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Dynamics of HEV viremia, fecal shedding and its relationship with transaminases and antibody response in patients with sporadic acute hepatitis E | Chandra et al. Virology Journal 2010 7 213 http www.virologyj.eom content 7 1 213 VIROLOGY JOURNAL RESEARCH Open Access Dynamics of HEV viremia fecal shedding and its relationship with transaminases and antibody response in patients with sporadic acute hepatitis E 1.2 2 3 1 Nidhi S Chandra 1 Asha Sharma Bharti Malhotra Ramesh R Rai Abstract Background There is paucity of data regarding duration of fecal excretion and viremia on sequential samples from individual patients and its correlation with serum transaminases and antibody responses in patients with acute hepatitis E. This prospective study was undertaken at a tertiary care center in Northern India over 15 months. Only those patients of sporadic acute hepatitis E who were in their first week of illness and followed up weekly for liver function tests IgM anti HEV antibody and HEV RNA in sera and stool were included. HEV RNA was done by RT - nPCR using two pairs of primers from RdRp region of ORF 1 of the HEV genome. Results Over a period of 15 months 60 patients met the inclusion criterion and were enrolled for the final analysis. The mean age of the patients was 29.2 8.92 years there were 39 males. The positivity of IgM anti HEV was 80 at diagnosis and 18.3 at 7th week HEV RNA 85 at diagnosis and 6.6 at 7th week and fecal RNA 70 at the time of diagnosis and 20 at 4th week. The maximum duration of viremia detected was 42 days and fecal viral shedding was 28 days after the onset of illness. Conclusion Present study reported HEV RNA positivity in sera after normalization of transaminases. Fecal shedding was not seen beyond normalization of transaminases. However viremia lasted beyond normalization of transaminases suggesting that liver injury is independent of viral replication. Background Hepatitis E virus is the etiological agent of non-HAV enterically transmitted hepatitis and major cause of sporadic as well as epidemic hepatitis 1 2 . In Indian subcontinent it accounts for 30-60 of sporadic hepatitis 3 4 . .
