HEPATITIS E VIRUS MONITORING RESULTS AND ITS LABORATORY SCREENING ALGORITHM
Abstract
Background. Individual cases of viral hepatitis E are recorded in the Republic of Belarus annually indicating the need for the pathogen monitoring at both the population and reservoir levels. Objective. To consolidate the monitoring data on hepatitis E virus over the period of 2018 - 2021, as well as to work out an effective algorithm for its laboratory screening. Material and methods. As part of the study, 345 samples were analyzed, including 227 human biological samples, 37 samples of biological materials of domestic pigs, 22 samples of food and 59 samples of waste water. Results. According to the results of serum diagnostics, in the group of kidney recipients (n = 29), the detection rate of IgM and IgG to hepatitis E virus was 6.9% [0.85%; 23.03%] and 17.2% [7.13%; 35, 02%] respectively; in the group of patients with pregnancy pathology (n = 44) - 6.8% [1.68%; 18.89%] and 11.4% [4.5%; 24.43%] respectively. In patients with acute hepatitis of unknown etiology (n = 26), antiviral IgM was not detected, while the frequency of antiviral IgG detection reached 7.7% [1.02%; 25.26]. In control group (blood donors, n = 53) IgM and IgG were detected in 1.9% [0.6%; 10.88%] and 5.7% [1.35%; 15.97] of those examined respectively. Hepatitis E virus RNA was detected in 8 human biological samples (3.8%) from kidney recipients. The identified hepatitis E viruses were represented by genotype GIII and belonged to a previously unidentified subgenotype (GIIIa - GIIIi). In the studied samples of biological material from pigs, as well as in samples of food and waste water, hepatitis E virus RNA was not detected. Conclusions. An algorithm for hepatitis E virus laboratory screening has been developed and tested. Its section concerning the diagnosis of viral hepatitis E is set out in the Instructions for use "Algorithm for laboratory diagnosis of viral hepatitis E" (No. 148-1220 from January 28, 2021).
References
Bystrova TN, Polyanina AV, Knyagina ON. Harakteristika gepatit E-infekcii na territorii s umerennym klimatom [Characteristics of hepatitis E-infection on the territory with moderate climate]. Medicinskij almanah [Medical Almanac]. 2010;2:236-239. (Russian).
Zubkin ML, Semenenko TA, Selkova EP, Kokoeva FK, Chervinko VI, Balakirev EM, Aleshkin VA. Gepatit E: novaja problema transplantologii? [Hepatitis E: a new problem in transpantology?]. Vestnik transplantologii i iskusstvennyh organov [Russian journal of transplantology and artificial organs]. 2012;14(4):103-114. (Russian).
Haagsma EB, van den Berg AP, Porte RJ, Benne CA, Vennema H, Reimerink JH, Koopmans MP. Chronic hepatitis E virus infection in liver transplant recipients. Liver Transpl. 2008;14(4):547-553. https://doi.org/10.1002/lt.21480.
Kamar N, Mansuy JM, Cointault O, Selves J, Abravanel F, Danjoux M, Otal P, Esposito L, Durand D, Izopet J, Rostaing L. Hepatitis E virus-related cirrhosis in kidney- and kidney-pancreas-transplant recipients. Am J Transplant. 2008;8(8):1744-1748. https://doi.org/10.1111/j.1600-6143.2008.02286.x.
Gérolami R, Moal V, Colson P. Chronic hepatitis E with cirrhosis in a kidney-transplant recipient. N Engl J Med. 2008;358(8):859-60. https://doi.org/10.1056/NEJMc0708687.
Nimgaonkar I, Ding Q, Schwartz RE, Ploss A. Hepatitis E virus: advances and challenges. Nat Rev Gastroenterol Hepatol. 2018;15(2):96-110. https://doi.org/10.1038/nrgastro.2017.150.
Polyanina AV, Bystrova TN. Sravnitelnaja jepidemiologicheskaja harakteristika gepatit A- i gepatit E-infekcii na territorii umerennogo klimata [The comparative epidemiologic characteristics of hepatitis A- and hepatitis E-infection on the territory of temperate climate]. Medicinskij almanah [Medical Almanac]. 2011;4:29-31. (Russian).
Ricci A, Allende A, Bolton D, Chemaly M, Davies R, Fernandez Escamez PS, Herman L, Koutsoumanis K, Lindqvist R, Nørrung B, Robertson L, Ru G, Sanaa M, Simmons M, Skandamis P, Snary E, Speybroeck N, Ter Kuile B, Threlfall J, Wahlström H, Di Bartolo I, Johne R, Pavio N, Rutjes S, van der Poel W, Vasickova P, Hempen M, et al. Public health risks associated with hepatitis E virus (HEV) as a food-borne pathogen. EFSA J. 2017;15(7):e04886. https://doi.org/10.2903/j.efsa.2017.4886.
Znovets TV, Zhavoronok SV, Baranovskaya EI, Arabey AA. Gepatit E u beremennyh s patologiej pecheni v Respublike Belarus [Hepatitis Е in pregnant women with liver disease in the republic of Belarus]. Zdravoohranenie [Healthcare]. 2016;5:9-15. (Russian).
European Food Safety Authority. Public health risks associated with hepatitis E virus (HEV) as a food-borne pathogen. Available from: https://www.efsa.europa.eu/en/efsajournal/pub/4886.
Amvrosieva T, Poklonskaya N, Arinovich A. Sovremennoe sostojanie problemy virusnogo gepatita E v mire i Respublike Belarus [Current state of the problem of viral hepatitis E in the world and in the Republic of Belarus]. Laboratornaja diagnostika. Vostochnaja Evropa [Laboratory diagnostics. Eastern Europe]. 2017;6(4):471-479. (Russian).
Zhavoronok SV, Yagovdik-Telezhnaya AN, Mikhaylov MM, Kyuregyan KK, Alatortseva GI, Zhmurovskaya LS, Soldatenko OV, Rogachyova TA, Anisko LA, Yurovsky NN. Ostryj avtohtonnyj gepatit E v Respublike Belarus [Acute autochthonic hepatitis E in Republic of Belarus]. Medicinskij zhurnal [Medical Journal]. 2017;2:132-134. (Russian).
Kishkurno EP, Amvrosieva TV, Dolgolikova AA, Kaltunova YB, Krapivina SV. Problema virusnogo gepatita E. Ostroe techenie infekcii u recipienta pochki v pozdnij posttransplantacionnyj period [Hepatitis E. Acute hepatitis e in kidney transplant recipients in the late post-transplant period]. Medicinskij zhurnal [Medical Journal]. 2019;4:15-21. (Russian).
Arabey AA, Mohammed AME, Zhavoronok SV, Kuregyan KK, Budko LV, Davydau VV, Mikhailov MI. Obnaruzhenie virusa gepatita E sredi krolikov v Respublike Belarus [Detection of hepatitis E virus among rabbits of Belarus]. Voennaja medicina [Military medicine]. 2015;2:51-53. (Russian).
Amvrosieva TV, Paklonskaya NV, Kaltunova YB, Belskaya IV, Kishkurno EP, inventors; Republican Research and Practical Center for Epidemiology and Microbiology, assignee. Algoritm laboratornogo kontrolja za virusnym gepatitom E. Instrukcija po primeneniju BY № 148-1220. 28.01.2021. Minsk; 2020. 13 p. (Russian).
