Objective: To report the first case of acute hepatitis E by a novel isolate acquired in the United States and confirmed by nucleotide sequencing.

Material and methods: We describe the clinical manifestations and the results of associated laboratory studies in a man who was found to have acute hepatitis E infection.

Results: A 62-year-old man was hospitalized because of fever, abdominal pain, and jaundice. After an initial evaluation did not provide a cause, his serum was found to be positive for IgG anti-hepatitis E virus (HEV) by three antibody assays. Serum was also positive for HEV RNA by reverse transcriptase polymerase chain reaction (PCR). Sequencing results from the PCR products demonstrated substantial differences at the nucleotide level between this strain and the known Mexican and Burmese strains.

Conclusion: On the basis of this initial report, HEV should be considered an etiologic agent in patients with acute non-ABC hepatitis in the United States.