
影响因子：
4.8
通讯作者：
Rai RR
中科院分区：
文献类型：
--
作者：
Chandra NS;Sharma A;Malhotra B;Rai RR
关于个体患者连续样本的粪便排泄和病毒血症持续时间及其与急性戊型肝炎患者血清转氨酶和抗体应答的相关性的数据很少。这项前瞻性研究是在印度北方的一家三级保健中心进行的，为期15个月。只有那些散发性急性戊型肝炎的患者，他们在发病的第一周，每周随访肝功能检查，血清和粪便中的抗HEV抗体IgM和HEVRNA。采用RT-nPCR方法，从HEV基因组ORF 1的RdRp区扩增HEV RNA.在15个月的时间内，60例患者符合入选标准，并入选进行最终分析。平均年龄29.2 ± 8.92岁，男性39例。抗HEV IgM阳性率诊断时为80%，第7周为18.3%，HEVRNA阳性率诊断时为85%，第7周为6.6%，粪便RNA阳性率诊断时为70%，第4周为20%。检测到的病毒血症的最长持续时间为42天，粪便病毒脱落为发病后28天。本研究报告转氨酶正常化后血清中HEV RNA阳性。除转氨酶正常化外，未观察到粪便脱落。然而，病毒血症持续超过正常的转氨酶表明肝损伤是独立的病毒复制。
There is paucity of data regarding duration of fecal excretion and viremia on sequential samples from individual patients and its correlation with serum transaminases and antibody responses in patients with acute hepatitis E. This prospective study was undertaken at a tertiary care center in Northern India over 15 months. Only those patients of sporadic acute hepatitis E who were in their first week of illness and followed up weekly for liver function tests, IgM anti HEV antibody and HEV RNA in sera and stool were included. HEV RNA was done by RT - nPCR using two pairs of primers from RdRp region of ORF 1 of the HEV genome. Over a period of 15 months 60 patients met the inclusion criterion and were enrolled for the final analysis. The mean age of the patients was 29.2 ± 8.92 years, there were 39 males. The positivity of IgM anti HEV was 80% at diagnosis and 18.3% at 7th week, HEV RNA 85% at diagnosis and 6.6% at 7th week and fecal RNA 70% at the time of diagnosis and 20% at 4th week. The maximum duration of viremia detected was 42 days and fecal viral shedding was 28 days after the onset of illness. Present study reported HEV RNA positivity in sera after normalization of transaminases. Fecal shedding was not seen beyond normalization of transaminases. However, viremia lasted beyond normalization of transaminases suggesting that liver injury is independent of viral replication.