Prevalence Of HEV Research Articles

Seroprevalence of Hepatitis A virus and Hepatitis E virus in patients presenting with acute viral hepatitis: A retrospective study of 2-years at tertiary care Hospital, Himachal Pradesh in Northern India

: Hepatitis-A virus and Hepatitis-E virus are spread enterically, resulting in acute viral hepatitis (AVH) in developing countries. Fecal-oral transmitted hepatitis cause major health problems in our country. The aim of present study is to determine the seroprevalence of HAV and HEV in AVH patients attending the tertiary care hospital at Dr. Rajendra Prasad Govt. Medical College Kangra at Tanda, Himachal Pradesh (DRPGMC). Insufficient data makes it difficult to determine an accurate prevalence of illness in this region of India.: The Viral Research and Diagnostic Laboratory (VRDL), in the Department of Microbiology at DRPGMC Tanda, Himachal Pradesh, consolidated retrospective data of 2-years duration. The study population included 784 serum samples received from outdoor and indoor patients were considered in the study.: Of the 784 serum samples that were chosen for our study, HAV and HEV reactive patients showed a seroprevalence of 11.20% and 1.80% respectively. During two years of the study, the co-infection rate of HAV and HEV in patients with acute viral hepatitis was 0.5%. Compared to females (31.80% and 42%), males reported higher seroprevalence of HAV (68.10%) and HEV (57.10%). Further data shows that HAV infection was observed in all age groups and the highest prevalence was reported in the age range from 11 to 20 years. The HEV infection was not observed in the pediatric age groups, it was only observed in adults. Maximum prevalence of HEV was reported in the age group of 21-30 years. The highest number of reactive cases was recorded in the month of August and September.: We found that the prevalence of HAV is significantly higher than that of HEV during two years of study period. In this study, we observed that HAV is more predominant in males as compare to females.HEV infections were only observed in adults.

Global burden of acute hepatitis E between 1990 and 2019 and projections until 2030.

Acute hepatitis E (AHE) is still a public health issue worldwide. Here, we report the global burden of AHE in 204 countries and territories from 1990 to 2019 by age, sex and socio-demographic index (SDI), and predict the future trends to 2030. Data on AHE were collected from the Global Burden of Diseases, Injuries and Risk Factors Study 2019. The average annual percentage change (AAPC) and joinpoint analysis were used to determine the burden trend. In 2019, there were 19.47 million (95% UI, 16.04 to 23.37 million) incident cases of AHE globally, with a 19% increase since 1990. Age-standardized rate (ASR) of disability-adjusted life years (DALYs), prevalent and incident cases declined from 1990 to 2019. In 2019, the ASR of incidence, prevalence and DALYs due to HEV infection were highest in the same regions of South Asia for both sexes. Southern Sub-Saharan Africa presented the highest increases in the ASR for incidence of HEV infection in both males (AAPC = .25) and females (AAPC = .24) from 1990 to 2019. Incident cases are higher in males than females before 55-59 years old. The SDI values were negatively correlated with the age-standardized DALYs. Between 2019 and 2030, the ASR for incidence and prevalence of HEV for both sexes showed an increasing trend. Although the overall ASR of AHE decreased, the burden of AHE remains an underappreciated problem for society. The findings may provide useful information for policymakers to develop appropriate strategies aimed at reducing the burden of AHE.

Detection of hepatitis E RNA in pork products at point of retail in Ireland – Are consumers at risk?

Hepatitis E (HEV), a zoonotic virus, is the leading cause of acute viral hepatitis in Europe. The presence of HEV in domestic pigs can result in infections in humans through consumption of pork products which are undercooked or where processing methods are insufficient to inactivate the virus. In Ireland, pork accounts for 34 % of all meat consumption (CSO, 2022) and the prevalence of HEV in products at point of retail has not previously been characterised.A sampling strategy was designed in which high pork content sausages, fresh pork liver and raw fermented sausages were systematically purchased from three types of retailers between May 2018 and March 2019. In total, 200 pork products were tested using a lysing agent to release the HEV from the product for detection. RT-PCR for HEV was performed on samples with an extraction efficiency >1 % (n = 188/200) (94 %). Low level HEV RNA was detected in 9/188 (4.8 %) pork products tested. The highest incidence of HEV RNA was in pork liver where 6/25 (24 %) samples were positive. The concentration of HEV ranged from 0.02 – to 9.4 genome copies/g of pork.Based on these data an exposure assessment was performed which found that if consumers followed advice from the Food Safety Authority of Ireland to achieve core temperatures of 70 °C or higher when cooking, the risk was likely to be negligible.

A Systematic Review and Meta-Analysis on Hepatitis E Virus Detection in Farmed Ruminants.

Swine are widely recognized as the main reservoir of zoonotic HEV; however, a growing body of data on the HEV prevalence in farmed ruminants of different species also points to a potential route for HEV transmission through ruminants and ruminant products and by-products. Definite information on the zoonotic potential of ruminants is still absent or unclear, compelling the necessity for increasing knowledge on this. The aim of the current study was to analyze the state-of-the-art in this research topic and provide a summary of HEV detection and characterization in farmed ruminants. A total of 1567 papers were retrieved from four search databases that resulted in 35 eligible papers after application of exclusion/inclusion criteria. Studies on HEV in farmed ruminants were mainly based on the detection of HEV RNA and were reported in Africa (n = 1), America (n = 3), Asia (n = 18) and Europe (n = 13), and focused on a variety of ruminants species, namely cow, goat, sheep, deer, buffalo and yak. The overall pooled prevalence of HEV was 0.02% (0.01-0.03, 95% CI). The subgroup pooled prevalence of HEV RNA was 0.01% (0.00-0.02, 95% CI) in cow milk, stool, serum, liver, intestinal, bile, blood, spleen and rectal swab samples; 0.09% (0.02-0.18, 95% CI) in goat serum, bile, stool, milk, liver, rectal swab and blood samples; 0.01% (0.00-0.04, 95% CI) in sheep stool, serum, milk, blood and liver samples. Most of the HEV genotypes found in farmed ruminants belonged to the zoonotic HEV-3 (subtypes 3a, 3c) and HEV-4 (subtype 4d, 4h), with Rocahepevirus also found. The wide HEV circulation observed in different farmed ruminants raises concerns for the possibility of HEV transmission through products from infected ruminants and alerts for the potential zoonotic route for HEV in ruminant products, such as meat and dairy products. Also, contact exposure to infected farmed animals could be a risk factor. Further research should be conducted in order to understand the circulation of HEV in these animals and its zoonotic potential, as there is currently a lack of data on this topic.

High prevalence of hepatitis A and E viruses in environmental and clinical samples from West Argentina.

Environmental surveillance of water sources is important to monitoring viral hepatitis transmission in clinical settings. This study investigated the circulation of hepatitis A (HAV) and E (HEV) viruses in sewage and clinical samples from Argentina. Between 2016 and 2017, 80 raw sewage samples and 86 clinical samples (stool and serum) from suspected cases of hepatitis A and hepatitis E were obtained. HAV and HEV were tested by both real-time and nested PCR. Positive samples were sequenced for genotype determination and phylogenetic analysis. Overall, HAV was recovered in 39% of sewage samples and 61.1% of clinical samples. HEV was detected in 22.5% of sewage samples and 15.9% of clinical samples. HAV was found more frequently in sewage during the winter and in clinical samples in spring; HEV was more prevalent in sewage during summer and in clinical samples in autumn. All HAV isolates belonged to genotype IA and HEV isolates belonged to genotype 3, the most prevalent genotypes in South America. High prevalence of HAV and HEV in environmental and clinical samples in Mendoza, Argentina was observed. These findings reinforce the importance of environmental surveillance and implementation of health strategies to control the spread of HAV and HEV in developing countries.

Hepatitis E Virus Prevalence Amongst Blood Donors in Kenya

Introduction: Hepatitis E (HEV) is an emerging cause of viral hepatitis mainly transmitted through the fecal-oral and parenteral routes. It has greatly affected populations in many parts of Kenya due to declined sanitation practices. The objective of the research was to determine IgM and IgG seroprevalence of HEV prevalence among blood donors in Kenya as well as its Anti-HEV sero-reactivity by demographic factors.
 Material and Methods: Cross sectional research design was used to collect blood samples from six from regional blood collecting centers, with blood donors selected through proportionate stratified sampling. Serum were matched to the age and gender distribution of the blood donors and tested by IgM and IgG enzyme immunoassays (EIA). The screening was carried out using human MP Diagnostics (0721150096T-96 wells) HEV ELISA kit. To test for IgM and IgM anti-HEV antibodies, microplates with 96-well plate were used. Results were averaged to generate a signal-to-noise ratio with ≥1.0 designated as positive per the manufacturer’s recommended cutoff.
 Result and Conclusion: On the analysis, IgM reactivity was associated with HEV (RR 1.66, 95%CI 1.07, 2.60; p = 0.024) while IgG reactivity was associated with increasing age (p < 0.001) and HIV (RR 1.93, 95%CI 1.52, 2.46; p < 0.001). AFI case-patients were more likely to be IgM (p = 0.002) and IgG (p<0.001) reactive compared to healthy residents. All the 19 hepatitis E virus IgM and/or IgG seropositive blood samples tested negative for HEV RNA since no bands were detected using RT-PCR technique. Serologic evidence for HEV in blood samples from selected areas suggests a high burden of infection, though age and gender exhibited no significant difference in prevalence of HEV among the blood donors in Kenya (p>0.05).

Prevalence of Hepatitis A and E Infection in a Suburban Tertiary Care Hospital

Background: Acute viral hepatitis causes high morbidity in children and young adults. Hepatitis A and E can lead to fulminant hepatitis in 0.1% -2%. Objective: To find prevalence of HAV and HEV among suspected cases of acute viral hepatitis and to co-relate the laboratory findings with clinical presentations, over a one year periodMaterial & Methods:A retrospective analysis of 396 suspected acute viral hepatitis cases, whose samples were received in the laboratory during over a period of 1 year was performed. All sera samples were tested for IgM anti HAV & IgM anti HEV using commercially available solid phase ELISA, in Microbiology laboratory, at our hospital.Results:Majority infected were male (69%) and young adults (98 %). Clinical presentations included fever (92%), jaundice/icterus (74%), nausea/vomiting (60%), hepatomegaly (45%), abdominal pain (40%), darkcoloredurine(15%), itching/rash (8.3%). ELISA revealed overall positivity :21.2% ; HAV: 38% ,HEV:62% and dual infection:5%. Increased serum bilirubin, AST and ALT occured in 68%.Conclusions:Awareness regarding sanitation and hygiene is imperative to curb the spread of acute viral hepatitis, especially in developing countries. Laboratory diagnosis is an essential supplementary tool in confirmation of suspected clinical cases and reduce transmission of this infection.

Prevalence and Diversity of Hepatitis Virus Markers among Patients with Acute Febrile Jaundice in Chad

Only a minority of the patients with acute febrile jaundice evaluated through the Yellow Fever surveillance program were found positive for antibodies against Yellow Fever Virus (YFV). In order to characterize patients with acute febrile jaundice negative for YFV, we collected 255 sera between January to December 2019. We screened for HBV antigens, and antibodies against HCV and HEV. The seroprevalences observed were 10.6% (27/255) for HBV, 2% (5/255) for HCV, 17.3% (44/255) for HEV IgG, 4.3% (11/255) for HEV IgM, and 12.5% (32/255) for both IgG and IgM HEV. Prevalence of HEV was significantly higher in females than males (p < 0.01). HEV IgG prevalence was highest in those 20–29 years old, but the highest incidence rate (IgM positive) was in children 0–9 years old. Exposure to HEV was higher in the Sahelian zone (55.8%, 95% CI: 40.97–70.66) than in the Sudanese zone (30.2%, 95% CI: 24.01–36.37, p = 0.003). The high prevalence rates and hepatitis virus diversity underline the challenge of routine clinical diagnosis in Chad’s Yellow Fever surveillance program.

Molecular detection of HEV in domestic pigs in Italy from Abruzzo and Molise regions

Abstract Background Hepatitis E virus (HEV) is a zoonotic pathogen transmitted through the faecal-oral route and it is responsible of disease in humans with more than 21.000 cases reported in the European Union (EU) over the last decade. It is a non-enveloped single stranded RNA virus that includes 8 genotypes; among these, genotypes 3 and 4 (HEV-3 and HEV-4) are the most prevalent in developed countries and infect both humans and some animal species such as domestic pigs. In this study, we investigated the prevalence of HEV in domestic pigs bred in Italy, in Abruzzo and Molise regions. Methods During the period October 2020-March 2021, 327 liver samples from individual pigs were analysed. In particular, 211 were collected in 1 slaughterhouse and originated from animals bred in Abruzzo in 8 different farms and 116 were collected in 7 slaughterhouses and originated from animals bred in Molise in 47 farms. The real time retro-transcriptase (RT)-polymerase chain reaction (PCR) technique was used to detect HEV by targeting the open reading frame (ORF) 3 region of the viral ribonucleic acid (RNA). Results None of the samples deriving from pigs bred in Abruzzo tested positive for the detection of HEV RNA. Instead, 4 samples from pigs bred in 2 different farms in Molise tested positive, showing a prevalence of 3.45%. Conclusions Pigs are considered important reservoirs for HEV virus. For this reason, it is opportune to investigate the role of these animals for better understanding their involvement in the human infection through the consumption of contaminated raw or undercooked pork-meat products. These findings need to be further investigated with in depth genomic characterization of positive RNA samples to highlight the role of the specific strains circulating in this region and to draw conclusions about connections between animals, potential contaminated food and human disease. Key messages The study paved the way for defining the role of pigs in the transmission of HEV virus to humans through the consumption of pork meat products. This study reports the prevalence of HEV in domestic pigs of Abruzzo and Molise regions, two Italian regions.

P-93 PREVALENCE OF HEPATITIS E VIRUS IN DIFFERENT GROUPS OF PATIENTS IN SALVADOR, BA, BRAZIL

Few studies have been published to assess the prevalence of HEV in our country. To determine the prevalence of HEV in patients with hepatitis C virus (HCV), hepatitis B virus (HBV), autoimmune hepatitis (HAI) and in patients with drug-induced liver injury (DILI). This is a cross-sectional study. A total of 300 volunteers were recruited at the Magalhães Neto Ambulatory, HUPES. Detection of anti-HEV antibodies was determined using the Mikrogen® ELISA (RecomWell anti-HEV IgG, Mikrogen®, Germany). Descriptive statistics was used. 46% (138/300) had HBV, 35.3% (106/300) HCV, 12.3% (37/300) HAI and 6.3% (19/300). The prevalence of anti-HEV IgG was 12.43%, after stratification of patient groups we observed a prevalence of anti-HEV IgG of 13.7% in patients with HCV, 12.9% of HBV, 6.7% of HAI and 21%. The means of TGO and TGP among patients VHE negative were 60.5 and 65.7 IU / mL, respectively, while the mean among those seropositive for HEV were 75.8 and 104.9 IU / mL, respectively, demonstrating an increase in the levels of TGO and TGP among HEV positive people. The mean TGP among DILI patients was 993.3 IU / mL and TGO was 641.4 IU / mL. Fibrosis staging among seropositive individuals was F1 in 21.7%, F2 in 42.2%, F3 in 27.2 and F4 8.9. In this sample, there was a higher prevalence of HEV among patients with DILI but the number is small, the levels of TGO and TGP were higher and fibrosis was more accentuated among patients with hepatitis E. This data suggest that infection with HEV may cause a worsening in the clinical condition of patients.

Prevalence of Hepatitis E Virus Infection Among Blood Donors in the Eastern Province of Saudi Arabia.

PurposeHepatitis E virus (HEV) causes acute hepatitis in humans and constitutes a major problem for immunocompromised patients, patients with hematological diseases, and pregnant women. It is transmitted mainly through fecal oral route; however, transmission through blood and blood products is reported globally and becoming a health concern. We sought to determine the prevalence of HEV among blood donors in the Eastern Province of Saudi Arabia using molecular as well as serological assays to assess the safety of blood transfusion and the need for HEV screening among blood donors.Patients and MethodsA total of 806 whole blood samples were collected from blood donors between May and November 2020 and tested for anti-HEV IgG and IgM antibodies by ELISA and for HEV RNA by RT-PCR.ResultsThe overall seroprevalence of HEV IgG antibodies was 3.2% with no statistically significant difference between the non-Saudis (3.28%) and Saudis (3.17%) (p value 0.929) or between males (3.14%) and females (4.88%) (p value 0.527). None of the IgG positive individuals had IgM antibodies. HEV RNA was not detected in any of the blood donors.ConclusionHEV seroprevalence is low among blood donors in the Eastern Province of Saudi Arabia and may constitute minimal risk for transfusion associated infections.

Identification and genetic diversity of hepatitis E virus in domestic swine from Slovakia

BackgroundHepatitis E virus (HEV) is agent causing hepatitis worldwide. Originally considered to be limited to developing countries, this virus was also detected in developed countries. In recent years an increasing number of reports indicate that farmed domestic pigs are widely infected with HEV in several European countries. The HEV status in Slovakia is still missing.ResultsIn this study, the circulation of HEV among domestic swine in Slovakia and genetic diversity of the virus was studied. Overall HEV RNA was detected in 53/388 (13.7, 95% CI: 10.40–17.48%) pig rectal swabs in five production stages (age categories) with statistically significant differences among all the stages. The highest HEV prevalence was observed in weaners 24/81 (29.6, 95% CI: 19.99–40.81%) and then significantly declined in growers and fatteners. No HEV was detected in suckling piglets and sows. Twenty-eight partial sequences of ORF1 (242 bp) and seventeen of ORF2 (304 bp) were analysed. Phylogenetic analysis and p-distance comparisons confirmed in both ORFs that all Slovak HEV sequences belong to the genotype HEV-3, major clade 3abchij with higher identity to 3a and 3i subtypes. Three sequences were outside of all lastly updated HEV-3 subtypes.ConclusionThis is the first report to fill the information gap about HEV infection in pigs in Slovakia. The results suggested a lower prevalence of HEV in Slovak pig farms than observed in other European countries. While most HEV isolates were typed as HEV-3 clade 3abchij, three sequences were unclassified.

The prevalence of HEV among non-A-C hepatitis in Qatar and efficiency of serological markers for the diagnosis of hepatitis E

BackgroundThe rapid growth of Qatar in the last two decades has attracted a large influx of immigrant workers who mostly come from HEV-hyperendemic countries. Thus, we aim to investigate the prevalence of HEV among acute non-A-C hepatitis patients in Qatar; and to evaluate the performance of four dominant commercial serological assays for HEV diagnosis.Methods259 patients with non-A-C hepatitis were tested using the Wantai HEV-IgM, HEV-IgG, HEV-Ag ELISA kits, and the MP Biomedical HEV-Total Ab ELISA kit. ALT levels were tested and HEV RNA (viral loads) was performed using Taqman AmpliCube HEV RT-PCR kit (Mikrogen, Neuried, Germany). The performance of each kit was assessed according to the RT-PCR results.ResultsHEV-RNA was detected in 23.1% of the samples. Most of these HEV-RNA-positive cases belonged to non-Qatari residents from the Indian subcontinent; India, Pakistan, etc. HEV-Ag, HEV-IgM, HEV-IgG, HEV-Total Ab were detected in 5.56%, 8.65%, 32.1%, and 34.2% of all tested samples, respectively. Elevated ALT levels were highly correlated with the HEV-Ag, HEV-IgM, HEV-RNA but not with the HEV-IgG and HEV-Total Ab. Although HEV-Ag was very specific (100%), yet its sensitivity was poor (36.7%). HEV-IgM demonstrated the best second marker for diagnosis of acute HEV after RT-PCR as jugged by the overall performance parameters: specificity (96.2%), sensitivity (71.4%), PPV (83.3%), NPP (92.7%), agreement with RT-PCR (91.0%), and Kappa-value (0.71).ConclusionOur study demonstrated a high prevalence of HEV virus in Qatar, mostly among immigrants from the Indian subcontinent. The HEV-IgM represents the best marker for detecting the acute HEV infection, where RT-PCR cannot be performed.

Seroprevalence of hepatitis E virus in risk populations and blood donors in a referral hospital in the south of Brazil

The prevalence of anti-hepatitis E virus (HEV) antibodies has a high heterogeneity worldwide. South American data are still scarce. The aim of this study was to evaluate the prevalence of HEV in populations at risk in comparison to blood donors (BD). A cross-sectional study was carried out in adults of different risk populations including crack users (CK), residents in a low income area (LIA), cirrhotic (CIR) and liver transplant patients (LT) compared with BD. The WANTAI HEV ELISA test was used and real-time PCR (in-house for screening and ALTONA as confirmatory test) for HEV RNA screening. A total of 400 participants were included. Anti-HEV IgG was positive in 19.5% of the total sample, reaching the highest rate in the CIR group, 22.5%, followed by CK, LT, and LIA (20%, 18.7%, and 17.5%, respectively). The prevalence found in BD individuals was of 18.7% (p = NS). Anti-HEV IgM was positive in only 1.5% of the sample (6/400). No blood or stools samples were positive for HEV RNA. The seroprevalence reported is among the highest rates ever found in Brazil. Considering the intense diagnostic investigation, data show that HEV circulation is more common that might be expected in our country.

High seroprevalence of viral hepatitis among animal handlers in Abeokuta, Ogun State, Nigeria

ABSTRACT Viral hepatitis is a deadly disease which can manifest as acute, chronic, hepatocellular carcinoma, and liver failure. Information about hepatitis is scarce among animal handlers. Due to Federal Government of Nigeria diversification programmes, many people are now involved in animal farming which can make them susceptible to viral hepatitis. This study aimed at determining the prevalence of Hepatitis B, C, and E viruses among animal handlers in Abeokuta, southwestern Nigerian. A total of 156 subjects were recruited for the study. Sociodemographic and risks factors data were fetched from subjects using interviewer-administered questionnaire. Blood samples were collected via venepuncture and tested for HCV, HBV, and HEV using ELISA technique. Results were analyzed using SPSS software version 21.0 and P value ≤ 0.05 was considered significant. The prevalence of HCV, HBV, and HEV were 46 (29.5%), 20 (12.8%), and 4 (2.6%) respectively while 6 (3.8%), 1 (0.6%), and 1 (0.6%) had co-infection of HBV-HCV, HBV-HEV, and HCV- HEV respectively. This study concludes that there is high prevalence of hepatitis C and B viruses among animal handlers in Abeokuta, Ogun state which is of significant public health problem, warranting further attention and research.

Serological evidence of HIV, Hepatitis B, C, and E viruses among liver disease patients attending tertiary hospitals in Osun State, Nigeria

ABSTRACT Hepatitis infection in HIV positive individuals with liver diseases causes high mortality worldwide. HIV worsens the pathological effect of hepatitis viruses and potentiates reactivation of latent hepatitis infections due to reduced immunity. This research therefore aimed to study the occurrence of HIV and hepatitis viruses among liver diseases patients (LVDP) attending tertiary hospitals in Osun State, southwestern Nigeria. A total of 121 LVDP blood samples collected were tested for HIV and Hepatitis B, C, and E using and enzyme linked Immunossorbent assay (ELISA). Data were analyzed using packages within SPSS and P ≤ 0.05 was considered significant. Prevalence of 32.2%, 0.8%, 10.7%, and 18.2% for HBsAg, Anti-HCV, HEV-IgM, and HIV were found respectively. Marital status showed a significant association with HEV-IgM infection (χ2 = 9.869, P = .020). The prevalence of HBsAg, HEV, and HIV among LVDP in Osun State is alarming and health education among the patients and general populace is hereby advocated. High HEV-IgM seroprevalence implies that HEV routine screening should be incorporated into blood screening. Since HEV is associated with unhygienic practice, people should be enlightened on how to improve their living conditions.

Prevalence and phylogenetic analysis of hepatitis E virus in pigs in Vietnam

BackgroundHepatitis E virus (HEV) is a zoonotic disease and has been reported around the world. The main objective of this study was to evaluate the sero-prevalence and phylogenetic analysis of HEV in Vietnam. Pig blood and fecal pooled samples were collected to assess the prevalence of HEV. We assessed the true prevalence (TP) of HEV from apparent prevalence (AP) by taking into account the sensitivity and specificity of diagnostic tests using a Bayesian approach. For phylogenetic analysis, the data compared with worldwide HEV reference strains including all eight genotypes (G1-G8) which were identified in previous study.ResultsA total of 475 sera and 250 fecal pooled samples were collected at slaughterhouses and pig farms from five provinces, in Viet Nam. Overall, the sero-AP of HEV was 58.53% (95% confidence interval: 53.95–62.70) while the sero-TP was slightly higher (65.43, 95% credible interval: 47.19–84.70). In terms of pooled samples, overall, the RNA-AP was 6.80% (95% confidence interval: 4.01–10.66). One strain in Hanoi, two strains in Dak Lak, seven strains in An Giang, four strains in Son La and two strains in Nghe An were isolated. The phylogenetic tree demonstrated that 19 Vietnamese strains were clustered into HEV 3 and 4.ConclusionsThis study provided evidence that HEV is circulating in domestic pigs in Vietnam. From a public health perspective, it is very important to raise public awareness for high-risk groups (e.g. slaughterhouse workers, pig traders, farmers and market sellers) who have more opportunities to come in contact with pig and contaminated meats.

Hepatitis E 3ra Genotype Infection in People Living With HIV in Spain.

BackgroundThe objective of our study was to assess the prevalence and incidence of HEV in people living with HIV (PLWH) in a Spanish national cohort.MethodsRetrospective longitudinal study including PLWH recruited in the cohort of adult HIV-infected patients of the AIDS Research Network in follow-up at 28 Spanish hospitals with available serum samples in 2014 and 2015. All samples were tested for HEV IgG, IgM, and RNA. Samples with detectable HEV viral loads were genotyped. Prevalence and incidence of HEV infection were calculated.ResultsThe study sample comprised 845 PLWH. At baseline, 101 patients were positive for HEV IgG antibodies (11.9%), none had HEV IgM antibodies, and 2 presented detectable HEV RNA (0.23%). Forty-two seroconverted for IgG, supposing a cumulative incidence of 5.7%. One subject was positive for IgM (0.13%), and 2 showed detectable HEV RNA (0.27%). One case was infected by the emergent HEV genotype 3ra.ConclusionOur study identifies one case of HEV 3ra genotype infection, the main host of which is rabbit, showing a potential zoonotic role of this emerging genotype in Spain.

The seropervelance of infectious hepatitis viruses (HBV, HCV and HEV) among blood donors and their correlation to risk factors in Qena governorate, Upper Egypt.

This study was performed to determine the prevalence of HBV and HCV infection among blood donors and the occurrence of HEV in hepatitis viruses seropositive blood donors. Also, to investigate the correlation between the occurrence of hepatitis viruses and other risk factors (gender, age, occupation, educational level, residency and donors' types). A total of 11,604 blood samples fromapparently healthy blood donors of age range 18-60years old were collected. The blood donors were categorized as voluntary and replacement donors. Blood samples from donors were tested for the presence of HBsAg, HCV and HEV antibodies by using Enzyme-linked immunosorbent assay. The overall results indicated that 671 out of 11,604 blood donors; 370 persons (3.188%) HCV, 295 persons (2.542%) HBV and 6 persons (0.052%) HCV and HBV; were hepatitis viruses seropositive donors. The prevalence of HEV were 193 (28.76%) among these seropositive blood donors. There is a highly significant correlation among HCV, HBV and other risk factors. Also, the HEV showed high significant with age and educational level and significant with donor types and locations. All investigated virus combinations (HEV/HCV, HEV/HBV and HEV/HCV/HBV) were highly significant with the risk factors except for occupation. In conclusion, the HEV is significantly correlated to HCV and HBV seropositive donors and should be screened among blood donors.

Hepatitis E virus infection among pregnant women in Africa: systematic review and meta-analysis

BackgroundThere have been a number of studies about seroprevalence of HEV among pregnant women in Africa. However, the finding of seroprevalence of HEV infection among pregnant women is variable and inconsistent. Therefore; this systematic review intended to provide the pooled seroprevalence of HEV among pregnant women in Africa.MethodsWe searched, Pub Med, Science direct, African online journals and Google scholar electronic data bases and all available references until August 30, 2018. We included cross sectional studies and cohort studies. The search was further limited studies done in African pregnant women. Statistical analysis done by using Stata (version 11) software. The overall pooled prevalence of HEV presented by using the forest plot with 95% CI. The methodological qualities of included studies were assessed using Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments.ResultThe pooled seroprevalence of HEV among pregnant women in Africa was 29.13% (95% CI 14.63–43.63). The highest seroprevalence was 84.3% in Egypt and the lowest 6.6% reported in Gabon. There was highest heterogeneity level where I2 = 99.7%; P < 0.0001.The observed heterogeneity attributed to geographic location/ region, country, assay method used in each study and year of study published. Moreover, HEV seroprevalence varies between countries and within countries. The HEV infection among African pregnant women seems to have a decreasing trend over time.ConclusionThe seroprevalence of HEV among pregnant women in Africa is high. The seroprevalence of HEV among pregnant women differ with geographic location and assay method. Therefore, it is recommended to conduct further research on commercial ELISA kit sensitivity and specificity, molecular tests, incidence, morbidity and mortality and vertical transmission of HEV from mother to infant in Africa.Trial registrationCRD42018084963.