Abstract
Hepatitis E virus (HEV) is viewed as an emerging pathogen. Many European countries, including Germany, have observed a steep increase of notified autochthonous hepatitis E cases in recent years. Our study investigated time trends in HEV seroprevalence in southern Germany between 2003 and 2015. A total of 3000 study sera were evenly distributed over sampling years 2003, 2006, 2009, 2012, and 2015, two age groups (20–29 and 30–39 years) and genders and were tested for anti-HEV IgG. Positive samples were quantified. The seroprevalence declined from 32.8% in 2003 over 22.5% in 2006 (p < 0.001) and 22.3% in 2009 to 17.7% and 17.8% in 2012 and 2015. A higher prevalence was found for males (p = 0.018) and the older age group (p < 0.001). Anti-HEV IgG concentrations ranged from 0.22 to 1783.19 WU mL−1. A higher median concentration (2.41 vs. 1.89 WU mL−1, p < 0.001) was found in the younger age group. The anti-HEV IgG seroprevalence decreased since 2003 and remains constant at ~18% since 2012. A rather low anti-HEV prevalence in young adults is indicative of a susceptible population and denotes a higher risk of HEV infections in this age group in the future. Therefore, reduction of HEV infection sources, close monitoring, and vigilance for proper control measures are warranted.
Highlights
Introduction The hepatitisE virus (HEV) is a single-stranded, nonenveloped RNA virus identified in 19831
The decrease started with 32.8% (2003) over 22.5% (2006) and 22.3% (2009), ended at 17.7% (2012) and remained constant at 17.8% in 2015
When analyzing the sampling year groups according to age or gender, we observed that the prevalences in these groups mirrored the observed overall decrease (Fig. 1b, c)
Summary
E virus (HEV) is a single-stranded, nonenveloped RNA virus identified in 19831. This virus in the genus Orthohepevirus has increasingly attracted attention since 20082,3. While there is only one known serotype, HEV genotypes differ by their epidemiology. HEV was associated with waterborne outbreaks in developing countries (genotypes 1 and 2). Since 2008, an increasing number of foodborne zoonotic infections worldwide, caused by genotypes 3 and 4, have been reported. The majority of HEV infections in Europe is reportedly caused by genotype 3 and is not travel associated. Known animal reservoirs include pigs, wild boars, and deer
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