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Volume 41, Number 3, June 2008

Hepatitis E virus coinfection with hepatotropic viruses in Egyptian children

Maysaa El Sayed Zaki, Osama Saad Salama, Fathy Awaad Mansour, Shaimaa Hossein
Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Egypt

Received: June 15, 2007    Revised: August 5, 2007    Accepted: October 30, 2007   


Corresponding author:

Dr. Maysaa El Sayed Zaki, Department of Clinical Pathology, Faculty of Medicine, Mansoura University, El Gomhoria Street, Mansoura, Egypt. E-mail: Dr. Maysaa El Sayed Zaki This e-mail address is being protected from spam bots, you need JavaScript enabled to view it



Background and purpose: 

Major hepatotropic viruses continue to be important causes of acute viral hepatitis in developing countries. This work was carried out to detect the seroprevalence of hepatitis E virus (HEV) markers in children with acute viral hepatitis due to hepatotropic viruses (A, B and C) and non-A, non-B, non-C acute hepatitis, and to ascertain the influence of HEV superinfection in individuals infected with hepatitis viruses (A, B and C).




We studied prospectively 162 children with sporadic acute hepatitis who reported to our hospital. Thirteen healthy controls were also included in the study. Laboratory investigations were performed, including complete liver function tests. Complete serological profiles for hepatitis viruses A, B, C and E were evaluated.




HEV immunoglobulin G was detected with highest percentage among patients with hepatitis B (56.7%), followed by patients with hepatitis C virus (52.0%), hepatitis A virus (34.1%) and combined hepatitis B and C viruses (30.0%). The detection rate among patients with non-A, non-B, non-C hepatitis was 7.1%. HEV immunoglobulin M was found in 4.5% of hepatitis A virus patients and in 3.3% of hepatitis B patients. The prevalence of HEV immunoglobulin G and immunoglobulin M correlated with the levels of hepatic aspartate aminotransferase and alanine aminotransferase in patients with dual markers of infection with hepatitis E and other viruses compared to patients with acute hepatitis due to A and C viruses.




HEV serological markers are common among children with acute viral hepatitis, especially from hepatitis C and B viruses. There may be increased sensitivity to HEV coinfection in association with hepatitis B and C infections. Dual infection with HEV and other hepatotropic viruses was associated with greater elevation of aspartate and alanine aminotransferases.



Key words:

Hepatitis A virus; Hepatitis B virus; Hepatitis C virus; Hepatitis E virus; Prevalence


J Microbiol Immunol Infect. 2008;41:254-258.