Indigenous Hepatitis E in England and Wales From 2003 to 2012: Evidence of an emerging novel phylotype of viruses

Samreen Ijaz*, Bengü Said, Elizabeth Boxall, Erasmus Smit, Dilys Morgan, Richard S. Tedder

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

95 Citations (Scopus)


Background. Enhanced surveillance and molecular characterisation studies of hepatitis E virus (HEV) in England and Wales have been undertaken since 2003. The dynamics of hepatitis E have changed recently with an increase in the number of indigenous cases and an observed viral shift.Methods. HEV antibody and RNA data were analysed to ascertain the annual number of acute infections, the HEV genotype disposition and viral phylogeny. These data were investigated in the context of collected travel history and demographic data.Results. In total, 2713 acute hepatitis E cases were diagnosed, of which 1376 were indigenous infections. Travel associated cases remained steady and mainly associated with Genotype 1 infections. In contrast, major fluctuations were noted in indigenously-acquired cases with a dramatic year on year increase during 2010-2012. Molecular characterisation demonstrated indigenous infections to cluster into two distinct phylogenetic groups with the emergence of a novel group of Genotype 3 viruses coinciding with the recent increase in cases.Conclusions. HEV infection rates are dynamic in England and Wales, influenced by changing trends in indigenously-acquired cases. The recent increase in indigenous cases and the emergence of indigenous viruses not commonly circulating prior to 2010 suggest that the risk of acquiring HEV has changed.

Original languageEnglish
Pages (from-to)1212-1218
Number of pages7
JournalJournal of Infectious Diseases
Issue number8
Publication statusPublished - 15 Apr 2014

Bibliographical note

Funding Information:
Financial support. This work was supported by resources from within the Virus Reference Department, MS-Colindale, Public Health England, London, UK.


  • England and Wales
  • hepatitis E
  • indigenous
  • molecular characterisation
  • patient demography
  • phylogeny
  • surveillance


Dive into the research topics of 'Indigenous Hepatitis E in England and Wales From 2003 to 2012: Evidence of an emerging novel phylotype of viruses'. Together they form a unique fingerprint.

Cite this