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Open accessJournal ArticleDOI: 10.1080/21645515.2020.1795458

Epidemiology, diagnosis, vaccines, and bibliometric analysis of the 100 top-cited studies on Hepatitis E virus

04 Mar 2021-Human Vaccines & Immunotherapeutics (Taylor & Francis)-Vol. 17, Iss: 3, pp 857-871
Abstract: In low-income countries, Hepatitis E infection is a common cause of acute hepatitis. So far, only two recombinant vaccines (rHEV and HEV 239) have been developed against Hepatitis E virus (HEV). Of...

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Topics: Hepatitis E virus (77%), Hepatitis E (72%)
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Open accessJournal ArticleDOI: 10.1016/J.TMAID.2020.101607
Tauseef Ahmad1, Muhammad Hassan Khan2, Haroon3, Taha Hussein Musa1  +4 moreInstitutions (5)
Topics: Coronavirus (64%), Betacoronavirus (58%)

81 Citations


Open accessJournal ArticleDOI: 10.1080/17441692.2020.1828982
Anna Friedler1Institutions (1)
Abstract: Although there has been increasing focus in recent years on interdisciplinary approaches to health and disease, and in particular the dimension of social inequalities in epidemics, infectious diseases have been much less focused on. This is especially true in the area of cultural dynamics and their effects on pathogen behaviours, although there is evidence to suggest that this relationship is central to shaping our interactions with infectious disease agents on a variety of levels. This paper makes a case for a biocultural approach to pandemics such as COVID-19. It then uses this biocultural framework to examine the anthropogenic dynamics that influenced and continue to shape the COVID-19 pandemic, both during its initial phase and during critical intersections of the pandemic. Through this understanding of biocultural interactions between people, animals and pathogens, a broader societal and political dimension is drawn as a function of population level and international cultures, to reflect on the culturally mediated differential burden of the pandemic. Ultimately, it is argued that a biocultural perspective on infectious disease pandemics will allow for critical reflection on how culture shapes our behaviours at all levels, and how the effects of these behaviours are ultimately foundational to pathogen ecology and evolution.

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Topics: Pandemic (51%)

9 Citations


Open accessJournal ArticleDOI: 10.5301/IJAO.2008.566
Abstract: Among uremic patients on hemodialysis and continuous ambulatory peritoneal dialysis treatment infectious complications leading to a high incidence of morbidity and mortality are a well documented problem. Polymorphonuclear leukocytes (PMNLs) are the main cells of the unspecific defence system during bacterial infections. There is a number of partly interdependent factors responsible for the diminished PMNL functions (chemotaxis, phagocytosis, intracellular killing by proteolytic enzymes and toxic oxygen radicals) found in uremia: iron overload, elevated levels of intracellular calcium and hemodialysis treatment per se has been shown to be involved in altered PMNL functions. Uremic toxins are circulating plasma factors accumulating in the serum of uremic patients. They are thought to play a crucial role in inhibiting the unspecific immune defence. A number of uremic toxins has already been purified and characterized. In our laboratory, a granulocyte inhibiting protein (GIP) with homology to immunoglobulin light chains has been isolated. We could show that free immunoglobulin light chains per se are able to interfere with essential PMNL functions. A GIP with homology to beta 2-microglobulin was also isolated from dialysis patients. Angiogenin was purified from uremic patients as a PMNL degranulation inhibiting protein and complement factor D was shown to adversely affect PMNL functions. A modified form of ubiquitin isolated from peritoneal dialysis patients interferes with PMNL chemotaxis. Furthermore, p-cresol was identified as a uremic solute that impairs the respiratory burst activity of PMNL. There is also increased clinical evidence for profound defects in the specific immune defence in uremia, such as the high susceptibility to viral infections in uremic patients, the deficient responses of their T lymphocytes, and the significantly depressed specific antibody responses.

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Topics: Uremia (57%)

7 Citations


Open access
01 Jan 2010-
Topics: Hepatitis E (54%), Outbreak (54%)

3 Citations


Open accessJournal ArticleDOI: 10.3390/HEALTHCARE9020133
29 Jan 2021-Healthcare
Abstract: The hepatitis E virus (HEV) is a positive single-stranded, icosahedral, quasi-enveloped RNA virus in the genus Orthohepevirus of the family Hepeviridae. Orthohepevirus A is the most numerous species of the genus Orthohepevirus and consists of eight different HEV genotypes that can cause infection in humans. HEV is a pathogen transmitted via the fecal–oral route, most commonly by consuming fecally contaminated water. A particular danger is the HEV-1 genotype, which poses a very high risk of vertical transmission from the mother to the fetus. Several outbreaks caused by this genotype have been reported, resulting in many premature births, abortions, and also neonatal and maternal deaths. Genotype 3 is more prevalent in Europe; however, due to the openness of the market, i.e., trade-in animals which represent a natural reservoir of HEV (such as pigs), there is a possibility of spreading HEV infections outside endemic areas. This problem is indeed global and requires increased hygiene measures in endemic areas, which entails special care for pregnant women in both endemic and non-endemic regions. As already highlighted, pregnant women could have significant health consequences due to the untimely diagnosis of HEV infection; hence, this is a population that should be targeted with a specific combination of testing approaches to ensure optimal specificity and sensitivity. Until we advance from predominantly supportive treatment in pregnancy and appraise the safety and efficacy of a HEV vaccine in this population, such screening approaches represent the mainstay of our public health endeavors.

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Topics: Hepatitis E (58%), Population (53%)

2 Citations


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82 results found


Open accessJournal ArticleDOI: 10.1016/0042-6822(91)90760-9
01 Nov 1991-Virology
Abstract: We have recently described the cloning of a portion of the hepatitis E virus (HEV) and confirmed its etiologic association with enterically transmitted (waterborne, epidemic) non-A, non-B hepatitis. The virus consists of a single-stranded, positive-sense RNA genome of approximately 7.5 kb, with a polyadenylated 3' end. We now report on the cloning and nucleotide sequencing of an overlapping, contiguous set of cDNA clones representing the entire genome of the HEV Burma strain [HEV(B)]. The largest open reading frame extends approximately 5 kb from the 5' end and contains the RNA-directed RNA polymerase and nucleoside triphosphate binding motifs. The second major open reading frame (ORF2) begins 37 bp downstream of the first and extends approximately 2 kb to the termination codon present 65 bp from the 3' terminal stretch of poly(A) residues. ORF2 contains a consensus signal peptide sequence at its amino terminus and a capsid-like region with a high content of basic amino acids similar to that seen with other virus capsid proteins. A third open reading frame partially overlaps the first and second and encompasses only 369 bp. In addition to the 7.5-kb full-length genomic transcript, two subgenomic polyadenylated messages of approximately 3.7 and 2.0 kb were detected in infected liver using a probe from the 3' third of the genome. The genomic organization of the virus is consistent with the 5' end encoding nonstructural and the 3' end encoding the viral structural gene(s). The expression strategy of the virus involves the use of three different open reading frames and at least three different transcripts. HEV was previously determined to be a nonenveloped particle with a diameter of 27-34 nm. These findings on the genetic organization and expression strategy of HEV suggest that it is the prototype human pathogen for a new class of RNA virus or perhaps a separate genus within the Caliciviridae family.

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Topics: RNA virus (55%), Hepatitis E virus (55%), Nucleic acid sequence (55%) ... read more

962 Citations


Journal ArticleDOI: 10.1159/000149370
01 Jan 1983-Intervirology
Abstract: Typical acute hepatitis was reproduced in a human volunteer immune to hepatitis A virus (HAV) after oral administration of pooled stool extracts from presumed cases of epidemic non-A, non-B hepatitis. Markers of hepatitis B infection, anti-HAV IgM, and increase in total anti-HAV level were not detectable in the volunteer’s sera during the course of infection. Spherical 27- to 30-nm virus-like particles were visualized by immune electron microscopy (IEM) in stool samples collected during preclinical and early postclinical phases. These particles banded in CsCl at a buoyant density of 1.35 g/cm3. They reacted in the IEM test with sera from individuals who had experienced two non-B hepatitis episodes but did not react with sera from routine anti-HAV IgM-positive hepatitis patients. Intravenous inoculation of cynomolgus monkeys with the virus-containing stool extract resulted in histopathologically and enzymatically confirmed hepatitis, excretion of virus-like particles, and antibody response to them.

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Topics: Hepatitis E virus (67%), Hepatitis (64%), Hepatitis E (64%) ... read more

710 Citations


Journal ArticleDOI: 10.1016/0002-9343(80)90200-4
Abstract: A common source waterborne epidemic of viral hepatitis was studied in Kashmir valley over the six month period from November 1978 to April 1979. Highly sensitive serologic tests for hepatitis B and hepatitis A failed to reveal either one as an etiologic agent of hepatitis. Of 16620 inhabitants of the area screened four times in these six months, viral hepatitis developed in 1.65 per cent. In addition, 27.3 per cent of 128 persons who had contacts with patients who had viral hepatitis had biochemical features of anicteric hepatitis. The mode of spread of the epidemic, length of incubation, clinical features and biochemical test results of the patients studied resembled that of hepatitis A. These findings were in contrast to that of non-A, non-B hepatitis following transfusion, which closely resembles hepatitis B. The data strongly suggest the possibility of another human hepatitis virus and established the fecal oral route of its spread.

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Topics: Viral hepatitis (75%), Hepatitis (73%), Hepatitis A (70%) ... read more

617 Citations


Journal ArticleDOI: 10.1016/S1473-3099(08)70255-X
Abstract: Hepatitis E is endemic in many developing countries where it causes substantial morbidity. In industrialised countries, it is considered rare, and largely confined to travellers returning from endemic areas. However, there is now a growing body of evidence that challenges this notion. Autochthonous hepatitis E in developed countries is far more common than previously recognised, and might be more common than hepatitis A. Hepatitis E has a predilection for older men in whom it causes substantial morbidity and mortality. The disease has a poor prognosis in the context of pre-existing chronic liver disease, and is frequently misdiagnosed as drug-induced liver injury. The source and route of infection remain uncertain, but it might be a porcine zoonosis. Patients with unexplained hepatitis should be tested for hepatitis E, whatever their age or travel history.

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Topics: Hepatitis (65%), Hepatitis E virus (64%), Hepatitis E (64%) ... read more

598 Citations


Journal ArticleDOI: 10.1016/S0140-6736(10)61030-6
Fengcai Zhu1, Jun Zhang2, Xuefeng Zhang1, Cheng Zhou  +19 moreInstitutions (2)
11 Sep 2010-The Lancet
Abstract: Summary Background Seroprevalence data suggest that a third of the world's population has been infected with the hepatitis E virus Our aim was to assess efficacy and safety of a recombinant hepatitis E vaccine, HEV 239 (Hecolin; Xiamen Innovax Biotech, Xiamen, China) in a randomised, double-blind, placebo-controlled, phase 3 trial Methods Healthy adults aged 16–65 years in, Jiangsu Province, China were randomly assigned in a 1:1 ratio to receive three doses of HEV 239 (30 μg of purified recombinant hepatitis E antigen adsorbed to 0·8 mg aluminium hydroxide suspended in 0·5 mL buffered saline) or placebo (hepatitis B vaccine) given intramuscularly at 0, 1, and 6 months Randomisation was done by computer-generated permuted blocks and stratified by age and sex Participants were followed up for 19 months The primary endpoint was prevention of hepatitis E during 12 months from the 31st day after the third dose Analysis was based on participants who received all three doses per protocol Study participants, care givers, and investigators were all masked to group and vaccine assignments This trial is registered with ClinicalTrialsgov, number NCT01014845 Findings 11 165 of the trial participants were tested for hepatitis E virus IgG, of which 5285 (47%) were seropositive for hepatitis E virus Participants were randomly assigned to vaccine (n=56 302) or placebo (n=56 302) 48 693 (86%) participants in the vaccine group and 48 663 participants (86%) in the placebo group received three vaccine doses and were included in the primary efficacy analysis During the 12 months after 30 days from receipt of the third dose 15 per-protocol participants in the placebo group developed hepatitis E compared with none in the vaccine group Vaccine efficacy after three doses was 100·0% (95% CI 72·1–100·0) Adverse effects attributable to the vaccine were few and mild No vaccination-related serious adverse event was noted Interpretation HEV 239 is well tolerated and effective in the prevention of hepatitis E in the general population in China, including both men and women age 16–65 years Funding Chinese National High-tech R&D Programme (863 programme), Chinese National Key Technologies R&D Programme, Chinese National Science Fund for Distinguished Young Scholars, Fujian Provincial Department of Sciences and Technology, Xiamen Science and Technology Bureau, and Fujian Provincial Science Fund for Distinguished Young Scholars

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Topics: Hepatitis B vaccine (63%), Vaccine efficacy (61%), Hepatitis E (60%) ... read more

544 Citations


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