Acute hepatitis E in south-west France over a 5-year period

Mansuy, Jean‐Michel; Abravanel, Florence; Miédougé, Marcel; Mengelle, Catherine; Merviel, C.; Dubois, Martine; Kamar, Nassim; Rostaing, Lionel; Alric, Laurent; Moreau, Jacques; Péron, Jean‐Marie; Izopet, Jacques

doi:10.1016/j.jcv.2008.09.010

Cited by 116 publications

(129 citation statements)

References 19 publications

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“…These individuals were mainly males and were 20-25 years older than the cases infected by genotype 1. This is in accordance with previous recent reports from the UK, France and Germany showing that genotype 3 is the autochthonous genotype of HEV, which gives disease mainly in males over the age of 50 [15,25].…”

Section: Ab094267supporting

confidence: 93%

“…However, several cases have been infected in Europe, which is generally regarded as a non-endemic region. There have been rather few reported cases of autochthonous hepatitis E in European countries to date [11,19,21], although several reports have shown a seroprevalence ranging from 5 to 33% in the adult population in Europe, Japan and the US [11,[15][16][17][18]. This indicates that hepatitis E is not uncommon in these countries, although most infections are subclinical or inapparent.…”

Section: Discussionmentioning

confidence: 99%

“…There have also been increasing numbers of reports on high seroprevalence in Europe and the US. Antibodies againts HEV (anti-HEV) were found in 17% of blood donors in the UK and in France, in 21-33% of blood donors and 50% of farmers in Denmark and 5 to 9% of the general population and 13% of veterinarians in Sweden [11,[15][16][17][18]. These data indicate that there is a high prevalence of hepatitis E infections also in Europe, albeit most infections are subclinical and most of them may be zoonotic.…”

Section: Introductionmentioning

confidence: 93%

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Endemic hepatitis E in two Nordic countries

et al. 2009

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Antibodies against hepatitis E virus (anti-HEV) were found in 248 Swedish and Danish patients between 1993 and 2007. Most patients were symptomatic and tested for anti-HEV due to travel abroad. Among patients with known country of infection, most were infected in Asia, mainly on the Indian subcontinent. However, 29 patients were infected in Europe, nine of these had HEV IgM and/or HEV RNA in serum. In sera from 65 of 141 tested patients HEV RNA could be detected, and 63 strains could be typed by limited sequencing within ORF2. HEV RNA was found in sera from 71% of the patients with HEV IgM and IgG and in 18% of the patients with only detectable HEV IgG. It was also found up to three weeks after the onset of disease in 67% of the patients with known date of onset. Patients infected in Europe were infected by genotype 3, and were older than those infected by genotype 1 (mean age 55.3 vs 30 years, p<0.001). Since it is known that genotype 3 can infect domestic pigs, HEV strains from 18 piglets in 17 herds in Sweden and Denmark were sequenced. Phylogenetic analyses of the genotype 3 strains showed geographical clades and high similarity between strains from patients and pigs from the same area. There are thus autochthonous hepatitis E cases in Scandinavia, and there are probably many undiagnosed ones. Patients with hepatitis of unknown etiology should therefore be investigated for anti-HEV even if they have not been outside Europe, since infections acquired from pigs or other animals should be taken into consideration.

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Section: Ab094267supporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

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Endemic hepatitis E in two Nordic countries

et al. 2009

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“…Genotype 3 is most commonly found in humans and is closely related to the swine strains isolated in Spain and France [10,11]. However, in these countries, the main routes of transmission have yet to be established.…”

Section: Discussionmentioning

confidence: 99%

First report of acute autochthonous hepatitis E in Portugal

Duque

Ventura

Seixas

et al. 2011

J Infect Dev Ctries

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Hepatitis E infection is usually a self-limiting disease. In industrialized countries, sporadic cases of acute hepatitis E virus (HEV) infections have been described; their number seems to be increasing in European countries. We report the first human case of autochthonous acute hepatitis E confirmed in Portugal. Patients with acute non-A-C hepatitis should be tested for HEV in Portugal and hepatitis E infection should be considered in the differential diagnosis of unexplained hepatitis cases.

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“…(4) Autochthonous infections are frequently reported in developed countries, particularly in western Europe. (5) The virus can be transmitted by contaminated food, (3) mainly undercooked pig meat, (6) although other modes of contamination have been described. They are often occupational, such as direct exposure to animals or to slaughterhouse meat.…”

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confidence: 99%

A nationwide survey of hepatitis E viral infection in French blood donors

et al. 2016

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Most cases of hepatitis E viral (HEV) infection in developed countries are autochthonous. Nevertheless, the reported seroprevalence of HEV varies greatly depending on the geographical area and the performance of the immunoassay used. We used validated assays to determine the prevalence of anti-HEV immunoglobulin G (IgG) and IgM among 10,569 French blood donors living in mainland France and three overseas areas. Epidemiological information was collected using a specific questionnaire. We found an overall IgG seroprevalence of 22.4% (8%-86.4%) depending on the geographical area (P < 0.001). The presence of anti-HEV IgG was associated with increasing age (P < 0.001) and eating pork meat (P 5 0.03), pork liver sausages (P < 0.001), game meat (P < 0.01), offal (P < 0.001), and oysters (P 5 0.02). Conversely, drinking bottled water was associated with a lower rate of anti-HEV IgG (P 5 0.02). Overall IgM seroprevalence was 1% (0%-4.6%). The frequency of anti-HEV IgM was higher in donors living in a high anti-HEV IgG seroprevalence area (1.9% versus 0.7%, P < 0.001) and in those eating pork liver sausage (1.4% versus 0.7%, P < 0.01), pât e (1% versus 0.4, P 5 0.04), and wild boar (1.3% versus 0.7%, P < 0.01). Conclusion: HEV is endemic in France and hyperendemic in some areas; eating habits alone cannot totally explain the exposure to HEV, and contaminated water could contribute to the epidemiology of HEV infection in France. (HEPATOLOGY 2016;63:1145-1154 H epatitis E virus (HEV) is a single-stranded, positive sense RNA virus that is a member of the Hepeviridae family.(1) Four major genotypes of human HEV are recognized. HEV genotypes 1 and 2 have been found only in humans and are prevalent in developing countries. They are responsible for both sporadic cases and large outbreaks linked to drinking contaminated water. HEV genotypes 3 and 4 are anthropozoonotic and prevalent in developed countries. These HEV genotypes have been detected in a wide range of domestic and wild animals, which are believed to play a major role in the human epidemiology of the virus. (2) HEV genotypes 1 and 2 mainly affect young adults, mostly men, aged 15-30. Almost half of all cases become jaundiced, and pregnant women during the third trimester and patients with underlying chronic liver disease are most at risk of a severe form of hepatitis E.(3) HEV genotypes 3 and 4 mainly affect older men. Most infections are asymptomatic, but patients suffering from chronic liver disease are at risk of developing acute liver failure.(3) Immunosuppressed individuals infected with genotype 3 or 4 may develop a chronic infection that can rapidly progress to cirrhosis. (4) Autochthonous infections are frequently reported in developed countries, particularly in western Europe. (5) The virus can be transmitted by contaminated food, (3) mainly undercooked pig meat, (6) although other modes of contamination have been described. They are often occupational, such as direct exposure to animals or to slaughterhouse meat. The risk of HEV transmission through blood pro...

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Acute hepatitis E in south-west France over a 5-year period

Cited by 116 publications

References 19 publications

Endemic hepatitis E in two Nordic countries

Endemic hepatitis E in two Nordic countries

First report of acute autochthonous hepatitis E in Portugal

A nationwide survey of hepatitis E viral infection in French blood donors

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