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Hepatitis E Virus

Biology, Pathogenesis, Epidemiology, Clinical Description, Diagnosis, and Prevention

  • Chapter
Viral Hepatitis

Abstract

Hepatitis E virus (HEV) is the etiologic agent responsible for the large majority of acute enterically-transmitted non-A hepatitis. While hepatitis E has been documented many times worldwide as major epidemic outbreaks involving thousands of infected individuals with overt disease (1,2), it also accounts for a significant proportion of sporadic hepatitis cases in endemic regions (1,2, see Table 1). The molecular virology and biology of the recently identified HEV, even with its genome completely cloned and sequenced, have not been fully characterized. Current understanding of HEV virus biology, disease manifestations, mode of pathogenesis, its seroepidemiology, and prospects for vaccine intervention will be reviewed in these ensuing sections.

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References

  1. Bradley, D. W. (1992) Hepatitis E: epidemiology, aetiology, and molecular biology. Med. Virol. 2, 19–28.

    Article  Google Scholar 

  2. Krawczynski, K. (1993) Hepatitis E. Hepatology 17, 932–941.

    Article  CAS  Google Scholar 

  3. Khuroo, S. M. (1980) Study of an epidemic of non-A, non-B hepatitis. Possibility of another human hepatitis virus distinct from post-transfusion non-A, non-B type. Amer. J. Med. 68, 818–824.

    Article  PubMed  CAS  Google Scholar 

  4. Wong, D. C., Purcell, R. H., Sreenivasan, M. A., Prasad, S. R., and Pavri, K. M. (1980) Epidemic and endemic hepatitis in India: evidence for non-A/non-B hepatitis virus etiology. Lancet 2, 876–878.

    Article  PubMed  CAS  Google Scholar 

  5. Balayan, M. S., Andjaparidze, A. G., Savinskaya, S. S., Ketiladze, E. S., Braginsky, D. M., Savinov, A. P., and Poleschuk, V. F. (1983) Evidence for a virus in non-A/ non-B hepatitis transmitted via the fecal-oral route. Intervirology 20, 23–31.

    Article  PubMed  CAS  Google Scholar 

  6. Bradley, D. W., Krawczynski, K., Cook, E. H., Jr., McCaustland, K. A., Humphrey, C. D., Spelbring, J. E., Myint, H., and Maynard, J. E. (1987) Enterically transmitted non-A, non-B hepatitis: Serial passage of disease in cynomolgus macaques and tamarins and recovery of disease-associated 27 to 34-nm viruslike particles. Proc. Natl. Acad. Sci. USA 84, 6277–6281.

    Article  PubMed  CAS  Google Scholar 

  7. Ticehurst, J., Rhodes, L. L., Krawczynski, K., Asher, L. V. S., Engler, W. F., Mensing, T. L., Caudill, J. D., Sjogren, T. L., Hoke, C. H., LeDuc, J. W., Bradley, D. W., and Binn, L. N. (1992) Infection of owl monkeys (Aotus trivirgatus) and cynomolgus monkeys (Macaca fascicularis) with hepatitis E virus from Mexico. J. Infect. Dis. 165, 835–845.

    Article  CAS  Google Scholar 

  8. Tsarev, S. A., Tsareva, T. S., Emerson, S. U., Kapikian, A. Z., Ticehurst, J., London, W., and Purcell, R. H. (1993) ELISA for antibody to hepatitis E virus (HEV) based on complete open-reading frame-2 protein expressed in insect cells: Identification of HEV infection in primates. J. Infect. Dis. 168, 369–378.

    CAS  Google Scholar 

  9. Uchida, T., Win, K. M., Suzuki, K., et al. (1990) Serial transmission of a putative causative virus of enterically transmitted non-A, non-B hepatitis to Macaca fascicularia and Macaca mulatta. Japan J. Exp. Med. 60, 13–21.

    CAS  Google Scholar 

  10. Bradley, D. W., Krawczynski, K., Cook, E. H., Jr., McCaustland, K. A., Robertson, B. H., Humphrey, C. D., Kane, M. A., Spelbring, J., Weisfuse, I., Andjaparidze, A., Balayan, M., Stetler, H., and Velazquez, O. (1988) Enterically transmitted non-A, non-B hepatitis: Etiology of disease and laboratory studies in nonhuman primates, in Viral Hepatitis and Liver Disease ( Zuckerman, A. J., ed.), Alan R. Liss, New York, pp. 138–147.

    Google Scholar 

  11. Tsarev, S. A., Emerson, S. U., Tsareva, T. S., Yarbough, P.O., Lewis, M., Govindarajan, S., Reyes, G. R., Shapiro, M., and Purcell, R. H. (1993) Variation in course of hepatitis E in experimentally infected cynomolgus monkeys. J. Infect. Dis. 167, 1302–1306.

    Article  CAS  Google Scholar 

  12. Bradley, D. W. (1990) Enterically-transmitted non-A, non-B hepatitis. Brit. Med. Bull. 46, 442–461.

    PubMed  CAS  Google Scholar 

  13. Bradley, D. W. (1990) Hepatitis non-A, non-B viruses become identified as hepatitis C and E viruses, in Progress in Medical Virology, vol. 37 ( Melnick, J. L., ed.), Karger, Basel, pp. 101–135.

    Google Scholar 

  14. Balayan, M. S. (1991) HEV infection: Historical perspectives, global epidemiology, and clinical features, in Viral Hepatitis and Liver Disease ( Hollinger, F. B., Lemon, S. M., and Margolis, H. S., eds.), Williams and Wilkins, Baltimore, pp. 498–501.

    Google Scholar 

  15. Ticehurst, J. (1991) Identification and characterization of hepatitis E virus, in Viral Hepatitis and Liver Disease ( Hollinger, F. B., Lemon, S. M., and Margolis, H. S., eds.), Williams and Wilkins, Baltimore, pp. 501–513.

    Google Scholar 

  16. Karetnyi, Y. V., Dzhumalieva, D. I., Usmanov, R. K., Titova, I. P., Litvak, Y. I., and Balayan, M. S. (1993) Probable involvement of rodents in the spread of viral hepatitis. Zh. Mikrobiol. Epidemiol. Immunobiol. 4, 52–56.

    PubMed  Google Scholar 

  17. Clayson, E. T., Snithan, R., Ngarmpochana, M., Vaughn, D. W., and Shrestha, M. P. (1996) Evidence that the hepatitis E virus (HEV) is a zoonotic virus: detection of natural infections among swine, rats, and chickens in an area endemic for human disease, in Enterically-Transmitted Hepatitis Viruses ( Buisson, Y., Coursaget, P., and Kane, M., eds.), La Simarre, Tours, pp. 329–335.

    Google Scholar 

  18. Balayan, M. S., Usmanov, R. K., Zamyatina, N. A., Djumalieva, D. I., and Karas (1990) Brief report: experimental hepatitis E infection in domestic pigs. J. Med. Virol. 32, 58–59.

    Article  CAS  Google Scholar 

  19. Maneerat, Y., Clayson, E. T., Khin, S. A., Myint, G., Young, D., and Innis, B. L. (1996) Experimental infection of the laboratory rat with the hepatitis E virus. J. Med. Virol. 48, 121–128.

    Article  CAS  Google Scholar 

  20. Cubitt, W. D., Blacklow, N. R., Hermann, J. E., Nowak, N. A., Nakata, S., and Chiba, S. (1987) Antigenic relationships between human caliciviruses and Norwalk virus. J. Infect. Dis. 56, 806–814.

    Article  Google Scholar 

  21. Bradley, D. W., Andjaparidze, A., Cook, E. H., Jr., McCaustland, K. A., Balayan, M., Steller, H., Velazquez, O., Robertson, B., Humphrey, C., Kane, M., and Weisfuse, I. (1988) Etiologic agent of enterically-transmitted non-A, non-B hepatitis. J. Gen. Virol. 69, 731–738.

    Article  PubMed  CAS  Google Scholar 

  22. Reyes, G. R. and Kim, J. P. (1991) Sequence-independent, single-primer amplification (SISPA) of complex DNA populations. Mol. Cell Probes 5, 473–481.

    Article  PubMed  CAS  Google Scholar 

  23. Reyes, G. R., Purdy, M. A., Kim, J. P., Luk, K. C., Young, L. M., Fry, K. E., and Bradley, D. W. (1990) Isolation of a cDNA from the virus responsible for enterically transmitted non-A, non-B hepatitis. Science 247, 1335–1339.

    Article  PubMed  CAS  Google Scholar 

  24. Reyes, G. R., Huang, C. C., Yarbough, P. O., Young, L. M., Tam, A. W., Moeckli, R. A., Yun, K. Y., Nguyen, D., Smith, M. M., Fernandez, J., Guerra, M. E., Kim, J. P., Luk, K. A., Krawczynski, K., Purdy, M. A., Fry, K. E., and Bradley, D. W. (1991) Hepatitis E virus (HEV): epitope mapping and detection of strain variation, in Viral Hepatitis C, D., and E ( Shikata, T., Purcell, R. H., and Uchida, T., eds.), Elsevier, Amsterdam, pp. 237–245.

    Google Scholar 

  25. Yarbough, P. 0., Tam, A. W., Fry, K. E., Krawczynski, K., McCaustland, K. A., Bradley, D. W., and Reyes, G. R. (1991) Hepatitis E virus: identification of type-common epitopes. J. Viral. 65, 5790–5797.

    CAS  Google Scholar 

  26. Tam, A. W., Smith, M. M., Guerra, M. E., Huang, C. C., Bradley, D. W., Fry, K. E., and Reyes, G. R. (1991) Hepatitis E virus (HEV): molecular cloning and sequencing of the full-length viral genome. Virology 185, 120–131.

    CAS  Google Scholar 

  27. van Cuyck-Gandre, H., Zhang, H. Y., Clements, N. J., Cohen, S. G., Caudill, J. D., Coursaget, P., Buisson, Y., Warren, R. L., and Longer, C. F. (1996) Partial sequence of HEV isolates from North Africa and Pakistan: comparison with known HEV sequences, in Enterically-Transmitted Hepatitis Viruses ( Buisson, Y., Coursaget, P., and Kane, M., eds.), La Simarre, Tours, pp. 301–310.

    Google Scholar 

  28. Aye, T. T., Uchida, T., Ma, X. Z., Iida, F., Shikata, T., Zhuang, H., and Win, K. M. (1992) Complete nucleotide sequence of a hepatitis E virus isolated from the Xinjiang epidemic (1986–1988) of China. Nucl. Acid Res. 20, 3512.

    CAS  Google Scholar 

  29. Bi, S. L., Purdy, M. A., McCaustland, K. A., Margolis, H. S., and Bradley, D. W. (1993) The sequence of hepatitis E virus isolated directly from a single source during an outbreak in China. Virus Res. 28, 233–247.

    CAS  Google Scholar 

  30. Yin, S. R., Purcell, R. H., and Emerson, S. U. (1994) A new Chinese isolate of hepatitis E virus: comparison with strains recovered from different geographical regions. Virus Genes 9, 23–32.

    CAS  Google Scholar 

  31. Ray, R., Jameel, S., Manivel, V., and Ray, R. (1992) Indian hepatitis E virus shows a major deletion in the small open reading frame. Virology 189, 359–362.

    CAS  Google Scholar 

  32. Panda, S. K., Nanda, S. K., Zafrullah, M., Ansari, I., Ozdener, M. H., and Jameel, S. (1995) An Indian strain of hepatitis E virus (HEV): cloning, sequence, and expression of structural region and antibody responses in sera from individuals from an area of high-level HEV endemicity. J. Clin. Microbiol. 33, 2653–2659.

    CAS  Google Scholar 

  33. Huang, C. C., Nguyen, D., Fernandez, J., Yun, K. Y., Fry, K. E., Bradley, D. W., Tam, A. W., and Reyes, G. R. (1992) Molecular cloning and sequencing of the Mexico isolate of hepatitis E virus (HEV). Virology 191, 550–558.

    Article  CAS  Google Scholar 

  34. Tsarev, S. A., Emerson, S. U., Reyes, G. R., Tsareva, T. S., Legters, L. J., Malik, I. A., Iqbal, M., and Purcell, R. H. (1992) Characterization of a prototype strain of hepatitis E virus. Proc. Natl. Acad. Sci. USA 89, 559–563.

    Article  CAS  Google Scholar 

  35. Fry, K. E., Tam, A. W., Smith, M. M., Kim, J. P., Luk, K. C., Young, L. M., Piatak, M., Feldman, R. A., Yun, K. Y., Purdy, M. A., McCaustland, K. A., Bradley, D. W., and Reyes, G. R. (1992) Hepatitis E virus (HEV): strain variation in the nonstructural gene region encoding consensus motifs for an RNA-dependent RNA polymerase and an ATP/GTP binding site. Virus Genes 6, 173–185.

    CAS  Google Scholar 

  36. Koonin, E. V., Gorbalenya, A. E., Purdy, M. A., Rozanov, M. N., Reyes, G. R., and Bradley, D. W. (1992) Computer-assisted assignment of functional domains in the nonstructural polyprotein of hepatitis E virus: delineation of an additional group of positive-strand RNA plant and animal viruses. Proc. Natl. Acad. Sci. USA 89, 8259–8263.

    CAS  Google Scholar 

  37. Dalgarno, L., Rice, C. M., and Strauss, J. H. (1983) Ross River virus 26S RNA: complete nucleotide sequence and deduced sequence of the encoded structural proteins. Virology 129, 170–187.

    Article  PubMed  CAS  Google Scholar 

  38. Frey, T. K. and Man, L. D. (1988) Sequence of the region coding for virion proteins C and E2 and the carboxyl terminus of the nonstructural proteins of the rubella virus: comparison with alphaviruses. Gene 62, 85–99.

    Article  PubMed  CAS  Google Scholar 

  39. Khudyakov, Y. E., Khudyakova, N. S., Fields, H. A., Jue, D., Starling, C., Favorov, M. O., Krawczynski, K., Polish, L., Mast, E., and Margolis, H. (1993) Epitope mapping in proteins of hepatitis E virus. Virology 194, 89–96.

    Article  CAS  Google Scholar 

  40. Heller, T., Purcell, R. H., Klimpel, K. R., and Emerson, S. U. (1996) Assessment of the function of the third open reading frame protein of the hepatitis E virus, in Abstracts, IX Trien. Intern. Symp. Viral Hep. Liver Dis., Rome, Italy, p. 79.

    Google Scholar 

  41. Purcell, R. H. (1996) Hepatitis E virus, in Fields Virology ( Fields, B. N and Knipe, D. M., eds.), Raven, Philadelphia, pp. 2831–2843.

    Google Scholar 

  42. Yarbough, P. O. and Tam, A. W. (1997) Hepatitis E virus: biology, diagnosis and prevention. Hepatologia Clinica,in press.

    Google Scholar 

  43. Schlauder, G., Dawson, G., Kwo, P., Gabriel, G., and Mushahwar, I. (1996) Partial sequence comparison of a United States isolate of hepatitis E virus, in Abstracts, IX Trien. Intern. Symp. Viral Hep. Liver Dis., Rome, Italy, p. 78.

    Google Scholar 

  44. Yarbough, P. 0., Tam, A. W., Gabor, K., Garza, E., Moeckli, R. A., Palings, I., Simonsen, C., and Reyes, G. R. (1994) Assay development of diagnostic tests for hepatitis E, in Viral Hepatitis and Liver Disease ( Nishioka, K., Suzuki, H., Mishiro, S., and Oda, T., eds.), Springer-Verlag, Tokyo, pp. 367–370.

    Chapter  Google Scholar 

  45. Chauhan, A., Dilawari, J. B., Kaur, U., Ganguly, N. K., Bushnurmath, S., and Chawla, Y. K. (1994) Atypical strain of hepatitis E virus (HEV) from North India. J. Med. Virol. 44, 22–29.

    CAS  Google Scholar 

  46. Arankalle, V. A., Chadha, M. S., Tsarev, S. A., Emerson, S. U., Risbud, A. R., Banerjee, K., and Purcell, R. H. (1994) Seroepidemiology of water-borne hepatitis in India and evidence for a third enterically-transmitted hepatitis agent. Proc. Natl. Acad. Sci. USA 91, 3428–3432.

    Article  PubMed  CAS  Google Scholar 

  47. Tsarev, S. A., Tsareva, T. S., Emerson, S. U., Govindarajan, S., Shapiro, M., Gerin, J. L., Robinson, R., Gorbalenya, A. E., and Purcell, R. H. (1996) Prospect for pre-

    Google Scholar 

  48. vention of hepatitis E, in Enterically-Transmitted Hepatitis Viruses (Buisson, Y., Coursaget, P., and Kane, M., eds.), La Simarre, Tours, pp. 373–383.

    Google Scholar 

  49. Zhang, Y., McAtee, P., Yarbough, P. 0., Tam, A. W., and Fuerst, T. R. (1997) Expression, characterization, and immunoreactivities of a soluble hepatitis E virus putative capsid protein species expressed in insect cells. Clin. Diag. Lab. Immunol,in press.

    Google Scholar 

  50. Kazachkov, Y. A., Balayan, M. S., Ivannikova, T. A., Panina, L. I., Orlova, T. M., Zamyatina, N. A., and Kusov, Y. Y. (1992) Hepatitis E virus in cultivated cells. Arch. Virol. 127, 399–402.

    Article  Google Scholar 

  51. Huang, R. T., Li, D. R., Wei, J., Huang, X. R., Yuan, X. T., and Tian, X. (1992) Isolation and identification of hepatitis E virus in Xinjiang, China. J. Gen. Virol. 73, 1143–1148.

    Article  Google Scholar 

  52. Li, D. R., Huang, R. T., Tian, X., Yin, S., Wei, J., Huang, X. R., Wang, B. Z., Li, R. X., and Li, Y. C. (1995) Morphology and morphogenesis of hepatitis E virus (strain 87A). Chinese Med. J. 108, 126–131.

    CAS  Google Scholar 

  53. Tam, A. W., White, R., Reed, E., Short, M., Zhang, Y., Fuerst, T. R., and Lanford, R. E. (1996) In vitro propagation and production of hepatitis E virus from in vivo-infected primary macaque hepatocytes. Virology 215, 1–9.

    CAS  Google Scholar 

  54. Jacob, J. R., Sureau, C., Burk, K. H., Eichberg, J. W., Dressman, G. R., and Lanford, R. E. (1991) In vitro replication of non-A, non-B hepatitis virus, in Viral Hepatitis and Liver Disease ( Hollinger, F. B., Lemon, S. M., and Margolis, H. S., eds.), Williams and Wilkins, Baltimore, pp. 387–392.

    Google Scholar 

  55. Lanford, R. E., Sureau, C., Jacob, J. R., White, R., and Fuerst, T. R. (1994) Demonstration of in vitro infection of chimpanzee hepatocytes with hepatitis C virus using strand-specific RT/PCR. Virology 202, 606–614.

    Article  PubMed  CAS  Google Scholar 

  56. Sureau, C., Jacob, J. R., Eichberg, J. W., and Lanford, R. E. (1991) Tissue culture system for infection with human hepatitis delta virus. J. Virol. 65, 3443–3450.

    PubMed  CAS  Google Scholar 

  57. Sureau, C., Moriarty, A. M., Thorton, G. B., and Lanford, R. E. (1992) Production of infectious hepatitis delta virus in vitro and neutralization with antibodies directed against hepatitis B virus pre-S antigens. J. Virol. 66, 1241–1245.

    PubMed  CAS  Google Scholar 

  58. Sureau, C., Guerra, B., and Lanford, R. E. (1993) Role of large hepatitis B virus envelope protein in infectivity of the hepatitis delta virion. J. Virol. 67, 366–372.

    PubMed  CAS  Google Scholar 

  59. Purcell, R. H. and Ticehurst, J. R. (1988) Enterically transmitted non-A, non-B hepatitis: epidemiology and clinical characteristics, in Viral Hepatitis and Liver Disease ( Zuckerman, A. J., ed.), Alan R. Liss, New York, pp. 131–137.

    Google Scholar 

  60. Velazquez, 0., Stetler, H. C, Avila, C., Ornelas, G., Alvarez, C., Hadler, S. C., Bradley, D. W., and Sepulveda, J. (1990) Epidemic transmission of enterically transmitted non-A, non-B hepatitis in Mexico, 1986–1987. JAMA 263, 3281–3285.

    Google Scholar 

  61. Hyams, K. C., Purdy, M. A., Kaur, M., McCarthy, M. C., Hussain, M. A. M., ELTigani, A., Krawczynski, K., Bradley, D. W. and Mitchell, C. (1992) Acute sporadic hepatitis E in Sudanese children: analysis based on a new western blot assay. J. Inf. Dis. 165, 1001–1005.

    CAS  Google Scholar 

  62. Hyams, K. C., McCarthy, M. C., Kaur, M., Purdy, M. A., Bradley, D. W., Mansour, M. M., Gray, S., Watts, D. M., and Carl. M. (1992) Acute sporadic hepatitis E in children living in Cairo, Egypt. J. Med. Virol. 37, 274–277.

    Article  CAS  Google Scholar 

  63. Skidmore, S. J.,Yarbough, P. 0., Gabor, K. A., Tam, A. W., Reyes, G. R., and Flower, A. J. E. (1991) Imported hepatitis E in UK. Lancet 337, 1541.

    Article  CAS  Google Scholar 

  64. Zaiijer, H. L., Kok, M., Lelile, P. N., Timmerman, R. J., Chau, K., and van der Pal, H. J. H. (1993) Hepatitis E in the Netherlands: imported and endemic. Lancet 341, 826.

    Google Scholar 

  65. Dawson, G. J., Mushahwar, I. K., and Chau, K. H. (1992) Detection of long-lasting antibody to hepatitis E virus in a US traveler to Pakistan. Lancet 340, 426–427.

    CAS  Google Scholar 

  66. Tong, M. J., Roue, R., Nahor, M., Gawara N’., Desrame, J., Buisson, Y., and Coursaget, P. (1996) Clinical aspects of hepatitis E and hepatitis A, in A Comparison in Enterically-Transmitted Hepatitis Viruses ( Buisson, Y., Coursaget, P., and Kane, M., eds.), La Simarre, Tours, pp. 1–10.

    Google Scholar 

  67. Longer, C. F., Elliot, J. E., Caudill, J. D., Binn, L. B., Bryan, J. R, Iqbal, M., Innis, B. L., Clayson, E. T., Shrestha, M. P., Tsarev, S. A., Zhang, H. Y., and Tichurst, J. (1996) Observations on subclinical hepatitis E virus (HEV) infection and protection against reinfection, in A Comparison in Enterically-Transmitted Hepatitis Viruses ( Buisson, Y., Coursaget, P., and Kane, M., eds.), La Simarre, Tours, pp. 362–372.

    Google Scholar 

  68. Khuroo, M. S., Rustgi, V. K., Dawson, G. J., Mushahwar, I. K., Yattoo, G. N., Kamili, S., and Khan, B. A. (1994) Spectrum of hepatitis E virus infection in India. J. Med. Virol. 43, 281–286.

    Article  CAS  Google Scholar 

  69. Goldsmith, R., Yarbough, P. 0., Reyes, G. R., Fry, K. E., Gabor, K. A., Kamel, M., Zakaria, S., Amer, S., and Gaffar, Y. (1992) Enzyme-linked immunosorbent assay for diagnosis of acute sporadic hepatitis E in Egyptian children. Lancet 339, 328–331.

    CAS  Google Scholar 

  70. Song D. Y., Zhuang, H., Kang, X. C., Liu, X. M., Li, Z., Hao W., Shi, K. C., Hao, F. M., Jia, Q., Chen, D. G., He, Z. X., and Ai, Z. Z. (1991) Hepatitis E in Hetian City: a report of 562 cases, in Viral Hepatitis and Liver Disease ( Hollinger, F. B., Lemon, S. M., and Margolis, H., eds.), Wilkins and Wilkins, Baltimore, pp. 528–529.

    Google Scholar 

  71. Chauhan, A., Jameel, S., Dilawari, J. B., ChawlaY. K., Kaur, U., and Ganguly, N. K. (1993) Hepatitis E virus transmission to a volunteer. Lancet 341, 149–150.

    CAS  Google Scholar 

  72. Mast, E. E. and Krawczynski, K. (1996) Hepatitis E: an overview. Annu. Rev. Med. 47, 257–266.

    Article  PubMed  CAS  Google Scholar 

  73. Arankalle, V.A., Chadha, M., Mehendale, S. M., and Banerjee, K. (1988) Outbreak of enterically transmitted non-A, non-B hepatitis among schoolchildren. Lancet 2, 1199–1200.

    Article  PubMed  CAS  Google Scholar 

  74. Uchida, T. (1992) Hepatitis E review. Gastroenterol. Jap. 27, 687–696.

    CAS  Google Scholar 

  75. Khuroo, M. S., Teli M. R., Skidmore, S., Sofi, M. A., and Khuroo, M. (1991) Incidence and severity of viral hepatitis in pregnancy. Amer. J. Med. 70, 252–255.

    Article  Google Scholar 

  76. Tsarev, S.A., Tsareva, T. S., Emerson, S. U., Rippy, M. K., Zack, P., Shapiro, M., and Purcell, H. (1995) Experimental hepatitis E in pregnant rhesus monkeys: failure to transmit hepatitis E virus (HEV) to offspring and evidence of naturally acquired antibodies to HEV. J. Inf. Dis. 172, 31–37.

    CAS  Google Scholar 

  77. Khuroo, M. S. and Dar, M. Y. (1992) Hepatitis E: evidence for person-to-person transmission and inability of low dose immune serum globulin from an Indian source to prevent it. Indian J. Gastroenterol. 11, 113–116.

    PubMed  CAS  Google Scholar 

  78. Mannucci, P. M., Gringeri, A., Santagostino, E., Romano, L., and Zanetti, A. (1994) Low Risk of transmission of hepatitis E virus by large-pool coagulation factor concentrates. Lancet 343, 597–598.

    CAS  Google Scholar 

  79. Khuroo, M. S., Kamili, S., and Jameel, S. (1995) Vertical transmission of hepatitis E virus. Lancet 345, 1025–1026.

    Article  CAS  Google Scholar 

  80. Longer, C. F., Denny, S. L., Caudill, J. D., Miele, T. A., Asher, L. V. S., Myint, K. S. A., Huang, C. C., Engler, W. F., LeDuc, J. W., Binn, L. N., and Ticehurst, J. R. (1993) Experimental hepatitis E: pathogenesis in cynomolgus macaques (Macaca fascicularis). J Infect. Dis. 168, 602–609.

    Article  PubMed  CAS  Google Scholar 

  81. Purdy, M. A., McCaustland, K. A., Krawczynski, K., Spelbring, J., Reyes, G. R., and Bradley, D. W. (1993) Preliminary evidence that a trpE-HEV fusion protein protects cynomolgus macaques against challenge with wild-type hepatitis E virus (HEV). J. Med. Virol. 41, 90–94.

    Article  CAS  Google Scholar 

  82. Tsarev, S. A., Tsareva, T. S., Emerson, S. U., Govindarajan, S., Shapiro, M., Gerin, J. L., and Purcell, R. H. (1994) Successful passive and active immunization of cynomolgus monkeys against hepatitis E. Proc. Natl. Acad. Sci. USA 91,10, 198–10, 202.

    Google Scholar 

  83. Fuerst, T. R.,Yarbough, P.O., Zhang, Y., McAtee, P., Tam, A., Lifson, J., McCaustland, K., Spellbring, J., Bradley, D., Margolis, H. S., Francotte, M., Garcon, N., Slaoui, M., Prieels, J. P., and Krawczynsi, K. (1996) Prevention of hepatitis E using a novel ORF2 subunit vaccine, in Enterically-Transmitted Hepatitis Viruses ( Bussion,Y. P., Coursaget, P., Kane, M., eds.), La Simarre, Tours, pp. 384–392.

    Google Scholar 

  84. McAtee, C. P., Zhang, Y., Yarbough, P. 0., Bird, T., Fuerst, T. R., Stone, K. L., Samander, S., and Williams, K. R. (1996) Purification and characterization of a recombinant hepatitis E protein vaccine candidate by liquid chromatography-mass spectrometry. J. Chromat. (B) 685, 91–104.

    CAS  Google Scholar 

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© 1999 Springer Science+Business Media New York

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Yarbough, P.O., Tam, A.W. (1999). Hepatitis E Virus. In: Specter, S. (eds) Viral Hepatitis. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-702-4_6

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  • DOI: https://doi.org/10.1007/978-1-59259-702-4_6

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-033-5

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