Hepatitis E Virus Genotype 4, Nanjing, China, 2001–2011

Xing Dai¹, Chen Dong¹, Zhenxian Zhou¹, Jiuhong Liang, Min Dong, Yan Yang, Jianguang Fu, Hua Tian, Song Wang, Jie Fan, Jihong Meng

, and Michael A. Purdy

Author affiliations: Southeast University School of Medicine, Nanjing, China (X. Dai, C. Dong, Z. Zhou, J. Liang, M. Dong, Y. Yang, J. Fu, H. Tian, S. Wang, J. Fan, J. Meng); Nanjing Second Hospital, Nanjing (Z. Zhou); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.A. Purdy)

Abstract

During 2001–2011, hepatitis E virus (HEV) was found in the blood of patients in Nanjing, China. All HEV-positive patients had virus genotype 4; subgenotype 4a was predominant. The effective population of HEV in Nanjing increased in ≈1980 and continued until ≈2003 when it plateaued.

Hepatitis E virus (HEV) is a positive-sense, single-stranded RNA virus of the family Hepeviridae. Strains of HEV infecting swine, boars, deer, mongooses, rabbits, and humans belong to the genus Hepevirus (1). Hepeviruses are divided into 4 genotypes that cause sporadic and epidemic outbreaks of hepatitis E in humans. Epidemic outbreaks occur primarily in developing countries in Asia and Africa, and sporadic outbreaks occur worldwide (2,3). A study showed that HEV causes autochthonous hepatitis E in industrialized countries (4).
Genotypes 1 and 2 are transmitted from human to human and cause epidemic and sporadic outbreaks (3,5). Genotypes 3 and 4 are transmitted to humans zoonotically (6) and cause primarily sporadic cases of hepatitis E. The dominant genotype of HEV in China is genotype 4 (5,7,8). The purpose of this study was to analyze the prevalence and genotypes of HEV among infected patients in Nanjing, China.