Seroprevalence Study of Anti-HEV IgG among Different Adult Populations in Corsica, France, 2019.

Capai Capai,Charrel Charrel,Masse Masse,Isnard Isnard,Peres Peres,Blanchon Blanchon,Gallian Gallian,Falchi Falchi,De Lamballerie De Lamballerie,Souty Souty

doi:10.3390/microorganisms7100460

Abstract

Hepatitis E virus (HEV) is a major cause of acute hepatitis worldwide. In France, hyperendemic areas including Corsica have an anti-HEV Immunoglobulin G (IgG) prevalence higher than 50%. The aim of this study was to determine the seroprevalence of anti-HEV IgG in three adult populations in Corsica and the risk factors associated with antibody detection. Between 2017 and 2019, a total of 930 individuals, including 467 blood donors, 393 students or university staff members and 70 patients from general practice, were tested for the presence of anti-HEV IgG using the Wantai HEV IgG enzyme immunoassay kit and filled a questionnaire. The association between seropositivity and potential risk factors was tested with univariate and multivariate analyses. Out of the 930 samples, 52.3% (486/930) were seropositive—54.4% (254/467) among blood donors, 47.6% (187/393) among university students and 64.3% (45/70) among patients of general practice. Three main risk factors were identified: (i) skinning and butchering (Adjusted Odds Ratio aOR = 2.76, 95% confidence interval [95% CI] [1.51–5.37]; p-value < 10−3), (ii) consumption of a local pork live raw sausage (fittonu) (aOR = 1.95 95% CI [1.45–2.64]; p-value = 10−5), and (iii) increasing age (p-value = 0.003). Seropositivity rates between the different populations were homogeneous after age stratification. This cross-sectional study indicates a high anti-HEV IgG seroprevalence in the Corsican adult population, not significantly different between women and men and increasing with age. This serosurvey also showed homogeneity regarding the exposure to HEV among three different types of populations. Finally, we confirmed the endemicity of Corsica with respect to HEV and identified a strong association between consumption of figatellu/fittonu and the practice of skinning and butchering with the detection of anti-HEV IgG.

Highlights

Hepatitis E virus (HEV) possesses a single-stranded positive-sense RNA genome of approximately 7.5 kb which contains three separate open reading frames (ORFs) [1,2]
The main objective of this study was to improve the knowledge about the epidemiology of HEV in Corsica island, using a seroprevalence study including a large cohort of adults consisting of blood donors, general practitioner patients and staff and students of the University of Corsica
In the Patient from General Practice (PGP) group, eight variables were significantly associated with a higher anti-HEV Immunoglobulin G (IgG) detection rate: hunting (OR = INF), skinning and butchering (OR = INF), tap water (OR =3.66 [1.14–12.58]), mountain spring waters (OR = 2.89 [1.01–9.21]), big wild game (OR = 3.14 [1.1–9.25]), fittonu (OR = 4.08 [1.46–12.47]), beef (OR = 8.38 [1.15–169.46]) and wild berries (OR = 3.38 [1.21–10.26])

Summary

Introduction

Hepatitis E virus (HEV) possesses a single-stranded positive-sense RNA genome of approximately 7.5 kb which contains three separate open reading frames (ORFs) [1,2] This virus belongs to family Hepeviridae (genus Orthohepevirus) [3]. Genotypes HEV-3 and 4 are zoonotic pathogens infecting domestic (e.g., pigs) and wild animal species (e.g., boars, deers) which constitute the animal reservoir [5]. They are mainly detected in industrialized countries and are responsible for sporadic and autochthonous cases [1,6]. In Europe, the majority of cases is due to HEV-3 genotype and HEV is the most common cause of acute viral hepatitis [7]

Objectives

Methods

Findings

Conclusion