Abstract
SummaryViral pathogens account for a significant proportion of the burden of emerging infectious diseases in humans. The Wellcome Trust-Vietnamese Initiative on Zoonotic Infections (WT-VIZIONS) is aiming to understand the circulation of viral zoonotic pathogens in animals that pose a potential risk to human health. Evidence suggests that human exposure and infections with hepatitis E virus (HEV) genotypes (GT) 3 and 4 results from zoonotic transmission. Hypothesising that HEV GT3 and GT4 are circulating in the Vietnamese pig population and can be transmitted to humans, we aimed to estimate the seroprevalence of HEV exposure in a population of farmers and the general population. We additionally performed sequence analysis of HEV in pig populations in the same region to address knowledge gaps regarding HEV circulation and to evaluate if pigs were a potential source of HEV exposure. We found a high prevalence of HEV GT3 viral RNA in pigs (19.1% in faecal samples and 8.2% in rectal swabs) and a high HEV seroprevalence in pig farmers (16.0%) and a hospital-attending population (31.7%) in southern Vietnam. The hospital population was recruited as a general-population proxy even though this particular population subgroup may introduce bias. The detection of HEV RNA in pigs indicates that HEV may be a zoonotic disease risk in this location, although a larger sample size is required to infer an association between HEV positivity in pigs and seroprevalence in humans.
Highlights
Emerging infectious diseases have an important impact on human health
This study demonstrates that Hepatitis E virus (HEV) is widely circulating in pig and human populations in southern Vietnam
The anti-HEV IgG unadjusted seroprevalence was lower in the farmer cohort (16.0%; 95% CI: 11.7%–20.2%) than the general population (31.7%, 95% CI: 29.5%–33.8%) in Dong Thap (Table 1, Figure 1)
Summary
It is well established that viruses account for a significant proportion of emerging infections in humans and the majority are have a zoonotic origin, as highlighted by the recent Ebola epidemic in Africa and the repeated MERS CoV outbreaks in the Middle East. Hepatitis E virus (HEV) is a public health concern, as it causes an estimated 20 million human infections annually, with over three million symptomatic HEV cases and 56,600 deaths worldwide (Kamar et al, 2012). Mortality in immunocompromised patients and pregnant women can approach 25% for those infected with genotype 1 (Kamar et al, 2012). HEV infections are responsible for >50% of cases of acute viral hepatitis in endemic countries (Kamar et al, 2012). It was observed that infection with HEV GT3 can become chronic in immunocompromised patients, such as organ transplant recipients or those infected with HIV (Galante et al, 2015)
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