Detection and assessment of infectivity of hepatitis E virus in urine

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• 作者：Yansheng Geng¹ ; Chenyan Zhao² ; Weijin Huang² ; Tim J. Harrison³ ; Hongxin Zhang¹ ; Kunjing Geng⁴ ; Youchun Wang² ; ^{wangyc@nifdc.org.cn" class="auth_mail" title="E-mail the corresponding author}
• 关键词：HEV ; hepatitis E virus ; ALT ; alanine aminotransferase ; AST ; aspartate aminotransferase ; ORF ; open reading frame ; GLU ; Glucose ; BUN ; blood urea nitrogen ; CRE ; creatinine ; CHO ; cholesterol ; TP ; total protein ; ALB ; albumin ; TBIL ; total bilirubin ; ALP ; alkaline phosphatase ; LDH ; lactate dehydrogenase ; CK ; creatine kinase ; URO ; urobilinogen ; BIL ; urobilin ; KET ; urine ketone ; BLD ; urine occult blood ; AlbU ; urine microalbuminuria ; α1MU ; urine α1-microglobulin ; TrfU ; urine transferrin ; IgGU ; urine Immun
• 刊名：Journal of Hepatology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：64
• 期：1
• 页码：37-43
• 全文大小：1785 K

文摘

Hepatitis E virus (HEV) is known to be excreted in the stool but there has been no report of its presence in urine. This study investigated the presence of HEV RNA and antigen (HEV-Ag) in urine and its possible transmission.

Methods

Serum and urine samples from patients with chronic or acute HEV infection and HEV infected monkeys were tested for viral and biochemical markers. Liver and kidney biopsies from the infected monkeys were analyzed by histopathology and immunohistochemistry. The infectivity of HEV from urine was assessed by inoculation into monkeys.

Results

HEV RNA and HEV-Ag were detected persistently in the urine of a patient with chronic HEV infection. Subsequently, HEV RNA was detected in the urine of three of the eight (37.5%) acute patients, all of whom had detectable HEV-Ag in their urine. HEV RNA and HEV-Ag were also detectable in the urine of HEV infected monkeys. The ratio of HEV-Ag to RNA in the urine of the infected monkeys was significantly higher than in their sera and feces. The parameters of routine urinalysis remained within the normal ranges in the hepatitis E patients and infected monkeys, however, pathological changes and HEV-Ag were observed in the kidneys of the infected monkeys. Furthermore, one of two monkeys became infected with HEV after inoculation with urine from another infected monkey.

Conclusions

HEV infection may result in kidney injury and the urine may pose a risk of transmission. HEV-Ag detection in urine may be valuable for diagnosis of ongoing HEV infection.