{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T00:15:21Z","timestamp":1794183321693,"version":"4.8.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Health and Medical Research"},{"DOI":"10.13039\/501100005407","name":"Food and Health Bureau","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005407","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hong Kong Special Administrative Region","award":["19180442"],"award-info":[{"award-number":["19180442"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatitis E virus (HEV) variants belonging to Orthohepevirus species A (HEV-A) are the primary cause of human hepatitis E. However, we previously reported that Orthohepevirus species C genotype 1 (HEV-C1), a divergent HEV variant commonly found in rats, also causes hepatitis in humans. Here, we present a clinical-epidemiological investigation of human HEV-C1 infections detected in Hong Kong, with an emphasis on outcomes in immunocompromised individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A surveillance system for detecting human HEV-C1 infections was established in Hong Kong. Epidemiological and clinical characteristics of HEV-C1 cases identified via this system between 1 August 2019 and 31 December 2020 were retrieved. Phylogenetic analysis of HEV-C1 strain sequences was performed. Infection outcomes of immunocompromised individuals with HEV-A and HEV-C1 infections were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HEV-C1 accounted for 8 of 53 (15.1%) reverse-transcription polymerase chain reaction (RT-PCR)\u2013confirmed HEV infections in Hong Kong during the study period, raising the total number of HEV-C1 infections detected in the city to 16. Two distinct HEV-C1 strain groups caused human infections. Patients were elderly and\/or immunocompromised; half tested negative for HEV immunoglobulin M. Cumulatively, HEV-C1 accounted for 9 of 21 (42.9%) cases of hepatitis E recorded in immunocompromised patients in Hong Kong. Immunocompromised HEV-C1 patients progressed to persistent hepatitis at similar rates (7\/9 [77.8%]) as HEV-A patients (10\/12 [75%]). HEV-C1 patients responded to oral ribavirin, although response to first course was sometimes poor or delayed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dedicated RT-PCR\u2013based surveillance detected human HEV-C1 cases that evade conventional hepatitis E diagnostic testing. Immunosuppressed HEV-C1\u2013infected patients frequently progress to persistent HEV-C1 infection, for which ribavirin is a suitable treatment option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciab919","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T15:13:11Z","timestamp":1635174791000},"page":"288-296","source":"Crossref","is-referenced-by-count":98,"title":["Hepatitis E Virus Species C Infection in Humans, Hong Kong"],"prefix":"10.1093","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2022-8307","authenticated-orcid":false,"given":"Siddharth","family":"Sridhar","sequence":"first","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"},{"name":"State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong , China"},{"name":"Carol Yu Centre for Infection, The University of Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril Chik Yan","family":"Yip","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin Hon Yin","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shusheng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwen","family":"Situ","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas Foo Siong","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kit Hang","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen Shuk Ying","family":"Chan","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally Cheuk Ying","family":"Wong","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Wai Shing","family":"Leung","sequence":"additional","affiliation":[{"name":"Princess Margaret Hospital , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy Wing Sze","family":"Tse","sequence":"additional","affiliation":[{"name":"Kwong Wah Hospital , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty S C","family":"Fung","sequence":"additional","affiliation":[{"name":"United Christian Hospital , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen Tak Yin","family":"Tsang","sequence":"additional","affiliation":[{"name":"Princess Margaret Hospital , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kam Lun","family":"Hon","sequence":"additional","affiliation":[{"name":"The Hong Kong Children\u2019s Hospital , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Chi Chung","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken Ho Leung","family":"Ng","sequence":"additional","affiliation":[{"name":"Public Health Laboratory Services Branch, Department of Health , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok Yung","family":"Yuen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Hong Kong , China"},{"name":"State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong , China"},{"name":"Carol Yu Centre for Infection, The University of Hong Kong , China"},{"name":"The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The University of Hong Kong , Hong Kong , 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