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The rat hepatitis E virus (HEV) was first discovered in 2010 and circulates in domestic rats (Rattus rattus) and sewer rats (Rattus norvegicus). It is very closely related to the variants of the human hepatitis E virus. Human infection with rat HEV has never been documented before.
A study led by Professor Yuen Kwok-Yung, Professor Henry Fok in Infectious Diseases, Professor of Infectious Diseases, and Dr. Siddharth Sridhar, Clinical Assistant Professor in the Department of Microbiology of the Li Ka Shing School of Medicine. University of Hong Kong (HKU) has discovered for the first time that the HEV of the rat can infect humans.
Results of the study
While studying the impact of hepatitis E infection in immunocompromised transplant recipients in Hong Kong, the researchers identified a 56-year-old man who was taking immunosuppressive drugs after liver transplantation by a deceased donor. He presented abnormal persistent liver function tests indicating dysfunction of the liver transplant.
HEV in rats has been identified in several of his clinical specimens, including stool, blood and liver tissue. Complete genome sequencing of the virus isolate showed that it was closely related to a previously identified strain of HEV in Vietnam. The epidemiological investigation did not reveal any evidence of HEV infection in the rat in the donor organ or the donor of blood products, with the exception of these individuals as a source of infection.
However, signs of rodent infestation have been noted in the patient's home. Rat HEV could not be detected in rodent stool specimens collected in the subdivision, but screening of rodent samples archived in the patient's residential area shows that rat HEV is circulating in rats Hong Kong. The patient received oral ribavirin, an antiviral effective against chronic infections with hepatitis E, and the infection was cured. His liver function has returned to normal.
Discussion
This study conclusively proves for the first time in the world that HEV in rats can infect humans by causing a clinical infection. This discovery is of major importance for public health and highlights the importance of new zoonotic infections in immunocompromised patients. The classic diagnostic tests for hepatitis E can completely miss the infection, new diagnostic tests have been developed by researchers to diagnose HEV infection in rats in cases following.
This study highlights the importance of rodent control measures and research on rodent viruses to prevent HEV infection in rats and other rodent-transmitted infections in Hong Kong.
This study was accepted for publication by Emerging infectious diseases, a reference journal on open access infectious diseases.
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