Prevalence of specific antibody to hepatitis E virus in the general population of the community of Madrid, Spain

Abstract

Hepatitis E virus (HEV) is an infectious agent causing hepatitis among humans. Although hepatitis E has been reported from many European countries, its incidence in Europe is largely unknown, and the prevalence of the HEV infection is also unknown for most countries of the region. Antibody to HEV (anti-HEV) was tested on 2,305 serum samples from the general population of the Community of Madrid (Spain) collected in the year 2008 among people aged 2-60 years. Total anti-HEV was tested by enzyme-immunoassay (EIA), and reactive samples were retested separately for anti-HEV IgG and IgM by recombinant immunoblot test (RIBT). Fifty samples (2.17%) displayed reactivity for total anti-HEV after EIA testing, and anti-HEV IgG was confirmed by RIBT in 25 (1.08%). The frequency of RIBT-confirmed anti-HEV ranged from 0.97% among the youngest to 3.61% among the oldest, and displayed a statistically significant trend to increasing with age. The rate of RIBT confirmation was also significantly higher among the individuals aged above 20 years old than among those younger of 21 years. HEV infection would be less frequent in the Community of Madrid than in Catalonia or the United Kingdom, and contact with HEV would be very uncommon among children and adolescents of the region. Confirmation of EIA-reactive samples by RIBT reduced the final numbers of anti-HEV testing as much as 50%, and some findings of this study suggest that such testing protocol would reflect better the real prevalence of anti-HEV in settings of low endemicity than the single testing by EIA.

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“…The prevalence of anti-HEV among adults from the Spanish general population was, in contrast, estimated 7.3% in Catalonia [20] and 2.2% in Madrid [19], which represents from less than one half to one eighth the prevalence found among the patients selected in the present study. Six of these eight patients were studied because detection of abnormal aminotransferase serum level of unexplained origin in absence of symptoms of acute hepatitis.…”

“…Performance parameters of this test were described previously [19]. Samples reactive for total anti-HEV were tested separately for anti-HEV IgG and IgM by recombinant immunoblot test RIBT (recombLine HEV, Mikrogen GmbH, Martinsried, Germany).…”

“…In Spain, HEV was found involved in 11% of cases from a series of acute hepatitis of unknown origin reported recently, and in 8% of those unrelated to international travel or immigration [2]. In addition, the overall prevalence of anti-HEV found in samples representative of the Spanish general population ranged from 1 to 7% in studies performed in Madrid [19] and Catalonia, [20] respectively.…”

Autochthonous Hepatitis E Virus Infections: A New Transfusion-Associated Risk?

“…This is a higher seroprevalence than that found in another serosurvey undertaken among homeless people in Marseille, which yielded a seroprevalence rate of 11.6% [50]. This value is rather high compared to other regions in Southern Europe: the seroprevalence has been estimated to be 1.5% in San Marino [51], 2.9% [52] in the Latium region in Italy and 1.08% in the community of Madrid [53]. However, before assuming a north-south divide in Europe concerning the seroprevalence of HEV, it should be noted that the compatibility of all these seroprevalence data is limited.…”

<b>Detecção e quantificação do vírus da hepatite E (HEV) por RT-PCR em tempo real e estudo experimental em primatas neotropicais (<i>Aotus azarai infulatus</i>) infectados pelo genótipo 3 do HEV</b>

“…Esta redução no número de casos em indivíduos positivos para anti-HEV IgM após uso de RIBT já foi demonstrada e pode representar uma redução de positividade de até 50% após o uso do teste confirmatório (FOGEDA et al, 2012). Adicionalmente, a ocorrência de reação cruzada e ocorrência de falso-positivos para hepatite E já foi demonstrada em pacientes com quadro agudo de infecção por Citomegalovírus ou vírus Epstein-Barr (FOGEDA et al, 2009).…”