Abstract
Although Hepatitis E is increasingly described as a major cause of liver disease in industrialized countries, the epidemiology is far from being fully elucidated. We provide here a comprehensive review of documented clusters of cases, and of serological studies conducted in populations with distinct types of exposure. Seroprevalence rates range from <5% to >50% depending on the countries and the groups of population. Such discrepancies can be attributed to the type of serological assay used, but this solves only a part of the problem. We performed a meta-analysis of studies performed with the broadly used Wantai HEV-IgG ELISA and found striking differences that remain difficult to understand with the current knowledge of transmission pathways.
Highlights
Hepatitis E virus (HEV) is the major cause of enterically transmitted hepatitis worldwide [1].There are two contrasting situations around the world with regard to hepatitis E
A total of 26 studies from 15 countries were included in the meta-analysis of seroprevalence in
A total of 26 studies from 15 countries were included in the meta-analysis of seroprevalence in industrialized countries using Wantai assays
Summary
Hepatitis E virus (HEV) is the major cause of enterically transmitted hepatitis worldwide [1]. There are two contrasting situations around the world with regard to hepatitis E. In developing countries, transmission is mainly fecal-oral with poorly treated water playing a major role. In these countries, the incriminated genotypes are HEV-1 and HEV-2. In industrialized countries, not all transmission pathways are well known [2], the main form of transmission is zoonotic with HEV-3 and HEV-4 genotypes [3,4]. A growing number of studies have been published concerning the seroprevalence of HEV antibodies in different human populations
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