Hepatitis E virus is highly resistant to alcohol-based disinfectants

DOI: https://doi.org/10.1016/j.jhep.2022.01.006

Commentary

Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide, which is thought to be transmitted by the fecal-oral route or by ingesting contaminated food.

Data on the sensitivity of HEVs to chemical disinfectants is limited due to the lack of efficient cell culture systems to grow HEVs, resulting in the current lack of prophylactic and evidence-based hygiene guidelines for HEV disinfection.

A robust HEV genotype 3 cell culture model that allows quantification of viral infection of quasi-enveloped and naked HEV particles was used and validated; in the case of HEV genotype 1 infection, primary isolate Sar55 in fecal suspension was applied. A standardized quantitative suspension test using endpoint dilution and large volume plating was performed to determine the virucidal activity of alcohol (1-propanol, 2-propanol, ethanol), WHO disinfectant formulations, and five different commercial hand sanitizers against HEV.

An iodixanol gradient was performed to elucidate the effect of ethanol on quasi-envelope virus particles.

The results showed that naked, quasi-enveloped HEVs were resistant to alcohol as well as alcohol-based formulations recommended by WHO. Of the commercial hand sanitizers tested, only one product exhibited virucidal activity against HEV.

This activity may be related to phosphoric acid as an essential ingredient.

It has been observed that ethanol and possibly inactive alcohol-based disinfectants disrupt the quasi-envelope structure of HEV particles while leaving the highly contagious and infectious naked virions intact.