Prevalence Of Hepatitis E Virus Research Articles

Assessment of Hepatitis E Virus RNA Detection in Meat Samples: Optimization of Pre-analytical Conditions.

Hepatitis E virus (HEV) is primarily transmitted via the fecal-oral route and is considered an anthropozoonosis. Genotypes with zoonotic potential (mainly HEV-3 and HEV-4) can be transmitted through the consumption of raw or undercooked pork, wild boar, deer meat, or processed products. This study aims to explore methodologies for processing meat samples to establish a protocol for HEV detection in meat. The analysis of pre-analytical conditions involved comparing homogenization with PBS versus TRIzol, comparing tissue disruption methods (ultra-turrax versus mortar and pestle), and assessing nucleic acid extraction techniques (spin columns and magnetic beads) across three types of artificially contaminated meat matrices: pork, salmon (fish-meat), and salami. Each test included a process control virus (PP7) and an HEV transcript. Molecular detection was performed via RT-qPCR. Results indicated that TRIzol provided better recovery rates for homogenization, while spin columns were the most effective option for RNA extraction. Both the ultra-turrax homogenizer and the mortar-pestle methods were effective for pork and fish-meat homogenization, while the use of the UT yielded superior results for salami. HEV recovery rates were 36.7%, 26.3%, and 34.1% for salami, salmon, and pork meat, respectively. In conclusion, we reached a simple and reliable protocol for the detection of RNA-HEV from three meat matrices. This method, which includes homogenization with TRIzol, mechanical tissue disruption, and RNA extraction using spin columns followed by real-time PCR, can be applied in future studies to evaluate HEV prevalence in food sources and contribute to the discussion about HEV detection methodologies.

Human-swine interface: is the hepatitis E virus a real risk for humans?

Abstract Background Hepatitis E virus (HEV) is the agent of hepatitis E, an emerging public-health infection with an increasing incidence in Europe. Due to the apparent lack of species barriers, HEV is considered a zoonotic agent, with swine as the main reservoir. This study investigated HEV prevalence in humans and domestic pigs in Northern Italy, a highly anthropic area with the highest pig farm density, to gain insights into the risk of HEV transmission from swine to humans. Methods A total of 508 blood samples were collected from blood donors (341 males and 167 females; from 18 to 66 years old) and from 1619 pigs in 40 different farms. Serological analyses were performed with ELISA to detect anti-HEV antibodies. In addition, 120 faecal pool samples collected from the pig farms with the highest seroprevalence and 69 salami produced in the same area were analysed to detect viral genome by Real-time PCR. Results In humans, HEV seroprevalence was 4.9% (CI95% 0.03-0.07); positive donors were mainly males, with seroprevalence increasing up to 12% (CI95% 0.09-0.15) in the 46-55 age group. Seroprevalence in swine was 53.00% (CI95% 0.50-0.55), with HEV detected in only 1% (CI95% 0.001-0.045) faeces. All food samples tested negative. Conclusions Even if the seroprevalence in pigs highlighted that HEV was actively circulating in the farms, the low seroprevalence in humans, the scarce HEV detection in swine faeces, and the absence in food products suggested that HEV transmission via faecal-oral or foodborne routes is unlikely, probably due to the implementation of severe biosecurity measures and high standards of hygiene in swine farms, and the continuous assessment of the critical points in the pig supply chain (from farm to fork). The serological surveillance of humans and the monitoring of farmed animals are needed to support the competent authorities in timely managing public health issues, improving human health and veterinary safety from a One Health perspective. Key messages • In the human-swine interface is important to monitor HEV presence. • The One Health approach is essential to control zoonotic diseases.

Prevalence of Hepatitis E Virus Infection among Blood Donors in a Tertiary Healthcare Facility in Osun State, Nigeria

Hepatitis E virus (HEV) is currently the most common cause of viral hepatitis in developing countries. While prospective blood donors are routinely screened for HIV, Hepatitis B and C globally in endemic areas, HEV is not included in the protocol, despite the increase in global prevalence of HEV. Till date, only a handful of studies exist on the prevalence of HEV in Nigeria. The aim of this study was to fill this knowledge gap by determining the prevalence of HEV among blood donors at the LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria. A total of 102 consenting individuals were enrolled into the study between ages 20 and 55. A volume of 5ml blood sample was collected, and the serum harvested, stored at 20°C until ready for analysis. A double antibody sandwich HEV ELISA was performed to analyze the sera in duplicate for HEV antigen, using an ELISA Kit. Of the 102 samples analyzed, 15 (14.7%) tested positive for HEV antigen, confirming the presence of HEV infection among blood donors in the study population. There was significant association between HEV seropositivity and contact with animals (P=0.010) and alcohol consumption (P=0.000), which means there was a higher chance of donors who consumed alcohol or have had contact with animals to get infected with HEV. However, age, educational status, occupation and gender did not show any statistically significant association with HEV infection. The prevalence of HEV seropositivity was high (14.7%) and a cause for concern as HEV continues to be a major public health issue especially in developing countries.

Seropositivity of hepatitis A and E viruses in patients attending a tertiary care center in central India

Objectives: Hepatitis A virus (HAV) and hepatitis E virus (HEV) infections are significant global health concerns that contribute to acute viral hepatitis. This study aimed to investigate the prevalence of HAV, HEV, and co-infections in a tertiary care hospital setting in central India. Materials and Methods: This retrospective observational study analyzed 987 clinical specimens collected from suspected acute viral hepatitis cases over 5 years (2019–2023). Commercially available enzyme-linked immunosorbent assay kits were used to detect HAV and HEV immunoglobulin M antibodies. Statistical analysis: Demographic data and clinical information were collected and analyzed using Chi-square tests. P < 0.05 was considered statistically significant, indicating a significant association between the variables under investigation. Results: Overall, 32.72% of patients were seropositive for either HAV, HEV, or both. The prevalence of HAV was 22.9%, HEV was 9.83%, and co-infection was 3.24%. HAV infection was more prevalent in children (0–14 years), whereas HEV was more prevalent in adults. Both HAV and HEV infections were associated with elevated liver function markers, with the highest levels observed in co-infected cases. The monsoon season had the highest number of cases. Conclusions: This study revealed a substantial burden of HAV, HEV, and co-infections in central India. The observed sex—and age-specific prevalence patterns warrant further investigation. Effective public health strategies addressing sanitation, hygiene practices, and HAV vaccination programs are crucial to reducing the disease burden.

Porcine-derived pancreatic enzyme replacement therapy may be linked to chronic hepatitis E virus infection in cystic fibrosis lung transplant recipients

ObjectivesIn high-income countries hepatitis E virus (HEV) is an uncommonly diagnosed porcine-derived zoonoses. After identifying disproportionate chronic HEV infections in persons with cystic fibrosis (pwCF) postlung transplant, we sought to...

High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden

Hepatitis E virus (HEV) and Rat Hepatitis E virus (RHEV), recognized for their zoonotic potential, pose significant public health concerns. Our previous research identified both viruses in effluent wastewater in Gothenburg, Sweden. However, there are lingering inquiries regarding the prevalence and genetic diversity of these viruses in influent wastewater, as well as the utility of wastewater surveillance in elucidating their community circulation dynamics. To address these knowledge gaps, we conducted weekly collection of wastewater samples at the Rya wastewater treatment plant in Gothenburg throughout 2023. The concentrations of HEV and RHEV were quantified using quantitative polymerase chain reaction (qPCR). Additionally, two semi/nested-PCR were utilized to amplify viral strains. Furthermore, HEV strains from patients within the same region, as well as other regions in Sweden in 2023, were incorporated into the analysis. Remarkably, we observed a high prevalence of HEV (86%) and RHEV (98%) in wastewater samples, with the majority of HEV sequences identified as subtype 3c/i (9/12). In contrast, HEV subtype 3f was the most sequenced among clinical patient samples (6/12). Notably, previously unreported HEV-3b and unclassified strains were detected in wastewater. Almost all RHEV strains (20/21) were clustered into European groups, with none of the RHEV genetically close to strains previously found in human cases. The notable discordance in prevalence and identified subtypes of HEV-3 in wastewater compared to clinical samples suggests either a significant underdiagnosis of HEV infections or differences in viral loads and shedding durations among humans between HEV-3 subtypes. This underscores the urgent need for improved diagnostic techniques and heightened awareness of HEV transmission dynamics. Furthermore, the consistent detection of RHEV in wastewater underscores the necessity for further investigations to assess the potential role of RHEV in hepatitis cases of unknown etiology, given that most currently available clinical diagnostic assays fail to detect RHEV.

Characterization of zoonotic hepatitis E virus in domestic pigs and wild boar in Vietnam: Implications for public health

Vietnam's unprecedented demand for meat from livestock, including pigs and farmed wildlife, underscores the importance of understanding zoonotic reservoirs for hepatitis E virus (HEV). This study aimed to identify and characterize circulating zoonotic HEV in domestic pigs and wild boar to understand genotype frequencies, transmission dynamics, and associated human health burdens. Rectal swabs, feces, and liver samples from 415 pigs and 102 wild boars were collected across various farms and slaughterhouses in central and southern Vietnam and screened for HEV RNA using nested PCR. HEV RNA-positive samples underwent sanger sequencing and genotyping. Overall, 10% (n = 54/517) of samples were HEV RNA-positive, with wild boars exhibiting the highest HEV positivity rate at 25%, followed by domestic pigs at 7%. Southern Vietnam showed a higher HEV RNA positivity rate (20%) compared to central Vietnam (7%). Notably, rectal swabs demonstrated the highest positivity rate (15%), followed by feces (8%) and liver (4%). HEV-3a was the predominant genotype at 85%, followed by HEV-4b at 9% and HEV-3f at 6%. While HEV-3a was distributed across both central and southern Vietnam, HEV-3f was exclusively detected in central Vietnam, and HEV-4b was identified in wild boar in southern Vietnam. These findings underscore the substantial prevalence of HEV in wild boars, emphasizing their potential as crucial zoonotic reservoirs alongside domestic pigs. Further investigations involving occupationally exposed individuals in high-prevalence areas are warranted to evaluate the human health impact of zoonotic hepatitis E and inform preventive measures. Regular epidemiological studies are imperative for assessing the prevalence and transmission of zoonotic HEV infections among common reservoirs, thereby aiding in the prevention of spillover events within the community.

Sero-prevalence of Hepatitis E Virus in Some Domesticated Animals in Ekiti State, Nigeria

Aim: This study is aimed to determine the prevalence of Hepatitis E virus (HEV) total antibody in some domesticated animals in Ekiti State, Nigeria. Study Design: The study was a cross-sectional study conducted at Ekiti State, Nigeria. Place and Duration of the Study: The study was conducted at Ekiti State, Nigeria between October 2023 and January 2024. Sample testing and analysis of serological test were performed at Department of Microbiology, Federal University of Technology Akure, Ondo State, Nigeria. Methodology: 186 blood samples from four animal species were randomly collected. The serum samples were obtained from the following animals in the study area using the technique of venipuncture: dogs (n=56), pigs (n=29), sheep (n=59) and goat (n=42). Blood samples were collected and separated serum for testing of HEV total antibody using Human (HEV-Ab) enzyme-linked immunosorbent assay (ELISA). Results: The overall seroprevalence of HEV total antibodies was 41.94%, among the four animal species sampled, Pigs had the highest seroprevalence (72.4%). Out of the five Local Government areas, Ido-Osi had the highest HEV seroprevalence (53.57%). The age group ranging from ˃12-≤18 months had higher HEV prevalence (29.41%) among the age group. All age groups of the domestic animals had statistically significant differences at (P ˂ 0.05). Among all the pregnant domestic animals, goats had a considerably higher seroprevalence of HEV total antibody (73.33%) than other pregnant animals in the study area. The HEV prevalence among the pregnant domestic animals was statistically significant (P˂ 0.05). Conclusion: Data suggest that HEV remains an under-recognized and significant public health problem, wanting further attention and research.

Testing Hepatitis E Seroprevalence among HIV-Infected Patients in Greece: The SHIP Study.

Hepatitis E virus (HEV) poses significant health concerns worldwide, particularly among people living with HIV (PLWHIV), due to an increased risk of chronic infection and progression to cirrhosis in individuals with low CD4 cell counts. This study aimed to investigate the prevalence, chronicity potential, and risk factors of HEV infection among PLWHIV in Greece, where data are currently absent. A synchronic multicentric study encompassing five major Greek university hospitals was executed over 24 months, recruiting 696 PLWHIV participants. The prevalence of HEV IgG antibodies was 16.5%, with 8.6% showing evidence of acute HEV infection (HEV IgM). Active viral replication (HEV RNA) was present in 2.3% of the study population. Longitudinal analysis revealed that of the 25 initially anti-HEV IgM-positive individuals, only 3 seroconverted to IgG positivity, and among those with prior HEV RNA positivity (16), none showed evidence of active replication in subsequent tests. Comparative subgroup analysis highlighted the lack of significant differences in HIV-related parameters between HEV seropositive and seronegative individuals. Laboratory evaluations generally showed no significant disparities across most parameters; however, a higher seropositivity for Hepatitis A was observed in the HEV-positive subgroup. Our findings highlight a considerable prevalence of HEV among PLWHIV in Greece, with no observed cases of chronicity.

Hepatitis E virus in children and adolescents living in an urban environment in central Argentina: An explorative study

In Argentina, circulation of hepatitis E virus (HEV) genotype 3 has been described, producing sporadic cases of acute and chronic hepatitis. Limited information is available regarding HEV infection in children, so we aimed to investigate this virus in a pediatric population from the country. Serum samples from Argentine children (0–18 years old) (n = 213) were studied for IgG anti-HEV, IgM anti-HEV and RNA-HEV: 202 samples belonged to individuals attending health-care centers for routine check-ups, and 11 samples from patients with acute hepatitis of unknown etiology. Seropositivity for IgG anti-HEV was 1.49 % (3/202). One sample from an 18-years-old female patient with acute hepatitis tested positive for IgM anti-HEV detection, negative for IgG anti-HEV and RNA-HEV, but also positive for IgM anti-EBV. The HEV prevalence was low and showed circulation among children in central Argentina.

Epidemiological study of hepatitis E virus infection among students and workers in Hebei Province of China.

Hepatitis E caused by the hepatitis E virus (HEV) is prevalent worldwide. In China, considerable shifts in the epidemiology of hepatitis E have been observed over the last two decades, with ongoing changes in the prevalence of HEV. This study, in conjunction with the health examinations for students and workers, aims to estimate the seroprevalence and assess the risk factors of HEV infection in general population in Hebei province, China. Epidemiological information was collected using a specific questionnaire and blood samples were collected from each participant during the process of health examination. Anti-HEV IgG and IgM in sera were tested using the Wantai ELISA assay kits. Logistic regression modelling was used to identify associated risk factors. The average positive rate of anti-HEV IgG in students (6-25 years) was 3.4%. One (0.2%) student was anti-HEV IgM positive, while also testing positive for IgG. The HEV seroprevalence was not related to students' gender, school, or family residence. In occupational populations, the overall seropositivity rate was 13.3% for anti-HEV IgG and 0.67% for IgM. HEV seropositivity increased significantly with age, ranging from 3.8% to 18.6% in age groups, and differed significantly among four occupation groups: farmers (17.6%), food supply workers (18.0%), other non-farm workers (14.7%) and healthcare workers (5.9%) (p = 0.002). Multivariable logistic analysis confirmed the significant correlations of seroprevalence with age and occupation. The study found a low seroprevalence of HEV in children and young adults in Hebei Province, China. Advanced age correlates with higher seroprevalence in occupational populations, indicating an accumulation of HEV infection over time. Seroprevalence varied significantly among different occupation groups, suggesting the important role of occupational exposure for HEV infection.

Prevalence and molecular characterization of hepatitis E virus (HEV) from wild rodents in Hubei Province, China

Hepatitis E, caused by the hepatitis E virus (HEV), is a global public health issue. Low similarity between the gene sequences of mouse and human HEV led to the belief that the risk of human infection was low. Recent reports of chronic and acute hepatitis E caused by murine HEV infection in humans in Hong Kong have raised global concerns. Therefore, it is crucial to investigate the epidemiology and prevalence of HEV in China. We comprehensively analyzed different rodent HEV strains to understand rocahepevirus occurrence in Hubei Province, China. The HEV positivity rate for was 6.43% (73/1136). We identified seven near-full-length rocahepevirus strains and detected rat HEV antigens in tissues from different mouse species. HEV has extensive tissue tropism and a high viral load in the liver. We highlight the genetic diversity of HEVs in rodents and underscore the importance of paying attention to their variation and evolution.

Water-Based Epidemiological Investigation of Hepatitis E Virus in South Africa.

Hepatitis E virus (HEV) is an emerging zoonotic pathogen that exhibits great host diversity. The primary means of transmission of the virus in low- and middle-income countries is contaminated water, often due to a lack of access to proper sanitation, which leads to faecal contamination of water sources. Environmental surveillance is an important tool that can be used to monitor virus circulation and as an early warning system for outbreaks. This study was conducted to determine the prevalence and genetic diversity of HEV in wastewater, surface water (rivers and standpipe/ablution water), and effluent from a piggery in South Africa. A total of 536 water samples were screened for HEV using real-time reverse transcription-polymerase chain reaction. Overall, 21.8% (117/536) of the wastewater, river, and ablution water samples tested positive for HEV, whereas 74.4% (29/39) of the samples from the piggery tested positive. Genotyping revealed sequences belonging to HEV genotypes 3 (98%, 53/54) and 4 (2%, 1/54), with subtypes 3c, 3f, and 4b being identified.

Detection of Rat Hepatitis E Virus in Pigs, Spain, 2023.

We identified rat hepatitis E virus (HEV) RNA in farmed pigs from Spain. Our results indicate that pigs might be susceptible to rat HEV and could serve as viral intermediaries between rodents and humans. Europe should evaluate the prevalence of rat HEV in farmed pigs to assess the risk to public health.

Molecular Epidemiology of Hepatitis E Virus Genotypes in Blood Donors in Peshawar, Khyber Pakhtunkhwa

Background: Hepatitis E virus (HEV), an RNA virus, poses a significant global health threat, affecting 2.3 billion people annually, causing 70,000 deaths, over 50% of acute viral hepatitis cases. In Pakistan, HEV prevalence is high among pregnant women (26%), with a mortality rate of 26 to 30%. Blood transmission is a leading source of sporadic HEV infection.
 Methodology: The blood specimens were investigated with HEV to detect anti- IgM and IgG antibodies. Anti HEV IgM positive specimens confirmed the incidence of viral RNA by Polymerase chain reactions. The positive cases containing viral RNA were subjected to sequencing of ORF2.
 Result: A total of 3480 blood specimens were screened serologically by ELISA for the existence of anti HEV IgM and anti-HEV IgG antibodies. Of these 3480 samples, 170 (4.9%) were confirmed positive when screened for HEV antibodies among study population, there was a statistically significant difference observed between males and females (p=0.00001). From 170 positive samples, 60 (1.72 %) were positive for having anti-HEV IgM antibodies in plasma, whereas 110 (3.16 %) were found with anti-HEV IgG antibodies. Among 60 (1.72 %) IgM-positive samples, 18 (0.51 %) were confirmed positive by PCR for the presence of HEV-RNA. Genotype 1 was observed in all 18 HEV RNA-positive samples. 
 Conclusion: The findings of this study underscore the urgency of implementing HEV screening protocols before blood donation. The risk of transmission through blood products is evident, with 4.9% of screened blood specimens exhibiting HEV antibodies. Therefore, the National Blood Transfusion Regulatory Authority must incorporate HEV screening as a routine procedure in Pakistan.

Seroprevalence of the Hepatitis E Virus in Indigenous and Non-Indigenous Communities from the Brazilian Amazon Basin.

Hepatitis E virus (HEV) infection is a common cause of acute viral hepatitis in tropical regions. In Brazil, HEV G3 is the only genotype detected to date. Reports on HEV prevalence are heterogeneous. We aimed to compare the prevalence of anti-HEV among three populations living in the Brazilian Amazon basin. Two cross-sectional studies were conducted in urban, rural, and Yanomami indigenous areas. Plasma samples from 428 indigenous and 383 non-indigenous subjects were tested for anti-HEV IgG using enzyme-linked immunosorbent assays. The overall prevalence of anti-HEV was 6.8% (95%CI: 5.25-8.72), with 2.8% (12/428) found in the Yanomami areas, 3% (3/101) in an urban area, and 14.2% (40/282) in a rural area. Multivariate logistic analysis indicated that patients aged 31-45 years or ≥46 years are more likely to present anti-HEV positivity, with a respective aOR of 2.76 (95%CI: 1.09-7.5) and 4.27 (95%CI: 1.58-12.35). Furthermore, residence in a rural area (aOR: 7.67; 95%CI: 2.50-33.67) represents a relevant risk factor for HEV infection. Additional studies detecting HEV RNA in fecal samples from both humans and potential animal reservoirs are necessary to comprehensively identify risk factors associated with HEV exposure.

Monitoring of hepatitis E virus in wastewater can identify clinically relevant variants.

Hepatitis E virus (HEV) is prevalent worldwide and can cause persistent infection with severe morbidity. Antiviral treatment approaches can lead to the emergence of viral variants encoding escape mutations that may impede viral clearance. The frequency of these variants remains unknown in the human population as well as environment due to limited comprehensive data on HEV diversity. In this study, we investigated the HEV prevalence and diversity of circulating variants in environmental samples, that is, wastewater and rivers from North-Rhine Westphalia, Germany. HEV prevalence could be determined with 73% of samples tested positive for viral RNA via qRT-PCR. Using high-throughput sequencing, we were able to assess the overall genetic diversity in these samples and identified the presence of clinically relevant variants associated with drug resistance. In summary, monitoring variants from environmental samples could provide valuable insights into estimating HEV prevalence and identifying circulating variants that can impact treatment outcome.

Zoonotic and Food-Related Hazards Due to Hepatitis A and E in Africa: A Systematic Review and Meta-Analysis.

Foodborne infections are caused by a wide spectrum of microbial pathogens, and they pose a significant global health threat, resulting in millions of cases and thousands of fatalities annually. Among these pathogens, human viruses, including Hepatitis A virus (HAV) and Hepatitis E virus (HEV), play a significant role in foodborne viral outbreaks, especially in Africa. This systematic review determined the prevalence of these viruses in livestock and produce in Africa. A systematic search strategy was implemented following the PRISMA guidelines. Databases such as African Journal Online, Web of Science, Scopus, and PubMed were searched from their inception until November 30, 2023. Descriptive statistics and a proportional meta-analysis utilising a random-effects model with a 95% confidence interval were employed in the data analysis. The Cochrane risk-of-bias tool (ROB2) was utilised to evaluate the potential for bias in each study. The search identified 27 articles that met the inclusion criteria, among which seven focused on HAV, comprising a total of 309 samples, whereas 20 studies focused on HEV, comprising a total of 4238 samples. Egypt had the highest number of studies, followed by Cameroon and Nigeria. The meta-analysis revealed an overall prevalence of 33.8% (95% CI: 17.0-50.6) for HAV in ducks and shellfish and 22.0% (95% CI: 12.1-31.8) for HEV in various livestock. Genotype 3 was identified as the predominant genotype, for both HAV and HEV. This review revealed a high prevalence of HAV and HEV in livestock populations in Africa, shedding light on the potential risks associated with zoonotic and/or food-related infections. There is a need for continued surveillance and monitoring of these viruses in both animals and food products to mitigate the risk of foodborne outbreaks and protect human health.

High Prevalence of Hepatitis E IgM Antibody among Pregnant Women in Their Second and Third Trimester in Southwest Nigeria

Background: Background: Pregnant women with Hepatitis E virus (HEV) infection, particularly those in the second or third trimester, are at increased risk of acute liver failure, fetal loss, and mortality; but unfortunately, routine HEV screening is yet to be introduced for pregnant women in Nigeria and many developing nations. This study was conducted to determine HEV prevalence and the associated risk factors among pregnant women unaware of their HEV status in three states of the southwestern geopolitical zone in Nigeria. Methods: Two hundred and thirty-two consenting pregnant women aged 18 -55 years from Lagos, Oyo, and Osun state were recruited for the study and screened for HEV IgM antibodies using DIAPRO HEV IgM ELISA KIT (Milanno-Italy). Sociodemographic data and risk factors were obtained using a structured questionnaire, and data were analyzed using SPSS version 23. Results: An overall HEV prevalence rate of 9.9% was observed among pregnant women in Southwest Nigeria. State-specific prevalence of 14.7%, 8.5%, and 6.7% was observed in Oyo, Lagos, and Osun, respectively. HEV prevalence increased with increase in trimester of pregnancy, with more than 80% of the HEV prevalence found among women in their second and third trimester. All the HEV prevalence occurring in women of active childbearing age (≤ 40 years) and among low-income earners. None of the risk factors considered was found to have a statistical correlation with HEV prevalence. Conclusion: High HEV prevalence in the second and third trimesters was reported in southwest Nigeria. We advocate routine screening of pregnant women for HEV IgM antibody for prompt HEV detection and proper HEV management to forestall HEV complications in pregnancy.

Prevalence of hepatitis E virus genotype 4 of probable human origin in Tibetan pigs from the Qinghai-Tibetan Plateau, China.

Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. In 2018-2022, we investigated the presence of HEV RNA in 1233 stool samples collected in the Qinghai-Tibetan Plateau, including humans (16), Tibetan pigs (624), yaks (312), sheep (267), and dogs (14). HEV RNA was only detected in Tibetan pig faecal samples (18.27%, 114/624). To perform molecular characterization of HEV strains in Tibetan pigs, we obtained 21 complete HEV genome sequences between 2018 and 2022. Sequence comparisons showed that 21 HEV strains from Tibetan pigs shared the mean nucleotide identities with the reference HEV strains ranging between 82.9% and 94.9% and 89.3% and 92.1% similarities with human HEV strains. Phylogenetic analysis confirmed that all HEV strains were genotype 4, closely related to human HEV strains. Sequence recombinant analysis showed five potential recombinant strains identified in this study, of which SWU/D18/2018 (GenBank No. MK410044) was recombinant with human and swine HEV strains, located 6509-6878 nt from the recombination point. Based on the Bayesian evolutionary trees, we found that most HEV strains diverged later than human HEV (16 Tibetan pig HEV strains diverged later than 1979, and seven human HEV strains diverged earlier than 1979). Therefore, we speculated that the prevalence of HEV 4 in Tibetan pigs possibly originated from humans in the Qinghai-Tibetan Plateau.