Hepatitis E Seroprevalence and Seroconversion among US Military Service Members Deployed to Afghanistan

Eick, Angelia A.; Ticehurst, John R.; Tobler, Steven K.; Nevin, Remington L.; Lindler, Luther E.; Hu, Zheng; MacIntosh, Victor H.; Jarman, Richard G.; Gibbons, Robert V.; Myint, Khin Saw Aye; Gaydos, Joel C.

doi:10.1086/656598

Cited by 23 publications

(32 citation statements)

References 42 publications

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“…There are other findings in contrast to the low prevalence that Eick et al [1] found in these US troops prior to deployment. A study of the National Health and Nutrition Examination Survey (NHANES) sample of the general US population, in which a similar assay was used, found an antibody seroprevalence of 21% to HEV and a seroprevalence of 8% among subjects under 30 years of age who were born in the United States [12].…”

contrasting

confidence: 63%

“…The data of Eick et al [1], however, raise several questions that are open to a few interpretations. As the authors discuss, the very low HEV seroprevalence found in subjects prior to their deployment could be related to the serum dilution used in the assay or the cutoff used for seropositivity [10].…”

mentioning

confidence: 97%

“…However, such infections have been limited in regiments of soldiers from industrialized countries [6,7]. Similarly, the findings of Eick et al [1] suggest that the detailed preventive measures undertaken by the Department of Defense for US troops in Afghanistan may have prevented their acquisition of viral hepatitis, in sharp contrast to the experience of Soviet troops sent to Afghanistan in the 1980s [8]. Acute viral hepatitis, of which 95% was originally believed to have been hepatitis A virus (HAV)-associated [8], was consistently responsible for nearly half of the infectious diseases among Soviet troops from 1980 through 1988 [8,9].…”

mentioning

confidence: 99%

“…We read with interest the report in this issue of the Journal from Eick and colleagues [1], who describe their study of the incidence of serologically diagnosed hepatitis E virus (HEV) infections among US military service members who were deployed to Afghanistan from 2002 through 2006. In this study, the investigators selected a random sample of 1500 paired serum samples, which were obtained from soldiers within 180 d prior to their deployment and after they had returned to the United States.…”

mentioning

confidence: 99%

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Hepatitis E Virus Infections among US Military Personnel Deployed to Afghanistan

Labrique

Nelson

2010

J INFECT DIS

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contrasting

confidence: 63%

mentioning

confidence: 97%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Hepatitis E Virus Infections among US Military Personnel Deployed to Afghanistan

Labrique

Nelson

2010

J INFECT DIS

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“…However, for some non-epidemic countries, i.e. the Netherlands (1.1%; [55]), Italy (1.0%; [56]), Switzerland (3.2%; [57]), Spain (2.8%; [58]), USA (1.1%; [59]) and Japan (5.3%; [60]) rather low prevalences were reported.…”

Section: Results Of Commercial Igg Line Immunoassaymentioning

confidence: 99%

Seroprevalence study in forestry workers from eastern Germany using novel genotype 3- and rat hepatitis E virus-specific immunoglobulin G ELISAs

Dremsek

Wenzel

Johne

et al. 2011

Med Microbiol Immunol

142

110

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Hepatitis E virus (HEV) is the causative agent of an acute self-limiting hepatitis in humans. In industrialized countries, autochthonous cases are linked to zoonotic transmission from domestic pigs, wild boar and red deer. The main route of human infection presumably is consumption of contaminated meat. Farmers, slaughterers and veterinarians are expected to be risk groups as they work close to potentially infected animals. In this study, we tested four Escherichia coli-expressed segments of the capsid protein (CP) of a German wild boar-derived HEV genotype 3 strain for their diagnostic value in an indirect immunoglobulin G (IgG) ELISA. In an initial validation experiment, a carboxy-terminal CP segment spanning amino acid (aa) residues 326-608 outperformed the other segments harbouring aa residues 112-608, 326-660 and 112-335. Based on this segment, an indirect ELISA for detection of anti-HEV IgG antibodies in human sera was established and validated using a commercial line immunoassay as reference assay. A total of 563 sera from forestry workers of all forestry oYces of Brandenburg, eastern Germany and 301 sera of blood donors from eastern Germany were surveyed using these assays. The commercial test revealed seroprevalence rates of 11% for blood donors and 18% for forestry workers. These rates are in line with data obtained by the in-house test (12 and 21%). Hence, the in-house test performed strikingly similar to the commercial test (sensitivity 0.9318, speciWcity 0.9542). An initial screening of forestry worker and blood donor sera with a corresponding CP segment of the recently discovered Norway rat-associated HEV revealed several strong positive sera exclusively in the forestry worker panel. Future investigations have to prove the performance of this novel IgG ELISA in large-scale seroepidemiological studies. In addition, the observed elevated seroprevalence in a forestry worker group has to be conWrmed by studies on groups of forestry workers from other regions. The epidemiological role of ratHEV in human disease should be assessed in a large-scale study of risk and non-risk groups.

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The global burden of hepatitis E virus genotypes 1 and 2 in 2005

et al. 2012

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We estimated the global burden of hepatitis E virus (HEV) genotypes 1 and 2 in 2005. HEV is an emergent waterborne infection that causes source-originated epidemics of acute disease with a case fatality rate thought to vary by age and pregnancy status. To create our estimates, we modeled the annual disease burden of HEV genotypes 1 and 2 for 9 of 21 regions defined for the Global Burden of Diseases, Injuries, and Risk Factors Study (the GBD 2010 Study), which represent 71% of the world's population. We estimated the seroprevalence of anti-HEV antibody and annual incidence of infection for each region using data from 37 published national studies and the DISMOD 3, a generic disease model designed for the GBD Study. We converted incident infections into three mutually exclusive results of infection: (1) asymptomatic episodes, (2) symptomatic disease, and (3) death from HEV. We also estimated incremental cases of stillbirths among infected pregnant women. For 2005, we estimated 20.1 (95% credible interval [Cr.I.]: 2.8-37.0) million incident HEV infections across the nine GBD Regions, resulting in 3.4 (95% Cr.I.: 0.5-6.5) million symptomatic cases, 70,000 (95% Cr.I.: 12,400-132,732) deaths, and 3,000 (95% Cr.I.: 1,892-4,424) stillbirths. We estimated a probability of symptomatic illness given infection of 0.198 (95% Cr.I.: 0.167-0.229) and a probability of death given symptomatic illness of 0.019 (95% Cr.I.: 0.017-0.021) for nonpregnant cases and 0.198 (95% Cr.I.: 0.169-0.227) for pregnant cases. Conclusion: The model was most sensitive to estimates of age-specific incidence of HEV disease. (HEPATOLOGY 2012;55:988-997)

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Hepatitis E Seroprevalence and Seroconversion among US Military Service Members Deployed to Afghanistan

Cited by 23 publications

References 42 publications

Hepatitis E Virus Infections among US Military Personnel Deployed to Afghanistan

Hepatitis E Virus Infections among US Military Personnel Deployed to Afghanistan

Seroprevalence study in forestry workers from eastern Germany using novel genotype 3- and rat hepatitis E virus-specific immunoglobulin G ELISAs

The global burden of hepatitis E virus genotypes 1 and 2 in 2005

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