Changing epidemiology of hepatitis A and hepatitis E in urban and rural India (1982–98)

Arankalle, Vidya A.; Ms, Chadha; Sd, Chitambar; Am, Walimbe; Lp, Chobe; Ss, Gandhe

doi:10.1046/j.1365-2893.2001.00279.x

Cited by 71 publications

(17 citation statements)

References 30 publications

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“…The present study showed that one third of hepatitis A patients had insufficient sanitation or poor hygienic conditions with overcrowded population. As reported earlier, low standards of sanitation promote transmission of the virus, therefore, to avoid any outbreak of this infection in new entrants there is urgent need for proper sanitation [29,30]. Traveler's account for 10-13% of the acute and fulminant hepatitis A in this study, similar to the earlier reports which estimate an annual infection rate of 3.5-7.2 per 100 individuals [18,31].…”

Section: Discussionsupporting

confidence: 86%

Immunological and molecular epidemiological characteristics of acute and fulminant viral hepatitis A

Hussain

Husain

Almajhdi

et al. 2011

Virol J

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BackgroundHepatitis A virus is an infection of liver; it is hyperendemic in vast areas of the world including India. In most cases it causes an acute self limited illness but rarely fulminant. There is growing concern about change in pattern from asymptomatic childhood infection to an increased incidence of symptomatic disease in the adult population.ObjectiveIn-depth analysis of immunological, viral quantification and genotype of acute and fulminant hepatitis A virus.MethodsSerum samples obtained from 1009 cases of suspected acute viral hepatitis was employed for different biochemical and serological examination. RNA was extracted from blood serum, reverse transcribed into cDNA and amplified using nested PCR for viral quantification, sequencing and genotyping. Immunological cell count from freshly collected whole blood was carried out by fluorescence activated cell sorter.ResultsFulminant hepatitis A was mostly detected with other hepatic viruses. CD8+ T cells count increases in fulminant hepatitis to a significantly high level (P = 0.005) compared to normal healthy control. The immunological helper/suppressor (CD4+/CD8+) ratio of fulminant hepatitis was significantly lower compared to acute cases. The serologically positive patients were confirmed by RT-PCR and total of 72 (69.2%) were quantified and sequenced. The average quantitative viral load of fulminant cases was significantly higher (P < 0.05). There was similar genotypic distribution in both acute and fulminant category, with predominance of genotype IIIA (70%) compared to IA (30%).ConclusionsImmunological factors in combination with viral load defines the severity of the fulminant hepatitis A. Phylogenetic analysis of acute and fulminant hepatitis A confirmed genotypes IIIA as predominant against IA with no preference of disease severity.

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Section: Discussionsupporting

confidence: 86%

Immunological and molecular epidemiological characteristics of acute and fulminant viral hepatitis A

Hussain

Husain

Almajhdi

et al. 2011

Virol J

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“…Family size was not significantly associated with income or education, making it difficult to explain as a proxy for improved socioeconomic status. This association is opposite from the increased risk shown for HAV infection in larger families in India [60].…”

Section: Discussioncontrasting

confidence: 63%

An Exploratory Case Control Study of Risk Factors for Hepatitis E in Rural Bangladesh

et al. 2013

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Hepatitis E virus (HEV) is the major cause of epidemic and sporadic hepatitis globally. Outbreaks are associated with fecal contamination of drinking water, yet the environmental reservoir of HEV between epidemics remains unclear. In contrast to neighboring countries, where epidemics and sporadic disease co-occur, HEV-endemic communities in rural Bangladesh seldom report outbreaks; sporadic hepatitis E is reported from urban and rural areas of the country. Besides typical enteric risk factors, other routes for HEV infection and disease are unclear. We conducted monthly household surveillance of a southern Bangladeshi community of 23,500 people to find incident cases of acute hepatitis E over a 22 month period. An algorithm was used to capture 279 candidate cases, of which 46 were confirmed acute HEV infections. An exploratory case-control study was conducted to identify putative risk factors for disease. Nearly 70% of cases were over 15 years old. Female gender seemed protective (OR:0.34) against hepatitis E in this conservative setting, as was the use of sanitary latrines (OR:0.28). Socioeconomic status or animal exposures were not significant predictors of disease, although outdoor employment and recent urban travel were. Unexpectedly, recent contact with a “jaundiced” patient and a history of injection exposure in the 3 months prior to disease (OR:15.50) were significant. Susceptible individuals from “endemic” communities share similar enteric exposure risks to those commonly associated with tourists from non-endemic countries. This study also raises the novel possibility of parenteral and person-to-person transmission of HEV in non-epidemic, sporadic disease settings.

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“…Seroprevalence reports vary dramatically from country to country and study to study with some studies reporting overall declines in seroprevalence over time, while other yield continued high levels of seroprevalence [ 80 , 82 , 83 ]. Prevalence of anti-HEV IgG tends to increase with age, especially in men [ 80 , 84 , 85 , 86 , 87 ]. Humans and other animals excrete a considerable amount of virus early in the acute phase of HEV infection and likely contribute to maintain the cycle of endemicity [ 76 ].…”

Section: Epidemiology Of Hev Infectionmentioning

confidence: 99%

Hepatitis E Virus: Foodborne, Waterborne and Zoonotic Transmission

Yugo

Meng

2013

IJERPH

217

181

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Hepatitis E virus (HEV) is responsible for epidemics and endemics of acute hepatitis in humans, mainly through waterborne, foodborne, and zoonotic transmission routes. HEV is a single-stranded, positive-sense RNA virus classified in the family Hepeviridae and encompasses four known Genotypes (1–4), at least two new putative genotypes of mammalian HEV, and one floating genus of avian HEV. Genotypes 1 and 2 HEVs only affect humans, while Genotypes 3 and 4 are zoonotic and responsible for sporadic and autochthonous infections in both humans and several other animal species worldwide. HEV has an ever-expanding host range and has been identified in numerous animal species. Swine serve as a reservoir species for HEV transmission to humans; however, it is likely that other animal species may also act as reservoirs. HEV poses an important public health concern with cases of the disease definitively linked to handling of infected pigs, consumption of raw and undercooked animal meats, and animal manure contamination of drinking or irrigation water. Infectious HEV has been identified in numerous sources of concern including animal feces, sewage water, inadequately-treated water, contaminated shellfish and produce, as well as animal meats. Many aspects of HEV pathogenesis, replication, and immunological responses remain unknown, as HEV is an extremely understudied but important human pathogen. This article reviews the current understanding of HEV transmission routes with emphasis on food and environmental sources and the prevalence of HEV in animal species with zoonotic potential in humans.

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Changing epidemiology of hepatitis A and hepatitis E in urban and rural India (1982–98)

Cited by 71 publications

References 30 publications

Immunological and molecular epidemiological characteristics of acute and fulminant viral hepatitis A

Immunological and molecular epidemiological characteristics of acute and fulminant viral hepatitis A

An Exploratory Case Control Study of Risk Factors for Hepatitis E in Rural Bangladesh

Hepatitis E Virus: Foodborne, Waterborne and Zoonotic Transmission

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