Seroepidemiology of Hepatitis E in Selected Population Groups in Croatia: A Prospective Pilot Study

Abstract

Hepatitis E has become an emerging infection in many European countries. We analysed the prevalence of hepatitis E virus (HEV) infection in selected population groups in Croatia. Overall HEV IgG seropositivity was 5.6%, while 1.9% participants showed IgM antibodies suggestive of recent infection. No IgM-positive sample was positive for HEV RNA. HEV IgG antibodies were most prevalent in alcohol abusers (8.9%) and war veterans (8.6%), compared with 6.1% among injecting drug users and 2.7% in healthcare professionals. No individual with high-risk sexual behaviour tested HEV seropositive. HEV IgG positivity increased significantly with age from 1.8% to 2.3% in individuals younger than 40 years to 11.3% in individuals older than 50 years (P = 0.023). The mean age of HEV-positive participants was significantly higher than that of HEV-negative participants (50.9 ± 11.8 years versus 41.2 ± 11.8 years, P = 0.008). Seroprevalence rates were significantly higher in residents of suburban and rural areas compared with residents of urban areas (14.5% versus 2.5%, P = 0.003). Additionally, an increasing prevalence of HEV IgG antibodies was observed from 1.8% in participants living in families with two household members to 12.1% in those living with more than four members (P = 0.046). Gender, marital status, educational level, sexual orientation, source of drinking water, history of blood transfusions, surgical procedures, tattooing and travelling were not associated with HEV seroprevalence. Logistic regression showed that living in suburban/rural areas was the main risk factor for HEV seropositivity (OR = 6.67; 95%CI = 1.89-25.0; AOR = 7.14, 95%CI = 1.89-25.0).

Evidence of hepatitis E virus infections among persons who use crack cocaine from the Midwest region of Brazil

“…As has been reported in many studies, age was significantly associated with the presence of anti‐HEV IgG in this study . The seroprevalence increased with age and those aged >35 years were three times more likely to be anti‐HEV IgG positive than those aged ≤35 years among our sample of person who use crack.…”

“…In this study, never use of condom in anal intercourse was associated with past‐HEV infection in the univariate analysis but not in the multivariate analysis. There is no direct evidence that HEV is transmitted by sexual contact, although some studies have shown high seroprevalence of anti‐HEV‐IgG in homosexual men . Persons who use crack spend long periods in drug use settings, they may be more predisposed to acquiring HEV infection through sharing personal utensils with poor hand hygiene allowing the risk of person‐to‐person transmission of infections .…”

“…Most persons who use crack live in situations of extreme poverty and housing instability . During the use of the drug, they are subjected to long outdoor living, frequently under poor sanitary and hygiene conditions, and may predispose them to various infections including HEV . In addition, epidemiological studies in hard‐to‐reach population, such as crack users, are needed for designing approaches for prevention and control measures.…”

“…9 During the use of the drug, they are subjected to long outdoor living, frequently under poor sanitary and hygiene conditions, and may predispose them to various infections including HEV. [10][11][12] In addition, epidemiological studies in hard-to-reach population, such as crack users, are needed for designing approaches for prevention and control measures. Thus, this study aimed to determine the prevalence of HEV infection among persons from the Midwest region of Brazil who use crack.…”

Differences in hepatitis E virus (HEV) presence in naturally infected seropositive domestic pigs and wild boars - an indication of wild boars having an important role in HEV epidemiology

“…In Croatia, autochthonous he was recognized in 2012 (ČIVLJAK et al, 2013). the seroprevalence in tested non a-C hepatitis patients with hepatic disorders was 10.70%, (ĐAKOVIĆ RODE et al, 2014), and 5.6% in asymptomatic individuals (VILIBIĆ-ČAVLEK et al, 2016).…”