Hepatitis E seroprevalence in the United States: Results for immunoglobulins IGG and IGM

Abstract

The combined and strata-specific HEV weighted seroprevalence increased from 2013-2014 to 2015-2016. Although prior studies had found increasing age as the only significant factor associated with HEV, the attribute of "non-Hispanic Asian" had a stronger association with HEV seropositivity than the age factor alone.

Low seroprevalence of hepatitis E on Reunion island

“…Our findings confirm the association between HEV exposure and increasing age [1,2,4,11,[19], [20], [21], [22]], which might indicate a lifetime cumulative exposure [19] or a past higher exposure risk [20]. However, the absence of HEV exposure in young people (≤20 years old) may be related to a sampling bias, given the underrepresentation of this age group in our study population.…”

Burden of hepatitis E infection and associated healthcare resource utilization among hematological malignancy-related hospitalizations: A national perspective in the United States, 2007–2014

“…Correspondingly, studies have suggested higher male predilection towards HEV infection. 3,4 Similar to findings from the study by von Felden et al, we found that non-Hodgkin lymphoma (60%) was the most frequent hematologic malignancy associated with HEV infection. The highest burden of HEV infection among admissions related to hematologic malignancy was noted in non-Hodgkin's' disease (1.73 per 100,000), followed by leukemia (0.86 per 100,000) and myeloproliferative disorders (0.56 per 100,000), which were significantly higher than the prevalence observed among the general inpatient cohort over the study period (0.42 per 100,000) (p <0.0001).…”

“…and leukemia is consistent with our findings 2 and further supports the notion that rituximab-exposed patients are at risk of hepatitis E, including severe complications. 3 Large scale data on the clinical relevance of hepatitis E in the U.S. is lacking and the study by Dr. Desai and colleagues represents the first of its kind. In contrast to the vast amount of clinically significant HEV infections reported in Europe, there are only limited data available from the U.S. An explanation could be the lack of FDA-approved diagnostic tests for HEV infections in the U.S.…”

“…Interestingly, Cangin et al, using data from the National Health and Nutrition Examination Survey (NHANES), reported that HEV seropositivity increased from 4.5% in 2013-2014 to 8.1% in 2015-2016. 3 Our study cohort of patients with HEV and hematological malignancy were mostly males (72.2%). Correspondingly, studies have suggested higher male predilection towards HEV infection.…”

Reply to: “Burden of hepatitis E infection and associated healthcare resource utilization among hematological malignancy-related hospitalizations: A national perspective in the United States, 2007–2014”

“…Despite an increase in HEV seroprevalence in the general U.S. population from 4.5% in 2013-2014 to 8.1% in 2015-2016, HEV seroprevalence still appears much lower compared to European countries where it reaches 8-32% depending on the assay and region. [4][5][6] Another explanation could be the predominance of HEV genotype 3a in the U.S., which differs from most European countries, where genotype 3e, 3f, or 3 g are most common. 2,[7][8][9] Interestingly, chronic hepatitis E in solid organ transplant recipients in Japan has been reported to be lower compared to European countries, 10 suggesting genotype 3a, which is also the most prevalent genotype in Japan, might cause less severe courses of HEV infection with a lower risk for chronicity.…”