Acute sporadic hepatitis E virus infection in southern China

J Hepatol. 1995 Sep;23(3):239-45.


Background/aims: The hepatitis E virus is responsible for epidemic and sporadic hepatitis in northwestern China, but its role as a cause of acute sporadic hepatitis in southern China has not been reported.

Methods: We applied the most practical current methods for diagnosis of hepatitis E virus infection, IgM and IgG anti-HEV detection by enzyme linked immunosorbent assay, to investigate the prevalence of hepatitis E virus infection among acute sporadic hepatitis.

Results: Anti-HEV IgM was found in 1 of 26 (3.8%), 4 of 20 (20.0%), 4 of 19 (21.1%), and 51 of 142 (35.9%), with acute hepatitis A, B, C and non-ABC, respectively. Anti-HEV IgM was not detectable in healthy subjects, while IgG anti-HEV was found in 14 of 77 healthy subjects (18.2%) and was long-lasting. Ninety-one cases without any evidence of hepatitis A, B or C infections and anti-HEV IgM were tentatively classified as non-A, B, C, D, E (non-ABCDE) hepatitis. By comparison with non-ABCDE, cases with hepatitis E were more frequently icteric and exhibited higher alanine aminotransferase levels (92.2% vs. 45.1%, 770 iu/l vs 377 iu/l, respectively, p < 0.005). Chronic cases were not observed in hepatitis E virus infections. However, 14 of 91 (15.4%) cases with non-ABCDE developed to chronicity (p < 0.005).

Conclusions: Hepatitis E virus infection is sporadic as well as endemic in southern China. Only IgM anti-HEV but not IgG anti-HEV can be used as an appropriate marker of acute hepatitis E virus infection. Superinfection of hepatitis E virus with other types of hepatitis viruses is frequent in this area. While the disease was associated with more severe clinical manifestations, patients usually recovered completely.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alanine Transaminase / blood
  • China / epidemiology
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Hepatitis E / epidemiology*
  • Hepatitis E / immunology
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Male
  • Middle Aged
  • Prevalence


  • Immunoglobulin G
  • Immunoglobulin M
  • Alanine Transaminase