Abstract

BackgroundPrevalence and incidence of hepatitis caused by HEV infection are usually higher in developing countries. This study demonstrated the HEV seroprevalence and incidence of HEV infection in patients with clinical hepatitis in a tertiary hospital in Thailand.MethodsA laboratory-based cross-sectional study was conducted using 1106 serum samples from patients suspected of HEV infection sent to the Serology laboratory, Siriraj Hospital, for detecting HEV antibodies during 2015–2018. Prevalence of anti-HEV IgG and IgM antibodies in general patients, including organ transplant recipients and pregnant women in a hospital setting, were determined using indirect enzyme-linked immunosorbent assay (ELISA) kits. Comparison of laboratory data between groups with different HEV serological statuses was performed.ResultsHEV IgG antibodies were detected in 40.82% of 904 serum samples, while HEV IgM antibodies were detected in 11.75% of 1081 serum samples. Similar IgG and IgM antibody detection rates were found in pregnant women. Interestingly, anti-HEV IgM antibodies were detected in 38.5% of patients who underwent organ transplantation. Patients who tested positive for anti-HEV IgM antibodies had higher alanine aminotransferase levels than those who had not. In contrast, patients who tested positive for anti-HEV IgG had more elevated levels of total bilirubin than those who tested negative.ConclusionsHEV seroprevalence and incidence in patients with clinical hepatitis were relatively high in the Thai population, including the pregnancy and organ transplant subgroups. The results potentially benefit the clinicians in decision-making to investigate HEV antibodies and facilitating proper management for patients.

Highlights

  • Prevalence and incidence of hepatitis caused by hepatitis E virus (HEV) infection are usually higher in developing countries

  • Risk factors associated with symptomatic HEV infection and more severe clinical outcomes are immunocompromised statuses, including organ transplantation, liver cirrhosis, very old age (> 80 years), and pregnancy [3,4,5,6,7,8]

  • Prevalence of anti‐HEV IgG in the study population During 2015–2018, a total of 1,106 serum samples of suspected HEV-infected cases were sent to the Serology laboratory, Siriraj Hospital, for the detection of HEV IgM/IgG antibodies

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Summary

Introduction

Prevalence and incidence of hepatitis caused by HEV infection are usually higher in developing countries. This study demonstrated the HEV seroprevalence and incidence of HEV infection in patients with clinical hepatitis in a tertiary hospital in Thailand. The incidence of acute hepatitis caused by HEV infection is higher in developing countries than in developed countries [2]. Risk factors associated with symptomatic HEV infection and more severe clinical outcomes are immunocompromised statuses, including organ transplantation, liver cirrhosis, very old age (> 80 years), and pregnancy [3,4,5,6,7,8]. HEV seroprevalence in Thai individuals, determined by positive anti-HEV IgG antibodies, was previously reported by Poovorawan et al, 1996 as 9–22%. The higher prevalence was observed in specific subpopulations, i.e., kidney and liver transplant recipients, ranging from 26 to 56% [12,13,14,15]

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