Incidence Of Hepatitis E Virus Infection Research Articles

Seroprevalence and incidence of hepatitisE virus infection in the general population of Iwate prefecture, Japan: A retrospective cohort study.

HepatitisE virus (HEV) causes subclinical or acute self-limiting hepatitis. We surveyed the current seroprevalence and incidence of HEV infection among the general population in Iwate Prefecture, Japan, where the endemic infection is presumed to be low. Between 2014 and 2016, we recruited individuals from Iwate Prefecture, Japan, who visited a general medical work-up program. Serum anti-HEV antibody and HEV RNA were measured twice, with an interval of 2years. Anti-HEV antibody was measured with enzyme-linked immunosorbent assay and HEV RNA with reverse transcription-polymerase chain reaction. Study participants comprised 1284 Japanese (650 men and 634 women) with age ranging 20-89years. A total of 90 participants were found to be positive for anti-HEV immunoglobulinG on the first visit, with a prevalence of 7.0% (95% confidence interval [CI] 5.6%-8.4%). Seroprevalence was higher in men than in women (10.1% vs. 3.7%, p<0.001), and in those aged in their 50s-80s than in those aged in their 20s-40s (p=0.006). Positive seroconversion indicating new HEV infection was found in seven of 1194 seronegative participants (0.59%; 95% CI 0.15%-1.0%), indicating the incidence of HEV infection to be 272 per 100000 person-years (95% CI 109-561). Our observations suggest that the incidence of HEV infection is high and that it is a leading cause of hepatitis virus infection in Iwate Prefecture, Japan.

The global trends and regional differences in incidence of HEV infection from 1990 to 2017 and implications for HEV prevention.

Hepatitis E virus (HEV) infection is an important cause of acute viral hepatitis worldwide, but it is long-neglected. We aimed to understand the global trends and regional differences in the incidence of HEV infection, thereby making global tailored prevention strategies. This study is a post-hoc analysis of the data from Global Burden of Disease Study 2017. Annual HEV incident cases and incidence rates from 1990 to 2017 were collected. Changes in incident cases and estimated annual percentage changes (EAPCs) of age-standardized incidence rates (ASRs) were calculated to quantify the temporal trends of HEV infection. Globally, HEV ASRs decreased by an average 0.16% (95% CI: 0.14%-0.17%) per year from 279.79 per 100000 in 1990 to 269.70 per 100000 in 2017; however, the number of HEV incident cases increased by 17.63% from 16.53million in 1990 to 19.44million in 2017. Against the global trend of ASR falling, an increasing trend was reported in Oceania (EAPC=0.03; 95% CI: 0.03-0.04) and Western Europe (EAPC=0.02; 95% CI: 0.01-0.03). The number of HEV incident cases increased remarkably in low (63.07%) and low-middle (37.46%) Socio-Demographic Index (SDI) regions between 1990 and 2017. Additionally, the number of HEV incident cases increased by 4.63% in high SDI regions, mainly in 40 plus age group. Surprisingly, more than 40% of HEV incident cases in Western Europe in 2017 were over 40years old. HEV is still pending in hyperendemic regions, and it is emerging in low endemic regions, suggesting more efforts should be done to make targeted prevention strategies.

Hepatitis E Virus Infections Among Human Immunodeficiency Virus-Positive Individuals During an Outbreak of Acute Hepatitis A in Taiwan.

Hepatitis A virus (HAV) and hepatitis E virus (HEV) share the similar fecal-oral transmission route. During an outbreak of sexually transmitted acute hepatitis A among men who have sex with men (MSM) worldwide between 2015 and 2017, we investigated the possibility of sexual transmission and related morbidity of HEV infection among human immunodeficiency virus (HIV)-positive patients. From March 1, 2015 to August 31, 2017, anti-HEV immunoglobulin G was retrospectively determined among 3,293 HIV-positive patients, who were mainly MSM (87.6%) with a median CD4 count of 575 cells/μL. Prevalence and incidence of HEV infection were 3.7% (123 of 3,293) and 4.35 per 1,000 person-years of follow-up (PYFU), respectively, which were significantly lower compared with those of HAV infection (31.1% [996 of 3,204] and 12.61 per 1,000 PYFU, respectively). The number of patients with HEV infection did not increase with the hepatitis A epidemic. The factor associated with prevalent HEV infection was older age (per 1-year increase, adjusted odds ratio, 1.07; 95% confidence interval, 1.05-1.09), but neither sexual orientation nor acquisition of sexually transmitted infections was related to prevalent or incident HEV infection. Among 23 patients with incident HEV infection, 22 patients had viremia caused by HEV genotype 4. No patients had prolonged HEV viremia or clinical symptoms, and only a mild elevation of serum aminotransferase, ranging from 34 to 77 IU/L, was noted. Although 4 patients had hepatitis for a prolonged duration of between 8 and 17 months, no abdominal imaging revealed liver fibrosis or cirrhosis. Conclusion: HEV endemicity remained low among HIV-positive patients in Taiwan during the outbreak of acute hepatitis A. Our data suggest that sexual transmission of HEV with significant morbidity of HEV infection, if any, is rare in this population.

Incidence and duration of hepatitis E virus infection in Dutch blood donors

The incidence of hepatitis E virus (HEV) infection in the Netherlands is high. Blood donors are not routinely screened for HEV infection, but since January 2013, donations used for the production of solvent/detergent (S/D)-treated plasma have been screened for HEV RNA. Donations were screened for HEV RNA in pools of 96 and 192 donations. In addition, all donations made between 60 days before and after each HEV RNA-positive donation were tested individually for HEV RNA and anti-HEV immunoglobulin G. The screening of 59,474 donations between January 2013 and December 2014 resulted in identification of 45 HEV RNA-positive donations (0.076%) from 41 donors. HEV RNA loads ranged from 80 to 2.3 × 10(6) IU/mL. The number of positive donations increased significantly over time (p = 0.03). Thirty-three of 90 donations made up to 60 days before or after HEV RNA-positive donations were positive when tested individually, while they had not been detected in the pool screening. The mean duration of HEV viremia in the healthy blood donor is estimated to be 68 days. The incidence of HEV infection in the Netherlands is high and increased during the study period. In 2013 and 2014, HEV RNA was detected in 1 per 762 donations intended for production of S/D plasma.

Is Hepatitis E a Vaccine Preventable Diseases?

Copyright © 2015, Infectious Diseases and Tropical Medicine Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. Hepatitis E virus (HEV) is a positive-sense single-stranded RNA icosahedral virus with a 7.5 kilobase genome, which has 5 genotypes (1 to 5) (1, 2). HEV genotypes 1 and 2 are the most common causes of waterborne infections that mainly occur in resource-limited countries (3). The other pattern of transmission is from animals and humans (zoonotic transmission), caused by HEV genotype 3 or 4 and occurs widely in both resource-limited and developed countries (3). HEV infection can occur either in large epidemics in endemic regions and some parts of the Middle East or in sporadic forms in developed or developing countries (3, 4). HEV infection is a self-limited and clinical illness, similar to other forms of viral hepatitis except in pregnant women in whom the illness is particularly severe with a mortality rate of up to 25% (3, 4). Recently, Zhang et al. reported the long-term efficacy of hepatitis E vaccine as 86.8%, which is new and hopefully promising (5). Although hepatitis E is known to be a problem among people living in crowded and unsanitary conditions such as camps for refugees and internally displaced people, regarding the absence of precise data, the disease and its mortality are serious problems, which make it difficult to define the clinical and public health applications of hepatitis E vaccination (6). For example, in Bangladesh, a study in which standardized interviews were conducted with family members and caregivers to assess the cause of maternal deaths revealed that one in five deaths was related to jaundice; although the published data suggested that about half of those deaths could be related to hepatitis E (7). If the efficacy of HEV vaccine is determined to be pan-genotypic, several public health questions must be answered, including who and when should be vaccinated, as well as the cost-effectiveness of the vaccination as a prevention tool (8). Additional data regarding the safety, immunogenicity, and efficacy of the hepatitis E vaccine in pregnant women, patients with chronic liver disease, and other vulnerable groups are needed too (8). Before adding hepatitis E vaccination to the childhood vaccination schedule, safety and efficacy data, including its interaction with other vaccines (simultaneously) are needed in children less than 16 years of age. Also, field trial studies must be conducted to establish an effective vaccination series (9). Although studies of the vaccine suggest that 2 doses may effectively prevent hepatitis E, a well-designed evaluation of the effectiveness of fewer doses with shorter dosing schedules is required (9). The World Health Organization’s Strategic Advisory Group of Experts (SAGE) on immunization recently cited the need for additional data regarding the incidence of HEV infection and disease and the safety and efficacy of the vaccine before recommending routine hepatitis E vaccination in countries where hepatitis E is highly endemic (10). Hepatitis E vaccine could become a powerful tool in the prevention and control of HEV transmission and disease. Most immediately, it can have a role in curbing outbreaks of hepatitis E in humanitarian crises. The benefits of broad adoption of hepatitis E vaccine can be far-reaching, if studies reveal that vaccination protects against all HEV genotypes and is safe and effective when used in people at high risk for hepatitis E-related illness and death, including pregnant women (5). In Iran, pigs and other animals have a minor role in HEV infection (11), so other measures such as preparing sanitary water for agriculture, especially vegetables, avoiding contamination of water pipelines with sources of infection, improving public awareness to preserve the hygiene of water, and enhancing epidemiological knowledge regarding HEV infection seem highly important for better application of HEV vaccine prevention program.

P0629 : First detection of genotype 3 and 4 hepatitis E virus (HEV) RNA among the general population in cambodia: Full-length sequence of HEV isolate, prevalence and incidence of HEV infection were clarified based on the Sero-epidemiological study

P0629 : First detection of genotype 3 and 4 hepatitis E virus (HEV) RNA among the general population in cambodia: Full-length sequence of HEV isolate, prevalence and incidence of HEV infection were clarified based on the Sero-epidemiological study

A study of viral hepatitis e infection in a tertiary care hospital in mysore, South India.

Background. In this study, we aimed to explore the clinical and epidemiological profile of all patients with hepatitis E virus (HEV) who were admitted to a tertiary care hospital in Mysore, India and to further assess various factors that influence the prognosis of these patients.Methods. Two hundred ninety patients with HEV infection were included in the study and interviewed. They were subjected to clinical examination and laboratory investigations, including complete hemogram, renal, and liver function tests. Viral markers for HBV, HAV, HCV, and HEV by hepatitis B surface antigen, anti-HAV, anti-HCV, and anti-HEV antibodies, respectively, were done using the enzyme-linked immunosorbent assay method. Final outcome was recorded in the form of discharge or death.Results. Males had higher (82.8%) incidence of HEV infection. Yellowish discoloration of urine was the most common symptom, and icterus was the most common sign at presentation. Hepatomegaly was most common finding on abdominal examination. Mean duration of hospital stay was higher among diabetics (10 days vs 7.11 ± 3.52 days). Overall, mortality observed was 3.45%. A higher mean age (P = .000) and duration of hospital stay (P = .000) were associated with higher mortality. Mortality was significantly higher among patients with alcohol abuse (25% vs 0%) (P = .004). Higher mean prothrombin time-international normalised ratio (PT-INR) (1.6 ± 0.13 vs 1.21 ± 0.32), total bilirubin (20.3 ± 5.08 vs 11.33 ± 7.26 mg/dL), and direct bilirubin (15.05 ± 3.64 vs 6.35 ± 3.71 mg/dL) were associated with higher mortality, whereas lower mean serum albumin (2.6 ± 0.11 vs 3.41 ± 0.40 gm/dL) was associated with higher mortality. Increase in renal parameters (ie, urea [97 ± 33.48 vs 32.43 ± 18.41 mg/dL] and creatinine [2.9 ± 1.38 vs 1.12 ± 0.64 mg/dL]) and electrolyte imbalances (ie, hyperkalemia [5.95 ± 1.21 vs 4.29 ± 0.51 mmol/L] and hyponatremia [123 ± 3.56 vs 136.04 ± 2.97 mmol/L]) were associated with higher mortality. There were 20-fold increases in mean serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT) values (SGPT: SGOT = 1.148) and a 1-fold increase in mean alkaline phosphatase.Conclusions. Higher mean age, duration of hospital stay, PT-INR, total bilirubin, direct bilirubin, blood urea, serum creatinine, potassium values, alcohol abuse, presence of ascites, and fulminant hepatitis were associated with higher mortality, whereas lower mean serum albumin and sodium values were associated with higher mortality. Diabetics had a higher mean duration of hospital stay.

Prevalence of Hepatitis E Virus Infection during Pregnancy

Background: Hepatitis E is considered as an emerging disease of global importance has been a subject of continuing interest and controversy and one of the most common diseases in the developing countries. Hepatitis E virus (HEV) infection in pregnant women is more common and fatal during the third trimester. The incidence of HEV infection in pregnancy is high and a significant proportion of pregnant women can progress to fulminant hepatitis.

Detection of Hepatitis E virus in samples of animal origin collected in Hungary

Hepatitis E virus (HEV) is an enterically transmitted human pathogen. HEV infections are mainly associated with acute, self-limited, icteric hepatitis with an average mortality rate of 1%. Animal reservoirs are considered to play an important role in the maintenance of the virus and in the spread of HEV to humans. HEV-induced seroconversion was described in several species, however clinical hepatitis in animals has not been observed to date. HEV strains from animals are genetically closely related to human HEV isolates, which supports the opinions on the zoonotic transmission of the virus. In this expansive study the occurrence of HEV was investigated in Hungarian wild and domesticated animal samples. HEV RNA was detected by reverse transcription-polymerase chain reaction in liver samples of wild boars, roe deer, and deer. The investigations of domestic swine samples detected HEV in 39% of the investigated Hungarian pig farms. Simultaneous investigation revealed no definite difference between liver and faeces samples of domestic pigs in the frequency of HEV positivity. The highest (36%) incidence of HEV infection was found among the 11–16-week-old pigs. Samples from domestic cattle and rodents collected in pig farms, forests and meadows were tested negative for HEV RNA. Phylogenetic analysis of partial sequences amplified within the ORF1 and ORF2 regions of selected strains revealed that the detected viruses belong to three subgroups of the third genogroup of HEV, and are closely related to human and swine HEV strains detected in different countries. The investigations revealed widespread distribution of HEV in Hungarian wild ungulate and domesticated swine populations, with considerable genetic diversity among the strains.

Hepatitis E virus seroprevalence in acute viral hepatitis in a developed country confirmed by a supplemental assay.

Hepatitis E virus (HEV) infection is prevalent among cases of acute viral hepatitis in young adults in developing countries. HEV infection is not restricted to endemic areas, but would appear to be worldwide in distribution. In order to document the incidence of HEV infection in acute hepatitis cases in a developed country, IgG and IgM anti-HEV antibodies and HEV RNA were tested in 101 Caucasian patients with acute viral hepatitis; 92 of these cases had markers of acute viral hepatitis other than HEV. Forty-seven (46.5%) cases had IgG anti-HEV; IgM anti-HEV and HEV viremia were not detected. As the incidence of anti-HEV was higher than would be expected, the possibility of the occurrence of false positive results was subsequently investigated. Supplemental antibody testing, using a broadly reactive epitope region, reduced the frequency of anti-HEV to 17%. Therefore, supplemental antibody testing confirms the hepatitis E virus seroprevalence in a developed country. Since IgM anti-HEV and HEV viremia were not detected, persons with IgG anti-HEV may be "subclinical HEV cases," or have long-lived antibodies in their circulation.