Declining prevalence of hepatitis E antibodies among Danish blood donors

Holm, Dorte Kinggaard; Moessner, Belinda Klemmensen; Engle, Ronald E.; Zaaijer, Hans L.; Georgsen, Jørgen; Purcell, Robert H.; Christensen, Peer Brehm

doi:10.1111/trf.13028

Cited by 61 publications

(67 citation statements)

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“…The analysis of 400 archived blood donor samples from Bern canton from 1997/98, 2006 and 2015/16 showed a similar declining anti-HEV IgG prevalence from 30.3% in 1997/98 to 27.0% in 2006 and 22.3% in 2015/16. The trends in seroprevalence in other studies has been questioned due to the differences in the sensitivities and specificities of the tests used [32,34]. Since the results presented here were all conducted with the same EIA, and often in the same experiment, the observed seroprevalence reduction over time appears to be real and may reflect a change in the level of contaminated food, which is regarded as the primary route of acquiring HEV infection.…”

Section: Discussionmentioning

confidence: 81%

“…In some countries, notably Denmark, the Netherlands and the United States, the analysis of archived samples has suggested the seroprevalence has declined in recent decades [32-35], whereas other countries have reported an increase [36]. The analysis of 400 archived blood donor samples from Bern canton from 1997/98, 2006 and 2015/16 showed a similar declining anti-HEV IgG prevalence from 30.3% in 1997/98 to 27.0% in 2006 and 22.3% in 2015/16.…”

Section: Discussionmentioning

confidence: 99%

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Current hepatitis E virus seroprevalence in Swiss blood donors and apparent decline from 1997 to 2016

et al. 2018

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Background and aimHepatitis E virus (HEV) is a virus of emerging importance to transfusion medicine. Studies from several European countries, including Switzerland, have reported high seroprevalence of hepatitis E as a consequence of endemic infections. Published HEV seroprevalence estimates within developed countries vary considerably; primarily due to improved diagnostic assays. The purpose of this study was to investigate the seroprevalence of anti-HEV IgG in Swiss blood donations. Methods: We used the highly sensitive Wantai HEV IgG EIA and assessed regional distribution patterns. We analysed age- and sex-matched archive plasma dating back 20 years from canton Bern to investigate recent changes in HEV seroprevalence levels. Results: On average, 20.4% (95% confidence intervals: 19.1–21.8) of the 3,609 blood samples collected in 2014–16 were anti-HEV IgG positive; however, distinct differences between geographical regions were observed (range: 12.8–33.6%). Seroprevalence increased with age with 30.7% of males and 34.3% of women being positive donors over > 60 years old. Differences between sexes may be attributed to dissimilarities in the average age of this group. Within the specified region of the Bern canton, overall prevalence has declined over two decades from 30.3% in 1997/98 to 27.0% in 2006 and 22.3% in 2015/6. Conclusions: HEV seroprevalence in Switzerland is high, but has declined over the last decades. The result shows that primarily endemic HEV infections occur and that current blood products may pose a risk to vulnerable transfusion recipients. Nucleic acid screening of all blood products for HEV will begin in November 2018.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Current hepatitis E virus seroprevalence in Swiss blood donors and apparent decline from 1997 to 2016

et al. 2018

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“…These increased IgG seroprevalence rates were also observed in The Netherlands. (22) In contrast, the prevalence of anti-HEV IgG among Danish blood donors decreased by 50% between 2003 and 2013, (23) and a similar trend was reported for the United States between 1988-1994 and 2009-2010. (24) The exposure to risk factors in southern France has probably continued to grow, and new risk factors may have appeared.…”

Section: Mansuy Gallian Et Al Hepatology April 2016mentioning

confidence: 87%

“…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][16][17][18][19][20][21][22][23][24][25][26][27][28][29][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.…”

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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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“…It appears that, at least in the UK, Denmark, and Germany, seroprevalence rates have fallen compared to 20 years ago [26,49,50,51]. There appears to be a cohort effect, related to date of birth, suggesting that high seroprevalence rates seen in the elderly are due to a surge of infection in the 1950s and 1960s.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis E Seroprevalence in Europe: A Meta-Analysis

Hartl

Otto

Madden

et al. 2016

Viruses

190

182

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There have been large numbers of studies on anti-HEV IgG seroprevalence in Europe, however, the results of these studies have produced high variability of seroprevalence rates, making interpretation increasingly problematic. Therefore, the aim of this study was to develop a clearer understanding of anti-HEV IgG seroprevalence in Europe and identify risk groups for HEV exposure by a meta-analysis of published studies. Methods: All European HEV-seroprevalence studies from 2003 to 2015 were reviewed. Data were stratified by assay, geographical location, and patient cohort (general population, patients with HIV, solid-organ transplant recipients, chronic liver disease patients, and individuals in contact with swine/wild animals). Data were pooled using a mixed-effects model. Results: Four hundred thirty-two studies were initially identified, of which 73 studies were included in the analysis. Seroprevalence estimates ranged from 0.6% to 52.5%, increased with age, but were unrelated to gender. General population seroprevalence varied depending on assays: Wantai (WT): 17%, Mikrogen (MG): 10%, MP-diagnostics (MP): 7%, DiaPro: 4%, Abbott 2%. The WT assay reported significantly higher seroprevalence rates across all cohorts (p < 0.001). Individuals in contact with swine/wild animals had significantly higher seroprevalence rates than the general population, irrespective of assay (p < 0.0001). There was no difference between any other cohorts. The highest seroprevalence was observed in France (WT: 32%, MP: 16%) the lowest in Italy (WT: 7.5%, MP 0.9%). Seroprevalence varied between and within countries. The observed heterogeneity was attributed to geographical region (23%), assay employed (23%) and study cohort (7%). Conclusion: Seroprevalcence rates primarily depend on the seroassy that is used, followed by the geographical region and study cohort. Seroprevalence is higher in individuals exposed to swine and/or wild animals, and increases with age.

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Declining prevalence of hepatitis E antibodies among Danish blood donors

Abstract: Anti-HEV prevalence had decreased by half among Danish blood donors over 10 years, but was still highly prevalent. The difference in reactivity of the two assays demonstrates the importance of using the same assay when comparing the anti-HEV prevalence in populations over time.

Cited by 61 publications

References 32 publications

Current hepatitis E virus seroprevalence in Swiss blood donors and apparent decline from 1997 to 2016

Current hepatitis E virus seroprevalence in Swiss blood donors and apparent decline from 1997 to 2016

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

Hepatitis E Seroprevalence in Europe: A Meta-Analysis

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