The global epidemiology of hepatitis E virus infection: A systematic review and meta‐analysis

Li, Pengfei; Liu, Jiaye; Li, Yang; Su, Junhong; Ma, Zhiyong; Bramer, Wichor M.; Cao, Wanlu; Man, Robert A. de; Peppelenbosch, Maikel P.; Pan, Qiuwei

doi:10.1111/liv.14468

Cited by 147 publications

(142 citation statements)

References 46 publications

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“…The global burden of human infection caused by zoonotic HEV strains is currently estimated to be 10 million symptomatic cases annually (Li et al., 2020). In Switzerland, hepatitis E is a notifiable disease since 2017, with an annual incidence of 1.32 per 100’000 inhabitants reported in 2019 (Swiss Federal Office of Public Health, 2020).…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of hepatitis E virus in dogs in Switzerland

Veronesi

Morach

Hübschke

et al. 2020

Zoonoses and Public Health

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Hepatitis E virus (HEV) is the causative agent of an acute and in most cases self‐limiting hepatitis. Of the four major HEV genotypes that infect humans, genotype 3 and 4 are zoonotic and have been identified in humans but predominantly in pigs and wild boar, which are considered the main reservoirs. However, the known host range of zoonotic HEV may be increasing to comprise additional species, including companion animals. Several studies have identified contact with dogs as a risk factor for HEV infection in humans, yet information on the occurrence of HEV in Swiss dogs is lacking. To examine a possible risk of exposure, this study was designed to assess the seroprevalence of HEV in 84 Swiss dogs. Serum and plasma samples collected from four veterinary clinics were screened for HEV‐specific antibodies by HEV‐antibody ELISA test kit. In addition, information of 22 dogs regarding the country of origin, the type of dog feed and any history of hunting was recorded. Samples from seropositive animals were also screened for the presence of HEV RNA by quantitative real‐time RT‐PCR (qRT‐PCR). Overall, 38% (32 of 84) of the dogs tested seropositive for anti‐HEV, indicating exposure to HEV. Among the 22 dogs for which information was available, HEV‐specific antibodies were detected in three of five dogs that were born abroad, in one of two dogs that were fed a raw meat‐based diet, and in one hunting dog. No viral RNA could be detected in any of the serum and plasma samples; thus, the genotype of the strains remained undetermined. This study provides further evidence for canine exposure and susceptibility to HEV and highlights the need to further assess the risks of HEV transmission to humans with contact to dogs.

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Section: Introductionmentioning

confidence: 99%

Seroprevalence of hepatitis E virus in dogs in Switzerland

Veronesi

Morach

Hübschke

et al. 2020

Zoonoses and Public Health

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“…Although studies on HEV burden have expanded geographically over time, existing data are insufficient to identify temporal or geographic trends in risk. Similar to other reviews, we note challenges in interpreting and comparing data from different studies due to variability in diagnostic assays used, definitions of suspected and confirmed cases of HEV (160)(161)(162), and lack of standardized age groups used in analysis. Unified guidance and best practices for measuring disease burden and risk factors are urgently needed to generate evidence needed for developing a global strategy for hepatitis E control.…”

Section: Discussionmentioning

confidence: 57%

Setting a course for preventing hepatitis E in low and lower-middle-income countries: A systematic review of burden and risk factors

Koyuncu

Mapemba

Ciglenečki³

et al. 2020

Preprint

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BackgroundHepatitis E virus is responsible for outbreaks of acute jaundice in Africa and Asia, many of which occur among displaced people or in crisis settings. While an efficacious vaccine for HEV has been developed, we lack key epidemiologic data needed to understand how best to use the vaccine for hepatitis E control in endemic countries.MethodsWe conducted a systematic review of articles published on hepatitis E in low and lower-middle-income countries (LMIC) in Africa and Asia. We searched PubMed, Scopus, and Embase databases to identify articles with data on anti-HEV IgG seroprevalence, outbreaks of HEV, or risk factors for HEV infection, disease, or death, and all relevant data were extracted. Using these data we describe the evidence around temporal and geographical distribution of HEV transmission and burden. We estimated pooled age-specific seroprevalence and assessed the consistency in risk factor estimates.ResultsWe extracted data from 148 studies. Studies assessing anti-HEV IgG antibodies used 18 different commercial assays. Most cases of hepatitis E during outbreaks were not confirmed. Risk factor data suggested an increased likelihood of current or recent HEV infection and disease associated with fecal-oral transmission of HEV, as well as exposures to blood and animals.ConclusionHeterogeneity in diagnostic assays used and exposure and outcome assessment methods hinder public health efforts to quantify burden of disease and evaluate interventions over time and space. Prevention tools such as vaccines are available, but require a unified global strategy for hepatitis E control to justify widespread use.

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“…However, the choice of the HEV serology test might influence the results and may also explain different results of anti-HEV IgG antibody seroprevalences in different publications [23,24].…”

Section: Discussionmentioning

confidence: 99%

Hepatitis E seroprevalence in a German cohort of patients with inflammatory bowel diseases

et al. 2020

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Background and aims The incidence of hepatitis E virus (HEV)-infections in industrialized nations has been increasing over the past years. Patients suffering from inflammatory bowel diseases (IBD) may be more prone to transmission. Data on HEV seroprevalence in IBD patients is scarce and has not been reported in German IBD patients. The German Health Examination Survey for Adults 2008-2011, which included 4.422 samples, found a HEV seroprevalence of 16.8%, increasing with age. The aim of the present study was to determine the seroprevalence of anti-HEV IgG in a German cohort of IBD patients, and to explore which parameters have an impact on HEV seroprevalence. Material and methods This is an uncontrolled, cross-sectional, retrospective monocentric study. Among the patients visiting the IBD outpatient clinic between 25 January, 2019 and 24 September, 2019, 328 patients with Crohn's disease (CD) and 150 patients with ulcerative colitis (UC) were included in the study. IgG antibodies against HEV were determined by enzyme-linked immunosorbent assay. Positive antibody titers were verified using immunoblot analysis. Medical records were reviewed for demographic and clinical parameters to identify potential risk factors for HEV infection. Results The prevalence of anti-HEV IgG antibodies was 17.4% in CD patients and 24.7% in UC patients. No patient with positive HEV PCR was detected. Greater age of CD und UC patients and longer duration of anti-interleukin 12/23 treatment in CD patients were associated with higher anti-HEV IgG antibody rates.

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The global epidemiology of hepatitis E virus infection: A systematic review and meta‐analysis

Cited by 147 publications

References 46 publications

Seroprevalence of hepatitis E virus in dogs in Switzerland

Seroprevalence of hepatitis E virus in dogs in Switzerland

Setting a course for preventing hepatitis E in low and lower-middle-income countries: A systematic review of burden and risk factors

Hepatitis E seroprevalence in a German cohort of patients with inflammatory bowel diseases

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