PROTRACTED VIREMIA DURING ACUTE SPORADIC HEPATITIS-E VIRUS-INFECTION

Background/Aims: Hepatitis E virus (HEV) is associated with epidemic a nd sporadic hepatitis in developing countries. The disease is largely self-limited with no long-term sequelae. The source of HEV for mainten ance of the disease in an endemic area is unknown, This study investig ated the occurrence and duration of viremia in patients with acute spo radic HEV infection. Methods: In 26 of 37 patients with sporadic acute non-A, non-B viral hepatitis, HEV infection was diagnosed based on po sitivity for immunoglobulin M anti-HEV and/or presence of viremia as s hown by reverse-transcription polymerase chain reaction. In 4 patients , fecal samples were analyzed for presence of virus using polymerase c hain reaction. Multiple samples were studied at varying times in 20 pa tients. Results: Viremia was detected in 19 of 26 patients. Two patien ts had viremia in the absence of immunoglobulin M anti-HEV. Four patie nts had protracted viremia of 45-112 days' duration. One patient showe d fecal virus shedding up to the 52nd day of illness, Conclusions: Pro tracted viremia and prolonged fecal shedding of HEV were shown in a sm all group of patients. These patients may serve as temporary virus car riers responsible for continuous contamination of the sewage water.