Journal of Clinical Virology 36 (2006) 100–102 Identification of a novel variant of human hepatitis E virus in Hungary G´ abor Reuter a,∗ , Domonka Fodor b , Andrea K´ atai c , Gy ¨ orgy Sz˝ ucs a a Regional Laboratory of Virology, ´ ANTSZ Baranya County Institute of State Public Health Service, Szabads´ ag u. 7, P´ ecs, Hungary b Department of Infectology, City Hospital of Szeged, Csongr´ ad County, Szeged, Hungary c Regional Laboratory of Microbiology, ´ ANTSZ Csongr ´ ad County Institute of State Public Health Service, Szeged, Hungary Received 19 August 2005; received in revised form 29 December 2005; accepted 18 January 2006 Abstract First human case of hepatitis E infection detected in Hungary is reported. This hepatitis E virus (HEV), Hungary1, belongs to genotype 3 and had 95% and 90% nucleotide identity within the capsid region of the European swine and human (Greece2) strains, respectively. Hungary1 represents a potential novel human variant of HEV in genus Hepevirus. © 2006 Elsevier B.V. All rights reserved. Keywords: Non-A; Non-C hepatitis; Genotype 3 hepatitis E virus 1. Introduction Hepatitis E virus (HEV) is a major cause of acute epi- demic and sporadic infectious hepatitis that is transmitted by fecally contaminated drinking water in endemic areas such as Asia, Africa and Latin America (Schlauder et al., 2003). North America and Europe have traditionally been consid- ered non-endemic for HEV infections. In these areas cases are thought to be imported, although seroprevalence ranges from 1% to 5% (Widdowson et al., 2003). In recent years, genetically divergent HEV strains isolated in Europe (Italy, Greece, Spain, UK and the Netherlands) have been compared with strains from HEV-endemic countries (Schlauder et al., 2003). In developed countries HEV strains related to those that infect humans have been found in swine, raising the pos- sibility that swine may act as a reservoir of human infections (Mansuy et al., 2004; van der Poel et al., 2001; Yazaki et al., 2003). The first swine HEV was identified in 1997 (Meng et al., 1997). Abbreviations: ELISA, enzyme-linked immunoassay; HAV, hepatitis A virus; HBsAg, hepatitis B surface antigen; HCV, hepatitis C virus; HEV, hepatitis E virus; ORF, open reading frame; RNA, ribonucleic acid; RT-PCR, reverse transcription-polymerase chain reaction ∗ Corresponding author at: Regional Laboratory of Virology, ´ ANTSZ Baranya County Institute of State Public Health Service, Szabads´ ag ´ ut 7., H-7623 P´ ecs, Hungary. Tel.: +36 06 72 514 970; fax: +36 06 72 514 949. E-mail address: reuterg@baranya.antsz.hu (G. Reuter). HEV is a non-enveloped virus with a positive-sense, single-stranded RNA genome approximately 7200 nucleo- tides in length. The genome has three open reading frames (ORFs): ORF2 encodes the capsid protein (Schlauder et al., 2003). Recently, HEV was classified in the family Hepeviri- dae, genus Hepevirus (Emerson et al., 2004) and divided into four (1–4) genotypes (Emerson et al., 2004; Schlauder et al., 2003). In endemic areas, the majority of the human infections are caused by genotypes 1 and 2 hepatitis E viruses, while only isolated cases of locally acquired (non-imported) infec- tions with genotypes 3 and 4 viruses have been described in industrialized countries. We report the detection of a novel HEV genotype 3 strain in a sample from a patient in Hungary who reported no his- tory of travel to HEV-endemic areas. This is the first report providing evidence for the presence of endemic HEV strains in Hungary. 2. Case A 60-year-old man was admitted to the City Hospital of Szeged (South East Hungary) on 28 June 2004, with nausea, weakness, jaundice, pale feces, dark urine, but no fever. His symptoms had begun 7 days previously. There was no history of travel abroad, but he reported eating pork sausage pre- pared from house-slaughtered meat 1 month before the onset 1386-6532/$ – see front matter © 2006 Elsevier B.V. All rights reserved. doi:10.1016/j.jcv.2006.01.016