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1Hepatitis E in Israel: A nation-wide retrospective study显示文摘AIM: To investigate the epidemiology, risk factors and clinical course of acute hepatitis E virus(HEV) infection in Israel, an industrialized country.METHODS: A retrospective analysis of acute HEV cases diagnosed in Israel from 1993 to 2013. Acute HEV was defined by ALT/AST elevation and a positive HEV PCR test or positive anti-HEV-Ig M serology. HEV RNA was tested by quantitative reverse transcription PCR. Antibodies to HEV were tested retrospectively using an ELISA assay. HEV-RNA was sequenced using RT-PCR of ORF1 and ORF2 regions to diagnose genotype of the virus. Epidemiologic and clinical data were collected by reviewing the clinical files and through a telephone interview according to a structured questionnaire.RESULTS: Acute HEV was diagnosed in 68 patients. Among the 59 patients who gave an informed consent a nd w e re int e r v ie w e d, 4 1% o f infe c t io ns w e re autochthonous(acquired in Israel), 44% travel-related and 15% imported by foreign workers. Autochthonous patients were mainly females(62.5%), more than half of them pregnant, 26% recalled consuming food or water in areas with poor sanitation, 44% ate nonkosher meat. Fulminant hepatitis developed in 3 patients(5%), all of them were females, two of them with post-partum infection, all acquired the disease in Israel(autochthonous). Israeli travelers with imported infection were predominantly males(73%), acquired the disease in the Indian subcontinent(81%), with 100% reporting having consumed fresh vegetables and drinks with ice cubes abroad. Six patients' sera were tested for genotype and revealed HEV genotype 1(all cases acquired in the Indian subcontinent). CONCLUSION: This is the first report which highlights the existence of hepatitis E as an autochthonous infection in Israel. Imported HEV originates mostly from the Indian subcontinent.Ortal Erez-Granat Tamar Lachish Nili Daudi Daniel Shouval Eli Schwartz 2016World Journal of Gastroenterology2016,22,24:0
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