Abstract
BackgroundHepatitis E virus (HEV) is a member of the Hepeviridae family; it has four main genotypes and one serotype. While genotypes 1 and 2 cause epidemic hepatitis and are transmitted via water and the fecal-oral route, genotypes 3 and 4 are zoonotic. In the various seroprevalence studies of hepatitis E in Brazil, the numbers reported vary widely and are difficult to interpret. The aim of this study was to analyze existing seroprevalence studies of hepatitis E in adults in Brazil.Main textWe searched the PubMed, Latin American and Caribbean Health Sciences and Embase databases for studies published from inception to May 12, 2018 concerning infection by HEV in Brazil without time period or language restrictions. We included studies that presented data concerning hepatitis E seroprevalence in adults in Brazil, had a sample size ≥50 patients and whose method used for the detection of anti-HEV was standardized and commercialized. We also evaluated the quality of the articles using a list of criteria that totalized 9 items. Of the 20 studies ultimately analyzed, 10 (50%) were from the southeast region of Brazil, 3 (15%) were from the central-west region, 3 (15%) were from the northern region, 2 (10%) were from the northeast region and 2 (10%) were from the southern region. Regarding the quality evaluation of the studies, the mean score was 5.6 (range: 4–8). The estimated overall seroprevalence of HEV infection in the adult population was 6.0% (95% CI: 5.0–7.0); in subgroup analyses, we observed that the prevalence of anti-HEV antibodies in blood donors was 7.0% (95% CI: 5.0–8.0), whereas in the general population, it was 3.0% (95% CI: 2.0–4.0).ConclusionsThe results of this systematic review indicate that there should be national investment in the prevention of hepatitis E virus infection in Brazil, including the implementation of improvements in basic sanitation and guidance regarding the appropriate handling of animal waste and the optimal cooking of vegetables, meat and their derivatives.
Highlights
We searched the PubMed, Latin American and Caribbean Health Sciences and Embase databases for studies published from inception to May 12, 2018 concerning infection by Hepatitis E virus (HEV) in Brazil without time period or language restrictions
Trinta et al [13] studied the prevalence of anti-HEV antibodies in groups of people in the general population, pregnant women, blood donors and patients undergoing hemodialysis
Through meta-regression analysis, we evaluated the influence of the year of study publication, the sample size, the study quality for the review objectives and the type of commercial kit used for the diagnosis of anti-HEV antibodies on the seroprevalence of hepatitis E (Table 2)
Summary
We searched the PubMed, Latin American and Caribbean Health Sciences and Embase databases for studies published from inception to May 12, 2018 concerning infection by HEV in Brazil without time period or language restrictions. A systematic review of published articles concerning the seroprevalence of HEV infection in adults in Brazil was carried out. Article search strategies We searched MEDLINE, Latin American and Caribbean Health Sciences (Literatura LatinoAmericana e do Caribe em Ciências da Saúde, Lilacs), and Embase databases for studies published from inception to May 12, 2018 regarding infection with HEV in Brazil without time period or language restrictions. In Europe, blood donor studies have shown that seroprevalence of hepatitis E ranges from 3.2% in France and 4.9% in Switzerland to 10.0% in the United Kingdom [7–9]. HEV is highly endemic in specific regions, such as southern France, where the seroprevalence in blood donors reaches as high as 52.5% [10]
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