Characterization and zoonotic potential of endemic hepatitis E virus (HEV) strains in humans and animals in Hungary.

BACKGROUND: Hepatitis E virus (HEV) is a common cause of acute, fecally transmitted hepatitis in developing countries. Identification of HEV in indigenous human infection and in domestic pig raising the possibility that HEV infection is also a zoonosis.

OBJECTIVES/STUDY DESIGN: Molecular detection and epidemiology of HEV in humans (South-East Hungary) with acute hepatitis and in domestic (pig, cattle) and wild (boar and roe-deer) animals (countrywide) by ELISA and RT-PCR.

RESULTS: Between 2001 and 2006, a total of 116 (9.6%) of 1203 human sera were positive by HEV IgM ELISA and 13 (24.5%) of 53 samples were also confirmed by RT-PCR and sequencing. Forty-two (27.3%) of 154, 11 (34.4%) of 32 and 9 (12.2%) of 74 samples were RT-PCR-positive from swine (feces: 22.7%; liver: 30.8%), roe-deer (liver) and wild boar (liver), respectively. Except for an imported infection caused by genotype 1, 19 sequences (human: 12, swine: 4, roe-deer: 1, wild boar: 2) belong to genotype 3 HEV. Genetically identical strains were detected in human and roe-deer and in 2 other human clusters.

CONCLUSIONS: HEV is an endemic agent in Hungary. Consumption of raw or undercooked meat-products is one of the possible sources of the indigenous HEV infections. Cross-species infection with genotype 3 HEV potentially involves a food-borne transmission route in Hungary.