The investigation of hepatitis A virus and hepatitis E virus co-infection in humans and animals in China.

The aim of this study was to investigate the prevalence of co-infection of hepatitis A and hepatitis E virus (HAV/HEV) in patients with acute hepatitis as well as in different animal species. A total of 46 serum samples from patients diagnosed as hepatitis A or hepatitis E and 675 fecal samples of 11 animal species were collected. The IgM class antibodies to HEV and HAV, respectively, were detected by enzyme-linked immunosorbent assay. HEV and HAV RNAs were extracted from serum and fecal samples for the nested reverse transcription polymerase chain reaction. At least 10.9% (5/46) of the patients were co-infected with both HAV and HEV. Fifteen percent (18/120) of rabbit fecal samples and 17.5% (7/40) of swine fecal samples were positive for HEV RNA, but only 1% (2/200) of ferret fecal samples were positive for HAV RNA. Our study showed that co-infection with both HAV and HEV in patients and animals is infrequent. At least in our study, we showed that ferrets may represent the potential HAV hosts. Keywords: hepatitis A virus; hepatitis E virus; co-infection; zoonosis; prevalence.