Two cases of fulminant hepatitis E occurred in Hakodate area 2010, suggesting infection with single source hepatitis E virus separated from small epidemic in Sapporo 2009

Abstract

In April 2010, two elder female patients presented fulminant hepatitis E in Hakodate city, Hokkaido, Japan. HEV strains identified in their blood sampled belonged to"new Sapporo strain"of Genotype 4 separated from the small epidemic happened in Sapporo 2009, showing significant similarity to each other by phylogenetic analysis. One patient of 63-year-old improved rapidly, however, another one of 73-year-old died from prolonged course of hepatitis. The quantified levels of HEV RNA in sera had promptly declined in the former, but those had sustained over 5 log copies/ml during 7 weeks in the latter. Lasting viremia in HEV infection might be associated with prolonged liver injury in the latter patient.