Study of serological and molecular markers of hepatitis e virus (HEV) infection in different population groups in São Paulo

Abstract

Hepatitis E virus (HEV) is an RNA virus, the only member of the genus Hepevirus in the family Hepeviridae, is the etiologic agent of hepatitis E, an acute viral hepatitis that usually evolves with self-limited course. Currently, HEV infection is recognized as a significant public health problem in several regions of the world. HEV is endemic especially in regions with poor sanitary conditions and is involved in large outbreaks of acute hepatitis due to the spread of the virus through water contaminated with infected feces. In endemic regions, HEV genotypes 1 and 2 are involved in large outbreaks and in sporadic cases. In developed countries, HEV infection occurs almost exclusively in people with a history of travel to endemic regions, but during the last decade an increasing number of autochthonous infections have been identified in these regions. HEV genotypes 3 and 4 have been found in such cases, which are commonly found in some animal species, characterizing hepatitis E as a zoonotic disease. Transmission of the virus in these cases occurs by human exposure to fluids of infected pigs or eating raw or undercooked pork, wild boar and deer infected with this virus. HEV prevalence in different regions of the world was not determined as well as the patterns of transmission and disease progression. This usually is recognized with benign and self-limited course but there is currently growing evidence of its evolution to chronicity in immunosuppressed individuals. Moreover, it has been shown that chronic HEV infection can evolve to progressive liver fibrosis up to cirrhosis development. Such findings raised the interest in studying different aspects of HEV infection to improve strategies for diagnosis, treatment and prevention of this infection. As there are few studies evaluating HEV prevalence in Brazil and it is unknown the involvement of this virus as a causative agent of chronic liver diseases in our country, the aim of this project is to evaluate the frequency of past, acute and chronic HEV infections between different populations in São Paulo. These data will bring relevant contributions to the knowledge about distribution, evolution and routes for the spreading of HEV infection in our country. (AU)