Severe Hepatitis E Virus Infection after Ingestion of Uncooked Liver from a Wild Boar

摘要: To the Editor-As was reported in Journal, by Takahashi et al. [ 1 ] as well authors of a letter to editor about al.'s article [2], hepatitis E virus (HEV) infection caused genotypes III and IV seems be cryptically endemic Japan, with transmission mode yet resolved. Zoonotic risks have been suggested for sporadic HEV infections, particularly industrialized countries [3]. We hereby report our recent experience which may support zoonosis hypothesis. A 53-year-old man (patient A) admitted one hospitals acute on 12 March 2003. His severe type, indicated levels total bilirubin (10.2 mg/dL) prothrombin (only 17%). Despite initial severity disease, he showed rapid recovery, without developing fulminant hepatic failure. Convalescence serum obtained 15 April positive both IgM IgG classes anti-HEV but negative RNA. Acute-phase from this patient not available. Later, surprise, it revealed that, same day that had admitted, his friends (a 70year-old man; B) another hospital, similarly (total bilirubin, 17.1 mg/ dL; prothrombin, 40%). Patient B developed coma died failure 13 April. found, retrospectively, Determination 326-nt partial open-reading frame-1 sequence RNA (accession no. AB114178) isolate segregates genotype During 3 months preceding onset neither nor traveled areas where is endemic, mentioned enjoyed eating uncooked boar liver together 5 times late January early February. Among patients' family members friends, no eaten contracted hepatitis. Chandler [4] serological evidence suggesting boars pigs candidate animal reservoirs Although we could prove source (since all eaten), appears likely case.