Severe Hepatitis E Virus Infection after Ingestion of Uncooked Liver from a Wild Boar

Abstract

To the Editor —As was reported in the Journal by Takahashi et al. [1] as well as by the authors of a letter to the editor about Takahashi et al.’s article [2], hepatitis E virus (HEV) infection caused by genotypes III and IV seems to be cryptically endemic in Japan, with the transmission mode yet to be resolved. Zoonotic risks have been suggested for sporadic HEV infections, particularly in industrialized countries [3]. We hereby report our recent experience in Japan, which may support the zoonosis hypothesis A 53-year-old man (patient A) was admitted to one of our hospitals for acute hepatitis on 12 March 2003. His hepatitis was a severe type, as indicated by the levels of total bilirubin (10.2 mg/dL) and prothrombin (only 17%). Despite the initial severity of the disease, he showed a rapid recovery, without developing fulminant hepatic failure. Convalescence serum obtained on 15 April was positive for both IgM and IgG classes of anti-HEV but was negative for HEV RNA. Acute-phase serum from this patient was not available