Swine Hepatitis E Virus: Cross-Species Infection and Risk in Xenotransplantation
Swine hepatitis E Virus (swine HEV), a ubiquitous agent recently discovered in pigs, is antigenically and genetically closely related to the human HEV. Swine HEV infection in pigs generally occurs at about 2-3 months of age, and about 80%-100% of the pigs
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Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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2 2.1 2.2 2.3 2.4
Hepatitis E Virus . . . . . . . . . . . . . . . . . . Hepatitis E as a Disease and Its Causative Agent. Biology and Classification of HEV . . . . . . . . Heterogeneity and Genotypes . . . . . . . . . . . Epidemiology . . . . . . . . . . . . . . . . . . . .
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186 186 187 188 190
3 3.1 3.2 3.3 3.4 3.5 3.6 3.7
Swine HEV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Discovery of Swine HEV . . . . . . . . . . . . . . . . . . . . . . . Genome Organization . . . . . . . . . . . . . . . . . . . . . . . . Pathogenesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Anti-HEV Prevalence in Swine Population . . . . . . . . . . . . . Experimental Infection of Nonhuman Primates with Swine HEV Anti-HEV Prevalence in Pig Handlers . . . . . . . . . . . . . . . Emergence of Novel Strains of Human HEV Closely Related to Swine HEV . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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192 192 195 196 200 201 203
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4 4.1 4.2 4.3 4.4
Animal Reservoirs for HEV: Risk for Zoonosis . Anti-HEV Prevalence in Animal Species . . . . . Genetic Identification of Animal Strains of HEV Experimental Cross-Species Infection of HEV . . Natural History of HEV: A Hypothesis . . . . . .
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205 205 205 206 207
5 5.1 5.2 5.3
Xenozoonotic Risk of Swine HEV Infection . . . . . . . . . . Sites of Viral Replication in Swine . . . . . . . . . . . . . . . Risk for Xenozoonosis . . . . . . . . . . . . . . . . . . . . . . Screening for Swine HEV Infection in Xenograft Donor Pigs.
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207 207 209 209
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Abstract Swine hepatitis E Virus (swine HEV), a ubiquitous agent recently discovered in pigs, is antigenically and genetically closely related to the human HEV. Swine HEV infection in pigs generally occurs at about 2–3 months of age, and about 80%–100% of the pigs in commercial farms in the USA were infected. Swine HEV infections have now
D. R. Salomon et al. (eds.), Xeno-transplantation © Springer-Verlag Berlin Heidelberg 2003
186
X. J. Meng
been recognized in pigs in many other countries of the world. Interspecies transmission has been documented, as swine HEV infects nonhuman primates and some strains of human HEV infect pigs. Recent seroepidemiological studies showed that swine veterinarians and other pig handlers are at higher risk of HEV infection compared to normal blood donors. In addition, novel strains of human HEV recovered from hepatitis patients in the USA, Japan and Taiwan a
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