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All 11 patients had detectable HEV RNA in serum at admission, with the highest viral load being 1.9 \u00d7 10\n            <jats:sup>3<\/jats:sup>\n            to 1.7 \u00d7 10\n            <jats:sup>7<\/jats:sup>\n            copies\/ml, and HEV viremia lasted until days 17 to 48 (mean, 28.3) after the onset of hepatitis. Even at the initial examination on days 10 to 29 (mean, 17.6), the HEV load in fecal supernatant was less than 5.7 \u00d7 10\n            <jats:sup>4<\/jats:sup>\n            copies\/ml for 10 of the 11 patients, while for the remaining patient (patient 1) it was markedly high, 2.0 \u00d7 10\n            <jats:sup>7<\/jats:sup>\n            copies\/ml on day 22. In addition, although HEV RNA in fecal supernatant continued to be positive until days 14 to 33 (mean, 22.4) for patients 2 to 11, that for patient 1 was detectable even on day 121. HEVs in fecal specimens obtained on days 22, 24, 26, 28, and 30, but not day 121, from patient 1 grew efficiently in PLC\/PRF\/5 cells, reaching the highest titer of up to 10\n            <jats:sup>7<\/jats:sup>\n            copies\/ml in culture medium on day 50 postinoculation. The HEV genome recovered from patient 1 had 29 unique nucleotides that were not seen in any of the 25 reported HEV isolates of the same genotype over the entire genome, with six amino acid substitutions in the ORF1 protein.\n          <\/jats:p>","DOI":"10.1128\/jcm.01086-07","type":"journal-article","created":{"date-parts":[[2007,8,30]],"date-time":"2007-08-30T01:14:33Z","timestamp":1188436473000},"page":"3671-3679","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":86,"title":["Prolonged Fecal Shedding of Hepatitis E Virus (HEV) during Sporadic Acute Hepatitis E: Evaluation of Infectivity of HEV in Fecal Specimens in a Cell Culture System"],"prefix":"10.1128","volume":"45","author":[{"given":"Masaharu","family":"Takahashi","sequence":"first","affiliation":[{"name":"Division of Virology, Department of Infection and Immunity"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshinori","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Virology, Department of Infection and Immunity"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Azuma","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Jichi Medical University School of Medicine, Tochigi-Ken, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Jichi Medical University School of Medicine, Tochigi-Ken, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Aikawa","sequence":"additional","affiliation":[{"name":"Aikawa Internal Medicine Hospital, Ibaraki-Ken, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Shibayama","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Metropolitan Toshima Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Yazaki","sequence":"additional","affiliation":[{"name":"Center for Gastroenterology, Kobayashi Hospital, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Mizuo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kin-ikyo Chuo Hospital, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Inoue","sequence":"additional","affiliation":[{"name":"Division of Virology, Department of Infection and Immunity"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Division of Virology, Department of Infection and Immunity"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"787","volume":"340","year":"1992","unstructured":"Aggarwal, R., and S. 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