OBJECTIVE We aimed to detect and characterize hepatitis E virus (HEV) RNA in sera samples from a pediatric population infected with the hepatitis A virus (HAV) exhibiting acute hepatitis and to correlate the infection status with the clinical outcome. METHODS Seventy-five ELISA-positive samples from children containing anti-HAV and anti-HEV IgM were used to amplify and characterize partial regions within HEV ORF2. A statistical comparison of clinical data between HEV IgM-positive/HEV RNA-positive patients and HEV IgM-positive/HEV RNA-negative patients was performed. RESULTS Thirteen out of 75 IgM-positive samples provided amplification of discrete regions of the HEV genome. Nested RT-PCR-based detection and subsequent sequencing of 5 samples confirmed the identity of HEV genotype 1 (G1), which had not been previously reported in Mexico. Though not significant, a trend towards exacerbated clinical manifestations was found in HEV RNA-positive patients relative to HEV RNA-negative patients. CONCLUSIONS An elevated rate of G1 RNA was detected. Hepatitis E seems to be a neglected disease in Mexico and epidemic strains of HEV are likely to play a role as causative agents of acute hepatitis in highly exposed children. Although HAV is endemic in Mexico, an HEV-RNA detection rate of 17% in co-infected samples shows the need for screening for HEV as a part of future vaccination strategies.

中文翻译：

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来自墨西哥的低社会经济地位的儿科患者戊型肝炎病毒基因型1和甲型肝炎病毒双重感染。

目的我们旨在检测和表征感染急性肝炎的甲型肝炎病毒（HAV）的儿科患者血清样本中的戊型肝炎病毒（HEV）RNA，并将其感染状况与临床结果相关联。方法使用含抗-HAV和抗-HEV IgM的儿童的75份ELISA阳性样品来扩增和鉴定HEV ORF2中的部分区域。对HEV IgM阳性/ HEV RNA阳性患者和HEV IgM阳性/ HEV RNA阴性患者之间的临床数据进行统计比较。结果75个IgM阳性样品中有13个提供了HEV基因组离散区域的扩增。基于嵌套式RT-PCR的检测和随后对5个样品的测序证实了HEV基因型1（G1）的身份，此前墨西哥尚未报道。尽管不显着，但相对于HEV RNA阴性患者，在HEV RNA阳性患者中发现了临床表现恶化的趋势。结论检测到G1 RNA升高。在墨西哥，戊型肝炎似乎是一种被忽视的疾病，戊型肝炎病毒的流行株很可能在高度暴露的儿童中充当急性肝炎的病原体。尽管在墨西哥流行HAV，但在合并感染的样本中HEV-RNA检出率为17％，这表明有必要筛查HEV作为未来疫苗接种策略的一部分。在墨西哥，戊型肝炎似乎是一种被忽视的疾病，戊型肝炎病毒的流行株很可能在高度暴露的儿童中充当急性肝炎的病原体。尽管在墨西哥流行HAV，但在合并感染的样本中HEV-RNA检出率为17％，这表明有必要筛查HEV作为未来疫苗接种策略的一部分。在墨西哥，戊型肝炎似乎是一种被忽视的疾病，戊型肝炎病毒的流行株很可能在高度暴露的儿童中充当急性肝炎的病原体。尽管在墨西哥流行HAV，但在合并感染的样本中HEV-RNA检出率为17％，这表明有必要筛查HEV作为未来疫苗接种策略的一部分。