Hepatitis in Kyrgyz Republic
Study on the etiology of non-A, non-C hepatitis, Zoonotic Reservoirs of Hepatitis E Virus, Genetic Diversity of Viral Isolates and Risk Factors for Transmission and Distribution of Hepatitis E and non-A, non-E Viruses in the Kyrgyz Republic
Tech Area / Field
- MED-DIS/Disease Surveillance/Medicine
- AGR-DIS/Disease Surveillance/Agriculture
3 Approved without Funding
Scientific and Production Center for Preventive Medicine, Kyrgyzstan, Bishkek
- National Academy of Sciences of Kyrgyzstan / Biotechnology Institution, Kyrgyzstan, Bishkek
- Centers for Disease Control and Prevention (CDC) / National Center for Infectious Diseases / Division of Viral Hepatitis, USA, GA, Atlanta
Project summaryThe goal of this project is to carry out molecular-epidemiologic and molecular-epizootologic investigations of hepatitis E (HE) in Kyrgyzstan, to detect new viral agents in the etiology of nonAnonE hepatitis.
The project is aimed at solving the problems of applied medical and veterinary science to provide biological safety of the environment. The use of the molecular component in epidemiologic surveillance will allow significant expansion of knowledge of risk factors for transmission and distribution of infection.
Viral hepatitides are important infectious diseases and cause a considerable number of cases of acute and chronic infection. The problem is complicated by the etiologic persity of viral hepatitides. There are at least 5 viral etiologic agAents of viral hepatitis (designated A, B, C, D, E). In a considerable part of cases the etiologic agent is not identified (nonAnonE hepatitis).
Of the known forms of viral hepatitis, hepatitis E is the least studied. Reasons for the periodic occurrence of large epidemics with high fatalities in pregnant women are unknown. It is established that HEV is widespread in domestic animals, rodents and chickens. The role of different species of domestic and wild animals is still not completely defined in the reservation of the virus during the inter-epidemic period as well as its persity in animal populations. The mechanism of the detected high rates of HEV in patients with chronic liver disease and autoimmune hepatitis remains unclear. Due to absent data on the etiologic agent the problem of nonAnonE hepatitis is far from solved.
As other CAR countries, the Kyrgyz Republic is referred to countries highly endemic for viral hepatitis. Annually more than 10000 cases of acute viral hepatitis are recorded, and there is a widespread prevalence of chronic forms of viral hepatitis. The last large outbreaks of HE infection were registered in the republic in 1986-1989 with incidence rates exceeding 5000 per 100000 in some territories. In the same period of time HE epidemics were observed in other CAR countries and China. In the Kyrgyz Republic with the support of CDC-CAR sentinel surveillance for the etiology of acute viral hepatitis has been established in representative territories. In more than 20% of cases within the sentinel surveillance system the etiology of viral hepatitis is not possible to determine (nonAnonC hepatitis). The absence of standardized commercial test systems for detecting HEV does not allow monitoring of this infection.
The accomplishment of this project will allow: establishing a zoonotic nature of HEV, the presence of HEV in chickens (HBS syndrome) in the republic, the biologic danger of animal sources of infection for humans, revealing new viruses in the etiology of nonAnonE hepatitis, with subsequent development of methods of diagnosis, prevention and treatment.
The proposed project plans participation of scientists who have worked for a long time on the problem of viral hepatitis and animal infections. Professor R. Usmanov under the supervision of Professor M. Balayan succeeded first in reproducing HE infection in piglets that were inoculated with human virus, these results showed for the first time the possibility for the HE virus to overcome the inter-species barrier and allowed postulating virus reservation in animal populations.
The implementation of the project will allow Kyrgyzstan scientists having weapons experience to direct their activities at peaceful research, will contribute to their integration in the international scientific community, the conduct of joint studies with the foreign collaborator as well as the solution of national and international problems in the area of medicine and veterinary science which will meet the goals and objectives of ISTC.
The following tasks will be carried out to achieve the goal of the project: determining the role of HEVand nonAnonE in the incidence of viral hepatitis; study of infection reservoirs among different species of domestic and wild animals; conducting partial or complete sequence of the genomes of virus isolates; revealing new viruses in the etiology nonAnonE hepatitis, collection of epidemiologically significant information and biostatistical analysis of the database.
The main results of the project will be: identification of epidemiologic and epizootologic patterns of HEV during the inter-epidemic period, establishing a zoonotic nature of HEV; demonstration of the presence of a new HE disease (HBSS) in chickens in Kyrgyzstan and possible transmission to humans from them; demonstration of genetic distinctions between epidemic and sporadic variants of human HEV; genetic characterization of animal HEV; establishment of new viral agents in the etiology of nonAnonE hepatitis.
The potential role of foreign collaborators will consist in: conducting joint research and carrying out particular tasks of the project; continual exchange of information; participation in seminars, joint publications; the use of project results in practice, and partnership in commercial development and licensing.
It is expected that results of the project will be able: to extend the arsenal of tools for reducing infectious disease morbidity and providing biologic safety; to determine sites of virus reservation during the inter-epidemic period and the mechanisms of emergence of epidemic variants of HEV; to determine the epidemic potential of nonAnonE hepatitis.
In implementing the project epidemiologic, biostatistical, serological and molecular methods will be used. New viruses in the etiology of nonAnonE hepatitis will be detected using new molecular technologies and approaches developed at the collaborator’s laboratory for identification and molecular characterization of unknown viral agents.
The International Science and Technology Center (ISTC) is an intergovernmental organization connecting scientists from Kazakhstan, Armenia, Tajikistan, Kyrgyzstan, and Georgia with their peers and research organizations in the EU, Japan, Republic of Korea, Norway and the United States.
ISTC facilitates international science projects and assists the global scientific and business community to source and engage with CIS and Georgian institutes that develop or possess an excellence of scientific know-how.