HEPATITIS-E VIRUS-INFECTION IN ACUTE HEPATITIS IN SPAIN

In order to study the prevalence of hepatitis E virus (HEV) infection in developed countries, IgG and IgM anti-HEV were determined in serum samples from 382 patients with acute viral hepatitis (244 hepatitis A, 48 hepatitis B and/or D, and 90 non-A, non-B, non-C hepatitis), 76 he althy subjects, 55 hemophiliacs and 50 patients on hemodialysis. IgG a nti-HEV antibodies were detected and confirmed by a synthetic peptide- based EIA in 5 (5.6%) non-A, non-B, non-C acute hepatitis, in 3 (6.5%) B and D acute hepatitis, in 10 (4%) acute A hepatitis, in 3 (5.5%) of 54 healthy adults in none of the hemophiliacs and in 3 (6%) patients on hemodialysis. IgM anti-HEV antibodies were only detected in two cas es of acute hepatitis B and/or D. Analysis of serial serum samples dem onstrated IgG anti-HEV seroconversion in 3 of the fand confirmed cases ; one of them was also positive for IgM anti-HEV. All 3 acute anti-HEV -positive hepatitis cases occurred in adults, were community-acquired (two of them were intravenous drug addicts) and had a self-limited cou rse. These results demonstrate that HEV is a minor cause of acute hepa titis in Spain. A similar low rate of IgG anti-HEV antibodies was dete cted in patients with different diseases, suggesting that HEV has a ve ry low epidemiological impact. An apparent association of HEV infectio n with hepatitis B and D suggests a possible parenteral transmission o f a mainly enteral pathogen.