Seroepidemiology of hepatitis E in patients on haemodialysis in Croatia

Mrzljak, Anna; Dinjar-Kujundzic, Petra; Knotek, Mladen; Kudumija, Boris; Ilić, Mario; Gulin, Marijana; Zibar, Lada; Hrstić, Irena; Jureković, Željka; Kolarić, Branko; Jemeršić, Lorena; Prpić, Jelena; Tomljenović, Morana; Vilibić-Čavlek, Tatjana

doi:10.1007/s11255-019-02363-3

Cited by 11 publications

(12 citation statements)

References 30 publications

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“…The seroepidemiological studies have shown that HEV is widespread in Croatia with seroprevalence rates ranging from 2.7% in healthcare professionals to 24.4% in liver transplant patients and up to 43.5% in hemodialysis patients[ 19 , 20 ]. However, only preliminary data are available on the HEV seroprevalence in animal-related professions.…”

Section: Introductionmentioning

confidence: 99%

Insights into hepatitis E virus epidemiology in Croatia

Jeličić¹,

Ferenc²,

Mrzljak³

et al. 2022

World J Gastroenterol

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BACKGROUND Hepatitis E virus (HEV) is an emerging virus of global health concern. The seroprevalence rates differ greatly according to geographic region and population group. AIM To analyze the seroprevalence of HEV in exposed (animal-related professions) and nonexposed populations, as well as solid organ and hematopoietic stem cell transplant patients. METHODS Forestry workers ( n = 93), hunters ( n = 74), and veterinarians ( n = 151) represented the exposed population. The general population ( n = 126) and pregnant women ( n = 118) constituted the control group. Transplant patients included liver transplant recipients (LTRs) ( n = 83), kidney transplant recipients (KTRs) ( n = 43), and hematopoietic stem cell transplant recipients (HSCRs) ( n = 39). HEV immunoglobulin G antibodies were detected using the enzyme-linked immunosorbent assay and confirmed by the immunoblot test. RESULTS The HEV seroprevalence significantly differed between groups: Veterinarians 15.2%, hunters 14.9%, forestry workers 6.5%, general population 7.1%, and pregnant women 1.7%. In transplant patients, the seropositivity was highest in LTRs (19.3%), while in KTRs and HSCRs, the seroprevalence was similar to the general population (6.9% and 5.1%, respectively). A significant increase in seropositivity with age was observed from 2.9% in individuals less than 30 years to 23.5% in those older than 60 years. Sociodemographic characteristics (sex, educational level, area of residence, and number of household members), eating habits (game meat, offal, and pork products consumption), and environmental and housing conditions (drinking water supply, type of water drainage/sewer, waste disposal, domestic animals) were not associated with HEV seropositivity. However, individuals who reported a pet ownership were more often seropositive compared to those who did not have pet animals (12.5% vs 7.0%). CONCLUSION The results of this study showed that individuals in professional contact with animals and LTRs are at higher risk for HEV infection. In addition, age is a significant risk factor for HEV seropositivity.

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Section: Introductionmentioning

confidence: 99%

Insights into hepatitis E virus epidemiology in Croatia

Jeličić¹,

Ferenc²,

Mrzljak³

et al. 2022

World J Gastroenterol

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“…The study identified several independent factors for IgG seropositivity: age > 60 years (OR = 8.17; 95% CI = 1.08-62.14), living in the continental region (OR = 2.58; 95% CI = 1.55-4.30) and being a recipient of blood products transfusion (OR = 1.66; 95% CI = 1.01-2.73). HEV IgM seropositivity was found in 3.7% of IgG-positive hemodialysis patients, and HEV RNA was not detected [57].…”

Section: Hepatitis E Virus In Croatia-human Studiesmentioning

confidence: 88%

“…In the context of chronic diseases, strong evidence supports that HEV infection is more prevalent in patients on hemodialysis compared with non-hemodialysis control groups [56]. In 2018, a seroprevalence study [57] conducted among 394 hemodialysis patients from continental and coastal Croatian regions showed an overall anti-HEV IgG prevalence of 27.9%, suggesting a high degree of previous exposure to HEV. There were significant variations between regions, with the highest (43.4%) being in the continental county around the city of Osijek, the region densely populated with pig farms.…”

Section: Hepatitis E Virus In Croatia-human Studiesmentioning

confidence: 99%

Hepatitis E Virus in Croatia in the “One-Health” Context

et al. 2021

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Hepatitis E virus (HEV) is the most common cause of viral hepatitis globally. The first human case of autochthonous HEV infection in Croatia was reported in 2012, with the undefined zoonotic transmission of HEV genotype 3. This narrative review comprehensively addresses the current knowledge on the HEV epidemiology in humans and animals in Croatia. Published studies showed the presence of HEV antibodies in different population groups, such as chronic patients, healthcare professionals, voluntary blood donors and professionally exposed and pregnant women. The highest seroprevalence in humans was found in patients on hemodialysis in a study conducted in 2018 (27.9%). Apart from humans, different studies have confirmed the infection in pigs, wild boars and a mouse, indicating the interspecies transmission of HEV due to direct or indirect contact or as a foodborne infection. Continued periodical surveys in humans and animals are needed to identify the possible changes in the epidemiology of HEV infections.

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“…They have reported the status of seroprevalence of HEV IgG antibodies were ranging from 5.2 to 43.4% in the different dialysis centers (p = 0.001). The HEV IgM antibodies were found in 0.04% of IgG positive HD patients while all the HD patients tested negative for HEV RNA ( 30 ). Scotto et al (2015) have described 14/231 (6%) of the HD were positive for HEV IgG and among the positive cases 2 of them were also positive for HEV IgM and 3 patients tested positive for HEV RNA ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Status of anti-HEV IgG and IgM antibodies among the hemodialysis patients in southwest region of Iran

Pirmoradi¹,

Makvandi²,

Navand³

et al. 2022

IJM

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Background and Objectives: Hepatitis E Virus (HEV) account for acute hepatitis, fulminant liver failure and chronic hep- atitis worldwide. Several high riskgroups including hemodialysis (HD) patients are at risk of HEV infection. Based on con- sequences of HEV infection it is important to determine the serologicaland molecular epidemiology of HEV in HD patients. The aim of this study was to evaluate the frequency of HEV antibodies and HEV RNA in HD patients. Materials and Methods: The sera of 84 HD patients were collected and tested for anti- HEV IgG and anti IgM antibodies using enzyme-linkedimmunosorbent assay (ELISA) at Golestan hospital in Ahvaz city during October 2014 and November 2014. HEV RNA was tested in HD patients using RT PCR. The prevalence of anti- HEV IgG was evaluated in the age group (52/84) > 50 and (31/84) < 50 years. Results: Out of 84 patients, 52 (61.9%) were males and 32 (38.1%) females. The mean age of participants was 52 ± 1.57 years. 43/84 (51.19%) casesincluding 26/52 (50%) males and 17/32 (53.1%) females were positive for anti-HEV IgG (p=0.95). Among the 43 cases positive anti-HEV IgG 8 cases including 5 (9.61%) males and 3 (9.37%) females tested posi- tive for anti-HEV IgM (p=0.729) while the HEV RNA was negative in HD patients. Thedistribution of anti- HEV IgG was 62.75% and 33.33% among the age group >50 and <50 respectively (p=0.015). Conclusion: This study showed high prevalence of anti-HEV IgG antibodies (51.19%) were observed among the HD pa- tients while the HEV RNA testednegative in HD patients. The rate of HEV IgG is significantly higher with increased age. Further investigation require to identify the factors account for high seroprevalence of HEV in Ahvaz HD units.

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Seroepidemiology of hepatitis E in patients on haemodialysis in Croatia

Cited by 11 publications

References 30 publications

Insights into hepatitis E virus epidemiology in Croatia

Insights into hepatitis E virus epidemiology in Croatia

Hepatitis E Virus in Croatia in the “One-Health” Context

Status of anti-HEV IgG and IgM antibodies among the hemodialysis patients in southwest region of Iran

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