A cross-sectional study among Polish hunters: seroprevalence of hepatitis E and the analysis of factors contributing to HEV infections

Abstract

Hepatitis E virus (HEV) is known as zoonotic agent. The main reservoirs of HEV in Europe are pigs, wild boars, and deer. Hunting activity is considered to be a risk factor for HEV infection. We conducted a cross-sectional study among 1021 Polish hunters. To understand socio-demographic characteristics of this population and to gather information on potential exposures, all participants completed a questionnaire. Commercial immunoassays were employed to estimate seroprevalence anti-HEV. Samples with confirmed positive result of anti-HEV IgM were examined for HEV RNA. Anti-HEV IgG were identified in 227 people, 22.2% of the studied group. Seroprevalence among the studied hunters was associated with age ≥65 [adjusted prevalence ratio (aPR) 1.6, p = 0.037), living in a house (aPR 1.54, p = 0.013), professional contact with farm animals (aPR 1.09, p = 0.01), and consumption of stewed offal (aPR 1.61, p = 0.00). Washing hands after disembowelment was linked to lower seroprevalence (aPR 0.53; p = 0.00). Lower prevalence of anti-HEV IgG among hunters living in cities was associated with age: 35–49 (aPR 0.52, p = 0.011) and 50–64 (aPR 0.93, p = 0.58), living in a house (aPR 1.58, p = 0.002) and owning a cat (aPR 0.58, p = 0.042). Among hunters living in rural areas, seropositivity was associated with contact with farm animals (aPR 1.66, p = 0.013) and consumption of stewed offal (aPR 1.81; p = 0.001). Contrary to initial assumptions, it was concluded that hunting was of significantly lesser importance than other factors. Due to the high level of HEV seroprevalence identified, we recommend conducting a large-scale study in the general population of Poland.

Prevalence and risk factors for hepatitis E virus infection in blood donors: a nationwide survey in Italy, 2017 to 2019

“…Moreover, faeces or bile of infected animals may more easily contaminate pork meat, equipment and utensils during homemade processing [ 35 ]. Lastly, like others [ 36 , 37 ], we found an association between hunting and anti-HEV IgG positivity, but it was not statistically significant (p = 0.056). If skinning and disembowelling of infected animals such as wild boars or deer without gloves, hunters may have direct contact with body fluids or faeces [ 36 , 37 ].…”

Seroprevalence of Hepatitis E Virus Infection among Blood Donors in Bulgaria

“…Schielke et al analyzed 126 German hunters and 21% were positive for anti-HEV IgG antibodies (95% CI: 13.0–28.0) [ 64 ]. Baumann-Popczyk et al showed that anti-HEV IgG results were identified in 22.2% (227/1021) of the studied Polish hunters [ 65 ]. Montagnaro et al published an estimated HEV seroprevalence among Italian hunters (Latium region, Central Italy) of 25.0% (5/20; 95% CI: 6.1–43.9) [ 66 ].…”

Genetic Diversity and Epidemiological Significance of Wild Boar HEV-3 Strains Circulating in Poland

“…The main pertinent route of human infection is the fecal – oral, through consumption of meat, liver, and offal originating from infected wild boars [ 34 , 35 ]. Direct contact with infected animals also seems to be important, as the presence of anti-HEV antibodies has been detected more often among hunters and forest workers [ 21 , 36 , 37 , 38 , 39 ]. The phylogenetic analysis of the ORF2 sequences of the detected Polish wild boar HEV strains showed their affiliation to the third virus genotype.…”