Abstract
Hepatitis E virus (HEV) is the most common cause of viral hepatitis globally. The first human case of autochthonous HEV infection in Croatia was reported in 2012, with the undefined zoonotic transmission of HEV genotype 3. This narrative review comprehensively addresses the current knowledge on the HEV epidemiology in humans and animals in Croatia. Published studies showed the presence of HEV antibodies in different population groups, such as chronic patients, healthcare professionals, voluntary blood donors and professionally exposed and pregnant women. The highest seroprevalence in humans was found in patients on hemodialysis in a study conducted in 2018 (27.9%). Apart from humans, different studies have confirmed the infection in pigs, wild boars and a mouse, indicating the interspecies transmission of HEV due to direct or indirect contact or as a foodborne infection. Continued periodical surveys in humans and animals are needed to identify the possible changes in the epidemiology of HEV infections.
Highlights
Hepatitis E virus (HEV), a nonenveloped RNA virus, is the most common cause of viral hepatitis with an estimated 939 million of people who have experienced HEV infection [1]
This narrative review comprehensively addresses the current knowledge on the HEV epidemiology in humans and animals in Croatia (“One Health” context)
The results indicate that HEV infection is widespread in Croatia: the seroprevalence in voluntary blood donors was 21.5%, significantly higher among people over 40 years old and those living in rural areas
Summary
Hepatitis E virus (HEV), a nonenveloped RNA virus, is the most common cause of viral hepatitis with an estimated 939 million of people who have experienced HEV infection [1]. In industrialized countries in Europe, predominantly genotype 3 and, less frequently, genotype 4 are causing zoonotic and foodborne infections in humans [3] Those genotypes are isolated from a number of animal species, domestic and wildlife (pigs, wild boars, sheep, deer, mongoose, rabbits, goat, yak and horse) [4,5]. The zoonotic HEV genotype 3 in Southeast Europe [40] HEV has been increasingly detected in animals (pigs [40,41,42,43] and wild boars [44,45]) and human populations [46,47,48,49], supporting the need for a closer look in the region.
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