Comparison of clinical features of acute hepatitis caused by hepatitis E virus (HEV) genotypes 3 and 4 in Sapporo, Japan

In Japan, indigenous acute hepatitis E is not a rare disease, and is mainly caused by hepatitis E virus (HEV) genotypes 3 and 4. Whether there is a difference in clinical features between the two genotypes remains unclear. This study compares the clinical features of patients infected with the two. From January, 1994, to December, 2003, 9 infected with HEV genotype 3 and 27 patients with genotype 4 were enrolled. Patients with genotype 4 had significantly higher peak alanine aminotransferase levels ( median 3430 IU/L, interquartile range 1747-4763 versus 1052 IU/L, 845 - 2707; p = 0.01). The lowest prothrombin time was lower in the genotype 4 group (61%, 42 - 77 versus 84%, 70 - 96; p = 0.05). In our series, patients with genotype 4 had longer median duration of hospital stay ( 26.5 days, 18 - 31 versus 18 days, 12 - 23.5; p = 0.06). The patients with genotype 4 infection tended to have more severe clinical manifestations than those with genotype 3 infection. (c) 2006 Elsevier Ireland Ltd. All rights reserved.