Abstract
The apparent seroprevalence of hepatitis E Virus (HEV)varies greatly among developed countries depending on the geographical area and the sensitivity of immunoassays. We used a validated assay to determine the prevalence of HEV IgG and IgM antibodies among 3,353 blood donors living in southern France,who gave blood during the two first weeks of October 2011 and participated in the study. Demographic and epidemiological information was collected using aspecific questionnaire. We also screened 591 samples for HEV RNA. Overall IgG seroprevalence was 39.1%and varied from 20% to 71.3% depending on the geographical area (p < 0.001) while IgM seroprevalence was 3.31%. Anti-HEV IgG was significantly correlated with increasing age (p < 0.001), eating uncooked pork liver sausages (p < 0.001), offal (p = 0.003), or mussels(p = 0.02). Anti-HEV IgM was associated with being male (p = 0.01) and eating uncooked pork liver sausages(p = 0.02). HEV RNA was detected in one of the 99 anti-HEV IgM-positive samples, but in none of the 492 anti-HEV IgM-negative samples. HEV is hyperendemic in southern France. Dietary and culinary habits alone cannot explain the epidemiology of HEV in this region, indicating that other modes of contamination should be investigated.
Highlights
Hepatitis E virus (HEV) is a non-enveloped singlestranded, positive-sense RNA virus, a member of the Hepeviridae family, genus Hepevirus [1]
We looked for HEV RNA in IgM-positive samples and in donors randomly selected from among those that were anti-HEV IgM-negative
The assay used gave an overall prevalence of HEV IgG antibodies as high as 39.1%, quite similar to those observed in China using the same assay [14]
Summary
Hepatitis E virus (HEV) is a non-enveloped singlestranded, positive-sense RNA virus, a member of the Hepeviridae family, genus Hepevirus [1]. Genotypes 1 and 2 are restricted to humans and are prevalent in developing countries in Asia and Africa, where hepatitis E is a waterborne disease associated with sporadic infections and large epidemics linked to drinking water contaminated with faeces. Genotypes 3 and 4 are transmitted zoonotically and are prevalent in many industrialised countries in Asia, Europe and North America. About half of HEV-infected patients in developing countries show symptoms of acute hepatitis. The patients most at risk of death are pregnant women (third trimester) and those with chronic liver disease [2]. Patients with chronic liver diseases are at great risk of fulminant hepatitis. An HEV infection can lead to chronic hepatitis in 60% of immunosuppressed patients, which can rapidly progress to cirrhosis [2,3]
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