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

Abstract

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.

Sero-epidemiology and Risk Assessment of Hepatitis E Virus Among Blood Donors in North Lebanon

“…A seroprevalence of 1.28% (1/78), and 12.82 % (10/78) of IgM and IgG anti-HEV antibodies, respectively, was reported in our study. Other studies conducted in China and South Brazil have reported similar IgM seropositivity levels accounting for 1.13% and 1.25%, respectively (12,13). The seroprevalence of IgM anti-HEV reported in our study was noticeably less than the seroprevalence recorded in Nepal (3.2%) and the Netherlands (8%) (5,27).…”

“…Blood transfusion has been documented as a potential route of HEV transmission (10), and several cases of transfusion-acquired HEV infection have been reported in different studies worldwide (5,(10)(11)(12)(13)(14)(15), highlighting the growing risk of HEV transmission via blood and blood products.…”

Seroprevalence of hepatitis E virus infection among volunteer blood donors in Central Brazil

“…The cultural high consumption of raw and undercooked pork meat, especially in the South region, is already known to be the major transmission route for HEV infection in Brazil. 14 A previous study in the South region including blood donors performed with the same commercial assay reported a HEV prevalence of 18.7%, 6 and another study reported a prevalence greater than 55% using an indirect in-house ELISA assay. 15 Therefore, consumption of raw or undercooked pork meat seems to be the main route of HEV transmission in Brazil and our results support this evidence as most of the anti-HEV positive participants declared being born in regions with high consumption of pork meat.…”

“… 7 However, screening studies carried out among Brazilian blood donors show large differences with seroprevalence ranging from 0.4% to 18.7%. 6 , 7 Differences in the sensitivity and specificity of the anti-HEV assays used, sample size, population, and region, could explain the discrepancies in the rates of HEV exposure published in the various previous studies in Brazil. It is worth mentioning that the kit used in this study has been reported to have high sensitivity (>99%) and specificity (>95%), 8 improving the prevalence data.…”

“…A recent meta-analysis reported a seroprevalence of exposure to HEV of 6.0% in the Brazilian adult population, but the seroprevalence in blood donors varies from 0.4% to 18.7%. 6 , 7 In addition, discrepancies in the sensitivity and specificity of diagnostic tests may have underestimated the HEV exposure prevalence and biased epidemiological data and prevention measures. 8 …”