Z Gastroenterol 2012; 50 - P4_63
DOI: 10.1055/s-0031-1295949

Phylogenetic Characterization of HEV Isolates Derived from Acute Hepatitis E Cases in Germany 2010/2011

JJ Wenzel 1, M Faber 2, B Huber 1, K Stark 2, W Jilg 1
  • 1Institut für Medizinische Mikrobiologie und Hygiene, Regensburg
  • 2Robert Koch Institut, Berlin

Introduction: Hepatitis E virus (HEV) has been identified as an emerging cause of infectious hepatitis over the last years in developed countries. In contrast to travel associated hepatitis E (HEV genotype 1), autochthonous cases in Europe are associated with HEV genotype 3 isolates. However, no comprehensive data on HEV genotype spectrum and distribution are available for Germany.

Methods: In 2010 and 2011 we received 50 HEV isolates from acute hepatits E cases in Germany. Samples were analyzed by quantitative RT-qPCR and conventional nested PCR prior to sequencing (variable regions in ORF1 and ORF2). Rooted maximum likelihood phylogenetic consensus trees for ORF1 nucleotide sequences were generated using the Phylip software package. Predefined prototype isolates for genotype 1–4 were included in the analysis. Sequence database searches were performed to find other closely related HEV isolates.

Results: We identified 5 HEV genotype 1 (10%) and 45 HEV genotype 3 isolates (90%). All genotype 1 isolates were found in travel associated cases and clustered in subgenotypes 1a (n=3) and 1e (n=2). The genotype 3 isolates segregated into 4 subgenotype clusters: 3a (n=1, 2%), 3c (n=26, 58%), 3e (n=9, 20%) and 3f (n=8, 18%). One isolate was not characterized reliably to subgenotype level. No conclusive geographical clustering of subgenotypes was observed.

Discussion: Until recently, Hepatitis E has been regarded as a travel associated disease in Germany. In the past years however, evidence has accumulated suggesting that the majority of cases are in fact autochthonous. Our findings are in line with these data. We demonstrate that the majority of hepatitis E cases in Germany found in 2010 and 2011 are in fact caused by genotype 3 isolates (90%). These isolates clustered in 4 subgenotypes. However, we were not able to predict the geographical location of cases within Germany on the basis of the subgenotype information.

Hepatitis E - Phylogenetic Analysis