{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:24:14Z","timestamp":1786947854978,"version":"build-2736575974"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HAV and HEV cause substantial preventable morbidity across India, yet contemporary clinico-epidemiological and molecular surveillance from the rural Indo-Gangetic plain is sparse, with no published series from the eastern Uttar Pradesh catchment of AIIMS Raebareli. We addressed this gap through an integrated hospital-based study of acute viral hepatitis (AVH) combining seroprevalence, clinical phenotyping, seasonality and molecular genotyping, with public deposit of all newly generated sequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Serum samples from 554 consecutive patients with clinically suspected AVH at AIIMS Raebareli between January 2023 and October 2024 were screened for anti-HAV and anti-HEV IgM by enzyme-linked immunosorbent assay. Seropositive samples underwent RT-PCR targeting the HAV VP1\u2013VP3 and HEV ORF2 regions, and representative amplicons were Sanger-sequenced. Phylogenetic relationships were reconstructed using maximum likelihood in MEGA 11 with 1,000 bootstrap replicates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Anti-HAV IgM was detected in 50 patients (9.0%) and anti-HEV IgM in 18 (3.2%); four (0.7%) showed dual seropositivity. The HAV-positive cohort was predominantly pediatric (median 14\u202fyears, IQR 7\u201319), with 44.0% aged 6\u201315 and 38.0% aged 16\u201340\u202fyears. HEV-positive patients spanned a wider age range (median 13, IQR 4\u201330). HAV cases peaked pre-monsoon (May\u2013June); HEV occurred year-round. Severe disease was uncommon: one HAV-positive patient developed acute liver failure and died in hospital. RT-PCR confirmed HAV viremia in 11\/50 (22.0%) and HEV in 7\/18 (38.9%). All sequenced HAV strains were HAV genotype IIIA and HEV strains HEV genotype 1a, with 98\u201399% nucleotide identity to Indian references.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HAV remains the dominant cause of enterically transmitted AVH in this previously unstudied rural catchment, with disease now concentrated in older children, adolescents and young adults; HEV-1a circulates at lower volume but year-round. Genotypic uniformity (HAV-IIIA, HEV-1a) indicates a stable transmission pattern, and the present sequences (GenBank PV454657\u2013PV454670) extend the molecular record from northern India. Three operational priorities follow: structured HAV immunization of older children and adolescents, a focused pre-monsoon (March\u2013May) WASH outreach window, and routine anti-HEV IgM screening of pregnant women presenting with jaundice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1902419","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:25:55Z","timestamp":1786944355000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatitis A and E in rural northern India: clinico-epidemiological and molecular surveillance from a tertiary care hospital"],"prefix":"10.3389","volume":"14","author":[{"given":"Shefali","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Priyanka","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Islahi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirudh","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mritunjay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sweta","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Dwivedi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niraj Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of General Surgery, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parul","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijeet","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukesh","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namita","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niraj","family":"Kumari","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS)","place":["Raebareli, Uttar Pradesh, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.clinmicnews.2020.10.001","article-title":"Hepatitis a and hepatitis E: clinical and epidemiological features, diagnosis, treatment, and prevention","volume":"42","author":"Webb","year":"2020","journal-title":"Clin Microbiol Newsl"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"a032136","DOI":"10.1101\/cshperspect.a032136","article-title":"Natural history, clinical manifestations, and pathogenesis of hepatitis E virus genotype 1 and 2 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