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Pathogenesis of hepatitis E infection is poorly understood. Toll\u2010like receptors (TLR<\/jats:styled-content>s) are the key players of innate immunity recognize pathogen\u2010associated molecular patterns (PAMP<\/jats:styled-content>s). Previously, we found higher TLR<\/jats:styled-content>4 expression (at protein and gene level) with impaired cytokine response upon stimulus of PBMC<\/jats:styled-content>s with LPS<\/jats:styled-content> in HEV<\/jats:styled-content>\u2010infected patients. In view of the earlier observations of the association of polymorphisms in TLR<\/jats:styled-content>4 genes (A299G, C399T) with liver diseases, we investigated TLR<\/jats:styled-content>4 polymorphisms in HEV<\/jats:styled-content>\u2010infected patients. We observed the significant association of TLR<\/jats:styled-content>4\u2010399CC<\/jats:styled-content> and CT<\/jats:styled-content> alleles with hepatitis E (both subclinical and acute patients). Carrier frequency of TLR<\/jats:styled-content>4\u2010399 CT<\/jats:styled-content> was lower in patients\u2019 categories in comparison with the controls. Higher frequency of allele TLR<\/jats:styled-content>4\u2010399C significantly correlated with disease progression. Acute hepatitis E patients showed the higher frequency of CG<\/jats:styled-content> and TA<\/jats:styled-content> haplotypes, while the rare haplotype (TG<\/jats:styled-content>) was more frequent in controls. The other single nucleotide polymorphism (SNP<\/jats:styled-content>) at TLR<\/jats:styled-content>4\u2010299 (A>G) did not show any difference. We report here for the first time the association of TLR<\/jats:styled-content>4 polymorphism with hepatitis E and suggest that TLR<\/jats:styled-content> 4 hyporesponsiveness during HEV<\/jats:styled-content> infection might be related to its polymorphism.<\/jats:p>","DOI":"10.1111\/jvh.12980","type":"journal-article","created":{"date-parts":[[2018,8,16]],"date-time":"2018-08-16T08:32:34Z","timestamp":1534408354000},"page":"1617-1623","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Association of Toll\u2010like receptor 4 polymorphism with hepatitis E virus\u2010infected Indian patients"],"prefix":"10.1111","volume":"25","author":[{"given":"Ravi P.","family":"Arya","sequence":"first","affiliation":[{"name":"ICMR Consultant and Scientist G National Institute of Virology Pune 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